Developing an agro-forestry system for production of a commercial organic chicken flock focusing on profits on a 'Triple bottom Line'

In most modern free-range poultry systems birds do not fully utilise the range provided. Knowledge of the ancestral history of the domestic chicken, and research observations suggests benefits of agro-forestry systems for chickens. A commercial organic poultry agro-forestry system was developed for Sheepdrove Organic Farm, Berkshire, UK, affording the benefi ts of an agro-forestry system, whilst retaining commercial viability. Five avenues of highly diverse parallel hedges incorporating tree, shrub and herb species were planted. On-going monitoring of the system was put in place to evaluate its development and help assess the types of ‘profits’ the system delivers. Conventionally profits tend to be viewed purely in terms of economic gain. However, in an organic farming system more emphasis is placed on the intrinsic and sustainable qualities it has. Organic farming adopts a holistic approach to profit, viewing it in environmental, social and economic terms. The profits afforded by the system are discussed

Diagnosis of gestational diabetes

peer reviewedGestational diabetes (GD) is a common complication of pregnancy. Its prevalence depends on the strategy used for screening and the studied population. Pregnant women with GD are at increased risk for maternal and fetal complications. The relationship between maternal blood sugar and complications is linear, without a clear threshold defining GD. Therefore, the diagnostic criteria for GD have been the subject of several controversies since many years. The choice of the one-step or two-step method, the test to be used and the cut-off levels validated to define GD are still debated. The same is true regarding a universal versus a at-risk population screening. International experts have recently proposed the use of a one-step approach with a 2-hour oral glucose tolerance test for a universal screening. The need for a better harmonization regarding the diagnosis of GD is indeed mandatory. The present article discusses both the advantages and disadvantages of the various approaches used for GD screening.Le diabète gestationnel (DG) est une complication fréquente de la grossesse. Sa prévalence varie fortement selon la stratégie de dépistage utilisée ainsi que la population étudiée. Le DG expose à un haut risque de complications, à la fois sur le plan maternel et foetal. Ces complications sont en relation directe avec l’hyperglycémie maternelle, mais cette relation est linéaire, sans valeur-seuil clairement définie. Cela explique sans doute pourquoi il est difficile d’énoncer des critères indiscutables de diagnostic du DG. De nombreuses controverses existent depuis plusieurs années dans la littérature quant aux méthodes les plus adéquates pour dépister le DG. Les questions sont relatives à l’intérêt d’une méthode en une ou deux étapes, au test à utiliser en priorité, aux valeursseuil à considérer en fonction du test retenu ainsi qu’au choix d’un dépistage universel ou uniquement ciblé sur les femmes à risque. Un groupe d’experts internationaux a proposé récemment un dépistage universel du DG avec la réalisation d’une hyperglycémie provoquée par voie orale de 2 heures. Une harmonisation des approches diagnostiques du DG est, en effet, indispensable. Cette vignette clinique discute les avantages et désavantages des différentes stratégies proposées pour dépister le DG

Recent Advances in the Management of Diabetes Mellitus

peer reviewedThe recent epidemic of type 2 diabetes and the recognition that achieving specific glycemic goals can reduce morbidity have made the effective treatment of hyperglycemia a priority. The new therapeutic agents and the development of algorithms for the adjustment of therapy might contribute to an improved management of the disease. Moreover, type 2 diabetes is frequently associated with other co-morbidities (obesity, hypertension, dyslipidaemia, prothrombotic state). The appropriate management of patients with type 2 diabetes requires a global approach targeting each risk factor in order to reduce cardiovascular morbidity and mortality. This challenge represents a major public health issue. In type 1 diabetes patients, intensive therapy such as in the Diabetes Control and Complications Trial (DCCT) has been shown to obtain long-term beneficial effects on the reduction of the risk of progressive retinopathy, neuropathy and nephropathy and of the risk of cardiovascular disease. This benefit reinforces the original DCCT message that intensive therapy should be implemented as early as possible in people with type 1 diabetes. The recent development of new insulin analogues and the technical improvements of portable insulin pumps might contribute to obtain such a better metabolic control.RÉSUMÉ : L’augmentation d’incidence, quasi épidémique, du diabète de type 2 et la démonstration que l’obtention de bons taux glycémiques permettait de réduire la morbidité ont fait du traitement de l’hyperglycémie une priorité. Le développement de nouvelles classes thérapeutiques et la mise au point d’algorithmes de traitement contribuent à améliorer cette prise en charge. De plus, le diabète de type 2 est souvent associé à d’autres comorbidités (obésité, hypertension artérielle, dyslipidémies, état pro-thrombotique). La prise en charge du patient diabétique de type 2 requiert une approche globale visant à corriger chaque facteur de risque, ce qui permet de réduire substantiellement la mortalité cardio-vasculaire. Cette stratégie doit être considérée comme un objectif majeur de santé publique. Chez le sujet diabétique de type 1, un traitement intensif, comme celui imposé dans l’étude DCCT, permet d’obtenir une réduction prolongée du risque de survenue et de progression de la rétinopathie, de la neuropathie, de la néphropathie ainsi que du risque de maladie cardio-vasculaire. Ce bénéfice persistant renforce le message initial de l’étude DCCT qui avait démontré que le traitement intensif du diabète de type 1 devait être instauré dès le début de la maladie. Le développement récent des analogues de l’insuline et les améliorations techniques des pompes à insuline portables pourraient contribuer à atteindre un meilleur contrôle métabolique

