Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SCOTLAND”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources
PubMed2004

Ammonia emission and deposition in Scotland and its potential environmental impacts.

The main source of atmospheric ammonia (NH3) in Scotland is livestock agriculture, which accounts for 85% of emissions. The local magnitude of emissions therefore depends on livestock density, type, and management, with major differences occurring in various parts of Scotland. Local differences in agricultural activities therefore result in a wide range of NH3 emissions, ranging from less than 0.2 kg N ha(-1) year(-1) in remote areas of the Scottish Highlands to over 100 kg N ha(-1) year-1 in areas with intensive poultry farming. Scotland can be divided loosely into upland and lowland areas, with NH3 emission being less than and more than 5 kg N ha(-1) year(-1), respectively. Many semi-natural ecosystems in Scotland are vulnerable to nitrogen deposition, including bogs, moorlands, and the woodland ground flora. Because NH3 emissions occur in the rural environment, the local deposition to sensitive ecosystems may be large, making it essential to assess the spatial distribution of NH3 emissions and deposition. A spatial model is applied here to map NH3 emissions and these estimates are applied in atmospheric dispersion and deposition models to estimate atmospheric concentrations of NH3 and NH4+, dry deposition of NH3, and wet deposition of NHx. Although there is a high level of local variability, modelled NH3 concentrations show good agreement with the National Ammonia Monitoring Network, while wet deposition is largest at high altitude sites in the south and west of Scotland. Comparison of the modelled NHx deposition fields with estimated thresholds for environmental effects ("critical loads") shows that thresholds are exceeded across most of lowland Scotland and the Southern Uplands. Only in the cleanest parts of the north and west is nitrogen deposition not a cause for concern. Given that the most intense effects occur within a few kilometres of sources, it is suggested that local spatial abatement policies would be a useful complement to traditional policies that mitigate environmental effects based on emission reduction technologies.

Ammonia↗
PubMed2006

Opportunity for change in the future roles for the health library and information professional: meeting the challenges in NHS Scotland.

BACKGROUND: NHS Education for Scotland (NES) is the Special Health Board responsible for supporting best practice in education, training and development for all staff groups within NHS Scotland. As part of its remit, the Knowledge Services Group within NES is responsible for the e-Library, a national electronic resource providing and supporting access to the evidence base. The Knowledge Services Group also supports the national development of library services to NHS Scotland. AIMS: This article aims to provide a reflective overview of some recent challenges within the health library and information field in Scotland, and the positive role opportunities these have afforded. METHODS: The information was gathered through extensive professional interaction with staff across the sector over the first year of establishing the new role of Librarian Staff Development Manager. FOCUS: New roles have emerged for health library and information professionals generally; for example, in response to new technology or new user groups. The development of the NHS Scotland e-Library provides examples of role development that emerges symbiotically from core skills applied to a new situation or applied in an innovative way. Role development among health library and information professionals operating at the local service level can be both reactive and proactive. Working together, the partnership between the national Knowledge Services Group and local library and knowledge services for NHS Scotland has resulted in the emergence of additional new roles, extending the role portfolio of the local professional (for example, the Librarian-Tutor role) and supported by other national infrastructures (for example, the competency framework initiative).

Access to Information↗
PubMed2002

The effects of new topical treatments on management of glaucoma in Scotland: an examination of ophthalmological health care.

