Search Results (593)

Background/Objectives: Strengthening antimicrobial stewardship (AMS) programs is an invaluable intervention in the ongoing efforts to contain the threat of antimicrobial resistance (AMR), particularly in low-resource settings. This study evaluates the impact of the Telementoring, Education, and Advocacy Collaboration initiative for Health through Antimicrobial Stewardship (TEACH AMS), which uses the virtual Extension for Community Healthcare Outcomes (ECHO) learning model to enhance AMS capacity in Kenya, Ghana, and Malawi. Methods: A mixed-methods approach was used, which included attendance data collection, facility-level assessments, post-session and follow-up surveys, as well as focus group discussions. Results: Between September 2023 and February 2025, 77 virtual learning sessions were conducted, engaging 2445 unique participants from hospital-based AMS committees and health professionals across the three countries. Participants reported significant knowledge gain, and data showed facility improvements in two core AMS areas, including the implementation of multidisciplinary ward-based interventions/communications and enhanced monitoring of antibiotic resistance patterns. Along those lines, participants reported that the program assisted them in improving prescribing and culture-based treatments, and also evidence-informed antibiotic selection. The evidence of implementing ward-based interventions was further stressed in focus group discussions, as well as other strengthened practices like point-prevalence surveys, and development or revision of stewardship policies. Substantial improvements in microbiology services were also shared by participants, particularly in Malawi. Other practices mentioned were strengthened multidisciplinary communication, infection prevention efforts, and education of patients and the community. Conclusions: Our findings suggest that a virtual case-based learning educational intervention, providing structured and tailored AMS capacity building, can drive behavior change and strengthen healthcare systems in low resource settings. Future efforts should aim to scale up the engagements and sustain improvements to further strengthen AMS capacity. Full article

Introduction: The wellbeing of humans and the planet is negatively impacted by unhealthy eating behaviors and excessive food waste. Mindfulness approaches have the potential to help people modify their behavior to achieve healthier outcomes. Pilot testing methods to sustainably support healthy eating and reduce food waste are essential for identifying effective ways to promote human and planetary health. Methods: A pilot study was conducted to test a virtual mindful eating program to improve eating behaviors and reduce food waste among a small sample of U.S. adults. Mixed-methods approaches were used to identify the efficacy of the piloted intervention on mindfulness, eating behaviors, and food waste while identifying participant perspectives of the mindful eating program. Results: Quantitative study outcomes indicated positive intervention effects on hunger/satiety cues and food appreciation. No significant intervention effects were detected on mindfulness or food waste. Qualitative findings highlighted participant reports of experiencing greater self-awareness, an improved relationship with food, and a sense of creativity with meal preparation. Conclusions: This pilot study tested a novel mindful eating program that improved eating behaviors related to hunger/satiety and increased food appreciation. The program was accepted by participants, but it did not increase mindfulness or reduce food waste. Future iterations of this mindful eating program will require modifications to test different approaches for increasing mindfulness and reducing food waste while expanding the positive effects on healthy eating. Full article

Tuberculosis (TB) remains a leading cause of death in Bangladesh, disproportionately affecting low socio-economic status (SES) populations. This review, guided by the WHO Social Determinants of Health framework and Rockefeller-Lancet Planetary Health Report, examined how social, economic, and ecological factors link SES to TB burden. The first literature search identified 28 articles focused on SES-TB relationships in Bangladesh. A second search through snowballing and conceptual mapping yielded 55 more papers of diverse source types and disciplines. Low-SES groups face elevated TB risk due to smoking, biomass fuel use, malnutrition, limited education, stigma, financial barriers, and hazardous housing or workplaces. These factors delay care-seeking, worsen outcomes, and fuel transmission, especially among women. High-SES groups more often face comorbidities like diabetes, which increase TB risk. Broader contextual drivers include urbanisation, weak labour protections, cultural norms, and poor governance. Recommendations include housing and labour reform, gender parity in education, and integrating private providers into TB programmes. These align with the WHO End TB Strategy, UN SDGs and Planetary Health Quadruple Aims, which expand the traditional Triple Aim for health system design by integrating environmental sustainability alongside improved patient outcomes, population health, and cost efficiency. Future research should explore trust in frontline workers, reasons for consulting informal carers, links between makeshift housing and TB, and integrating ecological determinants into existing frameworks. Full article

