Happy Earth Day !

We want an Earth that is not being polluted !

“Today, we honor the rich, vast Earth that’s sustained generations before us and continues to nurture life and inspire wonder. At an estimated 4.543 billion years of age, the Earth is still the only known object in the Universe known to harbor life. It’s also the densest planet in the Solar System and the largest of the four terrestrial planets.”

Google Doodle 2017

Click to view Earth Day 2017 doodle.

Today’s Doodle follows the story of a fox who dreams about an Earth that’s been polluted and adversely affected by climate change. The fox wakes with a startle, and urgently starts making small lifestyle changes to care for the Earth. Along the way, the fox enlists friends – including Momo the cat, and Google Weather’s favorite frog – to join its quest to protect and nurture the environment.

To combat things like coral bleaching and pollution, the three eco-rangers are inspired to take action such as eating less meat, carpooling, and unplugging unused electronic devices. That’s some heroic work for tiny animals!”

Google Doodle 2016

Click to view Earth Day 2016 doodle.

“The vastness of Earth’s diversity makes it an intimidating topic, but in the end I chose to highlight Earth’s five major biomes: the tundra, forest, grasslands, desert, and coral reefs. In each illustration, you’ll find one animal who’s been singled out for their 15 minutes of fame. Each time you visit Google.com, you’ll randomly receive one of the five doodles. Keep refreshing to admire a different side of Earth’s immense beauty.”

Google Doodle 2015

Click to view Earth Day 2015 doodle.

“Which animal are you? Take the Google Doodle Earth Day quizz

You can search Google for answers to all kinds of animal questions: What does an aye-aye eat?Where do narwhals live? How long is a toco toucan’s beak? And this Earth Day, you can turn to Google for the answer to something that you’ve always needed to know: which animal are you?”

Google Doodle 2014

Click to view Earth Day 2014 doodle.

“I had a lot of hair-brained ideas for Earth Day 2014, before at last stumbling upon the solution you see before you. My desk was littered with hastily scrawled notes and sketches involving old tractor tires, the number of water bottles consumed by north americans per annum, and sea turtles wearing plastic shopping bags like waist-coat travesties.”

Google Doodle 2013

Click to view Earth Day 2013 doodle.

“Today we are celebrating Earth Day with an interactive doodle that captures a slice of nature’s subtle wonders. We hope you enjoy discovering animals, controlling the weather, and observing the seasons. Use the sightseeing checklist below to make sure you do not miss anything!”

Google Doodle 2012

Click to view Earth Day 2012 doodle.

“An occasion to be particularly mindful of how we care for our planet, Earth Day is a time to show and practice appreciation for this sphere we call home. Fortunately for the doodle team, Earth Day is also the a chance to spruce up the homepage. Having celebrated this occasion with drawings of nature in previous years, we decided to get to the root of the inspiration and actually grow our doodle! Sure it was a simple and practically obvious solution for the logo, but it proved to be a surprising undertaking.”

Google Doodle 2011

Click to view Earth Day 2011 doodle.

“Truly a team effort for a global celebration, this year’s Earth Day doodle started with a desire to depict different environments around the world. Starting with Asia, the doodle walks users through Africa, Antarctica, Australia, and America. Having laid down the overall composition, I turned to my teammates to determine what should happen in this nature-packed doodle. We all huddled in a room and brainstormed various cute interactions, internet memes, and nature jokes that could fit into each region. When users hover over various parts of the doodle, they may catch a salmon swimming up stream, parrots darting through the sky, a frog leaping across the grass, a bear having a snack, a koala performing gymnastics, a sleepy lion, butterflies rustling trees, a penguin sliding down an iceberg, and a sneezing baby panda.”

Could Birth Control Pills Make You Feel Bad ?

It’s Not in Your Head: Your Birth Control Pills Might Be Making You Feel Crappy

A new study found that oral contraceptives lowered women’s quality of life. The average decrease was small, but for certain women the effects could be significant, researchers say.

2017 Study Abstract

Objective
To determine whether there is a causal effect of oral contraceptive (OC) treatment on general well-being and depressed mood in healthy women.

Design
Double-blind, randomized, and placebo-controlled trial.

