scholarly journals From ‘two medicines’ to ‘One Health’ and beyond

Author(s):  
Jakob Zinsstag ◽  
Andrea Meisser ◽  
Esther Schelling ◽  
Bassirou Bonfoh ◽  
Marcel Tanner

We first review historic and conceptual background to integrative thinking in medicine. Lacking a general theory of ‘One Health’, we provide an operational definition of ‘One Health’ and its leverage as: any added value in terms of human and animal health, financial savings or environmental benefit from closer cooperation of human and animal health sectors at all levels of organisation. Examples of such added value of ‘One Health’ are given from the fields of health systems, nutrition and zoonoses control in Africa and Asia. ‘One Health’ must become main-stream rather than a new discipline or new association; it should just become normal that practitioners and professionals in the health, animal and environment sectors work together as closely as possible. Current and future challenges in financing clean energy, migration flows, food security and global trade further warrant rethinking of human and animal health services. A conceptual outlook relates health as an outcome of human-environment systems called ‘health in social-ecological systems’. The paper ends with an outlook on the operationalisation of ‘One Health’ and its future potential, specifically also in industrialised countries.

Author(s):  
Helena Greter ◽  
Vreni Jean-Richard ◽  
Lisa Crump ◽  
Mahamat Béchir ◽  
Idriss O. Alfaroukh ◽  
...  

‘One health’ is particularly suited to serve mobile pastoralists. Dinka pastoralists in Sudan inspired Calvin Schwabe to coin the term ‘one medicine’, indicating that there is no difference in paradigm between human and veterinary medicine. Our contemporary definition of ‘one health’ is any added value in terms of improved health of humans and animals or financial savings or environmental services resulting from a closer cooperation of human and animal health sectors. Here we present a summary of ‘one health’ studies with mobile pastoralists in Africa which were done in research partnership, demonstrating such an added value. Initial joint human and animal health studies revealed higher livestock vaccination coverage than in the pastoralist community, leading to joint animal and human vaccination intervention studies which demonstrated a better access to primary health care services for pastoralists in Chad. Further simultaneous animal and human serological studies showed that camel breeding was associated with human Q-fever seropositivity. In Borana communities in Ethiopia, human cases of  Mycobacterium bovis infection could be related to strains isolated from cattle. A challenge remained with regard to how to assess vaccination coverage in mobile populations. With the advent of mobile phones, health and demographic surveillance could be established for mobile pastoralists and their animals. This presents vast possibilities for surveillance and control of human and animal diseases. Pastoralists prefer a ‘one health’ approach and therefore contribute toward the validation of this concept by showing real added value of the cooperation between human and animal health services.


Author(s):  
Karin Hediger ◽  
Andrea Meisser ◽  
Jakob Zinsstag

Background: The integration of animals into healthcare, referred to as animal-assisted intervention, is a rapidly growing research field and was previously related to One Health. However, the assessment of synergistic effects of animal-assisted interventions (AAI) has been poorly addressed to date. Method: We discuss experiences in integrated human and animal assessments in AAI and provide a methodical framework for One Health approaches in AAI research. We propose theoretical consideration of an integrated human and animal health assessment, as well as the use of such an integrated approach in research. Based on the existing research, we argue that, for a deeper understanding of AAI mechanisms, parallel research designs are needed. Results and Conclusion: Our paper shows that a One Health study design is necessary to ensure that a tradeoff in health of animals is prevented and that an added value, or synergistic benefit, can be achieved on both sides during animal-assisted interventions.


Author(s):  
Jonathan Rushton ◽  
Barbara Häsler ◽  
Nicoline De Haan ◽  
Ruth Rushton

One Health concepts and ideas are some of the oldest in the health discipline, yet they have not become main stream. Recent discussions of the need for One Health approaches require some reflection on how to present a case for greater investments. The paper approaches this problem from the perspective of the control and management of resources for health in general. It poses the following questions, (1) where do we need extra resources for One Health, (2) where can we save resources through a One Health approach and (3) who has control of the resources that do exist for One Health? In answering these questions three broad areas are explored, (1) The management and resources allocated for diseases, (2) The isolation of parts of the society that require human and animal health services and (3) The use of resources and skills that are easily transferable between human and animal health.The paper concludes that One Health approaches are applicable in many scenarios. However, the costs of getting people from different disciplines to work together in order to achieve a true One Health approach can be large. To generate tangible benefits requires careful management of specialist skills, knowledge and equipment, which can only be achieved by a greater openness of the human and animal health disciplines. Without this openness, policy makers will continue to doubt the real value of One Health. In summary the future success of One Health is about people working in the research, education and provision of health systems around the world embracing and managing change more effectively.


