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PubMed1993

Prenatal diagnosis and management of anterior abdominal wall defects in the west of Scotland.

An attempt was made to identify all the cases of abdominal wall defects occurring in the West of Scotland over a 7-year period to determine the current incidence, prenatal diagnosis, management, and prognosis for fetuses and neonates with abdominal wall defects. Cases were identified because they presented either for prenatal diagnosis, or to the Department of Pathology following termination or spontaneous pregnancy loss, or as neonates to the Neonatal Surgical Department. The incidence of abdominal wall defects was found to be 1 in 2500 births. Exomphalos was diagnosed before birth in 66 per cent of cases, and in 30 per cent of cases it was associated with another major abnormality. There was a 20 per cent intact survival in the cases diagnosed prenatally who had no fetal anomaly and who opted to continue with the pregnancy. Gastroschisis was diagnosed before delivery in 70 per cent of cases, and in the group who continued with the pregnancy there was an intact survival of 77 per cent. Body stalk anomalies were all diagnosed prenatally and terminated. Maternal serum alpha-fetoprotein was elevated in 89 per cent of the cases with exomphalos and in 100 per cent of the cases with gastroschisis and body stalk anomalies in which it was tested.

Abdominal Muscles↗

PubMed2005

Changes in prescribing of inhaled corticosteroids (1999-2002) in Scotland.

PURPOSE: To investigate the trend in prescribing of inhaled corticosteroids and general practitioner (GP) consultations for respiratory diseases. METHODS: A longitudinal observation study of all prescriptions, from primary care, for inhaled corticosteroids dispensed in Scotland from January 1999 to May 2002 was undertaken. The main outcome measures were the trends in prescribing of inhaled corticosteroids and GP consultations for respiratory diseases. RESULTS AND CONCLUSIONS: The prescribing of all inhaled corticosteroids has risen over the study period. The rise in prescribing of the combination product containing fluticasone and salmeterol appears not to have been at the expense of the prescribing of fluticasone alone while the prescribing of the budesonide/eformoterol combination may be at the expense of budesonide (BUD) alone. GP consultations for both asthma and chronic obstructive pulmonary disease (COPD) have declined over a similar period. The increased prescribing of inhaled corticosteroids over this period is associated with the increased use of the fluticasone/salmeterol combination rather than an increase in the use of all inhaled corticosteroids. The accompanying fall in number of consultations with GPs may be due to this increased prescribing or a move to nurse led clinics.

Administration, Inhalation↗

PubMed2001

Pharmacoepidemiological research at the Medicines Monitoring Unit, Scotland: data protection and confidentiality.

The Medicines Monitoring Unit (MEMO) is a University-based organization that uses record-linkage techniques to construct an observational database for the population of Tayside, Scotland (approximately 400,000 people). This contains healthcare data indexed by a unique identifier, including data on all prescriptions dispensed, which facilitates pharmacoepidemiological (and other) research. It has hitherto been possible to carry out drug safety studies in the entire population, with access to original medical records of patients where necessary, that have satisfied ethical concerns and confidentiality legislation. However, the recent UK Data Protection Act 1998 (which enforces the 1995 European Directive on Data Protection) has important implications for MEMO's research. The Act has necessitated changes to the way in which research studies are carried out, with MEMO's objective being to ensure that research can continue while protecting the rights and privacy of individual patients. This involves anonymization of data, seeking specific ethical approval for research studies and obtaining relevant permissions from 'Caldicott Guardians', as described in this article.

Bioethics↗

PubMed2002

Wild salmonids and sea louse infestations on the west coast of Scotland: sources of infection and implications for the management of marine salmon farms.

The sea louse (Lepeophtheirus salmonis Krøyer) is a major health problem for both farmed and wild salmonids. This paper investigates louse epidemiology and management in the salmon-farming zone of western Scotland. Based on a review of the marine ecology of wild salmon (Salmo salar L) and sea trout (Salmo trutta L), and catch and farm production statistics, best estimates were made for numbers of wild and farm hosts present in coastal waters in March-June 2000. Applying data for ovigerous female louse infections and fecundity, the sources and risks of larval transmission to wild salmon and sea trout were modelled. Farm salmon in the second spring of production were the primary host group (98% of fish), while numbers of wild salmonids (< 1%) and escaped farm salmon (2%) were relatively insignificant. Farm salmon produced 97% of louse eggs at high levels (eight ovigerous lice per fish), and 78% at low levels (one per fish). Wild salmonids produced < 1% of eggs under both scenarios, but escaped farm salmon produced 3% and 21%, respectively. All hosts potentially cross-infect one another, but farm salmon are more likely to infect wild and farm smolts, and also other farm salmon. Monitoring of lice on sea trout in June 1998-2000 by the Association of West Coast Fisheries Trusts corroborated the model's conclusions. Localised epizootics occurred every year and coincided with the presence of ovigerous lice on local farms. In areas of mixed-year class production on farms, epizootics were evident every spring, but occurred every second spring in areas of single-year class production. In 1998-2000 at least 14-40% of sea trout were infected with potentially lethal infestations of lice. Ovigerous louse levels of < 0.005 per fish were required on farm salmon in the spring of 2000 to produce less eggs than those emitted by wild salmonids. With the industry's continued expansion, and thus increased numbers of farm salmon, a target of zero ovigerous lice will be required on farms to minimise impacts on wild salmonids. Due to the limited long-term efficacy and availability of louse medicines, management strategies are discussed which will improve control, including single-year class production over large areas, alternate S1-S1/2 smolt inputs, and 11-month production cycles.