BACKGROUND: The management of glaucoma has been changed in the past decade by the introduction of new drugs. The impact of these changes on clinical care of patients was examined by examining operation and prescribing rates for glaucoma in four geographical areas of Scotland for the years 1994 to 1999. METHODS: A retrospective analysis of national health statistics: primary care prescribing data, hospital derived operation rates, consultant numbers, optometrist numbers, and eye test data, expressed by estimated population at risk of glaucoma. The outcome measures were prescribing volume and cost for glaucoma medications, and operation rates, corrected for population estimated to be at risk of glaucoma (PEG), for trabeculectomy, for Scotland as a whole, and for four geographical "regions" (north east, south east, central, and south west Scotland). RESULTS: Prescribed items per 1000 population estimated to have glaucoma (PEG) increased by 24.9% between 1994 and 1999. This was above the general increase in prescribing in Scotland (17.8%). This increase varied in the four health regions evaluated (14.3% to 31.9%). Prescribing of topical beta blockers increased little (6.4%), but there was a large increase in the use of new products (topical prostaglandins, carbonic anhydrase inhibitors, and alpha(2) agonists), at the expense of miotics (47.7% fall), and older sympathomimetics. This change in prescribing pattern was accompanied by a 61.5% increase in cost (range 42.2% to 73.4% in the four regions). New drugs accounted for more than half of total glaucoma expenditure in 1999. Operation rates (corrected for PEG) fell by 45.9% (range 43.1 to 58.6%) between 1994 and 1999. Other indicators suggested increased activity in ophthalmic areas (for example, cataract operations, eye tests, numbers of optometrists and ophthalmic surgeons all increased). Within north east Scotland operation rates decreased and prescribing increased less than in other regions, both from lowest regional baseline in 1994. CONCLUSIONS: The introduction of new drug classes has had dramatic effects on the prescribing of glaucoma treatments. There has been a decline in older treatments and an increase in new agents, which has been associated with a large reduction in operation rates for glaucoma in Scotland over 6 years. Comparison of prescribing and operation data indicates regional differences in healthcare delivery for glaucoma.

Administration, Topical↗
PubMed1994

Deprivation and mortality in Scotland, 1981 and 1991.

OBJECTIVE: To compare the mortality experience of Scottish postcode sectors characterised by socioeconomic census variables (Carstairs scores) in 1980-2 and 1990-2. METHODS: Variables derived from the 1981 and 1991 censuses were combined according to the method devised by Carstairs and Morris to obtain Carstairs scores for 1010 postcode sectors in Scotland in 1981 and 1001 sectors in 1991. For most analyses, these scores were grouped into seven deprivation categories ranging from affluent (category 1) to deprived (category 7) localities. MAIN OUTCOME MEASURES: Death rates and standardised mortality ratios for localities according to deprivation category. RESULTS: Postcode sectors in Scotland that were categorised as deprived in 1981 were relatively more deprived at the time of the 1991 census; the mortality experience of deprived localities relative to either Scotland or affluent neighbourhoods worsened over this period, with a 162% difference between the most affluent and most deprived categories in 1991-2. Although the age and sex standardised mortality for ages 0-64 in Scotland declined by 22% during the 1980s, the reduction in the deprived categories was only about half that of the affluent groups. Increases in the death rate for men (29%) and women (11%) aged 20-29 in the deprived groups were largely attributable to an increase in the rates of suicide. Death rates from ischaemic heart disease and carcinoma of the lung and bronchus at ages 40-69 were lower in all deprivation categories in 1990-2, but the reduction was greater in more affluent areas; the difference in rates for these conditions between affluent and deprived groups therefore increased over the decade. The observed worsening of the standardised mortality ratio for Glasgow relative to Scotland could be explained on the basis of these mortality differentials and the concentration of deprived postcode sectors in Glasgow. CONCLUSIONS: Differences in mortality experience linked to relative poverty increased in the 10 years between 1981 and 1991 censuses. Although mortality for Scotland as a whole is improving, the picture is one of an increasing distinction between the experience of the majority and that of a substantial minority of the population.

Adult↗
PubMed2006

Generation Scotland: the Scottish Family Health Study; a new resource for researching genes and heritability.

