Right into action na Leo nikona MC Mwenyewe, he is an artist, he is an entertainer, na bede, siyete mianza juzi, mianza kitambo, so I bet he has a lot in store for us. So this is the interview segment and I want to introduce the MC Mwenyewe, MC Ruel. Yo, what's up people, it's MC Ruel here. Representing hip-hop music, representing Onguaro Yondo Hood, what's up? Hey, what's good, what's popping? So, miyamge, mzik yu liyamzi shawin, liyamza wendrala? Okay, misiyalia siyete, nikiwa 3 nili kwa na niya na mbopa church, suji na na niniwa api, but nili kwa na nandika rhymes and stuff, but sii kwa ikwa serious? Buona. Ibuto ni time, time, time ekwa me fika. Na humwa. So, ya, kitukayo. So, time ble li fika nilianza, nilianza seriously 2017.  So, 2017. Okay, so 2017 was a political year for Kenya, everybody was trying to build their political career and do you here working on your music? How has it been, you know, from 2017 to now 2018, what's the growth like? Okay, first of all, I don't want it to sound like I don't care about, I don't care about politics. If you don't care, you don't care, bruh. So, I don't really care about politics, I'm about what's mine.  So, I've been through ups and downs like always.  So, sayuzi, I guess niko nisha after Z, niko faiza alfabet zingine kakuna past Z. So, sayuzi niko, niko pointi nini, I'm confident about my music, ya. Tell me, for an upcoming musician who wants to get into the music industry, umemenshon confidence niki tu ya mohimo, but kuna vilam sayu fi kapa mic and a speech rhymes, but zero confidence. What importance does confidence bring to the music industry? First of all, you can't have confidence. If you have confidence, you have confidence.  After I've written something down, after I've made music, that's when I get my confidence. My confidence comes from my music. Not the fact that if you're doing something, you have to be confident about it, even if it's good or bad. So, I get my confidence from my music and if you don't have confidence, if I didn't have confidence, I wouldn't be here in the first place. So, confidence is the most important thing. If you have confidence, there's nothing you can do. True that. Okay, so tell us about your albums. Umetua albums in Delhi so far. So, ya kwanza isha drum, but you're working on the other one. What's the first one like? Okay, the first one is that's... I'm the first born. I'm the first born one. So, I'm going to go into a bread of love. I'm going to check in, yu jinai nye rini, bread of love, like, hey, bread of love, na jwa. And I look up bread of love because I take myself as, jesus needs a bread of life. That means bread of love. So, na believe, na bring a lot of impact kwa hip-hop. Arakaa, arakaa, mini-upcoming, arakaa mini-artist, by the time was when I jwa, arakanga like, arakanga like, hey, bona, bona, the way I found the song and I feel it. So, um, Alba Mia Fast, Alba Mia Fast, that one is important to me and I know, I'm flexing. I know that everything is so great. and I'm flexing is my first song, I know that I was flexing was the first song for me. I'm flexing and You know what I should do? what inspired the track? The other song I did not say. Red of Rap was inspired by The fact that Jesus is the bread of life. That is the album. That is what it is. Okay, but kwa na umgoma bread of wrap, probablera play later. So, I'm flexing in goma kwanza kwa album ya bread of wrap. So, I'm flexing. I'm flexing ni kwa flex, oniza flex na anything. Na oniza kwa umedunga fiti end, ona flex, ona checki. Oniza kwa sila miko gym, amiko kitu yote, oniza flex na anything basically. So, I'm flexing ni, ni kitu easy ni cool. And bread of wrap i li kwa, i li kwa kitu easy kitu any. I'm flexing i li kwa kitu easy kitu any. Anyone muto ya ni gwa ima umflexing. Mma, I've been done is ima umflexing. Msi mimi ya kwa job an is ima umflexing. Uhuru an is ima umflexing. Na checki. Tukai yo. Kili am chana is ima umflexing. Kili am say, i li kwa about ibo bamba kili am say, ona. Mibu ni niza ni mention ya, laimoja kali kwa umflexing. Iki drop to, I mean you're the owner of the song but Iki drop to nuko place kwa manatru something, ema kwa baku. You scare that lady and you're like, you know, that's the omaze, that's MC Rewell omaze. Ani lega ni ina kwa. Una kwa nangofil kwa kwa yoso. See, I just want a specific line. Just kwa kwa wanba or something. Umflexing. Like, I'm flexing. Nkwa man kwa first years but see my best work. So kwa yo albam zima, kwa yo albam zima Nkwa nangomazing. Ani kali umflexing ni video tu. You want me to bring up. But ni kwa na, ni sukiyenda kwa lines, tukiyenda kwa, tukiyenda kwa go, like tukiyenda kwa go, like tuki kwa intricate na, na sonye nyeri. Umflexing, umflexing ni kuli, aki akuna, akuna, like sezi sema, sezi take away something. Ani sema iti indo, indo ili kama, indo ili kwa, the best thing. So niza sema, the whole of this song. Sama, so you're a Kenyan artist. Born and bred in Pongwaru. But sisa na tako toa mbe, in the music scene, whatever is happening, we have ethic, we have this new genre coming up. Who would you like to work with in the near future? Amma, you know. Umflexing ni nyeri, to create that path. Anyone who appreciates my music, anyone who sees my potential, I'm free to work with anyone. As long as whatever we'll be working on, it's going to be dope. I'm open to any kind of idea, any kind of genre. As long as it's going to be dope, that's my stance. As long as it's dope at the end.  So this is so random. Unona je kuhusu mafemsi wakenya. Mafemsi? By the way, mafemsi wako wako 50 inch. Achenu kufani kwe femsi, ache kwe msi, kusiku wana yo storya, female rapa, rapa ni rapa, unona hand. Kuna, kuna, kuna, kuna artist flani, mwanya, tukosa post, kudu something. So, tukona goma flani, iko, iko, in the kitchen, female, ya. And, I need a silver stone buzz. So, like, we ondo femsi mwanya, we ondo rapa mwanya, unona. Unona tamboa? Ya, unona tamboa. We ondo unona, like, ako hard, unona ako real. Ya. Okay, so, but wengine pia, when it's dimension. Wagani aw? When it's dimension, when it's CG. As long as, when it, when it rapa, um, iko, as long as wana joakit wana do, ita fika point flani enye, wasi watashinda kukudu no, ita uta kuwa apo, wana kami bling me kama apai. So, as long as wana, wana trust, wana do, keep going on. Keep going on. Ya, saizimi sikilam siyana nijua, but, I'm here, unona. So, miyupo tu. I like that.  Okay, so, acha ni turudi topic moja enye wasewame, kinogu miyenda chinia maji, play kenya music. Ever since we had that discussion, unona kakuna kitu me change, as a young upcoming artist. I guess, unona wasewame, kwenvood ma presenter, kani ni ma DJ, unona wene, wana hi fanyafori, but, unona wene bado, like, ukuchuwa presenter wene, ukuchuwa styleb vlani wene ni presenter, juli kana kila place, saki kama pasaisi, ataji fanyafene, play kenya music, ni DM ni text ni email, whatever, kusaba kwa kwa kibiyu na checki, ataki kwa ni kana like, kwa support kenya music, oku DM room say, as it is fun, unona. So, kuna asenge, ni me chai kwa, kwa DM, kwa text, kwa call, but, bado, yo, play kenya music, I guess, ni up to someone, no matter how loud, to make you know, it's here, play kenya music, ita kwa up to, kuiu presenter kwa ma like, ah, kachani play kenya music, unona, because, bado, bado, ni no offence to music, kwa asenge ni, bado, tu na skiza, kwa maza asenge ni, kwa radio, bado, ati jefkeo level, flania, kenya music is being played, on air, kila mahali, unona. So, but, tu na, keep pushing to, tafika point, flania ni, watashinu wapu, kwa saku play kenya music, unona. It's up to, ask kama, ask it, and it's up to you, kama, asenge kwa media, unona. But you see, if you don't reach out, we won't get to you, but tapasi, way to faithful, we do our best to get you, I mean to give you guys a platform, like, sit me, prioritize on kenya music, kama JJ. Sure. Rajes, ukuna asu, alimi hote ungependaku, joa kutoka, MC Rewel. Mages, amine jibu yo, kolabo. Pekei. Man of few words. Well, asha. Muli zaki tumoja maumu incarriage, wadu incarriagement? Yoloist point in your career? Loist point? Yeah. Loist point in it. Kukuna video, kuspend, kudu, kudu, what you have to do, adiuna fukapuntu kuna video, na video ni kaling hd, kilakitu, but badu, ujastika yo point, kilani inye, unataka. Yandomili loist point. Kukuna album, kukuna video, but badu, sija, sija, sija blow up, blingataka. Okay, but despite the challenges, what is motivating you to keep going, to keep pushing, adi... Like I said, my context, like there's so many times I've woken up and I'm like, lewisiski, lewisiski kukurab, na na, lewisiski kwandikainu. But, na kumbuka, jana, milikoivo, end, shite na milikamap na, jana, wajimifanayo nika kuwa like! Wa, wa, wa. Siizika wana na liyam, sisi julion tan dipii, siizika wana nii. Ika, siizika wana dika, Whitini kiya meti asubil, kusralazmanina dike, nezakwa za kupawa na iika, kiza kupa wana nii kava. But, elekteminii, meo ani dekia, lezmanina nii ki tu, lezma ii kutitu ke格i. Senya creative juices mii flow. Okay, all right. So, mi na yasakoto angushi, track moja, kandi, sama, yta kuwa nii gani. Amflexin sa polydim me shiastki. Kuwa albAPPLAUSE. Kus Zentapoua roba. Bow down. Bow down. Play Bow down. Takah tu play Bow down. Miibineza, andi shatraki yasi, give as a few rhymes. And then I will join you... if I am for the vibe. Let's go. Sh eta. Okay, so I will let you try. Okay. Check this. I'm a hunter. I drop in your site and make you spook.  You say I'm hot because I can't. Sayze kasi. My friend, my sister is watching. Hip up, hip up, hip up.  Hip up me hard in nature. So, okay, jut kwa live, jut kwa live, tabirini meji, meji finili. Umeji toa. All right, rajiz, you will drop the truck or what? Yeah. Let's drop it.


