Alternative Systems of Inquiry for a Sustainable Agriculture

Summary Scientific investigation has long been dominated by positivism, which holds that an independent reality driven by immutable laws exists. Consequently, it should be possible to define sustainability in absolute terms. Advances in alternative paradigms, however, suggest: that any attempt precisely to define sustainability is flawed; that problems are always open to interpretation; that the resolution of one problem inevitably leads to the production of another ‘problem?situation’, as problems are endemic; that the key feature now becomes the capacity of actors continually to learn about these changing conditions, so that they can act rapidly to transform existing activities; and that systems of learning and inquiry are needed to seek the multiple perspectives of the various stakeholders and encourage wider involvement and action. These systems of inquiry are participatory in nature, and the information and action arising from them is judged by a framework of trustworthiness criteria. Resumé Les systèmes de renseignement alternatifs pour l'agriculture durable Depuis longtemps, l'enquête scientifique se trouve dominée par le positivisme, qui maintient l'existence d'une réalité indépendante mue par des lois ellesmêmes immuables. Par conséquent, il devrait être possible de définir la durabilité dans des termes absolus. Toutefois, les progrès au niveau des paradigmes alternatifs auraient tendance à suggérer, d'abord, que toute tentative de définir la durabilité de manière précise est à priori fausse; ensuite, que tout problème est capable d'interprétations différentes; que la solution d'un problème mène inéluctablement à la production de situations problématiques, étant donné que les problèmes sont endémiques; que le facteur primordial est désormais, la capacité des acteurs à apprendre continûment quelles sont ces situations changeantes, de sorte qu'ils puissent agir rapidement pour transformer les activités existantes; et que la mise en place de systèmes d'enquête et d'acquisition des connaissances sont nécessaires afin que l'on puisse interroger les nombreuses perspectives des divers participants et par là, encourager une participation plus grande et plus active. Ces systèmes d'enquète sont intrinsèquement participatoires, aussi l'information et l'action qui en découlent doiventelles être jugées dans le cadre d'un ensemble de critères de fiabilité. Resumen Sistemas alternativos de investigación para una agricultura sostenible La investigación científica ha sido dominada durante mucho tiempo por el positivismo, que mantiene la existencia de una realidad independiente manejada por leyes inmutables. Consecuentemente, debe ser posible definir el mantenimiento en términos absolutos. Sin embargo, el avance de paradigmas alternativos sugiere: a) cualquier intento de definir la sostenibilidad con precisión es defectuoso; b) los problemas siempre están abiertos a la interpretación; c) la solución de un problema inevitablemente lleva a la producción de otra situación problemática, ya que los problemas son endémicos; d) el rasgo clave es la capacidad de los protagonistas para aprender continuamente de estas condiciónes cambiantes, y poder actuar rápidamente en la transformación de las actividades existentes; y e) se necesitan sistemas de averiguación y aprendizaje para registrar las múltiples perspectivas de las varias partes interesadas y estimular un compromiso y una acción mas emplios. Estos sistemas de averiguación son de por sí participatorios, y la información y acción que de ellos surgen son juzgadas por un conjunto de criterios de fiabilidad

Experiments in Globalisation, Food Security and Land Use Decision Making

The globalisation of trade affects land use, food production and environmentsaround the world. In principle, globalisation can maximise productivity andefficiency if competition prompts specialisation on the basis of productive capacity.In reality, however, such specialisation is often constrained by practical or politicalbarriers, including those intended to ensure national or regional food security.These are likely to produce globally sub-optimal distributions of land uses. Bothoutcomes are subject to the responses of individual land managers to economicand environmental stimuli, and these responses are known to be variable and often(economically) irrational. We investigate the consequences of stylised food securitypolicies and globalisation of agricultural markets on land use patterns under avariety of modelled forms of land manager behaviour, including variation inproduction levels, tenacity, land use intensity and multi-functionality. We find that asystem entirely dedicated to regional food security is inferior to an entirelyglobalised system in terms of overall production levels, but that several forms ofbehaviour limit the difference between the two, and that variations in land useintensity and functionality can substantially increase the provision of food and otherecosystem services in both cases. We also find emergent behaviour that results inthe abandonment of productive land, the slowing of rates of land use change andthe fragmentation or, conversely, concentration of land uses following changes indemand levels

Performance of STAR Virtual Trials for Diabetic and Non-Diabetic in HTAA Intensive Care Unit

Critically ill patients are commonly linked to stress-induced hyperglycaemia which relates to insulin resistance and the risk of per-diagnosed with diabetes and other metabolic illnesses. Thus, it is essential to choose the best practice of blood glucose management in order to reduce morbidity and mortality rates in intensive care unit. This study is focusing on clinical data of 210 critically ill patients in Hospital Tengku Ampuan Afzan (HTAA), Kuantan who underwent Intensive Insulin Therapy which utilized a sliding scale method. Patients were identified in two main groups of diabetic (123) and non-diabetic (87) where stochastic model is generated to observe 90% confidence interval of insulin sensitivity. Blood glucose levels comparison between these two cohorts is conducted to observe the percentage of blood glucose levels within targeted band of 4.4-10.0 mmol/L. It is found that 82% of BG levels are within tar gated band for non-diabetes cohort under stochastic targeted (STAR) glycaemic control protocol. However, only 59.6% and 70.6% BG levels are within targeted band for diabetes cohort for insulin infusion therapy used in HTAA and STAR protocols. Thus, further investigation on blood glucose control protocol for diabetes patients is required to increase the reliability and efficacy of current practice despite of patient safety

Acute Coronary Artery Dissection: A Review of the Literature and Current Evidence

Acute coronary artery dissection is a rare, complex disease occurring particularly in young women without traditional cardiovascular risk factors. The pathophysiology and treatment are different from acute coronary syndrome caused by plaque rupture or erosion. Its clinical presentation may vary from unstable angina to sudden cardiac death. Hence, early detection is crucial to manage the dissection and reduce the mortality and morbidity rates. Most coronary dissections will heal spontaneously, and conservative treatment is recommended for uncomplicated cases. In the acute phase, primary percutaneous coronary intervention remains the reperfusion strategy of choice; however, in small- and medium-sized arteries with normalized blood flow, conservative treatment is beneficial. Medical therapy should be tailored to the individual depending on the underlying severity of the condition. Percutaneous coronary intervention should be performed by experienced operators, with the use of intravascular imaging, and preferably with on-site surgical back-up due to the increased risk of complications. The prognosis is favorable; however, patients have a high risk of recurrent dissections in other arteries several weeks after the first event, suggesting a general weakness of the arteries. In the recent past, optical coherence tomography has played an important role in the diagnosis of acute coronary artery dissection; however, its therapeutic potential is underestimated. We recommend that long-term clinical trials should be conducted to fully determine the long-term mortality and morbidity rates of these patients