scholarly journals Enhancing pronunciation teaching in the tertiary EFL classrooom: A Vietnamese case study

2021 ◽  
Author(s):  
◽  
Loc Tan Nguyen

<p>Recent years have seen increasing research interest in the teaching of pronunciation in English as a second/foreign language classes (Thomson & Derwing, 2014), with particular strands of this research focused on understanding how pronunciation is represented in instructional materials and actual teaching practices in a range of settings and in teacher cognition (e.g., Couper, 2017; Derwing, Diepenbroek, & Foote, 2012; Foote, Trofimovich, Collins, & Urzúa, 2016). The study reported in this dissertation extends this research by investigating pronunciation teaching in a context where it has hitherto been under-researched, namely tertiary EFL in Vietnam.  The research involved two phases. Phase 1 was an introductory situation analysis which investigated pronunciation teaching practices of six Vietnamese tertiary EFL teachers teaching six intact classes at a Vietnamese university. First, the representation of pronunciation features in prescribed textbooks and supplementary materials of the EFL programme were analysed. Six ninety-minute lessons (one from each of the teachers) were then observed, and the teachers and 24 students across the six groups interviewed. The teacher interviews included both stimulated recall and general questions probing their beliefs about pronunciation teaching. Students were interviewed in focus groups (four each) regarding their teachers’ pronunciation teaching and their own pronunciation needs. The focus of Phase 1 was on how the teachers taught pronunciation, the factors shaping their pedagogical choices, and the students’ beliefs about their teachers’ pronunciation teaching and their instructional needs. The findings revealed that pronunciation was largely absent from course books and curriculum documents and that the teachers’ beliefs were in contrast with what they actually did in class. The teachers reported that they would follow deliberate steps if they taught pronunciation explicitly such as listening discrimination followed by explaining places of articulation and then practice. However, in the observed lessons, they only corrected their students’ pronunciation errors through recasts and/or prompts, with little if any explicit or pre-planned pronunciation teaching. In the interviews, the teachers confirmed that they never used any other techniques and that this was typically the only way they taught pronunciation in class.  The teachers’ pronunciation teaching was textbook-driven and was shaped by contextual factors including the curriculum and the learners. Decision making by all the teachers reflected a general commitment to strictly follow the mandated curriculum, with little evidence of pronunciation being taught explicitly. All the teachers reported a lack of initial training and professional learning in pronunciation pedagogy. In addition, there was a mismatch between the teachers’ and students’ preferences and beliefs about pronunciation teaching. Whereas the teachers believed error correction through recasts and/or prompts was effective, the students did not, and expressed a strong need for more explicit, communicative teaching of pronunciation. This pronunciation instructional need and the teachers’ lack of initial training and PL in pronunciation pedagogy motivated the Phase 2 study.  Phase 2 was an intervention study conducted with the same teachers teaching different classes. At the beginning of Phase 2, the teachers attended a teacher professional learning (TPL) workshop in which they were introduced to a pedagogic framework for teaching English pronunciation communicatively proposed by Celce-Murcia, Brinton, & Goodwin (2010). The teachers then planned communicative pronunciation teaching (CPT) lessons using this framework, and were subsequently observed implementing these lessons in their classes. Both the workshop and subsequent classes of this phase were audio-video recorded. A total of seven lesson plans and 24 classroom observations were made across the six teachers (four observations each). Right after the classroom observations, the teachers were interviewed to obtain their views of the TPL workshop and their implementation of the CPT lessons. Twenty-four students across the six groups were interviewed to reflect on their experience with the CPT lessons.  Observational data showed that the teachers understood and were able to translate what they learned about CPT from the workshop into actual classroom practice as reflected in their lesson planning and subsequent teaching. The lesson plans designed by the teachers closely followed the principles of the communicative framework. Interview data showed that the CPT model was favoured by both teacher and student participants. On the basis of the teachers’ implementation of the CPT lessons, both the teachers and students were confident that CPT has the advantages for promoting learners’ pronunciation knowledge, fostering their phonological ability, and developing their oral communication skills. They also reported that CPT can arouse learners’ interest and engagement in classroom learning.  Taken as a whole, this research highlights the need for pronunciation to be given a more explicit place in teaching and learning in tertiary EFL programmes in Vietnam, and for teachers to be better equipped for teaching pronunciation. Findings from interviews with teachers and learners in the study suggest that they would be receptive to such changes.</p>

