In three separate studies, this thesis examined stress and coping in nurse practitioners during first time exposure to post-mortem care. Using a self report questionnaire and a retrospective design, Study 1 (N=97) examined the nurse's first experience administering post-mortem care to the recently deceased. The results obtained from this exploratory investigation established that many nurses reported significant distress and used emotion-focused coping strategies (avoidance and palliation) to manage the experience. These data are consistent with those reported by others who have researched in the area, and support the hypotheses that first time exposure to post-mortem care can induce significant distress in some nurses, and that the memory is vividly recalled many years after the event. The second study used a prospective design. Base line data were collected prior to the nurse performing post-mortem care (N=59), 24 hours after they participated in their first post-mortem care procedure, and 1 and 5 weeks post-event. The General Health Questionnaire-28, the Revised Ways of Coping Checklist, the Revised Collett-Lester Fear of Death and Dying Scale, and the Impact of Event Scale were used to obtain data which were compared with that of a control group (N=59) of nurses undertaking an academic examination. The results confirmed that beginning nurse practitioners resort to using predominantly emotion-focused coping strategies when faced with stressful life events. Moreover, a direct linear relationship between the participants' fear of death and dying scores and the way they rated the impact of performing post-mortem care was found. Colaizzi's (1978) method of data analysis was used in the third and final study in the series (N=6) that explored the lived experience of nurses performing post-mortem care. The essence of the first experience was embedded in six key themes that structured the lived experience. Psychic disorganisation was experienced by the participants because they were unprepared both psychologically and educationally to deal with the experience and resorted to using emotion-focused coping strategies. It is concluded that nurses' first exposure to post-mortem care procedures is stressful and they use predominately emotion focused coping strategies to deal with the experience.

A primary goal of the forensic anthropologist is assisting in the estimation of a post-mortem interval. This assessment is largely based upon the degree and quality of soft tissue decomposition, influenced by factors including temperature, humidity, insect activity, carnivore and rodent activity, perimortem trauma and the depositional environment. While the effects of temperature on decomposition have been long appreciated and initially studied, little or no research has been conducted on the disruption of insect activity and how that disturbance may affect the decomposition process. This study was designed to determine if the exposure of skin surface of porcine remains to insect repellant (specifically, DEET) has an effect on the presence and overall activity of insects during decomposition. Two experiments were conducted in the spring and fall with results indicating that insect repellant slows the rate of decomposition. Such findings are important for criminal investigators requiring an accurate estimation of post-mortem time to appreciate those factors that may adversely affect the process and rate of soft tissue deterioration.

Thesis (M.S.F.S.) PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / This thesis looks at and analyzes the current body of research into the early-stage formation of adipocere as it pertains to post-mortem interval determination. Adipocere is a waxlike substance that can encase bodies after death if certain conditions are met: temperature, moisture content, other environmental factors, and the presence of bacteria that transform fatty acids into the hydroxy- and oxy-fatty acids that make up much of the adipocere substance. Adipocere formation arrests the process of decomposition, making it difficult for forensic pathologists to determine a post-mortem interval. The thesis identifies several issues with current research into early-stage adipocere. Firstly, the majority of scientific papers on the subject make use of pig adipose as a stand-in for human adipose due to ethical concerns. However, this traditional forensic method is not suited for studies into adipocere formation: the fatty acid profiles of pigs and humans have differing ratios of saturated and unsaturated fatty acids, making them an unreliable analog for adipocere testing. In addition, most studies assume a three-month timeframe for the formation process when preparing their experimental design, a timeframe thrown into question by both current data and several existing case studies demonstrating more rapid adipocere formation. Lastly, testing takes place in static environments, which does not reflect actual field conditions. There have been cases that suggest adipocere formation ceases during colder months once decomposition has initially halted. In these cases, the adipocere formation begins again once temperatures return to 22°C or higher. Another issue noted is the lack of chemical analysis conducted on early-formation adipocere. The changes in fatty acid ratios that take place during the process are not typically looked at by scientists investigating the phenomenon or forensic pathologists dealing with adipocere cases, but may offer a viable means of narrowing down post-mortem intervals and contribute to better timelines for pathologists and law enforcement. This thesis ultimately recommends a number of additional research directions necessary for building a temperature zone-based database of case and laboratory results, particularly ones that take into account the variable formation timeframe observed in previous experiments and case studies. / 2031-01-01

