Journal articles on the topic 'Ilona Andrews'

The complete list of authors is this: Maxime Cailleret, Steven Jansen, Elisabeth M. R. Robert, Lucía Desoto, Tuomas Aakala, Joseph A. Antos, Barbara Beikircher, Christof Bigler, Harald Bugmann, Marco Caccianiga, Vojtěch Čada, Jesus J. Camarero, Paolo Cherubini, Hervé Cochard, Marie R. Coyea, Katarina Čufar, Adrian J. Das, Hendrik Davi, Sylvain Delzon, Michael Dorman, Guillermo Gea-Izquierdo, Sten Gillner, Laurel J. Haavik, Henrik Hartmann, Ana-Maria Hereş, Kevin R. Hultine, Pavel Janda, Jeffrey M. Kane, Vyacheslav I. Kharuk, Thomas Kitzberger, Tamir Klein, Koen Kramer, Frederic Lens, Tom Levanic, Juan C. Linares Calderon, Francisco Lloret, Raquel Lobo-Do-Vale, Fabio Lombardi, Rosana López Rodríguez, Harri Mäkinen, Stefan Mayr, Ilona Mészáros, Juha M. Metsaranta, Francesco Minunno, Walter Oberhuber, Andreas Papadopoulos, Mikko Peltoniemi, Any M. Petritan, Brigitte Rohner, Gabriel Sangüesa-Barreda, Dimitrios Sarris, Jeremy M. Smith, Amanda B. Stan, Frank Sterck, Dejan B. Stojanović, Maria L. Suarez, Miroslav Svoboda, Roberto Tognetti, José M. Torres-Ruiz, Volodymyr Trotsiuk, Ricardo Villalba, Floor Vodde, Alana R. Westwood, Peter H. Wyckoff, Nikolay Zafirov, Jordi Martínez-Vilalta   The full reference for this paper is: Cailleret, M.; Jansen, S.; Robert, E.M.R.; DeSoto, L.; Aakala, T.; Antos, J.A.; Beikircher, B.; Bigler, C.; Bugmann, H.; Caccianiga, M. et al. & Martínez-Vilalta J. (2017) A synthesis of radial growth patterns preceding tree mortality. Global Change Biology 23:1675–1690  

Abstract Ovarian cancer is characterized by late stage disease and a poor prognosis. Endometrial cancer is a heterogeneous disease with different prognoses depending on the molecular subtype. Novel treatment strategies are needed to improve patient survival in both entities. T cell-based immunotherapy has significantly improved the treatment options for many malignancies. B7-H3 (CD276) is an interesting target for immunotherapeutic approaches because it is overexpressed on a wide range of tumor entities and has characteristics of immune checkpoint molecules. Its expression not only on tumor cells but also on the tumor vasculature allows improved infiltration of immune effector cells into the tumor to overcome the major limitation of T cell-based therapy of solid tumors, which is the access of immune cells to the tumor site. A novel bispecific antibody in an IgG-based format called CC-3 with B7-H3xCD3 specificity has already been shown to efficiently induce T cell responses against gastrointestinal malignancies. Here we show that B7-H3 is highly expressed on endometrial and ovarian cancer cell lines. Treatment with CC-3 induced T cell activation and degranulation as well as secretion of IL-2, IFNy and perforin. These results demonstrate CC-3 induced T cell reactivity against ovarian and endometrial cancer cells. In addition, CC-3 induced efficient T cell proliferation and formation of T cell memory subsets. This resulted in potent target cell lysis. Taken together, our results underscore the potential of CC-3, which is currently in GMP manufacturing, to enable clinical evaluation for the treatment of gynecologic malignancies. Citation Format: Sarah Maria Greiner, Jonas Mauermann, Martina Lutz, Ilona Hagelstein, Engler Tobias, André Koch, Hartkopf Andreas, Brucker Sara, Latifa Zekri, Melanie Märklin. IgG based B7-H3xCD3 bispecific antibody for treatment of gynecological tumors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6707.

Abstract Based on iOmx’ proprietary iOTargTM genetic screening platform, salt-inducible kinase (SIK) 3 was identified as a novel cell signaling modulator in cancer biology. OMX-0407, an orally available, spectrum-selective kinase inhibitor targets several members of the SIK family and is known to prevent tumor-promoting function of the SIK-family through repolarization of the tumor microenvironment by enhancing caspase-mediated apoptosis upon death-receptor signaling. In addition, OMX-0407 inhibits individual key members of the tyrosine and tyrosine-like kinase family that are involved in cancer cell proliferation and cell cycle regulation. Via this dual mode of action, OMX-0407 has the potential to effectively fight solid tumors as exemplified by its striking single-agent efficacy in multiple pre-clinical tumor models. A comprehensive anti-tumor viability screen of >200 human cancer cell lines revealed striking effects of OMX-0407 on cancer cell viability across various cancer indications, resulting in a distinct sensitivity profile across various tumor indications with particularly strong effects on renal cell carcinoma (RCC) and squamous non-small cell lung cancer (sqNSCLC). Phospho-proteomics screening demonstrated pharmacodynamic activity of OMX-0407 in sensitive tumor cell lines via inhibition of key cellular processes such as cell motility, proliferation, and cell cycle regulation across different indications. Orthogonal functional in vitro assays confirmed the association of the OMX-0407-mediated anti-tumor efficacy with the arrest of G1/S transition and corresponding downregulation of cell cycle associated proteins PAK1/2 and ARHGAP35. The profound impact of OMX-0407 on fundamental regulatory mechanisms of cell division and cancer cell apoptosis translates into dose-dependent single-agent, anti-tumor efficacy in various pre-clinical tumor models of selected indications. Combination with Axitinib, a selective orally available inhibitor of vascular endothelial growth factor receptor 2, significantly enhanced anti-tumor efficacy and pharmacodynamic inhibition of cell growth as well as angiogenesis. These data further strengthen the potential of OMX-0407 in the treatment of RCC as well as other indications. In summary, OMX-0407 is a novel spectrum selective kinase inhibitor, currently under evaluation in a clinical Phase I trial (NCT05826600). OMX-0407 demonstrates strong anti-tumor efficacy in monotherapy in selected sensitive indications through a dual-pronged MoA, by modulating the tumor microenvironment and exerting direct anti-tumor activity in solid tumor indications with high unmet medical need. Citation Format: Ilona-Petra Maser, Marisa Stebegg-Wagner, Bettina Bauer, Filippos Konstantinidis, Andreas Schirmer, Moritz Zulley, Sonja Lacher, Barbara Kracher, Parastou Kohvaei, Murray Yule, Hannes Loferer, Stefan Bissinger. Salt-inducible kinase inhibitor OMX-0407 drives cell-cycle arrest in vitro and in vivo: An in-depth MoA analysis by phospho-proteomics [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 514.

Abstract Black women with early-stage, hormone receptor-positive breast cancer have lower adjuvant endocrine therapy (AET) adherence and higher symptom burden than White women. We compared the effects of a symptom monitoring app and tailored messages on treatment-relevant outcomes among Black and White women with breast cancer starting AET. Patients prescribed AET for early-stage breast cancer at a cancer center from November 2018 until June 2021 were randomized into: (1) an “App” group that received instructions and access to the study app and weekly text reminders to use it (n=94); (2) an “App+Feedback (AF)” group that received additional weekly tailored messages about managing symptoms, adherence, and communication (n=100); or (3) a “Usual Care (UC)” group without app access (n=102). The intervention lasted 6-months, and participants completed surveys at enrollment and 12-months. Increasing/severe symptoms and missed doses triggered alerts that prompted follow-ups from the oncology team. Outcomes included AET adherence, captured with an electronically monitored pillbox, app use, alerts, symptom burden (FACT-ES), quality of life (SF-12), self-efficacy for managing symptoms (PROMIS 1.0), and healthcare utilization (6-month count of emergency department visits/urgent care/hospitalizations, and office visits). Analyses stratified by self-reported race. Overall, 102 (34%) Black and 194 (66%) White women were randomized. Retention at 12-months was 88%. Median age was higher among White participants (60 vs. 55 years, p<0.01). Number of weeks with app use was higher among White intervention participants (15.5 vs. 11.8, p<0.01), but resulted in fewer alerts (2.7 vs. 8.1, p<0.01) compared with Black participants. AET adherence over 12-months was lower among Black women (69% vs 76%, p=0.06), and such difference was similar across study arms. Black AF participants had fewer higher cost healthcare encounters compared to UC (0.27 vs. 0.97, p=0.03) but not for App only vs. UC. Black App participants had more office visits 6 to 12-months post enrollment compared to UC (4.4. vs. 2.6, p=0.04). White App participants reported 4.3 points higher physical health scores compared to UC (51.7 vs. 47.4, p=0.04). There were no significant differences by study arm in AET adherence, mental health score, symptom burden, or self-efficacy for managing symptoms among White or Black participants. Although Black intervention participants used the symptom monitoring app less often, they were more likely to report severe symptoms that triggered an alert to their oncology team than White participants. Among Black participants, the app combined with tailored messages resulted in fewer higher cost healthcare encounters, while App only resulted in more frequent office visits compared to UC. White participants did not have any differences in healthcare utilization, but App only participants reported higher physical health compared with UC. Symptom monitoring apps with tailored text messages improved different outcomes among Black and White patients with breast cancer on AET. Citation Format: Ilana Graetz, Xin Hu, Rebecca A. Krukowski, Mehmet Kocak, Janeane N. Anderson, Teresa M. Waters, Andrea N. Curry, Andrew Robles, Andrew Paladino, Edward Stepanski, Gregory A. Vidal, Lee S. Schwartzberg. A randomized controlled trial of a mobile symptom monitoring app and tailored messages: Differences in outcomes among Black and White women with breast cancer on adjuvant endocrine therapy [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A006.

Abstract OMX-0407 is an orally available spectrum-selective kinase inhibitor targeting key oncology-relevant tyrosine kinases and the salt-inducible kinase family. OMX-0407 offers a dual mode of action (MoA) in cancer by inducing cell cycle arrest in tumor cells and sensitizing the tumor environment to immune cell-mediated tumor cell killing. It is being developed as first-in-class treatment for solid tumor indications with high unmet medical need. Key oncogenic signaling pathways of tyrosine kinases drive cancer progression by regulating cell cycle and growth signaling cascades. Dysregulation of these kinases, such as platelet-derived growth factor receptors, Eph receptors, and Src family kinases, contributes to cancer progression and therapy resistance. OMX-0407 effectively disrupts these processes through potent inhibition of these kinases and their downstream signaling cascades. A comprehensive viability screen of over 380 human cancer cell lines revealed a selective anti-tumor activity across a subset of cancers, including in renal cell carcinomas (RCC) and sarcomas. Pharmacodynamics studies via phospho-proteomics, Simple-Western or functional kinase activity assays revealed that OMX-0407 induces a G1 cell cycle arrest, accompanied by dose-dependent downregulation of cell cycle-associated proteins and kinase signaling pathways. These effects have been confirmed across in vitro cell line studies, in vivo cell line-derived models or even patient-derived xenograft models. Besides its direct effect on tumor cells, OMX-0407 is repolarizing the tumor microenvironment by reducing immunosuppressive regulatory T cells in the tumor bed and shifting toward a pro-inflammatory state. This dual MoA contributes to the potent anti-tumor effects in various syngeneic animal studies. In a human patient-derived xenograft of epithelioid angiosarcoma (AS), derived from a 9-year-old patient, OMX-0407 demonstrated remarkable dose-dependent anti-tumor efficacy as a single agent. The strong anti-tumor efficacy, with tumor reduction in individual animals, was associated with dose-dependent downregulation of phosphoproteins and significant inactivation of key OMX-0407 regulated signaling pathways on kinase level. Clinical data from a patient, diagnosed with secondary radiation-induced AS, resistant to prior lines of chemotherapy, demonstrated that OMX-0407 was well tolerated and achieved a complete response at doses of up to 60 mg twice daily, which remains ongoing at 14 month. These findings support OMX-0407 as a promising first-in-class therapeutic candidate for the treatment of AS and RCC, with a dual mechanism combining direct anti-tumor effects with repolarization of an immunosuppressive tumor microenvironment. As of September 2024, Ph1b expansion cohorts of the first-in-human trial (NCT05826600) were initiated for patients with unresectable or metastatic AS or clear cell RCC. Citation Format: Ilona Petra Maser, Carolin Strobl, Bettina Bauer, Andreas Schirmer, Moritz Zulley, Carmen Amerhauser, Marisa Stebegg-Wagner, Tiantom Jarutat, Hannes Loferer, Stefan Bissinger. OMX-0407 - A spectrum selective kinase inhibitor shows preclinical efficacy in RCC as well as sarcomas [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 374.

