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 1,009 records · Page 56Linked to original sources
PubMed2004

Ethical issues in public health: a qualitative study of public health practice in Scotland.

STUDY OBJECTIVE: To identify ethical issues encountered by staff in the development and implementation of public health activities at two sites in Scotland. DESIGN: Qualitative research study involving face to face semi-structured interviews with participants. SETTING: A public health directorate in a National Health Service Trust, and a public health demonstration project in child health. PARTICIPANTS: Health promotion specialists, managers, nurses, public health consultants and specialists, researchers, trainees, and other public health staff. MAIN RESULTS: Three main categories of ethical issues were identified: paternalism, responsibilities, and ethical decision making. Consulting with the community and sharing information raised issues of paternalism and honesty. Participants identified multiple and sometimes conflicting responsibilities. Barriers to fulfilling responsibilities included meeting targets, working with partners, and political influences. Defining the limits of responsibilities posed challenges. Participants identified values for ideal decision making, but lack of time often led to a more pragmatic approach. CONCLUSION: These empirical findings complement and extend existing discussions of public health ethics, emphasising the complex nature of ethical issues in public health. The implications for public health policy and future research are discussed.

Child↗
PubMed2005

Socioeconomic gradients in the prevalence of cardiovascular disease in Scotland: the roles of composition and context.

OBJECTIVE: To investigate whether occupational social class and area deprivation are independently associated with the prevalence of cardiovascular disease (CVD) conditions after adjustment for smoking status. DESIGN: Stratified multistage random sample analysed using multilevel logistic regression. PARTICIPANTS: 8804 adults aged 18-74 at time of interview in 1998-1999, clustered in 312 small areas. The outcome considered was a self report of doctor diagnosis of one of a number of CVD conditions. The survey also provided information concerning the respondent's occupational social class and current smoking status. The Carstairs score (based on the 1991 census) was used to describe small area deprivation. MAIN RESULTS: The gradient in CVD prevalence across individual social class was attenuated and became insignificant when area deprivation was considered. The aggregation of individual social class and smoking to the area level increased the correlation with disease prevalence at the individual level. CONCLUSIONS: Although there is a relation between socioeconomic status and CVD prevalence in Scotland, the relation is dominated by area deprivation. When externally validated deprivation measures are not available, aggregated individual characteristics may show a contextual (as compared with compositional) relation.

Adolescent↗
PubMed2006

The psychosocial versus material hypothesis to explain observed inequality in disability among older adults: data from the West of Scotland Twenty-07 Study.

OBJECTIVES: The possible mechanisms for explaining health inequality are subject to debate. This study considers the roles of psychosocial and material mechanisms in observed inequalities in disability among older people. DESIGN: Cross-sectional analysis of cohort study. PARTICIPANTS: 723 respondents aged 63 years from the West of Scotland Twenty-07 Study. MAIN OUTCOME MEASURE: The Office of Population Census and Surveys Multidimensional Disability Severity Score. Respondents were dichotomised to the highest scoring tertile, and compared with the lowest and mid-tertiles combined. EXPLANATORY MEASURES: Socioeconomic position across adulthood was measured in three ways. Respondents reported perceptions of their own financial position (perceived financial hardship) across four decades of adult life. Data on possession of several indicators of material wealth (eg, ownership of television and washing machine; material conditions) during the same periods were also ascertained. Standard occupational classification was also recorded, based on longest held occupation. The relationship between the measures of socioeconomic position and disability was examined using logistic regression, adjusting for sex, morbidity and lifestyle factors. RESULTS: Perceived financial hardship and material conditions in earlier decades of life were found to be associated with reported disability. However, in the fully adjusted model, there was stronger evidence for material conditions as a predictor of disability: across four decades they remained an independent risk factor for disability after adjustment for sex, morbidity, lifestyle factors and perceived financial hardship. Those in the most deprived material conditions group had 2 1/2 times the odds of reporting severe disability than those in the reference group. After adjustment, evidence for an association between perceived financial hardship and reported disability was not convincing. CONCLUSION: The data provide evidence to support the "material" explanation for observed inequalities in reported disability among older people.

Comorbidity↗
PubMed1976

Anencephalus in Scotland 1961-72.

