Kitchen Floor Research Articles

Spread of multidrug-resistant Escherichia coli within domestic aggregates (humans, pets, and household environment)

Abstract Advances in veterinary medicine have been associated with recourse to antimicrobial therapies, which favors the emergence of resistant bacteria, potentially able to spread globally. The aim of the present study was to elucidate the manner in which shared environments between pets receiving antimicrobial treatments and their owners could contribute to the spread of antimicrobial drug-resistant Escherichia coli . Three domestic aggregates, including pets, owners, and household environment were studied. Each core pet had a history of previous antimicrobial therapies. Overall, 231 E. coli isolates were recovered from pets' feces, urine, oral secretion, skin, and fur; and owners' hands and stool swabs. Commonly touched household objects and surfaces (light switches, door knobs, TV remote control, mobile phones, banister, refrigerator door handle, kitchen floor, pet beds, leash, food, and water recipients) were also sampled. All strains were analyzed by antimicrobial susceptibility testing. Subsequently, some isolates were selected for Enterobacterial Repetitive Intergenic Consensus-Polymerase Chain Reaction and Pulsed-Field Gel Electrophoresis analyses, to evaluate their genetic relatedness. Antimicrobial susceptibility tests displayed 20 different phenotypic patterns with an important representation of multidrug-resistant ones (75.0%). The 3 core dogs presented multidrug-resistant E. coli clones disseminated over various body sites. In 2 of 3 domestic aggregates, A and B, clonal disseminations among animals, owners, and household surfaces were also observed. Results confirmed the dissemination of multidrug-resistant E. coli within and through the household environment, highlighting the relevance of pets in the community spread of antimicrobial resistance.

The Three Mouths of Little Tom Drum by Nancy Willard (review)

Reviewed by: The Three Mouths of Little Tom Drum by Nancy Willard Amy Atkinson Willard, Nancy The Three Mouths of Little Tom Drum; illus. by Kevin Hawkes. Candlewick, 2015 [48p] ISBN 978-0-7636-5476-4 $16.99 Reviewed from galleys M 5-7 yrs Tom’s mother has made his very favorite pie (strawberry) for his eighth birthday. Not content with the single slice he wheedles before bed, he wishes for three mouths; unfortunately, this birthday wish comes true. Plagued with three pieholes, he cannot possibly have a birthday party or even attend school, and his mother’s initial reaction is to shriek “There’s a monster in the house!” before the family falls together weeping on the kitchen floor. He studies with a tutor, begins inventing contraptions, and wishes fervently for his previous face; only when his innovations matter more than his appearance and the neighborhood children appreciate him just as he is does he return to his single-mouthed self. The message is ambiguous in this convoluted cautionary tale of greed and gluttony (or maybe of the superficiality of appearances—hard to say); the logic is unclear and random plot devices are confusing. The pen, ink, and pastel illustrations confound rather than clarify the issue, with an anthropomorphized moon implicated but never convicted in Tom’s initial transformation. With its combination of a 1950s-like backdrop, fable conventions, and incongruous inventions the art pairs realism and whimsy without really coming down on either side; lightness is never fully embraced nor darkness fully explored. Neither a clear morality tale nor a successful satire—and entirely too text-heavy for the crowd who could simply laugh at Tom blowing bubbles from all three mouths—this perplexing book, like a pie, is best left to cool on the shelf. Copyright © 2015 The Board of Trustees of the University of Illinois

