Region Of Scotland Research Articles

Drug network identification predicts injecting risk behavior among people who inject drugs on hepatitis C virus treatment in Tayside, Scotland

The risk of Hepatitis C Virus (HCV) acquisition among People Who Inject Drugs (PWID) remains high when injecting risk behavior within networks endures. Several psychosocial factors influence such behavior. Following a drive within Tayside, a geographic region in Scotland, to achieve World Health Organization HCV elimination targets, addressing HCV re-infection risk as a barrier to elimination is critically important. This cross-sectional study seeks to address this barrier to elimination by investigating associations between group identification (one’s subjective sense of belonging and connectedness to a social group coupled with a sense of shared goals, beliefs and values with the other members of the group) and injecting risk behavior among PWID on HCV treatment at needle and syringe provision sites in Tayside. Participants completed psychosocial questionnaires between treatment weeks zero and three of treatment. Correlation analyses were undertaken, and significant factors included in multiple linear regression models for injecting risk behavior. Injecting frequency, drug network identification, and family identification, were correlated with injecting risk behavior, and drug network identification had a positive predictive on injecting risk behavior. Identification with a social group, conventionally associated with improved health, may pose health risks in specific contexts. Healthcare providers should consider stratifying individuals with higher group identification with PWID networks for enhanced harm reduction engagement to mitigate transmissible infection risk among PWID. Additionally, psychological interventions to strengthen group identification with networks which impact positively on health behavior should be explored.

The hidden burden of medical testing: public views and experiences of COVID-19 testing as a social and ethical process

BackgroundIn May 2020, the Scottish Government launched Test and Protect, a test, trace and isolate programme for COVID-19 that includes a PCR testing component. The programme’s success depended on the willingness of members of the public to seek out testing when they experienced symptoms and to comply with guidelines on isolation should they test positive. Drawing on qualitative interview-based research, this paper analyses public understandings, expectations, and experiences of COVID-19 testing during the early stages of the programme. Through anthropological and sociological analysis of the findings we aim to contribute to social understandings of COVID-19 testing practices; and to inform the design of population level testing programmes for future pandemics.MethodsBetween 7 July and 24 September 2020, 70 semi-structured interviews were conducted with members of the general public (aged 19–85) living in the Lothian region of Scotland. Interviews were held online or by telephone, were transcribed verbatim and analysed using thematic analysis informed by anthropological and sociological theories of medical testing.FindingsSocial relationships and ethical considerations shape testing practices at every stage of the testing process. Members of the public viewed testing as a civic duty to society and moral duty to friends, family, and colleagues. However, the testing process also placed a significant social, economic, and practical burden on the individual and sometimes generated competing obligations. Many participants experienced a disconnect between the government’s portrayal of testing as easy and the everyday burden of testing.ConclusionsCOVID-19 testing is experienced as a social process shaped by multiple relationships and ethical considerations. The full burden of testing should be considered in the design of future testing programmes.

The Impact of the COVID-19 Pandemic on Hernia Surgery: The South-East Scotland Experience.

AimThe coronavirus disease 2019 (COVID-19) pandemic resulted in a lockdown in South East Scotland on 23 March 2020. This had an impact on the volume of benign elective surgery able to be undertaken. The degree to which this reduced hernia surgery was unknown. The aim of this study was to review the hernia surgery workload in the Lothian region of Scotland and assess the impact of COVID-19 on hernia surgery.MethodsThe Lothian Surgical Audit database was used to identify all elective and emergency hernia operations over a six-month period from 23 March 2020 and for the same time period in 2019. Data were collected on age, gender, anatomical location of the hernia, hernia repair technique, and whether elective or emergency operation. Statistical analysis was performed using the chi-squared test in R-Studio, with a p-value of <0.05 accepted as statistically significant.ResultsThe total number of hernia repairs reduced considerably between 2019 and 2020 (570 vs 149). The majority of this can be explained by a decrease in elective operating (488 vs 87), with the percentage of elective repairs reducing significantly from 85.6% to 58.4% (p<0.001). The inguinal hernia subgroup had a 24% rise in emergency operations from 21 to 26 operations, despite a reduction from 270 to 84 total inguinal repairs. There were just two elective hernia repairs carried out in the first three months of the 2020 study period (5.6% of all operations for April-June) compared to 265 (87.7%) for the same period in 2019 (p<0.001). No statistically significant differences were observed in the rates of laparoscopic versus open operating techniques across the two study periods on any analysis. The age and gender of the patients were similar over the two time periods.ConclusionThe COVID-19 pandemic led to a marked reduction in the number of elective hernia repairs (especially incisional hernia surgery), with the effect most pronounced over the first three months of lockdown. Despite an overall reduction in total emergency operative figures, possibly due to more widespread use of non-operative strategies, there was still an increase in emergency inguinal hernia repairs during the lockdown. Further studies are needed to evaluate if the delays to elective operating will result in a long-term increase in the rates of emergency presentation.

