The development of an intervention model for managing abrupt death trajectories in KwaZulu-Natal level 1 emergency departments.

Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2004.AIM: The aim of this research was to describe how the health professionals manage sudden/abrupt deaths in the ED and to foster change in current practice by involving the clients (dead or dying clients and their families) and the health professionals. METHOD: Action research was the approach used in this four year research project, and co-researchers (nurses) from three Level I ED's in KwaZulu-Natal were actively involved in shaping and guiding the project. The participants involved in the research were health professionals, bereaved families and mortuary staff members. FINDINGS: An intervention model, the Dealing with Sudden Death Model, was developed in order to guide the therapeutic management of sudden/abrupt deaths in ED's. Along with this was the development of the family pamphlet, the Preparation Checklist and the Incident Evaluation Checklist. Following the implementation of this model the health professionals emphasized the fact that this model provided guidance and meaning to the care rendered to the dead or dying client, the bereaved families and fellow colleagues. The Dealing with Sudden Death Model had resulted in a production of knowledge and planned changes in the management of sudden/abrupt deaths in the ED's

Different Coloured Tears: Bicultural Bereavement Perspectives

The research explored the pathways that Māori and Pākehā bicultural whānau follow in mourning, grieving and moving on through life, in response to the death of a signficant loved one. Of specific interest were sites of conflict, processes of negotiation and pathways to resolution occuring across cultural worlds whilst deciding on, organising and enacting tangi/funeral rituals for the deceased. These explorations were founded on the Pou Toko Manawa of the framework offered by Te Tiriti o Waitangi/The Treaty of Waitangi and related principles. The research was conducted across two distinct yet inter-related studies. The first study explored the bereavement experiences of individuals belonging to Māori and Pākehā bicultural families, offering insights related to the emergence of conflict, negotiation and pathways to resolution. The insights gathered gave rise to further explorations concerned with the perspectives of experts who facilitate, mediate and enact bereavement processes. As the second study, the expert perspectives revealed supports, constraints and legalitites that emerge in bicultural bereavement processes. The culmination of the two studies engender a multi-faceted understanding of key concepts, issues and processes in bicultural bereavement, and the cultural and socio-political landscapes within which these events are located. In considering the research findings within the theorectical framework of Te Tiriti o Waitangi/The Treaty of Waitangi, the research offers a unique bicultural and New Zealand specific understanding of conflict and resolution

The whānau experience of suicide loss : what contributes to resilience and wellbeing? : a thesis submitted in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Te Kunenga ki Pūrehuroa, Albany, Aotearoa New Zealand

The aim of this research was to explore and understand Māori whānau experiences of suicide loss and factors that increase resilience and wellbeing within this context. Māori have the highest suicide rates in New Zealand, yet there is limited literature that focuses exclusively on Māori whānau bereaved to suicide. Furthermore, there is limited literature that views Māori suicide bereavement through a family/whānau resilience lens. The present study took a Kaupapa Māori approach that validated Māori knowledge and tikanga and was cognisant of social structures and power imbalances that surround whānau. Six whānau bereaved by suicide were interviewed, as well as five Māori key informants who have extensive experience working with whānau in their various roles within community mental health, mental health services, and suicide prevention. Findings pointed to the ripple effect that a suicide has on a whānau and its members over the long term and intergenerationally. This is hindered by the stigma that is still evident in the dominant society and within Māori culture that creates a barrier to resilience and wellbeing. Resilience was enacted within whānau units, through wairuatanga, and connection to Te Ao Māori and mātauranga Māori. The current formal support available did not adequately support whānau resilience and wellbeing. The findings have implications at a societal level and for therapists or services engaged in supporting suicide bereaved whānau

The investigation of murder in France and England: a comparative account

This thesis – based on 13 months' fieldwork observing specialized murder squads and justice personnel - examines the processes and practices of murder investigation in France and England. There is relatively little, particularly ethnographic, research in this field and my work is - to my knowledge - the first comparison of how these countries, often contrasted as instances of the archetypal inquisitorial and adversarial criminal justice systems, respond in practice to criminal homicide. The thesis includes a detailed analysis of two similar cases that occurred in the French and English research sites. The cases are followed from the discovery of the body to the end of the trial. Highlighting two emblematic events within each process - the case conference in England and the reconstitution (or reconstruction) in France - I also explore the epistemological and sociological assumptions behind investigative procedures. Although some of the activities observed in the two countries were similar, key differences were also found in the methods by which the investigations were progressed and recorded, the involvement of detectives at various stages of the investigation, the manner in which the media were used, and the way in which the offender and victim were treated - all of which affected how the investigators viewed their work and the nature of what formed the substance of the cases. A key theme discussed is the way the words used to describe similar processes and roles revealed the different ways in which the two countries viewed the criminal justice process. In my conclusion, I suggest that part of the reason for the differences relates to the way the two societies conceive of the criminal. In England the criminal is seen as someone outside of society and this attitude to criminality affects all those who deal with it – including murder investigators. In France, crime and the investigation of murder has an accepted role in 'normal' life

A winter's tale : a pastoral and theological exploration of the responses of families and their carers to pre-natal, peri-natal and neo-natal deaths.

