The appropriation and mastery of cultural tools in computer supported collaborative literacy practices

The main focus of this thesis is how language is used to construct knowledge in social interaction. A more specific aim is the investigation of the strategies of British primary school children for constructing multimodal electronic documents, and in particular for constructing collaboratively WebPages in History. In the first part of the thesis the two themes are critically explored through a literature review of sociocultural theory, literacy, and lCT, and through two pilot studies. In the first study, I investigate how language use varies according to the difficulty of tasks. In the second study, I investigate how language use in situated literacy events relates to wider cultural practices for constructing e-mails and WebPages. Drawing on the result of these studies, I evaluate the relationship between the concepts of Zone of Proximal Development, scaffolding, exploratory talk, and Intermental Development Zone (IDZ), arguing in favour of the usefulness of IDZ for studies in social interaction. In the second part of the thesis, I explore different approaches to discourse analysis developing an analytic strategy for the main study. I identify the ethnography of communication as a starting point, choosing the 'communicative event' as the unit of analysis to investigate, using NVivo: how participants construct categories of meaning while constructing WebPages in History, and the categories of participants in relation to the activity frames of design, History, and group work. I conclude that, in contrast to a view of "effective use of language" linked to explicitness, participants demonstrated to be communicatively competent in managing deictic terms and intertextual references.> recognizing cultural patterns, and adjusting their efforts according to a division of labour, and the collaborative nature of meaning making. Finally, the notion of 'situated activity system' is enriched by illuminating how categories of participants, activity frames, and cultural tools are interrelated in such system

Análisis del diálogo en las aulas STEM en Ecuador: un contexto socioeconómico dual en una escuela de bachillerato general unificado

Science, Technology, Engineering and Maths education (STEM Education) is presented as a way to reduce marginalisation and promote inclusion in developing countries. This qualitative study aims to identify ways of reducing marginality and promoting inclusion through dialogic and transformative learning by high school teachers of the New Harvest School (NHS), particularly in STEM Education. Method: The study was carried out within the framework of the critical social approach identifying four characteristics of dialogism. The data comprised ethnographic observations of classes, and interviews with the selected teachers, the vice-chancellor and the administrator of the institution. Results: The dialogic characteristics of sequentiality, positioning, historicity and plurality were found in the science classes taught by the institution. Teachers have curricular knowledge capabilities regarding STEM education; however, recommendations were presented regarding the dialogic training that teachers should have, which made this study particularly relevant for improving teachers’ skills in this field. This article suggests options to create spaces for the use of educational dialogue and a liberating practice of education.La educación en ciencia, tecnología, ingeniería y matemáticas (educación STEM) se presenta como una forma de reducir la marginalidad y promover la inclusión en los países en vías de desarrollo. Este estudio cualitativo tiene como objetivo identificar formas de reducir la marginalidad y promover la inclusión a través del aprendizaje dialógico y transformador por parte de los maestros de bachillerato general unificado de la Unidad Educativa Nueva Cosecha (NC), particularmente en educación STEM. Método: El estudio se realizó en el marco del enfoque social crítico identificando cuatro características del dialogismo. Los datos incluyeron observaciones etnográficas de las clases, entrevistas con los maestros seleccionados, la vicerrectora y la administradora de la institución. Resultados: Las características dialógicas de secuencialidad, posicionamiento, historicidad y pluralidad se encontraron en las clases de ciencias impartidas por la institución. Los maestros tienen capacidades de conocimiento curricular con respecto a la educación STEM; sin embargo, se presentaron recomendaciones en relación con la capacitación dialógica que deberían tener los maestros, lo que hizo que este estudio fuera particularmente relevante para mejorar las habilidades de los maestros en este campo. Este artículo sugiere opciones para crear espacios para el uso del diálogo educativo y una práctica liberadora de la educación

Co-creating FabLab La Campana: Empowering a marginalised community in the North of Mexico

FabLabs are a celebrated approach to formal and informal learning through making with digital fabrication tools. This paper discusses the co-creation of a FabLab with a marginalised community in Monterrey, Mexico. One of the main challenges in establishing these Makerspaces is in sustaining the activities and community engagement on an ongoing basis. In responding to this challenge, this process focused on the empowerment of community members to make the changes they desire, either for themselves or their community. Beyond skills for making and playful engagement in STEAM learning, makerspaces also facilitate the building of networks and partnerships, and the development of social competencies and soft skills, that are often overlooked in the process of empowerment and social mobility. Primary insights from the co-creation process of the La Campana FabLab are reported here. A Mexican higher education institution with a strong social responsibility agenda facilitated the process, securing funds and connecting project partners, locally and globally. Framing the co-creation of the FabLab with the partners was and is an ongoing process. Key factors included the donation of a safe space and tools for the community to host and run the FabLab. Establishing the role of the FabLab in the community from the participants’ point-of-view and committing to regular ongoing educational dialogue was important in forming an equitable partnership between institutions and community. Beyond the physical space, equipment and educational activities, a community architecture intervention demonstrated the large-scale impact digital fabrication could have in creating spaces shaped by and for the community