BACKGROUND: Generation Scotland: the Scottish Family Health Study aims to identify genetic variants accounting for variation in levels of quantitative traits underlying the major common complex diseases (such as cardiovascular disease, cognitive decline, mental illness) in Scotland. METHODS/DESIGN: Generation Scotland will recruit a family-based cohort of up to 50,000 individuals (comprising siblings and parent-offspring groups) across Scotland. It will be a six-year programme, beginning in Glasgow and Tayside in the first two years (Phase 1) before extending to other parts of Scotland in the remaining four years (Phase 2). In Phase 1, individuals aged between 35 and 55 years, living in the East and West of Scotland will be invited to participate, along with at least one (and preferably more) siblings and any other first degree relatives aged 18 or over. The total initial sample size will be 15,000 and it is planned that this will increase to 50,000 in Phase 2. All participants will be asked to contribute blood samples from which DNA will be extracted and stored for future investigation. The information from the DNA, along with answers to a life-style and medical history questionnaire, clinical and biochemical measurements taken at the time of donation, and subsequent health developments over the life course (traced through electronic health records) will be stored and used for research purposes. In addition, a detailed public consultation process will begin that will allow respondents' views to shape and develop the study. This is an important aspect to the research, and forms the continuation of a long-term parallel engagement process. DISCUSSION: As well as gene identification, the family-based study design will allow measurement of the heritability and familial aggregation of relevant quantitative traits, and the study of how genetic effects may vary by parent-of-origin. Long-term potential outcomes of this research include the targeting of disease prevention and treatment, and the development of screening tools based on the new genetic information. This study approach is complementary to other population-based genetic epidemiology studies, such as UK Biobank, which are established primarily to characterise genes and genetic risk in the population.

Adolescent↗
PubMed1994

A base in Scotland for the FPA.

The FPA (Family Planning Association) has re-established a presence in Scotland with the appointment of Anne Marie McKay as manager for Scotland. She comes to the FPA with a background in health promotion, working until recently on HIV and sexuality issues. Anne Marie's appointment and an office base in Glasgow mean a strengthening of the FPA's commitment to providing its services throughout the UK. The public and professionals will have access to information services, training, and materials in Scotland with a Scottish perspective as well as the existing support of a well-established national organization committed to promoting sexual well-being and family planning. Anne Marie sees her role as an important one: "I'm convinced that the FPA as a well-respected voluntary organization has a vital role to play in the promotion of sexual health in Scotland. I look forward to the challenges of this new post." By the end of the summer, the office in Glasgow will be functioning as "full steam" with the appointment of an information officer and a launch to ensure that the public and professionals know that the FPA is back in Scotland. Independent research for the FPA shows that the return of the organization is welcomed by relevant professionals in Scotland and the FPA resources and services are valued by them.

Administrative Personnel↗
PubMed2003

Establishment of a database of diagnosed HCV-infected persons in Scotland.

To provide a comprehensive understanding of the epidemiology of hepatitis C virus (HCV) infection in Scotland, a database of all persons known to have been infected with HCV in Scotland was established. Non-identifying data, held on the computers and requests forms in Scotland's principal and confirmatory HCV testing laboratories, were entered onto a National Database at the Scottish Centre for Infection and Environmental Health. As at December 2001, records from 13,519 persons in Scotland known to have been infected with HCV had been entered on to the database (one in 378 of Scotland's population). Of the 13,519, 69% were male and 90% of the 9,092 for whom risk factor information was available had injected drugs; 37% were from Greater Glasgow. Fifty-six per cent of the 13,519 were diagnosed between 1998 and 2001; 1,727 (23%) of the new diagnoses from 1998 to 2001 were aged under 25 years. The data provide an insight into the epidemiology of HCV infection in Scotland. They support other data, which indicate that the current major risk factor for HCV in the country is injecting drug use.

Adolescent↗
PubMed1996

Cancer in older persons in Scotland.

BACKGROUND: The average age in many populations in increasing. As the risk of most epithelial cancers increases with age, numbers of people with cancer can also be expected to grow. METHODS: Incidence data from the Scottish Cancer Registry for the period 1981-1990 were used to examine the size of the cancer burden in those aged 75 years and over. The future burden of cancer in Scotland was estimated by applying current age specific rates to population projections. Cancer survival in older cancer patients in Scotland was examined and comparisons made with other selected countries. The place of treatment of people under and over 75 in Scotland was investigated. RESULTS: Approximately 30% of the total cancer burden in Scotland and other countries occurs in the elderly. The total number of incident cases in Scotland in those aged 75 and over is estimated to rise by approximately 60% in males and 20% in females by 2029. A decline in survival is seen with increasing age. Older people with cancer in Scotland are less likely to be treated outwit their area of residence and are more likely to be admitted to institutions which admit small numbers of patients. CONCLUSIONS: Cancer in older persons contributes a significant proportion of the overall cancer burden. The burden of cancer in the elderly is likely to grow. More work needs to be done characterising cancer and its treatment in older persons.