The thesis explores, from a theological and pastoral perspective, the responses of individuals, families and their carers to the deaths of children in the pre-natal, peri-natal and neo-natal period. Setting the changes in both the theory and practice of bereavement care in their historical context, the thesis critically examines a diverse range of international bereavement literature, bringing them into dialogue with each other and offering informed reflection from both a theoretical/academic and multidisciplinary practice perspective which is of relevance to both clinical and non-clinical practitioners. Challenging the predominance of the medical model, the thesis argues that the needs of the bereaved are best met by a dialogical, holistic, person-centred, multi-disciplinary approach, which engages both virtues (particularly characterised by the notion of agape) and skills in reflective practice. Critical questions of identity, relationality and care are addressed not merely as theoretical constructs, but as part and parcel of human experience The first chapter outlines the major themes in the development of bereavement studies from Freud onwards, showing how early-life deaths only became the focus of serious attention relatively late in the twentieth century, and arguing that such early-life deaths are both 'like' and 'un-like' other forms of bereavement. The three following chapters look at miscarriage (and related issues), stillbirth, and neo-natal deaths respectively. Each chapter raises issues which are specific to these particular forms of bereavement and others which re-surface as common themes, extending the scope of the thesis from the effects of such deaths on the individual, to their effects on the family matrix and on caregivers. There is separate discussion of the effects of early-life bereavement on siblings. Finally, through a discussion of ritual and through the collation and analysis of a broad range of liturgical material, including rites concerning both the beginning and end of life, the critical relationship between liturgy and pastoral care is established as a key theme of the thesi

The 2009 H1N1 pandemic narrative in newspapers distributed within Saskatoon, Saskatchewan

It is known that disease outbreaks, either at a local or a global scale, elicit a social response from the society that it affects which follows a characteristic narrative. An epidemic narrative reflects and shapes the perception of the outbreak. An examination of the mass media provides a glimpse of the epidemic narrative that occurs alongside a disease outbreak. The primary objective of this study is to construct the 2009 H1N1 pandemic narrative from newspaper coverage available in Saskatoon, Saskatchewan, with a focus on how discourse in the news changes over time and geographically. The study draws on and combines three conceptual frameworks: epidemic narrative, anchoring, and framing, in order to construct the pandemic narrative as reflected by the newspaper coverage. The three frameworks were combined to address three aspects of a narrative: 1) there are common stories for common experiences; 2) new stories relate to old stories; and 3) stories of the same experience can have multiple perspectives and interpretations. When combined, these frameworks provide a nuanced understanding and analysis of an epidemic narrative. Articles from four local Saskatoon papers, the StarPhoenix, Saskatoon Sun, Planet S, and The Sheaf and two Canadian national newspapers, the National Post and the Globe and Mail were analyzed for the study. To analyze the articles, an approach referred to as qualitative content analysis was adapted. The primary focus of this approach is on the discourse and meanings of the text. The study provides an overview of the evolving newspaper coverage of the 2009 H1N1 pandemic in newspapers distributed within Saskatoon, Saskatchewan. The findings of the study highlight the importance of meaning and how meanings are constructed and reflected with a narrative. The findings also show how the broader socio-cultural context influences a narrative. The results illustrate the difficulties with communication during a fluid and uncertain situation such as a pandemic. This work can provide a basis for communication advice for future disease outbreaks

Guttersnipes' and 'Eliterates': City College in the Popular Imagination

Young people go to college not merely to equip themselves for competition in the workplace, but also to construct new identities and find a home in the world. This dissertation shows how, in the midst of wrenching social change, communities, too, use colleges in their struggle to reinvent and re-situate themselves in relation to other groups. As a case study of this symbolic process I focus on the City College of New York, the world's first tuition-free, publicly funded municipal college, erstwhile "Harvard of the Poor" and birthplace of affirmative action programs and "Open Admissions" in higher education. I examine five key moments between 1940 and 2000 when the college dominated the headlines and draw on journalistic accounts, memoirs, guidebooks, fiction, poetry, drama, songs, and interviews with former students and faculty to chart the institution's emergence as a cultural icon, a lightning rod, and the perennial focus of public controversy. In each instance a variety of actors from the Catholic Church to the New York Post mobilized popular perceptions in order to alternately shore up and erode support for City College and, in so doing, worked to reconfigure the larger New York public. The five episodes consist of the following: (1) In 1940 a state judge barred the philosopher Bertrand Russell from joining the faculty and a sweeping "investigation" followed that resulted in a purge of fifty allegedly Communist professors from the faculty. (2) Ten years later seven members of City College's national championship basketball team, all of them Jewish or black, were convicted of consorting with professional gamblers to fix games. (3) Then in 1969, in the midst of a mayoral primary, black and Puerto Rican students seeking greater access for members of the surrounding Harlem community seized control of City's South Campus and shut down the college for two tense weeks that were followed by a series of violent racial clashes. (4) Those events in turn ushered in the school's radical and hotly contested experiment with "Open Admissions" along with a decade of relentless media attacks, nostalgia for an imaginatively constructed golden age, and series of dramatic cuts to the college's budget and staff that occasioned the end of its century-old tradition of free tuition. (5) Finally, in 1991 one Afrocentric professor's outrageous remarks about Jews coupled with an accident at a student-sponsored fundraiser in the college gym that claimed nine young lives came---through the offices of the mass media---to stand for the anarchy and physical danger that seemed to be engulfing not only the institution but the city itself. Taken together these five moments, with their attendant tabloid scandals, ritual sacrifices, and manufactured crises, foreground the cultural dimension of City College's history and the construction---including the self-construction, even performance---of particular varieties of student and teacher, both past and present. Newspapers and their various publics were central to---indeed, constitutive of---the process by which different communities claimed disparate meanings for the institution and deployed those meanings toward their own, distinctive ends. The press provided the main stage upon which to enact bitter struggles and excommunication ceremonies and encouraged readers to use the college to reimagine themselves and their place in the changing city and nation