The first item of business this afternoon is portfolio questions, and the first portfolio is constitution, external affairs and culture. As ever, I would make a plea for succinct questions and answers to allow as many members as possible to have their chance. Question number one, Mark Griffin not lodged. Question number two, Gillian Mackay. I apologise, Presiding Officer. My question has just disappeared off my screen. To ask the Scottish Government whether the UK Government has communicated any intention to provide exemptions to the United Kingdom Internal Market Act 2020 in relation to legislation passed by the Scottish Parliament. Cabinet Secretary, Angus Robertson. Presiding Officer, the Internal Market Act radically undermines the devolution settlement in Scotland and was imposed on this Parliament without its consent. We can see the outcome most clearly with the deposit return scheme. Laws passed in this Parliament are now threatened by the act, placing the whole scheme at risk, including significant industry investment. Regrettably, the UK Government has yet to reach a decision on excluding Scotland's deposit return scheme from the Internal Market Act. We have been engaging with the UK Government on this issue for nearly two years now. UK ministers themselves have acknowledged that we have followed the agreed exclusions process. We cannot wait any longer in providing businesses the clarity that they urgently need. We need a positive decision from the UK Government, and we need it now. Gillian Mackay. I thank the cabinet secretary for that answer. I have previously welcomed the creation of 140 new jobs in Motherwell as part of DRS, just some of the hundreds of jobs that are created across Scotland as part of the scheme. However, those jobs are now at risk because the UK Government is deliberately delaying over the IMA exclusion. There are many other issues that are being considered that may need an IMA exclusion, including a potential ban on disposable vapes. The common frameworks are meant to provide a forum for timely and collaborative decision making, but does the cabinet secretary agree that the DRS experience has shown them to be ineffective and could potentially put at risk some of the public health and environmental measures that we are trying to take? I agree with the member. The Scottish Government warned that the Internal Market Act would undermine devolution and that it would create confusion and uncertainty for businesses. Sadly, we have been proven right, as the example from the member's region shows. Brexit has been used as a pretext for eroding devolution and the powers of the Scottish Parliament, but common frameworks offer one of the few options available to us for engagement on mitigating some of the effects of the Brexit that Scotland did not vote for. The Scottish Government has spent a great deal of time trying to make common frameworks work, as intended, so the UK Government has now shown a similar commitment to take full account of the work undertaken collaboratively through the common framework and agreed to an internal market act exclusion and lift the threat of the act from Scotland's deposit return scheme. Does the cabinet secretary believe that the tensions arising from the UK Internal Market Act demonstrates that, under Westminster's control, Scotland's devolution settlement can be undermined at the whim of the UK Government, particularly by any hypothetical Scottish secretary who might harbour any scarcely concealed desire to act like a Government, a Governor General? As I have noted before, a Brexit that Scotland did not vote for is being used to roll back the powers of a Parliament that Scotland did vote for. The Internal Market Act imposed on this Parliament without its consent is the result. Despite that, we have acted in good faith to mitigate the act's worst effects, engaging through common frameworks to that end. That is what we are doing in respect of Scotland's deposit return scheme. We need the UK Government to finally recognise the evidence gathered through the common framework, agree to an exclusion and remove the threat that the act poses to the scheme. UK ministers have acknowledged that the Scottish Government has followed the agreed procedure. The fact that we are still waiting for a decision shows the vulnerability of the devolution settlement and the ability of the Scottish Parliament to use its powers to benefit the people of this country. To ask the Scottish Government whether it is considering replacing any retained EU law. The UK Government's retained EU law bill is still reckless legislation despite the sensible change removing the automatic sunset of retained EU law at the end of this year. Vital protections remain at risk and UK ministers can still act in devolved areas without a requirement for consent from Scottish ministers or indeed from this Parliament. This is unacceptable and why we continue to call for the bill to be withdrawn. We do not have plans to use powers in the bill to alter existing policy but continue to assess this as part of an on-going work, including to prevent laws from being lost. I thank the cabinet secretary for that answer. The cabinet secretary said in his statement of the 9th of May that the loss of Erasmus was the loss of opportunity for young people and we know it also has a loss to the economy. So whilst young people in England and Wales are accessing a replacement Turing or Tath scheme, young people in Scotland are still waiting, despite the SNP committing to a replacement in the 2021 manifesto. Does the cabinet secretary accept that this is yet another broken promise from the SNP to Scotland's young people? I am sure that the Presiding Officer would not wish me to answer questions. I appreciate the question seem to be a bit wide but if there is anything else that the cabinet secretary would wish to add perhaps as regards matters within his ministerial responsibility, he could always do so? Indeed. The question that was put was relating to retained EU law and the question of either the Erasmus scheme or Turing does not fall within the ambit of retained EU law. We are going to continue to work with partners, including members of the House of Lords, to do everything that we can to mitigate the disaster that the retained EU law bill still poses. We do not know the final outcome of that legislative process. Of the wider questions that Pam Duncan-Glancy has asked, I am always happy to answer questions at the appropriate stage about how we can maximise our educational co-operation between Scotland and the European Union. Question number four is not large. Question number five, Ruth Maguire. To ask the Scottish Government how it is supporting culture and the arts in Cunningham South constituency. Our culture strategy sets out our ambitions for nurturing culture and creativity across all of Scotland's communities. We support a range of initiatives and organisations in the Cunningham South constituency, including the culture collective programme, the youth music initiative and the Scottish Maritime Museum. For example, the traditional arts and culture Scotland is supported through the culture collective and is delivered by Creative Scotland. They bring together artists and people in local communities. In one area, focus is kill winning in North Ayrshire. Tracks have received £345,000 in total to support projects across nine communities. Ruth Maguire. I thank the cabinet secretary for that answer. There are many barriers that prevent our citizens, particularly families, on lower incomes from accessing art and culture, whether that is lack of expendable time, distance from events or festivals or affordability. How can the Scottish Government ensure that public money invested in arts and culture is to the benefit of all, whether that is those attending or indeed performers and artists creating outwith the main cities? Ruth Maguire raises an excellent point and one that is central to the work that we are doing. Our major cultural programmes actively work to break down those sort of barriers. Our youth music initiative, which recently celebrated its 20th anniversary, operates across the country in rural and urban areas. It aims to tackle inequality to engage young people who would not otherwise be able to participate in meaningful and high-quality music-making opportunities. Our culture collective programme, funded by over £10 million to date, has provided free, engaging community-focused activity again across the length and breadth of the country. Over the past two years, it has focused on access and participation. Later this year, we will publish our culture strategy action plan refresh, which will provide much more detail about our ambitions in this space. To ask the Scottish Government whether it will provide an update on how it is supporting the arts sector. I understand that this is an incredibly worrying time for the culture sector. The Scottish Government continues to provide significant support to the culture sector. That includes funding to Creative Scotland, totaling £35 million for the regularly funded organisations, more than £9 million for youth projects, more than £2 million for festivals. The Scottish Government is committed to maintaining the £22.496 million of funding for the five national performing companies, £3 million for the V&A in Dundee, and the Scottish Government is providing an additional £2.1 million to support increased costs in the national collections, reflecting the high fixed costs that those organisations have. The arts sector plays a crucial role in promoting cultural expression, creativity and bringing people together in communities. In their 2021 manifesto, the SNP pledged to create a new £2 million fund for public artwork. Seven months ago, I asked when that would happen but no information was provided. Can the cabinet secretary give us more detail on what the pledge actually means and also when that commitment will be made? I have just given Sharon Dowie an overview of the level of financial commitment right across the arts and culture piece. She has a very specific question. I will be happy to write back to her to update her about progress in that area. I hope that she can be assured that the Scottish Government is committed to supporting arts and culture right across Scotland, and that includes the area that she has highlighted in questions this afternoon. I have several members seeking to ask a supplementary question. I would intend to take each member who has pressed. First of all, I would like to have a supplementary question from Audrey Nicholl. With the summer festivals season approaching, Scotland's cities agree gearing up for a very busy and vibrant few months, kicking off with the fantastic new art Aberdeen festival of street art, which begins on 8 June. What role does the cabinet secretary see culture and the arts playing in Scotland's on-going pandemic recovery? I agree that culture can play an important role in the recovery from the pandemic, and we know that participation in cultural and creative activities supports our well-being, not only at an individual level, but also across our communities and for the country as a whole. That is why I am pleased to confirm the on-going support for the culture sector. In the last year, Creative Scotland has provided £7.73 million in funding to festivals across the whole of Scotland through their regularly funded organisations, and also their open fund. In addition, Edinburgh and Glasgow festivals have received £3 million from the expo and place funds. Another important aspect of our cultural life is obviously our built heritage, and I was delighted to be able to confirm this morning together with Historic Environment Scotland the silver city heritage and place programme with the Aberdeen City Council, which I think will bring great benefits, particularly in the regeneration of the east side of Union Street, which is high levels of vacancy. I think that will make a huge difference to people in Aberdeen as well. The Covid-19 pandemic has hit the culture and arts sector hard. Cherished and well-respected arts venues such as the film house here in Edinburgh have been forced to close. Other venues such as Litt Theatre are in this repair due to lack of support and funding. Can the cabinet secretary tell us what funding can be allocated to those struggling venues to avoid Scotland's valued arts venue closing for good? I am sure that I am getting difficult with the Presiding Officer if I were to repeat the statistics that I read out at the beginning of this interchange with colleagues in the chamber. The Scottish Government has multi-million-pound commitments to the arts and culture sector, and I think