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Graham Watt

Publications and source records attributed to Graham Watt.

15 recordsLinked to original sources
PubMed2006

Generation Scotland: the Scottish Family Health Study; a new resource for researching genes and heritability.

BACKGROUND: Generation Scotland: the Scottish Family Health Study aims to identify genetic variants accounting for variation in levels of quantitative traits underlying the major common complex diseases (such as cardiovascular disease, cognitive decline, mental illness) in Scotland. METHODS/DESIGN: Generation Scotland will recruit a family-based cohort of up to 50,000 individuals (comprising siblings and parent-offspring groups) across Scotland. It will be a six-year programme, beginning in Glasgow and Tayside in the first two years (Phase 1) before extending to other parts of Scotland in the remaining four years (Phase 2). In Phase 1, individuals aged between 35 and 55 years, living in the East and West of Scotland will be invited to participate, along with at least one (and preferably more) siblings and any other first degree relatives aged 18 or over. The total initial sample size will be 15,000 and it is planned that this will increase to 50,000 in Phase 2. All participants will be asked to contribute blood samples from which DNA will be extracted and stored for future investigation. The information from the DNA, along with answers to a life-style and medical history questionnaire, clinical and biochemical measurements taken at the time of donation, and subsequent health developments over the life course (traced through electronic health records) will be stored and used for research purposes. In addition, a detailed public consultation process will begin that will allow respondents' views to shape and develop the study. This is an important aspect to the research, and forms the continuation of a long-term parallel engagement process. DISCUSSION: As well as gene identification, the family-based study design will allow measurement of the heritability and familial aggregation of relevant quantitative traits, and the study of how genetic effects may vary by parent-of-origin. Long-term potential outcomes of this research include the targeting of disease prevention and treatment, and the development of screening tools based on the new genetic information. This study approach is complementary to other population-based genetic epidemiology studies, such as UK Biobank, which are established primarily to characterise genes and genetic risk in the population.

Adolescent↗
PubMed2006

The new Glasgow medical and dental graduation declaration.

The medical and dental graduation ceremony at the University of Glasgow in July 2003 marked not only the 300th anniversary of the first Glasgow medical graduation, but also the first major revision of the graduation oath. This paper records the process, and explains the reasons, behind the revision of the oath and the introduction of a new graduation declaration. The new declaration provides continuity with the past, while addressing current and future challenges for professionalism in medicine.

Codes of Ethics↗
PubMed2005

Improving management of hypertension in general practice: a randomised controlled trial of feedback derived from electronic patient data.

BACKGROUND: Although absolute risk of death associated with raised blood pressure increases with age, the benefits of treatment are greater in older patients. However, fewer patients in this group are identified, treated, and controlled. AIM: To evaluate the impact of the provision of different levels of feedback on identification, treatment, and control of older patients with hypertension. DESIGN OF STUDY: Randomised controlled trial. SETTING: Fifty-two Scottish general practices. METHOD: Practices were randomly allocated to either control (n = 19), audit only feedback (n = 16), or audit plus risk feedback, prioritising patients by absolute risk (n = 17). Electronic data were extracted from practice computer systems annually from 1999 to 2001 and used to develop feedback. Data were collected for 30 345 patients aged 65-79 years. RESULTS: The majority of known patients with hypertension in each group had an initial blood pressure recorded (control = 89.6%; audit = 80.4%; risk = 96.1%) and this increased over the study period (control = 92.3%; audit = 86.0%; risk = 96.6%). Initially, more than 80% of patients in each group were treated but many were uncontrolled (blood pressure >/=160/ >/=90 mmHg) (control = 41.5%; audit = 41.3%; risk = 36.1%). The numbers of untreated and uncontrolled patients in each group reduced (control = 32.3%; audit = 38.3%; risk = 32.6%). There was some evidence of a significant difference in mean systolic pressure between the audit plus risk and audit only groups: (149.6 versus 152.7 mmHg; P = 0.019) and of significantly greater control in the audit plus risk group compared with the other groups 49.4% (versus audit only = 35.4%; versus control = 46.5%; odds ratio = 1.72 [95% confidence interval = 1.09 to 2.70]; P = 0.019). CONCLUSIONS: Levels of identification, treatment, and control improved in each group. Although there were still significant numbers of patients with uncontrolled hypertension, there is some evidence to suggest that providing patient-specific feedback may have a positive impact on identification and management of hypertension in older people and produce an increase in control.

Aged↗
PubMed2004

Inverse association between birth weight and C-reactive protein concentrations in the MIDSPAN Family Study.

