In many Western societies there is increasing demand for counselling; in turn, heightened levels of support needs have been identified for counsellors themselves. Despite calls for practitioners to adopt a more proactive approach to self-care, research suggests many still pay insufficient attention to alleviating on-the-job stress or achieving 'workÁlife balance'. These issues were examined within the context of inviting six high school counsellors in New Zealand to talk generally about their professional lives. The authors suggest findings support calls for counsellor education programmes to offer structured opportunities for trainees to reflect upon the task of discursively constructing professional roles.

A project providing triage in acute maternity settings was developed to better manage demand and ensure the right service was available at the right time and in the right place. Data collected prior to implementing the telephone triage project identified that a significant number of women accessed the labour ward as their first point of contact for advice with maternity services resulting in an unnecessarily high volume and throughput where labour ward was in effect gate-keeping other clinical areas. The project was designed and introduced to maximize the use of the clinical expertise possessed by a group of practice development midwives. Early results suggest that demand and patient flow is better managed following the introduction of the telephone triage service. The development of a telephone triage service within an acute maternity service is beneficial and can result in a reduction in inappropriate admissions. There are benefits at a client, clinician, service and organizational level.

Background/Objectives Obesity in pregnancy has been associated with increased childhood cardiometabolic risk and reduced life expectancy. The UK UPBEAT multicentre randomised control trial was a lifestyle intervention of diet and physical activity in pregnant women with obesity. We hypothesised that the 3-year-old children of women with obesity would have heightened cardiovascular risk compared to children of normal BMI women, and that the UPBEAT intervention would mitigate this risk. Subjects/Methods Children were recruited from one UPBEAT trial centre. Cardiovascular measures included blood pressure, echocardiographic assessment of cardiac function and dimensions, carotid intima-media thickness and heart rate variability (HRV) by electrocardiogram. Results Compared to offspring of normal BMI women (n = 51), children of women with obesity from the trial standard care arm (n = 39) had evidence of cardiac remodelling including increased interventricular septum (IVS; mean difference 0.04 cm; 95% CI: 0.018 to 0.067), posterior wall (PW; 0.03 cm; 0.006 to 0.062) and relative wall thicknesses (RWT; 0.03 cm; 0.01 to 0.05) following adjustment. Randomisation of women with obesity to the intervention arm (n = 31) prevented this cardiac remodelling (intervention effect; mean difference IVS −0.03 cm (−0.05 to −0.008); PW −0.03 cm (−0.05 to −0.01); RWT −0.02 cm (−0.04 to −0.005)). Children of women with obesity (standard care arm) compared to women of normal BMI also had elevated minimum heart rate (7 bpm; 1.41 to 13.34) evidence of early diastolic dysfunction (e prime) and increased sympathetic nerve activity index by HRV analysis. Conclusions Maternal obesity was associated with left ventricular concentric remodelling in 3-year-old offspring. Absence of remodelling following the maternal intervention infers in utero origins of cardiac remodelling. Clinical trial registry name and registration number The UPBEAT trial is registered with Current Controlled Trials, ISRCTN89971375.

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At long last, the Scottish Government has indicated that it has begun detailed work towards presenting a Trusts Bill in the Scottish Parliament. 1 The key piece of Scots trusts legislation, the Trusts (Scotland) Act 1921, passed its centenary in August 2021. It is therefore welcome news that the Scottish Law Commission's extensive work in this area, and particularly their proposed Trusts (Scotland) Bill, updated in 2018, will be considered for implementation. This article will consider how the trusts landscape has shifted over the last century, identifying some ways in which trust law is out of kilter with modern practice. It will then analyse some aspects of the proposed legislation which seeks to consolidate and enhance trust law for the benefit of the Scottish economy and people. B. THE CHANGING USES OF TRUSTS SINCE 1921Trusts are now used in a wider range of private, charitable and commercial purposes than ever could have been envisaged by the drafters of the 1921 Act. Trust law is flavoured by its neighbouring fields of succession, family, tax, charity, insolvency, financial services, and commercial law, all of which have seen major updates. Many of the motives and incentives for using trusts in these various arenas have expanded substantially. 2 The protection of assets held for children or incapable or vulnerable beneficiaries is a major reason to use trusts. In Scotland, a teenager aged sixteen or seventeen inherits outright unless there is a will containing trust provisions. 3 Trusts are also used to hold assets for incapable beneficiaries as an alternative (or in addition) to guardianship. 4