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

Host Selection of the giant willow aphid (Tuberolachnus salignus)

The giant willow aphid [Tuberolachnus salignus (Gmelin)] has recently become noteworthy as a potential pest species due to the increased uptake of willow, its host-plant, for use in growing biomass for energy production. In this paper we describe host selection studies of T. salignus on short rotation coppice (SRC) willow varieties in laboratory bioassays and field experiments. In laboratory olfactometry tests, T. salignus was significantly attracted to certain SRC willow varieties, but not to others. Field trials during 2007 and 2008 showed that T. salignus infestation levels varied significantly on different SRC willow varieties and that levels are highest on the varieties to which they are most strongly attracted in the laboratory bioassays

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

Inquiries Into Real Estate and Macroeconomics: Zoning & Monetary Policy Regimes

In Chapter 1, I take advantage of uncertainty regarding future land use restrictions in order to empirically identify the value of the redevelopment option embedded in real estate prices for New York City (NYC) from 2003-2015. Using a two-stage estimation procedure, ergodic propensities to be zoned to either residential, commercial, or manufacturing land uses are interacted with a proxy for the propensity to be redeveloped. Results show that the interactions provide significantly greater explanatory power than using the intensity proxy alone. And that all option value terms are statistically significant. I estimate the average option value to redevelop in Manhattan \& Brooklyn for years 2003-2015 is 20\% and 8.5\% of total estimated property value in Manhattan and Brooklyn respectively. I also find evidence that manufacturing lots identified as residential by the model sell for a premium of 50\% per square foot. Chapter 2 considers commercial real estate (CRE), a major institutional asset class to which the banking sector has considerable exposure. Because CRE prices tend to be smoothed it is hard to infer their relationship with fundamentals. This is compounded by the presence of complicated underlying dynamics. For instance, inflation acts to increase discount rates but may also be associated with higher rental revenues. Thus it is difficult to sign the impact of inflation on CRE prices, especially given that the dynamics of macro fundamentals periodically undergo regime changes. Similar considerations apply to real economic growth and, by extension, interest rates. We estimate a model, consistent with rational expectations, where regime-dependent macro fundamentals are anticipated in prices. We find that real estate fundamentals and prices vary with macro fundamentals and are highly sensitive to potential regime changes. Correspondingly, information in real estate prices improves the identification macro regimes. Our model allows us to quantify sources of systematic risk in real estate and price mortgages (which are sensitive to the joint dynamics of interest rates and real estate prices). To the extent that regimes in macro fundamentals arise from shifts in monetary policy, our model may also be used for policy analysis.Doctor of Philosoph

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

PCR-based gut content analysis to identify arthropod predators of Haplodiplosis marginata

Saddle gall midge (Haplodiplosis marginata) is a cereal pest exhibiting sporadic outbreaks for which chemical control options are limited. Integrated Pest Management programs may offer a means of suppressing H. marginata outbreaks, reducing pesticide input. Many IPM programs benefit from the natural population suppression inflicted through predation and parasitism. The larval stage of H. marginata overwinters in the soil and may be preyed upon by ground-dwelling arthropods, however the natural enemies of H. marginata remain unrecognized. A PCR-based assay for detecting H. marginata in the guts of predators was designed using novel species-specific primers. Feeding trials involving H. marginata larvae showed a detectability half-life of 31.07 h post-feeding in Nebria brevicollis. The guts of field-caught Carabidae were screened for H. marginata DNA. Four species: Poecilus versicolor, Nebria brevicollis, Harpalus rufipes and Loricera pilicornis were identified as natural enemies of H. marginata for the first time. A higher proportion of positive results were obtained at the end of H. marginata emergence (July) compared to the beginning (May). The importance of understanding trophic interactions in the management of H. marginata is discussed in addition to the potential uses for the newly designed assay and primers

A review of the biology, ecology and control of saddle gall midge,Haplodiplosis marginata(Diptera: Cecidomyiidae) with a focus on phenological forecasting

Saddle gall midge Haplodiplosis marginata (Diptera: Cecidomyiidae) is a pest of cereals across Europe. The occasional nature of this pest has resulted in limited and sporadic research activity. There remain important gaps in knowledge due either to a genuine lack of research or to previous research being difficult to access. These knowledge gaps make the development of effective control options difficult. Here, we review the existing literature in an attempt to consolidate the information on H. marginata from research which spans several decades and encompasses many different countries. The current distribution and pest status of this insect are updated, along with the methods of cultural and chemical control available to growers. The biology and life history of the insect are described in detail and the ecological processes governing them are discussed. A forecasting model is presented which allows the emergence of this pest in the UK to be predicted from degree day data, and the potential application of this model in management decisions is discussed. Finally, the areas in most need of further research are identified, along with suggestions of how this information can be used to help develop effective and sustainable management solutions for this pest

Project MOSI: rationale and pilot-study results of an initiative to help protect zoo animals from mosquito-transmitted pathogens and contribute data on mosquito spatio–temporal distribution change

Mosquito-borne pathogens pose major threats to both wildlife and human health and, largely as a result of unintentional human-aided dispersal of their vector species, their cumulative threat is on the rise. Anthropogenic climate change is expected to be an increasingly significant driver of mosquito dispersal and associated disease spread. The potential health implications of changes in the spatio-temporal distribution of mosquitoes highlight the importance of ongoing surveillance and, where necessary, vector control and other health-management measures. The World Association of Zoos and Aquariums initiative, Project MOSI, was established to help protect vulnerable wildlife species in zoological facilities from mosquito-transmitted pathogens by establishing a zoo-based network of fixed mosquito monitoring sites to assist wildlife health management and contribute data on mosquito spatio-temporal distribution changes. A pilot study for Project MOSI is described here, including project rationale and results that confirm the feasibility of conducting basic standardized year-round mosquito trapping and monitoring in a zoo environment

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

The interaction between supportive and unsupportive manager behaviors on employee work attitudes

Purpose: To use Social Exchange Theory (SET) to examine a model where supportive (SMB) and unsupportive (UMB) manager behaviors interact to predict employees’ engagement, job satisfaction and turnover intention. Design/Methodology: A cross-sectional online survey collected data from 252 UK based employees of a global data management company. Findings: Factor analysis confirmed manager behaviors to consist of two constructs: supportive and unsupportive behaviors. Structural equation modelling indicated SMB predicted job satisfaction and turnover intentions, but not engagement. Job satisfaction, but not engagement, mediated the SMB-turnover intention relationship. UMB only predicted job dissatisfaction. Neither job satisfaction nor engagement mediated the UMB-turnover intention relationship. UMB undermined the positive relationship between SMB and turnover intention. Implications: The behaviors assessed can be integrated into various stages of a manager’s development process to serve as guidelines of good practice. Crucially, findings suggest managers can exhibit both supportive and unsupportive behaviors, and that consistency in behaviors is important. The study also provides evidence that supportive managers can help reduce turnover intention through job satisfaction. Originality/value: SET was used as a framework for SMB, UMB and engagement. To our knowledge this is the first study to examine the interaction between SMB and UMB