Adolescent↗
PubMed1999

Case and control recruitment, and validation of cases for the MICA case-control study in England, Scotland and Wales.

OBJECTIVES: To describe the processes involved in the selection of cases and controls, and the validation of case diagnosis, in a large case-control study on the association between myocardial infarction (MI) and oral contraceptives. DESIGN: Community case-control study in England, Scotland and Wales. SUBJECTS: Cases were women aged 16-44 with a diagnosis of MI. Controls were age and general practice matched women without a diagnosis of MI. RESULTS: The proportion of interviewed cases per number eligible was 19% (95% CI 12-26%) lower in England and Wales than in Scotland. The kappa score for agreement between three cardiologists on diagnostic categories of the potential cases was 0.52 overall ('moderate' agreement). For the 35 cases resubmitted for categorization, the kappa scores for agreement between the first and second classification for the two national committee cardiologists were 0.32 and 0.23 ('fair' agreement). Age matching of controls was better in Scotland than England and Wales, the proportion of the first choice controls being 14% (95% CI 8-19%) higher in Scotland. The mean time to complete a cluster of interviews (one case and four controls) was 36 days in Scotland and 63 days in England and Wales. CONCLUSIONS: Very close age-matching was achieved overall, although the process was more efficient in Scotland than in England and Wales. Some suggestions for improvement in the case validation process are made.

Journal Article↗
PubMed1999

Population-based cohort study of microbial keratitis in Scotland: incidence and features.

OBJECTIVE: To investigate the incidence and features of bacterial, fungal and protozoal keratitis in Scotland. DESIGN: Prospective, population-based cohort study of all persons who developed culture proven microbial keratitis over an 8 month period. SETTING: West of Scotland, UK. SUBJECTS: Approximately 3,000,000 population. MAIN OUTCOME MEASURES: Incidence and risk factors for microbial keratitis. METHODS: All patients were included who had presumed microbial keratitis from which bacteria, fungi or Acanthamoeba was isolated from the corneal scraping by the hospital laboratory using a standardised protocol. In addition, contact lens wearing patients with pathognomonic features of Acanthamoeba keratitis, who yielded a negative culture result when referred on chlorhexidine therapy, were included if Acanthamoeba could be cultured from their lens storage case. RESULTS: The overall annual incidence of culture-proven microbial keratitis was 0.26 per 10,000 with a rate of 1.8 per 10,000 for contact lens wearers (all types, soft and rigid). Based on a previous pilot study of 'presumed' microbial keratitis in Glasgow, it was possible to estimate the incidence of expected 'presumed' microbial keratitis as 0.36 per 10,000 overall and 2.44 per 10,000 for contact lens wearers (all types). The incidence for Acanthamoeba keratitis was 1.49 per 10,000 soft contact lens wearers; this infection was not detected in the absence of contact lens wear nor with use of gas permeable or rigid contact lenses. CONCLUSIONS: 'Presumed' microbial keratitis from all causes, in the adult population, was approximately three times less common in the West of Scotland (0.36 per 10,000) than would be expected from a comparable retrospective study from Minnesota, USA for the years 1980-1988 (1.1 per 10,000). It was rare (approximately one case expected in 2 million per year) in the absence of pre-existing corneal disease, cosmetic contact lens wear or trauma. Ocular surface disease was the underlying cause predisposing to infection in 58% of cases, with an incidence of 'presumed' keratitis of 0.21 per 10,000 population; the highest incidence was found in the elderly population. Contact lens wear was responsible for 38% of cases, emphasising the importance of preventive hygiene and effective disinfection in this group. The estimated incidence of 'presumed' microbial keratitis in the West of Scotland associated with cosmetic wear (daily and extended use) of soft contact lenses was significantly less (P<0.05) than that expected from a prospective study in New England, America in 1985 (266 per 10,000, rather than 8.05 per 10,000). However, the estimated incidence for presumed microbial keratitis for the West of Scotland associated with wearing soft contact lenses for cosmetic purposes in the daily wear modality (266 per 10,000) was less, but not significantly less, than that found in the prospective American study (4.20 per 10,000). The daily wear mode for contact lenses is almost universal in the West of Scotland, where extended wear has never been recommended. Extended wear has been shown in the USA to be associated with an incidence of presumed microbial keratitis between five and ten times higher than that associated with daily wear. This explains the lower incidence we have observed and a difference with the US study for overall infection rates but not when associated with daily wear alone. The incidence of proven Acanthamoeba keratitis found in the Scottish study among wearers of soft contact lenses for daily wear cosmetic purposes was exceptionally high at 1.49 per 10,000.