2021 ◽  
Author(s):  
◽  
Loc Tan Nguyen

<p>Recent years have seen increasing research interest in the teaching of pronunciation in English as a second/foreign language classes (Thomson & Derwing, 2014), with particular strands of this research focused on understanding how pronunciation is represented in instructional materials and actual teaching practices in a range of settings and in teacher cognition (e.g., Couper, 2017; Derwing, Diepenbroek, & Foote, 2012; Foote, Trofimovich, Collins, & Urzúa, 2016). The study reported in this dissertation extends this research by investigating pronunciation teaching in a context where it has hitherto been under-researched, namely tertiary EFL in Vietnam.  The research involved two phases. Phase 1 was an introductory situation analysis which investigated pronunciation teaching practices of six Vietnamese tertiary EFL teachers teaching six intact classes at a Vietnamese university. First, the representation of pronunciation features in prescribed textbooks and supplementary materials of the EFL programme were analysed. Six ninety-minute lessons (one from each of the teachers) were then observed, and the teachers and 24 students across the six groups interviewed. The teacher interviews included both stimulated recall and general questions probing their beliefs about pronunciation teaching. Students were interviewed in focus groups (four each) regarding their teachers’ pronunciation teaching and their own pronunciation needs. The focus of Phase 1 was on how the teachers taught pronunciation, the factors shaping their pedagogical choices, and the students’ beliefs about their teachers’ pronunciation teaching and their instructional needs. The findings revealed that pronunciation was largely absent from course books and curriculum documents and that the teachers’ beliefs were in contrast with what they actually did in class. The teachers reported that they would follow deliberate steps if they taught pronunciation explicitly such as listening discrimination followed by explaining places of articulation and then practice. However, in the observed lessons, they only corrected their students’ pronunciation errors through recasts and/or prompts, with little if any explicit or pre-planned pronunciation teaching. In the interviews, the teachers confirmed that they never used any other techniques and that this was typically the only way they taught pronunciation in class.  The teachers’ pronunciation teaching was textbook-driven and was shaped by contextual factors including the curriculum and the learners. Decision making by all the teachers reflected a general commitment to strictly follow the mandated curriculum, with little evidence of pronunciation being taught explicitly. All the teachers reported a lack of initial training and professional learning in pronunciation pedagogy. In addition, there was a mismatch between the teachers’ and students’ preferences and beliefs about pronunciation teaching. Whereas the teachers believed error correction through recasts and/or prompts was effective, the students did not, and expressed a strong need for more explicit, communicative teaching of pronunciation. This pronunciation instructional need and the teachers’ lack of initial training and PL in pronunciation pedagogy motivated the Phase 2 study.  Phase 2 was an intervention study conducted with the same teachers teaching different classes. At the beginning of Phase 2, the teachers attended a teacher professional learning (TPL) workshop in which they were introduced to a pedagogic framework for teaching English pronunciation communicatively proposed by Celce-Murcia, Brinton, & Goodwin (2010). The teachers then planned communicative pronunciation teaching (CPT) lessons using this framework, and were subsequently observed implementing these lessons in their classes. Both the workshop and subsequent classes of this phase were audio-video recorded. A total of seven lesson plans and 24 classroom observations were made across the six teachers (four observations each). Right after the classroom observations, the teachers were interviewed to obtain their views of the TPL workshop and their implementation of the CPT lessons. Twenty-four students across the six groups were interviewed to reflect on their experience with the CPT lessons.  Observational data showed that the teachers understood and were able to translate what they learned about CPT from the workshop into actual classroom practice as reflected in their lesson planning and subsequent teaching. The lesson plans designed by the teachers closely followed the principles of the communicative framework. Interview data showed that the CPT model was favoured by both teacher and student participants. On the basis of the teachers’ implementation of the CPT lessons, both the teachers and students were confident that CPT has the advantages for promoting learners’ pronunciation knowledge, fostering their phonological ability, and developing their oral communication skills. They also reported that CPT can arouse learners’ interest and engagement in classroom learning.  Taken as a whole, this research highlights the need for pronunciation to be given a more explicit place in teaching and learning in tertiary EFL programmes in Vietnam, and for teachers to be better equipped for teaching pronunciation. Findings from interviews with teachers and learners in the study suggest that they would be receptive to such changes.</p>


