Chronic lymphocytic leukaemia in 2020: the future has arrived

Purpose of Review Chronic lymphocytic leukaemia is now recognised as a heterogenous disease with a variety of clinical outcomes. Here we summarise the way it is currently stratified according to genetic risk and patient characteristics and the treatment approaches used for these different subgroups. Recent Findings Certain patients appear to sustain MRD negativity after combination chemoimmunotherapy, leading to the suggestion that their CLL may be cured. However, 17p-deleted, p53-mutated or IGHV-UM subgroups are generally resistant to FCR, and much better responses are seen with ibrutinib and venetoclax, frequently inducing MRD negativity that hopefully will be translated into durable remissions. Summary Small molecule inhibitors have already revolutionised CLL treatment. Going forward, we anticipate their use in the majority of patients, early after diagnosis and with curative intent

How men and women learn about sex: multi-generational perspectives on insufficient preparedness and prevailing gender norms in Scotland

Attitudes towards sexual health and relationships are learned from a young age, and there is an ongoing need for innovative and comprehensive approaches to sex education that keep pace with rapidly changing contexts of people’s lives. We used thematic analysis of data from two qualitative studies in Scotland to explore learning contexts from a multi-generational perspective, as well as the influence of different socio-cultural factors on provision, access to and experience of sex education. The importance, but inadequacy, of school as a source of learning, was a persistent theme over time. Participants’ strategies to address perceived gaps in knowledge included experience, conversations, vicarious and online learning. Gender and age differences emerged, with younger participants more likely to go online for information, and prevailing gender norms shaping attitudes and behaviours across both study groups. Participants who identified as gay, lesbian or bisexual described feeling particularly unprepared for sex and relationships due to the narrow, heteronormative content received. Although schools continue to be a common source of information, it appears that they fail to equip young people for their post-school sexual life-course. We recommend the mandatory provision of comprehensive, positive, inclusive and skills-based learning to improve people’s chances of forming and building healthy, positive relationships across the lifespan

Unpacking Support Types in Online Health Communities: An Application of Attraction-Selection-Attrition Theory

Online communities are increasingly becoming part of the healthcare ecosystem, as they allow patients, family members and carers to connect and support each other at any time and from any location. This support can take many forms, including information, advice, esteem support and solidarity. Prior research has identified the Attraction-Selection-Attrition Theory as a promising framework for modelling and explaining how participants join, participate, and leave organizations in general (and online communities specifically), and how the actions of individuals effect the organization as a whole. However, it has not previously been applied specifically to online health communities (i.e. those that focus on physical and/or mental health). We propose to gather empirical evidence from a large online community that provides support for Australians effected by cancer. In doing so, we hope to develop evidence-based policies and procedures for growing, maintaining and moderating these communities

International Scotland : an Update Following Ministerial Events & Engagement

At the start of 2022, international law firm CMS teamed up with the Fraser of Allander Institute on a thought leadership campaign, under the theme 'International Scotland'. Throughout March and April 2022, the institute undertook a series of non-attributed interviews with11 CMS partners to influence and shape this research. These interviews explored with partners the issues related to the topics of International Scotland and provided direction for analysis. In November 2022, the Institute published an analytical report setting out the evidence base of Scotland on the international stage and reflecting on the key barriers and enablers of Scotland's global success

Reductions in ambulatory blood pressure in young normotensive men and women after isometric resistance training and its relationship with cardiovascular reactivity

Background: There has been very little published work exploring the comparative effects of isometric resistance training (IRT) on blood pressure (BP) in men and women. Most of the previously published work has involved men and used resting BP as the primary outcome variable. Early evidence suggests that IRT is particularly effective in older women and has a positive influence on ambulatory BP, a better predictor of disease risk. Objectives: With the WHO now placing global emphasis on the primary prevention of hypertension, the goals of this proof-of-concept study were to (i) examine whether sex differences exist in the ambulatory BP-lowering effects of IRT in young, normotensive men and women and (ii) determine whether these reductions can be predicted by simple laboratory stress tasks (a 2-min sustained isometric contraction and a math task involving subtracting a two-digit number from a series of numbers). Results: There were no differences in the IRT-induced reductions in 24-h (men: Δ4 mmHg, women: Δ4 mmHg), daytime (men: Δ3 mmHg, women: Δ4 mmHg), or night-time (men: Δ4 mmHg, women: Δ3 mmHg) ambulatory BP in men (n=13) and women (n=11) (P0.05). Conclusion: Our data suggest that lower ambulatory BP can be achieved, to a similar magnitude in young healthy women as well as men, with IRT; however, the BP-lowering effectiveness cannot be predicted by systolic BP reactivity. Taken together, this work heralds a potentially novel approach to the primary prevention of hypertension in both men and women and warrants further investigation in a larger clinical outcome trial

