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PubMed2005

Comparison of drug use and psychiatric morbidity between prostitute and non-prostitute female drug users in Glasgow, Scotland.

AIMS: To compare psychiatric morbidity between 176 female drug users with lifetime involvement in prostitution (prostitutes) and 89 female drug users with no involvement (non-prostitutes) in Glasgow, Scotland. METHOD: The Revised Clinical Interview Schedule (CIS-R) measured current neurotic symptoms. RESULTS: Prostitutes were more likely to report adult physical (OR 1.8) or sexual abuse (OR 2.4), to have attempted suicide (OR 1.7) and to meet criteria for current depressive ideas (OR 1.8) than non-prostitutes. Seventy-two percent of prostitutes and sixty-seven percent of non-prostitutes met criteria for a level of current neurotic symptoms likely to need treatment (CIS-R > or = 18). Being in foster care (OR 8.9), being prescribed medication for emotional problems in the last 30 days (OR 7.7), adult sexual abuse (OR 4.5), poly drug use in the last 30 days (OR 3.6) and adult physical abuse (OR 2.6) were significantly associated with a CIS-R score of > or = 18 for prostitutes using multiple logistic regression. CONCLUSIONS: Higher rates of adulthood abuse among prostitutes may explain the greater proportion of prostitutes than non-prostitutes meeting criteria for current depressive ideas and lifetime suicide attempts.

Adult↗

PubMed2005

The long-term environmental behaviour of strontium and barium released from former mine workings in the granites of the Sunart region of Scotland, UK.

The concentrations of strontium and barium have been measured in water, sediment and the shells of mussels (Mytilus edulis) from a river system in the Sunart region of Scotland, UK. The aim was to establish the fate and mobility of these elements, which are slowly being released from old mine workings on the Strontian granites. Enhanced strontium (1500-2000 microg l(-1) and 250-290 microg l(-1)) and barium concentrations (316 microg l(-1) and 83 microg l(-1)) were found in the waters originating from the two mine drains studied. Both element were also found at significant levels in the river sediments taken from the vicinity of each drainage site (Sr: 225 microg g(-1) and 120-125 microg g(-1); Ba: 1380 microg g(-1) and 126-170 microg g(-1)). The data suggests that the sediments are acting as a reservoir for these group II cations from where they become distributed throughout the river system. Strontium is found to be incorporated into the shells (3.16-3.46 microg g(-1)) and pearls (3.57 microg g(-1)) of the blue mussel, located at the estuarine margin some 10 km downstream, at values close to the maximum expected (3.3% by weight of the calcium content). The study presents a view of the fate of barium and strontium in a river system over a prolonged period of time. As such it provides valuable information for studies that seek to model the impact of the accidental release of barium and strontium (including the important radionuclide 90Sr) into the environment.

Animals↗

PubMed2006

2,4-Dichlorophenoxyacetic acid (2,4-D) biodegradation in river sediments of Northeast-Scotland and its effect on the microbial communities (PLFA and DGGE).

A bench-scale study was conducted to investigate 2,4-D biodegradation rates at different concentrations (10, 100 and 1000 microg per gram of dry weight) in distinct sediments samples collected on the River Ythan, Northeast-Scotland. Mineralisation of 14C 2,4-D occurred mostly within 30 days for all tested concentrations with a degradation rate ranging from 5 to 750 microg d(-1). Biodegradation rates were affected by the biological and biochemical characteristics of the indigenous microbial community in the studied sediments rather than factors such as compound bioavailability and/or toxicity. PLFA-profiling provided evidences of the effect of 2,4-D amendments on the microbial communities and DGGE-profiling showed changes in the genetic potential of the microbial populations which might affect metabolic characteristics of the sediment. PLFAs biomarkers suggested that the pathway of alpha-ketoglutarate-dependent dioxygenase was the main route of 2,4-D biodegradation. This pathway is commonly found in microorganisms of the beta-subdivision of proteobacteria.

2,4-Dichlorophenoxyacetic Acid↗

PubMed2003

A polymorphism of the cholesteryl ester transfer protein gene predicts cardiovascular events in non-smokers in the West of Scotland Coronary Prevention Study.

