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At least 865 records · Page 48Linked to original sources
PubMed2003

Healthy eating: the views of general practitioners and patients in Scotland.

BACKGROUND: Scotland has one of the poorest health records of all Western countries, and this has been linked to poor diet. A key part of efforts to improve health has been an action plan to improve the Scottish diet. General practice has been identified as an important setting for health promotion and the provision of healthy eating advice. OBJECTIVE: The objective was to investigate the views of general practitioners (GPs) and their patients about healthy eating and the provision of healthy eating advice in general practice. DESIGN: This qualitative research study used semistructured in-depth interviews with 15 general practitioners (8 female and 7 male) and 30 patients (15 married couples in social class 3, 4, or 5 with young children). RESULTS: The study found that health was only one priority in patients' everyday lives and that these patients were also questioning the relevance of healthy eating advice. GPs were divided in their opinions, with greater enthusiasm being displayed by the younger and female doctors. However, despite their differing views, GPs felt that general practice was better suited to specific rather than general health advice. CONCLUSIONS: If programs in general practice to address dietary inequalities are to succeed, both patients' views and GPs' views must be taken into account.

Attitude of Health Personnel↗
PubMed2002

Height in young adulthood and risk of death from cardiorespiratory disease: a prospective study of male former students of Glasgow University, Scotland.

To investigate the association between height in young, socially homogeneous males and cause-specific mortality, the authors conducted a prospective study of 8,361 male former students who underwent medical examinations while attending Glasgow University, Scotland, from 1948 to 1968. The mean age at examination was 20.5 (range, 16.1-30.0) years. The median follow-up time was 41.3 years. There were 863 deaths. In Cox proportional hazards modeling, there was no association between height and all-cause mortality with age-adjusted hazard ratios per 10-cm increase in height (hazard ratio = 0.92, 95% confidence interval: 0.83, 1.02). Height was inversely associated with all cardiovascular disease and coronary heart disease mortality, with hazard ratios per 10-cm increase in height of 0.78 (95% confidence interval: 0.66, 0.93) and 0.76 (95% confidence interval: 0.62, 0.93), respectively. Sizeable inverse associations with stroke and respiratory disease were also found, although these did not reach conventional levels of significance. There was no association with cancer or noncardiorespiratory disease mortality. There was a positive, although nonsignificant, association between height and mortality from aortic aneurysm. Controlling for confounding variables had little effect on these results. The findings suggest that factors operating in early life, and which influence height, also influence future cardiovascular health in men.

Adult↗
PubMed2006

Previous preeclampsia, preterm delivery, and delivery of a small for gestational age infant and the risk of unexplained stillbirth in the second pregnancy: a retrospective cohort study, Scotland, 1992-2001.

Women with a previous stillbirth are known to be at increased risk of stillbirth in subsequent pregnancies. However, few studies have addressed the association between other complications of pregnancy and the future risk of stillbirth. Using linkage of national pregnancy and perinatal death registries, the authors performed a retrospective cohort study of 133,163 women having a second birth in Scotland between 1992 and 2001 whose first infant was liveborn. The risk of unexplained stillbirth was increased among women with a previous preterm birth (adjusted hazard ratio (HR) = 2.04, 95% confidence interval (CI): 1.34, 3.11), previous delivery of a small for gestational age (SGA) infant (HR = 2.14, 95% CI: 1.59, 2.87), and previous preeclampsia (HR = 1.68, 95% CI: 1.07, 2.62). The associations were similar after adjustment for maternal age, height, marital and smoking status, and interpregnancy interval. There was a statistically significant positive interaction between previous delivery of a SGA infant and previous preeclampsia (p = 0.01): Women with this combination in their first pregnancy had an approximately fivefold risk of unexplained stillbirth in the second pregnancy (HR = 4.95, 95% CI: 2.63, 9.32). Associations were stronger with SGA unexplained stillbirths. The authors conclude that complicated first births of liveborn infants are associated with an increased risk of unexplained stillbirth in the next pregnancy.

Confidence Intervals↗
PubMedDate not supplied

Korsakoff's psychosis in Scotland: evidence for increased prevalence and regional variation.

Surveys of new long-stay mental hospital patients in Scotland find that 9% have a diagnosis of alcohol-related brain damage, mainly Korsakoff's psychosis (KP), whereas the rate was 5% in the old long-stay patients. The national hospital database shows a rise in rates of KP in figures for discharge diagnosis and for diagnosis of hospital residents during the past three decades. There is an argument for more specialized provision given the significance of this group of patients.

