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Background: Clustering and co-occurring of family adversities, including mental health problems, substance use, domestic violence and abuse, as well as poverty can increase health and behavioural risks for children, which persist throughout the life course. Yet, interventions that acknowledge and account for the complex interactive nature of such risks are limited. This study aimed to develop intervention principles based on reflections from mothers, fathers, and young people who experience multiple and interacting adversities. These principles will show how family members perceive an intervention may bring about positive change and highlight key insights into design and delivery. Methods: A series of six co-design workshops with mothers, fathers, and young people who experienced multiple and interacting adversities (n = 41) were iteratively conducted across two regions in England (London and North-East) by four researchers. Workshop content and co-design activities were informed by advisory groups. Data from facilitator notes and activities were analysed thematically, resulting in a set of intervention principles. Results: The intervention principles highlighted that: (1) to reduce isolation and loneliness parents and young people wanted to be connected to services, resources, and peer support networks within their local community, particularly by a knowledgeable and friendly community worker; (2) to address feelings of being misunderstood, parents and young people wanted the development of specialised trauma informed training for practitioners and to have the space to build trusting, gradual, and non-stigmatising relationships with practitioners; and (3) to address the needs and strengths of individual family members, mothers, fathers, and young people wanted separate, tailored, and confidential support. Conclusions: The current study has important implications for practice in supporting families that experience multiple and interacting adversities. The intervention principles from this study share common characteristics with other intervention models currently on offer in the United Kingdom, including social prescribing, but go beyond these to holistically consider the whole families' needs, environments, and circumstances. There should be particular focus on the child's as well as the mothers' and fathers' needs, independently of the family unit. Further refinement and piloting of the developing intervention are needed. Plain English summary: Families can experience multiple difficulties. These difficulties include parental mental health problems, alcohol and drug use, domestic violence, and poverty. These difficulties can impact the wellbeing of both parents and children. Currently, support that is provided to families rarely accounts for these complex and multiple difficulties. This study aimed to gather insights from mothers, fathers, and young people about how to best support families who experience multiple difficulties at the same time. We ran six workshops with community groups of mothers, fathers, and young people from London and North East England. We learned that: (1) Parents and young people wanted to be connected to services, resources and peer support networks within their local community. (2) Parents and young people wanted to build trusting, gradual, and non-stigmatising relationships with practitioners. (3) Parents and young people wanted support that was personalised to their own needs and that focused on their strengths. This research contributes key ideas for supporting families, which will be used alongside other studies to develop new ways of supporting families. The next steps will be to complete and test the developing support model, by delivering it to families and measuring how well it works. [ABSTRACT FROM AUTHOR]

Introduction: Despite a decline in Sudden Unexpected Death in Infancy in the UK since 2004, inequalities have widened with higher rates among families from deprived backgrounds and those known to child protection services. Almost all cases involve parents who had engaged in unsafe sleeping practices despite awareness of safer sleeping advice. Objective: To understand the perspectives surrounding safer sleep of families supported by statutory child protection agencies, and use behavior change theory to inform how approaches to providing safer sleep advice to these families may be modified. Participants and setting: We interviewed 14 mothers, 2 fathers and one grandmother, who had recent contact with child protection services in northeast England. Methods: In-depth, semi-structured interviews, with purposive sampling. The COM-B model (Capability, Opportunity, and Motivation) structured our analysis. Results: Parents described how anxiety, sleep deprivation, settling infants, illness, and a desire to bond with infants influence their decision making about sleep. Parents valued credible, trusted sources and understanding how safer sleep practices protect infants. Responses to questions about 'out of routine' situations suggested social pressures surrounding routines and 'good parenting' may preclude parents from acknowledging risks and planning for these situations. Conclusion: Open conversations tailored to the needs of families, focused upon understanding why and when parent(s) do or do not follow safer sleep guidance seem a promising way of promoting safer sleep practices. Safer sleep discussions with these families are likely to be best delivered as part of wider infant care by professionals who have an established and continuing trusting relationship with parents. While advice and information should be provided by any professional in contact with the family with the necessary expertise, sensitive conversations around sleeping practices, particularly co-sleeping, may be more easily facilitated by professionals where the statutory responsibility for safeguarding is less apparent. [ABSTRACT FROM AUTHOR]

