Big Hearts, the official charity of Heart of Midlothian FC, raised £21,115 at the Big Hearts Gala at Tynecastle on Saturday 9 September.
The Big Hearts Gala is one of the biggest fundraising events in the charity’s calendar, and this year they have raised more than ever before, with all money going towards helping them to support people in their community.
The amount raised at this year’s Gala is double the amount of than last year.
Guests at the glittering event got a valuable insight into Big Hearts’ vital work across the community.
They learned about the That’s Me! group, which aims to make a positive impact on teenagers and young adults, aged 12 to 18, who could benefit from wellbeing support.
On top of this, guests were in the presence of legends as Paul Hartley, Darren Barr and Mark de Vries were all present in the Gorgie Suite as guest speakers.
The Big Hearts Gala is a celebration of the power of the club’s badge in changing lives in communities across south west Edinburgh.
As well as the funds raised from over 250 tickets sold, there were live and silent auctions, in which signed Hearts shirts, golf days and hotel stays were auctioned.
Craig Wilson, CEO at Big Hearts, said: “We are over the moon to have raised £21,115 at the Big Hearts Gala this year.
“It is one of our biggest fundraising efforts and I’m grateful to everyone who bought tickets and took part in our auctions.
“The money raised will go a long way in our mission to help improve the lives of people in our community.”
Fans at the Gala were delighted to meet three Hearts legends. Brian Chapman shared shared his excitement after hearing some of their stories.
“I am too young to have seen Mark de Vries play, but I was lucky enough to see Paul Hartley play. It was a really good moment to get a picture with him and actually see him in-front of my own eyes.
“I took part in the Hampden to Tynecastle charity walk and, along with three friends, raised £2500 for Big Hearts. I am here tonight to continue to show support after that.
“The charity does a lot of good work, and as we’ve heard tonight, poverty in Gorgie is among the highest in Edinburgh.”
Mark de Vries is fondly remembered by Hearts fans for his four goals on his debut against Hibs. He was glad to be back in Gorgie.
“It has been great to be back in Edinburgh and back at Tynecastle” he said.
“I loved my time here, so it has been an honour to come back as a guest of Big Hearts.
“I have been made to feel so welcome and it has been amazing to learn about the work of Big Hearts.”
Big Hearts is the only non-profit organisation based at the home of Heart of Midlothian FC.
The charity delivers free activities for adults and children to improve outcomes around mental health, social isolation and promote equal opportunities.
It costs Big Hearts over £600,000 each year to build and deliver programmes and services to the communities living in the surroundings of Tynecastle Park, one of the most disadvantaged wards of Edinburgh.
The MoonWalk Scotlandreturned to the streets of Edinburgh in a blaze of colour last night(Sat 9th Sept).
Women, men and young people wearing brightly decorated bras or colourful “bra t-shirts” set off from Holyrood Park in balmy, late summer temperatures at 11pm, to walk a half or full marathon through the capital.
Organised by breast cancer charity Walk the Walk, the first MoonWalk Scotland was staged in 2006. Since then, walkers have raised almost £22 million, which is granted across Scotland to help support those living with cancer.
Walk the Walk recently awarded £50,000 to the charity Cancer Support Scotland, to help reduce the waiting list for Scottish cancer patients and their families, who are in desperate need of emotional and wellbeing support.
Many buildings and landmarks across Edinburgh lit up pink throughout the night in honour of Walk the Walk’s amazing walkers and volunteers.
These included Edinburgh Castle; Camera Obscura, Lloyds on the Mound; Royal Society; Edinburgh; Victoria Quay, Leith, Radisson Blu Hotel, St. Andrew’s House, Prestonfield House Hotel; Edinburgh International Conference Centre.
Rachel Groves(59) from Edinburghcompleted the 26.2 miles Full Moon. Rachel was diagnosed with breast cancer in January 2023, having battled for almost a year to be examined in person by her GP.
Rachel said; “I’m chuffed to bits to have completed The MoonWalk with my daughter, sister, nieces and closest friend.
“It was quite an incredible experience: amazing volunteers, very non-traditional Edinburgh weather and a cause we all truly believe in.
“For me, personally, it was particularly humbling to be fundraising knowing that MoonWalk organisers breast cancer charity Walk the Walk funded the unit which treated me at the Western General Hospital in Edinburgh.