2020 ◽  
Author(s):  
Leigh-Ann McCrum ◽  
Sinead Watson ◽  
Laura McGowan ◽  
Bernadette Mcguinness ◽  
Chris Cardwell ◽  
...  

Abstract Background: Older adults suffering partial tooth loss may need additional intervention strategies other than natural tooth replacement alone to improve their nutritional status. This study aimed to design and develop a habit-based tailored dietary intervention and to assess the feasibility and acceptability of the intervention, in conjunction with natural tooth replacement, amongst partially dentate older adults. Methods: The design and development of the dietary intervention (Phase 1) consisted of analysis of the target population’s dietary intake and qualitative research through focus groups with community-dwelling older adults (aged 65 years and over). The dietary intervention consisted of forming three healthy dietary habits around fruits and vegetables, wholegrains and healthy proteins. Feasibility of the intervention was then tested among older adults receiving natural tooth replacement in a small non-randomised single arm study (Phase 2). The principal feasibility outcome was the usability and acceptability of the intervention which was measured using evaluation questionnaires and by conducting post-intervention semi-structured interviews. Supporting outcomes consisted of feasibility of screening procedures; recruitment strategies; and retention/ attrition rates as well as the participant’s compliance to the intervention assessed through self-monitoring tracking sheets. Results: Twenty-one older adults (mean [SD] age 72.1 [10.4].) took part in one of four focus group discussions (Phase 1). Twelve themes related to barriers (e.g oral health, appetite) and facilitators (e.g nutritional knowledge, retirement) of healthy eating guided intervention development, as did a further five themes when asked for direct intervention feedback. Nine older adult participants (mean [SD] age 72.5[9.7]) were recruited into the feasibility study (Phase 2) where eight themes were identified from feedback interview discussions. The principal outcome measures identified intervention feasibility as participants considered the intervention acceptable and useable as both the evaluation questionnaire and qualitative interview results were overwhelmingly positive. As a supporting outcome measure, strong intervention compliance was also achieved. Screening procedures were accepted but additional recruitment strategies (e.g incorporation of home study visits or recruitment via posters advertisement) may benefit future study enrolment and retention. Conclusion: Phase 1 and Phase 2 findings have allowed for an iterative, user-driven intervention to be developed and refined for a randomised control study to evaluate the intervention’s effectiveness. Trial registration: ISRCTN66118345


2021 ◽  
Vol 2 (4) ◽  
Author(s):  
J De Juan Baguda ◽  
M Pachon Iglesias ◽  
J J Gavira Gomez ◽  
V Martinez Mateo ◽  
M F Arcocha Torres ◽  
...  