The angle of the light on the bloodstained kitchen floor

The angle of the light on the bloodstained kitchen floor

Prepping for the Day You Hope Never Arrives: Facing Recurrence

Prepping for the Day You Hope Never Arrives:Facing Recurrence Terra Trevor My 14–year–old son was eight years past diagnosis of a brain tumor. Gone were the pristine sick days when his white hooded sweatshirt stayed spotlessly clean for weeks at a time. Each time he left a muddy footprint on the kitchen floor I rejoiced; it felt so good to have a healthy kid again. However, my son was a survivor of an anaplastic ependymoma, grade IV, brain tumor, and although I wanted to be out of the woods, I knew we were not. I’d climbed out of the space where medical problems were fi led in my mind, yet I kept the door open because statics showed that the type of brain tumor he had, frequently recurred. Still, I was determined to keep our lives as ordinary as possible. But for a brain tumor family this meant staying connected to sources of support. Parent programs, patient and sibling support groups [End Page 27] and camps, and we remained connected to hospital resources. Most of all we needed to have fun as a family, and we attended the cancer survivor picnics and parties our hospital hosted, where the doctors served as volunteers, grilling hamburgers and dishing up ice cream for the guest of honor patients. My husband and I felt confident that as long as we worked as a team with our doctors and stayed connected to resources offered, we would find a way to meet any challenges that might surface. In the end ultimately what saved us was this mosaic of support provided to us over the years from a multitude of good people and organizations offering help when we needed it most. And I had the opportunity to learn to accept help, which it turns out, is far harder than offering to help. Shortly after my son Jay celebrated his 8th year as a brain tumor survivor, I watched him open the medicine cabinet and reach for the bottle of Advil, for the second time in a row that day. “Do you have a headache again?” I asked. He shrugged his shoulders, then hiccupped hard, and ducked his head in the toilet and threw up. Tears welled in his eyes. I sank into the deep, silent panic that made me calm. Our primary care physician called in an authorization for an MRI. Jay hid his fear behind a mask of quiet strength. It was ten days before his fifteenth birthday. While we waited for the MRI appointment, that week Jay was elected student of the month, and he got a lead part in the school play. My idyll of family hood continued until the MRI confirmed my worst fear—the tumor was back, and this time its fingers spread into the brainstem. We had to decide on a plan of treatment. Surgery was scheduled. When Jay was admitted to the hospital and I requested that he be placed in the pediatric ward, an environment he was familiar with, they agreed. Although Jay was a teenager, the recurrence caused him to revert emotionally back to a younger age. It was as if he was seven–years–old again, reliving his first brain tumor experience, and he kept his childhood security item—a small teddy bear with him, tucked under the hospital covers, like he had with the first diagnosis. Luck held. With surgery most of the tumor was resected and symptoms disappeared. Three days later, on Thanksgiving, he was feeling well enough to be excited about the Thanksgiving dinner our hospital provided us. A table and chairs were brought in, along with a feast of good food. The nurses gave Jay lavish attention, they laughed at the corny jokes he told, and made us feel like special company. Within a week Jay was out of the hospital, recovering well. But what to do about the remaining brain tumor slivers that were inoperable? He had already received his lifetime dose of whole brain radiation, and chemotherapy available offered little hope of curing a recurrent tumor. But there was a small chance that stereotactic radiation might stall tumor growth. We set up a consultation. We had...

Norrland’s Regional Literature as World Literature

The work of Per Olov Enquist, one of the most important contemporary Swedish authors, is known far beyond Sweden’s and Europe’s borders, and thus even received in North America. A great many of his fictional documentary works and dramatic plays, the biographies of poets such Hans Christian Andersen, Selma Lagerlöf, Knut Hamsun, and August Strindberg, as well as the bestselling novels Lewis Journey, The Royal Physician’s Visit and The Book about Blanche and Marie, have secured a firm position for this Norrland author in the canon of world literature. The continuous transgression of the borders between historical facts and their fictionalization builds the basic characteristic of Enquist’s literature. For Enquist, the goal of writing is to sound out the “innermost space of human existence.” He is eager to explore those secrets and ambiguities that underlie certain historical events or individual life stories. How is individual life determined? And how do individuals find their place in the world? In several of his works, the author uses the metaphor of drawing topographical maps to illustrate the search for one’s own identity as an attempt to position oneself in the world. Starting from his memory of lying on the kitchen floor as a young boy and drawing maps of his native village Hjoggböle, the area around Bureå, the Västerbotten and Norrland region as well as of his native country Sweden, Enquist reveals to his readers what it is that he considers literature to be: the compression of real signs into a fictional space which resembles reality, but, at the same time, moves beyond the boundaries of reality. Through an analytical synopsis of those works that use the motif of map-drawing as a central theme and often refer to each other in direct intertextual reference, namely the novel Captain Nemo’s Library, the essay collection Kartritarna [‘The cartographers’], and Enquist’s biography Ett annat liv [‘A different life’], this article examines the metaphorical function and poetological meaning that the depiction of the author’s own region and home as well as references to his own life story and origin have in Enquist’s work.

