Double-edged effects of intra-operative redose of prophylactic antibiotics among diabetic surgery patients
Li Yan 中国医科大学
Objective: Surgical site infections (SSIs) has a high incidence in diabetic surgery patients. Preoperative antibiotic prophylaxis followed by an intra-operative redose was a common strategy in diabetic prolonged procedures. To clarify the relative benefits and harms associated with this strategy, our study compares the postoperative outcomes following administration of single-agent preoperative prophylaxis versus a combination of both pre- and intra-operative prophylaxis antibiotics, including SSIs and acute kidney injury (AKI). Methods: All patients who underwent cardiac, vascular, colorectal, orthopedic joint replacement, and hysterectomy procedures during the period from January 2014 to December 2017 were reviewed for diabetic status at the time of surgery and perioperative antibiotic use. Diabetic patients undergoing surgery procedures that lasted more than 4 hours after the preoperative administration of cefazolin, with or without intraoperative redose of cefazolin were include. The association between receipt of pre- and intra-operative antimicrobials versus pre-operative alone and 30-day incidence of SSI or 7-day incidence of postoperative AKI was evaluated.
Results: In all, 1,840 procedures (361 pre-operative antimicrobials only, 1,479 pre- and intra- operative antimicrobials combination) with 60 (3.3%) SSIs and 346 (18.8%) AKIs were included. Intra- operative redose of prophylactic antibiotics was associated with a lower incidence of SSI (2.7%) than pre-operative prophylaxis alone (5.5%; crude risk ratio [RR] 0.47, 95% CI 0.27-0.82). After adjusting for age, gender, BMI, smoking, American Society of Anesthesiologists score, hypertension, pre-operative hemoglobin and WBC level, the association was still statically significant (adjusted RR 0.55, 95% CI 0.31-0.98). AKI occurred in 298/1,479 (20.1%) patients who received both pre-operative and intra-operative prophylaxis versus 48/361 (13.3%) patients who received pre-operative prophylaxis alone (crude RR 1.65, 95% CI 1.18-2.29; adjusted RR 1.71, 95% CI 1.21-2.43).
Conclusions: For diabetic surgery patients, intraoperative redose of prophylactic antibiotics was associated with both reduction in SSIs and increase in postoperative AKI. Protocols optimizing benefits while minimizing harms in diabetic population is needed to improve the clinical decision making around perioperative antibiotics.
Inspiration and Possible Measures: On teaching of ESP from the perspective of the American 5C standards
Ji Chengbin 北京政法职业学院
Traditional ESP classrooms adopt a grammar-translation approach, in which teachers teach vocabulary and grammar in the target language and require students to memorize the concerned contents. It seems that Students are not encouraged to speak up or interact in classrooms.Furthermore, students are unfamiliar with the target culture, which very possibly results in misunderstanding the exact meaning of language or behaviors or life-style of the target culture. This lack of intercultural awareness leads to an inability to effectively communicate in future lives or jobs. Inevitably, all these situations will result in less motivation to further improve and expand English language skills. Sometimes, the continued frustration and failed experiences can lead to a vicious circle for learners. These problems attribute to the failure of teaching intercultural communication skills in the classroom. The American 5Cs Standards include: communications, cultures, connections, comparisons, and communities. This framework is used by most teachers in America and serves as a basis for teaching world languages. China’s ESP teaching maybe get inspired from 5Cs to review traditional teaching pattern and pay more attention to intercultural communication skills. In this case, the essay will provide some possible measures from three dimensions: educational authorities and individual school administrators, teachers and instructors, and students.
A Study on Military, English, Cultural and Regional Expertise Integration Education
Jiao Xinping 国防科技大学文理学院
Military English, as an important branch of ESP, is faced with a rare opportunity for development in China, in the face of the objective reality of the vigorous development of international military cooperation and exchange between the People’s Liberation Army and the foreign counterparts. This study analyzes the practice of integrating military, English, culture and regional expertise education at National University of Defense Technology from the perspective of need analysis and content language integrated learning (CLIL). It includes summary and analysis of the practice at the university from dimensions such as curriculum construction, teaching model,
teaching material construction, teachers development, cooperation of the university and the forces, and academic research.
