Association Between The Discharge Process And Post-Discharge Events In Patients With Heart Failure

Background: HF is a burden on healthcare resources due to the high cost of frequent readmissions. Predictive models have been reported for the post-discharge prognosis of HF. However, these models mostly included non-modifiable factors and their predictive accuracy was limited. This implies that potentially modifiable factors are needed, which could be attributed to the discharge process. This study aimed to explore the relationship between the discharge process and post-discharge events in patients with HF.Methods: Medical records were reviewed to identify patients who were admitted for HF exacerbation. Information related to the discharge process included post-discharge clinic appointments, educational contents before discharge, and family participation during patient education. HF-related events were defined as a composite of events, including emergency department visits, readmissions, or death. A multivariable Cox proportional hazards regression model was used to explore the association between the discharge process and HF-related events.Results: Of 201 patients, 41 had at least one HF-related event. Post-discharge clinic appointments were scheduled 8 days after discharge. Patients received their discharge education on average of one topic, and approximately the families of 70% of the patients participated in this educational activity. In the Cox regression model, family participation during education was independently associated with a longer time to HF events (hazard ratio: 2.105). However, and post-discharge follow-up appointments and the number of educational contents received were not associated with the time to HF events. Conclusion: We found that family participation during education is a protective factor for adverse prognosis in patients with HF. Our results highlight the importance of family engagement in HF management.

Proposing the Introduction of Personalised Learning and Differentiated Learning into Saudi Arabian Education: مقترح إدخال التعلّم الفردي والتعلّم المتمايز في التعليم السعودي

Personalised learning and the differentiated curriculum are ideal strategies to explore the needs of students and take full advantage of students’ abilities so they can achieve better outcomes in the learning process. This study focuses on the differentiated curriculum and explores its suitability for Saudi Arabia considering the country’s current education policies and vision. The study consists of three stages: reviewing the global personalised learning and differentiation literature, investigating the current education policies in Saudi Arabia, and reviewing the available differentiation literature conducted in Saudi Arabia. The findings suggest that despite the obstacles found in the application including low family participation and resistance from teachers this teaching strategy is suitable for Saudi Arabia. The Saudi vision for education and the country’s current policies do not conflict with the principles of differentiation, although success may require patience and building teacher capacity. With only a limited number of studies about differentiation in Saudi Arabia, more research about the impact of school management on the implementation of the differentiated curriculum is necessary.

The view of school management beyond the institutional framework: perceptions about their own performance and family participation in school

In this study, we analyzed the relationship between the management team of a State School in Minas Gerais and the families of the students, identifying perceptions about their own performance and the participation of families in the institutional scope. To this end, the theoretical-methodological axis is characterized by a case study, with a descriptive approach and a qualitative approach, based on a corpus consisting of information from seven Basic Education Specialists (BSE). Thus, we found that the management team, in general, admits the essentiality of family participation at the institutional level. However, according to the findings of this research, conflicting situations are evidenced between school members and family members/guardians of students, which demonstrates the constant need for school debates on interpersonal relationships, even with the possibility of stirring up controversies and causing confrontations of ideas, given the need to put democratic guiding principles into practice, through communicability.