Secondary Schools In Scotland Research Articles

Exploring longitudinal patterns of absences, exclusions and attainment in secondary schools in Scotland

Objective and ApproachWe seek to understand the impacts that absences and exclusions have on educational outcomes in secondary school pupils in Scotland. We adopt a Multilevel Structural Equations Modelling approach to analyse data from the newly linked administrative database created under the “Children’s Lives and Outcomes” research strand of the Scottish Centre for Administrative Data Research (SCADR), which includes data from Education Analytical Services (Scottish Government) and Public Health Scotland (NHS) from the period between 2007-2019, and the 2001 and 2011 Census. ResultsWhile exclusions, absences and attainment are known to be associated with each other and with individual and structural factors, less is known about how these phenomena play out over time in the Scottish education system. Our analyses focus on a particular cohort of students followed up over their entire schooling period to understand how longitudinal patterns of school absences and exclusions, and other relevant individual and structural factors are interrelated over time. We show that variation across schools and local authorities in these outcomes is significant and substantial in Scotland. We also analyse the impact of these longitudinal patterns on attainment, with an emphasis on mental health wellbeing and familial socioeconomic circumstances. Conclusions and ImplicationsBy elucidating further these relationships and interrelationships, we expect our findings to be pertinent to policymakers and practitioners, contributing to inform strategies, policies and/or interventions to reduce the inequalities in exclusions, absences and attainment, ultimately helping to improve children and young people’s school experiences and outcomes.

Behaviour change intervention (education and text) to prevent dental caries in secondary school pupils: BRIGHT RCT, process and economic evaluation.

The presence of dental caries impacts on children's daily lives, particularly among those living in deprived areas. There are successful interventions across the United Kingdom for young children based on toothbrushing with fluoride toothpaste. However, evidence is lacking for oral health improvement programmes in secondary-school pupils to reduce dental caries and its sequelae. To determine the clinical and cost effectiveness of a behaviour change intervention promoting toothbrushing for preventing dental caries in secondary-school pupils. A multicentre, school-based, assessor-blinded, two-arm cluster randomised controlled trial with an internal pilot and embedded health economic and process evaluations. Secondary schools in Scotland, England and Wales with above-average proportion of pupils eligible for free school meals. Randomisation occurred within schools (year-group level), using block randomisation stratified by school. Pupils aged 11-13 years at recruitment, who have their own mobile telephone. Two-component intervention based on behaviour change theory: (1) 50-minute lesson delivered by teachers, and (2) twice-daily text messages to pupils' mobile phones about toothbrushing, compared with routine education. Primary outcome: presence of at least one treated or untreated carious lesion using DICDAS4-6MFT (Decayed, Missing and Filled Teeth) in any permanent tooth, measured at pupil level at 2.5 years. Secondary outcomes included: number of DICDAS4-6MFT; presence and number of DICDAS1-6MFT; plaque; bleeding; twice-daily toothbrushing; health-related quality of life (Child Health Utility 9D); and oral health-related quality of life (Caries Impacts and Experiences Questionnaire for Children). Four thousand six hundred and eighty pupils (intervention, n = 2262; control, n = 2418) from 42 schools were randomised. The primary analysis on 2383 pupils (50.9%; intervention 1153, 51.0%; control 1230, 50.9%) with valid data at baseline and 2.5 years found 44.6% in the intervention group and 43.0% in control had obvious decay experience in at least one permanent tooth. There was no evidence of a difference (odds ratio 1.04, 95% confidence interval 0.85 to 1.26, p = 0.72) and no statistically significant differences in secondary outcomes except for twice-daily toothbrushing at 6 months (odds ratio 1.30, 95% confidence interval 1.03 to 1.63, p = 0.03) and gingival bleeding score (borderline) at 2.5 years (geometric mean difference 0.92, 95% confidence interval 0.85 to 1.00, p = 0.05). The intervention had higher incremental mean costs (£1.02, 95% confidence interval -1.29 to 3.23) and lower incremental mean quality-adjusted life-years (-0.003, 95% confidence interval -0.009 to 0.002). The probability of the intervention being cost-effective was 7% at 2.5 years. However, in two subgroups, pilot trial schools and schools with higher proportions of pupils eligible for free school meals, there was an 84% and 60% chance of cost effectiveness, respectively, although their incremental costs and quality-adjusted life-years remained small and not statistically significant. The process evaluation revealed that the intervention was generally acceptable, although the implementation of text messages proved challenging. The COVID-19 pandemic hampered data collection. High rates of missing economic data mean findings should be interpreted with caution. Engagement with the intervention and evidence of 6-month change in toothbrushing behaviour was positive but did not translate into a reduction of caries. Future work should include work with secondary-school pupils to develop an understanding of the determinants of oral health behaviours, including toothbrushing and sugar consumption, particularly according to free school meal eligibility. This trial is registered as ISRCTN12139369. This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 15/166/08) and is published in full in Health Technology Assessment; Vol. 28, No. 52. See the NIHR Funding and Awards website for further award information.