“And here I am, less than five months after a mastectomy, walking the walk!“
Fiona Watson,(56) from Elgin, took part in her first Moonwalk, completing the 13.1 miles Half Moon. Fiona has been on constant treatment for secondary breast cancer since 2014.
She said: “Our team thoroughly enjoyed completing the Half Moon. It was uplifting and challenging, amongst many other emotions, and there was a tremendous feeling of unity throughout the night – the organisers and the volunteers were first class from start to finish.
“The warmth we experienced from the city of Edinburgh was immeasurable and we are also quite overwhelmed and humbled by the generosity of all our sponsors.
“By taking part in The MoonWalk, I hope I’ve raised awareness that it is possible for anyone newly diagnosed with breast cancer (or indeed secondary breast cancer) to still lead a relatively normal life.”
Nina Barough CBE, Founder and Chief Executive of Walk the Walk,said: “What an incredible night! It was wonderful to see so many people taking part, including a large number who were totally new to MoonWalking.
“Together, everyone was uniting not only to raise awareness of breast cancer, but also valuable funds which will help improve the lives of people across Scotland living with the disease.
“The collective pink hug from so many iconic buildings across Edinburgh which had lit up pink for the occasion was such a huge boost for our Walkers and Volunteers, as was the unseasonably warm weather!
“Keep helping us make a difference by signing up for The MoonWalk Scotland 2024!”
Entries are already open for The MoonWalk Scotland on Saturday 7th September 2024. Sign up now www.walkthewalk.org
Scots severely underestimate the scale and seriousness of heart and circulatory diseases, according to a new survey by the British Heart Foundation.
While it’s estimated around half of people in this country will get a heart or circulatory condition during our lifetime, more than a quarter (27 per cent) of those surveyed in Scotland thought the likelihood of them developing a heart condition was just 1 in 10, while over a fifth (22 per cent) thought the chance was just 1 in 50.
Only three per cent of respondents knew the correct answer – which is 1 in 2.
When people were asked if they thought they would be directly affected, Gen Z (33 per cent) are most likely to think they will ever be affected by heart and circulatory diseases, whereas baby boomers are the least likely (22 per cent).
Despite heart and circulatory conditions affecting men and women almost equally, only 27 per cent of women thought they could be at risk compared to 33 per cent of men.
These perceptions stand in stark contrast to the fact that there are currently 700,000 people living with a heart or circulatory disease in Scotland.
Worryingly, the survey also found confusion among members of the public about the seriousness of a heart attack and cardiac arrest. While both are life-threatening emergencies that require immediate medical treatment, only 79 per cent of Scots would call 999 for an ambulance if they thought a person was having a heart attack, while only 60 per cent of people considered a cardiac arrest a medical emergency.
The BHF released the figures to coincide with the launch of a new campaign that aims to shine a spotlight on hidden heart conditions. The charity says that these conditions can often go undiagnosed for too long and that they often aren’t discovered until something goes wrong, or it becomes too late.
For mum-of-two, Hannah Kirkpatrick, from Dalbeattie, the impact heart conditions can have on the family, is something she knows all too well.
Her son Evan, now 10, was diagnosed with hypertrophic cardiomyopathy, an inherited heart condition which causes the heart muscle to thicken, when he was just 11 months old. But it wasn’t until August last year that he underwent surgery – a septal myectomy – which has helped improve his life.
Hannah said: “He was only diagnosed with his heart condition by accident. When he was born, he had a bit of a flat head and, while it seemed to be getting better after a couple of months, his health visitor referred him to have a check over by his paediatrician.
“At the appointment they spent a long time listening to his heart and I could just tell something was wrong. Why else would they be listening for so long? He was referred to Dumfries and Galloway Royal Infirmary for a scan where they detected a heart murmur. It was a huge shock.”
Doctors said they would closely monitor Evan’s condition and saw him every six-months for regular check-ups.
However, in March 2022 Evan started to become more breathless. His lips would also get a blue tinge after walking. Hannah, who is also mum to Caitlin, 22, and her husband, Christopher, took Evan back to his cardiologist and he was put on the waiting list for a septal myectomy – surgery which would remove some of the thickened muscle in his heart.
The self-employed domestic cleaner, 40, said: “His surgery was on August 13, 2022, in Glasgow. It was meant to take around four to five hours. It was the worst day of my life, waiting and not knowing if he was going to be OK.”
