Identity and Learning of Mathematics for Adult First Nations Students

The main goals of this article are twofold.  The first is to explore whether the General Education Development (GED) program has the potential to meet the academic requirements cited by the scholarship in the area of mathematics for First Nations upgrading programs. Secondly, this paper explores how the GED program influences identity in students who are several years behind mainstream mathematics programs and who are interested in securing their high school credential equivalencies. Research was carried out in one First Nations community through a study of 11 adult students working toward the writing of their GED mathematics examination. Ethnography was justified as a methodology as it allows all aspects of Indigenous Methodology requirements within its framework. The study used interviews relevant to the early life experiences of the participants and observations and artifacts throughout the GED program itself

Implementing the General Education Development (GED) Program in First Nations Communities: Struggles for Power

This paper describes an ethnographic case study of eleven First Nations adult learners in a Northern Ontario community attempting to earn secondary school equivalency through the General Education Development (GED) program. The paper maintains a focus on the power differentials at work in both the learners' prior educational endeavours and their experiences while working inside of the GED program. Based on the data, we argue that, despite appearances to the contrary, First Nations learners are subjected to a system of education that is failing to empower those learners to take advantage of educational opportunities that are available in mainstream Canadian society.Cet article décrit une étude ethnographique de cas auprès de onze apprenants adultes autochtones qui tentent, dans une communauté du Nord de l’Ontario, d’obtenir une équivalence d’études secondaires par des cours de formation générale (GED). Plus précisément, l’article porte sur les écarts systémiques de pouvoir qui entrent en ligne de compte tant dans les études préalables des apprenants que dans leurs expériences avec le programme GED. En s’appuyant sur les données, nous affirmons que, même si les apparences peuvent laisser supposer le contraire, les apprenants autochtones sont soumis à un système d’éducation qui ne réussit pas à les doter des compétences nécessaires pour saisir les possibilités éducatives offertes par la société canadienne

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570