L’encadrement juridique d’une personne décédée par le prisme de ses dernières volontés est une situation ordinaire offerte à tout testateur, afin d’anticiper la gestion des conséquences de son décès. Bien que reconnues par le discours juridique comme un indicateur précieux des traitements posthumes à opérer, les dernières volontés ont un caractère supplétif et détiennent, en conséquence, une assise relative dans le discours juridique. Si ce constat prévaut toujours à la lecture des règles formelles, il n’en demeure pas moins que nombre de dernières volontés trouvent à éclore au moment du décès du sujet du droit, sans précisément que ce dernier n’ait effectué une démarche positive. Consacrées depuis la loi Cavaillet dans le cadre spécifique du don d’organes, les présomptions de dernières volontés se développent insidieusement, sans qu’il ne soit toujours possible, y compris pour la personne de son vivant, de connaître leur contenu et leur amplitude. En opérant de la sorte, le discours juridique livre un message inaudible qui atténue la légitimité des dernières volontés. Pourtant, si le travail législatif entrepris est indéniablement perfectible, il a le mérite de laisser entrevoir le statut juridique auquel pourrait désormais prétendre la personne décédée. Ne faut-il pas y voir le signe que l’encadrement juridique des personnes décédées ne devrait pas pouvoir s’opérer autrement que par les dernières volontés ? / The legal framework of deceased people through their last wills is an ordinary situation offered to any testator, in order to anticipate the management of the consequences of their death. Though acknowledged by the legal writings as a valuable indicator of the posthumous process to follow, last will and testament being, by nature, ancillary; it only holds a relative base in the legal discourse. If this observation always prevails over the reading of formal rules, many of the last wishes come out and take effect nonetheless when people die without them having necessarily actively carried out any procedure. Codified since the Cavaillet bill in the specific framework of organ donation, the presumption of last will has developed insidiously, without it being necessarily possible, including for the person during his or her lifetime, to have knowledge neither of their substance nor of their extent. Thus, the implied message one can read between the lines of our current legislation reduces the legitimacy of the last will. However, if the legislative work which has been undertaken is undeniably perfectible, it has the merit of showing the legal status which deceased people could now access. Shouldn’t one take this as a sign that the legal framework of deceased people should only be possible through the respect their last wills?

This thesis is focused on the worthwhile lessons learned while creating a short animated film. The conventional way of teaching related to practice is to have students work on projects and learn from their own experience. This thesis strives to save the reader some of the pain, time, and effort required of this learning style, by presenting the hard learned lessons from this project. An overview of the project is provided, along with a reconstructed time-line. Also, each member of the team recounted their own dilemmas and successes on the project, and proposed potential solutions to problems encountered along the way. The findings are presented in the spirit of a post-mortem analysis, which acts to collect the knowledge obtained by those involved with a project in order to increase productivity for the next time a similar task is attempted. The postmortem approach was found to be effective in identifying, illuminating, and articulating the lessons learned concerning general, practical, team-related and problem solving issues encountered while working on a short animated film.

Orientador: Roberto de Oliveira Roça / Resumo: Das principais zoonoses detectadas pelo serviço de inspeção oficial durante o exame post-mortem, a cisticercose e a tuberculose merecem destaque pela importância que possuem para a saúde pública e por gerarem impactos significativos na economia e no rendimento final. O presente estudo teve como objetivo verificar a evolução das ocorrências de cisticercose e de tuberculose durante 21 anos de inspeção post-mortem de bovinos, realizada em um frigorífico do centro-oeste paulista, localizado na cidade de Lins (SIF 337). Os dados coletados foram analisados em software SigmaStat versão 3.5 e, posteriormente, construídos intervalos de 95% de confiança para a proporção de ocorrência e as variáveis resposta também foram submetidas à análise de variância utilizando o procedimento Proc Mixed do software SAS 9.4 TS1M2, teste de Tukey-Kramer com nível de significância de 5%. No decorrer de todo o período, foram abatidos 5.240.138 bovinos. A ocorrência de tuberculose verificada foi de 0,15% (7.741), sendo maior em 1996 (0,41%) e menor em 2015 (0,02%), demonstrando uma redução de 11 vezes. Em relação à cisticercose bovina, foi de 4,34% (227.728), na qual 75% das carcaças continham cisticercos vivos e 25% calcificados, sendo as maiores ocorrências de cisticercose total encontrados em 2000 (6,7%) e as menores em 2015 (2,0%), com redução de 2,13 vezes. Conclui-se que as melhorias nos sistemas produtivos que aconteceram em duas décadas e a eficácia dos programas sanitários e da inspeção realizad... (Resumo completo, clicar acesso eletrônico abaixo) / Mestre

