Annals of the New York Academy of Sciences
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Ann. N. Y. Acad. Sci. · Sep 2014
ReviewThe risk/benefit of predicting a post-antibiotic era: is the alarm working?
There have been concerns about antimicrobial resistance since the first widespread use of antibiotics in humans. More recently, this concern has grown and become the focus of clinical, scientific, and political activity. In part, the political interest is a consequence of publicizing a bleak picture of a post-antibiotic world. ⋯ Many governments now use a risk assessment approach to identify security concerns, based on reasonable worst-case scenarios. There is no doubt that for effective policy-based action to occur, antimicrobial resistance needs to be seen as a national and international security priority, particularly as the major cost of inaction will mostly be felt in the future. We conclude that presenting the evidence in a manner that is used to encourage prioritization of security policy is not only justified, it is essential to drive action in this area.
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Ann. N. Y. Acad. Sci. · Aug 2014
ReviewFine- and coarse-filter conservation strategies in a time of climate change.
As species adapt to a changing climate, so too must humans adapt to a new conservation landscape. Classical frameworks have distinguished between fine- and coarse-filter conservation strategies, focusing on conserving either the species or the landscapes, respectively, that together define extant biodiversity. ⋯ Novel approaches combine coarse- and fine-scale approaches--for example, prioritizing species within pretargeted landscapes--and accommodate the difficult reality of multiple interacting stressors. By taking a diversified approach to conservation actions and decisions, conservationists can hedge against uncertainty, take advantage of new methods and information, and tailor actions to the unique needs and limitations of places, thereby ensuring that the biodiversity show will go on.
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Ann. N. Y. Acad. Sci. · May 2014
ReviewWhen and for how long should glucocorticoids be used in rheumatoid arthritis? International guidelines and recommendations.
Glucocorticoids are widely used in rheumatoid arthritis (RA); however, their effectiveness and safety is still a subject of debate. In particular, when to introduce glucocorticoids, but also when and how to taper them, are important questions for clinicians. ⋯ The recommendations cover the introduction of glucocorticoids (and for whom they are recommended), doses and duration of treatment, and tapering strategies. Items still on the research agenda include more data on safety, particularly for long-term use, and small doses of glucocorticoids.
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Ann. N. Y. Acad. Sci. · Apr 2014
Alzheimer's disease research and development: a call for a new research roadmap.
Epidemiological projections of the prevalence of Alzheimer's disease (AD) and related dementias, the rapidly expanding population over the age of 65, and the enormous societal consequence on health, economics, and community foretell of a looming global public health crisis. Currently available treatments for AD are symptomatic, with modest effect sizes and limited impact on longer term disease outcomes. ⋯ An unprecedented collaborative effort of government, regulators, industry, academia, and the community at-large is needed to address this crisis and to develop an actionable plan for rapid progress toward successfully developing effective treatments. Here, we map out a course of action in four key priority areas, including (1) addressing the fundamental mechanisms of disease, with the goal of developing a core set of research tools, a framework for data sharing, and creation of accessible validated and replicated disease models; (2) developing translational research that emphasizes rapid progress in disease model development and better translation from preclinical to clinical stages, deploying leading technologies to more accurately develop predictive models; (3) preventing AD through the development of robust methods and resources to advance trials and creating fundamental resources such as continuous adaptive trials, registries, data repositories, and instrument development; and (4) innovating public/private partnerships and global collaborations, with mechanisms to incentivize collaborations and investments, develop larger precompetitive spaces, and more rapid data sharing.
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Ann. N. Y. Acad. Sci. · Jan 2014
Mapping modalities of self-awareness in mindfulness practice: a potential mechanism for clarifying habits of mind.
To better understand the neurobiological mechanisms by which mindfulness-based practices function in a psychotherapeutic context, this article details the definition, techniques, and purposes ascribed to mindfulness training as described by its Buddhist tradition of origin and by contemporary neurocognitive models. Included is theory of how maladaptive mental processes become habitual and automatic, both from the Buddhist and Western psychological perspective. Specific noting and labeling techniques in open monitoring meditation, described in the Theravada and Western contemporary traditions, are highlighted as providing unique access to multiple modalities of awareness. ⋯ Finally, a model is provided to describe the timing by which noting and labeling practices have the potential to influence different stages of low- and high-level neural processing. Hypotheses are proposed concerning both levels of processing in relation to the extent of practice. Implications for the nature of subjective experience and self-processing as it relates to one's habits of mind, behavior, and relation to the external world, are also described.