The Effects of Bereavement Time on the Relationship Between Coping Strategies and Psychological Distress.

The purpose of this study was to investigate the relationship between bereaved individuals' coping patterns, mental health, and time post-loss. A questionnaire using the Coping with Bereavement Scale (CBS) and the Kessler Psychological Distress Scale (K6) was completed by 173 family members of individuals who died from cancer between August 2013 and March 2016. Confirmatory factor analysis revealed a three-factor solution for the CBS comprised of "life orientation," "avoidance," and "retaining ties" with the deceased. Scores on retaining ties were significantly but weakly correlated with K6 scores; however, the intensity of this relationship increased with more time post-bereavement, and individuals who retained strong ties with the deceased for two years or more demonstrated poorer mental health. Although retaining ties with the deceased might be an adaptive psychological process following bereavement, in this study, long-term persistence with that coping strategy was associated with greater overall psychological distress. Further research is needed to identify optimal coping methods to address evolving needs during the bereavement process.

Dysmenorrhea due to undiagnosed obstructed hemi-vagina and ipsilateral renal anomaly syndrome can become a cause of suicide.

BACKGROUND: A Japanese woman in her early twenties had committed suicide, jumped from a 25-meter high bridge into a lake. She had been suffering from severe dysmenorrhea and general fatigue monthly. RESULTS: A forensic autopsy revealed indications of a bicorporeal uterus, obstructed hemi-vagina, and ipsilateral renal agenesis, which lead to a diagnosis of obstructed hemi-vagina and ipsilateral renal anomaly (OHVIRA) syndrome. On the right side of the uterus, an enclosed cavity composed of black clots was observed. Histological findings suggested that her endometrium was in the early proliferative phase, implying that she was in the menstrual phase just before her death. She may have been suffering from severe lower abdominal pain from the increased pressure of the closed uterus cavity. CONCLUSIONS: This case indicates that dysmenorrhea from undiagnosed OHVIRA syndrome can possibly lead to a suicide attempt. In Japan, because suicide was the leading cause of death for people aged 15 to 39 in 2019, preventive measures for suicide should be promoted. The present case also suggests that intervention for dysmenorrhea may prevent this in adolescent woman.

How Views on Death and Time Perspectives Relate to Palliative Care Nurses' Attitudes Toward Terminal Care?

This study's purpose was to explore how palliative care nurses' views on death and time perspectives are related to their terminal care attitudes. A questionnaire survey-consisting of the Death Attitude Inventory, Experiential Time Perspective Scale, and the Japanese version of the Frommelt Attitudes Toward Care of the Dying Scale-was administered to 300 individuals. Cluster analysis was conducted to categorize the way nurses perceive death, which revealed four types: Avoidant, middle, accepting, and indifferent. As a result of the analysis of variance on the terminal care attitudes, based on the types of views on death and time attitudes, it was found that the middle and accepting types, as well as the adaptive formation of time attitudes, were related to positive terminal care attitudes. In conclusion, more effective improvements in attitudes toward terminal care can be expected by incorporating time perspective, in addition to the conventional approaches focusing on death.

Determination of Both Fetus' and Mother's Blood Type from an Autopsy Case Immersed in Formalin for Over 50 Years.

A female fetus which had been immersed in formalin for more than 50 years was found in Japan. Because no liquid blood could be obtained, we tried to use immunohistochemistry (IHC) methods to tissue samples obtained at autopsy to identify both the fetal and mother's blood type. We detected B antigens on endothelial cells in paraffin sections of the fetal organs. Furthermore, we observed both anti-A- and anti-B-positive red blood cells in the intervillous space, which is indicative of the mother's blood type. To our knowledge, this is the first case report on determining the blood type of both the fetus and the mother from tissue immersed in formalin for such a long time. The results suggest that IHC is valuable for the determination of ABO blood type in circumstances of long postmortem duration and unfavorable storage conditions.

Autopsy of a patient with alcoholic suffering from cardiopulmonary arrest at the hospital.

A 48-year-old Japanese woman with >10 years history of alcoholic had been falling repeatedly during 1 week before her death. She complained of nausea and did not eat or drink for 2 days. Thereafter, she became drowsy and she was transferred to the hospital. On arrival at the hospital, she had cardiopulmonary arrest and died soon after. Although blood tests showed metabolic ketoacidosis, a hemorrhagic lesion was also found in the brain by computed tomography. To determine the cause of death,. a forensic autopsy was performed on the next day. At autopsy, cerebral contusion, skull fracture, and subdural hemorrhage caused.by the head injury received after falling were found. Histological examination showed fatty changes and Mallory bodies in the liver. There was a marked increase in ketone bodies, especially ß -hydroxybutyrate, in postmortem blood examination. Therefore, the cause of death was diagnosed as alcoholic ketoacidosis. Accurate diagnosis of mild trauma and metabolic disease is difficult by postmortem computed tomography; therefore, autopsy is required for sudden death. In this case, the cause of death and accompanying traumatic lesions that were compatible with her history was clarified by autopsy. Furthermore, because the blood was taken at the time of cardiopulmonary arrest, we.obtained reliable data from the terminal stage of alcoholic ketoacidosis. This case demonstrates the physiological and pathological changes in sudden death of a patient with alcoholic.