AIM: The association of cholesteryl ester transfer protein (CETP) gene polymorphisms with risk of a cardiovascular event and whether any association was explained by an influence on high-density lipoprotein (HDL) levels or low-density lipoprotein (LDL) size was tested in the West of Scotland Coronary Prevention Study (WOSCOPS). Gene-smoking and gene-treatment interactions were investigated. METHODS AND RESULTS: Cases (n=498) and controls (n=1108) were typed for TaqIB, C(-631)A, C(-629)A, I405V and D442G CETP polymorphisms. Homozygotes for the TaqIB2 allele (B2B2) had a 30% reduced risk of a cardiovascular event (odds ratio [OR] 0.70, CI(95)0.51-0.96, P=0.03) compared to B1B1 homozygotes. Inclusion of HDL or LDL diameter in multivariate analysis only marginally attenuated the relationships. Non-smokers, but not smokers, showed a dose-dependent association of risk with TaqIB genotype. Treatment benefit was not significantly different in B1B1 (OR 0.71, pravastatin vs placebo), B1B2 (OR 0.68) and B2B2 (OR 0.61) individuals. The other CETP polymorphisms studied had no significant association with cardiovascular risk. Haplotype analysis did not add to the information given by the individual polymorphisms. CONCLUSION: The association between CETP TaqIB genotype and cardiovascular risk is primarily in non-smokers, is not fully explained by effects on HDL levels or LDL size, and the benefit of pravastatin treatment was not influenced by this polymorphism.

Aged↗

PubMed2004

Improvements in survival for women with breast cancer in Scotland between 1987 and 1993: impact of earlier diagnosis and changes in treatment.

We investigated changes in survival, and their causes, in women with early breast cancer diagnosed in Scotland. The Scottish Cancer Registry identified 1617 and 2077 such women, without metastases at diagnosis who underwent surgery as part of their primary treatment, diagnosed in 1987 and 1993, respectively. There was a statistically significant 11% improvement in 8-year survival between 1987 and 1993. Survival improved across almost all clinical/pathological, treatment and health care delivery/deprivation categories; improvement was not limited to those women diagnosed through the screening programme. In a multivariate model, improved survival appeared to be explained largely by screening and clinical/pathological prognostic factors. Deprivation also had an adverse effect on survival; however, the geographical variation in survival observed for women diagnosed in 1987 was not apparent by 1993. We did not demonstrate a significant independent effect of surgical caseload on survival. We conclude that survival has increased partly as a consequence of screening and earlier diagnosis, but also due to improvements in the organisation and delivery of care.

Adult↗

PubMed2006

Aortic trauma in Scotland--a population based study.

OBJECTIVES: This population-based study aims to determine the incidence, mechanisms and outcomes of aortic trauma in patients from Scotland between 1992-2002. METHODS: Patients with aortic trauma were identified from the Scottish Trauma Audit Group database. Demographics, mechanism of injury, initial management and outcome were analysed. RESULTS: 165 (0.3%) patients suffered trauma to the thoracic or abdominal aorta. Of these, 130 (79%) patients had an injury of the thoracic aorta, 33 (20%) an injury of the abdominal aorta and two (1%) had injuries of both. There were 123 (75%) men and 42 (25%) women with a median (range) age of 36 (14-90) years. Blunt trauma was responsible for 121 (73%) injuries, of which road traffic accidents were the most common mechanism. A further 44 (27%) aortic injuries were due to penetrating trauma, of which assault was the most common cause. The median (range) Injury Severity Score was 43 (16-75). Ninety (55%) patients died in the emergency department while 59 (32%) underwent attempted operative repair. The operative mortality was 35 (59%) of 59 patients and overall mortality 141 (86%) of 165 patients. CONCLUSIONS: The incidence of aortic trauma presenting to Scottish hospitals is low. The majority of patients do not survive to surgical repair and operative and overall mortality remain prohibitive.