Thankfully Evan made a speedy recovery and within a few days the then nine year was back home. “He took everything in his stride and bounced back,” said Hannah. “It was a huge relief and we can look ahead to the future.”
An estimated 27,000 people in Scotland have an inherited heart condition. The charity say heart and circulatory conditions can affect almost anyone at any stage of life regardless of lifestyle choices and family history which contradicts common misconception we may have in our heads of them only affecting those who may be older with unhealthy lifestyles.
David McColgan, Head of BHF Scotland, said: “It is deeply concerning to see that so many people are unaware of the scale and seriousness of heart and circulatory diseases.
“Decades of lifesaving medical advances have perhaps lulled people into believing that we’ve beaten heart and circulatory diseases when nothing could be further from the truth.
“These potentially deadly or life-limiting conditions continue to rob families of loved ones or blight the lives of people facing a future with an incurable disease.
“With this campaign we want to shine a spotlight on heart and circulatory diseases and help people understand that everyone can be affected.
“By funding groundbreaking research, we can get a step closer to breakthroughs that that can save outsmart heart disease for good.”
This September, the BHF is shining a spotlight on hidden heart conditions and urging the whole of the UK to get involved by supporting the charity however they can. Stories, stuff, time, or money: whatever you can give, please give.
Samaritans Scotland has responded to yesterday’s release of data from National Records of Scotland in its annual update on suicide statistics for 2022.
Key Points
762 deaths by suicide were recorded in 2022 – an increase of nine from 2021.
People living in Scotland’s most deprived areas are 2.6 times more likely to die by suicide than those living in the least deprived areas.
At council level, the rate was higher than the Scottish average in Highland, Dundee City, East Ayrshire and Perth and Kinross.
Female deaths increased by 18 – however a decrease of 42 was recorded in 2021.
Although the number of probable suicides increased for females, men are still 2.9 times more likely to die by suicide in Scotland.
Neil Mathers, Executive Director of Samaritans Scotland, said: “Every life lost to suicide is a tragedy and 762 deaths reaffirms the importance of suicide prevention work in Scotland.
“Today’s figures show that it is imperative that we continue to take action on the range of factors that may contribute to suicide risk.
“Those living in Scotland’s most deprived areas are more than twice as likely to die by suicide than those in more affluent areas.
“Samaritans research has previously shown the importance of suicide prevention work with middle aged men. Today’s data reinforces the need to prioritise support for middle aged people and highlights the need for women in middle age and older to receive the help they need.
“While there has been an increase overall in the number of female deaths, men continue to account for most deaths, and are still 2.9 times more likely to die by suicide in Scotland.
“We know that suicide is complex and there is rarely a single reason why someone may decide to take their own life.
“As a lead partner in Suicide Prevention Scotland – a new initiative in delivering Scotland’s Suicide Prevention Action Plan 2022-25 – we will encourage a whole society approach to address the social determinants with the greatest link to suicide risk. We will also consider ‘access to means’, examining locations of concern across the country.
“We look forward to working with the Scottish Government and other partners on this ambitious strategy to reduce deaths by suicide in Scotland.”
Dr David Hall, suicide prevention lead, Royal College of Psychiatrists in Scotland, said: “Although the most recent figures do not show dramatic changes, it is particularly disappointing to note that the slight decrease noted in the last few years has not continued, despite ongoing efforts in suicide prevention.
“We must remember that every one of these probable deaths by suicide represent a terrible tragedy for all those affected.
“The dramatically increased rate in the most deprived areas of Scotland over the less deprived, illustrates the ongoing health inequalities experienced by many Scots.
“Ongoing efforts in suicide prevention and focus on ensuring that those in suicidal crisis can access prompt and appropriate help, wherever they are, remain vitally important.”
Suicide Prevention Scotland has responded to today’s release of data from National Records of Scotland (NRS) for 2022 which shows a small year on year increase in deaths by probable suicide.
Statistics released by NRS show that there were 762 suicides registered in 2022, a 1.2% increase on 2021 (which was down 6.5% on 2020’s data).
Annual data can fluctuate so it is important to also view the figures in terms of five year rolling averages which give a better understanding of the pattern of deaths over time.