Background: OMX-0407 is an orally available spectrum-selective kinase inhibitor targeting a set of oncology-relevant tyrosine kinases (TK) as well as the salt-inducible kinase (SIK) family, demonstrating a dual mode of action (MoA) in cancer. This involves OMX-0407-induced cell cycle arrest in tumor cells by de-phosphorylation and inactivation of TKs such as Src family kinases (SFK) and the SIK family, and increased sensitivity of the tumor microenvironment to immune-mediated tumor cell killing. OMX-0407 is currently undergoing early clinical testing for the treatment of angiosarcoma (AS) and clear cell renal cell carcinoma (ccRCC) (NCT05826600). Methods: Kinase activity profiling using the PamChip® kinase array was used to quantify OMX-0407 treatment effects. Moreover, a flow-cytometry-based “phosFlow” assay was developed to assess the phosphorylation status of SFKs. Both assays revealed dose-dependent inhibition of SFK phosphorylation and activity in peripheral blood mononuclear cells (PBMCs). Hence, they were implemented as pharmacodynamic biomarkers in the ongoing first-in-human trial (NCT05826600) of OMX-0407 in patients with previously treated unresectable solid tumors. Results: As of 30th of October 2024, 24 patients have received continuous treatment with OMX-0407 administered orally in 28-day cycles in a dose escalation study at dose levels of 10, 30, 60, 90, 100, and 140 mg twice daily (BID). Treatment was well tolerated with the main safety finding being gastro-intestinal adverse reactions. One patient with secondary radiation-induced angiosarcoma achieved a complete response at doses of up to 60 mg BID, which remains ongoing at 14 months. PhosFlow analysis confirmed OMX-0407 effects on the phosphorylation of SFKs in PBMCs at doses of 60mg and above. This was associated with the inhibition of oncology-relevant TKs as determined by functional kinase activity profiling. Treatment effects were significantly correlated with PK exposure. This confirms that both phosFlow and kinase activity profiling successfully resolve dose-dependent OMX-0407 activity in peripheral patient blood as pharmacodynamic biomarkers. These findings, together with safety findings and PK profiling, contributed to the selection of 100mg BID as the recommended phase 2 dose (RP2D) for the dose expansion. Conclusions & Outlook: OMX-0407 is a promising therapeutic candidate for the treatment of angiosarcoma and RCC with a potential dual MoA combining direct anti-tumor effects with modulation of the immune cell compartment towards a pro-inflammatory state. In September 2024, Ph1b expansion cohorts of the first-in-human trial (NCT05826600) were initiated for patients with unresectable/metastatic AS or ccRCC who have received at least one prior line of therapy, evaluating OMX-0407 at a dose of 100mg BID. Citation Format: Marisa Stebegg-Wagner, Ilona Petra Maser, Bettina Bauer, Andreas Schirmer, Moritz Zulley, Carmen Amerhauser, Thorsten Meyer, Tiantom Jarutat, Hannes Loferer, Stefan Bissinger. Pharmacodynamic biomarker modulation by OMX-0407, a novel, spectrum-selective kinase inhibitor for the treatment of angiosarcoma and renal cell carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4350.

Latgalian literature has received relatively little attention in most studies of Latvian literature, regardless of the time or the type of the studies made, be they studies of individual or collaborative nature. In the late 19th century and early 20th century, it was largely caused by prohibition of Latgalian publications printed in the Latin alphabet. In the following periods Latgalian literature was overlooked because of lack of awareness, sometimes, also by deliberate ignorance, which was dictated by the political situation. Exploration of the current situation is the goal of this study, namely, to present a summary of what has already been accomplished and to indicate the directions where new studies are urgently needed, ideally – through joint examination of Latvian and Latgalian literatures. The summary is based on the analysis of the regularities and main issues found in the works on the history of Latgalian literature. Careful analysis of the literary processes, authors and significant literary works of the late 19th and early 20th centuries, as well as their exposure in the studies of the history of Latvian literature reveals that a short insight in publishing of Latgalian books and periodicals was given, for instance, by Teodors Zeiferts in his fundamental study ‘History of Latvian Literature, Part 2 and 3’ (Latviešu rakstniecības vēsture, 1923, 1925), and Jānis Niedre in ‘Latvian Literature. Part 2’ (Latviešu literatūra, 1953); small essays were also included in the volumes of the collaborative study developed under Ludis Bērziņš’ chief editing ‘History of Latvian Literature’ (Latviešu literatūras vēsture, 1935–1937). However, Latgalian literature was hardly mentioned in the textbooks for the secondary schools (Vilis Plūdons ‘History of Latvian literature for secondary schools, Part 1 and 2’ (Latvju literatūras vēsture vidusskolām, 1927, 1928); Roberts Klaustiņš ‘History of Latvian Literature’ (Latviešu rakstniecības vēsture, 1907)). Neither was it paid any attention by Andrejs Upīts in his ‘History of Contemporary Latvian Literature’ (Latviešu jaunākās rakstniecības vēsture, 1885–1910 (1911)). This leads to a conclusion that the attitude towards the literature written in Latgalian was ambiguous in the first half of the 20th century as it was not fully incorporated in the conceptual analysis of the development processes of Latvian literature. The voluminous ‘History of Latvian Literature’ (Latviešu literatūras vēsture, Volume 1–6, 1956–1963), which was developed during the Soviet period, included depiction of several Latgalian writers: such as Andrivs Jūrdžs and Pīters Miglinīks (Volume 2, 1963); nevertheless they did not provide a sufficient overview of the singularity and development of Latgalian literature and its comparability with the history of Latvian literature. In the editions of the history of Latvian literature, which were written after regain of the national independence, Latgalian literature has not received any focused attention either by the authors of the 3-volume ‘History of Latvian Literature’ (Latviešu literatūras vēsture, 1998–2001) or by, for instance, Guntis Berelis in his monograph study ‘History of Latvian Literature, from the First Writings to 1999’. Having gained no wide coverage in the historical studies of Latvian literature, Latgalian literature has been fundamentally researched in several monographic works of Miķelis Bukšs, Francis Kemps, Janīna Kursīte, Valentīns Lukaševičs, Ilona Salceviča, Alberts Sprūdžs, Anna Stafecka, Vitolds Valeinis and other researchers at various time periods. Nonetheless, the question still stands: whether and how to compare and synchronise Latgalian literature with periodisation and trends of Latvian literature in order to include it in the comprehensive overview of the literature history.

Background:Gastroesophageal reflux (GER) is common in SSc and thus treatment with anti-acid therapy (AAT) is frequent. An association between GER and the development / progression of SSc-ILD has been hypothesized. However, outcomes of AAT on disease progression in SSc-ILD has only sparsely been studied.Objectives:Methods:The German Network for Systemic Scleroderma (DNSS), which includes SSc pts. prospectively, was analyzed for SSc-ILD. Those without progression at ILD 1stdiagnosis were categorized in AAT vs. no-AAT users and disease outcome was assessed.Results:SSc-ILD was reported in 1165 (28.2%) out of 4131 pts. 712 of SSc-ILD pts had no disease progression at ILD 1stdiagnosis. 567 used AAT while 145 did not. Baseline characteristics were similar between groups with regards to age (mean 54.7 years), BMI, time since SSc diagnosis and immunosuppressant use. Significant differences in no-AAT vs. AAT were found for gender (male 18% vs. 25%, p=0.05), SSc subtype (p=0.002, diffuse more common in AAT), lung function (DLCO 66% vs. 58%, p=0.001; FVC 86% vs. 77%, p=0.001), mRSS (8 vs. 11.5, p<0.01), esophageal involvement (32% vs. 56%, p<0.01) and steroid use (30% vs. 43%, p=0.005). While mortality did not differ between groups (3.9%, p= 0.59), disease progression was more common in the AAT group than in no-AAT users (24.5% vs. 13%, p=0.03). Furthermore, there was a significant difference in decline of FVC≥10% with 30% in the AAT compared to 14% in no-AAT (p=0.018); a decline in DLCO≥15% was more common in the AAT group by trend (23% vs. 14%, p=0.087).Conclusion:While results may have partially been biased by differences in baseline characteristics, this current analysis disfavors the approach of AAT use for SSc-ILD.Disclosure of Interests:Michael Kreuter Grant/research support from: Roche, Boehringer, Consultant of: Roche, Boehringer, Speakers bureau: Boehringer, Roche, Francesco Bonella Grant/research support from: Boehringer, Consultant of: Boehringer, Roche, Bristol MS, Galapagos, Speakers bureau: Boehringer, Roche, Gabriela Riemekasten Consultant of: Cell Trend GmbH, Janssen, Actelion, Boehringer Ingelheim, Speakers bureau: Actelion, Novartis, Janssen, Roche, GlaxoSmithKline, Boehringer Ingelheim, Pfizer, Ulf Müller-Ladner Speakers bureau: Biogen, Jörg Henes Grant/research support from: Novartis, Roche-Chugai, Consultant of: Novartis, Roche, Celgene, Pfizer, Abbvie, Sanofi, Boehringer-Ingelheim,, Elise Siegert Grant/research support from: Actelion, Consultant of: AEC, Speakers bureau: NA, Claudia Guenther: None declared, Ina Koetter Grant/research support from: Novartis, Roche, Speakers bureau: Abbvie, Actelion, Celgene, MSD, UCB, Sanofi, Lilly, Pfizer, Novartis, Chugai, Roche, Boehringer, Norbert Blank Speakers bureau: Actelion, Roche, Boehringer, Pfizer, Chugai, Christiane Pfeiffer: None declared, Marc Schmalzing: None declared, Gabriele Zeidler: None declared, PETER KORSTEN Grant/research support from: Novartis, Juarms GmbH, Consultant of: Abbvie, Pfizer, Lilly, BMS, Speakers bureau: Abbvie, Pfizer, chugai, BMS, Lilly, Sanofi aventis, Laura Susok: None declared, Aaron Juche: None declared, Margitta Worm Consultant of: Mylan Gemany, Bencard Allergie, BBV Technologies S.A., Novartis, Biotest, Sanofi, Aimmune Therapies, Regeneron, Speakers bureau: ALK-Abello, Novartis, Sanofi, Biotest, Mylan, Actelion, HAL Allergie, Aimmune Bencard Allergie, Ilona Jandova: None declared, Jan Ehrchen: None declared, Cord Sunderkoetter: None declared, Gernot Keyszer: None declared, Andreas Ramming Grant/research support from: Pfizer, Novartis, Consultant of: Boehringer Ingelheim, Novartis, Gilead, Pfizer, Speakers bureau: Boehringer Ingelheim, Roche, Janssen, Tim Schmeiser Speakers bureau: Actelion, UCB, Pfizer, Alexander Kreuter Speakers bureau: Sanofi, Abbvie, Merck Sharp&Dohme, Boehringer, Kathrin Kuhr: None declared, Hanns-Martin Lorenz Grant/research support from: Consultancy and/or speaker fees and/or travel reimbursements: Abbvie, MSD, BMS, Pfizer, Celgene, Medac, GSK, Roche, Chugai, Novartis, UCB, Janssen-Cilag, Astra-Zeneca, Lilly. Scientific support and/or educational seminars and/or clinical studies: Abbvie, MSD, BMS, Pfizer, Celgene, Medac, GSK, Roche, Chugai, Novartis, UCB, Janssen-Cilag, Astra-Zeneca, Lilly, Baxter, SOBI, Biogen, Actelion, Bayer Vital, Shire, Octapharm, Sanofi, Hexal, Mundipharm, Thermo Fisher., Consultant of: see above, Pia Moinzadeh: None declared, Nicolas Hunzelmann Speakers bureau: Actelion, Boehringer