Journal Article↗
PubMed1999

Acanthamoeba keratitis in Scotland: risk factors for contact lens wearers.

OBJECTIVE: To investigate risk factors for Acanthamoeba keratitis amongst contact lens wearers in Scotland. DESIGN: Patients with Acanthamoeba keratitis in the Scottish study, all of whom wore contact lenses, were compared with 46 healthy asymptomatic contact lens-wearing controls. They were all visited at home for contact lens and environmental microbiological sampling. In addition, all 288 optical practices in the West of Scotland were polled for contact lens types and disinfecting solutions sold in 1995, and a sample, each of whom fitted more than 500 contact lenses per year, were polled for a second time. Independently, a poll was commissioned by the Eyecare Information Service in July/August 1995 to estimate the numbers of contact lens wearers in Scotland and the UK. Industry was polled for numbers of each contact lens disinfecting regimen sold in Scotland in 1995. SETTING: West of Scotland, UK. SUBJECTS: All contact lens wearers among the 3 million population of the West of Scotland Health Board Areas. MAIN OUTCOME MEASURES: Risk factors for Acanthamoeba infection and recommendations for its prevention. RESULTS: When Acanthamoeba infection occurred, patients' home water systems were frequently (54%) found to be colonised by this amoeba. Patients more frequently washed their storage cases in tap water than controls (P<0.05) with resulting contamination, kept storage cases wet rather than air drying them (P<0.05), and had coliform bacteria cultured from the storage case (P<0.05) and had viable Acanthamoeba within the storage case (P<0.0001). Overall, patients were found to have significantly more risk factors than controls (P<0.0001). The noncompliant use of chlorine tablet disinfection, or failure to disinfect contact lenses at all, was associated with increased risk (P<0.05). Ionic high water content contact lenses (FDA group 4 material), when used without disinfection or with non-compliant use of low chlorine (Soflab) tablet-based disinfection, were associated with increased risk of Acanthamoeba infection (P<0.05). In log-linear modelling of risky hygiene behaviours associated with contamination of storage cases with Acanthamoeba, the most significant behaviour was found to be use of the less effective disinfection methods (chlorine tablets or no disinfection). However further investigation showed that these methods were associated with an increased probability of rinsing the storage case in tap water, so that these two behaviours are confounded in the group studied. CONCLUSIONS: Failure to disinfect contact lenses, non-compliant use of chlorine tablets and/or introduction of tap water rinsing of storage cases were associated with increased risk of Acanthamoeba infection. New multipurpose solutions and hydrogen peroxide gave the lowest risk of Acanthamoeba infection, with no statistically significant difference between them. Ionic high-water content (FDA group 4) contact lenses were at increased risk of being associated with Acanthamoeba keratitis if used without effective disinfection (multipurpose solutions or hydrogen peroxide). The use of domestic tap water for contact lens and storage case hygiene must be avoided, as a chain-of-causation' was identified from the home water supply.

Journal Article↗
PubMed2005

The dental caries experience of 5-year-old children in England and Wales (2003/4) and in Scotland (2002/3). Surveys co-ordinated by the British Association for the Study of Community Dentistry.

