Strengthening strategic management approaches to address antimicrobial resistance in global human health: a scoping review

Introduction The development and implementation of national strategic plans is a critical component towards successfully addressing antimicrobial resistance (AMR). This study aimed to review the scope and analytical depth of situation analyses conducted to address AMR in human health to inform the development and implementation of national strategic plans. Methods A systematic search of the literature was conducted to identify all studies since 2000, that have employed a situation analysis to address AMR. The included studies are analysed against frameworks for strategic analysis, primarily the PESTELI (Political, Economic, Sociological, Technological, Ecological, Legislative, Industry) framework, to understand the depth, scope and utility of current published approaches. Results 10 studies were included in the final review ranging from single country (6) to regional-level multicountry studies (4). 8 studies carried out documentary review, and 3 of these also included stakeholder interviews. 2 studies were based on expert opinion with no data collection. No study employed the PESTELI framework. Most studies (9) included analysis of the political domain and 1 study included 6 domains of the framework. Technological and industry analyses is a notable gap. Facilitators and inhibitors within the political and legislative domains were the most frequently reported. No facilitators were reported in the economic or industry domains but featured inhibiting factors including: lack of ring-fenced funding for surveillance, perverse financial incentives, cost-shifting to patients; joint-stock drug company ownership complicating regulations. Conclusion The PESTELI framework provides further opportunities to combat AMR using a systematic, strategic management approach, rather than a retrospective view. Future analysis of existing quantitative data with interviews of key strategic and operational stakeholders is needed to provide critical insights about where implementation efforts should be focussed, and also how to build contingency at the strategic level for agile responses to macro-level environmental influences

The diet of Eurasian Tree Sparrow Passer montanus nestlings in relation to agri-environment scheme habitats

It has been suggested by some authors that the UK agri-environment ‘wild bird seed’ option negatively impacts Tree Sparrow populations in the UK. Here we provide evidence for a change in nestling diet with increasing wild bird seed coverage and propose a possible mechanism for its negative impact on population trend

On-the-fly memory compression for multibody algorithms.

Memory and bandwidth demands challenge developers of particle-based codes that have to scale on new architectures, as the growth of concurrency outperforms improvements in memory access facilities, as the memory per core tends to stagnate, and as communication networks cannot increase bandwidth arbitrary. We propose to analyse each particle of such a code to find out whether a hierarchical data representation storing data with reduced precision caps the memory demands without exceeding given error bounds. For admissible candidates, we perform this compression and thus reduce the pressure on the memory subsystem, lower the total memory footprint and reduce the data to be exchanged via MPI. Notably, our analysis and transformation changes the data compression dynamically, i.e. the choice of data format follows the solution characteristics, and it does not require us to alter the core simulation code

Do natural enemies really make a difference? Field scale impacts of parasitoid wasps and hoverfly larvae on cereal aphid populations

Naturally occurring predators and parasitoids are known to reduce the abundance of pest invertebrates in arable crops, yet current treatment thresholds do not account for such a contribution to pest management. In the present study, we provide evidence for the presence of natural enemies correlating with a subsequent reduction in pest population growth. The abundance of cereal aphid pests and two key aphidophagous natural enemies, parasitoid wasps (Aphidiinae) and hoverfly larvae (Syrphinae), was assessed at field boundaries and interiors in southeast England. The highest rate of aphid population growth was associated with locations where no natural enemies were found. The presence of either Aphidiinae wasps or predatory Syrphinae larvae was associated with a reduction in the rate of aphid population growth, irrespective of location within the field, and overall aphid population growth was negatively correlated with increasing natural enemy abundance. The results of the present study indicate that natural enemies contribute significantly to pest control, and provide further evidence supporting the use of management strategies for promoting natural enemies in agro-ecosystems. Aphid predators and parasitoids make an important contribution to aphid pest control within cereal fields, and thresholds for insecticide application should account for this to avoid unnecessary treatments

The Effect of Proprioceptive Training on Directional Dynamic Stabilisation

Objectives: Significant loss of playing time and the impact of treatment costs due to lower limb injury in football demonstrates a need for improved protocols for injury risk reduction. The aim of the present study is to assess the effect of a proprioceptive training programme on the lower limb dynamic stability of elite footballers. Methods: Sixteen elite premier league footballers were randomly allocated by matched pair design to an 8-week proprioception training group (group A, n = 8) or non-training group (group B, n = 8), to determine the effect of this training over a 16-week period. Group A completed 8 weeks of bilateral proprioceptive training, 5 times per week for 10 minutes. Biodex Dynamic Stability (BSS) measures of Overall Stability Index (OSI), Anterior-Posterior (A-P), Medial-Lateral Stability (M-L) at levels 8-6-4-1 were taken for both groups at baseline, 4, 8 and 16 weeks. Main effects of time, level of stability and direction of stability were determined, with comparisons of effect made between the two groups. Results: The training group displayed significant differences for multi directional stability at week 8 (P ≤ 0.05). A-P stability within the training group displayed significant differences between baseline measures and 16 weeks (P > 0.05), with significant increases in scores displayed for M-L and A-P stability between weeks 8 and 16 (P ≤ 0.05), representing a detraining effect. No significant differences were detected at any time point for the non-training group (P > 0.05). Conclusions: Proprioceptive training over 8 weeks has a positive effect on all directions of stability. Greater declines in A-P stability were evident at 16 weeks when compared to M-L and OSI. Consideration must be given to the increased stability scores presented pre testing for A-P when compared to M-L. Findings of this work present implications for training design

