11-Investigating ch
高级商务英语 Unit 11
BenQ, Taiwanese diversified electronics maker, acquired Siemens’ mobile phone unit in June. It has reported sharply lower net profit in the first half of this year as competition hit sales in its key product lines.
3. What will happen if companies fail to meet listing requirements of NYSE?
They could be delisted from the exchange.
4. What are the technological changes made in NYSE?
Second listening: listen for specific information
• Notice the following expressions:
soar, sock, gush, pump out, swing, volatility
Third listening: sentence imitation
Third listening: sentences imitation
•You are asked to use the following active vocabularies to form sentences as what you have heard from listening
1. the share merger reform
【国家社会科学基金】_解释方法_基金支持热词逐年推荐_【万方软件创新助手】_20140804
流动性 洛伦茨曲线 汇率 比较研究 模型 概念隐喻 棉花贸易 案例评析 格范畴 核心价值 条约解释条约冲突 朱熹 本质含义 本质 期权定价 服务型政府 有效性基础 时变结构 时制 方法 新农村 教育者信条 效率 政治寻租 政治哲学 政权合法性 政府范式 政府生态服务 收入分配 探索性因素分析 指称表达 指导性案例 拒绝交易 扩散 情景缓冲器 情境事件 微观结构理论 影响因素 形式系统 形式-意义 应对策略 平等原则 市场效率 工作记忆模型 工作记忆 将来时间焦点 家庭压力理论 实现形式 实体性论证规则 学前儿童 学习范式 学习者信条 学习理论 学习日记
科研热词 青少年 退货政策 货币政策 解释结构模型 知识经济 知识产权垄断 法律解释 法律控制 比较分析 因子分析 回馈与惩罚策略 努力因素 供应链协调 高频金融时序数据 马克思历史观 马克思历史理论 马克思主义 风险机理 风险投资 顾颉刚 顾客满意度 非线性效应 非市场交易费用 非对称型模糊对偶问题 非参数统计 非凯恩斯效应 非互惠接入定价 需求冲击 需求与供给 集体行动 阶级分析 阶层分析 银行监管 金融物理学 金融创新 部落习惯法 部位 逻辑实证主义 通货膨胀模型 通货膨胀 通胀持久性 适用解释 追体验 进化生物学 进化主义 辩解市场 赔命价 资源基础 资助政策 资产评估 资产 贷款种类
53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106
动词37种形式 以investigate为例
动词37种形式Part I16种时态谓语动词部分以investigate为例(只要求会写第三人称单数作主语时的谓语动词部分，如现在完成时He has investigated the case这句话只要求会写has investigated)一般现在时investigates现在进行时is investigating现在完成时has investigated现在完成进行时has been investigating一般过去时investigated过去进行时was investigating过去完成时had investigated过去完成进行时had been investigating一般将来时will investigate将来进行时will be investigating将来完成时will have investigated将来完成进行时will have been investigating一般过去将来时would investigate过去将来进行时would be investigating过去将来完成时would have investigated过去将来完成进行时would have been investigating11种非限定动词形式(带to不定式6种，-ing分词5种)6种带to不定式形式[注意必须写出不带括号的to,课本10.3(4)小节表格仅作参考]:一般形式to investigate进行体形式to be investigating完成体形式to have investigated完成进行体形式to have been investigating一般形式的被动态to be investigated完成体形式的被动态to have been investigated5种-ing分词形式一般形式investigating完成体形式having investigated完成进行体形式having been investigating (补充)一般形式的被动态being investigated完成体形式的被动态having been investigated另外请注意there be句型的非限定形式是there to be和there being , there having been等，参见28.2节。
Unit 1 1.1 Reading and thinking高一英语(人教版2019必修第二册)
protection of cultural sites can be a big challenge. B．A committee was established to limit
Para.3 Para.4
damage. C．The proposal leads to protests. D．The project brought governments and
countless cultural relics were taken down piece by piece，moved and put
back together again in a place where they were safe 7. from the water.The project was considered 8. a great success.It's believed that it was possible for different countries 9. to work (work) together to build a
protest, turn to 2._U__N_, a
分
committee, work
helpful
together, success
spirit, best example,
global 3._c_o_m_m__u_n_i_ty_,
provide a solution
happy/sati 总 sfied
was because the new dam would 2. likely (like) destroy many cultural relics.Then the government 3. established (establish) a committee to find a solution to the 4. protection (protect) of Egypt's cultural heritage.After a proposal for how the relics could 5. be saved (save) was made，the project began in 1960 and ended in 1980.During those years，22 temples 6.__a_n_d_
the11billion self阅读理解
the11billion self阅读理解阅读理解。
The $11 billion self-help industry is built on the idea that you should turn negative thoughts like "Inever do anything right" into positive ones like "I can succeed." But was positive thinking advocateNorman Vincent Peale right? Is there power in positive thinking?Researchers in Canada just published a study in the journal Psychological Science that says tryingto get people to think more positively can actually have the opposite effect: it can simply highlight howunhappy they are.The study's authors, Joanne Wood and John Lee of the University of Waterloo and Elaine Perunovicof the University of New Brunswick, begin by citing(引用) older research showing that when peopleget feedback which they believe is overly positive, they actually feel worse, not better. If you tell yourdepressed friend that he has the potential of an Einstein, you're just underlining his faults. In one 1990sexperiment, a team including psychologist Joel Cooper of Princeton asked participants to write essaysopposing funding for the disabled. When the essayists were later praised for their sympathy, they felteven worse about what they had written.In this experiment, Wood, Lee and Perunovic measured 68 students' self-esteem. The participantswere then asked to write down their thoughts and feelings for four minutes. Every 15 seconds, onegroup of students heard a bell. When it rang, they were supposed to tell themselves, "I am lovable."Those with low self-esteem didn't feel better after the forced self-approval. In fact, their moodsturned significantly darker than those of members of the control group, who weren't urged to thinkpositive thoughts.The paper provides support for newer forms of psychotherapy (心理治疗) that urge people toaccept their negative thoughts and feelings rather than fight them. In the fighting, we not only oftenfail but can make things worse. Meditation (静思) techniques, in contrast, can teach people to puttheir shortcomings into a larger, more realistic perspective. Call it the power of negative thinking.1. What do we learn from the first paragraph about the self-help industry?A. It was established by Norman Vincent Peale.B. It is based on the concept of positive thinking.C. It is a highly profitable industry.D. It has brought positive results.2. What is the finding of the Canadian researchers?A. Encouraging positive thinking may do more harm than good.B. The power of positive thinking is limited.C. Unhappy people cannot think positively.D. There can be no simple therapy for psychological problems.3. What does the author mean by "…you're just underlining his faults"?A. You are pointing out the errors he has made. ks5uB. You are not taking his mistakes seriously enough.C. You are trying to make him feel better about his faults.D. You are emphasizing the fact that he is not intelligent.4. What do we learn from the experiment of Wood, Lee and Perunovic?A. It is important for people to continually increase their self-esteem.B. Forcing a person to think positive thoughts may lower their self-esteem.C. Self-approval can bring a positive change to one's mood.D. People with low self-esteem seldom write down their true feelings试题答案1-4BADB。
过程与结果（英文）
2009年4月第32卷 第2期中国英语教学(双月刊)CEL EA J ournal (Bimont hly)Apr.2009V ol.32N o.2L1INFL UEN CE O N L2WRITING :P ROCESS AN D PROD U CTH e Ya n qunSa njia n g U nive rsityAbs t r act B y employing a c ombina tion of researc h tec hni ques ,suc h as think 2aloud a nd sti m ulated r ecall ,this st udy investigates the cr oss 2linguistic i nf luence in sec ond la nguage w riting at both pr ocess a nd p roduct le vels a mong 20Chi nese colle ge st ude nts.In te rms of p rocess ,t he paper r eveals that t hough t he proportion of L 1thinking decreases wit h t he i mpr ove ment of English pr of iciency ,the e xte nt of decrease var ies with dif f e rent composing activities.I n ter ms of product ,lea rners wit h higher English pr of icie nc y e xhi bit a dec rease i n t he t otal nu mber of tra nsf e r er rors ,yet the decrease varies with dif f ere nt categor ies.What is i mportant is tha t ,c ont rar y to com mon belief ,there is no signif ica nt corr ela tion bet wee n the total volum e of L1use and the total num ber of tra nsf e r er rors per 100words.The f act is that L1use in dif f er ent t hi nki ng activities has dif f ere nt ef f ects on the occ urre nces of tra nsf e r er rors.While L1use in content c onception has a signif icant positive cor relation wit h lexical e rr ors f or t he sophomore group ,L1use i n te xt pr oduction has