Category: Analysis

Source: The Conversation – UK – By Johny Daniel, Associate Professor, School of Education, Durham University

Two children sit in different schools. Both struggle to read. Both have similar low scores on national tests. But while one gets a diagnosis of specific learning difficulties and a package of support, the other is left to fall behind.

My colleagues and I have carried out new research analysing the records of around 540,000 primary school children across England. It reveals a troubling picture. Whether a child gets identified with specific learning difficulties – an umbrella term for conditions involving difficulties with reading and mathematics – depends not just on how they perform academically, but on the school they go to, their gender, their family’s income, their first language, and even the average ability of their classmates.

Fewer than 2% of pupils in England are identified as having a specific learning difficulty. That figure sits well below international estimates suggesting that between 5% and 10% of children are affected. Some researchers put the true prevalence of reading difficulties as high as one in five. Clearly, in England, a large number of children are not getting the support they need.

Our study found that where a child goes to school plays a role in whether they get identified or not. We observed that children in high-achieving schools were actually more likely to be identified, even with the same test scores as peers elsewhere who weren’t identified. Findings suggest that when a child falls behind in a school where most pupils do well, they get noticed. In schools where low attainment is more common, the same child simply blends in. Same academic struggles, different school, different outcome.

Children being missed

One of the most striking findings concerns gender. After accounting for academic scores, boys were twice as likely as girls to be identified with specific learning difficulties. This isn’t simply because boys struggle more. It likely reflects how difficulties present differently by gender. Boys who struggle often act out while girls are more likely to struggle quietly with anxiety and inattention, which are far less visible in a classroom setting. Our findings suggest that a child who is silently struggling may go unnoticed and miss out on the support they need.

Children who speak a language other than English at home, around one in five pupils in England today, face the starkest disparity. Accounting for their actual test scores, these pupils were dramatically less likely to be identified with specific learning difficulties.

Read more:
Developmental language disorder can have life-long effects – and it’s easily missed in multilingual children

This is because assessment tools are largely designed for monolingual English speakers. When a child struggles to read, it can be easy for teachers to attribute the difficulty to language acquisition rather than a potential learning difficulty. But the two can coexist. Missing that distinction means missing a child.

Children from more deprived neighbourhoods were also less likely to be identified. In England, the most common route to a specific learning difficulty diagnosis such as dyslexia involves private assessment, a process that can cost hundreds of pounds. Affluent families can navigate and afford this – many others cannot.

What needs to change

England’s special educational needs and disabilities code of practice acknowledges specific learning difficulties, but offers no clear guidelines for how to identify pupils. The result is a system where practice varies enormously by school. That variability is not random. It follows fault lines of gender, language and poverty.

The most urgent priority is a national framework that sets out clearly what specific learning difficulties are and how schools should identify them. This was not addressed in the government’s recent policy paper on schools, which covered special educational needs provision. Alongside that, teachers need better training to recognise their own biases in referral. But training alone is not enough – identification should not be left to teacher judgement.

Standardised, objective reading and maths screening tools, applied consistently to all children, are the most reliable way to ensure every child who needs support is identified early, regardless of how they behave in class. Until then, which children get help will continue to depend far too much on luck.

Johny Daniel does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Why some children with learning difficulties get identified – and others don’t – https://theconversation.com/why-some-children-with-learning-difficulties-get-identified-and-others-dont-276433

Source: The Conversation – UK – By Pia Lindberg, PhD Candidate, Department of Medicine, Karolinska Institutet

Most people who get COVID recover within a few weeks. But for some, symptoms persist for months – a condition now known as long COVID. While it’s often associated with fatigue, breathlessness and “brain fog”, growing evidence suggests it may also affect something less visible, but potentially more serious: the heart.

In our recent study, we found that people with long COVID had higher risk of developing cardiovascular disease – including cardiac arrhythmias, heart attack and heart failure. Importantly, the increased risks were seen in people who had never been hospitalised during their initial COVID infection.

