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Objectives: The presence of kin is often, but not always, associated with higher fertility in historical populations. However, the effect of other household members on fertility is less frequently studied. While not genetically related, life-cycle servants lived and worked alongside household members and may have provided assistance to reproducing families. Female servants in particular may have helped mothers with small children through direct help with childcare activities or by replacing the economic effort of mothers whose work was not compatible with childcare. This study examines the presence of servants in the households of married women of reproductive age to assess whether households with young children are more likely to also have servants., Materials and Methods: This study uses individual-level census data from North Orkney, Scotland (1851-1911) to investigate the relationship between the presence of servants in households and a measure of recent net marital fertility, the number of women's own-children under age 5, using logistic regression models., Results: Households with young children were more likely to have a female, but not male, servant in the household after controlling for the effects of other possible helpers, including older children, mothers, and mothers-in-law., Discussion: These findings are consistent with prior research that indicates the importance of female labor to smallholder agricultural households and suggests that female servants may have provided support to reproducing families. Life-cycle servants should be considered one component of biocultural reproduction in historical Northwest Europe. The use of hired help is not restricted to contemporary or elite groups., (© 2020 Wiley Periodicals, Inc.)

Objectives: Recent research on the signal value of masculine physical characteristics in men has focused on the possibility that such characteristics are valid cues of physical strength. However, evidence that sexually dimorphic vocal characteristics are correlated with physical strength is equivocal. Consequently, we undertook a further test for possible relationships between physical strength and masculine vocal characteristics., Methods: We tested the putative relationships between White UK (N = 115) and Chinese (N = 106) participants' handgrip strength (a widely used proxy for general upper-body strength) and five sexually dimorphic acoustic properties of voices: fundamental frequency (F0), fundamental frequency's SD (F0-SD), formant dispersion (Df), formant position (Pf), and estimated vocal-tract length (VTL)., Results: Analyses revealed no clear evidence that stronger individuals had more masculine voices., Conclusions: Our results do not support the hypothesis that masculine vocal characteristics are a valid cue of physical strength., (© 2018 Wiley Periodicals, Inc.)

James Wardrop (1782-1869), a young Scottish surgeon and an early ophthalmologist in Edinburgh, is credited for describing in 1809 retinoblastoma as an entity in his treatise 'Observations on Fungus Haematodes or Soft Cancer'. His treatise also reveals that Allan Burns (1781-1813), another young Scottish surgeon and anatomist, had invited Wardrop to assist in enucleating an eye from a 41-year-old Glasgow woman who, in retrospect, had a uveal melanoma. Her eye had become blind 4 months after symptoms of exudative retinal detachment had appeared, and it had become painful after a further 2-4 months. The tumour eventually perforated the sclera, and she died within a year thereafter of hepatic metastases. Burns and Wardrop went on to publish detailed parallel accounts of the symptoms, signs, ophthalmic pathology and post-mortem findings regarding the primary, recurrent and metastatic tumour. Burns may have performed the post-mortem after exhuming the body, a common occurrence in early 19th Century Scotland, a thriving hub for teaching morbid anatomy to young surgeons at the time., (© 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Objective: To test whether different measuring techniques produce systematic differences in head size that could explain the large head circumferences found in Northern European children compared with the WHO standard., Design: Cross-sectional observational study., Setting: Scotland, UK., Patients: Study 1: 68 healthy children aged 0.4-18 months from mother and baby groups and a medical students teaching session. Study 2: 81 children aged 0.4 to 25 months from hospital wards and neonatal follow-up clinics., Interventions: Study 1: heads measured with plastic tape using both the WHO tight and UK loose technique. Study 2: heads measured using WHO research technique and a metal measuring tape and compared with routinely acquired measurements., Main Outcome Measures: Mean difference in head z-scores using WHO standard between the two methods., Results: The tight technique resulted in a mean (95% CI) z-score difference of 0.41 (0.27 to 0.54, p<0.001) in study 1 and 0.44 (0.36 to 0.53, p<0.001) in study 2. However, the mean WHO measurements in the healthy infants still produced a mean z-score that was two-third of a centile space (0.54 SD (0.28 to 0.79) p<0.001) above the 50th centile., Conclusion: The WHO measurement techniques produced significantly lower measures of head size, but average healthy Scottish children still had larger heads than the WHO standard using this method., Competing Interests: Competing interests: CMW led the group that implemented the WHO head standard into growth charts in the UK., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)

Importance: YARS2 mutations have been associated with a clinical triad of myopathy, lactic acidosis, and sideroblastic anemia in predominantly Middle Eastern populations. However, the identification of new patients expands the clinical and molecular spectrum of mitochondrial disorders., Objectives: To review the clinical, molecular, and genetic features of YARS2-related mitochondrial disease and to demonstrate a new Scottish founder variant., Design, Setting, and Participants: An observational case series study was conducted at a national diagnostic center for mitochondrial disease in Newcastle upon Tyne, England, and review of cases published in the literature. Six adults in a well-defined mitochondrial disease cohort and 11 additional cases described in the literature were identified with YARS2 variants between January 1, 2000, and January 31, 2015., Main Outcome and Measures: The spectrum of clinical features and disease progression in unreported and reported patients with pathogenic YARS2 variants., Results: Seventeen patients (median [interquartile range] age at onset, 1.5 [9.8] years) with YARS2-related mitochondrial myopathy were identified. Fifteen individuals (88%) exhibited an elevated blood lactate level accompanied by generalized myopathy; only 12 patients (71%) manifested with sideroblastic anemia. Hypertrophic cardiomyopathy (9 [53%]) and respiratory insufficiency (8 [47%]) were also prominent clinical features. Central nervous system involvement was rare. Muscle studies showed global cytochrome-c oxidase deficiency in all patients tested and severe, combined respiratory chain complex activity deficiencies. Microsatellite genotyping demonstrated a common founder effect shared between 3 Scottish patients with a p.Leu392Ser variant. Immunoblotting from fibroblasts and myoblasts of an affected Scottish patient showed normal YARS2 protein levels and mild respiratory chain complex defects. Yeast modeling of novel missense YARS2 variants closely correlated with the severity of clinical phenotypes., Conclusions and Relevance: The p.Leu392Ser variant is likely a newly identified founder YARS2 mutation. Testing for pathogenic YARS2 variants should be considered in patients presenting with mitochondrial myopathy, characterized by exercise intolerance and muscle weakness even in the absence of sideroblastic anemia irrespective of ethnicity. Regular surveillance and early treatment for cardiomyopathy and respiratory muscle weakness is advocated because early treatment may mitigate the significant morbidity and mortality associated with this genetic disorder.