EVALUATING EXTENSIVE SHEEP FARMING SYSTEMS

Data from each of 5 commercial, extensive sheep farms in Cumbria, UK were used as parameters in a linear program (LP) representing labour and grazing management in such farming systems. The LP maximised ewe enterprise gross margin subject to constraints dictated by the labour availability and land types on each farm. Under the assumptions used, labour availability and price restricted ewe numbers well below those observed in practice on 2 farms i.e. land resources were adequate for the farming system practiced. On two other farms stocking levels and hence returns were limited by the availability of forage and hence feed input prices relative to output. On one farm, greater grassland productivity was the key determinant of system performance. It was concluded that a holistic systems approach was needed to properly evaluate these farming systems in terms of their potential contribution to animal welfare, land use, profit and hence their sustainabilityLivestock Production/Industries, Extensive, Sheep, Economics, LP,

The Contribution of Medical Research Funding by Charities to the Scottish Economy

Third sector medical research plays an important role both in the Scottish economy and society. Medical research makes huge contributions to society through developing new treatments, improving existing ones and advancing technologies that can help save lives, such as vaccines that help to fight against infectious diseases like Covid-19.  Charities are major funders of medical research in Scotland. Medical research funding by charities has been estimated to be 46% of all third sector and public funding of medical research in Scotland, with active research funding of £122m in 2018. Without charities funding medical research and development in Scotland, the government and other public bodies would need to increase direct funding by 73%to make up for the shortfall.  Our findings in the accompanying report show that medical research funded by charities has grown since 2014 in Scotland, with a fall in funding in 2020 due to the pandemic

25 Years of the Scottish Business Monitor

Launched in 1998 and now in its 25th year, the Scottish Business Monitor is one of Scotland’s preeminent trackers of business sentiment and activity. The Scottish business survey is compiled by the Fraser of Allander Institute, an independent economics research institute at the University of Strathclyde, and is produced in partnership with Addleshaw Goddard, an international law firm. Over 25 years, Scotland has experienced many ups and downs, with economic crises and periods of growth influenced by domestic and global economic conditions. Today, Scotland finds itself in yet another difficult economic period, following years of turmoil for businesses, including the UK's exit from the European Union, COVID-19, and now the cost-of-doing business crisis. Despite these unprecedented challenges, the Scottish business base continues to show significant resilience. In celebration of 100 business monitors, this report looks at the past 25 years of business in Scotland, highlighting how Scottish firms have coped with significant changes in the economic landscape, and analysing key business indicators

New Horizons in Supporting Older People’s Health and Wellbeing: Is Social Prescribing a Way Forward?

Older people’s health and care needs are changing. Increasing numbers live with the combined effects of age-related chronic illness or disability, social isolation and/or poor mental health. Social prescribing has potential to benefit older people by helping those with social, emotional or practical needs to access relevant services and resources within the local community. However, researchers have highlighted limitations with the existing evidence-base, while clinicians express concerns about the quality of onward referral services, liability and upfront investment required. The current article provides a critical review of evidence on social prescribing, drawing on the RE-AIM Framework (Glasgow et al., 1999) to identify questions that will need to be addressed in order to inform both the design and delivery of services and the evolving research agenda around social prescribing. We emphasise the need for researchers and planners to work together to develop a more robust evidence-base, advancing understanding of the impacts of social prescribing (on individuals, services and communities), factors associated with variation in outcomes and strategies needed to implement effective and sustainable programmes. We also call on policymakers to recognise the need for investment in allied initiatives to address barriers to engagement in social prescribing programmes, provide targeted support for carers and improve access to older adult mental health services. We conclude that social prescribing has potential to support older people’s health and wellbeing, but this potential will only be realised through strategic alignment of research, local level implementation and national policy and investment

Scottish Business Monitor : 2022 Q3

This report summarises the key results from our latest Fraser of Allander (FAI) Scottish Business Monitor, published in partnership with Addleshaw Goddard. The survey sampled 400 firms in July from across the Scottish economy. The survey examined business sentiment in the second quarter of 2022 and the outlook and expectations throughout 2022. Our survey results indicate that businesses in Scotland were seeing some glimmers of hope in the second quarter of 2022, but while overall sentiment remains positive its level has fallen amid challenging conditions. The report finds that two-thirds of firms now expect growth in the Scottish economy to be weak, up from less than half of firms in the first quarter of the year