A scoping review of academic and grey literature on migrant health research conducted in Scotland

BACKGROUND

Migration to Scotland has increased since 2002 with an increase in European residents and participation in the Asylum dispersal scheme. Scotland has become more ethnically diverse, and 10% of the current population were born abroad. Migration and ethnicity are determinants of health, and information on the health status of migrants to Scotland and their access to and barriers to care facilitates the planning and delivery of equitable health services. This study aimed to scope existing peer-reviewed research and grey literature to identify gaps in evidence regarding the health of migrants in Scotland.

METHODS

A scoping review on the health of migrants in Scotland was carried out for dates January 2002 to March 2023, inclusive of peer-reviewed journals and grey literature. CINAHL/ Web of Science/SocIndex and Medline databases were systematically searched along with government and third-sector websites. The searches identified 2166 journal articles and 170 grey literature documents for screening. Included articles were categorised according to the World Health Organisation's 2016 Strategy and Action Plan for Refugee and Migrant Health in the European region. This approach builds on a previously published literature review on Migrant Health in the Republic of Ireland.

RESULTS

Seventy-one peer reviewed journal articles and 29 grey literature documents were included in the review. 66% were carried out from 2013 onwards and the majority focused on asylum seekers or unspecified migrant groups. Most research identified was on the World Health Organisation's strategic areas of right to health of refugees, social determinants of health and public health planning and strengthening health systems. There were fewer studies on the strategic areas of frameworks for collaborative action, preventing communicable disease, preventing non-communicable disease, health screening and assessment and improving health information and communication.

CONCLUSION

While research on migrant health in Scotland has increased in recent years significant gaps remain. Future priorities should include studies of undocumented migrants, migrant workers, and additional research is required on the issue of improving health information and communication.

Searching for a Solar Source of Magnetic-Field Switchbacks in Parker Solar Probe's First Encounter

Parker Solar Probe observations show ubiquitous magnetic-field reversals closer to the Sun, often referred to as "switchbacks". The switchbacks have been observed before in the solar wind near 1 AU and beyond, but their occurrence was historically rare. PSP measurements below ∼ 0.2 AU show that switchbacks are, however, the most prominent structures in the "young" solar wind. In this work, we analyze remote-sensing observations of a small equatorial coronal hole to which PSP was connected during the perihelion of Encounter 1. We investigate whether some of the switchbacks captured during the encounter were of coronal origin by correlating common switchback in situ signatures with remote observations of their expected coronal footpoint. We find strong evidence that timescales present in the corona are relevant to the outflowing, switchback-filled solar wind, as illustrated by strong linear correlation. We also determine that spatial analysis of the observed region is optimal, as the implied average solar-wind speed more closely matches that observed by PSP at the time. We observe that hemispherical structures are strongly correlated with the radial proton velocity and the mass flux in the solar wind. The above findings suggest that a subpopulation of the switchbacks are seeded at the corona and travel into interplanetary space.

Feline acromegaly: an underdiagnosed endocrinopathy?

BACKGROUND

Feline acromegaly has been reported infrequently in the veterinary literature and current knowledge of this endocrinopathy is based on limited numbers of animals with relatively advanced clinical signs.

HYPOTHESIS

This study was undertaken to screen diabetic cats for the presence of acromegaly.

ANIMALS

Diabetic cats with variable control examined by general practitioners in the United Kingdom.

METHODS

Blood samples were screened for the possible presence of acromegaly with basal serum concentrations of insulin-like growth factor 1 (IGF-1) and, when available, feline growth hormone (fGH). In patients with markedly increased IGF-1 concentrations intracranial computed tomography (CT) was offered, and in selected cats additional imaging was performed.

RESULTS

IGF-1 was determined in 184 variably controlled diabetic cats; 59 cats had markedly increased IGF-1 concentrations (>1,000 ng/mL; reference interval, 208-443 ng/mL). Eighteen cats subsequently were examined, and acromegaly was confirmed in 17 cats. Notable findings included absence of a detectable pituitary mass lesion in some affected cats regardless of whether CT or magnetic resonance imaging (MRI) was used. Hypertension was not found to be a complication in the evaluated cats and respiratory stridor was more prevalent than previously reported.

