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At least 433 records · Page 24Linked to original sources
PubMed1978

Incidence of salivary gland tumours in Scotland: accuracy of national records.

Statistics on discharge diagnoses in Scotland during 1968-74 show the incidence of all tumours of major salivary glands to exceed 40/million population yearly. This is higher than in any other nationality except Canadian Eskimos. Studies in two hospitals showed that numerous errors occurred in reporting these tumours, but the figures were more likely to be too low than too high. Probably eastern Scotland at least has an unusually high incidence, although in other countries using different methods of analysis the reported figures are likely to be low. Statistics based on discharge diagnoses will continue to be neglected in research until the standard of completion of discharge diagnoses improves.

Diagnostic Errors↗
PubMed1972

Survey of alimentary radiology findings in the North-east of Scotland Region (1967-70).

This report describes a survey of all barium contrast radiological examinations carried out in the years 1967-70 by the unit that serves 99% of the adult population of North-east Scotland. The survey method used yields useful estimates, not otherwise available, of the occurrence of some forms of alimentary lesions within a whole community. Rates of occurrence by age and sex were recorded for all lesions. The data on peptic ulceration, were compared with those from South-east and from North England, and this showed that duodenal, but not gastric, ulceration is much commoner in North-east Scotland. Occurrence rates for most lesions have been nearly unchanged throughout the four years of survey. The data provide a measure of the work load for these radiological examinations for a given population.

Adolescent↗
PubMed1978

Prevalence of multiple sclerosis in north-east Scotland.

An epidemiological study of multiple sclerosis (MS) in north-east Scotland was carried out based on data correct on 1 December 1970. The prevalence of MS was 127 cases/100 000 population, which is greater than in any other surveyed area with a comparable population. The disease was not spread homogeneously within the region, and in one district one in 400 people was affected. The geographical distributions of MS and the presence of HLA antigens A3 and B7,which are associated with the disease, are remarkably similar, and the prevalence of B7 in north-east Scotland is higher than elsewhere. This may partly explain the high prevalence of MS in this area, but the essential additional environmental factor remains to be established.

Age Factors↗
PubMed1981

Telephone monitoring of patients with pacemakers in the west of Scotland.

A regional telephone pacemaker follow-up service has been established in the west of Scotland. Medical care is provided by clinics at district general hospitals in Ayrshire, and the pacemaker signals are transmitted by telephone from these clinics to a pacemaker centre in Glasgow. The success of the pilot project in Ayrshire will allow expansion of the service to include hospitals in other areas of the west of Scotland. The scheme is carefully monitored to ensure that patients with pacemakers receive adequate attention with a minimum of inconvenience.

Ambulatory Care↗
PubMed1983

Alcohol and the fetus in the west of Scotland.

Forty children with the fetal alcohol syndrome were identified in the west of Scotland. All were growth retarded and had abnormal facial features, and all those who were tested were found to have neurological or developmental abnormalities. Two children died of associated physical defects. Most of the mothers were socially deprived, and all had drunk heavily while pregnant. Three women had subsequently died. These findings provide clear evidence that in the west of Scotland maternal alcohol abuse during pregnancy is a significant cause of morbidity and mortality in children.

Adult↗
PubMed1986

Scotland's liquor licensing changes: an assessment.

The impact of the changes in Scotland's liquor licensing laws was assessed by comparing trends in alcohol related problems in Scotland with those in England and Wales. The study showed no appreciable effect on the level of alcohol related morbidity and mortality, though some improvements were noted in relation to the rates of convictions for drunkenness. The changes introduced since 1976 appeared to be popular and there was widespread perception that public drunkenness had become less common-place.

Alcohol Drinking↗
PubMed1971

Anaesthetic staffing and training requirements in Scotland.