Accidents, Traffic↗

PubMed2005

Vegetation composition of roadside verges in Scotland: the effects of nitrogen deposition, disturbance and management.

Vehicular emissions of NO(x) and NH(3) result in elevated concentrations of nitrogen at roadside verges. To determine the extent that vehicular nitrogen emissions, disturbance and management affect the vegetation composition of road verges, a survey of 92 verges in Scotland was carried out with sites stratified by background nitrogen deposition and road type. NO(x) and NH(3) concentrations were monitored at 15 key sites for a year, and showed a decreasing gradient with increasing distance from the road. Ellenberg fertility indices of the vegetation communities also showed a general decrease with increasing distance from the road, but there was no straightforward correlation with NO(x) and NH(3) air concentrations between sites. Cover of bare ground, ruderal species and salt-tolerant species were highest at the verge edge. The proximity of the verge to traffic is important both in terms of NO(x) and NH(3) gradients, but also for deposited salt, grit and physical disturbance.

Air Pollutants↗

PubMed2005

Sequential extraction combined with isotope analysis as a tool for the investigation of lead mobilisation in soils: application to organic-rich soils in an upland catchment in Scotland.

Sequential extraction (modified BCR procedure) combined with isotope analysis has been investigated as a tool for assessing mobilisation of lead into streams at an upland catchment in NE Scotland. The maximum lead concentrations (up to 110 mg kg(-1) in air-dried soil) occurred not at the surface but at about 10 cm depth. The lowest (206)Pb/(207)Pb ratios in any profile occurred, with one exception, at 2.5-5 cm depth. In the one exception, closest to the only road in the area, significantly lower (206)Pb/(207)Pb ratios in the surface soil together with much increased chloride concentrations (in comparison to other surface waters) indicated the possible mobilisation of roadside lead and transfer to the stream. The (206)Pb/(207)Pb ratios in extractable fractions tended at depth towards the ratio measured in the residual phase but the ratios in the oxidizable fraction increased to a value higher than that of the residual phase.

Environmental Monitoring↗

PubMed2005

Geographical access to imaging facilities for stroke patients in Scotland.

This study examines the geographical access to imaging facilities for suspected stroke patients in Scotland. A survey of Scottish clinical directors of radiology was initially undertaken to determine the current and future provision of brain imaging for the diagnosis of stroke. We analysed geographical and digital population data with geographical information systems software to determine access to brain imaging services for stroke patients during 'normal' working hours and 'out-of-hours'. The findings suggest that, in general, most departments are able to deliver scanning for stroke as set within current guidelines, at least in normal working hours. However, radiological departments are generally operating at full capacity, and there is restricted availability of scanning services for stroke in certain regions during weekend periods. It is vital that policy makers consider these findings when reviewing the guidelines for recommending scanning for stroke.

Diagnostic Imaging↗

PubMed2004

Voluntary or compulsory health care reform? The case of primary care organisations in Scotland.

Previous studies have suggested that voluntary reform of the delivery of primary care services is more likely to occur in affluent areas. Health system reforms that include voluntary participation of GPs may therefore lead to a two-tier service in terms of access to and utilisation of medical services. New primary care organisations in Scotland (local health care co-operatives) were introduced in 1999. These are groups of general practices and membership was voluntary. The aim of this study is to examine whether the voluntary nature of membership was likely to exacerbate or reduce inequalities in the provision of primary care services. Logistic regression analysis was used to identify differences in population, practice, and GP characteristics between general practices that have joined a co-operative and those that have not. The results indicated that practices located in deprived areas and covering populations with high levels of morbidity were more likely to join a co-operative. High workload decreased the probability of membership. General practices that found it difficult to obtain access to local authority residential care homes were more likely to join a co-operative. The number of fee claims for minor surgery sessions per whole-time equivalent GP increased the probability of membership. There is therefore some evidence indicating that general practices located in areas of high need are more likely to join a co-operative. This suggests that voluntary participation in these new primary care organisations may reduce rather than exacerbate inequalities in the provision of primary care.

Community Networks↗

PubMed2005

An exploration of the caring attributes and perceptions of work place change among gerontological nursing staff in England, Scotland and China (Hong Kong).

