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101. Foreword: About ESS 2010

Author

Sarah Cornell and Cat Downy

Subjects
Open science, Engineering, Operations research, Process (engineering), business.industry, Biosphere, Context (language use), scientific responsibility, Anthroposphere, AIMES, Earth system science, Fundamental human needs, QUEST, interdisciplinarity, Knowledge integration, General Earth and Planetary Sciences, Engineering ethics, business, General Environmental Science
Abstract

ESS2010 was the first Open Science Conference of the international collaborative initiative AIMES, and was convened and organized by QUEST, the UK's directed research programme for Earth System science. The conference showcased advances in Earth system modelling, deploying observations and process understanding to develop more quantitative and predictive understanding of the interactions of the climate system, the biosphere and the anthroposphere. These tools extend understanding of the system dynamics of biogeochemical cycles, and give perspectives on the relationships between climate, ecosystems and human needs. As Earth system science is a global research endeavour, and its remit has important societal and policy implications, a recurrent theme in the conference was the responsibility of scientists working on knowledge integration in the global environmental change context.

Published
2011
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102. Organic Nitrogen in Precipitation: Real Problem or Sampling Artefact?

Author

A. Kirika, A. P. Rowland, John N. Cape, Sarah Cornell, Tim Jickells, and D. R. Wilson

Subjects
Biocide, Article Subject, Nitrogen, Rain, precipitation sampling, chemistry.chemical_element, lcsh:Medicine, lcsh:Technology, N deposition, General Biochemistry, Genetics and Molecular Biology, chemistry.chemical_compound, Nitrate, Chemical Precipitation, Ammonium, Precipitation, lcsh:Science, Ecosystem, General Environmental Science, Air Pollutants, Nitrates, Clinical Laboratory Techniques, lcsh:T, lcsh:R, Sampling (statistics), General Medicine, rain chemistry, Quaternary Ammonium Compounds, eutrophication, chemistry, Environmental chemistry, Composition (visual arts), lcsh:Q, Artifacts, Research Article
Abstract

Published observations of organic nitrogen (N) compounds in precipitation go back almost a century. Several different methods have been used to measure both the total and ionic concentrations of N. There is therefore some uncertainty as to whether reported �organic N� is real, or simply the result of uncertainties in chemical analyses or inadequate sampling methods. We found that the materials from which the collector was made (polypropylene, steel, or glass) had no significant effect on the composition of dissolved organic N (DON). The use of a biocide was found to be very important during sampling and storage of samples before analysis. We set up a network of seven collectors across the U.K., from the Cairngorms to Dorset, all operating to the same protocol, and including a biocide. Samples were analysed centrally, using proven methods. Over 6 months, organic N contributed about 20% to the total N in U.K. precipitation, but with a large variation across the country. This means that current estimates of wet deposited N to the U.K., which are based only on the ammonium and nitrate concentrations, are too small. Organic N is not an artefact, but a real problem that needs to be addressed.

Published
2001
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104. The Planet in 2050

Author

Jill Jager, Sarah Cornell, Brasseur, Guy P, Jager, Jill, LARESE, COSTANZA, Leemans, Rik, Katzenberger, John, Cornell, Sarah, Jacobsson, Torvald, Arabena, Kerry, Assadourian, Erik, Bandyopadhyay, Jayanta, Cherp, Aleh, Cesario, Manuel, Zoysa, Uchita de, Dong, Wenjie, Downy, Catherine, Falkenmark, Malin, Farley, Joshua, Hibbard, Kathy A., Hoffert, Martin, Johansson, Thomas B., Karlsson, Sylvia, Kaufman, Stefan, Kubiszewski, Ida, Marcotullio, Peter, Meybeck, Michel, Mohamed-Katerere, Jennifer, Mooney, Harold A, Ochola, Washington Odongo, Ojima, Dennis Shoji, Rosa, Luiz Pingueli, Richardson, Katherine, Ries, Tomas, Rockstrom, Johan, Running, Steven W., Sanchez-Rodriguez, Roberto, Scarborough, Vernon, Scholes, Mary, Seitzinger, Sybil P., Simon, Anthony, Simpson, Stephen, Singh, Simron Jit, Vaz, Sofia, Victor, Peter, Bhave, Ajay, Deshmukh, Anand, Timm, Jana, Ceausu, Silvia, Pan, Wayne J., Jewell, Jessica, Jill Jager, Sarah Cornell, Brasseur, Guy P, Jager, Jill, LARESE, COSTANZA, Leemans, Rik, Katzenberger, John, Cornell, Sarah, Jacobsson, Torvald, Arabena, Kerry, Assadourian, Erik, Bandyopadhyay, Jayanta, Cherp, Aleh, Cesario, Manuel, Zoysa, Uchita de, Dong, Wenjie, Downy, Catherine, Falkenmark, Malin, Farley, Joshua, Hibbard, Kathy A., Hoffert, Martin, Johansson, Thomas B., Karlsson, Sylvia, Kaufman, Stefan, Kubiszewski, Ida, Marcotullio, Peter, Meybeck, Michel, Mohamed-Katerere, Jennifer, Mooney, Harold A, Ochola, Washington Odongo, Ojima, Dennis Shoji, Rosa, Luiz Pingueli, Richardson, Katherine, Ries, Tomas, Rockstrom, Johan, Running, Steven W., Sanchez-Rodriguez, Roberto, Scarborough, Vernon, Scholes, Mary, Seitzinger, Sybil P., Simon, Anthony, Simpson, Stephen, Singh, Simron Jit, Vaz, Sofia, Victor, Peter, Bhave, Ajay, Deshmukh, Anand, Timm, Jana, Ceausu, Silvia, Pan, Wayne J., and Jewell, Jessica

Abstract

In 2050, the billions of people living on Earth have found a way to manage the planetary system effectively. Everyone has access to adequate food, shelter, and clean water. Human health is no longer considered outside of the health of the ecosystems in which people live. Ecological awareness is an integral part of education. People respond effectively to social and environmental hazards, and societies care for the most vulnerable amongst them. The economy, too, has shifted. Carbon dioxide management is under control, and energy efficiency is the norm. The remaining rainforests have been preserved. Coral reefs are recovering. Fish stocks are thriving. Is any of this really possible? How can our complex social and economic systems interact with a complex planetary system undergoing rapid change to create a future we all want? This book is a contextualised collation of ideas articulated by the 50 participants of the Planet 2050 workshop held in Lund in October 2008, as part of The Planet in 2050, an interdisciplinary Fast Track Initiative of the International Geosphere-Biosphere Programme. Participants were selected from academia and the sustainability practice community to give a wide-ranging, multi-cultural, trans-disciplinary set of perspectives. This collection explores four broad sectoral themes: energy and technologies; development, economies and culture; environment; and land use change. By doing so, this book emphasises the importance of a social dialogue on our collective future, and our responsibility to the Earth. It makes strong statements about what needs to happen to the global economy for a sustainable future and documents a new kind of scholarly discussion, engaging people from diverse knowledge communities in a spirit of exploration and reflexivity. The book provides a focus for dialogue and further study for postgraduates and researchers interested in global change as a multi-faceted, socio-environmental phenomenon, and as the book is written in an ac

Published
2011

105. Improved Understanding of the Earth System and Its Implications: Earth System Science 2010: Global Change, Climate and People: Edinburgh, United Kingdom, 10-13 May 2010

Author

Sarah Cornell and Catherine Downy

Subjects
Earth system science, Research program, Kingdom, Economy, Environmental protection, European research, Political science, General Earth and Planetary Sciences, Global change, China
Abstract

More than 200 people avoided the persistent ash cloud from Eyjafjallajokull volcano and met in the United Kingdom for Earth System Science 2010 (see http://earthsystemscience2010.org for more on the proceedings). This was the first Open Science Conference of the International Geosphere-Biosphere Programme's Analysis, Integration and Modeling of the Earth System (AIMES) project. It was convened by Quantifying and Understanding the Earth System (QUEST), a U.K. Natural Environment Research Council—funded research program with close strategic links with the international activities of AIMES. This connection meant that QUEST's established Anglophone and European research community was greatly expanded, with conference contributors from Brazil, Japan, India, and China.

Published
2010
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108. Atmospheric nitrogen deposition: revisiting the question of the invisible organic fraction

Author

Sarah Cornell

Subjects
Pollution, chemistry.chemical_classification, media_common.quotation_subject, atmospheric deposition, chemistry.chemical_element, air quality monitoring, Nitrogen, nitrogen, Aerosol, chemistry.chemical_compound, chemistry, Nitrate, Environmental chemistry, General Earth and Planetary Sciences, Environmental science, pollution, Organic matter, Ecosystem, Chemical composition, Air quality index, General Environmental Science, media_common
Abstract

Nitrogen-containing organic matter in rain and aerosol makes up a substantial proportion – 25–35% – of the total nitrogen in atmospheric deposition. Despite this quantitative significance, it is “invisible” in current policy; and existing global air quality and nitrogen deposition monitoring programmes routinely measure nitrate and ammonium but not the organic component. Although recent research, especially in Asia and Latin America, is helping to build up a global picture of organic nitrogen deposition, data sets are sparse and the chemical composition of the organic matter is relatively poorly characterised. As a result, its role in ecosystems and Earth system processes remains unclear. Organic nitrogen should now be included in initiatives dealing with nitrogen deposition and its management.

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110. Aiming higher to bend the curve of biodiversity loss

Author

Andy Purvis, Sarah Cornell, M. Grooten, M. Barrett, Robin Freeman, Neil D. Burgess, and Georgina M. Mace

Subjects
0301 basic medicine, Strategic planning, Global and Planetary Change, Window of opportunity, Convention on Biological Diversity, Ecology, Renewable Energy, Sustainability and the Environment, Geography, Planning and Development, Biodiversity, Plan (drawing), 15. Life on land, Management, Monitoring, Policy and Law, Urban Studies, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Action (philosophy), Business, Conservation biology, Environmental planning, 030217 neurology & neurosurgery, Nature and Landscape Conservation, Food Science, Global biodiversity
Abstract

The development of the post-2020 strategic plan for the Convention on Biological Diversity provides a vital window of opportunity to set out an ambitious plan of action to restore global biodiversity. The components of such a plan, including its goal, targets and some metrics, already exist and provide a roadmap to 2050.

