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1.
Nature ; 597(7876): 360-365, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34526707

RESUMO

Fish and other aquatic foods (blue foods) present an opportunity for more sustainable diets1,2. Yet comprehensive comparison has been limited due to sparse inclusion of blue foods in environmental impact studies3,4 relative to the vast diversity of production5. Here we provide standardized estimates of greenhouse gas, nitrogen, phosphorus, freshwater and land stressors for species groups covering nearly three quarters of global production. We find that across all blue foods, farmed bivalves and seaweeds generate the lowest stressors. Capture fisheries predominantly generate greenhouse gas emissions, with small pelagic fishes generating lower emissions than all fed aquaculture, but flatfish and crustaceans generating the highest. Among farmed finfish and crustaceans, silver and bighead carps have the lowest greenhouse gas, nitrogen and phosphorus emissions, but highest water use, while farmed salmon and trout use the least land and water. Finally, we model intervention scenarios and find improving feed conversion ratios reduces stressors across all fed groups, increasing fish yield reduces land and water use by up to half, and optimizing gears reduces capture fishery emissions by more than half for some groups. Collectively, our analysis identifies high-performing blue foods, highlights opportunities to improve environmental performance, advances data-poor environmental assessments, and informs sustainable diets.


Assuntos
Aquicultura , Ecossistema , Monitoramento Ambiental , Alimentos Marinhos , Desenvolvimento Sustentável , Animais , Aquicultura/tendências , Mudança Climática , Dieta , Ecologia , Política Ambiental , Pesqueiros , Abastecimento de Alimentos/métodos , Gases de Efeito Estufa , Humanos , Moluscos , Nitrogênio , Fósforo , Alimentos Marinhos/provisão & distribuição , Alga Marinha , Desenvolvimento Sustentável/tendências
3.
J Antimicrob Chemother ; 76(1): 1-21, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33057678

RESUMO

The global threat of antimicrobial resistance (AMR) requires coordinated actions by and across different sectors. Increasing attention at the global and national levels has led to different strategies to tackle the challenge. The diversity of possible actions to address AMR is currently not well understood from a One Health perspective. AMR-Intervene, an interdisciplinary social-ecological framework, describes interventions to tackle AMR in terms of six components: (i) core information about the publication; (ii) social system; (iii) bio-ecological system; (iv) triggers and goals; (v) implementation and governance; and (vi) assessment. AMR-Intervene provides a broadly applicable framework, which can inform the design, implementation, assessment and reporting of interventions to tackle AMR and, in turn, enable faster uptake of successful interventions to build societal resilience to AMR.


Assuntos
Saúde Única , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana
4.
BMC Infect Dis ; 21(1): 873, 2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34445962

RESUMO

BACKGROUND: Antimicrobial resistance (AMR) is among the most pressing One Health issues. While interventions and policies with various targets and goals have been implemented, evidence about factors underpinning success and failure of interventions in different sectors is lacking. The objective of this study is to identify characteristics of AMR interventions that increase their capacity to impact AMR. This study focuses on AMR interventions targeting E. coli. METHODS: We used the AMR-Intervene framework to extract descriptions of the social and ecological systems of interventions to determine factors contributing to their success. RESULTS: We identified 52 scientific publications referring to 42 unique E. coli AMR interventions. We mainly identified interventions implemented in high-income countries (36/42), at the national level (16/42), targeting primarily one sector of society (37/42) that was mainly the human sector (25/42). Interventions were primarily funded by governments (38/42). Most intervention targeted a low leverage point in the AMR system, (36/42), and aimed to change the epidemiology of AMR (14/42). Among all included publications, 55% (29/52) described at least one success factor or obstacle (29/52) and 19% (10/52) identified at least one success factor and one obstacle. Most reported success factors related to communication between the actors and stakeholders and the role of media, and stressed the importance of collaboration between disciplines and external partners. Described obstacles covered data quality, access to data and statistical analyses, and the validity of the results. CONCLUSIONS: Overall, we identified a lack of diversity regarding interventions. In addition, most published E. coli interventions were poorly described with limited evidence of the factors that contributed to the intervention success or failure. Design and reporting guidelines would help to improve reporting quality and provide a valuable tool for improving the science of AMR interventions.