Protocol for a pilot cluster randomised controlled trial of PRoGRAM-A (preventing gambling-related harm in adolescents): a secondary school-based social network intervention

BackgroundIn the UK, recent evidence of young people and gambling indicates a higher prevalence of gambling in comparison to other addictive behaviours. Engaging in gambling-related behaviour at a young age is associated with short and long-term consequences, including financial, emotional, academic, interpersonal, and physical and mental health detriments; otherwise known as gambling-related harms (GRH). Given the unique vulnerability of this younger group, early interventions aimed at delaying or preventing gambling are critical. PRoGRAM-A (Preventing Gambling-Related Harm in Adolescents) is a school-based, social network intervention to protect young people from future GRH, by delaying or preventing gambling experimentation.MethodsPilot cluster RCT with an embedded process evaluation and health economic scoping study.ParticipantsPRoGRAM-A will be delivered in four schools, with two control schools acting as a comparator. All are secondary schools in Scotland. Baseline surveys were conducted with students in S3 (ages 13–14). Follow-up surveys were conducted with the same cohort, six months post-baseline.InterventionPRoGRAM-A trainers will deliver a 2-day, out-of-school training workshop to Peer supporters. Peer supporters will be nominated by peers among their school year group (S3, age 13–14). Workshops will provide peer supporters with information on four gambling-related topics: (1) what is gambling? (2) gambling and gaming, (3) gambling marketing, (4) identifying harm and reducing risk. Peer supporters will disseminate the information (message diffusion) they have learned among their friends and family over a 10-week period. After the 2-day workshop, PRoGRAM-A trainers will conduct × 3 in-school follow-up sessions with peer supporters to offer support, encouragement, and advice to Peer Supporters as well as monitor and explore the extent of their message diffusion.Primary outcomeThe primary outcome of the pilot cluster RCT (cRCT) will be whether progression to a phase III RCT is justified.DiscussionThis will be the first pilot cluster RCT (cRCT) of an intervention to prevent gambling-related harms among young people within the UK. If findings indicate feasibility and acceptability, funding will be sought for a phase III RCT of effectiveness.Trial registrationResearchregistry8699. Registered 21st February 2023.