Much of the early research on long COVID and heart health focused on patients who were hospitalised, particularly those treated in intensive care. These patients often had multiple risk factors for cardiovascular disease such as being overweight and having hypertension or diabetes. This made it difficult to separate the effects of severe acute illness from the long-term effects of the infection.

However, the majority of people who had COVID were never admitted to a hospital – yet many still developed chronic symptoms of so-called long COVID. To explore the potential risks in this much larger group, we focused specifically on patients who had experienced a mild-to-moderate COVID infection which they managed at home.

We used healthcare data from more than 1.2 million adults living in Stockholm, Sweden. Among them, 9,000 were diagnosed by a doctor with long COVID. We then followed up these patients over time and compared occurrence of new cardiovascular disease – including heart attack, heart failure, arrhythmias, stroke and peripheral arterial disease – with people who did not have long COVID and had no previous cardiovascular disease.

After a follow-up period of up to four years, cardiovascular disease was more common among people with long COVID.

Among women with long COVID, 18% experienced some form of cardiovascular event, compared with 8% of women without long COVID. Among men, the corresponding figures were 21% versus 11%.

These results did not substantially differ even when we adjusted analyses for age, socioeconomic status and underlying health status – including conditions such as high blood pressure, diabetes, high cholesterol, obesity, depression, smoking and alcohol consumption which are known risk factors of cardiovascular disease.

Women with long COVID had more than double the risk of developing cardiovascular disease overall compared with women without long COVID, while men had around a 30% higher risk.

The strongest associations were seen for irregular heart rhythm and coronary heart disease. In women, we also observed an increased risk of heart failure and peripheral arterial disease. However, we did not find an association between long COVID and stroke risk.

Why long COVID might affect the heart

It’s not fully understood why long COVID is associated with cardiovascular disease, but several biological mechanisms have been proposed.

The virus can affect the lining of blood vessels, leading to what is known as endothelial dysfunction. It may also trigger long-lasting inflammation and changes in the immune system. Together, these processes can affect how blood flows through the body and how the heart functions.

There’s also growing evidence that long COVID can disrupt the autonomic nervous system – the automatic mechanisms that control heart rate and blood pressure. This may potentially explain why irregular heart rhythms and conditions such as postural orthostatic tachycardia syndrome (Pots) are more common in long COVID patients.

Another possibility is that long COVID may not necessarily cause entirely new disease, but rather reveal underlying conditions that had not yet been diagnosed. In some cases, symptoms such as chest pain or palpitations may lead to further medical evaluation, increasing the likelihood that cardiovascular disease is detected.

Our findings suggest that long COVID is not simply a transient condition, even among people who were never severely ill during the acute infection. Instead, it may have longer-term implications for cardiovascular health.

At the same time, it’s important to put the results into context. The overall risk of cardiovascular disease remains relatively low at the population level. But the relative increase in risk is meaningful and comparable to that seen with established cardiovascular risk factors such as hypertension or diabetes.

The increased cardiovascular risk in long COVID has also important implications for healthcare. Patients with long COVID – particularly women and younger patients – may benefit from more structured follow-up, including assessment of cardiovascular symptoms and better management of cardiovascular risk factors

It also suggests that long COVID should be included in future strategies for cardiovascular risk assessment and prevention, not only in specialist care but also in primary care settings where most of these patients are managed.

More research is now needed to understand the long-term trajectory of these risks and whether they persist, decrease or increase over time. Future studies should also explore whether early identification and management of cardiovascular symptoms in long COVID could help reduce the risk of more serious complications later on.

As the number of people living with long COVID continues to grow, understanding its broader health consequences will be essential – not only for each patient, but for healthcare systems as a whole.

Artur Fedorowski received funding from the Swedish Heart Lung Foundation.

Axel Carl Carlsson and Pia Lindberg do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

– ref. Long COVID associated with higher risk of heart disease – https://theconversation.com/long-covid-associated-with-higher-risk-of-heart-disease-279883

Source: The Conversation – UK – By Debra Ferreday, Senior Lecturer in Sociology, Lancaster University

The Testaments, now streaming on Disney+, has big shoes to fill. It arrives in a post-MeToo media landscape still shaped by the seismic impact of Margaret Atwood’s previous adaptation, The Handmaid’s Tale. Released in 2017, The Handmaid’s Tale quickly transcended its source material to become a feminist touchstone, inspiring a vivid visual and cultural language of resistance across politics, performance, music and the arts.

