Death is likely to result in very extensive biochemical changes in all body tissues due to lack of circulating oxygen, altered enzymatic reactions, cellular degradation, and cessation of anabolic production of metabolites. These biochemical changes may provide chemical markers for helping to more accurately determine the time since death (post-mortem interval), which is challenging to establish with current observation-based methodologies. In this study blood pH and changes in concentration of six metabolites (lactic acid, hypoxanthine, uric acid, ammonia, NADH and formic acid) were examined post-mortem over a 96 hour period in blood taken from animal corpses (rat and pig) and blood from rats and humans stored in vitro. The pH and the concentration of all six metabolites changed post-mortem but the extent and rate of change varied. Blood pH in corpses fell from 7.4 to 5.1. Concentrations of hypoxanthine, ammonia, NADH and formic acid all increased with time and these metabolites may be potential markers for post-mortem interval. The concentration of lactate increased and then remained at an elevated level and changes in the concentration were different in the rat compared to the human and pig. This is the first systematic study of multiple metabolic changes post-mortem and demonstrates the nature and extent of the changes that occur, in addition to identifying potential markers for estimating post-mortem interval.
So many of our dreams at first seem impossible, then they seem improbable, and then, when we summon the will, they soon become inevitable.
Death results in changes in some metabolites in body tissues due to lack of circulating oxygen, altered enzymatic reactions, cellular degradation, and cessation of anabolic production of metabolites and macromolecules. Metabolic changes may provide chemical markers to better determine the time since death (post-mortem interval), something that is challenging to establish with current observation-based methodologies. The aim of this research was to carry out a metabolic analysis of blood plasma postmortem, in order to gain a more complete understanding of the biochemical changes that occur following death. Gas chromatography was used to conduct a survey of post-mortem rat blood. Sixty six metabolites were detected post-mortem. Twenty six of these [18 amino acids, glutathione (GSH), 4-Amino-n-butyric acid (GABA), glyoxylate, oxalate, hydroxyproline, creatinine, a-ketoglutarate and succinate] had increased concentrations post-mortem. The remaining 40 metabolites had concentrations that were not dependant on time. This study demonstrates the range of metabolic changes that occur post-mortem as well as identifying potential markers for estimating post-mortem interval.
Background The global deficit of nurses demands urgent attention in the recruitment and education of this future workforce. Graduate entry nursing (GEN) programmes are one option for people with undergraduate degrees who are seeking nursing education. Determining the key motivations for enrolling in these programmes will support the development of new initiatives in the education sector to both recruit and retain this future workforce and inform future primary research. This scoping review aims to comprehensively describe what motivates graduates to enrol in GEN programmes. Methods Peer reviewed studies of quantitative, qualitative and mixed-method research investigating motivations to commence a graduate entry nursing programme were included, following a pre-determined protocol. Electronic databases searched included Cumulative Index to Nursing and Allied Health Literature (CINAHL), Emcare, ERIC, Medline and Scopus. Screening, data extraction and analysis was initially in duplicate and independent, then consensus reached. Qualitative and quantitative data was analysed and reported separately then combined thematically as a narrative synthesis in a convergent segregated approach. Reporting followed preferred reporting guidelines for scoping reviews. Results Of the 491 studies retrieved in July 2020, across the five databases and reference list search, six met the inclusion criteria. Four were qualitative studies, one mixed-methods, and one quantitative, respectively from Australia, USA, and New Zealand. Four themes of motivation were identified: 1) finding meaning and purpose through altruism and caring; 2) seeking a satisfying career, 3) looking for a change in direction and, 4) reduced financial burden due to course length and provision of scholarships. Conclusions There is a paucity of studies specifically seeking to investigate student motivations for enrolling in a GEN programme and only limited studies giving insights into motivators for enrolling in a GEN programme, therefore this scoping review contributes new understandings on the reason’s students choose GEN programmes. These are both altruistic and practical and include personal desires to help others, the need to pursue a satisfying and meaningful career and the shorter period out of the workforce offered by an accelerated programme of study.
The review investigated the barriers and facilitators associated with assessing and engaging with mental health in a rural setting. The aim is to describe and synthesize the literature that examines the experiences of adults who access or attempt to access mental health services in rural settings. A systematic search from 2010 to 2020 was conducted using CINAHL, PsycINFO, Web of Science Core Collection, PubMed, Psychology and Behavioural Sciences Collection, Google Scholar, and Scopus. PRISMA protocols located 32 relevant papers from the overall 573 first selected. Braun and Clarke (Qualitative Research in Psychology, 3:77–101, 2006) thematic analysis methodology was applied to the data resulting in two themes: first theme identified help‐seeking with subthemes of stigma and locality of health services. The second theme was connectedness, inclusive of subthemes of support systems and personal identity. The review identified gender‐related perspectives concerning accessing mental health support, exposing the need for more research to examine the diverse social connections and support networks in rural communities. The findings suggest the need to further explore the impediments that reduce the likelihood of accessing mental health services in rural communities.
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