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Aims and objectives: This paper explores children's experiences and perceptions of their own bilingualism in two contexts in Scotland, UK: a primary school with a high proportion of children using a language other than English at home; and a primary school where the language of instruction is an indigenous, minority language, Gaelic. Methodology: The paper draws upon data gathered from multiple qualitative methods, including interviews, group activities and discussion, with both children and their parents. The data in this paper draw upon a broader interdisciplinary project exploring children's experiences of bilingualism. Ethics were duly considered. Data and analysis: Data were gathered from 27 children and 11 parents. Data were coded and analysed using thematic analysis. Comparison between contexts was of particular interest for this article. Findings: This paper highlights the importance of research with children in order to gain an insight into their experiences and perceptions of their own bilingualism. In particular, our findings illustrate how children's language learning is encouraged and supported by children's connections with others and the fundamental role of family (particularly parents/carers) and diverse community-based support systems (which encompass a wide range of individuals and community groups) in order to develop active bilingualism. Originality: This paper addresses a research gap in a largely quantitative field, by adopting a qualitative approach to explore children's experiences and perceptions of their own bilingualism. A qualitative approach facilitates attention to complexity and the participants' own meanings and understandings. Significance: The paper highlights the value of research with children in order to explore their views and perspectives. In particular, qualitative research methodologies, where children's experiences are central to understanding the research phenomenon, and to facilitating the exploration of the range of complex issues that interact with a child's bilingualism. [ABSTRACT FROM AUTHOR]

Background: Delirium is a serious neuropsychiatric syndrome with adverse outcomes, which is common but often undiagnosed in terminally ill people. The 4 'A's test or 4AT (www.the4AT.com), a brief delirium detection tool, is widely used in general settings, but validation studies in terminally ill people are lacking. Aim: To determine the diagnostic accuracy of the 4AT in detecting delirium in terminally ill people, who are hospice inpatients. Design: A diagnostic test accuracy study in which participants underwent the 4AT and a reference standard based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. The reference standard was informed by Delirium Rating Scale Revised-98 and tests assessing arousal and attention. Assessments were conducted in random order by pairs of independent raters, blinded to the results of the other assessment. Setting/participants: Two hospice inpatient units in Scotland, UK. Participants were 148 hospice inpatients aged ⩾18 years. Results: A total of 137 participants completed both assessments. Three participants had an indeterminate reference standard diagnosis and were excluded, yielding a final sample of 134. Mean age was 70.3 (SD = 10.6) years. About 33% (44/134) had reference standard delirium. The 4AT had a sensitivity of 89% (95% CI 79%–98%) and a specificity of 94% (95% CI 90%–99%). The area under the receiver operating characteristic curve was 0.97 (95% CI 0.94–1). Conclusion: The results of this validation study support use of the 4AT as a delirium detection tool in hospice inpatients, and add to the literature evaluating methods of delirium detection in palliative care settings. Trial registry: ISCRTN 97417474. [ABSTRACT FROM AUTHOR]

Background: The use or non-use of mobile technologies and social media in residential outdoor adventurous education (OAE) remains contested and generates an often-cited for-and-against argument in both theory and practice. Purpose: This qualitative study explored instructor perceptions of mobile technologies and social media in their practice as members of instructional staff at the United Kingdom's Outward Bound Trust. Methodology/Approach: Grounded within a multiple-case study design, 20 members of instructional staff were interviewed online from three Outward Bound Trust centers across Wales, England, and Scotland. Findings/Conclusions: Two major themes are shared as statements: (1) phone-free outdoor experiences are more impactful for young people in contemporary society ; (2) social media is fake, outdoor adventurous education necessitates in-person and in-place interaction. These findings are presented within a postdigital conceptual lens which questions whether any residential outdoor experience can be truly "technology free." Implications: The study consolidates perspectives on mobile technologies and social media in the practices of residential OAE instructors. These perspectives are considered important in the framing and delivery of contemporary OAE practice. [ABSTRACT FROM AUTHOR]

