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Domestic abuse is a serious problem across the world and it is considered a public health issue. Nurses play a crucial role in recognising and responding to domestic abuse but they sometimes lack confidence in dealing with the issue. In this article, two recently completed studies are used to extract lessons for health visiting practice. The first study investigated primary healthcare professionals' beliefs about domestic abuse. Many healthcare professionals were confident in dealing with domestic abuse. However, there was disinclination among some to discuss the issue. People who experience abuse rarely discuss it unless asked. So the study highlighted a potential dynamic of silence between health professionals and abused people in their care. The second study investigated student nurses and student midwives' experiences of learning about domestic abuse. The student nurses had learned less than the student midwives. They had not been taught about domestic abuse in university and many had not had the opportunity to learn about it in clinical placement. They reported reluctance among some mentors to discuss the issue with them, with a resulting silencing of the issue. Both of these studies have important lessons for health visiting practice regarding opening up crucial conversations about domestic abuse. [ABSTRACT FROM AUTHOR]

Aims and objectives. To investigate the dynamics of domestic abuse awareness and recognition among primary healthcare professionals and abused women. Background. Domestic abuse is a serious, public health issue that crosses geographical and demographic boundaries. Health professionals are well placed to recognise and respond to domestic abuse, but empirical evidence suggests that they are reluctant to broach the issue. Moreover, research has shown that women are reluctant to disclose abuse. Design. A two-phase, qualitative study was conducted in Scotland. Methods. Twenty-nine primary health professionals (midwives, health visitors and general practitioners) participated in the first phase of the study, and 14 abused women took part in phase two. Data were collected in 2011. Semi-structured, individual interviews were conducted with the health professionals, and three focus groups were facilitated with the abused women. Data were analysed using a framework analysis approach. Findings. Differing levels of awareness of the nature and existence of abuse are held by abused women and primary healthcare professionals. Specifically, many women do not identify their experiences as abusive. A conceptual representation of domestic abuse - the "abused women, awareness, recognition and empowerment' framework - arising from the study - presents a new way of capturing the complexity of the disclosure process. Conclusion. Further research is necessary to test and empirically validate the framework, but it has potential pedagogical use for the training and education of health professionals and clinical use with abused women. Relevance to clinical practice. The framework may be used in clinical practice by nurses and other health professionals to facilitate open discussion between professionals and women. In turn, this may empower women to make choices regarding disclosure and safety planning. [ABSTRACT FROM AUTHOR]

Looked after children are significantly more likely than other children to go missing. They face significant risk of harm through, for example, exposure to alcohol, drugs and sexual victimisation. While research identifies some factors which may reduce the likelihood of looked after children going missing, it is recognised that a greater understanding of effective practice is needed. The aim of the study was to investigate young people's experiences of going missing from care and to identify the issues that contributed to them running away; trigger factors that prompted episodes of going missing; support received during or following instances where they went missing; and factors that might prevent future absconding. Research on children's experiences is often reported from the adult's perspective rather than allowing children to have a voice. We therefore recruited two young people to collaborate with the researchers as peer researchers. A qualitative study was undertaken using the Critical Incident Technique. Twenty-eight young people with a history of running away were recruited from different locations in Scotland. They took part in six focus groups, which were held during May 2012. Data were analysed using a framework approach. Four themes were identified regarding reasons for running away: authority and power; friction; isolation; and environmental issues. Commonly cited consequences were being 'grounded' and having shoes removed (to prevent further running away). Young people were critical of a lack of support on return and a lack of boundaries. They stressed the importance of being heard, being treated with respect, being able to exercise autonomy and feeling that someone cares. Copyright © 2013 John Wiley & Sons, Ltd. Key Practitioner Messages Looked after children are significantly more likely than other children to go missing., When missing, young people are exposed to significant risk of harm., Reasons for running away are: authority and power; friction; isolation; and environmental issues., Approaches to responding to young people who go missing should be supportive and facilitative rather than punitive., Being heard, being treated with respect, being able to exercise autonomy and feeling that someone cares are crucial preventative factors. [ABSTRACT FROM AUTHOR]

