ArticlePloS one2022
Factors influencing antimicrobial resistance in the European food system and potential leverage points for intervention: A participatory, One Health study.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Disrupting antimicrobial resistance in food systems from a One Health perspective: a complex systems analysis in Canada, Senegal and the Netherlands.BMC global and public health · 2026Article
- Antimicrobial resistance in the Northern Territory, Australia: insights from a systems thinking approach to human health.One health outlook · 2026Article
- Economic methods and spatial scales in One Health: Results from a scoping review.One health (Amsterdam, Netherlands) · 2025Review
- Interconnections between the food system and antimicrobial resistance: A systems-informed umbrella review from a One Health perspective.One health (Amsterdam, Netherlands) · 2025Review
- In Vitro Determination of Cytotoxic Effects of Ten Essential Oils onInternational journal of molecular sciences · 2025Article
- Systems thinking to understand the complexity of antimicrobial resistance across One Health: A systematic review of current approaches.One health (Amsterdam, Netherlands) · 2025Review
- Microbial profile of post-breeding endometritis in Arabian mares from the Al-Hira District, Iraq.Open veterinary journal · 2025Article
- Towards Sustainable Antibiotic Use in Aquaculture and Antimicrobial Resistance: Participatory Experts' Overview and Recommendations.Antibiotics (Basel, Switzerland) · 2024Article
- Article
- Exploring Nanotechnology as a Strategy to Circumvent Antimicrobial Resistance in Bone and Joint Infections.ACS omega · 2023Review
- Exploring the factors that contribute to the successful implementation of antimicrobial resistance interventions: a comparison of high-income and low-middle-income countries.Frontiers in public health · 2023Article
- Is scientific evidence enough? Using expert opinion to fill gaps in data in antimicrobial resistance research.PloS one · 2023Article
- Governing Antimicrobial Resistance (AMR) in a Changing Climate: A Participatory Scenario Planning Approach Applied to Sweden in 2050.Frontiers in public health · 2022Article
- Factors impacting antimicrobial resistance in the South East Asian food system and potential places to intervene: A participatory, one health study.Frontiers in microbiology · 2022Article
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAntimicrobial resistance (AMR) is a global crisis that evolves from a complex system of factors. Understanding what factors interact is key to finding solutions. Our objective was to identify the factors influencing AMR in the European food system and places to intervene. MATERIALS AND
methodsWe conducted two workshops involving participants with diverse perspectives to identify the factors influencing AMR and leverage points (places) to target interventions. Transcripts were open coded for factors and connections, then transcribed into Vensim 8.0.4 to develop a causal loop diagram (CLD) and compute the number of feedback loops. Thematic analysis followed to describe AMR dynamics in Europe's food system and places for intervention. The CLD and themes were confirmed via participant feedback.
resultsSeventeen participants representing human, animal and agricultural sectors identified 91 CLD factors and 331 connections. Seven themes (e.g., social and economic conditions) describing AMR dynamics in Europe's food system, five 'overarching factors' that impact the entire CLD system (e.g., leadership) and fourteen places for intervention (e.g., consumer demand) emerged from workshop discussions. Most leverage points fell on highly networked feedback loops suggesting that intervening at these places may create unpredictable consequences.
conclusionsOur study produced a CLD of factors influencing AMR in Europe's food system that implicates sectors across the One Health spectrum. The high connectivity between the CLD factors described by participants and our finding that factors are connected with many feedback mechanisms underscores the complexity of the AMR problem and the challenge with finding long-term solutions. Identifying factors and feedbacks helped identify relevant leverage points in the system. Some actions, such as government's setting AMU standards may be easier to implement. These actions in turn can support multi-pronged actions that can help redefine the vision, values and goals of the system to sustainably tackle AMR.
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