A gap analysis of the United States death care sector to determine training and education needs pertaining to highly infectious disease mitigation and management.

PURPOSE: A United States industry-specific gap analysis survey of the death care sector-which comprises organizations and businesses affiliated with the funeral industry and the handling of human remains- was developed, the results analyzed, and training and education needs in relation to highly infectious disease mitigation and management were explored in an effort to identify where occupational health and safety can be enhanced in this worker population. METHODS: Collaborating national death care organizations distributed the 47-question electronic survey. N = 424 surveys were initiated and results recorded. The survey collected death care sector-specific information pertaining to the comfortability and willingness to handle highly infectious remains; perceptions of readiness, current policies and procedures in place to address highly infectious diseases; current highly infectious disease training levels, available resources, and personal protective equipment. RESULTS: One-third of respondents have been trained on how to manage highly infectious remains. There was a discrepancy between Supervisor/Management and Employee/Worker perceptions on employees' willingness and comfortability to manage potentially highly infectious remains. More than 40% of respondents did not know the correct routes of transmission for viral hemorrhagic fevers. CONCLUSIONS: Results suggest death care workers could benefit from increasing up-to-date industry-specific training and education on highly infectious disease risk mitigation and management. Professional death care sector organizations are positioned to disseminate information, training, and best practices.

Autopsy Practice in Ghana - Reflections of a Pathologist.

Autopsy practice in Ghana can be said to be far from satisfactory. Most Ghanaians do not know that there are different categories of death, which categories of death require an autopsy and who is required to perform the autopsy. The problems have further been complicated by the fact that, unlike other countries where separate facilities are available for storage of the different categories of dead bodies, all dead bodies in Ghana are conveyed to the hospital mortuary, thus encouraging hospitals to expand body storage facilities in their mortuaries to meet the increasing demand. Public or community mortuaries used elsewhere for storage of bodies of deaths occurring in the community pending the Coroner's directions are non-existent in Ghana. Storage of all categories of dead bodies in hospital mortuaries has resulted in virtually all autopsies being done by the hospital pathologists, especially in the large centres, at the expense of other very important diagnostic functions of the pathologist. This paper explains relevant portions of the Coroner's Act of 1960 and emphasises the need to separate the few hospital autopsies that require the expertise of the pathologist from Coroner's autopsies that may be carried out by any registered medical officer, as specified in the Act, or better still, by specially trained Forensic Physicians/Medical Examiners, as pertains in other countries. The paper also clarifies the different categories of death, those that fall in the jurisdiction of the Coroner and the personnel required to assist the Coroner in his investigastions. Suggestions have also been made on how to approach manpower development to ensure that appropriate personnel are trained to assist the Coroner in the investgation of medico-legal cases.

[Discovering the mortuary during training]. / Découvrir la chambre mortuaire avant d'exercer.

The mortuary in Tenon hospital in Paris regularly receives trainee nurses and nursing auxiliaries. They discover the place, the practice of washing and preparing the deceased's body and learn how to support the families. The visit is an opportunity to face death and put any prejudices to one side.

No place, new places: death and its rituals in urban Asia.

In many land-scarce Asian cities, planning agencies have sought to reduce space for the dead to release land for the living, encouraging conversion from burial to cremation over several decades. This has caused secular principles privileging efficient land use to conflict with symbolic values invested in burial spaces. Over time, not only has cremation become more accepted, even columbaria have become overcrowded, and new forms of burials (sea and woodland burials) have emerged. As burial methods change, so too do commemorative rituals, including new on-line and mobile phone rituals. This paper traces the ways in which physical spaces for the dead in several east Asian cities have diminished and changed over time, the growth of virtual space for them, the accompanying discourses that influence these dynamics and the new rituals that emerge concomitantly with the contraction of land space.

Imagining the absent dead: rituals of bereavement and the place of the war dead in German women's art during the First World War.

