ArgumentDuring the 1950s it became apparent that antibiotics could not conquer all microbes, and a series of tests were developed to assess the susceptibility of microbes to antibiotics. This article explores the development and standardization of one such testing procedure which became dominant in the Nordic region, and how the project eventually failed in the late 1970s. The standardization procedures amounted to a comprehensive scheme, standardizing not only the materials used, but also the methods and the interpretation of the (...) results. Focusing on Sweden and Norway in particular, the article shows how this comprehensive standardization procedure accounted for several co-dependent factors and demanded collaboration within and across laboratories. Whereas literature on standardization has focused mostly on how facts and artefacts move within and across laboratories, I argue for the importance of also attending to regions and territories. More particularly, while arguing that the practices, ideals, and politics related to what have been called the “Nordic welfare state” were contributing to the design of the standardized procedure in the laboratory, I also argue that Scandinavia was drawn together as a unified region with and by these very same practices. (shrink)

“Antibiotic resistance is usually associated with a fitness cost” is frequently accepted as common knowledge in the field of infectious diseases. However, with the advances in high‐throughput DNA sequencing that allows for a comprehensive analysis of bacterial pathogenesis at the genome scale, including antibiotic resistance genes, it appears that this paradigm might not be as solid as previously thought. Recent studies indicate that antibiotic resistance is able to enhance bacterial fitness in vivo with a concomitant increase in (...) virulence during infections. As a consequence, strategies to minimize antibiotic resistance turn out to be not as simple as initially believed. Indeed, decreased antibiotic use may not be sufficient to let susceptible strains outcompete the resistant ones. Here, we put in perspective these findings and review alternative approaches, such as preventive and therapeutic anti‐bacterial immunotherapies that have the potential to by‐pass the classic antibiotics. (shrink)

The right to health is enshrined in the constitution of the World Health Organization and numerous other international agreements. Yet today, an estimated 5.7 million people die each year from treatable infectious diseases, most of which are susceptible to existing antimicrobials if they were accessible. These deaths occur predominantly among populations living in poverty in low- and middle-income countries, and they greatly exceed the estimated 700,000 annual deaths worldwide currently attributed to antimicrobial resistance. Ensuring universal appropriate access to antimicrobials is (...) not only a critical part of realizing the right to health, it is necessary for mobilizing effective collective action against the development and spread of AMR. (shrink)

Recent studies suggest that the tetracycline antibiotic minocycline, or its cousins, hold therapeutic potential for affective and psychotic disorders. This is proposed on the basis of a direct effect on microglia‐mediated frontocortical synaptic pruning (FSP) during adolescence, perhaps in genetically susceptible individuals harboring risk alleles in the complement component cascade that is involved in this normal process of CNS circuit refinement. In reviewing this field, it is argued that minocycline is actually probing and modulating a deeply evolved and intricate (...) system wherein psychosocial stimuli sculpt the circuitry of the “social brain” underlying adult behavior and personality. Furthermore, this system can generate psychiatric morbidity that is not dependent on genetic variation. This view has important ramifications for understanding “pathologies” of human social behavior and cognition as well as providing long‐sought potential mechanistic links between social experience and susceptibility to mental and physical disease. (shrink)

Analyzing two key figures in Elif Shafak’s novel The Island of Missing Trees—a schoolgirl’s scream and a narrating fig tree—this essay analyzes the intersection between susceptibility and resilience, particularly as these terms are developed in psychology, trauma studies, and ecology. I argue that the novel’s resonant scream critiques the discourse of psychological resilience on multiple counts: its inadequacy as a response to complex trauma, its focus on autonomous individuals, its assumption that responsibility for resilience rests on victims rather than (...) perpetrators of harm, its construction of a “resistance imperative” and its disavowal of the inequalities in access to resilience-building resources. By contrast, the novel’s fig tree, I contend, exemplifies an ecological model of resilience rooted in a recognition of the interdependence of the multiple and diverse organisms that comprise an ecosystem, and of susceptibility as an advantageous suite of capacities that are crucial to resilience. These contrasting conceptions of resilience lead me to advocate for a politics of susceptibility, an eco-psychosocial politics based on the recognition that individuals cannot become resilient on their own, through their own volition, intention, or “self-efficacy”, and that focuses instead on building systemic and sustainable forms of resilience inclusive of the diverse subjects that comprise a community, society or ecosystem; that, rather than fetishizing independence, liberty and rights, fortifies interdependence and reinforces mutual responsibilities; and that rather than exploiting susceptibility as a weakness, nurtures it as the soul of resilience itself. (shrink)