Background:Gastroesophageal reflux disease (GERD) occurs frequently in patients with systemic sclerosis (SSc) and SSc-associated interstitial lung disease (SSc-ILD). PPI use has to been shown to improve survival in patients with idiopathic pulmonary fibrosis, whereas to date there are no data on the use of PPI in SSc-ILD.Objectives:This study was aimed to assess whether use of PPI is associated with progression of SSc-ILD and survival.Methods:We retrospectively analysed 1931 patients with SSc and SSc-ILD from the German Network for Systemic Sclerosis (DNSS) database (2003 onwards). Kaplan–Meier analysis compared overall survival (OS) and progression-free survival (PFS) in patients with vs. without GERD (SSc and SSc-ILD), and PPI vs. no PPI use (SSc-ILD only). Progression was defined as a decrease in either % predicted forced vital capacity ≥10% or single-breath diffusing capacity for carbon monoxide ≥15%, or death.Results:GERD was not associated with decreased OS or PFS in patients with either SSc or SSc-ILD. In patients with SSc-ILD, PPI use was associated with improved OS vs. no PPI use after 1 year (98.4% [95% confidence interval: 97.6–99.3]; n=760 vs. 90.8% [87.9–93.8]; n=290) and after 5 years (91.4% [89.2–93.8]; n=357 vs. 70.9% [65.2–77.1]; n=106; p<0.0001). PPI use was also associated with improved PFS vs. no PPI use after 1 year (95.9% [94.6–97.3]; n=745 vs. 86.4% [82.9–90.1]; n=278) and after 5 years (66.8% [63.0–70.8]; n=286 vs. 45.9% [39.6–53.2]; n=69; p<0.0001).Conclusion:GERD had no effect on survival in SSc or SSc-ILD. PPIs improved survival in patients with SSc-ILD; however, controlled, prospective trials are needed to confirm this finding.Disclosure of Interests:Michael Kreuter Speakers bureau: Boehringer, Consultant of: Boehringer, Grant/research support from: Boehringer, Francesco Bonella Speakers bureau: Boehringer, Roche, GSK, Consultant of: Boehringer, Roche, GSK, Grant/research support from: Boehringer, Kuhr Kathrin: None declared, Jörg Henes Speakers bureau: Abbvie, Boehringer, Chugai, Roche, Janssen, Novartis, SOBI, Pfizer and UCB, Consultant of: Boehringer, Celgene, Chugai, Roche, Janssen, Novartis, SOBI, Grant/research support from: Chugai, Roche, Janssen, Novartis, SOBI, Pfizer, Elise Siegert: None declared, Gabriela Riemekasten Speakers bureau: Novartis, Janssen, Roche, GSK, Boehringer, Consultant of: Janssen, Actelion, Boehringer, Norbert Blank Consultant of: Sobi, Novartis, Roche, UCB, MSD, Pfizer, Actelion, Abbvie, Boehringer, Grant/research support from: Novartis, Sobi, Christiane Pfeiffer: None declared, Ulf Müller-Ladner: None declared, Alexander Kreuter Speakers bureau: MSD, Boehringer, InfectoPharm, Paid instructor for: MSD, PETER KORSTEN Consultant of: Glaxo, Abbvie, Pfizer, BMS, Chugai, Sanofi, Lilly, Boehringer, Novartis, Grant/research support from: Glaxo, Aaron Juche: None declared, Marc Schmalzing Speakers bureau: Chugai Roche, Boehringer, Celgene, Medac, UCB, Paid instructor for: Novartis, Abbvie, Astra Zeneca, Chugai Roche, Janssen, Consultant of: Chugai Roche, Hexal Sandoz, Gilead, Abbvie, Janssen, Boehringer, Margitta Worm Speakers bureau: Boehringer, Ilona Jandova Speakers bureau: Boehringer, Novartis, Abbvie, Laura Susok Speakers bureau: MSD, Novartis, BMS, Sunpharma, Consultant of: MSD, Tim Schmeiser Consultant of: Abbvie, Boehringer, Novartis, UCB, Claudia Guenther Paid instructor for: Advisory Board Boehringer January 2020, Employee of: Novartis 2002-2005, Gernot Keyszer Consultant of: Boehringer, Jan Ehrchen Speakers bureau: Boehringer, Janssen, Chugai, Sobi, Employee of: Pfizer, Actelion (now Janssen), Andreas Ramming Speakers bureau: Boehringer, Gilead, Janssen, Pfizer, Roche, Consultant of: Boehringer, Pfizer, Grant/research support from: Novartis, Pfizer, Ina Kötter Speakers bureau: several companies, Consultant of: several companies, Grant/research support from: several companies, Hanns-Martin Lorenz Speakers bureau: Abbvie, Astra Zeneca, Actelion, Alexion Amgen, Bayer Vital, Baxter, Biogen, Boehringer, BMS, Celgene, Fresenius, Genzyme, GSK, Gilead, Hexal, Janssen, Lilly, Medac, MSD, Mundipharm, Mylan, Novartis, Octapharm, Pfizer, Roche Chugai, Sandoz, Sanofi, Shire SOBI, Thermo Fischer, UCB, Grant/research support from: basic research studies: Pfizer, Novartis, Abbvie, Gilead, Lilly, MSD, Roche Chugai, Pia Moinzadeh Speakers bureau: Boehringer, Actelion, Grant/research support from: Actelion, Nicolas Hunzelmann Speakers bureau: Boehringer Janssen, Roche, Sanofi, Consultant of: Boehringer

Um sich in ihrer Welt zurechtzufinden halten Menschen Ausschau nach Beispielen von Personen, die mit ähnlichen Herausforderungen konfrontiert sind oder waren wie sie selbst, nach Situationen, die ihrer eigenen aktuellen Situation vergleichbar sind, sowie nach Handlungsmöglichkeiten für unterschiedliche Bedürfnislagen. Seit dem 18. Jahrhundert wird dieses Vorgehen als "sich orientieren" beschrieben. Da die Medien einen breiten Fundus an derartigen Angeboten vorhalten, werden sie oft als Orientierungsquelle herangezogen. Dass sie dabei insbesondere für Kinder und Jugendliche eine wichtige Rolle spielen, ist wissenschaftlich gut belegt (vgl. z. B. Theunert/Gebel 2000, Paus- Haase 1998). Die Bedeutung der Medien als Orientierungsinstanz und die damit verbundenen Möglichkeiten wurden von der Medienindustrie bald erkannt und (auch) für eigene Zwecke genutzt. Eine besondere Bedeutung kommt dabei heute auch dem sogenannten Social Web zu. Aufgrund der vielen persönlichen Daten, die die Nutzerinnen und Nutzer hier zum Teil freiwillig, zum Teil weil sie von den Anbietern dazu genötigt werden (bspw. weil die Angebote sonst nicht genutzt werden können) hinterlassen, ist es möglich, diese mit personalisierten, das heißt, auf ihr persönliches Profil zugeschnittenen Angeboten zu bedienen. Ob sie das auch wollen, steht dabei nicht zur Debatte. Dies kann auch als Manipulation bezeichnet werden. Menschen nutzen die Medien also auch deswegen, um hier nach Orientierungsangeboten für ihr eigenes Leben Ausschau zu halten. Die Medien wiederum machen selbst aktiv Angebote, an denen die Menschen sich orientieren sollen. In Anbetracht dieser Ausgangslage stellen sich viele Fragen, was das Potenzial der Netze für Orientierung und Orientierungsleistungen angeht. Woran orientieren sich die Kinder und Jugendlichen von heute, über welche Themen und warum ist das so? Wie geht Medienpädagogik mit den Orientierungspotenzialen von medialen Angeboten um, wie beurteilt sie sie, wie hilft sie Kindern und Jugendlichen, damit umzugehen, inwieweit vermittelt sie selbst Orientierungen und wie transparent geschieht das? Über solche Fragen ist bisher viel zu wenig geforscht worden.Einen ersten Schritt in die Richtung, diese Intransparenz in Sachen Orientierungsfunktion der Medien aufzuhellen geht das vorliegende Heft – natürlich nur in einzelnen Beispielen. In seinem einführenden Beitrag macht Friedrich Krotz deutlich, wie sich die Rolle der Medien als Orientierungsinstanz im Laufe der Zeit verändert hat. Um die Angebote der Medien nutzen zu können, mit dem Ziel, sich in einer komplexen Welt zurechtzufinden und einen eigenen Standpunkt zu entwickeln, sind und waren schon immer spezifische Fähigkeiten und Fertigkeiten notwendig. Denn durch die Monopolstellung globaler Player wie zum Beispiel Google dienen viele Orientierungsleistungen in erster Linie wirtschaftlichen Interessen und die Nutzenden stehen vor der Herausforderung zu erkennen, worin der Nutzen für sie selbst besteht. Folgt man Guido Bröckling ist hier insbesondere eine kritische Medienpädagogik gefordert, durch die die Nutzenden dazu befähigt werden, die Strukturen innerhalb der Medien zu durchschauen und sie ethisch zu bewerten: Nach welchen Kriterien geschieht die Auswahl von Information? Welchen Regeln folgen Meinungsbildungsprozesse in sozialen Netzwerken? Welche Rolle spielen dabei politische und kommerzielle Interessen? Dieses Wissen, mit dem die Komplexität der mediatisierten Welt reduziert werden kann, brauchen schon Kinder und Jugendliche, um die Angebote der Medien bewerten und souverän für ihre eigenen Bedürfnisse nutzen zu können. Dass dies im konkreten Alltagserleben Jugendlicher keine einfache Aufgabe ist, zeigt der Beitrag von Nadine Tournier. Soziale Netzwerkdienste wie etwa der Messenger WhatsApp oder bildorientierte Dienste wie Instagram und Snapchat haben hohen Beliebtheitswert unter Jugendlichen. Diese nutzen die Dienste, um sich mit anderen zu vergemeinschaften und in diesen Gemeinschaften relevante entwicklungsbezogene Fragen zu bearbeiten. Dies geschieht aber nicht unbeeinflusst von den plattformbezogenen Vorgaben und Funktionen. Einen Aushandlungsort von gesellschaftlichen Normen und Werten vor allem für Heranwachsende und junge Erwachsene stellen auch Casting Shows wie Germany’s next Topmodel (GNTM) dar. Dass diese derartigen Angebote dann oft auch kritisch gesehen werden, zeigt die Hashtag-Kampagne #notheidisgirl, die Miriam Stehling als ein Potenzial der Möglichkeiten in einer mediatisierten Welt analysiert. Schließlich wird noch ein Blick auf die für Jugendliche wichtige Videoplattform YouTube geworfen. Christa Gebel und Andreas Oberlinner haben im Rahmen des vom BMFSFJ unterstützten Projekts ACT ON! untersucht, wie YouTube von Jugendlichen wahrgenommen und genutzt wird. Die Ergebnisse der im Anschluss durchgeführten Analyse der beliebtesten YouTuber und YouTuberinnen stellen sie in diesem Heft vor. Die Wahrnehmung von YouTube-Stars durch ältere Kinder stand zudem im Mittelpunkt einer FLIMMO-Kinderbefragung. Michael Gurt fasst zusammen, inwiefern diese den Kindern als Orientierungsangebot dienen können. Abgerundet wird der Themenschwerpunkt mit einem Text aus der medienpädagogischen Praxis (Ilona Herbert und Martin Noweck). Im Juni soll LiFE starten, ein neues medienübergreifend angelegtes Sendungsformat, in dem sich Jugendliche und junge Erwachsene als Redakteurinnen und Redakteure erproben können. Die Teilnehmerinnen und Teilnehmer können sich hier mit ihren Themen auseinandersetzen und dies in Fernseh-, Film- oder Radiobeiträgen oder auch Internet-Angeboten zur Diskussion stellen und sich so aktiv an der Gestaltung und Entwicklung der Gesellschaft, in der sie leben, einbringen. Wir hoffen, dass wir mit diesem Spektrum Anregungen für eine Auseinandersetzung mit der Frage, wie Orientierung in der komplexen Welt, in der wir leben, geben können und wünschen viel Spaß beim Lesen!