Predictive biophysical models of bivalve larvae dispersal in Scotland

In Scotland, bivalves are widely distributed. However, their larvae dispersion is still largely unknown and difficult to assess in situ. And, while Mytilus spp. dominate shellfish production, it is mostly dependent on natural spat recruitment from wild populations. Understanding the larval distribution pattern would safeguard natural resources while also ensuring sustainable farming practises. The feasibility of a model that simulates biophysical interactions between larval behaviour and ocean motions was investigated. We employed an unstructured tri-dimensional hydrodynamic model (finite volume coastal ocean model) to drive a particle tracking model, where prediction of larval movement and dispersal at defined locations might aid in population monitoring and spat recruitment. Our findings reveal a strong link between larval distribution and meteorological factors such as wind forces and currents velocity. The model, also, depicts a fast and considerable larval movement, resulting in a substantial mix of plankton and bivalve larvae, forming a large connection between the southern and northern regions of Scotland’s West coast. This enables us to forecast the breeding grounds of any area of interest, potentially charting connectivity between cultivated and wild populations. These results have significant implications for the dynamics of ecologically and economically important species, such as population growth and loss, harvesting and agricultural management in the context of climate change, and sustainable shellfish fisheries management. Furthermore, the observations on Scottish water flow suggest that tracking particles with similar behaviour to bivalve larvae, such as other pelagic larval stages of keystone species and potential pathogens such as sea lice, may have policy and farming implications, as well as disease control amid global warming issues.

Towards a Scottish Safe Haven Federation.

ObjectivesBuilding upon the Scottish Safe Haven Network’s (SSHN) collaborative experience to develop an exemplar dataset on Scottish national level laboratory tests within the SSHN. To test the feasibility of a federated safe haven network in Scotland for clinical laboratory data using existing federation solutions. ApproachConsiderations were given to the clinical tests that are being commonly used across Scotland. An investigation of laboratory data structure was conducted using SQL with the assistance of White Rabbit which captures the metadata information from each safe haven. Data heterogeneity or commonalities were investigated in detail in R. We examined the inter-relationships among clinical laboratories from different regions of NHS Scotland. A common data structure was proposed to facilitate the sharing of clinical test results. We investigated multiple existing federation solutions to streamline access to data across the SSHN. ResultsA dataset of all laboratory tests for patients registered with the Scottish Health Research Register and Biobank (SHARE) from laboratory data sources within the network (Grampian Data Safe Haven, Health Informatics Center, Glasgow Safe Haven &amp; Lothian/DataLoch Safe Haven) were developed. An open-source toolkit that includes SQL scripts to harmonise laboratory data from multiple safe haven and R scripts to conduct heterogeneity investigation to streamline the sharing and the analysis was created. We have shown a working model for federation within Scotland for the first time with the view to expand into more routine projects. The project has developed a systematic concept mapping of data available across the SSHN to aid cohort discovery. ConclusionsThe exemplar national level laboratory data together with the toolkit will help provide researchers with information such as which data are available to access. It will also support and improve national-level research studies at a faster pace. The work has demonstrated the feasibility of a common process for federated data discovery and sharing across the SSHN.

The Impact of COVID-19 on Mental Health Services in Scotland, UK.