In Atwood’s world of Gilead, women are reduced to archetypes within a patriarchal rape culture: complicit, privileged wives; submissive house servants known as “Marthas”; or the Handmaids themselves, stripped to mere breeding stock for the regime.

As life in the US seemed eerily to catch up with Atwood’s vision, the hallmark red dress, white cap and down-turned gaze of the handmaids became iconic. For protesters, it provided a graphic symbol of the fate awaiting women in a world where the president has described himself as the “fertilisation president” “protecting” women whether they “like it or not”.

When Atwood returned to Gilead in 2019 with follow-up book The Testaments, she did so in the shadow of renewed assaults on women’s and LGBTQIA+ rights worldwide. The release of this adaptation of her sequel challenges viewers not only to face that reality, but to think about what popular culture can do in the face of cultural regression.

The Testaments also has to resolve the plot dilemmas established in The Handmaid’s Tale. Many fans had been disappointed that, after following along for six seasons, they did not get to see protagonist June (Elisabeth Moss) reunited with her daughter Hannah. Nor did we see an end to Gilead.

The Testaments returns to these themes while probing why Atwood’s world still grips us amid escalating crises. Can the series offer anything fresh, or has original show-runner Bruce Miller’s vision – mixing extreme violence with striking visuals – already run its course?

The aesthetics of Gilead

The Testaments looks strikingly different from its predecessor, although the two shows share a visual DNA.

Much like our own world, Gilead has become, in some ways, inured to tyranny. For the privileged at least, there is a sort of everyday acceptance recognisable from real-world examples of life under dictatorship.

Like the young audience it courts, Gilead’s young women – including protagonist Hannah, played with tensile calm by One Battle After Another’s Chase Infiniti – have grown up in a world where political violence and control of the reproductive body are explicitly intertwined. We pick up the story some years after the original show, although since girls in Gilead are not allowed calendars they don’t know exactly how long. We are told this in voice-over by Hannah, now renamed Agnes.

Another resonance with our own times is the importance of style as a means of both escape and control.

The costume and set designs of new Gilead resemble a contemporary AI-authored Pinterest board. For all its pretensions to timelessness, this world has fashion. The handmaids’ Puritan-plain red line dresses have been replaced by neat Kennedy-era ensembles in gentler tones of plum, pink and white.

The scarcity we saw in The Handmaid’s Tale has been superseded by a pastel-toned, cottagecore fantasy of colonial mansions and horses’ manes flowing in golden sunlight. Images of containment abound. Characters fill the frame or are seen through frames, gates, tantalisingly half-open windows and a dolls’ house which uncannily mirrors the home of commander Kyle, Agnes’ absent adopted father, in which she is held captive.

For all the old money theatrics, obsession with bodies is never far from the surface. “The Plums” are so called because they are ripe fruit, waiting to be plucked by much older, powerful men – a fate which becomes assured when a girl has her first period. Violence is never far away either. While the girls attend a sort of finishing school run by disappointed ideologue turned resistance figure Aunt Lydia (Anne Dowd, reprising her breakout villain role from The Handmaid’s Tale), the peacefulness of their education is disrupted by constant threats of corporal punishment.

Female friendship and hope

The Gilead of The Testaments is a fun-house mirror version of our own times. People are entertained by watching violence against groups treated as less than human – but instead of TikTok or constant news coverage, it’s public punishments like mutilations and executions.

“God’s justice is beautiful”, the girls are told, as they view a scaffold (a public hanging site) which they are told holds members of a supposed sex trafficking gang, though they are also told the victim was really to blame.

Obsessed with cleanliness, order, and control, this world is nastily prurient. It is fixated on spotting and rooting out impurity. It reminds us what is at stake when the state polices reproductive bodies.

Ultimately, though, it is the power of young women’s friendship and the inherent, ebullient anarchy of teen girls that holds the potential finally to bring down Gilead. This is what makes the show original.