OBJECTIVE: Inflammation markers and low birth weight each predict elevated risk of cardiovascular events and type 2 diabetes. However, potential associations between the low-grade inflammatory response as represented by C-reactive protein (CRP) concentrations and low birth weight have been sparsely examined. METHODS AND RESULTS: In the MIDSPAN Family Study, 1663 individuals had birth weight data and CRP concentrations measured as adults (age 30 to 59). The relationship between these parameters was examined after adjusting for factors known to influence CRP concentrations inclusive of age, body mass index, smoking, socio-economic deprivation, and hormone use in women. After adjusting for potential confounders, there was a negative association between birth weight and CRP, whereby a 1-kg increase in birth weight is associated with a 10.7% decrease in CRP (95% CI: 3.0% to 17.8% decrease). There was no strong evidence that the effects differed in men and women (P=0.32). CONCLUSIONS: Low birth weight contributes to elevated CRP concentration in adult life. Future studies are required to determine to what extent this association reflects catch-up centile crossing, in utero programming, or genetic factors.

Adult↗
PubMed2004

What will the new genetic information do for us?

The usefulness of new genetic information is frequently assumed, but depends crucially on asking the right research questions. Successful applications of the new knowledge will require effective integration with the ideas, concerns and expectations not only of patients and their families, but also health professionals in primary care. The answers to some of the most exciting questions, concerning new taxonomies of health and disease, are to be found not in teaching hospitals or academic centres, but in the population at large. New types of partnership are required between colleagues in biomedicine, epidemiology, social science and primary care. The greatest challenge, however, is to our social imagination. Can we develop the sustained relationships with families and communities, based on goodwill, mutuality and trust, on which the whole enterprise depends?

Genetic Research↗
PubMed2004

The long march: the development of academic general practice in the UK and Ireland.

Academic general practice and primary care is thriving in both the UK and Ireland, as judged by the content and vibrancy of the main annual scientific meetings of the discipline in the two countries. Problems and challenges abound, but the long-term trend is one of steady growth, with gradual increases in capacity and activity. Contributions to undergraduate medical education and to multidisciplinary professional development, and achievements in the UK University Research Assessment Exercise (RAE) show what the discipline is capable of. A major challenge remains the creation and funding of appropriate academic career structures in academic general practice and primary care, removing the current financial disincentives, uncertainties and problems in acquiring both clinical and academic experience. With increased numbers of clinical and non-clinical academics working in general practice and primary care, the discipline is set to play an important role in health service development in both the UK and Ireland.

Biomedical Research↗
PubMed2004

Using electronic patient records to inform strategic decision making in primary care.

Although absolute risk of death associated with raised blood pressure increases with age, the benefits of treatment are greater in elderly patients. Despite this, the 'rule of halves' particularly applies to this group. We conducted a randomised controlled trial to evaluate different levels of feedback designed to improve identification, treatment and control of elderly hypertensives. Fifty-two general practices were randomly allocated to either: Control (n=19), Audit only feedback (n=16) or Audit plus Strategic feedback, prioritising patients by absolute risk (n=17). Feedback was based on electronic data, annually extracted from practice computer systems. Data were collected for 265,572 patients, 30,345 aged 65-79. The proportion of known hypertensives in each group with BP recorded increased over the study period and the numbers of untreated and uncontrolled patients reduced. There was a significant difference in mean systolic pressure between the Audit plus Strategic and Audit only groups and significantly greater control in the Audit plus Strategic group. Providing patient-specific practice feedback can impact on identification and management of hypertension in the elderly and produce a significant increase in control.

Aged↗
PubMed2003

Victim-blaming revisited: a qualitative study of beliefs about illness causation, and responses to chest pain.

BACKGROUND: Health promotion is an established part of the general practice consultation. It is widely acknowledged that risk-behaviours are strongly affected by socio-economic status and the structural constraints of the individual, but little is known about the possible negative effects of lifestyle advice. OBJECTIVES: To examine the extent to which self-responsibility, blame for ill health and risk behaviours feature in accounts of respondents with chest pain, and to ascertain whether perceived victim-blaming influences lay interpretations and responses to chest pain, and to ill health in general. METHODS: Qualitative interviews were carried out in two socio-economically contrasting areas of Glasgow, with 30 respondents (15 men and 15 women) from a socio-economically deprived area, and 30 respondents (15 men and 15 women) from an affluent area. RESULTS: Respondents recognized the causative links between well-established cardiac risk factors and heart disease. Individuals blamed themselves for their heart disease and general ill health and many also believed that they would be blamed for their behaviour and health problems by doctors. For some respondents, self-blame and fear of blame appeared to contribute to a reluctance to seek care. Self-blame, experience of blame and fear of blame were more common in respondents from the deprived area. CONCLUSION: Emphasis by doctors on "unhealthy" behaviours may deter patients from seeking medical care. Lifestyle advice should be given taking into account the health beliefs and the socio-economic context of individuals. Future studies should focus on the theme of blame in order to explore further the possible negative effects of lifestyle advice given by health professionals.

Attitude to Health↗