Background: Place of cancer death varies ethnically and internationally. Palliative care reviews highlight limited ability to demonstrate equal access due to incomplete or unreliable ethnicity data., Aim: To establish place of cancer death by ethnicity and describe patient characteristics., Design: We linked census, hospital episode and mortality data for 117 467 persons dying of cancer, 2001-2009. With White Scottish population as reference, prevalence ratios (PR), 95% CIs and p values of death in hospital, home or hospice adjusted for sex and age were calculated by ethnic group., Results: White Scottish group and minority ethnic groups combined constituted 91% and 0.4% of cancer deaths, respectively. South Asian, Chinese and African Origin patients were youngest at death (66, 66 and 65.9 years). Compared with the Scottish White reference, the White Irish (1.15 (1.10 to 1.22), p<0.0001) and Other White British (1.07 (1.02 to 1.12), p=0.003) groups were more likely to die at home. Generally, affluent Scottish White patients were less likely to die in hospital and more likely to die at home or in a hospice regardless of socioeconomic indicator used., Conclusions: Cancer deaths occur most often in hospital (52.3%) for all ethnic groups. Regardless of the socioeconomic indicator used, more affluent Scottish White patients were less likely to die in hospital; existing socioeconomic indicators detected no clear trend for the non-White population. Regardless of ethnic group, significant work is required to achieve more people dying at home or the setting of their choice., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Background: The Generation Scotland Scottish Family Health Study (GS:SFHS) includes 23,960 participants from across Scotland with records for many health-related traits and environmental covariates. Genotypes at ~700 K SNPs are currently available for 10,000 participants. The cohort was designed as a resource for genetic and health related research and the study of complex traits. In this study we developed a suite of analyses to disentangle the genomic differentiation within GS:SFHS individuals to describe and optimise the sample and methods for future analyses., Results: We combined the genotypic information of GS:SFHS with 1092 individuals from the 1000 Genomes project and estimated their genomic relationships. Then, we performed Principal Component Analyses of the resulting relationships to investigate the genomic origin of different groups. We characterised two groups of individuals: those with a few sparse rare markers in the genome, and those with several large rare haplotypes which might represent relatively recent exogenous ancestors. We identified some individuals with likely Italian ancestry and a group with some potential African/Asian ancestry. An analysis of homozygosity in the GS:SFHS sample revealed a very similar pattern to other European populations. We also identified an individual carrying a chromosome 1 uniparental disomy. We found evidence of local geographic stratification within the population having impact on the genomic structure., Conclusions: These findings illuminate the history of the Scottish population and have implications for further analyses such as the study of the contributions of common and rare variants to trait heritabilities and the evaluation of genomic and phenotypic prediction of disease.

Aims: Von Willebrand factor (VWF), a key player in hemostasis and thrombosis, is released from endothelial cells during inflammation. Upon release, VWF is processed by ADAMTS13 into an inactive conformation. The aim of our study was to investigate whether plasma levels of active VWF, total VWF, ADAMTS13, osteoprotegerin (OPG) and the ratios between VWF and ADAMTS13 are risk factors for first ST-segment elevation myocardial infarction (STEMI)., Methods and Results: We assessed 1026 patients with confirmed first STEMI and 652 control subjects from China, Italy and Scotland, within six hours after their cardiovascular event. Median plasma levels of total VWF, active VWF, OPG and ratios VWF/ADAMTS13 were increased, while plasma levels of ADAMTS13 were decreased in patients compared to controls. The odds ratio (OR) of STEMI in patients with high plasma levels of active VWF was 2.3 (interquartile range (IQR): 1.8-2.9), total VWF was 1.8 (1.4-2.3), ADAMTS13 was 0.6 (05-0.8), OPG was 1.6 (1.2-2.0) and high VWF/ADAMTS13 ratios was 1.5 (1.2-2.0). The OR for total VWF, active VWF and ratios VWF/ADAMTS13 remained significant after adjustment for established risk factors, medical treatment, C-reactive protein, total VWF, ADAMTS13 and OPG. When we adjusted for levels of active VWF, the significance of the OR for VWF and ratios VWF/ADAMTS13 disappeared while the OR for active VWF remained significant., Conclusions: We found evidence that plasma levels of active VWF are an independent risk factor for first STEMI in patients from three different ethnic groups. Our findings confirm the presence of VWF abnormalities in patients with STEMI and may be used to develop new therapeutic approaches., (© The European Society of Cardiology 2014.)

