O projeto CLIL4U: implementação, monitorização e avaliação de um projeto de ensino bilingue

O fenómeno da pós-globalização, que se tem feito sentir a uma larga escala na sociedade, traz consigo con- sequências sociais, políticas, económicas e culturais e exige um grande esforço de toda a comunidade para uma adaptação às novas exigências que acarreta. É neste contexto que surge o projeto CLIL4U, tendo como principal objetivo potenciar este diálogo de culturas desde uma idade precoce através de um processo de ensino-aprendizagem de língua e conteúdos integrados. Neste artigo, apresentaremos o projeto e seus pres- supostos, consecução e avaliação. Utilizando uma metodologia de índole etnográfica e maioritariamente qualitativa, focaremos a nossa atenção nas representações que alunos, professores e encarregados de edu- cação têm da implementação do projeto e sua monitorização.Os resultados mostram que os projetos CLIL (Content and Language Integrated Learning) podem ser uma mais-valia para instituições do 1o Ciclo do Ensino Básico, no que concerne a construção de um ensino centrado na aprendizagem pró-ativa de conteúdos.info:eu-repo/semantics/publishedVersio

UNLOCKing creative & innovative teaching in higher education extended abstracts

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The UBUNTUfication of a 21st century transformative primary english classroom

This project targets on African oral tradition storytelling intermingled with the Ubuntu philosophy and traditional cultures (Varty, 2013) in primary school learning contexts, focusing on how oral traditional stories can be integrated into classroom practices as a means of transformation and of accommodating diversity to foster social cohesion and sustainable development (Battiste, 2005; Themane, et al., 2011). By encompassing oral traditional storytelling with an experiential communicative approach (Fernández- Corbacho, 2014), both strategies and materials, which take into account the Gamification Octalysis Framework (Chou, 2016), have been created and experimented in a 4th year primary school in Oporto. Departing on Chou’s (2016) Octalysis framework and how it can effectively be applied during the implementation of several gamification designs and practices, leading us to a greater understanding of how competitiveness fostered in gamified tasks can be favourable to Primary English learning. Moreover, it is the authors’ intention to tap into the core essence of classroom practice, by focusing on the gamified tasks which stimulated collaboration, communication, critical thinking and creativity, which are considered as the basis for 21st century skills (Duarte, & Cruz 2017). An ethnographic methodological approach, with triangulation of data collection tools (questionnaires, course books analysis grids, lesson plans, self-assessment worksheets and project works), was resorted. Gamified practices, which deal with South African cultural and linguistic varieties (Esteves, & Hurst, 2009) and 21st Century Learning skills, were analized. The main results show that the gamification approach can aid in the progression of dialogue, can promote cultural awareness and can expedite pupil’s cognitive and affective enthralment and engagement, fostering the development of these skills (Cruz, & Orange, 2016; Shatz, 2015).Este trabalho foca-se na narrativa das tradições orais Africanas, articuladas com a filosofia Ubuntu e as culturas tradicionais (Varty, 2013) em contextos de aprendizagem do 1º CEB, concentrando-se na forma como as histórias tradicionais orais podem ser integradas nas práticas de sala de aula como meio de transformação e de acolhimento da diversidade, de forma a estimular a coesão social e o desenvolvimento sustentável (Battiste, 2005; Themane, et al., 2011). Ao abranger a narrativa tradicional oral com uma abordagem comunicativa experiencial (Fernández-Corbacho, 2014), estratégias e materiais, que têm em consideração a Octalysis Framework de Gamificação (Chou, 2016), foram criados e experimentados numa turma de 4º ano de uma escola do 1º CEB no Porto. O nosso objetivo é refletir sobre a estrutura de Octalysis de Chou (2016) e como ela pode efetivamente ser aplicada durante a implementação de vários designs e práticas de gamificação, levando-nos a uma melhor compreensão de como a competitividade promovida através de tarefas gamificadas pode ser favorável à aprendizagem do inglês no 1º CEB. Além disso, é a intenção dos autores explorar a essência central da prática da sala de aula, concentrando-se nas tarefas gamificadas que estimularam a colaboração, comunicação, pensamento crítico e a criatividade, que são consideradas como base nas competências do século XXI (Duarte, & Cruz, 2017). Recorreu-se a uma abordagem metodológica etnográfica, com triangulação de instrumentos de recolha de dados (questionários, grelhas de análise de manuais, planos de aula, fichas de autoavaliaçao e trabalhos de projeto). Foram analisadas práticas gamificadas que se encontram relacionadas com as variedades culturais e linguísticas da África do Sul (Esteves, & Hurst, 2009) e as competências para o século XXI (Duarte, & Cruz, 2017). Os principais resultados mostram que a abordagem da gamificação pode auxiliar na progressão do diálogo, promover a conscientização cultural e acelerar o efetivo entusiasmo e engajamento cognitivo dos alunos, promovendo o desenvolvimento dessas competências (Cruz, & Orange, 2016; Shatz, 2015)

Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study

Background: Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs). Methods: This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24 h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support. Results: A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24 h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83-7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97-2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14-1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25-1.30]). Conclusions: In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality. Trial registration This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable

Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study

Background: Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs). Methods: This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24 h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support. Results: A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24 h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83–7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97–2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14–1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25–1.30]). Conclusions: In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality. Trial registration This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable

Liver injury in hospitalized patients with COVID-19: An International observational cohort study

Background: Using a large dataset, we evaluated prevalence and severity of alterations in liver enzymes in COVID-19 and association with patient-centred outcomes.MethodsWe included hospitalized patients with confirmed or suspected SARS-CoV-2 infection from the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) database. Key exposure was baseline liver enzymes (AST, ALT, bilirubin). Patients were assigned Liver Injury Classification score based on 3 components of enzymes at admission: Normal; Stage I) Liver injury: any component between 1-3x upper limit of normal (ULN); Stage II) Severe liver injury: any component & GE;3x ULN. Outcomes were hospital mortality, utilization of selected resources, complications, and durations of hospital and ICU stay. Analyses used logistic regression with associations expressed as adjusted odds ratios (OR) with 95% confidence intervals (CI).ResultsOf 17,531 included patients, 46.2% (8099) and 8.2% (1430) of patients had stage 1 and 2 liver injury respectively. Compared to normal, stages 1 and 2 were associated with higher odds of mortality (OR 1.53 [1.37-1.71]; OR 2.50 [2.10-2.96]), ICU admission (OR 1.63 [1.48-1.79]; OR 1.90 [1.62-2.23]), and invasive mechanical ventilation (OR 1.43 [1.27-1.70]; OR 1.95 (1.55-2.45). Stages 1 and 2 were also associated with higher odds of developing sepsis (OR 1.38 [1.27-1.50]; OR 1.46 [1.25-1.70]), acute kidney injury (OR 1.13 [1.00-1.27]; OR 1.59 [1.32-1.91]), and acute respiratory distress syndrome (OR 1.38 [1.22-1.55]; OR 1.80 [1.49-2.17]).ConclusionsLiver enzyme abnormalities are common among COVID-19 patients and associated with worse outcomes

The value of open-source clinical science in pandemic response: lessons from ISARIC

International audienc

Characteristics and outcomes of an international cohort of 600 000 hospitalized patients with COVID-19

Background: We describe demographic features, treatments and clinical outcomes in the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) COVID-19 cohort, one of the world's largest international, standardized data sets concerning hospitalized patients. Methods: The data set analysed includes COVID-19 patients hospitalized between January 2020 and January 2022 in 52 countries. We investigated how symptoms on admission, co-morbidities, risk factors and treatments varied by age, sex and other characteristics. We used Cox regression models to investigate associations between demographics, symptoms, co-morbidities and other factors with risk of death, admission to an intensive care unit (ICU) and invasive mechanical ventilation (IMV). Results: Data were available for 689 572 patients with laboratory-confirmed (91.1%) or clinically diagnosed (8.9%) SARS-CoV-2 infection from 52 countries. Age [adjusted hazard ratio per 10 years 1.49 (95% CI 1.48, 1.49)] and male sex [1.23 (1.21, 1.24)] were associated with a higher risk of death. Rates of admission to an ICU and use of IMV increased with age up to age 60 years then dropped. Symptoms, co-morbidities and treatments varied by age and had varied associations with clinical outcomes. The case-fatality ratio varied by country partly due to differences in the clinical characteristics of recruited patients and was on average 21.5%. Conclusions: Age was the strongest determinant of risk of death, with a ∼30-fold difference between the oldest and youngest groups; each of the co-morbidities included was associated with up to an almost 2-fold increase in risk. Smoking and obesity were also associated with a higher risk of death. The size of our international database and the standardized data collection method make this study a comprehensive international description of COVID-19 clinical features. Our findings may inform strategies that involve prioritization of patients hospitalized with COVID-19 who have a higher risk of death

ISARIC-COVID-19 dataset: A Prospective, Standardized, Global Dataset of Patients Hospitalized with COVID-19

The International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) COVID-19 dataset is one of the largest international databases of prospectively collected clinical data on people hospitalized with COVID-19. This dataset was compiled during the COVID-19 pandemic by a network of hospitals that collect data using the ISARIC-World Health Organization Clinical Characterization Protocol and data tools. The database includes data from more than 705,000 patients, collected in more than 60 countries and 1,500 centres worldwide. Patient data are available from acute hospital admissions with COVID-19 and outpatient follow-ups. The data include signs and symptoms, pre-existing comorbidities, vital signs, chronic and acute treatments, complications, dates of hospitalization and discharge, mortality, viral strains, vaccination status, and other data. Here, we present the dataset characteristics, explain its architecture and how to gain access, and provide tools to facilitate its use