Le rôle de la matérialité dans l'apprentissage de la lecture : aspects du curriculum enseigné, pratique enseignante et développement chez l'élève : une étude de cas à l'école primaire française

Notre étude consiste en une recherche longitudinale pour laquelle une cohorte d'élèves a été suivie depuis la Grande Section de l'école maternelle française (élèves de 5-6 ans) jusqu'au Cours Élémentaire 1re année de l'école élémentaire française (élèves de 7-8 ans) dans des situations ordinaires de classe. À ces niveaux scolaires, l'un des principaux objectifs du curriculum est l'apprentissage de la lecture. Nous considérons que l'élève construit les compétences de lecture à acquérir, i.e. les compétences caractérisant son développement potentiel, en s'appuyant sur les compétences caractérisant son développement actuel (Vygotski, 1934/1997). Lorsqu'il apprend à lire, l'élève a à sa disposition des moyens sémiotiques relatifs à la connaissance des objets et leurs usages, ainsi qu'aux gestes et leur signification (Moro & Rodriguez, 2005), ce que nous appelons globalement la matérialité. En conséquence, dans cette recherche, nous faisons l'hypothèse que ces premières habiletés relatives à la matérialité, constituent une ressource dans les situations d'enseignement- apprentissage de la lecture. Nous réalisons une étude de cas dont le recueil des données, à caractère ethnographique, est constitué de moments de classe enregistrés en vidéo, et ce, quatre fois par année scolaire. Ces douze enregistrements vidéo sont complétés par deux entretiens semi-directifs et un entretien d'auto- confrontation ; ils sont aussi mis en lien avec les Instructions officielles (programmes scolaires). L'analyse est à la fois macrogénétique et microgénétique. Pour chaque observation, concernant l'analyse macrogénétique, nous réalisons le synopsis à partir duquel nous sélectionnons des épisodes significatifs porteurs de matérialité. Les épisodes significatifs sont constitués des événements remarquables dont les analyses microgénétiques nécessitent l'utilisation d'outils, à savoir les tableaux des matérialités et les photogrammes. Notre étude montre que la matérialité permet aux élèves de devenir lecteurs et que les formes de cette matérialité changent en fonction de l'avancée des acquisitions des élèves et des dimensions de la lecture (code et compréhension) à apprendre. - Our research consists of a longitudinal study in which one group of pupils in ordinary classroom situations has been followed from the top level of French pre-elementary school (5- to 6 year-old pupils) to the second level of French primary school (7- to 8 year-old pupils). For these three school grades, one of the main objectives in the curriculum is learning to read. We consider that pupils build their new reading skills, i.e. the skills characterizing their potential development, by relying on skills characterizing their actual development (Vygotski, 1934/1997). When learning to read, pupils yet have at their disposal semiotic abilities related to knowledge both of material objects and their uses, and of basic gestures and their meaning (Moro & Rodriguez, 2005), all of this we sum up under the term of materiality. Consequently, in our research, we make the hypothesis that the children's basic abilities related to materiality constitute a resource in teaching-learning situations. We have chosen to carry out a case study. The data collected consist of videos of class sequences carried out four times a year for three years. These twelve videos are supplemented by two semi- structured interviews with the teacher, one "self-confronting" interview in which the teacher is brought to discuss her actions and by the analysis of the ministry's school curricula. Our analysis is both macrogenetic and microgenetic. For each teaching sequence, on the level of macrogenetic analysis, we have made up the synopsis from which we have selected significant episodes in terms of materiality. The significant episodes are composed of remarkable events the microgenetic analysis of which requires the use of tools such as materiality boards and photograms. Our study shows that materiality enables pupils to develop reading skills and that the forms that materiality takes on change according to the pupils' acquisition progress and the aspects of reading (code and comprehension) still to be learned.

Prevalence of overweight and obesity in children and adolescents in Seychelles : results of the School Screening Program in 2013

Results related to overweight and obesity in 2013: Participation to the school screening program was satisfactory in 2013, but a bit less than in previous years (4220 children seen out of a total of approximately 6000 eligible ones). Less than maximal participation to the screening program can relate to different factors, e.g.; a trend for obese children to decline participation; lack of time of school nurses to complete the screening program due to competing duties at health centre level. Good organization by the school nurses and adequate facilities for screening are also important factors for a good conduct of the screening program.