Opportunities for system level improvement in antibiotic use across the surgical pathway

Optimizing antibiotic prescribing across the surgical pathway (before, during, and after surgery) is a key aspect of tackling important drivers of antimicrobial resistance and simultaneously decreasing the burden of infection at the global level. In the UK alone, 10 million patients undergo surgery every year, which is equivalent to 60% of the annual hospital admissions having a surgical intervention. The overwhelming majority of surgical procedures require effectively limited delivery of antibiotic prophylaxis to prevent infections. Evidence from around the world indicates that antibiotics for surgical prophylaxis are administered ineffectively, or are extended for an inappropriate duration of time postoperatively. Ineffective antibiotic prophylaxis can contribute to the development of surgical site infections (SSIs), which represent a significant global burden of disease. The World Health Organization estimates SSI rates of up to 50% in postoperative surgical patients (depending on the type of surgery), with a particular problem in low- and middle-income countries, where SSIs are the most frequently reported healthcare-associated infections. Across European hospitals, SSIs alone comprise 19.6% of all healthcare-acquired infections. Much of the scientific research in infection management in surgery is related to infection prevention and control in the operating room, surgical prophylaxis, and the management of SSIs, with many studies focusing on infection within the 30-day postoperative period. However it is important to note that SSIs represent only one of the many types of infection that can occur postoperatively. This article provides an overview of the surgical pathway and considers infection management and antibiotic prescribing at each step of the pathway. The aim was to identify the implications for research and opportunities for system improvement

Exploring the Global Health and Defence Engagement Interface

Militaries have an important and inevitable role in global health and will interface with existing health systems on deployments. Whilst the primary concern of militaries is not global health, there are clear, and increasingly frequent, circumstances when global health activities align with the interests of defence. Recognising this link between global health and security warrants thoughtful consideration and action where concerns affecting both intersect. In addition to providing medical support to military personnel on operations, advantageous effects can be achieved directly from military medical activities as part of Defence Engagement. Whilst there are limitations and ethical boundaries to the role of militaries in global health, further training, research and conceptual development are warranted to optimise military medical activity at the intersection of security and global health to deliver advantageous effects. This paper forms part of a special issue of BMJ Military Health dedicated to Defence Engagement

Carabid (Coleoptera) community changes following prescribed burning and the potential use of carabids as indicators species to evaluate the effect of fire management in Mediterranean regions

Separata do Vol. 14, n.º da Revista Silva Lusitana.Pesquisável também em http://www.scielo.oces.mctes.pt/pdf/slu/v14n1/v14n1a07.pdfThis study investigates the effects of prescribed burning on ground beetle (Coleoptera: Carabidae) communities in two different habitats, a pine forest stand in Northern Portugal and a shrubland in a central region that were fire treated in spring of 1998. These two ecosystems were considerably different in floristically as well as structurally. Pitfall trapping was performed for two years in the pine stand and three years in the shrubland. Species of dryer open habitats dominated after fire in the shrubland site while the pine stand habitat showed a more or less constant carabid community structure for all treatments. Some Carabid taxa such as species/subspecies like Chrysocarabus lateralis, Petrophilus brevipennis sousai, Macrothorax rugosus celtiberus and Steropus globosus ebenus may be considered as indicators for fire managed areas in Mediterranean ecosystems

Outdoor learning spaces: the case of forest school

© 2017 The Author. Area published by John Wiley & Sons Ltd on behalf of Royal Geographical Society (with the Institute of British Geographers). This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.This paper contributes to the growing body of research concerning use of outdoor spaces by educators, and the increased use of informal and outdoor learning spaces when teaching primary school children. The research takes the example of forest school, a form of regular and repeated outdoor learning increasingly common in primary schools. This research focuses on how the learning space at forest school shapes the experience of children and forest school leaders as they engage in learning outside the classroom. The learning space is considered as a physical space, and also in a more metaphorical way as a space where different behaviours are permitted, and a space set apart from the national curriculum. Through semi-structured interviews with members of the community of practice of forest school leaders, the paper seeks to determine the significance of being outdoors on the forest school experience. How does this learning space differ from the classroom environment? What aspects of the forest school learning space support pupils’ experiences? How does the outdoor learning space affect teaching, and the dynamics of learning while at forest school? The research shows that the outdoor space provides new opportunities for children and teachers to interact and learn, and revealed how forest school leaders and children co-create a learning environment in which the boundaries between classroom and outdoor learning, teacher and pupil, are renegotiated to stimulate teaching and learning. Forest school practitioners see forest school as a separate learning space that is removed from the physical constraints of the classroom and pedagogical constraints of the national curriculum to provide a more flexible and responsive learning environment.Peer reviewe

On-the-fly memory compression for multibody algorithms

Memory and bandwidth demands challenge developers of particle-based codes that have to scale on new architectures, as the growth of concurrency outperforms improvements in memory access facilities, as the memory per core tends to stagnate, and as communication networks cannot increase bandwidth arbitrary. We propose to analyse each particle of such a code to find out whether a hierarchical data representation storing data with reduced precision caps the memory demands without exceeding given error bounds. For admissible candidates, we perform this compression and thus reduce the pressure on the memory subsystem, lower the total memory footprint and reduce the data to be exchanged via MPI. Notably, our analysis and transformation changes the data compression dynamically, i.e. the choice of data format follows the solution characteristics, and it does not require us to alter the core simulation code