To the extent that antibiotic resistance (ABR) is accelerated by antibiotic consumption and that it represents a serious public health emergency, it is imperative to drastically reduce antibiotic consumption, particularly in high‐income countries. I present the problem of ABR as an instance of the collective action problem known as ‘tragedy of the commons’. I propose that there is a strong ethical justification for taxing certain uses of antibiotics, namely when antibiotics are required to treat minor and self‐limiting (...) infections, such as respiratory tract infections, in otherwise healthy individuals. Taxation would allow a reduction in consumption (given certain behavioural economics assumptions) and/or ensure that individuals internalize or compensate for their contribution to the erosion of the common good of antibiotic effectiveness. I suggest that revenue from the tax could be used to fund conservation and innovation strategies. Taxation might be a coercive policy, especially for certain individuals, but the ethical case for coercive policies is very strong when the good to be preserved is important enough and when they force individuals to do something they have a moral obligation to do anyway. I argue that, in the case of mild and self‐limiting infections, individuals have a moral duty of easy rescue and a moral duty of fairness to make their contribution to the preservation of the common good of antibiotic effectiveness by foregoing antibiotics. I also suggest that taxing antibiotics in such cases is an all things considered ethically justified policy even if it would introduce inequalities in access to healthcare. (shrink)

Various U.S. laws, such as the Clean Air Act and the Food Quality Protection Act, require additional protections for susceptible subpopulations who face greater environmental health risks. The main ethical rationale for providing these protections is to ensure that environmental health risks are distributed fairly. In this article, we (1) consider how several influential theories of justice deal with issues related to the distribution of environmental health risks; (2) show that these theories often fail to provide specific guidance concerning policy (...) choices; and (3) argue that an approach to public decision making known as accountability for reasonableness can complement theories of justice in establishing acceptable environmental health risks for the general population and susceptible subpopulations. Since accountability for reasonableness focuses on the fairness of the decision-making process, not the outcome, it does not guarantee that susceptible subpopulations will receive a maximum level of protection, regardless of costs or other morally relevant considerations. (shrink)

The One Health approach to antimicrobial resistance (AMR) requires stakeholders to contribute to cross-sectoral efforts to improve antimicrobial stewardship (AMS). One Health AMR policy implementation is challenging in livestock farming because of the infrastructural role of antibiotics in production systems. Mitigating AMR may require the development of more stringent stewardship obligations and the future limitation of established entitlements. Drawing on Amatai Etzioni’s compliance theory, regulatory analyses and qualitative studies with stakeholder groups we examine the structural and socio-cultural dimension of (...) class='Hi'>antibiotic use and AMS compliance in Australian beef and dairy production. We found a disconnect between how antibiotic use is conceptualised by farmers and the way in which AMS policies construe agricultural AMR risks. Under the umbrella of food safety standards and national-level prescribing restrictions, farmers and veterinarians interact around antibiotic use with different operating logics and compliance mechanisms. These parallel regimes service distinct and sometimes competing common goods of food security and antibiotic preservation. Further reforms to mitigate AMR need to account for the value orientations of different groups and the embeddedness of the constraints imposed by existing systems. Advocacy for greater AMR precaution in agriculture should acknowledge and compensate for erosions in competing common goods and the cost of proposed interventions. (shrink)

Antibiotic resistance poses an urgent public health risk. High rates of ABR have been noted in all regions of the globe by the World Health Organization. ABR develops when bacteria are exposed to antibiotics either during treatments in humans or animals or through environmental sources contaminated with antibiotic residues. Spread beyond those administered antibiotics occurs through direct contact with the infected or colonized person or animal, through contact or ingestion of retail meat or agricultural products contaminated with ABR (...) organisms, or through the environment. ABR bacteria spread from individuals to populations and across countries. (shrink)

Antibiotic resistance presents a classic example of the “tragedy of the commons.” In this eponymous tragedy, the commons — shared, public access lands — are overgrazed because farmers can send their livestock onto the land at a zero price. The “tragedy” occurs because overgrazing destroys the land and reduces its ability to provide fodder. The application to antibiotics is obvious: the use of antibiotics creates selection pressure leading to increased proportions of resistant bacteria in the patient and the environment. (...) The increase in frequency of resistant organisms diminishes the effectiveness of antibiotics in treating future infections; thus, the long-term value of the antimicrobial resource is reduced. (shrink)