Data relating to the incidence of anencephalus for the 12-year period 1961-72 were abstracted from the Statistical Reviews of the Registrar General for Scotland. It was shown that considerable geographical variation is still apparent with the highlands having, in general, the lower incidences. In comparison with the earlier study of Edwards (1958), there were some changes: the incidence in the areas to the west had increased and that in those to the east decreased. During the 12-year period there was an overall decline in the incidence of the lesion; this was most marked in births to women under 20 years, and to those of social classes III, IV, and V. The decline was least apparent for births to women of high social class and the unmarried. It was shown that there was little seasonal variation in the time of delivery, but that even when the trend had been taken into account the yearly fluctuation was significantly different from that expected, with an excess of cases in 1961 and 1971.

Adult↗
PubMed1978

Smoking and health: the association between smoking behaviour, total mortality, and cardiorespiratory disease in west central Scotland.

The relationship of smoking to total mortality and to the prevalence of cardiorespiratory symptoms has been studied in three prospective surveys in west central Scotland in which 18 786 people attended a multiphasic screening examination. The prevalence of respiratory symptoms, and to a lesser extent cardiovascular symptoms, increased with the number of cigarettes smoked, with inhalation, and with a younger age of starting to smoke. A lower prevalence of respiratory symptoms in both sexes was observed in smokers of filter cigarettes than in smokers of plain cigarettes, and in those who smoked cigarettes with lower tar levels, irrespective of whether these were filtered or plain. In general, the relationships found between smoking and mortality were similar to those reported by other workers. Current cigarette smokers had a death rate from all causes which was twice that of those who had never smoked. No difference was found between the mortality rates of smokers of plain and filter cigarettes.

Age Factors↗
PubMed1979

The influence of availability of free school milk on the height of children in England and Scotland.

The effect is investigated of availability of free school milk on height gain in one year of six- and seven-year-old primary schoolchildren in England and Scotland, using data collected annually from 1972 to 1976. The height gain of children for whom milk was available for the whole year of observation was compared with that of children who had no milk. Out of 16 sex-country-year-specific analyses for children from manual social classes only, 13 showed no significant evidence of greater height gain in children who had milk. Comparison of children from Social Classes IV and V (semi-skilled and unskilled) showed no greater increase in height for those who had milk, nor was there a difference in height gain between manual social class children according to the number of glasses of milk they drank a day at home or at school. We concluded that, given the standard of living at the time of the survey, the drinking of free school milk did not increase the growth rate of six- and seven-year-old children.

Animals↗
PubMed1982

Perinatal mortality in Scotland: 1970-9.

An examination of the recent decline in perinatal mortality in Scotland during the 1970s showed that despite substantial changes in fertility and the demographic pattern of births, differences in the age, parity, and social class composition of the obstetric population in this decade accounted for just 7% of the overall improvement in perinatal mortality between 1970 and 1979. The general pattern of relative risks associated with maternal age, parity, and social class remained largely unchanged. Marginal changes in the birthweight distribution, however, were sufficient to account for 13% of the reduction in perinatal mortality. The low birthweight infant, especially those weighing under 1500 g, assumed increasing importance as a factor in perinatal mortality owing to a progressive worsening in the relative risk of perinatal mortality associated with low birth weight. Although regional differences in perinatal mortality persisted over this period, there occurred some lessening of the traditional inequality between western and eastern parts of the country. Finally, registered causes of perinatal mortality are reviewed. In the absence of other explanations the results of this analysis, collectively, suggest that much of the recent decline in perinatal mortality was perhaps due to changes in obstetric practice and in the clinical management of neonatal morbidity.

Adolescent↗
PubMed1986

Motor neurone disease in the Lothian Region of Scotland 1961-81.

One hundred and sixty one patients with motor neurone disease (MND), from the Lothian Region of Scotland, were studied in an attempt to identify factors important in disease aetiology. Onset of the disease was between 1961 and 1981 and the incidence was highest between 1968 and 1975. The probability of developing MND was greatest between the ages of 65 and 69, and a greater proportion of female patients than of males had onset in the bulbar muscles. Some 5% of patients had a positive family history of MND. There was no evidence that infective agents were important in the aetiology of the disease. There was a suggestion that the patient group contained a greater number of electrical workers, food, drink and tobacco workers, and rubber workers than would have been expected. However, a larger series of patients would be needed to confirm an increased susceptibility to MND in individuals engaged in these occupations.

Adult↗
PubMed1988

Cigarette smoking and male lung cancer in an area of very high incidence. I. Report of a case-control study in the West of Scotland.