School and area-level disparities in exclusions in Scottish secondary schools

ObjectivesThis paper explores the patterning of educational exclusions in Scottish secondary schools by variation across schools and council areas, and by structural socioeconomic factors and demographic characteristics of the pupils, their families, their schools and the areas in which they reside.
 MethodsThis research uses the newly linked administrative database created under the “Children’s Lives and Outcomes” research strand of the Scottish Centre for Administrative Data Research (SCADR). This linkage, the first of its kind in Scotland, includes data from Education Analytical Services and the Information Services Division of NHS Public Health Scotland from the period between 2007-2019, and the 2001 and 2011 Census. We adopt a Multilevel Modelling approach to ascertain the extent of the variation in the likelihood of a student being excluded across schools and council areas and its association with individual, school and area-level characteristics.
 ResultsPreliminary results suggest that the variation in exclusions across secondary schools in Scotland is substantial and significant in terms of size and importance. Moreover, variation across council areas is also non-negligible, and is smaller than the variation found between-schools. This suggests that the effect of policy and/or practice at the school level is greater than that at the local authority level. Our analyses continue and are currently focusing on prior exclusions in primary school, deprivation, mental health, household and demographic characteristics, as well as school and area-level indicators. We expect to be able to elucidate further the relationships and interrelationships between schools, areas and family circumstances in the likelihood of being excluded from school.
 ConclusionOur findings are pertinent to policymakers and practitioners in the context of a widening socio-economic gap exacerbated by COVID-19 restrictions and the current economic turmoil, to reduce the inequalities in exclusions and ultimately improve school experiences and outcomes.

The relationship between student's perceptions of their school environment and academic achievement.

Research within an educational context has demonstrated the importance of variables such as socioeconomic status, gender and school attendance as predictors of academic achievement, however research investigating the role of the physical learning environment on academic achievement is more limited and what research has been conducted often focuses on objective characteristics such as temperature, air quality and noise. In contrast this study measures students' subjective perceptions of their physical school environment and explores how these perceptions along with socioeconomic status, gender and school attendance relate to academic achievement. In addition, we also examined a range of other important variables that could be potential mediating factors between environmental perceptions and academic achievement. The study was conducted with 441, S5 students in five secondary schools in Scotland. Students completed a questionnaire that measured their perceptions of their school environment, their behavior in school, and their learning goals. In addition, data on student academic achievement, attendance and socioeconomic status was provided by the Local Authority. Regression analysis indicates that students' subjective perceptions of their physical school environment, along with attendance, socioeconomic status and gender are all significantly related to academic achievement. In addition, subsequent analysis indicates that the relationship between students' subjective perceptions of their physical school environment and academic achievement is mediated by important "in-school behaviours," namely engaging behavior and environmental difficulty. The implications of these findings are discussed in terms of the direct and indirect relationship between student perceptions of their school environment and their academic achievement.

Evaluating the feasibility of delivering a sleep education programme in secondary schools

Background: School-based sleep education programmes can promote the importance of sleep health and may improve adolescent sleep. To date, only limited research has examined the feasibility of integrating sleep programmes into the school curriculum. Objectives: This study evaluated the feasibility, acceptability and preliminary efficacy of the Strathclyde intervention to encourage good sleep health in teenagers (SIESTA). Methods: A total 171 students (12–15 years, 53% women) from secondary schools in Scotland participated in the study. Recruitment and retention, data collection and design procedures were assessed to establish feasibility. Qualitative feedback on acceptability was collected via focus group discussions. Outcome measures assessing insomnia symptoms, sleep hygiene, depression, anxiety and stress were completed at baseline and post-intervention to explore the preliminary effects of SIESTA. Results: All schools that were approached consented to participate, and most students completed assessments at both time points (171) with a dropout rate of 5%. Assessment measures provided sufficient data to compare baseline and post-intervention values. Training and delivery manuals ensured successful delivery of the programme. Qualitative feedback indicated SIESTA was acceptable, and students spoke favourably about the content, delivery and techniques. Students reported that SIESTA was age-appropriate, relevant and the techniques were beneficial. There were significant improvements in insomnia and stress, but no improvements were noted for sleep hygiene, depression or anxiety. Conclusion: The findings suggest that SIESTA is feasible and acceptable for delivery via the school curriculum. The results indicate that a controlled trial is required to further investigate the efficacy of SIESTA implemented in an educational context.

