Cracking the code : an approach to developing professional writing skills

The development of writing skills sufficient to meet the complexities of contemporary social work practice is a growing demand of employers and practice educators. This paper explores the development, implementation and evaluation of a university writing skills programme for social work students. The paper explores current pedagogical debate relating to student support and the development of writing skills and relates this debate to meeting the needs of social work students engaged in practice learning and professional practice. A number of questions are raised about current social work education in England and the needs of students entering from non-traditional academic backgrounds facing the increasingly rigorous demands of professional report writing. The discussion is then grounded in a practice example of staff from a university social work course and education guidance service working together to meet student need in respect of developing writing skills. The paper concludes by setting out a range of challenges arising from experience of the programme and a consideration of theory, and points to potential ways forward based on a social practice approach to teaching writing skills

Sex and gender in lung health and disease: more than just Xs and Ys

A new series explores the role of sex and gender-related factors in respiratory physiology, lung health, and across respiratory diseases https://bit.ly/3mP0BV

Exertional dyspnoea in pulmonary arterial hypertension.

Dyspnoea is a principal presenting symptom in pulmonary arterial hypertension (PAH), and often the most distressing. The pathophysiology of PAH is relatively well understood, with the primary abnormality of pulmonary vascular disease resulting in a combination of impaired cardiac output on exercise and abnormal gas exchange, both contributing to increased ventilatory drive. However, increased ventilatory drive is not the sole explanation for the complex neurophysiological and neuropsychological symptom of dyspnoea, with other significant contributions from skeletal muscle reflexes, respiratory muscle function, and psychological and emotional status. In this review, we explore the physiological aspects of dyspnoea in PAH, both in terms of the central cardiopulmonary abnormalities of PAH and the wider, systemic impact of PAH, and how these interact with common comorbidities. Finally, we discuss its relationship with disease severity

Pulmonary arterial hypertension registries: past, present and into the future

Registries have greatly contributed to knowledge about PAH epidemiology, risk factors, prognosis and treatment. Future registries face unique challenges but may benefit from integration of multiple data sources and capitalising on “Big Data” opportunitiesConflict of interest: J. Weatherald reports grants, personal fees and non-financial support from Janssen Inc. and Actelion, personal fees and non-financial support from Bayer, personal fees from Novartis, and grants from Alberta Lung Association, Canadian Vascular Network, European Respiratory Society and Canadian Thoracic Society, outside the submitted work. Conflict of interest: A. Reis reports grants, personal fees and non-financial support from Janssen Inc. and Actelion, outside the submitted work. Conflict of interest: O. Sitbon reports grants, personal fees and non-financial support from Actelion Pharmaceuticals, Bayer and Merck, grants from GlaxoSmithKline, grants, and personal fees from United Therapeutics and Gossamer Bio, outside the submitted work. Conflict of interest: M. Humbert reports personal fees from Actelion and Merck, and grants and personal fees from Bayer, GSK and United Therapeutics, outside the submitted work.info:eu-repo/semantics/publishedVersio

Screening strategies for pulmonary arterial hypertension

Pulmonary arterial hypertension (PAH) is rare and, if untreated, has a median survival of 2–3 years. Pulmonary arterial hypertension may be idiopathic (IPAH) but is frequently associated with other conditions. Despite increased awareness, therapeutic advances, and improved outcomes, the time from symptom onset to diagnosis remains unchanged. The commonest symptoms of PAH (breathlessness and fatigue) are non-specific and clinical signs are usually subtle, frequently preventing early diagnosis where therapies may be more effective. The failure to improve the time to diagnosis largely reflects an inability to identify patients at increased risk of PAH using current approaches. To date, strategies to improve the time to diagnosis have focused on screening patients with a high prevalence [systemic sclerosis (10%), patients with portal hypertension assessed for liver transplantation (2–6%), carriers of mutations of the gene encoding bone morphogenetic protein receptor type II, and first-degree relatives of patients with heritable PAH]. In systemic sclerosis, screening algorithms have demonstrated that patients can be identified earlier, however, current approaches are resource intensive. Until, recently, it has not been considered possible to screen populations for rare conditions such as IPAH (prevalence 5–15/million/year). However, there is interest in the use of artificial intelligence approaches in medicine and the application of diagnostic algorithms to large healthcare data sets, to identify patients at risk of rare conditions. In this article, we review current approaches and challenges in screening for PAH and explore novel population-based approaches to improve detection

