Orchestrating comfort: The role of funeral directors

In this ethnography, the affective role that funeral directors assume in comforting mourners is examined. Comforting strategies include mechanistic camfort (i.e., separating the ceremonial aspects of funerals from the technical aspects of embalming by demarcating “frontstage/backstage” work areas, controlling the frontstage environment with an aura of dignity and respect, and the mechanistic pacing of events); personal comfort (i.e., vigilant by surveilling mourners and tactfully providing support and control without intruding into the family group), and technical comfort (i.e., the embalming and restorative work on the deceased that enables the family to view death as a peaceful state). The authors conclude that funeral directors fill an extraordinary role in society as professional comforters of the bereaved. As frequently there is no previous relationship between the client and the professional, this is a unique, short-term, professional caring relationship that occurs between strangers.     

Anatomy and physiology of neurological compensatory mechanisms.

The skull is a unique part of anatomy. It exists in a state of dynamic equilibrium. The components of the skull and their role in maintaining integrity and normal intracranial pressure will be reviewed in this article. Compensatory mechanisms that attempt to prevent the destructive effects of cerebral ischemia and injury will be discussed.     

Reduced hip bone mineral density is related to physical fitness and leg lean mass in ambulatory individuals with chronic stroke

Following a stroke, the reduced level of physical activity and functional use of the paretic leg may lead to bone loss and muscle atrophy. These factors and the high incidence of falls may contribute to hip fractures in the stroke population. This study was the first to examine total proximal femur bone mineral content (BMC) and bone mineral density (BMD) and their relationship to stroke-specific impairments in ambulatory individuals with chronic stroke (onset >1 year). We utilized dual-energy X-ray absorptiometry (DXA) to acquire proximal femur and total body scans on 58 (23 women) community-dwelling individuals with chronic stroke. We reported total proximal femur BMC (g) and BMD (g/cm²) derived from the proximal femur scans, and lean mass (g) and fat mass (g) for each leg derived from the total body scans. Each subject was evaluated for ambulatory capacity (Six-Minute Walk Test), knee extension strength (hand-held dynamometry), physical fitness [maximal oxygen uptake (VO₂max)] and spasticity (Modified Ashworth Scale). Results showed that the paretic leg had significantly lower proximal femur BMD, lean mass and percent lean mass, but higher fat mass than the non-paretic leg for both men and women. Proximal femur BMD of the paretic leg was significantly related to ambulatory capacity ( r =0.33, P =0.011), muscle strength ( r =0.39, P =0.002), physical fitness ( r =0.57, P <0.001), but not related to spasticity ( r =–0.23, P =0.080). Multiple regression analysis showed that lean mass in the paretic leg was a major predictor ( r ²=0.371, P <0.001) of the paretic proximal femur BMD. VO₂max was a significant predictor of both paretic proximal femur BMD ( r ²=0.325, P <0.001) and lean mass in the paretic leg ( r ²=0.700, P <0.001). Further study is required to determine whether increasing physical fitness and lean mass are important to improve hip bone health in chronic stroke.     

Clinical features and psychosocial factors in young adults with genital herpes

Clinical features of genital herpes, perceived causes, stress symptoms, treatments, and psychosocial factors in 70 young adults as compared to normative data for non-patient controls are described. The clinical features of the disease were congruent with those of other groups studied. Stress was viewed as the major cause of recurrence, headaches the major stress symptom, and acyclovir (an antiviral drug), was the major treatment. Statistically significant differences were found between scores obtained from the sample of young adults with genital herpes on three of four standardized psychological instruments when compared with normative data for non patient controls. Young adults with genital herpes had a lower self concept, more psychopathology, a greater frequency of daily hassles, and less intensity of uplifts. No differences were found, however, between the two groups in scores on depression.     

Disposition of Butadiene Epoxides in Sprague-Dawley Rats Following Exposures to 8000 ppm 1,3-Butadiene: Comparisons with Tissue Epoxide Concentrations Following Low-Level Exposures