The number of deaths by suicide in 2022 is slightly below the previous five-year average (771). Apart from 2021, it’s the lowest number of suicide deaths since 2017 (680).
The average age of death by suicide has risen from the previous year. In 2022 this was 48.1 years; in 2022 it was 41.9 years.
The small increase in the past year can be attributed to an increase in female suicides by 18 and a reduction in male suicides, which decreased by nine. The rate for men remains three times that of women.
Compared to the previous female five-year average (198 for 2017-2021), 2022 shows an increase of eight deaths. Compared to the previous male five-year average (573 for 2017-2021), 2022 shows a decrease of 17 probable suicides.
There was an increase in suicide rate 2017-2019, followed by a decrease 2019-2021, with the lowest numbers seen since 2017 in 2021. Although the numbers released for 2022 do not continue to follow this decrease, it is too early to say if the downward trend has stalled, as several years’ data are needed to confirm an overall trend.
Probable suicides in the 15–24-year-old group have fallen by four to 69 in 2022, from 73 in 2021.
The biggest reduction seen is in the 25–34-year-old group, which fell by 35 to 113 in 2022 from 148 in 2021. However, the next oldest age category, the 35-44-year-olds, saw one of the highest increases (up 22 to 153).
There has also been a slight increase over the last year in older age groups, including the 55-64-year-olds (up 22, to 143 deaths, and mirroring similar findings for 2021) and the 65–74-year-olds (up 18, to 91 deaths).
The increase in these older age groups was driven mostly by male suicides, which increased by 37 to 121 in the 55-64-year-olds.
When we look at the rate of suicide, the highest rate seen in 2022 was among 35-44-year-old males (35.6 per 100,000), an increase from 27.4 in 2021.
In 2022, the suicide rate in the most deprived areas was 21.7 per 100,000, compared with least deprived areas of 8.4 per 100,000.
This means that deaths by suicides in 2022 occurred 2.6 times more in our most deprived communities, an improvement on inequality seen in previous years.
The five-year average 2018-2022 was three times more in the most deprived areas compared with least deprived areas. This is a small improvement from the previous five year average 2017-2021, which was 3.1 times more.
Last September, the Scottish Government and COSLA (Convention of Scottish Local Authorities) launched the country’s new long-term suicide prevention strategy and action plan, Creating Hope Together.
To deliver the new strategy, a new community of organisations and people, Suicide Prevention Scotland, has been established.
Creating Hope Together sets out four key outcomes. Partnership is at the heart of the approach, and so a strategic partner(s) has been appointed to drive delivery. They are:
Creating a safer environment that protects against suicide across the whole of Government and society – Samaritans
Improving understanding of suicide and tackling stigma – SAMH
Providing compassionate support for anyone affected by suicide – Penumbra & Change Mental Health
Working in a connected way, that always draws on evidence and lived experience – Public Health Scotland
A new National Suicide Prevention Advisory Group has also been established.
Led by Rose Fitzpatrick CBE QPM, its members represent many of the sectors leading work on the social determinants of suicide. This includes poverty, as well as partners who are working in key sectors affected by suicide – such as the criminal justice sector.
Their role is to provide advice to Suicide Prevention Scotland, Scottish Government and COSLA which helps us focus on the complexity, intersectionality and inequality of suicide.
Suicide Prevention Scotland’s recently appointed National Delivery Lead Haylis Smith comments: “Today we learnt that 762 families lost a loved one to suicide in 2022. Every person was a family member or friend – important to and loved by others. Each and every one drives our commitment to do everything we can to prevent suicide.
“Creating Hope Together – the new strategy and action plan, along with Suicide Prevention Scotland, the community of people across the country who are involved in suicide prevention, will help to ensure we deliver a joined up whole of government – and society – approach.
“The year one priorities provide a strong base for us to continue the detailed work that has been undertaken in recent years and the outcomes framework will help us measure our progress.
“Understanding the determinants of suicide is vital to our work and will continue to help shape the critical focus on inequalities, particularly the impact of poverty, because we know that you are 2.6 times more likely to die by suicide if you live in the most deprived areas, than the least.
“Everyday we should remind ourselves that talking about suicide saves lives. People often worry about bringing the subject up, about saying the word suicide, but we know that talking about suicide is an important way that we can ensure that no death is inevitable. ”
SteveMcHughis part of Suicide Prevention Scotland’s Lived Experience Panel. His son died by suicide in 2016. He said: “No one underestimates the complexity or the size of the challenge that we face, and we all understand that a lot of the work we are doing in Suicide Prevention Scotland is building institutional strength, capacity and awareness that will drive these numbers down over the longer term.
