38 research outputs found

    Liderança da escola e aprendizagem dos alunos: um estudo de caso numa escola secundária

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    O presente artigo debruça-se sobre a relação entre a liderança da escola e os resultados obtidos pelos alunos. A questão de pesquisa central que se procurou esclarecer foi a de saber se e de que modo aquela liderança tem impacto na aprendizagem escolar dos estudantes. Para esclarecer o assunto, foi realizado um estudo de caso único, de cariz qualitativo, numa escola secundária pública portuguesa. Os resultados parecem convergir com vários dos pressupostos dos modelos de práticas de liderança preconizados por Leithwood et al. (2004, 2006) e Day et al. (2009). De acordo com os testemunhos recolhidos, e apesar das limitações evidentes de uma escola localizada num meio rural, os resultados escolares dos alunos pareciam estar, de forma directa e indirecta, associados às práticas de liderança desenvolvidas pelo director.This article focuses on the relationship between school leadership and student attainment. The main research question that the study sought to answer was: does school leadership have an impact on students’ academic learning and, in affirmative case, how does this impact take place? To clarify this issue, we conducted a qualitative case study of a public Portuguese secondary school. The results seem to converge with various assumptions of Leithwood et al’s (2004, 2006) and Day et al’s (2009) leadership practice models. Accord ing to participants’ testimonies, and in spite of the obvious limitations of a school located in a rural context, students’ school results seemed to be, both directly and indirectly, associated with the leadership practices developed by the school directorinfo:eu-repo/semantics/publishedVersio

    As escolas privadas e os seus clientes : estratégias organizacionais de promoção da oferta e de regulação das admissões

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    Conhece-se ainda pouco sobre o modo como as organizações escolares privadas promovem a sua oferta junto dos potenciais clientes e como regulam a procura de que são objeto por parte das famílias. O presente artigo apresenta os resultados de um estudo de caso exploratório que investigou estas questões em duas escolas privadas com oferta formativa ao nível do 1º Ciclo do Ensino Básico. Os dados foram recolhidos através de entrevistas exploratórias realizadas aos diretores das escolas e a docentes de ambas. Os resultados mostram que as organizações estudadas procuram diferenciar-se das concorrentes através da criação e promoção de uma imagem de marca junto dos seus públicos e que regulam a procura de que são objeto através da utilização de estratégias seletivas de definição de perfis preferenciais de alunos a admitir.Little is still known about how school organizations promote their educational supply to potential customers and how they regulate demand from families. This paper presents an exploratory study that addressed these questions. The research took place in two private schools that offer education at the elementary level. The data was collected through exploratory interviews with school principals and teaching staff. The results show that the organizations attempt to differentiate themselves in the market by constructing a brand image of themselves and that they use selective admission strategies by defining preferential student profiles

    The validity and reliability of the Portuguese versions of three tools used to diagnose delirium in critically ill patients

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    OBJECTIVES: The objectives of this study are to compare the sensitivity and specificity of three diagnostic tools for delirium (the Intensive Care Delirium Screening Checklist, the Confusion Assessment Method for Intensive Care Units and the Confusion Assessment Method for Intensive Care Units Flowsheet) in a mixed population of critically ill patients, and to validate the Brazilian Portuguese Confusion Assessment Method for Intensive Care Units. METHODS: The study was conducted in four intensive care units in Brazil. Patients were screened for delirium by a psychiatrist or neurologist using the Diagnostic and Statistical Manual of Mental Disorders. Patients were subsequently screened by an intensivist using Portuguese translations of the three tools. RESULTS: One hundred and nineteen patients were evaluated and 38.6% were diagnosed with delirium by the reference rater. The Confusion Assessment Method for Intensive Care Units had a sensitivity of 72.5% and a specificity of 96.2%; the Confusion Assessment Method for Intensive Care Units Flowsheet had a sensitivity of 72.5% and a specificity of 96.2%; the Intensive Care Delirium Screening Checklist had a sensitivity of 96.0% and a specificity of 72.4%. There was strong agreement between the Confusion Assessment Method for Intensive Care Units and the Confusion Assessment Method for Intensive Care Units Flowsheet (kappa coefficient = 0.96) CONCLUSION: All three instruments are effective diagnostic tools in critically ill intensive care unit patients. In addition, the Brazilian Portuguese version of the Confusion Assessment Method for Intensive Care Units is a valid and reliable instrument for the assessment of delirium among critically ill patients

    Multigene mutation profiling and clinical characteristics of small-cell lung cancer in never-smokers vs. seavy smokers (Geno1.3-CLICaP)

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    Objectives: Lung cancer is a heterogeneous disease. Presentation and prognosis are known to vary according to several factors, such as genetic and demographic characteristics. Small-cell lung cancer incidence is increasing in never-smokers. However, the disease phenotype in this population is different compared with patients who have a smoking history. Material and Methods: To further investigate the clinical and genetic characteristics of this patient subgroup, a cohort of small cell lung cancer patients was divided into smokers (n = 10) and never/ever-smokers (n = 10). A somatic mutation profile was obtained using a comprehensive NGS assay. Clinical outcomes were compared using the Kaplan-Meier method and Cox proportional models. Results: Median age was 63 years (46–81), 40% were men, and 90% had extended disease. Smoker patients had significantly more cerebral metastases (p = 0.04) and were older (p = 0.03) compared to their non-smoker counterparts. For never/ever smokers, the main genetic mutations were TP53 (80%), RB1 (40%), CYLD (30%), and EGFR (30%). Smoker patients had more RB1 (80%, p = 0.04), CDKN2A (30%, p = 0.05), and CEBPA (30%, p = 0.05) mutations. Response rates to first-line therapy with etoposide plus cisplatin/carboplatin were 50% in smokers and 90% in never/ever smokers (p = 0.141). Median overall survival was significantly longer in never smokers compared with smokers (29.1 months [23.5–34.6] vs. 17.3 months [4.8–29.7]; p = 0.0054). Never/ever smoking history (HR 0.543, 95% CI 0.41–0.80), limited-stage disease (HR 0.56, 95% CI 0.40–0.91) and response to first-line platinum-based chemotherapy (HR 0.63, 95% CI 0.60–0.92) were independently associated with good prognosis. Conclusion: Our data supports that never/ever smoker patients with small-cell lung cancer have better prognosis compared to their smoker counterparts. Further, patients with never/ever smoking history who present with small-cell lung cancer have a different mutation profile compared with smokers, including a high frequency of EGFR, MET, and SMAD4 mutations. Further studies are required to assess whether the differential mutation profile is a consequence of a diverse pathological mechanism for disease onset

    Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

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    Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio
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