‘The one thing guaranteed in life and yet they won't teach you about it': The case for mandatory grief education in UK schools

Nearly all British children are bereaved of someone close to them by the time they turn 16 and, with the Covid-19 pandemic and world humanitarian crises across the news and social media, they are being exposed to more anxiety about death than ever before. Learners need to be taught about grief and death to prepare them to manage bereavement and support others. As it stands, although teaching resources exist and some curriculum guidance documents mention loss or death, there is no statutory requirement for schools anywhere in the UK to cover grief or bereavement and many pupils have no classes about these difficult topics. This article consolidates the case for grief education in schools. We discuss six key questions to examine evidence that children benefit from talking about grief, death and loss;the current provision for grief education in UK schools;the obstacles to teaching these topics and ways to overcome them;and the potential further implications of a policy change. Following the lead of child bereavement charities, research and new national reports on UK bereavement support, we demonstrate the need for mandatory grief education in all four countries of the UK and offer evidence-based recommendations for its implementation. © 2023, Cruse Bereavement Care. All rights reserved.

Trends in Glycemic Control during the COVID-Pandemic in a Large Academic Health Care System

The Emory Diabetes Management Program is a chronic care management model aimed to reduce the proportion (%) of adult patients with HbA1c >9% within the Emory Healthcare System. We report the proportion of patients with poor glycemic control (HbA1c >9% or missing values for 6 months) before and during the Covid-pandemic, from 02/01/18 to 10/30/2021.Among 27,061 patients with diabetes before COVID-pandemic, the % of patients with poor glycemic control decreased from 19.5% to 14.35% in 12/2019. During the COVID-pandemic, the % of patients with poor control rapidly increase to 21.70% (Fig 1A) by 2/1/21, primarily due to a 275% increased of patients with missing HbA1c testing and a minor increase in % of patients with HbA1c >9% (Fig 1B) . Expansion of telemedicine programs, access to care and resource implementation to identify and facilitate HbA1c testing reduced the % of patients with poor control to pre-pandemic levels. Conclusion: At a population-health level, COVID-pandemic had a significant negative impact in % of patients with poor control primarily due to HbA1c testing (3-fold increase) rather than worsening A1c values. Innovative solutions to increase access to A1C testing in future pandemics may help to maintain undisrupted glucose monitoring and control in individuals with diabetes in large academic health systems.

Inequalities in Access to Bereavement Support Before and During COVID-19: Findings from Voluntary and Community Sector Bereavement Services in the UK

Background/aims: The COVID-19 pandemic has resulted in global mass bereavement;in the UK alone there have been 140,000 deaths to date, with a disproportionate impact on Black, Asian or minoritized ethnic (BME) communities. Voluntary and community sector (VCS) bereavement services including hospices play an important role in bereavement support. We aimed to determine services' perspectives on access to their support. Methods: Cross-sectional online survey of VCS bereavement services in the UK, open March-May 2021, disseminated via national organisations, associations and networks and social media. Results: 147 organisations participated;53% served specific counties or smaller regions;16% were UK-wide. 36% were hospice or palliative care services, 15% national bereavement charities or NGOs;12% local bereavement charities. 67.3% reported there were groups with unmet needs not accessing their services before the pandemic;most frequently reported were people from BME communities (49%), sexual minority groups (26.5%), deprived communities (24.5%) and men (23.8%). 50% of services reported that, in the year before COVID-19, <5% of clients were from BME communities;25% did not collect this data and 25% reported >5% BME clients. Compared with before the pandemic, 3.4% of services were seeing more people from BME groups, 52% were seeing the same proportion, 6.1% were seeing fewer and 38% didn't know/didn't collect this data. Conclusions: For over two thirds of VCS bereavement services in the UK, there are known inequities in who accesses support, with people from BME groups most likely to be recognised as needing support but not Paediatric Palliative Care Commissioners (n=2) Gender Female:Male 2:0 accessing services. During the pandemic, the proportion of BME clients did not increase, despite these communities being disproportionately affected by COVID-19. More attention needs to be paid to assessing and meeting unmet needs for formal bereavement support among disadvantaged groups and routinely collecting client data to help determine and ensure equity. (Table Presented).

