Tanya Stivers
- Published in print:
- 2007
- Published Online:
- January 2010
- ISBN:
- 9780195311150
- eISBN:
- 9780199870837
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195311150.001.0001
- Subject:
- Linguistics, Sociolinguistics / Anthropological Linguistics
Antibiotics will soon no longer be able to cure common illnesses such as strep throat, sinusitis, and middle ear infections as they have done previously. Antibiotic-resistant bacteria are increasing ...
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Antibiotics will soon no longer be able to cure common illnesses such as strep throat, sinusitis, and middle ear infections as they have done previously. Antibiotic-resistant bacteria are increasing at a much faster rate than new antibiotics to treat them are being developed. The prescription of antibiotics for viral illnesses is a key cause of increasing bacterial resistance. Despite this fact, many children continue to receive antibiotics unnecessarily for the treatment of viral upper respiratory tract infections. Why do American physicians continue to prescribe inappropriately given the high social stakes of this action? The answer appears to lie in the fundamentally social nature of medical practice: physicians do not prescribe as the result of a clinical algorithm but prescribe in the context of a conversation with a parent and a child. Thus, physicians have a classic social dilemma which pits individual parents and children against a greater social good. This book examines parent-physician conversations in detail, showing how parents put pressure on doctors in largely covert ways. It also shows how physicians yield to this seemingly subtle pressure evidencing that apparently small differences in wording have important consequences for diagnosis and treatment recommendations. Following parents use of these interactional practices, physicians are more likely to make concessions, alter their diagnosis or alter their treatment recommendation. This book also shows how small changes in the way physicians present their findings and recommendations can decrease parent pressure for antibiotics. It carefully documents the important and observable link between micro social interaction and macro public health domains.Less
Antibiotics will soon no longer be able to cure common illnesses such as strep throat, sinusitis, and middle ear infections as they have done previously. Antibiotic-resistant bacteria are increasing at a much faster rate than new antibiotics to treat them are being developed. The prescription of antibiotics for viral illnesses is a key cause of increasing bacterial resistance. Despite this fact, many children continue to receive antibiotics unnecessarily for the treatment of viral upper respiratory tract infections. Why do American physicians continue to prescribe inappropriately given the high social stakes of this action? The answer appears to lie in the fundamentally social nature of medical practice: physicians do not prescribe as the result of a clinical algorithm but prescribe in the context of a conversation with a parent and a child. Thus, physicians have a classic social dilemma which pits individual parents and children against a greater social good. This book examines parent-physician conversations in detail, showing how parents put pressure on doctors in largely covert ways. It also shows how physicians yield to this seemingly subtle pressure evidencing that apparently small differences in wording have important consequences for diagnosis and treatment recommendations. Following parents use of these interactional practices, physicians are more likely to make concessions, alter their diagnosis or alter their treatment recommendation. This book also shows how small changes in the way physicians present their findings and recommendations can decrease parent pressure for antibiotics. It carefully documents the important and observable link between micro social interaction and macro public health domains.
Carl T. Bergstrom and Michael Feldgarden
- Published in print:
- 2007
- Published Online:
- April 2010
- ISBN:
- 9780199207466
- eISBN:
- 9780191728167
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199207466.003.0010
- Subject:
- Biology, Evolutionary Biology / Genetics
Bacteria evolve resistance to antibiotics with near certainty after several years of widespread use. Resistance can evolve via several genetic mechanisms and spread through and between species via ...
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Bacteria evolve resistance to antibiotics with near certainty after several years of widespread use. Resistance can evolve via several genetic mechanisms and spread through and between species via gene transfer. Resistance that evolves in agricultural settings can transfer into human populations. Associations among resistance genes, and the process of compensatory evolution, can cause retention of resistance genes, even in the absence of selection favoring resistance. Novel approaches to antimicrobial therapy may provide alternatives to traditional broad-spectrum antibiotics for which resistance is less quick to evolve. To eradicate antibiotic resistance from a hospital setting, researchers need a thorough understanding of the underlying ecology. For example, antibiotic cycling, the hospital equivalent of crop rotation, does not necessarily reduce the environmental heterogeneity at the scale relevant to bacterial clones spreading through the hospital and thus may be ineffective at reducing the frequency of resistant strains in a hospital setting.Less
Bacteria evolve resistance to antibiotics with near certainty after several years of widespread use. Resistance can evolve via several genetic mechanisms and spread through and between species via gene transfer. Resistance that evolves in agricultural settings can transfer into human populations. Associations among resistance genes, and the process of compensatory evolution, can cause retention of resistance genes, even in the absence of selection favoring resistance. Novel approaches to antimicrobial therapy may provide alternatives to traditional broad-spectrum antibiotics for which resistance is less quick to evolve. To eradicate antibiotic resistance from a hospital setting, researchers need a thorough understanding of the underlying ecology. For example, antibiotic cycling, the hospital equivalent of crop rotation, does not necessarily reduce the environmental heterogeneity at the scale relevant to bacterial clones spreading through the hospital and thus may be ineffective at reducing the frequency of resistant strains in a hospital setting.