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111. Safe and just operating spaces for regional social-ecological systems

Author

Elizabeth S. Jeffers, Anson W. Mackay, James G. Dyke, Ke Zhang, Terence P. Dawson, Sally Brown, John A. Dearing, Md. Sarwar Hossain, C. Patrick Doncaster, Felix Eigenbrod, Megan J. Cole, Guy M. Poppy, Björn Nykvist, Martina Flörke, Timothy M. Lenton, Sarah Cornell, Helmut Haberl, Rong Wang, Jacob Carstensen, Kate Raworth, and Peter G. Langdon

Subjects
Social wellbeing, Environmental thresholds, Geography, Planning and Development, Social Welfare, Management, Monitoring, Policy and Law, 12. Responsible consumption, Ecosystem services, 11. Sustainability, Regional planning, Planetary boundaries, Economics, Environmental degradation, Social policy, Sustainable development, Global and Planetary Change, Ecology, business.industry, Social-ecological systems, Environmental resource management, 1. No poverty, 15. Life on land, 6. Clean water, 13. Climate action, Sustainability, business, Regional boundaries
Abstract

This article is a contribution to the PAGES Focus 4 ‘Regional Integration’ theme. ABSTRACT: Humanity faces a major global challenge in achieving wellbeing for all while simultaneously ensuring that the biophysical processes and ecosystem services that underpin wellbeing are exploited within scientifically informed boundaries of sustainability. We propose a framework for defining the safe and just operating space for humanity that integrates social wellbeing into the original planetary boundaries concept (Rockström et al. 2009ab) for application at regional scales. We argue that such a framework can: (1) increase the policy impact of the boundaries concept as most governance takes place at the regional rather than planetary scale; (2) contribute to the understanding and dissemination of complexity thinking throughout governance and policy making; (3) act as a powerful metaphor and communication tool for regional equity and sustainability. We demonstrate the approach in two rural Chinese localities where we define the safe and just operating space that lies between an environmental ceiling and a social foundation from analysis of time series drawn from monitored and palaeoecological data and from social survey statistics respectively. Agricultural intensification has led to poverty reduction though not eradicated it but at the expense of environmental degradation. Currently the environmental ceiling is exceeded for degraded water quality at both localities even though the least well met social standards are for available piped water and sanitation. The conjunction of these social needs and environmental constraints around the issue of water access and quality illustrates the broader value of the safe and just operating space approach for sustainable development.

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112. Food in the Anthropocene: the EAT–Lancet Commission on healthy diets from sustainable food systems

Author

Fabrice DeClerck, Elizabeth L. Fox, Rami Zurayk, Sunita Narain, Jessica Fanzo, David Tilman, Sonja J. Vermeulen, Rina Agustina, Christopher J L Murray, Victoria Bignet, Johan Rockström, Amanda Wood, Max Troell, Therese Lindahl, Walter C. Willett, Anna Lartey, Corinna Hawkes, Lindiwe Majele Sibanda, Beatrice Crona, Michael Clark, Mario Herrero, Juan A Rivera, Brent Loken, Ashkan Afshin, Tara Garnett, K. Srinath Reddy, Wim de Vries, Marco Springmann, Sania Nishtar, Sudhvir Singh, Tim Lang, Abhishek Chaudhary, Line Gordon, Francesco Branca, Sarah Cornell, Shenggen Fan, and Malin Jonell

Subjects
Conservation of Natural Resources, Earth, Planet, Natural resource economics, 030204 cardiovascular system & hematology, Global Health, Food Supply, 12. Responsible consumption, 03 medical and health sciences, 0302 clinical medicine, 11. Sustainability, Sustainable agriculture, Animal source foods, Life Science, Humans, 030212 general & internal medicine, Duurzaam Bodemgebruik, Sustainable Soil Use, 2. Zero hunger, Sustainable development, WIMEK, Food security, business.industry, Agriculture, General Medicine, 15. Life on land, 6. Clean water, Environmental Systems Analysis, 13. Climate action, Milieusysteemanalyse, Sustainability, Food processing, Food systems, Diet, Healthy, business
Abstract

1. Unhealthy and unsustainably produced food poses a global risk to people and the planet. More than 820 million people have insufficient food and many more consume an unhealthy diet that contributes to premature death and morbidity. Moreover, global food production is the largest pressure caused by humans on Earth, threatening local ecosystems and the stability of the Earth system. 2. Current dietary trends, combined with projected population growth to about 10 billion by 2050, will exacerbate risks to people and planet. The global burden of non-communicable diseases is predicted to worsen and the effects of food production on greenhouse-gas emissions, nitrogen and phosphorus pollution, biodiversity loss, and water and land use will reduce the stability of the Earth system. 3. Transformation to healthy diets from sustainable food systems is necessary to achieve the UN Sustainable Development Goals and the Paris Agreement, and scientific targets for healthy diets and sustainable food production are needed to guide a Great Food Transformation. 4. Healthy diets have an appropriate caloric intake and consist of a diversity of plant-based foods, low amounts of animal source foods, unsaturated rather than saturated fats, and small amounts of refined grains, highly processed foods, and added sugars. 5. Transformation to healthy diets by 2050 will require substantial dietary shifts, including a greater than 50% reduction in global consumption of unhealthy foods, such as red meat and sugar, and a greater than 100% increase in consumption of healthy foods, such as nuts, fruits, vegetables, and legumes. However, the changes needed differ greatly by region. 6. Dietary changes from current diets to healthy diets are likely to substantially benefit human health, averting about 10·8–11·6 million deaths per year, a reduction of 19·0–23·6%. 7. With food production causing major global environmental risks, sustainable food production needs to operate within the safe operating space for food systems at all scales on Earth. Therefore, sustainable food production for about 10 billion people should use no additional land, safeguard existing biodiversity, reduce consumptive water use and manage water responsibly, substantially reduce nitrogen and phosphorus pollution, produce zero carbon dioxide emissions, and cause no further increase in methane and nitrous oxide emissions. 8. Transformation to sustainable food production by 2050 will require at least a 75% reduction of yield gaps, global redistribution of nitrogen and phosphorus fertiliser use, recycling of phosphorus, radical improvements in efficiency of fertiliser and water use, rapid implementation of agricultural mitigation options to reduce greenhouse-gas emissions, adoption of land management practices that shift agriculture from a carbon source to sink, and a fundamental shift in production priorities. 9. The scientific targets for healthy diets from sustainable food systems are intertwined with all UN Sustainable Development Goals. For example, achieving these targets will depend on providing high-quality primary health care that integrates family planning and education on healthy diets. These targets and the Sustainable Development Goals on freshwater, climate, land, oceans, and biodiversity will be achieved through strong commitment to global partnerships and actions. 10. Achieving healthy diets from sustainable food systems for everyone will require substantial shifts towards healthy dietary patterns, large reductions in food losses and waste, and major improvements in food production practices. This universal goal for all humans is within reach but will require adoption of scientific targets by all sectors to stimulate a range of actions from individuals and organisations working in all sectors and at all scales.

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113. Postoperative continuous positive airway pressure to prevent pneumonia, re-intubation, and death after major abdominal surgery (PRISM): a multicentre, open-label, randomised, phase 3 trial