The Impact of COVID-19 on the Provision of Voluntary and Community Sector Bereavement Services: A Cross-Sectional Survey from the UK

Background/aims: During the COVID-19 pandemic, voluntary and community sector (VCS) bereavement services including hospices have played a central role in supporting the bereaved. We aimed to describe the impact of the pandemic on these services to inform service development and policy. Methods: Cross-sectional online survey of VCS bereavement services in the UK, open March-May 2021, disseminated via national organisations, associations and networks, and social media. Results: 147 organisations participated;53% were regional, 16% UK-wide. 36% were hospice or palliative care services, 15% national bereavement charities or NGOs;12% local bereavement charities. During the pandemic referrals increased for 46% of organisations and decreased for 35%. 40.3% reported a current waiting list >3 weeks. 78.2% had changed services due to Covid;51.7% introduced new services. There had been a significant reduction in provision of all face-toface support including peer group meetings (50% to 4.1%, OR 0.04), facilitated group meetings (78% to 11%, OR 0.04), 1:1 support (87% to 27%, OR 0.06) and specialist intervention (44% to 16%, OR 0.25). Online and telephone provision saw major increases, particularly online 1:1 support (8.8% to 83%, OR 50.3), facilitated group meetings (4.1% to 56%, OR 30.48) and specialist intervention (3.4% to 36%, OR 16.01). Challenges included staff/volunteers providing support from home (69/64%), emotional impact on staff/volunteers (67/41%), increased pressure on staff due to client volume (41%) and complexity of needs (44%), implementing staff training (60%) and financial challenges (53%). 93% reported positive changes/opportunities during the pandemic, e.g., new coordination initiatives (47%). Conclusions: UK bereavement services rapidly transformed during the pandemic, despite significant challenges. To ensure positive changes and innovations are retained, the experiences and acceptability of new and adapted services among clients and staff require further investigation.

Experiences of Bereavement Across the UK, What Are the Challenges and What Might the Future Look Like - Findings From the UK Commission on Bereavement

Background/aims: The increased number of deaths due to the COVID-19 pandemic has left many people bereaved. Working in partnership with a number of UK charities and researchers, the UK Bereavement Commission was established to ensure that the voices of those affected by bereavement are heard and considered in future services and supports for bereaved people across the UK. Aims: To explore experiences of people bereaved in the last 5 years and identify recommendations for policy and practice with the aim of improving the experiences of people affected by bereavement. Methods: Two online surveys were launched in September 2021, one collected individuals' personal experiences of bereavement over the last 5 years while the other captured responses from organisations supporting people affected by bereavement. Both surveys captured qualitative and quantitative data. A lived experience advisory forum was established to ensure the voices of people affected by bereavement were included and considered in the both the formulation of survey questions and the identification of themes and recommendations from data collected. Qualitative data from were analysed using thematic analysis. Descriptive statistics summarised demographic characteristics of respondents, types of support received and satisfaction with support received. Results: Challenges experienced and recommendations for future support were identified by analysing individual and organisational perspectives. Conclusions: Understanding the experiences of bereaved people, from a range of different backgrounds and locations across the UK represents an essential first in ensuring that supports and services for those facing bereavement in the future are informed by people with direct experience of bereavement or of supporting those affected by bereavement. The Commissions plans for ensuring update of identified recommendations will also be discussed.

The Grief and Support Needs of Children and Young People Bereaved During the COVID-19 Pandemic: Parental Views From a UK National Survey

Background/aims: During the COVID-19 pandemic, many children and young people have experienced the death of close family members, whilst also facing unprecedented disruption to their lives. This study aimed to investigate the bereavement experiences and support needs from the perspective of their parents or guardians. Methods: We analysed cross-sectional free-text data from a survey of adults bereaved in the UK during the pandemic. Participants were recruited via media, social media, national associations and community/ charitable organisations. Thematic analysis was conducted on parent/ guardian responses to a question on the bereavement experiences and support needs of their children. Results: Free-text responses from 106 participants were included. Three main themes were identified: the pandemic-related challenges and struggles experienced by children and young people;family support and coping;and support from schools and services. Pandemic specific challenges include the impacts of being separated from the relative prior to their death, isolation from peers and other family members and disruption to daily routines and wider support networks. Examples were given of effective family coping and communication, but also difficulties relating to parental grief and children's existing mental health problems. The important role of schools and bereavement organisations in providing specialist support was demonstrated, but there was evidence of unmet need and lack of access to specialist grief or mental health support. Conclusions: Children and young people have faced additional strains and challenges associated with pandemic bereavement. We recommend initiatives that facilitate open and supportive communication within family and school settings, adequate resourcing of school and community- based specialist services and increased information and signposting to the support that is available.

