463 research outputs found

    A late 19th-Century British perspective on modern foreign language learning, teaching, and reform: the legacy of Prendergast’s “Mastery System”

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    The late 19th century saw a great rise in private foreign language learning and increasing provision of Modern foreign language teaching in schools. Evidence is presented to document the uptake of innovations in Thomas Prendergast’s (1807–1886) “Mastery System” by both individual language learners and educationalists. Although it has previously been suggested that Prendergast’s method failed to have much impact, this study clearly demonstrates the major influence he had on approaches to language learning and teaching in Britain and around the world both with his contemporaries and long after his death. This detailed case study illuminates the landscape of modern language pedagogy in Victorian Britain

    Natalizumab treatment shows low cumulative probabilities of confirmed disability worsening to EDSS milestones in the long-term setting.

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    Abstract Background Though the Expanded Disability Status Scale (EDSS) is commonly used to assess disability level in relapsing-remitting multiple sclerosis (RRMS), the criteria defining disability progression are used for patients with a wide range of baseline levels of disability in relatively short-term trials. As a result, not all EDSS changes carry the same weight in terms of future disability, and treatment benefits such as decreased risk of reaching particular disability milestones may not be reliably captured. The objectives of this analysis are to assess the probability of confirmed disability worsening to specific EDSS milestones (i.e., EDSS scores ≥3.0, ≥4.0, or ≥6.0) at 288 weeks in the Tysabri Observational Program (TOP) and to examine the impact of relapses occurring during natalizumab therapy in TOP patients who had received natalizumab for ≥24 months. Methods TOP is an ongoing, open-label, observational, prospective study of patients with RRMS in clinical practice. Enrolled patients were naive to natalizumab at treatment initiation or had received ≤3 doses at the time of enrollment. Intravenous natalizumab (300 mg) infusions were given every 4 weeks, and the EDSS was assessed at baseline and every 24 weeks during treatment. Results Of the 4161 patients enrolled in TOP with follow-up of at least 24 months, 3253 patients with available baseline EDSS scores had continued natalizumab treatment and 908 had discontinued (5.4% due to a reported lack of efficacy and 16.4% for other reasons) at the 24-month time point. Those who discontinued due to lack of efficacy had higher baseline EDSS scores (median 4.5 vs. 3.5), higher on-treatment relapse rates (0.82 vs. 0.23), and higher cumulative probabilities of EDSS worsening (16% vs. 9%) at 24 months than those completing therapy. Among 24-month completers, after approximately 5.5 years of natalizumab treatment, the cumulative probabilities of confirmed EDSS worsening by 1.0 and 2.0 points were 18.5% and 7.9%, respectively (24-week confirmation), and 13.5% and 5.3%, respectively (48-week confirmation). The risks of 24- and 48-week confirmed EDSS worsening were significantly higher in patients with on-treatment relapses than in those without relapses. An analysis of time to specific EDSS milestones showed that the probabilities of 48-week confirmed transition from EDSS scores of 0.0–2.0 to ≥3.0, 2.0–3.0 to ≥4.0, and 4.0–5.0 to ≥6.0 at week 288 in TOP were 11.1%, 11.8%, and 9.5%, respectively, with lower probabilities observed among patients without on-treatment relapses (8.1%, 8.4%, and 5.7%, respectively). Conclusions In TOP patients with a median (range) baseline EDSS score of 3.5 (0.0–9.5) who completed 24 months of natalizumab treatment, the rate of 48-week confirmed disability worsening events was below 15%; after approximately 5.5 years of natalizumab treatment, 86.5% and 94.7% of patients did not have EDSS score increases of ≥1.0 or ≥2.0 points, respectively. The presence of relapses was associated with higher rates of overall disability worsening. These results were confirmed by assessing transition to EDSS milestones. Lower rates of overall 48-week confirmed EDSS worsening and of transitioning from EDSS score 4.0–5.0 to ≥6.0 in the absence of relapses suggest that relapses remain a significant driver of disability worsening and that on-treatment relapses in natalizumab-treated patients are of prognostic importance

    Comparative effectiveness of autologous hematopoietic stem cell transplant vs fingolimod, natalizumab, and ocrelizumab in highly active relapsing-remitting multiple sclerosis