Norman A. Johnson
- Published in print:
- 2007
- Published Online:
- September 2007
- ISBN:
- 9780195306750
- eISBN:
- 9780199790203
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195306750.003.0001
- Subject:
- Biology, Evolutionary Biology / Genetics
The H5N1 avian flu virus has spread to fowl across several continents and has killed hundreds of people. Fortunately, this flu is not easily transmitted to humans yet; if it were, a deadly pandemic ...
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The H5N1 avian flu virus has spread to fowl across several continents and has killed hundreds of people. Fortunately, this flu is not easily transmitted to humans yet; if it were, a deadly pandemic would likely ensue. How did this virus arise? What are the factors that govern its evolution and its potential to be transmitted to humans? These are questions that can and have been addressed by the application of evolutionary principles. Evolutionary biology is also being applied to combat the evolution of resistance of bacteria to antibiotics, and insect pests to pesticides. This chapter addresses these and other applications of evolution, including plant and animal breeding, the human genome project, studies of aging and other maladaptations, and forensic uses. The facts and principles of evolutionary genetics are not just arcane, academic matters; they are highly relevant to “real world” problems.Less
The H5N1 avian flu virus has spread to fowl across several continents and has killed hundreds of people. Fortunately, this flu is not easily transmitted to humans yet; if it were, a deadly pandemic would likely ensue. How did this virus arise? What are the factors that govern its evolution and its potential to be transmitted to humans? These are questions that can and have been addressed by the application of evolutionary principles. Evolutionary biology is also being applied to combat the evolution of resistance of bacteria to antibiotics, and insect pests to pesticides. This chapter addresses these and other applications of evolution, including plant and animal breeding, the human genome project, studies of aging and other maladaptations, and forensic uses. The facts and principles of evolutionary genetics are not just arcane, academic matters; they are highly relevant to “real world” problems.
Richard Firn
- Published in print:
- 2009
- Published Online:
- February 2010
- ISBN:
- 9780199566839
- eISBN:
- 9780191721700
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199566839.003.0007
- Subject:
- Biology, Ecology, Biochemistry / Molecular Biology
Natural Products have been exploited by humans as a means of treating illness, ailments and infections throughout recorded human history. Worldwide, NPs are still of major importance in health care. ...
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Natural Products have been exploited by humans as a means of treating illness, ailments and infections throughout recorded human history. Worldwide, NPs are still of major importance in health care. However, there is currently a great debate as to whether NPs will retain their importance as pharmaceutical agents. By the end of the 20th century, all the major pharmaceutical multinational companies had massively reduced investment in NP research. Concurrently, many people interested in international development argued that it was time to increase the study of NP diversity in the less developed countries (bioprospecting) in order to provide novel drugs for the rich, and to provide an income stream for the poor. This chapter shows how an understanding of the evolution of NPs could help transform our approach to finding and exploiting novel pharmaceuticals.Less
Natural Products have been exploited by humans as a means of treating illness, ailments and infections throughout recorded human history. Worldwide, NPs are still of major importance in health care. However, there is currently a great debate as to whether NPs will retain their importance as pharmaceutical agents. By the end of the 20th century, all the major pharmaceutical multinational companies had massively reduced investment in NP research. Concurrently, many people interested in international development argued that it was time to increase the study of NP diversity in the less developed countries (bioprospecting) in order to provide novel drugs for the rich, and to provide an income stream for the poor. This chapter shows how an understanding of the evolution of NPs could help transform our approach to finding and exploiting novel pharmaceuticals.
Tanya Stivers
- Published in print:
- 2007
- Published Online:
- January 2010
- ISBN:
- 9780195311150
- eISBN:
- 9780199870837
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195311150.003.0001
- Subject:
- Linguistics, Sociolinguistics / Anthropological Linguistics
This chapter begins with a discussion of the history of antibiotics. It then discusses the determinants of bacterial resistance and bacterial resistance as a global problem. The chapter then ...