Social Places and Senior Pupils' Identity in a Secondary School Environment: An Interpretative Phenomenological Analysis

:This paper investigates the relationship between the school environment and senior pupils' identity development in a secondary school in Scotland. The study used semi-structured interviews and Photovoice along with Interpretative Phenomenological Analysis, to explore senior pupils' experience of the social places within their school. The findings reveal the relationship between the places that pupils can access for social interaction and their sense of identity, and their use of territoriality to protect these specific places. The findings are considered in the context of the role of the school environment, pupils' needs and their implications for school design and planning.

The Role of School Connectedness and Friend Contact in Adolescent Loneliness, and Implications for Physical Health.

The current study investigated how adolescents' loneliness relates to school connectedness, classmate support, teacher support, and offline and online communication with friends. We also examined the association between loneliness, physical health, and sleep. Data came from the Scottish Health Behavior in School-aged Children (HBSC). The total sample was 2983 adolescents (F = 1479 [49.6%]) aged 14-17years (M = 15.66, SD = 0.39) from 117 secondary schools in Scotland. Results showed that (1) higher teacher support, classmate support, and offline contact with friends predicted lower levels of loneliness, (2) online friendship engagement predicted higher levels of loneliness, and (3) poor health and sleep were positively associated with loneliness. The study offers new findings, highlighting the role played by classmates/peers and teachers in reducing loneliness. Supporting previous research, we also found associations between loneliness, poor sleep, and worse physical health.

Cost and Affordability of School Uniform and Child Poverty

Abstract Although there are no attendance or registration fees in the UK for publicly funded school education there are hidden costs in attending compulsory education. This article investigates one of the hidden costs: school uniform. We investigate the affordability of school uniform in Scotland, looking at what is required in school uniform policy (class uniform and Physical Education kit), the costs of uniform and to what extent the national minimum clothing grant makes uniform affordable for households on low incomes. For this research we use a unique national dataset of the school uniform policies of all 357 publicly funded secondary schools in Scotland and responses to Freedom of Information requests sent to all local authorities (n = 30). From analysis of the uniform policies and the requirements and application processes for the national minimum clothing grant we are able to draw together recommendations for the Scottish Government, local authorities and schools. We also found a compelling need for detailed data collection on how much it costs to clothe children for a whole school year.

Employability and school uniform policies: Projecting the employer’s gaze

This article examines employability discourse within school uniform policies as a way to justify uniform. The uniform policy of every publicly funded secondary school in Scotland ( n = 357) was studied using content and discourse analysis. Employability discourse was grouped into three themes: School as preparation for work; school to replicate a work environment; and young people creating a good impression for employers. The rationale of the uniform is revealed as a technology through which the employer’s gaze is projected onto pupils.

The effect of student voice on the perception of student agency

Student voice and agency are important topics in education, but related initiatives remain under-investigated. This study investigates the link between student voice and perception of student agency through the introduction of a student-led committee using a longitudinal mixed-method approach in an independent secondary school in Scotland. Paired-samples t-tests were conducted for the students’ (n = 95) responses showing an increase in mean effect (p = 0.025) of the introduction of the committee on student perception of student consultation and decision making in the school. Committee members reported a reduction in their sense of agency (n = 5, p = 0.045). Qualitative data is presented to support the discussion of results which suggest student-led committees affect the perception of student agency and wider school ethos is important.

Learning in lockdown: A small-scale qualitative study exploring the experiences of autistic young people in Scotland

