LITERATURA E PRÁTICA TRANSLÍNGUE: REFLEXÕES SOBRE PORTUNHOL E POESIA

This work aims to reflect on the linguistic repertoire (RYMES, 2014) present in the literature written in portunhol and to think about the translanguaging practice (CANAGARAJAH, 2013) that permeates it. In addition, this research seeks to reflect on issues of identity (SILVA, 2014) as they relate to the local identity performances (MOITA LOPES, 2013) present in this literature. For that, we selected as an object of study the poem "Trinticuatro", which is part of the book "Noite nu Norte" (2011), by the Uruguayan writer born in Artigas, Fabián Severo. The reflections on the poem demonstrated the relevance of the recognition of the portunhol as a legitimate practice, of identity and artistic importance. Furthermore, they corroborated the need to think of languages ​​no longer from a monolingual perspective, but as local practices through which subjects act creatively in the world according to their purposes.O objetivo deste trabalho é refletir sobre o repertório linguístico (RYMES, 2014) presente na literatura escrita em portunhol e ponderar sobre a prática translíngue (CANAGARAJAH, 2013) que a perpassa. Além disso, esta pesquisa busca refletir sobre questões de identidade (SILVA, 2014) no que se relacionam às performances identitárias locais (MOITA LOPES, 2013) presentes nessa literatura. Para isso, selecionamos como objeto de estudo o poema “Trinticuatro”, que faz parte do livro “Noite nu Norte” (2011), do escritor uruguaio nascido em Artigas, Fabián Severo. As reflexões qualitativas realizadas sobre o poema demonstraram a relevância do reconhecimento do portunhol enquanto língua, de importância identitária e artística. Além disso, corroboraram com a necessidade de pensar as línguas não mais a partir de uma perspectiva monolíngue, mas enquanto práticas locais por meio das quais os sujeitos agem no mundo de forma criativa segundo seus propósitos

Educação bilíngue: processos de aquisição da linguagem e capacitação de profissionais especializados

Este trabalho tem como objetivo apresentar a educação bilíngue em contexto formal de ensino de línguas de sociedades monolíngues bem como algumas das práticas observadas para o desenvolvimento dessa abordagem. Apresentaremos aqui um panorama dos aspectos que permeiam o desenvolvimento dos profissionais e alunos envolvidos nesse processo de aquisição de linguagem. Também estão presentes neste trabalho características pertinentes ao mundo atual que fizeram com que a perspectiva da educação bilíngue encerrasse a melhor opção de formação daquele indivíduo que estará diante de um fenômeno de globalização nunca antes observado. Com base nos estudos de Krashen (2003; 1982), Garcia (2009), Stryker & Leaver (1997), Mehisto et al (2008), Mejía (2002), Salgado (2008) e Myers-Scotton (2006), essa pesquisa discute questões tais como motivação, contexto de ensino, aspectos pedagógicos da abordagem e aquisição de línguas apresentados através das notas de campo colhidas das observações participantes feitas em uma instituição de ensino de línguas da cidade de Juiz de Fora/MG. A preocupação dessa instituição é oferecer aos alunos atividades em língua inglesa que visam a motivar a participação dos alunos e desenvolver neles autonomia e confiança quanto ao uso da língua. As notas de campo dos pesquisadores, que posteriormente foram expandidas, apresentam registros de abordagens por parte dos profissionais especializados, busca por motivação e interação dos estudantes, reações dos alunos face ao novo conhecimento apresentado, a manutenção da perspectiva de recriação constante de ambiente bilíngue entre outros aspectos. Esse trabalho também se propõe a elencar características básicas que permitam a compreensão de conceitos tais como bilinguismo e bilingualidade

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research