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The practice of using race or ethnicity in medicine to explain differences between individuals is being called into question because it may contribute to biased medical care and research that perpetuates health disparities and structural racism. A commonly cited example is the use of race or ethnicity in the interpretation of pulmonary function test (PFT) results, yet the perspectives of practicing pulmonologists and physiologists are missing from this discussion. This discussion has global relevance for increasingly multicultural communities in which the range of values that represent normal lung function is uncertain. We review the underlying sources of differences in lung function, including those that may be captured by race or ethnicity, and demonstrate how the current practice of PFT measurement and interpretation is imperfect in its ability to describe accurately the relationship between function and health outcomes. We summarize the arguments against using race-specific equations as well as address concerns about removing race from the interpretation of PFT results. Further, we outline knowledge gaps and critical questions that need to be answered to change the current approach of including race or ethnicity in PFT results interpretation thoughtfully. Finally, we propose changes in interpretation strategies and future research to reduce health disparities.

Background: Spirometry is the most common pulmonary function test. It is widely used in the assessment of lung function to provide objective information used in the diagnosis of lung diseases and monitoring lung health. In 2005, the American Thoracic Society and the European Respiratory Society jointly adopted technical standards for conducting spirometry. Improvements in instrumentation and computational capabilities, together with new research studies and enhanced quality assurance approaches, have led to the need to update the 2005 technical standards for spirometry to take full advantage of current technical capabilities.Methods: This spirometry technical standards document was developed by an international joint task force, appointed by the American Thoracic Society and the European Respiratory Society, with expertise in conducting and analyzing pulmonary function tests, laboratory quality assurance, and developing international standards. A comprehensive review of published evidence was performed. A patient survey was developed to capture patients experiences.Results: Revisions to the 2005 technical standards for spirometry were made, including the addition of factors that were not previously considered. Evidence to support the revisions was cited when applicable. The experience and expertise of task force members were used to develop recommended best practices.Conclusions: Standards and consensus recommendations are presented for manufacturers, clinicians, operators, and researchers with the aims of increasing the accuracy, precision, and quality of spirometric measurements and improving the patient experience. A comprehensive guide to aid in the implementation of these standards was developed as an online supplement.

Children with asthma face serious mental health risk, but the pathways remain unclear. This study aimed to examine bullying victimisation and perpetration in children with asthma and a comparison sample without a chronic health condition, and the role of bullying in moderating psychosocial adjustment outcomes for those with asthma. A sample of children with (n = 24) and without asthma (n = 39), and their parents, were recruited from hospital clinics. Parents rated children's psychosocial adjustment; children provided self-report of bullying victimisation and perpetration; from which co-occurring bully/victim status was derived. No differences in mean perpetration or victimisation were found, but children with asthma were more likely to be bully/victims (involved both as target and perpetrator), compared to those without asthma. Children with asthma who were victims of bullying had greater peer problems and overall adjustment problems; bully/victims did not show this pattern. Children with asthma may be more likely to be bully/victims, and those who are victims of bullying may be at elevated risk for psychosocial adjustment problems and require particular support in this area from school counsellors and psychologists.

This article investigates how group speaking test candidates manage group talk during assessed, time-limited tasks. Drawing on recorded and transcribed data, it explores how higher-scoring learners manage spoken assessment tasks through their talk, moving conversations on or slowing them down in order to perform and complete the tasks' requirements in a timely way. These data are contrasted with the ways in which lower-scoring test candidates attempt to organize and manage assessed group talk. While the data and findings from this particular study can be used to teach students about, and prepare them for, multi-person discussions and, more specifically, task-oriented and time-limited group speaking tests, we also suggest that our awareness-raising investigatory approach, if brought into the classroom, offers learners (and teachers) a way of uncovering some of what "actually" occurs during talk, illuminating the 'invisible rules' that guide how participants engage in and manage interaction.

There are numerous reference equations available for the single-breath transfer factor of the lung for carbon monoxide (T LCO); however, it is not always clear which reference set should be used in clinical practice. The aim of the study was to develop the Global Lung Function Initiative (GLI) all-age reference values for T LCOData from 19 centres in 14 countries were collected to define T LCO reference values. Similar to the GLI spirometry project, reference values were derived using the LMS (lambda, mu, sigma) method and the GAMLSS (generalised additive models for location, scale and shape) programme in R.12 660 T LCO measurements from asymptomatic, lifetime nonsmokers were submitted; 85% of the submitted data were from Caucasians. All data were uncorrected for haemoglobin concentration. Following adjustments for elevation above sea level, gas concentration and assumptions used for calculating the anatomic dead space volume, there was a high degree of overlap between the datasets. Reference values for Caucasians aged 5-85 years were derived for T LCO, transfer coefficient of the lung for carbon monoxide and alveolar volume.This is the largest collection of normative T LCO data, and the first global reference values available for T LCO.

Practitioner research is in progress at a Further Education college to improve the motivation of vocational students for numeracy and problem solving. A framework proposed by Tang, Sui, & Wang (2003) has been adapted for use in courses. Five levels are identified for embedding numeracy applications and modelling into vocational studies: Extension; Special Subject; Investigation Report; Paper Discussion; and Mini Scientific Research. These levels represent a progression from applications set by the teacher, through increasing student involvement in the solution of real world problems, to totally independent project work. Case studies are presented of the incorporation of the five levels of application in engineering, construction, computing, and environmental science courses. In addition to student motivation, teaching staff observed that improvements have occurred in: use of specialised mathematical vocabulary; the combined use of numerical and algebraic methods in problem solving; and abstract reasoning, and a deeper level of understanding of the mathematics used in problem solving. A difficulty which has not yet been fully resolved is the reconciliation of a problem solving and project based approach to numeracy, and the requirement by some Examination Board numeracy syllabuses to assess specific mathematical methods.

Background and Objective: Chronic, low‐intensity air pollution exposure has been consistently associated with reduced lung function throughout childhood. However, there is limited research regarding the implications of acute, high‐intensity air pollution exposure. We aimed to determine whether there were any associations between early life exposure to such an episode and lung growth trajectories. Methods: We conducted a prospective cohort study of children who lived in the vicinity of the Hazelwood coalmine fire. Lung function was measured using respiratory oscillometry. Z‐scores were calculated for resistance (R5) and reactance at 5 Hz (X5) and area under the reactance curve (AX). Two sets of analyses were conducted: (i) linear regression to assess the cross‐sectional relationship between post‐natal exposure to mine fire‐related particulate matter with an aerodynamic diameter of less than 2.5 micrometres (PM2.5) and lung function at the 7‐year follow‐up and (ii) linear mixed‐effects models to determine whether there was any association between exposure and changes in lung function between the 3‐ and 7‐year follow‐ups. Results: There were no associations between mine fire‐related PM2.5 and any of the lung function measures, 7‐years later. There were moderate improvements in X5 (β: −0.37 [−0.64, −0.10] p = 0.009) and AX (β: −0.40 [−0.72, −0.08] p = 0.014), between the 3‐ and 7‐year follow‐ups that were associated with mean PM2.5, in the unadjusted and covariance‐adjusted models. Similar trends were observed with maximum PM2.5. Conclusion: There was a moderate improvement in lung stiffness of children exposed to PM2.5 from a local coalmine fire in infancy, consistent with an early deficit in lung function at 3‐years after the fire that had resolved by 7‐years. [ABSTRACT FROM AUTHOR]