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Abstract
Objective: This review assesses the caregiving literature to understand what is known about health and well-being outcomes for informal carers in the context of caring for people living with chronic wounds. The first part of this review provides background information on caregiver characteristics, and physical and psychological deficits related to caregiving. The second part explores the positive aspects of caregiving through a number of moderating variables: social support, caregiving mastery, and subjective caregiver qualities.
Method: A structured literature review was carried out using the databases, CINAHL Plus, PsychARTICLES, PsychINFO, and PubMed.
Keywords were: [‘caregiving’ or ‘carer’ or ‘caregiver’] and [‘health’] and [‘well-being’ or ‘wellbeing’] and [‘quality of life’ or ‘QoL’]. Only those articles written in the English language and published in peer-reviewed journals were considered for inclusion. Relevant book chapters and web references were also assessed for inclusion. A total of 52 references were used in the review. Result: The relationship between caregiving, health and well-being is a complex one. Much research indicates detrimental physical and psychological outcomes for caregivers of those with wounds. However, a number of moderating variables appear to ‘buffer’ the stress of caregiving and may even lead to positive outcomes.
Conclusion: To date, there has been insufficient attention paid in the research literature to the health and well-being outcomes of carers of people living with chronic wounds. Given the predicted rise in the incidence of chronic wounds in Australia over the coming decades, it is vital that we understand how to maximise health and well-being outcomes for the carers of patients with chronic wounds.

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Abstract
Objective: This review assesses the caregiving literature to understand what is known about health and well-being outcomes for informal carers in the context of caring for people living with chronic wounds. Part 1 provided background information on caregiver characteristics, as well as physical and psychological deficits related to caregiving. Part 2 looks at the positive aspects of caregiving through a number of moderating variables: social support, caregiving mastery, and subjective caregiver qualities.
Method: A structured literature review was carried out using the databases, CINAHL Plus, PsychARTICLES, PsychINFO, and PubMed.
Keywords were: [‘caregiving’ or ‘carer’ or ‘caregiver’] and [‘health’] and [‘well-being’ or ‘wellbeing’] and [‘quality of life’ or ‘QoL’]. Articles written in the English language and published in peer-reviewed journals were considered for inclusion. Relevant book chapters and web references were also assessed for inclusion. A total of 52 references were used in the review.
Result: The relationship between caregiving, health and well-being is a complex one. Much research indicates detrimental physical and psychological outcomes for caregivers. However, a number of moderating variables appear to ‘buffer’ the stress of caregiving and may even lead to positive outcomes.
Conclusion: Much of the caregiving literature focuses on people caring for relatives with specific health and/or mental illnesses. To date, there has been insufficient attention paid to health and well-being outcomes for carers of people living with chronic wounds. Given the predicted rise in the incidence of chronic wounds in this country over the coming decades, it is vital that we understand how to maximise health and well-being outcomes for the carers of chronic wound patients.

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Abstract
Aims: To explore correlations between peak pressure and pressure gradient at 1.5 cm and 2.5 cm, and selected risk factors for pressure injury including Waterlow risk assessment score and body mass index.
Background: Accurately predicting pressure injury formation remains elusive. Exploring pressure gradients through pressure mapping systems may increase understanding of suspected deep pressure injury development.
Methods: A nested prospective correlational exploratory study recruited 120 medical and surgical patients with convenience sampling. Patients were positioned supine with a 30-degree head elevation, on a computer-linked pressure sensor mapping mat. Mean peak interface pressure and pressure gradients were calculated.
Results: Large correlation coefficients were identified between peak interface pressure and pressure gradients at distances of 1.5 cm and 2.5cm, indicating that the area at the base of the ‘cone-like’ pressure damaged area remained essentially constant, rather than increasing with peak interface pressure.
Conclusions: Pressure is experienced in a ‘V’ shape rather than a ‘U’ shape. Additionally, the area subjected to the highest pressure gradient is restricted in size and the impact of pressure reduces with distance from the point of peak interface pressure. The results suggest that with increasing peak interface pressure, the surrounding area becomes subject to higher gradients and shearing forces. Relevance to clinical practice: Increased use of pressure mapping systems in the clinical setting shows educational promise through visualisation of factors affecting deep tissue injury.

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Abstract
Background: This study was carried out based on the recent realisation about pain as a factor in diabetic foot ulcer (DFU) care and the significance and impact of DFU-related pain experiences on individual well-being.
Aim: To determine the presence of DFU-related pain and its relationship to quality of life (QoL).
Methods: This descriptive, cross-sectional study utilised the wound-related pain questionnaire and generic QoL instrument — the Medical Outcome Study Short Form (SF-12v2).
Results: All the participants (n=14) experienced DFU-related pain at rest and during performance of activities of daily living. In relation to dressing change, 78.6% of the participants reported the experience of DFU-related pain. DFU-related pain occurring as incident/background pain was significantly related to physical health status (physical functioning only) and mental health status (social functioning only), with p<0.05. General mental health concerning psychological distress and psychological well-being was found to be significantly related to DFU-related pain experienced in relation to dressing change (p=0.03).
Conclusion: DFU-related pain is inherent in patients with DFUs at rest, during performance of activities of daily living, and at dressing change, which could affect physical, social and mental functioning. To improve patients’ QoL outcomes, clinical practice should therefore incorporate strategies to assess and treat DFU-related pain.

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It is becoming increasing clear that microRNAs contribute to the regulation of many biological processes, including wound healing. After injury, keratinocytes need to undergo what is known as an epithelial-to-mesenchymal transition (EMT) to initiate re-epithelialisation. During this process, keratinocytes reduce their attachment to the underlying matrix, extend membrane protrusions, become motile and migrate over the wound bed, affecting wound closure. MicroRNAs that regulate EMT are aberrantly upregulated in keratinocytes at the edge of non-healing wounds and potentially play a role in the chronicity of these wounds. In vitro and in vivo, downregulation of these microRNAs promotes EMT and migration, facilitating re-epithelialisation in wound models. This review will focus on the role of microRNAs that regulate or have potential to regulate EMT and re-epithelialisation during wound healing.

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QUESTION
What is the best available evidence on the effectiveness of non-contact, low-frequency ultrasound (NCLFUS) in wound management?

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QUESTION
What is the best available evidence on using volumetry to assess lymphoedema?

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QUESTION
What is the best available evidence on tonometry to assess lymphoedema?

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