Integrating authoritative disciplinary voices in postgraduate writing

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Association of Upfront Peptide Receptor Radionuclide Therapy With Progression-Free Survival Among Patients With Enteropancreatic Neuroendocrine Tumors

open57noIMPORTANCE Data about the optimal timing for the initiation of peptide receptor radionuclide therapy (PRRT) for advanced, well-differentiated enteropancreatic neuroendocrine tumors are lacking. OBJECTIVE To evaluate the association of upfront PRRT vs upfront chemotherapy or targeted therapy with progression-free survival (PFS) among patients with advanced enteropancreatic neuroendocrine tumors who experienced disease progression after treatment with somatostatin analogues (SSAs). DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study analyzed the clinical records from 25 Italian oncology centers for patients aged 18 years or older who had unresectable, locally advanced or metastatic, well-differentiated, grades 1 to 3 enteropancreatic neuroendocrine tumors and received either PRRT or chemotherapy or targeted therapy after experiencing disease progression after treatment with SSAs between January 24, 2000, and July 1, 2020. Propensity score matching was done to minimize the selection bias. EXPOSURES Upfront PRRT or upfront chemotherapy or targeted therapy. MAIN OUTCOMES AND MEASURES The main outcome was the difference in PFS among patients who received upfront PRRT vs among those who received upfront chemotherapy or targeted therapy. A secondary outcome was the difference in overall survival between these groups. Hazard ratios (HRs) were fitted in a multivariable Cox proportional hazards regression model to adjust for relevant factors associated with PFS and were corrected for interaction with these factors. RESULTS Of 508 evaluated patients (mean ([SD] age, 55.7 [0.5] years; 278 [54.7%] were male), 329 (64.8%) received upfront PRRT and 179 (35.2%) received upfront chemotherapy or targeted therapy. The matched group included 222 patients (124 [55.9%] male; mean [SD] age, 56.1 [0.8] years), with 111 in each treatment group. Median PFS was longer in the PRRT group than in the chemotherapy or targeted therapy group in the unmatched (2.5 years [95%CI, 2.3-3.0 years] vs 0.7 years [95%CI, 0.5-1.0 years]; HR, 0.35 [95%CI, 0.28-0.44; P < .001]) and matched (2.2 years [95% CI, 1.8-2.8 years] vs 0.6 years [95%CI, 0.4-1.0 years]; HR, 0.37 [95%CI, 0.27-0.51; P < .001]) populations. No significant differences were shown in median overall survival between the PRRT and chemotherapy or targeted therapy groups in the unmatched (12.0 years [95%CI, 10.7-14.1 years] vs 11.6 years [95%CI, 9.1-13.4 years]; HR, 0.81 [95%CI, 0.62-1.06; P = .11]) and matched (12.2 years [95% CI, 9.1-14.2 years] vs 11.5 years [95%CI, 9.2-17.9 years]; HR, 0.83 [95%CI, 0.56-1.24; P = .36]) populations. The use of upfront PRRT was independently associated with improved PFS (HR, 0.37; 95%CI, 0.26-0.51; P < .001) in multivariable analysis. After adjustment of values for interaction, upfront PRRT was associated with longer PFS regardless of tumor functional status (functioning: adjusted HR [aHR], 0.39 [95%CI, 0.27-0.57]; nonfunctioning: aHR, 0.29 [95%CI, 0.16-0.56]), grade of 1 to 2 (grade 1: aHR, 0.21 [95%CI, 0.12-0.34]; grade 2: aHR, 0.52 [95%CI, 0.29-0.73]), and site of tumor origin (pancreatic: aHR, 0.41 [95%CI, 0.24-0.61]; intestinal: aHR, 0.19 [95%CI, 0.11-0.43]) (P < .001 for all). Conversely, the advantage was not retained in grade 3 tumors (aHR, 0.31; 95%CI, 0.12-1.37; P = .13) or in tumors with a Ki-67 proliferation index greater than 10% (aHR, 0.73; 95%CI, 0.29-1.43; P = .31). CONCLUSIONS AND RELEVANCE In this cohort study, treatment with upfront PRRT in patients with enteropancreatic neuroendocrine tumors who had experienced disease progression with SSA treatment was associated with significantly improved survival outcomes compared with upfront chemotherapy or targeted therapy. Further research is needed to investigate the correct strategy, timing, and optimal specific sequence of these therapeutic options.openPusceddu, Sara; Prinzi, Natalie; Tafuto, Salvatore; Ibrahim, Toni; Filice, Angelina; Brizzi, Maria Pia; Panzuto, Francesco; Baldari, Sergio; Grana, Chiara M.; Campana, Davide; Davì, Maria Vittoria; Giuffrida, Dario; Zatelli, Maria Chiara; Partelli, Stefano; Razzore, Paola; Marconcini, Riccardo; Massironi, Sara; Gelsomino, Fabio; Faggiano, Antongiulio; Giannetta, Elisa; Bajetta, Emilio; Grimaldi, Franco; Cives, Mauro; Cirillo, Fernando; Perfetti, Vittorio; Corti, Francesca; Ricci, Claudio; Giacomelli, Luca; Porcu, Luca; Di Maio, Massimo; Seregni, Ettore; Maccauro, Marco; Lastoria, Secondo; Bongiovanni, Alberto; Versari, Annibale; Persano, Irene; Rinzivillo, Maria; Pignata, Salvatore Antonio; Rocca, Paola Anna; Lamberti, Giuseppe; Cingarlini, Sara; Puliafito, Ivana; Ambrosio, Maria Rosaria; Zanata, Isabella; Bracigliano, Alessandra; Severi, Stefano; Spada, Francesca; Andreasi, Valentina; Modica, Roberta; Scalorbi, Federica; Milione, Massimo; Sabella, Giovanna; Coppa, Jorgelina; Casadei, Riccardo; Di Bartolomeo, Maria; Falconi, Massimo; de Braud, FilippoPusceddu, Sara; Prinzi, Natalie; Tafuto, Salvatore; Ibrahim, Toni; Filice, Angelina; Brizzi, Maria Pia; Panzuto, Francesco; Baldari, Sergio; Grana, Chiara M.; Campana, Davide; Davì, Maria Vittoria; Giuffrida, Dario; Zatelli, Maria Chiara; Partelli, Stefano; Razzore, Paola; Marconcini, Riccardo; Massironi, Sara; Gelsomino, Fabio; Faggiano, Antongiulio; Giannetta, Elisa; Bajetta, Emilio; Grimaldi, Franco; Cives, Mauro; Cirillo, Fernando; Perfetti, Vittorio; Corti, Francesca; Ricci, Claudio; Giacomelli, Luca; Porcu, Luca; Di Maio, Massimo; Seregni, Ettore; Maccauro, Marco; Lastoria, Secondo; Bongiovanni, Alberto; Versari, Annibale; Persano, Irene; Rinzivillo, Maria; Pignata, Salvatore Antonio; Rocca, Paola Anna; Lamberti, Giuseppe; Cingarlini, Sara; Puliafito, Ivana; Ambrosio, Maria Rosaria; Zanata, Isabella; Bracigliano, Alessandra; Severi, Stefano; Spada, Francesca; Andreasi, Valentina; Modica, Roberta; Scalorbi, Federica; Milione, Massimo; Sabella, Giovanna; Coppa, Jorgelina; Casadei, Riccardo; Di Bartolomeo, Maria; Falconi, Massimo; de Braud, Filipp

