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Loss-adaptation has been described as being characterized by 'waves of grief', which may result in a Prolonged Grief Disorder (PGD). Although this assumption about the fluctuating nature of grief is supported by theoretical work, it is not (yet) supported by empirical work. We are the first to explore to what extent PGD reactions fluctuate in everyday life and whether fluctuations in PGD reactions are related to overall PGD levels using experience sampling methodology (ESM). Data from 38 bereaved individuals (74% women, on average 6 years post-loss, 47% lost a parent) were analyzed. For two weeks, five times per day, participants reported on the severity of 11 PGD reactions in the past three hours (ESM-PGD). At baseline, overall PGD severity (B-PGD) in the past two weeks was assessed with telephone-interviews using the Traumatic Grief Inventory–Clinician Administered. Root Mean Square of Successive Differences (RMSSD) were calculated to reflect fluctuations in ESM-PGD. Spearman correlations between RMSSD values of the 11 ESM-PGD reactions and B-PGD scores were computed. Mean B-PGD scores were below the clinical cut-off. Some fluctuations in ESM-PGD reactions were found, as indicated by varying RMSSD values, but also floor effects were detected. B-PGD levels were related to RMSSD values for ESM-PGD (ρ between 0.37 and 0.68, all p <.05; and between 0.36 and 0.63 after removal of floor effects). We found that (some) ESM-PGD reactions fluctuated in everyday life. This may offer new theoretical insights into loss-adaptation, which may result in optimizing PGD treatment. [ABSTRACT FROM AUTHOR]

The concerted use of Greek-derived medical terms in the present day allows us to facilitate effective communication while honouring the historic roots of Western medicine. The word autopsy derives from its third century B.C. Hellenistic Greek etymon αὐτοψία ("to see for oneself"), later borrowed into Neo-Latin as autopsia and Middle French as autopsie. Throughout its etymological journey, autopsie underwent semantic narrowing from the passive sense "self-inspection of something without touching", to a purposeful action by an operator performing "an examination of the human body itself", to specifically "dissection of a dead human body". These curious turning points for the meaning of autopsie produced an auto-antonym: the same word now has multiple meanings, of which one is the reverse of another. The French autopsie used in the latter sense predates that documented for the English autopsy (attested 1829). Since the early nineteenth century, attempts were made to remedy the discrepancy between conflicting senses either by adding determining adjectives to the existing noun, or by substituting it with another word altogether. This review explores the etymological journey of autopsy, considers which related terms have been popularised throughout history, introduces the concept of lexical ambiguity and suggests unambiguous English compound (necropsy and necrotomy) and Latin-derived (non-invasive and invasive postmortem examination) alternatives to satisfy a recent appetite for clarity in international professional and next-of-kin communication. [ABSTRACT FROM AUTHOR]

Background: Neurologically critically ill patients present with unique disease trajectories, prognostic uncertainties, and challenges to end-of-life (EOL) care. Acute brain injuries place these patients at risk for underrecognized symptoms and unmet EOL management needs, which can negatively affect their quality of care and lead to complicated grief in surviving loved ones. To care for patients nearing the EOL in the neurointensive care unit, health care clinicians must consider neuroanatomic localization, barriers to symptom assessment and management, unique aspects of the dying process, and EOL management needs. Aim: We aim to define current best practices, barriers, and future directions for EOL care of the neurologically critically ill patient. [ABSTRACT FROM AUTHOR]

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Spousal bereavement is associated with health declines and increased mortality risk, but its specific impact on physical and cognitive capabilities is less studied. A historical cohort study design was applied including married Tromsø study participants (N=5739) aged 50–70 years with baseline self-reported overall health and health-related factors and measured capability (grip strength, finger tapping, digit symbol coding, and short-term recall) at follow-up. Participants had data from Tromsø4 (1994–1995) and Tromsø5 (2001), or Tromsø6 (2007–2008) and Tromsø7 (2015–2016). Propensity score matching, adjusted for baseline confounders (and baseline capability in a subset), was used to investigate whether spousal bereavement was associated with poorer subsequent capability. Spousal bereavement occurred for 6.2% on average 3.7 years (SD 2.0) before the capability assessment. There were no significant bereavement effects on subsequent grip strength, immediate recall, or finger-tapping speed. Without adjustment for baseline digit symbol coding test performance, there was a negative significant effect on the digit symbol coding test (ATT −1.33; 95% confidence interval −2.57, −0.10), but when baseline digit symbol coding test performance was taken into account in a smaller subsample, using the same set of matching confounders, there was no longer any association (in the subsample ATT changed from −1.29 (95% CI −3.38, 0.80) to −0.04 (95% CI −1.83, 1.75). The results in our study suggest that spousal bereavement does not have long-term effects on the intrinsic capacity components physical or cognition capability to a notable degree. [ABSTRACT FROM AUTHOR]

Childhood bereavement is an adverse event, yet children demonstrate considerable variability in health outcomes. Bereaved children are at risk of lower lifelong educational attainment, though the contribution of neurocognitive performance is yet to be investigated. Using data from the population-based Generation R Study wherein nearly 10,000 pregnant mothers were recruited between 2002 and 2006, we estimated the association of bereavement by age 10 years with four subtests of cognitive function and academic achievement at 13 years. Bereavement by 10 years of age was experienced by n = 796 (37.3%) of youth and was associated with a 1.12-point (SD = 0.55; p-value = 0.04) lower full-scale IQ at 13 years, which was mainly driven by lower matrix reasoning scores (βadjusted = −0.27, SE = 0.11, p < 0.02). There were no differences in academic achievement or other subtests of neurocognitive function between bereaved and non-bereaved children. Secondary analyses adjusting for pre-bereavement nonverbal cognitive ability and mental health problems revealed an overall association between bereavement and subsequent full-scale IQ and matrix reasoning, but only among those youth whose caregivers reported that the loss had an emotional influence on the child. These novel findings leveraging prospective assessments in a population-based birth cohort highlight risk and resilience mechanisms warranting further research. [ABSTRACT FROM AUTHOR]

This study investigates the childhood traumas of individuals who experienced parental death in childhood or adolescence in Turkey. Participants (n = 382; 63.1% female and 36.9% male; MAGE=29.41, SD = 9.6) are composed of individuals who lost either or both of their parents before the age of 18. The findings indicated that there is a significant difference between the subdimensions of Childhood Trauma Questionaire and the study variables including gender, marital status, educational status, number of siblings, gender of the deceased parent, the caregiver after the parental death, relationship with the surviving parent and the age at the time of parental death (p <.05). The results further show that individuals who lost their parents before the age of 10, who lost their mothers, and who received care from other relatives instead of parents are exposed to more neglect and abuse. By identifying childhood traumas in individuals and examining related variables, the findings contribute trauma-informed social work practices. Based on the results, it is recommended that school social work programs focus on monitoring the relationship between caregivers and children, as well as enhancing the psychosocial well-being of students. These programs can also serve as a means to raise awareness among professionals and students. [ABSTRACT FROM AUTHOR]