OBJECTIVE: This paper reports the results of standardized clinical caries examinations of 5 year old children from across England and Wales in 2003/4 and Scotland in 2002/3. These co-ordinated surveys are the latest in a series which seek to monitor the dental health of children and to assess the delivery of dental services. METHOD: The criteria and conventions of the British Association for the Study of Community Dentistry were used. Representative samples were drawn from participating strategic health authorities (SHAs), primary care trusts (PCTs) and health boards (HBs). Caries was diagnosed at the caries into dentine threshold using a visual method without radiography or fibre-optic transillumination. Data for Jersey and the Isle of Man are also included. RESULTS: The results again demonstrated a wide variation in disease prevalence and care strategies across Great Britain. Mean values for d3mft within the current English Strategic Health Authorities ranged from 0.47 in Maidstone Weald (South) to 3.69 in North Kirklees (North); in Wales mean values ranged from 1.48 in Flintshire (NW) to 3.73 in Merthyr (SE); while in Scotland they ranged from 1.29 in Borders to 3.67 in Argyll & Clyde. Mean d3mft across England was 1.49 (d3t = 1.12, mt = 0.19, ft = 0.18), across Wales it was 2.42 (d3t = 1.70, mt = 0.43, ft = 0.29) and across Scotland values were 2.76 (d3t = 1.87, mt = 0.65, ft = 0.24). Overall, 39.6% of children in England & Wales and 55.4% of children inspected in Scotland had evidence of caries experience in dentine (d3mft > 0, including visual dentine caries). The distribution of caries was highly skewed. Thus the mean caries experience for those with dentinal decay in England and Wales was 3.90, as opposed to the overall mean of 1.55; in Scotland the corresponding values were 4.98 and 2.76. Trends over time demonstrate virtually no change in the overall mean d3mft for England and Wales since 2001/2, although the mean value for those with dentine decay experience increased marginally from 3.83 to 3.90. In Scotland there had been deterioration in the overall mean (2.76 as compared to the 2.55 reported in 1999). The care index has also fallen (for example in England & Wales to 12% from 13.2% in 2001/2002 and 14.3% in 1999/2000). CONCLUSION: There has been no overall improvement in the dental health of 5 year old children over the last 2 years. Geographic variation in oral health is marked at both the local and national levels. Overall, the provision of operative care for those with dentinal decay has again decreased slightly. While many children enjoy good oral health, sizable groups remain within the population of 5 year old children who have a clinically significant burden of preventable dental disease.

Child, Preschool↗
PubMed2005

McDonald's restaurants and neighborhood deprivation in Scotland and England.

BACKGROUND: Features of the local fast food environment have been hypothesized to contribute to the greater prevalence of obesity in deprived neighborhoods. However, few studies have investigated whether fast food outlets are more likely to be found in poorer areas, and those that have are local case studies. In this paper, using national-level data, we examine the association between neighborhood deprivation and the density of McDonald's restaurants in small census areas (neighborhoods) in Scotland and England. METHODS: Data on population, deprivation, and the location of McDonald's Restaurants were obtained for 38,987 small areas in Scotland and England (6505 "data zones" in Scotland, and 32,482 "super output areas" in England) in January 2005. Measures of McDonald's restaurants per 1000 people for each area were calculated, and areas were divided into quintiles of deprivation. Associations between neighborhood deprivation and outlet density were examined during February 2005, using one-way analysis of variance in Scotland, England, and both countries combined. RESULTS: Statistically significant positive associations were found between neighborhood deprivation and the mean number of McDonald's outlets per 1000 people for Scotland (p<0.001), England (p<0.001), and both countries combined (p<0.001). These associations were broadly linear with greater mean numbers of outlets per 1000 people occurring as deprivation levels increased. CONCLUSIONS: Observed associations between presence or absence of fast food outlets and neighborhood deprivation may provide support for environmental explanations for the higher prevalence of obesity in poor neighborhoods.

England↗
PubMed2006

How has legislation restricting paracetamol pack size affected patterns of deprivation related inequalities in self-harm in Scotland?

