Linking Parental Wellbeing with the Wellbeing of Care Leaver and Care Experienced University Students: Analysing Relevance and Interconnections through the Lens of ‘Lived Lives’

This article analyses multidisciplinary research and theoretical perspectives on wellbeing, linking this with the findings from a narrative, biographical study of care-experienced university students in a UK university. In this paper, we examine the relevance of concepts of parental wellbeing, and wellbeing more generally, to \u27linked lives\u27\u27, defined as interrelated life events, experiences, memories and processes of narrativizing life histories both in and across time. While wellbeing is often depicted as an uplifting and uniformly positive concept in policy and research, it is also contested and opaque and is therefore difficult to define and operationalise. Elucidating young people\u27s voices on the complexity and \u27multilayeredness\u27 of everyday life events, we show that parental wellbeing, which is frequently negated from discussions of care experienced young people\u27s educational journeys requires greater critical scrutiny, arguing that temporalities and ever-changing personal and family histories indelibly affect individual care pathways for these young people. We thereby illuminate the significance of seemingly \u27ordinary\u27, everyday life events for care experienced students whilst showing how narrative interviews offer fruitful methodological approaches for understanding young people\u27s educational journeys

Apolipoprotein B, Residual Cardiovascular Risk After Acute Coronary Syndrome, and Effects of Alirocumab.

Background: Apolipoprotein B (apoB) provides an integrated measure of atherogenic risk. Whether apoB levels and apoB lowering hold incremental predictive information on residual risk after acute coronary syndrome beyond that provided by low-density lipoprotein cholesterol is uncertain. Methods: The ODYSSEY OUTCOMES trial (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) compared the proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab with placebo in 18 924 patients with recent acute coronary syndrome and elevated atherogenic lipoproteins despite optimized statin therapy. Primary outcome was major adverse cardiovascular events (MACE; coronary heart disease death, nonfatal myocardial infarction, fatal/nonfatal ischemic stroke, hospitalization for unstable angina). Associations between baseline apoB or apoB at 4 months and MACE were assessed in adjusted Cox proportional hazards and propensity score–matched models. Results: Median follow-up was 2.8 years. In proportional hazards analysis in the placebo group, MACE incidence increased across increasing baseline apoB strata (3.2 [95% CI, 2.9–3.6], 4.0 [95% CI, 3.6–4.5], and 5.5 [95% CI, 5.0–6.1] events per 100 patient-years in strata 35–<50, and ≤35 mg/dL, respectively). Compared with propensity score–matched patients from the placebo group, treatment hazard ratios for alirocumab also decreased monotonically across achieved apoB strata. Achieved apoB was predictive of MACE after adjustment for achieved low-density lipoprotein cholesterol or non–high-density lipoprotein cholesterol but not vice versa. Conclusions: In patients with recent acute coronary syndrome and elevated atherogenic lipoproteins, MACE increased across baseline apoB strata. Alirocumab reduced MACE across all strata of baseline apoB, with larger absolute reductions in patients with higher baseline levels. Lower achieved apoB was associated with lower risk of MACE, even after accounting for achieved low-density lipoprotein cholesterol or non–high-density lipoprotein cholesterol, indicating that apoB provides incremental information. Achievement of apoB levels as low as ≤35 mg/dL may reduce lipoprotein-attributable residual risk after acute coronary syndrome. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01663402.gov; Unique identifier: NCT01663402.URL: https://www