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PubMed2004

Fungi associated with shoots of silver birch (Betula pendula) in Scotland.

The fungi associated with diseased and healthy shoots of young, planted Betula pendula were studied at five sites in Scotland where crown die-back of birch is occurring. At each site, 30 diseased and 30 healthy shoots were sampled twice, with 1 yr-old shoots collected in May 2002, and 4-5-month-old shoots collected in September/October 2002. Overall, 34 different fungal species were recorded, with 92 % and 60 % of all diseased and healthy shoot pieces, respectively, colonised by at least one fungal species. The main colonisers of both diseased and healthy shoots were Melanconium bicolor, Discula betulina and Godronia urceolus, and the fungi most frequently found on diseased shoots only included Marssonina betulae and Fusarium avenaceum. The pathogenicity of these fungi was tested on seedlings of B. pendula and B. pubescens. Melanconium bicolor required a wound for lesion development on both birch species and caused larger lesions on B. pubescens than on B. pendula. Discula betulina caused lesions on stems and shoots of both birch species, including non-wounded current shoots. Marssonina betulae caused lesions and die-back of wounded and non-wounded current shoots of B. pendula seedlings. This fungus was not pathogenic on B. pubescens. Fusarium avenaceum caused restricted lesions on the main stems of both birch species. Godronia urceolus was not pathogenic on either birch species. Further work needs to focus on the role of these fungi in causing crown die-back of young, planted B. pendula in Scotland.

Betula↗
PubMed1999

A case-control study of melanomas of the soles and palms (Australia and Scotland).

OBJECTIVES: Because the factors that influence risk of acral melanomas on the soles and palms in White populations are unknown, we investigated these in a multi-center case-control study. METHODS: Cases of melanoma of the feet and hands diagnosed from 1987-93 in persons aged over 18 years were ascertained in eastern Australia and western Scotland. There were 275 cases of melanoma on the soles and palms matched to 496 controls (selected from the electoral roll) in Australia, and 36 cases matched to 72 controls (nominated by general practitioners) in Scotland. RESULTS: Acral melanoma was strongly associated with high total body nevus counts (adjusted relative risk [RR] = 6.3, 95% confidence interval [CI] = 2.5-15.6), and with nevi on the soles (RR = 7.5, CI = 3.0-18.6). There were also significant positive associations with a penetrative injury of the feet or hands (RR = 5.0, CI = 3.0-8.6) and with heavy exposure to agricultural chemicals (RR = 3.6, CI = 1.5-8.3). Sun-sensitive complexions, cumulative sun exposure and a past history of nonmelanoma skin cancer were also associated with increased risk of acral melanoma. Current cigarette smoking was inversely related to acral melanoma (RR = 0.6, CI = 0.4-0.9). CONCLUSIONS: Melanomas of the soles and palms resemble other cutaneous melanomas in their association with sun exposure, but are distinguished from them by their strong positive associations with nevi on the soles, previous penetrative injury, and exposure to agricultural chemicals, and by their inverse association with smoking.

Adolescent↗
PubMed1999

Psychopathy across cultures: North America and Scotland compared.

Differences in the prevalence and presentation of psychopathic personality disorder between North America and Scotland were evaluated. R. D. Hare's (1991) Psychopathy Checklist--Revised ratings obtained from a sample of 2,067 North American male prisoners and forensic patients were compared with ratings obtained from 246 Scottish male prisoners. Item response theory methods were used to examine differences in the performance of items and to equate the scale across settings. The items had equal relevance to the description of psychopathic personality disorder in both settings; however, the Scottish prisoners had to have higher levels of the underlying latent trait before certain characteristics became apparent. The prevalence of the disorder appears to be lower in Scotland. Explanations for the observed differences in terms of enculturation, socialization, and migration are explored.

Adolescent↗
PubMed1982

Cutaneous malignant melanoma in Scotland.

In view of the concern over the rising incidence of malignant melanoma in many parts of the world, and the suggestion that emigrants of Scottish and Irish descent have a higher incidence of melanoma in North America and Australia, a Scottish Melanoma Group has been formed to study epidemiological, pathological and therapeutic aspects of the tumour. In 1979, 260 histologically proven primary cutaneous malignant melanomas of the skin presented. This represents an incidence of 5.1/10(5) for Scotland as a whole. Studies over the next 5 years will determine whether the incidence of melanoma is rising in Scotland as rapidly as in other parts of the world.