Ceramics and its Importance

The term "ceramic" once referred only to clay-based materials. However, new generations of ceramic materials have tremendously expanded the scope and number of possible applications. Many of these new materials have a major impact on our daily lives and on our society. Ceramics has advanced far beyond its beginnings in clay pottery. Ceramic tiles cover the space shuttle as well as our kitchen floors. Ceramic electronic devices make possible high-tech instruments for everything from medicine to entertainment. Clearly, ceramics are our window to the future.The Himalayan Physics Vol. 4, No. 4, 2013 Page: 80-82 Uploaded date: 12/23/2013

Mies Julie by August Strindberg, and: Easter by August Strindberg, and: The Dance of Death by August Strindberg (review)

Reviewed by: Mies Julie by August Strindberg, and: Easter by August Strindberg, and: The Dance of Death by August Strindberg Sarah Balkin Mies Julie. By August Strindberg. Adapted and directed by Yael Farber. Baxter Theatre Centre. St. Ann’s Warehouse, New York City. 4 December 2012. Easter. By August Strindberg. Adapted and directed by Robert Greer. August Strindberg Repertory Theatre. Gene Frankel Theatre, New York City. 14 March 2013. The Dance of Death. By August Strindberg. Adapted by Mike Poulton. Directed by Joseph Hardy. Red Bull Theater. Lucille Lortel Theatre, New York City. 23 April 2013. Recent interest in Strindberg’s work, including the formation of the August Strindberg Repertory Theatre and its inaugural production in 2012, could be at least partly attributed to the centenary of Strindberg’s death in 2012. But the centenary does not explain the viral popularity of Eun-Ha Paek, [End Page 565] Erin Perkins, and James Bewley’s “Strindberg and Helium” cartoons since 2001 (the last of which, “Strindberg and Helium at the Beach,” was nominated by the YouTube Play jury and presented at the Guggenheim Museum in 2010), nor the continuing frequency with which Strindberg’s work is staged and adapted. Recent productions by Baxter Theatre Center, August Strindberg Repertory Theatre, and Red Bull Theater suggest that Strindberg’s relevance in the present moment has to do with his depiction of human lives determined by political, socioeconomic, and biological forces and expressed in the ethereal forms of human (and nonhuman) communication: haunting, telepathy, and vampirism. Three recent New York City productions of Strindberg’s plays featured striking convergences of naturalism and the occult. To Strindberg’s incompatible social and hereditary determinisms, Yael Farber’s South African Mies Julie added a Xhosa ghost who haunts the farm kitchen built over the grave of Christine’s ancestor. Set in present-day (2012) Eastern Cape Karoo, Farber’s adaptation casts Julie (Hilda Cronje) and John (Bongile Mantsai), respectively, as the Afrikaans daughter of a farmer and his Xhosa servant. This addition of racial tensions to the class and gender dynamics of Strindberg’s original was accompanied by a change in the character relationships: in Farber’s version, the cook Christine (played by Thoko Ntshinga) is John’s mother rather than his fiancée. Consequently, Farber’s John is constrained by ancestry as much as class, and Christine, who appeared as a mother figure to Julie as well as to John, drew attention to the history of the land and farm that produced them. This connection between the characters and the land was borne out further by the staging, which featured a tree stump growing out of the downstage kitchen floor. In a scene without precedent in Strindberg’s play, Christine tried to attack the floor with a pitchfork to free her ancestor, Ukhokho, who is buried under the tree and whose ghost haunts the production. Through this focus on Christine’s ties to both the stump and the kitchen—her rights and obligations to the land where her ancestors were buried and her disenfranchised domestic servitude—Farber’s production emphasized the characters’ status as products of political and cultural histories that could neither coexist nor dissever. Amid these connected histories, the production’s mix of contemporary and traditional dance and music both posited and withdrew the possibility of generational progress. In Strindberg’s play, the peasant ballet during Jean and Julie’s offstage intercourse is both a return to pre-naturalist nineteenth-century theatre and a scene of modernist rupture. Farber adapted Strindberg’s peasant ballet into a hip-hop number between John and Julie, who danced against the upstage wall, behind the open perimeter of the kitchen. As both a thriving transcultural dance form and a precursor to John and Julie’s sex on the kitchen table, the hip-hop number presented the play’s violent transcultural histories as artistically generative. But the dance, like the sexual charge between John and Julie, did not translate to personal or political viability. After Julie kills herself by thrusting a sickle into her womb, John stands motionless, wearing her father’s boots. More compelling than Julie’s fatal preemptive abortion or John’s realization that he could only...