Atwood has said she wrote The Testaments to offer hope. Hope, in 2026, seems like a dangerous thing: it can seem naïve given the demands of the current moment. But as the American writer and activist Rebecca Solnit puts it: “If the word hope doesn’t work for you, try ‘Never fucking surrender.’”

Aided by its talented young cast, The Testaments reworks Gilead into a space where resistance emerges spontaneously in a world structured to make it unthinkable. In this setting, girls’ friendships, their laughter and their power become seeds of rebellion. The result is a timely, absorbing reflection how we might at last burn the dolls’ house to the ground.

This article features references to books that have been included for editorial reasons, and may contain links to bookshop.org. If you click on one of the links and go on to buy something from bookshop.org The Conversation UK may earn a commission.

Debra Ferreday does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. The Testaments: female friendship fuels resistance in this Handmaid’s Tale sequel – https://theconversation.com/the-testaments-female-friendship-fuels-resistance-in-this-handmaids-tale-sequel-280062

Source: The Conversation – UK – By Susie Kilshaw, Professor in Medical Anthropology, UCL

I heard about the new BBC drama Babies the week before it aired and was keen to watch it, not least because miscarriage is so rarely portrayed on screen – particularly as a central storyline. I enjoyed it, insofar as that word can be applied to such a devastating subject. The series offers a raw, nuanced and deeply realistic account of recurrent miscarriage and it gets a great deal right.

Lisa (Siobhán Cullen) and Stephen (Paapa Essiedu) are a young couple in their thirties navigating the heartbreak caused by repeated miscarriages. The pacing of the show – at times almost painfully slow – mirrors the real experience of conception, early pregnancy and reproductive loss.

It allows the viewer to sit with emotional complexity – the shifting feelings, the uncertainty and the drawn-out liminality of making a family. Time appears suspended for the couple, even as life continues around them. We see Lisa returning to work increasingly detached, exhausted and withdrawn, while other pregnancies progress, babies are born and the world moves on.

Stephen’s insistence that they “must think positive” is familiar – the partner adopting a supportive role while masking their own grief. When Lisa challenges his suggestion that others don’t realise she has “been through so much,” reminding him that it has happened to both of them, the moment is ambiguous. Is she inviting him to share in the grief, or expressing frustration that he is not experiencing the loss in the same way? These tensions echo accounts shared by women I have interviewed through my work on fertility, reproduction and pregnancy endings.

Throughout the series, Lisa and Stephen navigate layers of distress – at times drawing close, at others remaining emotionally distant. Their oscillation between hope and despair, and between the need to “keep moving” and the pull of grief, reflects patterns commonly found in miscarriage stories.

Visceral realities of baby loss

I was most interested in how the physical experience of miscarriage would be portrayed. Early in the first episode, I felt a familiar disappointment. The miscarriages occur off-screen, with the focus placed almost entirely on emotional aftermath, with little attention paid to the reality of pain and bleeding. However, this shifts with Lisa’s third miscarriage, which is one of the most accurate portrayals I have seen.

We see blood, albeit briefly and only a very small amount. Lisa’s pain is audible in her cries and moans. The movement through different spaces – her place of work before returning home, then their bedroom, the bathroom, the living room – marks escalating levels of distress, capturing the duration and inconsistency of miscarriage.

This is not a quick or contained event, but an unfolding process. Stephen’s growing panic as he seeks help, culminating in the arrival of paramedics (seemingly against Lisa’s wishes), underscores the seriousness of the situation, the lack of preparation and the couple’s helplessness.

The series also conveys the diversity of miscarriage experience and response. Lisa’s first loss is a “spontaneous” miscarriage at seven weeks; the second, a missed miscarriage managed surgically; the third unfolds “naturally” after the onset of pain and bleeding. Importantly, the viewer witnesses these experiences in ways that may feel recognisable to many – this is not “just a heavy period”.

That said, I would have welcomed more detail on miscarriage management. While we learn that Lisa undergoes an “ERPC” (evacuation for retained products of conception) for her second miscarriage, the absence of discussion around her options and decision-making represents a missed opportunity to depict clinical care more fully, and to foreground women’s agency.