Made available in DSpace on 2014-06-11T19:22:23Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-01-27Bitstream added on 2014-06-13T19:48:40Z : No. of bitstreams: 1 fogaca_fhs_me_jabo.pdf: 596326 bytes, checksum: 558f30e4e45f55982f56059d2fab70b4 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Universidade Estadual Paulista (UNESP) / A vitamina E é usada nas dietas com a finalidade de melhorar o crescimento, a resistência ao estresse e a doenças, assim como a sobrevivência de peixes. Também pode ser eficiente na conservação do pescado durante o processamento e estocagem, inibindo a degradação dos lipídios pela oxidação. O presente trabalho avaliou os efeitos antioxidantes da vitamina E in vivo e in vitro na qualidade final dos hambúrgueres produzidos com filés de tilápias congelados durante 0, 30, 60 e 90 dias. Foi utilizado um delineamento inteiramente casualizado, com seis tratamentos, em esquema fatorial 3x2, caracterizado pela suplementação de dois níveis de vitamina E nas dietas (100 e 200 mg / kg de ração) e o grupo controle (zero mg/kg de ração) e adição ou não de 100 ppm de vitamina E aos hambúrgueres, com quatro repetições. Os peixes, com peso médio inicial de 184,23 + 1,68g foram alimentados com as dietas experimentais durante 63 dias. Após esse período, foram abatidos e os filés processados em hambúrgueres. Foram avaliados os parâmetros de desempenho, composição centesimal e a oxidação lipídica, determinada pelas substâncias reativas ao ácido tiobarbitúrico (SRATB). Os resultados mostraram que não houve diferença significativa para as variáveis de ganho de peso, conversão alimentar e crescimento específico entre os tratamentos. A composição química variou dentro dos valores encontrados para pescados. O aumento do nível de vitamina E promoveu redução nos valores de SRATB das amostras em todos os intervalos de tempo, e que a adição in vivo da vitamina E protegeu os hambúrgueres da oxidação lipídica de forma mais eficiente do que a adição in vitro, sendo que a interação entre ambas resultou em maior redução nas taxas de oxidação. / Vitamin E is used in diets with the aim of enhancing growth, resistance to stress and pathology, and also fish survival. It can be efficient in fish conservation during processing and frozen storage, inhibiting lipid degradation from oxidation. The present work evaluated the antioxidant effects of vitamin E utilization in vivo and in vitro in the final quality of hamburgers made from tilapia filets during frozen storage over 3 months. A randomized design, in a 3x2 factorial scheme was utilized, which correspond to the two levels of diet vitamin E (100 and 200 mg / kg diet) and the control group (zero mg/kg diet) and addition or not of 100 ppm of vitamin E to the hamburgers, with four repetitions. The fishes, with initial weight 184.23 + 1.68 g, were fed the experimental diets for 63 days, after which they were killed and processed into hamburgers. The performance parameters analyzed were centesimal composition and lipid oxidation, determined by the thiobarbituric acid reactive substances (TBARS). The results showed no significant difference between treatments for weight gain, food conversion or specific growth. The chemical composition varied within the values found for fish. Increased vitamin E levels promoted reduction of TBARS values over all time intervals. This means values suggested that the addition in vivo of tocopherol protected the hamburgers from lipid oxidation more efficiently when compared to in vitro addition, but the interaction between both resulted in higher reduction in rate of oxidation.

