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Background: Stiff person syndrome spectrum disorders (SPSD) are a rare group of disabling neuroimmunological disorders. SPSD often requires immune therapies, especially in the setting of inadequate response to symptomatic treatments. The safety and efficacy of therapeutic plasma exchange (TPE) in SPSD remains uncertain. Objectives: To describe the safety, tolerability, and efficacy of TPE in patients with SPSD. Design: A retrospective observational study. Methods: A retrospective review of SPSD patients seen at Johns Hopkins Hospital (JHH) from 1997 to 2021 was performed. Patient demographics/history, examination/diagnostic findings, treatment response, and TPE-related complications were recorded. Assessment for any associations between clinical characteristics, including age, sex, clinical phenotype, and time on immunotherapy, and response to TPE 3 months after treatment was performed. A subgroup of 18 patients treated with TPE at JHH and 6 patients treated with TPE at outside institutions were evaluated for any change in usage of symptomatic medications 3 months after the TPE treatment. Literature review of SPSD and TPE was also conducted. Results: Thirty-nine SPSD patients were treated with TPE (21 at JHH and 18 at outside institutions); median age 48 years, 77% female, median modified Rankin Scale 3; mean initial anti-GAD65 antibody titer was 23,508 U/mL. Twenty-four patients (62%) had classic SPS, 10 (26%) had SPS-plus, 2 (5%) had progressive encephalomyelitis with rigidity and myoclonus, and 3 (8%) had pure cerebellar ataxia. All patients were on symptomatic treatments, 30 (77%) previously received IVIg, and 3 (8%) previously received rituximab. Four patients (10%) had a TPE-related adverse event. One developed asymptomatic hypotension, another had both line thrombosis and infection, and two had non-life-threatening bleeding events. Twenty-three (59%) patients reported improvement in symptoms after TPE. Of the subgroup of 24 patients evaluated for any change in usage of symptomatic medications 3 months after the TPE treatment, 14 (58%) required fewer GABAergic symptomatic medications. Literature review identified 57 additional patients with SPSD; 43 (75%) reported temporary improvement after TPE. Conclusion: The majority of patients treated with TPE had improvement. Moreover, most patients evaluated for any change in usage of symptomatic medications after the TPE treatment no longer required as much symptomatic medications months after TPE. TPE appears safe and well-tolerated in SPSD. Further studies are needed to assess the long-term efficacy of TPE in SPSD and identify which patients may benefit the most from TPE. [ABSTRACT FROM AUTHOR]

This study examined the relationship of teachers’ perceptions of coping resources and demands to job satisfaction factors. Participants were 158 Advanced Placement Statistics high school teachers who completed measures of personal resources for stress prevention, classroom demands and resources, job satisfaction, and intention to leave the field of teaching. Results indicated that teachers’ preventive coping resources and job satisfaction were positively related, whereas both constructs were negatively related to classroom stress and teachers’ plans to leave the profession. [ABSTRACT FROM PUBLISHER]

In this rejoinder to Willis, Smagorinsky, and Douglas (this issue of Educational Researcher), the authors discuss how many of the points raised by Willis and Smagorinsky regarding their original article, which appeared in the March 2009 issue of Educational Researcher, are concerned less with the methods themselves than with different styles of science. The authors of this rejoinder examine their differing styles of science, using Stanovich's 2003 framework, and call for consilience and the understanding that multiple perspectives and methods are needed to solve the important and perplexing problems that students and teachers will face in the 21st century. [ABSTRACT FROM AUTHOR]

The Individualizing Student Instruction (ISI) classroom observation and coding system is designed to provide a detailed picture of the classroom environment at the level of the individual student. Using a multidimensional conceptualization of the classroom environment, foundational elements (teacher warmth and responsiveness to students, classroom management) and instructional elements (teacher-child interactions, context, and content) are described. The authors have used the ISI system to document that children who share the same classroom have very different learning opportunities, that instruction occurs through interactions among teachers and students, and that the effect of this instruction depends on children's language and literacy skills. This means that what is effective for one child may be ineffective for another with different skills. With improving classroom observation systems, the dynamics of the complex classroom environment as it affects student learning can be better understood. [ABSTRACT FROM AUTHOR]

Using a longitudinal cluster-randomized controlled design, we examined whether students' reading outcomes differed when they received 1, 2, or 3 years of individualized reading instruction from first through third grade, compared with a treated control group. More than 45% of students came from families living in poverty. Following students, we randomly assigned their teachers each year to deliver individualized reading instruction or a treated control condition intervention focused on mathematics. Students who received individualized reading instruction in all three grades showed the strongest reading skills by the end of third grade compared with those who received fewer years of such instruction. There was inconsistent evidence supporting a sustained first-grade treatment effect: Individualized instruction in first grade was necessary but not sufficient for stronger third-grade reading outcomes. These effects were achieved by regular classroom teachers who received professional development, which indicates that policies that support the use of evidence-based reading instruction and teacher training can yield increased student achievement. [ABSTRACT FROM AUTHOR]