The series doesn’t shy away from the visceral reality of loss. Lisa’s anguished description of “my baby dripping into the toilet”, is confronting but important. Miscarriage is often sanitised in public debate, and frequently unfolds in private domestic spaces. Babies portrays the reality of miscarriage, including toilets, where most miscarriages occur and are disposed of. The drama also gives a sense of the range of feelings that accompany miscarriage: hope, fear, anger, frustration, optimism, sadness and grief.

While Babies succeeds in many respects, the portrayal of clinicians is more problematic. The first doctor’s casual “Yup, yup, yup, all gone” during a scan devastates, with no sense that for Lisa what is “gone” is her longed-for baby.

During the second pregnancy the sonographer refers to their “baby” and suggests they look at the screen before becoming excruciatingly quiet. The abrupt shift from shared excitement to silence and blunt disclosure, and the GP’s depiction is emblematic of an unfeeling NHS system, all contributing to a narrative of insensitive care.

Some viewers may recognise these experiences. Over 15 years of research in Qatar and the UK, I have encountered accounts of poor and insensitive miscarriage care. However, more recent research suggests that particularly within the NHS, care has improved significantly, with women reporting compassionate and sensitive support. During 20 months of fieldwork in a large NHS foundation trust in England, I consistently observed responsive and empathetic clinical care.

This is not to suggest uniformity across and within settings, but rather to question whether Lisa’s experience reflects the norm in many NHS contexts today. As I have argued elsewhere, an understanding of miscarriage as bereavement increasingly underpins NHS care, reflecting a broader cultural shift that recognises miscarriage as a significant loss.

While Babies contributes to this important recognition, it also reinforces a dominant narrative in which miscarriage is always experienced as traumatic and devastating. While this will resonate with many – and such validation is important – it risks marginalising those whose experiences fall outside this, including some of the women I have interviewed in my work.

The involvement of consultants from Tommy’s Charity contributes to the series’ sensitivity and accuracy, underscoring the value of such collaborations. Cullen and Essiedu deliver compelling performances, conveying emotional complexity and intimacy with subtlety and depth.

Babies is slow, thoughtful and often heartbreaking. Despite some limitations, it is a welcome and important contribution – one that lays bare the realities of miscarriage with honesty and compassion.

Susie Kilshaw receives funding from the Wellcome Trust as part of a University Award in the Social and Historical
Science (Award number: 212731/Z/18/Z) and also holds a AHRC Curiosity Award (Award number: UKRI1126)
She has also received funding from ESRC Impact Acceleration grant (Award number: KEI2024-01-53 ESRC IAA KEIF).

– ref. Babies: raw, nuanced, real – what this BBC drama gets right about recurrent miscarriage – https://theconversation.com/babies-raw-nuanced-real-what-this-bbc-drama-gets-right-about-recurrent-miscarriage-280134

Source: The Conversation – UK – By Natasha Lindstaedt, Professor in the Department of Government, University of Essex

Pakistan’s prime minister, Shehbaz Sharif, announced that a two-week ceasefire had been agreed between the US and Iran in the early hours of April 8. Delegates from both sides are expected to attend further talks in the Pakistani capital of Islamabad on Friday.

This comes less than two weeks after Pakistan hosted talks with Saudi Arabia, Egypt and Turkey in which the four countries called for an end to hostilities in the Gulf. The meeting established the quartet as the primary negotiating channel between Tehran and Washington, and may signal the beginning of a new regional order designed to curb Israeli and Iranian dominance after the war.

Even before the war began in late February, Israel and Iran were both isolated in the region. There is no chance of any rapprochement between Israel and Saudi Arabia, which was the original goal of the 2020 Abraham accords. These accords sought to normalise relations between Israel and other countries in the Middle East.

The United Arab Emirates and Bahrain signed agreements with Israel as part of the accords. But the Saudis have long said they will not normalise ties with Israel before the establishment of a Palestinian state, which was ruled out by the Israeli parliament in a 2024 vote. Reports suggest that Saudi Arabia now wants to replace Israel with Syria as the transit country for a fiber-optic cable connecting the kingdom to Greece.