This study investigates caring attributes and perceptions of work place change among qualified and unqualified nursing staff working with older people in three countries. A Modified Caring Attributes Questionnaire and Perception of Workplace Change Schedule were administered to 737 staff. Caring attributes scores were highest for nurses working in long stay settings, and lowest in nurses aged 25-29 years. Nurses in Hong Kong appear better educated than UK counterparts. Staff development seemed more common in long stay settings. Results suggest workplace changes limiting care quality were more pronounced in Scotland. Reported job satisfaction and moral were lowest in the UK group.

Acute Disease↗

PubMed2006

The value of the electrocardiogram in risk assessment in primary prevention: experience from the West of Scotland Coronary Prevention Study.

Electrocardiograms (ECGs) were recorded at baseline, annually thereafter, and at run-out in the West of Scotland Coronary Prevention Study to which 6595 men aged from 45 to 65 years on entry were recruited. The baseline ECGs were analyzed with respect to (a) the primary end point of the study, namely, fatal or nonfatal myocardial infarction (MI) and (b) all-cause mortality. In addition, incident MIs were reviewed to determine those detected by ECG only. Heart rate, indexed left ventricular mass, frontal T axis, and T amplitude in lead I were all significantly predictive with respect to the primary end point in a multivariate analysis. With respect to all-cause mortality, minor ST-T changes, 10-second heart rate variability, and frontal T axis were similarly predictive. Of 355 incident MIs, 47.3% were silent or unrecognized and detected by ECG only. A simple ECG-based risk prediction equation for fatal and nonfatal MI is introduced.

Aged↗

PubMed2005

Bedsharing, roomsharing, and sudden infant death syndrome in Scotland: a case-control study.

OBJECTIVE: To examine the hypothesis that bedsharing with an infant is associated with an increased risk of sudden infant death syndrome (SIDS). STUDY DESIGN: A 1:2, case:control study in Scotland UK, population 5.1 million, including 123 infants who died of SIDS between January 1, 1996 and May 31, 2000, and 263 controls. The main outcome measure was sharing a sleep surface during last sleep. RESULTS: Sharing a sleep surface was associated with SIDS (multivariate OR 2.89, 95% CI 1.40, 5.97). The largest risk was associated with couch sharing (OR 66.9, 95% CI 2.8, 1597). Of 46 SIDS infants who bedshared during their last sleep, 40 (87%) were found in the parents' bed. Sharing a bed when <11 weeks (OR 10.20, 95% CI 2.99, 34.8) was associated with a greater risk, P = .010, compared with sharing when older (OR 1.07, 95% CI 0.32, 3.56). The association remained if mother did not smoke (OR 8.01, 95% CI 1.20, 53.3) or the infant was breastfed (OR 13.10, 95% CI 1.29, 133). CONCLUSIONS: Bedsharing is associated with an increased risk of SIDS for infants <11 weeks of age. Sharing a couch for sleep should be strongly discouraged at any age.

Beds↗

PubMed2025

Universal versus targeted chlorhexidine and mupirocin decolonisation and clinical and molecular epidemiology of Staphylococcus epidermidis bloodstream infections in patients in intensive care in Scotland, UK: a controlled time-series and longitudinal genotypic study.

