Region Of Scotland Research Articles

Looking back at Covid-19 government restrictions: were local lockdown regions with tighter restrictions less adherent before the restrictions and more adherent after?

It is assumed that increases in Covid-19 cases are caused by people not adhering to advised individual transmission-reducing behaviours. Upon the implementation of restrictions, the hypothesis is that those individuals will change their behaviour. We aimed to retrospectively explore adherence to physical distancing before and after restrictions (e.g., lockdowns) were implemented in a region of Scotland. We assessed adherence, intention, and self-efficacy to physical distancing in a series of cross-sectional telephone surveys of a representative sample of adults in Scotland. We included data from before regional restrictions and after restrictions and examined whether regions with and without restrictions differed in adherence. A total of 1724 Scottish adults (675 men, M age = 52.79 years, SD = 17.92) participated (879 (51.0%) pre-restriction, 466 (27.0%) from a restricted region). ANOVA showed that none of the main effects (for region or time) nor the interaction effect were significant. There was a main effect of time on self-efficacy, such that self-efficacy was lower post-restriction measures (M = 4.13, SD = 0.81) compared to pre-restriction time (M = 4.22, SD = 0.79). There was no evidence that adherence was weaker before restrictions were implemented in regions with higher case rates. Nor was there evidence that imposing restrictions increased adherence. In a future pandemic, it is advisable to assess behaviour and beliefs about Covid-19, risk, and behaviours on an ongoing basis and to use that as indicators of the need for intervention even before cases rates start to go up.

Explaining microvariation using the Tolerance Principle: plugging the amn’t gap

Abstract In this article, we describe and explain patterns of variation in acceptance of amn’t in varieties of Scots, drawing upon data from the Scots Syntax Atlas. Partly in line with findings from Bresnan (2001), we show that amn’t is much more widely accepted in inversion environments (amn’t I?) than in declaratives (I amn’t), but nevertheless, amn’t in declaratives is still accepted in certain regions of Scotland. We combine the productivity-based explanation of the amn’t gap in Yang (2016, 2017) with new insights into the syntax of Scots negation from Thoms et al. (2023) to provide a predictive account of the attested variation.

High-risk HPV mRNA testing on self-samples offered to those who do not attend for organised cervical screening – real world data from the Dumfries and Galloway region in Scotland

BackgroundHPV self sampling can act as a tool to engage women in cervical screening and population based studies can inform optimal implementation of this approach. MethodsSelf sampling kits were mailed to women who had defaulted from routine screening resident in an entire territorial health board in Scotland. Kit return rates and compliance to colposcopy follow up in those who were HPV mRNA positive were assessed. Concordance of the self-sample with samples taken later at colposcopy was measured alongside PPV of an mRNA positive result for CIN2+. ResultsOf 4173 women invited to participate, 20.5 %, returned their kit and a greater return rate with increasing age was observed. HPV mRNA positivity was 12.0 %, and invalidity rate was approximately 3 %. Compliance to colposcopy follow up was 88.3 % and the PPV for an mRNA test for CIN2+ on a self sample was 25.6 %. hr-HPV concordance on the initial swab and the follow up swab and liquid based cytology (LBC) sample taken at colposcopy was 67.1 % and 30 % respectively. ConclusionsHPV self sampling using a “mail to all” approach is feasible in Scotland although only 1 in 5 actively responded to the offer. Future work to monitor screening behaviours in those who were invited but did not engage initially will help quantify any additional benefit(s) incurred.

Potential deprescribing indications for antidepressants between 2012 and 2019: repeated cross-sectional analysis in two Scottish health boards