Health for life : annual report of activities for the period January-December 2013

In Seychelles, cardiovascular diseases (CVD), notably stroke, ischemic heart disease and hypertensive heart disease has become the largest contributor of deaths (40%) in the entire population. CVD also results in a large burden of disability and also has subsequent social and economic impact. The Unit for Prevention and Control of Cardiovascular Diseases (UPCCD) provides leadership, expertise and capacity at national level for the surveillance, prevention and control of cardiovascular diseases through education, programs and input into policy.

Swiss behavioural surveillance system 1986-2008

Background: Second generation surveillance is a central feature of HIV/AIDS policy in Switzerland. Behavioural surveys in the general population, men having sex with men (MSM) and injecting drug users (IDU) have been regularly conducted since the early nineties. After peaking at 2144 cases in 1991, the number of new HIV cases notified to the Ministry of Health decreased in each subpopulation until 2000 (n=578) and then rose again to 735 in 2006. The recent increase is mainly due to MSM. Methods: In the general population, representative cross-sectional telephone surveys have been conducted 11 times since 1987. Surveys in convenience samples of MSM, recruited through gay newspapers and gay organisations, have been conducted 5 times since 1992. Surveys among IDU's attending needle exchange programmes have been conducted 5 times since 1993. Condom statistics, available since 1986, are included in the behavioural surveillance system. Results: In the general population aged 17-30, systematic condom use with casual partners in the last six months increased from 8.0% in 1987 to 75.8% in 2007. The proportion of MSM reporting anal intercourse with casual partners in the last 12 months increased from 61% in 1992 to 79% in 2007 (lowest value 56% in 1994) and unprotected anal intercourse with these partners increased from 14 % in 1992 to 24% in 2007 (lowest value 9% in 1994). The proportion of IDUs reporting borrowing used injection equipment decreased from 16.5% in 1993 to 8.9% in 2006. The ratio condoms released to retail/population aged 15-65 increased from 1.68 in 1986 to 3.8 in 2006. Conclusions: It has been possible to maintain a coherent behavioural surveillance system on a long-term basis, allowing for the monitoring of HIV prevention policy outcome and forseeing the development and distribution of new HIV cases in the population.

Lessons learned from developing a national NCD programme in low- and middle-income countries (Seychelles)

This paper identifies selected issues and lessons learned from the implementation of a national program of prevention and control of non-communicable diseases (NCD) during the past 20 years in the Seychelles, a small island state in the African region. As early as in 1989, population-based surveys demonstrated high levels of several cardiovascular risk factors, which prompted an organized response by the government. The early creation of a NCD unit within the Ministry of Health, coupled with cooperation with international partners, enabled incremental capacity building and coherent development of NCD programs and policy. Information campaigns and screening for hypertension and diabetes in work/public places raised awareness and rallied increasingly broad awareness and support to NCD prevention and control. A variety of interventions were organized for tobacco control and comprehensive tobacco control legislation was enacted in 2009 (including total bans on tobacco advertising and on smoking in all enclosed public and work places). A recent School Nutrition Policy prohibits the sale of soft drinks in schools. At primary health care level, guidelines were developed for the management of hypertension and diabetes (these conditions are managed in all health centers within a national health system); regular interactive education sessions were organized for groups of high risk patients ("heart health club"); and specialized "NCD nurses" were trained. Decreasing prevalence of smoking is evidence of success, but the raising "diabesity epidemic" calls for strengthened health care to high-risk patients and broader multisectoral policy to mould an environment conducive to healthy behaviors. Key components of NCD prevention and control in Seychelles include effective surveillance mechanisms supplemented by focused research; generating broad interest and consensus on the need for prevention and control of NCD; mobilizing leadership and commitment at all levels; involving local and international expertise; building on existing efforts; and seeking integrated, multi-disciplinary and multisectoral approaches.

