Problematizing Complexities and Pedagogy in Teacher Education Programs: Enacting Knowledge in a Narrative Inquiry Teacher Education Discourse Community

This article describes how a cross-Canada cohort of teacher educators identified the benefits of participating in a narrative inquiry teacher education discourse community. The community enables conscious dialogue regarding the legitimacy of teacher knowledge, identification of personal and professional issues within educational contexts, and connections between local issues and global trends. Three themes are explored: (1) development of a non-hierarchical community, (2) unravelling of complexities in light of external pressures, and (3) personal ethical responses to current challenges. Teacher educator knowledge is deepened by providing a relational venue to attend to educational reform and programmatic complexity by grounding practices in collaborative experience

gathering mouse roots among the naukan and chukchi of the russian far east

The authors worked from 2014–2016, with 67 Naukan and Chukchi participants in six villages on the subject of "mouse roots," a category of edible plants, including tubers of five species, taken from caches of Microtus voles. Only eight out of 44 Chukchi and none of the Naukan respondents said that they still actively gather these foods. However, 43 out of 44 Chukchi and 21 out of 23 Naukan participants still possess specific knowledge of the process, for example: how to find nests, proper techniques and etiquette for gathering, storage, preparation, or botanical identity of species found. This reflects the rapid cultural changes that occurred during the Soviet period, including collectivization and consolidation of the population into larger villages. The maintenance of knowledge about resources that no longer play a large role in subsistence never-the-less aids in the resilience of local people to potential economic hardship and food insecurity. This particular relationship between humans, rodents, and plants provides an opportunity to examine the strengths and limitations for applying the concept of perspectivism in this cultural setting. These Chukotkan "mouse root" traditions show commonalities with similar practices among the neighboring Iñupiaq and Central Alaskan Yup'ik communities. Most notably, species gathered from rodent nests are similar on both sides of the Bering Strait as are rules for how to show proper respect to the animals when gathering. However, methods of preparation differ significantly between Chukotkan and Alaskan cultures

Naukan ethnobotany in post-Soviet times: lost edibles and new medicinals

Abstract Background This study focuses on health-related plant use among speakers of the critically endangered Naukan language (Inuit-Yupik-Unangan family) in the Russian Far East. The Naukan people were forced, in 1958, under Soviet consolidation, to move from their original settlement on Cape Dezhnev, leading to significant changes in spiritual worldview, subsistence, social structure, and language proficiency in the years that followed. Here, we focus on changes that elders report in their edible, medicinal, and spiritual uses of local plant species since their childhood. Methods The authors worked from 2014 to 2016 in the villages of Lavrentiya, Lorino, and Uelen, in the Chukotskiy district of the Chukotka autonomous region, directly adjacent to the Bering Strait. We conducted structured interviews, using an oral history approach, along with participant observation and collection of voucher specimens from the local arctic tundra. Those with Naukan names and uses represent 42 species in 25 families. Results Participants reported a decrease of 13% in the number of edible species that people currently harvest, from what they recall harvesting in their youth. On the other hand, the number of local species considered to be medicinal has actually increased by 225%. Current and past Naukan medicinal practices diverge in some notable ways from those of neighboring societies on the Alaskan side of the Bering Strait. Most of the spiritual significance of local plants species is remembered by only a few elders. Conclusions Naukan elders explained the large increase in use of medicinal plants by noting that their original concept of medicine emphasized prevention and that illnesses were often assigned a spiritual rather than physical cause. Increased integration with ethnic Russians after moving from Naukan led to the adoption not only of new plant uses, but also of an entirely different, more naturalistic way of viewing illness and treatment

Metformin in women with type 2 diabetes in pregnancy (MiTy): a multicentre, international, randomised, placebo-controlled trial