Background: Glasgow City has poorer adolescent and adult health outcomes in comparison to demographically similar cities in England and the rest of Scotland. Until now, little exploration of differences in child development between Glasgow and other areas has been made. The authors hypothesized that the poorer health outcomes and lifestyle behaviours of adults, coupled with relative economic deprivation, may impact on child social, emotional and behavioural development, compared with children from other parts of Scotland., Methods: Data from the Growing Up in Scotland national birth cohort study were used. Differences between Strengths and Difficulties Questionnaire (SDQ) scores and child and family characteristics of children living in the Greater Glasgow and Clyde (GGC) Health board vs. other health boards were examined. Logistic regression and linear regression models were fitted in order to explore independent associations between health board and SDQ raw and banded scores, respectively, whilst controlling for other contributing factors., Results: Children in GGC were demographically different from those in other areas of Scotland, being significantly more likely to live in the most deprived areas, yet no difference was found in relation to the mental health of preschool-aged children in GGC. Children in GGC had slightly better SDQ Conduct Problems scores once demographic factors were controlled for., Conclusions: At 46 months, there does not appear to be any difference in Glasgow with regards to social, emotional and behavioural development. Glaswegian children appear to have slightly fewer conduct problems at this age, once demographics are taken into account. A range of theories are put forward as to why no differences were found, including the inclusion of areas adjacent to Glasgow City in the analysis, sleeper effects, and rater bias.

Introduction: Racial differences in the ECG have been known about for many years but there has been no significant comparison of large population groups. This study set out to remedy this shortcoming., Methods: Digital ECG data were available for four population samples gathered in Scotland, Taiwan, Nigeria and India. All ECGs were recorded in the different countries and processed centrally by the University of Glasgow ECG Analysis Program. Measurements were analysed statistically to look for significant differences., Results: There were 4223 individuals in the study (2559 males and 1664 females). In general terms, findings such as QRS duration being longer in males than females applied to all four races. More specifically, QRS voltages were higher in young black males compared to others, while ST amplitudes, as in V2, were higher in Chinese and Nigerian males than in Caucasians., Conclusion: Race requires to be taken into account to enhance automated interpretation of the ECG., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Aims: To assess the validity and reliability of using alcohol retail sales data to measure and monitor population levels of alcohol consumption., Methods: Potential sources of bias that could lead to under- or overestimation of population alcohol consumption based on alcohol retail sales data were identified and, where possible, quantified. This enabled an assessment of the potential impact of each bias on alcohol consumption estimates in Scotland., Results: Overall, considering all the possible sources of overestimation and underestimation, and taking into account the potential for sampling variability to impact on the results, the range of uncertainty of consumption during 2010 was from an overestimate of 0.3 l to an underestimate of 2.4 l of pure alcohol per adult. This excludes the impacts of alcohol stockpiling and alcohol sold through outlets not included in the sampling frame. On balance, there is therefore far greater scope for alcohol retail sales data to be underestimating per adult alcohol consumption in Scotland than there is for overestimation., Conclusion: Alcohol retail sales data offer a robust source of data for monitoring per adult alcohol consumption in Scotland. Consideration of the sources of bias and a comprehensive understanding of data collection methods are essential for using sales data to monitor trends in alcohol consumption.

Background: To reduce the considerable organ deficit, living donation is being promoted. The subset of foreign population living in Spain could be potential patients for transplantation and/or donation. The objective of this study was to analyze the attitudes toward living donation (LD) of the population from the southeast of Spain who are natives of Scotland., Materials and Methods: Within the "International Collaborative Donor Project," a random representative sample was obtained of the adult population residing in the southeast of Spain and who were born in Scotland (n = 350). Attitudes were evaluated with the use of a validated questionnaire that was completed anonymously and was self-administered. The Student t test, χ(2) test, and Fisher exact test were applied., Results: The completion rate was 93% (n = 324); 90% of the respondents (n = 290) were in favor of related LD, decreasing to 26% (n = 85) if it was unrelated. In the analysis of variables affecting attitude toward LD, differences were found in: 1) attitude toward deceased donation (P < .001); 2) having had previous experience of the donation and transplantation process (P = .049); 3) a respondent's belief that his or her religion was in favor of LD (P < .001); and 4) a partner's attitude toward donation and transplantation (P = .007)., Conclusions: The attitude toward related LD among Scottish residents in the southeast of Spain is very favorable, and is very closely related to attitude toward deceased donation, family attitude, and religious attitude. Patients on the waiting list of Scottish origin will be one of the most appropriate groups for promoting LD when living donation is being promoted in Spain., (Copyright © 2013 Elsevier Inc. All rights reserved.)

Background: Physical, emotional, and psychosocial wellbeing are important domains of function. The aims of this study were to explore the existence of separable groups among 70-year olds with scores representing physical function, perceived quality of life, and emotional wellbeing, and to characterise any resulting groups using demographic, personality, cognition, health and lifestyle variables., Methods: We used latent class analysis (LCA) to identify possible groups., Results: Results suggested there were 5 groups. These included High (n = 515, 47.2% of the sample), Average (n = 417, 38.3%), and Poor Wellbeing (n = 37, 3.4%) groups. The two other groups had contrasting patterns of wellbeing: one group scored relatively well on physical function, but low on emotional wellbeing (Good Fitness/ Low Spirits,n = 60, 5.5%), whereas the other group showed low physical function but relatively well emotional wellbeing (Low Fitness/Good Spirits, n = 62, 5.7%). Salient characteristics that distinguished all the groups included smoking and drinking behaviours, personality, and illness., Conclusions: Despite there being some evidence of these groups, the results also support a largely one-dimensional construct of wellbeing in old age--for the domains assessed here--though with some evidence that some individuals have uneven profiles.

There is strong evidence for both genetic and environmental risk factors comprising the aetiology of multiple sclerosis (MS). While much progress has been made in recent years in identifying common genetic variants using genome-wide association studies, alternative approaches have remained relatively neglected. The prevalence of MS in Orkney and Shetland is among the highest in the world. Previous studies have suggested that a higher degree of parental relatedness in these isolated communities may contribute to the high rates of MS, indicating that recessive effects have an important role in MS aetiology. The Northern Isles Multiple Sclerosis (NIMS) study investigated the potential role of genome-wide homozygosity in MS risk by genotyping 88 MS patients, 89 controls matched by age, sex and ancestry, and a further 89 controls matched for sex and ancestry, but passed the majority of lifetime risk of developing MS (>70 years of age). Three participants were removed on the basis of pedigree-genomic anomalies (n=263). Three measures of genome-wide homozygosity were generated for each individual, and association with MS was assessed using logistic regression models. No effect of genome-wide homozygosity was detected, indicating that inbreeding and consanguinity are not risk factors for MS in this population.