Representativeness of terrestrial ecosystems in Chile's protected area system

Because protected areas are a major means of conservation, the extent to which ecosystems are represented under different protection regimes needs to be ascertained. A gap analysis approach was used to assess the representativeness of Chile's terrestrial ecosystems in differing kinds of protected areas. Terrestrial ecosystems were described in terms of potential vegetation, employing three protection scenarios. Scenario 1 was based exclusively on the Chilean National System of Protected Wild Areas (SNASPE). Scenario 2 included all types of public protected areas, namely SNASPE, nature sanctuaries and Ministry of National Heritage lands. Scenario 3 included all items in Scenario 2, but also included private protected areas and biodiversity priority sites. There is insufficient protection of terrestrial ecosystems under the Scenario 2. In addition to the low level of ecosystem protection provided by state protected areas (only 42 of the 127 terrestrial ecosystems had >10% of their area protected), 23 terrestrial ecosystems were identified as having no protection at the national level. Gaps in protection were concentrated in the North (both coastal and inland desertic scrub), Central (thorny scrub, thorny forests, sclerophyllous forests and deciduous coastal forests) and Austral (steppe ecosystems) regions of Chile. These gaps include ecosystems that are of global conservation importance.

Concomitant chemoradiotherapy versus acceleration of radiotherapy with or without concomitant chemotherapy in locally advanced head and neck carcinoma (GORTEC 99-02): an open-label phase 3 randomised trial.

BACKGROUND: Concomitant chemoradiotherapy and accelerated radiotherapy independently improve outcomes for patients with locally advanced head and neck squamous-cell carcinoma (HNSCC). We aimed to assess the efficacy and safety of a combination of these approaches. METHODS: In our open-label phase 3 randomised trial, we enrolled patients with locally advanced, stage III and IV (non-metastatic) HNSCC and an Eastern Cooperative Oncology Group performance status of 0-2. We randomly allocated patients centrally with a computer program (with centre, T stage, N stage, and localisation as minimisation factors) in a 1:1:1 ratio to receive conventional chemoradiotherapy (70 Gy in 7 weeks plus three cycles of 4 days' concomitant carboplatin-fluorouracil), accelerated radiotherapy-chemotherapy (70 Gy in 6 weeks plus two cycles of 5 days' concomitant carboplatin-fluorouracil), or very accelerated radiotherapy alone (64·8 Gy [1·8 Gy twice daily] in 3·5 weeks). The primary endpoint, progression-free survival (PFS), was assessed in all enrolled patients. This trial is completed. The trial is registered with ClinicalTrials.gov, number NCT00828386. FINDINGS: Between Feb 29, 2000, and May 9, 2007, we randomly allocated 279 patients to receive conventional chemoradiotherapy, 280 to accelerated radiotherapy-chemotherapy, and 281 to very accelerated radiotherapy. Median follow-up was 5·2 years (IQR 4·9-6·2); rates of chemotherapy and radiotherapy compliance were good in all groups. Accelerated radiotherapy-chemotherapy offered no PFS benefit compared with conventional chemoradiotherapy (HR 1·02, 95% CI 0·84-1·23; p=0·88) or very accelerated radiotherapy (0·83, 0·69-1·01; p=0·060); conventional chemoradiotherapy improved PFS compared with very accelerated radiotherapy (0·82, 0·67-0·99; p=0·041). 3-year PFS was 37·6% (95% CI 32·1-43·4) after conventional chemoradiotherapy, 34·1% (28·7-39·8) after accelerated radiotherapy-chemotherapy, and 32·2% (27·0-37·9) after very accelerated radiotherapy. More patients in the very accelerated radiotherapy group had RTOG grade 3-4 acute mucosal toxicity (226 [84%] of 268 patients) compared with accelerated radiotherapy-chemotherapy (205 [76%] of 271 patients) or conventional chemoradiotherapy (180 [69%] of 262; p=0·0001). 158 (60%) of 265 patients in the conventional chemoradiotherapy group, 176 (64%) of 276 patients in the accelerated radiotherapy-chemotherapy group, and 190 (70%) of 272 patients in the very accelerated radiotherapy group were intubated with feeding tubes during treatment (p=0·045). INTERPRETATION: Chemotherapy has a substantial treatment effect given concomitantly with radiotherapy and acceleration of radiotherapy cannot compensate for the absence of chemotherapy. We noted the most favourable outcomes for conventional chemoradiotherapy, suggesting that acceleration of radiotherapy is probably not beneficial in concomitant chemoradiotherapy schedules. FUNDING: French Ministry of Health.