In light of pressing global nutritional needs, the valorization of agri-food waste constitutes a vital strategy for enhancing human health and nutrition, while simultaneously supporting planetary health. This integrated approach is increasingly indispensable within sustainable and equitable food systems. Recently, a sustainability-driven focus has shifted attention toward the valorization of the agri-food by-products as rich sources of bioactive compounds useful in preventing or treating chronic diseases. Agri-food by-products, often regarded as waste, actually hold great potential as they are rich in bioactive components, dietary fiber, and other beneficial nutrients from which innovative food ingredients, functional foods, and even therapeutic products are developed. This review aims to provide a comprehensive analysis of the current advances in recovering and applying such compounds from agri-food waste, with a particular focus on their roles in human health, sustainable packaging, and circular economy strategies. Methods: This review critically synthesizes recent scientific literature on the extraction, characterization, and utilization of bioactive molecules from agri-food by-products. After careful analysis of the PubMed and Scopus databases, only English-language articles from the last 10 years were included in the final narrative review. The analysis also encompasses applications in the nutraceutical, pharmaceutical, and food packaging sectors. Results: Emerging technologies have enabled the efficient and eco-friendly recovery of compounds such as polyphenols, carotenoids, and dietary fibers that demonstrate antioxidant, antimicrobial, and anti-inflammatory properties. These bioactive compounds support the development of functional foods and biodegradable packaging materials. Furthermore, these valorization strategies align with global health trends by promoting dietary supplements that counteract the effects of the Western diet and chronic diseases. Conclusions: Valorization of agri-food by-products offers a promising path toward sustainable development by reducing waste, enhancing public health, and driving innovation. This strategy not only minimizes waste and supports sustainability, but also promotes a more nutritious and resilient food system. Full article

This study describes the first complete genomic sequence of an NDM-19 and QnrS11-producing multidrug-resistant (MDR) Escherichia coli isolate collected from a fecal swab from a poultry farm in 2019 in Egypt. The bla_NDM-19 was identified by PCR screening and DNA sequencing. The isolate was then subjected to antimicrobial susceptibility testing, conjugation and transformation experiments, and complete genome sequencing. The chromosome of strain M2-13-1 measures 4,738,278 bp and encodes 4557 predicted genes, with an average G + C content of 50.8%. M2-13-1 is classified under ST167, serotype O101:H5, phylogroup A, and shows an MDR phenotype, having minimum inhibitory concentrations (MICs) of 64 mg/L for both meropenem and doripenem. The genes bla_NDM-19 and qnrS11 are present on 49,816 bp IncX3 and 113,285 bp IncFII: IncFIB plasmids, respectively. M2-13-1 harbors genes that impart resistance to sulfonamides (sul1), trimethoprim (dfrA14), β-lactams (bla_TEM-1B), aminoglycosides (aph(6)-Id, aph(3′)-Ia, aph(3″)-Ib, aac(3)-IV, and aph(4)-Ia), tetracycline (tet(A)), and chloramphenicol (floR). It was susceptible to aztreonam, colistin, fosfomycin, and tigecycline. The genetic context surrounding bla_NDM-19 includes ISAba125-IS5-bla_NDM-19-ble_MBL-trpF-hp1-hp2-IS26. Hierarchical clustering of the core genome MLST (HierCC) indicated M2-13-1 clusters with global ST167 E. coli lineages, showing HC levels of 100 (HC100) core genome allelic differences. Plasmids of the IncX3 group and the insertion sequence (ISAba125) are critical vehicles for the dissemination of bla_NDM and its related variants. To our knowledge, this is the first genomic report of a bla_NDM-19/IncX3-carrying E. coli isolate of animal origin globally. Full article

Antimicrobial resistance (AMR) has emerged as a planetary health emergency, driven not only by the clinical misuse of antibiotics but also by diverse environmental dissemination pathways. This review critically examines the role of environmental compartments—water, soil, and air—as dynamic reservoirs and transmission routes for antibiotic-resistant bacteria (ARB) and resistance genes (ARGs). Recent metagenomic, epidemiological, and mechanistic evidence demonstrates that anthropogenic pressures—including pharmaceutical effluents, agricultural runoff, untreated sewage, and airborne emissions—amplify resistance evolution and interspecies gene transfer via horizontal gene transfer mechanisms, biofilms, and mobile genetic elements. Importantly, it is not only highly polluted rivers such as the Ganges that contribute to the spread of AMR; even low concentrations of antibiotics and their metabolites, formed during or after treatment, can significantly promote the selection and dissemination of resistance. Environmental hotspots such as European agricultural soils and airborne particulate zones near wastewater treatment plants further illustrate the complexity and global scope of pollution-driven AMR. The synergistic roles of co-selective agents, including heavy metals, disinfectants, and microplastics, are highlighted for their impact in exacerbating resistance gene propagation across ecological and geographical boundaries. The efficacy and limitations of current mitigation strategies, including advanced wastewater treatments, thermophilic composting, biosensor-based surveillance, and emerging regulatory frameworks, are evaluated. By integrating a One Health perspective, this review underscores the imperative of including environmental considerations in global AMR containment policies and proposes a multidisciplinary roadmap to mitigate resistance spread across interconnected human, animal, and environmental domains. Full article