Aim:This study aims to hear the voices of autistic learners to investigate the meaning they made of their learning experiences during the lockdown period of school closures necessitated by the Covid-19 pandemic – particularly, what were the factors that contributed to positive engagement in remote digital learning, and were there any challenges?Method/Rationale:Three mainstream secondary schools in Scotland were asked to identify pupils who they perceived to have demonstrated increased engagement with learning via virtual means. Semi-structured interviews were conducted with seven pupils, ranging from S1 – S3 (Years 8 - 10 in England and Wales) during lockdown, to ask about their experiences of learning at home.Findings:Thematic analysis identified six key themes – life at home, technology, working independently, curriculum, adult support and peer support – involving key elements that supported the young people’s engagement. Although all the participants identified supportive elements, aspects of remote learning that presented challenge to engagement were also expressed. These emerged under the same themes.Limitations:The sample size was small and allowed exploration rather than generalisation. The research is based on pupil voice and not triangulated with additional quantitative or qualitative measures.Conclusions:The study explored autistic young people’s experiences of learning during lockdown and found, consistent with prior literature, how tasks are mediated online and the nature of adult contact to support this, were key to supporting engagement in learning. Flexibility and control over a goal-directed timetable was also important. Reflections suggest planning implications for schools and educational psychologists, particularly as remote learning remains a key tenet for curricular delivery and development.

A Social-Ecological Approach to Understanding Adolescent Sexting Behavior

This study examined the extent to which active and passive sexting behaviors are associated with family-, school-, peer-, and romantic-level variables. Young people (N = 3,322; 49.1% female, 48.3% male, 2.6% other) aged 11 to 15 years old (M = 12.84, SD = 0.89) took part, and all attended mainstream secondary schools in Scotland. Participants completed self-report measures of school connectedness, parental love and support, perceived susceptibility to peer- and romantic-pressure (e.g., to display behaviors just to impress others), and their involvement in active and passive sexting. The importance of both school- and family-level factors was evident, though perceived romantic-pressure had the largest effect. However, neither school- nor family-level variables were moderated by either perceived romantic-pressure or perceived peer-pressure. Efforts to reduce sexting or increase its safety should primarily seek to tackle young people’s ability to respond effectively to romantic-pressure. It may also be helpful to develop school connectedness and to help families provide support that is constructive and not intrusive.

Using Appreciative Inquiry to explore approaches towards mental health in a Scottish secondary school

Rationale:In Scotland, two-thirds of children have faced at least one adverse childhood experience. Research demonstrates a graded relationship between adversity and mental health outcomes. As adolescents spend a large amount of time in school, it is no surprise that schools are vital when supporting and delivering mental health interventions.Aim:The research aims were two-fold: to gather a clear understanding of mental health and wellbeing supports within a secondary school in Scotland; and to explore the use of Appreciative Inquiry as an approach for organisational change.Method:Semi-structured interviews were conducted, using an Appreciative Inquiry approach. A purposive sampling method was employed to select 55 secondary school stakeholders.Findings:Results highlighted several targeted supports in place within the secondary school, with the adoption of more consistent and visible universal systems needed. Key themes identified included: the importance of relationships, ensuring mental health literacy is core to the curriculum and encouraging an open conversation about mental health. The use of Appreciate Inquiry led to a clear action plan for the secondary school, building upon strengths already identified within the organisation.Limitations:One secondary school took part in this research, therefore, results cannot be generalised. Participants were school-based, future research should consider the role of external agencies.Conclusions:This research provides an insight into the current mechanisms in place within a secondary school in Scotland to support mental health and wellbeing. The use of Appreciative Inquiry was an effective approach for creating a plan intended to impact organisational change.

“Maddie is online”: an educational video cartoon series on digital literacy and resilience for children