Author

Rupert Pearse, Marco Ranieri, Tom Abbott, Mari-Liis Pakats, Edoardo Piervincenzi, Akshaykumar Patel, Brennan Kahan, Andrew Rhodes, Priyanthi Dias, Russell Hewson, Ib Jammer, Michelle Chew, Cesar Aldecoa, Reitze Rodseth, Bruce Biccard, Tim Stephens, Sara Payne, David Hepworth, Soeren Pischke, Joerund Asvall, John Hausken, Shaman Jhanji, Martin Rooms, Neil Flint, Dawn Hales, Tamas Szakmany, Andrew Leitch, Savino Spadaro, Davide Chiumello, Paul Johnston, Joyce Yeung, Guglielmo Tellan, Tonny Veenith, Josep Macmillan, Pierpaolo Terragni, Caroline Sander, Vidya Kasipandian, Tahania Ahmad, Aaron Lee, Marcello Tammaro, Danny McAuley, Simon Skene, Ravinder Vohra, Matt Wilson, Mark Edwards, Ewen Griffiths, Naomi Pritchard, Claudia Filippini, Tor Aasmundstad, Einar Aksnes, Lise-Merete Alpers, Andreas Barratt-Due, Anita Dahl, Linda Feldt, Elisa Figari, Eva Flåten, Karen Granheim, Minna Hagring, Håkon Haugaa, Gisle Kjoesen, Inge Klaevahaugen, Harald Lenz, Marianne Myhre, Hilde Orrem, Emily Stitt, Tor Inge Toennessen, Samuel Al-Kadhimi, Robert Anker, Mihaela Balint, Lauren Barraclough, Ethel Black, Matt Clayton, Leonora Conneely, Zara Edwards, Alex Eeles, Matthew Evans, Michelle Gerstman, Nicole Greenshields, Eleanor Harvey, Aoife Hegarty, Natalie Hester, Jenna Hutchinson, Ramanathan Kasivisvanathan, Helen Lawrence, Veronica Marsh, Laura Matthews, Francesca Mazzola, Jamie McCanny, Ben Morrison, Michelle O'Mahony, Ching Ling Pang, David Parkinson, Katrina Pirie, Ravishankar Rao Baikady, Louisa Shovel, Lorna Smith, Kate Tatham, Peter Thomas, Sophie Uren, Susanna Walker, Alasdair Wills, Prematie Andreou, Alex Howson, Jasmin Kaur, Adam Lewszuk, Esther Molina, Nirmalabaye Ramsamy, Emma Roberts, Vanessa Amaral, Salma Begum, Soliana Bekele, Richard Cashmore, Carmen Correia, Steven Dunkley, Maria Fernandez, Alexander Fowler, Amaia Garcia, Maria Della Giovampaola, Kathryn Greaves, Bethan Griffiths, Ryan Haines, Richard Haslop, Ying Hu, Sarah Hui, Marta Januszewska, Vasi Manon, Tim Martin, Shaun May, Annamaria Minicozzi, Edyta Niebrzegowska, Monica Oliveira, Katherine Pates, Filipa Santos, Tasnin Shahid, Paolo Simili, Alastair Somerville, Emily Subhedar, Ruzena Uddin, Sophie Walker, Yize Wan, Jan Whalley, Parjam Zolfaghari, Una Gunter, Gemma Hodkinson, Gwenllian Howe, Valentina Baratozzi, Giulia Casotto, Giulia Darai, Erica Ferrari, Giovanni Mistraletti, Valentina Palmaverdi, Stefano Furlani, Paolo Priani, Riccardo Ragazzi, Marco Salmaso, Marco Verri, Carlo Volta, Chris Nutt, Emma McKay, Orla O'Neill, Jaimin Patel, Katie Atterbury, Sarah Ballinger, Natalie Carling, Kaytie Ellis, Jo Gresty, Teresa Melody, Jade Monk, Chloe Norman, Eleanor Reeves, Julia Sampson, Peter Sutton, Marie Thomas, Amy Bamford, Colin Bergin, Ronald Carrera, Lauren Cooper, Liesl Despy, Karen Ellis, Emma Fellows, Stephanie Goundry, Samantha Harkett, Peter Ip, Tracy Mason, Christopher McGhee, Aisling McLaughlin, Aoife Neal, Martin Pope, Stephanie Porter, Hazel Smith, Catherine Snelson, Elaine Spruce, Ylenia Vigo, Arlo Whitehouse, Tony Whitehouse, Maria Donatiello, Sergio Gazzanelli, Mario Mezzapesa, Martina Savino, Giacomo Settesoldi, Gudrun Kunst, Sian Birch, Louise Greig, Harriet Noble, Evita Pappa, Bethany Penhaligon, Andrea Cossu, Leda Floris, Davide Piredda, Alberto Racca, Olof Brattstrom, Bente Heggelund, Magnus Flodberg, Sandra Månsson, Mamoona Ahmed, Jonathan Allen, Paula Bell, Roman Genetu, Julia Glennon, Janice Hanley, Katy Jenner, Summayyah Jogi, Parisa Mahjoob, Clare McGovern, Anthony Murphy, Roonak Nazari, Jacki Routledge, Trishna Uttamlal, Sinead Ward, Giorgio Iotti, Raffaella Picchioni, Silvia Poma, Paolo Navalesi, Andrea Bruni, Brunella De Leonardis, Eugenio Garofalo, Panna Patel, Carol McArthur, Karen Burns, Steven Peters, Giuseppe Foti, Serena Calcinati, Alice Grassi, Silvia Villa, John Berridge, Muthuraj Kanakaraj, Hazel Cahill, Greg Forshaw, Andy Gibson, Lia Grainger, Kate Howard, Katherine James, Zoe Murphy, Helen Sweeting, Rebecca Tait, Danielle Wilcock, David Yates, Sean Cope, Ashley Allan, Rebecca Betts, Sarah Cornell, Julie Sheriff, Lindsey Woods, Giacomo Grasselli, Matteo Brioni, Luigi Castagna, Richard von Rahden, Zane Farina, Samantha Green, Simphiwe Gumede, Chantal Rajah, Arisha Ramkillawan, Susan Moug, David Alcorn, Carol Dalton, Natalie Dickinson, Jennifer Edwards, Steven Henderson, Erin McIlveen, Richard Ramsaran, Joanne Bell, Lorna Fleming, Kathleen Monks, Jane Parker, Sean Stamper, Jo Stokes-Denson, Elisa Elías, Yessica Guerra, Jesus Rico-Feijoo, Carlos Kidel, Helder Filipe, Gretchelle Asis, Yvonne Gleeson, Alice Harvey, Christine Jackson, Margaret McNeil, Sara Mingo, Glykeria Pakou, Manuel Pinto, Stephen Wright, Maite Babio-Galan, David Buckley, Verity Calder, Ahmad Chishti, Joseph Cosgrove, Katherine Cullen, Leigh Dunn, Matthew Faulds, Jonathan Fortune, Matthew Gardner, Abigail Harrison, Carole Hays, Gerry Jones, Caroline Macfie, Iain Mccullagh, Ian Nesbitt, Suzanne O'Neil, Catherine Phoenix, Girish Rangaswamy, Craig Samson, Carmen Scott, Tara Shrestha, Rita Singh, Graham Soulsby, Jon Walton, Kimberley Zwiggelaar, Ceri Lynch, Heidi Clarke, Bethan Deacon, Helen Ivatt, Leanne Jones, Ahmed Latif, Shaun Oram, Chris Perman, Lisa Roche, Rowan Duys, Margot Flint, Kamal Bhagwan, Ettienne Coetzee, Ivan Joubert, Felipe Montoya-Pelaez, Pradeep Navsaria, Guy Picken, Owen Porrill, Grant Strathie, Thembinkosi Zungu, Sireesha Aluri, Simon Chau, Deborah Cooper, Mishell Cunningham, Allison Daniels, Susan Hope, Alice Nicholson, Laura Walker, Antonino Giarratano, Giuseppe Accurso, Santi Raineri, Giuseppe Tricoli, Richard Innes, Patricia Doble, Joanne Hutter, Corinne Pawley, Moira Tait, Mark Hamilton, Edward Andrade, Veronica Barnes, Claire Dalton, Carlos Delgado, Sarah Farnell-Ward, Helen Farrah, Geraldine Gray, Luisa Howlett, Gipsy Joseph, Monika Krupa, Susannah Leaver, Joao Macedo, Karen Maher, Johannes Mellinghoff, Rachel Oguntimehin, Joel Pereira, Frances Robinson, Christine Ryan, Nirav Shah, Paula Shirley, Alexandra Torborg, Thuli Biyase, Leanne Drummond, Belinda Kusel, Mbalenhle Mbuyisa, Sivuyisiwe Solala, Jenna Taylor, Adanma Ezihe-Ejiofor, Maame Aduse-Poku, Gary Colville, Louise Davies, Soo Kang, Alex Phillips, Justin Kirk-Bayley, Leigh Kelliher, Paula Carvelli, Gokce Daysal, Matthew Dickinson, Nancileigh Doyle, Christina Hughes, Laura Montague, Elizabeth Potter, Armorel Salberg, Sheena Sibug, Sinduja Sivarajan, Milo Thomson, Nichola Wakeford, Monica Rocco, Daniela Alampi, Daniel Conway, Richard Clark, Jashmin Maria, Fiona Pomeroy, Tanviha Quraishi, Abigail Williams, Srikanth Chukkambotla, Caroline Aherne, Donna Harrison-Briggs, Jill Fitchett, Stephen Duberley, Andrea Zanoni, Daniela Cardinale, Claudia Righi, Mark Blunt, Tracy Fuller, Ruth Hodgson, Melissa Rosbergen, Andrew Brennan, Louise Akeroyd, Victoria Boardman, Christopher Bull, Mike Carrick, Ian Chadderton, Sarah Cooper, Sarah Goellner, Laura Graham, Carl Ilyas, James King, Muhammad Laklouk, Tom Lawton, Christopher Macrow, Michael Munro, Adam Neep, Martin Northey, Victoria Peacock, Kate Pye, Lydia Radley, James Sira, Beth Smithson, Stuart Syddall, David Tooth, Thomas White, Sindre Hoel, Elin Aakre, Monica Bakke, Tone Hoivik, Arystarch Makowski, Harry Alcock, Sean Cardoso, Samantha Coetzee, Mary Everett, Mohamed Ibrahim, Christina Kouridaki, Vongayi Ogbeide, Elisabetta Bertellini, Valentina Bertolotti, Antonio Buono, Maria Fanigliulo, Ram Kumar, Nicole Richards, Alisha Allana, Samantha Bacciarelli, Helen Barker, Jessica De Bois, Isabel Bradley, Jennifer Crooks, Peter Daum, Alex Feben, Lizzie Gannon, Sarah Kipling, Andrew Peetamsingh, Charlotte Quamina, Sahiba Sethi, Harry Sivadhas, Kathryn Sollesta, Andrew Swain, Evalyn Tan, Joan Willis, Maggie Zou, Julius Cranshaw, Nina Barratt, Katie Bowman, Debbie Branney, Maria Letts, Sally Pitts, Christopher Day, Sarah Benyon, Sara Eddy, Adam Green, Anna Grice, Sinéad Kelly, Daisy Mackle, Victor Mariano, Linda Park, Pauline Sibley, William Spencer, Elena Bignami, Valentina Bellini, Francesco Forfori, Maria Curci, Alessandra Leo, Matthew Jackson, Jennifer Awolesi, Sheila Hodgkinson, Alissa Kent, Dee Leonard, Claire Stapleton, Clare Tibke, Farhad Alexander-Sefre, Lorraine Campey, Kathryn Hall, Jennifer Spimpolo, Malin Nilsson, Helen Didriksson, Emma Hamilton, Mandy Carnahan, Chris Mowatt, Jo Stickley, Antonio Corcione, Giuseppe Rossi, Hege Fladby, Nina Andersen, Gunhild Bjoernå, Mads Reite, Linda Roertveit, Philipp Seidel, Glenn Arnold, Melissa Benavente, Anjalee Chattersingh, Nyasha Chironga, Gillian Hornzee, Joyce Kibaru, Ihtisham Malik, Laura McLeavy, Byiravey Pathmanathan, Florence Prior, Rhea Strudwick, Marios Vezyrgiannis, Aneeta Sinha, Sheeba Babu, Bisanth Batuwitage, Zoe Daly, Katharine Ellinor, Elizabeth Hawes, Ann Holmes, Karen Hudson, Jeremy Nightingale, Alison Le Poidevin, Lindsey Roberts, Agnieszka Kubisz-Pudelko, Joanna Allison, Lucy Pippard, Vincent Hamlyn, Angie Organ, Thaventhran Prabhahar, Hayley Bridger, Lee Dvorkin, Vitul Manhas, Rachel Vincent, Shondipon Laha, Terri-Louise Cromie, Donna Doyle, Rachel Howarth, Mark Verlander, Ailsa Watt, Alexandra Williams, Massimo Antonelli, Salvatore Cutuli, Luca Montini, Juan Graterol, Benita Adams, Sarah Bean, Karen Burt, Fiona Hammonds, Suyogi Jigajinni, Laura Fulton, Stephen Kinghorn, Jost Mullenheim, Kirsty Baillie, Martyn Cain, Kerry Colling, Carol Hannaway, Ruggero Corso, Morena Calli, Carlos Ferrando, Esther Romero, Pablo Jorge-Monjas, María Soria-García, José Gómez-Herreras, Rita Rodríguez-Jiménez, Blanca De