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At least 19 recordsLinked to original sources
PubMed1972

Differences in opportunities for the disabled in England and Scotland: a survey of paraplegics in Scotland.

The facilities available to disabled people living in Scotland were studied by visiting and interviewing a group of 50 paraplegics living in Glasgow and the surrounding counties. The degree of unemployment in the group (74%) was far greater than has been reported in other surveys, and no quadriplegic was in remunerative employment. Though the general unemployment level in the area is high services to help the disabled gain employment were only partially utilized.Liaison between social workers was not always successful. Some paraplegics were visited at home by both a medical social worker and a local authority social worker, while others were not supported by either. There was no apparent attempt by local authorities to identify the disabled, as is required in England under Section 1 of the Chronically Sick and Disabled Persons Act, 1970. Several paraplegics lacked facilities which are covered by Section 2 of the Act. The exclusion of Scotland from Sections 1 and 2 of the Chronically Sick and Disabled Persons Act may widen the differences between the two countries as the Scottish legislation is less specific.

Adolescent↗
PubMed1991

Gastric cancer in Scotland: changing epidemiology, unchanging workload.

OBJECTIVE: To determine the changes in incidence of and mortality from gastric cancer in Scotland between 1978 and 1987 and in the operative workload in Lothian between 1979 and 1988. DESIGN: Analysis of national incidence statistics for gastric cancer derived from the Scottish national cancer registry, deaths from gastric cancer recorded by the registrar general for Scotland, and Lothian surgical audit data. SETTING: Scotland and Lothian Health Board area. PATIENTS: Patients in Scotland with gastric cancer during 1978 to 1987 inclusive; patients in Scotland with gastric cancer recorded on their death certificate as cause of death during 1978 to 1987; patients who had an operation in Lothian for gastric cancer during 1979 to 1988. MAIN OUTCOME MEASURES: Changes in incidence of and mortality from gastric cancer in Scotland from 1978 to 1987 and in the number of operations performed for gastric cancer in Lothian from 1979 to 1988. RESULTS: Mortality from gastric cancer in Scotland fell by about 25% over the 10 years. The incidence and standardised incidence of gastric cancer showed a marginal decline of about 9%. The differences in trends between incidence and mortality were significant (p less than 0.05). CONCLUSIONS: This study shows that the surgical workload associated with gastric cancer is not declining. This is because the incidence has remained almost static, which may be due to the relative increase in the numbers of older people in the population, who are at greater risk of developing gastric cancer. Gastric cancer should not be regarded as a disease in decline. Incidence and workload should determine resources allocated to this disease rather than mortality statistics.

Adult↗
PubMed1992

Use of monitored CD4 cell counts: predictions of the AIDS epidemic in Scotland: CD4 Collaborative Group.

OBJECTIVE: We describe the CD4 database of the Scottish Immunology Laboratories, and its uses and limitations for making short-term predictions of a CD4 cell count less than or equal to 200 x 10(6)/l (CD4(200)) and of adult AIDS cases in Scotland. DESIGN: The date of the earlier of two consecutive samples (typically 3 months apart) both with CD4 cell counts less than or equal to 200 x 10(6)/l was taken to define when a patient had passed the CD4(200) threshold (referred to as a CD4(200) case). The CD4 database comprises HIV-1-seropositive adults in the four main risk groups [homosexual/bisexual (1), injecting drug users (IDU; 2), heterosexual contact (3), and undetermined (9)] from Scotland's three principal areas of population (Lothian, Tayside and Strathclyde) who have had a CD4 cell count of less than or equal to 500 x 10(6)/l. SETTING: Three hospitals in Scotland, the Communicable Diseases (Scotland Unit) and the Medical Research Council Biostatistics Unit, Cambridge, UK. PATIENTS, PARTICIPANTS: The CD4 database at 31 December 1990 listed 813 patients (of whom 52% were IDU): 390 were CD4(200)/AIDS cases (of whom 44% were IDU) and 192 were AIDS cases (of whom 32% were IDU). RESULTS: Individuals in risk groups 1, 2 and 3 were nearly equally represented among newly diagnosed HIV-1 infections in 1990. However, among patients with moderate immunodeficiency, IDU accounted for 50% of the total number. Co-incidence of first CD4 cell count with CD4(200) diagnosis was recorded for only 28% of IDU, but in over 50% of cases for each of the other exposure groups (57%). There was a highly significant decrease of around 80 x 10(6)/l per calendar-year-of-referral in first CD4 cell counts for patients on the CD4 database; and decreases of around 40 x 10(6)/lper decade of age at referral. Since 1988, median time from CD4(200) to AIDS diagnosis in Scotland has been approximately 2 years. Back-projection was applied to annual CD4(200)/AIDS diagnoses before 31 December 1990 and to AIDS diagnoses. From AIDS diagnoses, the central epidemic scenario underestimated past HIV-1-antibody-positive reports (up to the end of 1985). More dramatic underestimation was occasioned by back-projection from CD4(200)/AIDS diagnoses [319 inferred HIV infections compared with 445 HIV-1-antibody-positive reports to Communicable Diseases (Scotland) Unit]. CONCLUSIONS: First CD4 cell counts should complement new HIV-1 diagnoses. Past referrals for immunological monitoring were not uniform between risk groups in Scotland. Underascertainment of CD4(200) cases is a problem when CD4(200) cases are used as a basis for back-projection. More information concerning the incubation distribution from HIV seroconversion to CD4(200) diagnosis is required. It is likely that there are twice as many CD4(200)/AIDS as there are diagnosed cases of AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Origin, training, and subsequent practice location of Scotland's General and Community dentists.