OBJECTIVE: To describe how changes in legislation to control sales and thus restrict the general availability of paracetamol have affected deprivation-related inequalities in deliberate self-harm associated with the drug in Scotland. DESIGN AND SETTING: A descriptive analysis of routine death and hospital discharge data for the entire Scottish population between 1995 and 2002. PARTICIPANTS: Patients in Scotland admitted to hospital with a diagnosis of poisoning and deaths in Scotland due to poisoning 1995-2002. OUTCOME MEASURES: Changes in mortality and overdose rates by deprivation quintile, and case fatality rates due to poisoning involving paracetamol. RESULTS: Rates of overdose involving paracetamol, while much higher in disadvantaged quintiles, fell in each deprivation quintile following the 1998 legislation. They then returned to levels similar, or above those in the mid 1990s. All quintiles were affected to a similar extent with the relationship between them remaining constant over time. Case fatality rates were significantly higher in more disadvantaged quintiles. CONCLUSIONS: Marked inequalities exist in paracetamol related harm in Scotland. The most disadvantaged groups (both male and female) have higher overdose and death rates, as well as higher case fatality rates. Following the restrictions all social groups saw similar reductions in paracetamol related harm. This effect has been short-lived and rates have returned to pre-legislation levels. Legislation has not permanently affected overall use of paracetamol in overdose in Scotland or reduced the proportion of patients taking paracetamol as a component of the overdose in the longer term. An important public health policy has failed to achieve its objective and it is not clear why. We need a better understanding of why this measure had only short-term benefits if its full potential is to be achieved.

Acetaminophen↗
PubMed2005

Urban/rural inequalities in suicide in Scotland, 1981-1999.

Although suicide accounts for a small percentage of deaths in Scotland (1.4% in 1999), it has been steadily increasing over the last two decades. In the US, Australia, England and Wales the greatest rises in suicide for this time period, occurred in rural areas. This study describes the pattern and magnitude of urban/rural variation in suicide in Scotland, examines methods of suicide within differing geographies and looks at trends in suicides over time. Scotland is split into four rurality types. Suicide data for all areas of Scotland (apart from Grampian which underwent changes in postcode sector boundaries in 1996) are investigated using Standardised Mortality Ratios (SMRs) and multilevel Poisson modelling, adjusting for age, sex and deprivation. SMRs for 1981-85, 1989-93 and 1995-99 are created across the four geographies, using the populations of Scotland in 1983, 1991 and 1997 as the standard populations (SMR=100). The highest rates in 1995-99 are seen in "remote rural" areas, SMR=125 (95% confidence interval 107-146). Models adjusted for age and deprivation show significantly greater risk of male suicide in remote rural areas relative to urban areas and significantly lower risk of female suicide in accessible rural areas. The method of suicide varies across ruralities for both males and females. The study considers how the relationship between suicides and rurality varies over time and how methods of suicide vary across different ruralities. The steepest rises in suicide amongst men, adjusting for age and deprivation, were seen to occur in accessible rural areas, however highest rates remain in remote rural areas.

Adult↗
PubMed2001

Manganese and land-use in upland catchments in Scotland.

Manganese (Mn) in surface waters is a micronutrient, but elevated concentrations are toxic to fish and impair drinking water quality. In Scotland, undesirable Mn concentrations (> 0.05 mg l(-1)) occur predominantly in upland freshwaters because the acidic pH and organic nature of catchment soils favour Mn mobilisation. The relationship between upland land-use in Scotland and Mn concentrations in surface waters is reviewed. Conifer afforestation is associated with enhanced Mn in runoff. Mn is leached from conifer foliage and litter, and mature conifers enhance acid deposition and loss of Mn from acidified catchment soils. After harvesting, increased soil pools of water-soluble Mn and elevated Mn concentrations in runoff have been observed. Liming, fertiliser addition, drainage ditch construction and ploughing to improve upland pastures, and muirburn on grouse moors may also increase Mn concentrations in runoff, but the evidence is less clear-cut. The extent to which land-use influences Mn concentrations in upland catchments in Scotland is modified by catchment hydrology and soil type. Catchment geology, instream processes and standing water stratification are probably lesser influences on Mn concentrations in surface waters of upland catchments in Scotland. The location of land-use in upland catchments, especially in the riparian zone, is critical in determining its effect on Mn in runoff. Climate change is expected to increase Mn concentrations in runoff from upland catchments in Scotland because of predicted changes in soil hydrology.