Energy prosumption has become a common phrase as more householders and communities are producing and consuming their own electricity and heat. Prosumption is a combination of two words: production and consumption, and emerged as a concept at a time when consumers were beginning to be more proactive and take over steps traditionally thought of as ‘production’. In many ways, energy prosumption is nothing new (e.g. wood combustion), yet development of our modern energy system has changed the relationships between energy producers and consumers (e.g. smart meters, renewable energy production). Thus, there is a growing body of research interested in the motivation and conditions for the uptake of microgeneration technologies and the implications to energy infrastructures and big energy producers. However, this ‘energy prosumption’ scholarship generally lacks a strong conceptual foundation and misses the opportunity to build on existing prosumption literature and related debates. This paper brings the wealth of literature on prosumption into the energy context and reflects on the insights offered by a prosumption lens. Our study explores a particular manifestation of prosumption – when a household is simultaneously a producer and consumer of their heat and/or electricity via microgeneration – and we present data from semi-structured interviews with 28 households living with microgeneration technologies in Scotland, UK. Thus, we provide a robust framework from which future research on household and community energy prosumption can build. [ABSTRACT FROM AUTHOR]

Previous research investigating the UK economy impacts of introducing a new Scottish CO2 Transport and Storage (T&S) industry linked to carbon capture and storage (CCS) has focussed on supply chain and funding requirements in introducing such a new sector to service proximate Scottish industrial emissions via onshore pipelines. However, Scottish plans extend to shipping CO2 from outside Scotland for storage in North Sea reservoirs by also servicing sequestration requirements from elsewhere in the UK and/or overseas. This will involve investment in greater industry capacity but could ease associated domestic funding requirements. Here, we introduce improved economy-wide structural (input-output) data reflecting how a Scottish T&S sector may emerge from current Oil and Gas industry supply chain capacity to a computable general equilibrium (CGE) model, extending to simulate emergence of an export base. Our central finding is that exploiting overseas T&S export opportunities is crucial where the policy aim is to generate greater economic activity without increasing demands on the public purse. However, any extent of real wage bargaining and consequent producer cost pressure as labour demand increases will act to dampen expansionary power, displacing export production and employment, while driving consumer price impacts that limit real income and public budget gains. [ABSTRACT FROM AUTHOR]

Early mobilisation of mechanically ventilated patients has been suggested to be effective in mitigating muscle weakness, yet it is not a common practice. Understanding staff experiences is crucial to gain insights into what might facilitate or hinder its implementation. In this constructivist grounded theory study, data from two Scottish intensive care units were collected to understand healthcare staff experiences relating to early mobilisation in mechanical ventilation. Data included observations of mobilisation activities, individual staff interviews and two focus groups with multidisciplinary staff. Managing Risks emerged as the core category and was theorised using the concept of risk. The middle-range theory developed in this study suggests that the process of early mobilisation starts by staff defining patient status and includes a process of negotiating patient safety, which in turn enables performing accountable mobilisation within the dynamic context of an intensive care unit setting. [ABSTRACT FROM AUTHOR]

Background: Diabetes and eating disorders are frequently comorbid. This particular comorbidity is not only often poorly recognised, but is difficult to treat and has a high mortality. Method: In this article, we will briefly review the relationship between diabetes and eating disorders. We will review the current NICE and other guidance and reports concerning both diabetes and eating disorders in the United Kingdom. We will then describe the recommendations of the 2018 Welsh Government Eating Disorder Service Review and the 2021 the Scottish Government Eating Disorder Service Review regarding diabetes and eating disorders, which will lead to service change. Conclusions: We conclude that this is a relatively underdeveloped but important area where there needs to be further service development and more collaboration between diabetes and eating disorder services. [ABSTRACT FROM AUTHOR]