In view of the continuing concern, in the United Kingdom (UK) and many other countries, over the maldistribution of dental manpower and the far-reaching plans now being contemplated to correct existing imbalances, it was felt to be necessary to document the current situation in Scotland. This study set out to identify the origins, place of training, and subsequent practice locations of Scotland's General and Community dentists. A questionnaire was sent to a list of all General Dental Practitioners (GDPs) and Clinical Community Dental Officers (CCDOs) in Scotland. The final response rate was 72%. 85% of respondents had received the majority of their secondary school education in Scotland, and a total of 92.5% of respondents had received their undergraduate dental training at one of the three Scottish dental schools. Factors elicited as being associated with practice location choice included school of dental training, location of a dentist's original home and relatives, and, to some extent, market forces in terms of "demand for dentists" in some areas in Scotland.

Community Dentistry↗
PubMed1987

Coronary heart disease and water hardness in Scotland--is there a relationship?

Scotland has a mortality rate from coronary disease which is one of the highest in the world. There is also a considerable variation in this mortality rate within Scotland. Data on water hardness throughout Scotland have been collected from Regional Water Authorities to see whether variations in coronary mortality rates can be explained by variations in water hardness. Analysis demonstrates a much weaker negative association than has been demonstrated in studies in other countries. The geographical variation in coronary mortality rates in Scotland cannot be explained by variations in water hardness, and weak association between these in Scotland is discussed.

Adult↗
PubMed1990

Suicide in England and Wales and in Scotland. An examination of divergent trends.

The suicide rates in England and Wales and Scotland converged during the late 1960s, and from 1970 were higher in Scotland. The convergence occurred because of differences in the falls in rates of those aged over 45 years and not because of differences in frequency and decline of coal gas suicide. Male suicide increased more rapidly in Scotland during the 1970s. In England and Wales overall female suicide rates fell during 1958-76 whereas in Scotland there was no clear trend. Suicide by car exhaust increased similarly in both countries, but that by hanging and drug poisoning increased more rapidly in Scotland.

Adolescent↗
PubMed1991

Deaths from road traffic accidents in Scotland: 1979-1988. Does it matter where you live?

The purpose of this study was to calculate and compare the geographical distributions of male and female deaths from road traffic accidents in Scotland. A retrospective, nationwide study of deaths from road traffic accidents was undertaken; all road traffic deaths between 1979 and 1988 were included. Deaths were abstracted from the Annual Reports of the Registrar General for Scotland. Standardized mortality ratios (SMRs) for males and for females were calculated for 1979-83 and 1984-88. Maps showing the distributions of high SMRs (SMR greater than 135 or P less than 0.05) and low SMRs (SMR less than 65 or P less than 0.05) were prepared for males and females separately. The geographical distributions of deaths from road traffic accidents in Scotland were dissimilar to those of England and Wales. For both sexes, high mortality was predominantly in the sparsely populated regions of the north and south of Scotland; whereas low mortality was found in the cities and the populous central belt. Possible reasons for this pattern are discussed: speed, response time (both of notification of the accident and of arrival of the ambulance), distance to nearest hospital with suitable emergency facilities, and road conditions.

Accidents, Traffic↗
PubMed1976

Blood groups antigens, plasma protein and red cell isoenzyme polymorphisms in south-west Scotland.

Blood donor specimens from South-west Scotland were analysed for the following polymorphisms: ABO, Rhesus (D), Haptoglobin, Transferrin, Immunoglobulin (GM), RBC acid phophatase, RBC phosphoglucomutase and RBC adenylate kinase. Genetic differences exist between the regions in S.W. Scotland and between S.W. Scotland and other Irish and Irish Sea regions. This variability is detailed and discussed. The results are mapped by converting the data into distance values and by using a nonmetrical scaling technique. Overall the present S.W. Scotland data are similar to Cumbrian and Manx results and dissimilar to the Irish data.

ABO Blood-Group System↗
PubMed1992

Melanoma in people aged 65 and over in Scotland, 1979-89.