Setting
University hospital.

Patient(s)
Three hundred and forty healthy women aged 18–35 years randomized to treatment, of whom 332 completed the data collection at follow-up evaluation.

Intervention(s)
A combined OC (150 μg levonorgestrel and 30 μg ethinylestradiol) or placebo for 3 months of treatment.

Main Outcome Measure(s)
Primary outcome measures: global score of Psychological General Well-Being Index (PGWBI) and the Beck Depression Inventory (BDI); secondary outcome measures: six separate dimensions of the PGWBI.

A responsible physician should warn their patients that some women generally don’t feel well on the pill and, if this turns out to be the case, alternatives are available.

Result(s)
The OC treatment statistically significantly decreased general well-being compared with placebo −4.12 (95% CI, −7.18 to −1.06). Furthermore, OC decreased the following PGWBI dimensions compared with placebo: positive well-being −3.90 (95% CI, −7.78 to −0.01), self-control −6.63 (95% CI, −11.20 to −2.06), and vitality −6.84 (95% CI, −10.80 to −2.88). The effect of OC on depressive symptoms and on the PGWBI dimension depressed mood were not statistically significant.

Conclusion(s)
This study demonstrates a statistically significant reduction in general well-being by a first-choice OC in comparison with placebo in healthy women. We found no statistically significant effects on depressive symptoms. A reduction in general well-being should be of clinical importance.

Sources and Press Releases
  • A first-choice combined oral contraceptive influences general well-being in healthy women: a double-blind, randomized, placebo-controlled trial, Fertility and Sterility, dx.doi.org/10.1016/j.fertnstert.2017.02.120, April 19, 2017.
  • It’s Not in Your Head: Your Birth Control Pills Might Be Making You Feel Crappy, health, April 20, 2017.
  • The Pill image credit Sarah C.

European Environment Agency Technical Report No 2/2012

The impacts of endocrine disrupters on wildlife, people and their environments – The Weybridge+15 (1996–2011) report

The impacts of endocrine disrupters on wildlife, people and their environments – The Weybridge+15 (1996–2011) report.

Rates of endocrine diseases and disorders, such as some reproductive and developmental harm in human populations, have changed in line with the growth of the chemical industry, leading to concerns that these factors may be linked. For example, the current status of semen quality in the few European countries where studies have been systematically conducted, is very poor: fertility in approximately 40 % of men is impaired. There is also evidence of reproductive and developmental harm linked to impairments in endocrine function in a number of wildlife species, particularly in environments that are contaminated by cocktails of chemicals that are in everyday use. Based on the human and wildlife evidence, many scientists are concerned about chemical pollutants being able to interfere with the normal functioning of hormones, so-called endocrine-disrupting chemicals (EDCs), that could play a causative role in these diseases and disorders. If this holds true, then these ‘early warnings’ signal a failure in environmental protection that should be addressed.

The impacts of endocrine disrupters on wildlife, people and their environmentsThe Weybridge+15 (1996–2011) report.

Endocrine Disruptors

Antidepressant Use in Pregnancy and Preterm Birth, ASD, ADHD in Offspring

Is first-trimester maternal antidepressant use related to offspring birth problems, neurodevelopmental problems, or both?

1. Association Between Maternal Use of SSRI Medications and Autism in Their Children

In the February 2016 issue of JAMA Pediatrics, Boukhris and colleagues reported that in utero exposure to selective serotonin reuptake inhibitors (SSRIs) was associated with a significantly increased risk for autism. The authors examined all pregnancies from 1998 to 2009 in the Québec Pregnancy/Children Cohort database that resulted in children with autism spectrum disorder (ASD) as the primary outcome. Among 145 456 full-term infants included in the analysis, 1054 children were diagnosed with ASD by the mean age of 6.2 years (SD, 3.2 years) at follow-up, including 1008 cases of ASD among 140 732 children (0.72%) who were not exposed to antidepressants, and 31 cases of ASD among the 2532 (1.2%) children who were exposed to SSRIs during the second or third trimester. Based on these results, the authors concluded that second- or third-trimester exposure to SSRIs was associated with increased risk for ASD (adjusted hazard ratio, 1.87; 95% CI, 1.15-3.04).