“None of us are lying”: an interpretive description of the search for legitimacy and the journey to access quality health services by individuals living with Long COVID

Abstract Background Understanding of Long COVID has advanced through patient-led initiatives. However, research about barriers to accessing Long COVID services is limited. This study aimed to better understand the need for, access to, and quality of, Long COVID services. We explored health needs and experiences of services, including ability of services to address needs. Methods Our study was informed by the Levesque et al.’s (2013) “conceptual framework of access to health care.” We used Interpretive Description, a qualitative approach partly aimed at informing clinical decisions. We recruited participants across five settings. Participants engaged in one-time, semi-structured, virtual interviews. Interviews were transcribed verbatim. We used reflexive thematic analysis. Best practice to ensure methodological rigour was employed. Results Three key themes were generated from 56 interviews. The first theme illustrated the rollercoaster-like nature of participants’ Long COVID symptoms and the resulting impact on function and health. The second theme highlighted participants’ attempts to access Long COVID services. Guidance received from healthcare professionals and self-advocacy impacted initial access. When navigating Long COVID services within the broader system, participants encountered barriers to access around stigma; appointment logistics; testing and ‘normal’ results; and financial precarity and affordability of services. The third theme illuminated common factors participants liked and disliked about Long COVID services. We framed each sub-theme as the key lesson (stemming from all likes and dislikes) that, if acted upon, the health system can use to improve the quality of Long COVID services. This provides tangible ways to improve the system based directly on what we heard from participants. Conclusion With Long COVID services continuously evolving, our findings can inform decision makers within the health system to better understand the lived experiences of Long COVID and tailor services and policies appropriately

Snowball Earth climate dynamics and Cryogenian geology–geobiology

Geological evidence indicates that grounded ice sheets reached sea level at all latitudes during the long‐lived Sturtian (717–659 Ma) and Marinoan (ca 645–635 Ma) glaciations. Combined U-­‐Pb and Re-­‐Os geochronology suggests that the Sturtian glacial onset and both terminations were globally synchronous. Geochemical data imply that atmospheric pCO2 was 102x modern at the Marinoan termination, consistent with Snowball Earth hysteresis. Sturtian glaciation followed the breakup of a tropical supercontinent, and its onset coincided with the equatorial emplacement of a large igneous province. Modeling shows that the small thermal inertia of a globally frozen surface reverses the annual-mean Hadley circulation, resulting in equatorial net sublimation and net deposition elsewhere. Oceanic ice thickens, forming a sea glacier that flows gravitationally toward the equator, sustained by the hydrologic cycle and by basal freeze-on and melting. Tropical ice sheets flow faster as CO2 rises, but lose mass and become sensitive to orbital forcing. Dust accumulation in the equatorial zone engenders supraglacial oligotrophic meltwater ecosystems, favorable for cyanobacteria and many eukaryotes. Meltwater flushing through moulins enables organic burial and submarine deposition of subaerially-­‐erupted volcanic ash. The subglacial ocean is turbulent and well­‐mixed, in response to geothermal heating and conductive heat loss through the ice cover, increasing with latitude. Cap carbonates, unique to Snowball Earth terminations, are products of intense weathering and ocean stratification. Whole-­ocean warming and ice-sheet forebulge collapse allow marine coastal inundations to progress long after ice-sheet disappearance. The evolutionary legacy of Snowball Earth is perceptible in fossils and living organisms

Reinventing the blurry oval: Practitioner perceptions of deepfakes as a tool for anonymisation in documentary film and video journalism

In 2020, the documentary film Welcome to Chechnya disguised the sources it portrayed using deepfake-like 'digital masks', to wide acclaim: many described the use of the technology in this way to be game-changing for the industry. This qualitative study examines documentary filmmakers' and video journalists' (practitioners') perceptions of the benefits and limitations of the use of deepfakes, or AI-assisted synthetic media, to anonymise sources in their work, in the context of theoretical understandings of photographic realism and applied journalistic ethics. Through one unstructured interview with the film's visual effects supervisor, Ryan Laney, and eight semi-structured interviews with practitioners who have previously visually disguised sources, the study identifies four key themes of practitioners' views about the use of deepfakes as a tool to anonymise: the impacts on practitioner-source relations, practical considerations, aesthetic impacts of synthetic media and broader industry implications. Overall, practitioners emphasised the limitations of the potential use of deepfakes in this context, much more than the benefits