Domestic abuse is increasingly recognised as a serious, worldwide public health concern. There is a significant body of literature regarding domestic abuse, but little is known about health professionals' beliefs about domestic abuse disclosure. In addition, the intersection between health professionals' beliefs and abused women's views remains uninvestigated. We report on a two-phase, qualitative study using Critical Incident Technique ( CIT) that aimed to explore community health professionals' beliefs about domestic abuse and the issue of disclosure. We investigated this from the perspectives of both health professionals and abused women. The study took place in Scotland during 2011. The study was informed theoretically by the Common Sense Model of Self-Regulation of Health and Illness ( CSM). This model is typically used in disease-orientated research. In our innovative use, however, CSM was used to study the social phenomenon, domestic abuse. The study involved semi-structured, individual CIT interviews with health professionals and focus groups with women who had experienced domestic abuse. Twenty-nine health professionals ( Midwives, Health Visitors and General Practitioners) participated in the first phase of the study. In the second phase, three focus groups were conducted with a total of 14 women. Data were analysed using a combination of an inductive classification and framework analysis. Findings highlight the points of convergence and divergence between abused women's and health professionals' beliefs about abuse. Although there was some agreement, they do not always share the same views. For example, women want to be asked about abuse, but many health professionals do not feel confident or comfortable discussing the issue. Overall, the study shows the dynamic interaction between women's and health professionals' beliefs about domestic abuse and readiness to discuss and respond to it. Understanding these complex dynamics assists in the employment of appropriate strategies to support women post-disclosure. [ABSTRACT FROM AUTHOR]

Background: Child neglect is a pernicious child protection issue with adverse consequences that extend to adulthood. Simultaneously, though it remains prevalent, childhood dental caries is a preventable disease. Public health nurses play a pivotal role in assessing oral health in children as part of general health surveillance. However, little is known about how they assess dental neglect or what their thresholds are for initiating targeted support or instigating child protection measures. Understanding these factors is important to allow improvements to be made in care pathways. Methods: We investigated public health nurses' assessment of oral health in preschool children in relation to dental neglect and any associations they make with child neglect more broadly. A qualitative study was conducted in Scotland during 2011/12. Sixteen public health nurses were recruited purposively from one health region. Individual, semi-structured interviews were undertaken and data were analyzed inductively using a framework approach. Categories were subsequently mapped to the research questions. Results: Public health nurses assess oral health through proxy measures, opportunistic observation and through discussion with parents. Dental neglect is rarely an isolated issue that leads on its own to child protection referral. It tends to be other presenting issues that initiate a response. Threshold levels for targeted support were based on two broad indicators: social issues and concerns about child (and parental) dental health. Thresholds for child protection intervention were untreated dental caries or significant dental pain. Barriers to intervention are that dental neglect may be 'unseen' and 'unspoken'. The study revealed a communication gap in the care pathway for children where a significant dental problem is identified. Conclusions: Public health nurses take their child protection role seriously, but rarely make a link between dental caries and child neglect. Clear guidance on oral health assessment is required for public health nurses. Establishing formal communication pathways between child dental care providers and public health nurses may help close gaps in care pathways. However, further research is required into how these communication mechanisms can be improved. [ABSTRACT FROM AUTHOR]

Investigation of shallow-marine environments for submerged prehistoric archaeology can be hampered in many localities by extensive bedrock exposure and thus limited preservation potential. Using the concept of 'seamless archaeology' where land-based archaeology is integrated across the intertidal zone through to the offshore, a multi-disciplinary approach is essential. This approach taken in the Bay of Firth, Orkney uses geophysics, historical archive and ethno-archaeology, coastal geomorphology, palaeo-environmental analyses and sea-level science, and allows a clearer understanding of the landscape in which prehistoric settlers lived. While acknowledging the limitations of the preserved environment, we are successful in identifying areas of archaeological potential on the sea-bed for both upstanding structural elements as well as sediment preservation that contains evidence for human occupation. This has wider implications beyond Orkney's World Heritage sites to provide a blueprint for similar studies elsewhere in the coastal zone. © 2012 The Authors [ABSTRACT FROM AUTHOR]

This paper assesses the provision of cultural heritage information relating to offshore submerged archaeology for Environmental Impact Assessments as part of the management of the seabed around Scotland. Over the past millennia areas of the seabed around Scotland have at times been dry land. This means that they were available for human settlement and are likely to preserve the remains of ancient habitation and other activity. Elsewhere in the UK and in Europe work on submerged archaeology has confirmed the existence of an extensive and often well-preserved resource stretching back to the last Ice Age and beyond. This paper is concerned solely with sites that once comprised terrestrial archaeological sites; it does not cover wreck archaeology. The submerged terrestrial archaeological resource is fragile, and little understood. In Scotland it has been ignored until the inception of a research project in 2006, The Rising Tide, which is investigating past sea-level change and submerged archaeology around Orkney. Up to now, general management has been carried out through a system of benign neglect despite increasing threat to the resource from the development of the seabed. The Marine (Scotland) Act enshrines the need to protect and manage submerged sites and landscapes, through the implementation of marine planning, licensing, and Marine Protected Areas. One of the principal relevant measures for environmental protection through which this is carried out is the inclusion of archaeological information as a critical resource for Environmental Impact Assessments on the seabed. This is enshrined in EC Directives (and applies equally to sites on land). However, good management is hampered by a lack of baseline data on the resource and by a lack of awareness among those responsible. Responses to a questionnaire on the awareness of submerged archaeology and the need to consider it as part of the seabed planning process highlighted a number of serious weaknesses in the current system, not least a lack of awareness, of Scottish-based guidelines, and relevant skills. [ABSTRACT FROM AUTHOR]

