Around 780 people are diagnosed with the pancreatic cancer every year in Scotland: tragically, and more than half of people with will die within the first three months of diagnosis.
Pancreatic cancer hasn’t stopped because of COVID-19.
We know that during the first lockdown people were reluctant to go to their GP, that’s why during this year’s Pancreatic Cancer Awareness Month we’re doing all we can to raise awareness of the symptoms and, urging anyone whose systems persist, to use the NHS. There’s no time to wait.
If more of us know the symptoms – which include tummy and back pain, indigestion, itchy skin or yellow skin or eyes, unexplained weight loss and oily floating poo – it could lead to more people being diagnosed earlier. Crucially, this could increase their chances of being eligible for life-saving surgery.
I urge your readers to find out more about the disease and if they are worried that they have the symptoms of pancreatic cancer they should speak to their GP as soon as possible.
We’d like to make sure people living with pancreatic cancer and their loved ones across the UK (NI/Wales) know that Pancreatic Cancer UK is here for them. Our free and confidential Support Line is run by Specialist Nurses, my colleagues and myself.
If you would like to speak to a Specialist Nurse you can call 0808 801 0707 or email nurse@pancreaticcancer.org.uk, available Monday, Tuesday, Thursday and Friday 10am- 4pm and Wednesday 10am – 6pm.
Four thousand fewer pathologically confirmed cancer diagnoses in March – June 2020 compared to 2019
As part of the ongoing response to COVID-19, Public Health Scotland provides an overview of changes in health and use of healthcare services during the pandemic.
This week, data on the numbers of people who have had a diagnosis of cancer confirmed using a sample of tissue (a pathologically confirmed cancer) between 1 January and 21 June 2020, compared with how many there were in the same period in 2019 are included in our analysis for the first time.
This information is provided to help inform the ongoing response to COVID-19 and is a subset of the fuller information on cancer incidence in 2020, which is due to be published by the Scottish Cancer Registry in 2022.
The data show that between January and March 2020, the number of people who had a pathological diagnosis of cancer was similar to the number in the same period in 2019.
By the week ending 21 June 2020, around 4,000 fewer people in Scotland had a pathologically confirmed cancer diagnosis than would have been expected.
Between March and June 2020, numbers fell by about 40% of those in 2019. In total, therefore, between January and the end of June 2020, the overall number of patients diagnosed was down by 19% on 2019 figures in the same period.
The fall in numbers is unlikely to be due to a reduced occurrence of cancer, and is likely to reflect a combination of: patients with possible cancer symptoms not seeking out help from their GP (as they may be worried about catching COVID-19); changes to the national screening programmes in the first few months of the pandemic; or reductions in the availability of diagnostic services and treatment during this period.
It is clear that COVID-19 has caused substantial direct and indirect harm to the health of the people of Scotland. As we continue to provide guidance on and evidence for actions to stop the spread of the virus we will also monitor the wider impact it has in our communities.
PHS will do this so that, together with partners in Government, local Government and in Health Boards across Scotland, we can work to protect the health of all of Scotland’s people.
Professor David Morrison, Director of the Scottish Cancer Registry at Public Health Scotland said:“Understanding the impact of the pandemic on health and healthcare services is a crucial part of our efforts to respond to and recover from it.
“As part of the Scottish Cancer Registry’s response we wanted to help understand how cancer diagnoses and cancer services have been affected. The reduction in cancer diagnoses this year gives us a sense of the scale of the impact of COVID-19 on all stages of the journey from first seeking help to recovering from treatment.
“If you’re worried you might have cancer – see your GP and get checked out. It’s probably not cancer – but if it is, the sooner you’re diagnosed, the better your chances of successful treatment.”
To see the further information on the wider impacts of the COVID-19 pandemic on people’s health, and their use of healthcare services, including the data on cancer outlined above, please visit our COVID-19 wider impacts on the health care system web pages.
For information on screening, please visit NHS Inform.
People in Edinburgh are being encouraged to support a campaign to address bullying behaviour among Scotland’s young people which has launched during Anti Bullying Week 2020 (16-20 November).
The campaign seeks to empower young people with advice and approaches from those who have experienced bullying, after a consultation with young people and professionals highlighted that the management of bullying related incidents was a key area of concern.