From word to world: a multiliteracies approach to language, literacy and communication for curriculum 2005

This research report explores the relationship between two literacy curriculum reform projects, one global and the other local, which emerged at the same time. The former is the Multiliteracies approach, which is based on the concept of multiple literacies, the latter is the new language and literacy curriculum in South Africa. Taking the form of constructive comparative textual analysis, which shows how the local and global approaches to literacy pedagogy under examination articulate with each other, the research report aims to extend rather than criticise the work of South African curriculum designers. The research report argues that the local literacy curriculum reform initiative lacks a coherent theoretical framework, and therefore does not provide the foundational principles which are required for guiding implementation of what is seen as a paradigm shift in literacy education in South Africa, It proposes that since the Multiliteracies approach offers an overarching theory of text and a pedagogy, neither of which is inconsistent with what is presently proposed in the Language, Literacy and Communication curriculum, there is a case for inscribing Multiliteracies theory and pedagogy on to the new Language, Literacy and Communication curriculum framework in order to facilitate coherence and consistency at the level of interpretation and implementation. It suggests that the adoption of the Multiliteracies approach may offer a way of avoiding the collapse, at the level of implementation, of the principles o f Curriculum 2005, and of ensuring that the new Language, Literacy and Communication curriculum in South Africa can truly be described as a paradigm shift

A critical exploration of argumentation in the texts that third-year Development Studies students interpret and construct

Ph.D. ( Education)The purpose of the educational linguistic research represented in this thesis is to explore the construction of written argumentation in Development Studies and to establish the implications of the findings for higher education teaching and learning that provides students with epistemological access to powerful discourse (Morrow 2007; 2009). The research is designed around analysis of the texts within the textual network that represents Development Studies in one case study: the final semester of a three-year undergraduate course in Development Studies. The textual network consists of texts from the fields of knowledge production, recontextualisation and reproduction (Bernstein 2000). Critical discourse analysis (Fairclough 2001; 2010) is used to explore how disciplinary and educational texts position students in ways that are enabling or constraining of the construction of argument. The perspective on written academic argument is informed by discourse theory, specifically, systemic functional linguistics (Halliday 1978); discourse semantics (Martin 1992), genre theory, and different approaches to the study of textual interaction (White 2003; Hyland 2005; 2008; Martin and White 2005). The thesis identifies and extends an emerging dialogical perspective on argumentation that draws on Bakhtinian theory (1981; 1986) and rhetoric-based strands of argumentation theory from North America, Britain and continental Europe. A framework was developed and implemented for the analysis of argument in knowledge-focused texts as ‘positioning’ in three ‘levels’ of discourse. In the research site, it was found that legitimate argumentation requires the production of a finely-balanced disciplinary discourse. This discourse involves negotiation of conflicting positionings of the writer in relation to the reader, and textual interaction with authoritative disciplinary voices and with competing discourses of inquiry and persuasion. Analysis of student texts in the dominant genre used for assessment, the multiple-source discussion essay, showed that few texts exhibit strong disciplinary argumentation. Argumentation in the majority of texts was cause for concern. Common problems that undermined students’ argumentation were: misunderstanding the prescribed texts, overreliance on sources, the use of inappropriate source texts and discourses, and underdeveloped discursive resources for the construction of argument. It is concluded that weak argumentation is partly attributable to the following factors: the heterogeneity of discourses and genres in the texts that instantiate the knowledge domain, inadequate theorization of argument as a dimension of disciplinary discourse, limited educational knowledge about written argumentation, conflicting discourses of argumentation and knowledge-making in the production and recontextualising fields, and confusion about the position students can take up in pedagogical discourse