Recently, several studies have demonstrated that tetracyclines, the antibiotics most intensively used in livestock and that are also widely applied in biomedical research, interrupt mitochondrial proteostasis and physiology in animals ranging from round worms, fruit flies, and mice to human cell lines. Importantly, plant chloroplasts, like their mitochondria, are also under certain conditions vulnerable to these and other antibiotics that are leached into our environment. Together these endosymbiotic organelles are not only essential for cellular and organismal homeostasis stricto sensu, but (...) also have an important role to play in the sustainability of our ecosystem as they maintain the delicate balance between autotrophs and heterotrophs, which fix and utilize energy, respectively. Therefore, stricter policies on antibiotic usage are absolutely required as their use in research confounds experimental outcomes, and their uncontrolled applications in medicine and agriculture pose a significant threat to a balanced ecosystem and the well‐being of these endosymbionts that are essential to sustain health.Also watch the Video Abstract. (shrink)

Beginning in the 1940s, mass production of antibiotics involved the industrial-scale growth of microorganisms to harvest their metabolic products. Unfortunately, the use of antibiotics selects for resistance at answering scale. The turn to the study of antibiotic resistance in microbiology and medicine is examined, focusing on the realization that individual therapies targeted at single pathogens in individual bodies are environmental events affecting bacterial evolution far beyond bodies. In turning to biological manifestations of antibiotic use, sciences fathom material outcomes (...) of their own previous concepts. Archival work with stored soil and clinical samples produces a record described here as ‘the biology of history’: the physical registration of human history in bacterial life. This account thus foregrounds the importance of understanding both the materiality of history and the historicity of matter in theories and concepts of life today. (shrink)

The World Health Organization has published a global priority list of antibiotic-resistant bacteria to guide research and development of new antibiotics. Every pathogen on this list requires R&D activity, but some are more attractive for private sector investments, as evidenced by the current antibacterial pipeline. A “pipeline coordinator” is a governmental/non-profit organization that closely tracks the antibacterial pipeline and actively supports R&D across all priority pathogens employing new financing tools.

Most proposals for new international agreements aim to address important global challenges. If the goal is to solve problems, then the value of these agreements depends on their ability to influence the world — to shape norms, constrain behavior, facilitate cooperation, and mobilize action. A recent review of empirical studies has suggested that many international agreements fail to achieve their aspirations. The review indicates that the form in which states make commitments to each other — through an international legal agreement (...) or through other means — may not be as important as commonly thought. It is the content of the commitments and how these are supported by mechanisms to encourage implementation that matter the most. When developing proposals for new international agreements, like the one that has recently been proposed to address antibiotic resistance, attention to implementation mechanisms should therefore be equal to if not greater than the attention paid to its form. (shrink)

Numerous ethical issues have emerged from the industrialization of animal agriculture. Those issues ultimately rest in large measure upon overuse of antibiotics. How this has occurred is discussed in detail in this paper.

Numerous ethical issues have emerged from the industrialization of animal agriculture. Those issues ultimately rest in large measure upon overuse of antibiotics. How this has occurred is discussed in detail in this paper.

1. This paper investigates the viability of the harm principle (HP) to justify restricting consumer freedom regarding the purchase of products, such as meat, that require intense use of antibiotics...

Antibiotic allergies are commonly reported among patients, but most do not experience reactions on rechallenge with the same agents. These reported allergies complicate management of infections in patients labelled as having penicillin allergy, including serious infections where penicillin-based antibiotics are the first-line (most effective and least toxic) treatment option. Allergy labels are rarely questioned in clinical practice, with many clinicians opting for inferior second-line antibiotics to avoid a perceived risk of allergy. Reported allergies thereby can have significant impacts on (...) patients and public health, and present major ethical challenges. Antibiotic allergy testing has been described as a strategy to circumvent this dilemma, but it carries limitations that often make it less feasible in patients with acute infections or in community settings that lack access to allergy testing. This article provides an empirically informed ethical analysis of key considerations in this clinical dilemma, usingStaphylococcus aureusbacteraemia in patients with penicillin allergies as a case study. We argue that prescribing first-line penicillin-based antibiotics to patients with reported allergies may often present a more favourable ratio of benefits to risks, and may therefore be more ethically appropriate than using second-line drugs. We recommend changes to policy-making, clinical research and medical education, in order to promote more ethically acceptable responses to antibiotic allergies than the status quo. (shrink)

This study aimed to identify the antibiotic-relevant lessons from the controlled drug regimen for narcotics. Whereas several elements of the United Nations Single Convention on Narcotic Drugs could be advantageous for antibiotics, we doubt that an international legally binding agreement for controlling antibiotic consumption would be any more effective than implementing stewardship measures through national AMR plans.

