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At least 127 records · Page 7Linked to original sources
PubMed1994

Urethral stricture and urethritis in men in Scotland.

OBJECTIVES: To examine the incidence of urethral stricture in men in Scotland during the years 1982-1991 in relation to the changing incidence of gonococcal and non-gonococcal urethritis (NGU) over the past 20 years. DESIGN: Retrospective study of incidence of urethral stricture in Scotland. METHOD: The number of new men in whom a diagnosis of urethral stricture was made for the years 1982-1991 was obtained using the new Scottish Record Linkage system, and the number of cases of gonorrhoea and NGU was obtained from Communicable Diseases (Scotland) Unit. Age-specific rates of urethral stricture were calculated and the Poisson regression model was used to test if there was a trend of rate with age or time change. RESULTS: There was a highly significant increase in the incidence of urethral stricture with age but only a slight increase in incidence over the study period within each age group. CONCLUSION: As the interaction between age and time was not significant, it is concluded that urethritis associated with sexually transmitted organisms is an uncommon cause of urethral stricture in Scotland.

Adolescent↗
PubMed2005

Anatomy in Scotland: 20 years of change.

BACKGROUND AND AIMS: To document changes in the educational infrastructure of anatomy in Scotland over the past 20 years. To investigate the possible impact of the GMC 1993 recommendations and assess the preparedness of Scottish anatomy to meet the implications of the proposed amendment to the I984 Anatomy Act. RESULTS: Over the past 2 years in Scotland, the total number of teaching staff in anatomy (full time, part time and honorary) has decreased by over 24%, full time teaching staff numbers have decreased by more than 33% and the number of clinical demonstrators by more than 70%. However, medical student intake has risen by 38% and the overall student number experiencing anatomical teaching (medicine, science and dentistry) has more than doubled, resulting in a current average staff:student ratio of 1:58. Anatomy contact hours between staff and medical students have decreased by just over 60% in the last 20 years. CONCLUSIONS: In the last 20 years, contact hours and staffing levels have decreased substantially in Scotland whilst student numbers (medical, science and dental) have increased significantly. On average the anatomical input to the medical curriculum decreased by 28% between 1983 and 1993 but post the GMC initiative, there was a further decrease of 45% resulting in current medical students in Scotland experiencing a 60% reduction in contact anatomy time compared to their peers in the early 1980's. The decline in anatomical infrastructure is not a reassuring indicator of its ability to meet substantial future demands.

Anatomy↗
PubMed1993

Prevalence of maternal HIV infection in Scotland based on unlinked anonymous testing of newborn babies. Update.

In January 1990, unlinked anonymous testing of Guthrie cards for HIV antibody commenced in Scotland. Ethics Committee approval allowed testing of 99.6% of Scottish births. Twenty-one mothers spontaneously refused to allow testing of their baby's blood. Samples were coded by district postcodes. For 1990 through 1991, eluates of 132,531 dried blood spots were initially tested for HIV-1 antibody with the Fujirebio technique. Of the 49 positive samples 38 were confirmed to be positive by enzyme-linked immunosorbent assay and western blot (seroprevalence 0.3 per 1000). Thirty-five of 38 samples came from large metropolitan areas in Scotland. Prevalences were 2.0 per 1000 for Edinburgh city, 0.7 per 1000 for Dundee and Aberdeen, 0.15 per 1000 for Glasgow and 0.05 per thousand for all other areas in Scotland. Recent spread of HIV infection to Aberdeen may have occurred. These figures do not support an overall increase of HIV infection in childbearing women in Scotland.

Adult↗
PubMed1998

Second malignancies in cervical cancer patients in the west of Scotland.

A retrospective study was carried out to determine the incidence and nature of second primary malignancies in patients treated for cervical cancer in the West of Scotland. A total of 3911 patients treated for a primary cancer of cervix, diagnosed between 1975 and 1992, were identified from the West of Scotland Cancer Registry. The ratio of observed second primary cancers in the study cohort to the number expected to occur if incidence was the same as in the West of Scotland population as a whole was calculated. Of the 3911 women treated, 129 (3.3%) were diagnosed with a second primary malignancy. Tissues within the pelvic radiation field showed no significant excess of second primary tumours. A significant excess (O/E 2.52 [95% c.i. 1.89-3.30]) of second primary malignancy in the lung and pleura was identified even after correction for socio-economic deprivation. Women treated for cervical cancer in the West of Scotland appear to be at more risk of a subsequent cancer due to causes other than the late effects of radiotherapy.