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This chapter begins with a discussion of the history of antibiotics. It then discusses the determinants of bacterial resistance and bacterial resistance as a global problem. The chapter then describes the focus of the book, which is the inappropriate prescribing of antibiotics for viral upper respiratory tract infections (URTIs) among children in the United States, and the methodology and datasets sets used. An overview of the subsequent chapters is presented.Less
This chapter begins with a discussion of the history of antibiotics. It then discusses the determinants of bacterial resistance and bacterial resistance as a global problem. The chapter then describes the focus of the book, which is the inappropriate prescribing of antibiotics for viral upper respiratory tract infections (URTIs) among children in the United States, and the methodology and datasets sets used. An overview of the subsequent chapters is presented.
Slade A. Loutet, Anson C. K. Chan, Marek J. Kobylarz, Meghan M. Verstraete, Stephanie Pfaffen, Bin Ye, Angel L. Arrieta, and Michael E. P. Murphy
- Published in print:
- 2015
- Published Online:
- May 2016
- ISBN:
- 9780262029193
- eISBN:
- 9780262327619
- Item type:
- chapter
- Publisher:
- The MIT Press
- DOI:
- 10.7551/mitpress/9780262029193.003.0004
- Subject:
- Public Health and Epidemiology, Public Health
Metals are essential for all microorganisms; they are required as cofactors of enzymes that mediate metabolic processes which are indispensable for cellular energy production and growth. Some metals, ...
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Metals are essential for all microorganisms; they are required as cofactors of enzymes that mediate metabolic processes which are indispensable for cellular energy production and growth. Some metals, such as zinc, are readily bound and serve as key structural elements of many macromolecules. Thus, to grow, microorganisms have an essential quota for several metals. The catalytic and other chemical properties of metals that microorganisms value create issues for metal management. Due to their high affinity for amino acids and their reactive nature, uptake, intracellular transport, and storage of metals are mediated by tightly regulated proteins. Protein chaperones function to supply some specific metals to sites of utilization and, in some cases, storage. In particular, iron is difficult to acquire and is stored as a mineral in protein nanocages. Other metals, when present in excess, induce the expression of export systems to maintain a defined intracellular concentration of readily exchangeable metal.Less
Metals are essential for all microorganisms; they are required as cofactors of enzymes that mediate metabolic processes which are indispensable for cellular energy production and growth. Some metals, such as zinc, are readily bound and serve as key structural elements of many macromolecules. Thus, to grow, microorganisms have an essential quota for several metals. The catalytic and other chemical properties of metals that microorganisms value create issues for metal management. Due to their high affinity for amino acids and their reactive nature, uptake, intracellular transport, and storage of metals are mediated by tightly regulated proteins. Protein chaperones function to supply some specific metals to sites of utilization and, in some cases, storage. In particular, iron is difficult to acquire and is stored as a mineral in protein nanocages. Other metals, when present in excess, induce the expression of export systems to maintain a defined intracellular concentration of readily exchangeable metal.
Stephen C. Stearns and Jacob C. Koella (eds)
- Published in print:
- 2007
- Published Online:
- April 2010
- ISBN:
- 9780199207466
- eISBN:
- 9780191728167
- Item type:
- book
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199207466.001.0001
- Subject:
- Biology, Evolutionary Biology / Genetics
It is now increasingly acknowledged that an evolutionary perspective can give us important new insights into issues central to medical research and practice. This fully revised and updated edition, ...
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It is now increasingly acknowledged that an evolutionary perspective can give us important new insights into issues central to medical research and practice. This fully revised and updated edition, which consists of roughly 95% new material, contains contributions from leading researchers who provide a fresh summary of this rapidly expanding field. It takes a broad approach to the subject, discussing medically relevant research from evolutionary genetics, evolutionary ecology, evolutionary epidemiology, the evolution of aging, and any other biological disciplines where evolutionary approaches make important contributions. The medical conditions discussed include diabetes, obesity, cardiovascular disease, asthma, allergies and other autoimmune diseases, infectious diseases, emerging diseases, and aging. It also provides insights into the evolutionary responses of pathogens to antibiotics and vaccines. What will happen if we continue to expand our use of antibiotics and vaccines? Why do we respond inappropriately (for example by developing cardiovascular disease) to many modern conditions? How do cancers evolve, particularly in response to chemotherapy? Why must we grow old, and can we do anything about it? This book discusses answers to these and many other questions.Less
It is now increasingly acknowledged that an evolutionary perspective can give us important new insights into issues central to medical research and practice. This fully revised and updated edition, which consists of roughly 95% new material, contains contributions from leading researchers who provide a fresh summary of this rapidly expanding field. It takes a broad approach to the subject, discussing medically relevant research from evolutionary genetics, evolutionary ecology, evolutionary epidemiology, the evolution of aging, and any other biological disciplines where evolutionary approaches make important contributions. The medical conditions discussed include diabetes, obesity, cardiovascular disease, asthma, allergies and other autoimmune diseases, infectious diseases, emerging diseases, and aging. It also provides insights into the evolutionary responses of pathogens to antibiotics and vaccines. What will happen if we continue to expand our use of antibiotics and vaccines? Why do we respond inappropriately (for example by developing cardiovascular disease) to many modern conditions? How do cancers evolve, particularly in response to chemotherapy? Why must we grow old, and can we do anything about it? This book discusses answers to these and many other questions.