Abstract Background The HeartLogic algorithm measures data from multiple implantable cardioverter-defibrillator-based (ICD) sensors and combines them into a single index. The associated alert has proved to be a sensitive and timely predictor of impending heart failure (HF) decompensation. Objective To analyze the association between HeartLogic alerts and clinical events and to describe the implementation in clinical practice of the algorithm for remote management of HF patients. Methods The association between HeartLogic alerts and clinical events has been analyzed in the blinded study Phase 1 (from ICD implantation to HeartLogic alert activation) and in the following unblinded Phase 2 and 3 (after HeartLogic activation). During Phase 1, patients were managed according to the standard clinical practice and physicians were blinded to the alert status. During Phase 2 physicians reacted to alerts according to their clinical practice, while during Phase 3 they followed a standardized protocol in response to alerts. Results We enrolled 288 patients who received HeartLogic-enabled ICD or CRT-D at 15 centers. 101 patients contributed to Phase 1. During a median observation period of 10 [95% CI: 5 – 19] months, the HeartLogic index crossed the alert-threshold value 73 times (0.72 alerts/patient-year) in 39 patients. 8 HF hospitalizations and 2 emergency room admissions occurred in 9 patients (0.10 events/patient-year) during HeartLogic IN alert state. Other 10 minor events (HF in-office visits and non-HF hospitalization) were associated with HeartLogic alerts. During the active phases 267 patients were observed for a median follow-up of 16 [95% CI: 15 – 22] months. 277 HeartLogic alerts (0.89 alerts/patient-year) occurred in 136 patients. Thirty-three HeartLogic alerts were associated with hospitalizations for HF or with HF death (n=6), and 46 alerts were associated with unplanned in-office visits for HF. In 78 cases, HeartLogic alerts were associated with other clinically relevant events. The rate of unexplained alerts was low (0.39 alerts/patient-year). During the active phases, one HF hospitalization and one unplanned in-office visit for HF occurred when patients were in OUT of alert state. Patient phone contacts or in-person assessments were performed more frequently in Phase 3 (85%) than in Phase 2 (73%; p=0.047), while alert-triggered actions were similar in the two phases. Most alerts in both Phases (82% in 2 and 81% in 3; p=0.861) were managed remotely. The total number of patient phone contacts performed during Phase 2 was 35 (0.65 contacts/patient-year) and during Phase 3 was 287 (1.12 contacts/patient-year; p=0.002). Conclusions HeartLogic index was frequently associated with HF-related clinical events, with a low rate of unexplained events. The HeartLogic alert and a standardize protocol of actions allowed to remotely detect impending decompensation events and to implement clinical actions with a low workload for the centers. Funding Acknowledgement Type of funding sources: None.


2020 ◽  
Author(s):  
Leigh-Ann McCrum ◽  
Sinead Watson ◽  
Laura McGowan ◽  
Bernadette Mcguinness ◽  
Chris Cardwell ◽  
...  

Abstract BackgroundOlder adults suffering partial tooth loss may need additional intervention strategies other than oral rehabilitation alone to improve their nutritional status. This study aimed to design and develop a habit-based tailored dietary intervention and to assess the feasibility and acceptability of the intervention, in conjunction with oral rehabilitation, amongst partially dentate older adults.MethodsThe design and development of the dietary intervention (Phase 1) consisted of analysis of the target population’s dietary intake and qualitative research through focus groups with community-dwelling older adults (aged 65 years and over). Feasibility of the intervention was then tested among older adults receiving oral rehabilitation in a small non-randomised single arm study (Phase 2). The primary feasibility outcome was the usability and acceptability of the intervention which was measured using evaluation questionnaires and by conducting post-intervention semi-structured interviews. Secondary outcomes consisted of feasibility of screening procedures; recruitment strategies; and retention/ attrition rates as well as the participant’s compliance to the intervention assessed through self-monitoring tracking sheets.ResultsTwenty-one older adults (mean [SD] age 72.1 [10.4].) took part in one of four focus group discussions (Phase 1). Twelve themes related to barriers (e.g oral health, appetite) and facilitators (e.g nutritional knowledge, retirement) of healthy eating guided intervention development, as did a further five themes when asked for direct intervention feedback. Nine older adult participants (mean [SD] age 72.5[9.7]) were recruited into the feasibility study (Phase 2) where eight themes were identified from feedback interview discussions. Primary outcome measures identified intervention feasibility as participants considered the intervention acceptable and useable as both the evaluation questionnaire and qualitative interview results were overwhelmingly positive. As a secondary outcome measure, strong intervention compliance was also achieved. Screening procedures were accepted but additional recruitment strategies (e.g incorporation of home study visits or recruitment via posters advertisement) may benefit future study enrolment and retention.ConclusionPhase 1 and Phase 2 findings have allowed for an iterative, user-driven intervention to be developed and refined for a randomised control study to evaluate the intervention’s effectiveness.Trial registration: ISRCTN66118345