Age Factors↗
PubMedDate not supplied

Alcohol consumption, perceptions of community responses and attitudes to service provision: results from a survey of Indian, Chinese and Pakistani young people in Greater Glasgow, Scotland, UK.

AIMS: To gather prevalence data regarding alcohol consumption and gauge perceptions of community responses to alcohol and service provision in a sample of Pakistani, Indian and Chinese young people aged 16-25 years, in Greater Glasgow, Scotland, UK. METHODS: A survey methodology utilizing purposive sampling techniques (n = 174) was employed. Data were collected using an interviewer-administered questionnaire. RESULTS: Alcohol consumption amongst the target populations is currently lower than that of the general population. Predictors of alcohol consumption were found to include self-reported importance of religion (a negative association with consumption) and having same-ethnicity friends who drink alcohol. There was a lack of consensus amongst participants regarding whether service provision should be part of the mainstream or specialist for black and minority ethnic individuals. CONCLUSIONS: Alcohol consumption in the target populations may be increasing and service provision could benefit by including specialist services for black and minority ethnic groups, in addition to mainstream services that need to be culturally sensitive.

Adolescent↗
PubMed1987

Multiple sclerosis in north-east Scotland. An association with HLA-DQw1.

This study reports the frequencies of HLA antigens and the polymorphic variants of C4, C2, and Bf for 200 patients with multiple sclerosis (MS) living in the Grampian region of Scotland, an area of high disease prevalence. A group of 128 normal subjects from the same region were typed for comparison. Although the frequencies of HLA-B7 and DR2 in the patient group (43.3% and 49.4%, respectively) were found to be similar to those reported for other Northern European HLA studies on patients with MS, high frequencies of these antigens were also observed in the group of normal Grampian subjects (38.3% and 40.6%) the differences were not statistically significant. However, a significant association was found between the recently defined Class II HLA antigen, DQw1, and MS (P less than 0.006) when compared with controls. There were no significant differences in frequency of the polymorphisms of C4, C2, and Bf when the group of patients with MS was compared with the control group of normal subjects. The patients were subdivided according to disease severity, remittent versus progressive clinical course, age of onset of the disease and initial symptoms. The frequencies of the HLA and complement polymorphisms (C4, C2, and Bf) were analysed in these subdivisions. DQw1 was found with similar frequency in severe and benign disease (78% and 80%, respectively) but DR2 was most frequent in the group of patients with remittent disease (54%). There were no significant differences in frequency of the polymorphisms of C4, C2, and Bf between the above subgroups of patients and overall no significant HLA associations were found with age of onset of disease or initial symptoms. The findings suggest that in an area of high prevalence of MS, the disease is more closely associated with DQw1 than DR2. Furthermore, there was no evidence to support the hypothesis that the HLA region complement gene polymorphisms show significant association with a putative HLA-linked MS susceptibility gene.

Complement C4↗
PubMed1990

Clinical aspects of multiple sclerosis in north-east Scotland with particular reference to its course and prognosis.

The prognosis and course of multiple sclerosis (MS) and the factors that affect them were assessed in a group of 1055 patients, representing an unselected (epidemiological) sample observed in the north-east (Grampian region) of Scotland for a period ranging between 1 and 60 yrs. In 7% the disease began before the age of 20 yrs, in 12% after the age of 50 yrs, and in the remainder onset was between the ages of 20 and 50 yrs. The male/female ratio was 1:1.8. Mean disease duration in those observed until death (216 patients) was 24.5 yrs, with no significant difference between the sexes. Prognosis was assessed either by the interval between onset and death or by the degree of disability over a defined period of time. Depending on the length of follow-up, just over one-quarter (26%) to over one-third (36.3%) had a benign course and between 8.0 and 17.7% had a poor prognosis. Nearly a third had a remittent (32.8%) or relapsing cumulative (34%) course and 9% had a progressive course from the start. Several factors were noted to affect the prognosis. Prognosis was significantly better, independent of sex, in those with (1) an early onset (less than 40 yrs of age); (2) retrobulbar neuritis or a brainstem lesion or sensory symptoms alone at onset; (3) short duration of initial symptoms (less than 6 months); (4) a long onset--first relapse interval (greater than 1 yr); (5) a remittent course in the beginning and (6) lack of a family history of MS. The factors which predicted a poor prognosis included: (1) a late onset (greater than 40 yrs of age); (2) progressive course from the start; (3) multiple sites of lesions initially, or a cerebellar or spinal cord lesion at the onset; (4) psychiatric or persistent urinary symptoms at the onset or within 10 yrs; (5) persistent initial symptoms (beyond 1 yr); (6) early first relapse (within 6 months); (7) a family history of MS; (8) social class status IV and V; and (9) bilaterally prolonged visual evoked potential (VEP) P100 latency. Address in childhood and at the onset of the disease, changes in the CSF and CT brain scan were not of predictive value.