that that is hugely important. I think that there is agreement across the chamber that that is worthwhile. Faisel Chindry however does hit the nail on the head when he highlights that there are significant challenges to cultural institutions, particularly venues, yes here, elsewhere in the UK and internationally as well. It is a challenge for all of us, for the artistic organisations in question, the venue management, our arms-length organisation Creative Scotland that is responsible for working directly with those arts organisations and a Scottish Government that wants to ensure that we can protect as many of our venues as possible. I can assure him and other members that we are looking extremely closely at everything that we can do to make sure that the arts and culture infrastructure, including institutions that he has mentioned, are able to continue and thrive into the future. I remain seized of that. I know that he will be too. With high costs of travel and fewer accommodation options, islands in rural Scotland are expensive places for artists to visit and perform. Post-pandemic, there has been a loss of creative outlets and funding options have reduced, so how best can the Scottish Government work with local communities to ensure that rural and island areas can continue to attract artists' productions and events to their areas? As an introduction to my answer to Beatrice Wishart, I am sure that she would recognise that we are fortunate that Creative Scotland regularly funds funded organisations right across Scotland, including our island communities. That is hugely worthwhile. It is also important to stress that Creative Scotland's grant priorities are aimed at supporting culture and arts throughout Scotland. I know that there is a lot of active thinking going on in Creative Scotland about how it can give maximum financial assurance to the creative and art sector over a multi-annual basis, so one is able to plan, including touring and performing in different parts of the country. Whether that is people going to Shetland or people from Shetland wanting to perform elsewhere in Scotland, I agree with her that that is hugely important. I am sure that Creative Scotland will be listening closely to the points that she makes, and I will be happy to underline that when I meet them next. To ask the Scottish Government what plans it has to review its prospectus for an independent Scotland in light of reported divisions within the independence movement. I set out in the First Minister's recent policy prospectus equality opportunity community new leadership of fresh start. The people of Scotland will be given the information that they need to make an informed choice about whether Scotland should become an independent country. This Government will build the case for a thriving, socially just, independent Scotland. I thank the minister for that answer. Many people across the UK at the moment are looking at their power bills or household bills. We will be looking at the problems that are facing the UK. Many people in Scotland will be considering and concluding that an independent Scotland is more important than ever. With that in mind, a cohesive, vibrant, creative, cross-party wider movement is important in that way. It is important for designing a successful campaign. It is important for presenting that united front and then going on to win majority public support. Would the minister agree with me that establishing an independence convention is not only imperative right now, it is also urgent? Let me agree with the point that the member makes in respect of the urgency of the requirement for Scotland to become an independent country. My task, of course, is to make the Government's case through the series of prospective papers that we will lay out. There are three already published. There will be more to come. That is the activity that I will undertake. That will be laid out before the people. That will be a key part of making the case to the wider public. When I take the temperature of the independence movement at this moment on time, I see a real sense of unity of purpose and determination to work collaboratively towards that, and I intend to play my part in that regard. I have a number of supplementaries. First, Donald Cameron. I take the opportunity to warmly welcome the minister for independence to his new post. I know that he will work very hard on a subject that is clearly not a priority for the Scottish people right now. It is obvious from recent weeks that divisions in the independence movement have been trumped by divisions in the SNP. We have been treated to an internal melodrama of backbench rebellions and infighting. I ask him this. On that note, the minister's colleague Joanna Cherry recently described the Scottish Government's independence papers as lightweight. Does he agree with her? Minister. Let me thank Mr Cameron for his overdue warm welcome, certainly warmer than I have heard thus far. I have to say, it is an interesting perspective to say that we have no case or ability to make the case for independence. Of course, this Government was elected on the platform of advancing that particular case. We have, I believe, published three compelling perspective papers, and I can tell him and tend to publish many more in the coming months. Can I ask the minister for independence what budget he has and how many civil servants are working directly to him? Of course, that question has been put to me in the written form by a number of members. In respect of my own part, there is only one civil servant working directly to me. That is my private secretary. Of course, right across the entirety of Government's incumbent on civil servants to respond to the Government's priorities and independence is one of them. In that regard, the civil service is working towards our agenda. We should be grateful to Ash Regan for genuinely and honestly referring to the divisions in the independence movement, but she has also been incredibly creative with her most interesting suggestion about bringing her strange friends in from the cold. Will the minister for independence be seeking the advice from the former First Minister, Alex Salmond, when crafting his new prospectus? I will be working with dedicated civil servants to craft the prospectus papers. The minister will agree with me that one of the many strengths of the 2014 campaign was a wide range of organisations that were part of the yes movement at that time and continued to be. Can you ask what the Scottish Government is doing to engage with organisations in the wider yes movement and development of those prospectuses? I am in regular contact with a range of organisations. I will be happy to engage with any organisation with an interest in the future of Scotland, whether or not they support independence or otherwise, because at the end of the day, the future of this country is everybody's business. Thank you very much, Presiding Officer, to ask the Scottish Government what discussions it has had with the UK Foreign, Commonwealth and Development Office regarding the reported communique to UK ambassadors and diplomats and their involvement in the Scottish Government's international engagements. I have written to the foreign secretary to ask him to withdraw his guidance, which will damage Scotland's interests and undermine devolution. More than two weeks later, I have yet to receive a reply that says everything about the disrespect shown by the UK Government thus far. Despite what those documents assert, there is nothing in the Scotland Act which precludes Scottish ministers from discussing any issue with other Governments or indeed international organisations. On that basis, I had a very successful visit to Vienna this week promoting Scotland's energy and promoting Scotland's space sectors, our commitment to human rights and the rule of law and our work to achieve net zero. As ever, I was grateful for the positive and the constructive support provided by the FCDO in capital, both from the embassy to Austria and the mission to the United Nations. Bill Kidd. Thank you very much for that. As the cabinet secretary intimates, condescending Westminster attitudes could cost real jobs and real investment, like that announced by the energy cabinet secretary Neil Gray on his recent visit to Japan of plans for a subsea cable factory in the Highlands, which will bring much-needed jobs to that region and across Scotland. Westminster is endangering direct foreign investment, which rose here in Scotland by 14 per cent last year compared to 1.8 per cent across the UK. Does the cabinet secretary agree with me that we should all get behind Scotland's business and economy rather than meekly accept the Westminster Government's blatant contempt for Scottish interests? I thank the member for raising a vitally important reason that ministers travel overseas, namely securing investment and jobs for people in Scotland. My cabinet colleague Neil Gray was in Japan last month with the announcement from Sumitomo demonstrating the strength of confidence that investors have in our vision for a net zero economy. We have a world-beating pipeline of offshore wind projects, and the visit demonstrated the important role played by Scotland's international network and the value of growing and developing relationships with our partners around the world. The Government will therefore continue to promote Scotland's interests and fight attempts to undermine devolution. Thank you, cabinet secretary. That concludes portfolio questions on constitution, external affairs and culture. There will be a very brief pause before we move on to the next portfolio questions to allow front-bench teams to change positions. Thank you members. The next portfolio questions is justice and home affairs. Again, I would make a plea for succinct questions and answers in order to be able to take as many members as possible. To ask the Scottish Government what discussions it has had with Police Scotland regarding any changes to the policing of protests. Cabinet Secretary, Angela Constance. I regularly meet the chief constable and his team. There have been no discussions regarding change to the policing of protests, while there have been recent significant changes to the legislation concerning public order policing in England and Wales. Those provisions do not extend to Scotland and we have no plans to make any changes to the policing of protests in Scotland. Scotland has a proud tradition of peaceful protest and the Scottish Government is committed to uphold the democratic right to peaceful public assembly. There was widespread anger at reports of heavy-handed policing of policeful protests at the coronation. The cabinet secretary's reassurance is over support for peaceful protests here in Scotland. He is especially welcome following the Disgraceful Public Order Act in England in Wales, which Labour now says it is keeping on the books if in government. Does the cabinet secretary agree with me that trashing the right to peaceful protest is yet another example of where Tory's lead, Labour, follows? The member makes a political point, which I am compelled to agree with. By contrast to the legislation that has passed in England, some have described as draconian, a piece of legislation that clamps down on our basic democratic right to protest and describes as an anti-protest law that can be used to stop the public from seeking to hold even placards in the street. By contrast, we and this Parliament will uphold people's right to peaceful protest while always ensuring that balance between rights and responsibilities. I am glad to hear that the justice secretary confirmed that there is no intention to go down the same route as the UK Government in this area, but, as Ariane Burgess pointed out, there were concerns arising out of the policing around the death of the late Queen. There were also concerns in relation to COP26 about the use of stop-and-search and more general surveillance. Does the cabinet secretary intend to have discussions with Police Scotland about data gathering that could give us a greater sense of confidence that the human rights-based approach to policing by Police Scotland is, in fact, being delivered in practice? Police Scotland is one of the most scrutinised public services in Scotland and has a very clear track record and commitment to upholding human rights and the position of Police Scotland in terms of policing protests is, of course, to engage, to explain, to encourage and to do all that before they ever reach an enforcement stage. Of course, I will discuss matters with Police Scotland as you would expect me to do on matters in and around data to explore what would be proportionate and what would be possible. 