Keywords: needs analysis; content language integrated learning (CLIL); military, English, cultural,
regional expertise integrated education (MECRIE)
Implementing assessment as learning in EAP writing classrooms
Xiang Xiaoting, Rui Yuan Education University of Hong Kong
Assessment as learning (AaL) aims to develop students’ metacognitive awareness of their learning process and promote their academic study and self-regulated abilities. In second language writing, to date, limited research has been conducted on the implementation of AaL in the L2 writing classroom, especially in the university EAP context. To fill this gap, drawing on data from students’ written reflections and follow-up interviews, the study investigates the benefits and challenges perceived by students regarding the implementation of AaL strategies in a EAP writing course in a Chinese university. The findings reveal that students benefited from the AaL-oriented instruction in terms of their enriched content and enhanced quality in their writing. They also became open-mined and critical through their collaborative engagement in the writing process, which further contributed to their open-mindedness and resilience as a learning writer. On the other hand, the students encountered some challenges in their writing due to their limited linguistic and cognitive abilities, the grouping arrangement as well as a lack of immediate support in the course. The study concludes with some practical implications on how to integrate AaL with EAP teaching in current higher education contexts.
Keywords: assessment as learning; EAP writing classrooms; AaL-oriented instruction
Collaborative teaching between academic teachers and EAP teachers in a Content and Language Integrated Learning (CLIL) context
Bin Zou, Xiucai Lu, Chris Macallister Xi’an Jiaotong-Liverpool University
In recent years, Content and Language Integrated Learning (CLIL) has been identified as an important integration in helping college students to enhance their learning in academic disciplines.
This paper presents examples of collaborations between EAP teachers and subject teachers in delivering the content and language integrated learning (CLIL) programme at an English- mediuminstruction (EMI) University in Mainland China. The aim of the CLIL programme in this EMI University is to meet discipline needs and assist students in developing their academic literacy.
It also aims to reinforce communication between EAP teachers and subject teachers. We intend to investigate academic teachers’ understanding and perspectives of this CLIL programme to discuss how CLIL can reinforce students’ academic learning and development in academic literacy. This study adopted semi-structured interview as the research tool. 11 academic teachers from a variety of departments were interviewed. They have had co-teaching experience with EAP teachers for one to three years. The findings indicate that CLIL programme given by both academic teachers and EAP teachers is helpful for students’ development in language skills including listening and not- taking; writing; speaking in presentation, discussion and argument. All academic teachers in this study provide positive comments on EAP teachers’ help in the collaborative teaching. The result suggests that universities could consider it as a useful way to facilitate students’ academic studies. Recommendations will be provided to improve CLIL in the future.
Training Model of Business English Discourse Competence for Business English Majors
Chen Kunkun 浙江越秀外国语学院
The foreign language majors have gained a new round of development opportunities after the “One Belt, One Road” initiative in China. The business English major has been opened in more than 400 universities as an emerging major. In recent years, discourse study is becoming a new topic. Domestic and foreign business English professional construction experts and scholars have conducted numerous studies of business English discourse. However, there is still a lack of theoretical research and case practice to focus on the students and business English discourse competence. This paper conceptualizes the business English discourse competence from a theoretical perspective, and proposes that business English discourse competence is a practical, interdisciplinary and dynamic competence to use language in business context. Business English discourse competence is based on basic language knowledge like speech, vocabulary, syntax and cognitive knowledge like country knowledge, cultural knowledge, contextual cognition and is expressed by the language skills of listening, speaking, reading, writing and translating to from a series of written or verbal skills, such as coherence between sentences and paragraphs, genre judgment and use in different contexts, pragmatic competence in different cultural contexts, and communicative competence under different communicative purposes. The paper analyzes the composition of business English discourse competence and the influencing factors. The article takes Zhejiang Yuexiu University of Foreign Languages as an example to try to provide a business English discourse competence research framework for business English professionals.
An Indian English Teacher’s Journey of Fostering Research Skills and Enhancing Teaching Competencies Through Co-Book-Review-Writing for TESOL Quarterly
Tarun Sarkar & Xiangdong GU, Chongqing University
Richards (2010) in his competent teacher model emphasizes reflective teacher practice and the significance of integrating into professional communities of practice that demand both teaching and research skills. However, balancing weekly teaching commitments and persuing academic research is a real-time challenge for many novice teacher-researchers. They lack guidance, support, encouragement, and commitment. As a breakthrough, supervisors often recommend book review writing as the first stepping stone, because through this arduous process (Bitchener and Basturkmen, 2006), one can develop critical thinking and foundation for academic research (Ge, 2012).
Adopting a narrative autobiographical inquiry approach, this presentation documents an Indian English teacher’s experience of co-writing a book review from scratch to publication in TESOL Quarterly within a short span of time, accepting all academic responsibilities and challenges under the efficient guidance of a PhD supervisor of the concerned field in China. This presentation reveals how the whole process has not only helped the non-native English teacher from India to get established as a novice researcher, but also enhanced his professionalism and commitment to his teaching in the EFL context. It is hoped that this presentation underlines the value of joint ventures between local and international teacher-researchers at universities in China.
Key words: narrative autobiographical inquiry; book review; novice researcher; joint venture,
Indian English teacher