Adult↗
PubMedDate not supplied

Paralytic poliomyelitis and nonpolio enteroviruses: studies in Scotland.

Poliomyelitis has been well controlled in Scotland by vaccination. Occasional cases of paralysis still occur in association with enteroviruses, especially coxsackieviruses. Most cases were attributable to coxsackievirus A7, which was identified in 77 cases, 12 of them paralytic (one fatal), from 1956 to 1973 (including outbreaks in 1959 and 1963) but not since then. Serologic findings suggesting poliovirus infection have been obtained in several paralytic illnesses at a late stage, months after acute illnesses in which the possibility of poliomyelitis was not considered by physicians, who no longer expect to encounter cases of poliomyelitis.

Adult↗
PubMed1991

Managing miscarriage: the management of the emotional sequelae of miscarriage in training practices in the West of Scotland.

Miscarriage is a very common event which is rarely a medical emergency, and which, from a biomedical perspective, may justifiably be viewed as a 'normal' complication of early pregnancy. From the mother's point of view however, the loss of a wanted pregnancy may be viewed quite differently. A number of studies have identified significant levels of dissatisfaction with the medical care which women have received at the time of a miscarriage. This paper describes a survey of the management of miscarriage by general practitioner trainees and trainers in the West of Scotland and on the basis of responses to a series of MEQ-type questions, indicates GPs views on the importance of counselling, sympathetic listening and good information in this area. The translation of these attitudes and beliefs into practice is, of course, a different issue, and one which may be affected by the task-oriented approach of the new contract.

Abortion, Spontaneous↗
PubMed2005

How and why are non-prescription analgesics used in Scotland?

BACKGROUND: UK Government policy increasingly encourages self-care of minor illnesses, including self-medication. Analgesics constitute a quarter of UK over-the-counter medicines sales, but concerns have been expressed about their potential for inappropriate use. OBJECTIVES: To estimate the prevalence of recent use of non-prescription analgesics in Scotland, to describe by whom they are used, and to estimate inappropriate use. METHOD: A cross-sectional postal survey consisting of a self-completed questionnaire that collected data on respondents' use of non-prescription and prescription medicines, as well as demographic and lifestyle data. The sample comprised 2708 subjects of 18 years and over, randomly selected from the Scottish electoral roll. RESULTS: The response rate was 55% (n=1501). Some 37% (555/1501) of respondents had used a non-prescription analgesic in the previous two weeks. Analgesics accounted for 59% (636/1081) of all non-prescription medicines used in that period. After controlling for all other variables, age, sex, level of education, self-reported health status, prescription exemption status, and use of prescription analgesics, remained significant predictors of non-prescription analgesic use. There was evidence of possible inappropriate use of non-prescription analgesics including use of multiple analgesics (n=67), use by individuals self-reporting conditions associated with cautious use of certain analgesics (n=51), and potential drug-drug interactions (n=15). A few respondents appeared to be using non-prescription analgesics to supplement medical treatment of chronic conditions (n=4). CONCLUSIONS: Our findings have demonstrated a high level of use of non-prescription analgesics amongst the general public, with significant potential for inappropriate use. As we move towards a culture of increased self-management of minor illness, this demonstrated need for improved pharmacovigilance of non-prescribed medicines must be addressed.

Adult↗
PubMed1999

Introgression through rare hybridization: A genetic study of a hybrid zone between red and sika deer (genus Cervus) in Argyll, Scotland.

