Ethnoecology in pluricultural contexts: Theoretical and methodological contributions

This chapter is a contribution to current ethnoecology from a complex perspective, through a revision of the presuppositions that constitute its theoretical–methodological framework. The systemic approach of ecology understood as a science of synthesis based on relationships between the organism and its environment is discussed. The complex thinking applied to biocultural ecology, based on the relationships between the people and their environment is also discussed, including a reflection about the dissociation between nature and culture, and its conceptual implications. Ethnoecology as the study of local people knowledge system about their own relationships with their environment poses a discussion on sciences and ethnosciences, and its relationships with ecology and biocultural ecology. The reflection about the relationships between the observer and the observed people implies a discussion upon the researcher’s presence in his own research, and how he manages his thinking categories. The role of interviews as communication systems in which the generated knowledge is embodied in actions (discourses and behaviors) is revalued. Ultimately, three cases for the Rio de la Plata riverside (Buenos Aires province, Argentina) are presented. These cases illustrate how the local people identify and value the environmental changes in the pluricultural contexts of the urban areas, and how the obtained results have meaning in the theoretical–methodological framework developed. In conclusion, complex thinking allows us to construct adequate explanations for complex phenomena that ethnoecology tries to explain, and to avoid reductionisms.Fil: Hurrell, Julio Alberto. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Laboratorio de Etnobotánica y Botánica Aplicada; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; ArgentinaFil: Stampella, Pablo César. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Laboratorio de Etnobotánica y Botánica Aplicada; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; ArgentinaFil: Doumecq, María Belén. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Laboratorio de Etnobotánica y Botánica Aplicada; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; ArgentinaFil: Pochettino, María Lelia. Universidad Nacional de La Plata. Facultad de Ciencias Naturales y Museo. Laboratorio de Etnobotánica y Botánica Aplicada; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentin

The Canagliflozin and Renal Endpoints in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) Study Rationale, Design, and Baseline Characteristics

Background: People with diabetes and kidney disease have a high risk of cardiovascular events and progression of kidney disease. Sodium glucose co-transporter 2 inhibitors lower plasma glucose by reducing the uptake of filtered glucose in the kidney tubule, leading to increased urinary glucose excretion. They have been repeatedly shown to induce modest natriuresis and reduce HbA1c, blood pressure, weight, and albuminuria in patients with type 2 diabetes. However, the effects of these agents on kidney and cardiovascular events have not been extensively studied in patients with type 2 diabetes and established kidney disease. Methods: The Canagliflozin and Renal Endpoints in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial aims to compare the efficacy and safety of canagliflozin ­versus placebo at preventing clinically important kidney and cardiovascular outcomes in patients with diabetes and established kidney disease. CREDENCE is a randomized, double-blind, event-driven, placebo-controlled trial set in in 34 countries with a projected duration of â\u88¼5.5 years and enrolling 4,401 adults with type 2 diabetes, estimated glomerular filtration rate â\u89¥30 to 300 to â\u89¤5,000 mg/g). The study has 90% power to detect a 20% reduction in the risk of the primary outcome (α = 0.05), the composite of end-stage kidney disease, doubling of serum creatinine, and renal or cardiovascular death. Conclusion: CREDENCE will provide definitive evidence about the effects of canagliflozin on renal (and cardiovascular) outcomes in patients with type 2 diabetes and established kidney disease. Trial Registration: EudraCT number: 2013-004494-28; ClinicalTrials.gov identifier: NCT02065791