BackgroundAntidepressants have a pivotal role in the treatment of many psychiatric disorders, but there are concerns about long-term use and adverse effects. The objectives of this study were (1) to examine time trends in antidepressant use, (2) to estimate the prevalence of long-term and potential high-risk antidepressant use, and (3) to examine patient characteristics associated with potential deprescribing indications (PDIs) (i.e., simultaneous long-term and potential high-risk antidepressant use).MethodsRepeated population-based cross-sectional study for all 609,299 people aged ≥ 18 years resident in the Tayside or Fife regions of Scotland. The prevalence of antidepressant use was examined on June 30th (index date) of each year from 2012 to 2019, while the prevalence of long-term and potential high-risk use as well as PDIs was assessed and compared on the same dates in 2012 and 2019. Binary logistic regression modeling was used to examine patient characteristics associated with PDIs.ResultsAntidepressant use increased by 27% from 12.0 to 15.3% among adult residents between 2012 and 2019. While the proportion of antidepressants users dispensed ≥ 1 antidepressant for > 2 years increased from 54.3 to 61.9% between 2012 and 2019, the proportion of antidepressant users triggering ≥ 1 indicator of potential high-risk use decreased slightly from 37.9 to 34.7%. In 2019, potential high-risk use most commonly related to indicators targeting fall risk (16.0%), cardiovascular risks (14.1%), insomnia (10.6%), and risk of orthostatic hypotension (8.6%). More than 1 in 4 (25.8%) antidepressant users had PDIs. The main risk factors associated with PDIs included increasing age (65–79, adjusted OR 14.12; 95% CI, 13.15–15.17), increasing number of drugs taken concomitantly (≥ 15 drugs, adjusted OR 7.37; 95% CI, 6.71–8.10), use of tricyclic antidepressants (≥ 50 mg) (adjusted OR 5.49; 95% CI, 5.02–6.01), and concomitant use of ≥ 2 antidepressants (adjusted OR 5.52; 95% CI, 5.20–5.85).ConclusionsLong-term and potential high-risk use of antidepressants is widespread, and potential deprescribing indications (PDIs) are increasing, suggesting the need for a critical review of their ongoing use by clinicians. If deemed necessary, future deprescribing interventions may use the criteria applied here for identification of patients with PDIs and for evaluating intervention effectiveness.

Influence of preoperative embolisation on resection of brain arteriovenous malformations: cohort study

PurposePreoperative endovascular embolisation is a widely used adjunct for the surgical treatment of brain arteriovenous malformations (AVMs). However, whether this improves completeness of AVM resection is unknown, as previous analyses have not adjusted for potential confounding factors. We aimed to determine if preoperative endovascular embolisation was associated with increased rate of complete AVM resection at first surgery, following adjustment for Spetzler-Martin grade items.MethodsWe identified a cohort of all patients undergoing first ever AVM resection in a specialist neurosciences unit in the NHS Lothian Health Board region of Scotland between June 2004 and June 2022. Data was prospectively extracted from medical records. Our primary outcome was completeness of AVM resection. We determined the odds of complete AVM resection using binomial logistic regression with adjustment for Spetzler-Martin grading system items: maximum nidus diameter, eloquence of adjacent brain and the presence of deep venous drainage.Results88 patients (median age 40y [IQR 19–53], 55% male) underwent AVM resection. 34/88 (39%) patients underwent preoperative embolisation and complete resection was achieved at first surgery in 74/88 (84%). Preoperative embolisation was associated with increased adjusted odds of complete AVM resection (adjusted odds ratio [aOR] 8.6 [95% confidence interval (95% CI) 1.7–67.7]; p = 0.017). The presence of deep venous drainage was associated with reduced chance of complete AVM resection (aOR 0.18 [95% CI 0.04–0.63]; p = 0.009).ConclusionsPreoperative embolisation is associated with improved chances of complete AVM resection following adjustment for Spetzler-Martin grade, and should therefore be considered when planning surgical resection of AVMs.

Reduced size in a montane butterfly at its warm range boundaries

Abstract Variation in insect size is often related to temperature during development and may affect the persistence of populations under future climate warming if smaller individuals have reduced fitness. Montane species are particularly vulnerable to climate‐driven local extinctions due to range retractions at their warm range margins, and so we examined spatial and temporal variation in body size in the butterfly Erebia epiphron (Lepidoptera: Nymphalidae) in the United Kingdom, where it is restricted to two montane regions in England and Scotland. We examined spatial and temporal variation in body size in relation to temperature. We sampled 19 populations (6–15 individuals per population) in England and Scotland between 2018 and 2019 spanning elevations from 380 to 720 m and examined museum specimens collected between 1890 and 1980. We examined individual body size (forewing length) and its relationship with the local temperature of sites, as well as temporal variation in body size over the last century in relation to the temperature during larval development. The forewing lengths of field‐collected individuals in England were on average 7%–8% smaller than in Scotland (England, mean = 14.9 mm, Scotland, mean = 15.9 mm), and warmer sites also had smaller individuals (0.13 mm reduction in wing length per 1°C increase in local site mean temperature). However, we found no effect of temporal temperature variation on body size changes during larval development. The observed smaller body size in English populations could have impacts on fecundity and dispersal ability. Future work should seek to understand the life‐cycle lengths, genetics and phenotypic plasticity of these two populations to evaluate potential explanations for regional differences.