In this article we describe the structure of a hybrid zone in Argyll, Scotland, between native red deer (Cervus elaphus) and introduced Japanese sika deer (Cervus nippon), on the basis of a genetic analysis using 11 microsatellite markers and mitochondrial DNA. In contrast to the findings of a previous study of the same population, we conclude that the deer fall into two distinct genetic classes, corresponding to either a sika-like or red-like phenotype. Introgression is rare at any one locus, but where the taxa overlap up to 40% of deer carry apparently introgressed alleles. While most putative hybrids are heterozygous at only one locus, there are rare multiple heterozygotes, reflecting significant linkage disequilibrium within both sika- and red-like populations. The rate of backcrossing into the sika population is estimated as H = 0.002 per generation and into red, H = 0.001 per generation. On the basis of historical evidence that red deer entered Kintyre only recently, a diffusion model evaluated by maximum likelihood shows that sika have increased at approximately 9.2% yr-1 from low frequency and disperse at a rate of approximately 3.7 km yr-1. Introgression into the red-like population is greater in the south, while introgression into sika varies little along the transect. For both sika- and red-like populations, the degree of introgression is 30-40% of that predicted from the rates of current hybridization inferred from linkage disequilibria; however, in neither case is this statistically significant evidence for selection against introgression.

Alleles↗
PubMed2004

Issues of participation, ownership and empowerment in a community development programme: tackling smoking in a low-income area in Scotland.

Founded on community development principles and practice, the 'Breathing Space' initiative aimed to produce a significant shift in community norms towards non-toleration and non-practice of smoking in a low-income area in Edinburgh, Scotland. The effectiveness of Breathing Space was evaluated using a quasi-experimental design, which incorporated a process evaluation in order to provide a description of the development and implementation of the intervention. Drawing on qualitative data from the process evaluation, this paper explores the varied and sometimes competing understandings of the endeavour held by those implementing the intervention. The paper examines the principles that underpin health promotion in the community setting, particularly the concepts of ownership, empowerment and participation, and their differential interpretation and employment by participants. The data illustrate how these varied understandings had implications for the joint planning and implementation of Breathing Space objectives. In addition, the different understandings raise questions about the appropriateness and viability of utilizing community development approaches in this context.

Community Participation↗
PubMed2006

Becoming a health promoting school: evaluating the process of effective implementation in Scotland.

Increasingly, researchers are exploring alternative ways of assessing the impact of 'Health Promoting School' (HPS) initiatives, in recognition of the model's emphasis on achieving change that is both enduring and far-reaching. However, it is still assumed that initiatives will lead to immediate change at the individual level. This paper challenges that view and argues that potential markers of success associated with process need to be identified earlier as a means of supporting schools and teachers. Notwithstanding differences in the way the HPS is conceptualized and implemented, four themes are highlighted that have relevance beyond any one school or country. These were drawn from a process evaluation of a European Network of HPSs Project in Scotland. They highlight the ways in which schools were able to successfully adopt HPS principles and the conditions that need to be in place for the HPS concept to flourish. Such indicators need to be given greater recognition as HPS outcomes if schools are to progress beyond the early stages of project implementation.

Cooperative Behavior↗
PubMed2004

Contextualizing smoking: masculinity, femininity and class differences in smoking in men and women from three generations in the west of Scotland.

The epidemiology of smoking, and contemporary and historical accounts of tobacco consumption, together suggest that the patterning of smoking by class, gender and gender role identities may differ markedly for people born at different stages in the establishment and demise of smoking in the 20th century. Here, we report an analysis that examines this assertion using empirical data collected from men and women living in the west of Scotland, an area with high rates of smoking, who were born in the 1930s, 1950s and 1970s. Class trends in smoking were less apparent for men than for women in the older two cohorts and there was little evidence of class patterning in either sex in the youngest participants. There was little relationship between the measures of gender role orientation and current smoking amongst men. Amongst women, the strongest association was between smoking and a well-validated measure of 'femininity' in the 1950s cohort; each unit increase in 'femininity' score increased the odds of being a smoker by 46%. In this same cohort of women, there was also a weaker relationship between smoking and higher masculinity scores. These results are discussed in the context of continuing use of gendered imagery to exploit new markets in the developing world.

Adult↗
PubMed2004

The influence of the secondary school setting on the food practices of young teenagers from disadvantaged backgrounds in Scotland.