2017 Study Abstract

Importance
The association between the use of antidepressants during gestation and the risk of autism spectrum disorder (ASD) in children is still controversial. The etiology of ASD remains unclear, although studies have implicated genetic predispositions, environmental risk factors, and maternal depression.

Objective
To examine the risk of ASD in children associated with antidepressant use during pregnancy according to trimester of exposure and taking into account maternal depression.

Design, Setting, and Participants
We conducted a register-based study of an ongoing population-based cohort, the Québec Pregnancy/Children Cohort, which includes data on all pregnancies and children in Québec from January 1, 1998, to December 31, 2009. A total of 145 456 singleton full-term infants born alive and whose mothers were covered by the Régie de l’assurance maladie du Québec drug plan for at least 12 months before and during pregnancy were included. Data analysis was conducted from October 1, 2014, to June 30, 2015.

Exposures
Antidepressant exposure during pregnancy was defined according to trimester and specific antidepressant classes.

Main Outcomes and Measures
Children with ASD were defined as those with at least 1 diagnosis of ASD between date of birth and last date of follow-up. Cox proportional hazards regression models were used to estimate crude and adjusted hazard ratios with 95% CIs.

Results
During 904 035.50 person-years of follow-up, 1054 children (0.7%) were diagnosed with ASD; boys with ASD outnumbered girls by a ratio of about 4:1. The mean (SD) age of children at the end of follow-up was 6.24 (3.19) years. Adjusting for potential confounders, use of antidepressants during the second and/or third trimester was associated with the risk of ASD (31 exposed infants; adjusted hazard ratio, 1.87; 95% CI, 1.15-3.04). Use of selective serotonin reuptake inhibitors during the second and/or third trimester was significantly associated with an increased risk of ASD (22 exposed infants; adjusted hazard ratio, 2.17; 95% CI, 1.20-3.93). The risk was persistent even after taking into account maternal history of depression (29 exposed infants; adjusted hazard ratio, 1.75; 95% CI, 1.03-2.97).

Conclusions and Relevance
Use of antidepressants, specifically selective serotonin reuptake inhibitors, during the second and/or third trimester increases the risk of ASD in children, even after considering maternal depression. Further research is needed to specifically assess the risk of ASD associated with antidepressant types and dosages during pregnancy.

2. Associations of Maternal Antidepressant Use During the First Trimester of Pregnancy With Preterm Birth, Small for Gestational Age, Autism Spectrum Disorder, and Attention-Deficit/Hyperactivity Disorder in Offspring

Key Points

Findings
In this retrospect cohort study of 1 580 629 Swedish offspring using multiple statistical and methodical approaches to adjust for confounding, first-trimester antidepressant exposure was significantly associated with preterm birth (odds ratio, 1.3 in a sibling comparison analysis) but not with risk of being born small for gestational age or later autism spectrum disorder or attention-deficit/hyperactivity disorder.

Meaning
After accounting for confounding factors, first-trimester antidepressant exposure, compared with no exposure, was associated with a small increased risk of preterm birth but no increased risk of small for gestational age, autism spectrum disorder, or attention-deficit/hyperactivity disorder.

2017 Abstract

Importance
Prenatal antidepressant exposure has been associated with adverse outcomes. Previous studies, however, may not have adequately accounted for confounding.

Objective
To evaluate alternative hypotheses for associations between first-trimester antidepressant exposure and birth and neurodevelopmental problems.

Design, Setting, and Participants
This retrospective cohort study included Swedish offspring born between 1996 and 2012 and followed up through 2013 or censored by death or emigration. Analyses controlling for pregnancy, maternal and paternal covariates, as well as sibling comparisons, timing of exposure comparisons, and paternal comparisons, were used to examine the associations.

Exposures
Maternal self-reported first-trimester antidepressant use and first-trimester antidepressant dispensations.

Main Outcomes and Measures
Preterm birth (< 37 gestational weeks), small for gestational age (birth weight < 2 SDs below the mean for gestational age), and first inpatient or outpatient clinical diagnosis of autism spectrum disorder and attention-deficit/hyperactivity disorder in offspring.