In Scotland there is an average of 12 consultant vacancies and 14 Fellows qualifying per year, but these are insufficient to meet all the vacancies as several emigrate or return abroad. The existing registrar and senior registrar establishments are inadequate to meet the numbers of consultants required if full allowance is made for special factors, such as the high proportion of women graduates and the rising proportion of overseas trainees.A backlog of understaffing in Scotland relative to England and Wales is shown by comparison of the ratio of anaesthetists to surgeons. The existing rate of expansion of 6% per year must continue for many years or be increased if staffing levels are to come into line with those elsewhere in Britain.

Anesthesiology↗
PubMed1990

General practice computing in Scotland.

OBJECTIVE: To investigate a method of assessing the extent of routine patient data held on computer by Scottish general practitioners. DESIGN: An "electronic questionnaire" in the form of an interrogation questionnaire was used to extract a subset of data from practice computers running a standard software package (the general practice administrative system for Scotland, GPASS). The data were retained by each practice and also collected and analysed centrally to produce regional and national data. SUBJECTS: All 257 general practices in Scotland using GPASS software were sent the electronic questionnaire; data from 154 practices, including 759 general practitioners and covering 1,010,452 patients, were collected. RESULTS: Ninety three practices had all their patient records on computer; others had selectively entered data on, for example, only those patients receiving repeat prescriptions. The number of computerised patient records per practitioner ranged from 46 to 2373. Altogether 194,261 patients had repeat prescribing data and 204,005 morbidity or clinical data. CONCLUSION: An electronic questionnaire is a simple and effective way of investigating the information held on practice computers, allowing analysis and feedback of information to practitioners. Development of this system will provide a cumulative information system for Scottish general practitioners.

Computers↗
PubMed1991

"Heartstart Scotland"--initial experience of a national scheme for out of hospital defibrillation.

OBJECTIVE: To determine the outcome of out of hospital defibrillation in Scotland during the year after the introduction of automated external defibrillators in October 1988. DESIGN: Retrospective analysis of ambulance service reports and hospital records. SETTING: Scottish Ambulance Service and acute receiving hospitals throughout Scotland. MAIN OUTCOME MEASURES: Delay from cardiac arrest to first defibrillator shock; vital state on arrival at hospital accident and emergency department; survival to hospital discharge. RESULTS: During the study period 268 defibrillators were purchased by public subscription and 96% of the 2000 ambulance crew underwent an eight hour training programme in cardiopulmonary resuscitation and defibrillation. A total of 1111 cardiac arrests were recorded, and defibrillation was indicated and undertaken in 602 (54%) patients, mean age 63 (range 14-92) years. A spontaneous pulse was present on arrival at hospital in 180 (30%) of the defibrillated patients, and 75 (12.5%) were subsequently discharged alive. As expected, the likelihood of survival was inversely related to the delay from the onset of cardiac arrest to the time of the first shock and was greater in the case of witnessed arrest. If ventricular fibrillation occurred after the arrival of the ambulance, survival to discharge was 33%. CONCLUSIONS: An effective scheme for out of hospital defibrillation can be introduced rapidly, and with limited training implications and costs, by the use of automated external defibrillators in ambulances.

Adolescent↗
PubMed1993

Epidemiology of Alzheimer's presenile dementia in Scotland, 1974-88.

OBJECTIVE: To describe the epidemiology of presenile Alzheimer's disease in Scotland from 1974 to 1988. DESIGN: Retrospective review of hospital records of patients aged less than 73 years admitted to psychiatric hospital with various diagnoses of dementia. Diagnoses were classified by National Institute for Communicative Disorders and Stroke and Alzheimer's Disease and Related Disorders Association Criteria and the Hachinski score. Completeness of the study sample was evaluated by scrutiny of neurology outpatient and general hospital records. SETTING: All general psychiatric hospitals in Scotland. SUBJECTS: All patients with onset of dementia aged 40-64. MAIN OUTCOME MEASURES: Probable and broad Alzheimer's disease, sex of patient, age at onset. RESULTS: 5874 psychiatric hospital records, 129 neurology outpatient records, and 89 records from non-psychiatric hospitals were examined. 317 patients met criteria for probable Alzheimer's disease, 569 met criteria for broad Alzheimer's disease, and 267 met those for multi-infarct dementia. Minimal incidences per 100,000 population aged 40-64 years were 22.6 (95% confidence interval, 20.2 to 25.2) and 40.5 (38.9 to 42.3) per 100,000 for probable and broad Alzheimer's disease. In the 1981 census year the annual incidence of probable Alzheimer's disease was 1.6 (1.0 to 2.6). Women were at greater risk with incidence rates for probable Alzheimer's disease of 28.2 (24.5 to 32.4) per 100,000 compared with 16.5 (13.8 to 19.8) per 100,000 for men. The incidence per 100,000 for multi-infarct dementia was greater in men (25.1, 23.3 to 27.1) than women (13.4, 12.1 to 14.8). CONCLUSION: Female sex seems to be positively associated with development of Alzheimer's disease before age 65 years.