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    Importance: Autologous hematopoietic stem cell transplant (AHSCT) is available for treatment of highly active multiple sclerosis (MS). Objective: To compare the effectiveness of AHSCT vs fingolimod, natalizumab, and ocrelizumab in relapsing-remitting MS by emulating pairwise trials. Design, Setting, and Participants: This comparative treatment effectiveness study included 6 specialist MS centers with AHSCT programs and international MSBase registry between 2006 and 2021. The study included patients with relapsing-remitting MS treated with AHSCT, fingolimod, natalizumab, or ocrelizumab with 2 or more years study follow-up including 2 or more disability assessments. Patients were matched on a propensity score derived from clinical and demographic characteristics. Exposure: AHSCT vs fingolimod, natalizumab, or ocrelizumab. Main outcomes: Pairwise-censored groups were compared on annualized relapse rates (ARR) and freedom from relapses and 6-month confirmed Expanded Disability Status Scale (EDSS) score worsening and improvement. Results: Of 4915 individuals, 167 were treated with AHSCT; 2558, fingolimod; 1490, natalizumab; and 700, ocrelizumab. The prematch AHSCT cohort was younger and with greater disability than the fingolimod, natalizumab, and ocrelizumab cohorts; the matched groups were closely aligned. The proportion of women ranged from 65% to 70%, and the mean (SD) age ranged from 35.3 (9.4) to 37.1 (10.6) years. The mean (SD) disease duration ranged from 7.9 (5.6) to 8.7 (5.4) years, EDSS score ranged from 3.5 (1.6) to 3.9 (1.9), and frequency of relapses ranged from 0.77 (0.94) to 0.86 (0.89) in the preceding year. Compared with the fingolimod group (769 [30.0%]), AHSCT (144 [86.2%]) was associated with fewer relapses (ARR: mean [SD], 0.09 [0.30] vs 0.20 [0.44]), similar risk of disability worsening (hazard ratio [HR], 1.70; 95% CI, 0.91-3.17), and higher chance of disability improvement (HR, 2.70; 95% CI, 1.71-4.26) over 5 years. Compared with natalizumab (730 [49.0%]), AHSCT (146 [87.4%]) was associated with marginally lower ARR (mean [SD], 0.08 [0.31] vs 0.10 [0.34]), similar risk of disability worsening (HR, 1.06; 95% CI, 0.54-2.09), and higher chance of disability improvement (HR, 2.68; 95% CI, 1.72-4.18) over 5 years. AHSCT (110 [65.9%]) and ocrelizumab (343 [49.0%]) were associated with similar ARR (mean [SD], 0.09 [0.34] vs 0.06 [0.32]), disability worsening (HR, 1.77; 95% CI, 0.61-5.08), and disability improvement (HR, 1.37; 95% CI, 0.66-2.82) over 3 years. AHSCT-related mortality occurred in 1 of 159 patients (0.6%). Conclusion: In this study, the association of AHSCT with preventing relapses and facilitating recovery from disability was considerably superior to fingolimod and marginally superior to natalizumab. This study did not find evidence for difference in the effectiveness of AHSCT and ocrelizumab over a shorter available follow-up time

    De visie op homoseksualiteit bij mormonen : verkenning in een historisch-sociologisch kader

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    The Church of Jesus Christ of Latter-day Saints, commonly known as LDS Church or Mormon Church, typifies a conservative Christian branch that has been moving through phases in its views on homosexuality. We apply a historical-sociological framework, valid for most of Christianity, to identify how Mormon church leaders shifted from ambiguous tolerance to condemnation of homosexuality. A moral-theological rationale grew only afterwards. Individual church leaders determined the tone which morphed from homophobic to empathetic rhetoric with the nurture-nature debate, the fight against same-sex marriage, and the drama of teen suicides as backdrop. For Mormon gays and lesbians the present doctrine requires them to sacrifice their sexual identity in order to earn social inclusiveness and a promise of salvation. In a broader context of the development of newer religions, Mormonism wants to profile itself as a full-fledged church with both strong principles and Christian charisma, thus trying to shed a historically marginal heritag

    De visie op homoseksualiteit bij mormonen : verkenning in een historisch-sociologisch kader

    No full text
    The Church of Jesus Christ of Latter-day Saints, commonly known as LDS Church or Mormon Church, typifies a conservative Christian branch that has been moving through phases in its views on homosexuality. We apply a historical-sociological framework, valid for most of Christianity, to identify how Mormon church leaders shifted from ambiguous tolerance to condemnation of homosexuality. A moral-theological rationale grew only afterwards. Individual church leaders determined the tone which morphed from homophobic to empathetic rhetoric with the nurture-nature debate, the fight against same-sex marriage, and the drama of teen suicides as backdrop. For Mormon gays and lesbians the present doctrine requires them to sacrifice their sexual identity in order to earn social inclusiveness and a promise of salvation. In a broader context of the development of newer religions, Mormonism wants to profile itself as a full-fledged church with both strong principles and Christian charisma, thus trying to shed a historically marginal heritag

    Assessment of the implementation of speech acts in CALL

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    This .csv file contains data from the laboratory and field experiments described in the manuscript, including embryonic mortality and development times, maximum daily temperatures, hatchling sizes and body conditions, and juvenile growth rates estimated from von Bertalanffy growth models (for a subset of laboratory-reared lizards)

    Grammaire et lexiques

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