Margaret P. Battin, Leslie P. Francis, Jay A. Jacobson, and Charles B. Smith
- Published in print:
- 2009
- Published Online:
- May 2009
- ISBN:
- 9780195335842
- eISBN:
- 9780199868926
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195335842.003.0013
- Subject:
- Philosophy, General
Antimicrobial resistance is growing at an alarming rate: reports of extensive multiple-drug resistant tuberculosis (XDR-TB and MDR-TB) and methicillin-resistant Staphylococcus aureus (MRSA) are but ...
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Antimicrobial resistance is growing at an alarming rate: reports of extensive multiple-drug resistant tuberculosis (XDR-TB and MDR-TB) and methicillin-resistant Staphylococcus aureus (MRSA) are but two of the most serious examples. Among the many causes of antibiotic resistance are overuse and a failure to complete courses of treatment. This chapter considers how patients, considering themselves as both potential victims and as potential vectors, might take risks of resistance into account in their decisions about treatment. Some analyses of antimicrobial resistance treat it as a tragedy of the commons: of rational individual decisions about use adding up to a catastrophe of overuse. This analysis is incomplete because it fails to take into account the interests of patients who might be victims in practices that continue to make antibiotics available to them. The chapter also suggests the possibility of a small surcharge on antibiotic use in the developing world, to be dedicated to research on new generation antimicrobials, as a reflection of this interest in continued available of therapies for dangerous pathogens.Less
Antimicrobial resistance is growing at an alarming rate: reports of extensive multiple-drug resistant tuberculosis (XDR-TB and MDR-TB) and methicillin-resistant Staphylococcus aureus (MRSA) are but two of the most serious examples. Among the many causes of antibiotic resistance are overuse and a failure to complete courses of treatment. This chapter considers how patients, considering themselves as both potential victims and as potential vectors, might take risks of resistance into account in their decisions about treatment. Some analyses of antimicrobial resistance treat it as a tragedy of the commons: of rational individual decisions about use adding up to a catastrophe of overuse. This analysis is incomplete because it fails to take into account the interests of patients who might be victims in practices that continue to make antibiotics available to them. The chapter also suggests the possibility of a small surcharge on antibiotic use in the developing world, to be dedicated to research on new generation antimicrobials, as a reflection of this interest in continued available of therapies for dangerous pathogens.
James L. Hallenbeck
- Published in print:
- 2003
- Published Online:
- November 2011
- ISBN:
- 9780195165784
- eISBN:
- 9780199999897
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195165784.003.0006
- Subject:
- Palliative Care, Patient Care and End-of-Life Decision Making, Pain Management and Palliative Pharmacology
This chapter discusses special therapeutic issues in end-of-life care, particularly hydration, nutrition, and antibiotics. Hydration and nutrition are the means of accomplishing the two overt goals ...
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This chapter discusses special therapeutic issues in end-of-life care, particularly hydration, nutrition, and antibiotics. Hydration and nutrition are the means of accomplishing the two overt goals of sustaining life through the provision of calories, nutrients, and water and the alleviation of suffering associated with hunger, thirst, and decreased functional status. However, in palliative care, distinctions between life-prolonging and life-enhancing goals are often required because confusion about goals in this area causes a great deal of distress in palliative and end-of-life care. The chapter suggests that the main consideration in giving antibiotics is whether it will be helpful in reaching certain goals.Less
This chapter discusses special therapeutic issues in end-of-life care, particularly hydration, nutrition, and antibiotics. Hydration and nutrition are the means of accomplishing the two overt goals of sustaining life through the provision of calories, nutrients, and water and the alleviation of suffering associated with hunger, thirst, and decreased functional status. However, in palliative care, distinctions between life-prolonging and life-enhancing goals are often required because confusion about goals in this area causes a great deal of distress in palliative and end-of-life care. The chapter suggests that the main consideration in giving antibiotics is whether it will be helpful in reaching certain goals.
Kevin Outterson, Thomas Pogge, and Aidan Hollis
- Published in print:
- 2013
- Published Online:
- May 2013
- ISBN:
- 9780199917907
- eISBN:
- 9780199332878
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199917907.003.0018
- Subject:
- Law, Medical Law
This chapter illustrates how antibiotic resistance distorts markets for innovative antibiotics in unusual and counterintuitive ways. It also clarifies how proposals to produce a Health Impact Fund ...