How can we understand the phenomena of loss and mourning in the Heideggerian framework? There is no established interpretation of Heidegger that gives an elaborate account of the phenomena of loss and mourning, let alone gauges its importance for our understanding and assessment of authentic existence in Heidegger. This paper attempts to do both. First, I give a detailed exposition of Heidegger's analysis of the phenomena of mourning and loss and show that Heidegger's analysis of mourning in his early and late work is strikingly in line with his collectivist understanding of Being-with. This demonstrates, contrary to what some of his proponents argue, that Heidegger does not follow the kind of dynamic understanding of Being-with that places the other within fine-grained spaces of possibility. Second, with reference to Heidegger's existential philosophy, I construct a phenomenology of mourning and grief. Though Heidegger himself fails to explain the relationships in which one mourns after a close other, we can develop a unique phenomenology of mourning with reference to Heidegger, which shows that each loss is singular and can be equiprimordial with one's own death in opening one to the possibility of an authentic existence. In this new understanding of authenticity, loss is regarded as a powerful force, akin to death, in leading one toward their self-owned existence. [ABSTRACT FROM AUTHOR]

Background: Originally designed for use with adolescents in group-based settings, there has been limited evaluation of Trauma and Grief Component Therapy (TGCT) with respect to its use with individual patients across a wide age range of children and adolescents. Objectives: This study describes a pilot open trial of individually administered TGCT, an assessment-driven, modularized treatment for traumatized and/or bereaved children and adolescents. Key outcomes measures include posttraumatic stress, depressive symptoms, and maladaptive grief reactions. Method: The sample consisted of 58 treatment-seeking children and adolescents who experienced trauma and/or bereavement (ages 7–17 years, M = 12.78, SD = 2.93; 68.4% female; 45.6% Hispanic, 14.0% Black, 22.8% White, 14.0% Multiracial). The study used a single-group open trial design. Youth referred to the study due to experiencing a potentially traumatic event or death of a loved one completed self-report measures of posttraumatic stress, depressive symptoms, and maladaptive grief reactions (when applicable). Measures were also completed following Module 1 of the treatment. Results: Bayesian regression models revealed youth who completed TGCT Module 1 reported substantial reductions from baseline, with large effect sizes for posttraumatic stress, depressive symptoms, and maladaptive grief reactions. Rates of reliable improvement ranged from 42 to 65% across treatment outcomes with 69% of youth demonstrating reliable improvement in at least one outcome. Conclusions: The present study provides preliminary evidence supporting TGCT as an individual treatment for traumatized and/or bereaved children and adolescents experiencing posttraumatic stress, depressive symptoms, and/or maladaptive grief reactions. [ABSTRACT FROM AUTHOR]

This paper examines the role of individuals’ emotions in determining their concerns about international migration. For the empirical analysis, we exploit little-explored information in the German Socio-Economic Panel (SOEP) data on individuals’ negative emotions, e.g., anger, fear, and sadness. We find that the frequency of experiencing negative emotions is positively associated with immigration concerns. Moreover, we show that the relationship varies across employment status, birth cohort, and social media usage. Our analysis also underscores the real-life consequence of emotions by demonstrating their positive association with support for far-right political parties among males, but not among females. Finally, we exploit the exogenous variation in negative emotions induced by the death of a parent to infer causality. Fixed effects regressions with instrumental variables exhibit a positive impact of negative emotions on immigration concerns among females, but no significant effects are found among males. Further investigation into channels driving these gender differences in results underscores gender differences in roles played by other concerns that often carry over to determine individuals’ immigration concerns, e.g., concerns about international terrorism. [ABSTRACT FROM AUTHOR]

Family relations are essential for the bereaved in terms of healing and adjusting to life, especially after experiencing a traumatic death. Although 500 000 people die in drug-related deaths each year, few works focus on family interactions and the help needs of those bereaved by such losses. In this qualitative study, we interviewed 14 parents who had lost their child through a drug-related death. Through a reflexive thematic analysis, we generated three themes: (I) considerable needs in the family become our responsibility, capturing how parents try to mend the disrupted family system and provide adequate care for those who struggle after death, (II) conversations that are important for family connections are obstructed, encompassing how family members sometimes seem afraid of grief emotions and try to protect each other by not talking, and (III) as parents, we can strengthen family connections, encapsulating how parents create space to talk and listen to each other in the family and navigate relational challenges in maintaining relationships. The findings are discussed through the Dual Process Model of Coping with Bereavement as well as family resilience theory. Based on the results, we propose that professional family-oriented help efforts for drug death-bereaved families in two main domains should be considered. The first includes those related to the family's need and ability to adapt roles and relationships to the new reality, and the second involves those connected to creating a space and environment for emotional sharing and joint meaning-making processes in the family. [ABSTRACT FROM AUTHOR]

Objectives: The quality and scope of perinatal bereavement care in the United States has been evaluated by surveying bereaved parents, but little is known about how care varies across hospitals. We sought to survey clinicians about stillbirth bereavement care practices at U.S. hospitals and to evaluate care by hospital birth volume. Methods: Using American Hospital Association data, we employed stratified random sampling to select 300 hospitals from all centers with at least 100 annual deliveries. Within each state, we divided all hospitals into size quartiles and randomly selected from each until we reached the goal number per state. We then identified a staff member knowledgeable about typical bereavement care on labor and delivery at each hospital and sent an on-line survey about care. We linked survey data with hospital characteristics and used summary statistics, Chi squared, and Fisher's Exact test to compare care by hospital birth volume. Results: We reached an eligible respondent at 429/551 hospitals and 396 of the 429 (73%) agreed to participate. We received 289 usable surveys for an overall response rate of 67%. Only one third of hospitals (n = 96, 33%) reported staff protected time for perinatal bereavement care. Of 17 bereavement topics, just six were routinely offered by at least two-thirds of the hospitals. Financial limitations and staff shortages were the most commonly identified barriers to care and were most pronounced at small-volume hospitals. Conclusions for Practice: This study offers a snapshot in bereavement care and identified important gaps for both large and small hospitals. Significance: What is already known on this subject?: While there have been efforts to improve hospital bereavement care for families after stillbirth, no researchers have surveyed U.S. hospital practices to assess current bereavement practices or how these practices vary across hospitals. What this study adds?: This study systematically sampled hospitals in all U.S. states to assess stillbirth bereavement care including memory-making, parental education, and barriers to optimal care and analyzed differences by hospital birth volume. The study found significant gaps including limited bereavement education about normal grief, mental health, impact on relationships, return to work, and the father's experience. [ABSTRACT FROM AUTHOR]