conexus ◽  
2020 ◽  
pp. 8-25
Author(s):  
Simon R. Rüegg ◽  
Barbara Häsler

This article provides insights gained during a four-year project funded by the European Cooperation in Science and Technology (COST) named «Network for Evaluation of One Health», which brought together over 250 scientists, decision-makers and practitioners with expertise and/or interest in One Health to investigate the added value of One Health and elaborate and evaluation protocol for One Health. Here, we present our reflections on the significance of these findings for our common practice as health professionals. Two initial findings lie at the core of this analysis, namely the observation that 1) One Health integrates knowledge from various sources in a transdisciplinary way and that there are as many concepts of health as participants in a specific initiative; and 2) the nature of complex One Health problems necessitates systems thinking and consideration of emergences as a One Health initiative is implemented. An analysis of eight case studies, i.e., evaluations of different One Health initiatives, found that the capacity of an initiative to facilitate knowledge integration improves with the age of the initiative, political boundaries of any nature hinder knowledge integration, and the prevailing competitive mentality in academia may be a serious obstacle to trusted collaboration required for interdisciplinary progress. The COST project also revealed a number of important knowledge gaps, namely the need for: a scalable definition of health, balancing expert advice and citizen participation to tackle health challenges, bridging the scission between the benefits and risks arising from nature, discussing whether egoism will define the boundary to sustainable health, a biocentric social justice framework, and comparative values associated with health of people, animals, plants and ecosystems. Furthermore, methodological challenges were identified such as participatory methods that are scalable to large populations, a specific skill set to facilitate transdisciplinary research, and governing mechanisms alternative to legislation and markets. Finally, as a rather unexpected outcome, the project has revealed the tension between the academic and societal demands for infallibility and predictability versus the need for honesty, authenticity, humbleness and emotion to permit the full unfolding of human creativity.


2020 ◽  
pp. 35-56
Author(s):  
Keith S. Howe

One Health is a concept that sees human, animal, and environmental health as parts of a single interdependent system. The Covid-19 pandemic, its implications reaching far beyond the direct effects of a coronavirus on people’s health, underlines the importance of this increasingly influential perspective. In practice, One Health has its roots in early affiliations of human and animal health science. Over time, each sphere of inquiry evolved to address its own agenda. Recently, veterinary scientists have led the reintegration, extension, and promotion of One Health sciences to address modern-day problems in which health and people’s general wellbeing are viewed as inseparable. A prerequisite is to set out a framework of concepts and principles enabling clear definition of problems, interrelationships needing to be understood, and the level of aggregation appropriate for quantitative analysis. This paper extends the framework by considering economic trade-offs that inevitably must be made in the human, animal, and environmental sub-systems, and the consequences when policy interventions are superimposed on them. The New Forest National Park in southern England is a case where this perspective is essential. Following the Stone Mountain definition of One Health, first a conventional approach linking human and animal health is taken. Lyme disease, Alabama rot, bovine tuberculosis and strangles are examples of diseases known to be of significant concern. The focus is finding scope for socially efficient risk reduction in response to mitigation resource use. Superimposed on the grazing livestock subsystems are support payments for commoner farmers. The financial incentives provided by what effectively are headage payments have caused animal inventories to grow so much that the wider environment may well be subject to adverse spillover effects that merit investigation.


Author(s):  
André Jestin ◽  
Gilles Dreyfuss ◽  
Michel Fougereau ◽  
René Houin ◽  
Hubert Laude ◽  
...  

The One Health approach, in which feed, food, animal health, public health and contamination of the environment are considered as very closely linked, is regarded as the best way to achieve significant progress of health in these fields. The current European Union funded projects aimed to achieve a major step forward for Europe in the domains of foodborne zoonoses and antimicrobial resistance. The 6th and 7th Framework programs initiated networks, such as ERA-Net, Networks of Excellence (NoE), Joint Program initiatives (JPI), Infrastructure program. The European Joint Action (JA) aims to promote synergies among the EU Member States by developing and implementing effective One Health policies to combat the growing threat of antibiotic resistance. The One Health European Joint Project (EJP) is a large co-funded project on emerging threats, zoonoses and antimicrobial resistance. If a One Health approach has been proposed to tackle the challenges by accepting that their complexity requires interdisciplinary approach, no standardized methodologies were available for quantitative evaluation of One Health activities. The Network for Evaluation of One Health (NEOH) represents a major contribution in that field. Key Words : One health, European Networks, Human-animal interface, Zoonoses, Antimicrobial resistance, Evaluation, Added value.