Adult↗
PubMed1993

Hunting the gowk?--Psychiatric community care in Scotland.

The implementation of the community care changes throughout the United Kingdom from 1 April will mark the culmination of a series of major health and social care reforms. The avowed aims of achieving value for money and improved consumer choice through the introduction of competitive internal markets have yet to be tested. The political complexion of Scotland means that any proposed change to the NHS has tended to be greeted with a mixture of suspicion and resistance. As a result very few self governing trusts and fundholding general practices exist north of the border. And although Scotland has not had a wide reaching policy of moving psychiatric patients out of hospitals, community care for mentally ill people has advanced spontaneously.

Community Mental Health Services↗
PubMed1994

Breast feeding in Scotland.

OBJECTIVE: To measure the prevalence of breast feeding and to examine the value of using information collected on Guthrie cards (used for detecting inherited metabolic disease and hypothyroidism when newborn infants are 7 days old) to calculate this prevalence. DESIGN: Analysis, by geographical area and maternity unit, of information on breast feeding collected on Guthrie cards for 131,759 babies born in 1990 and 1991, and comparison with prevalences from other sources. SETTING: Scotland. RESULTS: Of the 131,759 babies, only 46,949 (35.6%) were breast feeding on day 7. The prevalence of breast feeding ranged from 59.1% (376/636) in Shetland to 21.1% (1836/8719) in Lanarkshire and < 8% in some postcode districts of cities. Analysis of the data by hospital of birth showed that the prevalence ranged from 51.2% (2701/5275) to 16.4% (507/3090). CONCLUSION: The prevalence of breast feeding in Scotland is low and varies among areas and maternity units. Intervention to increase this prevalence is essential, and information collected on Guthrie cards is a useful indication of mothers' intentions to breast feed.

Breast Feeding↗
PubMed1994

Grommets, tonsillectomies, and deprivation in Scotland.

OBJECTIVE: To see whether there is a relation between grommet insertion operation and tonsillectomy rates, otolaryngology services, and deprivation scores in Scotland. DESIGN: Analysis of routine 1990 NHS data on grommet insertions and tonsillectomies in Scottish children aged 0-15 years compared with data on general practitioner and otolaryngology services and Carstairs deprivation scores. SETTING: All 15 Scottish health boards. SUBJECTS: All children aged 0-15 (1,021,933). RESULTS: Tonsillectomy was more common than grommet insertion operations in Scotland (6182:4850). Health boards with high grommet insertion rates were more likely to have low tonsillectomy rates (Spearman's rank correlation -0.59; 95% confidence interval -0.87 to -0.03). Grommet insertion rates varied fourfold (from 2.4/1000 to 9.2/1000) and tonsillectomy rates twofold (from 3.6/1000 to 8.0/1000) across Scottish health boards. Variation between health boards had changed over the 15 years 1975-90. Variation in grommet insertion rates did not reflect variation in the supply of otolaryngology consultants (Spearman's rank correlation -0.25). There was a non-significant tendency for high general practitioner referral rates to be associated with high grommet insertion rates, low tonsillectomy rates, and less deprived areas (Spearman's rank correlation coefficients 0.50, -0.53, and -0.43). Deprivation (measured by Carstairs scoring for each health board) was associated with higher tonsillectomy rates (Spearman's rank correlation 0.41; 95% confidence interval -0.22 to 0.80) and significantly lower grommet insertion rates (-0.73; -0.92 to -0.28). CONCLUSION: Social factors as well as differences in disease prevalence and medical practice need to be considered when studying variation in childhood grommet insertion and tonsillectomy rates.

