scholarly journals Unknown Risk on the Farm: Does Agricultural Use of Ionophores Contribute to the Burden of Antimicrobial Resistance?

mSphere ◽  
2019 ◽  
Vol 4 (5) ◽  
Author(s):  
Alex Wong
Keyword(s):  
Antimicrobial Resistance ◽  
Human Health ◽  
The United States ◽  
Evidence Base ◽  
Systematic Investigation ◽  
Current Evidence ◽  
Cross Resistance ◽  
Unknown Risk ◽  
Current Evidence Base ◽  
Agricultural Use

ABSTRACT Ionophores are the second most widely used class of antibiotic in agriculture, with over 4 million kilograms sold in the United States in 2016. Because ionophores are not used in humans, it is widely assumed that their agricultural use will not impact human health. Consequently, these drugs have not been subject to the same regulations as medically important antibiotics. Here, I argue that the current evidence base is insufficient to conclude that ionophores do not contribute to human relevant antimicrobial resistance. It is unclear whether ionophore resistance can result in cross-resistance to medically important antibiotics. Moreover, recent evidence suggests that ionophore use may coselect for resistance to vancomycin in some cases. Systematic investigation of the consequences of agricultural ionophore use for human health is therefore imperative.

Pharmacotherapy of Anxiety Disorders

2013 ◽  
pp. 636-639
Author(s):  
James W. Murrough ◽  
Dan V. Iosifescu ◽  
Dennis S. Charney
Keyword(s):  
Anxiety Disorders ◽  
Treatment Options ◽  
The United States ◽  
Evidence Base ◽  
Current Evidence ◽  
Generalized Anxiety ◽  
Pharmacological Agents ◽  
Current Evidence Base ◽  
High Degree ◽  
Monoaminergic Agents

Anxiety disorders are among the most prevalent mental disorders in the United States and are associated with a high degree of morbidity and public health costs. This chapter will present a general approach to the diagnosis and treatment of these disorders and summarize the current evidence base for pharmacotherapeutic treatment options in individual disorders, including panic disorder, social phobia, posttraumatic stress disorder, generalized anxiety disorder.The serotonin-selective and serotonin norepinephrine reuptake inhibitors are generally considered first-line treatment while older monoaminergic agents are often efficacious but are limited by safety and tolerability issues. The benzodiazepines play an important role in the treatment of some anxiety disorders, however these agents also possess important limitations. Other pharmacological agents have a more limited evidence base. Continued progress in basic and translational neuroscience is expected to meet the need for new, more effective treatments for patients suffering from these disorders.

Marijuana Use in Young Adults: What Do We Know?

2020 ◽  
Vol 9 (2) ◽  
pp. 103-114
Author(s):  
Michael Wenzinger ◽  
Fayola Fears
Keyword(s):  
Young Adults ◽  
Marijuana Use ◽  
Risky Behaviors ◽  
The United States ◽  
Evidence Base ◽  
Cannabis Use ◽  
Current Evidence ◽  
Age Group ◽  
Current Evidence Base ◽  
General Functioning

Cannabis is the most commonly used illicit drug in the United States. Over the past decade its use has increased, with young adults/college aged individuals having the highest proportion of users compared to any other age group. Given the high rates of usage in this age group, cannabis use is an important aspect of mental and physical health in collegeaged adults. Current evidence indicates that marijuana use, especially early and dosedependent use, can have significant negative ramifications on general functioning, academic performance, psychiatric wellness, and may be causally related to development of other substance use disorders and risky behaviors. No strong evidence supports marijuana as a beneficial treatment for any psychiatric indication, however there is evidence supporting the use of cannabidiol (CBD) in illnesses such as epilepsy. Providers must be well apprised of the current evidence base for both detecting and treating marijuana use disorder given its increasing prevalence and decreasing perception of risk. Screening of cannabis use disorder and treatment with appropriate therapy is highly important for college mental health.

scholarly journals One Health Approach for combating Antimicrobial Resistance in Animals

2022 ◽  
Author(s):  
Chung-Ming Chang ◽  
Ramendra Pati Pandey ◽  
Riya Mukherjee
Keyword(s):  
Antimicrobial Resistance ◽  
One Health ◽  
Animal Health ◽  
Evidence Base ◽  
Current Evidence ◽  
Salmonella Spp ◽  
International Response ◽  
Current Evidence Base ◽  
Poultry Farms ◽  
Animal Medicine

