NHS Grampian is an NHS board which forms one of the fourteen regional health boards of NHS Scotland. It is responsible for proving health and social care services to a population of over 500,000 people living in Aberdeen, Aberdeenshire and Moray.NHS Grampian is also very closely linked with both the University of Aberdeen and The Robert Gordon University, especially in the fields of research, workforce planning and training.
PurposeThis study explored the experiences and perceptions of people with post-stroke communication disorders who had attempted or were attempting to return to work.Materials and methodsEleven participants (4 male, 7 female, mean age 57.7 +/- 6.36 years) who were an average of 6.55 (+/- 6.14) months post-stroke took part in semi-structured interviews. Data were analysed using reflexive thematic analysis.ResultsFive themes were generated. These were: (i) the reality of planning and actualising a return to work at different time-points during stroke recovery; (ii) intrapersonal barriers, including communication and cognitive impairments; (iii) external barriers, including lack of information or advice from healthcare professionals and lack of support or understanding from employers; (iv) intrapersonal facilitators, including personal attributes and use of strategies; and (v) external facilitators, including support from individual healthcare professionals, employers, colleagues and peers.ConclusionReturning to work with post-stroke communication disorders can be a challenging journey, with a number of potential barriers and facilitators. One of the major barriers is a lack of specialist and/or cohesive support for people with post-stroke communication disorders who wish to return to work. There is therefore a need for interventions designed specifically to facilitate return to work for this group.
In recent years there have been exciting developments in the diagnosis and treatment of mild cognitive impairment and dementia due to Alzheimer's disease. Robust biomarkers and potentially disease modifying therapies are now available, with multiple other agents in clinical trials alongside on-going validation studies of blood-based biomarkers. Recent and probable future developments in the diagnosis and care of people with Alzheimer's disease pathology warrants serious re-evaluation of the structure and function of cognitive clinical services. Here we report recommendations from the November 2024 Brain Health Scotland roundtable discussion of opportunities and challenges for modern memory services.
Metabolic dysfunction-associated steatohepatitis (MASH), a potentially progressive form of metabolic dysfunction-associated steatotic liver disease (MASLD), increases risk of fibrosis progression, cirrhosis, and liver-related and cardiometabolic morbidity. The first licensed pharmacotherapies, resmetirom and semaglutide, mark a shift in management but practical guidance for real-world implementation is lacking. The British Association for the Study of the Liver and British Society of Gastroenterology MASLD special interest group developed consensus recommendations on patient selection, lifestyle management, and follow-up for MASLD-MASH-specific pharmacotherapy. 37 participants participated in a Delphi process where draft statements developed in working groups were anonymously rated, discussed, and refined. Consensus (≥80% agreement) was reached for 49 statements. The group agreed on the following general recommendation. Two-step non-invasive tests, including the Fibrosis-4 index and vibration-controlled transient elastography, are recommended to identify patients with presumed stage F2-F3 fibrosis (ie, at-risk MASH). Individuals with liver stiffness more than 10 kPa but without evidence of cirrhosis should be considered eligible for treatment. Lifestyle behaviour change intervention should accompany pharmacological treatment, delivered by suitably trained practitioners without delaying access to medication. Treatment discontinuation is advised with evidence of disease progression, cirrhosis development, or drug-induced liver injury. These recommendations offer pragmatic guidance to clinicians and consensus clinical opinion to regulatory bodies to support equitable and effective use of new MASLD-MASH therapies.
BACKGROUND:There has been little examination of rural-urban residency and cancer screening. We investigated rural-urban variations in breast, cervical, and colorectal cancer screening uptake across Scotland. METHODS:Using aggregate data and cross-sectional analyses, we calculated uptake and detection rates (breast and bowel screening). We modelled uptake by urban and rural residency, age group, sex (bowel screening only), year, health board, and deprivation using multivariable logistic regression with appropriate interaction terms. RESULTS:Cervical screening uptake was higher in rural than urban areas (under 50s: 75.9% vs. 69.1%; 50+: 77.5% vs. 75.3%). Mammography uptake was: 77.0% in rural; 71.0% in urban areas. Bowel screening uptake was: 56.6% in urban; 62.5% in rural areas. In multivariable models, two-way interaction effects between residency and deprivation, and between residency and health board, were statistically significant (P < .05). Rural residency did not confer universally higher uptake. Breast and bowel cancer detection were similar in both areas. CONCLUSIONS:The relationship between residence and cancer screening uptake varied across Scotland. Uptake patterns were complex and not consistent across all rural areas, likely reflecting Scotland's topography and characteristics of the screening eligible. Efforts to improve screening uptake would likely benefit from local rather than national public health policies.