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This chapter illustrates how antibiotic resistance distorts markets for innovative antibiotics in unusual and counterintuitive ways. It also clarifies how proposals to produce a Health Impact Fund (HIF) that rewards companies for the health impacts of their drugs can be used to coordinate effectively global use of antibiotics in a way that manages the threat of resistance. The HIF would foster the development of new high-impact medicines. It would also raise appropriate financial access to new medicines. On the other hand, the antibiotic HIF (aHIF) is very appealing as a global coordination mechanism for antibiotic R&D. It is also scalable throughout the world, despite weak health governance in many countries. It can be stated that the aHIF can serve a key role as a global coordination mechanism for antibiotics, ensuring that this important drug class does not fade away, but continues to serve humanity.Less
This chapter illustrates how antibiotic resistance distorts markets for innovative antibiotics in unusual and counterintuitive ways. It also clarifies how proposals to produce a Health Impact Fund (HIF) that rewards companies for the health impacts of their drugs can be used to coordinate effectively global use of antibiotics in a way that manages the threat of resistance. The HIF would foster the development of new high-impact medicines. It would also raise appropriate financial access to new medicines. On the other hand, the antibiotic HIF (aHIF) is very appealing as a global coordination mechanism for antibiotic R&D. It is also scalable throughout the world, despite weak health governance in many countries. It can be stated that the aHIF can serve a key role as a global coordination mechanism for antibiotics, ensuring that this important drug class does not fade away, but continues to serve humanity.
Tanya Stivers
- Published in print:
- 2007
- Published Online:
- January 2010
- ISBN:
- 9780195311150
- eISBN:
- 9780199870837
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195311150.003.0006
- Subject:
- Linguistics, Sociolinguistics / Anthropological Linguistics
This chapter examines four main ways that parents overtly lobby for antibiotics and shows evidence that parents and physicians alike treat antibiotics as under negotiation. Unlike the other practices ...
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This chapter examines four main ways that parents overtly lobby for antibiotics and shows evidence that parents and physicians alike treat antibiotics as under negotiation. Unlike the other practices that are largely confined to a single phase of the interaction, overt lobbying for antibiotics occurs in virtually all phases of the medical encounter.Less
This chapter examines four main ways that parents overtly lobby for antibiotics and shows evidence that parents and physicians alike treat antibiotics as under negotiation. Unlike the other practices that are largely confined to a single phase of the interaction, overt lobbying for antibiotics occurs in virtually all phases of the medical encounter.
Tanya Stivers
- Published in print:
- 2007
- Published Online:
- January 2010
- ISBN:
- 9780195311150
- eISBN:
- 9780199870837
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195311150.003.0008
- Subject:
- Linguistics, Sociolinguistics / Anthropological Linguistics
This chapter begins with a summary of discussions in the preceding chapters. It concludes by speculating about the issues underlying the problems of inappropriate antibiotic prescribing, particularly ...
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This chapter begins with a summary of discussions in the preceding chapters. It concludes by speculating about the issues underlying the problems of inappropriate antibiotic prescribing, particularly in developed countries, but also as it contributes to the global problem of bacterial resistance to antibiotics.Less
This chapter begins with a summary of discussions in the preceding chapters. It concludes by speculating about the issues underlying the problems of inappropriate antibiotic prescribing, particularly in developed countries, but also as it contributes to the global problem of bacterial resistance to antibiotics.
James H. Mills
- Published in print:
- 2012
- Published Online:
- January 2013
- ISBN:
- 9780199283422
- eISBN:
- 9780191746161
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199283422.003.0005
- Subject:
- History, British and Irish Modern History, Cultural History
While Britain's colonial past began to shape the UK's experience of cannabis in these years, other overseas contexts were similarly important and Chapter 5 considers them. There was a flurry of ...