Setting or protagonist? The city in urban fantasy novels A city is the default setting for urban fantasy novels. The genre is based in its definition on the clash of the fantastic world with the real world (embodied by the city), which renders both realities more distinct and interesting. Thus, in this type of fantasy, the urban landscape is a background for magical or supernatural events, contrasting with them with its modernity, mundaneness and recognizability in the eyes of the reader. Since urban fantasy is characterized by its “world-centeredness”, researchers often point out that the importance of this space for the development of the plot goes beyond the usual role of the setting – one of the basic literary elements. Urban fantasy draws attention to various aspects of real everyday life and the space in which it takes place, picturing them in a distorted way and questioning their legitimacy or sense. According to some researchers, the city in this type of narrative can even be treated as an independent character, having personality, preferences, agency, and influence over the events. Others argue that the key to this genre is not the city itself nor its dynamics, but the experience of this city by individual characters, interest groups, or entire communities. Katarzyna Szyszka in the chapter „Setting or character? The city in urban fantasy novels” proposes an analysis of the way of presenting the urban landscape in urban fantasy, its role in the plot as a whole, its function in its formal construction and its significance for its genre features, using the example of the American book series about Kate Daniels, set in post-apocalyptic Atlanta, written by Ilona Andrews. Fragments from the novels, where the city is presented in the most interesting and representative way for the genre, will be analyzed in terms of their content and language. Based on the analysis, an attempt will be made to define the factors influencing whether the city is perceived more as a novel’s setting or a character.

The aim of the article is to familiarize with the use of fugue and other fugue-type forms in sacred vocal-instrumental compositions of Latvian composers. The usage of fugues and other related forms in the contemporary sacred music genres is predetermined by the historical tradition. Already since the baroque era one of the most important constructive components of sacred vocal-instrumental compositions is fugue. As regards the Latvian music, the fugue has presented itself forthe first time particularly in the sacred vocal- instrumental composition. Namely the Garīgā kantāte (Sacred Cantata, 1887) by Andrejs Jurjans. After A. Jurjans other composers have used fugue in their sacred vocal-instrumental music: Viktors Bastiks in Requiem (1979), Romualds Kalsons in oratorium Petrus (1993), Rihards Dubra in cantata Canticum fratris solis (1997), Romualds Jermaks in Requiem (2002), Ilona Brege in Requiem (2010) etc.

Abstract Digital and data tools are fundamentally changing approaches to health and the design of health systems and health services deliver, but governance models have neither followed nor kept up with the pace of innovation. In response to this challenge, The Lancet & Financial Times Commission Governing health futures 2030: Growing up in a digital world is exploring the convergence of digital health (DH), AI, and other frontier technologies with UHC to support attainment of SDG 3. The COVID-19 pandemic has presented unprecedented challenges, with serious implications for public health and healthcare systems worldwide. With online work and education having become the new norm, the COVID-19 pandemic has exponentially heightened the need to develop digital skills and literacy, while simultaneously revealing and exacerbating existing disparities in digital access and skills, thus widening existing digital divides. That being said, COVID-19 has accelerated the radical implementation and widespread adoption of digital technologies, providing opportunities for improved overall health and well-being outcomes, which may extend well into the future if appropriately and sustainably implemented, evaluated, and most importantly, governed. The findings and recommendations arising from the Commission's report, which will be presented and discussed, are fully aligned with this year's conference theme, “Public health futures in a changing world.” From the outset, the Commission framed its work through the notion that digital transformations, and the technologies that drive them, must be led by public value and governed to benefit population health and well-being. With growing investment in DH technologies in Europe, and increased recognition of governance challenges related to this field, this workshop offers an important and timely opportunity to present the Commission's work and discuss the implications of its findings and recommendations for European countries. The discussion in this workshop will centre around a set of critical questions, drawing from the experiences of experts involved in governance in the European context: Is the European DH ecosystem fit for purpose? To what extent is Europe's current legislative ecosystem and technical infrastructure capable of hosting digital transformations in health? Will the EHDS succeed in promoting citizens' control over their health data across Europe? How can national/regional approaches to governance of digital technologies and data better support public health outcomes and ensure that all Europeans can benefit from digital transformations in health and that no one is left behind? Workshop format: Opening remarks from each speaker to contextualise their work on DH governance in Europe and respond to the Commission's work (5 mins. each) Moderated roundtable discussion between panellists (15 mins.) Hearing & addressing audience questions/concerns (20 mins.) After the workshop, a policy brief and accompanying news article will be shared on the Commission's website. Speakers/Panelists Ilona Kickbusch Graduate Institute of International and Development Studies, Geneva, Switzerland Andrew Wyckoff Directorate for Science, Technology and Innovation, OECD, Paris, France Andrzej Rys European Commission, DG SANTE, Brussels, Belgium Anna Odone University of Pavia, Pavia, Italy Ioana-Maria Gligor Digital Health, European Reference Networks Unit, DG Health and Food Safety, European Commission, Brussels, Belgium Key messages The Lancet & Financial Times Governing health futures 2030 Commission report provides key recommendations for health governance and harnessing digital development for improving health outcomes. With growing investment in digital technologies in Europe, there remain governance challenges in ensuring all Europeans benefit from digital transformations in health and that no one is left behind.