School Choice and Student Screening in the Chilean Educational System: Who Chooses Whom?. The Case of the Catholic Education

The student´s screening made by schools corresponds to a regulatory mechanism for school inclusion and exclusion that normally overlaps the parental expectations of school choice. Based in "Parents survey 2006" data (n=188.073) generated by the Chilean Educational Ministry, this paper describe the parents reasons for choosing their children's school, and school´s criteria for screening students. It concludes that the catholic schools are the most selective institutions and usually exceed the capacity of parental choice. One of the reasons to select students would be the direct relationship between this practice and increasing the average score on the test of the Chilean Educational Quality Measurement System (SIMCE).

Correlates of frailty, prediction of functional decline and preventative approaches - selected results from the lausanne cohort 65+ (lc65+) study (Switzerland) (Lausanne) and the longitudinal urban cohort ageing study (Lucas) (Germany)

Overall introduction.- Longitudinal studies have been designed to investigate prospectively, from their beginning, the pathway leading from health to frailty and to disability. Knowledge about determinants of healthy ageing and health behaviour (resources) as well as risks of functional decline is required to propose appropriate preventative interventions. The functional status in older people is important considering clinical outcome in general, healthcare need and mortality. Part I.- Results and interventions from lucas (longitudinal urban cohort ageing study). Authors.- J. Anders, U. Dapp, L. Neumann, F. Pröfener, C. Minder, S. Golgert, A. Daubmann, K. Wegscheider,. W. von Renteln-Kruse Methods.- The LUCAS core project is a longitudinal cohort of urban community-dwelling people 60 years and older, recruited in 2000/2001. Further LUCAS projects are cross-sectional comparative and interventional studies (RCT). Results.- The emphasis will be on geriatric medical care in a population-based approach, discussing different forms of access, too. (Dapp et al. BMC Geriatrics 2012, 12:35; http://www.biomedcentral.com/1471-2318/12/35): - longitudinal data from the LUCAS urban cohort (n = 3.326) will be presented covering 10 years of observation, including the prediction of functional decline, need of nursing care, and mortality by using a self-filling screening tool; - interventions to prevent functional decline do focus on first (pre-clinical) signs of pre-frailty before entering the frailty-cascade ("Active Health Promotion in Old Age", "geriatric mobility centre") or disability ("home visits"). Conclusions.- The LUCAS research consortium was established to study particular aspects of functional competence, its changes with ageing, to detect pre-clinical signs of functional decline, and to address questions on how to maintain functional competence and to prevent adverse outcome in different settings. The multidimensional data base allows the exploration of several further questions. Gait performance was exmined by GAITRite®-System. Supported by the Federal Ministry for Education and Research (BMBF Funding No. 01ET1002A). Part II.- Selected results from the lausanne cohort 65+ (Lc65 + ) Study (Switzerland). Authors.- Prof Santos-Eggimann Brigitte, Dr Seematter-Bagnoud Laurence, Prof Büla Christophe, Dr Rochat Stéphane. Methods.- The Lc65+ cohort was launched in 2004 with the random selection of 3054 eligible individuals aged 65 to 70 (birth year 1934-1938) in the non-institutionalized population of Lausanne (Switzerland). Results.- Information is collected about life course social and health-related events, socio-economics, medical and psychosocial dimensions, lifestyle habits, limitations in activities of daily living, mobility impairments, and falls. Gait performance are objectively measured using body-fixed sensors. Frailty is assessed using Fried's frailty phenotype. Follow-up consists in annual self-completed questionnaires, as well as physical examination and physical and mental performance tests every three years. - Lausanne cohort 65+ (Lc65 + ): design and longitudinal outcomes. The baseline data collection was completed among 1422 participants in 2004-2005 through self-completed questionnaires, face-to-face interviews, physical examination and tests of mental and physical performances. Information about institutionalization, self-reported health services utilization, and death is also assessed. An additional random sample (n = 1525) of 65-70 years old subjects was recruited in 2009 (birth year 1939-1943). - lecture no 4: alcohol intake and gait parameters: prevalent and longitudinal association in the Lc65+ study. The association between alcohol intake and gait performance was investigated.