2. Brian Whittle Thank you, Deputy Presiding Officer, to ask the Scottish Government what concrete action it participates taking on the proposals outlined in relation to Michelle's law, which was discussed in the debate on Michelle's law campaign on 6 September 2018. Cabinet Secretary. Presiding Officer, the Scottish Government has already taken action in line with the Michelle's law campaign. We amended the parole board rules in March 2021 to make it clear that the board can take account of the safety and security of victims and families when deciding upon a prisoner's release. In addition, individuals registered with the victim notification service are advised when a prisoner is first being considered for temporary release and those that wish to can provide their views about that decision to the Scottish prison service. Victims can also make representations to the parole board for Scotland when someone is being considered for parole and, furthermore, the parole board can also already set exclusion zones as a condition of parole licence and parole licence conditions can include the requirement to be electronically monitored to stay away from a particular location or from named individuals, as well as monitoring that someone remains at a specified address at certain times.  The new justice bill does fail to introduce Michelle's law despite Humzaeus of previously promising action. I wonder if the cabinet secretary would agree with me that Michelle's law would give victims the reasons for a release decision in full and require their safety to be considered in every case. I very much appreciate the issues that Mr Whittle has raised in this regard and how different parts of the justice system can actually re-traumatise victims, but I hope that he would accept that a change to the parole board rules that are rooted in law is indeed a change in legislation. Of course, there is always more to do, we are currently in Parliament at stage 2 of bail and release where there are improvements. We hope to the victim support system and in the not too distant future we will of course be debating the victims witness and justice reform bill, so there will be ample opportunities for Mr Whittle and others to bring forward further improvements as required. I was very pleased to see victims at the heart of the recently introduced victims, witnesses and criminal justice reform bill. How will the cabinet secretary ensure that both victims and their families are supported to stay involved in the bill's passage through Parliament? The bill has indeed been shaped and developed through engagement and consultation with victims and witnesses who have had the courage and bravery to share their experiences. I have been clear that I will continue to engage with victims directly and through channels, such as the Victims Task Force, Victims Advisory Board and Rape Crisis Scotland's survivor reference group. I am sure that victims, witnesses and their families and advocates will also make their views known to Parliament as the bill progresses. To ask the Scottish Government what action it is taking to tackle youth anti-social behaviour. We support local agencies to reduce anti-social behaviour and are investing in prevention and early intervention. Local agencies are well placed to deal with these issues and have a wide range of powers to tackle anti-social behaviour, including where appropriate warnings and formal measures such as fixed penalty notices and anti-social behaviour orders. As part of our broader support for prevention, we are developing a new youth work strategy so that all of our young people reach their potential and between 23 to 26 are committing £20 million through the cash back programme to support over 33,000 young people in communities around Scotland. No one, not least the elderly, should have to put up with harassment or intimidation. Sometimes, however, due to the age of the apparent offenders, this ends up being a multi-agency issue, as she has mentioned. Sometimes there is a perception, including from some offenders themselves, that little can be done to challenge them. Can I ask what more the Scottish Government can do to help the police, social workers and schools to work together with children, particularly in the 12 to 16 age group? The member is very right to be concerned about the impact of anti-social behaviour on some of his most vulnerable constituents. However, I want to reassure him and others that something can indeed be done to address those issues, and indeed on a multi-agency basis. I am aware that there is a specific group that has been established in the Western Isles, involving key partners. I understand that local children's services have been developing plans to divert more young people in the area away from criminalisation and are preparing a bid for additional funding. I also know that there are four partners in phase six of cashback for communities, Ocean Youth Trust, Access to Industry and Youth Scotland and the Scottish Football Association, which are all focused on diverting young people at risk of participating in anti-social behaviour. Of course, enforcement measures are also available, including talking to parents, issuing those formal warnings, acceptable behaviour contracts and anti-social behaviour orders. They may also be considered for children over the age of 12. Retailers against Crime Scotland have told me about two Lanarkshire teenagers using free bus travel to inflict chaos in shops across the country, with a particularly horrific attack on Edinburgh leaving staff injured. Glasgow's Chamber of Commerce previously raised concerns that free bus travel for under-22s is fuelling some anti-social behaviour, so shop workers are asking this very specific question. Will the cabinet secretary consider finding a way to remove free bus passes from the small number of those who abuse them? I am advised that transport colleagues will be undertaking a full review of the free entitlement, but it is important to acknowledge that it is a national entitlement to all young people for very good reasons. I think that we should always have a focus, perhaps less in the mode of transport, notwithstanding the work that is done across agencies to ensure the safety of people who work in public transport, as well as other citizens who are travelling on public transport. We really need to get to the root causes of those behaviours. Of course, there are a number of well-proven, well-evidence approaches to diverting young people from criminal activity and anti-social behaviour, as I have already alluded to. It is undoubtedly a fact that, in my constituency, there is an uptake in this sort of anti-social behaviour, ranging from simple egg-throwing through to the assault of security guards at fast food outlets, all of which are matters that I have had to deal with. I just wondered if the cabinet secretary could answer whether there are not any additional measures and consequences that are being looked at in response to that. While no-one wants to lock people away or throw away the key, there is a feeling, as Alistair Allan pointed out, that there is no consequence to many of those actions. Mr Johnson raises an important point. While the overall statistics for anti-social behaviour do not show an increase, we also have to be fully cognisant that, very often, that is an under-reported behaviour as well. The Government is undertaking work with the SCCN to explore what the appetite is and what the benefits would be of revisiting some of our past more formalised approaches and whether there is a need to review that or not. If the member wishes to write to me, I will keep him fully informed of how we progress with that. So far, Glasgow City Council has unanimously agreed that lights in parks is the right thing to do to help with anti-social behaviour. However, many people are still afraid, and the council has said that it will take years to do that. Does the cabinet secretary think that lights in parks could help with that and what more can the Government do to help to move things along more quickly in Glasgow? I am always happy to engage with partners at a local level and indeed MSPs about what would assist in their local area. It is important to remember that what solution is best where is often best determined at a local level. From my perspective, it tends to be a range of solutions that need to be brought to the table, because some of those issues in terms of their causes and consequences are complex. Has the Scottish Government done any work to ascertain if there is any connection between anti-social behaviour and cuts in funding to youth services? The Government is continuing to invest in youth services. If I refer the member to my original answer to Dr Allan, I outlined the investment that has been made, particularly via the cashback for communities that will benefit 33,500 young people in Scotland. To ask the Scottish Government what work it has conducted to ascertain the public perception of the frequency of police patrols in their local area. Scotland continues to be a safe place to live with recorded crime at one of the lowest levels since 1974. Research shows that people in Scotland are significantly less likely to be a victim of crime than those living in England and Wales. The Scottish Crime and Justice Survey regularly has well-established questions asking respondents for their perceptions of safety in their local area and of local policing. In 2019-20, 65 per cent of respondents agreed that police in their local area could be relied on to be there when they need them. 73 per cent agreed that crime in their local area was either the same or lower compared to two years previously. The latest findings will be published in autumn 2023. The Scottish Crime and Justice Survey confirms that there has been a significant drop in the proportion of adults who were aware of police patrols in their area. In the year before Police Scotland was formed, 56 per cent of people said that they saw police regularly patrolling their area. That has now fallen to 37 per cent in 2019-20. A regular police presence reassures local communities and can often deter crime from being committed. What action will we put in place to reduce the current police Scotland's burden that they are under and boost the presence in our local communities? Policing continues to be a priority for this Government, and we have ensured that there have always been year-on-year increases to funding. I remind the member that 96 per cent of adults rated their neighbourhood as very or fairly good to live in and that 84 per cent of adults continue to trust the police. Of course, public perception and the presence of police is indeed important, but we also have to recognise that, given the nature of crime, it is changing under the stewardship of the chief constable that sometimes how we police to matters has to change with the times as well. I know that our police officers work very hard and do their utmost to respond quickly, efficiently and to have a very visible presence. The results of the Scottish Household Telephone Survey published last month showed that 84 per cent of respondents trusted the police, as the cabinet secretary just said, and that neighbourhood safety levels were also rated highly. With that in mind, what steps the Scottish Government has taken to ensure that neighbourhood safety remains a priority? As a central priority for this Government, we work for a society in which people feel and are safe in their communities. To that end, we will continue with our transformative policies, including those outlined in the vision for justice in Scotland and our programme for Government. In doing so, we will engage with a range of partners, including the emergency services, the wider community safety organisations that are referred to in the answer to Mr Johnston, organisations such as the Scottish Community Safety Network, Crime Stoppers and Neighbourhood Watch Scotland, as well as local community safety partnerships. To ask the Scottish Government how many front-line police officers have been trained to use and equipped with naloxone. The Scottish Government recognises the vital role emergency services play in providing and improving a response to drug overdoses to date. 10,300 officers have been trained and equipped with naloxone kits. As of today, Police Scotland has recorded 201 Administrations of Naloxone, which shows how crucial the intervention is in helping to tackle those preventable deaths. I want to thank each and every officer who has carried and administered life-saving naloxone. I thank the cabinet secretary for that answer. The roll-out to front-line police