Comparative analysis of the aromatic profile of single malt whiskies from different regions of Scotland using GC-MS, GC-O-MS and sensory evaluation

Single malt whiskies are popular around the world. The 37 esters, 10 alcohols, 10 phenols, 8 aldehydes, 8 acids, 6 alkanes, 4 ketones and 3 heterocycles were detected in the single malt whiskies extracted from different origins in Scotland by HS-SPME (headspace solid-phase microextraction) and LLE (liquid-liquid extraction) and identified by GC-MS (gas chromatography-mass spectrometry). QDA (quantitative descriptive analysis) combined with multivariate statistics were used to investigate the effects of the differential aroma-active compounds on the sensory aroma characteristics. O-cresol, ethyl 2-methylbutyrate, 5-methylfurfural and propionic acid might influence the flavor of single malt whiskies of different origins in Scotland. The 54 key whisky aroma compounds were analyzed, with isoamyl acetate having the highest OAV (odour activity value) of all whisky samples. In addition, the aromas of volatile compounds were analyzed using OSME (odor-specific magnitude estimation) and OAV. Based on these facts, the researchers developed a flavour wheel with 10 aroma profiles. This paper evaluates Scotch single malt whisky from a Chinese perspective, which helps the development of the Chinese whisky market.

O&M-aware techno-economic assessment for floating offshore wind farms: A geospatial evaluation off the North Sea and the Iberian Peninsula

The development of accurate techno-economic models is crucial to boost the commercialisation of floating offshore wind farms. However, conventional techno-economic models oversimplify operation and maintenance (O&M) aspects, neglecting key maintenance factors, such as component failure rates, metocean conditions, repair times, maintenance vessels and ports. To address this limitation, this paper presents an O&M-aware techno-economic model that comprehensively incorporates the most relevant maintenance factors and evaluates their impacts on site-identification across the North Sea and the Iberian Peninsula based on diverse O&M strategies. Results reveal that operational expenditure can contribute significantly to the levelised cost of energy, ranging from 22% to 50% in the North Sea and 19% to 46% in the Iberian Peninsula. Furthermore, results demonstrate that suitable sites vary based on O&M strategy: preventive strategies favour areas with abundant wind resources like northern Scotland, Norway and Galicia, whereas corrective strategy prioritise sites with less severe metocean conditions, such as southern Scotland and extensive regions in the Mediterranean Sea, including the Gulf of Roses and the Alboran Sea. Finally, the downtime of turbines, an aspect traditionally neglected in techno economic frameworks, emerges as a key factor for accurate techno-economic assessment and site-identification.

Regional differences in heart failure risk in the United Kingdom are partially explained by biological aging.

Heart failure (HF) risk is greater in rural versus urban regions in the United States (US), potentially due to differences in healthcare coverage and access. Whether this excess risk applies to countries with universal healthcare is unclear and the underlying biological mechanisms are unknown. In the prospective United Kingdom (UK) Biobank, we investigated urban-rural regional differences in HF risk and the mechanistic role of biological aging. Multivariable Cox regression was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of incident HF in relation to residential urban-rural region and a Biological Health Score (BHS) that reflects biological aging from environmental, social, or dietary stressors. We estimated the proportion of the total effect of urban-rural region on HF mediated through BHS. Among 417,441 European participants, 10,332 incident HF cases were diagnosed during the follow-up. Compared to participants in large urban regions of Scotland, those in England/Wales had significantly increased HF risk (smaller urban: HR = 1.83, 95%CI: 1.64-2.03; suburban: HR = 1.77, 95%CI: 1.56-2.01; very rural: HR = 1.61, 95%CI: 1.39-1.85). Additionally, we found a dose-response relationship between increased biological aging and HF risk (HRper 1 SD increase = 1.14 (95%CI: 1.12-1.17). Increased biological aging mediated a notable 6.6% (p < 0.001) of the total effect of urban-rural region on HF. Despite universal healthcare in the UK, disparities in HF risk by region were observed and may be partly explained by environmental, social, or dietary factors related to biological aging. Our study contributes to precision public health by informing potential biological targets for intervention.