Introduction: Children exposed to parental intimate partner violence and abuse, mental illness, and substance use experience a range of problems which may persist into adulthood. These risks often co-occur and interact with structural factors such as poverty. Despite increasing evidence, it remains unclear how best to improve outcomes for children and families experiencing these adversities and address the complex issues they face. Aims and Methods: Systematic review of systematic reviews. We searched international literature databases for systematic reviews, from inception to 2021, to provide an evidence overview of the range and effectiveness of interventions to support children and families where these parental risk factors had been identified. Results: Sixty-two systematic reviews were included. The majority (n = 59) focused on interventions designed to address single risk factors. Reviews mostly focused on parental mental health (n = 38) and included psychological interventions or parenting-training for mothers. Only two reviews assessed interventions to address all three risk factors in combination and assessed structural interventions. Evidence indicates that families affected by parental mental health problems may be best served by integrated interventions combining therapeutic interventions for parents with parent skills training. Upstream interventions such as income supplementation and welfare reform were demonstrated to reduce the impacts of family adversity. Conclusion: Most intervention approaches focus on mitigating individual psychological harms and seek to address risk factors in isolation, which presents potentially significant gaps in intervention evidence. These interventions may not address the cumulative impacts of co-occurring risks, or social factors that may compound adversities. [ABSTRACT FROM AUTHOR]

Dressings continue to be a key part of successful wound care, however, choosing the right product for the right patient at the right time can be challenging for the clinician (Hedger, 2014). Modern foam dressings have been widely available since the mid-1970s with the aim to manage light-to-heavy exuding wounds (Hedger et al, 2014). Historically, bordered foam dressings have utilised acrylic-based adhesives; however, these have been associated with increased risk of skin sensitisation and medical adhesive-related skin injuries (MARSI; Meuleneire and Rucknagel, 2013; Hedger et al, 2014; Mestach et al, 2018; Downie and Collier, 2021). A clinical evaluation was undertaken to detail the characteristics and performance of Suprasorb® P sensitive silicone foam dressing (L&R Healthcare). The evaluation comprised a minimum of four dressing changes over at least 2 weeks. Fifty patients (51 wounds) were included in the evaluation. At the final evaluation, 57% (n=29) of the wounds were recorded as improved, 37% (n=19) were recorded as static and 6% (n=3) were recorded as having deteriorated. Of the 27% (n=14) evaluations where patients reported self caring, 71% scored Suprasorb P sensitive as above average for ease of use, suggesting the dressing may be suitable for patients who were self-caring and can apply their own dressing. Suprasorb P sensitive performed well in all the parameters evaluated and may be considered where effective exudate handling, improved patient comfort and ease of handling is required. [ABSTRACT FROM AUTHOR]

This article describes the evaluation in clinical practice of Kliniderm foam bordered and non-bordered, including the heel-shaped wound dressing on 25 patients over a twoweek period, with an average of four dressing changes and a minimum of two dressing changes. An evaluation form was completed at each dressing change, which aimed to elucidate particular aspects of the dressing's performance, considering: patient comfort on application, ease of application, conformability of the dressing, the dressing's ability to manage exudate, ability to stay in place, ease of removal and patient comfort on removal, the condition of the wound and the surrounding periwound skin. The ratings on evaluation forms were collated and an average rating was calculated for each category. [ABSTRACT FROM AUTHOR]

This article describes the evaluation in clinical practice of Kliniderm silicone wound contact layer on 21 patients over a two-week period, with an average of four dressing changes and a minimum of two dressing changes. An evaluation form was completed at each dressing change; aspects being evaluated included patient comfort on application, ease of application, conformability, exudate transfer to secondary dressing, ability to stay in place, ease of removal, patient comfort on removal, the condition of the wound and periwound skin, and the wear time of the dressing. The ratings from each evaluation form were collated and an average rating was calculated for each category. [ABSTRACT FROM AUTHOR]

This post-market evaluation assessed the performance of ActivHeal® Aquafiber™ Extra dressing and gathered feedback from clinicians using it to treat a variety of wounds. The primary outcomes were the progression to healing through exudate management and maintenance of a moist wound healing environment. The evaluation took place across three sites in the UK. Forty-three patients were treated according to instructions to use and standard local practice. Data was collected at every dressing change. Aquafiber® Extra use had positive effects on exudate levels, periwound condition and tissue type(s) within the wound bed. The majority of wounds reduced in size during the evaluation period and three completely healed. Overall, clinician and patient satisfaction was high. No adverse events were reported. The results suggest Aquafiber® Extra use in clinical practice is safe, effective and acceptable to practitioners and patients. [ABSTRACT FROM AUTHOR]

The Wounds UK Best Practice Statement 'Improving holistic assessment of chronic wounds' emphasises the need for wide-ranging assessment that considers the impact of all aspects of the patient's health and wellbeing on the healing process. Each best practice statement has an accompanying 'Patient Expectation', which indicates to patients what to expect in care. This article provides a guide to the Patient Expectations and how to discuss these with your patients to engage them in their treatment. [ABSTRACT FROM AUTHOR]

This article describes the evaluation in clinical practice of a new absorbent silicone adhesive foam dressing on 20 wounds over three dressing changes. Aspects of the evaluation included pain, ease of dressing removal, exudate handling, conformability of the dressing and ease of use. [ABSTRACT FROM AUTHOR]