Suburban shrinkage, understood as a degenerative urban process stemming from the demise of the Fordist mode of urbanism, is generally manifested in a decline in population, industry and employment. It is also intimately linked to the global restructuring of industrial organization associated with the rise of the post-Fordist mode of urbanism and, more recently, the thrust of Asian industrialization. Framed in the discourse of industrial urbanism, this article examines the first ring of industrial suburbs that developed around large cities in their most rapid Fordist urbanization phase. These industrial suburbs, although they were formed at different times, are today experiencing specific mutations and undergoing profound restructuring on account of their particular spatial position between the central area and the expanding peripheries of the post-Fordist metropolis. This article describes and compares suburban decline in two European cities (Glasgow and Paris) and two Latin American Cities (São Paulo, Brazil and Guadalajara, Mexico), as different instances of places asymmetrically and fragmentarily integrated into the geography of globalization.

This article uses cases studies of Dundee and Manchester to explain juvenile property-offending in terms of young people's use of objects and spaces in the period 1945-60. A composite picture is assembled of objects stolen, which reflects growth of the specifically "teenage" consumer market as well as continued significance of young people's contribution to family economies. Concerns about youth, property, and space were reported in newspapers in terms of vandalism and hooliganism. "Play" and "nuisance" were overlapping and contested categories; re-education of young people in the correct use of place, space, and property was a key aim of the postwar juvenile justice system.

Traditionally marriage has been treated as one step in the life cycle, between youth and old age, singleness and widowhood. Yet an approach to the life cycle that treats marriage as a single step in a person's life is overly simplistic. During the eighteenth century many marriages were of considerable longevity during which time couples aged together and power dynamics within the home were frequently renegotiated to reflect changing circumstances. This study explores how intimacy developed and changed over the life cycle of marriage and what this meant for power, through a study of the correspondence of two elite Scottish couples.

In a large Scottish pedigree, a balanced translocation t (1;11)(q42.1;q14.3) disrupting the DISC1 and DISC2 genes segregates with major mental illness, including schizophrenia and depression. A frame-shift carboxyl-terminal deletion was reported in DISC1 in an American family with schizophrenia, but subsequently found in two controls. Herein, we test one hypothesis utilizing a large scale case-control mutation analysis: uncommon DISC1 variants are associated with high risk for bipolar spectrum disorder. We have analyzed the regions of likely functional significance in the DISC1 gene in 504 patients with bipolar spectrum disorder and 576 ethnically similar controls. Five patients were heterozygous for ultra-rare protein structural variants not found in the 576 controls (p=0.02, one-sided Fisher's exact test) and shown to be ultra-rare by their absence in a pool of 10,000 control alleles. In our sample, ultra-rare (private) protein structural variants in DISC1 are associated with an estimated attributable risk of about 0.5% in bipolar spectrum disorder. These data are consistent with: (i) the high frequency of depression in the large Scottish family with a translocation disrupting DISC1; (ii) linkage disequilibrium analysis demonstrating haplotypes associated with relatively small increases in risk for bipolar disorder (<3-fold odds ratio). The data illustrate how low/moderate risk haplotypes that might be found by the HapMap project can be followed up by resequencing to identify protein structural variants with high risk, low frequency and of potential clinical utility., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

Aims: Deaths caused by alcohol have increased in the UK, and Scotland in particular, but the change in the rates of alcohol-related deaths for migrants are uncertain, and could yield insights for the general population., Methods: Alcohol-related mortality in immigrants among Scotland's residents was assessed using 2001 census data and mortality data from 2000 to 2004., Results: Mortality from direct alcohol-related causes accounted for nearly 1500 deaths per year in Scotland. Age-standardized mortality ratios were comparatively low for people born in Pakistan, other parts of the UK (largely England and Wales) and those from elsewhere in the world., Conclusions: Scotland's propensity to alcohol-related deaths is not shared by all its residents. Studying such variations in more depth could yield lessons for prevention.

Introduction: It is important to discover whether xenotransplantation would be accepted in society. In populations where there are preclinical projects there is the possibility of xenotransplantation to humans. In the South East of Spain in recent years there has been a significant social change, due to the migratory influx, which is making it necessary to reconsider the level of acceptance of xenotransplantation. The objective of this study was to analyze the attitudes of and to determine relevant variables among the population from southeastern Spain who were born in Scotland., Method: A random sample of the population from the South East of Spain that was born in Scotland. (n = 350) answered a questionnaire with categories validated for our geographical area. The self-administered survey was completed anonymously between November 2005 and March 2006. The statistical analysis employed Student's t-test, the chi(2) test, and Fisher's exact test., Results: The questionnaire completion rate was 93% (n = 325). Assuming the results were comparable with those obtained using human organs, most respondents (67%) favored xenotransplantation with 8% against and 25% undecided. With regard to xenotransplantation, if the results were worse than those achieved using human organs, 26% (n = 83) would be in favor, 55% (n = 178) undecided, and the remaining 19% (n = 62) against these procedures. The attitude was related to belonging to the male gender (P < .001), marital status (P = .008), level of education (P = .041), a partner's favorable attitude toward transplantation (P < .001), and a favorable attitude toward organ donation, either from a deceased (P = .001) or a living (P < .001) donor., Conclusion: The attitudes of Scottish residents in southeastern Spain were similar to those of the native Spanish population and determined by many psychosocial factors, mainly related to previous attitudes toward various types of human organ donation., (Copyright 2010 Elsevier Inc. All rights reserved.)

