East London NHS Foundation Trust

OBJECTIVES:Endogenous bioelectric signaling (including transepidermal potential [TEP] and the current of injury) plays a fundamental role in normal wound repair. Despite this, commonly used wound management frameworks do not consider this important driver of healing. The objectives of this review are to explore whether the patient characteristics/pathologies common in delayed healing are associated with weakened electrical properties of the skin and to consider whether compromised currents of injury are a barrier to healing that could be addressed with electrical stimulation therapy (EST) and incorporated into existing frameworks. APPROACH:This systematic review of PubMed was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and aimed to explore the impact of three characteristics associated with delayed healing (older age, diabetes, and chronic inflammation) on the electrical properties of skin/wounds. RESULTS:Twelve relevant studies were identified, revealing that TEP in older or diabetic people is significantly lower, and the current of injury is approximately half that of young, healthy controls. INNOVATION:Lower currents of injury are associated with slower wound healing; therefore, the reduced current of injury/TEP identified here can be considered a barrier to healing. EST is designed to boost the weakened current of injury, back up to normal levels, stimulating a healing response. The incorporation of EST into existing wound management frameworks is therefore proposed. CONCLUSION:Endogenous bioelectrical signaling in the wound healing process appears to be compromised particularly in older people and those with diabetes. Patients may benefit from incorporating treatment with EST, which boosts bioelectrical signaling, into relevant wound treatment frameworks. [Figure: see text].

Emerging adulthood (ages 18–25) is a challenging period because of recent societal changes (e.g., later age of marriage) and ongoing biological and neural development. Those in this age range who have committed offences pose unique challenges to the criminal justice system and particularly the probation service. Whilst most young people desist from offending during this period, reoffending rates remain high. Unfortunately, there is limited evidence about how best to support emerging adults who are on probation. The Youth to Adulthood Hub (Y2A Hub) is a unique intervention embedded within one diverse probation area in London, England which uses a holistic approach aimed at fostering engagement. This intervention includes practical support (e.g., housing, employment), and tailored psychological support delivered in a trauma and culturally informed manner. Administrative data was used to compare the rates of attendance at statutory probation meetings between individuals who had received support from the Y2A hub (N = 73) and a control group of individuals (N = 860) from similar probation areas, controlling for age, ethnicity, and risk levels, using a multivariable binomial regression model. The results suggested that the Y2A was associated with a significant increase in engagement with probation and a reduction in unacceptable absences. The Y2A hub is a promising approach for addressing the needs of criminally justice involved young adults but further evaluation is warranted.

Aims: People with intellectual disability are frequently prescribed psychotropic medications for challenging behaviour, despite guidance advocating for holistic and non-pharmacological Multidisciplinary Team (MDT) support to understand and address the underlying causes of challenging behaviours. Approximately 17% of adults with intellectual disabilities receive antipsychotics for symptomatic management in the absence of mental illness, a rate 16 times higher than the general population. STOMP (Stopping The Over Medication of People with Intellectual Disabilities and/or Autism) is a national project to reduce inappropriate prescribing. Decreasing psychotropic medications without appropriate alternatives risks destabilisation, and so we wanted to ensure our STOMP pathway provided holistic support tomeet the needs and wishes of service users, their carers and care providers. We used a co-production methodology to achieve this. Methods: Service users eligible for STOMP review were identified. Semi-structured interviews were conducted with family carers (n=8) and care-provider representatives (n=4). Interview guides were based on STOMP principles and refined by the MDT. Interviews were analysed using content and thematic coding. Findings were reported back to participants and cross-verified using a large language model for research triangulation, and then translated into pathway components during MDT design meetings. Results: Interviews highlighted shared priorities for reducing challenging behaviour and improving quality of life. Both groups stressed the need for coordinated input from the Integrated Learning Disability Service and primary care, predictable routines, meaningful tasks with supported independence, clear plans for care changes, an allocated worker, and communication support. Participants felt medication provided stability but did not address underlying triggers. They requested more thorough medication reviews with clearer explanations of rationale and side effects. Significant concern was expressed about destabilisation if medication was reduced without reliable alternatives and clear crisis plans. Service improvement priorities included respite provision, timely social care responses, better access to physical healthcare, and tailored staff training. Conclusion: Co-production identified significant anxieties about medication reduction, but emphasised that it is feasible when reliable alternatives are in place, such as coordinated MDT input, communication support, and clear crisis plans. The analysis showed that good social care support forms a large and essential element of this, including community access,day opportunities and respite provision. Integrated Learning Disability Services (with health and social care working together in the same organisation) can make such a service user focused approach much easier to deliver, which should result in significant improvements in quality of life, and reduced side-effect burden.