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 986-986
Author(s):  
Samantha Smith ◽  
Allison Lindauer ◽  
Leslie Tran

Abstract Frontotemporal dementia (FTD) often presents with pronounced behavioral symptoms that contribute to family Care Partner (CP) burden and psychological strain. FTD-specific interventions that support the unique challenges of FTD-CPs are lacking. The present focus group study (Phase 1), elicited feedback from twelve CPs of persons with FTD on the multi-component video-based STELLA intervention (Support via TEchnology: Living and Learning with Advancing ADRDs), to inform the revision and adaptation of STELLA for FTD-CPs (Phase 2). Using Thomas’s (2006) analytic approach to evaluation data, the investigators reviewed the raw text from two focus groups and used an inductive approach to create categories that informed future STELLA adaptation and revision. To address trustworthiness, each investigator independently analyzed the transcripts and CP-annotated STELLA booklets. Six commonalities emerged. Three address the caregiver experience: Burden and living with complex behaviors; Difficulties in getting a diagnosis; and Barriers to participation. The other three reflect specific intervention adaptations: Make a Roadmap, STELLA-FTD Structure, and Booklet edits. The focus group findings offer practical suggestions to create a revised STELLA intervention to address the needs of families living with FTD. The suggestions are nested in the intense caregiving experience of living with complex behavioral symptoms, feeling burdened, isolated, and “living in darkness.” Both the investigators and caregivers appreciate the difficulty in crafting an intervention that meets the needs of all families living with FTD, but the caregivers encouraged the team to develop “something”: “…You won't be able to solve every problem or meet every need… [but] please, please do something.”


2016 ◽  
Vol 6 (1) ◽  
pp. 9
Author(s):  
Mary G. Clasquin-Johnson

This article reports on the findings of a study consisting of two phases. Both phases aimed at investigating how professional development, physical resources and instructional support influenced teachers’ responses to curriculum change. Despite more than 90% of Grade R teachers being under-qualified, they have had to implement two radically different curricula over the past decade. The initial study (‘Phase 1’), conducted in 2007–2010, investigated teachers’ responses to the National Curriculum Statement. The 2015 follow-up study (‘Phase 2’) focused on the same teachers, but the focus fell on the Curriculum and Assessment Policy Statements. The latter occurred in a drastically different context because of the improved monitoring and support systems. A qualitative case study design was employed within an interpretive paradigm. The findings of Phase 1 suggested that the teachers ignored, resisted, adopted and adapted curriculum change. Their highly individualised responses could be attributed to their professional isolation. In contrast, the findings of Phase 2 reveal policy fidelity because of their enhanced capacity to adopt curriculum change. Notably, curriculum implementation is presently occurring within a community of practice. This has the potential to be a catalyst for effecting curriculum change.


2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e31-e32
Author(s):  
Alexa Eberle ◽  
Philippe Jouvet ◽  
Sylvie Charette ◽  
Bryan Provost