The European Union membership referendum (i.e. the Brexit referendum) in the United Kingdom in 2016 triggered a process of introspection among non-British European Union citizens with respect to their right to remain in the United Kingdom, including their right to entry, permanent residence, and access to work and social welfare. Drawing on interview data collected from 42 European Union nationals, namely Finnish and Polish migrants living in Scotland, we explore how European Union migrants' decision-making and strategies for extending their stay in the United Kingdom, or returning to their country of origin, are shaped by and, in turn, shape their belonging and ties to their current place of residence and across state borders. In particular, we draw on the concept of embedding, which is used in migration studies to explain migration trajectories and decision-making. Our key argument is that more attention needs to be paid to the socio-political context within which migrants negotiate their embedding. To this end, we employ the term 'politics of embedding' to highlight the ways in which the embedding of non-British European Union citizens has been politicized and hierarchically structured in the United Kingdom after the Brexit referendum. By illustrating how the context of Brexit has changed how people evaluate their social and other attachments, and how their embedding is differentiated into 'ties that bind' and 'ties that count', we contribute to the emerging work on migration and Brexit, and specifically to the debate on how the politicization of migration shapes the sense of security on the one hand, and belonging, on the other. [ABSTRACT FROM AUTHOR]

Background: Morbid obesity (body mass index ⩾40 kg/m2) carries a higher risk of non-communicable disease and is associated with more complex health issues and challenges than obesity body mass index ≥30kg/m2 and <40kg/m2, resulting in much higher financial implications for health systems. Although obesity trends have previously been projected to 2035, these projections do not separate morbid obesity from obesity. This study therefore complements these projections and looks at the prevalence and development of morbid obesity in the UK. Methods : Individual level body mass index data for people aged >15 years in England, Wales (2004–2014) and Scotland (2008–2014) were collated from national surveys and stratified by sex and five-year age groups (e.g. 15–19 years), then aggregated to calculate the annual distribution of healthy weight, overweight, obesity and morbid obesity for each age and sex group. A categorical multi-variate non-linear regression model was fitted to these distributions to project trends to 2035. Results : The prevalence of morbid obesity was predicted to increase to 5, 8 and 11% in Scotland, England and Wales, respectively, by 2035. Welsh women aged 55–64 years had the highest projected prevalence of 20%. In total, almost five million people are forecast to be classified as morbidly obese across the three countries in 2035. Conclusions : The prevalence of morbid obesity is predicted to increase by 2035 across the three UK countries, with Wales projected to have the highest rates. This is likely to have serious health and financial implications for society and the UK health system. [ABSTRACT FROM AUTHOR]

Background: From diagnosis through to adulthood, a cleft lip and/or palate (CL/P) poses a number of challenges for those affected. Alongside the care provided by clinical teams, complementary information and support is offered by charitable organizations. In 2011, the Cleft Lip and Palate Association received funding to implement a new regional service across England and Scotland, with the aim of increasing support at a local level. The Centre for Appearance Research at the University of the West of England were commissioned to conduct an independent evaluation of the service over 7 years. Methods: A pragmatic, mixed-methods approach was utilized to assess the impact of the service from the perspective of charity volunteers; children, young people, and adults with CL/P; caregivers; and clinicians. Feedback forms were distributed to stakeholders at a variety of events, and qualitative feedback was collected via focus groups and an online survey. Results: The majority of participants indicated they had gained access to a local support network, felt more able to cope with CL/P-related challenges, and felt more confident in themselves. Qualitative investigation provided further support for these findings and highlighted additional benefits of the regional service for clinical teams. Conclusions: The evaluation provides encouraging evidence toward the contribution of a relatively small charitable organization in the context of cleft care. The importance of a pragmatic approach to community-based evaluation and the benefits of collaborative working between researchers and the charitable sector were also highlighted. [ABSTRACT FROM AUTHOR]

The potential of area-based initiatives as a mechanism for addressing health inequities is coming increasingly to the fore within local policy and planning. The need to move beyond 'bricks and mortar' in order to mitigate and reverse concentrations of disadvantage is now well established within academic and policy discourse, yet plans to stimulate economic development may be of limited benefit to local communities without addressing poor population health. Drawing on attempts to introduce assets-based community development made by a health and social care partnership in Scotland, UK, this article explores the opportunities, risks and tensions that arise when statutory organisations seek to incorporate 'bottom up' approaches to community development within hierarchical organisational cultures. Those working within such structures frequently welcome more participatory approaches. However, syndicalist and co-operative models of health promotion risk dilution, as statutory organisations supporting more radical approaches to addressing the social determinants of health are forced to function within a context of increasingly strained public sector budgets. [ABSTRACT FROM AUTHOR]