There is a global emergency in relation to mental health (MH) and healthcare. In the UK each year, 1 in 4 people will experience MH problems. Healthcare services are increasingly oversubscribed, and COVID-19 has deepened the healthcare gap. We investigated the effect of COVID-19 on waiting times for MH services in Scotland. We used national registers of MH services provided by Public Health Scotland. The results show that waiting times for adults and children increased drastically during the pandemic. This was seen nationally and across most of the administrative regions of Scotland. We find, however, that child and adolescent services were comparatively less impacted by the pandemic than adult services. This is potentially due to prioritisation of paediatric patients, or due to an increasing demand on adult services triggered by the pandemic itself.

77P A real-world population study in early breast cancer to identify patient characteristics, treatment and outcomes in Scotland

Despite adjuvant endocrine treatment (AET) advances, hormone receptor positive (HR+), human epidermal growth factor receptor 2-negative (HER2−), node-positive early breast cancer (EBC) is associated with a considerable (∼20%) risk of recurrence. We conducted a retrospective study to describe demographic/clinical characteristics and outcomes alongside treatment patterns in patients (pts) with HR+, HER2− node-positive EBC in the region of Scotland served by the Edinburgh Cancer Centre, a specialist referral centre.

Mediterranean-Type Diet and Brain Structural Change from 73 to 79 Years in the Lothian Birth Cohort 1936

ObjectivesTo test whether Mediterranean-type Diet (MeDi) at age 70 years is associated with longitudinal trajectories of total brain MRI volume over a six-year period from age 73 to 79.DesignCohort study which uses a correlational design.SettingParticipants residing in the Lothian region of Scotland and living independently in the community.ParticipantsA relatively healthy Scottish sample drawn from the Lothian Birth Cohort 1936.MeasurementsTotal brain volume measurements were available at ages 73, 76 and 79 (N ranged 332 to 563). Adherence to the MeDi was based on food frequency questionnaire data collected three years before the baseline imaging scans, and was used in growth curve models to predict the trajectory of total brain volume change.ResultsNo association was found (p>.05) between adherence to the MeDi at age 70 and total brain volume change from 73 to 79 years in minimally-adjusted (sex) or fully adjusted models controlling for additional health confounders.ConclusionsVariation in adherence to the MeDi was not predictive of total brain atrophy over a six-year period. This suggests that previous findings of dietary associations with brain volume are not long lasting or become less important as ageing-related conditions account for greater variation in brain volume change. More frequent collection of dietary intake data is needed to clarify these findings.

Classic localities explained 25

Britain's geology is perhaps more diverse than any equivalent area in the world, spans almost 3 billion years, and has been studied for more than two centuries yet, for too long, it seemed that we could find no evidence here for one of the most spectacular events on the Earth—a giant meteorite impact. Perhaps, the only evidence might be localized and easily overlooked, like the thin layer of millimetre‐scale microtektites, once molten beads of rock blasted out by an impact, found near Bristol in 2001. Alas, these proved actually to have originated more than a thousand kilometres from Britain, in the 100 km Manicouagan Crater in eastern Canada. However, just a few years later, a spectacular discovery revealed that a world‐class impact deposit, metres thick and extending for tens of kilometres, had been hiding in plain sight at a location visited by countless geology students and their teachers. For decades, the Assynt region in northwest Scotland has been a training ground for geologists, drawn by the immensely old Lewisian Gneiss, the spectacular hills of Torridon sandstone that overlie it, and the structural complexity of the Moine Thrust Zone. How could this remarkable impact deposit have gone unnoticed for so long?

”I don’t think a lot of people respect us” – police and social worker experiences of interagency working with looked-after children

ABSTRACT This original qualitative study investigated the experiences of police and social workers who worked closely with Looked-after Children (LAC) and each other in an inter-agency capacity. Participants were based in different local councils and police stations across various regions in Scotland including rural communities and the Northern Isles. Semi-structured interviews were conducted with an experienced cohort (n = 12). Those participants, police (n = 6) and social workers (n = 6), occupied different roles within their disciplines. The interview findings elicited three distinct main themes including numerous instances of traumatic experiences in working with LAC, some conflict in inter-agency working, and a lack of formal support in the workplace. The practical implications of those findings are discussed.