Altogether 656 male lung cancer cases and 1312 age and sex matched controls were interviewed between 1976 and 1981 in a case-control study of cigarette smoking habits and lung cancer in Glasgow and the West of Scotland, an area with the highest recorded incidence in the world. The relative risk of lung cancer increased significantly for smokers whose consumption was below 20 cigarettes per day but did not rise significantly in those who smoked more than 20 cigarettes per day. Other smoking characteristics such as inhalation and tar yields of brands smoked did not explain this finding. Additionally, the relative risks observed at all levels of cigarette consumption were low in comparison with those in the published literature. By constructing an index of cigarette exposure which included the tar yields of brands smoked, an assessment of the risk of lung cancer in relation to tar exposure independent of amount smoked was derived. Only in smokers of less than 15 cigarettes per day was there a statistically significant reduction in risk of lung cancer associated with lower levels of tar yield.

Age Factors↗
PubMed1989

School meals, school milk and height of primary school children in England and Scotland in the eighties.

In a nutritional surveillance system of primary school children in England and Scotland we assessed the possible effects on height gain of changes in school meals and school milk policies following the 1980 Education Act (No. 2). Mean height and height gain were estimated separately for English and Scottish samples from 1982 to 1984, and for a selective sample of inner city areas with a high proportion of ethnic minorities from 1983 to 1985 in children from 5.00 to 9.99 years. Children receiving free school meals were smaller than children paying for school meals or receiving a meal prepared elsewhere, while children receiving free school milk were of similar stature to other children in the study. The rate of growth was assessed in children receiving school meals or lunches prepared at home, and in those for whom arrangements changed during the study period; it was also assessed in those children for whom school milk was available, not available, or for whom the provision changed. No consistent association was found between provision of school meals or school milk and the rate of growth in the three samples studied when stratified according to poverty status and ethnic background. We conclude that this observational study does not provide any evidence that the current availability of school meals or school milk increases the rate of growth of primary school children in any social stratum.

Animals↗
PubMed1992

Problems in the interpretation of small area analysis of epidemiological data: the case of cancer incidence in the West of Scotland.

STUDY OBJECTIVE: The aim was to examine the extent to which random variation alone will produce differences in observed incidence rates between small areas which will affect measures of spatial clustering and estimates of relative risk. DESIGN: This was a study of changes in the pattern of spatial concentration of cancer incidence over a five year time period. A comparison was made of observed incidence rates for 34 tumour sites with randomly generated values and, where possible, with expected values derived from known relative risks. SETTING: Twenty six local government districts in the West of Scotland. MAIN RESULTS: A statistically significant relationship was observed between sample size and the stability of a summary measure of spatial concentration. Almost all observed highest:mean rate ratios were within the 95% confidence interval of the simulated distribution of these values. In three cases examined, both observed and simulated highest:lowest rate ratios were larger than those expected on the basis of known exposures to risk. CONCLUSIONS: In the absence of a prior hypothesis, small area analysis of epidemiological data for periods of less than 10 years will almost always give misleading results for all but the most common diseases.

Analysis of Variance↗
PubMed1994

Leukaemia and non-Hodgkin's lymphoma: incidence in children and young adults resident in the Dounreay area of Caithness, Scotland in 1968-91.

STUDY OBJECTIVE: To review the incidence of leukaemia and non-Hodgkin's lymphoma in children and young adults in the area less than 25 km from the Dounreay nuclear installation and the remainder of the Kirkwall postcode area in the full time period for which data are now available (1968-91), and to determine whether the excess incidence reported in the period up to 1984 has continued in subsequent years. DESIGN: Geographical incidence study. SETTING: The Kirkwall postcode area of Scotland. SUBJECTS: Children and young adults resident in the area in the period 1968-91. MAIN RESULTS: Observed numbers of cases of leukaemia and non-Hodgkin's lymphoma and observed to expected ratios with expected numbers based on Scottish national rates were determined. In 1968-91, 12 cases were observed compared with 5.2 expected in the zone < 25 km from the Dounreay plant (p = 0.007). In the latest period, 1985-91, which has not previously been examined, four cases were observed compared with 1.4 expected (p = 0.059). CONCLUSION: The observation of an excess of borderline statistical significance in 1985-91 following the substantial excess incidence which occurred in the early 1980s suggests that the incidence of leukaemia and non-Hodgkin's lymphoma in this area should continue to be a matter of concern. The phenomenon of high incidences of childhood and young adult leukaemia and lymphoma near some nuclear installations in isolated areas is yet to be explained, but certain aspects of the data examined in the present report are consistent with the hypothesis of an infectious aetiology for leukaemia in very young children.