Postgraduate study in uncharted territory: a comparative study

CITATION: Leibowitz, B., Wisker, G. & Lamberti, P. 2016. Postgraduate Study in Uncharted Territory: A Compartative Study, in M. Fourie-Malherbe, R. Albertyn, C. Aitchison & E. Bitzer. (eds.). Postgraduate Supervision: Future Foci for the Knowledge Society. Stellenbosch: SUN PRESS. 189-202. doi:10.18820/9781928357223/11.The original publication is available from AFRICAN SUNMeDIA - www.sun-e-shop.co.zaINTRODUCTION: Worldwide many mid-career professionals in a variety of professional occupations now undertake PhDs (Kiley 2015). In the UK for example, the drive for post-1992 universities to be more research-active, and the impetus from the Research Excellence Framework (REF) 2014, and upcoming REF 2020, has put the spotlight on recruiting, developing and motivating researchers, and encouraging academic staff already in posts to complete doctorates. And in South Africa, the achievement of a PhD is seen as a contribution to education for the public good, and an enhancement to the development of the knowledge economy (ASSAf 2010). This focus emphasises the importance of the PhD award for the academic career trajectory, and highlights the drive to encourage research-informed and research-led teaching and learning, with students as co-constructors of knowledge. The move underlines the vital role that mid-career researchers play in research productivity. The requirement that staff obtain PhDs can create pressures (Harley 2002), where staff have to become ‘ringmasters’, juggling the various institutional roles they have to play (Toews & Yazedjian, 2007). It also can lead to ‘creeping credentialism’, where a PhD is seen as essential in academic life but might be a troublesome extra demand on a professional with qualifications in their own profession (Griffith 1995; Harley 2000; Harley & Lee 1997; Henkel 1997; Henkel 2000).Publishers' versio

‘Crossing Over' into Research on Teaching and Learning

Academics teaching in higher education institutions who choose interdisciplinary projects for their postgraduate studies that link their own discipline with that of education or with teaching and learning, face opportunities and challenges that are similar to other part-time post-graduate students as well as issues that are specific to them as a group. They face the usual challenges, such as of time management, but they experience specific opportunities and achievements related to academic identity and the research process. The focus for this volume, ‘spaces, journeys and new horizons' aptly conveys the experiences of ‘crossing over', as these academics travel between their own disciplines and the field of education, journeying inwards to focus on their own practice and teaching and learning contexts in order to move ultimately, towards ‘new horizons'. Our understanding about the issues faced by academics moving from their own discipline base to engage with research and innovation in education or learning and teaching areas can be theorised using the literature on the scholarship of teaching and learning (SoTL)

Chemotherapy in Well Differentiated Neuroendocrine Tumors (NET) G1, G2, and G3: A Narrative Review

Neuroendocrine tumors (NETs) are rare neoplasms with a wide spectrum of clinical behavior, from the long survival of well-differentiated NETs to the dismal prognosis of high-grade neuroendocrine carcinomas (NECs), being G3 NETs a recently recognized intermediate entity. While the role of chemotherapy is well established in NECs, data on NETs mostly derives from small studies, experts’ opinions, and extrapolating results from small-cell lung cancer studies. This narrative review aims to summarize available evidence about the use of chemotherapy in the setting of G1-2 NETs and G3 NETs. We performed literature research in PubMed Library for all articles published up to September 2022 about the efficacy of chemotherapy in NETs. Treatment regimens with STZ-5FU, CAPTEM, and anti-metabolite-based treatment are the most active and tolerated in gastroenteropancreatic NETs (GEP-NETs) G1-G2, while platinum-based regimens (FOLFOX/XELOX) and TEM/CAPTEM showed the best activity in thoracic NETs. Solid evidence about chemotherapy efficacy in G3 NETs is still lacking. Literature data support the use of chemotherapy in low-intermediate grade NETs after the failure of other therapies or if tumor shrinkage is needed. Studies assessing G3 NETs independently from NECs are needed to better understand the role of chemotherapy in this setting