Rate Of Future Change Research Articles

The effect of aldosterone and aldosterone blockade on the progression of chronic kidney disease: a randomized placebo-controlled clinical trial

The progression of chronic kidney disease (CKD) cannot be completely inhibited. We first explored factors contributing to CKD progression in patients with CKD in a prospective observational study. In the next phase, we focused on the effects of aldosterone, conducting a single-blinded placebo-controlled study using the selective mineralocorticoid receptor antagonist (MRA), eplerenone (25 mg/day). We recruited patients with CKD stage 2 and 3 whose plasma aldosterone concentration was above 15 ng/dL based on the prior data of a prospective observational study. In the CKD cohort study (n = 141), baseline plasma aldosterone concentration was identified as an independent contributory factor for the future rate of change in estimated glomerular filtration rate (eGFR). When the cut-off value for aldosterone was set at 14.5 ng/dL, the decline rate was significantly higher in patients with higher plasma aldosterone concentration (− 1.22 ± 0.39 ml/min/1.73 m2/year vs. 0.39 ± 0.40 ml/min/1.73 m2/year, p = 0.0047). In the final intervention study, in the eplerenone group, eGFR dropped at 6 months after the initiation of the study, and thereafter eGFR was maintained until the end of the study. At 24 months and 36 months, eGFR was significantly higher in the eplerenone group than in the placebo group. In conclusion, MRA can be an effective strategy in preventing CKD progression, especially in patients with high plasma aldosterone.

Changing to more efficient irrigation technologies in southern Alberta (Canada): an empirical analysis

Results from an irrigator survey in southern Alberta (Canada) indicate that more than half of irrigators changed irrigation technologies during the five-year period (crop years 2007/08–2011/12) and this potentially improved application efficiency. Changes were made from flood irrigation to wheel-move sprinklers to high- and then low-pressure pivot systems. The intended future rate of change is lower than that experienced over the previous five years. Important factors causing these changes were identified: reducing irrigation application, labour and energy inputs, and increasing crop yields and quality. Econometric modelling shows that irrigators who have commenced the process of adopting more efficient sprinklers are full-time farmers, operate their farm as corporations or partnerships, obtain information from extension agencies, and are more likely to upgrade their technologies in future.

Sleep Timing Moderates the Concurrent Sleep Duration–Body Mass Index Association in Low-Income Preschool-Age Children

ObjectiveTo test the independent main and moderating effects of sleep timing on body mass index (BMI) in low-income preschool-age children (M = 4.11 years, SD = 0.54). MethodsParents reported demographics and children's sleep concurrently, and a subset of children was followed longitudinally. Child height and weight were measured and BMI z score (BMIz) calculated. Regression analysis evaluated main effects of sleep timing (bedtime, weekday-to-weekend schedule shifting, napping) on concurrent BMIz and future rate of change, and their moderating effects on the sleep duration–BMIz association. ResultsOf 366 children (longitudinal subsample = 273), 50% were boys, 57% white, and 37% overweight or obese. Nocturnal sleep duration predicted concurrent BMIz, but not rate of change in BMIz over time. Bedtime was a moderator; the sleep duration–BMIz association was present only among children with bedtimes after 9 pm (β = −0.44; 95% confidence interval −0.69, −0.18). Schedule shifting was a moderator; the association between greater nocturnal sleep duration and lesser rate of future BMIz increase was present only among children with the most consistent sleep schedules (<45-minute delay in weekend bedtime: β = −0.12; 95% confidence interval −0.23, −0.01). Daytime napping did not moderate the nocturnal sleep duration–BMIz association. Covariates (sleep-disordered breathing, soda consumption, home chaos) did not explain these associations. ConclusionsAmong low-income preschoolers, sleep timing moderated the nocturnal sleep duration–BMIz association. Understanding how sleep timing and sleep duration relate to childhood obesity is important for prevention efforts.

Coral Reefs and Environmental Change: Adaptation to What?

SYNOPSIS. The present concern about future climate change and sea-level rise due to the enhanced greenhouse effect is put in the context of past changes. Best estimates of future changes are detailed, with an explanation of methods and uncertainties. Considerable progress is being made in regard to estimates of future sealevel rise and its regional variation, and towards predicting likely changes in the behaviour of the El Nino-Southern Oscillation (ENSO) and tropical cyclones. Changes in rainfall amounts and intensity, and in extremes of surface temperature are other critical climatic variables for coral reefs. Impacts on coral reefs will result from a combination of stresses arising from several aspects of global change, including stresses due to sea-level rise, extreme temperatures, human damage (from mining, dredging, fishing and tourism), and changes in salinity and pollutant concentrations (nutrients, pesticides, herbicides and particulates), and in ocean currents, ENSO, and storm damage. These may be exacerbated by any reduction in calcification rates of corals due to changes in ocean chemistry. In view of ongoing uncertainties regarding future rates of change, especially at the local scale, impact and adaptation assessments cannot provide unequivocal answers, but rather must be couched in terms of probabilities and risk. Reef communities which are presently under stress are likely to be particularly vulnerable. Both autonomous and managed (or planned) adaptations should be considered.