Why didn’t she fight back? An exploration of victim blaming through tonic immobility reactions to sexual violence

Despite research showing that tonic immobility is the most common reaction to sexual violence, it is often is understood by some and disregarded by others. Research also indicates that holding prejudicial or false beliefs about victims can impact the judicial system, affecting reporting and conviction rates. This study explored rape myth acceptance and victim blaming in relation to victims’ reactions to sexual violence. This was done through an online survey, utilising the updated Illinois Rape Myth Acceptance Scale and featuring four vignette scenarios, producing both quantitative and qualitative data. The research showed that rape myths and victim blaming are linked phenomena, that there were distinct differences in the perceived blame and naturality assigned to victims based on how they reacted to sexual violence, and that tonic immobility was the least understood reaction to trauma. This research highlighted the continual presence of rape culture, through rape myths and victim blaming attitudes, and the need to educate the public on common reactions to sexual abuse, with the hope to improve the judicial system and make a positive impact on society

Smells with cultural value: How to recognise and protect this heritage at risk?

Our engagement with heritage is largely visual whereas the potential of other sensory approaches is largely unexplored. Olfactory heritage is an emerging, interdisciplinary field linking material, intangible, and digital expressions of heritag

Geriatric Oncology as an Unmet Workforce Training Need in the United Kingdom—A Narrative Review by the British Oncology Network for Undergraduate Societies (BONUS) and the International Society of Geriatric Oncology (SIOG) UK Country Group

Cancer is a disease associated with ageing. Managing cancer in older adults may prove challenging owing to pre-existing frailty, comorbidity, and wider holistic needs, as well as the unclear benefits and harms of standard treatment options. With the ongoing advances in oncology and the increasing complexity of treating older adults with cancer, the geriatric oncology field must be a priority for healthcare systems in education, research, and clinical practice. However, geriatric oncology is currently not formally taught in undergraduate education or postgraduate training programmes in the United Kingdom (UK). In this commentary, we outline the landscape of geriatric oncology undergraduate education and postgraduate training for UK doctors. We highlight current challenges and opportunities and provide practical recommendations for better preparing the medical workforce to meet the needs of the growing population of older adults with cancer. This includes key outcomes to be considered for inclusion within undergraduate and postgraduate curricula

Case Reports1. A Late Presentation of Loeys-Dietz Syndrome: Beware of TGFβ Receptor Mutations in Benign Joint Hypermobility

Background: Thoracic aortic aneurysms (TAA) and dissections are not uncommon causes of sudden death in young adults. Loeys-Dietz syndrome (LDS) is a rare, recently described, autosomal dominant, connective tissue disease characterized by aggressive arterial aneurysms, resulting from mutations in the transforming growth factor beta (TGFβ) receptor genes TGFBR1 and TGFBR2. Mean age at death is 26.1 years, most often due to aortic dissection. We report an unusually late presentation of LDS, diagnosed following elective surgery in a female with a long history of joint hypermobility. Methods: A 51-year-old Caucasian lady complained of chest pain and headache following a dural leak from spinal anaesthesia for an elective ankle arthroscopy. CT scan and echocardiography demonstrated a dilated aortic root and significant aortic regurgitation. MRA demonstrated aortic tortuosity, an infrarenal aortic aneurysm and aneurysms in the left renal and right internal mammary arteries. She underwent aortic root repair and aortic valve replacement. She had a background of long-standing joint pains secondary to hypermobility, easy bruising, unusual fracture susceptibility and mild bronchiectasis. She had one healthy child age 32, after which she suffered a uterine prolapse. Examination revealed mild Marfanoid features. Uvula, skin and ophthalmological examination was normal. Results: Fibrillin-1 testing for Marfan syndrome (MFS) was negative. Detection of a c.1270G > C (p.Gly424Arg) TGFBR2 mutation confirmed the diagnosis of LDS. Losartan was started for vascular protection. Conclusions: LDS is a severe inherited vasculopathy that usually presents in childhood. It is characterized by aortic root dilatation and ascending aneurysms. There is a higher risk of aortic dissection compared with MFS. Clinical features overlap with MFS and Ehlers Danlos syndrome Type IV, but differentiating dysmorphogenic features include ocular hypertelorism, bifid uvula and cleft palate. Echocardiography and MRA or CT scanning from head to pelvis is recommended to establish the extent of vascular involvement. Management involves early surgical intervention, including early valve-sparing aortic root replacement, genetic counselling and close monitoring in pregnancy. Despite being caused by loss of function mutations in either TGFβ receptor, paradoxical activation of TGFβ signalling is seen, suggesting that TGFβ antagonism may confer disease modifying effects similar to those observed in MFS. TGFβ antagonism can be achieved with angiotensin antagonists, such as Losartan, which is able to delay aortic aneurysm development in preclinical models and in patients with MFS. Our case emphasizes the importance of timely recognition of vasculopathy syndromes in patients with hypermobility and the need for early surgical intervention. It also highlights their heterogeneity and the potential for late presentation. Disclosures: The authors have declared no conflicts of interes

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Research Data supporting "Sex-specific effects of a maternal obesogenic diet high in fat and sugar on offspring adiposity, growth and behaviour"

