| 1. |
- Barazzoni, R, et al.
(författare)
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Carbohydrates and insulin resistance in clinical nutrition : Recommendations from the ESPEN expert group.
- 2017
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Ingår i: Clinical Nutrition. - : Elsevier BV. - 0261-5614 .- 1532-1983. ; 36:2, s. 355-363
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Tidskriftsartikel (refereegranskat)abstract
- Growing evidence underscores the important role of glycemic control in health and recovery from illness. Carbohydrate ingestion in the diet or administration in nutritional support is mandatory, but carbohydrate intake can adversely affect major body organs and tissues if resulting plasma glucose becomes too high, too low, or highly variable. Plasma glucose control is especially important for patients with conditions such as diabetes or metabolic stress resulting from critical illness or surgery. These patients are particularly in need of glycemic management to help lessen glycemic variability and its negative health consequences when nutritional support is administered. Here we report on recent findings and emerging trends in the field based on an ESPEN workshop held in Venice, Italy, 8-9 November 2015. Evidence was discussed on pathophysiology, clinical impact, and nutritional recommendations for carbohydrate utilization and management in nutritional support. The main conclusions were: a) excess glucose and fructose availability may exacerbate metabolic complications in skeletal muscle, adipose tissue, and liver and can result in negative clinical impact; b) low-glycemic index and high-fiber diets, including specialty products for nutritional support, may provide metabolic and clinical benefits in individuals with obesity, insulin resistance, and diabetes; c) in acute conditions such as surgery and critical illness, insulin resistance and elevated circulating glucose levels have a negative impact on patient outcomes and should be prevented through nutritional and/or pharmacological intervention. In such acute settings, efforts should be implemented towards defining optimal plasma glucose targets, avoiding excessive plasma glucose variability, and optimizing glucose control relative to nutritional support.
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| 2. |
- Hamann, M., et al.
(författare)
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Scenarios of Good Anthropocenes in southern Africa
- 2020
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Ingår i: Futures. - : Elsevier BV. - 0016-3287 .- 1873-6378. ; 118
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Tidskriftsartikel (refereegranskat)abstract
- In the rapidly changing and uncertain world of the Anthropocene, positive visions of the future could play a crucial role in catalysing deep social-ecological transformations to help guide humanity towards more sustainable and equitable futures. This paper presents the outcomes from a novel visioning process designed to elicit creative and inspirational future scenarios for southern Africa. The approach based scenario development on seeds of good Anthropocenes, i.e. existing initiatives or technologies that represent current, local-scale innovations for sustainability. A selection of seeds was used to create four distinct, positive visions in a participatory workshop process. Common themes that independently emerged in all four visions were i) decentralized governance and decision-making; ii) a strong emphasis on equity and empathy; iii) high levels of connectedness between people; and iv) a reinforced, respectful relationship with nature. The visions mainly differ in the extent of fusion between people and technology in everyday life, and how much nature plays a role in defining the human experience. The narratives presented here describe worlds that have undergone a more significant paradigm shift towards shared human values and stewardship of resources than is explored in most other ambient narratives for the region. These Good Anthropocene scenarios therefore demonstrate more radical, previously unimagined ways of thinking about sustainability futures on the African continent and beyond.
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| 4. |
- Bennett, Elena M., et al.
(författare)
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Bright spots : seeds of a good Anthropocene
- 2016
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Ingår i: Frontiers in Ecology and the Environment. - : Wiley. - 1540-9295 .- 1540-9309. ; 14:8, s. 441-448
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Tidskriftsartikel (refereegranskat)abstract
- The scale, rate, and intensity of humans' environmental impact has engendered broad discussion about how to find plausible pathways of development that hold the most promise for fostering a better future in the Anthropocene. However, the dominance of dystopian visions of irreversible environmental degradation and societal collapse, along with overly optimistic utopias and business-as-usual scenarios that lack insight and innovation, frustrate progress. Here, we present a novel approach to thinking about the future that builds on experiences drawn from a diversity of practices, worldviews, values, and regions that could accelerate the adoption of pathways to transformative change (change that goes beyond incremental improvements). Using an analysis of 100 initiatives, or seeds of a good Anthropocene, we find that emphasizing hopeful elements of existing practice offers the opportunity to: (1) understand the values and features that constitute a good Anthropocene, (2) determine the processes that lead to the emergence and growth of initiatives that fundamentally change human-environmental relationships, and (3) generate creative, bottom-up scenarios that feature well-articulated pathways toward a more positive future.
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| 5. |
- Fazey, Ioan, et al.
(författare)
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Transforming knowledge systems for life on Earth : Visions of future systems and how to get there
- 2020
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Ingår i: Energy Research & Social Science. - : Elsevier. - 2214-6296 .- 2214-6326. ; 70
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Tidskriftsartikel (refereegranskat)abstract
- Formalised knowledge systems, including universities and research institutes, are important for contemporary societies. They are, however, also arguably failing humanity when their impact is measured against the level of progress being made in stimulating the societal changes needed to address challenges like climate change. In this research we used a novel futures-oriented and participatory approach that asked what future envisioned knowledge systems might need to look like and how we might get there. Findings suggest that envisioned future systems will need to be much more collaborative, open, diverse, egalitarian, and able to work with values and systemic issues. They will also need to go beyond producing knowledge about our world to generating wisdom about how to act within it. To get to envisioned systems we will need to rapidly scale methodological innovations, connect innovators, and creatively accelerate learning about working with intractable challenges. We will also need to create new funding schemes, a global knowledge commons, and challenge deeply held assumptions. To genuinely be a creative force in supporting longevity of human and non-human life on our planet, the shift in knowledge systems will probably need to be at the scale of the enlightenment and speed of the scientific and technological revolution accompanying the second World War. This will require bold and strategic action from governments, scientists, civic society and sustained transformational intent.
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| 6. |
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| 7. |
- Preiser, JC, et al.
(författare)
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Glucose Control in the ICU: A Continuing Story
- 2016
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Ingår i: Journal of diabetes science and technology. - : SAGE Publications. - 1932-2968. ; 10:6, s. 1372-1381
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Tidskriftsartikel (refereegranskat)abstract
- In the present era of near-continuous glucose monitoring (CGM) and automated therapeutic closed-loop systems, measures of accuracy and of quality of glucose control need to be standardized for licensing authorities and to enable comparisons across studies and devices. Adequately powered, good quality, randomized, controlled studies are needed to assess the impact of different CGM devices on the quality of glucose control, workload, and costs. The additional effects of continuing glucose control on the general floor after the ICU stay also need to be investigated. Current algorithms need to be adapted and validated for CGM, including effects on glucose variability and workload. Improved collaboration within the industry needs to be encouraged because no single company produces all the necessary components for an automated closed-loop system. Combining glucose measurement with measurement of other variables in 1 sensor may help make this approach more financially viable.
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