GP trainee prescribing assessment – a qualitative evaluation of the involvement of pharmacists

ABSTRACT In 2019, the Royal College of General Practitioners (RCGP) introduced a mandatory workplace-based prescribing assessment for general practice trainees in their final year of training (GPST3). This assessment aimed to improve the quality of prescribing and reduce prescribing errors and it did not require pharmacist involvement. NHS Education for Scotland (NES) is the education and training body for NHS Scotland: delivering postgraduate training for GP trainees working in NHS Scotland. NES wished to evaluate the role that general practice pharmacists could have in this assessment. A training event for pharmacists was designed and delivered by the researchers in collaboration with the NES pharmacy team. Pharmacists attached to training practices in the West region of Scotland, where a GPST3 was undertaking the prescribing assessment, were invited to attend. The training described the prescribing assessment and the value that pharmacists could add to this workplace-based assessment. The evaluation aimed to explore the role of appropriately trained pharmacists in the prescribing assessment and their feedback to GP trainees, and evaluate the impact pharmacists had by exploring the views of GP trainers, GP trainees and pharmacists. Results showed that the intervention was viewed as a positive educational experience for all participants, and the interprofessional approach broadened the learning experience for GP trainees. We believe this to be innovative work replicable to primary healthcare colleagues to promote prescribing safety and interprofessional learning with pharmacy colleagues.

Bryozoan carbonate skeletal geochemical composition in the White Sea compared with neighbouring seas

A fundamental question underlying skeletal mineral secretion in marine invertebrates is the extent to which the physico-chemical parameters of seawater (e.g., salinity, temperature) and animal physiology influence their skeletal mineralogy and chemistry. Groups with more complex mineralogies, such as bryozoans, have the ability to actively control their own skeletal composition in response to environmental conditions and could be considered indicators of global environmental change. Thus, this study aims to reveal how the unique environmental conditions of low salinity (circa 24–26), prominent seasonality and semi-isolation of the White Sea (WS) subarctic region caused by the last glaciation (12,000 ya) affect the carbonate skeletal geochemical composition of bryozoans. X-ray diffraction analysis of 27 bryozoan taxa (92 specimens) revealed a completely monomineral calcite composition of skeletons with a mean value of 6.9 ± 1.8 mol% MgCO3 and moderate variability at the species and family levels. Most specimens (43.5%) precipitated skeletal magnesium within the range of 7–8 mol% MgCO3. Regional analysis of the mineralogical profile of the White Sea bryozoans shows that they differ statistically from bryozoan species living in the neighbouring Arctic and temperate Scotland regions in terms of magnesium content in calcite (approximately 7 mol% MgCO3 in the White Sea versus 5 mol% MgCO3 in other regions). We suggest that the effect of low salinity on magnesium content was compensated by relatively high summer temperature causing rapid growth and calcification and possibly resulted in the increased Mg contents in the White Sea (WS) bryozoans. However, on a local scale (between sampling locations), the influence of temperature and salinity could be excluded as a source of observed intraspecific variability. The concentration of MgCO3 in skeletons of the studied bryozoans is controlled by other environmental variables or is species-specific and depends on the physiological processes of the organisms.

Network governance and coordination of a regional entrepreneurial ecosystem

ABSTRACT This study looks to understand the dynamics of entrepreneurial ecosystems by exploring the complex interactions between multiple stakeholders operating at different levels of governance. Drawing on network governance, it provides new insights into collective and individual actions taken to coordinate and implement enterprise support. Through an in-depth study of the Tay Cities Region in Scotland, UK, the study details the relational organizing various stakeholders undertake to form, structure and interrupt the entrepreneurial ecosystem network. Through effective coordination, the region attracts inward investment and creates new valuable programmes, which increases the efficacy of enterprise support.