officers in naloxone began at last year's International Overdose Awareness Day and is an emergency first aid treatment for use and potentially life-threatening overdose situations. When does the cabinet secretary see the results of the use of naloxone on the figures for overdose deaths? Of course, there are many factors that contribute to reducing overdose deaths. Obviously, the national statistics are published every year in the summer months. However, in terms of the number of Administrations of 201 recorded incidents where police officers have administered naloxone, they have done that in a wide variety of circumstances and locations. On all but seven occasions, the individuals have survived their ordeal. On the occasions where the individual did not survive most were and circumstances where the officers suspected that the person was already deceased prior to the police arrival, but administered naloxone to give them the best possible chance of survival. Once again, I want to thank Police Scotland for its leadership in this area and its front-line officers for playing their part to save lives. To ask the Scottish Government how many fines have been issued by courts to companies for breach of health and safety rules resulting in workers' deaths in the last five years? In the period 2018-19 to 2022-23, information provided by the Crown Office indicates that 164 companies have been convicted and fined for criminal breaches of health and safety law. Information is not available relating to the number of specific health and safety cases where death has occurred. The health and safety executive found that Scotland has the highest rate of fatal injuries for deaths in the workplace of all UK nations. It is highly concerning that no cases have been prosecuted in Scotland under the Corporate Manslaughter and Homicide Act 2007, despite 164 companies being legally deemed responsible for workers' deaths. Whilst that law is reserved, will the Scottish Government review why those cases are not being brought as Corporate Manslaughter and how it can make this option more accessible for victims' loved ones? Of course, the member is correct that that is concerning. Health and safety legislation is reserved and the legislation that she refers to was UK legislation in 2007. While there is an argument progressed by some that the legislation acts as a deterrent because ensures that organisations are aware that they must meet the duty of care to employers and the public, the member and some of our other colleagues have narrated very effectively how the legislation in effect bypassed what was referred to as the transchool loophole as opposed to closing those loopholes. Of course, we will consider further what more we can do within our powers in this area. I recognise that the member and, indeed, Clare Baker have a long-standing issue in this area. The recent work of the SCC in the Scottish Hazards Group shows that we need to consider the best way to reform legislation to better allow medullant companies to be prosecuted. Enforcement of safe working environments is essential, too. It is a disgrace that the UK Government has cut the health and safety sector budget by 40 per cent. Does the cabinet secretary also agree with the Scottish Hazards Group that only full devolution of health and safety regulation allowing convergence with existing default powers will provide the necessary foundation of a health and safety system that protects workers and delivers justice for those impacted by health and safety failure? I very much agree with the member. Given the Parliament's powers over health and safety as something that the Smith commission considered but did not ultimately recommend, I am aware that the STU said that this failure was a missed opportunity to allow this Parliament to shape how workers can be better protected. I am sure that many members would agree with that statement, but the Parliament would be able to do more to protect workers if those powers sat here. To ask the Scottish Government what its response is to the Court of Sessions' ruling that a nail cap for sexual entertainment venues under provisions in the Air Weapons and Licensing Scotland Act 2015 is unlawful. The Scottish Government delivered new powers through the Air Weapons and Licensing Scotland Act 2015, enabling local authorities to set policy on sexual entertainment venues, taking into account views from stakeholders and the community. The judgment does not mean that a nail cap is unlawful. Instead, the judgment made clear that the council ought to be aware of the impact of setting a nail cap in their area. In response, the council has delayed the introduction of a licensing scheme until 31 December this year, and prior to that, it will carry out a statutory 12-week consultation to review its licensing policy on sexual entertainment venues. Can I thank the minister for that answer? When I previously raised the issue in the chamber, her predecessor was very supportive of that policy. Although there is now a consultation on going, what steps will the minister and the wider Scottish Government now take to make modifications to policy and, if need be, to legislation to ensure that our councils can lawfully implement nail caps if that is their democratic decision after they have carried out consultation? I am very supportive of local areas who carry out their local consultations and come to a view on what is in the best interest of their area. If Edinburgh council wishes to continue to pursue a policy of a nail cap and follow-up process, I will indeed be supportive of that. I do not think that the issue in this instance will be happy to discuss further. I do not think that the issue is in relation to our policy as a Government or our legislation, but my door is always open to the member and others on that matter. Through its equally safe strategy, the Government has long recognised that commercial sexual exploitation in all its forms is both a cause and a consequence of men's violence against women. Can I ask the cabinet secretary for an update on legislation to tackle male demand and end that violence? The member is quite right to make that connection and we have to ensure that our work in this area does indeed align with equally safe. The Scottish Government continues to make progress to deliver on the programme for government commitment to develop a framework that effectively tackles and changes men's demand for prostitution and to support those with experience of it. There are, of course, several aspects of this work, as I have said, in particular, around equally safe, that recognises that commercial sexual exploitation is a form of violence against women and girls and that there are a number of reforms and measures that have been developed to underpin this work and will keep the member informed as we take it forward. Thank you, cabinet secretary. That concludes portfolio questions on justice and home affairs and there will be a very short pause before we move on to the next item of business.


student in this module we are going to take overview of our course my dear students let me first congratulate that we have successfully completed this course we completed this quantitative research methodology course in this course you have read a lot of things I cannot discuss all these things one by one here but let's have a quick overview of the things we have studied in this course in this course we firstly talked about the ontology and epistemology of social research first we saw what social research is alternatives to social research i.e. one person can gain knowledge from other sources as compared to the social research after this we talked about ontology what are the ontologies of social research what is realism what is objectivism after this we discussed epistemology what is positivism what is empiricism we discussed this in detail after this we saw quantitative research process in this course we studied different research designs of quantitative research methodology in which we studied survey research experimental research some experimental research then we studied content analysis and at the end we studied mixed method as part of quantitative research methodology so we studied all these research designs in this course apart from this we talked about sampling procedure we talked about levels of measurement and we saw that measuring units scales, licker scale, gutman scale semantic differential scale and in sampling we discussed probability and non-probability after discussing all these things we learned data analysis techniques in this course that when you bring data how do we enter it in SPSS after entering it how do we edit it and after editing it how do we analyze it what is descriptive analysis and what is inferential analysis and then how do we make graphs so in descriptive analysis I taught you to take out frequency, percentage mean, standard deviation, skewness, torsisk and taught you to take out graphs after this in inferential analysis we studied parametric test, non-parametric test we studied correlation we studied chi-square, t-test we studied anova we studied gamma we studied grammar v and we studied regression i.e. simple linear regression and multiple linear regression and after this we talked about factor analysis the last element of this course it was a section it was a reporting the analysis we did we saw how they report according to the APF format how they make tables and how they write the text according to the APF format how the nomenclature of the text is followed in the APF format we saw that too this is a brief overview of our course I hope that when you see it and listen to the modules then you will be able to understand quantitative research methodology this will be very helpful apart from this if you are concerned or curious then you can mail me on my official email id you can contact me if you are concerned then you can ask me from there so I hope so that this course will be beneficial in the process of your learning I wish you all the best


Hello Columbia and welcome to This Week in the City. Highlights brought to you from the public relations, media and marketing department with the City of Columbia. I am your host, Lisha Yutzi. This week in the City we start on Tuesday, March 1st with a Chamber of Commerce forum with our new City Council members. On March 1st the Chamber of Commerce will host an issues featuring the new City Council members including Councilwoman Aditi Bussells, Councilwoman Tina Herbert and Councilman Joe Taylor. This open forum will be held from 8 a.m. until 9 a.m. at the Richland Library main branch located at 1421 Assembly Street. Registration in advance is online at columbiasc.gov. This event is free and open to the public. For any additional information please contact the Chamber of Commerce. Also on Tuesday, March 1st, Columbia City Council will hold their regular meeting beginning at 4 p.m. in the afternoon. The meeting will be held at City Hall on the 3rd floor and Council chambers. For agenda items please visit our website at columbiasc.gov. This meeting will be live streamed as well as it held in person. On Wednesday, March 2nd is International Rescue Cat Day. On Wednesday, March 2nd, Animal Services will host International Rescue Cat Day with our adoption special where you can get your furry friend for only $5 all day. Again that's Wednesday, March 2nd, all day long. Adoptions for cats will be $5 only. For additional information you may call Animal Services at 803-776-PETS or visit our website at columbiasc.gov for more information. Also on Wednesday, March 2nd, it's time for All Access Columbia hosted by the Community Development Department. The City of Columbia's Community Development Department will present All Access Columbia which is a training session and it will be held virtually. Let's talk code enforcement will be featuring David Hatcher. This workshop again will be held virtually on Wednesday, March 2nd from 3 p.m. until 4 p.m. In order to register for this virtual event please visit our website at columbiasc.gov. On Thursday, March 3rd, the Board of Zoning Appeals will meet at 4 p.m. at City Hall and Council Chambers. This meeting will be hybrid. It will be held both in person and also available to view via live stream at our website at columbiasc.gov. You can also find agenda items on the same website. That wraps up this edition of This Week in the City. Please continue to stay connected with us on our social media platforms on Facebook, Twitter and Instagram, and also on our website at columbiasc.gov. Of course, you can reach out to us at our telephone number<PHONE_NUMBER> or you may email us at pioatcolumbiasc.gov. And remember, we are columbia.