2019 ◽  
Vol 30 (2) ◽  
pp. 109-122
Author(s):  
Aleksandar Bulajić ◽  
Miomir Despotović ◽  
Thomas Lachmann

Abstract. The article discusses the emergence of a functional literacy construct and the rediscovery of illiteracy in industrialized countries during the second half of the 20th century. It offers a short explanation of how the construct evolved over time. In addition, it explores how functional (il)literacy is conceived differently by research discourses of cognitive and neural studies, on the one hand, and by prescriptive and normative international policy documents and adult education, on the other hand. Furthermore, it analyses how literacy skills surveys such as the Level One Study (leo.) or the PIAAC may help to bridge the gap between cognitive and more practical and educational approaches to literacy, the goal being to place the functional illiteracy (FI) construct within its existing scale levels. It also sheds more light on the way in which FI can be perceived in terms of different cognitive processes and underlying components of reading. By building on the previous work of other authors and previous definitions, the article brings together different views of FI and offers a perspective for a needed operational definition of the concept, which would be an appropriate reference point for future educational, political, and scientific utilization.


2010 ◽  
Vol 15 (3) ◽  
pp. 193-201 ◽  
Author(s):  
Elisabeth Norman

A series of vignette examples taken from psychological research on motivation, emotion, decision making, and attitudes illustrates how the influence of unconscious processes is often measured in a range of different behaviors. However, the selected studies share an apparent lack of explicit operational definition of what is meant by consciousness, and there seems to be substantial disagreement about the properties of conscious versus unconscious processing: Consciousness is sometimes equated with attention, sometimes with verbal report ability, and sometimes operationalized in terms of behavioral dissociations between different performance measures. Moreover, the examples all seem to share a dichotomous view of conscious and unconscious processes as being qualitatively different. It is suggested that cognitive research on consciousness can help resolve the apparent disagreement about how to define and measure unconscious processing, as is illustrated by a selection of operational definitions and empirical findings from modern cognitive psychology. These empirical findings also point to the existence of intermediate states of conscious awareness, not easily classifiable as either purely conscious or purely unconscious. Recent hypotheses from cognitive psychology, supplemented with models from social, developmental, and clinical psychology, are then presented all of which are compatible with the view of consciousness as a graded rather than an all-or-none phenomenon. Such a view of consciousness would open up for explorations of intermediate states of awareness in addition to more purely conscious or purely unconscious states and thereby increase our understanding of the seemingly “unconscious” aspects of mental life.


2000 ◽  
Vol 14 (3) ◽  
pp. 325-341 ◽  
Author(s):  
Heather M. Hermanson

The purpose of this study is to analyze the demand for reporting on internal control. Nine financial statement user groups were identified and surveyed to determine whether they agree that: (1) management reports on internal control (MRIC) are useful, (2) MRICs influence decisions, and (3) financial reporting is improved by adding MRICs. In addition, the paper examined whether responses varied based on: (1) the definition of internal control used (manipulated as broad, operational definition vs. narrow, financial-reporting definition) and (2) user group. The results indicate that financial statement users agree that internal controls are important. Respondents agreed that voluntary MRICs improved controls and provided additional information for decision making. Respondents also agreed that mandatory MRICs improved controls, but did not agree about their value for decision making. Using a broad definition of controls, respondents strongly agreed that MRICs improved controls and provided a better indicator of a company's long-term viability. Executive respondents were less likely to agree about the value of MRICs than individual investors and internal auditors.


Author(s):  
Flavio Mercati

This chapter explains in detail the current Hamiltonian formulation of SD, and the concept of Linking Theory of which (GR) and SD are two complementary gauge-fixings. The physical degrees of freedom of SD are identified, the simple way in which it solves the problem of time and the problem of observables in quantum gravity are explained, and the solution to the problem of constructing a spacetime slab from a solution of SD (and the related definition of physical rods and clocks) is described. Furthermore, the canonical way of coupling matter to SD is introduced, together with the operational definition of four-dimensional line element as an effective background for matter fields. The chapter concludes with two ‘structural’ results obtained in the attempt of finding a construction principle for SD: the concept of ‘symmetry doubling’, related to the BRST formulation of the theory, and the idea of ‘conformogeometrodynamics regained’, that is, to derive the theory as the unique one in the extended phase space of GR that realizes the symmetry doubling idea.


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