Introduction: Stigma associated with mental health problems is a significant public health issue. Patterns of stigma and discrimination vary between and within communities and are related to conceptualisations of, and beliefs about, mental health. Population approaches to addressing stigma rarely consider diverse cultural understandings of mental health., Methods: 257 members of the major black and minority ethnic communities in Scotland participated in 26 mental health awareness workshops that were designed and delivered by community organisations. Questionnaires measuring knowledge, attitudes and behavioural intent were completed before and after the intervention., Results: Community led approaches that acknowledge cultural constructs of mental health were received positively by community groups. The study found significant reported stigma in relation to public protection, marriage, shame and contribution, but also high levels of recovery optimism. The workshops resulted in significant positive change in relation to knowledge, attitudes and behavioural intent amongst participants, with most aspects of stigma showing significant improvement, with the exception of dangerousness., Discussion: The paper argues community approaches to tackling stigma are more valuable than top-down public education and could form the basis of national initiatives. Refinements to the evaluation framework are considered.

The physical and ideological boundaries between public and private in early modern Scotland were constantly contested, resulting in a shifting reality of what was public and private. This fluidity has been recognized by historians, but how, when, and why the shifting took place is not as clear. The moral church courts (Kirk Sessions) of Reformation Scotland allow a unique opportunity to begin to understand the largely elusive boundaries between public and private in the early modern era.

The roles, affordances and social agency of natural history museums are discussed in relation to the writings of Edward Forbes. These signal a motivation, in the mid-nineteenth-century, to naturalize the established social order through the systematic arrangement and display of natural history specimens. The perceived importance of the embodied messages of social order, as an antidote to radicalism and revolution, overrode concerns about temperance and abstinence and immediate fears for the physical safety of collections. The tensions between temperance, and the broader concerns about social order, were played out over the matter of the museums themselves being licensed premises.

Purpose: The association between a specific polymorphism (3435C>T) in the ABCB1 gene, coding for the membrane drug transporter P-glycoprotein (PgP), and pharmacoresistance to seizure control is controversial. Studies have been limited by multiple drug use, chronic cohorts with varying definitions, and retrospective clinical data. Herein we examine the relationship of this polymorphism with seizure recurrence in three independent international cohorts of patients newly treated for epilepsy., Methods: Data were collected on demographics, medication details, and seizure control after 12  months of treatment. The distribution of ABCB1 3435C>T genotypes was compared between patients with and without recurrent unprovoked seizures., Results: Five hundred forty-two newly treated patients were enrolled (212 from Australia, 285 from Scotland, and 45 from Hong Kong). A total of 38.4% had recurrent unprovoked seizures after starting antiepileptic drug (AED) treatment. Genotype frequencies and ethnicity did not differ between the Scottish and Australian cohorts, but both were significantly different in the Hong Kong cohort. There was no significant relationship between the ABCB1 3435C>T genotype and the rate of recurrence of unprovoked seizures in the three cohorts individually or combined; however the epilepsy syndrome and a greater number of seizures pretreatment was associated with an increased risk of seizure recurrence., Conclusions: The ABCB1 3435C>T genotype does not have a major role in determining the efficacy of seizure control with initial AED therapy. The study highlights issues that arise in combining pharmacogenetic datasets from different ethnic regions and health systems, an approach that is essential to advance this field.

The radical psychiatrist R.D. Laing's first book, "The Divided Self" (1960), is informed by the work of Christian thinkers on scriptural interpretation -- an intellectual genealogy apparent in Laing's comparison of Karl Jaspers's symptomatology with the theological tradition of "form criticism." Rudolf Bultmann's theology, which was being enthusiastically promoted in 1950s Scotland, is particularly influential upon Laing. It furnishes him with the notion that schizophrenic speech expresses existential truths as if they were statements about the physical and organic world. It also provides him with a model of the schizoid position as a form of modern-day Stoicism. Such theological recontextualization of "The Divided Self" illuminates continuities in Laing's own work, and also indicates his relationship to a wider British context, such as the work of the "clinical theologian" Frank Lake.

Background: Southeastern Spain is a habitual area of residence for the native population of Scotland., Objective: To assess the attitude toward donation in the immigrant population in our regional community who were born in Scotland and to analyze the variables that influence this attitude., Materials and Methods: A random sample was taken (n = 350) of the population group born in Scotland and living in southeastern Spain. The instrument used to measure attitude was a previously validated questionnaire, which was self-administered and completed anonymously between December 2005 and March 2006. For a control group, we used a sample of the autochthonous population (n = 2000). Statistical analysis included Student t test, the chi(2) test, Fisher exact test, and logistical regression analysis., Results: The attitude toward donation was favorable among 73% of respondents (n = 237), with 7% (n = 22) against and 21% (n = 68) undecided. The attitude was more favorable than among the Spanish control group (73% vs 63%; P = .002). The following variables were related to this attitude: an understanding of the concept of brain death (P = .025); having discussed the matter within the family unit (P < .001); a partner's attitude toward donation (P < .001); being in favor of donating a family member's organs (P < .001); attitude toward cremation (P < .001); attitude toward autopsy (P = .002); and concern about mutilation after donation (P < .001)., Conclusions: The attitude of Scottish residents in southeastern Spain is more favorable than that of the Spanish population. It is mainly affected by factors related to the family and to the attitude toward manipulation of the cadaver.

