Education for Environmental Citizenship plays an important role in social change toward sustainable development, achieving economic, social, and environmental balance through informed, cooperative, and participative citizens. There are several pedagogical models with the potential to involve students in environmental activities, but no specific model suitable for primary education is found. This article describes the preliminary investigation phase of a Design-Based Research that resulted in the development of the first prototype of a Pedagogical Model of Education for Environmental Citizenship in Primary Education (students aged 6 to 10 years), in Portugal. This preliminary investigation phase was based on a systematic analysis and literature review on the topic (thesis, articles, projects, and curricular guidelines for primary education), seeking to answer the following research questions: (1) According to the current world characteristics, which learning outcomes should an environmental citizen achieve, and which of them can be promoted in primary education? (2) What are the most appropriate teaching methodologies and strategies for promoting environmental citizen learning outcomes in primary education? The methodology used is presented, and the proposed prototype is described, along with the desired learning outcomes that are considered necessary for the formation of an Environmental Citizen and the most appropriate methodologies and educational activities to promote them.

Este artículo evalúa la implementación de un modelo pedagógico de educación para la ciudadanía ambiental en el primer ciclo de educación básica (1º CEB), en Portugal (alumnos entre 6 y 10 años). El objetivo era probar un modelo didáctico en un contexto escolar real, intentando responder a las siguientes preguntas de investigación: (1) ¿Cuáles son los principales factores que apoyan o justifican la implantación de un modelo didáctico de educación para la ciudadanía ambiental en el 1º CEB? (2) ¿Cuáles son los principales factores que dificultan la implantación de un modelo didáctico de educación para la ciudadanía ambiental en el 1º CEB, y cómo superarlos? (3) ¿Cómo interpreta el profesorado de primaria el modelo didáctico y lo ponen en práctica en el aula? (4) ¿Cuál es la percepción del profesorado de 1º CEB sobre la idoneidad de este modelo para la realización de una educación para la ciudadanía ambiental en este nivel de escolarización? Este trabajo constituye una de las iteraciones de una Investigación Basada en el Diseño cuyo objetivo es desarrollar un Modelo Didáctico para la educación para la ciudadanía ambiental en el 1º de CEB en Portugal. Esta implementación se llevó a cabo en cuatro escuelas públicas, en Portugal, con 23 clases (dirigidas por 23 maestras) y unos 500 estudiantes en total, repartidos en 4 cursos escolares (1º a 4º). A partir de la observación directa, notas de campo y entrevistas semiestructuradas con las maestras, se respondió a las cuestiones de investigación y se identificaron sus percepciones sobre las principales competencias a desarrollar por los estudiantes, así como las respectivas metodologías y estrategias educativas consideradas más adecuadas para una educación promotora de competencias de ciudadanía ambiental en la enseñanza primaria. Además, fue posible observar cómo las maestras implementaron en el aula el modelo didáctico propuesto e identificar las dificultades experimentadas durante su aplicación. Palabras clave: Educación para la Ciudadanía Ambiental, Educación Primaria, Investigación Basada en el Diseño, Modelo Didáctico. Implementation and evaluation of a pedagogical model of education for environmental citizenship in Portugal by primary school teachers This article evaluates the implementation of a pedagogical model of education for environmental citizenship in primary education, in Portugal (students between 6 and 10 years old). The objective was to test a pedagogical model in a real school context, trying to answer the following research questions: (1) What are the main factors that support or justify the realization of an education for environmental citizenship in primary education? (2) What are the main factors that make difficult to conduct an education for environmental citizenship in primary education, and how to overcome them? (3) What are the perceptions of the primary education teachers about the suitability of this model for conducting an education for environmental citizenship at this school level? This test is one of the iterations of a