This study investigates the implications of sewage contamination in the coastal and riverine environments of Hout Bay, Cape Town, South Africa. Chemical analyses were applied to quantify the presence of pollutants such as pharmaceutical and personal care products (PPCPs) in sentinel marine organisms such as mussels, as well as microbial indicators of faecal contamination in river water and seawater, for estimating the extent of impact zones in the coastal environment of Hout Bay. This research investigated the persistent pharmaceuticals found in marine outfall wastewater effluent samples in Hout Bay, examining whether these substances were also detectable in marine biota, specifically focusing on Mytilus galloprovincialis mussels. The findings reveal significant levels of sewage-related pollutants in the sampled environments, with concentrations ranging from 32.74 to 43.02 ng/g dry weight (dw) for acetaminophen, up to 384.96 ng/g for bezafibrate, and as high as 338.56 ng/g for triclosan. These results highlight persistent PPCP contamination in marine organisms, with increasing concentrations observed over time, suggesting a rise in population and pharmaceutical use. Additionally, microbial analysis revealed high levels of E. coli in the Hout Bay River, particularly near stormwater from the Imizamo Yethu settlement, with counts exceeding 8.3 million cfu/100 mL. These findings underscore the significant impact of untreated sewage on the environment. This study concludes that current sewage treatment is insufficient to mitigate pollution, urging the implementation of more effective wastewater management practices and long-term monitoring of pharmaceutical levels in marine biota to protect both the environment and public health. Full article

The environmental detriments of the growing global production and overconsumption of beef, including greenhouse gas emissions, deforestation, and biodiversity loss, are well-documented. However, public awareness of how dietary choices affect the environment remains limited. This study examines sustainability views on beef consumption and the potential for behavioral change as a step toward more sustainable intake levels. An observational web-based survey was conducted (n = 1367) to assess respondents’ current beef intake frequency, views on beef consumption related to planetary health, tropical deforestation, greenhouse gas emissions, and climate change, and willingness to modify beef consumption behavior. Chi-square tests were used for group comparisons, and weighted average scores were applied to rank levels of resistance to reducing beef intake. Environmental concern related to beef consumption was associated with greater beef cutback intentions and lower long-term intake reduction resistance amongst beef eaters. Beef eaters who strongly agreed that global beef consumption negatively impacts the environment were considerably more likely to express intentions to reduce their long-term beef intake compared to those who strongly disagreed (94.4% vs. 19.6%). Overall, 76.6% of beef eaters indicated wanting to eat less beef or phase it out entirely (30.7% reduce, 29.4% minimize, 16.6% stop), with only 23.4% of them intending to keep their consumption unchanged. Compelling messages that help translate awareness into action, such as the #NoBeefWeek concept explored in this study, may support individuals in adopting more sustainable food choices. These cross-national findings provide evidence for a ‘knowledge–intent’ gap in sustainable diet research, with relevance for health communicators and policymakers. Future research could examine the factors and motivations influencing decisions to modify beef consumption, including the barriers to achieving sustainable consumption levels and the role of suitable alternatives in facilitating this transition. Full article

Dietary choices and patterns have enormous consequences along the lines of individual, community, and planetary health. Excess meat consumption has been linked to chronic disease risk, and at large scales, the underlying industries maintain a massive environmental footprint. For these reasons, public and planetary health experts are unified in emphasizing a whole or minimally processed plant-based diet. In response, the purveyors of ultra-processed foods have added “meat alternatives” to their ultra-processed commercial portfolios; multinational corporations have been joined by “start-ups” with new ultra-processed meat analogues. Here, in our Viewpoint, we revisit the 1990s food industry rhetoric and product innovation, a time in which multinational corporations pushed a great “low-fat transition.” We focus on the McLean Deluxe burger, a carrageenan-rich product introduced by the McDonald’s Corporation in 1991. Propelled by a marketing and media-driven fear of dietary fats, the lower-fat burger was presented with great fanfare. We reflect this history off the current “great protein transition,” a period once again rich in rhetoric, with similar displays of industry detachment from concerns about the health consequences of innovation. We scrutinize the safety of carrageenan and argue that the McLean burger should serve as a cautionary tale for planetary health and 21st century food innovation. Full article