Prada-Martín, Pearse, Rupert, Ranieri, Marco, Abbott, Tom, Pakats, Mari-Lii, Piervincenzi, Edoardo, Patel, Akshaykumar, Kahan, Brennan, Rhodes, Andrew, Dias, Priyanthi, Hewson, Russell, Jammer, Ib, Chew, Michelle, Aldecoa, Cesar, Rodseth, Reitze, Biccard, Bruce, Stephens, Tim, Payne, Sara, Hepworth, David, Pischke, Soeren, Asvall, Joerund, Hausken, John, Jhanji, Shaman, Rooms, Martin, Flint, Neil, Hales, Dawn, Szakmany, Tama, Leitch, Andrew, Spadaro, Savino, Chiumello, Davide, Johnston, Paul, Yeung, Joyce, Tellan, Guglielmo, Veenith, Tonny, Macmillan, Josep, Terragni, Pierpaolo, Sander, Caroline, Kasipandian, Vidya, Ahmad, Tahania, Lee, Aaron, Tammaro, Marcello, McAuley, Danny, Skene, Simon, Vohra, Ravinder, Wilson, Matt, Edwards, Mark, Griffiths, Ewen, Pritchard, Naomi, Filippini, Claudia, Aasmundstad, Tor, Aksnes, Einar, Alpers, Lise-Merete, Barratt-Due, Andrea, Dahl, Anita, Feldt, Linda, Figari, Elisa, Flåten, Eva, Granheim, Karen, Hagring, Minna, Haugaa, Håkon, Kjoesen, Gisle, Klaevahaugen, Inge, Lenz, Harald, Myhre, Marianne, Orrem, Hilde, Stitt, Emily, Toennessen, Tor Inge, Al-Kadhimi, Samuel, Anker, Robert, Balint, Mihaela, Barraclough, Lauren, Black, Ethel, Clayton, Matt, Conneely, Leonora, Edwards, Zara, Eeles, Alex, Evans, Matthew, Gerstman, Michelle, Greenshields, Nicole, Harvey, Eleanor, Hegarty, Aoife, Hester, Natalie, Hutchinson, Jenna, Kasivisvanathan, Ramanathan, Lawrence, Helen, Marsh, Veronica, Matthews, Laura, Mazzola, Francesca, McCanny, Jamie, Morrison, Ben, O'Mahony, Michelle, Pang, Ching Ling, Parkinson, David, Pirie, Katrina, Rao Baikady, Ravishankar, Shovel, Louisa, Smith, Lorna, Tatham, Kate, Thomas, Peter, Uren, Sophie, Walker, Susanna, Wills, Alasdair, Andreou, Prematie, Howson, Alex, Kaur, Jasmin, Lewszuk, Adam, Molina, Esther, Ramsamy, Nirmalabaye, Roberts, Emma, Amaral, Vanessa, Begum, Salma, Bekele, Soliana, Cashmore, Richard, Correia, Carmen, Dunkley, Steven, Fernandez, Maria, Fowler, Alexander, Garcia, Amaia, Della Giovampaola, Maria, Greaves, Kathryn, Griffiths, Bethan, Haines, Ryan, Haslop, Richard, Hu, Ying, Hui, Sarah, Januszewska, Marta, Manon, Vasi, Martin, Tim, May, Shaun, Minicozzi, Annamaria, Niebrzegowska, Edyta, Oliveira, Monica, Pates, Katherine, Santos, Filipa, Shahid, Tasnin, Simili, Paolo, Somerville, Alastair, Subhedar, Emily, Uddin, Ruzena, Walker, Sophie, Wan, Yize, Whalley, Jan, Zolfaghari, Parjam, Gunter, Una, Hodkinson, Gemma, Howe, Gwenllian, Baratozzi, Valentina, Casotto, Giulia, Darai, Giulia, Ferrari, Erica, Mistraletti, Giovanni, Palmaverdi, Valentina, Furlani, Stefano, Priani, Paolo, Ragazzi, Riccardo, Salmaso, Marco, Verri, Marco, Volta, Carlo, Nutt, Chri, McKay, Emma, O'Neill, Orla, Patel, Jaimin, Atterbury, Katie, Ballinger, Sarah, Carling, Natalie, Ellis, Kaytie, Gresty, Jo, Melody, Teresa, Monk, Jade, Norman, Chloe, Reeves, Eleanor, Sampson, Julia, Sutton, Peter, Thomas, Marie, Bamford, Amy, Bergin, Colin, Carrera, Ronald, Cooper, Lauren, Despy, Liesl, Ellis, Karen, Fellows, Emma, Goundry, Stephanie, Harkett, Samantha, Ip, Peter, Mason, Tracy, McGhee, Christopher, McLaughlin, Aisling, Neal, Aoife, Pope, Martin, Porter, Stephanie, Smith, Hazel, Snelson, Catherine, Spruce, Elaine, Vigo, Ylenia, Whitehouse, Arlo, Whitehouse, Tony, Donatiello, Maria, Gazzanelli, Sergio, Mezzapesa, Mario, Savino, Martina, Settesoldi, Giacomo, Kunst, Gudrun, Birch, Sian, Greig, Louise, Noble, Harriet, Pappa, Evita, Penhaligon, Bethany, Cossu, Andrea, Floris, Leda, Piredda, Davide, Racca, Alberto, Brattstrom, Olof, Heggelund, Bente, Flodberg, Magnu, Månsson, Sandra, Ahmed, Mamoona, Allen, Jonathan, Bell, Paula, Genetu, Roman, Glennon, Julia, Hanley, Janice, Jenner, Katy, Jogi, Summayyah, Mahjoob, Parisa, McGovern, Clare, Murphy, Anthony, Nazari, Roonak, Routledge, Jacki, Uttamlal, Trishna, Ward, Sinead, Iotti, Giorgio, Picchioni, Raffaella, Poma, Silvia, Navalesi, Paolo, Bruni, Andrea, De Leonardis, Brunella, Garofalo, Eugenio, Patel, Panna, McArthur, Carol, Burns, Karen, Peters, Steven, Foti, Giuseppe, Calcinati, Serena, Grassi, Alice, Villa, Silvia, Berridge, John, Kanakaraj, Muthuraj, Cahill, Hazel, Forshaw, Greg, Gibson, Andy, Grainger, Lia, Howard, Kate, James, Katherine, Murphy, Zoe, Sweeting, Helen, Tait, Rebecca, Wilcock, Danielle, Yates, David, Cope, Sean, Allan, Ashley, Betts, Rebecca, Cornell, Sarah, Sheriff, Julie, Woods, Lindsey, Grasselli, Giacomo, Brioni, Matteo, Castagna, Luigi, von Rahden, Richard, Farina, Zane, Green, Samantha, Gumede, Simphiwe, Rajah, Chantal, Ramkillawan, Arisha, Moug, Susan, Alcorn, David, Dalton, Carol, Dickinson, Natalie, Edwards, Jennifer, Henderson, Steven, McIlveen, Erin, Ramsaran, Richard, Bell, Joanne, Fleming, Lorna, Monks, Kathleen, Parker, Jane, Stamper, Sean, Stokes-Denson, Jo, Elías, Elisa, Guerra, Yessica, Rico-Feijoo, Jesu, Kidel, Carlo, Filipe, Helder, Asis, Gretchelle, Gleeson, Yvonne, Harvey, Alice, Jackson, Christine, McNeil, Margaret, Mingo, Sara, Pakou, Glykeria, Pinto, Manuel, Wright, Stephen, Babio-Galan, Maite, Buckley, David, Calder, Verity, Chishti, Ahmad, Cosgrove, Joseph, Cullen, Katherine, Dunn, Leigh, Faulds, Matthew, Fortune, Jonathan, Gardner, Matthew, Harrison, Abigail, Hays, Carole, Jones, Gerry, Macfie, Caroline, Mccullagh, Iain, Nesbitt, Ian, O'Neil, Suzanne, Phoenix, Catherine, Rangaswamy, Girish, Samson, Craig, Scott, Carmen, Shrestha, Tara, Singh, Rita, Soulsby, Graham, Walton, Jon, Zwiggelaar, Kimberley, Lynch, Ceri, Clarke, Heidi, Deacon, Bethan, Ivatt, Helen, Jones, Leanne, Latif, Ahmed, Oram, Shaun, Perman, Chri, Roche, Lisa, Duys, Rowan, Flint, Margot, Bhagwan, Kamal, Coetzee, Ettienne, Joubert, Ivan, Montoya-Pelaez, Felipe, Navsaria, Pradeep, Picken, Guy, Porrill, Owen, Strathie, Grant, Zungu, Thembinkosi, Aluri, Sireesha, Chau, Simon, Cooper, Deborah, Cunningham, Mishell, Daniels, Allison, Hope, Susan, Nicholson, Alice, Walker, Laura, Giarratano, Antonino, Accurso, Giuseppe, Raineri, Santi, Tricoli, Giuseppe, Innes, Richard, Doble, Patricia, Hutter, Joanne, Pawley, Corinne, Tait, Moira, Hamilton, Mark, Andrade, Edward, Barnes, Veronica, Dalton, Claire, Delgado, Carlo, Farnell-Ward, Sarah, Farrah, Helen, Gray, Geraldine, Howlett, Luisa, Joseph, Gipsy, Krupa, Monika, Leaver, Susannah, Macedo, Joao, Maher, Karen, Mellinghoff, Johanne, Oguntimehin, Rachel, Pereira, Joel, Robinson, France, Ryan, Christine, Shah, Nirav, Shirley, Paula, Torborg, Alexandra, Biyase, Thuli, Drummond, Leanne, Kusel, Belinda, Mbuyisa, Mbalenhle, Solala, Sivuyisiwe, Taylor, Jenna, Ezihe-Ejiofor, Adanma, Aduse-Poku, Maame, Colville, Gary, Davies, Louise, Kang, Soo, Phillips, Alex, Kirk-Bayley, Justin, Kelliher, Leigh, Carvelli, Paula, Daysal, Gokce, Dickinson, Matthew, Doyle, Nancileigh, Hughes, Christina, Montague, Laura, Potter, Elizabeth, Salberg, Armorel, Sibug, Sheena, Sivarajan, Sinduja, Thomson, Milo, Wakeford, Nichola, Rocco, Monica, Alampi, Daniela, Conway, Daniel, Clark, Richard, Maria, Jashmin, Pomeroy, Fiona, Quraishi, Tanviha, Williams, Abigail, Chukkambotla, Srikanth, Aherne, Caroline, Harrison-Briggs, Donna, Fitchett, Jill, Duberley, Stephen, Zanoni, Andrea, Cardinale, Daniela, Righi, Claudia, Blunt, Mark, Fuller, Tracy, Hodgson, Ruth, Rosbergen, Melissa, Brennan, Andrew, Akeroyd, Louise, Boardman, Victoria, Bull, Christopher, Carrick, Mike, Chadderton, Ian, Cooper, Sarah, Goellner, Sarah, Graham, Laura, Ilyas, Carl, King, Jame, Laklouk, Muhammad, Lawton, Tom, Macrow, Christopher, Munro, Michael, Neep, Adam, Northey, Martin, Peacock, Victoria, Pye, Kate, Radley, Lydia, Sira, Jame, Smithson, Beth, Syddall, Stuart, Tooth, David, White, Thoma, Hoel, Sindre, Aakre, Elin, Bakke, Monica, Hoivik, Tone, Makowski, Arystarch, Alcock, Harry, Cardoso, Sean, Coetzee, Samantha, Everett, Mary, Ibrahim, Mohamed, Kouridaki, Christina, Ogbeide, Vongayi, Bertellini, Elisabetta, Bertolotti, Valentina, Buono, Antonio, Fanigliulo, Maria, Kumar, Ram, Richards, Nicole, Allana, Alisha, Bacciarelli, Samantha, Barker, Helen, De Bois, Jessica, Bradley, Isabel, Crooks, Jennifer, Daum, Peter, Feben, Alex, Gannon, Lizzie, Kipling, Sarah, Peetamsingh, Andrew, Quamina, Charlotte, Sethi, Sahiba, Sivadhas, Harry, Sollesta, Kathryn, Swain, Andrew, Tan, Evalyn, Willis, Joan, Zou, Maggie, Cranshaw, Juliu, Barratt, Nina, Bowman, Katie, Branney, Debbie, Letts, Maria, Pitts, Sally, Day, Christopher, Benyon, Sarah, Eddy, Sara, Green, Adam, Grice, Anna, Kelly, Sinéad, Mackle, Daisy, Mariano, Victor, Park, Linda, Sibley, Pauline, Spencer, William, Bignami, Elena, Bellini, Valentina, Forfori, Francesco, Curci, Maria, Leo, Alessandra, Jackson, Matthew, Awolesi, Jennifer, Hodgkinson, Sheila, Kent, Alissa, Leonard, Dee, Stapleton, Claire, Tibke, Clare, Alexander-Sefre, Farhad, Campey, Lorraine, Hall, Kathryn, Spimpolo, Jennifer, Nilsson, Malin, Didriksson, Helen, Hamilton, Emma, Carnahan, Mandy, Mowatt, Chri, Stickley, Jo, Corcione, Antonio, Rossi, Giuseppe, Fladby, Hege, Andersen, Nina, Bjoernå, Gunhild, Reite, Mad, Roertveit, Linda, Seidel, Philipp, Arnold, Glenn, Benavente, Melissa, Chattersingh, Anjalee, Chironga, Nyasha, Hornzee, Gillian, Kibaru, Joyce, Malik, Ihtisham, McLeavy, Laura, Pathmanathan, Byiravey, Prior, Florence, Strudwick, Rhea, Vezyrgiannis, Mario, Sinha, Aneeta, Babu, Sheeba, Batuwitage, Bisanth, Daly, Zoe, Ellinor, Katharine, Hawes, Elizabeth, Holmes, Ann, Hudson, Karen, Nightingale, Jeremy, Le Poidevin, Alison, Roberts, Lindsey, Kubisz-Pudelko, Agnieszka, Allison, Joanna, Pippard, Lucy, Hamlyn, Vincent, Organ, Angie, Prabhahar, Thaventhran, Bridger, Hayley, Dvorkin, Lee, Manhas, Vitul, Vincent, Rachel, Laha, Shondipon, Cromie, Terri-Louise, Doyle, Donna, Howarth, Rachel, Verlander, Mark, Watt, Ailsa, Williams, Alexandra, Antonelli, Massimo, Cutuli, Salvatore, Montini, Luca, Graterol, Juan, Adams, Benita, Bean, Sarah, Burt, Karen, Hammonds, Fiona, Jigajinni, Suyogi, Fulton, Laura, Kinghorn, Stephen, Mullenheim, Jost, Baillie, Kirsty, Cain, Martyn, Colling, Kerry, Hannaway, Carol, Corso, Ruggero, Calli, Morena, Ferrando, Carlo, Romero, Esther, Jorge-Monjas, Pablo, Soria-García, María, Gómez-Herreras, José, Rodríguez-Jiménez, Rita, and De Prada-Martín, Blanca