Antibiotic resistance (AR) is a major threat to public health and healthcare worldwide. In this article, we analyse and discuss the claim that taking actions to minimize AR is everyone's responsibility, focusing on individual moral responsibility. This should not be merely interpreted as a function of knowledge of AR and the proper use of antibiotics. Instead, we suggest a circumstantial account of individual responsibility for AR, where individuals do or do not engage in judicious antibiotic behaviour with different (...) degrees of voluntariness. Furthermore, we suggest a notion of responsibility as a virtue, in which individuals have the opportunity to develop a sensitivity towards the AR theme and, consequently, are capable of engaging, actively and voluntarily, in judicious antibiotic behaviour. The development of such sensitivity depends on the creation of adequate circumstances, that is individual capacities and availability of resources. (shrink)

This essay reads a short narrative, “Savoir” by Hélène Cixous, to describe susceptibility as a problem organized around two lines of impingement: between subject and world and between consciousness and the wayward impulses of interior life. The young girl in Cixous’s text suffers a moment of disorientation and distress one misty morning and, against presumptions of inviolability and ideals of subjective consistency, this unhappy event comes to resonate with her disappointed trust in the generosity of the world, her anxious (...) sense of betrayal with respect to those who ought to protect her and her insecurity about her own role in this complex of associations. The frame of susceptibility thus opens up a space for Cixous’s reader and this essay to think the subject in her inconsistency and self-strangeness. (shrink)

The scope and type of property rights recognized over the effectiveness of antibiotics have a direct effect on how those claiming ownership engage in the exploitation and stewardship of this scarce resource. We examine the different property claims and rights the four major interest groups are asserting on antibiotics: (i) the inventors, (ii) those demanding that the resource be treated like any other transferable commodity, (iii) those advocating usage restrictions based on good stewardship principles and (iv) those considering the resource (...) as common heritage of humankind. (shrink)

Antibiotic resistance has become a problem of global scale. Resistance arises through mutation or through the acquisition of resistance gene(s) from other bacteria in a process called horizontal gene transfer (HGT). While HGT is recognized as an important factor in the dissemination of resistance genes in clinical pathogens, its role in the environment has been called into question by a recent study published in Nature. The authors found little evidence of HGT in soil using a culture‐independent functional metagenomics approach, (...) which is in contrast to previous work from the same lab showing HGT between the environment and human microbiome. While surprising at face value, these results may be explained by the lack of selective pressure in the environment studied. Importantly, this work suggests the need for careful monitoring of environmental antibiotic pollution and stringent antibiotic stewardship in the fight against resistance. (shrink)

Decisions to use antibiotics require that patient interests are balanced against the public good, that is, control of antibiotic resistance. Patients carry the risks of suboptimal antibiotic treatment and many physicians are reluctant to impose even small avoidable risks on patients. At the same time, antibiotics are overused and antibiotic-resistant microbes are contributing an increasing burden of adverse patient outcomes. It is the criteria that we can use to reject the use of antibiotics that is the focus (...) of this paper. Scanlon's contractualism explains why antibiotics should not be used to gain small benefits, even when the direct costs of antibiotics are low. We know that some individuals now (and probably more in the future will) carry a burden of irretrievable harm as a consequence of treatment- (antibiotic-) resistant infection. If we accept that the dominant justification for use of antibiotics is to prevent irretrievable harm to an individual or contact, then the use of antibiotics for self-limiting conditions, or for the treatment of individuals with conditions for which antibiotics do not substantially impact on outcomes (eg, in the latter stages of terminal illness), or for access based on preference or willingness to pay (internet or over-the-counter access), or the use of antibiotics as animal growth promoters can be rejected. Scanlon's approach also suggests that, with few new antibiotics in the pipeline and an increasing burden of disease attributable to resistant microbes, control of the spread of antibiotic-resistant microbes should be given increasing priority. (shrink)