a signif icant negativ e corr elation wit h syntactic er rors f or t he se nior group.Key w or dsL1thinki ng;think 2aloud ;transf e r er r ors11Int roducti onSe c on d la nguage ac quisiti on (SL A )is a c omple x pr ocess involving m a ny i nte r re late d f a ct ors ,a m ong w hic h t he le a r ner πs f irst la nguage (L1)is c onsi de r e d to be a ma jor f ac tor.Act ua ll y ,t he i nf lue nce of L1on the ac quisiti on a n d use of a se cond la ngua ge (L2)has long bee n a f oc us of inte r est within SLA r ese a rc h.M uc h of t he r esea r c h a tte ntion was conf ine d t o t he se nte nc e or utt e ra nce le vel.H owe ve r ,in t he p ast t wo dec a des ,t he st udy of L 2writi ng has be c ome pa rt of t he mai nst re a m in SL A r ese a rc h.I n pr evious rese a r ches ,ef f ec ts of L1on L 2w riting have be e n studi ed f r om two dif f e re nt pe rspe cti ves ,na mely ,t he pr oduct a nd p r oc ess pe rsp ecti ves.I n te r ms of pr oduct ,studi es of c omp ositions wr itte n by L2w rite rs f oc us ,m ost nota bl y ,on t hose e r r ors whic h a ppe a r to be t he r esult of ne gative t ra nsf e r f r om L1(e 1g 1Zobl 1979,1984,1986;Sc hac hte r 1983;Gass 1984,1987;We nz ell 1989).In t er ms of p r oc ess ,t he study of c omposi ng p roc esses t hr ough t hink 2a loud p r ot oc ols h as le d t o t wo c ontr over sial f i ndi ngs.One clai ms tha t non 2na tive write rs thinking in L1det ra cts t he p r oduc tion of good wr iting (e 1g 1We n &J ohnson 1997)w hile t he ot her suggests tha t suc h c og nitive be ha vior pla ys a positive r ole in L 2wri ti ng.L2write rs have bee n obse r ved t o em ploy t hei r L1t o “ge t a st r ong i mpr essio n a nd associati on of ideas f or essa ys ”a nd pr oduce essays “of be tte r qualit y i n t er ms of i deas ,orga niza tion a nd de tails ”(L a y 1982:406).The y ha ve a lso bee n f oun d to use t heir nati ve la ngua ge as “a n i mpor ta nt r esour ce in t heir c ont inual pr oc ess of de cision ma king while writing ”(Cu mmi ng 1989:128).I ,ff f L L y f T f f y (11;L &Z )n C hi na t he rese a rc h on t he e ect o 1on 2w r iting has mai nl be e n oc use d at the pr oduct le vel.h ose rese a rc hes ta ke t he or m o eit he r c ont r astive a nal sis e g Cai 1998i ha ng 2002ore r r or a na lysis (e 1g 1Li &Cai 2001;C he n 2002).The r esults s how t ha t t ra nsf er is a n im por ta nt f a ct or in a cc ounti ng f or er r ors r anging f r om le xic al t o disc our se le ve l (e 1g 1L ou 2002;Ha n &Zhou 2003;F an 2001).The limita tions of th ose r esea r c hes a r e of t wo maj or types.First ,in m ost of t he studies ,lit tle ca r e has bee n t a ke n to sepa r at e t he e r r or s m a de by le a r ne rs a t dif f e re nt st ages of de vel op me nt or le ar ne rs of diff er e nt la ngua ge p r of icie ncy ,t hus af f or di ng only a stat ic vie w of L2a cquisition.The se co nd p r oble m is t hat t he investigati on m et hod usually e xcl udes i nt e rviews with t he s ubjec ts ,whic h is a n imp ort a nt st ep in t he judgm ent of tr a nsf e r er r ors.Am ong t he f e w rese a r ches investigating the i nf lue nce of L 1thin ki ng on L2writi ng ,t he st udy by Guo &L iu (1997)esp ecially wa r ra nts notic e.I n t he ir st udy ,thin k 2aloud te ch ni que is em ployed t o de tec t w hat is goi ng on in the p a rticipa nts πmind while t hey ar e wr iting.The 12pa r ticipa nts a re sele cte d thr ough str ict t esti ng f ro m a m ong 50c a ndi da tes.B ase d on t he fi ndings of t he study ,Guo &Liu pr opose a c ognitive f r a me wor k f or e xplai ni ng L1inf luenc e on L 2L e ar ne r πs thin ki ng ope r ati ons duri ng L2wr iting.F ollowi ng t his line ,We n &Guo (1998)f ur t her a nalyze p a rt of t he da ta ga the r e d by Guo &L iu (1997),a nd t her e by investigati ng t he r ela ti ons hip bet wee n t hi nking i n L 1an d L 2writi ng a bility.Thes e two st udies c ontr ibute a lot t o t he r esea r c h i nto t he L1i nf lue nc e on L2w riting.Howe ve r ,it is note d t ha t in t hese two studies ,t he r elat ions hip be twe en t he qua lit y of c omp ositions a nd L1t hin ki ng i n dif f e re nt c omposi ng ac tivities (se e3.2.1)has not be en r espe ctively assesse d ,t hough the r e a r e r ea sons t o beli eve t ha t L1t hi nking in diff er e nt c omp osi ng ac tivities ma y e xe r t dif f e r e nt ef f e cts o n the pr oductio n (Wa ng &We n 2002b ).2.Res earc h Quest ionsConsider ing the above 2me ntio ne d lim it at ions ,this study of L 1inf luenc e on L2writi ng at b ot h p r ocess a nd p r oduct le ve ls e mploys a c ombina tion of r ese a rc h t ec hniques ,suc h as thin k 2aloud an d stimulat e d r ec all.The st udy a ddr esses t he f ollowing t hr ee r esea r c h questi ons :1)D o lea r ne rs wit h highe r L2p r of icie nc y ex hibit a dec r ease in t he use of L1in t he p r oc ess ofc omp osing i n a L 2?D oes t he exte nt of dec r ease va ry wit h dif f e r ent co mposi ng a cti vities ?2)Do tr a nsf e r er r ors de cr e ase wit h t he i mpr ove me nt of le a r ne rs πL 2p r of icie ncy ?Does t he e xt e nt ofde cr e ase va r y wit h dif f er e nt la ngua ge asp ec ts ?3)Ar e qua ntity a n d dist ribution of t ra nsf e r er r ors i n stude nts πL2co mpositions re lat ed to st ude nts πL1t hi nking duri ng t he writi ng p r oc ess ?Does this var y wit h le a r ne rs πL 2pr ofic ie nc y ?The or igina lit y of t his study lies i n t he t hir d obj ect ive me ntione d a bove.A c a ref ul re vie w of t he p re vious r esea r ches r e ve als t ha t f e w of th em have t rie d t o investigat e t he r elati ons hip be twe en t he L 1use d in the wri ti ng p r oc ess a nd t he distri buti on a nd pr opor tion of t r ansf er e rr ors in t he co mp ositions ,t hough it is a p op ula r belief a mong L2t ea c her s tha t t hin king in L 1will inc re ase th e numbe r of tr a nsf e r er r ors.3.Met hodol ogy3.1D at a Collecti on3.1.1Part icipantsA t ot al of 20univer sit y stude nts f r om US TC a nd An hui Unive rsit y pa r ticipa te d in t his c ross 2sec tional study.The gr oup consists of 10se con d 2ye a r English maj ors a nd 10senior Englis h m ajors.The 20subj ects e ve nt ua lly i nvolve d in t his study wer e c hose n t hr ough th re e sta ges.At t he f irst st age ,51st udents (24sop hom or es a nd 27se niors )we re r ec om me nde d by t heir tea c her s as stude nts w ho we r e e xt r ove r t a n d tal kative a nd mor e likel y to be c o 2op er a tive in acc omplishing t he t ask of think 2aloud.I t is assume d by L2wr iting rese a rc he rs tha t only t hose tal kati ve a n d e xt r ove r t st ude nts ca n ac comp lish th e task of t hi nk 2al oud (We n 2001).The n t he subjec ts we r e p r ovide d we ll 2c onst r uc te d t r aining.The tr ai ni ng sta rt e d wit h t he r es ea rc he r πs de m onst ra tion i n which we ve r baliz e d wha t was going t hr ough our min ds as we i nf er r e d a missing num ber a m ong a list of r e gular numbe rs.The n all t he sele ct ed subje cts we r e aske d t o p e rf or m two t asks by t hin k 2aloud.The f irst one was a n a na gr a m t ask (f ollowi ng Er icsson &Si m on 1987:49).The subjec ts we r e p rese nte d wit h a n English wor d whose constitue nt p a rts ha d be en r e a rr a nged.The y we r e r e quir e d t o think a loud a s t he y unsc ra m ble d t he wor d.The sec ond one wa s an (f &S 3)W ,j f 2y T f T L 1I nf lue nc e on L 2Wr it ing :Pr oc e s s a nd Pr oduc t He Y a nquna rit hm etic pr oble m ollow ing E ricsson im on 1987:4.it h tha t pr ep a ra tion t he sub ec ts knew t he mea ning o t hi nk a loud a nd how t o ca r r it out.he se con d se lec ti on w as m a de a t er t he t r aining.heCEL EA J our na lπ84c rite ri on f or the sec ond se lec tion was a p ositive a ttit ude t owa r ds thin k2aloud.The sec ond sele cti on r e duc e d22subje cts be ca use t hey did notf e el good wit h t hink2aloud.The t hir d sele cti on was ma de a f te r we c ollec te d a ll t he da ta by t hink2a loud.This st age e li mina te d9subje cts whose notic ea ble pa usec omp rised more tha n20%of t he t ot al re c or de d tim e(f oll owi ng