BACKGROUND: There are concerns that biocide skin and mucous membrane decolonisation, which is widely used to prevent health-care-associated infections in intensive care units (ICUs), might select for multidrug-resistant pathogens. We aimed to evaluate the effects of de-escalating from universal to targeted skin and nasal decolonisation on Staphylococcus epidermidis bloodstream infections (SE-BSI). METHODS: We did a retrospective, before-after-control-impact time-series analysis and longitudinal genotypic study in two ICUs with divergent decolonisation practice in tertiary care hospitals of adjacent health boards in Scotland, UK. Participants were aged at least 16 years and admitted between July 1, 2009, and Feb 28, 2022. There were no exclusion criteria for the study. In ICU one (intervention site) universal decolonisation in all admissions was de-escalated to targeted decolonisation of meticillin-resistant Staphylococcus aureus (MRSA) carriers on Feb 1, 2019, while in ICU two (control site) targeted decolonisation was applied throughout. We collected bloodstream infection data from all causes, including clinically significant SE-BSI. Antimicrobial susceptibility testing was used to define meticillin-resistant S epidermidis (MRSE) and chlorhexidine susceptibility. We used multilocus sequence typing to identify sequence types from archived SE-BSI isolates. Whole-genome sequencing was applied to a sample from ICU one. The primary outcomes were incidence densities of all bloodstream infections, SE-BSI, and meticillin-resistant S epidermidis bloodstream infections (MRSE-BSI), and the percentage probability that SE-BSI were MRSE-BSI. The effects of de-escalation on primary outcomes were estimated by differences between the intervention and control sites, before and after de-escalation, using a before-after-control-impact time-series design. Secondary outcomes included the proportion of multidrug resistant sequence types, carriage of mobile genetic elements and genes for multidrug resistance and biofilm production. FINDINGS: Between July 1, 2009, and Feb 28, 2022, S epidermidis was identified in 334 (45%) of 735 bloodstream infections in ICU one, of which 197 occurred before the de-escalation intervention in Feb 1, 2019, and S epidermidis was identified in 167 (60%) of 278 bloodstream infections in ICU two. There was no increase in all bloodstream infection incidence coinciding with de-escalation in ICU one, whereas MRSE-BSI incidence declined significantly from 10·4 cases per 1000 occupied bed days (OBDs; 95% credible interval [CrI] 7·2-15·4) to 4·3 cases per 1000 OBDs (2·5-6·7), as did the percentage probability of MRSE (from 89·2%, 95% CrI 77·8-96·5 to 56·7%, 34·3-77·5%). No significant changes in the primary outcomes were seen in ICU two. MRSE-BSI incidence density was positively associated with chlorhexidine use, but not mupirocin use. De-escalation was associated with a reduced proportion of SE-BSI due to multidrug-resistant sequence types and reduced carriage of mobile genetic elements and genes for multidrug resistance and biofilm production, as observed by multi-locus sequence typing and whole genome sequencing. INTERPRETATION: In ICU settings with low MRSA incidence, the benefits of universal decolonisation should be balanced against the risks of selecting MRSE sequence types adapted for invasive and device-associated infection. FUNDING: National Health Service Grampian Charity.

Humans↗

PubMed2006

Legal aspects of conserving native oysters in Scotland.

Native oysters (Ostrea edulis) historically supported valuable fisheries in Scotland, but are now absent from areas of former abundance on the east coast and occur mainly in isolated populations in west coast sea lochs. The main contemporary threat is from unauthorized gathering. In most places, the exclusive right to gather is retained by the Crown, as a remnant of the feudal system, but in some areas the right has been acquired by individuals or institutions. A temporary right to gather oysters may be obtained by permit from the proprietor, or through a Several or Regulating Order made under shellfish fisheries legislation. The right to gather oysters is separate from ownership of the foreshore or sea bed on which they are located. To receive the maximum legal protection, oyster beds must be marked out, or the rights to them otherwise adequately made known. Wild or formerly-cultivated oyster beds may not meet this criterion and, in any case, enforcement is difficult in remote locations. It has been proposed that there should be a statutory public right to gather oysters. Were this to be created, then strong conservation measures would need to be implemented to protect native oysters from eradication by uncontrolled gathering.

Animals↗

PubMed2006

A longitudinal follow up of women in their practice of perinatal pelvic floor exercises and stress urinary incontinence in North-East Scotland.