Animals↗

PubMedDate not supplied

Incorporating HIV test data into forecasts of the AIDS epidemic in Scotland.

For AIDS cases in Scotland the date of HIV antibody positive diagnosis (HIV test date) is recorded on the AIDS case reports. Data are also available on the total numbers of individuals with HIV positive test reports in Scottish laboratories in each year since testing became available. These data are incorporated into a model of the HIV epidemic described in terms of testing rates by calendar year. The HIV infection curve is modelled as a step function, and the testing rates are allowed to differ between steps. Results are presented for intravenous drug users (IDUs) and for homosexual/bisexual men. The estimated rates of testing for the IDUs (estimates from 19 per cent to 44 per cent per year) are considerably higher than those for homosexual/bisexual men (estimates of 10 per cent to 17 per cent per year). Data on the year of testing for AIDS diagnoses gave relatively little improvement in estimates of the HIV infection curve. However, when this information is combined with data on the total number of HIV positive diagnoses per year, there is a dramatic improvement in the estimate of the HIV infection curve. This is particularly marked for infections in the most recent period and for the estimates of cumulative infections up to the present. However, these improvements are gained at the cost of assumptions of similar testing rates applying to all sections of the HIV infected populations, which will be difficult to check in practice. This suggests that these methods should not be used in isolation but in combination with other evidence about the spread of HIV infection in a population.

Acquired Immunodeficiency Syndrome↗

PubMed2002

Heterosexual risk behaviour among young teenagers in Scotland.

This paper provides the first detailed data on the heterosexual sexual experience of a large sample of 14-year-olds in Scotland. The paper investigates the prevalence, nature and correlates of early heterosexual intercourse, and the extent and correlates of condom use. Questionnaires were administered in 24 schools under examination conditions (N=7630). Eighteen per cent of boys and 15% of girls reported having had intercourse. Sixty per cent reported condoms were "used throughout". The most important correlate of sexual experience was low level of parental monitoring; the key predictor for condom use was whether or not the respondent talked to their partner about protection before having sexual intercourse.

Adolescent↗

PubMed1999

The molecular basis of GROD-storing neuronal ceroid lipofuscinoses in Scotland.

Two distinct clinical subtypes of neuronal ceroid lipofuscinosis caused by mutations in the PPT gene, INCL and vJNCL/GROD, occur at a high frequency in the central region of Scotland. In this paper we summarize the clinical details and the molecular basis underlying the disease in the Scottish patients. Comparison of the combination of mutations in the different clinical types reveals a clear genotype-phenotype correlation.

Adolescent↗

PubMed1983

Renal cadmium content in the West of Scotland.

The trace element content of kidneys has been documented in very few international centres. Significant differences can be demonstrated between the cortical and medullary levels of calcium, zinc and cadmium. For the West of Scotland the values for the latter are similar to those found in Scandinavia. There are significantly higher cadmium contents in subjects who smoke and who have evidence of ischaemic heart disease.

Adolescent↗

PubMed1976

The occurrence of Hb E Saskatoon in Scotland.

The finding of several examples of Hb E Saskatoon in the Orkney Islands, in Edinburgh and in individuals of Scottish descent in Canada but nowhere else, suggests that the original mutation occurred in Scotland, perhaps in the Orkneys.

Genetics, Population↗

PubMed1983

Epidemiology of type 1 (insulin-dependent) diabetes in Scotland 1968-1976: evidence of an increasing incidence.