PurposeThis paper examines children's development of digital literacy, resilience and citizenship in the online environment, addressing active engagement and participation via cartoon videos. Previous research has emphasised the positive role of cartoons in different educational contexts, as important agents of attracting children's attention and interest with opportunities to engage in contextual and collaborative learning.Design/methodology/approachThe work describes the design and an initial pilot study of the animated cartoon video series, with a group of 30 children in an S1 class, at a secondary school in Scotland as part of workshop addressing digital resilience themes. Children worked individually and in teams in a series of interactive activities, which were evaluated by means of a short questionnaire survey.FindingsThe majority of the children enjoyed the cartoon videos which addressed a story of cyberbullying and, in teams, they chose different copying strategies. Children's verbalisations included expressions of positive feelings when connecting online, linked to socialising, creative and playful activities and they expressed a preference towards speaking to their parents and friends rather than their teachers when dealing with online challenges.Research limitations/implicationsChildren not only enjoyed watching the cartoon story but had an interest to learn more about how other children deal with the pressures and challenges of the online world, how to manage their own digital footprint and, particularly, how easy it is to spread personal information online.Practical implicationsCartoon animations present an opportunity to act as a basis for encouraging children to exchange ideas and engage in dialogue in class and at home by means of creating a point of reference which creates an environment, where pressure is taken away from the “self”. The cartoon character can be the focal point for discussion on issues that may be difficult to address directly and on a personal level because of insecurity or fear.Social implicationsBoth teachers and parents have a responsibility to offer support and advice to children and ensure their online safety and resilience. Engaging with children in open further dialogue via fun and interactive cartoon-based activities may help to further explore and understand their perspectives.Originality/valueThe work addresses everyday life issues encountered online and aims to offer educators and parents an engaging and fun series of activities, harnessing the advantages of cartoon video animation as a didactical resource that can utilised as a supplementary learning tool inside the classroom and at home.

Social inequality in Catholic schools in Scotland in the second half of the twentieth century

Denominational secondary schools in Scotland have been an influential means by which Catholics have achieved full social citizenship. Most of the Catholic population of Scotland has its origins in late-nineteenth-century migration from Ireland into low-skilled occupations. Although the church built a system of Catholic primary schools, it could not afford to extend this for secondary education, and so a compromise of 1918 allowed the state to take over the funding and management of almost all Catholic schools while the church retained a role in appointing teaching staff. The resulting public-sector secondary schools provided the Catholic population with unprecedented opportunities. The patterns of social and educational change affecting Catholic schools are studied here using a unique series of surveys of school leavers covering the whole of the second half of the twentieth century. Supplemental data for this article is available online at https://doi.org/10.1080/01425692.2020.1811080.

"Farmers Don't Dance"

In this article we examine the influence of rurality on the construction of masculinity and femininity for, and by, pupils in a rural secondary school in Scotland. Using data from semi-structured interviews with male and female pupils and a teacher, as well as observations of classroom interactions over a period of 12 months, we highlight how girls take up multiple and complex gendered identities in a rural context and we emphasize the tensions they experience as they negotiate a feminine identity in a rural space constructed and described as masculine. Findings suggest that this construction is, at times, supported by teachers’ practices and their interactions with pupils. We conclude by discussing the implications for teachers in rural schools and point to the need to support girls to ensure that their educational opportunities are not limited by the deep-rooted associations that exist between rurality and masculinity.

Education and health outcomes of children treated for chronic conditions

Background with rationaleThis retrospective cohort study linked Scotland-wide education data to national health data to explore associations between childhood chronic conditions and subsequent educational and health outcomes.
 Main AimConditions studied were diabetes, asthma, epilepsy, attention deficit hyperactivity disorder (ADHD) and depression. We also explored neurodevelopmental multimorbidity (comorbid autism, learning disability, ADHD or depression). Educational outcomes were school absenteeism and exclusion, special educational need, academic attainment and subsequent unemployment. Health outcomes were hospital admissions and all-cause mortality.
 Methods/ApproachPupil census data and associated education records for all children attending primary and secondary schools in Scotland between 2009 and 2013 were linked to national prescribing data, acute and psychiatric hospital admissions, death records and retrospective maternity records enabling conditions to be studied whilst adjusting for sociodemographic and maternity factors and comorbid conditions. Conditions were ascertained from prescribing data and school records.
 ResultsAll conditions were associated with increased school absenteeism, special educational need, and hospitalisation. All, excluding diabetes, were associated with poorer academic attainment and all, excluding ADHD were associated with increased mortality. ADHD and depression were associated with increased exclusion from school whilst epilepsy, ADHD and depression were associated with subsequent unemployment. Children experiencing neurodevelopmental multimorbidity had poorer outcomes across all educational domains. Depression was the biggest driver of absenteeism and ADHD was the biggest driver of exclusion.
 ConclusionIn addition to poorer health outcomes, schoolchildren with these chronic conditions appear to experience significant educational disadvantage compared to their peers. Therefore interventions and further understanding of the intricate relationships between health and education among children with these conditions is required.