Assuntos
Escherichia coli , Saúde Única , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana , Humanos
5.
Proc Natl Acad Sci U S A ; 115(12): 2958-2963, 2018 03 20.
Artigo em Inglês | MEDLINE | ID: mdl-29507224

RESUMO

Food production is a major driver of global environmental change and the overshoot of planetary sustainability boundaries. Greater affluence in developing nations and human population growth are also increasing demand for all foods, and for animal proteins in particular. Consequently, a growing body of literature calls for the sustainable intensification of food production, broadly defined as "producing more using less". Most assessments of the potential for sustainable intensification rely on only one or two indicators, meaning that ecological trade-offs among impact categories that occur as production intensifies may remain unaccounted for. The present study addresses this limitation using life cycle assessment (LCA) to quantify six local and global environmental consequences of intensifying aquaculture production in Bangladesh. Production data are from a unique survey of 2,678 farms, and results show multidirectional associations between the intensification of aquaculture production and its environmental impacts. Intensification (measured in material and economic output per unit primary area farmed) is positively correlated with acidification, eutrophication, and ecotoxicological impacts in aquatic ecosystems; negatively correlated with freshwater consumption; and indifferent with regard to global warming and land occupation. As production intensifies, the geographical locations of greenhouse gas (GHG) emissions, acidifying emissions, freshwater consumption, and land occupation shift from the immediate vicinity of the farm to more geographically dispersed telecoupled locations across the globe. Simple changes in fish farming technology and management practices that could help make the global transition to more intensive forms of aquaculture be more sustainable are identified.


Assuntos
Aquicultura/economia , Animais , Bangladesh , Benchmarking , Comércio , Meio Ambiente , Peixes/fisiologia , Humanos , Modelos Teóricos
6.
Environ Sci Technol ; 54(24): 16062-16070, 2020 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-33251804

RESUMO

Seafood is seen as promising for more sustainable diets. The increasing production in land-based closed Recirculating Aquaculture Systems (RASs) has overcome many local environmental challenges with traditional open net-pen systems such as eutrophication. The energy needed to maintain suitable water quality, with associated emissions, has however been seen as challenging from a global perspective. This study uses Life Cycle Assessment (LCA) to investigate the environmental performance and improvement potentials of a commercial RAS farm of tilapia and Clarias in Sweden. The environmental impact categories and indicators considered were freshwater eutrophication, climate change, energy demand, land use, and dependency on animal-source feed inputs per kg of fillet. We found that feed production contributed most to all environmental impacts (between 67 and 98%) except for energy demand for tilapia, contradicting previous findings that farm-level energy use is a driver of environmental pressures. The main improvement potentials include improved by-product utilization and use of a larger proportion of plant-based feed ingredients. Together with further smaller improvement potential identified, this suggests that RASs may play a more important role in a future, environmentally sustainable food system.


Assuntos
Aquicultura , Pesqueiros , Ração Animal/análise , Animais , Estágios do Ciclo de Vida , Suécia
7.
Environ Sci Technol ; 52(4): 2152-2161, 2018 02 20.
Artigo em Inglês | MEDLINE | ID: mdl-29406730

RESUMO

Interpretation of comparative Life Cycle Assessment (LCA) results can be challenging in the presence of uncertainty. To aid in interpreting such results under the goal of any comparative LCA, we aim to provide guidance to practitioners by gaining insights into uncertainty-statistics methods (USMs). We review five USMs-discernibility analysis, impact category relevance, overlap area of probability distributions, null hypothesis significance testing (NHST), and modified NHST-and provide a common notation, terminology, and calculation platform. We further cross-compare all USMs by applying them to a case study on electric cars. USMs belong to a confirmatory or an exploratory statistics' branch, each serving different purposes to practitioners. Results highlight that common uncertainties and the magnitude of differences per impact are key in offering reliable insights. Common uncertainties are particularly important as disregarding them can lead to incorrect recommendations. On the basis of these considerations, we recommend the modified NHST as a confirmatory USM. We also recommend discernibility analysis as an exploratory USM along with recommendations for its improvement, as it disregards the magnitude of the differences. While further research is necessary to support our conclusions, the results and supporting material provided can help LCA practitioners in delivering a more robust basis for decision-making.