Adolescent↗
PubMed1995

Seasonal variation in coronary heart disease in Scotland.

STUDY OBJECTIVE: Seasonality of coronary heart disease (CHD) was examined to determine whether fatal and non-fatal disease have the same annual rhythm. DESIGN: Time series analysis was carried out on retrospective data over a 10 year period and analysed by age groups ( < 45 to > 75 years) and gender. SETTING: Data by month were obtained for the years 1962-71. The Registrar General provided information on deaths and the Research and Intelligence Unit of the Scottish Home and Health Department on hospital admissions. SUBJECTS: In Scotland, between 1962 and 1971, 123 000 patients were admitted to hospital for CHD, of whom 29 000 died. There were a further 97 000 CHD deaths outside hospital. These two groups were also examined as one (coronary incidence) - that is, all coronary deaths and coronary admissions discharged alive. STATISTICAL ANALYSIS AND MAIN RESULTS: Where there was a single annual peak, the sine curve was analysed by cosinor analysis. When there were two peaks the analysis was by normal approximation to Poisson distribution. In younger men (under 45 years) admitted to hospital there was a dominant spring peak and an autumn trough. A bimodal pattern of spring and winter peaks was evident for hospital admissions in older male age groups: with increasing age the spring peak diminished and the winter peak increased. In contrast, female hospital admissions showed a dominant winter/summer pattern of seasonal variation. In male and female CHD deaths seasonal variation showed a dominant pattern of winter peaks and summer troughs, with the winter peak spreading into spring in the two youngest male age groups. CHD incidence in women showed a winter/summer rhythm, but in men the spring peak was dominant up to the age of 55. CONCLUSION: The male, age related spring peak in CHD hospital admissions suggests there is an androgenic risk factor for myocardial infarction operating through an unknown effector mechanism. As age advances and reproduction becomes less important, the well defined winter/summer pattern of seasonal variation of CHD is superimposed, and shows a close relationship with the environment, especially temperature, or the autumn and early winter fall in temperature.

Adult↗
PubMed1996

Estimating the prevalence of drug misuse in Dundee, Scotland: an application of capture-recapture methods.

STUDY OBJECTIVES: To apply capture-recapture methods to provide an estimate of the prevalence of opiate and benzodiazepine misuse in Dundee, Scotland. DESIGN: A four sample capture-recapture method using data from both statutory and non-statutory data sources to estimate drug misuse prevalence in Dundee between January 1990 and December 1994. PARTICIPANTS: Users of benzodiazepines or opiates residing within Dundee. RESULTS: Altogether 855 drug misusers were identified from various sources within Dundee; many were identified from more than one source. Using this data, the estimated unknown population was 1702, giving a total population of 2557 (95% confidence interval (CI) 1974, 3458) who misuse benzodiazepines or opiates. This represents a prevalence of 28.8 (95% CI 22.3, 39.0) per thousand. CONCLUSIONS: Capture-recapture techniques can be applied to statutory and non-statutory agency data to produce an estimate of at least certain sections of the drug misusing population. However, it is important to recognise the limitations of this methodology and in future to seek to combine a range of approaches to the problem of estimating prevalence rather than sticking rigidly to any single approach.

Adolescent↗
PubMed1997

Suicide in the 12 months after discharge from psychiatric inpatient care, Scotland 1968-92.

STUDY OBJECTIVE: To investigate the rate of suicide in the 12 months after discharge from psychiatric hospital and to determine its relationship to age, diagnosis, and period. DESIGN: Cohort study of patients discharged from psychiatric hospital. SETTING: Scotland. PARTICIPANTS: Altogether 159,742 men and 178,271 women, aged 15-84, who were discharged from Scottish psychiatric hospitals during 1968-92. MAIN RESULTS: During the 25 year period, 1212 male patients committed suicide in 198,059 person years at risk (612 per 100,000; 95% confidence interval (CI) 578,647) and 1099 female patients committed suicide in 228,993 person years at risk (480 per 100,000; 95% CI 452, 509). The overall standardised mortality ratio (general population rate = 1) was 27 (95% CI 26, 29) in men and 40 (95% CI 38, 43) in women. There were variations in the suicide rates in relation to age, diagnosis, and period. The ratio of the 1-28 day rate to the rate between days 29 and 365 over the whole study period was 1.7 (95% CI 1.4, 1.9) in men and 1.6 (95% CI 1.3, 1.8) in women. CONCLUSIONS: The variations in the post discharge suicide rate by age, sex, diagnosis, geographical location, and period suggest that there are several risk factors which vary in their distribution. Further study of these may lead to the development of effective interventions.