Background: This study was developed as a result of a court case involving conflicts between midwives' professional practice and their faith when caring for women undergoing abortions in Scotland. Research questions: What are practising Roman Catholics' perspectives of potential conflicts between midwives' professional practice in Scotland with regard to involvement in abortions and their faith? How relevant is the 'conscience clause' to midwifery practice today? and What are participants' understandings of Canon 1398 in relation to midwifery practice? Research design: The theoretical underpinning of this study was Gadamer's hermeneutic out of which the method developed by Fleming et al. involving a five-stage approach was utilised. Participants and research context: The research was conducted in the south of Scotland. A purposive sampling method was used. Eight participants who were practising Roman Catholics familiar with the subject of conscientious objection who were either midwives, lawyers (civil, canon or both) or priests contributed. Ethical considerations: The major ethical issues related to respect for autonomy, maintaining confidentiality and obtaining voluntary informed consent. Parish priests agreed to act as gatekeepers to prospective participants. All legal requirements were addressed regarding data collection and storage. Approval was given by the ethics committee of the university with which one of the researchers were associated. Findings: Three key themes provide an understanding of the situation in which midwives find themselves when considering the care for a woman admitted for an abortion: competing legal systems, competing views of conscience and limits of participation. Conclusion: Clear guidelines for practice should be developed by a multi-professional and consumer group based on an update of the abortion law to reflect the change from a surgical to medical procedure. Clarification of Canon 1398 in relation to what is and is not participation in the procurement of abortion would be of benefit to midwives with a conscientious objection. [ABSTRACT FROM AUTHOR]

UK policy has increasingly promoted early intervention and permanence planning for children who experience, or are at risk of experiencing, abuse or neglect, raising the question of whether these practices have actually increased ‘on the ground.’ There is already evidence of growing early intervention in the form of out of home care, in England as well as Australia and Canada. However, we do not yet know whether this trend also exists in Scotland. Furthermore, there is no research investigating whether rates of permanence planning have changed anywhere in the UK or globally. The current study addressed these gaps through a comparison of two samples of children in Scotland: 110 children born in 2003 and 117 born in 2013, all of whom were placed under compulsory measures of supervision prior to three years of age. The 2013 cohort was significantly more likely than the 2003 cohort to be removed from their parents at birth, to reside away from parents throughout the first three years of life and to live apart from parents at three years of age. Significantly more of the 2013 cohort than the 2003 cohort had a plan for permanence by three years. These findings are consistent with the view that policy changes in the UK are affecting practice (although practice changes may have resulted from other sources as well/instead). The fall in parental care was largely compensated by an increase in the use of foster care, which has resource implications. Children removed from their parents at birth were usually not returned in the first three years of life, not raised by extended family members, and were separated from one or more siblings. This typically reduced instability for young children, but also entailed substantial birth family fragmentation. The impact on children and families of early removal into foster care must therefore be carefully assessed in light of the increasing prevalence of this practice in Scotland and elsewhere. [ABSTRACT FROM AUTHOR]

This study is concerned with welfare state development and the intersection between the twin global phenomena of sub-state nationalism and ‘governance transitions’. Specifically, how minority nationalist parties (MNPs) use discourse to exert pressure for welfare change. Accordingly, here, we explore their discourse in Scottish and Welsh elections, and the UK ‘Brexit’ referendum on European Union membership. The findings reveal how pressure for welfare change is framed using key tropes including nation-building, extending social protection and resistance to central government programmes. The wider significance to understanding global social policy lies in the following: (1) revealing the discursive processes associated with multi-level welfare state dynamics, (2) demonstrating how MNPs and governance transitions combine to pressure for welfare state change, and (3) showing how the resultant territorialisation of policy discourse advances ‘sub-state’ models of social citizenship. [ABSTRACT FROM AUTHOR]

The article focuses on two Afghan boys arrived in North East of England and placed in long-term foster placement, and mentions about decision taken by court regarding them. Topics include properly accommodating unaccompanied asylum-seeking children under section 20 of the Children Act 1989; supporting the leaving care provisions, and implementing decisions about education, care and medical treatment.