The influence of backrest support and handgrip contractions on acute metabolic, respiratory, and cardiovascular responses were evaluated in 13 healthy men during exposure to whole-body vibration (WBV).
Following assessment of aerobic fitness during arm cranking, subjects were exposed to frequencies 3, 4.5, and 6 Hz with 0.9 g(r.m.s) acceleration magnitude on a vibrating base in randomized order, on separate days. Each exposure included 6 min baseline without WBV, 8 min of WBV exposure either 'with' or 'without' backrest, 4 min recovery, followed by 8 min of WBV with opposite backrest condition, and 4 min recovery. During the final minute of WBV, subjects performed right hand maximal rhythmic handgrip contractions for one minute. During baseline and before completion of WBV session 'with' and 'without' backrest, cardiac output was estimated indirectly by carbon dioxide rebreathing.
At 3 and 4.5, and 3 and 6 Hz, absolute and relative oxygen uptake demonstrated significantly greater responses during sitting 'without' backrest than 'with' backrest (P
In this keynote address, the author discusses perception of the body in the context of chronic illness compared with that of health. She describes changes that occur in illness with respect to time, space, morality, aesthetics, morality, technology, information, and interpersonal relationships using examples from her research, and explores the construction of illness and health identities.
OBJECTIVE--To evaluate people's reactions to procedures involving the dead body by comparing their attitudes toward autopsy, organ donation, and dissection. DESIGN--Survey, using a questionnaire with 24 items that address reactions toward autopsy, organ donation, and donation of the whole body, including religious and sociodemographic issues. PARTICIPANTS--An age-stratified, random sample of 1950 individuals in Sweden, 18 to 75 years old. The response rate was 65%. RESULTS--Eighty-four percent reported acceptance of an autopsy for themselves and 80% for a close relative. Sixty-two percent were willing to donate their own organs and 39% to donate the organs of a family member; 15% accepted donation of their whole body for dissection. Practically all who accepted dissection also were willing to donate their organs and to be autopsied; practically all who were willing to donate their organs also accepted autopsy. About 65% to 70% felt some discomfort at the thought of autopsy and organ donation. Women seemed more sensitive toward operations on the dead body than men. CONCLUSIONS--The rank order of medical procedures after death, based on the proportion of individuals positive toward the procedures, can be used to form a scale with autopsy and dissection at each end point and organ donation in the middle. This scale has the characteristics of a Guttman scale and can be looked on as a comfort-discomfort continuum regarding procedures involving the dead body.
There has been a marked increase in the use of complementary and alternative medicine (CAM) in the West since the 1970s. However, biomedicine is still prevailing within public health services and health services covered by private insurance. Different therapies, conventional and CAM, represent different perceptions of the the body. Perceptions of the body are closely related to perceptions of illness, health, disease, and risk. The cultural models of the body are related to social organization and the development of technologies. In a study on spiritual healers and their clients in Norway, I found that clients adapted to a multitude of medical regimes by processes of recognition through cognitive models, learning, and socialization. I describe five models that are evident in communication between healers and clients; the model of the body as machine, plumbing system, energetic, programmable, and as wireless network. People hold diverse perceptions of health, illness, body, and risk, which influence attitudes and behavior. Changes in perceptions of body, health, and illness may be one factor enforcing that CAM is increasingly becoming a first-line intervention. Health authorities meet this challenge emphasizing the regulation of CAM to safeguard patients but could also choose to focus on what clients define as their needs. The shift in cultural understandings of the body, and how people cope with this diversity, ought to be an area for further investigation, as it may affect the choices citizens make and the legitimacy of health authorities.
Ethical concerns on patents in the biological sciences are increased by the prospect of patents for higher life forms. A Canadian patent grants the owner the right to exclude others in Canada from making, using, or selling or offering for sale his or her invention for the term of the patent; however, it does not give the patent owner any positive rights to do likewise. As with other forms of property, the right to make, use, or sell a patented invention may be regulated by other laws or guidelines. In Canada, higher life forms, medical and surgical methods are not patentable subject matter. Unicellular life forms and subcellular material are considered patentable. Decisions on ethical issues are not considered by patent officers. The Patent Office is guided only by legislation. Other regulations by the legislatures can direct public policy and minimize risks.
Living organ donation should be recognized as an ethical compromise to the principle of nonmaleficence (doing no harm), given the risks healthy donors are allowed to assume. Living organ donation should be reserved for situations in which there is no acceptable alternative. Increasing the availability of cadaveric organs is most desirable, since it would decrease (although probably not eliminate) the need for living organ transplantation and would provide organs (ie, hearts) that could not otherwise be obtained. We propose the development of an incentive-based Advance-Directive Organ Registry, in which all adults are encouraged to register their advance directive regarding organ donations. Those individuals agreeing to permit usable organs to be taken at the time of death would receive priority for organs generated by the program, should a transplant become necessary when there is a shortage of organs. The proposed Advance-Directive Organ Registry is firmly founded on the principles of autonomy, beneficence, and justice.
Comment In: Arch Intern Med. 1993 Feb 22;153(4):529-308435032