This study investigates the effect of maternal diet-induced obesity in mice on maternal and offspring (male and female) nutrient intake, growth and adiposity, and investigates the effects of maternal diet on the behaviour of male and female offspring in four tasks. Figure 1 describes the nutrient intake of pre-pregnant, pregnant and lactating mice on a control versus a high fat and high sugar (HFHS) diet (mean and SD across cages). Figure 2 describes the body weight (mean and SD), the fat mass (individual mice) and lean mass (individual mice) of pre-pregnant, pregnant and lactating mice on a control versus a HFHS diet. Figure 3 describes the body mass and fractional growth rate of the male and female pre-weaning offspring (2 to 21 days of age) of mothers on the control versus HFHS diet. Figure 4 describes the nutrient intake of the male and female offspring, after weaning (21 to 91 days of age) of mothers on the control versus HFHS diet. Figure 5 describes the body weight (mean and SD), fractional growth rate (mean and SD) and fat & lean masses (individual mice) in the male and female offspring, after weaning (21 to 91 days of age) of mothers on the control versus HFHS diet. Figure 6 describes 4 measures of anxiety-related behaviour in the elevated plus maze by male and female offspring of mothers on the control versus HFHS diet. Figure 7 describes 4 measures of cognitive behaviour in the novel object recognition task by male and female offspring of mothers on the control versus HFHS diet. Figure Supplementary 2 describes 4 measurements of locomotion and anxiety-related behaviour int he open field task by male and female offspring of mothers on the control versus HFHS diet. Figure Supplementary 3 describes 2 measures of social preference behaviour of male and female offspring of mothers on the control versus HFHS diet. Table 1 gives all of the body weights, organ weights and fat deposit weights measured in this study in the pre-pregnant, pregnant and lactating female mice and int he male and female offspring.This research was funded by an MRC STP studentship to Emily J. Mort (Grant number; MR/N013433/1

The Increase of Cultural Heritage Protection Impacts on Property Right: Belgian Case Law

Private ownership and cultural heritage protection are two interests in tension with one another. The traditional conception of property right is based on an absolute individual right to the peaceful enjoyment of possessions. However, interference in this right may restrict its exercise and impose charges on the owner, such as classification measures and conservation easements in name of the general interest of the community to protect cultural heritage. This paper formulates a hypothesis about an increased protection of cultural heritage as well as of private ownership in Belgian law. At the one hand, Belgium, inspired by international and European law, has adopted more and broader legislation for the safeguard of cultural heritage. The famous Palais Stoclet case has clearly confirmed that Belgian jurisprudence also widely recognise the importance of protecting cultural heritage. On the other hand, Belgian judges, who traditionally don’t recognise any compensation right when the protective measure only restricts the ownership without expropriating the owner, gradually appear to undertake a more thorough analysis of the fair balance between the conflicting interests, notably in favour of the owner. Under the impulse of Strasbourg jurisprudence, the Constitutional Court recently annulled a classification decree that failed to provide any compensation right thereby imposing an ‘excessive burden’ on the owner. These recent developments indicate that the apparent trend towards increased cultural heritage protection, requiring more sacrifices from the individual owner, calls for a counterbalancing exercise based on a kind of proportionality test. The question is whether any model can be distinguished that is suitable to cultural heritage protection in all circumstances now that specific cases have demonstrated that the traditional (ownership vs protection) models have shown some of their limits

Sex-specific effects of a maternal obesogenic diet high in fat and sugar on offspring adiposity, growth and behaviour

Abstract: With rising rates of human obesity, the study aimed to determine the relationship be-tween maternal diet-induced obesity and offspring morphometrics and behaviour in mice. Pregnant and lactating female mice fed a diet high in fat and sugar (HFHS) commonly consumed by human populations showed decreased food, calorie, and protein intake but increased adiposity at the expense of lean mass. The pre-weaning body weight of HFHS offspring was reduced for the first postnatal week but not thereafter with HFHS female offspring having higher body weights by weaning, due to continuing higher fractional growth rates. Post-weaning, there were minor dif-ferences in offspring food and protein intake. Maternal diet, however, affected fractional growth rate and total body fat content of male but not female HFHS offspring. Maternal diet did not affect offspring locomotor activity or social behaviour in either sex. Both male and female HFHS off-spring displayed reduced anxiety-related behaviours with sex differences in particular aspects of the elevated plus maze task. In the novel object recognition task, performance was impaired in male but not female HFHS offspring. Collectively, the findings demonstrate that maternal obesity alters the growth, adiposity, and behaviour of male and female offspring, with sex-specific dif-ferences.This research was funded by an MRC STP studentship to Emily J. Mort (Grant number; MR/N013433/1)

Protecting cultural heritage: whose burden?

Together with the evolving definition of cultural heritage, legislation on the matter has extended over the last decades. Not only has the number of legal texts increased, it has also imposed heavier burdens on the owner, adding active to passive conservation obligations. Case law concerning compensation claims demonstrates that some burdens may be excessive, breaking the balance between public and private interests. Moreover, most public interference into property right has been unilateral (classification measures, expropriation), reducing the dialogue between the authorities and the owner to a mere opposition of interests, instead of focusing on common heritage. This paper aims to analyse how the allocation of burdens could be rebalanced. The focus would shift to multilateral protection instruments, taking public and private but also collective interests into consideration. Every interest has a corresponding responsibility, understood as the sharing of burdens for the future and not as the liability for past wrongdoings. Lying in the grey zone between technical law and ethics, the concepts of interest and responsibility are innovative tools to rethink cultural heritage law. Acting to preserve and transfer cultural heritage is acting responsibly, but this may vary depending on the degree of power: a common but differentiated responsibility. In other words, public authorities should be responsible to make sure protected goods aren’t in danger, therefore providing sufficient financial and legal aid to overburdened owners, or even to (fiscally) encourage private financial support. Public and private owners on the other hand should act as reasonable managers – as “stewards” – of their listed goods and prevent them from damage or loss. The heritage community should share responsibility to take part in the protection and be given the right to take legal action when cultural heritage is at risk. Thought must also be given to resolving possible conflicts of interests among those actors