We explore the phenomenon of organ donation between rivals in time of war when a significant gift such as organ donation is given not just to a \"stranger\" but to a stranger who may be considered an enemy. This is a case study of a unique organ donation event that occurred in Israel during Operation Guardian of the Walls in May 2021. It involved a Palestinian boy killed by a Jewish policeman and a Jewish man killed by Palestinian youths. Both victims, lacking organ donor cards, had their organs donated by their families with the awareness that recipients could come from the \"opposing\" group. We ask: (1) How do families from rival groups construct meaning in their decision to donate organs? (2) How do they construct meaning in their experience of loss? The findings reveal that bereaved families imbue their actions with political and religious significance, framing the organ donations as a \"universal gift\" guided by religious commandments to save lives. While these acts initially transcend cultural and national boundaries, a lack of recognition and gratitude afterward can lead to disillusionment, reinforcing \"us\" versus \"them\" boundaries. This study underscores the intricate dynamics in organ donations during political conflict and the pivotal role of religious authorities in shaping perceptions and meaning. Moreover, it highlights the potential for organ donations to foster reconciliation and coexistence amidst conflict, provided mutual recognition in cases where compassion and understanding of loss are prioritized.

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There is a growing recognition globally that care regarding lactation following a perinatal death needs to potentially offer the opportunity for maternal donation. This article discusses this experience and perspectives from a human milk bank (HMB) in Vietnam. This is a descriptive exploratory case study that has a long tradition in both the social and health sciences. Triangulated data collection involved a review of video data, interview data with the donor, and data review for the Da Nang HMB, a Center for Excellence in Breastfeeding. We found that although it is common for mothers in Vietnam to donate breastmilk to HMBs, it is less common for this to occur following perinatal loss. We offer a descriptive case study of the maternal loss of twins and a subsequent choice to donate for approximately 1 month to the Da Nang HMB, the first HMB in Vietnam. We discuss four reasons derived from this case regarding donation following perinatal loss. (1) A strong motivation to donate breastmilk when aware of the service, (2) donating breastmilk helped her deal with grief, (3) family members supported her through this tough time and supported her decision, and (4) health staff supported her decision. While human milk sharing (e.g., wet nursing) has been practiced in Vietnam, breastmilk donation from bereaved mothers has neither been discussed nor well-researched. Because maternal grief is complex and individual, deciding to donate breastmilk is a personal decision that needs to be supported, without creating guilt for those who do not wish to donate.

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BACKGROUND: Patient and family-centred care is considered best practice. Such an approach is associated with high quality and positive experiences of care, and family presence at the bedside is encouraged and enabled. The COVID-19 pandemic, however, resulted in strictly enforced restrictions on hospital visitation, which threatened health professionals\' ability to provide family-centred care.
OBJECTIVE: To explore the impact of COVID-19 visitor restrictions on family relationships during critical illness at the end of life in the intensive care unit.
METHODS: A retrospective collective case study approach was taken, using semi-structured interviews, conducted via telephone or Zoom, in accordance with COVID-19 restrictions.
METHODS: Two participant groups, bereaved next-of-kin of patients who died in the intensive care unit (n = 6) and critical care nurses (n = 3) from a major metropolitan hospital were included.
RESULTS: Interviews with bereaved next-of-kin lasted 25-59 (mean = 41) minutes, and critical care nurse interviews lasted 31-52 (mean = 43) minutes. Inductive content analysis revealed five themes: (i) the first farewell, the significance not realised at the time; (ii) confusing rules and restrictions, which emphasised physical and created emotional barriers to family connections; (iii) inadequate communication, which further impacted next-of-kin; (iv) final farewells, which were rushed, emotional and afforded no privacy; and (v) reflecting back.
CONCLUSIONS: This collective case study demonstrates the profound impact visitor restrictions have had on bereaved next-of-kin and the wider family. A family-centred approach to care, protecting and prioritising family connection, and recognising the patient as a person who is part of a larger family unit must be emphasised.
CONCLUSIONS: Critical care teams must consider their own approach to end-of-life care during times of visitor restrictions, finding new, flexible and innovative ways to improve communication, promote family-centred care, maintain the patient-family connection and facilitate end-of-life cultural customs, and rituals imperative to next-of-kin and the wider family unit.