With this in mind, respectme has created a suite of resources for primary and secondary aged children to help approach and guide conversations at a time when learning supervision is has been reduced, while also supporting young people with advice from those who have been there themselves.
Anyone involved in influencing the life of a young person is invited to download the free resources available at www.whatmadeitbetter.com.
Supporting the call is the Deputy First Minister and Cabinet Secretary for Education and Skills, John Swinney, who said: “Anti-Bullying Week is an ideal opportunity to send a clear message that bullying of any kind is completely unacceptable and when it occurs we all have a responsibility to address it.
“Children and young people need to be educated about all faiths and beliefs and learn about tolerance, respect, kindness and good citizenship. We want all children and young people to be able to speak to someone they trust when bullying happens and that is why campaigns like this are so important.
“I look forward to taking part in Anti-Bullying week to highlight to those being bullied, that things will get better, and how we can be that person that did make things better.”
“There’s a wealth of evidence highlighting a rise in bullying behaviour since lockdown, particularly in an online setting, which has no time boundary and is difficult to monitor and supervise. This makes Anti-Bullying Week and the campaign all the more poignant as we seek to start the conversation and share valuable advice.
“The #WhatMadeItBetter? resources are free for anyone to explore, and we’d urge adults who have experienced bulling to get involved and help us shape future resources by taking our online survey which looks at what more can be done to support young people.”
Speaking out to young people is James Allan, frontman of award-winning Scottish indie band Glasvegas, who shared his personal advice: “As humans, we carry so many experiences with us, and in some way can blame ourselves or believe what other people say.
“If anybody does experience these things, try and challenge that insecurity or doubt in yourself and to know it’s the way we’re wired up. Things will get better and, in the meantime, be yourself, stay true to yourself and believe in yourself.”
A leading charity is urging the Scottish Government to include parents of children with complex disabilities and life limiting conditions to be amongst the first to receive the promising COVID-19 vaccine.
The plea comes from Kindred, an advocacy organisation supporting parents of children with complex needs, which has warned of the impact on these children if their parents contract the virus and are unable to provide care.
The charity has released a report today (16th November) highlighting the “devastating” impact of the pandemic lockdown on families of children with exceptional health needs.
Kindred is calling for public acknowledgement of the extraordinary efforts of these parents, many of whom had started shielding weeks before lockdown, and has asked for a letter from the Scottish Government to families. Such a letter would enable parents to feel that their efforts had not gone unnoticed and, in some way, help them come to terms with the trauma experienced over this period.
The charity conducted a survey of parents from 17 local authorities to better understand the ramifications of the lockdown months on these vulnerable families in August 2020 as schools prepared to reopen.1
The results show that:
93 percent of these families experienced an impact on their ability to meet their children’s medical and care needs due to the pandemic; 63 percent said that the impact of the pandemic on their ability to provide care was ‘big’ or ‘severe’.
Two out of every three parents who took part in the survey said sleep deprivation was one of the main factors that impacted their ability to care for their children. It was the norm for these parents to get an average of five hours of broken sleep per night. Kindred has called for an urgent need to investigate the provision of overnight respite care across Scotland.
Over a third of parents received no respite care before the pandemic and this dropped to 60 per cent after the start of the pandemic. This highlights the importance of schools in supporting parents and giving them a break from caring. Almost all the children attended special school with access to therapy, and the expertise of Additional Support for Learning staff. There is no doubt that schools are preventing crisis and family breakdown where a child has high care needs.
The charity has written to the Cabinet Secretary for Health and Sport, Jeane Freeman MSP, and to Deputy First Minister and Cabinet Secretary for Education and Skills, John Swinney MSP, urging that these parents be given priority when distributing the recently announced vaccine.
The report provides evidence that parents were left caring entirely alone in the home environment. There was an even greater impact on single parents. Despite the high level of need of all the children, some parents did not even get a phone call from professionals during the pandemic. These parents fear falling sick and being unable to look after their vulnerable children.
This is the case for Alex Davey from East Lothian and her six-year-old son, Benjamin, who has complex medical needs including tube-feeding, epilepsy and overnight ventilation.
Alex received a letter instructing her that Benjamin met the criteria for shielding in March. For his safety all respite and at-home care services received were brought to a halt, leaving Alex and her husband to be the only people providing care for Benjamin and his two sisters. Since March, Benjamin has been hospitalised six times, often involving full-time ventilation in critical care.