Hyperlocal Learning Network ‘La Campana-Altamira’: Using low-cost technologies to support maker education during lockdown times

The Covid-19 pandemic worsened access to education and socio-economic development opportunities for marginalized communities around the globe. ‘Hyperlocal Learning Network La Campana-Altamira’ has used low-cost technologies to target this challenge in a city in the Northeast region of Mexico. With the collaboration of academics from Mexico and the United Kingdom, the project in progress has aimed to build hyperlocal and creative learning networks under a socio-constructivist and grounded approach that could empower individuals (children, parents and general community) and nurture makerspace characteristics at home during lockdown. The project established a hyperlocal learning network in La Campana-Altamira with 11 families, using a combination of craft kits and low-cost digital networks to enable making, reflecting, and sharing in the neighbourhood while schools and makerspaces were closed. This paper presents initial findings of the research process and seeks to open a debate on innovative methods and transnational collaboration during pandemics

A Silent Corticotroph Pituitary Carcinoma: Lessons From an Exceptional Case Report

Nowadays, neither imaging nor pathology evaluation can accurately predict the aggressiveness or treatment resistance of pituitary tumors at diagnosis. However, histological examination can provide useful information that might alert clinicians about the nature of pituitary tumors. Here, we describe our experience with a silent corticothoph tumor with unusual pathology, aggressive local invasion and metastatic dissemination during follow-up. We present a 61-year-old man with third cranial nerve palsy at presentation due to invasive pituitary tumor. Subtotal surgical approach was performed with a diagnosis of silent corticotroph tumor but with unusual histological features (nuclear atypia, frequent multinucleation and mitotic figures, and Ki-67 labeling index up to 70%). After a rapid regrowth, a second surgical intervention achieved successful debulking. Temozolomide treatment followed by stereotactic fractionated radiotherapy associated with temozolomide successfully managed the primary tumor. However, sacral metastasis showed up 6 months after radiotherapy treatment. Due to aggressive distant behavior, a carboplatine-etoposide scheme was decided but the patient died of urinary sepsis 31 months after the first symptoms. Our case report shows how the presentation of a pituitary tumor with aggressive features should raise a suspicion of malignancy and the need of follow up by multidisciplinary team with experience in its management. Metastases may occur even if the primary tumor is well controlled.This work was supported by grants from the ISCIII-Subdirección General de Evaluación y Fomento de la Investigación co-funded with Fondos FEDER (PI16/00175 to AS-M and DC) and the Sistema Andaluz de Salud (A-0003-2016 and A-0006-2017 to AS-M, C-0015-2014 and RC-0006-2018 to DC)

A Randomized Comparison of Drug-Eluting Balloon Versus Everolimus-Eluting Stent in Patients With Bare-Metal Stent–In-Stent Restenosis The RIBS V Clinical Trial (Restenosis Intra-stent of Bare Metal Stents: Paclitaxel-eluting Balloon vs. Everolimus-eluting Stent)

ObjectivesThis study sought to compare the efficacy of drug-eluting balloons (DEB) with that of everolimus-eluting stents (EES) in patients with bare-metal stents (BMS) in-stent restenosis (ISR).BackgroundTreatment of patients with ISR remains a challenge.MethodsThis was a prospective, multicenter, randomized trial comparing DEB with EES in patients with bare-metal stents (BMS) in-stent restenosis (ISR). The primary endpoint was the minimal lumen diameter at 9 months' follow-up.ResultsA total of 189 patients with BMS-ISR from 25 Spanish sites were included (95 were allocated to DEB and 94 to EES). Procedural success was achieved in all patients. At late angiography (median 249 days; 92% of eligible patients), patients in the EES arm had a significantly larger minimal lumen diameter (2.36 ± 0.6 mm vs. 2.01 ± 0.6 mm, p < 0.001; absolute mean difference: 0.35 mm; 95% confidence interval [CI]: 0.16 to 0.53) and a lower percent of diameter stenosis (13 ± 17% vs. 25 ± 20%, p < 0.001). However, late loss (0.04 ± 0.5 mm vs. 0.14 ± 0.5 mm, p = 0.14) and binary restenosis rate (4.7% vs. 9.5%, p = 0.22) were very low and similar in both groups. Clinical follow-up (median 365 days) was obtained in all (100%) patients. Occurrences of the combined clinical outcome measure (cardiac death, myocardial infarction, and target vessel revascularization; 6% vs. 8%; hazard ratio [HR]: 0.76; 95% CI: 0.26 to 2.18, p = 0.6) and the need for target vessel revascularization (2% vs. 6%; HR: 0.32: 95% CI: 0.07 to 1.59, p = 0.17) were similar in the 2 groups.ConclusionsIn patients with BMS-ISR, both DEB and EES provided excellent clinical results with a very low rate of clinical and angiographic recurrences. However, compared with DEB, EES provide superior late angiographic findings. (Restenosis Intra-stent of Bare Metal Stents: Paclitaxel-eluting Balloon vs. Everolimus-eluting Stent [RIBS V]; NCT01239953