This paper examines diverse perspectives around the concept of responsibility concerning antibiotic use in animal agriculture. Antibiotic use in agriculture has been identified as a source of antimicrobial resistance, one of the largest public health threats today. In the United States, efforts to curb antibiotic use in farming draws on a diverse range of actors—including farmers, veterinarians, consumers, and public health advocates—and relies on a mix of industry standards and federal guidelines around responsible use. The paper selects (...) a similarly diverse range of people and employs Q methodology to query the points of disagreement and consensus around the practices that constitute responsible antibiotic use in animal agriculture, and who is responsible for antimicrobial resistance. We find a diverse mix of actor types across three discourses, but with clear differences between farmers and public health advocates. We also argue that, in some cases, points of disagreement and agreement are often based on different interpretations of ideas, indicating points of common ground where there might appear to be disagreement, and areas of difference where there appears to be agreement. We argue that these flexible interpretations of some of the key issues around antibiotic use are nevertheless grounded in durable differences in views of what agriculture is and what it should be. (shrink)

This article assesses which policies for addressing antibiotic resistance as part of a multi-pronged approach would benefit from legalization through an international legal agreement. Ten candidate policies were identified based on a review of existing literature, especially The Lancet Series on Antimicrobial Resistance, The Lancet Infectious Diseases Commission on AMR, and the World Health Organization Global Action Plan for AMR. These policies were then grouped under the headings of access, conservation, and innovation.Each of the ten policies were assessed using (...) four criteria developed by Hoffman, Røttingen, and Frenk to help consider why their legalization may be helpful, necessary and/or justified. These criteria are: the problem has a significant transnational dimension; the goal justifies the coercive nature of law; the outcome is likely to be beneficial; and legalization represents the best commitment mechanism among competing alternatives. (shrink)

Securing equitable antibiotic access as an essential component for health system resilience and pandemic preparedness requires a systems perspective. This article discusses key components that need to be coordinated and paired with adequate financing and resources to ensure antibiotic effectiveness as a global public good, which should be central while discussing a new global agreement.

The use of subtherapeutic doses of antibiotics in food-producing animals has been linked to antibiotic resistant infections in humans. Although this practice has been banned in Europe, the U.S. regulatory authorities have been slow to act. This paper discusses the regulatory hurdles and ethical dilemmas of banning this practice within the context of the risk analysis model (risk assessment, risk management, and risk communication). Specific issues include unethical use of scientific uncertainty during the risk assessment phase, the rejection of (...) the precautionary principle leading to ineffective risk management, and the criticality of risk communication to build consensus and force action. The underlying root cause is a conflict of values (Type I ethical problem) among key stakeholders, which is examined in depth along with an ethical analysis using public health ethical values. (shrink)

Setting goals in the workplace can motivate improved performance but it might also compromise ethical behavior. In this paper, we propose that individual differences in the dispositional tendency to morally justify behavior moderate the effects of specific performance goals on unethical behavior. We conducted an experimental study in which working participants, who were randomly assigned to a specific goal condition or to a condition with a vague goal that lacked a specific target, completed two tasks in which they had the (...) opportunity to act unethically. In an ethical dilemma task, participants in the specific goal condition were more likely to advocate using unethical methods. However, in an anagram task, only those with high moral justification overstated their performance to a greater degree in the specific goal condition. As such, individuals may not be equally susceptible to the ‘dark side’ of goal-setting. (shrink)

Antibiotic resistance is widely recognized as a major threat to public health and healthcare systems worldwide. Recent research suggests that pollution from antibiotics manufacturing is an important driver of resistance development. Using Sweden as an example, this article considers how industrial antibiotic pollution might be addressed by public actors who are in a position to influence the distribution and use of antibiotics in high-income countries with publicly funded health systems. We identify a number of opportunities for these actors (...) to incentivize industry to increase sustainability in antibiotics production. However, we also show that each alternative would create tensions with other significant policy goals, necessitating trade-offs. Since justifiable trade-offs require ethical consideration, we identify and explore the main underlying normative issues, namely, the weighing of local versus global health interests, the weighing of present versus future health interests, and the role of individualistic constraints on the pursuit of collective goals. Based on this analysis, we conclude that the actors have weighty principled reasons for prioritizing the goal of addressing pollution, but that translating this stance into concrete policy requires accommodating significant pragmatic challenges. (shrink)