What is up guys? Karma Medic here and welcome back to another dose. In today's video I'm going to be talking about my last medical placement of my first year ever as a doctor which was in renal medicine and then renal transplant surgery. So by this point I had already done four months in geriatrics, four months in vascular surgery and now my last placement was split up into two two-month blocks which is quite rare for the foundation program but I'm happy that I got it because it effectively meant that I got two placements in one. So as you might imagine I'm going to split this video largely into two sections, one for renal medicine and one for renal transplant surgery. So for those of you who don't know, renal medicine means medicine of the kidneys and if you are a medical specialist in the kidneys then you are called a nephrologist which is named after the nephron, the single basic unit of the kidney which I'm sure you've probably studied at some point in biology class, I'll know later on years in university etc. Now my renal medicine placement was quite similar in big picture terms to my geriatrics placement which I have a whole video about that you can watch up over here so I'll go into a lot more detail about the renal transplant side of things but let's start off by talking about the team. So renal medicine was actually a huge team, we had two wards on the same floor next to each other that both had renal patients on them, one of the wards had a special bay for patients needing dialysis and the other one of the wards had special side rooms for patients who had received or were going to receive kidney transplants. Each of the wards had about 30 patients on them and then there were anywhere between 10 to 20 outliers in the rest of the hospital and so the number of staff needed to cover all those patients was quite large. We had a team for ward A, we had a team for ward B, we had a team for the medical outliers and we had a special team just for taking admissions for kidney patients coming in from A and E as well as the renal transplant surgery team. Each one of these teams having one consultant, one registrar and then several juniors. So when we'd have our handovers in the morning or our board rounds in the middle of the day we were typically about 15 doctors in the room on top of other staff like physiotherapists, occupational therapists etc. So what does renal medicine do? Renal medicine looks after patients who are having problems with their kidneys as you might expect. Largely speaking problems with the kidneys can be broken down into pre-renal, intra-renal and post-renal. So pre-renal meaning something before you reach the kidney that has affected the kidneys. This is typically something like hypovolemia or low blood pressure which means that you don't get enough blood perfusing the kidneys and it can cause injury. Intra-renal means that there's something in the actual kidney causing a problem. A lot of this can be reactions to drugs like interstitial nephritis, more auto immune diseases that can deposit all kinds of different things in the kidney causing problems. And then post-renal we would normally be talking about obstruction. So maybe you have a kidney stone that is preventing urine from properly leaving the ureters or you have a problem in the bladder that is causing back up or back flow of urine to go up the ureters to the kidneys causing hydronephrosis, anything like that. And then of course kidney problems can also largely be split into acute kidney injury or chronic kidney disease. As you might expect one of them has occurred in a relatively short period of time and the other one has been going on for longer. So let's talk about dialysis. Dialysis is something that I would see very very regularly on this placement every single day but it's something that I was very rarely involved in or made any decisions about. Dialysis is the process of filtering someone's blood outside of the body. So effectively doing the job off the kidneys in a patient where the kidneys are not working or not doing a good enough job of filtering the blood we do it using a machine outside of the body called a dialysis machine. In very broad terms you either do this using hemodialysis which is a machine that has a special membrane which can filter the blood outside of the body or you do peritoneal dialysis which is where you use a membrane inside the abdomen of the patient to act as that filter to help filter the blood. It also requires a machine to get the fluids pumping so that you can have that exchange of metabolites, toxins etc. Dialysis was pretty much completely managed by the consultants and the specialist dialysis nurses. Dialysis is an incredibly complicated topic an incredibly complicated process one that I certainly am not competent enough or don't know enough about to manage acutely and actively for a patient that's in front of me. What I can make decisions about is this patient needs dialysis they need off loading or they need filtering of their blood but I can't actually fiddle around and tinker with the machine in order to get it done. The reason for this is that it is so incredibly complicated there's all kinds of filtering speeds filtering pressures different dialysate or fluids that you can use depending on how much or how quickly you want to filter someone it's an entire topic that people study entire masters degrees for and they are the people who help take care of the dialysis but this is a good example of how much of a patient's management on these renal placements was completely out of my scope of practice and was left to the more senior members of the team like consultants or members of the team who had specifically studied and worked in this field and this brings me nicely on to my next point one of the biggest differences I found on my renal medicine placement was just how senior led it was and what do I mean by this what I mean is that the consultants lend all of the decision making and all of the treatment decisions that we would do for patients and then it was left to me to organize those treatment decisions or to enact those plans I wouldn't actually make them myself whereas on geriatric medicine or vascular surgery like I've talked about in the previous videos that you can click up over here a lot of the times it was just me seeing the patient having to make decisions about how to treat them and then I could go to my seniors for advice or approval of my treatment and management plans consultants on this placement were so involved in patient care that they wanted to see all of the bloods every single day they wanted to see all of the vitals and observations themselves with their own eyes and they wouldn't even trust us to say hey I think this patient is stable their hopes have been static for the last x number of hours or days or have reviewed their bloods their inflammatory markers are static their kidney function is stable but I think x y and z they would want to do all of that and see all of that for themselves now obviously renal patients are quite complex and they do require a lot of senior led input but the flip side to this is there were times when I was working on this placement thinking to myself what am I actually doing here because when this was going on I would only be responsible for typing down what the consultant was saying or what the consultant was doing and then later on going and doing all the things that they sense organizing their scans getting that treatment started getting their medication they need whatever it is and I felt what am I really doing here as a doctor on my previous placements I would go see the patient I would examine them I would take their history I would holistically try to figure out what is going on and then come up with a treatment and management plan and then act that plan so I felt like I was doing a lot of doctoring whereas on this placement certainly on the renal medicine side I really didn't feel like I was doing a lot of doctoring it was a lot of just doing what my seniors were telling me to do now I'm not saying that I was perfectly capable of managing all of these patients and making these treatment decisions that's definitely not the case but I think there is a happy medium in between you know being extremely senior led and basically having no input or advice or learning about what is going on with the patient and being left to manage the situation completely on my own what I would have really appreciated is if consultants and seniors took a little bit more time to talk to us about what is going on with the patient why they're making the decisions that they make and then next time they can maybe ask us hey what do you think we should do in the situation I could give my answer and then they could tell me why I've given a good management plan or why they think they would do something different and that way I feel like at least I would be learning a lot more about how to treat and manage these patients on renal medicine and you know me I'm not a shy person I was constantly asking lots of questions trying to get myself involved and trying to learn as much as I can but the honest truth is with the number of patients that we were seeing and how much we had to do I could barely keep up with you know typing and documenting everything that was going on and then having to enact all those plans for the rest of the day it was just a constant game of trying to do everything as quickly as possible to finish all the jobs for all of these patients so this placement was also my first time working with PAs or physicians assistants or physicians associates something that I hadn't had on either of my previous placements and geriatrics or vascular surgery now working with PAs was quite interesting typically and traditionally the role of PA or physician's assistant is to help the physician do the jobs that they need to do help them to do the tasks that are maybe more menial or time consuming so that the doctor can focus on doing the doctoring and all the other learning and training opportunities that they need to do instead of having to do lots of different bloods placing cannulas changing catheters ordering scans etc now a lot of the time this was the experience that I had if we had just finished a ward round and there were eight sets of bloods to do which would take me several hours to do by myself I could split those up with one of the physicians assistants or physicians associates and we could say you do half of them I'll do half of them and then I can get on and move on to the other things that I need to do but one of the problems that we ended up having was that PAs or physicians assistants they're not allowed to prescribe medication and they're not allowed to order scans with ionizing radiation so those two tasks would always be left to the junior doctors and what this meant was that when we were splitting up the teams in the morning to go to ward A to ward B to the outliers or down to A and E they would always need to be a junior doctor present somewhere over there so that we could prescribe and what that meant was that oftentimes we were taken to a particular job or role just because we could do those menial boring repetitive tasks that no one else could do because only we could prescribe and so annoyingly in some ways it actually ended up increasing our workload of those smaller more miniscule administrative tasks now there's recently been a lot of talks about PAs creeping into the scope of junior doctors and taking over some of the role of junior doctors and I have a lot to say about that but I'm going to do it in a different video specifically about this placement I found that PAs were used in the traditionally correct way to help ease the workload of the junior doctors on the team and help free up some of our times that we could do the things that only doctors could do for example if there's an unwell patient who needs assessment and treatment and management that's only something we could do so we would be freed up to go do that and then some of the other tasks could