Antenatal care of women who use opioids: a qualitative study of practitioners’ perceptions of strengths and challenges of current service provision in Scotland

BackgroundThe increasing rise of women using opioids during pregnancy across the world has warranted concern over the access and quality of antenatal care received by this group. Scotland has particularly high levels of opioid use, and correspondingly, pregnancies involving women who use opioids. The purpose of this study was to investigate the different models of antenatal care for women using opioids during pregnancy in three Scottish Health Board Areas, and to explore multi-disciplinary practitioners’ perceptions of the strengths and challenges of working with women who use opioids through these specialist services.MethodsThirteen semi-structured interviews were conducted with health and social care workers who had experience of providing antenatal and postnatal care to women who use drugs across three Scottish Health Board Areas: NHS Greater Glasgow and Clyde, NHS Lothian, and NHS Tayside. Framework Analysis was used to analyse interview data. The five stages of framework analysis were undertaken: familiarisation, identifying the thematic framework, indexing, charting, and mapping and interpretation.ResultsEach area had a specialist antenatal pathway for women who used substances. Pathways varied, with some consisting of specialist midwives, and others comprising a multidisciplinary team (e.g. midwife, mental health nurse, social workers, and an obstetrician). Referral criteria for the specialist service differed between health board areas. These specialised pathways presented several key strengths: continuity of care with one midwife and a strong patient-practitioner relationship; increased number of appointments, support and scans; and highly specialised healthcare professionals with experience of working with substance use. In spite of this, there were a number of limitations to these pathways: a lack of additional psychological support for the mother; some staff not having the skills to engage with the complexity of patients who use substances; and problems with patient engagement.ConclusionsAcross the three areas, there appears to be high-quality multi-disciplinary antenatal services for women who use opioids during pregnancy. However, referral criteria vary and some services appear more comprehensive than others. Further research is needed into the perceptions of women who use opioids on facilitators and barriers to antenatal care, and provision in rural regions of Scotland.

Кельтская триада: кинематографии британских национальных меньшинств и «внутренний колониализм»

The global success, both in viewership and expert community, of auteur feature films Belfast, directed by Kenneth Branagh, and The Banshees of Inisherin, directed by Martin McDonagh, and produced by independent Northern Irish companies in 2022–2023, prompts a closer examination of the challenges faced by the national minority cinemas of Great Britain. Specifically, we focus on the culturally and linguistically related regions of Northern Ireland, Wales, and Scotland, collectively referred to in this article as the Celtic Triad, which represent a significant presence in the world cinema landscape. A number of British film historians and sociologists argue that national film industries are on the verge of survival, highlighting two main trends in the context of national cinema: inclusivity and sovereignty. From the perspective of the dominant ethnic group and its major production companies, inclusivity entails assimilation into the mainstream, while sovereignty involves preserving distinct national cultural characteristics. The representatives of national minorities are striving to safeguard these characteristics in the face of what American sociologist Michael Hechter termed internal colonialism—a policy implemented by the dominant Anglo-Saxon ethnic group towards cultures of national minorities and expressed in their marginalization and Anglification. A negative consequence of these dynamics, according to Hechter, is ethnocentrism, that is, the prevalence of one’s own culture in shaping perceptions of the world. Nevertheless, as this article demonstrates, the strategies employed by the Celtic Triad in pursuit of economic independence and artistic self-determination not only ensure the survival of national cinema but also establish its distinct sovereignty and success beyond the borders of Great Britain. Television broadcasting in national languages, which has gained popularity with the advent of digital broadcasting, plays a significant role in this process. An important contributing factor here is the economic and socio-cultural collaborations of these cinemas with both domestic and international partners, relying primarily on the influence of soft power and implying adaptation not only by adjusting to them, but also by active interchange and cross-fertilization of cultures.