Female↗
PubMed1975

A further investigation of differences in the suicide rates of England and Wales and of Scotland.

National samples of case records of suicidal-type deaths from England and Wales and from Scotland were reassessed by officials in the other country. It emerged that similar criteria for suicide existed in both countries, and that there was no age-related tendency to misclassify cases. The lower official suicide rate amongst the old in Scotland was therefore considered not to result from ascertainment differences. It was also concluded that Scottish records were not so briefly documented as to prevent the conclusive ascertainment of cause by England and Wales coroners. Cases which were designated 'undetermined' in Scotland tended to be classified 'accidental' by coroners. Reasons for the lower incidence of suicide in Scotland are discussed.

Adolescent↗
PubMed1995

Epidemiology of presenile Alzheimer's disease in Scotland (1974-88) I. non-random geographical variation.

BACKGROUND: Factors that determine geographical differences in incidence rates of 'probable' presenile Alzheimer's disease (AD PSD) may help to clarify the possible role of the environment in its aetiology. METHOD: We have ascertained the treated incidence of AD PSD in Scotland by scrutiny of hospital cassenotes and searched for cases outside hospital settings. Small area geographical analysis compared the observed distribution of cases (each allocated to one of Scotland's 898 postcode sectors) with the estimated random distribution of cases. RESULTS: There was non-random geographical distribution of AD PSD but not of the comparison conditions (vascular dementia (VaD), motor neurone disease, prostatic or ovarian cancers). Substantial differences between Scottish regions were probably not attributable to methodological artefact, as other techniques of case finding showed the same regional differences. CONCLUSIONS: The observed differences in incidence of AD PSD between Scotland's regions are real and some localities have a higher incidence, mostly in central Scotland.

Adult↗
PubMed2006

Flexible trainees in Scotland.

INTRODUCTION: Demand for flexible training is increasing. The contribution of such trainees to the trained medical workforce is not clear. METHODS: All full time and flexible trainees in Scotland were 'tracked' at the completion of training. RESULTS: 80% of flexible trainees took up a consultant post of which 93% were in Scotland. 82% of full time trainees took up a consultant post of which 80% were in Scotland. DISCUSSION: Flexible trainees become consultants at the same rate as their full time counterparts. They are commonly geographically tied and are therefore more likely to remain in Scotland and contribute to retention of doctors in this country.

Attitude of Health Personnel↗
PubMed1991

International collaborative effort (ICE) on birth weight, plurality, perinatal, and infant mortality. IV. Differences in obstetrical delivery practice: Norway, Scotland and the United States.

We have carried out a comparative study on differences in operative obstetrical practice during the 1970s and 1980s, in Norway, Scotland and the United States of America. It was based on information from official sources in each country. We compared rates of cesarean section (CS) and operative vaginal delivery according to maternal age, parity and gestational age at delivery, birthweight, fetal presentation, and other characteristics of the child, indications for operative delivery, and hospital size and teaching status. While all three countries had rising CS rates, the Scottish rates, which lay between those of the U.S.A. and Norway, rose more slowly than in the latter. In 1985, the rates were 22.8% in the U.S.A., 13.5% in Scotland and 12.0% in Norway. Use of forceps and vacuum extractor declined in the U.S.A. and Scotland, but increased in Norway. CS rates in mothers aged 35 and over were uniformly high in 1970 and rose relatively little. Specific CS rates for very low birthweight children, breech presentation and twins rose to 30-50% in all three countries with some national trend differences. Rate ratios of operative delivery between large and small hospitals fell from about 2-3 in the 1970s to approximately 1.5 in 1985, least markedly in Scotland. The impact of previous CS as an indication for CS cannot be resolved because of notification and recording differences.

Adult↗
PubMed1981

Drinking habits in Finland and Scotland: a comparison of survey results.

An unusual opportunity to compare drinking habits in two countries in a technically satisfying way is offered by two surveys, one conducted in Scotland in 1972 by Dight and the other in Finland in 1976 by this author. Both Scotland and Finland represent ambivalent sociocultural attitudes toward alcohol, and the total alcohol consumption per capita is approximately the same in both countries. In Finland the distribution of alcoholic beverages is controlled by a state alcohol monopoly whereas in Scotland the distribution is in private hands and controlled by a very different system. Moreover, the dominating beverage type in Scotland is beer in spite of the famous whisky tradition, while the Finns prefer distilled spirits to other beverages. Thus there exist notable similarities as well as interesting dissimilarities in the general framework of drinking habits in these two countries. In this paper only the shares of drinkers and abstainers in demographic groups, the number of problem drinkers, as well as some results concerning the attributes of drinking occasions are considered. The results reveal interesting differences in the sociocultural sphere of drinking. The problem to be further discussed is whether these differences arise from the deeply noted traditions or from the influence of control systems. These two are, of course, complexly connected.

