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Introduction Millions became bereaved during the pandemic, with many facing challenges accessing support. Aims To describe the use and helpfulness of different types of support in a cohort of people bereaved during the pandemic in the UK. Methods A longitudinal survey of people bereaved during the pandemic over four time points. At 7- and 13-months post-bereavement (T2 and T3), participants rated the helpfulness of support used and described how they had been helped by this support. Results 420 participants completed at least one follow-up survey (T2, T3 or both). Most respondents were female (88.3%) and had lost a parent (57.6%) or partner (24.3%), with 3.3% from a minoritised ethnic background. Support from family and friends, reported by 89.3% of participants, was rated as ‘quite helpful’ (mean rating 4.3 out of 5), and included help with practical tasks, expressing feelings/sharing grief, remembering, feeling cared for and less isolated. The most commonly used form of other support was 1:1 support (e.g. counselling), used by 40.5% of participants, with an average helpfulness rating of 4.1, helping participants feel listened to and process their grief. Online community support, used by 31.0% of participants, was also rated ‘quite helpful’ (3.9), enabling sharing with similar others, feeling understood and less alone. Informal and formal bereavement groups were rated as similarly helpful (4.2) while helplines and specialist mental health support were slightly less helpful (3.6) (used by 9.3%, 4.8%, 7.1% and 4.5% of participants, respectively). Conclusions Results demonstrate the perceived benefits and helpfulness of different forms of bereavement support used during the pandemic. Impact These findings highlight the value of informal as well as formal support, particularly bereavement counselling. Policy makers must attend to the foundational and second tiers of the public health model of bereavement support, supporting communities as well as services.

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-to-face 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 f

Background: Millions of people became bereaved during the Covid-19 pandemic, with many facing significant challenges accessing both informal and formal sources of support. Rational: We describe the use and experiences of bereavement support in a cohort of people bereaved during the pandemic in the UK. Design: A longitudinal online survey over three time points. Participants were asked about the support they had used and in free-text comments explained how they felt helped by this support. Evaluation: By 7-months post-bereavement, 88.3% of T2 survey participants (N=384; 88% female) continued to be supported by family and friends. They were helped with practical tasks, expressing feelings and sharing their grief, remembering the person they had lost, and feeling cared for and less isolated. 36.7% had received formal 1:1 support (e.g. counselling), helping them feel listened to and process their grief in a non-judgmental environment. Online communities (e.g. online bereavement forums and Facebook groups, used by 31%) helped people by sharing with similar others and feeling understood and less alone. 18.8% had contacted a physician for help with sick notes, medication or referrals to specialist bereavement or mental health support. Helplines, informal and formal bereavement groups, and mental health support were accessed less frequently (7%, 8.1%, 3.6%, and 3.1%, respectively). Conclusion: Results demonstrate the different types and benefits of bereavement support used during the pandemic. These insights can help support providers strengthen the mechanisms through which they benefit support-users, whilst also helping bereaved people identify support that is most relevant to their individual needs

Background: Millions of people became bereaved during the Covid-19 pandemic, with many facing significant challenges accessing both informal and formal sources of support. Rational: We describe the use and experiences of bereavement support in a cohort of people bereaved during the pandemic in the UK. Design: A longitudinal online survey over three time points. Participants were asked about the support they had used and in free-text comments explained how they felt helped by this support. Evaluation: By 7-months post-bereavement, 88.3% of T2 survey participants (N=384; 88% female) continued to be supported by family and friends. They were helped with practical tasks, expressing feelings and sharing their grief, remembering the person they had lost, and feeling cared for and less isolated. 36.7% had received formal 1:1 support (e.g. counselling), helping them feel listened to and process their grief in a non-judgmental environment. Online communities (e.g. online bereavement forums and Facebook groups, used by 31%) helped people by sharing with similar others and feeling understood and less alone. 18.8% had contacted a physician for help with sick notes, medication or referrals to specialist bereavement or mental health support. Helplines, informal and formal bereavement groups, and mental health support were accessed less frequently (7%, 8.1%, 3.6%, and 3.1%, respectively). Conclusion: Results demonstrate the different types and benefits of bereavement support used during the pandemic. These insights can help support providers strengthen the mechanisms through which they benefit support-users, whilst also helping bereaved people identify support that is most relevant to their individual needs

This thesis examines the migration strategy, diet and foraging ecology of the smallest Atlantic seabird, the European Storm Petrel Hydrobates pelagicus.Evidence was found for sex-specific migration behaviour, opportunistic feeding, temporal variation in diet, and the strategy regulation of energy reserves in response to varying environmental conditions, as a buffer against starvation during migration. Molecular sexing from feather and faecal samples revealed an unexpectedly strong female bias in the sex ratio of Storm Petrels attracted to tape-lures of conspecific calls, during their northwards migration past the coast of SW Portugal. The thesis describes the development and application of molecular techniques, in combination with stable isotope analysis, to study Storm Petrel diet by the detection of prey DNA from faecal samples. The major category of prey detected was fish (chiefly European Sardines Sardina pilchardus). Other components of the diet were other pelagic and demersal fish species, Cephalopoda (primarily cuttlefish Sepia spp.), Amphipoda, Isopoda and a range of terrestrial invertebrates. Large between-year fluctuations in the level of body reserves carried by these birds were observed over the 21-year study period (1990-2010). The pattern of body mass variation followed a smooth oscillation, which was not an artefact of differences among years in the distribution of capture effort, body size or sex ratio changes. Local sea surface temperature (SST), net primary production (NPP) and European Sardine biomass were key factors associated with between-year changes in Storm Petrol body reserves. These associations suggest that Storm Petrels strategically regulate their body reserves to buffer against starvation in years of low food abundance.

This thesis examines the migration strategy, diet and foraging ecology of the smallest Atlantic seabird, the European Storm Petrel Hydrobates pelagicus.Evidence was found for sex-specific migration behaviour, opportunistic feeding, temporal variation in diet, and the strategy regulation of energy reserves in response to varying environmental conditions, as a buffer against starvation during migration. Molecular sexing from feather and faecal samples revealed an unexpectedly strong female bias in the sex ratio of Storm Petrels attracted to tape-lures of conspecific calls, during their northwards migration past the coast of SW Portugal. The thesis describes the development and application of molecular techniques, in combination with stable isotope analysis, to study Storm Petrel diet by the detection of prey DNA from faecal samples. The major category of prey detected was fish (chiefly European Sardines Sardina pilchardus). Other components of the diet were other pelagic and demersal fish species, Cephalopoda (primarily cuttlefish Sepia spp.), Amphipoda, Isopoda and a range of terrestrial invertebrates. Large between-year fluctuations in the level of body reserves carried by these birds were observed over the 21-year study period (1990-2010). The pattern of body mass variation followed a smooth oscillation, which was not an artefact of differences among years in the distribution of capture effort, body size or sex ratio changes. Local sea surface temperature (SST), net primary production (NPP) and European Sardine biomass were key factors associated with between-year changes in Storm Petrol body reserves. These associations suggest that Storm Petrels strategically regulate their body reserves to buffer against starvation in years of low food abundance.