Antimicrobial resistance (AMR) is an increasing hazard to human and animal health that necessitates an international response. Surveillance methods in high-income nations aided in the development of measures to combat AMR in animals. Demand for meat is increasing in countries making it critical to implement anti-AMR initiatives. Surveillance of AMR, on the other hand, is at best in its infancy, and the current evidence base for informing policymakers is geographically disparate. All of the isolates had high rates of AMR to medicines that are critical/highly important in human and animal medicine. A higher incidence of AMR was found in poultry farms. Our findings show that AMR, including MDR, is common in coli, Salmonella spp., commonly found in poultry. The study promotes the development of national policies, programs, and additional research based on a "One Health" approach that helps humans and animals, as well as the environment.

scholarly journals resistancebank.org, an open-access repository for surveys of antimicrobial resistance in animals

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Nicola G. Criscuolo ◽  
João Pires ◽  
Cheng Zhao ◽  
Thomas P. Van Boeckel
Keyword(s):  
Antimicrobial Resistance ◽  
Focal Point ◽  
Evidence Base ◽  
Current Evidence ◽  
Surveillance Systems ◽  
Middle Income ◽  
Global Database ◽  
Country Level ◽  
Current Evidence Base ◽  
Resistance Rates

AbstractAntimicrobial resistance (AMR) is a growing threat to the health of humans and animals that requires global actions. In high-income countries, surveillance systems helped inform policies to curb AMR in animals. In low- and middle-income countries (LMICs), demand for meat is rising, and developing policies against AMR is urgent. However, surveillance of AMR is at best nascent, and the current evidence base to inform policymakers is geographically heterogeneous. We present resistancebank.org, an online platform that centralizes information on AMR in animals from 1,285 surveys from LMICs. Surveys were conducted between 2000 and 2019 and include 22,403 resistance rates for pathogens isolated from chickens, cattle, sheep, and pigs. The platform is built as a shiny application that provides access to individual surveys, country-level reports, and maps of AMR at 10 × 10 kilometers resolution. The platform is accessed via any internet browser and enables users to upload surveys to strengthen a global database. resistancebank.org aims to be a focal point for sharing AMR data in LMICs and to help international funders prioritize their actions.

scholarly journals Polyphenols and Cognition In Humans: An Overview of Current Evidence from Recent Systematic Reviews and Meta-Analyses

2020 ◽  
pp. 1-15
Author(s):  
Daniel Joseph Lamport ◽  
Claire Michelle Williams
Keyword(s):  
Systematic Reviews ◽  
Evidence Base ◽  
Epidemiological Studies ◽  
Cognitive Outcome ◽  
Current Evidence ◽  
Duration Of Treatment ◽  
Current Evidence Base ◽  
Cognitive Benefits ◽  
Meta Analyses ◽  
The Impact

There is increasing interest in the impact of dietary influences on the brain throughout the lifespan, ranging from improving cognitive development in children through to attenuating ageing related cognitive decline and reducing risk of neurodegenerative diseases. Polyphenols, phytochemicals naturally present in a host of fruits, vegetables, tea, cocoa and other foods, have received particular attention in this regard, and there is now a substantial body of evidence from experimental and epidemiological studies examining whether their consumption is associated with cognitive benefits. The purpose of this overview is to synthesise and evaluate the best available evidence from two sources, namely meta-analyses and systematic reviews, in order to give an accurate reflection of the current evidence base for an association between polyphenols and cognitive benefits. Four meta-analyses and thirteen systematic reviews published between 2017–2020 were included, and were categorised according to whether they reviewed specific polyphenol-rich foods and classes or all polyphenols. A requirement for inclusion was assessment of a behavioural cognitive outcome in humans. A clear and consistent theme emerged that whilst there is support for an association between polyphenol consumption and cognitive benefits, this conclusion is tentative, and by no means definitive. Considerable methodological heterogeneity was repeatedly highlighted as problematic such that the current evidence base does not support reliable conclusions relating to efficacy of specific doses, duration of treatment, or sensitivity in specific populations or certain cognitive domains. The complexity of multiple interactions between a range of direct and indirect mechanisms of action is discussed. Further research is required to strengthen the reliability of the evidence base.