Hydro-PE: gridded datasets of historical and future Penman–Monteith potential evaporation for the United Kingdom

Abstract. We present two new potential evaporation datasets for the United Kingdom: a historical dataset, Hydro-PE HadUK-Grid, which is derived from the HadUK-Grid gridded observed meteorology (1969–2021), and a future dataset, Hydro-PE UKCP18 RCM, which is derived from UKCP18 regional climate projections (1980–2080). Both datasets are suitable for hydrological modelling and provide Penman–Monteith potential evapotranspiration parameterised for short grass, with and without a correction for interception on days with rainfall. The potential evapotranspiration calculations have been formulated to closely follow the methodology of the existing Meteorological Office Rainfall and Evaporation Calculation System (MORECS) potential evapotranspiration, which has historically been widely used by hydrological modellers in the United Kingdom. The two datasets have been created using the same methodology to allow seamless modelling from past to future. Hydro-PE HadUK-Grid shows good agreement with MORECS in much of the United Kingdom, although Hydro-PE HadUK-Grid is higher in the mountainous regions of Scotland and Wales. This is due to differences in the underlying meteorology, in particular the wind speed, which are themselves due to the different spatial scales of the data. Hydro-PE HadUK-Grid can be downloaded from https://doi.org/10.5285/9275ab7e-6e93-42bc-8e72-59c98d409deb (Brown et al., 2022) and Hydro-PE UKCP18 RCM can be downloaded from https://doi.org/10.5285/eb5d9dc4-13bb-44c7-9bf8-c5980fcf52a4 (Robinson et al., 2021).

Musical messages – Creating a bespoke climate story for the Outer Hebrides

Exposed to westerly and south-westerly Atlantic weather systems, the Outer Hebrides (off the west coast of Scotland) are a series of islands where the inhabitants are already well versed in coping with severe weather. Headed by the Outer Hebrides Community Planning Partnership (OHCCP) Climate Change Working Group (CCWG), a range of adaptation planning documents are in production. Driven by a desire to engage with local communities, the CCWG alongside the Làn Thìde Climate Beacon, Adaptation Scotland and the Met Office created a project to explore the development of a storyline to communicate climate change information to the Outer Hebrides community. Collaborating with a local artist, Tuil is Geil (Gaelic for “Flood and Wind”) was created through a combination of sonified climate data, local voices and field recordings of local weather. Three themed pieces were created and these pieces (alongside a science presentation on projections of climate change for the Outer Hebrides) formed the centre of public engagement sessions when members of the public were able to share their thoughts about vulnerabilities and adaptation needs on the islands. As a project team we learned a number of important lessons around the process for creating a bespoke storyline for a community which included: i) The need to set appropriate boundaries and manage expectations, ii) The importance of local partner organisations and networks, iii) The need to bridge between science and art, and iv) The need to collaborate with the local community. We strongly believe that this approach has major community impact and it is the intention to support similar storyline projects in other regions of Scotland.

"Nordic Aspirations"

This article explores the Scottish discourse on the Nordic region, that is, dominant conceptualisations of the Nordic region in contemporary Scotland in the context of the current Scottish nation-building project. Since the early 2000s, the Nordic region has received wide political attention and been presented as a viable and desirable role model for Scottish development by key political and social actors, including the Scottish Government and the Scottish National Party (SNP). This interest in the Nordic countries and the idea that they offer an alternative for Scotland which is line with dominant self-images of Scotland as egalitarian and social democratic has established itself as a central argument and aspect of the Scottish independence movement and the wider Scottish public debate. This article examines the historical development of the discourse on the Nordic region in Scotland, and its content by showing how the Nordic region is a multifaceted concept which intersects with Scottish nationalism and long-standing associations to the North. The Nordic region, in the Scottish context, is hence both a reality and a myth, a practical example and an idea. This dual quality is at the heart of the appeal and resilience of the Nordic region in contemporary Scotland, making the Nordic region Scotland’s main positive Other. Keywords The Nordic region, Scottish nationalism, the Other, discourse, conceptualisations of North

Flemish Immigration and Geoffrey of Monmouth's De gestis Britonum

Flemish Immigration and Geoffrey of Monmouth's <i>De gestis Britonum</i>

Improved health-related quality of life after hepatitis C viraemic clearance among people who inject drugs may not be durable.