Drawing on women's visual responses to the First World War, this article examines female mourning in wartime Germany. The unprecedented death toll on the battlefronts, military burial practices and the physical distance from the remains of the war dead disrupted traditional rituals of bereavement, hindered closure and compounded women's grief on the home front. In response to these novel circumstances, a number of female artists used their images to reimagine funerary customs, overcome the separation from the fallen and express acute emotional distress. This article analyses three images produced during the conflict by the artists Katharina Heise, Martha Schrag and Sella Hasse, and places their work within the civilian experience of bereavement in war. By depicting the pain of loss, female artists contested the historical tradition of proud female mourning in German society and countered wartime codes of conduct that prohibited the public display of emotional pain in response to soldiers' deaths. As a largely overlooked body of sources, women's art adds to our understanding of the tensions in wartime cultures of mourning that emerged between 1914 and 1918.

"The last thing that tells our story": the Roodepoort West Cemetery, 1958-2008.

This article attempts to capture some of the complexity in the way that memory, meaning and agenda interact in the history of the cemetery of Roodepoort West. Roodepoort West was the 'old location' where Africans and others lived until 1955, after which a gradual process of removals took place until 1967, when it was finally destroyed. However, not everything was lost of the old location. The cemetery remained, after unrest caused by the proposed removal of the local cemetery during the late 1950s persuaded the authorities to leave it alone. More recently, the cemetery has played a part in land restitution, becoming both a site of tension and remembrance. This article explores the many meanings attached to the old cemetery, and funerals more broadly, over a period of time beginning from the 1950s to 2005. By looking at the history of funerals, and the cemetery, new insights and an alternative understanding of what it meant to live in an urban area in Apartheid South Africa can be gained.

The bones of the body politic: thoughts on the Savorgnan de Brazza Mausoleum.

This essay examines three examples of political treatment of the dead (specifically their bones) in the Republic of the Congo: the return of the remains of its capital's founder, Savorgnan de Brazza; the disappearance of the body of André Matswa, hailed by the people as their messianic 'saviour' guardian; and finally, the treatment of unidentified victims of the various armed conflicts that occurred during the years 1990­2002. These events can be analysed through the prism of two different historical perspectives: in terms of the moyenne durée, the treatment of Matswa's bones paved the way for the subsequent occurrences by creating a precedent; in the context of the 'present of history', the construction of a Brazza mausoleum is contemporaneous with official denial of the presence of human remains scattered across the capital city of Brazzaville as a result of armed conflicts. The comparative analysis of these historical configurations posits a set of circumstances whereby the bones become a symbolic buttress of the capital. The historical puzzle here is to understand how that which came together in claiming Matswa's bones becomes, in the context of democratization of the regime, an aesthetic sense of the 'beauty of death' as expressed by people when they see the shrine as their country's finest architectural accomplishment. Through the splendour of the monument, this aesthetic sense articulates the denial of the presence of the nameless dead.

Confessions of a Wannabe (American Folklore Society Presidential Invited Plenary Address, October 2009).

This paper is a written rendering of a plenary address delivered at the 2009 Annual Meeting of the American Folklore Society. Drawing on materials from his forthcoming book Confessions of a Wannabe, the author provides a personal account of the deeply emotional sense of responsibility, obligation, and reciprocity involved in long-term ethnographic research among Native American communities, particularly the Omaha and Pawnee tribes of Nebraska. The author details the ways in which personal relations with the people and communities he has observed have shaped his personal and professional life, and he calls into question the ideal of purportedly neutral or distanced ethnography. Details are provided of the author's experiences in converting his farm into an appropriate reburial site for repatriated Pawnee remains recovered under the aegis of the Native American Graves Repatriation and Protection Act (NAGPRA).

[Training of mortuary staff: a shared approach to care]. / La formation des agents de chambre mortuaire, une visée soignante partagée.

Mortuary staff are seeing a profound transformation in their profession. All of their duties (care for the deceased, support to families, other activities assigned to the mortuary) require training. Training is a legitimate aspiration for the caregivers concerned and is part of giving the profession the recognition it deserves.