L'angioscanner post-mortem (ATDMPM) est une technique en plein essor. Notre travail a consisté en l'application des protocoles d'ATDMPM sur plusieurs types de populations. D'abord, nous avons acquis une expérience, notamment concernant les décès par chute d'un lieu élevé. Puis, nous avons eu la chance de travailler sur une collection rare de cœurs archéologiques momifiés et très bien conservés, datant entre le XVème et le XVIIème siècle. Les résultats radiologiques, autopsiques et histologiques concordaient. Nous avons également étudié une momie artificielle bretonne bien conservée du XVIIème siècle, qui avait comme particularité un arbre aortique abdominal et iliaque intact, permettant de réaliser la première angiographie post-mortem d'une momie de plus de 350 ans. Enfin, nous avons tenté d'adapter le protocole adulte de l'ATDMPM aux enfants en utilisant le modèle porcin. Dans un premier temps, nous avons testé une modification des moyens d'injection, en remplaçant les canules chirurgicales par des introducteurs radiologiques. Forts de ces résultats, nous avons réalisé des ATDMPM sur un modèle porcin. Nous avons utilisé deux machines différentes. L'opacification vasculaire globale a été satisfaisante pour l'ensemble des groupes. La réalisation des ATDMPM avec la machine Virtangio(r) s'est révélée très difficile en raison du seuil limite de pression. Les tests de corrélation ont mis en évidence une relation significative entre les caractères anthropométriques des porcs, les paramètres d'injection et le pourcentage de segments opacifiés. Notre travail confirme ainsi la complémentarité entre les techniques classiques d'investigations post-mortem et l'imagerie moderne, avec ou sans injection de produit de contraste. Il permet également d'entrevoir un futur riche de recherche et d'interdisciplinarité dans les domaines de recherche archéologique, anthropobiologique, médico-légale et radiologique. / Post-mortem Computed Tomography Angiography (PMCTA) is a growing technique. Our work consisted in the application of the protocols of PMCTA on several types of populations. First, we gained experience regarding deaths in a context of great height falls. Then, we had the chance to work a rare collection of mummified archaeological hearts and very well preserved, dating between the XVth and XVIIth centuries. We also studied a well-preserved artificial mummy from French Brittany dating from the XVIIth century, characterized by an intact abdominal aortic and iliac tree. We applied the first PMCTA of a mummy of more than 350 years. Finally, we tried to adapt the adult protocol of PMCTA to children, using a porcine model. First, we tested a modification of the injection procedure by replacing the surgical cannulas by radiological introducers. Based on these results, we carried out a series of PMCTAs on pigs. We used two different machines. Overall vascular opacification was satisfactory for all groups. The realization of the MPMCTA with the Virtangio(r) machine proved very complex due to the upper limit of pressure. Spearman correlation tests showed a significant relationship between anthropometric characteristics of pigs, injection parameters and percentage of opacified segments. A higher percentage of opacification is obtained for individuals of smaller weights, with comparatively smaller quantities of contrast agent injected. Our work confirms the complementarities between classical techniques of post-mortem investigations and modern imaging, with or without injection of contrast media. It also allows us to foresee a rich future of research and interdisciplinarity in the fields of archaeological, anthropobiological, medico-legal and radiological researches.

Bakgrund: När en patient avlider fortsätter vården även efter dödsögonblicket, vårdpersonal tar hand om både patient och närstående även efter att döden har inträtt. Att göra iordning den avlidne (post mortem care) är en uppgift omgärdad av symboliska handlingar och ritualer. Utbildningar lägger ringa vikt vid att lära ut färdigheter kring denna typ av vård och upplevelsen av att vårda en avliden patient är sparsamt undersökt i forskning och litteratur. Syfte: Att beskriva vad sjuksköterskor upplever som viktigt och meningsfullt i sitt arbete med vård av avlidna patienter i palliativ verksamhet. Metod: Arbetet har en deskriptiv design och är en kvalitativ intervjustudie med både fokusgruppintervju och enskild intervju som datainsamlingsmetod. Materialet bearbetades med kvalitativ innehållsanalys. Resultat: Analysen resulterade i tre huvudkategorier och sju underkategorier: Kunskap och erfarenhet: teoretisk kunskap erfarenhetsbaserad kunskap Relationer och roller: sjuksköterskors relation till patienten närståendes roll och betydelse för sjuksköterskor Handlingar och ritualer: symboliska handlingar avslut och avsked reflektion Diskussion: Resultatet diskuterades med KASAM som teoretisk referensram och överensstämmer med tidigare forskning. I resultatet framkom att vården av avlidna ansågs vara meningsfull och en arbetsuppgift som sträcker sig längre än omvårdnad, t.ex. inkluderades närståendestöd och egen reflektion som delar av post mortem care. Resultatet visar också att kunskapen till största del är erfarenhetsbaserad och att deltagarna i studien tycker det är viktigt att erfarna får tid och möjlighet att lära nya/oerfarna.

The memory grove [in Swedish: minneslund] is becoming an increasingly popular custom of burial in Sweden. Unlike traditional Swedish burial customs, the memory grove is a collective and anonymous gravesite, unmooring the obligation and cost of traditional grave maintenance. The absence of religious, institutional, or individualized symbols or displays leaves the memory grove with few indicators of death, in fact, death has been minimized and made discrete to the extent that the memory grove is hardly recognizable as a place of burial. Consequently, the memory grove raises unique emotional, ontological, and social concerns for the bereaved. The purpose of this study was to examine how individuals experience the memory grove as a site of commemoration. Drawing from the theoretical framework of lived religion and a phenomenological approach, the study provides a perspective vacant from previous research, mapping experiences of the memory grove based on seven qualitative deep interviews with individuals who have relatives or acquaintances resting at a memory grove. The findings demonstrated how experiences of the memory grove are governed by the emotional, social, and ontological assumptions that the respondents negotiate and enact as they commemorate on the memory grove. Furthermore, the results demonstrate how customs of burial have significant implications for how the bereaved maintain and experience post-mortem relations, and the extent to which they are able to experience the presence of the deceased. Lived religion was used to recognize how individuals negotiate, experience, and make meaning of that which is absent, invisible, intangible, and silent.