Adolescent↗
PubMed2001

Breastfeeding rates are increasing in Scotland.

OBJECTIVE: To measure the change in prevalence of breastfeeding between 1990/1991 and 1997/1998 in Scotland, using information collected on Guthrie cards when newborn infants are about seven days old. DESIGN: Analysis, by geographic postcode area, health board and maternity unit, for babies born in 1990/1991 and 1997/1998. For 1997, maternity unit and health board breastfeeding rates were also compared after standardisation for maternal age, deprivation and age of infant. SETTING: Scotland. SUBJECTS: 131,759 babies born in 1990/1991 and 118,055 in 1997/1998. RESULTS: In 1990/1991, 46,949 (35.6%) were breastfed as were 49,615 (42.0%) in 1997/1998, an increase of 6.4% (95% CI 6.0, 6.8) over eight years. A 3.8% increase remained after adjustment for change in maternal age. Maternity units with the Baby Friendly award improved 8.1% (95% CI 7.0, 9.2) compared with those with a certificate of commitment 6.1% (95% CI 5.2, 7.0). Other units improved 2.2% (95% C1 1.6, 2.8) no more than estimates due to increase in maternal age. Standardised rates were higher on the East Coast of Scotland 111 (109, 112) than the West or Central Regions 97 (96, 99). CONCLUSION: Breastfeeding has increased over eight years in Scotland. Less than half can be explained by demographic change in maternal age. However present breastfeeding targets are unlikely to be met. Maternity units should be urged to participate fully in the UNICEF U.K. Baby Friendly Initiative. Effective interventions prior to pregnancy are required so that more young men and women want their babies to be breastfed.

Breast Feeding↗
PubMed2001

Oral health in Scotland 1972-1998.

OBJECTIVE: To determine the oral health of adults in Scotland in 1998 and the trends underlying it. DESIGN: Epidemiological survey including attitudinal/behavioural interview. SUBJECTS AND SETTING: Across the UK as a whole a total of 5,540 addresses were selected of which 89% were found to be eligible for inclusion; 3,666 of these (74%) yielded at least one adult who was prepared to be interviewed. Overall 92% of adults in the responding households agreed to be interviewed. In Scotland, this amounted to 1,204 adults; of these 953 had some natural teeth and were asked if they would be dentally examined; 668 (70%) of them agreed. Weighting procedures were used to reduce bias. RESULTS: The proportion of Scots who have retained none of their natural teeth in 1998 (18%) has more than halved since 1972 (44%). More of the teeth which are retained are sound and untreated or restored but otherwise sound, fewer are decayed. The proportion of older adults who report going to a dentist for regular check-ups in 1998 (60%) has doubled since 1972 (29%). However, there is an indication that fewer of those aged 16-24 years in 1998 went for dental check-ups (46%) in comparison to ten years previously (51%). The overall oral health status among those living in the most deprived areas were roughly equivalent to the average seen in Scotland at the time of the previous survey in 1988. CONCLUSION: Whilst many aspects of oral health have improved in Scotland since 1972 it is generally behind many of the levels found throughout England and falls behind the UK average.

Adolescent↗
PubMed2001

Consultant outreach, 1991 to 1998. An update and extension on its distribution in Scotland.

OBJECTIVE: To assess the extent and distribution of consultant outreach in Scotland between 1991 and 1998. DESIGN: The paper has three parts. First a description of the trends in consultants and consultant activity provides the background. This is followed by the results of an update of the 1991 survey of all health centres in Scotland and its extension to all GP premises considered suitable to hold consultant clinics. Finally, binary regression analysis of outreach is used to test the importance of total list size, distance to alternative provision and deprivation. Fourteen of the most common consultant specialties are studied. SETTING AND SUBJECTS: Scotland-wide data on consultants and consultant activity using annual data over the 1990s; and a Scotland-wide survey of 231 health centres and 312 GP premises over the period July to December 1998. RESULTS AND CONCLUSIONS: Consultant full time equivalents (ftes) increased and, with minor exceptions, consultant activity did so too. In respect of outreach, the increase was largely at GP premises and for psychiatry. For only two specialties of the fourteen studied, obstetrics and general psychiatry, could outreach be considered important. Such outreach provision as was made went where the total list size was largest and alternative provision farthest distant. The evidence that deprivation had an influence on outreach varies with specialty and is qualified.

