Introduction Increased mortality has been demonstrated in older adults with COVID-19, but the effect of frailty has been unclear. Methods This multi-centre cohort study involved patients aged 18 years and older hospitalised with COVID-19, using routinely collected data. We used Cox regression analysis to assess the impact of age, frailty, and delirium on the risk of inpatient mortality, adjusting for sex, illness severity, inflammation, and co-morbidities. We used ordinal logistic regression analysis to assess the impact of age, Clinical Frailty Scale (CFS), and delirium on risk of increased care requirements on discharge, adjusting for the same variables. Results Data from 5,711 patients from 55 hospitals in 12 countries were included (median age 74, IQR 54–83; 55.2% male). The risk of death increased independently with increasing age (>80 vs 18–49: HR 3.57, CI 2.54–5.02), frailty (CFS 8 vs 1–3: HR 3.03, CI 2.29–4.00) inflammation, renal disease, cardiovascular disease, and cancer, but not delirium. Age, frailty (CFS 7 vs 1–3: OR 7.00, CI 5.27–9.32), delirium, dementia, and mental health diagnoses were all associated with increased risk of higher care needs on discharge. The likelihood of adverse outcomes increased across all grades of CFS from 4 to 9. Conclusions Age and frailty are independently associated with adverse outcomes in COVID-19. Risk of increased care needs was also increased in survivors of COVID-19 with frailty or older age.
The digital revolution is rapidly transforming the world of work and the skills profiles of many occupations. The pace of change necessitates continuous skilling and reskilling, through lifelong learning. Traditional models of TVET which view formal training as terminal will not prepare workers for the constantly evolving world of work in an age of technological transformations. This paper argues for the need to integrate informal and non-formal learning in TVET systems and address the pedagogical implications of this integration. Research on emerging innovative approaches to TVET in both developed and developing country contexts is reviewed, with a special focus on new models for work-based and community-based learning, which can promote transformative, lifelong learning. The actual and potential role of technology within these models is highlighted, together with recommendations for policy and practice.
COVID-19 has had a major impact on international higher education with border closures, cancelled flights, and a shift to online teaching and learning. As a result, many international students have decided to either abandon or defer their plans to study abroad. If students stay in their home countries, many institutions that rely heavily on foreign students’ fees will suffer, with potential impacts on national economies. Beyond the economic implications, it is also important to consider the personal impact of COVID-19 on international students, who may face delays or obstacles to program completion, employment and/or immigration. Though there are certainly risks and losses in the short term, the demand for international education, and the benefits it offers, are expected to grow. This presents an opportunity for higher education institutions (HEIs) and governments, not just to lessen the impact of COVID-19 on their current business models, but to explore new models and opportunities. HEIs and governments must look at redefining international higher education for the new normal, which will entail a shift in policies and programmes. This paper outlines the implications of the COVID-19 crisis for international higher education and presents potential opportunities for governments and higher education institutions to refresh and redefine their approaches for the new normal.
The relationship between education and empowerment has been widely debated in development literature. In recent times, social capital and community-centric learning have been increasingly recognized as important variables in the empowerment process. This paper outlines the development of a Three-dimensional Framework for Empowerment, and looks at the relationship between a community-centric learning process and empowerment in selected villages in Uganda. Based on a comparative study of two villages, the paper evaluates the role of the Lifelong Learning for Farmers (L3F) programme, developed and supported by the Commonwealth of Learning (COL), in empowering farming communities. The study shows that the integration of human capital (viewed purely from learning, knowledge acquisition, reflective practices, skills and competencies) social capital and financial capital, has a positive impact on development outcomes such as empowerment.
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