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Parental involvement in their child's care in hospital has undergone great change over the last century. Studies have shown how 'maternal deprivation' and 'separation anxiety' expressed by children are detrimental to a child's recovery in hospital. Striving efforts have been made to develop family-centred care, promote normality of the family unit and continue with the normal routine of the child's life within the limitations of a hospital environment and the child's illness. Expectations of the parental role in hospital need to be identified and expressed from both the parents and staff to establish an understanding that will ultimately be best for the child. Many studies have highlighted benefits to both parent and child from parental participation in hospital. However, disadvantages have been identified from resident parents who feel captive to their new situation and role. Efforts for family-centred care are highly advocated now. Care-by-Parent units have been set up in some areas to promote this idea and, although many advantages have been identified, they are not without their problems. The success of parental involvement is dependent on both parents' and staff's attitudes, enthusiasm and willingness to work together.

The factors that control the relative and absolute stereochemistry of 1.3-disubstituted and 1,2,3trisubstituted tetrahydro-P-carbolines formed via the Pictet-Spengler reaction are discussed. in particular, the stereochemical factors that lead to the predominance of cis-1.3-disubstituted products under conditions of kinetic control are presented, with the aid of X-ray crystallographic data on a number of compounds; methods for assigning relative stereochemistry on the basis of NMR data are given; the mechanism by which racemisation can occur during the Pictet-Spengler reaction has also been studied, and procedures for eliminating this problem are given.The Pictet-Spengler reaction' is the most direct method of forming the tetrahydro-P-carboline system 1, which is the commonest structural unit of indole alkaloids. For members 1 7 3 Paper 2/05 1691

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Foreign body ingestion and foreign body aspiration commonly affect young children between 6 months and 6 years. A large number of these events remain unwitnessed and asymptomatic while the swallowed foreign body traverses the gastrointestinal tract and is passed in the stool. Recent literature has shown an increase in morbidity associated with button battery and (neomydium) magnet ingestions in children, particularly over the last decade. Early identification and management in a time critical manner is required in cases where button batteries get lodged in the oesophagus or multiple magnets are swallowed. Deaths, although rare, have been reported with these dangerous foreign body ingestions in children where diagnoses were delayed. Nurses through their direct contact with children in different clinical settings play a vital role in managing foreign body ingestions.