04–255 Belcher, Diane D. Trends in teaching English for Specific Purposes. Annual Review of Applied Linguistics (New York, USA), 24 (2004), 165–186.04–257 Burden, P. (Okayama Shoka U., Japan; Email: burden-p@po.osu.ac.jp). An examination of attitude change towards the use of Japanese in a University English ‘conversation’ class. RELC Journal (Singapore),35,1 (2004), 21–36.04–258 Burns, Anne (Macquarie U., Australia; Email: anne.burns@mq.edu.au). ESL curriculum development in Australia: recent trends and debates. RELC Journal (Singapore), 34, 3 (2003), 261–283.04–259 Bush, Michael D. and Browne, Jeremy M. (Brigham Young U., USA; Email: Michael_Bush@byu.edu). Teaching Arabic with technology at BYU: learning from the past to bridge to the future. Calico Journal (Texas, USA), 21, 3 (2004), 497–522.04–260 Carlo, María S. (U. of Miami, USA; Email: carlo@miami.edu), August, Diane, McLaughlin, Barry, Snow, Catherine E., Dressler, Cheryl, Lippman, David N., Lively, Teresa J. and White, Claire E. Closing the gap: addressing the vocabulary needs of English-language learners in bilingual and mainstream classrooms. Reading Research Quarterly (Newark, USA), 39, 2 (2004), 188–215.04–261 Chambers, Gary N. and Pearson, Sue (School of Education, U. of Leeds, UK). Supported access to modern foreign language lessons. Language Learning Journal (Oxford, UK), 29 (2004), 32–41.04–262 Chesterton, Paul, Steigler-Peters, Susi, Moran, Wendy and Piccioli, Maria Teresa (Australian Catholic U., Australia; Email: P.Chesterton@mary.acu.edu.au). Developing sustainable language learning pathway: an Australian initiative. Language, Culture and Curriculum (Clevedon, UK), 17, 1 (2004), 48–57.04–263 Chin, Cheongsook (Inje U., South Korea; Email: langjin@inje.ac.kr). EFL learners' vocabulary development in the real world: interests and preferences. English Teaching (Anseongunn, South Korea), 59, 2 (2004), 43–58.04–264 Corda, Alessandra and van den Stel, Mieke (Leiden U., The Netherlands; Email: a.corda@let.leidenuniv.nl). Web-based CALL for Arabic: constraints and challenges. Calico Journal (Texas, USA), 21, 3 (2004), 485–495.04–265 Crawford, J. (Queensland U. of Technology, Australia; Email: j.crawford@qut.edu.au). Language choices in the foreign language classroom: target language or the learners' first language?RELC Journal (Singapore), 35, 1 (2004), 5–20.04–266 Derewianka, Beverly (Email: bevder@uow.edu.au). Trends and issues in genre-based approaches. RELC Journal (Singapore), 34, 2 (2003), 133–154.04–267 Esteban, Ana A. and Pérez Cañado, Maria L. (U. de Jaén, Spain). Making the case method work in teaching Business English: a case study. English for Specific Purposes (Oxford, UK), 23, 2 (2004), 137–161.04–268 Fang, Xu and Warschauer, Mark (Soochow University, China). Technology and curricular reform in China: a case study. TESOL Quarterly (Alexandria, VA, USA), 38, 2 (2004), 301–323.04–269 Foster, James Q., Harrell, Lane Foster, and Raizen, Esther (U. of Texas, Austin, USA; Email: jqf@hpmm.com). The Hebrewer: a web-based inflection generator. Calico Journal (Texas, USA), 21, 3 (2004), 523–540.04–270 Grabe, William (Northern Arizona University, USA). Research on teaching reading. Annual Review of Applied Linguistics (New York, USA), 24 (2004), 44–69.04–271 Grünewald, Andreas (University of Bremen, Germany). Neue Medien im Unterricht: Status quo und Perspektiven. [New media in the classroom: status quo and perspectives.] Der fremdsprachliche Unterricht Spanisch (Seelze, Germany), 6 (2004), 4–11.04–272 Hahn, Laura D. (U. of Illinois at Urbana-Champaign, USA). Primary stress and intelligibility: research to motivate the teaching of suprasegmentals. TESOL Quarterly (Alexandria, VA, USA), 38, 2 (2004), 201–223.04–273 Hai, T., Quiang, N. and Wolff, M. (Xinyang Agricultural College, China; Email: xytengha@163.com). China's ESL goals: are they being met?English Today (Cambridge, UK), 20, 3 (2004), 37–44.04–274 Hardy, Ilonca M. and Moore, Joyce L. (Max Planck Institute of Human Development, Germany). Foreign language students' conversational negotiations in different task environments. Applied Linguistics (Oxford, UK), 25, 3 (2004), 340–370.04–275 Helbig-Reuter, Beate. Das Europäische Portfolio der Sprachen (II). [The European Language Portfolio (II).] Deutsch als Fremdsprache (Leipzig, Germany), 3 (2004), 173–176.04–276 Hughes, Jane (University College London, UK; Email: jane.hughes@ucl.ac.uk), McAvinia, Claire, and King, Terry. What really makes students like a web site? What are the implications for designing web-based learning sites?ReCALL (Cambridge, UK), 16, 1 (2004), 85–102.04–277 Jackson, J. (The Chinese U. of Hong Kong). Case-based teaching in a bilingual context: perceptions of business faculty in Hong Kong. English for Specific Purposes (Oxford, UK), 23, 3 (2004), 213–232.04–278 Jenkins, Jennifer (Kings College London, UK). Research in teaching pronunciation and intonation. Annual Review of Applied Linguistics (New York, USA.), 24 (2004), 109–125.04–279 Kanda, M. and Beglar, D. (Shiga Prefectural Adogawa Senior High School, Japan; Email: makiko-@iris.eonet.ne.jp). Applying pedagogical principles to grammar instruction. RELC Journal (Singapore), 35, 1 (2004), 105–115.04–280 Kang, I. (Korea Advanced Institute of Science and Technology; Email: iyang@mail.kaist.ac.kr). Teaching spelling pronunciation of English vowels to Korean learners in relation to phonetic differences. English Teaching (Anseonggun, South Korea), 58, 4 (2003), 157–176.04–281 Kiernan, Patrick J. (Tokyo Denki University, Japan; Email: patrick@cck.dendai.ac.jp) and Aizawa, Kazumi. Cell phones in task based learning. Are cell phones useful language learning tools?ReCALL (Cambridge, UK), 16, 1 (2004), 71–84.04–282 Kim, Eun-Jeong (Kyungpook National U., South Korea; Email: ejkbuffalo@yahoo.co.kr). Considering task structuring practices in two ESL classrooms. English Teaching (Anseongunn, South Korea), 59, 2 (2004), 123–144.04–283 Kondo, David and Yang, Ying-Ling (University of Fukui, Japan). Strategies for coping with language anxiety: the case of students of English in Japan. ELT Journal (Oxford, UK), 58, 3 (2004), 258–265.04–284 Lin, Benedict (SEAMO RELC, Singapore). English in Singapore: an insider's perspective of syllabus renewal through a genre-based approach. RELC Journal (Singapore), 34, 2 (2003), 223–246.04–285 Lu, Dan (Hong Kong Baptist U., Hong Kong; Email: dan_lu@hkbu.ac.hk). English in Hong Kong: Super Highway or road to nowhere? Reflections on policy changes in language education of Hong Kong. RELC Journal (Singapore), 34, 3 (2003), 370–384.04–286 Lui, Jun (U. of Arizona, USA). Effects of comic strips on L2 learners' reading comprehension. TESOL Quarterly (Alexandria, VA, USA), 38, 2 (2004), 225–243.04–287 Lukjantschikowa, Marija. Textarbeit als Weg zu interkultureller Kompetenz. [Working with texts as a means to develop intercultural competence.] Deutsch als Fremdsprache (Leipzig, Germany), 3 (2004), 161–165.04–288 Lüning, Marita (Landesinstitut für Schule in Bremen, Germany). E-Mail-Projekte im Spanischunterricht. [E-Mail-Projects in the Spanish classroom.] Der fremdsprachliche Unterricht Spanisch (Seelze, Germany), 6 (2004), 30–36.04–289 Lyster, R. (McGill U., Canada; Email: roy.lyster@mcgill.ca). Differential effects of prompts and recasts in form-focussed instruction. Studies in Second Language Acqusition (New York, USA), 26, 3 (2004), 399–432.04–290 McCarthy, Michael (University of Nottingham, UK) and O'Keeffe, Anne. Research in the teaching of speaking. Annual Review of Applied Linguistics (New York, USA), 24 (2004), 26–43.04–291 Mitschian, Haymo. Multimedia. Ein Schlagwort in der medienbezogenen Fremdsprachendidaktik. [Multimedia. A buzzword for language teaching based on digital media.] Deutsch als Fremdsprache (Leipzig, Germany), 3 (2004), 131–139.04–292 Mohamed, Naashia (U. of Auckland, New Zealand). Consciousness-raising tasks: a learner perspective. ELT Journal (Oxford, UK), 58, 3 (2004), 228–237.04–293 Morrell, T. (U. of Alicante, Spain). Interactive lecture discourse for university EFL students. English for Specific Purposes (Oxford, UK), 23, 3 (2004), 325–338.04–294 Nassaji, Hossein and Fotos, Sandra. Current developments in research on the teaching of grammar. Annual Review of Applied Linguistics (New York, USA), 24 (2004), 126–145.04–295 Pérez Basanta, Carmen (U. of Granada, Spain; Email: cbasanta@ugr.es). Pedagogic aspects of the design and content of an online course for the development of lexical competence: ADELEX. ReCALL (Cambridge, UK), 16, 1 (2004), 20–40.04–296 Read, John. Research in teaching vocabulary. Annual Review of Applied Linguistics (New York, USA), 24 (2004), 146–161.04–297 Rössler, Andrea (Friedrich-Engels-Gymansium in Berlin, Germany). Música actual. [Contemporary music.] Der fremdsprachliche Unterricht Spanisch (Seelze, Germany), 4 (2004), 4–9.04–298 Sachs, Gertrude Tinker (Georgia State U., USA; Email: gtinkersachs@gsu.edu), Candlin, Christopher N., Rose, Kenneth R. and Shum, Sandy. Developing cooperative learning in the EFL/ESL secondary classroom. RELC Journal (Singapore), 34, 3 (2003), 338–369.04–299 Seidlhofer, Barbara. Research perspectives on teaching English as a lingua franca. Annual Review of Applied Linguistics (New York, USA), 24 (2004), 200–239.04–300 Silva, Tony (Purdue U., USA) and Brice, Colleen. Research in teaching writing. Annual Review of Applied Linguistics (New York, USA), 24 (2004), 70–106.04–301 ková, Alena. Zur jüngeren germanistischen Wortbildungsforschung und zur Nutzung der Ergebnisse für Deutsch als Fremdsprache. [The newest German research in word formation and its benefits for learning German as a foreign language.] Deutsch als Fremdsprache (Leipzig, Germany), 3 (2004), 140–151.04–302 Simmons-McDonald, Hazel. Trends in teaching standard varieties to creole and vernacular speakers. Annual Review of Applied Linguistics (New York, USA), 24 (2004), 187–208.04–303 Smith, B. (Arizona State U. East, USA; Email: bryan.smith@asu.edu). Computer-mediated negotiated interaction and lexical acquisition. Studies in Second Language Acquisition (New York, USA), 26, 3 (2004), 365–398.04–304 Son, Seongho (U. Kyungpool, South Korea). DaF – Unterricht digital. [A digital teaching of German as a foreign language.] Deutsch als Fremdsprache (Leipzig, Germany), 2 (2004), 76–77.04–305 Spaniel, Dorothea. Deutschland-Images als Einflussfaktor beim Erlernen der deutschen Sprache. [The images of Germany as an influencing factor in the process of learning German.] Deutsch als Fremdsprache (Leipzig, Germany), 3 (2004), 166–172.04–306 Steveker, Wolfgang (Carl-Fuhlrott-Gymnasium Wuppertal, Germany). Spanisch unterrichten mit dem Internet – aber wie? [Internet-based teaching of Spanish – how to do this?] Der fremdsprachliche Unterricht Spanisch (Seelze, Germany), 6 (2004), 14–17.04–307 Stoller, Fredricka L. Content-based instruction: perspectives on curriculum planning. Annual Review of Applied Linguistics (Cambridge, UK), 24 (2004), 261–283.04–308 Thompson, L. (U. of Manchester, UK; Email: linda.thompson@man.ac.uk). Policy for language education in England: Does less mean more?RELC Journal (Singapore), 35,1 (2004), 83–103.04–309 Tomlinson, Brian (Leeds Metropolitan U., UK; Email: B.Tomlinson@lmu.ac.uk). Helping learners to develop an effective L2 inner voice. RELC Journal (Singapore), 34, 2 (2003), 178–194.04–310 Vandergrift, Larry (U. of Ottawa, Canada). Listening to learn or learning to listen?Annual Review of Applied Linguistics (New York, USA), 24 (2004), 3–25.04–311 Vences, Ursula (University of Cologne, Germany). Lesen und Verstehen – Lesen heißt Verstehen. [Reading and Comprehension – Reading is Comprehension.] Der fremdsprachliche Unterricht Spanisch (Seelze, Germany), 5 (2004), 4–11.04–312 Xinmin, Zheng and Adamson, Bob (Hong Kong U., Hong Kong; Email: sxmzheng@hkusua.hku.hk). The pedagogy of a secondary school teacher of English in the People's Republic of China: challenging the stereotypes. RELC Journal (Singapore), 34, 3 (2003), 323–337.04–313 Zlateva, Pavlina. Faktizität vs. Prospektivität als Stütze beim Erwerb grammatischer Erscheinungen im Deutschen. [Factuality versus Prospectivity in aid of the acquisition of grammar phenomena in German.] Deutsch als Fremdsprache (Leipzig, Germany), 3 (2004), 158–160.

