Across the USA and various parts of the world, ambulatory surgery centers have transitioned to accepting patients with advanced ASA statuses, leading to a larger volume and higher complexity of surgeries performed, while still urging for same-day patient discharges. Inadequate postoperative pain management and opioid analgesia side effects, such as sedation, respiratory depression, and postoperative nausea and vomiting, are the most common complications and most common reasons for readmission after ambulatory surgery. The trend to limiting these complications and achieve a more rapid patient discharge currently emphasizes a multifactorial, balanced analgesia strategy. This article reviews the multimodal approach by detailing the important aspects of specific regional nerve blocks, nerve blockade with catheter techniques, acetaminophen, non-selective NSAIDs, Cox-2 inhibitors, membrane stabilizers, and corticosteroids. Pain management in the ambulatory surgery patient will thus be optimized with a thorough preoperative evaluation, recognizing intraoperative events, and implementing multiple analgesic modalities.
In this design challenge by the Texas Space Grant Consortium, the researchers design a cooling system for a lithium-ion battery. Lithium-ion batteries are an effective and reliable source of energy for small, portable devices. However, similar to other existing sources of energy, there is always a problem with overheating. The objective is to design a cooling system for lithium-ion batteries that will work in a zero gravity environment for orbital and interplanetary space systems. The system is to serve as a backup battery and a signal booster that can be incorporated into a spacesuit. The design must be able to effectively cool the batteries without the use of an atmosphere to carry away heat but also be a lightweight and reliable design. The design incorporates carbon nanotubes suspended in distilled water creating a nano-fluid environment. This design must include a failsafe in the event of thermal runaway, a problem common to lithium-ion batteries. This failsafe will completely shut off the system if the batteries reach a certain temperature. A cooling system that incorporates nano-fluids will achieve a lightweight and efficient way of cooling batteries.
<p><b>The way English is taught at all educational levels has been a matter of big concern in Vietnam. This is clearly shown by the National Foreign Languages Project 2020 (phases 2008-2016 and 2017-2025) which aims to renovate all aspects of English teaching including teaching facilities, teacher proficiency, curriculum, assessment methods, and learning outcomes, particularly in tertiary English teaching (Vietnamese Government, 2008). Teachers’ classroom English communication is an important part of English teaching and learning; thus, closely examining how they use classroom English and communication strategies is a necessity. However, most international and Vietnamese research of English communication in English as a Foreign Language (EFL) teaching contexts has focused on the perspectives of learners, with limited attention given to the role of teachers. This thesis fills this gap by examining tertiary teachers’ practices of English communication in relation to learners’ perspectives. </b></p><p>This study investigated how English communication was used by five Vietnamese lecturers of English who were teaching non-English major students at two public colleges in Vietnam. This research adopted a mixed methods and qualitative dominant approach. The data were collected via classroom observations, survey questionnaires, individual interviews with lecturers, and focus group interviews with students. Findings reveal that, while most of the lecturers said they used more English than Vietnamese, classroom observation and student interview data suggested that they spent marginally less time speaking English than Vietnamese. Both lecturers and students shared viewpoints on the benefits of an English-only approach, but many did not think this approach would be applicable and effective in classes. Both lecturers and students believed that lecturers’ choice and use of classroom language was predominantly influenced by the desire to ensure comprehension and to provide concern to students. Findings further show seven key communication strategies used by the lecturers, with humour having not been previously identified in communication strategy research. </p><p>The lecturers’ roles as language users and language analysts are assumed to be mutually interconnected to lead to their practices of communication strategies; and the role of language teachers with their pedagogical learner knowledge shaped their perceptions on the functions and usages of communication strategies. Mismatches between the lecturers’ and students’ perceptions of classroom English communication were also identified. Those mismatches were caused by a limitation on communication at the interpersonal level between the lecturers and students and the particularly hierarchical and formal teacher-learner relationship in Vietnamese culture. To minimise those perceptual gaps, it is recommended that lecturers need to consider the perspectives of students to know what they expect to learn and how to learn that effectively. Lecturers’ classroom communication styles and strategies are also shown to be important to help alleviating those perceptual mismatches. It is also suggested that EFL classrooms should offer features of a supportive and motivating environment such as a well-designed classroom layout, teachers’ systematic corrective feedback, less asymmetrical power, and plentiful interaction opportunities. In the communicative and learner-centred teaching approaches, EFL teaching needs to be innovative to better engage and motivate students and to create more learning opportunities. </p><p>Taken as a whole, this thesis suggests that socially affective classroom culture plays an important role in students’ foreign language (FL) and second language (L2) learning and development. A positive lecturer-student relationship, a supportive learning environment, and interaction opportunities are the three main factors that can mediate and construct students’ FL/L2 learning. This study also emphasises the essential role of lecturers in shortening the perceptual gaps between them and students and opening learning space for students. Lecturers’ classroom communications strategies are used for communicative, affective, motivational, and pedagogical purposes and can be converted into students’ learning strategies with mediation tools. To improve EFL teaching and learning, this study also recommends an English-dominant teaching policy, job-oriented and communicative-based syllabus and assessment, and frequent teacher self-reflection and students’ feedback. Lastly, the research has useful implications for EFL teacher education and proficiency development. </p>
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