Adolescent↗
PubMed1993

Age, socio-economic status and survival from cancer of cervix in the West of Scotland 1980-87.

The outcome of treatment by age and socio-economic status was examined for 1,588 women with invasive cancer of cervix resident in the West of Scotland and diagnosed between 1980 and 1987. There was no difference in prognosis according to either variable once analysis was controlled for stage at presentation, treatment type and tumour grade. Tumour histology, date of treatment and health board of residence had no significant effect on survival independent of other variables. A strong correlation was found between socio-economic status and the incidence of cervical cancer in the West of Scotland. Women aged 45 and over and living in deprived areas were more likely to present with later stage tumours and to survive less well than younger patients from the more affluent parts of the region. Any additional resources which may be made available for cervical cancer screening should be directed more effectively towards those most at risk.

Adult↗
PubMed1994

Cancer incidence in a population potentially exposed to radium-226 at Dalgety Bay, Scotland.

Cancer incidence in the Dalgety Bay area of Fife, Scotland, was examined following the detection of radium-226 particles by routine radiation monitoring. The study was confounded by rapid population growth, demographic change and the relatively high socioeconomic status of the Dalgety Bay population. Health Board Primary Care Division records were used to calculate population estimates and Carstairs deprivation score was used to adjust for socioeconomic characteristics. In the period 1975-90, 211 residents were registered as having cancer compared with 214.21 expected from Scottish national rates. Of specific cancers possibly associated with radiation, the incidence of stomach, liver, lung, bone, prostate, bladder and kidney cancer and lymphoma were lower than expected while colon, rectum, pancreas, skin, breast and thyroid cancer and multiple myeloma and leukaemia were higher. There were three cases of childhood leukaemia compared with 1.22 expected. The only statistically significant differences observed were for pancreas (11 cases, O/E 2.28), lung (25 cases, O/E 0.65) and non-melanoma skin (36 cases, O/E 1.50). Stomach cancer was of borderline statistical significance (four cases, O/E 0.40). Adjustments for socioeconomic factors accounted for the apparently low incidence of stomach and lung cancer and, to a lesser extent, skin cancer, which remained of borderline statistical significance. Results in relation to pancreas cancer were unchanged. The observations of raised incidence of pancreas and skin cancer arose in the context of a survey of 17 cancer sites, from which the finding of two or more statistically significant results is not unusual (P = 0.21), and the numbers of cases involved were small. The epidemiological evidence for an association between radiation exposure and pancreas cancer risk is weak. Stronger evidence exists for an association with skin cancer. In the present study the anatomical distribution of the 36 cases was similar to that found elsewhere in Scotland.

Adolescent↗
PubMed1994

The epidemiology of carcinoid tumours in England and Scotland.

Relatively little is known about the epidemiology of carcinoid tumours in contrast to the extensive information available on their biochemical effects and natural history. Accordingly, we have used cancer registrations in England from 1979 to 1987, and in Scotland from 1980 to 1989, to estimate the incidence of carcinoid tumours in Britain. Age-standardised incidence rates for England, based on 3,382 registrations, were 0.71 (0.68-0.75) for men and 0.87 (0.83-0.91) for women, per 100,000 per year. The equivalent rates for Scotland, based on 639 registrations, were 1.17 (0.91-1.44) for men and 1.36 (1.09-1.63) for women. There was a consistent female excess of carcinoid tumours in the reproductive years, which was reversed after the age of 50. The female excess was most striking for gastrointestinal carcinoid tumours in women aged 15-19 years (F:M ratio = 2.14). The sex differences are probably due in part to incidental diagnosis of carcinoid tumours during abdominal procedures, which are more common in women than men at ages 15-49 years. However, there is some evidence to suggest a true sex difference in incidence, particularly the fact that the sex ratio for thoracic tumours varies with age in a similar way to that for gastrointestinal tumours. Hormonal factors may, therefore, be important in the aetiology of carcinoid tumours.

Adolescent↗
PubMed1995

Referral patterns within Scotland to specialist oncology centres for patients with testicular germ cell tumours. The Scottish Radiological Society and the Scottish Standing Committee of the Royal College of Radiologists.