“It is totally regretful that we’ve seen a short term increase from 2021 to 2022, but we believe we are working extremely hard on the right things. That being said, we have to try and move quicker from the ideas into implementation in our communities.
“We were all very fearful that lockdown was going to have a spike impact on suicide rates, and that didn’t happen, but we are aware that lockdown has had a long-term impact on the population’s mental health and there are going to be further challenges ahead.”
NadineDougall, Professor of Mental Health & Data Science at Edinburgh Napier University and a member of the Suicide Prevention Scotland Academic Advisory Group comments: “Every death by suicide has devastating consequences on families, friends, and communities. The deaths by suicide registered in 2022 showed a 1% increase on the previous year, although they were also slightly below the previous five year average.
“The 2022 data also reveals that stark inequalities remain between our most and least deprived communities, with 2.6 times as many deaths registered in our most deprived areas.
“Although we have seen a slight improvement in this inequality comparing previous five year averages, it is still clear that as well as bringing down numbers of deaths by suicide, we must tackle the wider inequalities that contribute to suicide.”
If you or someone you know is struggling with their mental health or feeling suicidal, please don’t hesitate to ask for help by contacting your GP, NHS24 on 111, Samaritans on 116 123 or Breathing Space on 0800 83 58 87.
The impact of poor housing will be explored in the inquiry into how to prevent ill-health. In tomorrow’s second session focusing on ‘healthy places’, MPs will question experts on the relationship between housing and health with questions expected to cover the costs of poor housing to the NHS, the quality of rental properties, indoor ventilation and noise pollution.
The inquiry is seeking evidence on how housing can be designed to improve people’s health.
The session is also likely to consider the extent to which UK Government plans to create more homes through housebuilding or the transformation of non-residential buildings will help to deliver healthy homes.
The role of ‘healthy places’ is the second theme to be explored by the Health and Social Care Committee in its major inquiry into how to prevent ill-health.
There have been reports in the media that some buildings in the NHS Estate across Scotland may have been constructed using Reinforced Autoclaved Aerated Concrete (RAAC). This material, which was widely in use between 1960 and 1980, was used mainly for components such as roof and floor planks. It is known to be weaker than other forms of concrete and its use was phased out in the 1990’s.
Work is underway at a national level to check and risk assess all NHS buildings which may potentially contain RAAC.
As part of that work, NHS Lothian has identified those candidate buildings in our Estate and supplied the information to NHS Scotland Assure. We have identified the following buildings as requiring investigation:
• Bonnyrigg Health Centre
• Lauriston Building
• Princess Alexandra Eye Pavilion
• Royal Edinburgh Hospital – Cullen/River Centre Extension
• Royal Edinburgh Hospital – Link Corridor/X-Ray
• Stoneyburn Health Centre
• Tranent Medical Practice
• Western General Hospital – Gas Store
It is worth noting that the risk assessment that took place by NHS Scotland Assure was based on a desktop exercise and does not confirm the presence of RAAC within our buildings.
The next stage of the process will be for discovery surveys to be undertaken by an independent contractor appointed by NHS Assure to confirm or rule out the presence of RAAC within our buildings. This is a national process and the surveys are scheduled to be carried out in Lothian in the Autumn.
The output of these surveys will provide further information on any recommended remedial actions. This work is precautionary and not the result of any known issues in any of our buildings.
Come, along for a blether, laugh, cuppa, or a good greet! M Club provides a safe space to do all and to get the support you need when experiencing pre, peri, or even post-menopausal symptoms. Learn how to cope and explore new solutions.
We also have our very own Jules coming to offer taster sessions of Seasonal Yoga
People and businesses are invited to share their views on how to make non-surgical cosmetic procedures safer as thousands complain of ‘botched’ procedures
UK Government to seek views on how to make non-surgical cosmetic procedures safer for consumers
Calls for views from industry and people who have undergone these procedures will be used to shape regulations
Proposals considered include restrictions on who can perform certain high-risk procedures and age limits for those undergoing cosmetic procedures
People and businesses are being invited to share their views on how to make non-surgical cosmetic procedures – including Botox, laser hair removal and dermal fillers – safer as thousands complain of ‘botched’ procedures.
