Glucose-stimulated insulin response in pregnant sheep following acute suppression of plasma non-esterified fatty acid concentrations

BACKGROUND: Elevated non-esterified fatty acids (NEFA) concentrations in non-pregnant animals have been reported to decrease pancreatic responsiveness. As ovine gestation advances, maternal insulin concentrations fall and NEFA concentrations increase. Experiments were designed to examine if the pregnancy-associated rise in NEFA concentration is associated with a reduced pancreatic sensitivity to glucose in vivo. We investigated the possible relationship of NEFA concentrations in regulating maternal insulin concentrations during ovine pregnancy at three physiological states, non-pregnant, non-lactating (NPNL), 105 and 135 days gestational age (dGA, term 147+/- 3 days). METHODS: The plasma concentrations of insulin, growth hormone (GH) and ovine placental lactogen (oPL) were determined by double antibody radioimmunoassay. Insulin responsiveness to glucose was measured using bolus injection and hyperglycaemic clamp techniques in 15 non-pregnant, non-lactating ewes and in nine pregnant ewes at 105 dGA and near term at 135 dGA. Plasma samples were also collected for hormone determination. In addition to bolus injection glucose and insulin Area Under Curve calculations, the Mean Plasma Glucose Increment, Glucose Infusion Rate and Mean Plasma Insulin Increment and Area Under Curve were determined for the hyperglycaemic clamp procedures. Statistical analysis of data was conducted with Students t-tests, repeated measures ANOVA and 2-way ANOVA. RESULTS: Maternal growth hormone, placental lactogen and NEFA concentrations increased, while basal glucose and insulin concentrations declined with advancing gestation. At 135 dGA following bolus glucose injections, peak insulin concentrations and insulin area under curve (AUC) profiles were significantly reduced in pregnant ewes compared with NPNL control ewes (p < 0.001 and P < 0.001, respectively). In hyperglycaemic clamp studies, while maintaining glucose levels not different from NPNL ewes, pregnant ewes displayed significantly reduced insulin responses and a maintained depressed insulin secretion. In NPNL ewes, 105 and 135 dGA ewes, the Glucose Infusion Rate (GIR) was constant at approximately 5.8 mg glucose/kg/min during the last 40 minutes of the hyperglycaemic clamp and the Mean Plasma Insulin Increment (MPII) was only significantly (p < 0.001) greater in NPNL ewes. Following the clamp, NEFA concentrations were reduced by approximately 60% of pre-clamp levels in all groups, though a blunted and suppressed insulin response was maintained in 105 and 135 dGA ewes. CONCLUSIONS: Results suggest that despite an acute suppression of circulating NEFA concentrations during pregnancy, the associated steroids and hormones of pregnancy and possibly NEFA metabolism, may act to maintain a reduced insulin output, thereby sparing glucose for non-insulin dependent placental uptake and ultimately, fetal requirements

Innovative Education in Agroecology: Experiential Learning for a Sustainable Agriculture

The transdisciplinary field of agroecology provides a platform for experiential learning based on an expanded vision of research on sustainable farming and food systems and the application of results in creating effective learning landscapes for students. With increased recognition of limitations of fossil fuels, fresh water, and available farmland, educators are changing focus from strategies to reach maximum yields to those that feature resource use efficiency and resilience of production systems in a less benign climate. To help students deal with complexity and uncertainty and a wide range of biological and social dimensions of the food challenge, a whole-systems approach that involves life-cycle analysis and consideration of long-term impacts of systems is essential. Seven educational case studies in the Nordic Region and the U.S. Midwest demonstrate how educators can incorporate theory of the ecology of food systems with the action learning component needed to develop student potentials to create responsible change in society. New roles of agroecology instructors and students are described as they pursue a co-learning strategy to develop and apply technology to assure the productivity and security of future food system

Learning through exchange about organic agriculture - case of Europe and Australia