Results
Among 1 580 629 offspring (mean gestational age, 279 days; 48.6% female; 1.4% [n = 22 544] with maternal first-trimester self-reported antidepressant use) born to 943 776 mothers (mean age at childbirth, 30 years), 6.98% of exposed vs 4.78% of unexposed offspring were preterm, 2.54% of exposed vs 2.19% of unexposed were small for gestational age, 5.28% of exposed vs 2.14% of unexposed were diagnosed with autism spectrum disorder by age 15 years, and 12.63% of exposed vs 5.46% of unexposed were diagnosed with attention-deficit/hyperactivity disorder by age 15 years. At the population level, first-trimester exposure was associated with all outcomes compared with unexposed offspring (preterm birth odds ratio [OR], 1.47 [95% CI, 1.40-1.55]; small for gestational age OR, 1.15 [95% CI, 1.06-1.25]; autism spectrum disorder hazard ratio [HR], 2.02 [95% CI, 1.80-2.26]; attention-deficit/hyperactivity disorder HR, 2.21 [95% CI, 2.04-2.39]). However, in models that compared siblings while adjusting for pregnancy, maternal, and paternal traits, first-trimester antidepressant exposure was associated with preterm birth (OR, 1.34 [95% CI, 1.18-1.52]) but not with small for gestational age (OR, 1.01 [95% CI, 0.81-1.25]), autism spectrum disorder (HR, 0.83 [95% CI, 0.62-1.13]), or attention-deficit/hyperactivity disorder (HR, 0.99 [95% CI, 0.79-1.25]). Results from analyses assessing associations with maternal dispensations before pregnancy and with paternal first-trimester dispensations were consistent with findings from the sibling comparisons.

Conclusions and Relevance
Among offspring born in Sweden, after accounting for confounding factors, first-trimester exposure to antidepressants, compared with no exposure, was associated with a small increased risk of preterm birth but no increased risk of small for gestational age, autism spectrum disorder, or attention-deficit/hyperactivity disorder.

Image credit Jamie Campbell.

Sexual Differentiation of the Brain

Hormones and sexual differentiation of human behavior

Includes Gonadal hormones and sexual differentiation of human behavior : Effects on psychosexual and cognitive development.

by Akira Matsumoto, 1999.

Sexual difference in the brain has long been one of the more intriguing research areas in the field of neuroscience. This thorough and comprehensive text uncovers and explains recent neurobiological and molecular biological studies in the field of neuroscience as they relate to the mechanisms underlying sexual differentiation of the brain.

Attempts have been made to clarify sex differences in the human brain using noninvasive techniques such as magnetic resonance imaging. Sexual Differentiation of the Brain thoroughly examines these techniques and findings, providing an up-to-date, comprehensive overview written by leading researchers in the field.

Chapter 14

Gonadal hormones and sexual differentiation of human behavior: Effects on psychosexual and cognitive development

Melissa Hines is a DES Daughter who has substantial research experience investigating impact of prenatal DES exposure in females and subsequent impact on gender and sexual orientation. She has several books which further investigate these themes of “brain gender”.

Contents
  1. Introduction and Overview
  2. Core Gender Identity
  3. Sexual Orientation
    1. Genetic Females
      1. CAH
      2. DES
    2. Genetic Males
      1. Androgen Insensivity Syndrome (AIS)
      2. Enzymatic Deficiencies
      3. Exposure to DES or Progestins
  4. Gender Role Behaviors
    1. Childhood Play Behavior
    2. Cognitive Abilities
  5. Summary and Conclusions
    References

Testing Medical Treatments : DiEthylStilbestrol

Testing Treatments Interactive, promoting better research for better healthcare

Audio published mid 2016 by Testing Treatments Interactive, promoting better research for better healthcare.

Press Play > to listen to the recording.

Sources and more information

Our SoundCloud Playlists
More DES DiEthylStilbestrol Resources

Short-term use of oral corticosteroids linked to serious health problems

Common drugs, uncommon risks? Higher rate of serious problems after short-term steroid use

Millions of times a year, Americans get prescriptions for a week’s worth of steroid pills, hoping to ease a backache or quell a nagging cough or allergy symptoms.

new study from the University of Michigan suggests that we need to pay more attention to the potential side effects of oral corticosteroids, even for short term use.