Chronic infection with the hepatitis C virus (HCV) has a detrimental impact on health-related quality of life (QoL). Scale-up of HCV direct-acting antiviral (DAA) therapy among people who inject drugs (PWID) is underway in several countries since the introduction of interferon-free regimens. This study aimed to assess the impact of DAA treatment success on QoL for PWID. Cross-sectional study using two rounds of the Needle Exchange Surveillance Initiative, a national anonymous bio-behavioural survey and a longitudinal study involving PWID who underwent DAA therapy. The setting for the cross-sectional study was Scotland (2017-2018, 2019-2020). The setting for the longitudinal study was the Tayside region of Scotland (2019-2021). In the cross-sectional study PWID were recruited from services providing injecting equipment (n = 4009). In the longitudinal study, participants were PWID on DAA therapy (n = 83). In the cross-sectional study, the association between QoL (measured using the EQ-5D-5L quality of life instrument) and HCV diagnosis and treatment was assessed using multilevel linear regression. In the longitudinal study, QoL was compared at four timepoints using multilevel regression, from treatment commencement until 12 months following commencement. In the cross-sectional study, 41% (n = 1618) were ever chronically HCV infected, of whom 78% (n = 1262) were aware of their status and of whom 64% (n = 704) had undergone DAA therapy. There was no evidence for a marked QoL improvement associated with viral clearance among those treated for HCV (B = 0.03; 95% CI, -0.03 to 0.09). In the longitudinal study, improved QoL was observed at the sustained virologic response test timepoint (B = 0.18; 95% CI, 0.10-0.27), but this was not maintained at 12 months following start of treatment (B = 0.02; 95% CI, -0.05 to 0.10). Successful direct-acting antiviral therapy for hepatitis C infection may not lead to a durable improvement in quality of life among people who inject drugs, although there may be a transient improvement around the time of sustained virologic response. Economic models of the impact of scaling-up treatment may need to include more conservative quality of life benefits over and above reductions in mortality, disease progression and transmission of infection.

Assessment tools used in adult safeguarding practice within the UK and Ireland: results from a small-scale qualitative study

PurposeAcross the UK and Ireland, there are a range of processes and interventions offered to adults who, because of personal characteristics or life circumstances, require help to keep themselves safe from potential harm or abuse. The ways in which the statutory and voluntary sectors have chosen to safeguard these adults varies. Different models of intervention and the utilisation of a range of assessment tools, frameworks and approaches have evolved, often in response to policy and practice wisdom. Empirical research in this area is limited. The primary research purpose of the project on which this paper is based is to gather information on the range of tools and frameworks that are used in adult safeguarding practice across the UK and Ireland. In so doing, this paper seeks to contribute and inform the future development of an evidence based adult safeguarding assessment framework.Design/methodology/approachA team of academics from England, Scotland, Northern Ireland and Ireland wanted to explore the possibility of adapting a pre-existing assessment framework currently in use in family and childcare social work to consider its utility in assessing carers involved in adult safeguarding referrals. This paper reports on a small pilot study which sought to inform the adaptation of this framework for use in adult safeguarding. This paper is based on a qualitative study involving 11 semi-structured telephone interviews with adult safeguarding social work managers and experienced practitioners. Two to four professionals from each region of England, Scotland, Northern Ireland and Ireland were interviewed to elicit their perceptions and experiences of engaging in adult safeguarding assessment processes and their views about models of assessment.FindingsThis study identified considerable variation in and between the nations under review, in terms of the assessment frameworks and tools used in adult safeguarding practice. To a large extent, the assessment frameworks and tools in use were not evidence based or accredited. Participants acknowledged the value of using assessment frameworks and tools whilst also identifying barriers in undertaking effective assessments.Originality/valueThere is limited evidence available in the literature regarding the utility of assessment frameworks and tools in adult safeguarding practice. This primary research identifies four themes derived from professional’s experiences of using such frameworks and identifies broader recommendations for policy and practice in this area.