Attachment theory is a key paradigm for understanding individual differences for the elaboration of the grieving processes, however limited attempts to systematically synthesize are found on the literature. Our aim is to conduct a bibliometric analysis about the relationship between complicated grief and attachment over the past twenty years. A bibliographic search was made in the Core Collection of Web of Science, the bibliometric analysis was performed using the software Hiscite version 2010.12.6, and VosViewer were used for the construction of bibliometric maps. Results show 276 publications from 2003 until 2023 from 789 authors, published in 143 scientific journals. The field presents a regular increase and sustained number of publications. The topics most researched were bereavement, complicated grief and attachment, and since 2018 has been increased interest in prolonged grief disorder. In conclusion, this bibliometric analysis contributes to the understanding of the current state of this topic and its evolution, being relevant to consider attachment style in bereavement interventions. [ABSTRACT FROM AUTHOR]

Amid the COVID-19 pandemic, measures were enforced that constrained people's ability to engage in conventional funeral and mourning rituals, which in general serve as vital mechanisms for coping with the experience of loss. This study aimed to investigate how these limitations affected early grief symptoms and the influence of alternative mourning rituals (paying tribute on social media, lighting candles in memory of the deceased, and using objects of the deceased) on moderating the relationship between individuals' perception of these limitations (such as being unable to perform the present body ceremony or fulfill the funeral wishes of the deceased) and the intensity of the grief symptoms. The study involved 227 participants, aged between 18 and 77 years, who had experienced the loss of a loved one during the pandemic. Results demonstrated that higher levels of perceived limitation in funeral ceremonies are associated with greater intensity of grief responses. Paying tribute on social media and lighting candles in memory of the deceased person moderated the relationship between the perception of limitation in fulfilling the deceased's wishes in relation to the funeral ceremonies and the intensity of the grief responses. Using objects moderates the relationship between the perception of limitation in performing a present body ceremony and the intensity of the grief responses. Results underline the relevance of psychological flexibility, in particular concerning alternative morning rituals, that can be used as a way of buffering the impact of the perception of limitation in funeral ceremonies on the intensity of grief responses. This study offers a distinctive insight into bereavement during the pandemic, highlighting the role of flexibility in morning rituals in mitigating the deleterious effect of ritual restrictions on bereavement outcomes. [ABSTRACT FROM AUTHOR]

This exploratory research investigated the work of healthcare professionals during the COVID-19 pandemic, highlighting the major critical aspects, including healthcare providers' needs as well as personal, professional, and social changes brought about by the pandemic upon both living and dying. In general, for many healthcare providers, the changes imposed by COVID-19 together with their inadequate training led to an excessive emotional load that caused high levels of stress and, consequently, the risk of burnout. In the present study, we wanted to investigate the impact of the COVID-19 pandemic on healthcare professionals and to explore if and how spirituality influenced their experience. We adopted a qualitative methodological design based on interpretative phenomenological analysis. The respondents were 15 healthcare professionals (12 general practitioners, 1 physician, and 2 nurses). This research was carried out in Italy during the first lockdown, that is, between March and September 2020. Following the analysis of participants' experiences, four main themes were created: (1) critical issues in healthcare, critical incidents, and changes in the attitudes and habits of general practitioners during the pandemic; (2) emotional experiences and primary needs during the emergency; (3) dying during the pandemic and new psychological symptoms in noninfected patients; and (4) resilience and the role of spirituality. Since healthcare professionals, and general practitioners more specifically, were extensively exposed to the dying process and to changes in the end-of-life scenario, the support offered by palliative care is desirable, in terms of both the special skills that palliative physicians can provide and the presence of psychologists as well as through death education. [ABSTRACT FROM AUTHOR]

Eco-anxiety, grief and despair are increasing, yet these emotions tend to remain private, rarely expressed in public. Why is it important and necessary to grieve for ecological loss? Why are we not—as individuals and societies—coming together to express and share our grief for ecological destruction? I address these questions from three angles. Firstly, I draw on recent literature on ecological grief and prior work on grief for human lives, to argue for the importance and urgency of grieving publicly for ecological loss. Building on this, I identify perceptual, cognitive, affective, ritual and political obstacles to ecological mourning; these obstacles point at critical intersections between emotions, practices, disciplines, public and private realms, which can turn into fruitful venues for further research, debate and action on ecological grief (and its absence). In closing, I propose a set of 'ecological skills' that might help us overcome these obstacles, and lead us to embrace ecological grief and mourning as acts of ethical responsibility and care for the planet. [ABSTRACT FROM AUTHOR]

Objective: To assess the degree of openness of communication about illness and death between patients with advanced cancer and their relatives during the last three months of the patient’s life, and its association with relatives’ characteristics and bereavement distress. Methods: We used data from bereaved relatives of patients with advanced cancer from the prospective, longitudinal, multicenter, observational eQuipe study. Univariate and multivariable linear regression analyses were used to assess the association between the degree of openness of communication (measured using the validated Caregivers’ Communication with patients about Illness and Death scale), the a priori defined characteristics of the relatives, and the degree of bereavement distress (measured using the Impact of Event Scale). Results: A total of 160 bereaved relatives were included in the analysis. The average degree of open communication about illness and death between patients with advanced cancer and their relatives was 3.86 on a scale of 1 to 5 (SE=0.08). A higher degree of open communication was associated with a lower degree of bereavement distress (p=0.003). No associations were found between the degree of open communication and the relatives’ age (p=0.745), gender (p=0.196), level of education (p>0.773), (religious) worldview (p=0.435), type of relationship with the patient (p>0.548), or level of emotional functioning before the patient’s death (p=0.075). Conclusions: Open communication about illness and death between patients and relatives seems to be important, as it is associated with a lower degree of bereavement distress. Healthcare professionals can play an important role in encouraging the dialogue. However, it is important to keep in mind that some people not feel comfortable talking about illness and death. [ABSTRACT FROM AUTHOR]

Tulak breuh, or a ritual of payment of fidyah, refers to a ritual in which the deceased's family pays the fine for the dead by a specific procession of giving and receiving rice. It is a ritual carried out by some Acehnese with complete confidence that it is closely related to the teachings of Islam, as the primary purpose is to pay fidyah, a fine for the ṣalāt left by the deceased. This study aimed to discover the views of madhhab 'ulamā's (school), dayah 'ulamā, modernists, academicians, and commoners toward the tulak breuh ritual. The study implemented ethnographic research in which observation and interviews were used in collecting the data. Qualitative data analysis was done by data reduction, data display, and conclusion drawing. The result showed that the tulak breuh ritual was carried out upon someone's death. The ritual constitutes a payment method of fidyah (indemnity) by distributing rice, gold, or money to pay off the ṣalāt left by the deceased. 'Ulamās of the Shāfi'ī school do not allow the payment of fidyah for ṣalāt nor do they allow others to perform ṣalāt on behalf of the deceased. However, the 'ulamā of the Ḥanafī School make an exception for the fidyah paid off with the agreement of the dead, while the 'ulamā of other Schools do not agree with the ritual practice. Yet, in Aceh, there are several views in this regard. The dayah 'ulamā endorse the practice relying upon a fiqh robust basis laid by former 'ulamā, while the modernists choose not to side with it. Academicians believe that tulak breuh is a ritual to show respect for the deceased's family members and enhance community development. Similarly, commoners believe that the ritual represents devotion and is a sacred habit through which Allāh will grant forgiveness to the dead. [ABSTRACT FROM AUTHOR]

