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Patent filings suggest increasing intensity of antibacterial drug discovery in recent years, but the share of patents published by commercial companies has declined.
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Antibacterianos , Descoberta de DrogasRESUMO
Objectives: Clinical guidelines or guidance is an important tool for preventing and treating antimicrobial-resistant (AMR) infections. We sought to understand and support the effective use of guidelines and guidance for AMR infections. Methods: Key informant interviews and a stakeholder meeting on the development and use of guidelines and guidance for management of AMR infections; the interview findings and meeting discussion informed a conceptual framework for AMR infection clinical guidelines. Participants: Interview participants included experts with experience in guidelines development and physician and pharmacist hospital leaders and antibiotic stewardship program leaders. Stakeholder meeting participants included federal and nonfederal participants involved in research, policy, and practice related to prevention and management of AMR infections. Results: Participants described challenges related to timeliness of guidelines, methodologic limitations of the development process, and issues with usability across a range of clinical settings. These findings, and participants' suggestions for mitigating the challenges identified, informed a conceptual framework for AMR infection clinical guidelines. The framework components include (1) science and evidence, (2) guideline and guidance development and dissemination, and (3) implementation and real-world practice. These components are supported by engaged stakeholders whose leadership and resources help to improve patient and population AMR infection prevention and management. Conclusions: Use of guidelines and guidance documents for management of AMR infections can be supported through (1) a robust body of scientific evidence to inform guidelines and guidance; (2) approaches and tools to support timely, transparent guidelines that are relevant and actionable for all clinical audiences; and (3) tools to implement guidelines and guidance effectively.
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Pesquisa Biomédica/normas , Sexo , Animais , Feminino , Humanos , Masculino , National Institutes of Health (U.S.) , Estados Unidos , Saúde da MulherRESUMO
Protection of the world's remaining forests and biodiversity is a matter of global concern. Yunnan, China is home to China's only mainland tropical rainforests, and 20% of China's total biodiversity. Despite restoration measures and establishment of new protected areas, this region is still experiencing biodiversity loss due to inadequate management and monitoring. We evaluate restoration success of China's tropical forests in Xishuangbanna National Nature Reserve (XSBN-NNR), Yunnan, China using dung beetles as an indicator taxon. We sampled across a land-use gradient of human alteration: protected forest, restored forest, community owned forest, and rubber plantation. We collected 3,748 dung beetles from 21 species over a 3 month period. Multivariate analyses revealed unique assemblages in each land-use category, but with restored forest most similar to protected areas, suggesting restoration success in this region. Community forests were more diverse than plantations, suggesting that community forests may be a valuable and practical conservation tool in this region. Most species were generalists, although some had dietary and habitat preferences. Furthermore, dietary niche breadths were, on average, higher in disturbed areas, suggesting that disturbance may result in dietary changes. We show that restoration of tropical forests appears to be successful for a key ecological and biological indicator group- dung beetles. Furthermore, community-owned forests appear to be valuable and practical method of maintaining ecosystem health and biodiversity in the region. Future management in this region would likely benefit from encouragement to maintain community-owned forests, economic incentives for restoring farmland to forest, and increased environmental monitoring across the land-use gradient.
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Biodiversidade , Besouros/fisiologia , Conservação dos Recursos Naturais , Agricultura Florestal/métodos , Floresta Úmida , Animais , China , HumanosRESUMO
Research on the spatial patterns of human-wildlife conflict is fundamental to understanding the mechanisms underlying it and to identifying opportunities for mitigation. In the state of Xishuangbanna, containing China's largest tropical forest, an imbalance between nature conservation and economic development has led to increasing conflicts between humans and Asian elephants (Elephas maximus), as both elephant numbers and conversion of habitable land to rubber plantations have increased over the last several decades. We analyzed government data on the compensation costs of elephant-caused damage in Xishuangbanna between 2008 and 2012 to understand the spatial and temporal patterns of conflict, in terms of their occurrence, frequency and distribution. More than 18,261 incidents were reported, including episodes involving damage to rubber trees (n = 10,999), damage to crops such as paddy, upland rice, corn, bananas and sugarcane (n = 11,020), property loss (n = 689) and attacks on humans (n = 19). The conflict data reconfirmed the presence of elephants in areas which have lacked records since the late 1990s. Zero Altered Negative Binomial models revealed that the risk of damage to crops and plantations increased with proximity to protected areas, increasing distance from roads, and lower settlement density. The patterns were constant across seasons and types of crop damaged. Damage to rubber trees was essentially incidental as elephants searched for crops to eat. A predictive map of risks revealed hotspots of conflict within and around protected areas, the last refuges for elephants in the region, and along habitat corridors connecting them. Additionally, we analyzed how mitigation efforts can best diminish the risk of conflict while minimizing financial costs and adverse biological impacts. Our analytical approach can be adopted, adjusted and expanded to other areas with historical records of human-wildlife conflict.
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Conservação dos Recursos Naturais , Elefantes , Animais , China , Produtos Agrícolas , Florestas , HumanosRESUMO
Translating policy into action is a complex task, with much debate surrounding the process whereby US and Canadian health funding agencies intend to integrate sex and gender science as an integral component of methodological rigor and reporting in health research. Effective January 25, 2016, the US National Institutes of Health implemented a policy that expects scientists to account for the possible role of sex as a biological variable (SABV) in vertebrate animal and human studies. Applicants for NIH-funded research and career development awards will be asked to explain how they plan to factor consideration of SABV into their research design, analysis, and reporting; strong justification will be required for proposing single-sex studies. The Canadian Institutes of Health Research is revising their peer review accreditation process to ensure that peer reviewers are skilled in applying a critical lens to protocols that should be incorporating sex and gender science. The current paper outlines the components that peer reviewers in North America will be asked to assess when considering whether SABV is appropriately integrated into research designs, analyses, and reporting. Consensus argues against narrowly defining rules of engagement in applying SABV, with criteria provided for reviewers as guidance only. Scores will not be given for each criterion; applications will be judged on the overall merit of scientific innovation, rigor, reproducibility, and potential impact.
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This report describes a school-based screening project to improve early identification of children at risk for attention-deficit/hyperactivity disorder (ADHD) and communicate these concerns to parents, recommending that they contact their child's primary care provider (PCP). Of 17,440 eligible children in first through fifth grades in five school districts, 47.0% of parents provided required written consent, and teachers completed 70.4% of the online screeners (using the Vanderbilt AD/HD Diagnostic Teacher Rating Scale). Of 5,772 screeners completed, 18.1% of children (n = 1,044) were identified as at risk. Parents of at-risk children were contacted to explain risk status and recommended to visit their child's PCP for further evaluation. It was not possible to contact 39.1% of parents of at-risk children. Of the 636 parents of at-risk children who could be contacted, 53.1% (n = 338) verbally accepted the recommendation to follow-up with their PCP, which was not related to ADHD symptom severity. Parents of children with IEPs or related services were more likely to accept the recommendation to visit the PCP. Our exploration of the potential for school-based screening for ADHD identified a number of barriers to successful execution, but the data also indicated that this is an important problem to address.