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This paper considers the extent to which people drinking at harmful levels responded to minimum unit pricing (MUP) in Scotland in the way they, family members and those providing services anticipated they would. It examines data taken from a larger evaluation of the impact of MUP on people who are drinking at harmful levels. Qualitative interview data, (utilizing interviews and focus groups, with individuals, treatment services, and family members) was generated prior to the implementation of MUP in Scotland to provide insights into anticipated responses and comparable data generated across an extended 19-month period post-implementation and provided insights into actual responses. Overall, the data showed consistency between anticipated and actual responses, with fewer differences observed. In line with anticipated responses, many drinkers switched from cheap, strong ciders to other alcohol products, notably vodka. They consistently responded to the decrease in alcohol affordability by utilizing existing behavior such as managing finances and prioritizing spends on alcohol, including borrowing money, foregoing essentials, and using savings. There was less evidence of anticipated harmful consequences of MUP occurring, such as increased crime, switching to other drugs, or examples of acute withdrawal. Drinkers and those living and working with them, have a good command of how alcohol affordability is maintained or impacts on expenditure and other choices, and how they respond to any decrease in affordability including the introduction of minimum price policies. [ABSTRACT FROM AUTHOR]

Family group conferences (FGCs) in child welfare share decision-making with family members by bringing the immediate and wider family together to make a plan to meet a child's needs. This paper reports survey findings on FGC provision in the UK in 2022 and explores whether in England the presence of an FGC service and the rate of FGC provision is associated with the rate of children in care, entering care, in kinship foster care and leaving care. Seventy-nine per cent (n  = 167) of local authorities in the UK provided FGCs to families, and 14 per cent (n  = 29) did not. Services that were more established offered a more diverse range of FGCs. The introduction of FGCs in English local authorities was associated with a higher rate of children in care, but also higher rates of kinship foster care, a key goal of FGCs where it is not possible for children to stay with their parents. Higher rates of FGCs were associated with more children leaving care, possibly due to reunification with birth families. To understand in more detail, the circumstances of children in and leaving care in local authorities with FGCs, individual data linkage studies are needed. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to uncover perspectives on the COVID‐19 pandemic and the responses implemented by the UK and Scottish Governments to help control the spread of infection. Such understanding could help to inform future responses to pandemics at individual, community and national levels. Method: Q methodology was used to elicit perspectives from people in England and Scotland with different experiences of the pandemic including public health officials, key workers, those on furlough, those who were unvaccinated or vaccinated to different levels, those who were 'shielding' because they were at higher risk and people with different scientific expertise. Participants rank‐ordered phrases about different aspects of COVID‐19 according to their viewpoint. Factor analysis was then conducted in conjunction with interview material from the same respondents. Results: A four‐factor solution was statistically supported and was interpretable alongside the qualitative accounts of participants loading on these factors. These four perspectives are titled Dangerous and Unaccountable Leadership, Fear and Anger at Policy and Public responses, Governing Through a Crisis and Injustices Exposed. Conclusion: The four perspectives demonstrate plurality and nuance in views on COVID‐19 and the associated policies and restrictions, going beyond a binary narrative that has been apparent in popular and social media. The four perspectives include some areas of common ground, as well as disagreement. We argue that understanding the detail of different perspectives might be used to build cohesion around policy initiatives in future. Patient or Public Contribution: The development of the statement set, which is rank‐ordered by participants in a Q study, and factor interpretations were informed by views of the general public. The statement set was initially developed using existing publicly available material based on members of the general public experiencing the pandemic first hand. It was then piloted with members of the public experiencing different challenges as a result of COVID‐19 and the subsequent lockdown and updated based on feedback. Finally, interpretations of the identified factors were presented publicly and edited according to their feedback. [ABSTRACT FROM AUTHOR]