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_treatment, Population, NO, 03 medical and health sciences, 0302 clinical medicine, CPAP, Abdomen, Settore MED/41 - ANESTESIOLOGIA, Intubation, Intratracheal, medicine, Humans, Intubation, 030212 general & internal medicine, Continuous positive airway pressure, Adverse effect, education, education.field_of_study, Continuous Positive Airway Pressure, business.industry, respiratory complications, continuous positive airway pressure, major abdominal surgery, Pneumonia, Middle Aged, medicine.disease, respiratory tract diseases, Intratracheal, Treatment Outcome, 030228 respiratory system, Respiratory failure, Anesthesia, Vomiting, medicine.symptom, Respiratory Insufficiency, business, Abdominal surgery
Abstract

BackgroundRespiratory complications are an important cause of postoperative morbidity. We aimed to investigate whether continuous positive airway pressure (CPAP) administered immediately after major abdominal surgery could prevent postoperative morbidity.MethodsPRISM was an open-label, randomised, phase 3 trial done at 70 hospitals across six countries. Patients aged 50 years or older who were undergoing elective major open abdominal surgery were randomly assigned (1:1) to receive CPAP within 4 h of the end of surgery or usual postoperative care. Patients were randomly assigned using a computer-generated minimisation algorithm with inbuilt concealment. The primary outcome was a composite of pneumonia, endotracheal re-intubation, or death within 30 days after randomisation, assessed in the intention-to-treat population. Safety was assessed in all patients who received CPAP. The trial is registered with the ISRCTN registry, ISRCTN56012545.FindingsBetween Feb 8, 2016, and Nov 11, 2019, 4806 patients were randomly assigned (2405 to the CPAP group and 2401 to the usual care group), of whom 4793 were included in the primary analysis (2396 in the CPAP group and 2397 in the usual care group). 195 (8·1%) of 2396 patients in the CPAP group and 197 (8·2%) of 2397 patients in the usual care group met the composite primary outcome (adjusted odds ratio 1·01 [95% CI 0·81-1·24]; p=0·95). 200 (8·9%) of 2241 patients in the CPAP group had adverse events. The most common adverse events were claustrophobia (78 [3·5%] of 2241 patients), oronasal dryness (43 [1·9%]), excessive air leak (36 [1·6%]), vomiting (26 [1·2%]), and pain (24 [1·1%]). There were two serious adverse events: one patient had significant hearing loss and one patient had obstruction of their venous catheter caused by a CPAP hood, which resulted in transient haemodynamic instability.InterpretationIn this large clinical effectiveness trial, CPAP did not reduce the incidence of pneumonia, endotracheal re-intubation, or death after major abdominal surgery. Although CPAP has an important role in the treatment of respiratory failure after surgery, routine use of prophylactic post-operative CPAP is not recommended.FundingNational Institute for Health Research, Barts Charity, Intersurgical, Association of Anaesthetists, and Sapienza Università di Roma.

114. Reading Clarice Lispector's 'Sunday before Going to Sleep'

Author

Hélène Cixous, Ann Liddle, Betsy Wing, Marguerite Sandre, and Sarah Cornell

Subjects
Cultural Studies, Literature, History, Literature and Literary Theory, Sociology and Political Science, business.industry, media_common.quotation_subject, Port (computer networking), Reading (process), Sleep (system call), Youngest daughter, business, media_common
Abstract

The story is about a family's Sunday outings. The family used to go to the port where the father stared at the oily waters in such a way that if he "were still alive he would perhaps still have before his eyes the oily water(. . .)." His look disquieted the daughters. At nightfall, the youngest daughter who enjoys the father's special favors, climbs on a high swivelling stool in one of the city's numerous bars. This, the father found amusing

Published
1984
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115. L'Agenda 2030 indivisible. La durabilité au prisme de l'analyse systémique

Author

Collste, David, Centre d'Études et de Recherches sur le Développement International (CERDI), Institut de Recherche pour le Développement (IRD)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne (UCA), Université Clermont Auvergne, Stockholms universitet, Arnaud Diemer, Sarah Cornell, Ana Paula Aguiar, and Thomas Hahn

Subjects
Agenda 2030, ODD, Participatory approach, Sustainable Development Goals, synergy, systemism, System dynamics, Limites planétaires, policy coherence, Planetary boundaries, integrated policy, participatory approach, Systemism, human well-being, SDGs, 2030 Agenda, Objectifs de développement durable, Participation, Cohérence politique, Policy coherence, Bien-être humain, planetary boundaries, Tvärvetenskapliga studier inom samhällsvetenskap, [SHS.ECO]Humanities and Social Sciences/Economics and Finance, Integrated policy, Synergy, Synergies, system dynamics, Human well-being, Social Sciences Interdisciplinary
Abstract

