Non-intubated patients with acute respiratory failure due to COVID-19 could benefit from awake proning. Awake proning is an attractive intervention in settings with limited resources, as it comes with no additional costs. However, awake proning remains poorly used probably because of unfamiliarity and uncertainties regarding potential benefits and practical application. To summarize evidence for benefit and to develop a set of pragmatic recommendations for awake proning in patients with COVID-19 pneumonia, focusing on settings where resources are limited, international healthcare professionals from high and low- and middle-income countries (LMICs) with known expertise in awake proning were invited to contribute expert advice. A growing number of observational studies describe the effects of awake proning in patients with COVID-19 pneumonia in whom hypoxemia is refractory to simple measures of supplementary oxygen. Awake proning improves oxygenation in most patients, usually within minutes, and reduces dyspnea and work of breathing. The effects are maintained for up to 1 hour after turning back to supine, and mostly disappear after 6–12 hours. In available studies, awake proning was not associated with a reduction in the rate of intubation for invasive ventilation. Awake proning comes with little complications if properly implemented and monitored. Pragmatic recommendations including indications and contraindications were formulated and adjusted for resource-limited settings. Awake proning, an adjunctive treatment for hypoxemia refractory to supplemental oxygen, seems safe in non-intubated patients with COVID-19 acute respiratory failure. We provide pragmatic recommendations including indications and contraindications for the use of awake proning in LMICs.
The aim of this dissertation is to examine how adult learners with a spoken language background who are acquiring a signed language, learn how to use the space in front of the body to express grammatical and topographical relations. Moreover, it aims at investigating the effectiveness of different types of instruction, in particular instruction that focuses the learner's attention on the agreement verb paradigm. To that end, existing data from a learner corpus (Boers-Visker, Hammer, Deijn, Kielstra & Van den Bogaerde, 2016) were analyzed, and two novel experimental studies were designed and carried out. These studies are described in detail in Chapters 3–6. Each chapter has been submitted to a scientific journal, and accordingly, can be read independently.1 Yet, the order of the chapters follows the chronological order in which the studies were carried out, and the reader will notice that each study served as a basis to inform the next study. As such, some overlap in the sections describing the theoretical background of each study was unavoidable.
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Studentassistenten verrichten verschillende soorten onder-wijstaken in het hoger onderwijs. Deze systematische literatuurstudiebracht het onderzoek in kaart naar hoe studentassistenten worden voor-bereid op hun inzet in het onderwijs, welke soorten onderwijs ze ver-zorgen en wat dit oplevert voor de studentassistenten en hun studenten.De studentassistenten werden vooral bij praktisch vaardigheidsonder-wijs en laboratoriumonderwijs in medische en scheikundige opleidingeningezet, en in mindere mate ook bij casusonderwijs en studievaardig-heden. Qua voorbereiding hadden ze het meeste baat bij een trainingwaar het verwachte gedrag voorgedaan wordt, waar ze kunnen oefenenen hier feedback op krijgen. Wanneer onderwijs door studentassisten-ten als aanvulling op het bestaande onderwijs wordt georganiseerd leidthet tot hogere studenttevredenheid en betere prestaties bij de studen-ten die dit aangeboden krijgen t.o.v. wie dit niet krijgt aangeboden. Deprestaties en tevredenheid van studenten die practica van studentas-sistenten versus docenten zijn vergelijkbaar. Bij de organisatie van stu-dentassistenten in het onderwijs kan geleerd worden van de twee stro-mingen die nu prevaleren: Supplementele Instructie (si-pass ) enPeerAssistedLearning(pal ). Centrale coördinatie van het opleiden van bege-leiders en studentassistenten, duidelijke complementaire functieprofie-len, inzet bij praktische vakken, en inbedding binnen de opleidingen opbasis van passende leeruitkomsten kunnen bijdragen aan duurzame bor-ging.Students perform various types of educational tasks in higher education as teaching assistants. This systematic literature review mapped out the research on how teaching assistants are prepared for their tasks,what types of instruction they provide, and what this yields for both teaching assistants and students. The teaching assistants were primarily deployed in practical skills education and laboratory education in medical and chemistry programs, and to a lesser extent also in case-based education and metacognitive education. In terms of preparation, they benefited most from training that demonstrates expected behaviour, provides opportunities for practice, and offers feedback. The deployment of teaching assistants in education, as a supplement to regular instruction, resulted in higher student satisfaction and better performance. Regarding practical sessions, students taught by teaching assistants did not perform differently or express less satisfaction than those taught by teachers. In organizing student assistants in education, lessons can be learned from the two prevailing approaches: SI-PASS and PAL. Both central coordination with clear complementary job profiles for student assistants or integration within programs based on appropriate learning outcomes can contribute to sustainable implementation.