Background: Dietary assessment in inflammatory bowel disease (IBD) is moving away from individual food and nutrient analyses and towards dietary patterns (e.g., Mediterranean diet, Western diet) and diet quality assessment that are increasingly implicated in IBD onset and course. However, an IBD-specific diet quality index (DQI) does not exist. This review aimed to identify current DQIs and assess their suitability for an IBD population. Methods: MEDLINE and EmCare databases were systematically searched for a-priori, food-based DQI reflecting current dietary guidelines and/or nutrition science. Data extracted were adapted from optimal DQI criteria, including quality measures of adequacy, moderation, variety and balance and DQI evaluation. Results: Twenty-four DQI were identified. No DQI included all optimal DQI criteria. The Dietary Guideline Index 2013 (DGI-2013) most closely met the criteria, followed by the Dutch Healthy Diet Index-2015 (DHD-Index 2015), Planetary Health Diet Index (PHDI) and Healthy Eating Index for Australian Adults-2013 (HEIFA-2013). Most DQI assessed adequacy (22/24, 92%) and moderation (21/24, 88%), half assessed balance (12/24) while few assessed variety (8/24, 33%). Application of other optimal DQI criteria varied. Food frequency questionnaire (13/24) and 24 h diet recall (12/24) were the most common dietary assessment methods used. Most DQI (17/24, 71%) were validated; however, not for an IBD population. Few were evaluated for reliability (6/24) or reproducibility (1/24). Conclusions: No DQI meets all optimal criteria for an IBD-specific DQI. The DGI-2013 met the most criteria, followed by the DHD Index-2015, PHDI and HEIFA-2013 and may be most appropriate for an IBD population. An IBD-specific DQI is lacking and needed. Full article

Background: This study aimed to evaluate the changes in fat utilization associated with transitioning from a traditional to a vegan Mediterranean diet in healthy, physically active men during a ramp exercise test. Methods: In a controlled crossover design, fourteen healthy, physically active men followed a traditional Mediterranean diet for three weeks (baseline). Then, participants transitioned to a four-week isocaloric vegan version of the Mediterranean diet, matched for macronutrient distribution but excluding all animal foods. Immediately after each dietary intervention, participants completed an incremental exercise test (from 30% to 70% of VO_2peak) on a cycle ergometer in a fasted state to determine peak fat oxidation (PFO) and its associated exercise intensity (Fatmax). Exercise heart rate and the rating of perceived exertion were also recorded at each exercise intensity. Results: The traditional and vegan Mediterranean diets provided comparable amounts of energy (2599.6 ± 180.8 and 2634.9 ± 148.3 kcal/day, p = 0.140) and total fat (97.0 ± 17.8 and 99.0 ± 13.2 g/day; p = 0.620). However, the vegan Mediterranean diet contained a lower proportion of saturated fat (25.2 ± 6.8 vs. 13.6 ± 4.4% of total fat, p < 0.010). Still, the dietary transition was not associated with modifications in PFO (0.323 ± 0.153 and 0.347 ± 0.147 g/min; p = 0.678) or Fatmax (40.51 ± 7.30 and 40.51 ± 10.71%VO_2peak; p = 1.000) during exercise. Moreover, the dietary transition did not significantly change the response curves across exercise intensities for fat oxidation (p = 0.553), heart rate (p = 0.280), or the rating of perceived exertion (p = 0.433). Conclusions: Switching from a traditional to a vegan Mediterranean diet did not affect fat oxidation, exercise intensity at peak fat oxidation, or perceptual responses during exercise in healthy, active men. These findings suggest that physically active individuals can adopt a vegan version of the Mediterranean diet without compromising fat utilization during submaximal aerobic exercise. Clinical Trial Registry: NCT06008886. Date of registration: 28 July 2023. Full article

Sub-Saharan Africa (SSA) is experiencing escalating climate variability, land degradation, and food insecurity, which threaten livelihoods and economic stability. Sustainable agricultural practices (SAPs), including climate-smart agriculture, conservation agriculture, and agroecology, offer promising strategies to boost productivity while enhancing ecological stability. This review proposes that multidisciplinary integration of SAPs, encompassing agronomy, socioeconomics, and governance, is the most promising route to achieving climate-resilient food systems in SSA by 2030. Despite its proven benefits, the use of SAPs remains limited. This is largely because of financial constraints, weak institutional frameworks, and inadequate infrastructure. To address these challenges, this review evaluates the role of SAPs in mitigating climate risk, improving soil health, and enhancing food security. It also identifies systemic adoption barriers and examines the effectiveness of policy and financing frameworks. Drawing on evidence from across SSA, including Ethiopia’s agroforestry success and Senegal’s millet resilience, this review highlights how integrating sustainable practices with postharvest innovation and community-driven approaches can strengthen food systems. Ultimately, the findings underscore that weaving science, policy, and grassroots action is essential for building a resilient and food-secure SSA, particularly within the context of the 2025 global adaptation agenda. Full article