People taking the pills were more likely to

  • break a bone,
  • have a potentially dangerous blood clot
  • or suffer a life-threatening bout of sepsis in the months after their treatment,

compared with similar adults who didn’t use short-term steroids…

2017 Study Abstract

Objective
To determine the frequency of prescriptions for short term use of oral corticosteroids, and adverse events (sepsis, venous thromboembolism, fractures) associated with their use.

Design
Retrospective cohort study and self controlled case series.

Setting
Nationwide dataset of private insurance claims.

Participants
Adults aged 18 to 64 years who were continuously enrolled from 2012 to 2014.

Main outcome measures
Rates of short term use of oral corticosteroids defined as less than 30 days duration. Incidence rates of adverse events in corticosteroid users and non-users. Incidence rate ratios for adverse events within 30 day and 31-90 day risk periods after drug initiation.

Results
Of 1 548 945 adults, 327 452 (21.1%) received at least one outpatient prescription for short term use of oral corticosteroids over the three year period. Use was more frequent among older patients, women, and white adults, with significant regional variation (all P<0.001). The most common indications for use were upper respiratory tract infections, spinal conditions, and allergies. Prescriptions were provided by a diverse range of specialties. Within 30 days of drug initiation, there was an increase in rates of sepsis (incidence rate ratio 5.30, 95% confidence interval 3.80 to 7.41), venous thromboembolism (3.33, 2.78 to 3.99), and fracture (1.87, 1.69 to 2.07), which diminished over the subsequent 31-90 days. The increased risk persisted at prednisone equivalent doses of less than 20 mg/day (incidence rate ratio 4.02 for sepsis, 3.61 for venous thromboembolism, and 1.83 for fracture; all P<0.001).

Conclusion
One in five American adults in a commercially insured plan were given prescriptions for short term use of oral corticosteroids during a three year period, with an associated increased risk of adverse events.

Sources and Press Releases
  • Short term use of oral corticosteroids and related harms among adults in the United States: population based cohort study, The BMJ, doi.org/10.1136/bmj.j1415, 12 April 2017.
  • Common drugs, uncommon risks? Higher rate of serious problems after short-term steroid use, medicalxpress, April 13, 2017.

Glyphosate found in one third of food products in Canada

A third of Canada food samples tested contain residue of controversial pesticide

2017 Study Abstract

Introduction

Chemical hazards may occur in foods either from their deliberate use in food production (e.g. veterinary drugs, pesticides, food additives) or by accidental contamination from the environment, during processing, or due to the presence of natural toxins. Regardless of the source of the hazard, food producers, manufacturers and importers must ensure their products are safe to eat and compliant with applicable Canadian standards. The Canadian Food Inspection Agency‘s (CFIA) priority is to protect consumers by safeguarding Canada’s food supply. Testing foods for pesticides is one of the tools used by the CFIA to detect food safety risks and ensure that the food supply is safe.

Glyphosate Testing

Objective and Rationale
Glyphosate is an herbicide that is used to kill weeds and it can also be used to dry grains and legumes before harvesting. Health Canada has approved its use on a variety of crops and has set Maximum Residue Limits (MRL) for residues of glyphosate in foods which can be found in their MRL Database. The MRL is the amount of pesticide residue that is expected to remain in or on a food product when a pesticide is used according to the label directions and which will not be a concern to human health.

These testing activities were designed to:

  • generate information on the presence and levels of glyphosate residues in foods;
  • verify the safety of the food supply and compliance with Canadian standards.

Sample Collection
Testing for Glyphosate residues was added to the CFIA’s food surveillance program in 2015. In 2015-2016, 3188 samples of domestic and imported food products were collected and tested for glyphosate residues in three programs:

  • Testing of 482 samples of fresh and processed fruits and vegetables as part of the National Chemical Residue Monitoring Program (NCRMP);
  • Retail survey of 2497 samples of grains (barley, buckwheat, and quinoa), beverages, bean, pea, lentil, chickpea and soy products;
  • A survey of over 209 retail samples of infant foods as part of the 2015-2016 Children’s Food Project.