be done by the PAs the PAs that I worked with were all very lovely and I appreciated them very much on this placement I think with the workload that existed it would be very difficult to do if it was only junior doctors around so I definitely had a positive experience there okay finally let's move on from all the boring stuff all the renal medicine and let's talk about renal transplant surgery which was easily the most fun that I had on this placement now being a doctor inherently comes along with a lot of stress we've got a lot of high pressure situations emotional stressors and even serious conversations about life and death happening on a regular basis because of this keeping my mental health in check has been a top priority for me and I've been doing this with better help this next segment is a paid partnership with better help if you don't already know better help is the world's largest therapy service and it's 100% online and their mission is to make therapy accessible with better help you can tap into a network of credentialed and experienced therapists that can help you with a wide range of issues to get started you answer a few questions about your needs and preferences in therapy so that better help can match you with the right therapist from their network then you can talk to your therapist however it is you feel comfortable whether it's via text chat phone or video call you can message your therapist at any time and schedule in live sessions when it's convenient for you and if you feel like your therapist isn't a good fit for any reason you can switch to a new one at no additional cost with better help you get the same professionalism and quality that you would expect from in office therapy but with the therapist that's custom picked for you and with more scheduling flexibility personally doing therapy over the last couple of years has completely changed my life it's taught me to approach life in a more slow and meaningful way and has better equipped me to deal with the emotional stressors that come along with my job of being a doctor i couldn't recommend it more and i think talking to someone is one of the most important things that you can do for yourself click the link in the description down below betterhelp.com slash karma medic to get 10% off your first month and help support the channel back to the video so i was on this placement for two months and for the first month it was me an sho and a registrar and we had literally we had the best time ever the sho i was working with was so positive and fun and always just happy and excited to be there we would always be laughing and bantering having a good time working really hard to get all of our work done so that we could go down to theater and see what was going on in the afternoon i honestly enjoyed that one month probably the most out of all the placements and work that i've done in the nhs so far no matter how difficult the day was how much work we had or how many jobs there were to do we were always in a good mood and we'd always just work hard to get everything done and crack on and the sad thing is this person this shl they left after one month and what that meant was is that for the remaining month instead of there being three of us on the team there was only two of us and one of them was always a registrar who doesn't get involved with doing the small tiny jobs that all the juniors have to do and so my workload literally doubled from my first month to my second month because all the work that that shl was helping me do previously they were now gone and so all that workload came onto me when i was working with that shl our kind of mantra or goal for every day was to do the ward round do all of the jobs and finish all the work that we had as quickly as possible and efficiently as possible and then in the afternoon go down to theater and see all of the other renal transplant surgeons what they were up to sit in on the surgeries with them scrub up and go and observe surgeries and that was honestly so much fun i'll talk about that a little bit more in the video but after that shl left because the workload was so much larger for me as one person i rarely got time to do that pretty much didn't get to do that at all and most of my time was spent doing the jobs from the ward in the afternoon which was kind of frustrating particularly because i want to do and see and observe as much surgery as possible one of the best parts about this surgical placement was how many little procedures there were for us to do on a regular basis pretty much every day we'd often get asked to assess patients for fistula creation which would involve using an ultrasound to assess the different arteries and veins in the arm see if they were big enough to have a fistula created we would often get asked to remove tunneled hemodialysis lines which are lines that sit in the chest and i'll talk about in a little bit and then there were all kinds of opportunities for doing some suturing abscess drainage all kinds of little you know hands-on technical skills that i find the most exciting and are pretty much what i live for when i'm working in the hospital let's talk about some of these in a little bit more detail so th child stands for tunneled hemodialysis line and what this is is a line that comes out of the chest here tunnels underneath the skin into one of the major veins and then goes and sits directly in the right atrium of the heart the purpose of this line is to facilitate hemodialysis which is that dialysis with the machine outside of the body that we talked about before in order to filter the blood you need to pass blood very very quickly at high speeds and you can only do that using a thick line you can't use something like a small cannula you need a thick thick line that goes directly into one of the major vessels and then goes into the heart the benefit of having this line in place is that you can have it for a long period of time sometimes up to a year or up to even two years as an outpatient on dialysis you are receiving dialysis two to three times a week and so you need to use this line to pass blood through and filter it at very high speeds with the dialysis machine and you need to do that many times a week for up to a year or two years now the obvious disadvantage of having this line or piece of plastic tunneled underneath your skin exposed to the outside environment and going directly into the heart is that it makes you prone to having an infection or the line becoming infected and when it does become infected the renal transplant surgeons are asked to remove that line so thl line removal is something that we did pretty commonly every thursday or friday patients would be booked into a thl line removal clinic then we would go down to see at least one to two patients a day for the removal in the afternoon but also up on the wards sporadically throughout the week we would get asked to remove lines that were infected this for me was a very cool procedure so as i mentioned the line comes out of the chest over here and is tunneled underneath the skin before entering one of the major veins and going into the heart so once it's entered the skin about two centimeters up underneath the skin there's something called a cuff now what this cuff is is a part of the tube that is made of a special material so then it sticks to the surrounding skin over time and you get a bit of fibrosis there the reason for that is if you were to take this tube and tug on it and pull it out there would be a direct line or opening to a major vessel near the heart which you obviously don't want because it's a major risk for bleeding and so this cuff would hold the line in place it would get literally fused and fibrosis to the skin over there so that it could stay in place and not move but of course when it's time to remove that line you need to free it from that surrounding tissue from the surrounding fibrosis in order to pull it out so what this procedure would involve is anesthetizing the local area and then taking a scalpel and making a small incision above the cuff then using some tools to dissect the skin around that cuff to free the plastic line from the surrounding tissue and once you had done that you'd ask the patient to take a deep breath pull on the line get it out of there and then apply pressure to stop the bleeding from inside now although it sounds very simple and I'm sure it's not that exciting to a lot of people this was the first time that I had taken a scalpel and cut on someone's skin a lot of the previous times I've been involved in surgery you know I would never make the initial incisions into someone's body most of the time what I would be doing is helping the surgeon with different tools once the body was already open and once we were inside the area with that we needed to be more closing up the tissues and the skin at the end of the surgery but actually opening the skin was something I had never done before and this was a particular kind of milestone or exciting moment in time for me I'll never forget that first time that I made the incision in the skin and you know I felt like it was me performing this procedure and me doing this which was really really cool of course I wasn't allowed to do this whole thing by myself I needed appropriate supervision and teaching from my seniors to be able to do this procedure but after a few times of doing it they would let me do the whole thing from start to finish while watching which was extremely extremely exciting and it feels so good to say that I can remove a tunnel hemodiasis line so the other surgery that was very commonly done on this placement was creation of a fistula so fistulas are where you make a connection between a vein and an artery and you put them together the reason for doing this is that you want to arterialize the vein you want to make the properties of the vein similar to that of the artery so that you can pass high volumes of blood at high speeds through the vein for the purposes of dialysis now veins and arteries as you know are going to be very very different both in their elasticity their structural integrity and the volumes of flow of blood that they can withstand but in the process of making a fistula you connect the vein to an artery and then the high pressure and high flow blood from the artery goes into the vein and over a period of several weeks the vein arterializes or becomes more similar to an artery and it becomes capable of withstanding the high pressures and volumes that are required for dialysis so that later in the future you can use a needle to stick into the vein and you can pass that high flow and high volume of blood that we talked about before like when you had a tunneled hemo dialysis line okay construction's gone let's continue so before making a fistula we need to assess if a patient is suitable to have a fistula made and what we do is we use an ultrasound machine to look at the arteries and the veins in the arm to see if they're large enough and suitably close to each other or in the right place to be able to make a fistula and I realize this is all a little bit confusing without an explanation so let's zoom in I'm gonna put on this 20k and let me do my best to explain this is a little hard doing on yourself all right I'm a little bit hairy so bear with me I'm not sure how clearly this is gonna come across on camera but we typically make fistulas either down here by the wrist using the radial artery which is here by the thumb which is where you feel to get the radial pulse and you can also use an ABG so you can arterial blood gas over here or we make them up over here using the radial artery which sits just inside of the bicep over here so the radial artery runs over here and right above it we have the catholic vein that is well I can see and feel it here but I'm not sure if it comes up on camera but the catholic vein runs something like this up to that classic Y that you probably know over here and then goes up the bicep and further up the arm so if you're making a fistula down here using the radial artery and