Colonial bones: the 2006 burial of Savorgnan de Brazza in the Congo.

The Franco-Congolese agreement to enshrine the corpse of Pierre Savorgnan de Brazza in a grand memorial tomb in Brazzaville (2006) has been decried by many observers as neo-colonial farce. This article interprets France's agenda to propose a "suave reconquest" of its former colonies, and Sassou Nguesso's forceful mobilization of national and regional support. Beyond the immediate political significance of the episode, however, the article proposes new ideas on the ways in which modern states, North and South, depend on "tournaments of value" that assign polarized worth to persons, and often back up international deals with transactions in sanctified human remains. The tactic, forged in part during the colonial era, illuminates important aspects of today's global imaginaries of domination. Brazza's bones work, in France and Africa, as a carnal fetish that, borrowing form various philosophies of power, merges Western and African beliefs in the body politic.

Prendas-Ngangas-Enquisos: turbulence and the influence of the dead in Cuban-Kongo material culture.

Cuban-Kongo praise of the dead in Havana turns insistently around complex agglomerations of materials called "prendas,""ngangas," and "enquisos." This article addresses the ontological status of "prendas-ngangas-enquisos," which practitioners of Cuban-Kongo affliction practices care for as entities that determine the very possibility of their healing and harming craft. Cuban-Kongo societies of affliction, in Havana collectively referred to as "Palo," stake their claim to influence others in and through these entities. In this essay I seek to position the influence generated in prendas-ngangas-enquisos as a problem for Euro-American materialism, to be addressed not through symbolic or representational solutions but, rather, by refocusing the problem itself via alternate distributions of its epistemological, historical, and ethnographic elements. Contextualized within ethnographic description, I first propose that prendas-ngangas-enquisos do not conform to dialectical logic, and should thus be positioned conceptually as something other than "objects" or "fetishes." From there, I consider Creole turns on the term prenda and explore scholarly accounts of 19th-century Cuban slavery and manumission, which I place alongside what is known about pawn slavery among BaKongo people prior to and during the Atlantic slave trade. Having established a basic series of conceptual and historiographic coordinates, I then suggest ethnographically how prendas-ngangas-enquisos come to command others, thereby guaranteeing Cuban-Kongo healing and harming sovereignty in Cuba today.

A clinical group's attempt to raise awareness of organ and tissue donation.

CONTEXT: Little is known about factors that influence attitudes and beliefs about organ and tissue donation among health science college students. OBJECTIVE: To assess health sciences college students' knowledge, attitudes, and beliefs about organ donation and to determine if an educational session increases awareness and influences their attitudes and beliefs related to organ donation. DESIGN: Quantitative quasi-experimental study with semistructured questions administered to a convenience sample. SETTING: School of health sciences in a large, urban, multicultural community college in Ontario, Canada. PARTICIPANTS: 240 health sciences' college students from 6 academic programs: bachelor of nursing from first and fourth year, practical nursing, paramedic, funeral services, and occupational therapy/physical therapy assistant. INTERVENTION: An educational session and 7-minute audiovisual presentation on organ donation. The educational session included a 20-minute PowerPoint presentation addressing statistics of organ and tissue need and donation; types of donation--deceased (brain-dead), live, and tissue; clarification on the criteria for brain death; donor cards; family consent, including clarification that the family member has the ultimate decision to sign it and the importance of communicating one's wishes to one's family; and religious beliefs and common myths and misconceptions. RESULTS: Of 235 students who completed the postintervention survey, 86% (n = 202) were more aware of organ donation, and 85% (n = 199) were more aware of living donation. Awareness of the need for family consent for donation increased significantly (from 52% to 96%, P < .001). The percentage of participants willing to donate their organs increased from 52% to 63% (n = 26, P < .01). Among the 20% of participants (n = 47) who responded that they would not donate their organs, the predominant rationale was "fear." CONCLUSIONS: Educational sessions in the health sciences curriculum can increase awareness of organ and tissue donation.