Slow-healing, chronic wounds have a negative impact on patient wellbeing, are challenging for clinicians to manage and are costly to the health economy (Frykberg and Banks, 2015). Woulgan is a newly available wound care gel containing the active ingredient 2% soluble beta-glucan. Beta-glucan has immunomodulating properties and has been shown to kick-start the healing of slow-healing wounds. A working group of key opinion leaders met in January 2018 to determine the potential role of Woulgan gel in slow-healing wounds, such as diabetic foot ulcers, pressure ulcers and venous leg ulcers, and to develop a decision pathway for clinical practice to support clinicians in escalating treatment promptly to avoid unnecessary impact on patient wellbeing and costs. The group's consensus recommendations on appropriate use are presented here. [ABSTRACT FROM AUTHOR]

The management of exudate is an essential requirement in wound care. It is important that an optimal moist environment is created and the surrounding skin protected from the risk of maceration and subsequent risk of infection. Selected antimicrobial dressings for wounds aim to manage exudate levels, maintain a moist wound environment, aid progression and reduce any signs of infection. This article reports on how the ActivHeal Aquafiber Ag dressing performs on a diverse range of patients with complex infected and non-infected wounds. [ABSTRACT FROM AUTHOR]

Sir,--Will Stone (Letters, July 4) finds fault with Anthony Phelan's review of Gottfried Benn translations (June 27), in my view somewhat unfairly, for not acknowledging Michael Hamburger's earlier ('seminal') versions. [...]

The following iron(II) complexes of 2,6- bis(oxazolinyl)pyridine (PyBox; LH) derivatives are reported: [Fe( LH)2][ClO4]2 ( 1); [Fe(( R)- LMe)2][ClO4]2 (( R)- 2; LMe=2,6- bis{4-methyloxazolinyl}pyridine); [Fe(( R)- LPh)2][ClO4]2 (( R)- 3) and [Fe(( R)- LPh)(( S)- LPh)][ClO4]2 (( RS)- 3; LPh=2,6- bis{4-phenyloxazolinyl}pyridine); and [Fe(( R)- L iPr)2][ClO4]2 (( R)- 4) and [Fe(( R)- L iPr)(( S)- L iPr)][ClO4]2 (( RS)- 4; L iPr=2,6- bis{4- isopropyloxazolinyl}pyridine). Solid ( R)- 3⋅MeNO2 exhibits an unusual very gradual, but discontinuous thermal spin-crossover with an approximate T [ABSTRACT FROM AUTHOR]

Objectives: A clinical evaluation was undertaken to detail the characteristics and performance of a next generation Silicone foam dressing and how it impacted skin sensitisation and medical adhesive-related skin injuries (MARSIs) Methods: The evaluation comprised a minimum of four dressing changes over at least 2 weeks. Fifty patients (51 wounds) were included in the evaluation. The evaluation was undertaken in a community setting and an acute Diabetic Foot Clinic. Each patient evaluation ran for a minimum of 2 weeks with a minimum of four contacts including the first contact and application of the Silicone foam. All patients over the age of 18 years who had a wound with low to moderate levels of exudate were invited to be involved in the evaluation. The aim was to include at least 40% of patients with friable and vulnerable skin, or who were known to have experienced MARSIs in the past. Results: At the final evaluation, 57% (n=29) of the wounds were recorded as improved, 37% (n=19) were recorded as static and 6% (n=3) were recorded as having deteriorated. Silicone foam dressing was rated highly by both clinicians and patients, in all aspects of comfort, softness, ease of removal and ability to stay in place, with no reports of skin damage from the adhesive. Conclusions: In this 51-wound evaluation, the Silicone foam dressing performed well in patient comfort and ease of handling, exudate management and where there was existing poor peri-wound skin condition. Generally, the peri-wound skin condition improved, suggesting that the dressing could be included as part of a holistic wound care plan to support effective exudate management and care of the peri-wound skin. [ABSTRACT FROM AUTHOR]

The article discusses the highlights of the Made Easy workshop held during the Wounds UK annual conference on November 10, 2015. The workshop's objective is to provide guidance in dealing with challenges of exudate management. During the event, participants were able to have an experience of using Sorbion Sachet S dressings to assist with exudate management.

There are a number of mechanisms at play that can delay wound healing. Wounds can become stuck in a prolonged inflammatory stage resulting in high volumes of wound exudate, which contains agents that contribute to delayed healing. Exudate plays an essential role in wound healing but at excessive volumes it can also facilitate biofilm formation, which can further delay healing. Maintaining optimum levels of exudate is vital for healthy wound healing, as is the prevention or disruption of biofilm formation in the wound bed. This article also looks at Sorbion Sachet S® (BSN medical), a tried- and-tested superabsorbent dressing, which is now back on the Drug Tariff, but at a lower price. This article discusses the mechanisms used in the reintroduced superabsorbent dressing and how it provides a cost-effective solution to the problem of treating highly exuding chronic wounds where clinical efficacy and budgetary concerns are both top priorities. [ABSTRACT FROM AUTHOR]