Addressing non-communicable diseases in the Seychelles: towards a comprehensive plan of action.

This article reviews the different steps taken during the past 20 years for the prevention and control of non-communicable diseases (NCDs) in the Seychelles. National surveys revealed high levels of several cardiovascular risk factors and prompted an organized response, starting with the creation of an NCD unit in the Ministry of Health. Information campaigns and nationwide activities raised awareness and rallied increasingly broad and high-level support. Significant policy was developed including comprehensive tobacco legislation and a School Nutrition Policy that bans soft drinks in schools. NCD guidelines were developed and specialized 'NCD nurses' were trained to complement doctors in district health centers. Decreasing smoking prevalence is evidence of success, but the raising so-called diabesity epidemic calls for an integrated multi-sector policy to mould an environment conducive to healthy behaviors. Essential components of these efforts include: effective surveillance mechanisms supplemented by focused research; generating broad interest and consensus; mobilizing leadership and commitment at all levels; involving local and international expertise; building on existing efforts; and seeking integrated, multi-disciplinary and multi-sector approaches.

Chemotherapy and radiotherapy in nasopharyngeal carcinoma: an update of the MAC-NPC meta-analysis.

BACKGROUND: A previous individual patient data meta-analysis by the Meta-Analysis of Chemotherapy in Nasopharynx Carcinoma (MAC-NPC) collaborative group to assess the addition of chemotherapy to radiotherapy showed that it improves overall survival in nasopharyngeal carcinoma. This benefit was restricted to patients receiving concomitant chemotherapy and radiotherapy. The aim of this study was to update the meta-analysis, include recent trials, and to analyse separately the benefit of concomitant plus adjuvant chemotherapy. METHODS: We searched PubMed, Web of Science, Cochrane Controlled Trials meta-register, ClinicalTrials.gov, and meeting proceedings to identify published or unpublished randomised trials assessing radiotherapy with or without chemotherapy in patients with non-metastatic nasopharyngeal carcinoma and obtained updated data for previously analysed studies. The primary endpoint of interest was overall survival. All trial results were combined and analysed using a fixed-effects model. The statistical analysis plan was pre-specified in a protocol. All data were analysed on an intention-to-treat basis. FINDINGS: We analysed data from 19 trials and 4806 patients. Median follow-up was 7·7 years (IQR 6·2-11·9). We found that the addition of chemotherapy to radiotherapy significantly improved overall survival (hazard ratio [HR] 0·79, 95% CI 0·73-0·86, p<0·0001; absolute benefit at 5 years 6·3%, 95% CI 3·5-9·1). The interaction between treatment effect (benefit of chemotherapy) on overall survival and the timing of chemotherapy was significant (p=0·01) in favour of concomitant plus adjuvant chemotherapy (HR 0·65, 0·56-0·76) and concomitant without adjuvant chemotherapy (0·80, 0·70-0·93) but not adjuvant chemotherapy alone (0·87, 0·68-1·12) or induction chemotherapy alone (0·96, 0·80-1·16). The benefit of the addition of chemotherapy was consistent for all endpoints analysed (all p<0·0001): progression-free survival (HR 0·75, 95% CI 0·69-0·81), locoregional control (0·73, 0·64-0·83), distant control (0·67, 0·59-0·75), and cancer mortality (0·76, 0·69-0·84). INTERPRETATION: Our results confirm that the addition of concomitant chemotherapy to radiotherapy significantly improves survival in patients with locoregionally advanced nasopharyngeal carcinoma. To our knowledge, this is the first analysis that examines the effect of concomitant chemotherapy with and without adjuvant chemotherapy as distinct groups. Further studies on the specific benefits of adjuvant chemotherapy after concomitant chemoradiotherapy are needed. FUNDING: French Ministry of Health (Programme d'actions intégrées de recherche VADS), Ligue Nationale Contre le Cancer, and Sanofi-Aventis.