Powering cancer screening for overall mortality.

Powering cancer screening for overall mortality.

Development of a Bacterial Resistant Concrete for Use in Low Cost Kitchen Floors

Development of a Bacterial Resistant Concrete for Use in Low Cost Kitchen Floors

Indoor Air Quality in Green vs. Non-green Homes

Background: Green building features are designed to have a minimal negative impact on the environment and reduce energy consumption. However, the indoor air quality (IAQ) within green buildings has not yet been quantified. We assessed the indoor air quality in 20 green-renovated and 20 control apartments in Cincinnati, Ohio, USA. A 5-day IAQ assessment in each home included measurement of temperature, relative humidity and ventilation as well as concentrations of fine particles, allergens, volatile organic compounds (VOCs), and pesticides. Aims: Determine how green renovation features affect the indoor air quality Methods: Temperature and relative humidity were monitored using continuous data loggers. Sampling for particle mass ? 2.5 µm (PM2.5) was conducted using single-stage Personal Modular Impactors with 37-mm, 2.0-µm pore-size PTFE membrane filters. VOC sampling was performed using passive diffusion dosimeters and pesticide samples were collected from kitchen floor by wiping. Dust samples were vacuumed from beds and kitchen floors and analyzed for allergens.Results: Preliminary data obtained immediately after renovation shows that relative humidity and formaldehyde levels were significantly higher in green vs. non-green homes (p=0.04). In contrast, isopropyl alcohol levels were significantly higher in non-green homes (p=0.05). Overall, there were higher detectable levels of pesticides in non-green vs. green homes. Additionally, we identified a trend of higher PM2.5levels in green homes (p=0.08). Higher concentrations of allergens were observed in non-green homes though the difference was not statistically significant. Conclusions: The baseline data immediately after renovation shows conflicting trends between green-renovated and renovated homes for different indoor pollutants. Follow-up sampling performed 6 and 12 months after renovation may help identify how the IAQ will change in green-renovated homes over time.

Effectiveness of a dry kitchen system on controlling the microbiological safety of food and contact surfaces

The aim of this study was to examine the effect of dry and wet kitchens on the microbial quality of food and facility. Samples were 3 foods items and 4 surface samples taken from 2 dry and 4 wet kitchens in Korea. Total mesophilic count (TMC), coliforms, Escherichia coli, Staphylococcus aureus, Salmonella sp. were analyzed. The TMC levels of the food were within 5.97 log CFU/g, but E. coli were detected from 1 wet kitchen. The compatibility rates of the surface samples in the dry kitchen were significantly higher than those in the wet kitchen for TMC, coliforms and E. coli. As the results of the growth rate of TMC and coliforms under simulation conditions, the dry kitchen samples showed longer lag time and slower specific growth rate than wet kitchen samples. In conclusion, dry kitchen floor is a more effective way for ensuring the microbiological safety of food.

Seasonal Changes in Endotoxin Exposure and Its Relationship to Exhaled Nitric Oxide and Exhaled Breath Condensate pH Levels in Atopic and Healthy Children

Endotoxin, a component of the cell walls of gram-negative bacteria, is a contaminant in organic dusts (house dust) and aerosols. In humans, small amounts of endotoxin may cause a local inflammatory response. Exhaled nitric oxide (eNO) levels, an inflammation indicator, are associated with the pH values of exhaled breath condensate (EBC). This study evaluated seasonal changes on indoor endotoxin concentrations in homes and the relationships between endotoxin exposure and eNO/EBC pH levels for healthy children and children with allergy-related respiratory diseases. In total, 34 children with allergy-related respiratory diseases and 24 healthy children were enrolled. Indoor air quality measurements and dust sample analysis for endotoxin were conducted once each season inside 58 surveyed homes. The eNO, EBC pH levels, and pulmonary function of the children were also determined. The highest endotoxin concentrations were on kitchen floors of homes of children with allergy-related respiratory diseases and healthy children, and on bedroom floors of homes of asthmatic children and healthy children. Seasonal changes existed in endotoxin concentrations in dust samples from homes of children with allergic rhinitis, with or without asthma, and in EBC pH values among healthy children and those with allergy-related respiratory diseases. Strong relationships existed between endotoxin exposure and EBC pH values in children with allergic rhinitis.