Wen&Guo1998).3.1.2D at a Collection ProceduresThe da ta collec ti on include d two st eps:a t hi nk2al oud t ask a nd a re tr ospe cti ve inte r vie wI n t he f irst st ep,e ac h pa r ticipa nt was as ked t o w rite a p a ra gr ap h i n English of m ore t ha n120wor ds gi ving t heir opinions on t he issue of unde r gra duat es li ving in r e nt e d houses of f ca mp us.M ea nw hile,t he y we r e re quir e d t o ve rba liz e wha te ve r wa s goi ng t hr ough the ir mi nds.The expe ri me nt was ca r rie d out indivi dua lly so t hat we c ould of f e r help whe n t he pa r ticipa nts ha d a ny misunde rst an ding a bout t he t hink2 al oud t ec hnique.The y we r e as ked t hat t he ir thin k2aloud s hould be nat ura l in t he s ense t ha t wh at t he y utt er e d s hould be t he sa me la nguage a s t he one t hey we re t hin ki ng in.I n ot he r wor ds,if t he i nne r sp ee ch was c onducte d i n C hinese,t hen t hey sh ould sp ea k in Chinese;if i n English,t hen English s hould be e mpl oye d.A digit al r e cor de r was use d to r ec ord ea c h subje ctπs t hink2al oud pr ocess a nd the c omp ositions wr itte n by t he subjec ts we re also collec te d as t he da ta of p r oduct.A r e tr ospe ctive inte r vie w was con duct e d i m me di ate ly af t er t he t hi nk2al oud tas k,i n w hic h t he subje cts we re as ked t o r ef lec t o n thei r t h oughts to see w he t her t he y coul d r ec all a ny unr ep or te d t hi nki ng p rocesses.As sti mulati on,the r ec or de d think2aloud p r ot oc ol was pla ye d ba ck to the subje cts.Whe n t he subje cts f elt nec essa r y to a dd some t hi ng,t he r esea r c her stoppe d t he mac hine a nd wr ot e down t he ne wly elicit ed i nf or m at ion.For exa mple,i n one of th e s op hom oreπs r e cor de d t hink2a loud p r ot oc ols,t he r e is an utt er a nce li ke“怎么来组织呢?嗯……”which i ndic at es t he f oll owi ng utt e ra nces s hould be a bout t he c oncep tion of str uc tur e,yet w hat f oll ows is“First,f irst,li ving wit h,well,pr oba bl y classma tes,pr ovi des c onvenie nt lif e.You a r e going t o be la te f or class a nd your classm at es ma y j ust wa ke you up...”.I t ma y well be t hat som e of t he t hi nki ng a ctivities a bout c onc eption of str uctur e get un re por te d.Wit h t he p ro mpt of t he re c or de d t hi nk2al oud p r ot oc ol,the pa r ticipa nt re calle d t hat he was t hinking of“就是原来的f ir st, sec ond,t hir d的结构,这样写比较有层次感”af te r he aske d himself“怎么来组织呢?”3.2D at a Analysis3.2.1Transcription of t he Thi nk2aloud ProtocolsOnce t he dat a c olle ctio n was f inis hed,t he ver bal r ep orts we r e tr a nsc ri bed.The t ra nscr ip tions include t he p a rticip a ntsπver ba liz atio n of t he wh ole writin g pr ocess a nd the“unre por te d m e nt al a ctivit ies”(se e3.1.2)t hat we re r ec alle d in t he r et r ospe ctive i nt e rview con duct e d rig ht af t e r the t hink2a loud tas k. Foll owing Cum ming(1989)a nd Wa ng&We n(2002a),t he t ra nsc rip tions att e mpt e d to rep r ese nt t he pa r ticipa ntsπtap e2r ec orde d sp ee c h as it would us ually ap pe ar in e xp ositor y p r ose,alth ough seve ra l spe cial c onventi ons we r e used.A c apita l le tte r i ndic ates t he be gin ni ng of t he spoke n e quiva le nt of a se nte nce a nd a pe riod indica tes its closur e.Susp ensi on p oi nts i ndic at e a pa use.A questi on ma r k indica tes a quest ioni ng int onatio n.Wor ds in double quot ati on m ar ks indica te pa r ti cip a nts we re r ea ding f r om a sourc e te xt(such as t he dir ecti ons f or wr iting).3.2.2L1Use in Different Composing Act ivitiesB ase d on t he res ea r ch of Wang&We n(2002a),the wri ti ng p r ocess is divi de d int o f ive dif f e re nt c omp osi ng ac tivities,na mely t opic a nalysis,c onte nt conc epti on,st ruct ure c onc ep ti on,te xt pr oducti on a nd c ontr ol of pr ocess.The de fi niti ons a nd e xa mples of t he f ive comp osing a ctivities a re s hown in Ta ble 321.I n e ac h co mposi ng ac tivit y,t he num be r of Englis h w ords an d Chinese w ords we r e c ount e d,includi ng t he r ep ea te d ut te r a nc es.Then t he p e rc e nt age t ha t Chinese wor ds c onstit ute of t he tota l wor ds was c alculat ed as a n i ndex of t he a mount of L1t hi nki ng(f ollowi ng We n&Guo1998;Wa ng&We n2002a). To det er mi ne t he c han ges in t he pr opor tion a nd distri buti on of L1us e in t he writi ng p r oc ess,me a ns a nd sta nda r d deviati ons of t he a mount of L1t hi nki ng of t he two gr oups we r e r esp ec ti ve ly calc ula te d.Ta ble 321.Def initions a nd e xa mp les of co mposi ng a cti vitiesD efi niti onExa mples Topic Ana lysis :a n a nal ysis of t het opic a nd t he re m a rks on t he topic “Write a n Englis h pa r agr ap h of mor e t ha n 120wor ds givi ng your opinions on unde rgr a dua tes ”,un de r gra duat es ,本科生,“living in re nte d houses off ca mp us ”.本科生出去租房子住是吧。
(完整word版)全新版大学英语(第二版)综合教程2课后练习答案
（完整word版）全新版⼤学英语（第⼤版）综合教程2课后练习答案Key t o Exercises o f C ollege English B ook 2Unit 1★Text AVocabularyI.1.1) insert 2) on occasion 3) investigate 4) In retrospect 5) initial 6) phenomena 7) attached 8) make up for 9) is awaiting 10) not…in the least 11) promote 12) emerged2. 1) There is a striking contrast between the standards of living in the north of the country and thesouth.2) Natural fiber is said to be superior to synthetic fiber.3) The city’s importance as a financial center has evolved slowly.4) His nationality is not relevant to whether he is a good lawyer.5) The poems by a little-known sixteenth-century Italian poet have found their way into someEnglish magazines.3. 1) be picked up, can’t accomplish, am exaggerating2) somewhat, performance, have neglected, they apply to3) assist, O n t he other h and, a re v alid, a s uperiorII.1. 1) continual 2) continuous 3) continual 4) continuous2. 1) principal 2) principal 3) principle 4) principles 5) principalIII.1. themselves2. himself/herself3. herself/by herself/on her own4. itself5. ourselves6. yourself/ by yourself/on your ownComprehensive ExerciseI. Cloze1. 1) contrast 2) exaggerating 3) priority 4) on the other hand 5) promoting 6) pick up 7) assist 8) accomplish 9) on occasion 10) neglecting 11) worthwhile 12) superior2. 1) end 2) perform 3) facing 4) competent 5) equipped6) designed 7) approach 8) rest 9) definitely 10) qualityII. Translation1.1) It takes an enormous amount of courage to make a departure from the tradition.2) Tom u sed to be very shy, but this time he was bold enough to give a performance in front o fa large audience.3) Many educators think it desirable to foster the creative spirit in the child at an early age.4) Assuming (that) this painting really is a masterpiece, do you think it’s worthwhile tobuy/purchase it?5) If the data is statistically valid, it will throw light on the problem we are investigating.2. To improve our English, it is critical to do more reading, writing, listening and speaking.Besides, learning by heart as many well-written essays as possible is also very important.Without an enormous store of good English writing in your head you cannot express yourself freely in English. It is also helpful to summarize our experience as we go along, for in so doing, we can figure out which way of learning is more effective and will produce the most desirable result. As long as we keep working hard on it, we will in due course accomplish the task of mastering English.★Text BComprehension check: c c d a c bLanguage Practice1.g h e c f a b d2.1) adopt 2) account 3) from your point of view 4) ended up 5) furthermore 6) fund7) annual 8) keeping track of 9) pace 10) intends11) perspective 12) deviseUnit 2★Text AVocabularyI. 1. 1) abrupt 2) emotional 3) bless 4) wear and tear 5) dated 6）consequences 7）seemingly 8) in contrast to 9) Curiosity 10) genuine11) primarily 12) sentiments2. 1) W hen you a re c onfronted with m ore t han o ne p roblem, t ry t o s olve t he e asiestone first.2) Water is vital to the existence of all forms of life.3) There is still some confusion among the students about what to do after classto follow up on the subject.4) As a person of s imple living habits, h e needs nothing more than a job and anapartment to be happy.5) It tickled him to think that she’d come to as his advice.3. 