Details of 1123 patients registered in Scotland between 1983 and 1990 for testicular cancer under the Scottish Cancer Registration Scheme were obtained and compared with registrations within the five Scottish oncology centres. Some registration discrepancies were identified. Twenty-eight cancer registrations (2.5%) were coded to the wrong site, 29 patients seen at oncology centres had no cancer registration and 14 cancer registrations had the wrong histology. Five hundred and twenty-seven patients with testicular non-seminomatous germ cell tumours (NSGCT) and 567 with testicular seminoma were identified. Referral rates to specialist oncology centres for testicular germ cell tumours were measured by period and health board area of residence. For the whole study period 92% of NSGCT and 93% of seminoma patients were referred to specialist centres for treatment. Referral rates for different health board areas of residence were not significantly different. This study shows that within Scotland the majority of patients with testicular NSGCT and seminoma are referred to specialist centres, and suggests referral rates of around 92% are underestimates. Access is not related to area of residence.

Cancer Care Facilities↗
PubMed1995

Oesophageal and gastric cancer in Scotland 1960-90.

In Scotland over the last 31 years the incidence of gastric cancer has significantly declined by 0.6% per annum in males and 1.1% in females. In contrast, for oesophageal cancer, incidence rates have risen significantly by 3.0% and 2.0% per annum in males and females respectively. Increasing incidence of both adenocarcinomas and squamous carcinomas of the oesophagus in men and squamous and recently adenocarcinomas in women has been observed. This cannot be entirely accounted for by a growth in the proportion of histologically verified (HV) tumours over time. The incidence of adenocarcinoma of the stomach increased over the study period, most likely because of increasing proportions of HV tumours and improved diagnostic precision. Areas with high levels of deprivation in Scotland are strongly associated with high rates of oesophageal cancer in men, and of gastric cancer in both men and women. All these observations are discussed in the context of current knowledge of risk factors for these diseases.

Adenocarcinoma↗
PubMed1996

Trends in survival from cancers of the oral cavity and pharynx in Scotland: a clue as to why the disease is becoming more common?

Data were examined to determine trends in survival from cancers of the oral cavity and pharynx in Scotland between 1968 and 1987, and to analyse survival rates and the previously noted increases in the incidence of such cancers according to the level of social deprivation. Incidence data on oral cavity and pharyngeal cancer and survival rates following diagnosis were obtained from the Information and Statistics Division of the Common Services Agency for the National Health Service in Scotland, covering the period 1968-92. It was found that survival rates for cancers of the tongue, mouth and pharynx diagnosed among persons less than 65 years of age decreased between 1968-72 and 1983-87. Five year relative survival rates fell from 47% to 39% over this period, while the equivalent rates among persons older than 65 years have shown a modest improvement from 34% to 38%. When considered by level of social deprivation, survival is lower among persons from the most deprived areas, and it is among such persons that the recent increases in occurrence of cancers of the oral cavity and pharynx have primarily occurred. The poorer survival among those from more socially deprived areas, and the evidence that the largest increase in incidence has occurred in such areas may to some extent explain the non-favourable trends in mortality. More importantly it emphasises the potential benefits of targeting such a population for oral health information. An educational campaign should include both information on the risk factors for developing oral cancer, and also the importance of seeking an early professional consultation in the case of symptoms.

Aged↗
PubMed1998

Variation in the survival of women with breast cancer in Scotland. The Scottish Breast Cancer Focus Group and The Scottish Cancer Therapy Network.

We have investigated factors influencing the survival of women with early breast cancer in Scotland. In a retrospective study, clinical, treatment and 'service' factors, e.g. surgical case load, deprivation and geographical area (health board of first treatment) were recorded from hospital records. A total of 2148 women with invasive breast cancer diagnosed in 1987 were identified from the Scottish Cancer Registry, of whom 1619 without metastases at diagnosis underwent surgery as part of their primary treatment. In a multivariate analysis, clinical factors (age, clinical stage, pathological tumour size, node status and oestrogen receptor status) all influenced survival. After allowing for these clinical factors, surgical case load and deprivation did not have statistically significant effects on survival. By contrast, health board did affect survival. This was explained in part by the selection of patients for surgery. There appeared, however, to be a residual effect that may be related to differences in the use of adjuvant systemic treatment among the different health boards. We conclude that, in Scotland, geographical variation in both surgical and non-surgical treatment has a greater effect on variability in survival for women with breast cancer than surgical case load and deprivation.

