A systematic review of the health, social and financial impacts of welfare rights advice delivered in healthcare settings

BACKGROUND: Socio-economic variations in health, including variations in health according to wealth and income, have been widely reported. A potential method of improving the health of the most deprived groups is to increase their income. State funded welfare programmes of financial benefits and benefits in kind are common in developed countries. However, there is evidence of widespread under claiming of welfare benefits by those eligible for them. One method of exploring the health effects of income supplementation is, therefore, to measure the health effects of welfare benefit maximisation programmes. We conducted a systematic review of the health, social and financial impacts of welfare rights advice delivered in healthcare settings. METHODS: Published and unpublished literature was accessed through searches of electronic databases, websites and an internet search engine; hand searches of journals; suggestions from experts; and reference lists of relevant publications. Data on the intervention delivered, evaluation performed, and outcome data on health, social and economic measures were abstracted and assessed by pairs of independent reviewers. Results are reported in narrative form. RESULTS: 55 studies were included in the review. Only seven studies included a comparison or control group. There was evidence that welfare rights advice delivered in healthcare settings results in financial benefits. There was little evidence that the advice resulted in measurable health or social benefits. This is primarily due to lack of good quality evidence, rather than evidence of an absence of effect. CONCLUSION: There are good theoretical reasons why income supplementation should improve health, but currently little evidence of adequate robustness and quality to indicate that the impact goes beyond increasing income

Wound Healing and Tissue Engineering: Physiology of Wound Healing

In order to understand the pathophysiology of the traumatized lower extremity, one must first understand the classical phases of wound healing: inflammatory phase, repair phase, and maturation phase. The inflammatory phase of wound healing is initiated by injury: be it trauma, infection, or antigen–antibody reaction; and is nonspecific in response. Although wound strength continues to increase, the net collagen production slows down because synthesis and degradation come into equilibrium around six weeks postinjury. In addition to the direct limb damage from high-energy trauma, traumatic injuries involving burns, cold injury, pressure injury, and radiation may result in the development of wounds. The debridement of necrotic tissue by either surgical or nonsurgical means is an essential component of wound care. Adequate tissue oxygenation is necessary for all phases of wound healing. The diversity of growth factors and types of chronic wound suggest that these factors have potential as new treatments if patients’ individual requirements can be identified