A computer file of all Scottish hospital admissions in the period 1968-1976 was searched to identify the 2,505 children (aged less than 19 years) with a diagnosis of diabetes. The average annual incidence of the disease (based on first hospital admission) was estimated to be 13.8 per 100,000 children aged less than 19 years (boys 14.4 per 100,000; girls 13.2 per 100,000). The highest incidence, 20.0 per 100,000 was in the age group 10-14 years and the lowest 7.1 per 100,000 in those aged less than 5 years. It is estimated that during the study period there was an 80% increase in the annual incidence of juvenile diabetes, from about 10 per 100,000 in 1968 to about 18 per 100,000 in 1976. First admission rates showed seasonal variations for those aged 5 years or more, with peaks in October/November and January/February. Marked variation was found in the incidence rates in the different counties of Scotland. The central lowlands which includes the cities of Edinburgh and Glasgow was an area of low incidence. There appeared to be an inverse correlation between the incidence rate in each county and population density. In Glasgow, there was an inverse association between the incidence rate in each city ward and the average number of persons per room. There was no evidence of space-clustering of the disease in different years within the parishes (rural districts) of each county and there was no convincing evidence that the variation in the incidence of diabetes between parishes in the same county was more than might have been expected to arise by chance. The observations are compatible with the disease having a viral aetiology but it is difficult to explain the striking rise in incidence over the study period on this basis.

Adolescent↗

PubMed1990

Mental illness in Northern Ireland. A comparison with Scotland and England.

First and all admissions to psychiatric hospitals and units during 1981 were obtained from the DHSS in England, Scotland and Northern Ireland. Age and sex standardized rates were calculated for each country. Possible reasons for observed rate differences are discussed. Whilst overall high rates of admissions in Northern Ireland are most likely attributable to provision and use of beds, these factors may not entirely account for high rates of admissions for neurotic disorder, particularly among males.

Adolescent↗

PubMed1994

A review of completed suicides in the Lothian and Borders Region of Scotland (1987-1991).

A review of 400 completed suicides encountered during a 5-year period (January 1987-December 1991) in the Lothian and Borders Region of Scotland (LBRS) was conducted. The incidence was 9.4 per 100,000 with a M:F ratio of 2.4:1; the elderly had a significantly higher (P < 0.001) rate (9.9 per 100,000) compared to adolescents (3.3 per 100,000). Significantly (P < 0.001) more cases occurred in the rural communities. Overall, the peak incidence was in the 45- to 54-year age group. Drug overdose was the most common (39%) method used by both sexes and in both urban and rural communities; it was the first choice for virtually all age groups, and females exhibited greater preference. Analgesics and tricyclic antidepressants were the most common drugs used. Hanging (19.8%) was popular among the young and the elderly (> 64 years) suicides. Inhalation of car exhaust (13.3%) was a rural phenomenon and was common in the 25- to 54-year age group. Jumping from heights (9.8%) was more common in the urban areas; an increasing trend in the use of this method by females was possibly emerging. Drowning (8.3%) exhibited no particular pattern and the use of firearms was relatively uncommon (2.8%). This study and any subsequent assessment of socio-medical factors associated with completed suicide in this region should provide a basis for the formulation of preventive strategies. A continuous monitoring of the trends in the LBRS is necessary.

Adolescent↗

PubMed1980

Studies on the parasite fauna of juvenile Atlantic salmon, Salmo salar L., cultured in fresh water in eastern Scotland.

The parasite fauna of juvenile Atlantic salmon, Salmo salar L., at a smolt-rearing unit in eastern Scotland was monitored from two weeks after first-feeding until smolting occurred (May 1973-April 1975). A total of 625 fish was examined. Wild salmon from the river supplying the unit with unfiltered water were also examined. The cultured fish yielded eight protozoan and seven metazoan parasite species, all derived from wild fish. The parasite fauna of cultured fish became established quickly, subsequent changes involving loss of some species and increasing abundance of others. The metazoan parasite fauna was restricted to those species with free-swimming infective stages capable of entering the tanks.

Acanthocephala↗

PubMed1991

Haemolytic uraemic syndrome in the defined population of northeast of Scotland.

Twenty seven cases of haemolytic-uraemic syndrome (HUS) were admitted to the Royal Aberdeen Children's Hospital between 1978 and 1989. All cases were from the defined childhood population of the Grampian region of Northeast of Scotland. Thirteen cases were admitted during the 2-year period 1987-1988 (Group 1). Of the 13 cases, 9 (Group 1 a) were admitted within the 11-month period between August 1987 and June 1988, and were from a small area (7 miles radius) within and around the City of Aberdeen. Their mean age was 7.1 years. Twelve cases of HUS were admitted between 1978 and 1986 and 2 cases were admitted in 1989 (total 14 cases; Group 2). Mean age was 3.0 years with no geographical clustering. The average annual incidence for group 2 was 1.25 per 100,000 children 0-16 years old.

Adolescent↗

PubMed1999

Life events in suicide and undetermined death in south-east Scotland: a case-control study using the method of psychological autopsy.