Assuntos
Interpretação Estatística de Dados , Reciclagem , Probabilidade , Incerteza
8.
Beilstein J Org Chem ; 12: 1629-37, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27559416

RESUMO

Two high bandgap benzodithiophene-benzotriazole-based polymers were synthesized via palladium-catalysed Stille coupling reaction. In order to compare the effect of the side chains on the opto-electronic and photovoltaic properties of the resulting polymers, the benzodithiophene monomers were substituted with either octylthienyl (PTzBDT-1) or dihexylthienyl (PTzBDT-2) as side groups, while the benzotriazole unit was maintained unaltered. The optical characterization, both in solution and thin-film, indicated that PTzBDT-1 has a red-shifted optical absorption compared to PTzBDT-2, likely due to a more planar conformation of the polymer backbone promoted by the lower content of alkyl side chains. The different aggregation in the solid state also affects the energetic properties of the polymers, resulting in a lower highest occupied molecular orbital (HOMO) for PTzBDT-1 with respect to PTzBDT-2. However, an unexpected behaviour is observed when the two polymers are used as a donor material, in combination with PC61BM as acceptor, in bulk heterojunction solar cells. Even though PTzBDT-1 showed favourable optical and electrochemical properties, the devices based on this polymer present a power conversion efficiency of 3.3%, considerably lower than the efficiency of 4.7% obtained for the analogous solar cells based on PTzBDT-2. The lower performance is presumably attributed to the limited solubility of the PTzBDT-1 in organic solvents resulting in enhanced aggregation and poor intermixing with the acceptor material in the active layer.

9.
Environ Sci Technol ; 49(24): 14176-83, 2015 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-26512735

RESUMO

We investigated aquaculture production of Asian tiger shrimp, whiteleg shrimp, giant river prawn, tilapia, and pangasius catfish in Bangladesh, China, Thailand, and Vietnam by using life cycle assessments (LCAs), with the purpose of evaluating the comparative eco-efficiency of producing different aquatic food products. Our starting hypothesis was that different production systems are associated with significantly different environmental impacts, as the production of these aquatic species differs in intensity and management practices. In order to test this hypothesis, we estimated each system's global warming, eutrophication, and freshwater ecotoxicity impacts. The contribution to these impacts and the overall dispersions relative to results were propagated by Monte Carlo simulations and dependent sampling. Paired testing showed significant (p < 0.05) differences between the median impacts of most production systems in the intraspecies comparisons, even after a Bonferroni correction. For the full distributions instead of only the median, only for Asian tiger shrimp did more than 95% of the propagated Monte Carlo results favor certain farming systems. The major environmental hot-spots driving the differences in environmental performance among systems were fishmeal from mixed fisheries for global warming, pond runoff and sediment discards for eutrophication, and agricultural pesticides, metals, benzalkonium chloride, and other chlorine-releasing compounds for freshwater ecotoxicity. The Asian aquaculture industry should therefore strive toward farming systems relying upon pelleted species-specific feeds, where the fishmeal inclusion is limited and sourced sustainably. Also, excessive nutrients should be recycled in integrated organic agriculture together with efficient aeration solutions powered by renewable energy sources.


Assuntos
Aquicultura/métodos , Meio Ambiente , Ração Animal , Animais , Bangladesh , Peixes-Gato , China , Crustáceos , Eutrofização , Aquecimento Global , Método de Monte Carlo , Praguicidas , Tailândia , Tilápia , Vietnã
10.
J Am Chem Soc ; 136(4): 1190-3, 2014 Jan 29.
Artigo em Inglês | MEDLINE | ID: mdl-24422463

RESUMO

Here we report on the synthesis of two novel very low band gap (VLG) donor-acceptor polymers (Eg ≤ 1 eV) and an oligomer based on the thiadiazoloquinoxaline acceptor. Both polymers demonstrate decent ambipolar mobilities, with P1 showing the best performance of ∼10(-2) cm(2) V(-1) s(-1) for p- and n-type operation. These polymers are among the lowest band gap polymers (≲0.7 eV) reported, with a neutral λmax = 1476 nm (P2), which is the farthest red-shifted λmax reported to date for a soluble processable polymer. Very little has been done to characterize the electrochromic aspects of VLG polymers; interestingly, these polymers actually show a bleaching of their neutral absorptions in the near-infrared region and have an electrochromic contrast up to 30% at a switching speed of 3 s.


