72 research outputs found

    No More Games: A Pronunciation Guidebook for New EFL Teachers Working in Asian Countries

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    Many cram schools in Asia and online TESOL certificate programs often do not include training focused on pronunciation instruction. Consequently, teachers lack confidence and skills to teach pronunciation. The area of instruction is commonly ignored, and a need exists for instructional materials designed for new EFL teachers to support their students. This guidebook is a tool for inexperienced pre-service or in-service EFL teachers who plan to teach abroad. The overall purpose of the project was to raise the level of pronunciation training for inexperienced teachers, give them confidence to include it as a part of their curriculum, and to instill a desire for them to become self- learners of pronunciation features in English and across languages. The materials were developed based on communicative teaching strategies and include suggestions for assessing, monitoring, and providing feedback to learn

    Utilization of mechanical power and associations with clinical outcomes in brain injured patients: a secondary analysis of the extubation strategies in neuro-intensive care unit patients and associations with outcome (ENIO) trial

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    Background: There is insufficient evidence to guide ventilatory targets in acute brain injury (ABI). Recent studies have shown associations between mechanical power (MP) and mortality in critical care populations. We aimed to describe MP in ventilated patients with ABI, and evaluate associations between MP and clinical outcomes. Methods: In this preplanned, secondary analysis of a prospective, multi-center, observational cohort study (ENIO, NCT03400904), we included adult patients with ABI (Glasgow Coma Scale ≤ 12 before intubation) who required mechanical ventilation (MV) ≥ 24 h. Using multivariable log binomial regressions, we separately assessed associations between MP on hospital day (HD)1, HD3, HD7 and clinical outcomes: hospital mortality, need for reintubation, tracheostomy placement, and development of acute respiratory distress syndrome (ARDS). Results: We included 1217 patients (mean age 51.2 years [SD 18.1], 66% male, mean body mass index [BMI] 26.3 [SD 5.18]) hospitalized at 62 intensive care units in 18 countries. Hospital mortality was 11% (n = 139), 44% (n = 536) were extubated by HD7 of which 20% (107/536) required reintubation, 28% (n = 340) underwent tracheostomy placement, and 9% (n = 114) developed ARDS. The median MP on HD1, HD3, and HD7 was 11.9 J/min [IQR 9.2-15.1], 13 J/min [IQR 10-17], and 14 J/min [IQR 11-20], respectively. MP was overall higher in patients with ARDS, especially those with higher ARDS severity. After controlling for same-day pressure of arterial oxygen/fraction of inspired oxygen (P/F ratio), BMI, and neurological severity, MP at HD1, HD3, and HD7 was independently associated with hospital mortality, reintubation and tracheostomy placement. The adjusted relative risk (aRR) was greater at higher MP, and strongest for: mortality on HD1 (compared to the HD1 median MP 11.9 J/min, aRR at 17 J/min was 1.22, 95% CI 1.14-1.30) and HD3 (1.38, 95% CI 1.23-1.53), reintubation on HD1 (1.64; 95% CI 1.57-1.72), and tracheostomy on HD7 (1.53; 95%CI 1.18-1.99). MP was associated with the development of moderate-severe ARDS on HD1 (2.07; 95% CI 1.56-2.78) and HD3 (1.76; 95% CI 1.41-2.22). Conclusions: Exposure to high MP during the first week of MV is associated with poor clinical outcomes in ABI, independent of P/F ratio and neurological severity. Potential benefits of optimizing ventilator settings to limit MP warrant further investigation

    Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

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    BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

    Connecting Personal History and Organizational Context: Suggestions for Developing Educational Programs for Youth Soccer Coaches

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    Literature underscores the complex role of coaches in sport organizations, especially in youth sectors. Their need for support, not only on the technical level, is emerging. In recent years an interesting international debate has evolved regarding what education is most suitable to support coach development. The article intends to enter this debate by proposing an educational model for youth soccer coaches. This educational proposal is the outcome of reflection that originated from various experiences with about 110 Italian youth soccer coaches over the past six years. The first part is dedicated to a review of the literature on coaching education, and the second to the educational model presented (e.g., theoretical background, characteristics, setting, outcomes, and considerations regarding the management of this educational process). The strength of this model was precisely to have put some recurrent issues in dialogue with the specific organizational contexts in which the educational programs were implemented

    Does corporate social performance yiedl any tangible financial benefit during a crisis? An event study on Lehman Brothers' Bankruptcy

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    The aim of this article is to empirically test – through the event study methodology – whether Corporate Social Performance (CSP) had any impact on Corporate Financial Performance (CFP) in the context of the crisis due to Lehman Brothers ’ bankruptcy. Drawing on previous studies belonging to different streams of literature, this article proposes three mechanisms that may have linked CSP to CFP in the context of the crisis. Stock prices of the non-fi nancial companies included in the S & P 500 stock market index are examined before and during the bankruptcy announcement. Empirical fi ndings show that in the context of the crisis due to Lehman Brothers ’ bankruptcy, CSP was positively correlated with short-term CFP (Abnormal Returns), thus providing a buffer effect

    Erectile dysfunction and its management in patients with diabetes mellitus

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    Risk factors of extubation failure in neurocritical patients with the most impaired consciousness

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