The Resolved Through Sharing (RTS) Perinatal bereavement model is an approach used for working with birthing people and their families who have experienced a perinatal loss. RTS is designed to help families cope with their grief and integrate the loss in their lives, meet the needs of the families during the initial crisis, and offer comprehensive care to each member of the family affected by the loss. This paper utilizes a case illustration to describe a year-long bereavement follow-up of an undocumented underinsured Latina woman who suffered a stillbirth during the beginning of the COVID-19 pandemic and the hostile anti-immigrant policy during the Trump presidency. The case illustration is based on a composite case of several Latina women who had pregnancy losses with similar outcomes, demonstrating how a perinatal palliative care (PPC) social worker provided ongoing bereavement support to a patient who experienced a stillbirth. The case illustrates how the PPC social worker utilized the RTS model, incorporated the patient's cultural values, and acknowledged systemic challenges which resulted in the patient receiving comprehensive, holistic support that aided her emotional and spiritual recovery from her stillbirth. The author ends with a call to action for providers in the field of perinatal palliative care to incorporate practices that allow for greater access and equity for all birthing people. [ABSTRACT FROM AUTHOR]

“Deathbots,” digital constructs that emulate the conversational patterns, demeanor, and knowledge of deceased individuals. Earlier moral discussions about deathbots centered on the dignity and autonomy of the deceased. This paper primarily examines the potential psychological and emotional dependencies that users might develop towards deathbots, considering approaches to prevent problematic dependence through temporary use. We adopt a hermeneutic method to argue that deathbots, as they currently exist, are unlikely to provide substantial comfort. Lacking the capacity to bear emotional burdens, they fall short of meeting idealistic expectations. By repositioning deathbots, we aim to mitigate the risk of emotional dependency and respect the natural grieving process. Our goal is to propose the use of deathbots as a novel means of mourning through transitory use, rather than as a method to alleviate grief or as a patterns for communication with the deceased. [ABSTRACT FROM AUTHOR]

This article studies the importance of the loss of family ties and its symbolic burden in the narrative of homeless people in familistic societies. The family is the main reason why poverty does not directly lead to social exclusion in southern European countries. However, the economic crises of the last two decades have weakened the ability of the family to protect its members. The new forms of poverty that imply processes of individualized social exclusion that lead to homelessness in southern Europe can be understood as a consequence of the overload currently suffered by families in those countries due to the recent economic crises. The loss of family ties in this type of society is so stigmatizing that, even if the person is living on the street for structural reasons such as having been unemployed and having lost their home due to the effects of the recent economic crises and not receiving aid from social services, always reproduces a characteristic story of self-victimization and mourning for not having had a good family that has helped him in times of need. [ABSTRACT FROM AUTHOR]

Sadness has typically been associated with failure, defeat and loss, but it has also been suggested that sadness facilitates positive and restructuring emotional changes. This suggests that sadness is a multi-faceted emotion. This supports the idea that there might in fact be different facets of sadness that can be distinguished psychologically and physiologically. In the current set of studies, we explored this hypothesis. In a first stage, participants were asked to select sad emotional faces and scene stimuli either characterized or not by a key suggested sadness-related characteristic: loneliness or melancholy or misery or bereavement or despair. In a second stage, another set of participants was presented with the selected emotional faces and scene stimuli. They were assessed for differences in emotional, physiological and facial-expressive responses. The results showed that sad faces involving melancholy, misery, bereavement and despair were experienced as conferring dissociable physiological characteristics. Critical findings, in a final exploratory design, in a third stage, showed that a new set of participants could match emotional scenes to emotional faces with the same sadness-related characteristic with close to perfect precision performance. These findings suggest that melancholy, misery, bereavement and despair can be distinguishable emotional states associated with sadness. [ABSTRACT FROM AUTHOR]

The death of a family member is a stressful life event that undermines survivors’ health. However, most research in this area focuses on spousal deaths among older, white adults. This paper uses data from the National Longitudinal Study of Adolescent to Adult Health to examine the association between the death of a range of family members and obesity among diverse American adults aged 33–43. One-third of U.S. young adults report having experienced the death of one or more close family members, with Black adults experiencing these losses much more frequently than White or Hispanic adults. Results using logistic regression models show that the death of two or more family members is associated with higher odds of young adult obesity compared to those who have experienced no family member deaths by young adulthood. Further, findings suggest the relationship between the death of family members and obesity differs by race/ethnicity. The probability of obesity is uniformly around 50–55 percent for Black adults who experienced zero, one, or two or more family member deaths. Meanwhile, the probability of obesity among White adults is significantly higher for those who experienced two or more family member deaths compared to those who experienced zero or one death. In addition, we found no association between family member death and obesity among Hispanic adults, although statistical power is limited. All told, the findings point to family member death as a significant risk factor for obesity among young Americans. [ABSTRACT FROM AUTHOR]

While childhood bereavement is common, children's bereavement needs are not well understood. It is recognized that children's understandings of death fundamentally differ from those of adults, however, limited research has explored this from a child's perspective. Insight about children's understandings and needs can be drawn from the questions they ask about it. Bereaved children aged 5–12 years were invited to submit questions about death and grief during a camp for grieving children. Children's questions (N = 213) from 10 camps were analyzed using conventional content analysis. Five themes were identified: Causes and Processes of Death; Human Intervention; Managing Grief; The Meaning of Life and Death; and After Death. Children's questions revealed that they are curious about various biological, emotional, and existential experiences and concepts, demonstrating complex and multi-faceted considerations of death and its subsequent impact on their lives. Findings suggest that bereaved children may benefit from opportunities to freely discuss their thoughts about death, which may facilitate appropriate education and emotional support. Highlights: Content analysis of 213 questions asked by bereaved children aged between 5 and 12 years resulted in five themes: Causes and Processes of Death, Human Intervention, Managing Grief, The Meaning of Life and Death, and After Death. Bereaved children ask meaningful questions about death and grief and are curious about biological, emotional, and existential experiences and concepts. Bereaved children may benefit from support that offers opportunities to ask questions alongside basic death and grief education, and strategies for emotion regulation. [ABSTRACT FROM AUTHOR]

Parental bereavement is associated with distress and poorer long-term outcomes among adolescents. Adolescents who lose a parent to suicide fare worse than their peers even before bereavement. Based on the current literature, we cannot distinguish such initial differences from the medium and long-term effect of parental suicide. We study the impact of parental suicide on adolescents' General Practitioner visits for mental health or psychosocial reasons. Within-individual models account for time-invariant differences between the bereaved and non-bereaved. We investigate if effects differ from the impact of parental death from other causes, and vary with sex and socioeconomic background. Full population data on Norwegian residents aged 10–19 in the period 2006–2015 are drawn from registers (N = 1 405 suicide bereaved, 12 982 bereaved by other causes, and 1 182 819 non-bereaved controls). Records include data on use of health services, parental mortality, and sociodemographic characteristics of parent and child. Mental health consultations increase gradually in the quarters leading up to the parental suicide, significantly more for girls than for boys. Two years prior to bereavement, 2.4% of the subsequently suicide bereaved have a mental health consultation in any given quarter. In the year of bereavement, this increases with 6% points. Health care workers should be aware that boys are less likely to turn to their GP for support before parental bereavement from suicide. [ABSTRACT FROM AUTHOR]