CONCLUSIONS AND CLINICAL IMPORTANCE

Measurement of IGF-1, growth hormone (GH), or both is useful in the diagnosis of acromegaly in cats.

Validation and application of a radioimmunoassay for ovine growth hormone in the diagnosis of acromegaly in cats

The validity of an ovine growth hormone (OGH) assay for the detection of feline growth hormone (FGH) was demonstrated by the parallel displacement of radiolabelled OGH by standard concentrations of OGH and serial dilutions of pooled FGH-rich serum. The minimum detectable limit of the assay was 1.67 microg/l. The mean (sd) basal fasting FGH level in 19 non-acromegalic, non-diabetic cats aged two to 16 years was 4.01 (1.38) microg/l (range 1.87 to 6.33); 19 acromegalic cats had significantly higher FGH levels (range 8.45 to 33.2 microg/l). There were no significant differences in the FGH levels measured when aprotinin was added to the samples or when plain serum and serum gel separation tubes were used for blood collection, but the FGH levels were significantly higher when the samples were collected into EDTA. There were also no significant differences between the concentrations of FGH measured in samples in which the separation of the serum and storage had been delayed by 24 hours, or in samples that had been stored for up to four weeks at -20 degrees C.

The Scottish multi-centre prospective study of bronchoscopy for bronchial carcinoma and suggested audit standards

Fibre-optic bronchoscopy is widely used to diagnose bronchial carcinoma. There is considerable variation in techniques for patient sedation, methods of obtaining samples and histopathological yield. We wished to examine variations in practice in different centres throughout Scotland and derive realistic audit standards for best clinical practice from these results. Diagnostic bronchoscopies from five centres were included. Patient details, grade of individual performing the test, endobronchial abnormalities, specimens taken and the histocytological yield were recorded. A patient satisfaction questionnaire was completed. One thousand eight hundred and two bronchoscopies were performed to look for bronchial carcinoma. Sedation and anaesthesia techniques varied considerably between centres. There were marked differences in patient satisfaction between centres. Nearly twice as many females as males would prefer not to have bronchoscopy repeated. Six hundred and fifty-eight carcinomas were confirmed by histocytology. Yield was unaffected by the grade of doctor performing bronchoscopy. Improving yield may be achieved by increasing the number of sampling techniques employed and changing the order in which specimens are taken (biopsies first and washings last). Eighty-seven percent of endoscopically visible tumours were confirmed histocytologically. There was a considerable variation in histological spectra between centres that may relate to differences in pathological interpretation rather than actual differences in case mix. Suggested audit standards are discussed. This study demonstrates the variety of techniques and also the levels of histocytological yield and patient satisfaction that can be achieved. Provisional standards of practice for this procedure have been agreed with a view to auditing performance against these. It is hoped that centres will adopt the methods that are shown to achieve the highest standards.

Surgical treatment of intrahepatic portosystemic shunts in six cats

The surgical treatment of intrahepatic portosystemic shunts in six cats is described. The preoperative diagnoses were based on the results of abdominal ultrasonography, and mesenteric portography was used during surgery to confirm the diagnosis and establish the morphology of the shunting vessel. In four of the cats the shunt vessel passed through the left division of the liver, compatible with a patent ductus venosus (PDV), in one cat the shunt passed through the central hepatic division and in the other cat it passed through the right hepatic division. During surgery the shunt vessel was manipulated directly either intrahepatically, or post hepatically in the four cats with PDV. In five cats the shunt vessel was partially ligated, and in the other the vessel was completely ligated. The attenuation procedure produced a mean increase in mesenteric venous pressure of 17 cm H2O, with a range from 14 to 20 cm. All the cats recovered from the surgical procedure, but one developed neurological signs shortly after the operation and died from respiratory failure. Four of the cats were clinically normal and required no medication by one month after the operation. One cat required long-term medication to control its continued clinical signs.