Foci of Schistosomiasis mekongi, Northern Cambodia: II. Distribution of infection and morbidity.

In the province of Kracheh, in Northern Cambodia, a baseline epidemiological survey on Schistosoma mekongi was conducted along the Mekong River between December 1994 and April 1995. The results of household surveys of highly affected villages of the East and the West bank of the river and of school surveys in 20 primary schools are presented. In household surveys 1396 people were examined. An overall prevalence of infection of 49.3% was detected by a single stool examination with the Kato-Katz technique. The overall intensity of infection was 118.2 eggs per gram of stool (epg). There was no difference between the population of the east and west shore of the Mekong for prevalence (P = 0.3) or intensity (P = 0.9) of infection. Severe morbidity was very frequent. Hepatomegaly of the left lobe was detected in 48.7% of the population. Splenomegaly was seen in 26.8% of the study participants. Visible diverted circulation was found in 7.2% of the population, and ascites in 0.1%. Significantly more hepatomegaly (P = 0.001), splenomegaly (P = 0. 001) and patients with diverted circulation (P = 0.001) were present on the west bank of the Mekong. The age group of 10-14 years was most affected. The prevalence of infection in this group was 71.8% and 71.9% in the population of the West and East of the Mekong, respectively. The intensity of infection was 172.4 and 194.2 epg on the West and the East bank, respectively. In the peak age group hepatomegaly reached a prevalence of 88.1% on the west and 82.8% on the east bank. In the 20 schools 2391 children aged 6-16 years were examined. The overall prevalence of infection was 40.0%, ranging from 7.7% to 72.9% per school. The overalls mean intensity of infection was 110.1 epg (range by school: 26.7-187.5 epg). Both prevalence (P = 0.001) and intensity of infection (P = 0.001) were significantly higher in schools on the east side of the Mekong. Hepatomegaly (55.2%), splenomegaly (23.6%), diverted circulation (4. 1%), ascites (0.5%), reported blood (26.7%) and mucus (24.3%) were very frequent. Hepatomegaly (P = 0.001), splenomegaly (P = 0.001), diverted circulation (P = 0.001) and blood in stool (P = 0.001) were significantly more frequent in schools of the east side of the Mekong. Boys suffered more frequently from splenomegaly (P = 0.05), ascites (P = 0.05) and bloody stools (P = 0.004) than girls. No difference in sex was found for the prevalence and intensity of infection and prevalence of hepatomegaly. On the school level prevalence and intensity of infection were highly associated (r = 0. 93, P = 0.0001). The intensity of infection was significantly associated only with the prevalence of hepatomegaly (r = 0.44, P = 0. 05) and blood in stool (r = 0.40, P = 0.02). This comprehensive epidemiological study documents for the first time the public health importance of schistosomiasis mekongi in the Province of Kracheh, Northern Cambodia and points at key epidemiological features of this schistosome species, in particular the high level of morbidity associated with infection

Evaluation of sedimentary bacterial community dynamics and contamination assessment of lower Des Plaines River