Dance/movement therapy (DMT) is a somatic-based psychotherapy approach that can supplement existing therapy techniques or stand on its own as effective psychological treatment. As a growing field, DMT continues to expand its application to different populations. This literature review analyzed the implications of DMT application for individuals who are dying. While the application of DMT with diverse populations has been studied, the literature regarding the application of DMT with dying individuals is slim. Medical, spiritual, and emotional treatment during death have received considerable attention in academic literature, however, the application of many body-based psychological treatment interventions has not been studied as thoroughly. Literature concerning the cultural attitudes towards death in Western and non-Western cultures, mental illness and death, and the literature that has been published thus far concerning DMT and death were analyzed as a framework to better understand the potential application of DMT with dying individuals. While research still needs to be conducted in order to best apply DMT in the treatment of dying individuals, the research points to strong potential for the creation of further evidence-based care. [ABSTRACT FROM AUTHOR]

Objectives: Evidence is lacking for trait mindfulness as a longitudinal protective factor following bereavement and other stressful life events. This study aimed to determine whether trait mindfulness predicted better mental health adjustment (i.e., decreased distress and greater positive states of mind) in young adults following the recent loss of a loved one. This study also examined cognitive (e.g., intrusive and deliberate thoughts) and somatic (e.g., sleep disturbance) processes as possible underlying mechanisms linking trait mindfulness to mental health consequent to bereavement. Method: Recently-bereaved undergraduate students (n = 117) completed questionnaires evaluating multifaceted aspects of mental health adjustment following their loss at three time points (T1: baseline, T2: 3 weeks, T3: 6 weeks). Results: Trait mindfulness significantly predicted reduced distress symptoms (i.e., anxiety, depression, and stress) and increased positive states of mind over time. Trait mindfulness significantly impacted mental health following loss indirectly through its effect on sleep disturbance, but it had no significant indirect effects through intrusive or deliberate thoughts. Conclusions: Trait mindfulness may be a key protective factor for young adults who experience highly stressful events. Findings underscore the importance of sleep disturbance as a critical factor linking trait mindfulness and mental health adjustment consequent to bereavement. This study contributes to our understanding of risk and resilience factors following loss, which can also inform targeted mindfulness-based interventions as well as future studies to eventually establish causal pathways between trait mindfulness and mental health consequent to bereavement. Preregistration: This study was not preregistered. [ABSTRACT FROM AUTHOR]

We construct a mourning and funeral index, using online search volume for "wreath and elegiac couplet", "obituary", "mortuary house", "cinerary casket", "cremation" and "pass away", to infer excess cases of mortality in China during the COVID-19 pandemic. During the 3-month period (December 2022–February 2023) after China ended its Zero-COVID policy, there were around 712 thousand excess cases of mortality. These excess cases of mortality, bench marked against the 2-year period preceding the pandemic, could be directly or indirectly related to COVID-19. During the 35-month Zero-COVID regime (January 2020–November 2022), the excess death toll was a negative 1480 thousand. Overall, by delaying the surge in infections, China might have saved 767 thousand lives. While these estimates are based on various assumptions and can be imprecise, China's COVID-19 experience could reasonably be characterized by a sharp surge in deaths after its departure from Zero-COVID and a steady pattern of lives saved during the Zero-COVID regime. [ABSTRACT FROM AUTHOR]

Grandparental loss might be an emotionally challenging experience in cultures where intergenerational connectedness and family harmony are highly valued. Given the developmental changes college students go through, grandparental loss might impose unique challenges in non-Western contexts, where grandparents are usually regarded as part of the nuclear family. Nevertheless, prior studies on this topic have been limited to the Western context. The current study aimed to examine the impact of grandparental loss on Turkish college students from a developmental and cultural perspective. Accordingly, semi-structured interviews were conducted with seven bereaved college students. The obtained data were analyzed through interpretative phenomenological analysis because of the context-dependent and relational nature of the bereavement experience. Five super-ordinate themes emerged: (1) "I have lost my second mother/father" (i.e., grandparental loss perceived as parental loss), (2) first contact with death as a transformative experience, (3) ambivalence regarding death-related rituals, (4) grandparental loss as a dual grief process, and (5) university as a barrier and shelter during the grieving process. The findings were discussed in line with the relevant literature employing both a developmental and culture-sensitive perspective. [ABSTRACT FROM AUTHOR]

When a loved one dies, it is common for the bereaved to feel profoundly lonely, disconnected from the world with the sense that they no longer belong. In philosophy, this experience of 'loss and loneliness' has been interpreted according to both a loss of possibilities and a loss of the past. But it is unclear how these interpretations apply to the distinctive way in which loss and loneliness manifest in old age. Drawing on the phenomenological analyses of old age given by de Beauvoir and Améry, I consider how the diminishment of the capacity for projection and recollection complicate recent interpretations of loss and loneliness, whilst nevertheless reinforcing the conclusion that in old age subjectivity is necessarily impoverished. Developing a critical stance on de Beauvoir and Améry's underlying conception of subjectivity, I turn to Levinas in considering whether or not there is a way to reimagine subjectivity such that the estrangement and alienation of older adults might be ameliorated rather than exacerbated. Grounded in the passive body-in-itself rather than the self-transcending capacity of the body-for-itself, I suggest it becomes possible to reconceptualise the experience of loss and loneliness in old age; both in terms of what is lost and what needs to be restored if older adults are to be helped to find themselves at home in the world in the midst of, and indeed because of, manifold loss. [ABSTRACT FROM AUTHOR]

The loss of a child is considered one of the most tragic experiences that parents can go through. The present systematic review aims to compile the most recently published interventions in bereavement support for these parents, being particularly interested in those made from a meaning-centered approach. The search for the units of analysis was guided by the standards of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) Statement and was entered in Web of Science, Scopus and EBSCO, obtaining a total of 485 papers of which 21 have been included in this article. The results found are heterogeneous in terms of the type of intervention used and results, but they all seem to have something in common: the lack of research and reliable interventions that exist for this population. With this systematic review we intend to achieve a better understanding of these parents' needs and to highlight the enormous work that still remains ahead in order to make their bereavement experience a little less devastating. [ABSTRACT FROM AUTHOR]