In 2015 the United Nations adopted the 2030 Agenda with 17 global sustainable development goals (SDGs) to shift the world onto a sustainable path. By referring to the SDGs as indivisible, the Agenda emphasises the interdependence of social and ecological concerns. But what does it mean that the goals are interdependent and how is indivisibility to be handled in research and implementation? In this dissertation, I investigate how models and participatory methods grounded in systems thinking can be used to facilitate the understanding and realisation of the 2030 Agenda. The dissertation explores and examines: (a) how system dynamics models can be used to represent integrated goals and their synergies at multiple levels, (b) how human well-being can be more inclusively integrated into systems models, and (c) how systems approaches can help to bridge local aspirations to global sustainability goals, incorporating multiple values and worldviews in the operationalisation of the Agenda.This thesis comprises four papers. Paper I explores the interdependence of different 2030 Agenda goals through the use of a national-level system dynamics model applied to Tanzania to analyse anticipated social and economic impacts of substantial investments in photovoltaic capacity. Model simulations indicate that, in addition to building more sustainable energy systems, the investments in photovoltaics positively affect life expectancy, years of schooling as well as access to electricity. Furthermore, progress in these dimensions leads to broader system-wide impacts. This indicates that identifying policy synergies across sectors before policies are implemented can provide important insights for achieving the 2030 Agenda. In Paper II, we present a method for identifying policy synergies and assessing them quantitatively. The developed synergy approach is then operationalised over three case studies representing Côte d’Ivoire, Malawi and Senegal. In order to further explore the synergies and interdependencies between different human wellbeing goals, Paper III studies data on the achievement of SDGs 1- 7 in seven world regions and the world as a whole. In an analysis of the correlations between these SDGs and GDP per person, we find uniform patterns for all regions above a certain income threshold. This indicates that there is an income level at which human needs and capabilities are achieved, consistent with the Easterlin’s paradox of life satisfaction. In order to address the importance of including diverse perspectives, Paper IV investigates how the pursuit of the 2030 Agenda can be grounded in local worldviews. The paper introduces a stakeholder-based approach grounded in systems thinking for visioning and exploring sustainable development pathways to meet the SDGs. The approach focuses on identifying divergences and convergences across scales and worldviews about how to implement the Agenda. The paper presents a case study, the 2018 African Dialogue on the World in 2050, which deliberated on how transforming the agricultural and food systems in African regions could lead to achieving the SDGs in an integrated manner, comparing local perspectives to global sustainability trajectories. (...); En 2015, les Nations Unies ont adopté l’Agenda 2030 avec 17 Objectifs de développement durable (ODD) pour amener le monde sur une trajectoire durable. En conférant aux ODD le caractère indivisible, l'Agenda met l'accent sur l'interdépendance des préoccupations sociales et écologiques. Mais que signifie cette interdépendance et comment gérer cette indivisibilité à la fois dans la recherche scientifique et dans l’implémentation des Objectifs ?Dans cette thèse, nous avons cherché à comprendre comment les modèles et les méthodes participatives se revendiquant de la pensée systémique pouvaient être utilisés pour faciliter la compréhension et la réalisation de l'Agenda 2030. La thèse entend répondre à trois interrogations : (a) comment la modélisation des systèmes dynamiques peut être utilisée pour représenter des Objectifs intégrés et leurs synergies à plusieurs niveaux ? ; (b) comment le bien-être humain peut être intégré de manière plus inclusif dans la modélisation systémique ?; et (c) comment les approches systémiques peuvent aider à combler l’écart entre les aspirations locales et les Objectifs mondiaux de durabilité ? Notamment via l’incorporation de valeurs et de visions du monde plurielles. Cette thèse comprend quatre articles. L’Article I explore l'interdépendance de différents Objectifs de l'Agenda 2030 à l’aide d'un modèle de dynamiques de système, developpé au niveau national et appliqué à la Tanzanie. Il s’agit d’anticiper l’impact sur la société et l’économie d'investissements considérables dans la production d’énergie photovoltaïque. Les simulations du modèle indiquent qu'en plus de construire des systèmes énergétiques plus durables, les investissements dans le photovoltaïque affectent positivement l'espérance de vie, la durée de scolarisation ainsi que l'accès à l'électricité. De plus, les progrès dans ces dimensions conduisent à des impacts plus vastes à l'échelle du système. Ces résultats suggèrent qu'identifier les synergies possibles entre des politiques dans différents secteurs, avant même la mise en œuvre de ces politiques, peut fournir des renseignements précieux afin d’atteindre les Objectifs de l’Agenda 2030. Dans l’Article II, nous présentons une méthode visant à identifier les synergies entre différentes politiques, puis à les évaluer quantitativement. Cette méthode est appliquée à trois études de cas : la Côte d’Ivoire, le Malawi et le Sénégal. Afin d'explorer plus avant les synergies et les interdépendances entre les différents Objectifs liés au bien-être humain, l’Article III étudie des données sur le degré d’avancement des ODD 1 à 7, dans sept régions du monde séparément, et dans le monde dans son ensemble. L’analyse des corrélations entre ces ODD et le PIB par habitant montre certaines constantes qui sont valables pour toutes les régions au-dessus d'un certain seuil de revenu. Cela suggère qu’il existe un niveau de revenu à partir duquel les besoins et les capabilités des humains sont satisfaits, conformément au paradoxe d’Easterlin. Afin de prendre en compte l'importance d'inclure diverses perspectives, l’Article IV examine comment la poursuite de l'Agenda 2030 peut être ancrée dans des visions du monde locales. L’article introduit une approche basée sur la participation des parties prenantes, qui permet de visualiser et d’explorer différentes trajectoires de développement durable dans le but d’atteindre les ODD. L’article présente une étude de cas, le Dialogue Africain sur le monde en 2050, qui en 2018 a suscité des délibérations sur les orientations futures des systèmes alimentaires dans différentes régions africaines et les a mises en relation avec les trajectoires mondiales en matière de durabilité. L’article conclut que les approches participatives qui intègrent la pensée systémique constituent un moyen prometteur de lier les aspirations locales aux Objectifs mondiaux de l'Agenda 2030.

