Bereavement outcomes: a quantitative survey identifying risk factors in family carers bereaved through cancer.

Background: Enabling patients to die in their preferred place is important but achieving preferred place of death may increase the informal carer’s risk into bereavement. Aim: to determine risk factors of family carers bereaved through cancer in Northern Ireland. Design: These results form part of a larger QUALYCARE-NI study which used postal questionnaires to capture quantitative data on carer’s bereavement scores using the Texas Revised Inventory of Grief. Setting/participants: Participants were individuals who: registered the death of a person between 1st December 2011 and 31st May 2012; where cancer (defined by ICD10 codes C00-D48) was the primary cause; where the deceased was over 18 years of age and death occurred at home, hospice, nursing home or hospital in Northern Ireland. Participants were approached in confidence by the Demography and Methodology Branch of the Northern Ireland Statistics and Research Agency. Those wishing to decline participation were invited to return the reply slip. Non-responders received a second questionnaire six weeks after initial invitation. Results indicated that risk factors positively influencing bereavement outcomes included patients having no preference for place of death and carers remaining in employment pre or post bereavement. In contrast, patients dying in hospital, carers stopping work, being of lower socio-economic status and close kinship to the deceased negatively impacted on bereavement scores. Family carers should be adequately supported to continue in employment; priority should be given to assessing the financial needs of families from lower socio-economic areas; and bereavement support should focus on close relatives of the deceased.

Towards a better understanding of flood-risk preparedness: A typological review

Preparedness has become a central component to contemporary approaches to flood risk management as there is a growing recognition that our reliance on engineered flood defences is unsustainable within the context of more extreme and unpredictable weather events. Whilst many researchers have focused their attention on exploring the key factors influencing flood-risk preparedness at the individual level, little consideration has been attributed to how we understand preparedness conceptually and practically in the first instance. This paper seeks to address this particular gap by identifying and analysing the diverse range of conceptualisations of preparedness and typologies of preparedness measures that exist within the literature in order to identify areas of convergence and divergence. In doing so, we demonstrate that a considerable degree of confusion remains in terms of how preparedness is defined, conceptualised and categorised. We conclude by reflecting on the implications this has from an academic perspective, but also in terms of the more practical aspects of flood risk management.

Phonic skills mediate improved literacy outcomes in at-risk primary school children: results from the Ready-to-Learn Programme

Background
Learning to read is a key goal during primary school: reading difficulties may curtail children’s learning trajectories. Controversy remains regarding what types of interventions are effective for children at risk for academic failure, such as children in disadvantaged areas. We present data from a complex intervention to test the hypothesis that phonic skills and word recognition abilities are a pivotal and specific causal mechanism for the development of reading skills in children at risk for poorer literacy outcomes.
Method
Over 500 pupils across 16 primary schools took part in a Cluster Randomised Controlled Trial from school year 1 to year 3. Schools were randomly allocated to the intervention or the control arm. The intervention involved a literacy-rich after-school programme. Children attending schools in the control arm of the study received the curriculum normally provided. Children in both arms completed batteries of language, phonic skills, and reading tests every year. We used multilevel mediation models to investigate mediating processes between intervention and outcomes.
Findings
Children who took part in the intervention displayed improvements in reading skills compared to those in the control arm. Results indicated a significant indirect effect of the intervention via phonics encoding.
Discussion
The results suggest that the intervention was effective in improving reading abilities of children at risk, and this effect was mediated by improving children’s phonic skills. This has relevance for designing interventions aimed at improving literacy skills of children exposed to socio-economic disadvantage. Results also highlight the importance of methods to investigate causal pathways from intervention to outcomes.

Influence of Heterogamy by Religion on Risk of Marital Dissolution: A Cohort Study of 20,000 Couples

Heterogamous marriages, in which partners have dissimilar attributes (e.g. by socio-economic status or ethnicity), are often at elevated risk of dissolution. We investigated the influences of heterogamy by religion and area of residence on risk of marital dissolution in Northern Ireland, a country with a history of conflict and residential segregation along Catholic–Protestant lines. We expected Catholic–Protestant marriages to have elevated risks of dissolution, especially in areas with high concentrations of a single religious group where opposition to intermarriage was expected to be high. We estimated risks of marital dissolution from 2001 to 2011 for 19,791 couples drawn from the Northern Ireland Longitudinal Study (a record linkage study), adjusting for a range of compositional and contextual factors using multilevel logistic regression. Dissolution risk decreased with increasing age and higher socio-economic status. Catholic–Protestant marriages were rare (5.9 % of the sample) and were at increased risk of dissolution relative to homogamous marriages. We found no association between local population composition and dissolution risk for Catholic–Protestant couples, indicating that partner and household characteristics may have a greater influence on dissolution risk than the wider community.