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Two separate bodies of literature point to the link between family bereavement and cardiovascular health and between sleep quality and cardiovascular outcomes. However, less is known about the joint influence of family bereavement and sleep quality on cardiovascular functioning. The aims of this study were to examine the relationships between experiencing the death of a family member and heart rate variability (HRV) and to further explore whether these associations differ by sleep quality. Using data from the Midlife in the United States (MIDUS) Biomarker Project, the sample for this study included respondents who experienced the death of an immediate family member – father, mother, spouse, sibling, or child – within a year before the Biomarker project and those who did not experience any deaths (N = 962). We used two measures of HRV and sleep quality was measured using the Pittsburgh Sleep Quality Index. Results showed that experiencing the death of a family member was associated with worse HRV only among those with poor sleep quality and not for those with good sleep quality. These results suggest that poor sleep quality may indicate psychophysiological vulnerability for those who experienced the death of a family member. Interventions to improve sleep quality could be effective in enhancing cardiovascular health of bereaved individuals. [ABSTRACT FROM AUTHOR]

The central thesis of this paper is that human unconscious processes influence the behavior and design of artificial intelligence (AI). This thesis is discussed through the case study of a chatbot called Replika, which intends to provide psychological assistance and friendship but has been accused of inciting murder and suicide. Replika originated from a trauma and a work of mourning lived by its creator. The traces of these unconscious dynamics can be detected in the design of the app and the narratives about it. Therefore, a process of de-psychologization and de-humanization of the unconscious takes place through AI. This psychosocial approach helps criticize and overcome the so-called "standard model of intelligence" shared by most AI researchers. It facilitates a new interpretation of some classic problems in AI, such as control and responsibility. [ABSTRACT FROM AUTHOR]

Prospective bereavement studies from community samples that are focused on examining changes in the coping process over time and the effect of moderating factors is lacking. This study aimed to examine the moderating role of gender in the process of coping with the loss of a spouse. The research was organized as a correlation study with three repeated measurements. The first measurement was done in the first 40 days following the loss of the spouse (M = 26.86; SD = 8.20). The second measurement was performed one month after the first, and the third was done six months after the spouse's death. The study involved 32 women and 32 men aged between 65 and 89 years (M = 71.94; SD = 6.02) who lost their spouses in the last 40 days. Elderly care organizations and municipalities provided assistance in finding the participants. Results indicate a decrease in general distress in both men and women, whereas life satisfaction shows a curvilinear pattern and meaning in life stability over time. Correlations between coping styles and recovery outcomes were significant only among widows, where a decrease in loss-oriented coping and increase in restorative coping were related to higher levels of life satisfaction. In widowers, there is a significant linear decrease in loss-oriented coping and a nonlinear increase in restoration-oriented coping; however, these changes are not correlated with changes in recovery indicators. The research indicates a greater reactivity of widows to the effects of coping strategies, but also some similarities in the recovery pathways. [ABSTRACT FROM AUTHOR]

The death of a loved one is extremely impactful. Although much of the focus now on helping people who are experiencing bereavement grief is oriented to distinguishing complicated from non-complicated grief for early pharmaceutical or psychiatric treatment, lay bereavement support comprises a more common and thus highly important but often unrecognized consideration. A wide variety of lay bereavement programs with diverse components have come to exist. This scoping research literature review focused on bereavement humor, one possible component. Humor has long been recognized as an important social attribute. Researchers have found humor is important for lifting the spirits of ill people and for aiding healing or recovery. However, humor does not appear to have been recognized as a technique that could benefit mourners. A multi-database search revealed only 11 English-language research articles have been published in the last 25 years that focused in whole or in part on bereavement humour. Although minimal evidence exists, these studies indicate bereaved people often use humor and for a number of reasons. Unfortunately, no investigations revealed when and why bereavement humor may be inappropriate or unhelpful. Additional research, multi-cultural investigations in particular, are needed to establish humor as a safe and effective bereavement support technique to apply or to use. Bereavement humor could potentially be used more often to support grieving people and bereaved people should perhaps be encouraged to use humor in their daily lives. [ABSTRACT FROM AUTHOR]

The death of a loved one represents one of the most distressing and potentially traumatic life events in childhood and adolescence. Grief reactions in youth are influenced by ongoing developmental processes and manifest differently depending on the child's age and developmental stage. These grief-related processes unfold within youths' caregiving context, as children and adolescents rely heavily on the adults in their environment to navigate and cope with the death of a loved one. Despite the field's increasing recognition of the potential for maladaptive grief reactions to impede functioning over time, few longitudinal research studies on childhood grief currently exist. In this article, we will (a) provide a brief overview of the childhood bereavement literature; (b) review the new DSM-5 and ICD-11 Prolonged Grief Disorder diagnostic criteria through a developmentally-informed lens; (c) describe how grief reactions manifest in children and adolescents of different ages through the lenses of multidimensional grief theory and relational developmental systems theory; (d) highlight key moderating factors that may influence grief in youth, and (e) discuss a primary moderating factor, the caregiving environment, and the potential mechanisms through which caregivers influence children's grief. [ABSTRACT FROM AUTHOR]

Family-based bereavement interventions have shown promises to prevent problem outcomes and promote resilience in parentally bereaved children. Evidence of the broad range of mental and physical health problems following the death of a parent supports the need for a transdiagnostic approach that promotes adaptation and reduces multiple problem outcomes for parentally bereaved families. We discuss self-compassion as a promising framework for a transdiagnostic approach. We argue that three elements of self-compassion—mindfulness (vs. over-identification), self-kindness (vs. self-judgment), and common humanity (vs. isolation)—can facilitate loss-oriented coping, restoration-oriented coping, and the oscillation process between the two. This sets the foundation for individual and family processes that support bereavement adjustment. To explain how self-compassion promotes adjustment outcomes in parentally bereaved families, we review the extant literature with a focus on parental emotion regulation and effective parenting and propose a conceptual model with testable hypotheses to guide more research in this area. The model suggests that caregivers' self-compassion is a resilience resource for multiple adaptive outcomes for themselves and for their child through its positive impacts on emotion regulation and effective parenting. We illustrate the utility of the framework with an example of a family-based bereavement prevention program that integrated self-compassion training. Future directions for research are discussed. [ABSTRACT FROM AUTHOR]

Grief reactions to the bereavement of a close individual could involve empathy for pain, which is fundamental to social interaction. To explore whether grief symptoms interact with social relatedness to a person to whom one directs empathy to modulate the expression of empathy, we administered an empathy task to 28 bereaved adults during functional magnetic resonance imaging, in which participants were subliminally primed with facial stimuli (e.g., faces of their deceased or living relative, or a stranger), each immediately followed by a visual pain stimulus. Individuals' grief severity promoted empathy for the pain stimulus primed with the deceased's face, while it diminished the neural response to the pain stimulus primed with the face of either their living relative or a stranger in the medial frontal cortex (e.g., the right dorsal anterior cingulate cortex). Moreover, preliminary analyses showed that while the behavioral empathic response was promoted by the component of "longing" in the deceased priming condition, the neural empathic response was diminished by the component of "avoidance" in the stranger priming condition. Our results suggest an association between grief reactions to bereavement and empathy, in which grief symptoms interact with interpersonal factors to promote or diminish empathic responses to others' pain. [ABSTRACT FROM AUTHOR]