Limitations
Due to the low number of samples and products analyzed, care must be taken when interpreting these results. Regional differences, impact of product shelf-life, storage conditions, or cost of the commodity on the open market were not examined in this survey.
Samples were tested as sold; no inference can be made on the levels of glyphosate in foods as consumed.

Results
The overall compliance rate for these surveys, based on Canadian Maximum Residue Limits (MRL), was 98.7 %. No samples of fruits and vegetables, soy products, or infant foods were found to contain residues exceeding Canadian limits. Most samples found with levels of residues exceeding Canadian limits were predominantly associated with grain products.

Summary
In 2015-2016, the CFIA tested a total of 3,188 food samples for glyphosate. Glyphosate was found in 29.7% of samples. Glyphosate residues above MRLs were found in only 1.3% of samples. This data was evaluated by Health Canada and no human health concerns were identified.

Sources and More Information

  • Safeguarding with Science: Glyphosate Testing in 2015-2016, CFIA- Science Branch Survey Report, Food Safety Science Directorate, Canadian Food Inspection Agency, 04.2017.
  • Nearly a third of food samples in CFIA testing contain glyphosate residues, CBC News, Apr 13, 2017.

Drivers, dynamics and epidemiology of antimicrobial resistance in animal production

Excessive Use of Antibiotics Turns Food Into Catastrophic Threat

The widespread use of antibiotics through food chains is thus becoming catastrophic. A review by the Food & Agriculture Organization of the United Nations explains how antibiotic-resistant bacteria in animals are infecting humans, through direct contact with animals or indirect transmission through the food we eat.

Executive Summary

It is now accepted that increased antimicrobial resistance (AMR) in bacteria affecting humans and animals in recent decades is primarily influenced by an increase in usage of antimicrobials for a variety of purposes, including therapeutic and non-therapeutic uses in animal production. Antimicrobial resistance is an ancient and naturally occurring phenomenon in bacteria. But the use of antimicrobial drugs – in health care, agriculture or industrial settings – exerts a selection pressure which can favour the survival of resistant strains (or genes) over susceptible ones, leading to a relative increase in resistant bacteria within microbial communities. It has been observed that, in countries where use of particular substances (e.g. fluoroquinolones) is banned in animal production, there are low levels of resistance to these antimicrobials in livestock populations. The rate of AMR emergence in ecosystems such as the human or animal gut is likely to be highly dependent on the quantity of antimicrobials used, along with the duration and frequency of exposure. In animal production, the prolonged use of antimicrobial growth promoters (AGPs) at subtherapeutic levels in large groups of livestock is known to encourage resistance emergence, and is still common practice in many countries today. Due to the interdependence and interconnectedness of epidemiological pathways between humans, animals and the environment, determining the relative importance of factors influencing AMR emergence and spread in animal production is a significant challenge, and is likely to remain one for some time.

In intensive livestock production systems, resistant bacteria can spread easily between animals and this can be exacerbated if biosecurity is inadequate. While some studies have shown reduced levels of AMR on organic farms, a high prevalence of multidrug-resistant (MDR) Campylobacter strains has been detected in organic pig farms in the United States even in the absence of antimicrobial usage (AMU).

In aquaculture, AMR can develop in aquatic and fish gut bacteria as a result of antimicrobial therapy or contamination of the aquatic environment with human or animal waste. The extent and persistence of antimicrobial residues in aquatic systems is unknown and current evidence is conflicting. Furthermore, no international guidelines currently exist for maximum antimicrobial residue limits in water. Water is an important vehicle for the spread of both antimicrobial residues and resistance determinants, since contaminated water can be consumed directly by humans and livestock and used to irrigate crops.

Food is likely to be quantitatively the most important potential transmission pathway from livestock to humans, although direct evidence linking AMR emergence in humans to food consumption is lacking. There is a theoretical risk of widespread dissemination of AMR due to the increasingly global nature of food trade and human travel. This would mean that strains of resistant bacteria could now very quickly reach parts of the world where they had previously not been present. Agricultural systems in emerging economies such as China and India have changed radically in recent years, becoming increasingly intensive in order to meet growing domestic and global demands for animal protein. This is likely to heighten the occurrence and spread of infectious diseases in these systems, thereby leading to increased AMU and therefore resistance.