Alex’s main concern is that she and her husband will themselves contract Covid-19, rendering them incapable of meeting Benjamin’s complex care needs, potentially for a long period of time.
Early access to the vaccine is therefore imperative according to Kindred to ensure that families like Alex’s can be sure that they can continue to care for their child.
Further recommendations to the Scottish Government:
The report shows a disparity between the experience of those families who received the support and advice from health professionals, particularly on shielding, compared to those who didn’t. On this evidence, Scottish Government is being urged to ensure that professionals contact parents and charities should be funded to provide peer support.
Siblings play a vital role in the care and support of a disabled brother or sister and Kindred is urging that Self-Directed Support is available for adult siblings to be paid as carers within the home in the event of another lockdown. (see case study of Dr Gael Gordon in Notes to Editors and image attached)
The needs of families for respite should be taken into consideration with regards to special schools, with consideration given to keeping them open in the event of a second lockdown and providing the resources to do this.
Sophie Pilgrim, Director of Kindred, commented: “Our report provides evidence that the Covid-19 pandemic had a devastating impact on families of children with complex needs and life limiting conditions.
“Anyone reading this report will be moved by their plight. Many families started shielding before schools closed with the loss of all care and support. Some of these children require two to one support in school and other care settings, and yet parents had to cope from March to August, many with no help at all.
“As the vaccine becomes available, we must prioritise parents who are providing medical care for their children and cannot afford to get sick themselves.
“Many parents received no respite care before the pandemic, and those that did lost their care with lockdown. Serious sleep deprivation puts parents at risk of depression, accidents and long-term conditions. One of the parents told us ‘I feel like I am drunk’. We found that many parents have to cope on five hours of broken sleep a night, well below the NHS recommendation of a minimum seven hours a night.
“We need to recognise the long-term exhaustion of these families. Special schools are all the more important and need to be supported to carry on their excellent work and to keep their doors open.
“Parents put their children first. And we must work together and ensure they are amongst the first to get the vaccine.“
Dangerous crowding and corridor care has returned to Emergency Departments in England.
NHS England Performance figures for October 2020 show that patients waiting for treatment on trollies has increased by 50%, with patients waiting longer than 12 hours from decision to admission having quadrupled from September 2020.
The data also shows:
patients waiting longer than 12 hours (from decision to admit) has nearly doubled from the same month last year
the proportion of patients attending A&E who require admission is up by 3 percentage points on last year
the number of ambulances dispatched by NHS111 is higher than last month
ambulances response times are up on last month and the same month last year
Performance of the four-hour target is down by 4.1 percentage points in type 1 Emergency Departments from last month, with nearly 1 in 4 patients waiting longer than four hours to be seen
Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said: “I am appalled and alarmed; the data is massively worrying.
“Despite our repeated calls for action, crowding and corridor care is back and it has to stop. It is a dangerous and unsafe situation that puts enormous pressure on staff and departments and now increases the risk of hospital acquired infection to patients.
“We simply cannot leave patients for hours in crowded corridors without social distancing, making infection prevention control measures impossible; potentially exposing them to infections.
“Hospitals and trusts must, as a necessity, implement and follow strict IPC guidance ensuring staff are using the right PPE and are trained in how to fit it correctly to maximise safety for themselves and their patients. We welcome the news that there will be regular staff tests and look forward to hear how this will be operationalised. We need patients to be confident they are not being seen by staff who might be carrying the virus.
“But this only tackles part of the problem. To function as it should and provide the best care possible for patients, the Emergency Care system must have good flow. Without it ambulances are stuck waiting to offload patients and paramedics are unable to return to the community; waiting times increase across the board and patients suffer.
“The recent rise in covid infections in the community and a rise in general hospital admissions means there has been an increase in the number of patients in hospital. We already had a bed base far smaller than required, and the consequence of too few staffed beds is that patients are becoming stranded in EDs, putting them unnecessarily at risk. Hospitals need to be given guidance about how to prioritise the multiple demands they are trying to balance.
“Winter has only just begun and with the rise in community covid transmission it is only likely to get worse. We must stop crowding and corridor care now, we must ensure patients and staff are safe, we must ensure there is good flow so ambulances can admit patients into EDs quickly and waiting times are reduced. If these practices continue and we do not act I dread to think of the suffering this winter will bring.”
