21 research outputs found

    Embedding learning as a practice of value:Learning from the experiences of early career social workers in Scotland

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    Across the Global North, professional learning for social workers has become a matter of concern. Efforts to ‘fix’ the problem have focused narrowly on formal methods of learning and show limited connect with recent research. In this article we report on findings from a mixed-method longitudinal cohort study, which examined early career social workers experiences of learning over the first five years of professional practice. Drawing on a repeat-measure annual online survey, our findings provide an inside-view of how early career social workers in Scotland experience work-based learning over time and how professional learning for social workers can be enhanced. Quantitative and qualitative data were analysed using descriptive statistical analysis and reflexive thematic analysis respectively and integrated using a convergence coding matrix to identify meta-themes. Our findings support an integrative, developmental and ecological approach to professional learning, embedded in a value-led understanding of social work as practice. We invite the profession to embrace and embed learning as a ‘practice of value’, both as an antidote to managerial approaches to practice and learning and as a way of valuing the extraordinary work that social workers do

    Abdominal aortic aneurysm is associated with a variant in low-density lipoprotein receptor-related protein 1

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    Abdominal aortic aneurysm (AAA) is a common cause of morbidity and mortality and has a significant heritability. We carried out a genome-wide association discovery study of 1866 patients with AAA and 5435 controls and replication of promising signals (lead SNP with a p value < 1 × 10-5) in 2871 additional cases and 32,687 controls and performed further follow-up in 1491 AAA and 11,060 controls. In the discovery study, nine loci demonstrated association with AAA (p < 1 × 10-5). In the replication sample, the lead SNP at one of these loci, rs1466535, located within intron 1 of low-density-lipoprotein receptor-related protein 1 (LRP1) demonstrated significant association (p = 0.0042). We confirmed the association of rs1466535 and AAA in our follow-up study (p = 0.035). In a combined analysis (6228 AAA and 49182 controls), rs1466535 had a consistent effect size and direction in all sample sets (combined p = 4.52 × 10-10, odds ratio 1.15 [1.10-1.21]). No associations were seen for either rs1466535 or the 12q13.3 locus in independent association studies of coronary artery disease, blood pressure, diabetes, or hyperlipidaemia, suggesting that this locus is specific to AAA. Gene-expression studies demonstrated a trend toward increased LRP1 expression for the rs1466535 CC genotype in arterial tissues; there was a significant (p = 0.029) 1.19-fold (1.04-1.36) increase in LRP1 expression in CC homozygotes compared to TT homozygotes in aortic adventitia. Functional studies demonstrated that rs1466535 might alter a SREBP-1 binding site and influence enhancer activity at the locus. In conclusion, this study has identified a biologically plausible genetic variant associated specifically with AAA, and we suggest that this variant has a possible functional role in LRP1 expression

    Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

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    IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

    Man vs. Wild: India\u27s Struggle with Industrialization and Environmental Change

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    This poster examines the effects of climate change, flooding, deforestation, river contamination and industrialization on India

    Embedding learning as a practice of value:learning from the experiences of early career social workers in Scotland

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    Across the Global North, professional learning for social workers has become a matter of concern. Efforts to ‘fix’ the problem have focused narrowly on formal methods of learning and show limited connect with recent research. In this article we report on findings from a mixed-method longitudinal cohort study, which examined early career social workers experiences of learning over the first five years of professional practice. Drawing on a repeat-measure annual online survey, our findings provide an inside-view of how early career social workers in Scotland experience work-based learning over time and how professional learning for social workers can be enhanced. Quantitative and qualitative data were analysed using descriptive statistical analysis and reflexive thematic analysis respectively and integrated using a convergence coding matrix to identify meta-themes. Our findings support an integrative, developmental and ecological approach to professional learning, embedded in a value-led understanding of social work as practice. We invite the profession to embrace and embed learning as a ‘practice of value’, both as an antidote to managerial approaches to practice and learning and as a way of valuing the extraordinary work that social workers do

    Embedding Learning as a Practice of Value:Learning from the Experiences of Early Career Social Workers in Scotland

    No full text
    Across the Global North, professional learning for social workers has become a matter of concern. Efforts to ‘fix’ the problem have focused narrowly on formal methods of learning and show limited connect with recent research. In this article, we report on findings from a mixed-method longitudinal cohort study, which examined early career social workers experiences of learning over the first five years of professional practice. Drawing on a repeat-measure annual online survey, our findings provide an inside-view of how early career social workers in Scotland experience work-based learning over time and how professional learning for social workers can be enhanced. Quantitative and qualitative data were analysed using descriptive statistical analysis and reflexive thematic analysis respectively and integrated using a convergence coding matrix to identify meta-themes. Our findings support an integrative, developmental and ecological approach to professional learning, embedded in a value-led understanding of social work as practice. We invite the profession to embrace and embed learning as a ‘practice of value’, both as an antidote to managerial approaches to practice and learning and as a way of valuing the extraordinary work that social workers do

    Embedding Learning as a Practice of Value:Learning from the Experiences of Early Career Social Workers in Scotland

    No full text
    Across the Global North, professional learning for social workers has become a matter of concern. Efforts to ‘fix’ the problem have focused narrowly on formal methods of learning and show limited connect with recent research. In this article, we report on findings from a mixed-method longitudinal cohort study, which examined early career social workers experiences of learning over the first five years of professional practice. Drawing on a repeat-measure annual online survey, our findings provide an inside-view of how early career social workers in Scotland experience work-based learning over time and how professional learning for social workers can be enhanced. Quantitative and qualitative data were analysed using descriptive statistical analysis and reflexive thematic analysis respectively and integrated using a convergence coding matrix to identify meta-themes. Our findings support an integrative, developmental and ecological approach to professional learning, embedded in a value-led understanding of social work as practice. We invite the profession to embrace and embed learning as a ‘practice of value’, both as an antidote to managerial approaches to practice and learning and as a way of valuing the extraordinary work that social workers do
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