Developing an understanding of coherent approaches between primary and secondary teachers: a case study within the design and technology curriculum in Scotland

This study is based around Education Scotland’s ambition to create a coherent learning framework for pupils aged 3–18, with particular focus on the technologies curricular area, and more specifically the subject of design and technology (D&T). The study investigates the views, definitions, and approaches adopted by primary and secondary educators applied to the D&T curricular area. Furthermore, the research explores curricular understanding and pedagogical approaches in addition to individual teacher’s understanding of technology education. A mixed method research approach was utilised and applied within one local authority region in Scotland. Data was collected from primary teachers and secondary design and technology teachers using online questionnaires and interviews. Findings reveal that there is a varied approach to teaching design and technology across primary and secondary schools with educators recognising different definitions and pedagogical approaches in the subject. This indicates that pupils transitioning from primary to secondary learning will have to cope with these differing teaching approaches when studying design and technology. However, participants agree on the importance of the design element and application of the subject to real world scenarios. It is recommended that school communities find opportunities to collaborate further with the aim of creating a more continuous, coherent learning journey for young people in the design and technology curriculum area. These findings provide a basis for future professional discussion and critical reflection for practitioners in both primary and secondary sectors, and for leaders and administrators across Scotland, the UK and around the world.

Variations in the uptake of telemental health technologies in community and crisis mental health services during the early pandemic: a survey of mental health professionals in the UK

One of the many challenges faced by mental health services during the COVID-19 pandemic was how to deliver care during lockdown. In community and crisis services, this often meant rapidly adopting or expanding the use of telemental health technologies, including phone and video calls. The aim of this study is to explore variations in use and report staff views of such technologies during the early stages of the pandemic. The primary analysis compared rates of use between professions, demographic groups, genders, regions, and crisis and community services. We used data from an online survey conducted by the Mental Health Policy Research Unit in Spring 2020 regarding the impact of the pandemic on mental healthcare in the United Kingdom. We included quantitative data from all professional groups working in community or crisis services providing care to working age adults, including general and specialist services. Our outcome of interest was the percentage of clients whom clinicians primarily interacted with via videocall. We also collected demographics and professional characteristics such as the type of mental health service respondents worked in. In addition, we explored respondents' views and experiences of telemental health as a medium for providing care. 978 participants were included in the primary analysis (834 provided outcome data for community services, 193 for crisis services). In community services, virtually all staff reported stopping some or all face-to-face appointments following the onset of the pandemic, with a large majority using video or phone call appointments where possible instead. Telemental health use was higher in community than in crisis services, and amongst professionals who mainly provided psychotherapy or peer support than in other groups. There was also evidence of use being lower in regions in Northern England, Scotland, and Wales than elsewhere. There was no evidence of an association with staff gender, age, or ethnicity. Staff were generally positive about telemental health and intended to make more use of technologies following the pandemic. However, significant barriers to its use were also reported, often involving skills and available infrastructure. Despite its rapid implementation, telemental health was viewed positively by clinicians who saw it as an effective alternative to face-to-face appointments in some contexts, including during the pandemic. However, adoption of the technology also has the potential to exacerbate existing or create new inequalities without effective management of training and infrastructure needs.

Investigating how interprofessional simulation influences tolerance of ambiguity

IntroductionDecision making in clinical practice is only possible if we are able to understand the limits of our own knowledge and manage the associated uncertainty. Tolerance of ambiguity is therefore an important attribute for trainee pharmacists and medical students to develop. This study aimed to explore the impact of an interprofessional simulation on the tolerance of ambiguity of trainee pharmacists and medical students. MethodsTrainee pharmacists and final year medical students participated in interprofessional simulation in two regions of Scotland. Participants completed pre- and post-session tolerance of ambiguity questionnaires. Analysis included differences between the pre-session scores of the two groups; the trainee pharmacists' pre- and post-session scores; and the medical students' pre- and post-session scores. ResultsA total of 15 trainee pharmacists and 15 medical students participated. Baseline tolerance of ambiguity was slightly higher in medical students than trainee pharmacists (56.9 vs. 52.6), but the study was insufficiently powered to detect whether this was a true difference (P = .21). Trainee pharmacists showed a statistically significant increase in self-reported tolerance of ambiguity (52.6 to 60.8, P = .004), but medical students did not (56.9 to 63.8, P = .04). ConclusionsTrainee pharmacists' tolerance of ambiguity was improved following participation in an interprofessional simulation. Further research could establish whether the improvements differ between professional groups, and explore the reasons why tolerance of ambiguity may be affected by interprofessional simulation.