Design-Based Research aimed to design a pedagogical model of education for environmental citizenship in primary education, in Portugal. This implementation was carried out in four public schools, in Portugal, with 23 classes (guided by 23 teachers), and about 500 students, in total, distributed over the 4 years of schooling. Based on direct observation, field notes and semi-structured interviews with teachers, it was possible to answer the research questions as well as identify their perceptions regarding the main skills to be developed by students, the respective methodologies and the teaching-learning strategies considered the most appropriate for an education that promotes environmental citizenship skills. Keywords: Education for environmental citizenship, Primary education, Design-based research, Pedagogical model. Este artículo evalúa la implementación de un modelo pedagógico de educación para la ciudadanía ambiental en el primer ciclo de educación básica (1º CEB), en Portugal (alumnos entre 6 y 10 años). El objetivo era probar un modelo didáctico en un contexto escolar real, intentando responder a las siguientes preguntas de investigación: (1) ¿Cuáles son los principales factores que apoyan o justifican la implantación de un modelo didáctico de educación para la ciudadanía ambiental en el 1º CEB? (2) ¿Cuáles son los principales factores que dificultan la implantación de un modelo didáctico de educación para la ciudadanía ambiental en el 1º CEB, y cómo superarlos? (3) ¿Cómo interpreta el profesorado de primaria el modelo didáctico y lo ponen en práctica en el aula? (4) ¿Cuál es la percepción del profesorado de 1º CEB sobre la idoneidad de este modelo para la realización de una educación para la ciudadanía ambiental en este nivel de escolarización? Este trabajo constituye una de las iteraciones de una Investigación Basada en el Diseño cuyo objetivo es desarrollar un Modelo Didáctico para la educación para la ciudadanía ambiental en el 1º de CEB en Portugal. Esta implementación se llevó a cabo en cuatro escuelas públicas, en Portugal, con 23 clases (dirigidas por 23 maestras) y unos 500 estudiantes en total,...

Este artigo avalia a implementação de um modelo pedagógico de educação para a Cidadania Ambiental no 1.º Ciclo do Ensino Básico (CEB) em Portugal (alunos entre seis e dez anos). O objetivo foi testar o modelo em contexto real escolar, de modo a ser avaliado pelos próprios alunos, procurando responder às seguintes questões de investigação: (1) Quais as perceções dos alunos do 1.º CEB sobre as atividades de Cidadania Ambiental realizadas?; e (2) Quais as aprendizagens que resultaram das atividades de Cidadania Ambiental realizadas? Esta testagem constitui uma das iterações de uma Investigação Baseada em Design destinada a conceber um Modelo Pedagógico de Educação para a Cidadania Ambiental no 1.º CEB em Portugal. A implementação do modelo pedagógico foi realizada em quatro escolas públicas do 1.º CEB, num total de 23 turmas (orientadas por 23 professoras) e cerca de 500 alunos, distribuídos pelos 4 anos de escolaridade. Com base em observação direta, notas de campo e entrevistas semiestruturadas realizadas aos alunos, procurou-se identificar as suas perceções acerca das atividades de Cidadania Ambiental realizadas e as aprendizagens que resultaram dessas atividades. De um modo geral, os alunos, após a realização das atividades de Cidadania Ambiental, desenvolveram competências de Cidadania Ambiental, mudaram os seus comportamentos e atitudes e demonstraram vontade em participar de forma mais ativa na resolução de problemas ambientais locais em conjunto com a comunidade escolar e local, tendo ficado, desta forma, mais empoderados para a ação. A implementação do modelo pedagógico foi realizada em quatro escolas públicas do 1.º CEB, num total de 23 turmas (orientadas por 23 professoras) e cerca de 500 alunos distribuídos pelos 4 anos de escolaridade. Com base em observação direta, notas de campo e entrevistas semiestruturadas realizadas aos alunos, procurou-se identificar as suas perceções acerca das atividades de Cidadania Ambiental realizadas e as aprendizagens que resultaram dessas atividades. De um modo geral, os alunos, após a realização das atividades de Cidadania Ambiental, desenvolveram competências de Cidadania Ambiental, mudaram os seus comportamentos e atitudes e demonstraram vontade em participar de forma mais ativa na resolução de problemas ambientais locais em conjunto com a comunidade escolar e local, tendo ficado, desta forma, mais empoderados para a ação.