425 The Impact Of COVID-19 On Hernia Surgery in The Lothian Region Of Scotland

Abstract Aim The COVID-19 pandemic resulted in a lockdown in South East Scotland on the 23 March 2020. This had an impact on the volume of benign elective surgery able to be undertaken. The degree to which this reduced hernia surgery was unknown. The aim of this study was to review the hernia surgery workload in the Lothian region of Scotland and assess the impact of COVID-19 on hernia surgery. Method The Lothian Surgical Audit database was used to identify all elective and emergency hernia operations over a six-month period from 23 March 2020, and for the same time period in 2019. Data was collected on age, gender, location of the hernia, type of hernia repair and whether elective or emergency operation. Results The number of hernia repairs reduced dramatically between 2019 and 2020 (570 versus 149). The majority of this can be explained by a reduction in elective operating (488 versus 87). There was, however, also a reduction in the numbers of hernias repaired as an emergency over the same study periods (82 to 62). Lockdown in 2020 had the biggest effect on elective incisional hernia repair (74 versus 2). Conclusions The COVID-19 pandemic has reduced both the number of elective and emergency hernia operations in 2020 compared to 2019. While the reduction in elective surgery has not resulted in an associated increase in emergency surgery over the study period, it is possible that if continuing reduced availability to elective hernia surgery continues in Lothian, the emergency hernia workload may increase.

Workplace preparedness for an ageing workforce: a case study

PurposeFor many nations, their workforces are ageing. The purpose of this paper is to explore the concerns and attitudes of employers to employing older workers and what information they require.Design/methodology/approachA questionnaire survey of workplaces was undertaken in the Fife region of Scotland, which in economic and demographic terms is representative of wider Scotland and other nations in Northern Europe. Descriptive analysis was undertaken to give insight into concerns and actions taken regarding ageing workforces.FindingsMost workplaces perceive more advantages to employing older workers than challenges. Many have adapted training and work practices, but many have not. The majority surveyed believe that existing policies and strategies are sufficient. This points to the need for national and local government and employer associations to become more active to persuade workplaces to better manage future workplaces.Research limitations/implicationsGeneralisability is problematic and the small sample restricted the scope of statistical analysis.Practical implicationsThe authors were unable to judge the severity of how an ageing workforce impacts on workplace performance, as employers found it difficult to conceptualise and identify the impact of ageing from market and economic pressures.Social implicationsResulting from population ageing the workforce of many societies are becoming older, this will impact on workplace relations and the social identity of those over the age of 50 years.Originality/valueLittle research has been undertaken to assess workplaces awareness of, and how to adapt to, an ageing workforce, and research is required to inform and guide management strategy of employers.

The role of transport and telecommunications technology in the development of the Scottish Highlands and Islands Medical Service: a historical perspective.

The Highlands and Islands Medical Service (HIMS) was introduced across the Scottish Highlands and Islands region after the publication of the Dewar Report in 1913. It was the first state-funded medical service in the UK and one of the first in the world. The Dewar Committee recommended the establishment of HIMS following research into healthcare provision in the region, concluding that there was insufficient provision. Among Dewar's major findings were the lack of sufficient transport infrastructure, high transport costs and low availability, and the lack of telecommunication services. This historical study with current relevance has addressed the contribution of transport and telecommunication technologies to the overall success of the Highland and Islands Medical Service. We have considered the crucial role of developments in the transport and telecommunications industries in overcoming contemporaneous healthcare problems. Through the study of contemporary letters, newspaper articles and government reports, this study assesses whether the views expressed at the time agree with the central contention that automobiles and telecommunication services were essential to the success of HIMS. This study also assesses the parallels drawn between the problems faced by HIMS in the 1900s and modern-day rural healthcare providers. Automobile use allowed those in the Highlands and Islands to commute with far greater ease, indirectly allowing doctors and members of the healthcare team to travel to see patients further afield and in greater numbers due to reduced travelling time. Additionally, funds provided by other government departments as well as HIMS allowed telecommunication technology to develop in the region, resulting in improved communication between widely dispersed healthcare workers, thereby improving healthcare provision. Prior to the formation of HIMS, the Highlands and Islands region in Scotland struggled to provide sufficient health care to its residents. The formation of HIMS resulted in improved health care in the region while simultaneous developments in the transport and telecommunication industries occurred. Past scholars have established links between the transport and telecommunication industries and healthcare provision in several countries. This study has contributed to existing literature by providing an insight into the relationship between such services in the Highlands and Islands region as well as rural life in the early 1900s. To conclude, the development of the transport and telecommunications industries acted synergistically with HIMS to lead to success in provision of good health care in the region.