Assuntos
Compostos Azo/química , Polímeros/química , Quinoxalinas/química , Estrutura Molecular , Polímeros/síntese química , Teoria Quântica
11.
Phys Chem Chem Phys ; 16(45): 24853-65, 2014 Dec 07.
Artigo em Inglês | MEDLINE | ID: mdl-25318819

RESUMO

A series of nine donor-acceptor polymers, including three new and six polymers from previous work, have been investigated experimentally and theoretically. The investigation focuses on narrow band gaps and strong absorptions of the polymers, where experimentally determined first peak absorption energies range from 1.8 to 2.3 eV, and peak absorption coefficients vary between 19-67 L g(-1) cm(-1). An overall assessment of each polymer's light-harvesting capability is made, and related to the chemical structure. Oligomer calculations using density functional theory are extrapolated to obtain size-converged polymer properties, and found to reproduce the experimental absorption trends well. Accurate theoretical predictions of absorption energies to within 0.06 eV of experiments, and absorption strength to within 12%, are obtained through the introduction of an empirical correction scheme. The computational and experimental results provide insight for the design of polymers with efficient absorption, concerning the intrinsic properties of the constituent units and the use of bulky side-groups.

14.
PLoS One ; 18(8): e0290464, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37616319

RESUMO

BACKGROUND: Antimicrobial Resistance (AMR) is a global problem with large health and economic consequences. Current gaps in quantitative data are a major limitation for creating models intended to simulate the drivers of AMR. As an intermediate step, expert knowledge and opinion could be utilized to fill gaps in knowledge for areas of the system where quantitative data does not yet exist or are hard to quantify. Therefore, the objective of this study was to identify quantifiable data about the current state of the factors that drive AMR and the strengths and directions of relationships between the factors from statements made by a group of experts from the One Health system that drives AMR development and transmission in a European context. METHODS: This study builds upon previous work that developed a causal loop diagram of AMR using input from two workshops conducted in 2019 in Sweden with experts within the European food system context. A secondary analysis of the workshop transcripts was conducted to identify semi-quantitative data to parameterize drivers in a model of AMR. MAIN FINDINGS: Participants spoke about AMR by combining their personal experiences with professional expertise within their fields. The analysis of participants' statements provided semi-quantitative data that can help inform a future of AMR emergence and transmission based on a causal loop diagram of AMR in a Swedish One Health system context. CONCLUSION: Using transcripts of a workshop including participants with diverse expertise across the system that drives AMR, we gained invaluable insight into the past, current, and potential future states of the major drivers of AMR, particularly where quantitative data are lacking.


Assuntos
Antibacterianos , Prova Pericial , Humanos , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana , Conhecimento , Assistência Médica
15.
Lancet Planet Health ; 7(7): e630-e637, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37438004

RESUMO

Social-ecological systems conceptualise how social human systems and ecological natural systems are intertwined. In this Personal View, we define the scope and applicability of social-ecological resilience to antimicrobial resistance. Resilience to antimicrobial resistance corresponds to the capacity to maintain the societal benefits of antimicrobial use and One Health systems' performance in the face of the evolutionary behaviour of microorganisms in response to antimicrobial use. Social-ecological resilience provides an appropriate framework to make sense of the disruptive impacts resulting from the emergence and spread of antimicrobial resistance; capture the diversity of strategies needed to tackle antimicrobial resistance and to live with it; understand the conditions that underpin the success or failure of interventions; and appreciate the need for adaptive and coevolutionary governance. Overall, resilience thinking is essential to improve understanding of how human societies dynamically can cope with, adapt, and transform to the growing global challenge of antimicrobial resistance.


Assuntos
Antibacterianos , Farmacorresistência Bacteriana , Humanos , Ecossistema
16.
Front Public Health ; 11: 1230848, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37900049