The Opportunity for “Design” to Influence the Ageing Process Itself

The unprecedented shift in the age composition of the world, which the JPA has often highlighted, will impact upon all aspects of society—how we live, how we work, how we play and consume, and importantly the environments within which we do this. For the world of design this brings not only the growing necessity of engaging with this demographic trend, but also the opportunities and advantages of doing so. There are, however, many myths surrounding this “grey burden”. The first misconception is that ageing populations herald a world of disabled frail elderly people requiring purpose-built geriatric care centres. Rather, we are heading for a future with fit, active, older adults, who will need to adapt their living and working environments to cope with their slow reduction in physical, sensory, and sometimes mental, capacity. Nowhere will this occur more than in the arena of domestic architecture and design—for it is here, in our homes, that most of us will spend the last decades of our lives. Current design interest, however, is still focusing on the “care” environment” with purpose built accommodation—sheltered housing and assisted living—comprising floor drainage suitable for a roll-in shower, wide staircases with handrails, and features which prevent falls, such as non-slip bathroom and kitchen floors. Driven by the growing need for long term eldercare in the community, both the UK and US, for example, will face a 30% increase in those over 80 during the next two decades, this has promoted the development of so-called hybrid homes—a combination of private living and community space. Retirement villages, like De Paul Manor Estate on Australia’s Gold Coast, the UK’s Westbury Fields in Bristol, and Wexford Creek Campus of Care, in Nanaimo, British Columbia, Canada, all combine housing, apartments and care facilities within the one complex. While good design within caring environments is important, it ignores the opportunity for innovative creative design for the growing segment of the population who will remain active and independent well into their 80’s, but will benefit from some Population Ageing (2013) 6:157–159 DOI 10.1007/s12062-013-9087-y

Rain

Rain Terry Douglas (bio) Early that morning Cooley Price pulled his shirt tighter as he walked in the drizzling rain down to the corner where New River and Jasper Creek converged. He had lived there so long he no longer noticed the splendor of the two Appalachian waters. They now commanded attention. A tree floated down river clinging to a clump of broken planks and a piece of plywood. A large propane tank bobbed along moving much faster than a casual kayaker. The sound of rushing water felt unsettling, and Cooley’s thoughts shouted, stay in the bank, you son of a bitch. A restless night and jittery headache tightened the back of his neck. The appreciation for the place once so alluring had completely soured. Walking back up the slope of the yard to the house, he wondered how there could be such crazy people in the world who’d build so close to so much potential danger. The wind had blown hard, and when the wind blew like that, the electricity would go out. The night before, he had caught up tap water in five-gallon buckets which now sat on the kitchen floor. He hated not taking a bath every day, and the stored water usually set him at ease. That morning, with the river coming up, the buckets seemed foolishly in the way. He tried to practice blues licks on his electric guitar. Usually he could lose himself in his music, and playing and singing would soothe him. Now his thoughts continually shifted out the window. A doghouse joggled by. Then a picnic table. The creek side of the house didn’t appear menacing, but the river, normally content to stay in its bed, now licked over the bank. The current at the edge appeared deceivingly calm, like a pond, but farther out debris continued to flow. About noon he pushed a stick into the soggy ground to mark the edge of the river’s climb. Cooley’s fingers stopped cooperating with guitar strings, and he put on a DVD. Halfway into the movie the phone rang, and he jerked to his feet. Kemper Lee, a friend who knew he didn’t have cable news, gave him [End Page 67] a flood report. It would be midnight before the river crested. Yes, there was a chance it could come into the house. It had in the nineties; it had in the seventies. It had swept the entire bottom away back in the forties. Kemper Lee would come over to help. Good. Cooley surveyed the contents of the house for what he would lose. Then started putting things on tables, countertops, chairs, and the couch. If the water came in he could save things from getting wet. Move everything off the floor. He had heard of people doing this. Everything higher. The more precious it was, the higher it would go. He moved books from lower to higher shelves. In the bedroom he stacked stuff on the bed. In the living room, he picked the Christmas cactus up off the floor, placed it on the counter top, and gently edged it to the center where it would be safer. It was past full red bloom but still beautiful. Somehow, he had kept it alive all these years. At first it almost died, but he checked books out of the library and learned how to tend it and had very carefully transported it from place to place each time he moved. Outside, he pushed another stick in the ground. His dog and the neighbor’s dog followed, sniffing the strange changing world. One, then the other, stopped to lap river water growing in the yard. Where was Kemper Lee? He should be here by now. And why hadn’t Bob, his neighbor, come over to show his concern for the river? Neighbors used to stand by each other no matter what happened. But times had changed. Gone with the wind. Not coming back anytime soon. Especially, not in these kind of times. But can’t Bob see the river would take his stuff next? Cooley could figure why Bob hadn’t come over. Bob was a drinking man...