We are living in uncertain times. Recent and ongoing crises, such as the COVID-19 pandemic, climate change and natural disasters, and increasing geopolitical and economic instability, have arguably led to a growing awareness of our existential precarity. Recent studies suggest that mental health is poor: among the general population, 24.4% experience anxiety and 22.9% suffer from symptoms of depression. These figures rise to an alarming 41.1% and 32.5% respectively in vulnerable populations (Bower et al.). As Maree Teesson, Director of the University of Sydney’s Matilda Centre for Research in Mental Health and Substance Use, points out, “what worries me is that rather than having an intense recovery phase [after the pandemic] in Australia we’ve had further crises, including marked increases in costs of living and natural disasters, all of which we know exacerbate mental health problems” (anon.). How do we not only survive but flourish in such times? As we are coming up against the financial as well as conceptual limitations of biomedically informed approaches to mental health (McDonald and Hollenbach 5), the therapeutic potential of the arts is receiving renewed attention. While art, music, and writing therapy are widely recognised, bibliotherapy, although practiced in clinical as well as many informal settings, is less prominent in our cultural imagination – perhaps because the creativity in the act of reading is less obvious, perhaps because our reading practices tend to bleed into each other: we read for pleasure, distraction, information, guidance, etc., often all at the same time. And yet, research shows that bibliotherapy can make significant contributions to mental health (Monroy-Fraustro et al.). In our article, we explore how the practice of Shared Reading, a form of creative bibliotherapy, can nurture the wellbeing of individuals and communities in our uncertain times. Neither a book club nor a self-help group, Shared Reading brings a small group of people together to listen to a story and a poem, which are read out by a trained facilitator, who gently guides the conversation to tease out the emotional undercurrents of the text, to reflect on literary characters and their predicaments, and generally use literature as a springboard for broader reflections on life and personal experience. The format combines the benefits of reading with those of being part of a community. The positive effects have been documented in a range of studies: Shared Reading has the capacity to reduce anxiety, alleviate symptoms of depression, increase confidence, and, importantly, create a sense of connectedness and social inclusion in a non-medicalised setting (see Billington Reading; Davis Literature; Dowrick et al.; Pettersson). While Shared Reading has been extensively researched from the perspective of specific mental health issues, less attention has been paid to how it contributes to an overall sense of flourishing in which a person feels good about their life (emotional wellbeing) and functions well within it (psychological and social wellbeing) – as opposed to subsisting in a state of languishing characterised by feelings of “emptiness”, “stagnation”, and “quiet despair” (Keyes 210), without amounting to actual mental illness (Keyes et al. 2367). The distinction between languishing and mental illness is crucial to avoid conflation of “normal human sadness” (Haslam and DeDeyne n.p.) and “common human sorrows – normality under severe strain” (Billington, Literature 2) – with the pathological psychological states of mental illness. Understanding what makes us flourish is important, not least because Keyes’s findings suggest that flourishing in life may foster resilience and provide a “stress buffer” against challenging life events and transitions (218), while languishing individuals may be more susceptible to mental illness (213). The flourishing individual, it seems, is better placed to make the best of ‘the mingled yarn’ of their life (All’s Well That Ends Well, Act 4, Scene 3). The workings and effects of Shared Reading can best be captured with current concepts of eudaimonic wellbeing, which expand Aristotle’s notion of human flourishing by integrating the fulfilment of psychological needs (see Huta; Besser-Jones). Aristotle’s idea of eudaimonia is characterised by reason and moderation in aiming for an embodiment of particular virtues or excellences. Ryan, Huta, and Deci update Aristotle’s normative concept of the good life into the mindful, freely chosen pursuit of intrinsic goals, such as personal growth, relationships, and community. A eudaimonic life, they argue, will satisfy basic psychological needs for autonomy, relatedness, and competence. Like Aristotle, they consider pleasure and positive affect as welcome by-products rather than goals in themselves. Besser-Jones concurs: we have needs to experience competency over our environments and as such to engage in experiences that allow us to exercise our skills; to experience belongingness with others, to both care for others and be cared for by others; to experience autonomy through selecting and pursuing goals with which we identify. When we engage in these activities in an ongoing fashion, we experience eudaimonic well-being. (Besser-Jones 190) Significantly, the eudaimonic life is one of active reflection and conscious volition (Besser-Jones 187), rather than passive acquiescence to either outside forces or inner drives. Mindfulness is a crucial ingredient, enabling a person to see “what is true” in their inner and outer experience (Ryan, Huta, & Deci 158). Research suggests that the fruits of such a life may include a sense of meaning, enhanced vitality, inner peace, and even physical health (Ryan, Huta, & Deci 161–2). Shared Reading contributes to eudaimonic wellbeing in several ways. Rather than fostering wellbeing through a cumulation of moments of hedonic pleasure (see Diener), Shared Reading does not provide exclusively pleasurable experiences; instead it creates “a little community ... whose first concern is the serious business of living” (Billington, Literature 132). While this undoubtedly affords moments of heightened positive affect, participants may also experience heightened negative affect. However, engagement with the negative through literature can, in fact, positively contribute to a deepened sense of purpose, meaning, and connection with others (Ryff & Singer 10), and thereby contribute to an improved sense of psychological wellbeing (Billington et al. 267-8; see also Davis et al., Literature 19) as tensions, uncertainties, and memories can be articulated, contextualised and, ultimately, integrated (McNicol 23–40). In that respect Shared Reading resonates with Vittersø’s reflection that “eudaimonic well-being is strange. It contains a kind of complex goodness that is not necessarily associated with pleasure – and it may be valued only after a bit of reflection” (Vittersø 254). As a practice, Shared Reading unfolds its full potential over time in accordance with eudaimonism, which defines wellbeing as “an active state ... that, while experiential, requires agency and ongoing activity” (Besser-Jones 187). Given the limited scope of this article, we want to focus on just some of the ways in which Shared Reading contributes to eudaimonic wellbeing by offering opportunities for self-growth and greater autonomy through a sense of connectedness, which may lead to a greater sense of overall liveness and a fuller experience of the amplitude of human life. Corcoran and Oatley note that “the interpersonal context in which to think about human challenges and complex, day-to-day human situations” in reading groups is “a luxury that is not typically afforded by pressured, busy and demanding lives, but which is invaluable as an underpinning life resource to enhance sustainable psychological wellbeing” (338). Throughout our exploration, we will draw on surveys and interviews with Shared Reading participants from a pilot study at La Trobe University, in which, together with Senior Lecturer Sara James, we ran five groups for eight weeks in a range of community settings in greater Melbourne. Three of these groups, at Yarra Libraries and the La Trobe University Library as well as the Warrandyte Neighbourhood House, were conducted face-to-face. Two more groups, one with outpatient cancer survivors at Ringwood Hospital and one with La Trobe University alumni, were held on Zoom. The study consisted of 27 participants – 20 female, 6 male, and one non-binary – ranging from young adulthood to elderly. All participants self-selected to join after advertising campaigns in conjunction with our partner institutions; participation in the research component of the project was entirely voluntary. All participants, whose statements we quote, have been de-identified. The positive effects on both a sense of personal autonomy and social connection are reflected in our research findings: 92.5% of the participants found they had grown more confident since joining the group. 92.6% of the participants reported that the groups helped them understand themselves better, while 77.7% found the sessions helped them relate to others in a deeper way. In Shared Reading the connection between reader and text expands into connections formed within the group. Recognising aspects of one’s own life in a story is powerful in “confirming that I am not entirely alone, that there are others who think or feel like me. Through this experience of affiliation, I feel myself acknowledged; I am rescued from the fear of invisibility, from the terror of not being seen” (Felski 54). In this way, even solitary reading has the capacity to normalise a broad range of individual experiences and to stave off loneliness. We find friends in books. In Shared Reading this moment of connection is intensified and multiplied by also offering recognition from others – groups bond quickly. Beth, a shy participant who struggles with anxiety, found “it was really, really special to find a way to really honestly understand someone else without judgement, which is hard to do”. She reported that the sessions had increased her confidence because she “felt seen” within the group. A number of participants commented on the depth and quality of the conversations and found the groups “nourishing” or “nurturing”. By focussing on the text, meaningful and even personal conversations spring up that are not easily had in other contexts. Such rich and intimate encounters with the text and others are predicated on the practice of joint “close” or “deep” reading. By immersing oneself in the text, the borders between self and text become porous. In “bringing the work into existence as an imaginary space within oneself” (Miller 38), we allow the text to “get under our skin” in an act of “compenetration” (Rosenblatt 12). This process holds significant transformative potential, as Radway notes: when reading, “‘I’ become something other than what I have been and inhabit thoughts other than those I have been able to conceive before” (13). Billington credits reading as a unique form of thinking in its own right (Literature 115–37). Thinking with the text collaboratively can deepen into self-reflection through our internal and external conversations with the voices of others (Archer 458–472). Self-reflexivity becomes a relational process in which individuals experiment with new modes of selfhood and ways of relating to others (Holmes 139–41). This resonates with research into Shared Reading, which suggests an “impact upon psychological wellbeing by improving a sense of personal growth through increased self-development” (Davis et al., Values 7). In fact, one of the strongest themes to emerge from the post-program interviews was how strongly participants appreciated the broadening of inner horizons through the group conversations. Reading