Live long in Scotland - the relative contribution of medicine and standards of living to Scotland's falling mortality rates

Between 1950 and 1999 the Scottish death rate, standardised to the 1950 population, declined from 13.1 per 1000 to 7.8 for men and from 12 per 1000 to 6.3 for women. The main aim of this thesis has been to establish the key influences on this decline. Thomas McKeown examined the decline of mortality in an earlier time period (up to the 1970s) and concluded that: falls in deaths from infectious diseases were responsible for the majority of the decline in mortality rate; and the main influence on their decline was standards of living, in particular diet. This thesis has updated McKeown's study for the latter half of the 20th century by establishing which causes of death contributed the most to the fall in mortality in Scotland, and the main influences on their decline.The causes of death which contributed most to the decline in mortality rates 1950-1999 were established by digitising GRO(S) mortality records and calculating 'potential lives saved'. This method allows an estimate to be made of the number of deaths which would be expected to occur in 1999, taking into account changing age structure, ifthe death rates from 1950 still applied. Tuberculosis (TB), stomach cancer (SC), ischemic heart disease (IHD) and stroke were selected as case studies; these accounted for over 70% of the decline of male and female mortalityThe trajectory of decline in these causes of death was then considered in detail and set in social and medical context. The role of medicine was defined broadly, including not only treatments, but also changes in the environment or in population behaviour which benefited health and could be proven to have been inspired by medicine. This differs from McKeown's approach which had a more clinical focus.The thesis has reached an alternative conclusion from that ofThomas McKeown. It is argued that improving standards of living were responsible for some of the decline in SC and haemorrhagic stroke mortality, and the pre-1950 decline ofTB; however, the main influence on the decline of TB, IHD and ischemic stroke mortality post-1950 was medicine. Using the wider definition of the influence of medicine adopted in this study, medicine is considered to account for the majority of the decline in the identified causes of mortality. Medicine has, at last, delivered important contributions to the life expectancy of the Scottish population

The shopfloor experience of regional policy: work and industrial relations at the Bathgate motor plant, c.1961-1986

This thesis explores the experience of work and industrial relations at the British Motor Corporation’s commercial vehicle assembly plant at Bathgate in West Lothian, from its establishment in 1961 until its closure in 1986. The plant opened in Scotland as a result of a government regional development policy which sought to create jobs and ameliorate the rundown of heavy industry in areas of high unemployment. The thesis considers the role of such policy in shaping industrial development since 1945, and, using the oral history testimony of former Bathgate workers to examine the impact of economic and social change on Scotland’s industrial population, contributes to the regional policy literature by extending the analysis beyond questions about its efficacy and considering the experiences of the workers and communities directly affected by such initiatives. What emerges from this study of regional policy from the perspective of the shopfloor is the extent to which the plant’s establishment on a greenfield site, in an area of high unemployment, very much on the periphery of the UK motor industry and with little tradition of mass assembly production processes, shaped the subsequent evolution of its working conditions, industrial relations, and worker attitudes, as well as its position within the Bathgate community. The Bathgate experience therefore illuminates a number of key debates in the wider historiography of Britain and Scotland since 1945, not only in relation to regional policy itself, but also with regard to the motor industry, its industrial relations, and the development, in the post-war context of relatively high wages and the increasing stability of work, of a more typically ‘affluent’ working class. The thesis is divided into two parts. Part One explores some of the issues surrounding the plant’s establishment in West Lothian, particularly the regional policy aspects, and the plant’s position within and relationship to both the wider BMC – later British Leyland – organisation and the British motor industry more generally. Part Two draws extensively on the influential ‘affluent worker’ thesis, as well as the literature around the industrial relations of motor manufacturing, in developing and exploring questions related to the way in which work was experienced at Bathgate, and the extent to which the attitudes and behaviour of its workforce came to reflect those which typified the motor worker elsewhere. Throughout, the thesis engages with and adds nuance to debates over the role of shopfloor organisation and strike activity in damaging the performance of British motor manufacturing, and, by drawing on the oral testimony of former Bathgate workers themselves, offers a fresh perspective on the post-war experience of regional policy both in a particular, under-researched regional policy plant, and in Scotland and Britain more broadly

Land-use drives the temporal stability and magnitude of soil microbial functions and modulates climate effects