LEAFSE is the catch word for an innovative program of exchange study for young Australians and Europeans, with organic agriculture as the focal point of their Masters level studies. Two years ago, the European Commission and the Australian Department of Education, Science and Technology (DEST) came up with the call for applications for a pilot project to support international mobility of tertiary students between the two continents. The grand aims set for the exchange included providing students with an international outlook and a range of perspectives, preparing them for the global marketplace, enable their understanding and empathy for different cultures and traditions and foster exchange of information. A number of us with an interest and an already existing academic network in organic agriculture proposed LEAFSE - Learning through Exchange - Agriculture, Food Systems and Environment, a winning project, which was chosen as the single pilot project from a field of well over a dozen contenders. Within the broader theme of Agriculture, Food Systems and Environment, we named organic farming as the focal point of the exchange, and we were aware of the immense possibilities for learning through exchange inter-continentally in this field. Under this project, Master's level students from EU study for a semester at a partner university in Australia, and students from Australia study for a semester at a partner university in EU. The partners in the programme are, from Europe: • The Royal Veterinary and Agricultural University, Denmark • University of Wales, Aberystwyth, United Kingdom • Wageningen University and Research Centre, The Netherlands • University of Kassel, Witzenhausen, Germany, and from Australia: • University of Western Sydney, New South Wales • University of New England, New South Wales • University of Western Australia, Western Australia • University of Queensland, Queensland The project has an innovative but manageable framework for mobility of the students, a joint programme of study which incorporates many novel elements including holistic thinking, experiential and integrated learning and use of newer tools of communication technologies, and above all, a structure that fosters a high degree of inter-cultural understanding and network building. When completed, the pilot phase of the project would have enabled exchange of 36 students from each continent, nine from each participating institution. The respective government agencies provide the students with an adequate stipend to cover travel and living expenses for six months of study. The project has been running on target and the results of the first year of exchange have been more than impressive. This presentation will be a joint effort by the faculty and a number of participating students to demonstrate the cultural, agricultural, pedagogic, and practical lessons that have been learnt from this exchange in the field of organic farming. It will also highlight some of the challenges which need to be overcome in our efforts towards shaping sustainable agricultural and food systems which are cognizant of our respective environments

The risk of venous thromboembolism associated with peripherally inserted central catheters in ambulant cancer patients

Background Deep vein thrombosis (DVT) is a common complication of peripherally inserted central catheters (PICCs). PICCs are increasingly utilised in the management of cancer patients, a group which carries both additional risks for vascular thromboembolism as well as for complex morbidity. We analysed a cohort of cancer patients subjected to PICC insertion in a single cancer centre for the incidence of all-type vascular thromboembolism (VTE) and investigated relative risk factors. Methods In this clinical audit, the records of patients referred for PICC insertion in our centre in the period between 1/1/2011 and 1/4/2014 were retrospectively reviewed. The primary outcomes investigated were a) PICC-related deep vein thrombosis (PRDVT) and b) distant VTE (lower limb DVT and pulmonary embolism). 4Fr single lumen PICCs were placed in all patients. The Kaplan Meier method was used to study time from PICC insertion to PRDVT/VTE. Survival curves were compared using the log rank method. Logistic and Cox regression analyses were used to assess local, distant and combined endpoints. Results Four hundred ninety patients were included in the analysis of which 27 (5.5%) developed a PRDVT. Statistically significant risk factors for developing PRDVT in multivariate analysis included more than one attempt for insertion (OR 2.61, 95%CI: 1.12–6.05) and the use of fluoropyrimidine containing chemotherapy (OR 4.27, 95%CI 1.3–14.07). Twenty-six patients developed a distant VTE. Male gender was the only significant risk factor for distant VTE. When all-type VTE were considered together fluoropyrimidine containing chemotherapy (OR 4.54, 95% CI 1.63–12.61), male gender (OR 2.03, 95% CI 1.04–3.93) and white cell count (OR 1.12, 95% CI 1.00–1.26) were statistically significant as risk factors in this analysis. Conclusions This is a large study of VTE following PICC insertion in cancer patients which also looks at the rate of distant VTE. The observed PRDVT incidence is comparable with available literature. Fluoropyrimidine containing chemotherapy and more than one attempt for PICC insertion were independent predictors of PICC-associated VTE whilst the former remained an independent predictor of all-type VTE. Anticoagulation did not prevent thrombotic events in this cohort