Intestinal permeability and function in dogs with small intestinal bacterial overgrowth

Small intestinal bacterial overgrowth (SIBO) has been reported to occur commonly in dogs with signs of chronic intestinal disease. There are usually few intestinal histological changes, and it is uncertain to what extent bacteria cause mucosal damage. The aim of this study was to apply a differential sugar absorption test for intestinal permeability and function to the objective assessment of intestinal damage in dogs with SIBO. Studies were performed on 63 dogs with signs of chronic small and, or, large bowel disease, in which SIBO (greater than 10(5) total or greater than 10(4) anaerobic colony forming units/ml) was diagnosed by quantitative culture of duodenal juice obtained endoscopically. None of the dogs had evidence of intestinal pathogens, parasites, systemic disease or pancreatic insufficiency. differential sugar absorption was performed by determining the ratios of urinary recoveries of lactulose/rhamnose (L/R ratio, which reflects permeability) and D-xylose/3-O-methylglucose (X/G ratio, which reflects intestinal absorptive function) following oral administration. Dogs with SIBO comprised 28 different breeds, including 13 German shepherd dogs. SIBO was aerobic in 18/63 dogs (29 per cent), and anaerobic in 45/63 (71 per cent). Histological examination of duodenal biopsies showed no abnormalities in 75 per cent, and mild to moderate lymphocytic infiltrates in 25 per cent of the dogs. The L/R ratio was increased (greater than 0.12) in 52 per cent, and the X/G ratio reduced (less than 0.60) in 33 per cent of the dogs. Differential sugar absorption was repeated in 11 dogs after their four weeks of oral antibiotic therapy. The L/R ratio declined in all 11 dogs (mean +/- SD pre: 0.24 +/- 0.14; post: 0.16 +/- 0.11; P < 0.05), but changes in the X/G ratio were more variable. These findings show that SIBO is commonly associated with mucosal damage not detected on histological examination of intestinal biopsies, and that changes in intestinal permeability following oral antibiotics may be used to monitor response to treatment.

Effect of buffer pH and peptide composition on the selectivity of peptide separations by capillary zone electrophoresis

A series of 10 synthetic peptides containing varying degrees of charge and hydrophobicity was used to study the effects of peptide composition and buffer pH on the selectivity of separations by capillary zone electrophoresis (CZE). A simple model is used to explain the effect of buffer pH on the separation. It was found that pH is an important parameter affecting the selectivity of CZE separations. Furthermore, it is shown that the selectivity of the separation is such that peptides differing in neutral amino acid composition can be resolved, and that even differences in a peptide's amino acid sequence can be detected. A protease digest of beta-lactoglobulin A is shown as a practical example of a separation of a complex peptide mixture.

Neonaticide, infanticide and child homicide

A total population study of neonaticide, infanticide and child homicide is reported. There are seven defineable syndromes of unlawful child killing which include: neonaticide, infanticide, non-accidental injury, the deprivation-starvation syndrome, euthanasia, killing of family members followed by the suicide of the killer, and child murder. 49 such cases are reported from a base population of 2 million people, over a 10-year period of investigation. The syndromes of neonaticide and non-accidental injury each contribute some 20 per cent of cases in the full spectrum of unlawful child killing. 18 cases of fatal non-accidental injury were reported over this time. With modern crisis intervention facilities, standard hospital rules for the management of acute cases of non-accidental injury, and co-ordinated child abuse centres, approximately 2 per cent only of non-accidental injury cases should come to a fatal conclusion.

Who accepts first aid training?

The percentage of individuals trained in first aid skills in the general community is inadequate. We report here a study to investigate factors which influence motivation to accept voluntary training in first aid. A group of 700 randomly selected owners of inground swimming pools (a parental high-risk group) was offered a course of formal first aid instruction. Nine per cent attended the offered training course. The time commitment involved in traditional courses (eight training nights spread over four weeks) is not a deterrent, the same percentage accepting such courses as that who accept a course of one night's instruction. Cost is an important deterrent factor, consumer resistance rising over 15 cost units (one cost unit = the price of a loaf of bread). The level of competent first aid training within the community can be raised by (a) keeping to traditional course content, but (b) by ensuring a higher acceptance rate of first aid courses by a new approach to publicity campaigns, to convince prospective students of the real worth of first aid training. Questions concerning who should be taught first aid, and factors influencing motivation, are discussed.