Adult↗
PubMed1997

Changing indications for penetrating keratoplasty in the west of Scotland from 1970 to 1995.

In an attempt to predict the trends which might occur in the changing patterns of corneal surgery in the next decade and hence the financial implications, a retrospective study of the treatment of corneal disease was carried out using the pathological reports issued during the last 25 years in the West of Scotland Ophthalmic Pathology Service. This is a supra-regional specialist service which covers the major population areas in Scotland, although most of the specimens were submitted by consultants in the teaching hospitals in Glasgow. The major indications for surgery in the 1486 specimens received were post-inflammatory scarring (387 cases), repeat penetrating keratoplasty (309), keratoconus (257), Fuchs' dystrophy (120) and secondary endothelial failure after cataract surgery (158). In the past 6 years the indications changed and the commonest indications were secondary endothelial failure and post-inflammatory scarring. The study demonstrates a regional difference when compared with other reports and highlights the increasing demand for penetrating keratoplasty and the consequent resource implications.

Cataract Extraction↗
PubMed2000

Antibiotic prescribing by general dental practitioners in the Greater Glasgow Health Board, Scotland.

OBJECTIVE: To investigate antibiotic prescribing patterns by general dental practitioners (GDPs) in the Greater Glasgow Health Board Area, Scotland. STUDY DESIGN: A 10% sample of prescriptions were selected at random from 35,545 prescriptions written by GDPs over a 6-month period. MAIN OUTCOME MEASURES: Absolute and relative frequencies were used to describe the different classes of antibiotics used and the variations in prescribing practice. RESULTS: GDPs prescribed a wide range of antibiotics. Seventeen different antibiotics were prescribed with amoxycillin, metronidazole and penicillin V accounting for almost 90% of the prescriptions. In general the antibiotics were prescribed at the British National Formulary (BNF) recommended doses. There were, however, wide variations in the frequencies and durations of the prescriptions for all antibiotics. CONCLUSIONS: The present study provides evidence of sub-optimal prescribing of antibiotics by dentists in Scotland, with considerable variation from the recommended frequencies and doses.

Anti-Bacterial Agents↗
PubMed2001

The reasons for extraction of permanent teeth in Scotland: a 15-year follow-up study.

AIMS: Although Scotland has the highest proportion of edentulous adults in the UK, the frequency of edentulousness has fallen by 21% during the last 20 years. This study, carried out in 1999, was designed to establish whether the reasons for tooth loss have also changed since 1984 when they were last determined. METHODS: The Scottish Dental Practice Board provided the names of every fourth dentist on its list among which 425 general dental practitioners were identified. They were asked to record permanent tooth extractions for 1 week, specifying the age, sex and dental attendance of patients who underwent extractions and the reasons for these extractions. 352 dentists took part: a response rate of 82.8%. RESULTS: The study confirmed that there has been a reduction in the number of extractions between 1984 and 1999: there were 25% fewer teeth extracted per patient and 30% fewer per dentist per week. From 0-20 years of age, orthodontics has replaced caries as the commonest reason for extraction and in all age groups over 20 years, caries has become the commonest reason in contrast to 1984 when periodontal disease was the principal reason in patients over 40 years old. CONCLUSIONS: Caries and its sequelae remain the most important cause of tooth loss throughout adult life in Scotland and, therefore, caries prevention and maintenance of restorations are of great importance at all ages.

Adolescent↗
PubMed1992

Dental attendance behaviour of children in Scotland between 1983 and 1988.

Parental permission was sought to monitor longitudinally the dental care of a sample of 5, 8, 12 and 15-year-olds in Scotland who took part in the 1983 national survey of children's dental health. The dental treatment records of those who volunteered were released by the Scottish Dental Practice Board and the Information and Statistics Division of the Common Services Agency to the Dental Health Services Research Unit at Dundee University. The baseline epidemiological survey data was passed on by the Office of Population Censuses and Surveys. During the period 1983 to 1988, less than half of the children in the sample attended for dental care at least once a year on average (ie at least five times in five years) and most also let a lapse of more than 2 years occur between dental visits at some time within the 5-year study period. Around 20% of the three youngest age groups changed dentist three or more times. These results indicate that steps need to be taken to improve the dental attendance of children in Scotland if the principle of continuing care underlying the new General Dental Service contract is to be achieved.

Adolescent↗
PubMed2005

The dental practitioner and child protection in Scotland.