1) a lingering, fabricating, s entiments2) fill out, every item, vital, consequences3) be denied, tangible, cherish, attainII.1.It’s a long trip and will take us five hours by bus.2.She arrived early and took a front row seat.3. Don’t take me for a f ool.4. It takes a lot of imagination to fabricate such a story.5. My u ncle w ill t ake m e (along on h is t rip) t o t he Arctic t his s ummer.6.He took the dinner plate I passed to him.7.Kevin took second prize in the weight-lifting competition.8.If you don’t take my advice, you will regret it.III.1. hanging2. to give3. to return4. being praised5. not having written6. to say7. to open8. being helpedComprehensive ExerciseI.1. 1) well-off/affluent 2) dated 3) falling into 4) bracket 5) deny6) tangible 7) pursuit 8) cherishes 9) out of place 10) abrupt11) focus 12) donations2. 1) consume 2) fueled 3) annual 4) plain 5) physically 6) security7) indicates 8) equally 9) traditional 10) followsII. Translation1.1) The company denied that its donations had a commercial purpose.2) Whenever he was angry, he would begin to stammer slightly.3) Education is the most cherished tradition in our family. That’s why my parents never took me to dinner at expensive restaurants, but sent me to the best private school.4) Shortly after he recovered from the surgery, he lost his job and thus had to go through another difficult phase of his life.5) In contrast to our affluent neighbors, my parents are rather poor, but they have always tried hard to meet our minimal needs.2. With more and more donations coming in, our university will be much better offfinancially next y ear. W e w ill thus b e a ble t o focus o n t he most i mportant t ask that w e, e ducators, m ust t ake on: t o e ncourage students to attain their scholarly/academic goals, to train them to be dependable and responsible individuals, to prepare them for the life ahead, and to guide them in their pursuit of spiritual as well as material satisfaction.★Text BComprehension Check: b b d c d dLanguage Practice1. f c g e b a h d2.1) stunned 2) hold (fast) to 3) folks 4) generosity 5) discount 6) liable7) ranks 8) on the run 9) make up 10) blends in 11) by all accounts 12)comes into contact withUnit 3★Text AVocabularyI.1．1) typical 2)dumb 3) junior 4) glorious 5) welfare 6)came over 7) interference8) f ading 9) narrowed down 10) frank 11)schemes 12) at any rate2. 1) The Security council consists of five generals and four police officers.2) The new hotel will be in a location overlooking the lake.3) I was humiliated by her comments about my family background in front of so many people.4) Do you have any proof that it was Henry who stole the computer?5) the boy was exhausted after the long cycle ride.3. 1) hysterical; was handed down; should have known better than2) twisted, over and over, talented son3) patience, not to keep him in suspense, assured, repeatedlyII.1. adequate2. anxious3. certain4. content5. crazy6. likely7. fortunate8. keen III.1. be admitted2. live3. be postponed4. buy5. be banned6. be Comprehensive ExerciseI. 1. 1) typical 2) welfare 3) constant 4) frank 5) talent 6) dumb7) know better than that 8) repeatedly 9) dread 10) interference 11) bet 12) assure2. 1) despite 2) really 3) same 4) contact 5) admitted 6) attempt7) not 8) tend 9) different 10) mannerII. Translation1. 1) Have scientists found proof of water on Mars?2) The planning committee has narrowed down the possible locations for the nuclear powerplant to two coastal towns.3) Sam not only lost his job but also both legs; he had to live on welfare for the rest of his life.4) A jury consisting of 12 members voted in unison that Mary was guilty.5) Sean felt humiliated ti hear his talent being questioned.2. George, the son of Mr. Johnson, liked listening to heavy metal music in the evenings,which made it hard for other residents in the community to fall asleep. Eventually the exhausted neighbors lost their patience and decided on direct interference. They called Mr.Johnson to tell him in a frank manner w hat t hey were thinking. M r. Johnson assured them that he would certainly settle the issue. As soon as he put down the phone he scolded his son, “What has come over you? You should know better than to disturb others for your own amusement.”In the end George traded his CD’s for computer games software from his classmates.★Text BComprehension Check: b a b c d aLanguage Practice1. d e f g a b h c2. 1) and he like 2) popularity 3) had been kept in the dark 4) define 5) was aware of6)relate 7) were up to 8) trend 9)opportunity 10)mobile 11)comments12) interviewedUnit 4★Text AVocabularyI.1. 1) conversely 2). but then 3) symptom 4) spitting 5) abusing 6) tone7) took…in8) editing 9) have arranged 10) in sight 11) stretched 12) data 2. 1) The sight of teenagers smoking cigarettes jars on me.2) A lot of American teenagers don’t like street gangs, but they find themselves gettingsucked in.3) Jeffrey’s computer crashed again this morning. The manager has arranged for atechnician from the computer store to check and repair it.4) During the Vietnam War, many young Americans fled their country to avoid militaryservice/fled to other countries to avoid military service.5) The new government is planning an anti-corruption campaign so as to restore people’sconfidence in it.3. 1) the virtual, on line, via 2) nightmare, routine, any appointment, arrange for3) cue, remarks, his tuneII. 1. We came here all the way on foot.2. Private cars are not allowed on campus.3. They are on vocation in Florida.4. Mary has been talking to her friend on the phone for an hour.5. Don’t worry, Lucy is always on time.6. Industrial demand on fuel is on the r ise.III. 1. hard 2. difficult 3. impossible 4. tough 5. hard 6. easyComprehensive ExerciseI.1. 1) internet 2) click 3) virtual 4) routines 5) arrange 6) nightmare 7) annoying 8)connection 9) crawls 10) take in 11) spit 12) data 13) sucked into 14) At times 15) flee 16) on line2. 1) companion 2) deliver 3) access 4) enables 5) customers 6) delights 7) provides 8)small 9) remote 10) informationII. Translation1. 1) Research shows that laughter can bring a lot of health benefits.2) A slow Internet connecting speed is really annoying.3) As the law stands, helping someone commit suicide is a crime.4) In her report, Mary tries to interpret the data from a completely different angle.5) Sue is a girl of great talent. Her amazing memory sets her apart from her classmates.2. Perhaps you envy me for being able to work from home on the computer. I agree that theInternet has made my job a lot easier. I can write，submit and edit articles via email, chat with my colleagues on line and discuss work with my boss. With a click of the mouse, I can get all the data I need and keep up with the latest news. But then, communicating through the Net can be frustrating at times. The system may crash. Worse still, without the emotional cues of face-to-face communication, the typed words sometimes seem difficult to interpret.★Text BComprehension Check: c a a b d cLanguage Practice1．d e a c b f g h2.1) vehicle 2) hooked on 3)intense 4)worldwide 5)overnight 6)slipped7) on the whole 8) called forth 9) outwards 10)Needless to say 11) to myknowledge 12) On top of t hatUnit 5★Text AVocabularyI.1. 1) startled 2) mere 3) motion 4) sweating 5) stretched 6) vain 7) On one occasion 8) anxiety 9) emotions 10) ashamed 11) In my mind’s eye 12)recurring2. 1) Mrs. White’s birthday coincides with her husband’s.2) They make big profits on the stuff they sell by creating an artificial shortage, which send sthe prices soaring/results in the soaring of prices.3) It has been a week of alternate sunshine and rain.4) Politics and philosophy have been his lifelong passions, although he studied economics atuniversity.5) Tension came over her, as she waited for her first TV interview.3. 