Phase III Trial of Adjuvant Capecitabine After Standard Neo-/Adjuvant Chemotherapy in Patients With Early Triple-Negative Breast Cancer (GEICAM/2003-11_CIBOMA/2004-01)

© 2019 by American Society of Clinical Oncology. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ This document is the Published version of a Published Work that appeared in final form in Journal of Clinical Oncology (JCO). To access the final edited and published work see https://doi.org/10.1200/JCO.19.00904Purpose.- Operable triple-negative breast cancers (TNBCs) have a higher risk of relapse than non-TNBCs with standard therapy. The GEICAM/2003-11_CIBOMA/2004-01 trial explored extended adjuvant capecitabine after completion of standard chemotherapy in patients with early TNBC.Patients and Methods.- Eligible patients were those with operable, node-positive—or node negative with tumor 1 cm or greater—TNBC, with prior anthracycline- and/or taxane-containing chemotherapy. After central confirmation of TNBC status by immunohistochemistry, patients were randomly assigned to either capecitabine or observation. Stratification factors included institution, prior taxane-based therapy, involved axillary lymph nodes, and centrally determined phenotype (basal v nonbasal, according to cytokeratins 5/6 and/or epidermal growth factor receptor positivity by immunohistochemistry). The primary objective was to compare disease-free survival (DFS) between both arms.Results.- Eight hundred seventy-six patients were randomly assigned to capecitabine (n = 448) or observation (n = 428). Median age was 49 years, 55.9% were lymph node negative, 73.9% had a basal phenotype, and 67.5% received previous anthracyclines plus taxanes. Median length of follow-up was 7.3 years. DFS was not significantly prolonged with capecitabine versus observation [hazard ratio (HR), 0.82; 95% CI, 0.63 to 1.06; P = .136]. In a preplanned subgroup analysis, nonbasal patients seemed to derive benefit from the addition of capecitabine with a DFS HR of 0.53 versus 0.94 in those with basal phenotype (interaction test P = .0694) and an HR for overall survival of 0.42 versus 1.23 in basal phenotype (interaction test P = .0052). Tolerance of capecitabine was as expected, with 75.2% of patients completing the planned 8 cycles.Conclusion.- This study failed to show a statistically significant increase in DFS by adding extended capecitabine to standard chemotherapy in patients with early TNBC. In a preplanned subset analysis, patients with nonbasal phenotype seemed to obtain benefit with capecitabine, although this will require additional validation

Phase III Trial of Adjuvant Capecitabine After Standard Neo-/Adjuvant Chemotherapy in Patients With Early Triple-Negative Breast Cancer (GEICAM/2003-11_CIBOMA/2004-01)

Altres ajuts: Agustí Barnadas: Honoraria: Pfizer. Consulting or Advisory Role: Pfizer, Novartis, Eli Lilly. Speakers'Bureau: Roche, Pfizer, Novartis, Genomic Health International. Travel, Accommodations, Expenses: Roche, Pfizer; Miguel A. Seguí: Consulting or Advisory Role: Roche, Pfizer, Novartis, Amgen, Eisai, Eli Lilly. Speakers' Bureau: Roche, Pfizer, Amgen. Research Funding: Roche (Inst), Novartis (Inst). Travel, Accommodations, Expenses: Roche, Pfizer, Novartis, Amgen.Operable triple-negative breast cancers (TNBCs) have a higher risk of relapse than non-TNBCs with standard therapy. The GEICAM/2003-11_CIBOMA/2004-01 trial explored extended adjuvant capecitabine after completion of standard chemotherapy in patients with early TNBC. Eligible patients were those with operable, node-positive-or node negative with tumor 1 cm or greater-TNBC, with prior anthracycline- and/or taxane-containing chemotherapy. After central confirmation of TNBC status by immunohistochemistry, patients were randomly assigned to either capecitabine or observation. Stratification factors included institution, prior taxane-based therapy, involved axillary lymph nodes, and centrally determined phenotype (basal v nonbasal, according to cytokeratins 5/6 and/or epidermal growth factor receptor positivity by immunohistochemistry). The primary objective was to compare disease-free survival (DFS) between both arms. Eight hundred seventy-six patients were randomly assigned to capecitabine (n = 448) or observation (n = 428). Median age was 49 years, 55.9% were lymph node negative, 73.9% had a basal phenotype, and 67.5% received previous anthracyclines plus taxanes. Median length of follow-up was 7.3 years. DFS was not significantly prolonged with capecitabine versus observation [hazard ratio (HR), 0.82; 95% CI, 0.63 to 1.06; P =.136]. In a preplanned subgroup analysis, nonbasal patients seemed to derive benefit from the addition of capecitabine with a DFS HR of 0.53 versus 0.94 in those with basal phenotype (interaction test P =.0694) and an HR for overall survival of 0.42 versus 1.23 in basal phenotype (interaction test P =.0052). Tolerance of capecitabine was as expected, with 75.2% of patients completing the planned 8 cycles. This study failed to show a statistically significant increase in DFS by adding extended capecitabine to standard chemotherapy in patients with early TNBC. In a preplanned subset analysis, patients with nonbasal phenotype seemed to obtain benefit with capecitabine, although this will require additional validation