Purpose: Communication with family members is important to end-of-life care for patients with cancer. It is an interactive engagement between terminally-ill cancer patients and their families through which they expand their mutual understanding to cope with losses and find meaning in death. This study aimed to describe the experiences of end-of-life communication between patients with cancer and their family members in South Korea. Methods: This is a qualitative descriptive study using in-depth semi-structured interviews. Ten bereaved family members with end-of-life communication experience with terminal cancer patients were recruited through purposive sampling. Data were analyzed using qualitative content analysis. Results: A total of 29 constructed meanings, 11 sub-categories, and the following 3 categories were derived: “Offering a space for patients to reminisce and reflect,” “Building a bond,” and “Reflections on what we need.” End-of-life communication primarily centered on the patients, with families struggling to share their stories with them. Although the families coped well, they also regretted the lack of meaningful communication with the patients, indicating a need for support to facilitate effective end-of-life communication. Conclusion: The study highlighted concrete communication for finding meaning at the end-of-life for cancer patients and their families. We found that the families have the potential to communicate appropriately to cope with the patients’ end-of-life. Nevertheless, end-of-life presents a unique challenge in which families require adequate support. Given the increasing number of patients and families dealing with end-of-life care in hospitals, healthcare providers should be mindful of their needs and help them cope effectively. [ABSTRACT FROM AUTHOR]

The death of a loved one has been associated with a range of emotional and cognitive impacts, with up to 10% of the bereaved population experiencing a prolonged grief reaction. Direct investigation of the role of self-identity in the maintenance of grief symptoms is limited and has not discriminated between relationship type. This longitudinal study investigated the differences in grief symptoms over time depending on relationship to the deceased person (partner or adult child), as well as the association between long-term grief symptoms and identity, attachment, and cognitive interdependence. Data from bereaved partners and adult children in The Aarhus Bereavement Study at two- and 18-months post-bereavement were included in this study. They completed questionnaires measuring their grief symptoms at both time points, a measure of attachment at Time 1, and measures of the interdependence of their pre- and post-loss identity with the deceased, their cognitive interdependence, and everyday memory retrieval failures at Time 4. Compared with adult children, bereaved partners experienced more intense grief symptoms at both time points. Regression analysis identified that over and above immediate grief symptoms, key predictors of prolonged grief symptoms were a merged post-bereavement identity with the deceased, younger age, and everyday memory retrieval difficulties. Relationship type and pre-bereavement identity contributed to initial but not prolonged grief symptoms. We discuss these findings in terms of the role of interdependence in prolonged grief. [ABSTRACT FROM AUTHOR]

In recent years, virtual reality (VR) has been effectively employed in several settings, ranging from health care needs to leisure and gaming activities. A new application of virtual stimuli appeared in social media: in the documentary 'I met you' from the South-Korean Munhwa Broadcasting, a mother made the experience of interacting with the avatar of the seven-year-old daughter, who died four years before. We think that this new application of virtual stimuli should open a debate on its possible implications: it represents contents related to grief, a dramatic and yet natural experience, that can have deep psychological impacts on fragile subjects put in virtual environments. In the present work, possible side-effects, as well as hypothetical therapeutical application of VR for the treatment of mourning, are discussed. [ABSTRACT FROM AUTHOR]

Despite all the advances in healthcare technology and all the care services in the field of neonates, many infants die in neonatal intensive care units (NICUs). This qualitative study investigated socio-cultural factors influencing the care for bereaved parents in three main NICUs of northwest Iran between March 2018 and April 2019. The purposeful sampling method with the maximum variation was used, and data collection was continued until obtaining rich data to answer the research question. Twenty-eight interviews were conducted with 26 healthcare providers. The thematic analysis method was applied to analyze the data, and two main themes, including "Religious context as a restriction on the parental involvement in the infant's end-of-life care" and the "Socio-cultural challenges of the grieving process among parents", were generated accordingly. The religious and socio-cultural contexts in the NICUs of Iran are a restriction to the presence of parents at their infants' end-of-life phase, and health care providers are less inclined to have parents in the NICU at the time of infant death. [ABSTRACT FROM AUTHOR]

The philosophy of grief has directed little attention to bereavement's impact on perceptual experience. However, misperceptions, hallucinations and other anomalous experiences are strikingly common following the death of a loved one. Such experiences range from misperceiving a stranger to be the deceased, to phantom sights, sounds and smells, to nebulous quasi-sensory experiences of the loved one's presence. This paper draws upon the enactive sensorimotor theory of perception to offer a phenomenologically sensitive and empirically informed account of these experiences. It argues that they can be understood as deriving from disruption to both sensorimotor expectations and perceived opportunities for action, stemming from the upheaval of bereavement. Different facets of the enactive sensorimotor approach can help to explain different types of post-bereavement perceptual experience. Post-bereavement misperceptions can be accounted for through the way that alterations to sensorimotor expectations can result in atypical 'amodal completion', while bereavement hallucinations can be understood as 'appearances' that fail to form part of the usual patterns of sensorimotor contingency. Quasi-sensory experiences of the presence of the deceased can be understood as resulting from changes to perceived affordances. This paper aims to demonstrate the explanatory value of key aspects of the sensorimotor approach by highlighting how they can help to explain the phenomenology of post-bereavement experiences. However, it also illuminates certain areas in which the sensorimotor approach ought to be supplemented, especially if it is to account for tight connections between perception, affect, and intersubjectivity that are salient in grief. [ABSTRACT FROM AUTHOR]

Thousands of people have died of COVID-19 in El Salvador. However, little is known about the mental health of those who are mourning the loss of a loved one to COVID-19. Therefore, the objective of this study was to examine the dysfunctional grief associated with COVID-19 death among Salvadoran adults. A sample of 435 Salvadorans (M = 29 years; SD = 8.75) who lost a family member or loved one to COVID-19 completed a digital survey using the Google Forms platform, during April 2 and 28, 2022. The results revealed that 35.1% reported clinically elevated symptoms of dysfunctional grief and among those mourners, and 25.1% also exhibited clinical levels of coronavirus anxiety. A binary logistic regression revealed that predictor variables such as COVID-19 anxiety (p =.003), depression (p =.021), and COVID-19 obsession (p =.032) were significant (χ2 = 84.31; Nagelkerke R2 =.242) and predict a 24.2% chance of dysfunctional bereavement. [ABSTRACT FROM AUTHOR]

The death of a parent is a traumatic event usually accompanied by profound grief and psychological challenges. This study explored some of the factors which may predict sense of self, depression and adaption to grief in 328 parentally bereaved emerging adults. Our findings revealed a presence of pathological grief among young adults. The results also highlighted a strong negative relationship between sense of self and depression. Furthermore, depression was accounted for by sense of self, adaption to grief and time since loss of the parent/s. Interventions for parentally bereaved emerging adults should aim at strengthening their sense of self, for example through boosting resilience, social and professional support, meaningful relationships and ameliorative lifestyle changes. [ABSTRACT FROM AUTHOR]