Agriculture↗
PubMed2002

Living with uncertainty: climate change, river flows and water resource management in Scotland.

The recent increased variability of Scotland's hydroclimate poses major problems for water resource managers charged with making informed investment decisions given the likely impact of future climate change. Two strategies are developed in this paper to assist managers faced with this environmental uncertainty. The first involves trend analysis of precipitation and runoff since the 1960s and 1970s viewed against longer-term variability reported from instrumental records. The second strategy is based upon current climate change scenarios coupled with GCMs, and downscaling of precipitation and temperature to provide inputs to rainfall-runoff models. The long-term records of precipitation (back to the 1860s) and runoff (back to the 1930s) reveal the late 1980s and early 1990s as the wettest period on record for the west but not for the east. Over the period 1961-1996 the precipitation gradient has intensified across Scotland: wetter west; relatively dry east. Changes in runoff over the period 1970-1996 are also reported with increases in annual flows at 33 out of 38 stations (significantly at 12 stations) and decreases in low flows at 21 out of 38 stations (significantly at one station). The bulk of these flow increases occurred in the south and west especially in the autumn and spring. In terms of high flows over the period 1970-1996, four out of 44 stations reported a change in magnitude and 15 reported an increase in the frequency of POT events. In terms of future climate change, Hulme and Jenkins (1998) predict annual precipitation increases of 6-16% (Scotland) and 6-14% (Scottish Borders) from the 2020s to the 2080s based on the Hadley Centre model (HadCM2) medium-high scenario. Seasonal changes are concentrated in the autumn (SON) and winter (DJF) with increases as high as 24 and 29% for the autumn by the 2080s. (Arnell NW, et al. Institute of Hydrology Report No. 107, Wallingford, 1996), using an earlier transient Hadley experiment (IS92a), predict a 5-15% increase in annual runoff across Scotland by the 2050s, locally rising to 25%. Simulation flow duration curves for the 2050s generate Q95 values up by 5% or less (Rivers Don, Almond and Nith) and Q5 up by 10-24% (Rivers Don, Almond, Nith and Lyne Water). In terms of water resource planning, these predicted changes should be regarded as first order approximations, as they take no account of natural climatic variability, and could generate different absolute values if other scenarios were used. The predictions are, however, broadly consistent with trends in precipitation and runoff for Scotland since the 1970s. Major issues of concern to water resource managers are identified and commented upon in the light of these predictions.

Climate↗
PubMed2002

Referral for secondary restorative dental care in rural and urban areas of Scotland: findings from the Highlands Et Islands Teledentistry Project.

OBJECTIVES: To compare the reported level of use of secondary care services for restorative dental care in rural and urban areas of Scotland. DESIGN: Postal questionnaire survey SUBJECTS AND METHODS: Postal questionnaire sent to all dentists in the Highland region, the island regions in Scotland and Dumfries Et Galloway (n = 150) and an equal number were sampled from the remainder of Scotland stratified by health board area. Non-respondents were sent 2 reminders after which 62% of the sample had responded. RESULTS: Most dentists (85%) who practised in what they considered were urban areas of Scotland said they felt that they had good access to a secondary referral service. Whereas most of those who practised in what they considered were rural areas either said they had no access to such a service (26%) or that access was difficult (53%), only 3% of those in urban areas said they had no access to a secondary restorative consultative service compared with 14% of dentists practising in rural areas of mainland Scotland and 54% of those practising on Scottish islands. CONCLUSIONS: The survey suggests the people of the Scottish islands and some of the remoter parts of the Scottish mainland would be among those who might benefit from improvement in access to a restorative dentistry consultant service.

Adult↗