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While Britain's colonial past began to shape the UK's experience of cannabis in these years, other overseas contexts were similarly important and Chapter 5 considers them. There was a flurry of interest in British medical circles about the therapeutic potential of synhexl, or synthetic cannabis, early on in the period of research into antibiotics. However, events at the United Nations and the World Health Organization were to kill off any chance of a revival of therapeutic applications of substances based on the plant in the 1950s. A determined campaign against cannabis was waged by the WHO and the UN in this period which was to ensure that little doubt was left that it was a useless and dangerous material. However, the intervention of British delegates and their colleagues from India served to prevent an even more radical position on the drug in the 1961 Single Convention on Narcotic Drugs.Less
While Britain's colonial past began to shape the UK's experience of cannabis in these years, other overseas contexts were similarly important and Chapter 5 considers them. There was a flurry of interest in British medical circles about the therapeutic potential of synhexl, or synthetic cannabis, early on in the period of research into antibiotics. However, events at the United Nations and the World Health Organization were to kill off any chance of a revival of therapeutic applications of substances based on the plant in the 1950s. A determined campaign against cannabis was waged by the WHO and the UN in this period which was to ensure that little doubt was left that it was a useless and dangerous material. However, the intervention of British delegates and their colleagues from India served to prevent an even more radical position on the drug in the 1961 Single Convention on Narcotic Drugs.
Nizam Damani
- Published in print:
- 2011
- Published Online:
- May 2012
- ISBN:
- 9780199698356
- eISBN:
- 9780191732126
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199698356.003.0010
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
Microbes, due to their adaptability, have not only survived the selective pressures exerted by the indiscriminate use of antimicrobial agents but have successfully adapted and evolved in to ...
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Microbes, due to their adaptability, have not only survived the selective pressures exerted by the indiscriminate use of antimicrobial agents but have successfully adapted and evolved in to multidrug-resistant organisms. A plethora of guidelines to control and promote rational use of antimicrobials has not curtailed the plague of antimicrobial resistance. The chapter discusses antibiotic stewardship, meticillin-resistant Staphyloccocus aureus, vancomycin-resistant enterococci, and multi-resistant Gram negative bacteria.Less
Microbes, due to their adaptability, have not only survived the selective pressures exerted by the indiscriminate use of antimicrobial agents but have successfully adapted and evolved in to multidrug-resistant organisms. A plethora of guidelines to control and promote rational use of antimicrobials has not curtailed the plague of antimicrobial resistance. The chapter discusses antibiotic stewardship, meticillin-resistant Staphyloccocus aureus, vancomycin-resistant enterococci, and multi-resistant Gram negative bacteria.
Michael Kinch
- Published in print:
- 2016
- Published Online:
- May 2017
- ISBN:
- 9781469630625
- eISBN:
- 9781469630649
- Item type:
- chapter
- Publisher:
- University of North Carolina Press
- DOI:
- 10.5149/northcarolina/9781469630625.003.0004
- Subject:
- Business and Management, Innovation
This chapter details the birth of the pharmaceutical industry, whose roots trace back more than six millennia. While modern society struggles with opiate addiction, the problem is centuries old and ...
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This chapter details the birth of the pharmaceutical industry, whose roots trace back more than six millennia. While modern society struggles with opiate addiction, the problem is centuries old and fostered a literal trade war in the form of the Opium Wars of the 19th century and whose scars still muddle international relations of China with the West today. During this same time period, improvements in understanding opium facilitated the discovery of new and more potent products that nurtured modern companies such as Merck & Co. Perhaps no other discovery has impacted the industry or public health as much as antibiotics and we trace the history of these medicines and debunk misunderstandings and misattributions associated with their discovery. The impact of antibiotics was propelled by the Second World War, which also gave rise to the first treatments for cancer when two top-secret projects, one at Yale and another resulting from an audacious raid by the Luftwaffe upon an Italian port town, unexpectedly revealed the life-saving implications of mustard gas. Finally, we relate the triumphant and turbulent relationships that gave rise to the discoveyr of insulin and its widespread distribution by a paragon of “ethical pharmaceuticals”, Eli Lilly & Company.Less
This chapter details the birth of the pharmaceutical industry, whose roots trace back more than six millennia. While modern society struggles with opiate addiction, the problem is centuries old and fostered a literal trade war in the form of the Opium Wars of the 19th century and whose scars still muddle international relations of China with the West today. During this same time period, improvements in understanding opium facilitated the discovery of new and more potent products that nurtured modern companies such as Merck & Co. Perhaps no other discovery has impacted the industry or public health as much as antibiotics and we trace the history of these medicines and debunk misunderstandings and misattributions associated with their discovery. The impact of antibiotics was propelled by the Second World War, which also gave rise to the first treatments for cancer when two top-secret projects, one at Yale and another resulting from an audacious raid by the Luftwaffe upon an Italian port town, unexpectedly revealed the life-saving implications of mustard gas. Finally, we relate the triumphant and turbulent relationships that gave rise to the discoveyr of insulin and its widespread distribution by a paragon of “ethical pharmaceuticals”, Eli Lilly & Company.