Ambulatory Care Facilities↗
PubMed1999

Bed-blocking in the National Health Service in Scotland: a study of bed-blocking in Scottish National Health Service trusts; its nature and extent.

OBJECTIVE: To determine the perceptions of managers in Scottish NHS trusts concerning bed-blocking. To help determine the causes of bed-blocking and suggest possible solutions to the problem. DESIGN: The first part of the study consisted of qualitative research interviews with key figures in NHS trusts and an examination of the existing literature on bed-blocking. This informed the second stage which was based on a questionnaire survey of senior managers in 35 trusts. SETTING: Interviews were carried out in three trusts in Forth Valley Health Board and Grampian Health Board areas. Questionnaires were sent out to 44 trusts throughout Scotland. The three trusts that were excluded from this study did not contain bed-blocking patients. SUBJECTS: Questionnaires were sent to chief executives of 44 NHS trusts in Scotland. Respondents were nominated by chief executives on the basis of their experience and understanding of bed-blocking problems within their own trust. RESULTS: Of the 44 questionnaires sent to trusts in Scotland, there were 35 responses (80%) which identified a total of 1845 beds as being blocked. The NHS secondary care-based respondents indicated that social services were responsible for 1406 bed-blocking patients in 35 trusts, an average of 40 patients per trust between August and September 1997. Some 600 of these "social services responsible" bed-blocking patients, an average of 21 patients per trust, were reported as awaiting comprehensive assessment by a social worker. In addition, 710 of these "social services responsible" bed-blocking patients, an average of 24 patients per trust, were awaiting funding authorization for a nursing home or residential home placement. NHS trusts were responsible for 237 bed-blocking patients, an average of seven patients per trust. In a further 202 cases bed-blocking was deemed to be neither the responsibility of the trust nor of social services as patients were awaiting vacancies in the patient's or carer's specific choice of residential or nursing home. CONCLUSION: Results from this study show that there would appear to be a significant number of blocked beds in NHS trust hospitals throughout Scotland. Trust staff, whilst acknowledging the complex nature of bed-blocking, perceive social services, who are responsible for the assessment, placement and financing of patients being transferred from hospitals to residential care in the community, as being responsible for the majority of these beds being blocked. It is, however, acknowledged that social services are under-funded and under-resourced. If the situation is to be improved, consideration should be given to changing service delivery processes in the context of the implementation of Designed to Care.

Bed Occupancy↗
PubMed1999

Implementation of a national guideline on prophylaxis of venous thromboembolism: a survey of acute services in Scotland. Thromboembolism Prevention Evaluation Study Group.

BACKGROUND: Deep vein thrombosis (DVT) and pulmonary embolism (PE) are major complications for hospital patients in developed countries. In 1995, the Scottish Intercollegiate Guidelines Network (SIGN) published an evidence-based guideline to encourage the appropriate use of prophylaxis for DVT among hospitalised patients at risk. The guideline was widely distributed within the NHS in Scotland; however, it is not clear what actions trusts have taken to implement it. OBJECTIVE: To investigate the type and extent of DVT guideline implementation activities in acute trusts in Scotland. METHOD: A semi-structured telephone interview with senior clinical audit staff in those trusts with acute services in Scotland. RESULTS: Twenty-nine of the 30 trusts approached participated in the survey (97%). A range of responses to the guideline were reported, including development of local protocols (n = 20), audit of DVT prophylaxis (n = 19), patient specific reminders (n = 13) and provision of a specialist DVT adviser (n = 3). Overall, 25 of the trusts had undertaken guideline development and dissemination activities, and 17 were involved in more active guideline implementation strategies. CONCLUSIONS: The majority of acute trusts in Scotland have responded to the SIGN guideline, usually through the development of local protocols. Strategies to implement the guideline or local protocol are less common. Further guidance is needed on this in the next edition of the guideline.

Clinical Protocols↗
PubMed2004

Estimates of true birth order for Scotland, 1945-1999.

Over the last three decades fertility in Scotland, as measured by the total fertility rate (TFR), has moved from being higher than in England and Wales, to being lower. The annual number of births in Scotland has declined so that in the mid-1990s low fertility became the main driver of the overall population decline that Scotland has been experiencing since 1974. Analysis of fertility by birth order is instrumental in gaining an understanding of past and future fertility trends. Until the rise in births outside marriage in the 1980s data from registration could be used as a proxy for true birth order. However, because birth order is not collected for births outside marriage true birth order now has to be estimated. This article presents the first official estimates of true birth order for Scotland. The construction of these estimates based on a modified version of the method used for England and Wales is discussed. This article also presents analysis relating births by true birth order estimate to the population of women by parity on a cohort basis, and makes comparisons with England and Wales.