In a large Scottish pedigree, a balanced translocation t(1;11)(q42.1;q14.3) segregates with major mental illness, including schizophrenia, bipolar disorder, and recurrent major depression. The translocation is predicted to result in the loss of the C-terminal region of the protein product of Disrupted In SChizophrenia 1 (DISC1), a gene located on 1q42.1. Since this initial discovery, DISC1 has been functionally implicated in several processes, including neurodevelopment. Based on the genetic and functional evidence that DISC1 may be associated with schizophrenia, we sequenced portions of DISC1 in 28 unrelated probands with schizophrenia and six unrelated probands with schizoaffective disorder, ascertained as part of a large sibpair study. We detected a 4 bp deletion at the extreme 3' end of exon 12 in a proband with schizophrenia. The mutation was also present in a sib with schizophrenia, a sib with schizoaffective disorder, and the unaffected father, while the mutation was not detected in 424 control individuals. The mutation is predicted to cause a frameshift and encode a truncated protein with nine abnormal C-terminal amino acids. The truncated transcript is detectable, but at a reduced level, in lymphoblastoid cell lines from three of four mutation carriers. These findings are consistent with the possibility that mutations in the DISC1 gene can increase the risk for schizophrenia and related disorders.

Background: The gene encoding oestrogen receptor alpha (ESR1) appears to regulate bone mineral density (BMD) and other determinants of osteoporotic fracture risk., Objective: To investigate the relation between common polymorphisms and haplotypes of the ESR1 gene and osteoporosis related phenotypes in a population based cohort of 3054 Scottish women., Results: There was a significant association between a common haplotype "px", defined by the PvuII and XbaI restriction fragment length polymorphisms within intron 1 of the ESR1 gene, and femoral neck bone loss in postmenopausal women who had not received hormone replacement therapy (n = 945; p = 0.009). Annual rates of femoral neck bone loss were approximately 14% higher in subjects who carried one copy of px and 22% higher in those who carried two copies, compared with those who did not carry the px haplotype. The px haplotype was associated with lower femoral neck BMD in the postmenopausal women (p = 0.02), and with reduced calcaneal broadband ultrasound attenuation (BUA) values in the whole study population (p = 0.005). There was no association between a TA repeat polymorphism in the ESR1 promoter and any phenotype studied, though on long range haplotype analysis subjects with a smaller number of TA repeats who also carried the px haplotype had reduced BUA values., Conclusions: The ESR1px haplotype is associated with reduced hip BMD values and increased rates of femoral neck bone loss in postmenopausal women. An association with BUA may explain the fact that ESR1 intron 1 alleles predict osteoporotic fractures by a mechanism partly independent of differences in BMD.

Objectives: We sought to evaluate the hypothesis that the relatively high HFE C282Y allele frequency in White persons in central Alabama (0.0896) is due to a predominance of persons of Irish and Scots descent, and is not attributable to Native American ancestry common in this geographic area., Design: Eighty evaluable hemochromatosis probands with C282Y homozygosity and 319 White controls reported countries of ancestry of their grandparents. Frequencies of country of ancestry reports were tabulated. The reports were also converted to scores that reflect proportional countries of ancestry in individuals. Using the scores, we computed aggregate country of ancestry indices as estimates of group ancestry composition. Results were compared to those of European populations with C282Y allele frequencies >0.0800., Results: The respective frequencies of "British Isles" and Scotland reports were significantly greater in hemochromatosis probands than in controls. The respective frequencies of "Europe Not British Isles," Italy, and Poland reports were significantly greater in controls. Aggregate "British Isles" and Scotland indices were significantly greater in hemochromatosis probands. The "Europe Not British Isles" index was significantly greater in controls. Approximately one-quarter of hemochromatosis probands and controls reported "Native American" ancestry; the corresponding country of ancestry index was not significantly different in probands and controls. C282Y frequencies >0.0800 were reported from England, Ireland, Scotland, Wales, Brittany, and Denmark., Conclusions: The present results indicate that hemochromatosis probands with C282Y homozygosity in central Alabama report significantly different countries of ancestry than control subjects. It is unlikely that Native American ancestry is associated with an enrichment of hemochromatosis among adult probands. British Isles ancestry, not exclusively Irish and Scots ancestries, likely accounts for the relatively high C282Y frequency in White persons in central Alabama.

Background: We sought to evaluate the hypothesis that the high incidence of cutaneous melanoma in white persons in central Alabama is associated with a predominance of Irish and Scots descent., Methods: Frequencies of country of ancestry reports were tabulated. The reports were also converted to scores that reflect proportional countries of ancestry in individuals. Using the scores, we computed aggregate country of ancestry indices as estimates of group ancestry composition. HLA-DRB1*04 allele frequencies and relationships to countries of ancestry were compared in probands and controls. Results were compared to those of European populations with HLA-DRB1*04 frequencies., Results: Ninety evaluable adult white cutaneous melanoma probands and 324 adult white controls reported countries of ancestry of their grandparents. The respective frequencies of Ireland, and Scotland and "British Isles" reported countries of ancestry were significantly greater in probands than in controls. The respective frequencies of Wales, France, Italy and Poland were significantly greater in controls. 16.7% of melanoma probands and 23.8% of controls reported "Native American" ancestry; the corresponding "Native American" country of ancestry index was not significantly different in probands and controls. The frequency of HLA-DRB1*04 was significantly greater in probands, but was not significantly associated with individual or aggregate countries of ancestry. The frequency of DRB1*04 observed in Alabama was compared to DRB1*04 frequencies reported from England, Wales, Ireland, Orkney Island, France, Germany, and Australia., Conclusion: White adults with cutaneous melanoma in central Alabama have a predominance of Irish, Scots, and "British Isles" ancestry and HLA-DRB1*04 that likely contributes to their high incidence of cutaneous melanoma.