Published
2021

116. Effect of hydrocortisone on mortality and organ support in patients with severe COVID-19

Author

Angus, Derek, Derde, Lennie, Al-Beidh, Farah, Annane, Djillali, Arabi, Yaseen, Beane, Abigail, van Bentum-Puijk, Wilma, Berry, Lindsay, Bhimani, Zahra, Bonten, Marc, Bradbury, Charlotte, Brunkhorst, Frank, Buxton, Meredith, Buzgau, Adrian, Cheng, Allen, de Jong, Menno, Detry, Michelle, Estcourt, Lise, Fitzgerald, Mark, Goossens, Herman, Green, Cameron, Haniffa, Rashan, Higgins, Alisa, Horvat, Christopher, Hullegie, Sebastiaan, Kruger, Peter, Lamontagne, Francois, Lawler, Patrick, Linstrum, Kelsey, Litton, Edward, Lorenzi, Elizabeth, Marshall, John, Mcauley, Daniel, Mcglothin, Anna, Mcguinness, Shay, Mcverry, Bryan, Montgomery, Stephanie, Mouncey, Paul, Murthy, Srinivas, Nichol, Alistair, Parke, Rachael, Parker, Jane, Rowan, Kathryn, Sanil, Ashish, Santos, Marlene, Saunders, Christina, Seymour, Christopher, Turner, Anne, van de Veerdonk, Frank, Venkatesh, Balasubramanian, Zarychanski, Ryan, Berry, Scott, Lewis, Roger, Mcarthur, Colin, Webb, Steven, Gordon, Anthony, NIHR, Hôpital Raymond Poincaré [AP-HP], Writing Committee for the REMAP-CAP Investigators, Farah Al-Beidh, Derek Angus, Djillali Annane, Yaseen Arabi, Wilma van Bentum-Puijk, Scott Berry, Abigail Beane, Zahra Bhimani, Marc Bonten, Charlotte Bradbury, Frank Brunkhorst, Meredith Buxton, Allen Cheng, Menno De Jong, Lennie Derde, Lise Estcourt, Herman Goossens, Anthony Gordon, Cameron Green, Rashan Haniffa, Francois Lamontagne, Patrick Lawler, Edward Litton, John Marshall, Colin McArthur, Daniel McAuley, Shay McGuinness, Bryan McVerry, Stephanie Montgomery, Paul Mouncey, Srinivas Murthy, Alistair Nichol, Rachael Parke, Kathryn Rowan, Christopher Seymour, Anne Turner, Frank van de Veerdonk, Steve Webb, Ryan Zarychanski, Lewis Campbell, Andrew Forbes, David Gattas, Stephane Heritier, Lisa Higgins, Peter Kruger, Sandra Peake, Jeffrey Presneill, Ian Seppelt, Tony Trapani, Paul Young, Sean Bagshaw, Nick Daneman, Niall Ferguson, Cheryl Misak, Marlene Santos, Sebastiaan Hullegie, Mathias Pletz, Gernot Rohde, Kathy Rowan, Brian Alexander, Kim Basile, Timothy Girard, Christopher Horvat, David Huang, Kelsey Linstrum, Jennifer Vates, Richard Beasley, Robert Fowler, Steve McGloughlin, Susan Morpeth, David Paterson, Bala Venkatesh, Tim Uyeki, Kenneth Baillie, Eamon Duffy, Rob Fowler, Thomas Hills, Katrina Orr, Asad Patanwala, Steve Tong, Mihai Netea, Shilesh Bihari, Marc Carrier, Dean Fergusson, Ewan Goligher, Ghady Haidar, Beverley Hunt, Anand Kumar, Mike Laffan, Patrick Lawless, Sylvain Lother, Peter McCallum, Saskia Middeldopr, Zoe McQuilten, Matthew Neal, John Pasi, Roger Schutgens, Simon Stanworth, Alexis Turgeon, Alexandra Weissman, Neill Adhikari, Matthew Anstey, Emily Brant, Angelique de Man, Francois Lamonagne, Marie-Helene Masse, Andrew Udy, Donald Arnold, Phillipe Begin, Richard Charlewood, Michael Chasse, Mark Coyne, Jamie Cooper, James Daly, Iain Gosbell, Heli Harvala-Simmonds, Tom Hills, Sheila MacLennan, David Menon, John McDyer, Nicole Pridee, David Roberts, Manu Shankar-Hari, Helen Thomas, Alan Tinmouth, Darrell Triulzi, Tim Walsh, Erica Wood, Carolyn Calfee, Cecilia O’Kane, Murali Shyamsundar, Pratik Sinha, Taylor Thompson, Ian Young, Shailesh Bihari, Carol Hodgson, John Laffey, Danny McAuley, Neil Orford, Ary Neto, Michelle Detry, Mark Fitzgerald, Roger Lewis, Anna McGlothlin, Ashish Sanil, Christina Saunders, Lindsay Berry, Elizabeth Lorenzi, Eliza Miller, Vanessa Singh, Claire Zammit, Wilma van Bentum Puijk, Wietske Bouwman, Yara Mangindaan, Lorraine Parker, Svenja Peters, Ilse Rietveld, Kik Raymakers, Radhika Ganpat, Nicole Brillinger, Rene Markgraf, Kate Ainscough, Kathy Brickell, Aisha Anjum, Janis-Best Lane, Alvin Richards-Belle, Michelle Saull, Daisy Wiley, Julian Bion, Jason Connor, Simon Gates, Victoria Manax, Tom van der Poll, John Reynolds, Marloes van Beurden, Evelien Effelaar, Joost Schotsman, Craig Boyd, Cain Harland, Audrey Shearer, Jess Wren, Giles Clermont, William Garrard, Kyle Kalchthaler, Andrew King, Daniel Ricketts, Salim Malakoutis, Oscar Marroquin, Edvin Music, Kevin Quinn, Heidi Cate, Karen Pearson, Joanne Collins, Jane Hanson, Penny Williams, Shane Jackson, Adeeba Asghar, Sarah Dyas, Mihaela Sutu, Sheenagh Murphy, Dawn Williamson, Nhlanhla Mguni, Alison Potter, David Porter, Jayne Goodwin, Clare Rook, Susie Harrison, Hannah Williams, Hilary Campbell, Kaatje Lomme, James Williamson, Jonathan Sheffield, Willian van’t Hoff, Phobe McCracken, Meredith Young, Jasmin Board, Emma Mart, Cameron Knott, Julie Smith, Catherine Boschert, Julia Affleck, Mahesh Ramanan, Ramsy D’Souza, Kelsey Pateman, Arif Shakih, Winston Cheung, Mark Kol, Helen Wong, Asim Shah, Atul Wagh, Joanne Simpson, Graeme Duke, Peter Chan, Brittney Cartner, Stephanie Hunter, Russell Laver, Tapaswi Shrestha, Adrian Regli, Annamaria Pellicano, James McCullough, Mandy Tallott, Nikhil Kumar, Rakshit Panwar, Gail Brinkerhoff, Cassandra Koppen, Federica Cazzola, Matthew Brain, Sarah Mineall, Roy Fischer, Vishwanath Biradar, Natalie Soar, Hayden White, Kristen 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Waele, Liesbet De Bus, Jan Fierens, Stephanie Bracke, Brenda Reeve, William Dechert, Michaël Chassé, François Martin Carrier, Dounia Boumahni, Fatna Benettaib, Ali Ghamraoui, David Bellemare, Ève Cloutier, Charles Francoeur, François Lamontagne, Frédérick D’Aragon, Elaine Carbonneau, Julie Leblond, Gloria Vazquez-Grande, Nicole Marten, Maggie Wilson, Martin Albert, Karim Serri, Alexandros Cavayas, Mathilde Duplaix, Virginie Williams, Bram Rochwerg, Tim Karachi, Simon Oczkowski, John Centofanti, Tina Millen, Erick Duan, Jennifer Tsang, Lisa Patterson, Shane English, Irene Watpool, Rebecca Porteous, Sydney Miezitis, Lauralyn McIntyre, Laurent Brochard, Karen Burns, Gyan Sandhu, Imrana Khalid, Alexandra Binnie, Elizabeth Powell, Alexandra McMillan, Tracy Luk, Noah Aref, Zdravko Andric, Sabina Cviljevic, Renata Đimoti, Marija Zapalac, Gordan Mirković, Bruno Baršić, Marko Kutleša, Viktor Kotarski, Ana Vujaklija Brajković, Jakša Babel, Helena Sever, Lidija Dragija, Ira Kušan, Suvi Vaara, Leena Pettilä, Jonna Heinonen, Anne Kuitunen, Sari Karlsson, Annukka Vahtera, Heikki Kiiski, Sanna Ristimäki, Amine Azaiz, Cyril Charron, Mathieu Godement, Guillaume Geri, Antoine Vieillard-Baron, Franck Pourcine, Mehran Monchi, David Luis, Romain Mercier, Anne Sagnier, Nathalie Verrier, Cecile Caplin, Shidasp Siami, Christelle Aparicio, Sarah Vautier, Asma Jeblaoui, Muriel Fartoukh, Laura Courtin, Vincent Labbe, Cécile Leparco, Grégoire Muller, Mai-Anh Nay, Toufik Kamel, Dalila Benzekri, Sophie Jacquier, Emmanuelle Mercier, Delphine Chartier, Charlotte Salmon, PierreFrançois Dequin, Francis Schneider, Guillaume Morel, Sylvie L’Hotellier, Julio Badie, Fernando Daniel Berdaguer, Sylvain Malfroy, Chaouki Mezher, Charlotte Bourgoin, Bruno Megarbane, Sebastian Voicu, Nicolas Deye, Isabelle Malissin, Laetitia Sutterlin, Christophe Guitton, Cédric Darreau, Mickaël Landais, Nicolas Chudeau, Alain Robert, Pierre Moine, Nicholas Heming, Virginie Maxime, Isabelle Bossard, Tiphaine Barbarin Nicholier, Gwenhael Colin, Vanessa Zinzoni, Natacham Maquigneau, André Finn, Gabriele Kreß, Uwe Hoff, Carl Friedrich Hinrichs, Jens Nee, Mathias Pletz, Stefan Hagel, Juliane Ankert, Steffi Kolanos, Frank Bloos, Sirak Petros, Bastian Pasieka, Kevin Kunz, Peter Appelt, Bianka Schütze, Stefan Kluge, Axel Nierhaus, Dominik Jarczak, Kevin Roedl, Dirk Weismann, Anna Frey, Vivantes Klinikum Neukölln, Lorenz Reill, Michael Distler, Astrid Maselli, János Bélteczki, István Magyar, Ágnes Fazekas, Sándor Kovács, Viktória Szőke, Gábor Szigligeti, János Leszkoven, Daniel Collins, Patrick Breen, Stephen Frohlich, Ruth Whelan, Bairbre McNicholas, Michael Scully, Siobhan Casey, Maeve Kernan, Peter Doran, Michael O’Dywer, Michelle Smyth, Leanne Hayes, Oscar Hoiting, Marco Peters, Els Rengers, Mirjam Evers, Anton Prinssen, Jeroen Bosch Ziekenhuis, Koen Simons, Wim Rozendaal, F Polderman, P de Jager, M Moviat, A Paling, A Salet, Emma Rademaker, Anna Linda Peters, E de Jonge, J Wigbers, E Guilder, M 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Whileman, Thomas Spencer, Nick Spittle, Vidya Kasipandian, Amit Patel, Suzanne Allibone, Roman Mary Genetu, Mohamed Ramali, Alison Ghosh, Peter Bamford, Emily London, Kathryn Cawley, Maria Faulkner, Helen Jeffrey, Tim Smith, Chris Brewer, Jane Gregory, James Limb, Amanda Cowton, Julie O’Brien, Nikitas Nikitas, Colin Wells, Liana Lankester, Mark Pulletz, Patricia Williams, Jenny Birch, Sophie Wiseman, Sarah Horton, Ana Alegria, Salah Turki, Tarek Elsefi, Nikki Crisp, Louise Allen, Iain McCullagh, Philip Robinson, Carole Hays, Maite Babio-Galan, Hannah Stevenson, Divya Khare, Meredith Pinder, Selvin Selvamoni, Amitha Gopinath, Richard Pugh, Daniel Menzies, Callum Mackay, Elizabeth Allan, Gwyneth Davies, Kathryn Puxty, Claire McCue, Susanne Cathcart, Naomi Hickey, Jane Ireland, Hakeem Yusuff, Graziella Isgro, Chris Brightling, Michelle Bourne, Michelle Craner, Malcolm Watters, Rachel Prout, Louisa Davies, Suzannah Pegler, Lynsey Kyeremeh, Gill Arbane, Karen Wilson, Linda Gomm, Federica 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David Shaw, Zudin Puthucheary, Timothy Martin, Filipa Santos, Ruzena Uddin, Alastair Somerville, Kate Colette Tatham, Shaman Jhanji, Ethel Black, Arnold Dela Rosa, Ryan Howle, Redmond Tully, Andrew Drummond, Joy Dearden, Jennifer Philbin, Sheila Munt, Alain Vuylsteke, Charles Chan, Saji Victor, Ramprasad Matsa, Minerva Gellamucho, Ben Creagh-Brown, Joe Tooley, Laura Montague, Fiona De Beaux, Laetitia Bullman, Ian Kersiake, Carrie Demetriou, Sarah Mitchard, Lidia Ramos, Katie White, Phil Donnison, Maggie Johns, Ruth Casey, Lehentha Mattocks, Sarah Salisbury, Paul Dark, Andrew Claxton, Danielle McLachlan, Kathryn Slevin, Stephanie Lee, Jonathan Hulme, Sibet Joseph, Fiona Kinney, Ho Jan Senya, Aneta Oborska, Abdul Kayani, Bernard Hadebe, Rajalakshmi Orath Prabakaran, Lesley Nichols, Matt Thomas, Ruth Worner, Beverley Faulkner, Emma Gendall, Kati Hayes, Colin Hamilton-Davies, Carmen Chan, Celina Mfuko, Hakam Abbass, Vineela Mandadapu, Susannah Leaver, Daniel Forton, Kamal Patel, Elankumaran Paramasivam, Matthew Powell, Richard Gould, Elizabeth Wilby, Clare Howcroft, Dorota Banach, Ziortza Fernández de Pinedo Artaraz, Leilani Cabreros, Ian White, Maria Croft, Nicky Holland, Rita Pereira, Ahmed Zaki, David Johnson, Matthew Jackson, Hywel Garrard, Vera Juhaz, Alistair Roy, Anthony Rostron, Lindsey Woods, Sarah Cornell, Suresh Pillai, Rachel Harford, Tabitha Rees, Helen Ivatt, Ajay Sundara Raman, Miriam Davey, Kelvin Lee, Russell Barber, Manish Chablani, Farooq Brohi, Vijay Jagannathan, Michele Clark, Sarah Purvis, Bill Wetherill, Ahilanandan Dushianthan, Rebecca Cusack, Kim de Courcy-Golder, Simon Smith, Susan Jackson, Ben Attwood, Penny Parsons, Valerie Page, Xiao Bei Zhao, Deepali Oza, Jonathan Rhodes, Tom Anderson, Sheila Morris, Charlotte Xia Le Tai, Amy Thomas, Alexandra Keen, Stephen Digby, Nicholas Cowley, Laura Wild, David Southern, Harsha Reddy, Andy Campbell, Claire Watkins, Sara Smuts, Omar Touma, Nicky Barnes, Peter Alexander, Tim Felton, Susan Ferguson, Katharine Sellers, Joanne Bradley-Potts, David Yates, Isobel Birkinshaw, Kay Kell, Nicola Marshall, Lisa Carr-Knott, Charlotte Summers, and Mégarbane, Bruno