Background: Although metformin is increasingly being used in women with type 2 diabetes during pregnancy, little data exist on the benefits and harms of metformin use on pregnancy outcomes in these women. We aimed to investigate the effects of the addition of metformin to a standard regimen of insulin on neonatal morbidity and mortality in pregnant women with type 2 diabetes. Methods: In this prospective, multicentre, international, randomised, parallel, double-masked, placebo-controlled trial, women with type 2 diabetes during pregnancy were randomly assigned from 25 centres in Canada and four in Australia to receive either metformin 1000 mg twice daily or placebo, added to insulin. Randomisation was done via a web-based computerised randomisation service and stratified by centre and pre-pregnancy BMI (<30 kg/m2 or ≥30 kg/m2) in a ratio of 1:1 using random block sizes of 4 and 6. Women were eligible if they had type 2 diabetes, were on insulin, had a singleton viable pregnancy, and were between 6 and 22 weeks plus 6 days' gestation. Participants were asked to check their fasting blood glucose level before the first meal of the day, before the last meal of the day, and 2 h after each meal. Insulin doses were adjusted aiming for identical glucose targets (fasting glucose <5·3 mmol/L [95 mg/dL], 2-h postprandial glucose <6·7 mmol/L [120 mg/dL]). Study visits were done monthly and patients were seen every 1–4 weeks as was needed for standard clinical care. At study visits blood pressure and bodyweight were measured; patients were asked about tolerance to their pills, any hospitalisations, insulin doses, and severe hypoglycaemia events; and glucometer readings were downloaded to the central coordinating centre. Participants, caregivers, and outcome assessors were masked to the intervention. The primary outcome was a composite of fetal and neonatal outcomes, for which we calculated the relative risk and 95% CI between groups, stratifying by site and BMI using a log-binomial regression model with an intention-to-treat analysis. Secondary outcomes included several relevant maternal and neonatal outcomes. The trial was registered with ClinicalTrials.gov, NCT01353391. Findings: Between May 25, 2011, and Oct 11, 2018, we randomly assigned 502 women, 253 (50%) to metformin and 249 (50%) to placebo. Complete data were available for 233 (92%) participants in the metformin group and 240 (96%) in the placebo group for the primary outcome. We found no significant difference in the primary composite neonatal outcome between the two groups (40% vs 40%; p=0·86; relative risk [RR] 1·02 [0·83 to 1·26]). Compared with women in the placebo group, metformin-treated women achieved better glycaemic control (HbA1c at 34 weeks' gestation 41·0 mmol/mol [SD 8·5] vs 43·2 mmol/mol [–10]; 5·90% vs 6·10%; p=0·015; mean glucose 6·05 [0·93] vs 6·27 [0·90]; difference −0·2 [–0·4 to 0·0]), required less insulin (1·1 units per kg per day vs 1·5 units per kg per day; difference −0·4 [95% CI −0·5 to −0·2]; p<0·0001), gained less weight (7·2 kg vs 9·0 kg; difference −1·8 [–2·7 to −0·9]; p<0·0001) and had fewer caesarean births (125 [53%] of 234 in the metformin group vs 148 [63%] of 236 in the placebo group; relative risk [RR] 0·85 [95% CI 0·73 to 0·99]; p=0·031). We found no significant difference between the groups in hypertensive disorders (55 [23%] in the metformin group vs 56 [23%] in the placebo group; p=0·93; RR 0·99 [0·72 to 1·35]). Compared with those in the placebo group, metformin-exposed infants weighed less (mean birthweight 3156 g [SD 742] vs 3375 g [742]; difference −218 [–353 to −82]; p=0·002), fewer were above the 97th centile for birthweight (20 [9%] in the metformin group vs 34 [15%] in the placebo group; RR 0·58 [0·34 to 0·97]; p=0·041), fewer weighed 4000 g or more at birth (28 [12%] in the metformin group vs 44 [19%] in the placebo group; RR 0·65 [0·43 to 0·99]; p=0·046), and metformin-exposed infants had reduced adiposity measures (mean sum of skinfolds 16·0 mm [SD 5·0] vs 17·4 [6·2] mm; difference −1·41 [–2·6 to −0·2]; p=0·024; mean neonatal fat mass 13·2 [SD 6·2] vs 14·6 [5·0]; p=0·017). 30 (13%) infants in the metformin group and 15 (7%) in the placebo group were small for gestational age (RR 1·96 [1·10 to 3·64]; p=0·026). We found no significant difference in the cord c-peptide between groups (673 pmol/L [435] in the metformin group vs 758 pmol/L [595] in the placebo group; p=0·10; ratio of means 0·88 [0·72 to 1·02]). The most common adverse event reported was gastrointestinal (38 events in the metformin group and 38 events in the placebo group). Interpretation: We found several maternal glycaemic and neonatal adiposity benefits in the metformin group. Along with reduced maternal weight gain and insulin dosage and improved glycaemic control, the lower adiposity and infant size measurements resulted in fewer large infants but a higher proportion of small-for-gestational-age infants. Understanding the implications of these effects on infants will be important to properly advise patients who are contemplating the use of metformin during pregnancy.The trial was funded by the Canadian Institutes of Health Research, the Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada, and the Department of Medicine, University of Toronto, Toronto, ON, Canada