Investigating mortuary services in hospital settings

Changes to the retention of human tissues and Department of Health guidance on good practice have resulted in the extension of the role of Anatomical Pathology Technologists (APTs). In the twenty-first century the APT role demands a wide variety of abilities, including an adroit blend of clinical knowledge and communication skills. The APT role is framed by a blurred occupational past. The need for clarity and a distinct professional identity is one of the driving forces behind the Association of Anatomical Pathology Technologists calls for standardisation of education, training and regulation. Currently, there are two qualifications for APTs provided through the Royal Society for Public Health (RSPH): the Certificate in Anatomical Pathology Technology and the Diploma in Anatomical Pathology Technology. These have been developed and accredited by the RSPH since 1962. APTs in teaching hospitals or with high-risk facilities - although not usually part of the formal education process for any clinical staff beyond pathologists - are in a position to establish best practice as they are involved in ‘lifting the lid’ on what goes on in the mortuary. In this hospital, APTs promoted the work of the mortuary by going ‘out’ into the hospital and participating in different forums, including formal and informal meetings. They also invited colleagues into the mortuary. Identifying the deceased person as a patient rather than a body was a highly symbolic effort to ‘join up’ the work of the mortuary with the rest of the hospital, ensuring that the deceased person remained a patient of the hospital until they left the premises. An association with death was a potential barrier to communicating with colleagues outside of the mortuary, as the APTs found themselves stigmatised by what they perceived to be and what would be called sociologically their literal ‘embodiment’ of medical failure. This could be isolating for the APTs, to the point that when they went to other hospital departments, they were treated with caution. There is a strong case to be made for national regulation as part of the professionalisation of the APT role, in order to align individual’s responsibilities with accountability at the level of the regulating professional body itself

A social insight into bereavement and reproductive loss

Abstract not available

The production of death and dying in care homes for older people: an ethnographic account

This thesis explores 'death and dying' in care homes for older people. Residents who are admitted to care home institutions are increasingly more likely to be extremely old and frail and it follows that the final product of most care homes is death. Indeed, up to one third of care home residents will die each year. In particular, the thesis explores the gap between the rhetoric of a 'good death' that heads of homes were keen to produce and the practice reality of what happened when a resident was categorised as 'dying' and at the time of death. The study draws on ethnographic data from one year of participant observation in eight care homes in England. Observing the daily life events in care homes for older people has illuminated the strategies that staff and residents deployed to manage 'death and dying' and the complexities of managing the narrow margin between life and death. The materiality of the body is not something that can be controlled or contained easily within a category. The findings highlight performances around death and what purpose these might serve, including the role of symbolism in the production of 'living' and 'dying'. They also show how the ageing body might resist powerful practices. The thesis draws on the literature of symbolic interactionism, the sociology of the body and anthropology to explain how the ageing bodies of residents were managed on their journey to death. The thesis concludes with suggestions on how this type of in-depth study might contribute to practice in those settings which house ageing and deteriorating bodies and which have been marginalised by society

The social dimensions of reproductive loss

Abstract not available

Recovering the body in grief: Physical absence and embodied presence.

This paper addresses the complex issue of the embodiment of grief. It explores how a theoretical shift to the body has influenced scholarly literature about grief and bereavement. Despite this shift, we argue that bodily interpretations and experiences are undertheorised in western psychological literature on bereavement. Specifically, we argue that linear stage models of grief have encouraged the view that grief needs 'working through' in the mind, and not necessarily the body. We draw on empirical data from interviews with bereaved people undertaken in England to illustrate aspects of the embodied experience of grief that differ from how psychological grief theories conceive of the bereaved person's body. Findings highlight the role of the bereaved person's body in managing grief and how the absence and continuing presence of the deceased person is managed through embodied practices. We conclude that understanding grief as an embodied experience can enable the development of grief theories that better capture the complex negotiation between the psychological processes of grief and the materiality of bodies

Conceptualizing reproductive loss: a social sciences perspective

This paper defines and explores reproductive loss and, drawing on a social sciences perspective, reflects on the lack of attention that has been given to the subject within the study of human fertility. The authors argue that whilst reproductive loss (broadly defined) is exceptionally common, scholars have – with some exceptions – focused on the study of reproductive ‘success’, and continue to do so. The paper examines the implications of this for policy, practice and the role of healthcare professionals and focuses on the significance of appreciating difference and diversity in the study of reproductive loss and the importance of placing such experiences within the social structure

Evaluación de seis fórmulas usadas para el cálculo de la superficie corporal

Antecedentes: La superficie corporal es unavariable antropométrica que se obtiene aplicandofórmulas basadas en el peso y en la talla.Algunas fórmulas se han diseñado para aplicarsementalmente o con calculadoras de bolsillo, perola exactitud de estas fórmulas «fáciles» no seha evaluado sistemáticamente.Objetivos: evaluar la correlación de cincofórmulas «fáciles» con la fórmula de Boyd, yproponer una fórmula nueva basada solo en latalla, desarrollada por uno de los autores(Rincón).Material y métodos: se tomaron 518 datos depeso y talla de las tablas de crecimiento delNational Center for Health Statistics (NCHS).Todos los datos se procesaron con MicrosoftExcel®. Se realizo una regresión lineal con cadauna de las fórmulas para encontrar el coeficientede correlación (r), coeficiente de determinación(r2), pendiente de la recta (m), intersección dela recta (b), y valor p.Resultados. Se consideraron fórmulas adecuadasaquellas con r ³ 0.99, r2³ 0.98, m = 1 ± 0.10,b = 0 ± 0.05 y valor p and lt; 0.05. Cuatro de lasseis fórmulas evaluadas cumplen con loscriterios de selección, entre ellas la nuevafórmula propuesta.Conclusiones. La superficie corporal debeobtenerse en lo posible con fórmulas que utilicenpeso y talla, pero en los casos en los quealguno de estos datos no esté disponible, se puedeacudir a la fórmula correspondiente

Endothelin receptor antagonists for the treatment of pulmonary artery hypertension

AbstractAimsThe demonstration that endothelin production is upregulated in pulmonary artery hypertension (PAH) served as the rationale for developing endothelin-receptor antagonists (ERAs) as a treatment for PAH. This article reviews the primary studies demonstrating efficacy of ERAs in PAH.Main methodsMulticenter, placebo-controlled trials and open-label extension studies.Key findingsTwo orally active ERAs are currently approved for the treatment of PAH — the dual receptor antagonist bosentan, and the more selective ETA receptor antagonist ambrisentan-based on multicenter randomized clinical trials demonstrating efficacy and safety. Long-term experience with both agents supports maintenance of therapeutic effects in most patients. Adverse effects, including altered liver function and edema may occur and require careful monitoring.SignificanceDespite failure to demonstrate efficacy of ERAs in other cardiopulmonary conditions, ERAs have a major role in the treatment algorithm for PAH