ZusammenfassungDieser Artikel beschreibt die ethischen Herausforderungen, die sich durch das Problem der Antibiotikaresistenz ergeben. Wir legen die Ursachen für ABR dar und argumentieren, dass eine effektive Bekämpfung der ABR es erforderlich macht, den derzeitigen Antibiotikagebrauch drastisch zu reduzieren. Allerdings müssen hierbei auch die ethischen Probleme, die durch ABR entstehen, berücksichtigt werden. ABR führt zum einen zur Verstärkung bereits bestehender Herausforderungen im Infektionsschutz, zum anderen wirft sie neue ethische Probleme auf. Wir argumentieren, dass sich diese Probleme vor allem in Bezug auf (...) kollektive Handlungsentscheidungen und gerechte Ressourcenverteilung ergeben. Um den Konsum von Antibiotika fair zu reduzieren, entwickeln wir anschließend sowohl ein kontraktualistisches Prinzip für die Rationierung, als auch erste Vorschläge zu dessen Implementierung. Hierbei skizzieren wir Risikogrenzen für die Patienten, bei denen ein Verzicht auf Antibiotikatherapie gerechtfertigt werden kann. (shrink)

There are substantial inequalities associated with antibiotics and the determinants of their effectiveness, including the risk of exposure to antibiotic‐resistant microbes, access to relevant treatment advice, diagnostic facilities, risk of life‐threatening infectious disease, and access to antibiotics. Current arrangements (social, political, economic) allow inequalities in the distribution of antibiotic benefits and burdens. This article focuses on the justification of relevant inequalities from a contractualist perspective.

ZusammenfassungProduktion und Verbrauch von Nahrungsmitteln sind traditionell mit weit reichenden Ängsten verknüpft. Bezogen diese sich in vormodernen Gesellschaften vorrangig auf eine ausreichende Versorgung, sind sie in der modernen Industriegesellschaft eher auf die Qualität der Nahrungsmittel gerichtet. In diesem Zusammenhang spielten in der Nachkriegszeit Antibiotika eine zentrale Rolle. Der Aufsatz stellt die Einführung der Antibiotika in die westdeutsche Veterinärmedizin, ihre frühe Diskussion als Konservierungsmittel und ihre wachsende Rolle als Wachstumsförderer dar. Vor dem Hintergrund einer zunehmend industrialisierten, auf Maximierung ausgerichteten Produktionspolitik werden (...) die Rolle der Veterinäre, der Forschung und der wissenschaftlichen Experten sowie die Probleme der Regulierung des Antibiotikaeinsatzes in der Landwirtschaft diskutiert, die in die Entstehung eines unübersichtlichen grauen Marktes für Antibiotika und die Verlagerung ihres Einsatzes in die Therapie mündete. Besondere Aufmerksamkeit wird der Frage zugewandt, welche Rolle das Vertrauen und die Ängste der Verbraucher in diesem Prozess spielten. (shrink)

Antibiotic resistance threatens the capacity to treat life-threatening infections. If it is accepted that it will be many years until the production of new antibiotics overcomes current concerns with antibiotic resistance then ways to conserve the effectiveness of current antibiotics will have to be found. For many bacterial agents of infection levels of antibiotic resistance are directly dependent on the quantity of antibiotic prescribed. Antibiotics are currently underutilised in many parts of the world. If a just (...) distribution of access to antibiotics requires equal access for individuals with equal need irrespective of wealth then responding to this requirement of justice has the potential to shorten the effective life of currently available antibiotics. Increasing the range and numbers of individuals treated with antibiotics would seem to threaten sustainability and also potentially undermine the access of future generations to cost-effective treatments for bacterial infection. The control of antibiotic resistance requires that the determinants of infectious disease transmission are addressed, such as poor housing, education and nutrition as well as the provision of antibiotics. The apparent tension between intragenerational justice and sustainability diminishes when the account of distributive justice extends beyond access to antibiotics and includes plural entitlements. Controlling antibiotic resistance requires more than the redistribution or reduction of antibiotics. (shrink)

Horizontal gene transfer (HGT) is a major mechanism responsible for the spread of antibiotic resistance. Conversely, it is often assumed that antibiotics promote HGT. Careful dissection of the literature, however, suggests a lack of conclusive evidence supporting this notion in general. This is largely due to the lack of well‐defined quantitative experiments to address this question in an unambiguous manner. In this review, we discuss the extent to which HGT is responsible for the spread of antibiotic resistance and (...) examine what is known about the effect of antibiotics on the HGT dynamics. We focus on conjugation, which is the dominant mode of HGT responsible for spreading antibiotic resistance on the global scale. Our analysis reveals a need to design experiments to quantify HGT in such a way to facilitate rigorous data interpretation. Such measurements are critical for developing novel strategies to combat resistance spread through HGT. -/- . (shrink)