1) media, dedication to, grace 2) his competitors, in excitement, hug him, congratulate him on 3) emotions, numerous, intensity, passion forII.1.Mike, a Green, made the suggestion that a large park be built near the community.2.In a letter to his daughter, Mr. Smith expressed his wish that she (should) continue hereducation to acquire still another degree.3. There is no reason to hold the belief that humans have no direct moral responsibility tosafeguard the welfare of animals.4. Children need to feel safe about the world they grow up in, and it is unwise to give them theidea that everything they come into contact with might be a threat.5. Anxiety can result from the notion that life has not treated us fairly.6.Nobody believed his claim that he was innocent.III.1.I work out in the gym for one hour every morning.2. Florence has worked as cleaner at the factory for five years.3. The wounded man worked his way across the field on his hands and knees.4.The safe load for a truck of this type works out at about twenty-five tons.5. It is difficult to understand how human minds work.6. To my disappointment, the manager’s plan of promoting the new products doesn’t work at all.7.The teacher has a lot of experience of working with children who don’t know how to learn.8.The medicine was like magic, and it worked instantly after you took it.Comprehensive ExerciseI.1. 1) In my mind’s eye 2) groan 3) competitor 4) intensity 5) anxiety 6) tense7) sweat 8) tension 9) soaring 10) recurring 11) brought me back to earth12) fantasy 13) sweat 14) congratulate 15) numerous 16) media2. 1) engineer 2) forget 3) convinced 4) how 5) build 6) accident7) thought 8)only 9) sharp 10) touched 11) instructions 12) finallyII. Translation1. 1) It is the creativity and dedication of the workers and executives that turned the companyinto a profitable business.2) The prices of food and medicine have soared in the past three months.3) We plan to repaint the upper floors of he office building.4) His success shows that popularity and artistic merit sometimes coincide.5) I don’t want to see my beloved grandmother lying in a hospital bed and groaning painfully.2. Numerous facts bear out the argument/statement/claim that in order to recover speedilyfrom negative emotion, you should allow yourself to cry. You needn’t/don’t have to be ashamed of crying. Anxiety and sorrow can flow out of the body along with tears.Consider t he case of/Take Donna, H er s on unfortunately died in a car a ccident. T he intensity of the blow made her unable to cry. She said, “It was not until two weeks later that I began to cry. And then I felt as if a big stone had been lifted from my shoulders. It was the tears that brought me back to earth and helped me survive the crisis.”★Text BComprehension Check: b c b b c aLanguage Practice1. a e d c b h f g2.1) aid 2) inclined 3) in good health 4) shortcomings 5) penetrated6) dismiss 7)has suffered from 8)progressive 9)optimistic 10)to a degree 11)hold on to12)installUnit 6★Text AVocabularyI.1. 1) culture/cultural 2) indication 3) miniature 4) ironic 5) stumbled into 6) decent7) buzzing 8) abnormal 9) mechanical 10) Shuddering 11) implied 12) leap2. 1) You can convert RMB into US dollars in the foreign exchange office a the airport.2) I f igured s he d idn’t k now the f irst t hing a bout c ooking a s she l ooked p uzzled a s t o h ow tocook rice with the rice cooker.3) The manager glowed with pleasure upon hearing that in spite of their faulty equipment theteam had accomplished some very useful work.4) I’m g rateful t o m y c ompany f or a llowing m e t o w ork f lexible h ours a s l ong a s I w ork e ighthours a day.5) On seeing the comments made in the margins by previous readers, Tom couldn’t helpthinking the book must be quite fascinating.3. 1) will not panic/feel panic, ’ll be at a disadvantage 2) hybrid, transmission3) crave, One indication, to distinguishII. 1. also 2. as well/too 3. too 4. also 5. as well/too 6. too 7. also 8. AlsoIII. 1. I’ve had enough 2. When I was old enough to work and earn money3. can’t get enough sleep at night4. has so far collected enough of them5. have strong enough arms6. have j ust e nough m oney t o l ive onComprehensive ExerciseI.1. 1) stumbled into 2) not know the first thing about 3) mechanical 4) when it comes to5) hybrid 6) gritted her teeth 7) premise 8) at a disadvantage 9) panic 10) cultural 11) flexible 12) imply2. 1) chair 2) force 3) secrets 4) painstaking 5) recognized 6) steered 7) essentially 8) observation 9) women 10) tutor 11) inspired 12) unlessII. Translation1. 1) He is a man of few words, but when it comes to playing a computer games, he is far tooclever for his classmates.2) Children who don’t know any better may think these animals are pretty cute and startplaying with them.3) There is no way to obtain a loan, so to buy the new equipment, I will just have to grit myteeth and sell my hybrid car.4) The h unter w ould not h ave fired the s hots i f h e hadn’t s een a h erd o f e lephants c omingtowards his campsite.5) I f ind it i ronic that T om has a selective memory --- he does not s eem t o remember p ainfulexperiences in the past, particularly those of his own doing.2. Nancy Hopkins is a biology professor at MIT. She craves knowledge and works hard.However, as a scientist, she could not help noticing all kinds of indications of gender inequality on campus. Men and women professors did the same work, but when it came to promotion the administrators were rather selective. It was ironic that after so much cultural progress, women were still at a disadvantage in institutions of higher education. When her request for more lab space was refused, she knew she had to fight. So she gritted her teeth and complained to the President. The fight ended in victory and Nancy was converted into a gender-equality advocate.★Text BComprehension Check: b a d b d c aLanguage Practice1. b d a e g c f h2.1) crisis 2) weighed down 3) supportive 4) takes all the credit 5) pleaded6) in control of 7) party 8) expense 9) lives for 10) semester11) at every opportunity 12) stirUnit 7★Text AVocabularyI.1. 1) S trictly s peaking 2) d rifted 3) r esembles 4) i nvaded 5) i s c onquered 6) f ascinating 7) s nack 8) p ut…into practice 9) source 10) climate 11) surrendered 12) were aroused2. 1) an absolute necessity rather than a luxury 2) is a valuable addition to the football team.3) will get out of control, if the firemen do not arrive within ten minutes.4) alternative but to g via Vancouver to get to Seattle5) declared a ll b eef i mports w ill b e banned f or t he next s ix months as a n e mergency m easure t ostop the spread of mad c ow disease.3. 1) systematic, have invented, to a very real extent, mysteries2) to establish, to be modifies/ modifying 3) tolerance towards, strike out, enrichII. 1. a) wish b) wish c) want d) want/wish 2. a) skin b) hide/skin c) hide d) skin3. a) raise/rear b) raise c) rear/raise d) raise4. a) royal b) kingly/royal c) sovereignd) royal/kinglyIII. 1. Indeed 2. though 3. Frankly 4. Moreover 5. To my knowledge6. however7. nevertheless8. Yet9. instead 10) in other words Comprehensive ExerciseI.1. 1) fascinating 2) tolerance 3) invented 4) addition 5) ban 6) corrupt7) out of control 8) influenced 9) elite 10)came up with 11) establishing12) Massive 13）sources 14）enrich2. 1) early 2) similar 3) source 4) observation 5) examine6) features 7) declared 8) stronger 9) accident 10) sprungII. Translation1. 1) Many small businesses have sprung up in the city since the new policy went into effect.2) On hearing the news, she smiled briefly, and then returned to her habitual frown.3) He paused for effect, then said:“We can reach/enter these markets through new channels.”4) The addition of a concert hall to the school will help it nourish young musical talents.5) We have no way to protect our personal liberties until we have established a sovereignstate,/We can’t protect our personal liberties unless we, first of all, establish a sovereign state.2. Though how the English language came into existence remains a mystery to manypeople，linguists believe that English and most other European languages have descended from a common source: the Indo-European parent language. English was first spoken by the Anglo-Saxons who invaded England in the fifth century. They passed onto us the basic vocabulary of English. In over fifteen centuries of its development, English has enriched itself by massive borrowing. As British immigrants landed in America and established the United States as an independent nation, a new variety was added to the English language : American English. Though some people worry that the language is running out of control, many native speakers of English take pride in the tolerance of their language.