Adult↗
PubMed1996

Completeness and accuracy of morbidity and repeat prescribing records held on general practice computers in Scotland.

BACKGROUND: A high proportion of Scottish general practices use a standard computer software package (GPASS, general practice administration system for Scotland), and thus, Scotland is uniquely placed to amalgamate primary care data on a national scale. Practices, however, vary widely in the nature and extent of data entered on computer and a major limitation on the use of the collected data is the absence of information on the completeness and accuracy of the computer database. AIM: This study set out to assess the quality of morbidity and repeat prescribing records held on computer by general practices in Scotland. METHOD: Forty-one practices, with above average levels of morbidity data recorded on computer, were selected on a geographic basis in relation to the national population distribution. Within each practice, 250 patients aged 45-64 years were selected at random. Data relating to 19 diagnoses, six surgical procedures and 40 repeat prescription drugs were extracted from the computer records of these patients and compared with information held on patients' paper records and supplied by patients in response to a postal questionnaire. The completeness and accuracy of computer entries were assessed in terms of sensitivity and positive predictive value, respectively. RESULTS: For the 5567 patients for whom all three sources of data (validated computer records, paper records and questionnaire responses) were available, sensitivity (completeness) of morbidity recording had median values of 0.67 for diagnoses, 0.93 for surgical procedures and 0.75 over all conditions examined. Practices varied both in the completeness of recording of each condition and in their overall performance. The predictive value (accuracy) of morbidity data was uniformly high for all conditions examined (median 1.00). For repeat prescription drugs, recording on GPASS was both complete and accurate. CONCLUSION: The recording of morbidity data on GPASS for 45-64-year-old patients in a selected group of 41 highly-computerized practices is about 75% complete and highly accurate. For national morbidity studies, it seems likely that amalgamated data from the best GPASS practices will be as complete and accurate as the morbidity statistics currently derived from hospital-based activities in Scotland.

Drug Prescriptions↗
PubMed1997

Paediatricians' views on renal services for children and adolescents in Scotland.

BACKGROUND: Paediatric nephrology is a small subspecialty whose patients are widely scattered geographically within Scotland making provision of uniform and optimal care difficult. AIM: We set out to determine what services are provided throughout Scotland as well as seeking paediatricians' views on improving services for children and adolescents with renal disease. METHOD: All 12 paediatric units in Scotland were visited and a senior consultant within each unit undertook to complete a questionnaire on behalf of his or her unit. RESULTS: Questionnaires were returned by 11/12 centres (92%). The scope of renal services offered varied widely. Most (10/11) favoured a 'shared care' approach using the comprehensive paediatric nephrology service in Glasgow as a focal point. Outreach services and a telephone advisory service were suggested by 7/10 and 6/10 units respectively. The development of a Scottish paediatric nephrology group was supported by 10/11 centres returning the questionnaire. CONCLUSION: There is both a need and an interest in developing a national strategy for paediatric nephrology in Scotland.

Adolescent↗
PubMed2006

Small intestinal cancer in England & Wales and Scotland: time trends in incidence, mortality and survival.

BACKGROUND: Time trends in mortality from small intestinal cancer have not been studied for the 1990s. OBJECTIVE: To examine secular trends in incidence of, mortality from, and survival from, small intestinal cancer in England & Wales and Scotland from 1975 to 2002, considering also histological type (incidence), subsite (incidence) and indices of social deprivation (incidence and survival). METHODS: Data were extracted from the Scottish Cancer Registry database and the General Register Office for Scotland, and from the National Cancer Intelligence Centre at the Office for National Statistics for England & Wales. RESULTS: Incidence rates for small intestinal cancer increased for both England & Wales and Scotland over the study period. They were highest among older individuals and generally greater for males than for females. Despite the increase in incidence rates, mortality rates from small intestinal tumours tended to remain stable over the study period, and the general trend was towards increasing survival. Indices of social deprivation were not obviously related to the incidence of small intestinal cancer and did not influence survival. CONCLUSIONS: Incidence rates for small intestinal cancer for both England & Wales and Scotland increased in the last quarter of the 20th century, but survival rates improved and mortality rates declined.

Female↗