This paper reviews recent trends and developments in the study of the Mesolithic period in Scotland and places them in their historical context. The last decade has witnessed a flourishing of research activity, not just in terms of discovery and excavation, but also artefact studies, dating programmes, and other types of research. The contribution of development-led projects is challenging traditional interpretations that have relied heavily on the evidence from the maritime west. These and other major issues such as chronology, subsistence strategies and archaeological signatures are reviewed and some future research priorities are suggested. [ABSTRACT FROM AUTHOR]

This article considers the trajectory and effectiveness of policy, procedures and practice in the UK since the early 1990s in responding to young people who display problematic and harmful sexual behaviours. It draws on data from three publications in which research, policy and practice in the last 20 years have been reviewed. Key themes raised by Masson and Hackett are revisited including: denial and minimisation; terminology and categorisation; similarities with other young offenders; the child protection and youth justice systems; and assessment and interventions. The authors find that there is improvement in recognition of, and practice in response to, this group of young people, but good practice standards are inconsistently applied. With devolution of political powers, Scotland and Northern Ireland are now embarking on a more strategic response than England. The absence of a public debate and prioritising of primary prevention of child sexual abuse is noted. [ABSTRACT FROM PUBLISHER]

Background: Women and their babies are entitled to equal access to high quality maternity care. However, when women fit into two or more categories of vulnerability they can face multiple, compound barriers to accessing and utilising services. Disabled women are up to three times more likely to experience domestic abuse than non-disabled women. Domestic abuse may compromise health service access and utilisation and disabled people in general have suboptimal access to healthcare services. Despite this, little is known about the compounding effects of disability and domestic abuse on women's access to maternity care., Methods: The aim of the study was to identify how women approach maternity care services, their expectations of services and whether they are able to get the type of care that they need and want. We conducted a qualitative, Critical Incident Technique study in Scotland. Theoretically we drew on Andersen's model of healthcare use. The model was congruent with our interest in women's intended/actual use of maternity services and the facilitators and barriers impacting their access to care. Data were generated during 2013 using one-to-one interviews., Results: Five women took part and collectively reported 45 critical incidents relating to accessing and utilising maternity services. Mapped to the underpinning theoretical framework, our findings show how the four domains of attitudes; knowledge; social norms; and perceived control are important factors shaping maternity care experiences., Conclusions: Positive staff attitude and empowering women to have control over their own care is crucial in influencing women's access to and utilisation of maternity healthcare services. Moreover these are cyclical, with the consequences and outcomes of healthcare use becoming part of the enabling or disabling factors affecting future healthcare decisions.Further consideration needs to be given to the development of strategies to access and recruit women in these circumstances. This will provide an opportunity for under-represented and silenced voices to be heard.

Island evolution may be expected to involve fast initial morphological divergence followed by stasis. We tested this model using the dental phenotype of modern and ancient common voles (Microtus arvalis), introduced onto the Orkney archipelago (Scotland) from continental Europe some 5000 years ago. First, we investigated phenotypic divergence of Orkney and continental European populations and assessed climatic influences. Second, phenotypic differentiation among Orkney populations was tested against geography, time, and neutral genetic patterns. Finally, we examined evolutionary change along a time series for the Orkney Mainland. Molar gigantism and anterior-lobe hypertrophy evolved rapidly in Orkney voles following introduction, without any transitional forms detected. Founder events and adaptation appear to explain this initial rapid evolution. Idiosyncrasy in dental features among different island populations of Orkney voles is also likely the result of local founder events following Neolithic translocation around the archipelago. However, against our initial expectations, a second marked phenotypic shift occurred between the 4th and 12th centuries AD, associated with increased pastoral farming and introduction of competitors (mice and rats) and terrestrial predators (foxes and cats). These results indicate that human agency can generate a more complex pattern of morphological evolution than might be expected in island rodents., (© 2014 The Authors. Evolution published by Wiley Periodicals, Inc. on behalf of The Society for the Study of Evolution.)