In this paper, we explore the secondary school environment as an important context for understanding young teenagers' eating habits and food practices. We draw on data collected during semi-structured interviews with 36 young teenagers (aged 13/14 years) living in disadvantaged circumstances in Scotland. We found that the systems inherent in school had an impact on what, where and when participants ate their lunch. Each school had rules governing use of the school dining hall and participants sometimes chose to leave this environment to buy food outside school premises. Our interviews showed that parents determined how much money young people took to school and, therefore, had some control over their food choices. Participants rarely spoke of giving priority to food and eating during the non-curriculum parts of the school day, preferring to spend time 'hanging out' with friends. Eating with friends was sometimes reported as a cause of anxiety, particularly when participants had concerns about body image, appetite or appearance. We suggest that young teenagers' dislike for queuing for food, their ability to budget for food at school and their desire to maximize time spent with friends influence food choices; therefore, these are issues which have implications for health education and will be of interest to those responsible for school meal provision.

Adolescent↗
PubMed1989

Breathlessness, chronic bronchitis and reduced pulmonary function as predictors of cardiovascular disease mortality among men in England, Scotland and the United States.

Relationships between cardiovascular disease (CVD) mortality and breathlessness, a definition of chronic bronchitis, and pulmonary function are investigated among men in two employed populations (17,717 London civil servants and 4904 Scottish workers) and in two communities (844 men in Tecumseh, Michigan and 6859 men in Renfrew and Paisley Burghs, Scotland). Men are aged 40-64 years at entry in all studies except Renfrew-Paisley, where they are aged 45-64 years. Length of follow-up ranges from 6 to 16 years. Age and smoking habits were controlled for in all analyses. Chronic phlegm production is not significantly associated with CVD mortality, and 'chronic bronchitis' is significantly associated with mortality only in the employed populations. Low FEV1 is significantly associated with CVD mortality only in the Whitehall study; however, the rate ratios are above one in all studies. Breathlessness is significantly associated with CVD mortality in all studies. These associations between CVD mortality and 'chronic bronchitis', low FEV1, and breathlessness persist after also controlling for employment grade, systolic blood pressure, antihypertensive medication, ECG changes, plasma cholesterol level, body mass index and diabetes. Only the associations between breathlessness and mortality persist after further controlling for low FEV1 and myocardial ischaemia. The rate ratios between breathlessness and mortality are about two for all studies. It is concluded that in these populations, breathlessness is an independent and major predictor of CVD mortality.

Adult↗
PubMed1990

Trends in infant deaths from congenital anomalies: results from England and Wales, Scotland, Sweden and the United States.

Major strides have been made in reducing infant mortality in many parts of the world. As the number of infants dying from infectious diseases has declined, further reductions will require progress in reducing mortality in less tractable causes of death. As a result, the proportion of infant deaths attributable to congenital anomalies has been rising. Mortality due to different types of congenital anomalies is examined for the period 1976-1985 in the United States, England and Wales, Scotland and Sweden.

Congenital Abnormalities↗
PubMed1992

The antimicrobial susceptibility of Moraxella catarrhalis isolated in England and Scotland in 1991.

Between 1 January and 31 March 1991, 20 laboratories in England and Scotland sent a total of 413 consecutive clinical isolates of Moraxella catarrhalis to The London Hospital Medical College (LHMC). After confirmation of identity, the susceptibility of all isolates to 11 antimicrobial agents was determined. Of the 375 (90.8%) isolates which were found at LHMC to be beta-lactamase-positive, 174 produced zones of inhibition around 2 micrograms ampicillin disc which were greater than or equal to 20 mm in diameter and 252 were inhibited by less than or equal to 0.5 mg/L of ampicillin. However, 71 of these 375 had been reported to be ampicillin-susceptible by peripheral centres. While beta-lactamase had not been detected in 35 of these 71 isolates, the other 36 had been reported to be ampicillin-susceptible and beta-lactamase-positive. All 38 beta-lactamase-negative isolates produced zones greater than or equal to 30 mm in diameter and were inhibited by less than or equal to 0.06 mg/L of ampicillin. No M. catarrhalis isolate was found to be resistant to co-amoxiclav, tetracycline, chloramphenicol or cefaclor. Two strains showed intermediate susceptibility to erythromycin (MIC 1 mg/L) and 27 required greater than or equal to 32 mg/L of sulphamethoxazole for inhibition. Resistance to trimethoprim was uniform (MICs 2-128 mg/L). Two isolates showed intermediate susceptibility to cefixime (MIC 2 mg/L) but none was resistant to the new oral cephalosporin cefetamet or to the oral carbacephem loracarbef.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