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Aim To determine the attitudes and awareness of dental and medical practitioners in Scotland to the provision of oral appliances for the management of snoring and sleep apnoea.Setting The questionnaire was completed by general dental practitioners randomly selected from across Scotland and by doctors specialising in sleep medicine within Scotland.Method A questionnaire was devised and sent to 17 specialists in sleep medicine and 210 general dental practitioners, community dental service practitioners and hospital-based dental practitioners. A reply-paid envelope was included with each questionnaire.Results There were 14 replies (82%) from specialists and 105 (50%) from dentists. All the specialists felt that dentists had a role in the management of these patients. Of the replies from dentists, 60 (57%) stated that they provided appliances but their screening for sleep apnoea and discussion of the side-effects of appliances varied widely. Seventy-eight dentists (74%) expressed an interest in attending a course on the management of sleep apnoea and snoring.Conclusions The current practice of specialists and dentists in the management of obstructive sleep apnoea and socially disruptive snoring with oral appliances in Scotland is varied. Many dentists expressed a wish for further training in this area. [ABSTRACT FROM AUTHOR]

Objectives To test the validity of the Kushida Index for screening for sleep apnoea in a West of Scotland adult population.Methods Specific intra-oral measurements and respiratory polysomnography were carried out on 71 patients in this prospective study. The intra-oral measurements were applied to the Kushida formula to obtain a value for the Kushida Index. This value was compared to the diagnosis obtained using polysomnography in the conventional manner.Results The sensitivity of the Kushida Index in this present study was 68% (95% CI 50-81) and the specificity was 71% (95% CI 52-84). The positive predictive value was 71% and the negative predictive value was 67%. The Mallampati score, Epworth sleepiness score and enlargement of the tongue, soft palate or tonsils were not statistically significantly related to a diagnosis of sleep apnoea (p >0.05).Conclusion With the limited sensitivity and specificity of the Kushida Index demonstrated in this study, this test cannot be recommended as a screening tool for sleep apnoea in a West of Scotland population. [ABSTRACT FROM AUTHOR]

Background: Major changes in the treatment of schizophrenia have taken place in recent years, including a shift from inpatient to community care, and the introduction of second-generation antipsychotics and psychosocial interventions. Recent evidence has questioned the superiority of these interventions over older treatments., Aims: We wished to ascertain the impact of changes in the treatment of schizophrenia in a geographically-defined area, focusing on clinical symptoms and psychosocial outcome., Methods: In 2006, we replicated the survey carried out in 1981, identifying the population of people with schizophrenia living in Nithsdale, South-West Scotland, measuring prevalence using the 'key informant' method. We assessed their clinical and social functioning, using similar scales, and compared measures across both time periods., Results: We identified 205 people with schizophrenia, a point prevalence of 3.59/1000 general population. In 2006, while fewer people experienced negative symptoms, a greater number experienced positive symptoms. There were no significant differences in the prevalence of tardive dyskinesia or Parkinsonism, though tremor was less common in the 2006 population. In 2006, there were fewer people living with a spouse/partner or parents, and fewer were in open employment in comparison to the 1981 population. The overall level of social adjustment had not changed., Conclusions: The clinical manifestation of schizophrenia appears to have changed over the last 25 years, within this geographically-defined area, the prevalence of negative symptoms having decreased, and positive symptoms seem to have increased. The level of social functioning does not appear to have changed over the last 25 years., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Background: Reasons for the increased prevalence of cigarette smoking in schizophrenia are unclear. Studies assessing clinical symptoms have sampled heterogeneous populations, with discrepant findings., Aims: To examine the relationship between clinical features, social adjustment and nicotine dependence in a geographically defined population of people with schizophrenia., Method: Cross-sectional clinical study of 131 people with schizophrenia in Nithsdale, Scotland., Results: Smokers were younger, mostly males and three times more likely to be unemployed. Those with severe nicotine dependence had greater scores on the positive subscale of the Positive and Negative Syndrome Scale (PANSS), and were prescribed higher doses of antipsychotic. Those with mild-moderate dependence had greater scores on the PANSS negative subscale. Greater symptom severity was associated with poorer social adjustment. Psychopathology and social adjustment were similar in quitters and never-smokers., Conclusions: Our findings indicate an association between nicotine dependence, clinical symptoms and social adjustment in schizophrenia. Although causal links cannot be inferred, identifying the relationship between nicotine dependence and psychopathology may have some value in the management of smoking in schizophrenia. Further longitudinal studies are required to explore this relationship.