Improving the efficiency and effectiveness of an industrial SARS-CoV-2 diagnostic facility.

On 11th March 2020, the UK government announced plans for the scaling of COVID-19 testing, and on 27th March 2020 it was announced that a new alliance of private sector and academic collaborative laboratories were being created to generate the testing capacity required. The Cambridge COVID-19 Testing Centre (CCTC) was established during April 2020 through collaboration between AstraZeneca, GlaxoSmithKline, and the University of Cambridge, with Charles River Laboratories joining the collaboration at the end of July 2020. The CCTC lab operation focussed on the optimised use of automation, introduction of novel technologies and process modelling to enable a testing capacity of 22,000 tests per day. Here we describe the optimisation of the laboratory process through the continued exploitation of internal performance metrics, while introducing new technologies including the Heat Inactivation of clinical samples upon receipt into the laboratory and a Direct to PCR protocol that removed the requirement for the RNA extraction step. We anticipate that these methods will have value in driving continued efficiency and effectiveness within all large scale viral diagnostic testing laboratories.

Radical Interrelated Qualitative Space in the Midst of Multipandemics: A Collaborative Scholarly Personal Narrative

Given the current unprecedented multiple pandemics of COVID-19, anti-Black and anti-Asian violence, and white supremacy, we—a group of graduate students and a faculty member who hold diverse identities across disciplines, race, gender, nationality, and additional categories—came together to focus on qualitative research as an ontological, epistemological, and axiological space toward community and culture change. Specifically, we took up scholarly personal narrative, which centers postmodernism and focuses on the reality that “we see what we believe;we observe what we narrate;we transform what we reframe.” What emerged were radical interrelated understandings of privilege, guilt, and the importance of kinship. As such, this vulnerable group reflected on graduate student experiences with multiple pandemics and how the academy may enact transformative change, reframing our own understandings of qualitative space. [ABSTRACT FROM AUTHOR] Copyright of Cultural Studies/Critical Methodologies is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Middle Grades Teacher Practices during the COVID-19 Pandemic

As of March 31, 2020, the closure of schools in 192 countries due to the COVID-19 pandemic had resulted in over 1.6 billion learners being temporarily forced out of school buildings. New educational inequities arose, and existing ones were exacerbated. Acknowledging that disruption may also stimulate innovation, the purpose of this qualitative research was to identify possible improvements in middle grades teachers’ practices as they enacted emergency remote instruction. Through narrative responses provided to an online survey administered between May 27 and June 19, 2020, 332 middle grades educators self-identified aspects of their teaching practice that improved while teaching remotely. Findings included deepened knowledge of individual learners;increased individualized instruction;greater opportunities for student choice and self-pace;more timely assessment feedback;enhanced family engagement;and increased technology skills. Implications of this study for educational practice, and for school scheduling in particular, are examined.

An iteratively optimised process for improving the efficiency and effectiveness of an industrial SARS-CoV-2 diagnostic facility (preprint)

On 11th March 2020, the UK government announced plans for the scaling of COVID-19 testing, and on 27th March 2020 it was announced that a new alliance of private sector and academic collaborative laboratories were being created to generate the testing capacity required. The Cambridge COVID-19 Testing Centre (CCTC) was established during April 2020 through collaboration between AstraZeneca, GlaxoSmithKline, and the University of Cambridge, with Charles River Laboratories joining the collaboration at the end of July 2020. The CCTC lab operation focussed on the optimised use of automation, introduction of novel technologies and process modelling to enable a testing capacity of 22,000 tests per day. Here we describe the optimisation of the laboratory process through the continued exploitation of internal performance metrics, while introducing new technologies including the Heat Inactivation of clinical samples upon receipt into the laboratory and a Direct to PCR protocol that removed the requirement for the RNA extraction step. We anticipate that these methods will have value in driving continued efficiency and effectiveness within all large scale viral diagnostic testing laboratories.