Adolescent↗
PubMed1996

Information needs of cancer patients in west Scotland: cross sectional survey of patients' views.

OBJECTIVE: To assess the needs of patients with cancer for information about their condition. DESIGN: Cross sectional survey of patients' views by means of semistructured interview with questionnaire. SETTING: A regional cancer centre and two university hospitals in west Scotland. SUBJECTS: 250 (93%) of 269 cancer patients invited to participate in study who were selected by age, sex, socioeconomic status, and tumour site to be representative of cancer patients in west Scotland. MAIN OUTCOME MEASURES: Patients' need to know whether they had cancer, the medical name of their illness, progress through treatment, how treatment works, side effects, chances of cure, and treatment options. RESULTS: 79% (95% confidence interval 73% to 84%) of patients wanted as much information as possible, and 96% (93% to 98%) had a need or an absolute need to know if they had cancer. Most patients also wanted to know the chance of cure (91% (87% to 94%)) and about side effects of treatment (94% (90% to 97%)). When the replies were cross tabulated with patients' age, sex, deprivation score, and type of treatment there was a linear trend for patients from more affluent areas to want more information and those from deprived areas to want less. There was a strong preference for diagnosis of cancer to be given by a hospital doctor (60% (53% to 66%). CONCLUSION: Almost all patients wanted to know their diagnosis, and most wanted to know about prognosis, treatment options, and side effects.

Adolescent↗
PubMed1996

Doctors' retainer scheme in Scotland: time for change?

OBJECTIVES: To describe the present doctors' retainer scheme in Scotland and ascertain the need for change. DESIGN: Semistructured postal questionnaires to current and past members of the doctors' retainer scheme and general practitioner employers. SETTING: Scotland, October to December 1994. SUBJECTS: 152/160 current and 104/124 former members responded together with 101/118 general practitioner employers. RESULTS: 93% of members currently working in general practice were either vocationally trained or had previously worked as principals. 84% of current members held postgraduate qualifications. 73% of former members had left the scheme within 4 years and 72% of current members had been with the scheme for 4 years or less. 66% of current members said that the scheme prevented them from leaving medicine. Both members and employers were dissatisfied with the current limit of two working sessions per week, 77% of employers wanting it increased. 61% of current members would not have joined the scheme if suitable part time work had been available and 46% of those would have preferred to work flexibly, up to 5 sessions per week. 52% of members do not receive BMA rates of pay and, of those, 46% work more than 3.5 hours per session. CONCLUSION: The scheme appears to be appreciated and would be more so if inconsistencies in pay and conditions were addressed. An increase in the permitted number of weekly sessions would enable these highly qualified doctors to maintain their skills and confidence.

Family Practice↗
PubMed1998

Case-control study of childhood leukaemia and cancer in Scotland: findings for neonatal intramuscular vitamin K.

