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The COVID-19 pandemic significantly impacted mental health, health-related behaviours such as drinking and illicit drug use and the accessibility of health and social care services. How these pandemic shocks affected 'despair'-related mortality in different countries is less clear. This study uses public data to compare deaths from alcohol, drugs and suicide in the United States and the United Kingdom to identify similarities or differences in the impact of the pandemic on important non-COVID causes of death across countries and to consider the public health implications of these trends. Data were taken from publicly available mortality figures for England and Wales, Northern Ireland, Scotland and the United States of America, 2001–2021, and analysed descriptively through age-standardised and age-specific mortality rates from suicide, alcohol and drug use. Alcohol-specific deaths increased in all countries between 2019 and 2021, most notably in the United States and, to a lesser extent, England and Wales. Suicide rates did not increase markedly during the pandemic in any of the included nations. Drug-related mortality rates rose dramatically over the same period in the United States but not in other nations. Mortality from 'deaths of despair' during the pandemic has displayed divergent trends between causes and countries. Concerns about increases in deaths by suicide appear to have been unfounded, whereas deaths due to alcohol have risen across the United Kingdom and in the United States and across almost all age groups. Scotland and the United States had similarly high levels of drug-related deaths pre-pandemic, but the differing trends during the pandemic highlight the different underlying causes of these drug death epidemics and the importance of tailoring policy responses to these specific contexts. [ABSTRACT FROM AUTHOR]

The research goals were to obtain an understanding of who the users of e‐books in the NHS are, what they are using e‐books for, and when and how they use them. This article presents the methodology used and the findings from the research. It also explores the outputs and next steps from the research, both for the individual countries and collectively. The Five Nations group, (library leads in England, Northern Ireland, Ireland, Scotland and Wales) commissioned research into healthcare staff use and non‐use of e‐books to understand the behaviours, needs and expectations of healthcare staff and to identify shared challenges around e‐books to inform policy and practice. [ABSTRACT FROM AUTHOR]

Background and aims: Mortality and drug treatment data suggest that the median age of people who inject drugs is increasing. We aimed to describe changes in the characteristics of people injecting drugs in the United Kingdom (UK). Design: Repeat cross‐sectional surveys and modelling. Setting: Low‐threshold services in the United Kingdom such as needle and syringe programmes. Participants: A total of 79 900 people who recently injected psychoactive drugs in the United Kingdom, recruited as part of the Unlinked Anonymous Monitoring Survey (England, Wales, Northern Ireland, 1990–2019) and Needle Exchange Surveillance Initiative (Scotland, 2008–2019). Measurements Age of people currently injecting, age at first injection, duration of injecting (each 1990–2019) and estimates of new people who started injecting (1980–2019). Findings In England, Wales and Northern Ireland between 1990 and 2019, the median age of people injecting increased from 27 (interquartile range [IQR], 24–31) to 40 (IQR, 34–46); median age at first injection increased from 22 (IQR, 19–25) to 33 (IQR, 28–39); and median years of injecting increased from 7 (IQR, 3–11) to 18 (IQR, 9–23). Values in Scotland and England were similar after 2008. The estimated number that started injecting annually in England increased from 5470 (95% prediction interval [PrI] 3120‐6940) in 1980 to a peak of 10 270 (95% PrI, 8980‐12 780) in 1998, and then decreased to 2420 (95% PrI, 1320‐5580) in 2019. The number in Scotland followed a similar pattern, increasing from 1220 (95% PrI, 740–2430) in 1980 to a peak of 3080 (95% PrI, 2160–3350) in 1998, then decreased to a 270 (95% PrI, 130–600) in 2018. The timing of the peak differed between regions, with earlier peaks in London and the North West of England. Conclusions: In the United Kingdom, large cohorts started injecting psychoactive drugs in the 1980s and 1990s and many still inject today. Relatively few people started in more recent years. This has led to changes in the population injecting drugs, including an older average age and longer injecting histories. [ABSTRACT FROM AUTHOR]

Background: In 2010, a national enquiry into elderly patient outcomes after surgery identified that only 36% received 'good' care. Guidance was subsequently published by the Association of Anaesthetists of Great Britain and Ireland regarding perioperative care of the elderly and those with dementia; this study aims to assess current adherence to these guidelines in anaesthetic departments across Scotland. Methods: A web-based survey was sent to all Scottish departments. The questions assessed department patient demographic, access to specialist pre-assessment services, availability of multidisciplinary input, perioperative care of patients with cognitive impairment and departmental training on geriatric perioperative care. Results: Responses were collected from November-December 2020 with a 92.6% response rate. A total of 64% of departments stated that > 50% of their workload involved patients over 75. One department had a lead clinician for geriatric anaesthesia, whilst 20% could access a geriatric specialist when coordinating perioperative care. Specialist geriatric pre-assessment services operate in 20% of centres. A total of 60% of respondents used a clinical frailty score when pre-assessing patients over 75, with 48% specifically screening for cognitive impairment. The vast majority of centres, 76%, did not routinely provide information regarding post-operative delirium and 24% 'never or very rarely' invite caregivers to accompany patients with dementia into the department. Education sessions regarding perioperative elderly care had occurred in 56% of departments. Conclusions: Elderly patients represent a significant proportion of anaesthetic workload in Scotland. Despite this, adherence to recommended practice is low. The vast majority of centres lack access to specialist multidisciplinary input or specialist pre-assessment services which are essential to providing good care. Reported screening for frailty and cognitive impairment is variable, with opportunities for improvement in communication and education (patient and clinician) surrounding these conditions. [ABSTRACT FROM AUTHOR]

Background: In 2010, a national enquiry into elderly patient outcomes after surgery identified that only 36% received 'good' care. Guidance was subsequently published by the Association of Anaesthetists of Great Britain and Ireland regarding perioperative care of the elderly and those with dementia; this study aims to assess current adherence to these guidelines in anaesthetic departments across Scotland. Methods: A web-based survey was sent to all Scottish departments. The questions assessed department patient demographic, access to specialist pre-assessment services, availability of multidisciplinary input, perioperative care of patients with cognitive impairment and departmental training on geriatric perioperative care. Results: Responses were collected from November-December 2020 with a 92.6% response rate. A total of 64% of departments stated that > 50% of their workload involved patients over 75. One department had a lead clinician for geriatric anaesthesia, whilst 20% could access a geriatric specialist when coordinating perioperative care. Specialist geriatric pre-assessment services operate in 20% of centres. A total of 60% of respondents used a clinical frailty score when pre-assessing patients over 75, with 48% specifically screening for cognitive impairment. The vast majority of centres, 76%, did not routinely provide information regarding post-operative delirium and 24% 'never or very rarely' invite caregivers to accompany patients with dementia into the department. Education sessions regarding perioperative elderly care had occurred in 56% of departments. Conclusions: Elderly patients represent a significant proportion of anaesthetic workload in Scotland. Despite this, adherence to recommended practice is low. The vast majority of centres lack access to specialist multidisciplinary input or specialist pre-assessment services which are essential to providing good care. Reported screening for frailty and cognitive impairment is variable, with opportunities for improvement in communication and education (patient and clinician) surrounding these conditions. [ABSTRACT FROM AUTHOR]