Spinoza unequivocally states in the Ethics that intuitive knowledge is more powerful than reason. Nonetheless, it is not clear what exactly this greater power promises in the face of the passions. Does this mean that intuitive knowledge is not liable to akrasia? Ronald Sandler offers what, to my knowledge, is the only explicit answer to this question in recent Spinoza scholarship. According to Sandler, intuitive knowledge, unlike reason, is not susceptible to akrasia. This is because, intuitive knowledge enables the knower (...) to greater power over the passions due to its immediacy, its foundation and because it engenders the boundlessly powerful intellectual love of God. In this paper, I consider to what extent intuitive knowledge is liable to akrasia by exploring whether Sandler's claim can justifiably be attributed to Spinoza. I argue that, given our modal status, it is not plausible to claim that akrasia would never apply to intuitive knowledge. Since intuitive ideas are the ideas of a finite .. (shrink)

Complex diseases involve both a genetic component and a response to environmental factors or lifestyle changes. Recently, genome-wide association studies (GWAS) have succeeded in identifying hundreds of polymorphisms that are statistically associated with complex diseases. However, the association is usually weak and none of the associated allelic forms is either necessary or sufficient for the disease occurrence. We argue that this promotes a network view, centred on functional redundancy. We adapted reliability theory to the concerned sub-network, modelled as a parallel (...) array of functional modules. In our model, as long as one module remains active, the function correlated with the respective disease is ensured and disease does not occur. Genetic factors reduce the initial number of available modules while environment, contingent surroundings, personal history, epigenetics, and some intrinsic stochasticity influence their persistence time. This model reproduces age-specific incidence curves and explains the influence of environmental changes. It offers a new paradigm, according to which disease occurs due to a lack of functional elements, depending on many idiosyncratic factors. Genetic risk assessed from GWAS is only a statistical notion with no direct interpretation at the individual level. However, genomic profiling could be useful at population level in devising models to guide decisions in health care policy. (shrink)

Jerry Fodor has consistently cited the persistence of illusions--especially the M.

This study is set forth to explore whether the susceptibility to persuasion—as articulated by Cialdini’s persuasion strategies—could vary with culture and acculturation. We examined individuals from the Arabic culture and their susceptibility to persuasion, according to the following strategies: reciprocity, commitment, liking, scarcity, consensus, and authority. The study involved 1,315 Arab Muslims between 18 and 60 years old. The respondents were recruited from among residents of the Arab region, immigrant Arabs in non-Arabic Muslim countries, immigrant Arabs in East (...) Asian countries, and immigrant Arabs in Western countries. Respondents completed an online Qualtrics survey. Controlling for socio-demographic variables, our results indicated that susceptibility to the strategies differed significantly among Arab Muslims in the Arab region, with reciprocity being the highest and authority the lowest prevailing strategies. The same pattern of susceptibility emerged among immigrant Arab Muslims, regardless of their host country and the acculturation mode they endorse. These findings suggest that there is a consistent persuasion susceptibility pattern in the Arabic Muslim culture that does not seem to be modified by immigration and acculturation modes. Our findings are contrasted with the scarce research on cross-cultural differences in susceptibility to Cialdini’s persuasion strategies. (shrink)

According to the theoretical framework relating hypnosis to attention, baseline attentional functioning in highly hypnotizable individuals should be more efficient than in low hypnotizable individuals. However, previous studies did not find differences in Stroop-like tasks in which the measure indicative of the Stroop interference effect was based on response latencies. This study was designed to determine whether subjects with different levels of hypnotic susceptibility show differences in baseline attentional functioning. To assess this hypothesis, high, medium, and low hypnotizable subjects (...) performed a Stroop task designed to evaluate accuracy performance, before being subjected to hypnotic induction. Results showed that the Stroop interference effect was smaller in high hypnotizable subjects than in low hypnotizable subjects, whereas it was not different between high, and medium hypnotizable subjects. This outcome supports the notion that baseline attentional functioning is related to hypnotic susceptibility. (shrink)