OBJECTIVE: To test the hypothesis of an association between neonatal intramuscular vitamin K and childhood leukaemia and other cancers. DESIGN: Population based case-control study with data abstracted from hospital records. SETTING: Scotland. SUBJECTS: Children aged 0-14 years resident in Scotland from 1991-4 and diagnosed with leukaemia (150), lymphomas (46), central nervous system tumours (79), a range of other solid tumours (142), and a subset of acute lymphoblastic leukaemia (129). Controls were 777 children matched for age and sex, providing 417 matched sets (360 triplets and 57 pairs) for analysis. MAIN OUTCOME MEASURE: Odds ratios for the risk of childhood leukaemia and cancer and intramuscular vitamin K versus a combined group of oral doses, none, and no record. Results are given for information recorded in medical notes and data supplemented by hospital policy. RESULTS: Odds ratios based on medical record abstractions showed no significant positive association for leukaemias (odds ratio 1.30; 95% confidence interval 0.83 to 2.03), acute lymphoblastic leukaemia (1.21; 0.74 to 1.97), lymphomas (1.06; 0.46 to 2.42), central nervous system tumours (0.74; 0.40 to 1.34), and other solid tumours (0.59; 0.37 to 0.96). There was no association with acute lymphoblastic leukaemia in children aged 1 to 6 years. Imputation of exposure from hospital policy gave similar results. Adjustment for deprivation and type of delivery moved risk estimates closer to unity for all major diagnostic groups. CONCLUSIONS: The observation of an increased risk of childhood leukaemia and cancer associated with intramuscular vitamin K is not confirmed by this independent population based study.

Adolescent↗
PubMed2000

Demand for and supply of out of hours care from general practitioners in England and Scotland: observational study based on routinely collected data.

OBJECTIVES: To determine the level of demand and supply of out of hours care from a nationally representative sample of general practice cooperatives. DESIGN: Observational study based on routinely collected data on telephone calls, patient population data from general practices, and information about cooperatives from interviews with managers. SETTING: 20 cooperatives in England and Scotland selected after stratification by region and by size. SUBJECTS: 899 657 out of hours telephone calls over 12 months. MAIN OUTCOME MEASURES: Numbers and age and sex specific rates of calls; variation in demand and activity in relation to characteristics of the population; timing of calls; proportion of patients consulting at home, at a primary care centre, or on the telephone; response times; hospital admission rates. RESULTS: The out of hours call rate (excluding bank holidays) was 159 calls per 1000 patients/year, with rates in children aged under 5 years four times higher than for adults. Little variation occurred by day of the week or seasonally. Cooperatives in Scotland experienced higher demand than those in England. Patients living in deprived areas made 70% more calls than those in non-deprived areas, but this had little effect on the overall variation in demand. 45.4% (408 407) of calls were handled by telephone advice, 23.6% (212 550) by a home visit, and 29.8% (267 663) at a centre. Cooperatives responded to 60% of calls within 30 minutes and to 83% within one hour. Hospital admission followed 5.5% (30 743/554 179) of out of hours calls (8 admissions per 1000 patients/year). CONCLUSIONS: This project provides national baseline data for the planning of services and the analysis of future changes.

Adult↗
PubMed2000

Association between illegal drugs and weapon carrying in young people in Scotland: schools' survey.

OBJECTIVES: To identify the type and extent of weapons being carried among young people in Scotland, and to determine the relation between use of illegal drugs and weapon carrying. DESIGN: Questionnaire school survey. SETTING: Independent schools in central Scotland and schools in Lanarkshire and Perth and Kinross. PARTICIPANTS: 3121 students aged 11 to 16 in 20 schools. MAIN OUTCOME MEASURES: Self completion questionnaire reporting history of drug use and weapon carrying. RESULTS: Overall, 34.1% of males and 8. 6% of females reported having carried a weapon (P<0.0001), ranging from 29.2% of boys aged 11-13 (classes S1 to S2) to 39.3% of boys aged 13-15 (S3 to S4). These values are higher than those in a recent survey of young people in England. Weapon carrying in Lanarkshire was 70% higher for males than in the rural area of Perth and Kinross. Both males and females who had taken drugs were more likely to carry weapons (63.5% of male drug users versus 20.5% of non-users and 22.8% of female drug users versus 3.7% of non-users; both P<0.0001). The proportions of males carrying weapons who used none, one, two, three or four, or five or more illegal drugs were 21%, 52%, 68%, 74%, and 92% respectively. A similar trend was found among females. CONCLUSIONS: Better information is needed on the nature and extent of weapon carrying by young people in the United Kingdom, and better educational campaigns are needed warning of the dangers of carrying weapons.

Adolescent↗