Although sensory and quasi-sensory experiences of the deceased (SED) have been the subject of much debate, research on the phenomenology of auditory verbal experiences in the bereaved has been neglected. This case study describes the phenomenology of a regularly occurring voice hearing experience and its meaning for a single bereaved individual. The voice of the deceased can be heard as though in external space, and the experience can feel real, even when the death is fully acknowledged. A bereaved individual can welcome and benefit from the experience even when it is not recognized as a normal part of grieving in the individual\'s cultural context, when no afterlife belief is present, and when the experience remains unexplained. The case study demonstrates that hearing the voice of the deceased can be a regular occurrence without causing distress or dysfunction and lends support to the idea that SED are a common concomitant of normal bereavement.

OBJECTIVE: To investigate mechanisms of suicide risk in people bereaved by suicide, prompted by observations that bereaved people experience higher levels of distress around dates of emotional significance. We hypothesised that suicide-bereaved first-degree relatives and partners experience an increased risk of self-harm and suicide around dates of (i) anniversaries of the death and (ii) the deceased\'s birthday, compared with intervening periods.
METHODS: We conducted a self-controlled case series study using national register data on all individuals living in Denmark from 1 January 1980 to 31 December 2016 and who were bereaved by the suicide of a first-degree relative or partner (spouse or cohabitee) during that period, and who had the outcome (any episode of self-harm or suicide) within 5 years and 6 weeks of the bereavement. We compared relative incidence of suicidal behaviour in (i) the first 30 days after bereavement and (ii) in the aggregated exposed periods (6 weeks either side of death anniversaries; 6 weeks either side of the deceased\'s birthdays) to the reference (aggregated unexposed intervening periods). As an indirect comparison, we repeated these models in people bereaved by other causes.
RESULTS: We found no evidence of an elevated risk of suicidal behaviour during periods around anniversaries of a death or the deceased\'s birthdays in people bereaved by suicide (adjusted incidence rate ratio [IRRadj] = 1.00; 95% confidence interval [CI] = 0.87-1.16) or other causes (IRRadj = 1.04; 95% CI = 1.00-1.08) compared with intervening periods. Rates were elevated in the 30 days immediately after bereavement by other causes (IRRadj: 1.95, 95% CI: 1.77-2.22).
CONCLUSIONS: Although people bereaved by suicide are at elevated risk of self-harm and suicide, our findings do not suggest that this risk is heightened around emotionally significant anniversaries. Bereavement care should be accessible at all points after a traumatic loss as needs will differ over the grief trajectory.

Introduction: Psychotherapy added to usual hospital care is beneficial. This study reports on two contrasting cases, one responder and one nonresponder, from a randomized controlled trial on the effectiveness of intensive and brief psychodynamic psychotherapy (IBPP) for depressed inpatients, in which reduction in depressive severity was maintained for up to 1 year after completion of IBPP. We aimed to explore how the psychotherapist and patient interacted to work through the themes of focalization (described in the IBPP manual) and how their work was part of a potential process of change. Methods: This case study is part of the general framework of mixed methods in psychotherapy combining quantitative analysis of data collected in a randomized controlled trial with a qualitative case study. Results: Two general categories emerged-(1) becoming the subject of one\'s depression and (2) regaining a sense of support-which combine specific functions. In the first, the functions relate to interactions in line with the psychoanalytic work of mourning, which aims for an appropriation of depressive symptoms. In the second, interactions have as their functions the construction of a therapeutic space and the restoration of an epistemic trust by acknowledging the patient\'s melancholic state and maintaining emotional contact. Work related to regaining a sense of support was observed in both cases, whereas work related to becoming the subject of one\'s depression was more specific to the responder case. Discussion: These results highlight the importance of interventions that help generate a sense of support and mobilize the internal processes of symbolization, understanding, and appropriation, leading patients to develop the capacity to give meaning to their symptoms and to understand the personal psychological factors related to the depressive episode.

To support older mourners after the loss of their partner, LEAVES, an online self-help service that delivers the LIVIA spousal bereavement intervention, was developed. It integrates an embodied conversational agent and an initial risk assessment. Based on an iterative, human-centered, and stakeholder inclusive approach, interviews with older mourners and focus groups with stakeholders were conducted to understand their perspective on grief and on using LEAVES. Subsequently, the resulting technology and service model were evaluated by means of interviews, focus groups, and an online survey. While digital literacy remains a challenge, LEAVES shows promise of being supportive to the targeted end-users.

Bereaved older people face stressors from the changes in roles associated with the death of a spouse. To illustrate the lived experience of everyday life during a period of aging after a woman\'s loss of her spouse. One woman born in 1918 was followed between 74 and 80 years of age after her husband died. Data consisted of daily diary. The text from the diaries were analyzed with a phenomenological hermeneutical approach. Everyday life after becoming a widow is characterized by balancing between personal resources to manage everyday life and vulnerability. In health and social care, it is important to identify experiences of vulnerability because these are associated with poor health.