Childhood bereavement is a significant issue globally, affecting millions of children each year, with incidence rates significantly increasing following the COVID-19 pandemic. The loss of an important adult, particularly in the ICU environment, can lead to lasting psychological and behavioural challenges for children. While family-centred practices in the ICU have advanced, the unique bereavement needs of grieving children in the family remain insufficiently addressed. Both families and healthcare professionals (HCPs) often feel unprepared and uncomfortable engaging in honest, supportive conversations with children about bereavement, further complicating children’s grief processing. This narrative review examines the pivotal role ICU HCPs can play in facilitating child-centred bereavement support, focusing on promoting honest communication, supportive visitation practices, creating a child-friendly and humanised ICU environment, and encouraging child involvement during end-of-life care. It recommends prioritising research on the lived experiences of bereaved children, caregivers, and ICU HCPs to inform targeted interventions addressing children’s developmental and psychological needs during ICU bereavement. The review also advocates for specialised training to equip ICU staff with the necessary skills to support grieving children and families. Developing comprehensive, child-centred ICU bereavement guidelines will provide evidence-based frameworks that recognise children as integral family members during end-of-life care while advocating for the participation of children in meaningful rituals will empower families to make informed decisions about their involvement. Together, these recommendations aim to create a more compassionate, inclusive, and supportive bereavement experience in ICU settings, prioritising the unique needs of children and promoting healthy emotional adjustment after losing an important adult. [ABSTRACT FROM AUTHOR]

Background: Guidelines for modelling in economic evaluation recommend that it may be necessary to consider costs and outcomes until all modelled patients have died. Some guidelines also recommend that carers’ health-related quality of life (HRQoL) outcomes should be included. However, it is unclear whether economic evaluations should continue to include carers’ HRQoL after patients have died, and whether there is any evidence to support an additional bereavement effect for carers.We used the UK Household Longitudinal Study waves 1–12. We used Difference-in-Differences to estimate the short- and long-term bereavement effects on the SF-6D for people who reported that they did and did not provide care to a household member who then died. We assumed parallel trends conditional on age, sex, long-term health conditions, education, and household income.Carers and non-carers experienced a significant loss in HRQoL in the year immediately following bereavement. Carers potentially experienced a loss in HRQoL in the year before bereavement, whereas the bereavement effect may have lasted longer for non-carers. For both groups, HRQoL became comparable to the non-bereaved population around 3 years after bereavement.Bereavement has a statistically significant negative impact on HRQoL in the short-term, for both carers and non-carers. However, the effect size is small and is not sustained, suggesting that including bereavement in economic evaluation would make little difference to results.Methods: Guidelines for modelling in economic evaluation recommend that it may be necessary to consider costs and outcomes until all modelled patients have died. Some guidelines also recommend that carers’ health-related quality of life (HRQoL) outcomes should be included. However, it is unclear whether economic evaluations should continue to include carers’ HRQoL after patients have died, and whether there is any evidence to support an additional bereavement effect for carers.We used the UK Household Longitudinal Study waves 1–12. We used Difference-in-Differences to estimate the short- and long-term bereavement effects on the SF-6D for people who reported that they did and did not provide care to a household member who then died. We assumed parallel trends conditional on age, sex, long-term health conditions, education, and household income.Carers and non-carers experienced a significant loss in HRQoL in the year immediately following bereavement. Carers potentially experienced a loss in HRQoL in the year before bereavement, whereas the bereavement effect may have lasted longer for non-carers. For both groups, HRQoL became comparable to the non-bereaved population around 3 years after bereavement.Bereavement has a statistically significant negative impact on HRQoL in the short-term, for both carers and non-carers. However, the effect size is small and is not sustained, suggesting that including bereavement in economic evaluation would make little difference to results.Results: Guidelines for modelling in economic evaluation recommend that it may be necessary to consider costs and outcomes until all modelled patients have died. Some guidelines also recommend that carers’ health-related quality of life (HRQoL) outcomes should be included. However, it is unclear whether economic evaluations should continue to include carers’ HRQoL after patients have died, and whether there is any evidence to support an additional bereavement effect for carers.We used the UK Household Longitudinal Study waves 1–12. We used Difference-in-Differences to estimate the short- and long-term bereavement effects on the SF-6D for people who reported that they did and did not provide care to a household member who then died. We assumed parallel trends conditional on age, sex, long-term health conditions, education, and household income.Carers and non-carers experienced a significant loss in HRQoL in the year immediately following bereavement. Carers potentially experienced a loss in HRQoL in the year before bereavement, whereas the bereavement effect may have lasted longer for non-carers. For both groups, HRQoL became comparable to the non-bereaved population around 3 years after bereavement.Bereavement has a statistically significant negative impact on HRQoL in the short-term, for both carers and non-carers. However, the effect size is small and is not sustained, suggesting that including bereavement in economic evaluation would make little difference to results.Conclusions: Guidelines for modelling in economic evaluation recommend that it may be necessary to consider costs and outcomes until all modelled patients have died. Some guidelines also recommend that carers’ health-related quality of life (HRQoL) outcomes should be included. However, it is unclear whether economic evaluations should continue to include carers’ HRQoL after patients have died, and whether there is any evidence to support an additional bereavement effect for carers.We used the UK Household Longitudinal Study waves 1–12. We used Difference-in-Differences to estimate the short- and long-term bereavement effects on the SF-6D for people who reported that they did and did not provide care to a household member who then died. We assumed parallel trends conditional on age, sex, long-term health conditions, education, and household income.Carers and non-carers experienced a significant loss in HRQoL in the year immediately following bereavement. Carers potentially experienced a loss in HRQoL in the year before bereavement, whereas the bereavement effect may have lasted longer for non-carers. For both groups, HRQoL became comparable to the non-bereaved population around 3 years after bereavement.Bereavement has a statistically significant negative impact on HRQoL in the short-term, for both carers and non-carers. However, the effect size is small and is not sustained, suggesting that including bereavement in economic evaluation would make little difference to results. [ABSTRACT FROM AUTHOR]

Every year many children enter the alternative care system due to the unsuitable circumstances in the care of their biological parents, leading to their statutory removal and placement in alternative care, including temporary safe care, foster care or child- and youth care centres. For a child, this is a significant life transition which is characterized by experiences of trauma, loss and grief. These children need therapeutic services (intervention) in order to address these experiences. Literature covers non-death experiences and bereavement intervention of children in different contexts, but only to a limited degree in terms of children in alternative care. This paper reviews past and current literature on what is known about non-death bereavement for children in alternative care by focusing on intervention approaches to address such loss. The study is a rapid review with qualitative data analysis. A total of 14 documents are reviewed. The review indicates that a standard intervention model to address loss and grief as experienced by children in the alternative care system has not yet been established. Although various treatment approaches, activities and models have been suggested, there is no indication of an empirically tested standardized intervention model in the present review. [ABSTRACT FROM AUTHOR]