This study investigates the empowering role of public–private partnerships (PPPs) in the economic sustainability of waste management (ESW) and the circular industry economy (CIE), specifically in the small, rapidly industrialising Emirate of Ajman, UAE. Embracing a circular economy is vital for the sustainability agenda while forging a transformative commitment to planetary health (PH) in a manner that is especially crucial for small states with limited carrying capabilities. A quantitative methodological orientation is employed in a survey-based research design, followed by the Partial Least Squares Structural Equation Modelling statistical technique to test the hypothesised relationships. Sampling involved the three sub-populations of government employees (n = 123), managers/employees of private waste collection businesses (n = 106), and employees of private industrial waste generation industries (n = 276). Findings indicate that PPP empowerment positively impacts ESW and contributes to the creation of CIE. Moreover, ESW fosters the growth of CIE in Ajman. Notably, the perspectives of government stakeholders differ from those of non-government actors. This research underscores the significance of PPP empowerment in the development of CIE towards SDGs 11, 12, and 17, emphasising the mediating role of ESW between PPPs and CIE in small, rapidly industrialising states. The study recommends that the Ajman government implement training and social initiatives aimed at aligning the sustainability perspectives of all stakeholders involved in waste management to promote the mutual benefits of “people, places, and planet”. Full article

Climate scientists, systems theorists, and policymakers increasingly suggest that global sustainability challenges stem from dysfunctional worldviews and values that drive individual and collective behaviors, undermining both human flourishing and planetary health. Recognizing that paradigmatic shifts in values and worldviews can arise from transformative experiences, this study employed Integral Inquiry in a mixed-methods design to examine the nature of the relationship between such experiences and engagement with sustainability. A sample of 145 adults was recruited based on self-identification of having undergone a life-changing experience and demonstrated evidence of transformative growth and integration. In the qualitative phase, 73 participants completed an open-text survey detailing their perspectives on sustainability and their related practices and behaviors. Ten individuals from this subset were interviewed to explore the depth and dimensions of their engagement with sustainability. Using Constructivist Grounded Theory analysis, three tentative themes emerged: intraconnection, personal equilibrium, and defining social change. Whilst the study was exploratory in nature, the analysis indicated that transformative experiences seemed to foster a profound felt sense of intraconnection—a deep awareness of interconnectedness with all life. This awareness appeared to naturally clarify participants’ values and beliefs, aligning their actions toward sustainability. Moreover, participants emphasized the importance of cultivating personal equilibrium—a state of inner balance and congruence in daily choices—as a foundation for meaningful social and environmental change. This study tentatively highlights the role transformative experiences can play in bringing about more pro-ecological behavior, and it underscores the need for further research into how such experiences can be more readily integrated to support global sustainability efforts. Full article

The EAT-Lancet diet is an outstanding model of a healthy, environmentally sustainable diet. However, its effects on the gut microbiota remain poorly explored. This study assessed the asso-ciation between adherence to the EAT-Lancet diet in habitual intake and the relative abundance of selected gut bacteria in a Mexican subpopulation. Fifty-four young adults (18–35 years) completed a validated Food Frequency Questionnaire (FFQ) and were nutritionally assessed. Participants were grouped into low, moderate, and high adherence levels to the EAT-Lancet diet. Blood samples were analysed for glucose and lipid profiles, and gDNA from faecal samples was analysed using Real-time qPCR to quantify gut bacteria. While no significant differences in bacterial abundance were observed across adherence levels, correlations emerged with increased adherence. Notably, Bifidobacterium negatively correlated with beef and lamb intake (rho −0.5, p < 0.05), and Akkermansia muciniphila negatively correlated with fish intake (rho −0.8, p < 0.05). Bilophila wadsworthia positively correlated with triglycerides, while Prevotella copri and Faecalibacterium prausnitzii negatively correlated with body fat and blood pressure, respectively. In addition, a non-significant trend toward a higher abundance of Firmicutes, Akkermansia muciniphila, and Prevotella copri was observed in the high-adherence group, whereas Lactobacillus tended to be more abundant in participants with low and moderate adherence. These findings suggest that adherence to the EAT-Lancet diet modulates gut microbiota composition. However, further controlled interventional studies are needed to confirm these effects and their implications for human health. Full article