itself offers “a literary rendering of how worlds create selves, but also of how selves perceive and react to worlds made up of other selves” (Felski 132). It involves exercising the imagination; it is the practice of “going out from one’s self toward other lives” and stimulates “sympathy, fellowship, spirituality and [the] morality of being human” (Donoghue 73; see also Charon). Shared Reading fosters self-growth as a relational activity, as group participant Ian describes: [Shared Reading] will open up a world to your own feelings and views ... and expand that beyond your expectations ... . As a group you have that cross-fertilisation of emotions, feelings, experiences. ... It is amazing what it will do for your own mental wellbeing, your own intellectual stimulation, and your sense of engagement with your fellow human being. Ian’s statement captures something integral to Shared Reading and to eudaimonic flourishing: a sense of “liveness” and vibrancy. Participants experience the literature freshly during the session, without preparation – indeed without warning – as to what will be encountered (Davis, Reading 4). Participant Anna notes: “you really have to be in the moment, present to the text”. Nina likens this quality of attention to that of “meditating and connecting at the same time”, which resonates with the mindfulness of a eudaimonic life (Ryan, Huta, & Deci 158). Literature can enliven us by disrupting habitual patterns of response, defences, pat attitudes and opinions; it nudges us, so to speak, out of the “insidiously lazy default language” (Davis, Reader 3) of familiar, well-worn conceptual and linguistic paths into unexplored territory. The reader may be caught off guard when a story abruptly triggers an emotion, a memory, or some other element of inner experience (Billington, Literature 91–93), which then emerges, often haltingly, into the light of conscious thought. Such ambushing is recognised by both facilitators and researchers when a participant’s normal fluency falters or breaks down into a “creative inarticulacy” (Davis et al. 11–14) as they actively, arduously attempt to express what the literature has summoned (Billington, Literature 91–2). Such linguistic groping signals the emergence of fresh insight; it is personal growth in action. Anna relates how Sharma Shields’s story “The Mcgugle Account” exhumed a long-buried memory: “it really disturbed me a lot. And it was not until a week or so later that I recognised what it was … that it summoned up in me, a memory of something that had happened … [that] I’d always felt a lot of shame about. And I’ve never, I’ve never really shared it with anybody”. She continues, “and it was so good to talk about it and process something I’ve not been able to [indistinct] for 30 years”. Anna experiences a moment of “recovery” or “awakening” (Billington, Literature 88) as a “second chance” (Davis, Reading 14) to return to an experience and reframe, maybe even redeem it. Davis notes that literature widens and enriches the human norm [by] accepting and allowing for trauma, troubles, inadequacies, and other experiences usually classed as negative or even pathological. It is a process of recovery – in the deeper sense of spontaneously retrieving for use experiences and qualities that were lost, regretted or made redundant. (Davis et al. Values, 33) Similarly, Beth describes what happened when another participant recalled an argument with his ex-wife: we all laughed, really, which is quite a tender moment and it’s really a vulnerable expression of something that was potentially really painful in someone’s past. But for some reason we all laughed, and it was fine. He was happy with us laughing too …. . I can’t remember many, many moments like that where we just – yeah , collectively kind of laughed about this. This life. Yeah. The laughter shared during such moments expresses relief, reassurance that we are not alone in the painful experiences of “this life”. These are moments of connection and of re-storying or recuperating a painful past. The sense of vitality is often palpable, manifesting sometimes as an alert stillness – a taut “leaning in” (Davis et al., Value 9) to what’s being read –, at others as an eruption into laughter as we have seen. In its embrace of the full spectrum of human experience it is “as though literature itself said implicitly ‘Nothing human is alien to me’” (Billington, Literature 3). Within this capacious, generous space, participants can grow into a more expansive self-awareness. Beth explains: I find it hard to understand what I’m feeling sometimes and articulate that, and through the stories and through the group and through the process, I found that easier. Which was such a surprise to me. Because that wasn’t what I thought would happen. … I can’t quite place what it is about the experience that had that catalyst for me … . And there was something in each of the stories that was really relatable, and I found that it just drew something out of me that I wasn’t expecting then. “Alive”, “enriched”, and “stimulated” are some of the participants’ descriptors for how they feel in Shared Reading sessions. As with any practice, these feelings deepen and spread into other areas of life over time. Tom, who describes “reading as a way of life”, explains its power: “to be an appreciator of the text is a practice in itself without being a writer of text or a critic. … And the more I appreciate, the better my life becomes”. After the program, Beth reported that she started exploring the library in more detail, and one of the groups started meeting at the pub to share reading tips, discuss “ideas”, and catch up. As has perhaps become clear, in Shared Reading the individual aspects of a eudaimonic life work together synergistically to promote a sense of eudaimonic wellbeing. The attentive and sincere engagement with literature and its representations of human complexity facilitates connection and reflection that may inspire self-growth and an overall sense of vitality. In the practice of reading together these aspects remain entangled and interdependent, reinforcing each other over time into a sense of eudaimonic wellbeing that can accommodate pain or negative affect and potentially transform them into something meaningful. The process of restoration, of unfolding, articulating, and reintegrating what was submerged, considered lost, or pushed aside is never linear, often surprising, and never complete, just as expressions of eudaimonic flourishing are unique to each individual and bear all the complexity of human experience. References Anon. “Moving On from COVID Means Facing Its Impact on Mental Health, Say Experts.” Sydney University, 9 Mar. 2023. <https://www.sydney.edu.au/news-opinion/news/2023/03/09/moving-on-from-covid-means-facing-its-impact-on-mental-health--s.html>. Archer, Margaret. Structure, Agency and the Internal Conversation. Cambridge: Cambridge UP, 2003. Besser-Jones, Lorraine. “Eudaimonism.” The Routledge Handbook of Philosophy of Well-Being. Ed. Guy Fletcher. London: Routledge, 2015. 187–96. Billington, Josie. Is Literature Healthy? Oxford: Oxford UP, 2016. Billington, Josie, ed. Reading and Mental Health, Palgrave Macmillan, 2019. Billington, Josie, Rhiannon Corcoran, Megan Watkins, Mette Steenberg, Charlotte Christiansen, Nicolai Ladegaard, and Don Kuiken. “Quantitative Methods.” Reading and Mental Health. Ed. Josie Billington. Palgrave Macmillan, 2019. 265–92. Bower, Marlee, Scarlett Smout, Amarina Donohoe-Bales, Siobhan O’Dean, Lily Teesson, Julia Boyle, Denise Lim, Andrew Nguyen, Alison L. Calear, Philip J. Batterham, Kevin Gournay, and Maree Teesson. “A Hidden Pandemic? An Umbrella Review of Global Evidence on Mental Health in the Time of COVID-19.” Frontiers in Psychiatry 14 (Mar. 2023): 1–19. Charon, Rita. “The Narrative Road to Empathy.” Empathy and the Practice of Medicine: Beyond Pills and the Scalpel. Eds. H.M. Spiro, M.G. McCrea Curnen, E. Peschel and D. St. James. New Haven: Yale UP. 147-59. Corcoran, Rhiannon, and Keith Oatley. “Reading and Psychology I. Reading Minds: Fiction and Its Relation to the Mental Worlds of Self and Others.” Reading and Mental Health. Ed. Josie Billington. Palgrave Macmillan, 2019. 331–43. Davis, Philip. Reading and the Reader: The Literary Agenda. Oxford: Oxford UP, 2013. ———. Reading for Life. Oxford: Oxford UP, 2020. Davis, Philip, et al. Cultural Value: Assessing the Intrinsic Value of The Reader Organisation’s Shared Reading Scheme. The Reader Organisation UK, 2014. <https://www.thereader.org.uk/wp-content/uploads/2022/11/Cultural-Value.pdf>. Davis, Philip, et al. What Literature Can Do (An Investigation into the Effectiveness of Shared Reading as a Whole Population Health Intervention). The Reader Organisation UK, 2015. <https://www.thereader.org.uk/wp-content/uploads/2022/11/What-Literature-Can-Do.pdf>. Diener, Edward. The Science of Wellbeing: The Collected Works of Ed Diener. New York: Springer, 2009. Donoghue, Denis. The Practice of Reading. New Haven CT: Yale UP, 2000. Dowrick, Christopher, Josie Billington, Jude Robinson, Andrew Hamer, and Clare Williams. “Get into Reading as an Intervention for Common Mental Health Problems: Exploring Catalysts for Change.” Medical Humanities 38.1 (2012): 15–20. Felski, Rita. Uses of Literature. Chichester: Wiley, 2011. Monroy-Fraustro, Daniela, Isaac Maldonado-Castellanos, Monical Aboites-Molina, Susana Rodriguez, Perla Sueiras, Nelly F. Altamirano-Bustamante, Adalberto de Hoyos-Bermea, and Myriam M. Altamirano-Bustamante. “Bibliotherapy as a Non-Pharmaceutical Intervention to Enhance Mental Health in Response to the COVID-19 Pandemic: A Mixed Methods Systematic Review and Bioethical Meta-Analysis.” Frontiers in Public Health 9 (Mar. 2021): 1-15. Haslam, N., and Simon De Deyne, “Mental Health vs. Wellbeing, Health and Medicine.”Pursuit 19 July 2021. <https://pursuit.unimelb.edu.au/articles/mental-health-wellbeing>. McDonald, Robin Alex, and Julie Hollenbach. Introduction. Re/Imagining Depression: Creative Approaches to “Feeling Bad”. Eds. Julie Hollenbach and Robin Alex McDonald. Cham: Palgrave Macmillan, 2021. 1–11. Holmes, Mary. “The Emotionalization of Reflexivity.” Sociology 44.1 (2010): 139–54. Huta, Veronika. “Eudaimonia.” Oxford Handbook of Happiness. Eds. Ilona Boniwell, Susan A. David, and Amanda Conley Ayers. Oxford: Oxford UP, 2013. 201–13. Keyes, Corey L.M. “The Mental Health Continuum: From Languishing to Flourishing in Life.” Journal of Health and Social Behavior 43.2 (June 2002): 207–22. Keyes, Corey L.M., Satvinder S. Dhingra, and Eduardo J. Simoes. “Change in Level of Positive Mental Health as a Predictor of Future Risk of Mental Illness.” American Journal of Public Health 100.12 (Dec. 2010): 2366–71. McNicol, Sarah. “Theories of Bibliotherapy.” Bibliotherapy. Eds. Sarah McNichol and Liz Brewster. London: Facet Publishing, 2018. 23–40. Miller, J. Hillis. On Literature. London: Routledge, 2002. Pettersson, Cecilia. “Psychological Well-Being, Improved Self-Confidence, and Social Capacity: Bibliotherapy from a User Perspective.” Journal of Poetry Therapy 31.2 (2018): 124–34. Radway Janice A. A Feeling for Books: The Book-of-the-Month Club, Literary Taste, and Middle-Class Desire. Chapel Hill: U North Carolina P, 1997. Rosenblatt, Louise M. The Reader, the Text, the Poem: The Transactional Theory of the Literary Work. Carbondale, Ill.: Southern Illinois UP, 1978. Ryan, Richard M., Veronika Huta, and Edward L. Deci. “Living Well: A Self-Determination Theory Perspective on Eudaimonia.” Journal of Happiness Studies 9 (2008): 139–70. Ryff, Carol D., and Burton H. Singer. “The Contours of Positive Human Health.” Psychological Inquiry 9.1 (1998): 1–28. Vittersø, Joar. “The Feeling of Excellent Functioning: Hedonic and Eudaimonic Emotions.” Handbook of Eudaimonic Well-Being. Ed. Joar Vittersø. Cham: Springer, 2016. 253–76.