A Clostridium perfringens outbreak traced to temperature-abused beef stew, Norway, 2012

On 21 January 2012, the Norwegian Food Safety Authority was informed about gastrointestinal illness among 111 swimming club members, who were staying at a hotel in Trondheim. A hotel dinner on 20 January was their only common meal. Kitchen staff were interviewed, and food leftovers and kitchen environment were sampled. A case was defined as a swimming team member staying at the hotel from 20 to 22 January, who fell ill with diarrhoea, abdominal pain or nausea during this period. A total of 43 cases were identified, with median duration of symptoms of 35 hours. cpe-positive Clostridium perfringens (3.8 x 108 CFU), but not Bacillus cereus, was isolated from beef stew eaten by cases. cpe-negative C. perfringens was detected in a sample from the kitchen floor. SDS-PAGE showed indistinguishable protein profiles among C. perfringens cultures isolated from the beef stew, but slightly different profiles from the culture isolated from the kitchen floor. Cohort analysis showed that eating beef stew and rice was significantly associated with illness. No pathogens were detected in the rice. The temperature control of the stew, but not of the rice, was poor. Our results strongly indicate that cases were infected by Clostridium perfringens in beef stew that had inadequate temperature control during preparation.

Measurements of Friction Coefficient on Kitchen Floors in Restaurants

Friction measurements in the field were conducted in twelve restaurants in Taiwan. Four restaurants for each of the Chinese style, western style, and western style fast food restaurant were visited. The Brungraber Mark II slipmeter was adopte to measure the coefficient of friction (COF) in three areas in each of the restaurant. The results showed that three, two Chinese style and one western style, of the restaurants had mean COF lower than 0.5, a safety standard commonly adopted in the USA. Engineering/managerial interventions are required for those restaurants as far as employee safety is concerned. The fast food restaurants had more consistent COF levels than those of the other two types of restaurants as these restaurants only operate down-stream food preparation in the store. The Chinese style restaurants had significantly (p<0.05) lower COF than those of the western style restaurants. This was consistent with the commonly belief that Chinese style cuisine is much greasy, in general, as compared to those of western cooking.

The impact of drinking water, indoor dust and paint on blood lead levels of children aged 1–5 years in Montréal (Québec, Canada)

Lead is neurotoxic at very low dose and there is a need to better characterize the impact of domestic sources of lead on the biological exposure of young children. A cross-sectional survey evaluated the contribution of drinking water, house dust and paint to blood lead levels (BLLs) of young children living in old boroughs of Montréal (Canada). Three hundred and six children aged 1 to 5 years and currently drinking tap water participated in the study. For each participant, residential lead was measured in kitchen tap water, floor dust, windowsill dust and house paint and a venous blood sample was analyzed. Multivariate logistic regression was used to evaluate the association between elevated BLL in the children (≥ 75th percentile) and indoor lead contamination by means of odds ratios (OR) using 95% confidence intervals (CI). There was an association between BLL ≥75th percentile (1.78 μg/dL) and water lead when the mean water concentration was >3.3 μg/L: adjusted OR=4.7 (95% CI: 2.1–10.2). Windowsill dust loading >14.1 μg/ft2 was also associated with BLL ≥1.78 μg/dL: adjusted OR=3.2 (95% CI: 1.3–7.8). Despite relatively low BLLs, tap water and house dust lead contribute to an increase of BLLs in exposed young children.

Neuropsychiatric Symptoms as a Putative Crescendo Warning of a Striatocapsular Infarct?

Neuropsychiatric Symptoms as a Putative Crescendo Warning of a Striatocapsular Infarct?