Soil microbial community functions are essential indicators of ecosystem multifunctionality in managed land-use systems. Going forward, the development of adaptation strategies and predictive models under future climate scenarios will require a better understanding of how both land-use and climate disturbances influence soil microbial functions over time. Between March and November 2018, we assessed the effects of climate change on the magnitude and temporal stability of soil basal respiration, soil microbial biomass and soil functional diversity across a range of land-use types and intensities in a large-scale field experiment. Soils were sampled from five common land-use types including conventional and organic croplands, intensive and extensive meadows, and extensive pastures, under ambient and projected future climate conditions (reduced summer precipitation and increased temperature) at the Global Change Experimental Facility (GCEF) in Bad Lauchstädt, Germany. Land-use and climate treatment interaction effects were significant in September, a month when precipitation levels slightly rebounded following a period of drought in central Germany: compared to ambient climate, in future climate treatments, basal respiration declined in pastures and increased in intensive meadows, functional diversity declined in pastures and croplands, and respiration-to-biomass ratio increased in intensive and extensive meadows. Low rainfall between May and August likely strengthened soil microbial responses toward the future climate treatment in September. Although microbial biomass showed declining levels in extensive meadows and pastures under future climate treatments, overall, microbial function magnitudes were higher in these land-use types compared to croplands, indicating that improved management practices could sustain high microbial ecosystem functioning in future climates. In contrast to our hypothesis that more disturbed land-use systems would have destabilized microbial functions, intensive meadows and organic croplands showed stabilized soil microbial biomass compared to all other land-use types, suggesting that temporal stability, in addition to magnitude-based measurements, may be useful for revealing context-dependent effects on soil ecosystem functioning

Nitrogen dynamics after two years of elevated CO2 in phosphorus limited Eucalyptus woodland

It is uncertain how the predicted further rise of atmospheric carbon dioxide (CO2) concentration will affect plant nutrient availability in the future through indirect effects on the gross rates of nitrogen (N) mineralization (production of ammonium) and depolymerization (production of free amino acids) in soil. The response of soil nutrient availability to increasing atmospheric CO2 is particularly important for nutrient poor ecosystems. Within a FACE (Free-Air Carbon dioxide Enrichment) experiment in a native, nutrient poor Eucalyptus woodland (EucFACE) with low soil organic matter (≤ 3%), our results suggested there was no shortage of N. Despite this, microbial N use efficiency was high (c. 90%). The free amino acid (FAA) pool had a fast turnover time (4 h) compared to that of ammonium (NH4+) which was 11 h. Both NH4-N and FAA-N were important N pools; however, protein depolymerization rate was three times faster than gross N mineralization rates, indicating that organic N is directly important in the internal ecosystem N cycle. Hence, the depolymerization was the major provider of plant available N, while the gross N mineralization rate was the constraining factor for inorganic N. After two years of elevated CO2, no major effects on the pools and rates of the soil N cycle were found in spring (November) or at the end of summer (March). The limited response of N pools or N transformation rates to elevated CO2 suggest that N availability was not the limiting factor behind the lack of plant growth response to elevated CO2, previously observed at the site

The influence of elevated CO2 and soil depth on rhizosphere activity and nutrient availability in a mature Eucalyptus woodland

Elevated carbon dioxide (eCO2) in the atmosphere increases forest biomass productivity but only where soil nutrients, particularly nitrogen (N) and phosphorus (P), are not limiting growth. eCO2, in turn, can impact rhizosphere nutrient availability. Our current understanding of nutrient cy cling under eCO2 is mainly derived from surface soil, leaving mechanisms of the impact of eCO2 on rhizosphere nutrient availability at deeper depths unexplored. To investigate the influence of eCO2 on nutrient availability in soil at depth, we studied various C, N, and P pools (extractable, microbial biomass, total soil C and N, and mineral-associated P) and nutrient cycling processes (enzyme activity and gross N mineralisation) associated with C, N, and P cycling in both bulk and rhizosphere soil at different depths at the Free Air CO2 enrichment facility in a native Australian mature Eucalyptus woodland (EucFACE) on a nutrient-poor soil. We found de creasing nutrient availability and gross N mineralisation with depth; however, this depth-associated decrease was reduced under eCO2, which we suggest is due to enhanced root influence. Increases in available PO3− 4 , adsorbed P, and the C : N and C : P ratio of enzyme activity with depth were observed. We conclude that the influences of roots and of eCO2 can affect available nutrient pools and processes well beyond the surface soil of a mature forest ecosystem. Our findings indicate a faster recycling of nutrients in the rhizosphere, rather than additional nutrients becoming available through soil organic matter (SOM) decomposition. If the plant growth response to eCO2 is reduced by the constraints of nutrient limitations, then the current results would call to question the potential for mature tree ecosystems to fix more C as biomass in response to eCO2. Future studies should address how accessible the available nutrients at depth are to deeply rooted plants and if fast recycling of nutrients is a meaningful contribution to biomass production and the accumulation of soil C in response to eCO2

Creation and Initial Validation of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale

OBJECTIVE: To assess consensual validity, interrater reliability, and criterion validity of the International Dysphagia Diet Standardisation Initiative Functional Diet Scale, a new functional outcome scale intended to capture the severity of oropharyngeal dysphagia, as represented by the degree of diet texture restriction recommended for the patient. DESIGN: Participants assigned International Dysphagia Diet Standardisation Initiative Functional Diet Scale scores to 16 clinical cases. Consensual validity was measured against reference scores determined by an author reference panel. Interrater reliability was measured overall and across quartile subsets of the dataset. Criterion validity was evaluated versus Functional Oral Intake Scale (FOIS) scores assigned by survey respondents to the same case scenarios. Feedback was requested regarding ease and likelihood of use. SETTING: Web-based survey. PARTICIPANTS: Respondents (N=170) from 29 countries. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Consensual validity (percent agreement and Kendall tau), criterion validity (Spearman rank correlation), and interrater reliability (Kendall concordance and intraclass coefficients). RESULTS: The International Dysphagia Diet Standardisation Initiative Functional Diet Scale showed strong consensual validity, criterion validity, and interrater reliability. Scenarios involving liquid-only diets, transition from nonoral feeding, or trial diet advances in therapy showed the poorest consensus, indicating a need for clear instructions on how to score these situations. The International Dysphagia Diet Standardisation Initiative Functional Diet Scale showed greater sensitivity than the FOIS to specific changes in diet. Most (\u3e70%) respondents indicated enthusiasm for implementing the International Dysphagia Diet Standardisation Initiative Functional Diet Scale. CONCLUSIONS: This initial validation study suggests that the International Dysphagia Diet Standardisation Initiative Functional Diet Scale has strong consensual and criterion validity and can be used reliably by clinicians to capture diet texture restriction and progression in people with dysphagia

Access to patients' clinical healthcare records: inclusion for community pharmacists in NHS Tayside.

The 2020 Workforce Vision in Scotland envisages 'making more and better use of technology ....to increase access to services and improve efficiency' across the healthcare interface. Services offered by community pharmacy remain limited by lack of shared access to patients' clinical information. In Scotland, every patient has a unique identifier, their CHI (community health index), which facilitates identification of/searching for patient records. The aim of this research was to explore the experiences of community pharmacists granted clinical portal access to patients' records

Synthetic community improves crop performance and alters rhizosphere microbial communities

Introduction: Harnessing synthetic communities (SynCom) of plant growth‐promoting (PGP) microorganisms is considered a promising approach to improve crop fitness and productivity. However, biotic mechanisms that underpin improved plant performance and the effects of delivery mode of synthetic community are poorly understood. These are critical knowledge gaps that constrain field efficacy of SynCom and hence large‐ scale adoption by the farming community. Material & Methods: In this study, a SynCom of four PGP microbial species was constructed and applied to either as seed dressing (treatment T1, applied at the time of sowing) or to soil (treatment T2, applied in soil at true leaf stage) across five different cotton (Gossypium hirsutum) cultivars. The impact of SynCom on plant growth, rhizosphere microbiome and soil nutrient availability, and how this was modified by plant variety and mode of applications, was assessed. Results: Results showed that the seed application of SynCom had the strongest positive impact on overall plant fitness, resulting in higher germination (14.3%), increased plant height (7.4%) and shoot biomass (5.4%). A significant increase in the number of flowers (10.4%) and yield (8.5%) was also observed in T1. The soil nitrate availability was enhanced by 28% and 55% under T1 and T2, respectively. Results further suggested that SynCom applications triggered enrichment of members from bacterial phyla Actinobacteria, Firmicutes and Cyanobacteria in the rhizosphere. A shift in fungal communities was also observed, with a significant increase in the relative abundance of fungi from phyla Chytridiomycota and Basidiomycota in SynCom treatments. A structural equation model suggested that SynCom directly increased crop productivity but also indirectly via impacting the alpha diversity of bacteria. Conclusion: Overall, this study provides mechanistic evidence that SynCom applications can shift rhizosphere microbial communities and improve soil fertility, plant growth, and crop productivity, suggesting that their use could contribute toward sustainable increase in farm productivity

The fatty acid compositions of erythrocyte and plasma polar lipids in children with autism, developmental delay or typically developing controls and the effect of fish oil intake

The erythrocyte and plasma fatty acid compositions of children with autism were compared in a case-control study with typically developing (TD) children and with children showing developmental delay (DD). Forty-five autism subjects were age-matched with TD controls and thirty-eight with DD controls. Fatty acid data were compared using paired t tests. In addition, blood fatty acids from treatment-naive autism subjects were compared with autism subjects who had consumed fish oil supplements by two-sample t tests. Relatively few differences were seen between erythrocyte fatty acids in autism and TD subjects although the former had an increased arachidonic acid (ARA):EPA ratio. This ratio was also increased in plasma samples from the same children. No changes in n-3 fatty acids or ARA:EPA ratio were seen when comparing autism with DD subjects but some SFA and MUFA were decreased in the DD subjects, most notably 24 : 0 and 24 : 1, which are essential components of axonal myelin sheaths. However, if multiple comparisons are taken into account, and a stricter level of significance applied, most of these values would not be significant. Autism subjects consuming fish oil showed reduced erythrocyte ARA, 22 : 4n-6, 22 : 5n-6 and total n-6 fatty acids and increased EPA, 22 : 5n-3, 22 : 6n-3 and total n-3 fatty acids along with reduced n-6:n-3 and ARA:EPA ratios. Collectively, the autism subjects did not have an underlying phospholipid disorder, based on erythrocyte fatty acid compositions, although the increased ARA:EPA ratio observed suggested that an imbalance of essential highly unsaturated fatty acids may be present in a cohort of autism subjects