A pioneering, inter-agency partnership, led by NHS Lothian, NHS Fife, NHS Borders and the six local authorities in the region, is working together to reduce type 2 diabetes across the East of Scotland.
Type 2 diabetes has been on the rise across the country for the past decade, having a significant impact on the lives of individuals and health of Scotland’s population as a whole.
Over 62,000 people are living with type 2 diabetes in the East of Scotland – around 5% of the total population – and there are over 3,700 new cases in the region each year.
Recognising that diet and excess weight is driven by a range of environmental, societal and individual factors, regional health and social care providers have joined forces with stakeholders from the public, third and private sectors to advance sustainable change.
Growing evidence of the link between obesity and an increased risk of complications from COVID-19 has reinforced the importance of this shared vision, compounded by the measures recently revealed as part of the UK government’s new obesity strategy.
With national investment of £1.46 million in the East of Scotland programme this year, regional director Nicky Waters said: “Our programme is a priority initiative – reflecting the need for urgent action to reduce the prevalence of type 2 diabetes in Scotland and support people to lead healthy lifestyles.
“By adopting a Whole Systems Approach and bringing a wide range of partners together, our programme is centred on tackling structural, systemic root causes – such as poverty, inequality and childhood trauma – and the part that we all need to play in addressing them.”
Four core intervention programmes – Get Moving with Counterweight, Type 2 Diabetes Remission through Counterweight Plus, Gestational Diabetes education and Let’s Prevent Diabetes – are being rolled out across the region, with partners taking advantage of technology to support people throughout the pandemic.
Over 1900 adults have been referred to Get Moving with Counterweight and the remission programme since October 2019, with 60 patients currently taking part in Counterweight Plus.
Counterweight Plus, a free two-year programme being delivered by specialist NHS dietitians, is based on ground-breaking evidence from the Diabetes Remission Clinical Trial (DiRECT).
A combination of intensive, long-term support and Total Diet Replacement (TDR) of nutritional shakes and soups, is key to the intervention’s success.
Jenny*, a patient going through Counterweight Plus in Lothian, has overcome various hurdles to continue on the programme at home throughout the pandemic – receiving virtual support whilst juggling family and working life under lockdown.
Despite the challenges, Jenny’s blood glucose results, weight loss and largely positive experience to date, all indicate that she’s heading in the right direction. She said: “The programme hasn’t been easy but the consistent emotional support and awareness of the long-term health benefits has really spurred me on. I’ve lost twenty kilos since I was first diagnosed and feel great because of it.”
Jonathan Hayes, the dietitian supporting Jenny, reflected: “It’s brilliant to see that, despite this unprecedented situation, there are people out there like Jenny who have turned things around for the positive. And who stand a very good chance of coming out of the pandemic, having put their type 2 diabetes into remission. That is an incredible outcome.”
Regional health and social care providers are further committed to improving the working environment for their 84,000 employees and local areas are rolling out community based pilot projects to test a Whole Systems Approach (WSA) to diet and healthy weight.
Laurie Eyles, one of the newly appointed professional advisers for diet and healthy weight at the Scottish Government, who prior to this had been supporting partners as the programme’s clinical lead, said: “From delivering targeted interventions, to addressing the widespread issue of weight stigma and tackling the health inequalities which exist across the region – partners are committed to making lasting improvements to the environment in which we live.
“It is this that will allow us to build an East of Scotland where we eat well, have a healthy weight and are physically active – reducing our risk of developing type 2 diabetes for the long-term.”
For weight management and type 2 diabetes support during this time, please visit:
Heart Research UK Healthy Heart Tip, written by Dr Helen Flaherty, Head of Health Promotion at Heart Research UK
Cut down on sugar in your drinks
TODAY 14th November is World Diabetes Day. Consuming too much sugar in your diet can lead to weight-gain as well as increasing your risk of type 2 diabetes and heart disease.
Over a quarter of the added sugar in our diets is believed to come from the drinks we consume. The focus of this week’s tip is on reducing the amount of sugar in your drinks.
Choose sugar-free or reduced-sugar drinks
When you feel thirsty, water is always the best option. Try swapping your sugary soft drink for a glass of water or a sugar-free or reduced-sugar drink. If you are not keen on the taste of water, you could try adding a slice of lemon and/or some mint leaves.
