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Emotional support from family members may have an important effect on adolescent health outcomes, and has been identified as a target for policy to protect against the impacts of poverty and other early life adversities. However, few studies have assessed the extent to which poverty and adversity themselves influence the nature of emotional support that parents can provide to adolescents. We, therefore, aimed to investigate the impact of trajectories of income poverty and family adversities, including parental mental ill health, alcohol misuse and domestic violence across childhood developmental stages on young people's relationships with their families and perceived emotional support received. We analysed longitudinal data on 10,976 children from the nationally representative UK Millennium Cohort study. Exposure trajectories of poverty and family adversities were characterised using group-based multi-trajectory models (age 9 months–14 years). The outcomes were perceived emotional support and quality of family relationships, measured by the three-item Short Social Provisions Scale (SPS-3) and levels of parent–adolescent closeness and conflict, measured at age 14. ORs and 95% CIs were estimated using multivariable logistic regression models, adjusting for potential confounding factors. At age 14, the overall prevalence of low perceived emotional support was 13% (95% CI: 12, 14). Children of mothers with lower socioeconomic status (SES) were more likely to report low emotional support, with a clear social gradient (education—degree plus: 10.3% vs. no qualifications: 15.4%). Compared with children exposed to low levels of poverty and adversity, children in the persistent adversity trajectory groups experienced higher odds of low emotional support and low-quality parent–adolescent relationship; those exposed to both persistent poverty and poor parental mental health were particularly at increased risk of experiencing poor family relationships and low perceived emotional support (adjusted odds ratio 2·2; 95% CI 1·7–2·9). Low perceived emotional support and poor family relationships in adolescence are more prevalent among socially disadvantaged children and adolescents and those experiencing social adversity. Policies to improve levels of family support for UK adolescents should focus on improving modifiable determinants such as child poverty and family mental health. [ABSTRACT FROM AUTHOR]

Children in care of the state are amongst the most disadvantaged in society. They have often experienced adverse childhood experiences leading to their care entry including abuse and neglect. Longitudinal data suggests problems children in care of the state experience within adolescence persist into adulthood, showing "a continuing legacy of adversity." Emerging literature shows that edge of care interventions can bring about benefits. These interventions support families to meet their child's needs and prevent, or reduce, the likelihood of children going into care. However, it is not clear how or why these interventions work. It is important to develop this understanding to inform the development of effective, theory-informed practice to benefit this population. We reviewed and synthesised published literature to expose mechanisms by which interventions may promote and support family preservation for children at the edge of care. Our synthesis uses a realist approach to examine mechanisms by which interventions, in various contexts, can promote and support family preservation for children at the edge of care. Previous work by the team shaped the initial search strategy and in line with RAMESES realist review guidelines, no restrictions were placed on the types of study to be included in the synthesis. From 7,530 potentially relevant references identified, 61 papers were included in final extraction. Extracted data was themed, prior to developing narrative and formulating programme theories. Effective edge of care service operation seemed to be based on four core programme theories pertaining to the need for family skills training, home-based delivery, dedicated worker, and rapid response to need. [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]

PHC374 Bowers K, Barrett S (2009) Wound-related pain: features, assessment and treatment. Primary Health Care. 19,10, 37-45. Date of acceptance: September 15 2009. Abstract This article explores the problem of [...]

Franic, Teo V., Louise M. Judd, David Robinson, Simon P. Barrett, Katrina L. Scarff, Paul A. Gleeson, Linda C. Samuelson, and Ian R. van Driel. Regulation of gastric epithelial cell development revealed in [H.sup.+]/[K.sup.+]-ATPase [beta]-subunit- and gastrin-deficient mice. Am J Physiol Gastrointest Liver Physiol 281: G1502--G1511, 2001.--The gastric [H.sup.+]/[K.sup.+]-ATPase is essential for normal development of parietal cells. Here we have directly assessed the role of the [H.sup.+]/[K.sup.+]-ATPase [beta]-subunit (H/K-[beta]) on epithelial cell development by detailed quantitation of the epithelial cell types of the gastric mucosa of H/K-[beta]-deficient mice. H/K-[beta]-deficient mice had a 3.1-fold increase in the number of immature cells per gastric unit; however, the numbers of surface mucous and parietal cells were similar to those in the gastric units of wild-type mice. The effect of elevated gastrin levels in the H/K-[beta]-deficient mice was determined by producing mice that are also deficient in gastrin. We demonstrated that the increased production of immature cells and resulting hypertrophy is caused by the overproduction of gastrin. However, the depletion of zymogenic cells, which is another feature of H/K-[beta]-deficient mice, is independent of hypergastrinemia. Significantly, parietal cells of H/K-[beta]- and gastrin-deficient mice had abnormal secretory membranes and were devoid of resting tubulovesicular membranes. Together these data suggest a homeostatic mechanism limiting the number of immature cells that can develop into end-stage epithelial cells and indicate a direct role for H/K-[beta] in the development of mature parietal cells. parietal cell, gastric mucosa, membrane biosynthesis Received 11 April 2001; accepted in final form 11 September 2001

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]

Studies have earlier shown that metal-bound [L.sup.tBu] can form binding pockets for anion guests through hydrogen-bonding and hydrophobic interactions involving the tert-butyl substituents. These capabilities are extended by showing that L(super tBu] building blocks can be linked into anion-binding scaffolds in the solid state by secondary interactions as well as the coordinative bond.

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]