Background: Despite great advances in the diagnosis and treatment of lupus, the scientific community does not know the perception of our patients regarding the knowledge of the disease and the relationship between patients and disease. Fatigue had the greatest impact on activities of daily living, yet the majority reported receiving no support or poor support in managing it¹. Objectives: Through this initiative, it is intended to investigate about the knowledge of the disease and impact of the disease on quality of life of Lupus patients. Another objective is to give visibility to the current needs of people living with lupus. Methods: It was performed a national survey with 1,263 interviews with Lupus patients who reside in Spanish territory and belonging to lupus patient associations in Spain. The survey was carried out by the Spanish Lupus Federation (FELUPUS) in collaboration with GSK company. Online interview lasting approximately 25 minutes. The collection of information was anonymously carried out from May 21 to June 30, 2020. Results: 1.263 lupus patients were interviewed, 92% diagnosed with SLE and 8% with CLE. Survey sample is representative of the Lupus patient population in Spain [associated sampling error: 2.76%]. Questions about knowledge of the disease showed that 73% of patients considered that there is very little knowledge of the disease by society. Patient awareness of lupus increases as the disease progresses, so at the time of diagnosis, level of knowledge of the patient about Lupus is low in 92% of patients and at the moment of survey, 68% of patient had high knowledge. In terms of the perception of his illness, the affectation of the kidneys and heart (97%), fatigue and skin rashes (97%), are the statements that generate the greatest consensus. The survey about the relationship to disease demonstrated that 3 out of 4 patients have symptoms related to the disease, muscle and joint pain (75%) and fatigue (74%) are the symptoms that cause the greatest discomfort (Graph 1). Remarkable degree of agreement with the fact of not being able to sunbathe (78%), as well as the lack of energy (61%) and weakness in the body (60%). Flare-ups (86%), followed by fatigue (78%) and pain (77%) cause great concern. At diagnosis, 92% of patients have some organic involvement and regarding the diagnosis, at present, a greater number of patients present damage to the CNS (17%) and bones (21%). Many patients do not understand the concept of organ damage, wrongly relating it to fatigue (38%) or joint pain (47%). Conclusion: Among the conclusions of the survey, it stands out that society and the general population are unaware of what lupus is, while in the case of lupus patients, knowledge increases as the disease progresses. Citizen awareness campaigns about this disease are necessary, where patient associations together with health authorities have a crucial job. On the other hand, 92% of patients present organ damage at diagnosis. This means that we are arriving late to the diagnosis of many patients, which makes it necessary to promote a close collaboration between Primary Care and Hospitals, to refer patients as soon as they suspect SLE. References: [1]Sloan M, Harwood R, Sutton S, D’Cruz D, Howard P, Wincup C, Brimicombe J, Gordon C. Medically explained symptoms: a mixed methods study of diagnostic, symptom and support experiences of patients with lupus and related systemic autoimmune diseases. Rheumatol Adv Pract. 2020 Feb 26;4(1):rkaa006. What worries the most to Lupus patients? Question P12. Please indicate your level of concern with the following aspects of Lupus. Percentage of patients who have scored a 4 or 5 for each item (% T2B). Acknowledgements: GSK funded the study presented in the Disclosure of Interests: Patricia Fanlo Grant/research support from: GSK funded the study presented in the

Background: Articular involvement can reach up to 95% within the multisystemic manifestations of SLE. Originally, a non-erosive pattern of articular inflammation was described, but the emergence of more sensitive imaging techniques, such as Magnetic Resonance Imaging (MRI), show synovitis (S), erosions (E), bone marrow edema (BME) and tenosynovitis (TS) in patients with systemic lupus erythematosus (SLE). Nowadays, a specific validated pattern of articular involvement associated with this disease does not yet exist, although it has begun to be studied (1,2). Objectives: To asses the extent of structural joint involvement in proximal interphalangeal joints (PIP), hand and wrist: E, BME, S, TS and peritendinitis (PT) by MRI, in patients diagnosed with SLE with hand arthritis or arthralgia. Methods: All patients with SLE who manifested hand pain and/or swelling in the prior 6 months were consecutively included in the study. They were divided into two groups: arthritis or arthralgia, according to the physical examination by an expert rheumatologist. All patients underwent an MRI with contrast injection on their non-dominant hand. The images obtained were evaluated following RAMRIS criteria extended to PIP and Tenosinovitys score for RA by two expert musculoskeletal radiologists, blind to the groups. Results: 32 patients were included: arthritis: n = 13, arthralgia: n = 19, with a mean age of 50.91 ± 13.37 years and a disease evolution time of 10.21 ± 8.26 years. The average SLEDAI score 6.30 ± 3.40 for the arthritis groups and 3.79 ± 2.14 for the arthralgia group. The average SLICC score was 0.23 ± 0.42 in the arthritis group and 0.1 ± 0.31 in the arthralgia group. E was found in 7 patients with arthritis (53.84%) (15.38% in PIP, 0% in hand and 53.84% in wrist) and in 13 patients with arthralgia (68.42%) (0% in PIP, 10.52% in hand and 68.42% in wrist). BME was observed in 4 patients with arthritis (30.76%) (7.69% in PIP, 0% in hand and 30.76% in wrist) and in 5 patients with arthralgia (26.31%) (5.26% in PIP, 10, 52% in hand and 15.78% in wrist). S was observed in 12 patients with arthritis (92.30%) (61.58 in PIP, 76.92% in hand and 84.61% in wrist) and in 8 patients with arthralgia (42.10%) (31.57% in PIP, 36.84% in hand and 36.84% in wrist). TS was observed in 6 patients with arthritis (46.15%) (38.46% in flexor tendons and 23.07% in extensor tendons) and in 8 patients with arthralgia (42.10%) (31.57% in flexor tendons and 21.05 % in extensor tendons). PT was found in 6 patients with arthritis (23.07%) and in no patient with arthralgia (0%) Conclusion: MRI allows us to diagnose musculoskeletal involvement in SLE, morphologically similar to rheumatoid arthritis (erosion, bone marrow edema, synovitis and tenosynovitis), which usually are underestimated on plain radiography. This study also shows the important erosive burden of arthritis in SLE, which has not been well characterised yet. In addition, it demonstrates the underestimation of physical examination to diagnose active inflammatory damage, such as subclinical synovitis, in patients with inflammatory arthralgias. References: [1]Mosca M, Tani C, Carli L, Vagnani S, Possemato N, DelleSedie A, et al. The role of imaging in the evaluation of joint involvement in 102 consecutive patients with systemic lupus erythematosus. Autoimmun Rev. 2015; 14: 10-5 [2]Tani C, D’Aniello D, Possemato N, DelleSedie A, Caramella D, Bombardieri S, Mosca M. MRI pattern of arthritis in systemic lupus erythematosus: a comparative study with rheumatoid arthritis and healthy subjects. Skeletal Radiol. 2015;44:261-6 Disclosure of Interests: None declared

Este artigo apresenta a avaliação por especialistas de um protótipo de um Modelo Pedagógico de Educação para a Cidadania Ambiental destinado aos quatro primeiros anos de escolaridade em Portugal (1.º Ciclo do Ensino Básico: alunos entre 6 e 9 anos). Esta avaliação integra-se numa Investigação Baseada em Design que tem por objetivo o desenvolvimento desse modelo pedagógico. Um primeiro protótipo, desenvolvido a partir da análise da literatura foi submetido a uma avaliação por três painéis de especialistas de reconhecido mérito nas áreas de Educação Ambiental, Educação do 1.º Ciclo do Ensino Básico e Líderes da Comunidade. Esta avaliação foi efetuada através da resposta a um questionário on-line (um para cada grupo de especialistas) destinado a recolher sugestões de melhoria do primeiro protótipo. Segundo os especialistas o protótipo atende aos objetivos de uma Educação para a Cidadania Ambiental, constituindo um bom ponto de partida para potenciar a consciencialização ambiental precoce e um maior contato com a realidade ambiental. Contudo, e apesar de implícitas no protótipo avaliado, foram introduzidas as competências de capacidade de tomada de decisões, capacidade de resolução de problemas, capacidade de comunicação e pensamento crítico, que foram sugeridas pelos especialistas de modo a evidenciar essas competências. Foram igualmente efetuadas algumas alterações às metodologias e às etapas do protótipo, para adequá-las aos objetivos do estudo. Desta forma, com base na análise de conteúdo das respostas dos diferentes especialistas e em literatura relevante foi construído um segundo protótipo que é apresentado no final deste artigo.