Previous reports have found that non-Jewish Americans with ancestry from Ireland have an increased frequency of heterozygosity for Tay-Sachs disease (TSD), although frequency estimates are substantially different. Our goal in this study was to determine the frequency of heterozygosity for TSD and Sandhoff diseases (SD) among Irish Americans, as well as in persons of English, Scottish, and/or Welsh ancestry and in individuals with Italian heritage, who were referred for determination of their heterozygosity status and who had no known family history of TSD or SD or of heterozygosity for these conditions. Of 610 nonpregnant subjects with Irish background, 24 TSD heterozygotes were identified by biochemical testing, corresponding to a heterozygote frequency of 1 in 25 (4%; 95% CI, 1/39-1/17). In comparison, of 322 nonpregnant individuals with ancestry from England, Scotland, or Wales, two TSD heterozygotes were identified (1 in 161 or 0.62%; 95% CI, 1/328-1/45), and three TSD heterozygotes were ascertained from 436 nonpregnant individuals with Italian heritage (1 in 145 or 0.69%; 95% CI, 1/714-1/50). Samples from 21 Irish heterozygotes were analyzed for HEXA gene mutations. Two (9.5%) Irish heterozygotes had the lethal + 1 IVS-9 G --> A mutation, whereas 9 (42.8%) had a benign pseudodeficiency mutation. No mutation was found in 10 (47.6%) heterozygotes. These data allow for a frequency estimate of deleterious alleles for TSD among Irish Americans of 1 in 305 (95% CI, 1/2517-1/85) to 1 in 41 (95% CI, 1/72-1/35), depending on whether one, respectively, excludes or includes enzyme-defined heterozygotes lacking a defined deleterious mutation. Pseudodeficiency mutations were identified in both of the heterozygotes with ancestry from other countries in the British Isles, suggesting that individuals with ancestry from these countries do not have an increased rate of TSD heterozygosity. Four SD heterozygotes were found among individuals of Italian descent, a frequency of 1 in 109 (0.92%; 95% CI, 1/400-1/43). This frequency was higher than those for other populations, including those with Irish (1 in 305 or 0.33%; 95% CI, 1/252-1/85), English, Scottish, or Welsh (1 in 161 or 0.62%; 95% CI, 1/1328-1/45), or Ashkenazi Jewish (1 in 281 or 0.36%; 95% CI, 1/1361-1/96) ancestry. Individuals of Irish or Italian heritage might benefit from genetic counseling for TSD and SD, respectively.

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.

Polymerase chain reaction-sequence-specific oligonucleotide probes typing methods have been applied to 1000 individuals from the Northern Ireland population to give human leukocyte antigen DRB1 (HLA-DRB1) allele assignment. HLA-DRB1 allele frequencies and four-locus haplotypes (A/B/C/DR) for this Caucasian population, based on HLA class I and class II allele assignment, are now presented. No significant deviations from Hardy-Weinberg proportions were observed. The HLA-C locus exhibited marginal evidence of selection (p<0.03, uncorrected one-sided test) in the direction of balancing selection; the HLA-A, -B, and -DRB1 allele frequency distributions were compatible with expectations under a neutral model (which does not mean that selection is not operating). Evidence for selection was seen on haplotypes HLA-A*010101-B*0801-DRB1*030101 and HLA-A*290201-B*440301-DRB1*070101 based on their patterns of linkage disequilibrium.

Background: Fluoroquinolone antibiotics (FQs) are associated with phototoxic skin reactions following exposure to sunlight., Objectives: We aimed to compare the phototoxic potential of sitafloxacin, a novel FQ with three others: sparfloxacin, enoxacin, levofloxacin and placebo in Caucasian volunteers. In a second study, two dosage regimens of sitafloxacin were compared with placebo in Oriental subjects., Methods: Randomized, placebo-controlled, assessor-blinded clinical trial. In 40 healthy Caucasians, sitafloxacin 100 mg twice a day (n = 8), sparfloxacin 200 mg day-1 (n = 8), enoxacin 200 mg three times a day (n = 8), levofloxacin 100 mg three times a day (n = 8) and placebo (n = 8) were given in oral doses for 6 days. In the second study, sitafloxacin 50 mg and 100 mg, both twice daily, were compared with placebo in 17 healthy Oriental subjects. Using an established monochromator technique, baseline threshold erythema levels were established pre-drug and on-drug. The phototoxic index (PI) baseline, minimal erythema dose (MED) divided by on-drug MED for each medication at each wavelength was determined and related to sitafloxacin peak plasma levels. The duration of susceptibility to phototoxicity was assessed by repeat phototesting daily after stopping medication., Results: In the Caucasian study, sitafloxacin 100 mg twice a day produced mild ultraviolet (UV) A-dependent phototoxicity (median PI = 1.45) at 365 +/- 30 nm (half-maximum bandwidth), maximal at 24 h with normalization by 24 h postdrug cessation. The sparfloxacin group experienced severe phototoxicity maximal at 24 h and, unusually for an FQ, extended in the visible region (430 +/- 30 nm), maximal at 400 +/- 30 nm (median PI = 12.35) with abnormal pigmentation at on-drug phototest sites lasting, although fading, for up to 1 year. Enoxacin showed UVA-dependent phototoxicity (335-365 +/- 30 nm) median PI 3.94 (at 365 +/- 30 nm) returning to normal 48 h after stopping the drug. Fading pigmentation at phototoxic sites also lasted up to 1 year. Phototoxicity was not detected in the levofloxacin or placebo groups. In the Oriental study, no clinically relevant phototoxicity was seen with either sitafloxacin or placebo groups., Conclusions: We conclude that 100 mg twice a day sitafloxacin in Caucasians is associated with a mild degree of cutaneous phototoxicity. Enoxacin 200 mg three times a day and sparfloxacin 200 mg day-1 are much more photoactive. Sparfloxacin phototoxicity is induced by UVA and visible wavelengths. Levofloxacin and placebo failed to show a phototoxic effect. In the Oriental study, sitafloxacin 50 mg twice a day and 100 mg twice a day failed to demonstrate a clinically significant phototoxic effect.