Masking Frailty

Masking Frailty Anne Derrig (bio) Stupid Children. Lenore Zion. Emergency Press. http://www.emergencypress.org. 176 pages; paper, $15.95. Lenore Zion’s Stupid Children reads like an articulate fairy tale—like Hansel and Gretel’s child-baking witch craving a savory meal, or Jack’s giant’s (capitalist) desire for the golden egg, it takes a bewilderingly practical view of utter insanity. The book is a first-person account from Jane, who weaves through her story a psycho-babble which illuminates only a bit more than it obscures. Jane is introduced to us first through her description of her father, a widower. Her father is an affectionate, flawed man: he repeatedly wakes pre-pubescent Jane in the middle of the night, and, citing loneliness, hauls her off to an all-night diner. This ritual, according to Jane, served to remind her father that “he was not alone, and that he had me, and he would always have me, barring some sort of tragedy that might take my life.” The threat of tragedy is an ever-looming one, because Jane inhabits a perilous world. In fairy-tale speak, the crumbs set down to guide her through the forest are being gobbled up by birds rapidly—so Jane is left to wander the woods. And—as the tragedy-savvy reader may have predicted—Jane is ripped from her father at the age of ten when her father slits his own throat. The sight of it is a grisly after-school discovery; watching his blood drip across the kitchen floor, Jane notes that the blood is “dripping from the table’s edge, pooling in a corner of the room,” which causes her to make note of the fact that the foundation of the house is tilted. Jane is removed from her tilted house and shipped off to a new foster home, where she is indoctrinated in the cult of the Second Day Believers. The rules of this cult are left hazy, but the reader has plenty of evidence that the whole production is batty. Balloons are shoved up the nostrils of would-be members and then inflated, to break the nose in hopes of driving out “mental impurities.” (The procedure is just different enough from what goes on in doctors’ offices throughout Hollywood to assure the reader that Jane is in immediate peril.) Cult members are numbered in order of importance within the cult: Sir One, Madam Three, etc. This methodical, logical, yet totally odd system is perhaps why Jane seems rather in her element in the cult: faux-logic meets psycho-babble. At any rate, she doesn’t seem bothered by the proceedings. Jane rises in the ranks of the cult largely due to her ability to refrain from visiting the restroom for long periods of time. Her courtship with the leader of the cult is due primarily to, as she describes it, “my ability to hold my urine for long periods of time without medical consequence.” Stupid Children is a cerebral novel, and for this reason, it stands to reason that the primary torture— nose-cracking—occurs near the brain; a broken nose, after all, would seem to matter more to the brain than a broken toe, if proximity is correlated with importance. And Jane’s brain, however burdened with stubborn bladders and broken noses, is a delight for a reader to inhabit. Jane is not a stupid child, but she is surrounded by infantile folks. As soon as her brunch-impulsive father is removed from Jane’s life, the void is filled with cultists and a friend named Virginia. Virginia sees herself as having a “tremendous power” over small children in that she can destroy their psyche with a well-placed withering comment. She refrains from making such comments, but, Jane notes, “[T]he one thing that Virginia didn’t have the ability to recognize was that no child should be required to show gratitude to those people who fail to cause them pain.” The novel’s title is put to use in a sharp, clever scene that portrays Jane in therapy. She tells her therapy group that she does not enjoy being around stupid children; her therapy group...

Correlation between CT and postmortem findings in choking deaths

<h3>Introduction</h3> Invariably, adult choking deaths are accidental and the bolus is food. Deaths are associated with neurological or psychiatric conditions, acute alcohol intoxication, or poor/missing dentition. Computed tomography (CT) is a useful tool for investigating these deaths. Four case studies are presented. <h3>Cases</h3> Case 1 was a 45-year-old male with a history of alcohol abuse, who was found deceased on his kitchen floor. A foreign body in the upper airways was found on CT, and a meat bolus confirmed on autopsy. His blood alcohol level (BAL) was 0.24%. Case 2 was 62-year-old male with a history of Parkinsonism, found dead in bed. The upper airways were obstructed by a food bolus. Case 3 was a 52-year-old male with motor neurone disease, found dead in his kitchen. A foreign body in his hypopharynx was demonstrated on CT and a meat bolus confirmed on internal examination. His BAL was 0.053%. Case 4 was an 87-year-old woman with a history of dementia, found deceased in bed. CT showed extensive foreign material within her airways. External examination showed food material in her oropharynx. <h3>Conclusion</h3> Four cases of unwitnessed upper airway obstruction by food are presented. All patients had conditions compromising their motor functioning. CT correlation is informative, and may guide the extent of adjuvant testing at autopsy.