Introduction Alcohol use is known to be associated with the self-medication hypothesis as a maladaptive coping mechanism of individuals who have difficulties in emotion regulation. The capacity for emotion regulation develops in line with the bonding characteristics with the caregivers in the early stages of development. Objectives This study aims to explore the relationship between parental bonding and addiction severity in Alcohol Use Disorder (AUD), with a focus on the mediating role of emotion regulation difficulties. Methods A total of 210 male participants (105 diagnosed with AUD, 105 healthy controls) aged 18–65 were recruited from outpatient and inpatient AUD units. Data were collected using the Sociodemographic and Clinical Data Form, the Parental Bonding Inventory (PBI), the Difficulties in Emotion Regulation Scale (DERS), and the Addiction Profile Index (API). Parental bonding, emotion regulation difficulties, and addiction severity were assessed through the PBI, DERS, and API, respectively. Parametric tests (t-test, ANOVA), regression, and mediation analyses (Hayes & Preacher, 2004, PROCESS in SPSS) were conducted to examine group differences, predictors, and mediating effects related to the severity of alcohol addiction. Results Statistical analysis revealed that the AUD group had lower scores on the PBI Protection subscale for both mothers and fathers compared to the control group (p<0.05), and higher scores on the DERS Nonacceptance, Goals, Impulse, Strategy, Clarity, and Total scores (p<0.05). Mother and father PBI Care/Control and Total scores were negatively associated with API Substance Use Characteristics (p<0.05). API Total score was positively associated with DERS Nonacceptance, Goals, Impulse, Strategy, Clarity, and Total scores (p<0.05). A full mediating effect of DERS Total score was found in the relationship between mother’s PBI Care/Control, mother and father’s PBI Total scores, and API Substance Use Characteristics (p<0.05). A partial mediating effect of DERS Total score was found in the relationship between father’s PBI Care/Control and API Substance Use Characteristics (p<0.05). Conclusions The findings suggest that AUD patients reported more overprotective parental bonding styles during childhood and adolescence compared to healthy controls. Difficulties in emotion regulation were also more severe in the AUD group. Higher levels of parental care and control were associated with lower severity of alcohol addiction, with emotion regulation difficulties mediating this relationship.These results indicate that early bonding experiences and the development of emotion regulation strategies may play a crucial role in both assessing risk and predicting the course of AUD. Based on these findings, treatment approaches that target early relational patterns and emotion regulation, such as Cognitive Analytic Therapy, which emphasises early caregiver experiences, may provide promising treatment options. Disclosure of Interest None Declared

Aims: The training scheme prospectus is usually the initial reference for prospective Higher Trainees (HT) in ranking training programmes. An outdated prospectus fails to showcase the strength of individual training schemes, resulting in failure to attract prospective trainees. The North Central and East London (NEL) Prospectus for Child and Adolescent Psychiatry (CAP) on the Health Education England (HEE) website had not been updated since2021 and recruitment into the scheme had declined resulting in up to 40% vacancies for the February 2025 recruitment cycle. The aim of this QIP is to revise and update the NEL CAP training scheme prospectus to improve recruitment and retention of HTs by enhancing trainee confidence. Methods: A PDSA cycle using surveys and focus groups including trainees and trainers at each placement across 4 Trusts, was used to gather feedback to identify gaps in the Prospectus. The key areas identified for revision included providing detailed placement descriptions and job-specific teaching, research, psychotherapy, special interest and leadership opportunities. Results: An initial survey of the trainees in the last 3 years indicated that more than half of the trainees (53%) never referred to the outdated Prospectus to guide their scheme selection to inform placement ranking, or to explore training opportunities. Of the 47% who referred to the prospectus, only 31% felt that their scheme selection was guided by the prospectus. Only 33% of the trainees used the outdated prospectus to rank their placements and to explore job-specific special interest opportunities. Following the initial survey, the updated prospectus was distributed to all the trainees in February 2026. Formal qualitative feedback from trainees showed that the updated job descriptions of posts ‘reads well’, ‘pitched at a good level of detail’, shows ‘what to expect’,‘eases anxieties’,helped them ‘understand their roles’,and provides job-specific opportunities. Consultant feedback suggested that the updated prospectus was necessary in reflecting the strength of the training scheme and the broad range of opportunities available to the trainees. The revised prospectus will be shared with HEE and the second cycle of PDSA will be completed in the next recruitment cycle in August 2026. Conclusion: The revised prospectus has improved trainee confidence in the Scheme and in guiding their training progression. Further cycles will evaluate its impact on trainee recruitment and retention to the scheme.