Subjects
[SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, General Medicine, [SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, Writing Committee for the REMAP-CAP Investigators, [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.TOX] Life Sciences [q-bio]/Toxicology, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.TOX]Life Sciences [q-bio]/Toxicology, General & Internal Medicine, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, [SDV.MHEP.PSR] Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract, 11 Medical and Health Sciences
Abstract

Importance Evidence regarding corticosteroid use for severe coronavirus disease 2019 (COVID-19) is limited. Objective To determine whether hydrocortisone improves outcome for patients with severe COVID-19. Design, Setting, and Participants An ongoing adaptive platform trial testing multiple interventions within multiple therapeutic domains, for example, antiviral agents, corticosteroids, or immunoglobulin. Between March 9 and June 17, 2020, 614 adult patients with suspected or confirmed COVID-19 were enrolled and randomized within at least 1 domain following admission to an intensive care unit (ICU) for respiratory or cardiovascular organ support at 121 sites in 8 countries. Of these, 403 were randomized to open-label interventions within the corticosteroid domain. The domain was halted after results from another trial were released. Follow-up ended August 12, 2020. Interventions The corticosteroid domain randomized participants to a fixed 7-day course of intravenous hydrocortisone (50 mg or 100 mg every 6 hours) (n = 143), a shock-dependent course (50 mg every 6 hours when shock was clinically evident) (n = 152), or no hydrocortisone (n = 108). Main Outcomes and Measures The primary end point was organ support–free days (days alive and free of ICU-based respiratory or cardiovascular support) within 21 days, where patients who died were assigned –1 day. The primary analysis was a bayesian cumulative logistic model that included all patients enrolled with severe COVID-19, adjusting for age, sex, site, region, time, assignment to interventions within other domains, and domain and intervention eligibility. Superiority was defined as the posterior probability of an odds ratio greater than 1 (threshold for trial conclusion of superiority >99%). Results After excluding 19 participants who withdrew consent, there were 384 patients (mean age, 60 years; 29% female) randomized to the fixed-dose (n = 137), shock-dependent (n = 146), and no (n = 101) hydrocortisone groups; 379 (99%) completed the study and were included in the analysis. The mean age for the 3 groups ranged between 59.5 and 60.4 years; most patients were male (range, 70.6%-71.5%); mean body mass index ranged between 29.7 and 30.9; and patients receiving mechanical ventilation ranged between 50.0% and 63.5%. For the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively, the median organ support–free days were 0 (IQR, –1 to 15), 0 (IQR, –1 to 13), and 0 (–1 to 11) days (composed of 30%, 26%, and 33% mortality rates and 11.5, 9.5, and 6 median organ support–free days among survivors). The median adjusted odds ratio and bayesian probability of superiority were 1.43 (95% credible interval, 0.91-2.27) and 93% for fixed-dose hydrocortisone, respectively, and were 1.22 (95% credible interval, 0.76-1.94) and 80% for shock-dependent hydrocortisone compared with no hydrocortisone. Serious adverse events were reported in 4 (3%), 5 (3%), and 1 (1%) patients in the fixed-dose, shock-dependent, and no hydrocortisone groups, respectively. Conclusions and Relevance Among patients with severe COVID-19, treatment with a 7-day fixed-dose course of hydrocortisone or shock-dependent dosing of hydrocortisone, compared with no hydrocortisone, resulted in 93% and 80% probabilities of superiority with regard to the odds of improvement in organ support–free days within 21 days. However, the trial was stopped early and no treatment strategy met prespecified criteria for statistical superiority, precluding definitive conclusions.

Published
2020
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117. L’économie politique de la décroissance

Author

Parrique, Timothée, Centre d'Études et de Recherches sur le Développement International (CERDI), Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Université Clermont Auvergne [2017-2020], Stockholms universitet, Arnaud Diemer, Sylvie Ferrari, Sarah Cornell, and STAR, ABES

Subjects
Political economy, Degrowth, Post-croissance, Écologie politique, Économie politique, Post-growth, [SHS.ECO] Humanities and Social Sciences/Economics and Finance, [SHS.ECO]Humanities and Social Sciences/Economics and Finance, Political ecology, Décroissance
Abstract

What is degrowth and what are its implications for political economy? Divided in three parts, this dissertation explores the why, what, and how of degrowth. The first part (Of growth and limits) studies the nature, causes, and consequences of economic growth. Chapter 1: Understanding economic growth answers a series of questions about the nature of economic growth: What is it exactly that grows? By how much does it grow? When and where does it grow? How does it grow? And why should it grow? The three following chapters develop a triple objection to economic growth as no longer possible (Chapter 2: Biophysical limits to growth), plausible (Chapter 3: Socioeconomic limits to growth), and desirable (Chapter 4: Social limits of growth). The second part (Elements of degrowth) is about the idea of degrowth, especially its history, theoretical foundations, and controversies. Chapter 5: Origins and definitions traces the history of the concept from 1968 to 2018. Chapter 6: Theoretical foundations presents a normative theory of degrowth as de-economisation, that is a reduction in importance of economic thoughts and practices. Chapter 7: Controversies reviews the attacks the concept has received. Whereas the first part diagnosed economic growth as the problem, this part offers a solution. The take-home message is that degrowth is not only a critique but also a fully-fledged alternative to the growth society. The third part (Recipes for degrowth) is about the transition from a growth economy to a degrowth society. It opens with an inventory of the policies that have been mobilised by degrowthers until today (Chapter 8: Strategies for change). The three following chapters on property (Chapter 9: Transforming property), work (Chapter 10: Transforming work), and money (Chapter 11: Transforming money) go from theory to practice and translate the values and principles of degrowth into operational transition strategies. Chapter 12: Transition strategy presents a method to study the interactions between degrowth policies in order to craft effective transition strategies. The central claim of this final part is that degrowth is a powerful conceptual tool to think about societal transformations for social-ecological justice., Qu'est-ce que la décroissance et quelles sont ses implications pour l'économie politique ? Divisée en trois parties, cette thèse explore le pourquoi, le quoi, et le comment de la décroissance.La première partie (De la croissance et des limites) étudie la nature, les causes, et les conséquences de la croissance économique. Chapitre 1 : Comprendre la croissance économique répond à plusieurs questions : Qu'est-ce qui croît exactement ? À quelle vitesse ? Quand et où est-ce que ça croît ? Comment est-ce que ça croît ? Et pourquoi est-ce que ça devrait croître ? Les trois chapitres suivants développent une triple objection à la croissance économique qui n'est plus possible (Chapitre 2 : Limites biophysiques de la croissance), plausible (Chapitre 3 : Limites socioéconomiques de la croissance), et souhaitable (Chapitre 4 : Limites sociales à la croissance).La deuxième partie (Éléments de décroissance) porte sur l'idée de la décroissance, en particulier son histoire, ses fondements théoriques, et ses controverses. Le Chapitre 5 : Origines et définitions retrace l'histoire du concept de 1968 à 2018. Le Chapitre 6 : Fondements théoriques présente une théorie normative de la décroissance comme déséconomisation, c'est-à-dire une réduction de l'importance de la rationalité et des pratiques économiques. Le Chapitre 7 : Controverses passe en revue les attaques reçues par le concept. Si la première partie a diagnostiqué la croissance économique comme étant le problème, cette partie propose une solution. L’argument principal est que la décroissance n'est pas seulement une critique mais aussi une alternative complète à la société de croissance.La troisième partie (Recettes de décroissance) concerne la transition d'une économie de croissance à une société de décroissance. La partie s'ouvre sur un inventaire des politiques mobilisées par les décroissants jusqu'à aujourd'hui (Chapitre 8 : Stratégies de changement). Les trois chapitres suivants, sur la propriété (Chapitre 9 : Transformer la propriété), le travail (Chapitre 10 : Transformer le travail) et l'argent (Chapitre 11 : Transformer l'argent) passent de la théorie à la pratique et transforment les valeurs et les principes de la décroissance en stratégies de transition. Le Chapitre 12 : Stratégie de transition décrit une méthode pour étudier l'interaction entre plusieurs politiques de décroissance, et cela pour mieux planifier la transition. Le message central de cette troisième partie est que la décroissance est un outil conceptuel puissant pour réfléchir à une transition vers la justice sociale et écologique.

Published
2019

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