If the selection pressure resulting from AMU in animals and humans were to be removed, this would still not completely halt the emergence and global spread of AMR due to the ability of AMR genes to move between bacteria, hosts and environments, and the occurrence of spontaneous mutations.

However, the release of large quantities of antimicrobials or resistant bacteria into the environment is still thought to be an important point for control, and therefore measures which encourage the prudent use of antimicrobials are likely to be extremely useful in reducing the emergence and spread of AMR. Future development of quickly biodegradable antimicrobials could help to reduce environmental contamination, and pharmacodynamic studies in livestock can be used to inform the optimization of AMU. Improved hygiene and biosecurity should be a major focus for all types of animal production systems so that the risks of introducing pathogens and resistance genes – and the spread of these within animal populations – can be reduced. Detailed, specific recommendations for countries to move towards more prudent AMU in different agricultural settings are, however, beyond the scope of this paper.

An improved understanding of the epidemiology of AMR emergence and spread in animal production will provide an essential foundation for successful mitigation strategies. There are still considerable gaps in our understanding of the complex mechanisms that lead to the emergence of AMR in bacteria, and the interactions that take place within microbial ecosystems enabling the transfer of resistance between bacteria. There are insufficient data at present to determine quantitatively how important the selection pressure of AMU is for the emergence of AMR in bacteria. Evidence regarding AMR transmission pathways between food animals and humans is lacking, especially from low- and middle-income countries (LMICs).

Such pathways are likely to be highly complex and multi-directional, especially in LMICs, but are still largely unknown. There remains little doubt, however, that the most significant factor in AMR emergence in humans is AMU for human treatment and prevention. It is clear that both human and animal AMU can contribute to environmental contamination, although collection of meaningful data is challenging. The relationships between different types of farming systems and both AMU and the emergence and spread of AMR are discussed in this paper, including extensive and organic systems, but there is still a notable lack of knowledge on the role that sustainable agriculture systems can play in combatting AMR. Most importantly, future research needs to involve an interdisciplinary (e.g. One Health) approach, integrating agricultural, medical, environmental and social sciences, and especially recognizing the importance of human behaviour. A set of specific recommendations to fill current knowledge gaps is presented in the final section of this technical paper.

  • Drivers, dynamics and epidemiology of antimicrobial resistance in animal production, FAO Newsroom, 2016.
  • Excessive Use of Antibiotics Turns Food Into Catastrophic Threat, truth-out, April 12, 2017.

Man and woman, boy and girl

The differentiation and dimorphism of gender identity from conception to maturity

The differentiation and dimorphism of gender identity from conception to maturity.

Baltimore : Johns Hopkins University Press, 1972 book that combines experimental and clinical data in this report on human development and the relation of sexual differentiation and social roles.

In Man and Woman, Boy and Girl, John Money and Anke Ehrhardt offer a comprehensive account of sexual differentiation using genetics, embryology, endocrinology and neuro-endocrinology, psychology, and anthropology. Their multidisciplinary approach to gender identity avoids the old arguments over nature versus nurture. Money and Ehrhardt focus instead on the interaction of hereditary endowment and environmental influence. Money and Ehrhardt’s work will lead many readers to the conclusion that the differences between man and man, or woman and woman, can be as great as between man and woman.

This was required reading in my human sexuality class in college. I thought it was well presented and researched. It defies some of the gender role and gender identification theories by explaining the gender spectrum in very graphic terms. It will make some people VERY uncomfortable, but it makes a valid point I believe, there are many ways to define gender and how individuals identify with their gender. It does not support the popular theory that we are born genetically predisposed to a particular sexual orientation. Instead the book suggests that regardless of how male or how female you may be genetically you may choose which sex you prefer in your physical or emotional relationships. Blasphemy to some, but it goes a long way to clearing up some of the ambiguity about gender roles and gender identification.

Jonathan Van Voorhees, August 4, 2015.