Adolescent↗
PubMed1998

Epidemiology of Epstein-Barr virus infection in pre-adolescent children: application of a new salivary method in Edinburgh, Scotland.

STUDY OBJECTIVE: To describe the epidemiology of Epstein-Barr virus (EBV) among primary school children by testing saliva with a new EBV capsid antigen "G" antibody capture radioimmunoassay (GACRIA). DESIGN: A population based sample of 7 year old schoolchildren were followed up at age 11. SETTING: 30 randomly chosen primary schools in Edinburgh, Scotland. PARTICIPANTS: 552 schoolchildren. MEASUREMENTS: Data on risk factors for infection were collected by questionnaire at ages 7 and 11. Saliva samples collected at age 11 were examined by GACRIA for evidence of previous infection with EBV. For 102 subjects, a second salivary specimen collected approximately one month after the first sample was available for testing as a measure of the repeatability of the method. MAIN RESULTS: Unequivocal results were found in 91% of samples and the repeatability of the test was good (kappa = 0.71). Fifty six per cent of children had antibodies to EBV. In a logistic regression analysis, independent risk factors for infection were sharing a room (odds ratio 1.78, 1.14, 2.79), head of household's social class IV/V compared with I (odds ratio 2.87, 1.08, 7.34), and schools serving predominantly rented housing estates (odds ratio 2.3, 1.09, 4.84). CONCLUSION: This study is the first application of EBV viral capsid GACRIA to salivary samples. The method was successfully used to describe the epidemiology of EBV. In this study, characteristics of the home seemed to be more important than those of the school in determining the likelihood of infection with EBV.

Adult↗
PubMed1998

Health benefits of joint replacement surgery for patients with osteoarthritis: prospective evaluation using independent assessments in Scotland.

STUDY OBJECTIVES: To determine extent of change in psychological, functional, and social health after knee and hip joint replacement surgery using independent assessments. DESIGN: Patients were recruited before surgery and interviewed preoperatively, three months after surgery, and nine months after surgery. Interviews were conducted in the patients' own homes. SETTING: Two orthopaedic surgery units in Scotland. PARTICIPANTS: A consecutive sample of 107 patients with osteoarthritis having primary replacement of the knee or hip. MAIN OUTCOME MEASURES: Assessments of depression, anxiety, pain, functional activity, informal care, and formal service utilisation were made at three time points. MAIN RESULTS: Anxiety and pain were significantly reduced and functional activity levels significantly increased after surgery. While gains in anxiety and pain reduction occurred between the preoperative and three month assessments, gains in activity were made between the three month and nine month assessments. Although pain was reduced and activity increased, levels of depression were unchanged after surgery. Patients reported need for assistance with fewer activities after surgery, but increases in the use of formal services and increases in the number of hours per week of informal support received were observed at both three month and nine month follow up. CONCLUSIONS: The main benefit of joint replacement surgery is pain relief. Gains in functional activity, particularly mobility and leisure activities are made by many patients. Paradoxically, surgery for osteoarthritis seems to act as a "gateway" to increases in formal and informal community support, which are maintained into the longer term.

Activities of Daily Living↗
PubMed1976

Chromosome survey of total population of mentally subnormal in North-East of Scotland.

A cytogenetic survey of the complete population of mentally subnormal in the North-East of Scotland has been undertaken. A register for the mentally subnormal within the region already existed, and all persons recorded, whether they resided at home or in subnormality hospitals or other institutional care, were included. The total number recorded was 3020 and of these 2770 were examined cytologically. In all 297 (10.7%) were shown to have a chromosomal abnormality, and of these Down's syndrome accounted for 250 (9%). Within this category was an unexpected excess of males. Deletions and supernumeraries comprised the remaining autosomal anomalies. Increased numbers of sex chromosome abnormalities among high grade mentally subnormal individuals were confirmed for both sexes. The survey has shown that abnormal chromosome complements contribute significantly to the causation of mental retardation, and has also provided estimates which cannot be obtained from hospital surveys alone.

Adult↗