This study represents the first randomized prospective, double-blind, placebo-controlled trial of the efficacy of 1,25(OH)2D3 on bone histology and serum biochemistry in patients with mild to moderate renal failure. Sixteen patients with chronic renal impairment (creatinine clearance 20 to 59 ml per min) received either 1,25(OH)2D3, at a dose of 0.25 to 0.5 microgram daily (eight patients), or placebo. Transiliac crest bone biopsies were performed before entrance into the study and after 12 months of experimental observation. None of the patients were symptomatic or had radiological evidence of bone disease. Of the thirteen patients who completed the study, initial serum 1,25(OH)2D levels were low in seven patients and parathyroid hormone levels were elevated in seven patients. Bone histology was abnormal in all patients. 1,25(OH)2D3 treatment was associated with a significant fall in serum phosphorus and alkaline phosphatase concentrations as well as with histological evidence of an amelioration of hyperparathyroid changes. In contrast to previous reports, no deterioration of renal function attributable to the treatment occurred, perhaps because a modest dose of 1,25(OH)2D3 was employed combined with meticulous monitoring. Further investigation is required to determine whether alternative therapeutic strategies (smaller doses or intermittent therapy) may avoid the potential for suppressing bone turnover to abnormally low levels in the long term.

Often, English‐language development (ELD) is taught during a dedicated time of the school day. There is often a mismatch between the content of ELD and the lessons taught during core instruction provided during the remainder of the day. During core instruction, teachers use specially designed academic instruction in English strategies to ensure comprehensible input, but struggle to find ways to incorporate ELD. Content‐based ELD links language learning and academic vocabulary directly to core instruction, and includes four steps: (1) preview the text to determine the core concept, (2) match the concept to the appropriate language function, (3) select and teach academic vocabulary, and (4) develop sentence frames for oral‐language practice that incorporates the language function with the academic vocabulary. Content‐based ELD provides English learners with the language, vocabulary, and structured language practice necessary to think, talk, and write about the concepts that they are expected to comprehend. This article demonstrates how to develop content‐based ELD for social studies.

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