Introduction: In the United Kingdom, fractures of the cervical dens process in older and/or frail patients are usually managed nonsurgically in a hard collar. However, hard collars can lead to complications and this management approach is now being questioned, with growing interest in maximising patients' short‐term quality‐of‐life. It is vital that patients' perspectives are considered; yet, there is a dearth of literature examining the aspect. To help inform wider decision‐making about use of collar/no collar management of dens fractures in older/frail people, we explored older/frail people's experience of the two management approaches and how they affected their perceived quality‐of‐life. Methods: We interviewed older and/or frail adults with a recent dens fracture (aged ≥65 years or with a clinical frailty score of ≥5) or their caregiver. Participants were recruited from both arms of a clinical trial comparing management using a hard collar for 12 weeks (SM) with early removal of the collar (ERC) and were interviewed following randomisation and again, 12–16 weeks later. Data were analysed using a framework approach. Results: Both participant groups (SM/ERC) reported substantial, negative quality‐of‐life (QoL) experiences, with the fall itself and lack of access to care services and information being frequent major contributory factors. Many negative experiences cut across both participant groups, including pain, fatigue, diminished autonomy and reduced involvement in personally meaningful activities. However, we identified some subtle, yet discernible, ways in which using SM/ERC reinforced or alleviated (negative) QoL impacts, with the perceived benefits/burdens to using SM/ERC varying between different individuals. Conclusion: Study findings can be used to support informed decision‐making about SM/ERC management of dens fractures in older/frail patients. Patient or Public Contribution: Public and patient involvement contributors were involved in the study design, development of interview topic guides and interpretation of study findings. [ABSTRACT FROM AUTHOR]

Background: In 2021, Scotland became the first UK country to launch a Women's Health Plan. This policy signals increasing commitment to broader ambitions surrounding gender equality in health. Research shows a connection between discrimination and health, representing a contributor to health inequalities. There remains sparse evidence on how certain groups experience discrimination that could be useful for policymaking. This research set out to address this evidence gap through exploring how discrimination shapes young women's experiences of mental health and inequalities in Scotland. Methods: We interviewed women aged 16-25 years (n=28), living in Scotland, UK, adopting an intersectional approach to recruitment and data analysis. We used a semi-structured topic guide to facilitate open discussion about discrimination and health. Transcripts were analysed by two researchers using Thematic Analysis and NVivo software. Findings: We identified three themes that illuminate intersectional discrimination and the impact on mental health. The first outlines how experiences of discrimination in school, work and public spaces (and the anticipation of such) creates stress leading to mental health problems, particularly for participants from ethnic minority groups. The second highlights the lack of support for mental health, both at structural and interpersonal levels, which was viewed by young women as a form of intersectional discrimination, largely because of their gender and age. Finally, we developed a mid-level theory termed the 'chain of dismissal' that displays that for both physical or mental health symptoms, young women's concerns are immediately "written off" as anxiety-related and in turn a natural attribute of young women. These themes show that discrimination has the potential to amplify mental health problems for young women and is a likely contributor to health inequalities. Conclusions: Structural disadvantages such as racism intersect with gender and age to compound the experience of discrimination for marginalised young women. To improve mental health and reduce health inequalities for young women, multi-level approaches are needed, with strong consideration of how the structural and cultural landscape as well as assumptions made by healthcare professionals have critical implications for young women's health. [ABSTRACT FROM AUTHOR]

Objective. To characterise cancer diagnosis in Scottish primary care in 2018/19 and draw comparisons with diagnostic activity in 2014. Methods. A national audit of cancer diagnosis undertaken in Scottish general practices. Participating GPs collected diagnostic pathway data on patients diagnosed with cancer in 2018/19 from medical records. These data were supplemented by linkage to the Scottish Cancer Registry and previous audit data from 2014. Analyses explored and compared patient demographics, presentation, diagnostic routes, and intervals. Results. Seventy-three practices submitted data on 2,014 cases in 2014 and 90 practices submitted data on 2,318 cases in 2018/2019. Individual demographics and types of cancer were similar. There was a higher proportion of USC (urgent suspected cancer) referrals in 2019 than 2014 (42.9% vs 38.1%, p = 0.008) but a similar proportion of emergency presentations (19.2% vs 20.4%). Primary care (median 4 (IQR 0–22) vs 5 (0–23)) and diagnostic intervals (27 (10–59) vs 30 (13–68)) were similar in both periods. Significantly fewer (24.5% vs 28.3, p = 0.015) had a diagnostic interval >60 days in 2019 than 2014. Harder to diagnose cancers were more likely to present as emergencies and be subject to prolonged delays in both cohorts. Conclusions. The 2014 and 2018/19 cohorts were broadly similar. There is limited evidence that USC use had increased between 2014 and 2018/19. Harder to diagnose cancers are still most likely to present as emergencies and be subject to delays. Overall, it seems there were small improvements in cancer diagnosis prepandemic and a further audit could examine evidence for a postpandemic recovery. [ABSTRACT FROM AUTHOR]