1,3-Butadiene (BD), a compound used extensively in the rubberindustry, is weakly carcinogenic in Sprague-Dawley rats afterchronic exposures to concentrations of 1000 and 8000 ppm. Conversely,in B6C3F1 mice, tumors occur after chronic exposures to concentrationsas low as 6.25 ppm. Previously, we have shown that tissue concentrationsof the mutagenic BD metabolites, butadiene monoepoxide (BDO)and butadiene diepoxide (BDO₂), are present in greater concentrationsin mice than in rats following acute exposures to low levels(100 ppm or less). This disparity was particularly significantfor the diepoxide. We hypothesized that if these epoxides areinvolved in the carcinogenic response of BD, then they willalso be present in rat tissues at relatively high concentrationsfollowing exposures to 8000 ppm BD. In the present study, concentrationsof the BD epoxides, BDO and BDO₂, were determined in blood offemale Sprague-Dawley rats following a single 6-h exposure and10 repeated exposures to a target concentration of 8000 ppmBD. Concentrations of these epoxides were also determined ina number of other tissues, including the primary rat targetorgan—mammary gland—following 10 repeated exposures.Blood concentrations of BDO were 4030 pmol/g ± 191 followinga 6-h exposure and were 18% lower following the 10-day exposure.Blood concentrations of BDO₂, following the 8000 ppm exposures,were very similar to those previously observed after exposuresto 62.5 ppm BD (11 ± 1 and 17 ± 1 pmol/g followingexposures of 6h and 6h/day for 10 days, respectively.) Concentrationsof BDO ranged from 740 ± 110 (femur) to 8990 ±1150 (fat) pmol/g tissue. Concentrations of BDO₂ were similaramong eight tissues analyzed, ranging from 5 ± 1 (femur)to 17 ± 3 (heart) pmol/g tissue. Tissue concentrationsof butadiene mono-epoxide were increased by 17- to 50-fold intissues from rats exposed by inhalation to 8000 ppm BD as comparedto tissues from rats exposed to 62.5 ppm BD. Based on earlierstudies at our institute the internal dose of BD increases approximately14-fold in the 8000 ppm-exposed rats compared to rats exposedto 62.5 ppm BD. Concentrations of butadiene diepoxide in rattissues following an exposure to 8000 ppm BD were similar tothose observed in rat tissues following exposures to 62.5 ppmBD. This study shows that pathways responsible for the accumulationof BDO₂ in rats are saturated following low-level BD exposures.This suggests that the primary determinant of BD tumorigenicityin rats is not butadiene diepoxide. The high levels of BDO observedin rat mammary tissue suggest that this metabolite may be amore important determinant of BD carcinogenesis in the rat.     

Emotion framing: does it relate to children's emotion knowledge and social behavior?

This study examined the associations between maternal emotion framing and mother-child relationship quality and children's emotional and social competence. Sixty-one mothers and their preschool children (33 boys) completed dyadic and individual measures. Observations were made of mother-child synchrony and maternal emotion framing. Children's emotion understanding and receptive vocabulary was assessed via individual interviews. Teachers reported on children's social skills. Results show that maternal emotion framing, particularly mildly positive framing, significantly contributes to children's emotion understanding. Children in higher quality relationships with their mothers had better emotion understanding. Therefore, support was found for the roles of relationship quality and maternal emotion framing in children's emotional competence. Unexpectedly, fewer significant associations were found between maternal emotion framing, synchrony and children's social competence. The implications of examining emotion framing and relationship quality as correlates of children's emotional and social competence are discussed.     

Strategies for recovery from a trip in early and late swing during human walking

The movement strategies and the underlying organization of the muscular responses for recovery from a tripping perturbation applied in early and late swing during walking were studied in humans. The latencies of the reflex response (60–140 ms) suggested that polysynaptic pathways are involved. The most common movement outcome was an elevating strategy of the swing limb in response to the early swing perturbation and a lowering strategy in response to the late swing perturbation. The elevating strategy comprised a flexor component of the swing limb and an extensor component of the stance limb. There was a temporal sequencing of the swing limb biceps femoris prior to the swing limb rectus femoris response to remove the limb from the obstacle prior to accelerating the limb over the obstacle. The extensor response of the stance limb generated an early heel-off to increase the height of the body. Thus, the lower limb joints collaborated to increase the height of the centre of mass and provide extra time to extend the swing limb in preparation for the landing. Flexion of the swing limb would be dangerous in response to the late swing perturbation as the swing limb is approaching the ground and the body mass has passed forward of the stance foot. Instead, a lowering strategy was accomplished by inhibitory responses of the swing limb vastus lateralis and/or excitatory responses of the swing limb biceps femoris. Both these responses resulted in a rapid lowering of the limb to the ground with a flat foot or forefoot landing and a shortening of the step length. Thus, in response to the late swing perturbation, the same recovery strategy was achieved by different patterns of muscle activation. These results demonstrate that the recovery strategies provided a functionally appropriate response for overcoming the obstacle and maintaining the ongoing locomotion.     

Reliability of hip range of motion using goniometry in pediatric femur shaft fractures

INTRODUCTION: The purpose of this study was to determine the interrater reliability of the assessment of range of motion of the hip joint through goniometry. METHODS: We included children aged 4 to 10 years with a femoral shaft fracture, from 4 study sites, who had had either an early hip spica cast or an external fixator. An assessor blind to treatment received at each site measured range of hip joints motion, using a standardized goniometric technique at 15 and 24 months postfracture. RESULTS: The intraclass correlation coefficient (ICC) was used to quantify concordance or agreement. Most ICCs for the different aspects of hip range were between 0.2 and 0.5, indicating only slight agreement. The most reliable measure was hip flexion, with an ICC of 0.48 (95% confidence interval 0.29-0.63). CONCLUSION: Goniometric measurement, using standardized protocols for the hip, has low reliability. Only when differences in rotation exceed at least 30 degrees and in flexion-extension exceed 50 degrees should clinicians conclude that true change has occurred.