Michael Kinch
- Published in print:
- 2016
- Published Online:
- May 2017
- ISBN:
- 9781469630625
- eISBN:
- 9781469630649
- Item type:
- chapter
- Publisher:
- University of North Carolina Press
- DOI:
- 10.5149/northcarolina/9781469630625.003.0012
- Subject:
- Business and Management, Innovation
Despite and arguably because of the enormous public health benefits arising from the introduction of new medicines, the industry is in the midst of crisis. We detail in this chapter the decline in ...
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Despite and arguably because of the enormous public health benefits arising from the introduction of new medicines, the industry is in the midst of crisis. We detail in this chapter the decline in research and development efficiency, which has been termed “Eroom's Law,” a playful inversion of the bettern known Moore's Law of Computing. An explanation of declining efficiency follows as is a brief summary of some remedies taken by many biopharmaceutical entities, including the abandonment of therapeutics targeting particularly difficult indications such as Alzheimer's disease and antibiotics. We also convey how the industry has developed into a sort of food chain, with smaller companies and government grants supporting the earliest stages of research, which are then acquired by medium-sized companies, which in turn are consolidated into large companies. This food chain is fundamentally in doubt based on shrinking Federal spending on research combined with a decline in venture capital support for early-stage start-ups.Less
Despite and arguably because of the enormous public health benefits arising from the introduction of new medicines, the industry is in the midst of crisis. We detail in this chapter the decline in research and development efficiency, which has been termed “Eroom's Law,” a playful inversion of the bettern known Moore's Law of Computing. An explanation of declining efficiency follows as is a brief summary of some remedies taken by many biopharmaceutical entities, including the abandonment of therapeutics targeting particularly difficult indications such as Alzheimer's disease and antibiotics. We also convey how the industry has developed into a sort of food chain, with smaller companies and government grants supporting the earliest stages of research, which are then acquired by medium-sized companies, which in turn are consolidated into large companies. This food chain is fundamentally in doubt based on shrinking Federal spending on research combined with a decline in venture capital support for early-stage start-ups.
Alexandra M. Levitt, D. Peter Drotman, and Stephen Ostroff
- Published in print:
- 2006
- Published Online:
- September 2009
- ISBN:
- 9780195150698
- eISBN:
- 9780199865185
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195150698.003.01
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
The marked decline in infectious-disease-associated mortality that took place in the United States during the first half of the 20th century contributed to the sharp drop in infant and child ...
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The marked decline in infectious-disease-associated mortality that took place in the United States during the first half of the 20th century contributed to the sharp drop in infant and child mortality and the more than thirty-year average increase in life expectancy over the past 100 years. The 19th-century discovery that microorganisms are the cause of many diseases led to substantial improvements in sanitation and hygiene, formulations of vaccinations, development of diagnostic tests, and the introduction of antibiotics. Despite this overall progress, devastating pandemics of infectious diseases occurred during the 20th century including the influenza in 1918 and human immunodeficiency virus first recognized in 1981. This chapter reviews major 20th-century achievements in the control of infectious diseases in the United States and ends with a discussion of challenges for the 21st century.Less
The marked decline in infectious-disease-associated mortality that took place in the United States during the first half of the 20th century contributed to the sharp drop in infant and child mortality and the more than thirty-year average increase in life expectancy over the past 100 years. The 19th-century discovery that microorganisms are the cause of many diseases led to substantial improvements in sanitation and hygiene, formulations of vaccinations, development of diagnostic tests, and the introduction of antibiotics. Despite this overall progress, devastating pandemics of infectious diseases occurred during the 20th century including the influenza in 1918 and human immunodeficiency virus first recognized in 1981. This chapter reviews major 20th-century achievements in the control of infectious diseases in the United States and ends with a discussion of challenges for the 21st century.
Jill E. Cooper
- Published in print:
- 2006
- Published Online:
- September 2009
- ISBN:
- 9780195150698
- eISBN:
- 9780199865185
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195150698.003.03
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
In 1939, René Dubos announced his discovery of tyrothricin, the first clinically useful antibiotic. Convinced of the power and efficiency of chemotherapeutic wonder drugs, Dubos abandoned his ...
