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(Siddall et al, 1997) The mechanisms of pain below the site of lesion are not well understood, but research suggests that there are psychophysiological indicators of such pain Research using single photon emission computed tomography (Ness et al, 1998) has recorded observed changes in cerebral ow, and these changes corresponded with the individual s pain reports Pressure Sores Pressure sores result from restriction of blood ow to the skin, depletion of oxygen, and gradual erosion of tissue Immobilization, paralysis, and loss of neuronal innervation and sensory input following SCI interact to set the stage for this sequence of events to which persons are at risk for the remainder of their lives Skin is susceptible to persistent applications of even moderate pressure with a direct relationship between tissue damage, intensity, and duration of pressure (Yarkony, 1994).

Atrophy, repeated trauma, scarring and/or secondary bacterial infection, shearing force, reduced transcutaneous oxygen tension, and friction are also major etiologic factors (Mawson et al, 1993; Yarkony, 1994) Metabolic and local factors thought to contribute to pressure ulcers include increased moisture, hypoalbuminemia, vitamin C de ciency, anemia, lean body build, muscle atrophy, older age, fever, and poor personal hygiene (Mawson et al, 1993; Yarkony, 1994) Sites most prone to development of pressure ulcers are bony prominences such as sacrum, ischium, heels, ankles, and trochanter Untreated or improperly treated pressure ulcers that do not heal place persons at risk for potentially life-threatening complications Pressure ulcers are one of the most common, costly, and debilitating secondary complications in persons with SCI.

The ecology of developmental processes In W Damon (Series Ed) & R M Lerner (Vol Ed), Handbook of child psychology: Vol 1 Theoretical models of human development (5th ed, pp 993 1028) New York: Wiley Brown, B A, Frankel, B G, & Fennell, M P (1989) Hugs or shrugs: Parent and peer influences on continuity of involvement in sport by female adolescents Sex Roles, 20, 397 409 Brustad, R J (1988) Affective outcomes in competitive youth sport: The influence of intrapersonal and socialization factors Journal of Sport and Exercise Psychology, 10, 307 321 Brustad, R J (1993) Who will go out and play Parental and psychological influences on children s attraction to physical activity Pediatric Exercise Science, 5, 210 223 Brustad, R J (1996) Attraction to physical activity in urban schoolchildren: Parental socialization and gender influences Research Quarterly for Exercise and Sport, 67, 316 323.

Persons who develop severe pressure sores often require expensive and intensive medical intervention for repair, rehabilitation, and management of the skin ulcer (over $17,000 per person, excluding physician fees; Johnson, Brooks, & Whiteneck, 1996) Unquanti ed indirect costs include frustration; inconvenience; interference with rehabilitation, education, and vocational activities; and separation from the family unit with its impact on psychological and social development and successful reintegration into the community (Yarkony, 1994) About 50% to 80% of persons with SCI will develop a pressure ulcer at some time in their lives (Mawson et al, 1993; Yarkony, 1994) Incidence ranges from 22% to 59% during acute care/rehabilitation and from 20% to 30% during one to ve years postinjury (Stover, Whiteneck, et al, 1995; Yarkony, 1994) Pressure sores are considered preventable complications, as individuals who develop these sores are often noncompliant with recommended self-care regimens,.

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Reagents and Materials Nonsterile Cell lysis solution: Triton X-100, 0.1% (v/v) in UPW (if samples are also used for ALP Assay, use Triton X-100, 0.2% (v/v) + 5 mM Magnesium chloride in UPW) PicoGreen dsDNA Quantitation Kit Paper towel Razor blade Microcentrifuge tubes with screw cap, 2 ml Steel balls Para lm Analytical balance MinibeadBeater Microcentrifuge Microtiter plate for uorescence Fluorescence microplate reader Protocol A. Preparation of the scaffolds (a)