★Text BComprehension Check: c c c d b dLanguage Practice1. g e d c b h f a2. 1) give way to 2) predict 3) substantial 4) integrate 5) in transition 6) aspect7) to name a few 8) authority 9) dominate 10) had contributed to 11) unique12) rid yourself ofUnit 8VocabularyI. 1) barking 2) evil 3) brooding, hatched 4) migrant 5) tragedies 6) counterpart7) are complaining/complain 8) grim 9) flocks, fed on 10) vegetation11) patches 12) Scores of2. 1) was lined with people who came to welcome the distinguished foreign guests2) the boss silenced all lively conversation in the office3) wearing a pair of sun glasses, the famous movie star passed the crowded unnoticed.4) looked deserted 5) were stricken by i t3. 1) patches, came into full bloom, were puzzled, mysterious2) throbbed with, sickened, migrant, a chorus 3) had crept into. Flickered, the starkII. 1. age-old, air force, daughter-in-law, first-rate, greenhouse, half brother, ice-cream, lifelike, light year, salesperson, self- centered, threefold, overuse, stone-still, worldwide2.1) poverty-stricken people 2) heart-breaking news 3) newly-built 4) well-fed kids5) successful spacewalk 6) peace-loving 7) need-based scholarships 8) color-blindpeopleIII. 1. lying 2. laid 3. lay 4. lain 5. lie 6. lay 7. lie 8. lay 9. lay 10. lies Comprehensive ExerciseI.1. 1) spell 2) stricken 3) misfortunes 4) surroundings 5) blossom/bloom 6) migrant7)deserted 8) silence 9) sickened 10) hatch 11) puzzled 12) in harmony with2. 1) rate 2) publication 3) dangerous 4) banned 5) export6) profit 7) accept 8)comprehend 9) boundaries 10) ultimatelyII. Translation1.1) This is a prosperous town, but there is still poverty in the midst of wealth and abundance.2) The Brown family was stricken with one misfortune after another, but their children nevercomplained.3) The m useum i s d esigned i n such a w ay that i t s tands i n p erfect h armony w ith i tssurroundings.4) It was a miracle that these flowers did not wither at all in the blazing sun.5) Flocks of sheep feed on the patches of vegetation that rise above the winter snow.2. This village was once famous for its beautiful natural surroundings. All the year round,the trees were green and the flowers in bloom. Clear streams flowed out of the hills through a checkerboard of rice fields. Birds sang all day, and deer came and went in a leisurely manner.However, w ith the coming of D DT and other pesticides, a n evil spell seemed to have settled over the village. M isfortunes came one after another. Chicken died suddenly, cattle and sheep were stricken by mysterious maladies, and farmers complained about a sickening feeling that puzzled the village doctor. The village square, once throbbing with life, was now deserted.★Text BComprehension Check: b d a b b cLanguage Practice1. c d g a h b e f2.1) adapt 2) injured 3) immune 4) hostile 5) gives out 6) slight 7) take up8) significance 9) for the most part 10) deliberate 11)span 12) get caught up in。
Expert consensus and recommendations on safety criteria for active mobilization of MV
Expert consensus and recommendations on safety criteria for active mobilization of mechanically ventilated critically ill adultsCarol L Hodgson 1,2*,Kathy Stiller 3,Dale M Needham 4,Claire J Tipping 2,Megan Harrold 5,Claire E Baldwin 6,7,Scott Bradley 2,Sue Berney 8,Lawrence R Caruana 9,Doug Elliott 10,Margot Green 11,Kimberley Haines 8,12,Alisa M Higgins 1,Kirsi-Maija Kaukonen 1,13,Isabel Anne Leditschke 14,15,Marc R Nickels 16,Jennifer Paratz 17,18,Shane Patman 19,Elizabeth H Skinner 20,21,Paul J Young 22,23,Jennifer M Zanni 24,Linda Denehy 25and Steven A Webb 1,26IntroductionIn the past,critically ill patients who were receiving mech-anical ventilation were often managed with deep sedation and bed rest,at least during the early stages of their ICU admission.Despite long-standing evidence that prolonged bed rest results in deconditioning [1,2],studies investigating the effectiveness of early progressive mobilization for ICU patients have only started appearing in the literature in the last 10to 15years [3,4].While the earlier publicationsdocumented the feasibility,safety and physiological effects associated with the mobilization of ICU patients [5-8],point-prevalence studies [9,10]and controlled trials investi-gating the effectiveness of early progressive mobilization have been published in more recent years [11-16].These studies,and concomitant systematic reviews [4,17-22],pro-vide evidence that early progressive mobilization of adult ICU patients is feasible,safe,and may result in benefits in-cluding improved functional outcomes,and reduced ICU and hospital length of stay.These findings are contributing to a shift in ICU clinical practice,where patients who once would have received deep sedation and bed rest,are now less heavily sedated and receive early progressive mobilization [23].The inci-dence of reported adverse events associated with early progressive mobilization of ICU patients is low (≤4%)[17].*Correspondence:carol.hodgson@ 1Australian and New Zealand Intensive Care Research Centre (ANZIC-RC),Department of Epidemiology and Preventive Medicine,School of Public Health and Preventive Medicine,Monash University,99Commercial Road,Melbourne,Victoria 3004,Australia 2Department of Physiotherapy,The Alfred,55Commercial Road,Melbourne,Victoria 3004,AustraliaFull list of author information is available at the end of thearticle©2014Hodgson et al.;licensee BioMed Central.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/4.0),which permits unrestricted use,distribution,and reproduction in any medium,provided the original work is properly credited.The Creative Commons Public Domain Dedication waiver (/publicdomain/zero/1.0/)applies to the data made available in this article,unless otherwise stated.Hodgson et al.Critical Care (2014) 18:658 DOI 10.1186/s13054-014-0658-yMoreover,most of these adverse events were transient and benign.Whilst it is important that consideration is given to the potential benefits versus the potential adverse events associated with early progressive mobilization,it is possible that undue concern about adverse events may be resulting in mobilization being withheld where it might otherwise be beneficial.In order for early progressive mobilization to be undertaken safely in an ICU setting, with a minimal risk of adverse sequelae,it is essential that patients be carefully assessed prior to any mobilization intervention.Such assessment is facilitated by the avail-ability of objective criteria that indicate that it is reason-able or safe to initiate mobilization[24].A logical process for the development of such criteria is to utilize expert opinion to achieve consensus and,subsequently,deter-mine the validity of these criteria by empiric research.The aim of this study was to develop consensus recommenda-tions on safety criteria that should be considered prior to mobilizing adult,mechanically ventilated,ICU patients. MethodsA group of23multidisciplinary experts who had consider-able clinical experience and were currently involved in re-search about early mobilization of adult ICU patients were invited to participate in a consensus meeting.All partici-pants were based at tertiary centers.All23invitees attended a face-to-face meeting on21June2013.These23partici-pants comprised17physiotherapists,5intensivists and1 nurse,who were from Australia(n=19),United States (n=2),New Zealand(n=1)and Finland(n=1).Prior to the