Turkey also halted its relationship with Israel in 2024 over the conflict in Gaza. And relations between Israel and Qatar soured in September 2025 after an Israeli strike on Hamas leaders in Doha, which drew unanimous condemnation from the UN security council.

Iran’s only main allies are Russia and, to a much lesser extent, China and the Houthi rebel group in Yemen. Since the conflict with the US and Israel began, China has distanced itself from Iran. The Houthis recently became involved in the war in support of Iran, but they have been weakened by Israeli attacks in recent years.

The solid relationship between Qatar and Iran has been severed after Iranian missiles struck the country’s main gas facility, Ras Laffan, on March 18. And Iran’s partial detente with Saudi Arabia, which was brokered by China in 2023 after years of hostility, has now been destroyed following Iranian attacks on Saudi energy facilities.

It is against this backdrop, in which both Iran and Israel are considered regional pariahs, that Pakistan, Saudi Arabia, Turkey and Egypt have ramped up their efforts to secure stability in the Middle East.

A new order?

These four countries share some common areas of interest that help explain their desire to reshape the region. They all have political and economic ties with the US and are members of Donald Trump’s Board of Peace. Established in 2026, the board aims to tackle global conflicts and achieve lasting peace and reconstruction in Gaza.

Each country also brings important contributions to their burgeoning alliance. Pakistan possesses nuclear weapons, Saudi Arabia has the world’s second-largest oil reserves, Egypt controls access to the vital Suez canal waterway and Turkey is a member of the Nato alliance. All have fairly advanced defence industries and a combined population of 500 million people. Taken together, they represent the most politically and militarily influential Muslim-majority countries in the world.

But these four nations are not necessarily natural allies, and their relationships have experienced turbulence over the years. Egypt’s relationship with Saudi Arabia, for example, has often been described as a “difficult marriage”. Egypt was once the driver of pan-Arab nationalism, a movement that promotes a secular and unified Arab political identity.

The Saudi kingdom has historically viewed this movement as a threat. But since Abdel Fattah el-Sisi came to power as Egypt’s president in 2014, their differences have been overcome. Sisi offered political and military support to the Saudi operation against the Houthis in 2015, with Egypt and Saudi Arabia subsequently deepening their defence ties.

Particularly under the leadership of Recep Tayyip Erdoğan, Turkey has positioned itself as a regional leader and problem solver. But Turkey, too, has endured periods of frosty relations with other regional powers. Ankara’s relations with Cairo deteriorated sharply after the Egyptian president, Mohammed Morsi, a close ally of Turkey, was ousted in a 2013 coup.

Similarly, tensions between Turkey and Saudi Arabia became particularly acute following the 2018 murder of journalist Jamal Khashoggi in the Saudi consulate in Istanbul. A 2021 US intelligence report found that Saudi crown prince Mohammed bin Salman approved the murder, though he denies this allegation.

A process of rapprochement took place between Turkey and Saudi Arabia in 2022, and then between Turkey and Egypt in 2025. Erdoğan visited Cairo and Riyadh in February 2026 and has proposed several different geoeconomic frameworks to connect Asia with Europe. These include the so-called Middle East Corridor, a planned economic corridor aimed at fostering economic integration between Asia, the Persian Gulf and Europe.

Pakistan, meanwhile, has so far not come to Saudi Arabia’s aid when it has come under attack from Iran in the current conflict. This is despite the signing of a strategic mutual defence agreement between the two countries in 2025.

Saudi Arabia, Egypt, Pakistan and Turkey have not always seen eye to eye. But their relationships of convenience are now becoming increasingly significant as Israel and Iran’s regional isolation grows.

Natasha Lindstaedt does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. Pakistan, Turkey, Egypt and Saudi Arabia emerge as a new regional power bloc amid Iran war – https://theconversation.com/pakistan-turkey-egypt-and-saudi-arabia-emerge-as-a-new-regional-power-bloc-amid-iran-war-279782