OBJECTIVE: Detailed analysis of primary cutaneous melanoma first diagnosed in Scotland in patients aged 65 and over. DESIGN: Comparison of changing incidence, sex distribution, site, histogenetic type, tumour thickness, and prognosis of all primary cutaneous melanomas in patients aged 65 and over diagnosed in Scotland in the 11 years 1979-89 with similar data for patients aged under 65. SETTING: Data were obtained from the Scottish Melanoma Group's database, established in 1979, which aims to record detailed clinical, pathological, and surgical follow up details of all primary cutaneous melanomas registered in Scotland. PATIENTS: 1430 patients (954 women, 476 men) aged 65 and over; comprising over a third of the 3903 patients with primary melanoma recorded for all age groups in Scotland during this period. RESULTS: The overall incidence of melanoma in patients aged 65 and over increased from 12.2/100,000 in 1979 to 20.7/100,000 in 1989, with the greatest increase seen in older men, from 7.8/100,000 in 1979 to 18.0/100,000 in 1989. The site most commonly affected was the face in both men and women (33% of all tumours). The most common histogenetic type was superficial spreading melanoma. 526 patients (37%) had melanomas with a tumour thickness of 3.5 mm or greater in the older age group, compared with 453 patients (18%) in those aged under 65. The highest proportion of thick tumours was seen in older men. Five year survival figures for 616 patients diagnosed between 1979 and 1984 were 88%, 66%, and 47% for thin, intermediate, and thick tumours respectively. Overall five year survival for the older age group was 64% compared with 78% for the younger age group. CONCLUSION: The increase in melanoma in the elderly and the high proportion of thick tumours, especially in men, require a specific educational programme for both primary and secondary prevention directed towards the older population.

Age Factors↗
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↗
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↗
PubMed1991

The changing incidence of neural tube defects in Scotland.

The impact of neural tube defects on neonatal surgery has been declining in Scotland over the past two decades. The Scottish statistics for neural tube defects were studied from 1971 to 1988. The incidence of neural tube defects in Scotland has declined from 5.50 to 1.10 per 1,000 births over this period (3.00 to 0.58 per 1,000 births for spina bifida and 2.50 to 0.52 per 1,000 births for anencephaly). Antenatal maternal alpha-fetoprotein (AFP) screening was introduced to Scotland on a wide scale in 1976. The number of terminations for anencephaly peaked in 1980 (85), and for spina bifida in 1981 (70), and both have since declined. The Scottish birth rate has been about 67,000 per year over this period. The declining incidence of neural tube defects is not explained by the effect of antenatal screening and terminations alone. A downward trend was apparent before 1976, and although antenatal screening has had a considerable impact on anencephaly births (peak terminations 89% in 1983), it has had only a modest impact on spina bifida births (peak terminations 53% in 1984). We conclude that the natural decline in incidence of neural tube defects is the major factor in the observed decline in neonatal surgical admissions for these defects.

Abortion, Eugenic↗
PubMed1990

Human listeriosis in Scotland 1967-1988.

In order to study the epidemiology of listeriosis from 1967-1988 in Scotland, various sources of data were examined. These included reports by laboratories, reference laboratory records, hospital death and discharge records, death certificates and hospital laboratory records. Cases were reported from 13 of Scotland's 15 Health Boards. Case ascertainment via laboratory reports to the Communicable Diseases (Scotland) Unit was validated in two Health Boards. A total of 198 cases was identified with an overall attack rate which increased from 0.5 per million in 1967-1971 to 7.0 per million in 1987-1988. Feto-maternal cases were the commonest (64%). Of all cases, 33% were neonates; 53% presented with bacteraemia and 41% with meningitis. The predominant serovar of Listeria monocytogenes was 4b.

Adolescent↗
PubMed1987

Changes in testicular cancer in Scotland.

There are two purposes to this paper. Firstly to describe the temporal pattern of germ-cell testicular cancers in Scotland, both as a single entity and as the histological sub-types (pure) seminoma and teratoma. Incidence rates rose by over 50% between 1959 and 1984, with the rates of seminoma increasing only marginally and the majority of the overall increase accounted for by the substantial increase observed among the sub-type teratoma. Secondly, to investigate the impact of new therapies on the mortality rate from germ-cell testicular cancer in Scotland in the light of improvements in survival rate reported during the last 25 years from clinical trials and clinical series. Noticeable changes have occurred in the temporal pattern of mortality which cannot be explained by changes in incidence. The ever-widening gap between the increasing incidence rate and the declining mortality rate, particularly apparent in the high-risk age group 15-44, indicates an improving prognosis for patients with this malignancy in Scotland.

Adolescent↗
PubMed1988

Improving prognosis of Hodgkin's disease in Scotland.

Time trends in mortality from Hodgkin's disease have been studied in Great Britain for the 70-year period, 1911-1980, and incidence in Scotland since 1959. In both Scotland and England and Wales, in each sex, mortality from Hodgkin's disease rose steadily from 1911 until 1970 and thereafter dropped substantially; the greatest fall was apparent in Scottish males. While mortality rates continue to decline in Scotland the incidence has remained fairly constant over the last 25 years suggesting a major change in prognosis for this disease. The introduction of effective chemotherapy and improved techniques of radiotherapy appear to have improved prognosis sufficiently, and to have been made adequately widely available, as to influence overall mortality rates at a national level as well as at the level of the clinical trial. No such improvement in prognosis, however, explains the declines observed in mortality rates among children of each sex in both areas which have taken place since the 1930s. In view of the current knowledge of the aetiology of Hodgkin's disease this fall may have been brought about by changes in socioeconomic factors.

Age Factors↗