Save sugary drinks for an occasional treat
If you don’t want to stop drinking your favourite sugary drink permanently, try limiting the amount you drink by consuming it less frequently and in smaller quantities. Unsweetened fruit juices and smoothies also contain sugar, so try to limit your intake to no more than 150ml a day.
Avoid adding sugar, syrups and honey to hot drinks
If you usually add sugar, syrups or honey to hot drinks, why not gradually reduce the amount you add, until you can cut it out altogether. Alternatively, you could use an artificial sweetener, however this will not help you to adjust your taste preference for sweet drinks.
Cut down on sugar from alcoholic drinks
Alcoholic drinks can be high in sugar. A pint of cider contains around five teaspoons of sugar. Try to reduce your sugar intake by consuming alcoholic drinks less frequently, in smaller measures and by combining alcoholic drinks with sugar-free or reduced-sugar mixers, such as sugar-free tonic water.
Anti-bullying toolkit launched by NSPCC Scotland and respectme
Children’s Minister Maree Todd says toolkit will ‘help guide adults across Scotland on how to best support youth-led anti-bullying work’
A toolkit to help schools across Scotland run youth-led campaigns to tackle online bullying has been launched by NSPCC and respectme.
The Think B4 You Type toolkit, which was designed by the two children’s organisations alongside a group of young people from Angus, gives guidance to adults on setting up anti-bullying campaigns.
The resource was born out of a campaign run last year by NSPCC Scotland, respectme and Angus Council, which saw eight secondary schools in the area work to raise awareness of online bullying and find local, youth-led solutions to prevent and address it.
The activities put on by the young people in the schools included arranging sessions with peers to discuss online bullying, making a film on the impact of text bullying and social media comments, holding peer support drop in sessions and giving presentations in assemblies.
Rachel Talbot, who attends Brechin High School in Angus, was on the youth advisory group for the original campaign.
The 13-year-old said: “By working with our peers in our schools and sharing our own experiences, together we were able to create the Think B4 You Type campaign and make recommendations to Angus City Council regarding their anti-bullying policy in our schools.
“This issue matters to me so much personally, because when I was in primary school I was bullied both in person and online.
“It’s important to me to do as much as I can to try to stop anyone from going through the same thing and to help the ones who unfortunately do.
“I believe the activities that we ran at school during anti-bulling week, made everyone really think about the issue and the impact it can have on people’s lives.”
Every year, hundreds of young people from across Scotland contact the NSPCC’s Childline service about their bullying concerns, with cyberbullying becoming increasingly prevalent.
A 14-year-old girl told Childline: “I am being bullied by a girl at school. She has taken photos of me and posted them on Snapchat calling me fat and ugly and how I will never have a boyfriend.
“I have been having suicidal thoughts as this girl is really popular and she has turned my whole year against me.”
Another teenage girl told a counsellor: “Every day I wake up scared to go to school, scared about the comments people will make and scared about walking home.Then I get in and log onto my social networking site and there are horrible messages everywhere.
“It’s like there’s no escaping the bullies. I’m struggling to cope with how upset I feel so sometimes I cut myself just to have a release but it’s not enough. I can’t go on like this.”
Carla Malseed, NSPCC Scotland’s campaigns manager, said:“All children who are affected by bullying can suffer harm – whether they are bullied, they bully others or they witness bullying – and the effects of bullying can last into adulthood.
“Our Childline counsellors talk to hundreds of children in Scotland about bullying each year. Many young people talk about it affecting their self-worth and feeling trapped and isolated.
“While this toolkit focuses on online bullying, it is important that this is looked at in the wider context of relationships, and that any campaign considers the link between online and offline bullying.”
Wendy Harrington, director of respectme, Scotland’s anti-bullying service, said:“The youth-led campaign and activities run in Angus schools last year showed the power of young people to create change in their communities.
“It is vital that young people are empowered to support improvement in their own and their peers’ lives; they are the experts in their own experiences, and their understanding, ideas and solutions are essential to make these campaigns a success.”
Scotland’s Minister for Children and Young People, Maree Todd said:“All forms of bullying, including online bullying, are totally unacceptable. It is great to see young people coming together to take charge and make changes for the better.