Urban rivers often contain elevated concentrations of contaminants such as organic pollutants and heavy metals which can be amplified in lotic ecosystems receiving effluents from wastewater treatment plants (WWTP). However, the impact of WWTPs on the microbial parameters of the urban river sediments has not been well documented compared to urban surface water. Collecting sediment samples at five different locations over a 9,000 m transect during four sampling periods, we investigated spatiotemporal variations of microbial parameters in sediments of lower Des Plaines River; the largest effluent-dominated stream in the United States and the effects of sediment physicochemical properties on the variations were explored. We reported reduced microbial biomass, CFUs, and distinct bacterial communities at the WWTP outfall compared to other sites, indicating that WWTP effluents have the potential to moderate bacterial community structure. Seasonal variations in the sedimentary bacterial community structure were evident regardless of the spatial variations imposed by the effluents. Our community-level physiological profiling of the sedimentary bacterial community structure indicated that temperature was more important than water chemistry, whereas total microbial biomass by phospholipid phosphate analysis responded to the influences of both temperature and water chemistry. Metal concentrations showed values that fall within the “fair” to “very poor” range of biological conditions outlined by the Midwest Biodiversity Institute. We posit that the increased sediment metal loads select for metal-tolerant microorganisms that help to maintain microbial biomass. In the spring, sequencing of bacterial 16S rRNA genes revealed significant effects of effluent on bacterial community composition at the WWTP outfall, showing increases in abundances of Caldilinea, Candidatus, Allochromatium, Sulfuritalea, and Nitrospira sequences, linked to anthropogenic inputs from WWTP effluents. Given that human dependence on effluent-dominated ecosystems for water resources will increase with rapidly increasing urbanization, studies focusing on remediation and policy changes are dire to develop effective management of existing urban rivers

Haemodynamic changes during a squat test, pulsatile stress and indices of cardiovascular autonomic neuropathy in patients with long-duration type 1 diabetes.

AIM: Cardiovascular autonomic neuropathy (CAN) and pulsatile stress are considered to be independent cardiovascular risk factors. This study compared haemodynamic changes during an active orthostatic test in adult patients with type 1 diabetes (T1DM), using low versus high RR E/I ratios as a marker of CAN. METHODS: A total of 20 T1DM patients with low RR E/I ratios were compared with 20 T1DM patients with normal RR E/I ratios, matched for gender (1/1 ratio), age (mean: 46years) and diabetes duration (22-26years); 40 matched healthy subjects served as controls. All subjects were evaluated by continuous monitoring of arterial blood pressure (Finapres((R))) and heart rate using a standardized posture test (1-min standing, 1-min squatting, 1-min standing), thus allowing calculation of baroreflex gain. RESULTS: Compared with controls, T1DM patients showed lower RR E/I ratios, reduced baroreflex gains, higher pulsatile stress (pulse pressurexheart rate), greater squatting-induced pulse pressure rises, orthostatic hypotension and reduced reflex tachycardia. Compared with T1DM patients with preserved RR E/I ratios, T1DM patients with low RR E/I ratios showed reduced post-standing reflex tachycardia and baroreflex gain, and delayed blood pressure recovery, but no markers of increased pulsatile stress. Interestingly, decreased baroreflex gain was significantly associated with both pulsatile stress and microalbuminuria. CONCLUSION: The use of RR E/I ratios to separate T1DM patients allows the detection of other CAN markers during an orthostatic posture test, but with no significant differences in pulsatile stress or microalbuminuria. In this context, squatting-derived baroreflex gain appears to be more informative.Peer reviewe

Pulsatile Stress in Middle-Aged Patients With Type 1 or Type 2 Diabetes Compared With Nondiabetic Control Subjects

AbstractBackground: Arterial pulse pressure (PP) is considered as an independent cardiovascular risk factor. We compared PP during an active orthostatic test in middle-aged patients with type 1 diabetes and with type 2 diabetes, and corresponding nondiabetic controls. Methods: 40 patients with type 1 diabetes (mean age 50 years, diabetes duration 23 years, BMI 23.0 kg/m(2)) were compared to 40 non hypertensive patients with type 2 diabetes (respectively, 50 years, 8 years, 29.7 kg/m(2)). Patients taking antihypertensive agents or with renal insufficiency were excluded. All patients were evaluated with a continuous noninvasive arterial blood pressure monitoring (Finapres(R)) in standing (1 min), squatting (1 min) and again standing position (1 min). Patients with type 1 or type 2 diabetes were compared with two groups of 40 age-, sex- and BMI-matched healthy subjects. Results: Patients with type 1 diabetes and patients with type 2 diabetes showed significantly higher PP, heart rate (HR) and PPxHR double product (type 1 : 5263 vs 4121 mmHg/min, p=0.0004; type 2 : 5359 vs 4321 mmHg, p=0.0023) levels than corresponding controls. There were no significant differences between patients with type 1 diabetes and type 2 diabetes regarding PP (59 vs 58 mmHg), HR (89 vs 88/min), and PPxHR product (5263 vs 5359 mmHg/min). Conclusion: Patients with type 1 diabetes have comparable increased levels of peripheral PP, an indirect marker of arterial stiffness, and PPxHR, an index of pulsatile stress, as non-hypertensive patients with type 2 diabetes at similar mean age of 50 years