Integrating environmental learning into mainstream education is an important countermeasure to address the challenges to the sustainability of the earth and children's integrated development. To be effectively integrated into mainstream education, an environmental learning program should be designed in ways that elicit the support of stakeholders, while at the same time without scarifying the environmental learning goals. The purpose of this study therefore is to explore an environmental learning model that meets the above mentioned goal using a case study design.Key principles for designing such environmental learning programs are identified first based on the theoretical framework. Then, the actual enactment of these principles in a practical setting and the effects on students in terms of environmental learning goals and traditional educational goals are explored through a case study of a pilot environmental learning program designed with these guiding principles. It presents a detailed portrait of the design process, the actual enacted curriculum, and the experiences of key stakeholders with this environmental learning program. It also evaluates this program's effects on students in environmental literacy (the environmental learning goal), academic achievement and social development (the traditional educational goals). The enactment of the guiding principles and factors that influence the enactment of this program are discussed thereafter. It concludes with the construction of the curriculum integration through environmental learning model based on the case study and a discussion of the model in light of the curriculum integration framework.

Doctor of Philosophy / Curriculum and Instruction Programs / Rosemary S. Talab / The goal of this exploratory case study was to answer two questions: 1. How does an exemplary on-campus undergraduate large Introduction to Cultural Anthropology course encompass the PBL learning model characteristics, specifically focusing on the following: 1.1) Driving question, 1.2) Student construction of an artifact, 1.3) Teachers’ role, and 1.4) Assessment? 2. How is technology used by the professor, teacher assistants, and students to support project-based learning? To answer these questions, the researcher studied a large Introduction to Cultural Anthropology class, which consisted of the professor, ten teaching assistants (TAs), and 400 students. The students were divided into 20 recitation sections, with 20 students in each section. Each TA was assigned two recitation sections. Observations were conducted on twice-weekly Professor’s lectures and three once-weekly recitation sessions. Additionally, interviews and follow-up interviews were conducted of the professor, three teaching assistants (TA), and nine students. Finally, documents analyzed included the professor’s course materials and course management documents. With respect to Research Question 1, “How does an exemplary on-campus undergraduate large Introduction to Cultural Anthropology course encompass the PBL learning model characteristics, specifically focusing on the following: 1.1) Driving question, 1.2) Student construction of an artifact, 1.3) Teachers’ role, and 1.4) Assessment?”, research findings indicated that all four elements of the PBL model were present in this class and were executed well. Research Question 2, “How is technology used to support PBL,” findings indicated that advanced technologies were used by the professor for course purposes. These technologies included Wetpaint (the wiki course management system) and Facebook. More conventional technologies, such as e-mail, were also used for this purpose. Though students were hesitant to use course technology in the beginning. However, with the help of the professor and TA’s, the students learned to use the course technology and grew to enjoy it. Two additional themes emerged through open coding: Emotional Involvement and Non-Participation. First, the TA’s and students developed emotional ties to the cultures that they created in their recitation sections. Second, some students did not participate in either the lecture or the recitation sessions. The TAs took non-participation seriously, both in terms of class participation, individually, and in terms of student responsibilities to the group recitation session in culture construction.

Alemtuzumab is a humanized monoclonal antibody approved for the treatment of relapsing-remitting multiple sclerosis (RRMS), given as two annual courses on five consecutive days at baseline and on three consecutive days 12 months later. Here we provide an update on the long-term efficacy and safety of alemtuzumab in RRMS, including realworld experience, and advances in our understanding of its mechanism of action. Recent data from the phase II/III extension study have demonstrated that alemtuzumab reduces relapse rates, disability worsening, and the rate of brain volume loss over the long term, with many patients achieving no evidence of disease activity. In high proportions of patients, preexisting disability remained stable or improved. Alemtuzumab is associated with a consistent safety profile over the long term, with no new safety signals emerging and the overall annual incidence of reported adverse events decreasing after the first year on treatment. Acyclovir prophylaxis reduces herpetic infections, and monitoring has been shown to mitigate the risk of autoimmune adverse events, allowing early detection and overall effective management. Data from clinical practice and ongoing observational studies are providing additional information on the real-world use of alemtuzumab. Recent evidence on the mechanism of action of alemtuzumab indicates that in addition to its previously known effects of inducing depletion and repopulation of T and B lymphocytes, it also results in a relative increase of cells with memory and regulatory phenotypes and a decrease in cells with a proinflammatory signature, and may further promote an immunoregulatory environment through an impact on other innate immune cells (e.g. dendritic cells) that play a role in MS. These effects may allow preservation of innate immunity and immunosurveillance. Together, these lines of evidence help explain the durable clinical efficacy of alemtuzumab, in the absence of continuous treatment, in patients with RRMS.

Prolonged-release (PR) fampridine is the only approved medication to improve walking in multiple sclerosis (MS), having been shown to produce a clinically meaningful improvement in walking ability in the subset of MS patients with Expanded Disability Status Scale 4–7. Recent responder subgroup analyses in the phase III ENHANCE study show a large effect size in terms of an increase of 20.58 points on the patient-reported 12-item MS Walking Scale in the 43% of patients classified as responders to PR-fampridine, corresponding to a standardized response mean of 1.68. Use of PR-fampridine in clinical practice varies across Europe, depending partly on whether it is reimbursed. A group of European MS experts met in June 2017 to discuss their experience with using PR-fampridine, including their views on the patient population for treatment, assessment of treatment response, re-testing and retreatment, and stopping criteria. This article summarizes the experts’ opinions on how PRfampridine can be used in real-world clinical practice to optimize the benefits to people with MS with impaired walking ability.