OBJECTIVE To evaluate factors associated with hospital death in older inpatients for specific diseases of the circulatory system in the Brazilian Unified Health System considering the risk-adjusted hospital mortality as an indicator of effectiveness.METHODS The data were extracted from the Brazilian Hospital Information System. A total of 385,784 hospitalizations of older were selected for hypertensive diseases, ischemic heart disease, congestive heart failure, and stroke in the Brazilian Southeast region between 2011 and 2012. Age, sex, emergency admission, principal diagnosis, and two comorbidity indexes were included in the logistic regression for the risk adjustment of hospital death. The analyses were developed at two levels: hospitalization and hospital.RESULTS A greater chance of death was observed with increasing age, emergency hospitalizations, stroke, presence of comorbidities, especially pneumonia and weight loss, hospitalizations for clinical care, and use of intensive care units. The risk-adjusted hospital mortality rate was 11.1% in for-profit private hospitals, 12.3% in non-profit private hospitals, and 14.4% in public hospitals, but there was great variability among the hospitals. The hospital standardized mortality ratio (ratio between observed and predicted deaths) ranged from 103.3% in non-profit private hospitals to 118.2% in for-profit private hospitals.CONCLUSIONS Although the information source has its shortcomings, the ability for discrimination of the risk adjustment model was reasonable. The variability in the risk-adjusted hospital mortality was great and comparatively higher in for-profit private hospitals. Despite the limits, the results favor the use of the risk-adjusted hospital mortality in the monitoring of the quality of hospital care provided to the older adult.

In recent years, many programs in Educational Administration have added the requirement of an administrative internship. This paper explores how internship learning differs from classroom learning using a theoretical framework of legitimate peripheral participation. The paper also explores how the internship impacts both the intern and the mentor as well as how reflection opportunities can be built into the internship. The paper concludes with an Intern Transition Model.

The study of social identity can unlock many features of local culture. This article presents a theoretical model of social identity as a pragmatic text iterated within routine social interaction. Identities are repeatedly claimed during social life as part of the pragmatic infrastructures through which humans interact. Qualitative researchers can study social identity through direct observations of social life and through encouraging participants to talk, in interviews, about a variety of activities in which they routinely take part. In the later stages of qualitative interview, paraphrasing and active listening responses may be appropriately used to discuss the self directly, but in terms still tied to contexts of daily activity. Subsequent analysis of identity claims must be theory guided, because of their tacit and textual properties. A case study of 20 high-achieving Hispanic students is used to illustrate our theory, and methodological implications are summa rized at the end of the article.

In early 2020, the rapid spread of the COVID-19 pandemic was an unprecedented shock to the global education system, resulting in most educational institutions closing their doors and turning to various forms of remote learning to ensure continuous education for their communities. Since the world has not experienced this scale of school closure before, the goal of this study was to explore what, if anything, non-state schools (NNSs) were doing to support remote learning that may help them to prepare for future events that curtail education. In May 2020, Edify, an international non-governmental organization (INGO) operating in eleven nations in Latin America (LATAM), Sub-Saharan Africa and India conducted a telephone survey with a stratified random sample of 388 school leaders. Since the extent learning had continued across contexts was relatively unknown, the survey aimed to inform the organization's current and future responses to the COVID-19 pandemic and potential future educational interruptions. In addition to identifying the various uses of technology and possible innovations as to how non-state schools can respond when a crisis impacts their operating status, this paper describes three areas of concern expressed by the school leaders: (1) the health and safety of children and adults in their schools; (2) the various challenges of maintaining financial sustainability; and (3) the learning loss of students from the lack of preparedness for such a massive interruption in their school's normal operations.