Using Scotland-wide record linkage to investigate the educational and health outcomes of children treated for chronic medical conditions: a retrospective population cohort study

BackgroundChronic ill health can affect children's educational and health outcomes. Previous studies have reported poorer school outcomes among children with diabetes, asthma, epilepsy, attention deficit hyperactivity disorder (ADHD), and depression; however, many have limitations, very few have analysed multiple outcomes or population-wide data, and literature in Scotland and the UK is scarce. We aimed to identify children prescribed medication for these chronic medical conditions and investigate their educational and health outcomes compared with their peers. MethodsWe retrospectively linked Scotland-wide education records for children attending primary and secondary schools in Scotland between 2009 and 2013 to prescribing data, acute and psychiatric hospital admissions, maternity records, and deaths. School absenteeism, exclusion, and special educational need were analysed annually using generalised estimating equations. Academic attainment was analysed using generalised ordinal logistic regression and unemployment with binomial logistic regression. All-cause hospitalisation and mortality were analysed using Cox proportional hazards or Poisson piecewise regression. Analyses were restricted to singleton children born in Scotland and adjusted for sociodemographic or maternity factors and comorbid conditions Findings766 244 schoolchildren were included in the analyses. All conditions were associated with increased school absenteeism (diabetes incidence rate ratio [IRR] 1·34, asthma 1·25, epilepsy 1·50, ADHD 1·18, depression 1·95), special educational need (diabetes odds ratio [OR] 2·45, asthma 1·28, epilepsy 10·11, ADHD 8·77, depression 2·24], and all-cause hospitalisation (diabetes hazard ratio [HR] 3·97, asthma 1·69, epilepsy 3·72, ADHD 1·33, depression 2·56). All, excluding diabetes, were associated with poorer academic attainment (asthma OR 1·11, epilepsy 4·07, ADHD 3·64, depression 3·44] and all, excluding ADHD, were associated with increased all-cause mortality [diabetes HR 3·84, asthma 1·77, epilepsy 24·77, depression 6·21]. ADHD (IRR 5·82) and depression (1·65) were associated with increased exclusion from school, whereas epilepsy (OR 1·99), ADHD (1.42), and depression (1·98) were associated with subsequent unemployment. InterpretationIn addition to poorer health outcomes, schoolchildren with these chronic medical conditions have significant educational disadvantage compared with their peers. Interventions and further understanding of the relationships between health and education among children with these conditions is required. FundingHealth Data Research UK

High School Students' Perspectives of Participating in a STEM-Related Extracurricular Programme

This article reports on secondary school students’ perspectives of participating in science, technology, engineering and mathematics (STEM) related extracurricular activities in six secondary schools in Scotland. The extracurricular activities aimed at supporting students in developing knowledge of STEM subjects and confidence in their preparation for high school examinations, post-secondary schooling and the world of work. The study used a mixed-methods design. This entailed collecting data using qualitative semi-structured interviews, focus group discussion and a quantitative questionnaire. Findings indicate that students viewed extracurricular activities positively. They felt that the activities they participated in made a difference in their overall development. STEM related extracurricular activities provided students with relevant subject knowledge, wider learning opportunities and confidence in their own abilities, thereby contributing towards academic and social development. Students also reported increased knowledge of post-schooling opportunities. The activities resonated with the Scottish Curriculum for Excellence (CfE), thereby complemented formal learning.