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In 1939, René Dubos announced his discovery of tyrothricin, the first clinically useful antibiotic. Convinced of the power and efficiency of chemotherapeutic wonder drugs, Dubos abandoned his immunological approach to infectious disease in favor of one that privileged cure over prevention. But by 1941 his enthusiasm waned in light of tyrothricin's limitations, and he changed from champion to critic of chemotherapeutic agents. His admonitions against the overzealous use of antibiotics, however, went largely unheeded. As a result, many of his predictions regarding the danger of antibiotic-resistant bacterial strains have been realized in modern medicine. This chapter traces Dubos' research at the Rockefeller Institute that led to the discovery of tryothricin, and his rapid disaffection with over-reliance upon antibiotics.Less
In 1939, René Dubos announced his discovery of tyrothricin, the first clinically useful antibiotic. Convinced of the power and efficiency of chemotherapeutic wonder drugs, Dubos abandoned his immunological approach to infectious disease in favor of one that privileged cure over prevention. But by 1941 his enthusiasm waned in light of tyrothricin's limitations, and he changed from champion to critic of chemotherapeutic agents. His admonitions against the overzealous use of antibiotics, however, went largely unheeded. As a result, many of his predictions regarding the danger of antibiotic-resistant bacterial strains have been realized in modern medicine. This chapter traces Dubos' research at the Rockefeller Institute that led to the discovery of tryothricin, and his rapid disaffection with over-reliance upon antibiotics.
Robert L. Perlman
- Published in print:
- 2013
- Published Online:
- December 2013
- ISBN:
- 9780199661718
- eISBN:
- 9780191774720
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780199661718.003.0007
- Subject:
- Biology, Evolutionary Biology / Genetics
Humans are home to a myriad of microorganisms that are known collectively as the human microbiome. Our bodies may also become infected by disease-causing organisms, or pathogens. Pathogens have ...
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Humans are home to a myriad of microorganisms that are known collectively as the human microbiome. Our bodies may also become infected by disease-causing organisms, or pathogens. Pathogens have complex life histories, which involve replication within an individual host and transmission among hosts. In general, pathogens evolve in ways that maximize their basic reproductive number, R0 , the number of secondary infections that would result from the introduction of one infectious host into a population of susceptible individuals. Pathogens do not necessarily evolve to be benign; instead, they evolve the level of virulence that optimizes their R0 . Because pathogens evolve to grow most efficiently in abundant host genotypes, they cause frequency-dependent selection of rare host genotypes. Hosts evolve in ways that minimize the fitness cost of pathogen infections. The manifestations of infectious diseases may be adaptations that benefit the hosts or manipulations of host physiology that enhance replication and transmission of the pathogens. The recent spread of methicillin-resistant Staphylococcus aureus (MRSA) is a reminder that evolution of antibiotic resistance remains a major challenge for medicine. Study of host-pathogen coevolution should help to guide medical and public health practices such as regimens of antibiotic therapy and immunization strategies.Less
Humans are home to a myriad of microorganisms that are known collectively as the human microbiome. Our bodies may also become infected by disease-causing organisms, or pathogens. Pathogens have complex life histories, which involve replication within an individual host and transmission among hosts. In general, pathogens evolve in ways that maximize their basic reproductive number, R0 , the number of secondary infections that would result from the introduction of one infectious host into a population of susceptible individuals. Pathogens do not necessarily evolve to be benign; instead, they evolve the level of virulence that optimizes their R0 . Because pathogens evolve to grow most efficiently in abundant host genotypes, they cause frequency-dependent selection of rare host genotypes. Hosts evolve in ways that minimize the fitness cost of pathogen infections. The manifestations of infectious diseases may be adaptations that benefit the hosts or manipulations of host physiology that enhance replication and transmission of the pathogens. The recent spread of methicillin-resistant Staphylococcus aureus (MRSA) is a reminder that evolution of antibiotic resistance remains a major challenge for medicine. Study of host-pathogen coevolution should help to guide medical and public health practices such as regimens of antibiotic therapy and immunization strategies.
Philip S. Brachman
- Published in print:
- 2007
- Published Online:
- September 2009
- ISBN:
- 9780195325256
- eISBN:
- 9780199864409
- Item type:
- chapter
- Publisher:
- Oxford University Press
- DOI:
- 10.1093/acprof:oso/9780195325256.003.0006
- Subject:
- Public Health and Epidemiology, Public Health, Epidemiology
This chapter describes the public health response to the anthrax epidemic in 2001. It discusses historical background, epidemiology of anthrax, terrorist use of anthrax, and evaluation of the public ...
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This chapter describes the public health response to the anthrax epidemic in 2001. It discusses historical background, epidemiology of anthrax, terrorist use of anthrax, and evaluation of the public health response to the anthrax outbreak in 2001. It concludes that the public health response to the anthrax bioterrorist event in 2001 was rapid and comprehensive, and it may have prevented the further spread of anthrax.Less
This chapter describes the public health response to the anthrax epidemic in 2001. It discusses historical background, epidemiology of anthrax, terrorist use of anthrax, and evaluation of the public health response to the anthrax outbreak in 2001. It concludes that the public health response to the anthrax bioterrorist event in 2001 was rapid and comprehensive, and it may have prevented the further spread of anthrax.