RESUMO

Introduction: Antimicrobial resistance (AMR) is a challenge to modern medicine. Interventions have been applied worldwide to tackle AMR, but these actions are often not reported to peers or published, leading to important knowledge gaps about what actions are being taken. Understanding factors that influence the implementation of AMR interventions and what factors are relevant in low-middle-income countries (LMICs) and high-income countries (HICs) were the key objectives of this exploratory study, with the aim to identifying which priorities these contexts need. Methods: A questionnaire was used to explore context, characteristics, and success factors or obstacles to intervention success based on participant input. The context was analyzed using the AMR-Intervene framework, and success factors and obstacles to intervention success were identified using thematic analysis. Results: Of the 77 interventions, 57 were implemented in HICs and 17 in LMICs. Interventions took place in the animal sector, followed by the human sector. Public organizations were mainly responsible for implementation and funding. Nine themes and 32 sub-themes emerged as important for intervention success. The themes most frequently reported were 'behavior', 'capacity and resources', 'planning', and 'information'. Five sub-themes were key in all contexts ('collaboration and coordination', 'implementation', 'assessment', 'governance', and 'awareness'), two were key in LMICs ('funding and finances' and 'surveillance, antimicrobial susceptibility testing and preventive screening'), and five were key in HICs ('mandatory', 'multiple profiles', 'personnel', 'management', and 'design'). Conclusion: LMIC sub-themes showed that funding and surveillance were still key issues for interventions, while important HIC sub-themes were more specific and detailed, including mandatory enforcement, multiple profiles, and personnel needed for good management and good design. While behavior is often underrated when implementing AMR interventions, capacity and resources are usually considered, and LMICs can benefit from sub-themes captured in HICs if tailored to their contexts. The factors identified can improve the design, planning, implementation, and evaluation of interventions.


Assuntos
Antibacterianos , Países em Desenvolvimento , Animais , Humanos , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana , Renda , Conhecimentos, Atitudes e Prática em Saúde
17.
Int J Life Cycle Assess ; 17(3): 304-313, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-26069396

RESUMO

PURPOSE: As capture fishery production has reached its limits and global demand for aquatic products is still increasing, aquaculture has become the world's fastest growing animal production sector. In attempts to evaluate the environmental consequences of this rapid expansion, life cycle assessment (LCA) has become a frequently used method. The present review of current peer-reviewed literature focusing on LCA of aquaculture systems is intended to clarify the methodological choices made, identify possible data gaps, and provide recommendations for future development within this field of research. The results of this review will also serve as a start-up activity of the EU FP7 SEAT (Sustaining Ethical Aquaculture Trade) project, which aims to perform several LCA studies on aquaculture systems in Asia over the next few years. METHODS: From a full analysis of methodology in LCA, six phases were identified to differ the most amongst ten peer-reviewed articles and two PhD theses (functional unit, system boundaries, data and data quality, allocation, impact assessment methods, interpretation methods). Each phase is discussed with regards to differences amongst the studies, current LCA literature followed by recommendations where appropriate. The conclusions and recommendations section reflects on aquaculture-specific scenarios as well as on some more general issues in LCA. RESULTS: Aquaculture LCAs often require large system boundaries, including fisheries, agriculture, and livestock production systems from around the globe. The reviewed studies offered limited coverage of production in developing countries, low-intensity farming practices, and non-finfish species, although most farmed aquatic products originate from a wide range of farming practices in Asia. Apart from different choices of functional unit, system boundaries and impact assessment methods, the studies also differed in their choice of allocation factors and data sourcing. Interpretation of results also differed amongst the studies, and a number of methodological choices were identified influencing the outcomes. CONCLUSIONS AND RECOMMENDATIONS: Efforts should be made to increase transparency to allow the results to be reproduced, and to construct aquaculture related database(s). More extensive data reporting, including environmental flows, within the greater field of LCA could be achieved, without compromising the focus of studies, by providing supporting information to articles and/or reporting only ID numbers from background databases. More research is needed into aquaculture in Asia based on the latest progress made by the LCA community.

18.
Antibiotics (Basel) ; 11(5)2022 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-35625282

RESUMO

Antimicrobial resistance (AMR) affects the environment, and animal and human health. Institutions worldwide have applied various measures, some of which have reduced antimicrobial use and AMR. However, little is known about factors influencing the success of AMR interventions. To address this gap, we engaged health professionals, designers, and implementers of AMR interventions in an exploratory study to learn about their experience and factors that challenged or facilitated interventions and the context in which interventions were implemented. Based on participant input, our thematic analysis identified behaviour; institutional governance and management; and sharing and enhancing information as key factors influencing success. Important sub-themes included: correct behaviour reinforcement, financial resources, training, assessment, and awareness of AMR. Overall, interventions were located in high-income countries, the human sector, and were publicly funded and implemented. In these contexts, behaviour patterns strongly influenced success, yet are often underrated or overlooked when designing AMR interventions. Improving our understanding of what contributes to successful interventions would allow for better designs of policies that are tailored to specific contexts. Exploratory approaches can provide encouraging results in complex challenges, as made evident in our study. Remaining challenges include more engagement in this type of study by professionals and characterisation of themes that influence intervention outcomes by context.