OBJECTIVES: To identify from general dental practitioners: undergraduate and postgraduate training experience in child protection; numbers of suspected cases of child physical abuse; reasons for failing to report suspicious cases of child physical abuse; knowledge of local child protection protocols and procedures for referral. MATERIALS AND METHODS: Postal questionnaires were sent to 500 randomly selected general dental practitioners in Scotland, with a further 200 sent to a random sample of the original 500 to increase response rate. RESULTS: Sixty-one per cent (306) of the original 500 questionnaires, and 35% (69) of the second random mail shot of 200 questionnaires were returned. Only 19% could remember any undergraduate training and 16% had been to a postgraduate lecture or seminar in child protection. Twenty-nine per cent of dentists had seen at least one suspicious case in their career. Only 8% of suspicious cases were referred on to the appropriate authorities. Reasons for failure to refer revealed that 11% were concerned about a negative impact on their practice, 34% feared family violence towards the child, 31% feared violence directed against them, and 48% feared litigation. Only 10% of dentists had been sent a copy of the local child protection guidelines on commencing work and only 15% had seen their Area Child Protection Committee (ACPC) Guidelines via any route. CONCLUSIONS: Due to lack of training or clear guidelines for dentists in Scotland, most practitioners were unsure what to do in the event of a suspicion of child abuse. Twenty-one per cent of dentists had encountered suspicious cases but failed to take any action. Dentists overwhelmingly requested appropriate training. This training should address dental competence in assessment of suspicious indicators and involve dentists in inter-agency child protection training.

Adult↗
PubMed2006

General dental practitioners' perceptions of the West of Scotland Cancer Awareness Programme oral cancer campaign.

OBJECTIVES: The 2003/04 West of Scotland Cancer Awareness Programme (WoSCAP) oral cancer campaign was designed to raise public awareness of the signs and symptoms of oral cancer. The objectives of this study were to explore general dental practitioners' (GDPs) awareness and perceptions of the campaign, and its impact on local dental practices. METHODS: A self-completing questionnaire was sent to GDPs in the West of Scotland (N = 983) at the conclusion of the public awareness campaign. RESULTS: A response rate of 68.6% was achieved. Most dentists (92%) had heard of the campaign and a large percentage had displayed the promotional materials in their practice. The majority of respondents rated the campaign materials, including a television advertisement, in a very positive manner. Over 40% of dentists reported that, during the active phase of the campaign, patients had asked for information concerning the programme, and 66% indicated that registered patients had asked for advice regarding a specific lesion. Additionally, 41% of dentists reported non-registered patients had attended asking for advice regarding a 'worrying' lesion. Over 60% of dentists had referred a patient during the campaign and 40% of these practitioners indicated an increased referral rate during this period. CONCLUSIONS: Most respondents were positive in their assessment of the campaign and reported an increased awareness of oral cancer among patients.

Adult↗
PubMed2004

Causes of blindness and visual impairment in the West of Scotland.

AIMS: To determine the overall reported incidence and causes of registrable blindness and visual impairment in the West of Scotland and any trends that have occurred in the previous 16 years since data from the same area were published. METHODS: Data for analysis were obtained from BP1 registration forms returned to the Resource Centre for the Blind serving the Strathclyde region in the West of Scotland between 1 April 1996 and 31 March 1997. RESULTS: A total of 1595 visually handicapped people were registered during the study year. Of these, 99 forms (6.2%) were excluded from further analysis because of insufficient information. The remaining 1496 completed BP1 Forms were in respect of 530 males and 966 females. Of these, 253 males and 450 females were legally blind (total 703 or 47.0%) and 277 males and 516 females were partially sighted (total 793 or 53.0%). The five leading causes of blindness, in decreasing frequency, were age-related macular degeneration (ARMD), glaucoma, diabetic retinopathy, myopic degeneration, and optic atrophy. ARMD and diabetic retinopathy were the most common causes of blindness in those over 65 years and persons of working age, respectively. CONCLUSIONS: In adults, cataract is no longer a significant cause of registrable visual impairment. The proportions of registrations owing to glaucoma, diabetic retinopathy, and myopia have not significantly changed since 1983 and the proportion owing to macular degeneration has increased. In children, congenital glaucoma, cataract, and corneal infection were no longer causes of registration, but impairment of vision caused by brain damage is now a significant contributor.

Adolescent↗