A place-based approach to population sustainability: Demographic and economic change at the local level in Fife, Scotland

Population sustainability is a prevalent yet nebulous concept within academic and policy debates surrounding the nature and consequences of demographic and economic change. This research seeks to add nuance to understandings of population sustainability in ageing societies. The fiscal challenges posed by population ageing mean that more and more states are implementing specific policies in response to it, with limited degrees of success thus far. This investigation examines place-based understandings of population sustainability on the part of local stakeholders in a region of Scotland, a country facing significant demographic challenges and which is enacting policy measures specifically aimed at promoting population sustainability. The findings suggest that the on-the-ground realities of population sustainability are nuanced and complex. As such, there is scope for greater attention to the diversity and complexities of population and economic change at the sub-national scale in broader academic conceptualisations of and policy responses to the increasingly pressing issue of population sustainability.

Occurrence of tick-borne pathogens in questing Ixodes ricinus ticks from Wester Ross, Northwest Scotland

BackgroundLyme borreliosis and other tick-borne diseases emerge from increased interactions between humans, other animals, and infected ticks. The risk of acquiring a tick-borne infection varies across space and time, so knowledge of the occurrence and prevalence of pathogens in ticks can facilitate disease diagnosis in a specific area and the implementation of mitigation measures and awareness campaigns. Here we identify the occurrence and prevalence of several pathogens in Ixodes ricinus ticks in Wester Ross, Northwest Scotland, a region of high tourism and tick exposure, yet data-poor in terms of tick-borne pathogens.MethodsQuesting I. ricinus nymphs (n = 2828) were collected from 26 sites in 2018 and 2019 and tested for the presence of tick-borne pathogens using PCR-based methods. Prevalence was compared with other regions of Scotland, England, Wales, and the Netherlands.ResultsAnaplasma phagocytophilum (4.7% prevalence), Borrelia burgdorferi sensu lato (s.l.) (2.2%), Babesia from clade X (0.2%), Rickettsia helvetica (0.04%), and Spiroplasma ixodetis (0.4%) were detected, but no Neoehrlichia mikurensis, Borrelia miyamotoi, or Babesia microti. Typing of A. phagocytophilum using a fragment of the GroEL gene identified the presence of both ecotype I and ecotype II. Genospecies identification of Borrelia burgdorferi s.l. revealed B. afzelii (53% of infected nymphs), B. garinii (9%), B. burgdorferi sensu stricto (7%), and B. valaisiana (31%). We found similar prevalence of A. phagocytophilum in Wester Ross as in the Netherlands, but higher than in other parts of Great Britain. We found lower B. burgdorferi s.l. prevalence than in England or the Netherlands, and similar to some other Scottish studies. We found higher prevalence of B. valaisiana and lower prevalence of B. garinii than in other Scottish studies. We found S. ixodetis at much lower prevalence than in the Netherlands, and R. helvetica at much lower prevalence than in England and the Netherlands.ConclusionsAs far as we know, this is the first description of S. ixodetis in Great Britain. The results are relevant for disease surveillance and management for public and veterinary health. The findings can also aid in designing targeted public health campaigns and in raising awareness among outdoor recreationists and professionals.Graphical abstract

The Dialect Features and Distinguish Approach of Scottish English (Note 1)

If standard official language is a glass of water, the dialect is like soup with a flavor of your hometown. The locals in Scotland pride themselves on speaking English with a Scottish accent, but its obscurity always leaves us at a loss. In order to understand Scottish English dialects better, this article first briefly analyzes the language classification in Scotland. Then, using empirical research methods, interviews with the 10 most representative speakers of Scottish English dialects are selected from the eight regions of Scotland. The audio is used as a research corpus. The corpus is 49 minutes and 17 seconds long, with a total number of 9293 words. It focuses on the analysis of the accent, vocabulary, and grammatical structure of the Scottish English dialect. Finally, suggestions are made on Scottish English listening and discerning ability training.

De]-Centering the Victim: Police Perceptions of Victims of Sexual Violence through a Comparative Lens of Evidence Collection and Processing

Police are central to the statutory response to sexual violence, shaping the direction an investigation may take. Evidence provided by victims is also key to the processing of sexual assault cases. From a 2013 comparative qualitative study involving interviews with police officers in one province in Canada ( n = 11) and one region in Scotland ( n = 10) who investigate such cases, we discovered striking unanticipated differences between the two groups in terms of how they perceived victims and the evidence they provide. This paper presents a thematic analysis of these data and considers possible implications and explanations.