Abstract BACKGROUND Nursing workload evaluation tools are designed to determine adequate staffing for a given shift. Only retrospective tools that do not predict the number of nurses needed to start a shift exist. A prospective nursing workload evaluation tool (SJ score), developed by a group of nurses with items based on previously published retrospective scores and clinical experience, includes 16 weighted sections (scored from 0 to >100 with 1 point ≈ 5 min nurse workload). OBJECTIVES This study’s aim is to assess the reliability and validity of the SJ score in the Paediatric Intensive Care Unit (PICU). DESIGN/METHODS Inclusion criteria: children admitted in a PICU, age < 18 yo. Exclusion criteria: already included 3 times in this study (phase 1 only) or children discharged 2 hr after the beginning of the nurse shift studied. Children were scored for 8 hr nursing shifts. Phase 1 (pilot validation) required simultaneous prospective SJ scoring by the nurse in charge (NIC) and chief nurse (SC), then a retrospective SJ score by an independent trained investigator (AE). Phase 2 (validation in the real context of the PICU), which used an improved SJ score, required that each child had an SJ score prospectively by the NIC of the previous shift, then retrospectively by the NIC of the dedicated shift. Statistical analysis included the intraclass correlation (ICC) and a Bland Altman plot. Bland Altman was considered acceptable if mean difference was closed to 0. For ICC: 0.40<ICC<0.59_Fair, 0.60<ICC<0.74_Good, 0.75<ICC<1_Excellent. RESULTS 165 patients’ shifts observations were performed in phase 1. In the comparison between the prospective score performed by the NIC and SC, the Bland Altman mean difference was -0.03 with limits of agreement between -3.63 and 3.58, and the ICC was good: 0.63 with 95%confidence interval (95ICC) from 0.40 to 0.93. In the comparison between the prospective score of the NIC and AE retrospective score, the ICC was fair: 0.52 with 95ICC from 0.32 to 0.78. In phase 2, 2599 patients’ shifts were studied. The Bland Altman mean difference was 0.21 with limits of agreement between -10.5 and 10.9, and the ICC was excellent: 0.86 with 95ICC from 0.85 to 0.87. CONCLUSION The SJ score prospectively predicted well nursing workload in a single PICU. Additional studies are needed to determine the validity in other PICUs.


10.2196/17345 ◽  
2020 ◽  
Vol 7 (5) ◽  
pp. e17345 ◽  
Author(s):  
Ewa K Czyz ◽  
Alejandra Arango ◽  
Nathaniel Healy ◽  
Cheryl A King ◽  
Maureen Walton

Background Suicide is the second leading cause of death among adolescents. A critical need exists for developing promising interventions for adolescents after psychiatric hospitalization who are at a high risk of experiencing repeated suicidal behaviors and related crises. The high-risk period following psychiatric hospitalization calls for cost-effective and scalable continuity of care approaches to support adolescents’ transition from inpatient care. Text messages have been used to improve a wide range of behavioral and health outcomes and may hold promise as an accessible continuity of care strategy for youth at risk of suicide. Objective In this study of 40 adolescents at elevated suicide risk, we report on the iterative development and acceptability of a text-based intervention designed to encourage adaptive coping and safety plan adherence in the high-risk period following psychiatric hospitalization. Methods Adolescents (aged 13-17 years) who were hospitalized because of last-month suicide attempts or last-week suicidal ideation took part in either study phase 1 (n=25; 19/25, 76% female), wherein message content was developed and revised on the basis of feedback obtained during hospitalization, or study phase 2 (n=15; 11/15, 73% female), wherein text messages informed by phase 1 were further tested and refined based on feedback obtained daily over the course of a month after discharge (n=256 observations) and during an end-of-study phone interview. Results Quantitative and qualitative feedback across the 2 study phases pointed to the acceptability of text-based support. Messages were seen as having the potential to be helpful with the transition after hospitalization, with adolescents indicating that texts may serve as reminders to use coping strategies, contribute to improvement in mood, and provide them with a sense of encouragement and hope. At the same time, some adolescents expressed concerns that messages may be insufficient for all teens or circumstances. In phase 2, the passage of time did not influence adolescents’ perception of messages in the month after discharge (P=.74); however, there were notable daily level associations between the perception of messages and adolescents’ affect. Specifically, higher within-person (relative to adolescents’ own average) anger was negatively related to liking text messages (P=.005), whereas within-person positive affect was associated with the perception of messages as more helpful (P=.04). Conclusions Text-based support appears to be an acceptable continuity of care strategy to support adolescents’ transition after hospitalization. The implications of study findings are discussed. Future work is needed to evaluate the impact of text-based interventions on suicide-related outcomes.