face-to-face meeting,a systematic review of the literature was performed by two members of the group(CH,CT).Protocols and publications that out-lined safety criteria for early mobilization in ICU were identified and distributed to the group.Additionally,any publication or protocol that a member of the consensus committee deemed important was circulated prior to the meeting.The face-to-face meeting was divided into three parts. First,there were presentations from individual panel members of any published or unpublished safety criteria for mobilization.Second,the panel members were divided into small working groups to determine where there was clear agreement and where further discussion was re-quired regarding safety criteria.Third,the entire group then re-formed and discussed the recommendations from the smaller working parties in order to determine where consensus had been reached and where further discussion was required.Following the face-to-face meeting,a sum-mary of the safety criteria for mobilization was drafted and,using an iterative process,was circulated to panel members via email until the group had reached consensus or agreed that they could not reach consensus.Consensus was defined as100%agreement amongst the group.ResultsNature of the safety recommendationsThe consensus group agreed that the recommendations were aimed at assisting in the assessment of adult,mech-anically ventilated ICU patients to determine if and when mobilization could commence.A critical element that was adopted was that these criteria should be regarded as a guide and should always be used in conjunction with clin-ical reasoning.It was agreed that the input into the deci-sion to mobilize should lie with all members of the multidisciplinary team(that is,physiotherapy,medical, nursing staff)with the treating clinician having ultimate responsibility for decision making.The safety criteria developed by the group are intended to be used whenever mobilization is considered,which might be up to several times per day for an individual patient.The consensus group agreed that a standard traffic-light system of recommendations would be used to assist clinicians in evaluating safety criteria,where red would indicate the need for caution as the risk of an adverse event,or consequences of an adverse event,was high,yellow would indicate that mobilization was possible,but only after further consider-ation and/or further discussion among the ICU multidiscip-linary team,and green would indicate that the patient was safe to be mobilized(see Figure1).It was agreed that the most conservatively scored parameter must take precedence over all other scores(for example,a single red would be suf-ficient to caution about the potential for high risk of an ad-verse event during mobilization,even if all other parameters were green).In considering the decision to mobilize a pa-tient,the criteria should be assessed on the status of the pa-tient at the time of planned mobilization,but changes in condition,and direction of trends,in the preceding hours should also be taken into account.The potential conse-quences of an adverse event in an individual patient should also be considered as part of the overall clinical reasoning process.The group decided that recommendations would be de-veloped only for active mobilization and that no guidance would be provided with respect to safety criteria for pas-sive mobilization.Active mobilization was defined as any activity where the patient assists with the activity using their own muscle strength and control:the patient may need assistance from staff or equipment,but they are ac-tively participating in the exercise.Activities that comprise active mobilization are out-of-bed mobilization(that is, any activity where the patient sits over the edge of the bed (dangling),stands,walks,marches on the spot or sits out of bed)and in-bed mobilization(that is,any activity undertaken whilst the patient is sitting or lying in bed such as rolling,bridging,upper-limb weight training).The level of mobilization should be determined by the patient’s strength and endurance,as well as an assessment of the safety criteria.The safety criteria covered by the consensus group were divided into four categories:(1)respiratory considerations, including intubation status,ventilatory parameters and the need for adjunctive therapies;(2)cardiovascular consider-ations,including the presence of devices,cardiac arrhyth-mias and blood pressure;(3)neurological considerations, including level of consciousness,delirium and intracranial pressure,and(4)other considerations,including lines and surgical or medical conditions.Respiratory safety considerationsPrior to each episode of mobilization,an appropriate health-care professional,according to the procedures of each indi-vidual ICU,should check that any artificial airway present (that is,orotracheal,nasotracheal or tracheostomy tube)is correctly positioned and secure.Additionally,any supple-mental oxygen that may be required by the patient should be available with an adequate oxygen reserve that exceeds the expected duration of the mobility activity(as unexpected delay or increased requirements may occur).The group agreed that endotracheal tube intubation was not in itself a contraindication to early mobilization and that a fraction of inspired oxygen(FiO2)less than0.6was a safe criterion for in-and out-of-bed mobilization if there were no other con-traindications.Other respiratory safety recommendations are summarized in Figure2.If the patient was at the safety limits for several categories(for example,low percutaneous oxygen saturation,high FiO2and high positive end expira-tory pressure),an experienced medical team should be con-sulted prior to mobilization.Cardiovascular safety considerationsThe cardiovascular considerations to be assessed prior to mobilization are summarized in Figure3.Of note,panel members were unable to reach consensus regarding the dose of vasoactive drugs(and combination of these drugs) that would allow safe mobilization in the ICU setting; views on the dose,unit of measurement and combination of these drugs were variable across panel members of the con-sensus group.However,the group did reach consensus around the principles that were important to consider,which were that the administration of vasoactive drugs, perse,was not an absolute contraindication to mobilization but the appropriateness of mobilization was influenced by the absolute dose,the change in dose(for example, rising doses should result in caution or contraindication to mobilization),and,irrespective of the dose,whether or not the patient is clinically well-perfused.The group was unable to achieve consensus on a threshold dose of vasoactive medications below which it was acceptable to mobilize patients,the rate of change in dose and cri-teria for impaired perfusion and shock.It was therefore agreed that clinicians at individual ICUs should discuss the safe dose and combinations of vasoactive drugs that allows mobilization on a case-by-case basis with the ap-propriate ICU staff and that this represented a priority area for empiric research.Neurological and other safety considerationsThese are summarized in Figures4and5respectively. DiscussionThe aim of this study was to develop consensus recom-mendations on safety criteria to determine readiness for actively mobilizing adult,mechanically ventilated,ICU patients.Utilizing previous evidence and expert opinion, the consensus group achieved consensus for most of the respiratory,cardiovascular,neurological and other safety considerations.The criteria that have been used to determine when critically ill patients can be mobilized have varied be-tween studies.Criteria for the early mobilization of adult ICU patients were published by Stiller and Phillips in2004[25],primarily based on physiological principles and their clinical experience,and were later endorsed by Gosselink et al.for the European Society of Intensive Care Medicine[26].However,the level of evidence supporting these recommendations is pared to