Background: The endothelium is a major organ that plays a central role in the regulation of blood flow, resists thrombus formation and maintains blood fluidity. Environmental, dietary, but also genetic factors might affect endothelial cell function and vascular activity., Methods and Results: Endothelium-dependent and -independent vascular responses were evaluated in 42 male subjects from two different populations: 30 Scottish and 12 Arabic (transient visitors to UK) (20-41 years old). Endothelium-dependent and -independent vascular responses were measured in the forearm skin using laser Doppler imaging after iontophoresis of increasing doses of acetylcholine and sodium nitroprusside, respectively. Endothelium-dependent responses were significantly greater in Arabic subjects compared with responses in Scottish subjects (mean ACh ratio 4.9 +/- 1.2 v 3.8 +/- 1.5, respectively, P = 0.013, ANOVA). Although there was no significant difference between the groups in endothelium-independent vascular responses (mean SNP ratio 3.4 +/- 1.2 v 2.8 +/- 1.2, respectively, P = 0.26, ANOVA), there was a trend however towards a higher peak SNP response in the Arabic group (5.3 +/- 1.5 v 4.1 +/- 1.9, respectively, P = 0.019)., Conclusions: These results suggest that a significant difference exists in the endothelial function and vascular reactivity between these populations. Although the reasons for these differences are not clear, they may be related to differences in life styles, tradition, food intake, environmental and genetic factors.

Objective: This study explored contemporary understandings of the psychosocial costs and benefits associated with learning one's HIV status within a purposive sample of Scottish gay men. It seeks to provide insight into the psychosocial factors associated with decision-making processes relating to the HIV antibody test., Method: Transcripts of one-to-one interviews (N = 19) and four focus groups (N = 18) were analysed using Interpretative Phenomenological Analysis. Participants had varied HIV testing histories, and the sample included men who identified their HIV status as positive, men who identified it as negative, and men who did not know., Results: The HIV test could resolve doubt and anxiety for some men, but only when 'not knowing' was experienced as less tolerable than an imagined positive result. Many participants were deterred from seeking an HIV test because of their fears of the implications of a positive result. The decision to take an HIV test could be understood as a choice between living with uncertainty and the perceived impact of ascertaining HIV status., Conclusion: For the participants in this study, the decision to test or not involved many complex medical, psychological and social factors. It is argued that the development of HIV testing policy must start with a perspective grounded in an understanding and appreciation of these complexities.

Background: Hereditary motor and sensory neuropathy type 2C (HMSN2C, Charcot-Marie-Tooth 2C [CMT2C]) is an autosomal dominant motor and sensory neuropathy involving limb, diaphragm, vocal cord, and intercostal muscles., Objective: To identify the chromosome localization for this disorder in one large American family of English and Scottish ethnicity., Methods: Variable clinical severity led the authors to combine several approaches to accurately identify affected patients. Genome-wide two-point linkage analysis, high-definition mapping, and multipoint and recombinant haplotype analyses were performed. Mutation analysis of the triplet repeat region of ataxin-2 was also carried out., Results: The initial genome-wide scan identified a region at 12q24, and fine mapping provided a maximal lod score of 4.73 (D12S1645 and D12S1583 at theta = 0.01 and 0, respectively). With multipoint analysis, a higher lod score of 5.17 was obtained and localized to the same region at 119.0 cM. Haplotype analysis narrowed the region to approximately 5.0 cM between D12S1646,D12S1330 and D12S105,D12S1339 (12q23.3-24.21). Ataxin-2, the gene responsible for spinocerebellar ataxia type 2 (SCA2), localizes to this region, but no triplet repeat expansion or point mutations within the repeat were found., Conclusions: The gene for HMSN2C maps to 12q23-24. This region is associated with SCA2, scapuloperoneal spinal muscular atrophy, and congenital distal spinal muscular atrophy. Further studies are needed to demonstrate the specific gene alteration and its relationship with nearby genes.

Objective: to analyse the meanings that women gave to their childbearing experiences in order to provide some useful insights as to how their experiences might be improved., Setting: maternity units in Scotland., Design: four semi-structured interviews with each of ten Chinese and ten Scottish women in their own language; and unstructured interviews with 45 health workers, women's relatives and their friends., Findings: having children was meaningful to Scottish and Chinese women in Scotland in different ways which were related to their social positions, beliefs and practices involved and the change in social status on the birth of a child. Different meanings demanded different coping strategies in healthy childbearing. Scottish women took greater interest in their sense of control over their childbearing. Some Chinese women were experiencing more extensive cultural conflicts and changes as they tried to identify with the new culture, while the others were experiencing gradual changes over a period of time consciously or unconsciously. Both Chinese and Scottish women in the study were in a struggle between autonomy and control over their childbearing--between the mind and the body., Conclusion: childbearing is socially shaped and culturally specific. Maternity services need to consider ways in which cultural sensitive care can be provided to women in a multi-ethnic modern society., (Copyright 2002 Elsevier Science Ltd.)

Objective: to provide some insights as to how women's childbearing experiences might be improved., Design: a qualitative comparative approach., Setting: maternity units in Scotland., Method: two case comparison, four tape-recorded semi-structured interviews with each of ten Chinese and ten Scottish women, and one unstructured interview with 45 health workers, women's relatives and friends. This study was set against the background of existing literature and the author's personal experience as a midwife in both Chinese and Scottish societies and as a Chinese mother having her first baby in Scotland., Findings: the issues of 'choice' and 'control' in childbearing regulated the social relationships between women, women's bodies, their babies, health workers, obstetric technology and the wider social context. Although the Chinese and Scottish women under investigation were in Scotland, their different cultural backgrounds gave them different expectations, choices and experiences. These differences are further examples of the social and cultural construction of choice and control., Conclusion: 'choice' and 'control' offered some new dimension for the women to achieve; for the health workers and society to facilitate a new dynamic and stimulating childbearing experience. Women's bodies' cues, their babies and their feeling of being in control could be important in the management and their experience of care.