OBJECTIVES: to establish the reported practice of pelvic floor exercises and stress urinary incontinence after delivery. DESIGN: a longitudinal study using a postnatal postal questionnaire. PARTICIPANTS: 257 women in the North-East of Scotland were sent questionnaires between June and December 2000, 6-12 months after delivery (previously recruited and interviewed during the last trimester of pregnancy). One hundred and sixty-three women responded (63.4%). FINDINGS: more women reported the practice of pelvic floor exercises after delivery than during pregnancy: 134 (83.2%) compared with 123 (76.4%). Six to 12 months after delivery, 96 (60%) women said that they were still doing the exercises. A third of respondents (n=54, 33.1%) reported stress incontinence at some time since having the baby. Of those reporting incontinence at the time of questionnaire completion, six (19.3%) said the incontinence was moderate or severe, whereas eight (34.7%) reported incontinence once a week or more. Women who had an operative vaginal delivery (forceps or ventouse delivery) were more likely to report the practice of pelvic floor exercises than those having a spontaneous vaginal delivery. No significant difference was found in reported rates of stress incontinence between women who had different modes of delivery. The practice of pelvic floor exercises daily or more often during pregnancy was associated with less reported postnatal incontinence compared with less frequent practice. KEY CONCLUSIONS: self-reported rates of practice of pelvic floor exercises increased from pregnancy to the immediate postnatal period and subsequently declined. A third of women reported the symptoms of stress incontinence after delivery. Daily or more frequent practice of the exercises during pregnancy may be required in order to prevent postnatal incontinence (although further research is required to confirm this finding). IMPLICATIONS FOR PRACTICE: midwives should continue to encourage regular and frequent practice of pelvic floor exercises in the postnatal period and beyond. They also need to ask about symptoms of stress incontinence and refer as necessary.

Adolescent↗

PubMed2007

A cross-sectional study of knowledge and practice of pelvic floor exercises during pregnancy and associated symptoms of stress urinary incontinence in North-East Scotland.

OBJECTIVES: to establish levels of knowledge about pelvic floor exercises during pregnancy; reported practice of pelvic floor exercises in pregnancy; and prevalence of stress urinary incontinence in a sample of women in the third trimester of pregnancy. DESIGN: structured cross-sectional interview survey. PARTICIPANTS: pregnant women over the age of 16 years and more than 30 weeks gestation attending antenatal clinics in North-East Scotland. Of 350 women who agreed to participate, 289 (82.6%) were interviewed between July 1999 and March 2000. FINDINGS: 225 women (77.9%) reported being given or obtaining information about pelvic floor exercises in the current pregnancy. Books were the most frequently mentioned source of information. Midwives were the health professionals most likely to give information about pelvic floor exercises. Younger women, first-time mothers and those from more deprived backgrounds were less likely to report having information about the exercises. A third of women (n=90, 31.1%) said that they would have liked more information about the exercises. Practice of the exercises during pregnancy was reported by just over half the sample (n=156, 54.0%) and more than once a day by 26.3% (n=76). Younger women, and those from more deprived backgrounds, were less likely to report the practice of exercises. No difference was found in reported practice according to parity. More than half (n=157, 54.3%) of the women reported incontinence during the current pregnancy. No relationship was found between reported practice of pelvic floor exercises and stress urinary incontinence. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: the number of women who indicated a desire for more information and the low number who reported practice of the exercises suggest that improvements could be made. The gaps in information provision and practice suggest areas for future health promotion about the exercises, particularly by midwives, as not all women are seen by a physiotherapist during pregnancy. Reported levels of incontinence during pregnancy confirm previous findings and highlight the prevalence of incontinence in pregnancy.

Adolescent↗

PubMed2004

A comparative study of the course-related family and financial problems of mature nursing students in Scotland and Australia.

This study reports a comparative survey of mature students undertaking pre-registration undergraduate nursing education in Australia and Scotland. The study aimed to explore comparisons between the course-related and course-related financial difficulties faced by mature students in two very different educational and funding systems. Financial stress is a predictor of both physical and mental health problems. A similar pattern of course-related problems were reported by both Australian and Scottish students with the exception that Scottish students experienced more problems with childcare and caring for elderly relatives. Course-related problems may be inherent in the nature of undergraduate nursing education although the relatively time-intensive nature of Scottish curricula may explain the childcare and elderly relatives difference. Scottish students reported higher overall financial-related problems but Australian students reported more problems with funding placements. These findings have implications for both curriculum designers and policy makers.

Adaptation, Psychological↗