Practically any good story follows certain narrative conventions in order to hold its readers' attention and leave them with a feeling of satisfaction -- this goes for fictional tales as well as for many news reports (we do tend to call them 'news stories', after all), for idle gossip as well as for academic papers. In the Western tradition of storytelling, it's customary to start with the exposition, build up to major events, and end with some form of narrative closure. Indeed, audience members will feel disturbed if there is no sense of closure at the end -- their desire for closure is a powerful one. From this brief description of narrative patterns it is also clear that such narratives depend crucially on linear progression through the story in order to work -- there may be flashbacks and flashforwards, but very few stories, it seems, could get away with beginning with their point of closure, and work back to the exposition. Closure, as the word suggests, closes the story, and once reached, the audience is left with the feeling of now knowing the whole story, of having all the pieces necessary to understand its events. To understand how important the desire to reach this point is to the audience, just observe the discussions of holes in the plot which people have when they're leaving a cinema: they're trying to reach a better sense of closure than was afforded them by the movie itself. In linearly progressing media, this seems, if you'll pardon the pun, straightforward. Readers know when they've finished an article or a book, viewers know when a movie or a broadcast is over, and they'll be able to assess then if they've reached sufficient closure -- if their desires have been fulfilled. On the World Wide Web, this is much more difficult: "once we have it in our hands, the whole of a book is accessible to us readers. However, in front of an electronic read-only hypertext document we are at the mercy of the author since we will only be able to activate the links which the author has provided" (McKnight et al. 119). In many cases, it's not even clear whether we've reached the end of the text already: just where does a Website end? Does the question even make sense? Consider the following example, reported by Larry Friedlander: I watched visitors explore an interactive program in a museum, one that contained a vast amount of material -- pictures, film, historic explanations, models, simulations. I was impressed by the range of subject matter and by the ambitiousness and polish of the presentation. ... But to my surprise, as I watched visitors going down one pathway after another, I noticed a certain dispirited glaze spread over their faces. They seemed to lose interest quite quickly and, in fact, soon stopped their explorations. (163) Part of the problem here may just have been the location of the programme, of course -- when you're out in public, you might just not have the time to browse as extensively as you could from your computer at home. But there are other explanations, too: the sheer amount of options for exploration may have been overwhelming -- there may not have been any apparent purpose to aim for, any closure to arrive at. This is a problem inherent in hypertext, particularly in networked systems like the Web: it "changes our conception of an ending. Different readers can choose not only to end the text at different points but also to add to and extend it. In hypertext there is no final version, and therefore no last word: a new idea or reinterpretation is always possible. ... By privileging intertextuality, hypertext provides a large number of points to which other texts can attach themselves" (Snyder 57). In other words, there will always be more out there than any reader could possibly explore, since new documents are constantly being added. There is no ending if a text is constantly extended. (In print media this problem appears only to a far more limited extent: there, intertextuality is mostly implicit, and even though new articles may constantly be added -- 'linked', if you will -- to a discourse, due to the medium's physical nature they're still very much separate entities, while Web links make intertextuality explicit and directly connect texts.) Does this mark the end of closure, then? Adding to the problem is the fact that it's not even possible to know how much of the hypertextual information available is still left unexplored, since there is no universal register of all the information available on the Web -- "the extent of hypertext is unknowable because it lacks clear boundaries and is often multi-authored" (Snyder 19). While reading a book you can check how many more pages you've got to go, but on the Web this is not an option. Our traditions of information transmission create this desire for closure, but the inherent nature of the medium prevents us from ever satisfying it. Barrett waxes lyrical in describing this dilemma: contexts presented online are often too limited for what we really want: an environment that delivers objects of desire -- to know more, see more, learn more, express more. We fear being caught in Medusa's gaze, of being transfixed before the end is reached; yet we want the head of Medusa safely on our shield to freeze the bitstream, the fleeting imagery, the unstoppable textualisations. We want, not the dead object, but the living body in its connections to its world, connections that sustain it, give it meaning. (xiv-v) We want nothing less, that is, than closure without closing: we desire the knowledge we need, and the feeling that that knowledge is sufficient to really know about a topic, but we don't want to devalue that knowledge in the same process by removing it from its context and reducing it to trivial truisms. We want the networked knowledge base that the Web is able to offer, but we don't want to feel overwhelmed by the unfathomable dimensions of that network. This is increasingly difficult the more knowledge is included in that network -- "with the growth of knowledge comes decreasing certainty. The confidence that went with objectivity must give way to the insecurity that comes from knowing that all is relative" (Smith 206). The fact that 'all is relative' is one which predates the Net, of course, and it isn't the Internet or the World Wide Web that has destroyed objectivity -- objectivity has always been an illusion, no matter how strongly journalists or scientists have at times laid claims ot it. Internet-based media have simply stripped away more of the pretences, and laid bare the subjective nature of all information; in the process, they have also uncovered the fact that the desire for closure must ultimately remain unfulfilled in any sufficiently non-trivial case. Nonetheless, the early history of the Web has seen attempts to connect all the information available (LEO, one of the first major German Internet resource centres, for example, took its initials from its mission to 'Link Everything Online') -- but as the amount of information on the Net exploded, more and more editorial choices of what to include and what to leave out had to be made, so that now even search engines like Yahoo! and Altavista quite clearly and openly offer only a selection of what they consider useful sites on the Web. Web browsers still hoping to find everything on a certain topic would be well-advised to check with all major search engines, as well as important resource centres in the specific field. The average Web user would probably be happy with picking the search engine, Web directory or Web ring they find easiest to use, and sticking with it. The multitude of available options here actually shows one strength of the Internet and similar networks -- "the computer permits many [organisational] structures to coexist in the same electronic text: tree structures, circles, and lines can cross and recross without obstructing one another. The encyclopedic impulse to organise can run riot in this new technology of writing" (Bolter 95). Still, this multitude of options is also likely to confuse some users: in particular, "novices do not know in which order they need to read the material or how much they should read. They don't know what they don't know. Therefore learners might be sidetracked into some obscure corner of the information space instead or covering the important basic information" (Nielsen 190). They're like first-time visitors to a library -- but this library has constantly shifting aisles, more or less well-known pathways into specialty collections, fiercely competing groups of librarians, and it extends almost infinitely. Of course, the design of the available search and information tools plays an important role here, too -- far more than it is possible to explore at this point. Gay makes the general observation that "visual interfaces and navigational tools that allow quick browsing of information layout and database components are more effective at locating information ... than traditional index or text-based search tools. However, it should be noted that users are less secure in their findings. Users feel that they have not conducted complete searches when they use visual tools and interfaces" (185). Such technical difficulties (especially for novices) will slow take-up of and low satisfaction with the medium (and many negative views of the Web can probably be traced to this dissatisfaction with the result of searches -- in other words, to a lack of satisfaction of the desire for closure); while many novices eventually overcome their initial confusion and become more Web-savvy, others might disregard the medium as unsuitable for their needs. At the other extreme of the scale, the inherent lack for closure, in combination with the societally deeply ingrained desire for it, may also be a strong contributing factor for another negative phenomenon associated with the Internet: that of Net users becoming Net junkies, who spend every available moment online. Where the desire to know, to get to the bottom (or more to the point: to the end) of a topic, becomes overwhelming, and where the fundamental unattainability of this goal remains unrealised, the step to an obsession with finding information seems a small one; indeed, the neverending search for that piece of knowledge surpassing all previously found ones seems to have obvious similarities to drug addiction with its search for the high to better all previous highs. And most likely, the addiction is only heightened by the knowledge that on the Web, new pieces of information are constantly being added -- an endless, and largely free, supply of drugs... There is no easy solution to this problem -- in the end, it is up to the user to avoid becoming an addict, and to keep in mind that there is no such thing as total knowledge. Web designers and content providers can help, though: "there are ways of orienting the reader in an electronic document, but in any true hypertext the ending must remain tentative. An electronic text never needs to end" (Bolter 87). As Tennant & Heilmeier elaborate, "the coming ease-of-use problem is one of developing transparent complexity -- of revealing the limits and the extent of vast coverage to users, and showing how the many known techniques for putting it all together can be used most effectively -- of complexity that reveals itself as powerful simplicity" (122). We have been seeing, therefore, the emergence of a new class of Websites: resource centres which help their visitors to understand a certain topic and view it from all possible angles, which point them in the direction of further information on- and off-site, and which give them an indication of how much they need to know to understand the topic to a certain degree. In this, they must ideally be very transparent, as Tennant & Heilmeier point out -- having accepted that there is no such thing as objectivity, it is necessary for these sites to point out that their offered insight into the field is only one of many possible approaches, and that their presented choice of information is based on subjective editorial decisions. They may present preferred readings, but they must indicate that these readings are open for debate. They may help satisfy some of their readers' desire for closure, but they must at the same time point out that they do so by presenting a temporary ending beyond which a more general story continues. If, as suggested above, closure crucially depends on a linear mode of presentation, such sites in their arguments help trace one linear route through the network of knowledge available online; they impose a linear from-us-to-you model of transmission on the normally unordered many-to-many structure of the Net. In the face of much doomsaying about the broadcast media, then, here is one possible future for these linear transmission media, and it's no surprise that such Internet 'push' broad- or narrowcasting is a growth area of the Net -- simply put, it serves the apparent need of users to be told stories, to have their desire for closure satisfied through clear narrative progressions from exposition through development to end. (This isn't 'push' as such, really: it's more a kind of 'push on demand'.) But at the same time, this won't mean the end of the unstructured, networked information that the Web offers: even such linear media ultimately build on that networked pool of knowledge. The Internet has simply made this pool public -- passively as well as actively accessible to everybody. Now, however, Web designers (and this includes each and every one of us, ultimately) must work "with the users foremost in mind, making sure that at every point there is a clear, simple and focussed experience that hooks them into the welter of information presented" (Friedlander 164); they must play to the desire for closure. (As with any preferred reading, however, there is also a danger that that closure is premature, and that the users' process or meaning-making is contained and stifled rather than aided.) To return briefly to Friedlander's experience with the interactive museum exhibit: he draws the conclusion that visitors were simply overwhelmed by the sheer mass of information and were reluctant to continue accumulating facts without a guiding purpose, without some sense of how or why they could use all this material. The technology that delivers immense bundles of data does not simultaneously deliver a reason for accumulating so much information, nor a way for the user to order and make sense of it. That is the designer's task. The pressing challenge of multimedia design is to transform information into usable and useful knowledge. (163) Perhaps this transformation is exactly what is at the heart of fulfilling the desire for closure: we feel satisfied when we feel we know something, have learnt something from a presentation of information (no matter if it's a news report or a fictional story). Nonetheless, this satisfaction must of necessity remain intermediate -- there is always much more still to be discovered. "From the hypertext viewpoint knowledge is infinite: we can never know the whole extent of it but only have a perspective on it. ... Life is in real-time and we are forced to be selective, we decide that this much constitutes one node and only these links are worth representing" (Beardon & Worden 69). This is not inherently different from processes in other media, where bandwidth limitations may even force much stricter gatekeeping regiments, but as in many cases the Internet brings these processes out into the open, exposes their workings and stresses the fundamental subjectivity of information. Users of hypertext (as indeed users of any medium) must be aware of this: "readers themselves participate in the organisation of the encyclopedia. They are not limited to the references created by the editors, since at any point they can initiate a search for a word or phrase that takes them to another article. They might also make their own explicit references (hypertextual links) for their own purposes ... . It is always a short step from electronic reading to electronic writing, from determining the order of texts to altering their structure" (Bolter 95). Significantly, too, it is this potential for wide public participation which has made the Internet into the medium of the day, and led to the World Wide Web's exponential growth; as Bolter describes, "today we cannot hope for permanence and for general agreement on the order of things -- in encyclopedias any more than in politics and the arts. What we have instead is a view of knowledge as collections of (verbal and visual) ideas that can arrange themselves into a kaleidoscope of hierarchical and associative patterns -- each pattern meeting the needs of one class of readers on one occasion" (97). To those searching for some meaningful 'universal truth', this will sound defeatist, but ultimately it is closer to realism -- one person's universal truth is another one's escapist phantasy, after all. This doesn't keep most of us from hoping and searching for that deeper insight, however -- and from the preceding discussion, it seems likely that in this we are driven by the desire for closure that has been imprinted in us so deeply by the multitudes of narrative structures we encounter each day. It's no surprise, then, that, as Barrett writes, "the virtual environment is a place of longing. Cyberspace is an odyssey without telos, and therefore without meaning. ... Yet cyberspace is also the theatre of operations for the reconstruction of the lost body of knowledge, or, perhaps more correctly, not the reconstruction, but the always primary construction of a body of knowing. Thought and language in a virtual environment seek a higher synthesis, a re-imagining of an idea in the context of its truth" (xvi). And so we search on, following that by definition end-less quest to satisfy our desire for closure, and sticking largely to the narrative structures handed down to us through the generations. This article is no exception, of course -- but while you may gain some sense of closure from it, it is inevitable that there is a deeper feeling of a lack of closure, too, as the article takes its place in a wider hypertextual context, where so much more is still left unexplored: other articles in this issue, other issues of M/C, and further journals and Websites adding to the debate. Remember this, then: you decide when and where to stop. References Barrett, Edward, and Marie Redmont, eds. Contextual Media: Multimedia and Interpretation. Cambridge, Mass.: MIT P, 1995. Barrett, Edward. "Hiding the Head of Medusa: Objects and Desire in a Virtual Environment." Barrett & Redmont xi- vi. Beardon, Colin, and Suzette Worden. "The Virtual Curator: Multimedia Technologies and the Roles of Museums." Barrett & Redmont 63-86. Bolter, Jay David. Writing Space: The Computer, Hypertext, and the History of Writing. Hillsdale, N.J.: Lawrence Erlbaum Associates, 1991. Friedlander, Larry. "Spaces of Experience on Designing Multimedia Applications." Barrett & Redmont 163-74. Gay, Geri. "Issues in Accessing and Constructing Multimedia Documents." Barrett & Redmont 175-88. McKnight, Cliff, John Richardson, and Andrew Dillon. "The Authoring of Hypertext Documents." Hypertext: Theory into Practice. Ed. Ray McAleese. Oxford: Intellect, 1993. Nielsen, Jakob. Hypertext and Hypermedia. Boston: Academic Press, 1990. Smith, Anthony. Goodbye Gutenberg: The Newspaper Revolution of the 1980's [sic]. New York: Oxford UP, 1980. Snyder, Ilana. Hypertext: The ELectronic Labyrinth. Carlton South: Melbourne UP, 1996. Tennant, Harry, and George H. Heilmeier. "Knowledge and Equality: Harnessing the Truth of Information Abundance." Technology 2001: The Future of Computing and Communications. Ed. Derek Leebaert. Cambridge, Mass.: MIT P, 1991. Citation reference for this article MLA style: Axel Bruns. "What's the Story: The Unfulfilled Desire for Closure on the Web." M/C: A Journal of Media and Culture 2.5 (1999). [your date of access] <http://www.uq.edu.au/mc/9907/closure.php>. Chicago style: Axel Bruns, "What's the Story: The Unfulfilled Desire for Closure on the Web," M/C: A Journal of Media and Culture 2, no. 5 (1999), <http://www.uq.edu.au/mc/9907/closure.php> ([your date of access]). APA style: Axel Bruns. (1999) What's the story: the unfulfilled desire for closure on the Web. M/C: A Journal of Media and Culture 2(5). <http://www.uq.edu.au/mc/9907/closure.php> ([your date of access]).