BACKGROUND: Adverse life events have been associated with increased risk of suicide. Mental disorders are also major risk factors for suicide. Matching cases and controls for mental disorder is thus appropriate in studies of suicide. This procedure was used to study the degree to which excess adversity was more common in cases who committed suicide as opposed to living controls matched for mental disorder. METHODS: The study formed part of a retrospective case-control comparison of cases of suicide/undetermined death with living controls using psychological autopsy in south-east Scotland. Cases and controls were matched for age, sex and mental disorder. Informants were those closest to cases and controls. Cases and controls were assessed for life events using the Interview for Life Events. The subjects were 45 cases of suicide/undetermined death and 40 living controls. RESULTS: Cases and controls did not differ significantly in severity of mental disorder. Adverse interpersonal events within the family (P = 0.01) with an odds ratio (OR) of 9.0 (95% CI, 1.3-399) and adverse physical health-related events (OR 5.0, 95% CI 1.1-47, P = 0.04) were significantly more common in cases than controls. CONCLUSIONS: Cases had significantly more adverse life events than controls overall. The categories accounting for these differences were interpersonal family adversity and physical ill-health. There were no significant differences in either the number or severity of ongoing difficulties between cases and controls. Recent adverse life events contribute to the increased risk of suicide even when age, sex and mental disorder are controlled for. Future research should examine interactions between social support and acute and chronic adversity.

Adult↗

PubMed2000

Psychometric properties of the Parental Bonding Instrument and its association with psychological distress in a group of incarcerated young offenders in Scotland.

BACKGROUND: The Parental Bonding Instrument (PBI) was developed in order to help quantify the parental contribution to psychological distress. It has subsequently been shown to be of value in examining the influence of parents in many diverse areas including delinquency. METHOD: A shortened form of the PBI and the Hospital Anxiety and Depression Scale (HADS) were administered to a group of young offenders held in custody in Scotland. RESULTS: High levels of psychological distress were linked with low parental care, but there were no associations between psychological distress and parental control. However, an analysis of the factor structure found that, although the care factor of the PBI showed good internal reliability, the control factor was less well defined in this group. CONCLUSIONS: It is suggested that a three-factor solution representing care, control with regard to independence and protective control may be more appropriate.

Adolescent↗

PubMed2000

Arsenic metabolism in seaweed-eating sheep from Northern Scotland.

Cation exchange and anion exchange liquid chromatography were coupled to an ICP-MS and optimised for the separation of 13 different arsenic species in body fluids (arsenite, arsenate, dimethylarsinic acid (DMAA), monomethylarsonic acid (MMAA), trimethylarsine oxide (TMAO), tetramethylarsonium ion (TMA), arsenobetaine (AsB), arsenocholine (AsC), dimethylarsinoyl ethanol (DMAE) and four common dimethylarsinoylribosides (arsenosugars). The arsenic species were determined in seaweed extracts and in the urine and blood serum of seaweed-eating sheep from Northern Scotland. The sheep eat 2-4 kg of seaweed daily which is washed ashore on the most northern Island of Orkney. The urine, blood and wool of 20 North Ronaldsay sheep and kidney, liver and muscle from 11 sheep were sampled and analysed for their arsenic species. In addition five Dorset Finn sheep, which lived entirely on grass, were used as a control group. The sheep have a body burden of approximately 45-90 mg arsenic daily. Since the metabolism of arsenic species varies with the arsenite and arsenate being the most toxic, and organoarsenic compounds such as arsenobetaine the least toxic compounds, the determination of the arsenic species in the diet and their body fluids are important. The major arsenic species in their diet are arsenoribosides. The major metabolite excreted into urine and blood is DMAA (95 +/- 4.1%) with minor amounts of MMAA, riboside X, TMA and an unidentified species. The occurrence of MMAA is assumed to be a precursor of the exposure to inorganic arsenic, since demethylation of dimethylated or trimethylated organoarsenic compounds is not known (max. MMAA concentration 259 microg/L). The concentrations in the urine (3179 +/- 2667 microg/L) and blood (44 +/- 19 microg/kg) are at least two orders of magnitude higher than the level of arsenic in the urine of the control sheep or literature levels of blood for the unexposed sheep. The tissue samples (liver: 292 +/- 99 microg/kg, kidney: 565 +/- 193 microg/kg, muscle: 680 +/- 224 microg/kg) and wool samples (10470 +/- 5690 microg/kg) show elevated levels which are also 100 times higher than the levels for the unexposed sheep.

Animals↗

PubMed1998

Contrasting child and adolescent psychiatry services in Szeged, Hungary, and Glasgow, Scotland.

International comparisons of child and adolescent psychiatry services are rarely reported in the literature. The present study arose out of a TEMPUS collaborative project between the University Departments of Child and Adolescent Psychiatry in Szeged, Hungary, and Glasgow, Scotland. Using the Glasgow Audit Questionnaire, a profile of each service was obtained, including basic demographic data, types of disorders referred, treatment modalities used, and a measure of outcome. The results of this descriptive study indicate that although the two centres were broadly similar, there were major differences in the treatment modalities used. Reasons for the findings are discussed, as are the limitations of the study.

Adolescent↗