The UK Government’s first-ever consultation on treatments – also known as aesthetic procedures – will be used to shape a new licensing scheme for practitioners and cosmetic businesses which operate in England. This could include age limits and restrictions for high-risk procedures, including those involving injecting fillers into intimate parts of the body – including the breasts and buttocks.
Any new licensing scheme would protect patients from potential harm associated with poorly performed procedures. This will provide reassurance to people that wherever they go to get their treatments, they will receive the same high standards of practice.
The beauty industry is hugely important for the UK economy and is largely made up of female-owned small and medium sized businesses, with the non-surgical cosmetic industry previously being valued at an estimated £3.6 billion in the UK.
New regulations will support businesses by introducing high standards across the sector, raising the reputation and professionalism of the industry.
Minister for the Women’s Health Strategy, Maria Caulfield said: “Whether it’s Botox, dermal fillers or even a chemical peel, we have heard too many stories of people who’ve had bad experiences from getting a cosmetic procedure from someone who is inexperienced or underqualified.
“There’s no doubt that the popularity of cosmetic procedures is increasing, so it’s our role to ensure consistent standards for consumers and a level playing field for businesses and practitioners.
“We want to make sure we get this right for everyone, which is why we want to hear your opinions and experiences through our new consultation.”
An estimated 900,000 Botox injections are carried out in the UK each year. Save Face – a government approved register of accredited practitioners – received almost 3,000 complaints in 2022, with over two-thirds of those complaints relating to dermal fillers and almost a quarter relating to Botox.
Ashton Collins, director, Save Face said: “Whilst we appreciate that we are still at very early stages of any potential licensing scheme being implemented in England, we are delighted to have been invited by the government to contribute our thoughts and ideas ahead of the release of this public consultation.
“Being involved in the process has enabled Save Face to actively contribute to roundtable discussions with ministers, policy makers and key stakeholders.
“As the largest and longest established Professional Standards Authority accredited register, we are able to provide a unique level of insight based on ten years of gathering data from practitioner and clinic audits as well as patient reported complaints, adverse reactions, and complications.
“This will enable us to help develop a fit for purpose scheme that has public safety as its primary focus. We look forward to continuing to work closely with the government and key stakeholders during the next stages of the process.”
Professor David Sines CBE, Chair of the Joint Council for Cosmetic Practitioners, said: “I warmly welcome the government’s decision to consult on this new, proposed licensing scheme.
“It will help to ensure that people who undergo non-surgical cosmetic procedures receive treatment from practitioners who are properly trained and qualified, have the necessary insurance cover and operate from premises that are safe and hygienic.
“I would urge everybody to seize the opportunity provided by this consultation and support the move towards sensible and proportionate regulation in this important sector.”
Victoria Brownlie, Chief Policy Officer at the British Beauty Council: “Since its inception, the British Beauty Council has been working to raise the reputation of the beauty industry and we see greater checks and balances around aesthetic procedures as a key part of this.
“Having worked with the government to achieve the ban on injectables for under 18s in 2021, we are delighted that they have continued this momentum with the commitment to introduce a licensing scheme covering a raft of higher-risk aesthetic treatments, many of which are largely unregulated.
“Those seeking treatments deserve to do so with confidence that their practitioner is properly qualified in the service they’re offering, to the appropriate level of government approved educational standards.
“The Council has worked closely with the Department of Health and Social Care to get to this point, so we look forward to seeing the outcome of the consultation and helping to shape the regulatory framework as it progresses.”
The consultation will run for 8 weeks and will close on Saturday 28 October.
It follows the passing of the Health and Care Act in April 2022, which gave the Health and Social Care Secretary the power to introduce a licensing regime.
Under the proposed scheme, which will be operated by local authorities in England, practitioners will need to be licensed to perform specific procedures, and the premises from which they operate will also need to be licensed.
The government has already made it illegal for under-18s to access Botox and filler treatments for cosmetic purposes and banned TV and social media adverts targeting under-18s with cosmetic procedures.
Anyone considering a cosmetic procedure should reflect fully on the possible impact of the procedure on both their physical and mental health and, if they decide to go ahead, take the time to find a reputable, insured and qualified practitioner.
