BackgroundEarly physical rehabilitation in the intensive care unit (ICU) has been shown to improve short-term clinical outcomes but long-term benefit has not been proven and the optimum intensity of rehabilitation is not known.MethodsWe conducted a randomised, parallel-group, allocation-concealed, assessor-blinded, controlled trial in patients who had received at least 48 hours of invasive or non-invasive ventilation. Participants were randomised in a 1:1 ratio, stratified by admitting ICU, admission type and level of independence. The intervention group had a target of 90 min physical rehabilitation per day, the control group a target of 30 min per day (both Monday to Friday). The primary outcome was the Physical Component Summary (PCS) measure of SF-36 at 6 months.ResultsWe recruited 308 participants over 34 months: 150 assigned to the intervention and 158 to the control group. The intervention group received a median (IQR) of 161 (67–273) min of physical rehabilitation on ICU compared with 86 (31–139) min in the control group. At 6 months, 62 participants in the intervention group and 54 participants in the control group contributed primary outcome data. In the intervention group, 43 had died, 11 had withdrawn and 34 were lost to follow-up, while in the control group, 56 had died, 5 had withdrawn and 43 were lost to follow-up. There was no difference in the primary outcome at 6 months, mean (SD) PCS 37 (12.2) in the intervention group and 37 (11.3) in the control group.ConclusionsIn this study, ICU-based physical rehabilitation did not appear to improve physical outcomes at 6 months compared with standard physical rehabilitation.Trial registration numberISRCTN 20436833.

Although a long tradition of theoretical and sociohistorical analysis has suggested that religious practices and values help African Americans in coping with the distressing sequelae of racism and discrimination, few studies have examined this issue with systematic, quantitative, empirical data. Our work contributes to the literature by: (a) outlining a series of arguments regarding the potential significance of multiple aspects of religious involvementattendance at services, church-based social support, and religious guidance in daily life-in dealing with harmful psychosocial effects of recent experiences of discrimination; and (b) testing hypotheses derived from two alternative models of the racism-religion-distress relationship using longitudinal data from a nationwide survey. Results indicate that both religious guidance and religious attendance moderate the effects of racism on psychological distress, while congregational support has a direct (but not interactive) effect on distress, thereby partly offsetting (but not buffering) the negative effects of discrimination.

This article contributes to recent work investigating the role of religious sanctification, that is, the process via which one's spouse or marital relationship is perceived as having divine character or sacred significance. We outline a series of theoretical arguments linking marital sanctification with specific aspects of marital quality. A recent probability sample of Texas adults is used to gauge the links between general religiousness, marital sanctification, and marital quality and functioning. Key findings include the following: (1) General religiousness bears a weak link with marital outcomes; (2) sanctification strongly predicts desirable marital outcomes; and (3) sanctification appears to buffer the deleterious effects of financial and general stress on marital quality. Study limitations and practical implications are discussed, and promising directions for future research are identified.Throughout much of the 20th century, social scientific research indicated that the institutions

Anandamide can be metabolized by cyclooxygenase-2 to produce prostaglandin E(2) (PGE(2)) ethanolamide. The purpose of this study was to investigate the pharmacology of this novel compound. Radioligand binding experiments in membranes from human embryonic kidney cells transfected with PGE(2) receptor subtypes EP(1), EP(2), EP(3), and EP(4) revealed that PGE(2) ethanolamide has pK(i) values of 5.61 +/- 0.1, 6.33 +/- 0.01, 6.70 +/- 0.13, and 6.29 +/- 0.06, respectively, compared with 8.31 +/- 0.16, 9.03 +/- 0.04, 9.34 +/- 0.06, and 9.10 +/- 0.04 for PGE(2). PGE(2) inhibits electrically evoked contractions of the guinea pig vas deferens (EP(3) receptor-mediated), with a pEC(50) value of 9.09 +/- 0.06, compared with that of 7.38 +/- 0.09 for PGE(2) ethanolamide. In the guinea pig trachea, 100 nM PGE(2) and 1 microM PGE(2) ethanolamide produced contractions of 51.8 +/- 10.6 and 38.9 +/- 5.6% (of the histamine E(max)), respectively. The EP(1) receptor antagonist SC-51089 (10 microM) prevented the contractions induced by both compounds. In the presence of 10 microM 8-chlorodibenz[b,f][1,4]oxazepine-10(11H)-carboxylic acid, 2-[1-oxo-3-(4-pyridinyl)propyl]hydrazide, monohydrochloride (SC-51089), PGE(2) caused a concentration-related relaxation of histamine-induced contractions of this tissue (EP(2) receptor-mediated), the pEC(50) value being 8.29 +/- 0.17 compared with that of 7.11 +/- 0.18 for PGE(2) ethanolamide. In the rabbit jugular vein, PGE(2) induces relaxation (EP(4) receptor-mediated) with a pEC(50) of 9.35 +/- 0.25, compared with 7.05 +/- 0.4 for PGE(2) ethanolamide. In dorsal root ganglion neurons in culture, 3 microM PGE(2) ethanolamide evoked an increase in intracellular calcium concentration in 21% of small-diameter capsaicin-sensitive neurons. We conclude that this compound is pharmacologically active, however its physiological relevance has yet to be established.