scholarly journals P-26 Challenging the pressure on nhs resources: could 48-hour continuous subcutaneous infusions (CSCIS) help? a systematically-structured review of the current evidence base

2017 ◽  
Vol 7 (Suppl 1) ◽  
pp. A9.3-A10
Author(s):  
James Baker ◽  
Andrew Dickman ◽  
Stephen Mason ◽  
John Ellershaw ◽  
Paul Skipper ◽  
...  
Keyword(s):  
Evidence Base ◽  
Current Evidence ◽  
Current Evidence Base

scholarly journals Rates of violence in patients classified as high risk by structured risk assessment instruments

2014 ◽  
Vol 204 (3) ◽  
pp. 180-187 ◽  
Author(s):  
Jay P. Singh ◽  
Seena Fazel ◽  
Ralitza Gueorguieva ◽  
Alec Buchanan
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Risk Groups ◽  
Evidence Base ◽  
Assessment Tools ◽  
Current Evidence ◽  
Assessment Instruments ◽  
Individual Liberty ◽  
Current Evidence Base ◽  
Study Heterogeneity

BackgroundRates of violence in persons identified as high risk by structured risk assessment instruments (SRAIs) are uncertain and frequently unreported by validation studies.AimsTo analyse the variation in rates of violence in individuals identified as high risk by SRAIs.MethodA systematic search of databases (1995–2011) was conducted for studies on nine widely used assessment tools. Where violence rates in high-risk groups were not published, these were requested from study authors. Rate information was extracted, and binomial logistic regression was used to study heterogeneity.ResultsInformation was collected on 13 045 participants in 57 samples from 47 independent studies. Annualised rates of violence in individuals classified as high risk varied both across and within instruments. Rates were elevated when population rates of violence were higher, when a structured professional judgement instrument was used and when there was a lower proportion of men in a study.ConclusionsAfter controlling for time at risk, the rate of violence in individuals classified as high risk by SRAIs shows substantial variation. In the absence of information on local base rates, assigning predetermined probabilities to future violence risk on the basis of a structured risk assessment is not supported by the current evidence base. This underscores the need for caution when such risk estimates are used to influence decisions related to individual liberty and public safety.

scholarly journals Toward the diagnosis of rare childhood genetic diseases: what do parents value most?

2021 ◽  
Author(s):  
Samantha Pollard ◽  
Deirdre Weymann ◽  
Jessica Dunne ◽  
Fatemeh Mayanloo ◽  
John Buckell ◽  
...  
Keyword(s):  
Focus Groups ◽  
Genetic Disease ◽  
Diagnostic Yield ◽  
Management Strategies ◽  
Health Benefit ◽  
Sampling Technique ◽  
Evidence Base ◽  
Current Evidence ◽  
Genomic Testing ◽  
Current Evidence Base

AbstractGenomic testing is becoming routine for diagnosing rare childhood genetic disease. Evidence underlying sustainable implementation is limited, focusing on short-term endpoints such as diagnostic yield, unable to fully characterize patient and family valued outcomes. Although genomic testing is becoming widely available, evidentiary and outcomes uncertainty persist as key challenges for implementation. We examine whether the current evidence base reflects public tolerance for uncertainty for genomics to diagnose rare childhood genetic disease. We conducted focus groups with general population parents in Vancouver, Canada, and Oxford, United Kingdom, to discuss expectations and concerns related to genomic testing to diagnose rare childhood genetic disease. Applying a purposive sampling technique, recruitment continued until thematic saturation was reached. Transcripts were analysed using thematic analysis. Thirty-three parents participated across four focus groups. Participants valued causal diagnoses alongside management strategies to improve patient health and wellbeing. Further, participants valued expanding the evidence base to reduce evidentiary uncertainty while ensuring security of information. Willingness to pay out of pocket for testing reflected perceived familial health benefit. Diagnostic yield fails to fully capture valued outcomes, and efforts to resolve uncertainty better reflect public priorities. Evaluations of genomic testing that fully integrate valued endpoints are necessary to ensure consistency with best practices and public willingness to accept the uncertain familial benefit.

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