the catholic vein they're both very close together and you can simply connect the vein to the artery and you can get a nice fistula coming up over here there's also the bacillic vein which starts somewhere up over here and then runs down under the arm underneath the elbow and up here deep under the bicep so if you're gonna use the bacillic vein and the radial artery you obviously need to transpose it or move it closer to the radial artery to create that fistula up over here we've got the brachial artery which you can feel for the brachial pulse you've probably done this if you're in medical school studying for the cardiac exam so the brachial artery runs over here when we have the bacillic vein like we talked about right over here and then the catholic vein which runs up over here you can use the brachial artery and the catholic vein or the brachial artery and the bacillic vein if you're making a fistula up over here okay so when we're using the ultrasound machine we're assessing the size of these arteries and veins and whether they're big enough or suitable enough to be able to stitch them onto each other to make a fistula now although i was scrubbed into a lot of these fistula creating surgeries i never actually did any these are highly technical where you're taking literally an artery in a vein and you're stitching them onto each other very very technical surgery that uses loops or magnifying kind of lenses or glasses which i obviously can't do so i couldn't do any of it but i observed a lot of them i watched a lot of youtube videos about them so that i could understand what it is that i was seeing and i found it very very interesting so on calls and night shifts on renal medicine were kind of interesting so in renal medicine our on calls and nights would only cover the renal medicine wards so those were the wards a and b that we talked about the renal outliers and the rest of the hospital and then patients coming up from a and e the evenings on call for these shifts weren't too busy i found that a lot of renal medicine patients could become unwell fairly quickly like on vascular surgery but in terms of busyness and hecticness they weren't that bad renal medicine nights on the other hand were particularly busy and particularly stressful the reason is that there were a lot of patients to cover you have about 30 patients on each of wards a and b and then like we said before somewhere between 10 and 20 medical outliers and then the patients coming in from a and e as well and so there were a lot of patients with a lot of things that can go wrong and you were responsible for all of them with of course the help of a registrar on top of that in renal medicine there was this kind of protocol called early morning bloods so for patients that were going to be seen on the early morning ward round and needed decisions made about them at that time early on in the day we would want a set of bloods that had already been taken at like 5am or 6am so that they were back by the time we saw them at about 9 o'clock in the morning now what this meant was if you were on the night shift you had to do early morning bloods for a whole lot of patients and sometimes this would be something like six or seven or eight patients where you had to go take their blood at about five o'clock six o'clock in the morning and renal patients are notoriously difficult to bleed their veins are particularly deep or small or i don't know just flat just they were so difficult to bleed and waking up a patient at five o'clock in the morning to take blood from them is never going to be a fun experience and what this meant was is that you're basically acting like a phlebotomist from about four thirty five o'clock in the morning until i don't know something like seven just taking all of these bloods that need to get done as early morning bloods on the renal transplant side of things when i was on call or working on the weekend i'd be working in oncology or infectious disease similar to how i was when i was on my geriatrics placement now this was great because those two wards typically didn't have a lot of things to do they typically weren't very busy for those shifts and so whenever i finished all of my jobs i would go down to theater on the third floor i would look at the big board that listed all the different surgeries that were going on and see if i recognized anyone's name and if i recognized anyone's name because they were going to be doing a procedure i would text them on my phone and say hey do you mind if i join do you mind if i sit in with you and they would almost always say yes which was incredible because you're operating out of hours and there's pretty usually only the registrar who's doing the surgery or the operation unless it's something more complicated than the consultant needs to be called in which means as the second person scrumped up or assisting you get to do a lot more you're a lot more involved and my favorite experience for this by far was when i saw one of my registrars from vascular surgery on the board i texted them i said hey can i come and they said yeah sure come and it was something which if you're a surgeon is going to be extremely basic and simple and not fun or interesting at all but for me it was absolutely incredible which was incision and drainage of an obsessive infection in someone's foot this registrar was absolutely lovely they let me do pretty much the whole thing from start to finish under their guidance and assistance and it was you know one of the times where i felt like i'm doing the surgery and i was even put down as the first surgeon on the notes which was really really exciting it was an absolutely great learning and teaching experience of course with the consent of the patient and i'm just really appreciative for those opportunities particularly in f1 and f2 you don't you don't get any surgical theater time allocated to you and so anytime you spend in theater you kind of have to make for yourself or really be keen and push for and do in any spare time that you have and so i did my best to take all of those opportunities and spend as much time as i could in theater because i know i would otherwise never get it and if you're done with all of your jobs and there's nothing left for you to do you might as well be doing something interesting and fun whilst you're in the hospital i didn't really want to sit at my desk and scroll through my phone doing nothing so that was great and if i looked on that board and i didn't recognize anyone's name i would literally just look for a procedure or surgery that i thought was interesting or cool i would go to that theater knock on the door introduce myself to the people operating and say hey you know my name is nasser i'm an f1 on x or y placement would you mind if i observed this surgery and they would always say yes no one ever told me no and through doing that i was able to meet so many different consultants and different surgical specialties and just have long conversations with them about what is your day-to-day life like working as a surgeon in this specialty what's the training like and they would talk to me about the procedures that we were seeing and it was just incredible i found like i was actually getting the teaching that i'm supposed to get but of course this was happening out of hours once i'd already finished all of my other jobs and i was kind of making the time for this it was really great experience it was so much fun to go down there during my own cool shifts and see what was going on in theater and in surgery and i'm very happy that i did okay so final thoughts about renal medicine and renal transplant surgery for renal medicine the first two months of this placement i think this was easily my personally my least favorite or least enjoyable a specialty rotation that i did in my first year as an f1 doctor i found the day-to-day to be pretty boring and extremely focused and lasered in on the numbers and making sure every little number for the patients was being actively managed or treated or modified in some way shape or form it was very very academic for my liking i just think my personal interests in medicine and surgery didn't quite mesh with what was happening on the day-to-day job in the renal medicine wards on top of that it was extremely senior led which made me feel like i wasn't learning and progressing as a doctor and i wasn't having as much autonomy and learning experiences as i wanted and as i had had in my previous specialty rotations renal transplant surgery on the other hand was easily a 10 out of 10 for me i think this is the first 10 out of 10 rating that i've given to one uh one of the rotations that i've been through i thought it was incredible i just loved the team we gone on so well everyone was in a positive mood we were always working efficiently and quickly to get everything done and i got to spend tons of time in theaters whoops learning about and observing so many different procedures getting to do a lot of procedures on the wards like those tunneled line arrivals that we talked about ultrasound scanning lots of stitching drainage of abscesses and making incisions i really really enjoyed it and i had such a good time i felt like i was looked after every day and the seniors would really make a good effort to teach me and talk to me about the things that we were doing and seeing which made me feel like a part of the team and b like i was actually learning and progressing and becoming a more competent doctor yeah i think i can safely say i genuinely enjoyed pretty much every minute of my renal transplant surgery placement even though the workload was extremely high in the second half because i lost that sho who is working with me but overall 10 out of 10 so this rotation actually finished a few months ago now i'm now an f2 doctor working in a different hospital i'm currently working in acute medicine and that is uh that it's it's its own it's its own field i need to make an entire video about that because there's definitely a lot to dive into and talk about so if you enjoy these types of videos please do subscribe to the channel like this video leave a comment let me know what you think and that video will be out soon once i've finished this rotation and have some time to collect my thoughts on it and come tell you what my experience has been like thank you so much for watching i hope you enjoyed this video and i will catch you in the next one peace


Let's set you you sign Brett Gardner to a one-year nine million dollar deal, okay? So if you if Clint Frazier is your everyday left fielder, then what amounts to a three-man bench? You have a guy that could simply play the outfield center and left and Brett Gardner That doesn't make sense If Clint Frazier wants to make this team He's gonna have a great he has to have a great spring training and force himself into some sort of cartoon Would say don't want to do it either because again you're limiting yourself to players that can only play the outfield the guy I think if they had their druthers That they want to be the 25th man on the team is Tyler Wade because Tyler Wade could play all the infield positions Except for first and he could go there in an emergency and he could do a serviceable job in the outfield And he runs the bases extraordinarily well, but up to this point Tyler Wade has been a quadruple a hitter He hits in spring training. He hits a triple a when he comes up the big league. He doesn't do it It's all about roster construction. You've got to have guys that could be moved around That's why DJ LaMay you is a perfect guy for a bench because he could play anywhere on any given day So could Tyler Wade Clint Frazier or Brett Gardner cannot That's why one of them makes the roster in all likelihood The only way the only other way that Clint Frazier makes a roster is if in fact Tyler Wade is awful in spring training And they have no other options. That's that that's the way, but then if Tyler Wade Shows again in spring training what he usually shows they're gonna give him a chance on the 25 men roster