19.
PLoS One ; 17(2): e0263914, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35192666

RESUMO

INTRODUCTION: Antimicrobial resistance (AMR) is a global crisis that evolves from a complex system of factors. Understanding what factors interact is key to finding solutions. Our objective was to identify the factors influencing AMR in the European food system and places to intervene. MATERIALS AND METHODS: We conducted two workshops involving participants with diverse perspectives to identify the factors influencing AMR and leverage points (places) to target interventions. Transcripts were open coded for factors and connections, then transcribed into Vensim 8.0.4 to develop a causal loop diagram (CLD) and compute the number of feedback loops. Thematic analysis followed to describe AMR dynamics in Europe's food system and places for intervention. The CLD and themes were confirmed via participant feedback. RESULTS: Seventeen participants representing human, animal and agricultural sectors identified 91 CLD factors and 331 connections. Seven themes (e.g., social and economic conditions) describing AMR dynamics in Europe's food system, five 'overarching factors' that impact the entire CLD system (e.g., leadership) and fourteen places for intervention (e.g., consumer demand) emerged from workshop discussions. Most leverage points fell on highly networked feedback loops suggesting that intervening at these places may create unpredictable consequences. CONCLUSIONS: Our study produced a CLD of factors influencing AMR in Europe's food system that implicates sectors across the One Health spectrum. The high connectivity between the CLD factors described by participants and our finding that factors are connected with many feedback mechanisms underscores the complexity of the AMR problem and the challenge with finding long-term solutions. Identifying factors and feedbacks helped identify relevant leverage points in the system. Some actions, such as government's setting AMU standards may be easier to implement. These actions in turn can support multi-pronged actions that can help redefine the vision, values and goals of the system to sustainably tackle AMR.


Assuntos
Resistência Microbiana a Medicamentos , Qualidade dos Alimentos , Controle de Qualidade , Pesquisa Participativa Baseada na Comunidade/normas , Europa (Continente) , Humanos
20.
Front Microbiol ; 13: 992507, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36687632

RESUMO

Background: With AMU projected to increase, South East Asia (SEA) is at high risk of experiencing disproportionate health, social, and economic burdens due to antimicrobial resistance (AMR). Our objective was to identify factors influencing AMR in SEA's food system and places for intervention by integrating the perspectives of experts from the region to inform policy and management decisions. Materials and methods: We conducted two 6.5 h workshops and two 90-min interviews involving 18 AMR and other disciplinary experts from human, animal, and environment sectors who brainstormed the factors influencing AMR and identified leverage points (places) for intervention. Transcripts and workshop materials were coded for factors and their connections and transcribed into a causal loop diagram (CLD). Thematic analysis described AMR dynamics in SEA's food system and leverage points for intervention. The CLD and themes were confirmed via participant feedback. Results: Participants constructed a CLD of AMR in the SEA food system that contained 98 factors interlinked by 362 connections. CLD factors reflected eight sub-areas of the SEA food system (e.g., government). Seven themes [e.g., antimicrobial and pesticide use and AMR spread (n = 40 quotes)], six "overarching factors" that impact the entire AMR system [e.g., the drive to survive (n = 12 quotes)], and 10 places for intervention that target CLD factors (n = 5) and overarching factors (n = 2) emerged from workshop discussions. Conclusion: The participant derived CLD of factors influencing AMR in the SEA food system demonstrates that AMR is a product of numerous interlinked actions taken across the One Health spectrum and that finding solutions is no simple task. Developing the model enabled the identification of potentially promising leverage points across human, animal, and environment sectors that, if comprehensively targeted using multi-pronged interventions, could evoke system wide changes that mitigate AMR. Even targeting some leverage points for intervention, such as increasing investments in research and capacity building, and setting and enforcing regulations to control antimicrobial supply, demand, and use could, in turn, shift mindsets that lead to changes in more difficult to alter leverage points, such as redefining the profit-driven intent that drives system behavior in ways that transform AMU and sustainably mitigate AMR.

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