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Objectives Psychological consequences of grief among relatives are insufficiently known. We reported incidence of prolonged grief among relatives of deceased patients with cancer. Methods Prospective cohort study of 611 relatives of 531 patients with cancer hospitalized for more than 72 hours and who died in 26 palliative care units was conducted. The primary outcome was prolonged grief in relatives 6 months after patient death, measured with the Inventory Complicated Grief (ICG > 25, range 0–76, a higher score indicates more severe symptoms) score. Secondary outcomes in relatives 6 months after patient death were anxiety and depression symptoms based on Hospital Anxiety and Depression Scale (HADS) score (range 0 [best]–42 [worst]), higher scores indicate more severe symptoms, minimally important difference 2.5. Post-traumatic stress disorder symptoms were defined by an Impact Event Scale-Revised score >22 (range 0–88, a higher score indicates more severe symptoms). Results Among 611 included relatives, 608 (99.5%) completed the trial. At 6 months, significant ICG scores were reported by 32.7% relatives (199/608, 95% CI, 29.0–36.4). The median (interquartile range ICG score) was 20.0 (11.5–29.0). The incidence of HADS symptoms was 87.5% (95% CI, 84.8–90.2%) at Days 3–5 and 68.7% (95% CI, 65.0–72.4) 6 months after patient’s death, with a median (interquartile range) difference of −4 (–10 to 0) between these 2 time points. Improvement in HADS anxiety and depression scores were reported by 62.5% (362/579) relatives. Significance of results These findings support the importance of screening relatives having risk factors of developing prolonged grief in the palliative unit and 6 months after patient’s death.

Gracia argues for an unacknowledged legacy of Arthur Conan Doyle’s Sherlock Holmes—mistrust of the professional police force, originating early in the force’s history—and explores how that legacy colours our experience of law enforcement today. She defines a sub-genre of detective television series focused on extraordinary sidekicks supporting professional detectives and provides a partial taxonomy of the extraordinary sidekick based on three characteristics: an innate or acquired ability or specialist knowledge base outside of the usual law enforcement structure; a stable partnership with a single detective or small team of detectives; and use as a resource to improve law enforcement. She then demonstrates how extraordinary sidekicks both reflect an inherent Sherlockian mistrust in policing per se and serve to plug this trust gap.