“The hard work the young people in Angus have invested into the ‘Think B4 You Type’ campaign which has led to the development of the toolkit, shows the true passion and commitment of everyone involved.
“The toolkit will help guide adults across Scotland on how to best support youth-led anti-bullying work and it will act as a valuable legacy for the campaign.”
As well as providing guidance for adults, the toolkit includes templates and further learning for direct use by the young people themselves. Schools can download a copy of the toolkit from respectme.org.uk
Education, flexibility, training and risk assessment are some ways that employers up and down the country can provide support to diabetic employees.
Health and safety experts at CE Safety have revealed actionable steps for employers to ensure that they have the correct workplace procedures to deal with a diabetic emergency.
It is World Diabetes Day on November 14th, prompting CE Safety to offer guidance about first aid and diabetes in the workplace. With 4.8 million people in the UK living with diabetes, employers should be clued up and support staff who have the disease.
This is especially important in the time of Covid-19, as research has revealed that people with diabetes are at greater risk of dying from the virus. People with diabetes should be taking steps to look after themselves to avoid complications, such as maintaining healthy blood sugar targets and staying fit and healthy.
It is a basic minimum standard to ensure workplaces are risk assessed and suitable for diabetics.
A spokesperson for CE Safety says: “Diabetes is a lifelong serious condition and involves having to control the blood glucose levels in the body to stop it getting too high, which can be dangerous. Among the different types of diabetes, type 1 and type 2 are the most common.
“Huge efforts to raise awareness about the chronic condition are being made around the globe, and not without reason. The statistics on people who already have the disease are stark enough, however, experts also believe there are more than 13 million people in the UK who are at risk or already have undiagnosed type 2 diabetes.
“The team at CE Safety deliver health and safety training in the workplace and feel passionate about ensuring every place of work has the correct procedures and policies to look after their staff.”
Here are practical steps for business owners to support employees with diabetes:
Open up the conversation
Allowing the conversation to open up, and having an honest chat around diabetes can help in a variety of ways. It can improve the mental health and wellbeing of the employee; remove any discrimination; employers can gain an understanding of how staff are coping, and provide a forum to outline initiatives and measures which everyone gains from.
Educate yourself on the disease
There are alarming numbers of people out there who don’t even understand the disease they’re living with, so it’s unlikely that employers without diabetes will fully understand it. There are many resources out there so a quick read will give you a lot of insight. For example, did you know that there’s a link between diabetes and depression?
Be flexible
Understanding what your staff with diabetes need, means you can then put measures in place to help them. Be accommodating for attending healthcare appointments for starters, but also support them around working hours, any modified equipment they need or simply show patience for when the disease becomes debilitating. It’s not easy to balance work with managing a disease.
Provide privacy
Staff with diabetes may need to take injections of insulin or check blood sugar levels throughout the working day. Give them a private and clean space to do this, which will provide peace of mind and inclusivity, and even reduce stress.
Revisit working practices
Do your terms allow for assessing a worker on an individual basis? For example, some employees may benefit from flexible working patterns or a higher level of sick leave. Diabetes can cause short and long term complications, so factor this into any relevant policies.
Train your staff in first aid
Your workforce should know what to do in an emergency situation, but do they know what to do in a diabetic emergency? Pass on the information you have gathered.
Do a diagnostic diabetes risk assessment
Get the overall picture of your workforce. Understand the full health picture of your staff, then you can take steps towards pinning down your approach, ensuring the workplace is prepared, safe and supportive to those who need it.
Look at your company culture
As well as supporting people who already have diabetes, there are many improvements employers can make to do their bit in eradicating the disease. We know there is plenty that can be done to avoid getting type 2 diabetes. Promote healthier choices in available food and drink, encourage work-life balance and exercise, and have policies around mental wellbeing.
Stop sitting down
A study in the journal Diabetologia discovered that people who sit still for long periods of time double the risk of developing type 2 diabetes, even if they exercise too.
The NHS says many adults in the UK sit for about nine hours a day, and that living a sedentary lifestyle is linked to obesity, type 2 diabetes, some types of cancer and early death.
Because many people spend hours sitting at a desk while at work, employers should be finding ways to reverse this problem. For example, encourage people to take the stairs, set reminders to stand, create standing workstations, go for a walk while speaking on the phone or regular coffee breaks.
For further information on diabetes and first aid, please see –