2019 ◽  
Author(s):  
Ewa K Czyz ◽  
Alejandra Arango ◽  
Nathaniel Healy ◽  
Cheryl A King ◽  
Maureen Walton

BACKGROUND Suicide is the second leading cause of death among adolescents. A critical need exists for developing promising interventions for adolescents after psychiatric hospitalization who are at a high risk of experiencing repeated suicidal behaviors and related crises. The high-risk period following psychiatric hospitalization calls for cost-effective and scalable continuity of care approaches to support adolescents’ transition from inpatient care. Text messages have been used to improve a wide range of behavioral and health outcomes and may hold promise as an accessible continuity of care strategy for youth at risk of suicide. OBJECTIVE In this study of 40 adolescents at elevated suicide risk, we report on the iterative development and acceptability of a text-based intervention designed to encourage adaptive coping and safety plan adherence in the high-risk period following psychiatric hospitalization. METHODS Adolescents (aged 13-17 years) who were hospitalized because of last-month suicide attempts or last-week suicidal ideation took part in either study phase 1 (n=25; 19/25, 76% female), wherein message content was developed and revised on the basis of feedback obtained during hospitalization, or study phase 2 (n=15; 11/15, 73% female), wherein text messages informed by phase 1 were further tested and refined based on feedback obtained daily over the course of a month after discharge (n=256 observations) and during an end-of-study phone interview. RESULTS Quantitative and qualitative feedback across the 2 study phases pointed to the acceptability of text-based support. Messages were seen as having the potential to be helpful with the transition after hospitalization, with adolescents indicating that texts may serve as reminders to use coping strategies, contribute to improvement in mood, and provide them with a sense of encouragement and hope. At the same time, some adolescents expressed concerns that messages may be insufficient for all teens or circumstances. In phase 2, the passage of time did not influence adolescents’ perception of messages in the month after discharge (<i>P</i>=.74); however, there were notable daily level associations between the perception of messages and adolescents’ affect. Specifically, higher within-person (relative to adolescents’ own average) anger was negatively related to liking text messages (<i>P</i>=.005), whereas within-person positive affect was associated with the perception of messages as more helpful (<i>P</i>=.04). CONCLUSIONS Text-based support appears to be an acceptable continuity of care strategy to support adolescents’ transition after hospitalization. The implications of study findings are discussed. Future work is needed to evaluate the impact of text-based interventions on suicide-related outcomes.


2009 ◽  
Vol 53 (10) ◽  
pp. 4422-4428 ◽  
Author(s):  
Christopher M. Rubino ◽  
Scott A. Van Wart ◽  
Sujata M. Bhavnani ◽  
Paul G. Ambrose ◽  
Jill S. McCollam ◽  
...  

ABSTRACT Oritavancin is a novel glycopeptide antimicrobial agent with potent in vitro activity against a wide variety of gram-positive bacteria, including multidrug-resistant strains of staphylococci and enterococci. A population pharmacokinetic model was developed to describe the disposition of oritavancin with data from a pooled population of phase 1 healthy subjects and phase 2 and 3 patients with complicated skin and skin structure infections or Staphylococcus aureus bacteremia. In addition, the potential influence of factors such as the subject's age, gender, and clinical laboratory measures on oritavancin disposition was evaluated. Oritavancin was administered as both single- and multiple-dose intravenous (i.v.) infusions in fixed doses ranging from 100 to 800 mg or weight-based doses ranging from 0.02 to 10 mg/kg of body weight, with infusion durations ranging from 0.13 to 6.5 h across all studies. The most robust fit to the data (n = 6,290 oritavancin plasma concentrations from 560 subjects) was obtained using a three-compartment model with zero-order i.v. infusion and first-order elimination. The model was parameterized using total clearance (CL), volume of central compartment (Vc), distributional clearances from the central to both the first and second peripheral compartments, and volumes of distribution for both the first and second peripheral compartments. Weight and study phase (phase 1 versus phase 2/3) were identified as significant predictors of the interindividual variability in CL, while body surface area and age were significant for Vc. These results suggest that dose modification may be warranted in patients weighing >110 kg. However, the mild nature of the observed relationships for Vc suggest that dosing adjustments are not necessary for elderly patients.


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