previous studies that have outlined safety parameters for the early mobilization of ICU patients,the recommendations outlined in this papercoding definitions.appear to be less conservative and more comprehen-sive by covering a wider array of clinical scenarios. The recommendations and clinical scenarios were identified by the group in an attempt to maximize mobilization of ICU patients.We believe these rec-ommendations will assist in standardizing safety pre-cautions regarding mobilization in ICUs across different healthcare centers and are appropriate for use by experienced ICU clinicians.However,each ICU should consider the recommendations in light of their own staffing levels and expertise.In the current study,panel members were unable to reach consensus for some safety considerations,specifically,the level of vasoactive drugs as noted earlier.Clearly,there is a need for research in this area to clarify safety parameters.Respiratory safety considerations.PEEP,positive end-expiratory pressure.The strength of the safety recommendations out-lined in this paper is that they are based on evidence from relevant clinical studies and required consensus of panel members,all of whom have clinical expertise and were currently involved in research regarding the early mobilization of ICU patients.There are several lim-itations to the current study as follows.The consensus group was predominantly comprised of clinicians working in Australia,therefore the recommendations may be reflect-ive of Australian ICU culture and practice and thus may not be generalizable to other countries.However,the results of the consensus were presented at the Seventh International Meeting of Physical Medicine and Rehabilitation in Critically Ill held in San Diego on17May2014.At this meeting there were94multidisciplinary clinicians,from both academic and non-academic hospitals,interested in early mobilization in ICU.Each of the criteria was discussed individually as documented and consensus was sought from attendees. Consensus was reached when100%of attendees agreed to the proposed wording of the document.As a result of their feedback,minor amendments were made to the con-sensus document to reflect international practice.It is also acknowledged that the consensus recommendations are pre-dominantly based on the experts’interpretation of literature and their opinions which are based on their clinical practice. Further research is required to validate each of the safety considerations discussed in these recommenda-tions and the recommendations as a whole,both in centers with expertise in ICU mobilization and in centers without. Furthermore,as early progressive mobilization continues to be more extensively practiced and researched,and critical care medicine advances,it may be that criteria currently noted in red may become yellow in future versions of these recommendations.Finally,while the consensus group dis-cussed safety parameters that should be assessed prior to mobilization,safety parameters that should be monitored during mobilization interventions were not considered. ConclusionThis study reports on the development of consensus recommendations outlining safety considerations prior to the mobilization of adult,mechanically ventilated pa-tients in an ICU setting.The implementation of these recommendations has the potential to maximize earlyFigure3Cardiovascular safety considerations.mobilization while minimizing the risk of adverse safety events,which in turn might improve functional out-comes and translate into reduced ICU and hospital length of stay.Future research required includes system-atic evaluation of these recommendations.Key messagesThe safety criteria for mobilizing patients in ICU may be considered according to a traffic-light system of low risk of an adverse event(green),potential risk of an adverse CAM-ICU,confusion assessmentevent is outweighed by the benefit of early mobilization (yellow)and significant potential risk of an adverse event requiring consultation with senior ICU staff(red)The consensus for safe mobilization was provided for respiratory,cardiovascular,neurological andother considerations including lines and drainsThe group provided recommendations for active mobilization.No guidance was provided withrespect to safety criteria for passive mobilization Competing interestsThe authors declare that they have no competing interests.Authors’contributionsCH conceived of the study,chaired the consensus meeting,coordinated the group and drafted the manuscript.KS provided expert advice on content and manuscript preparation.DN coordinated and chaired the international meeting and recommendations.CT and CH performed the systematic review.MH conceived the traffic-light system of reporting safety of mobilization.SW provided expert advice about the process and manuscript content.All(CH,KS,DN,CT,MH,CB,SB,SueB,LC,DE,MG,surgical and other safety considerations.KH,AH,KMK,IL,MN,JP,SP,ES,PY,JZ,LD,SW)authors provided information from previous studies,both published and unpublished.All authors provided expert input regarding the recommendations and read and approved the final manuscript.CH was supported by an Early Career Research Fellowship from the National Health and Medical Research Council(NHMRC)of Australia and the Australian and New Zealand Intensive Care Research Centre,Monash University.ES was supported employed by Western Health.Author details1Australian and New Zealand Intensive Care Research Centre(ANZIC-RC), Department of Epidemiology and Preventive Medicine,School of Public Health and Preventive Medicine,Monash University,99Commercial Road, Melbourne,Victoria3004,Australia.2Department of Physiotherapy,The Alfred,55Commercial Road,Melbourne,Victoria3004,Australia.3Department of Physiotherapy,Royal Adelaide Hospital,North Terrace,Adelaide,South Australia5000,Australia.4Outcomes After Critical Illness&Surgery(OACIS) Group,Division of Pulmonary&Critical Care Medicine,Department of Physical Medicine&Rehabilitation,Johns Hopkins Hospital,600N.Wolfe Street,Meyer1-130,Baltimore,Maryland21287,USA.5School of Physiotherapy&Exercise Science,Curtin University of Technology,Kent Street,Bentley,Western Australia6102,Australia.6School of Health Sciences, University of South Australia,City East Campus,North Terrace,Adelaide, South Australia5001,Australia.7Physiotherapy Department,Flinders Medical Centre,Flinders Drive,Bedford Park,South Australia5042,Australia.8Physiotherapy Department,Austin Hospital,145Studley Road,Heidelberg, Victoria3084,Australia.9The Prince Charles Hospital,627Rode Road, Chermside,Queensland4032,Australia.10Faculty of Health,University of Technology,Sydney(UTS),235Jones Street,Broadway,New South Wales 2007,Australia.11Physiotherapy Department,Canberra Hospital,Yamba Drive, Garran,Australian Capital Territory2605,Australia.12Department of Physiotherapy,St.Vincent’s Hospital Melbourne,41Victoria Parade,Fitzroy, Victoria3065,Australia.13Department of Anaesthesiology and Intensive Care, TöölöHospital,Helsinki University Central Hospital,Topeliuksenkatu5, Helsinki,Finland.14Intensive Care Unit,Canberra Hospital,Yamba Drive, Garran,Australian Capital Territory2605,Australia.15Australian National University Medical School,The Canberra Hospital,Hospital Road,Garran, Australian Capital Territory2606,Australia.16Physiotherapy Department, Princess Alexandra Hospital,199Ipswich Road,Woolloongabba,Queensland 4102,Australia.17Burns,Trauma&Critical Care Research Centre,School of Medicine,The University of Queensland,Department of Intensive Care Medicine,Royal Brisbane and Women’s Hospital,Herston,Queensland4029, Australia.18School of Allied Health Sciences,Griffith University,Gold Coast Campus,Parklands Drive,Southport,Queensland4215,Australia.19School of Physiotherapy,The University of Notre Dame Australia,Fremantle Campus, 19Mouat Street,Fremantle,Western Australia6959,Australia.20Department of Physiotherapy,Western Health,Western Hospital,Gordon Street,Footscray, Victoria3011,Australia.21Department of 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