Sustainable Livelihoods and Ecosystem Health: Exploring Methodological Relations as a Source of Synergy

Using ecohealth as a transdisciplinary lens to explore the connections among overlapping domains of inquiry, this article examines methodological relations between Sustainable Livelihoods and Ecosystem Health, two approaches for improving rural health and well-being. The experience of working on a project tasked with developing an integrated, systems-based approach for understanding the nature of rural livelihoods and ecosystems provides the base for analysis. Several key insights are discussed: The overarching goals of health and sustainability facilitate collaboration among disciplines; differences arise from how each approach operationalizes systems as variables and indicators; the dependent variables for one approach can be used as the independent variables for the other. In summary, while broad concepts like health and sustainability help transcend differences across disciplines and scales of analysis, variables and indicators cannot, as they are bound to how an observed system is operationalized. An advantage of using an ecohealth lens is that it creates conceptual and analytical spaces in which differences can be reconciled and used as sources of synergy. A source of synergy revealed in this article is the interdependence of variables used by each approach.     

Ecosystem Approaches to Health for a Global Sustainability Agenda

International research agendas are placing greater emphasis on the need for more sustainable development to achieve gains in global health. Research using ecosystem approaches to health, and the wider field of ecohealth, contribute to this goal, by addressing health in the context of inter-linked social and ecological systems. We review recent contributions to conceptual development of ecosystem approaches to health, with insights from their application in international development research. Various similar frameworks have emerged to apply the approach. Most predicate integration across disciplines and sectors, stakeholder participation, and an articulation of sustainability and equity to achieve relevant actions for change. Drawing on several frameworks and on case studies, a model process for application of ecosystem approaches is proposed, consisting of an iterative cycles of participatory study design, knowledge generation, intervention, and systematization of knowledge. The benefits of the research approach include innovations that improve health, evidence-based policies that reduce health risks; empowerment of marginalized groups through knowledge gained, and more effective engagement of decision makers. With improved tools to describe environmental and economic dimensions, and explicit strategies for scaling-up the use and application of research results, the field of ecohealth will help integrate both improved health and sustainability into the development agenda.     

Using Network Analysis to Explore if Professional Opinions on Japanese Encephalitis Risk Factors in Nepal Reflect a Socio-ecological System Perspective

Japanese encephalitis (JE) is the leading cause of viral encephalitis in Asia and a significant public health problem in Nepal. Its epidemiology is influenced by factors affecting its amplifying hosts (pigs), vectors (mosquitoes), and dead-end hosts (including people). While most control efforts target reduced susceptibility to infection either by vaccination of people or pigs or by reduced exposure to mosquitoes; the economic reality of Nepal makes it challenging to implement standard JE control measures. An ecohealth approach has been nominated as a way to assist in finding and prioritizing locally relevant strategies for JE control that may be viable, feasible, and acceptable. We sought to understand if Nepalese experts responsible for JE management conceived of its epidemiology in terms of a socio-ecological system to determine if they would consider ecohealth approaches. Network analysis suggested that they did not conceive JE risk as a product of a socio-ecological system. Traditional proximal risk factors of pigs, mosquitoes, and vaccination predominated experts’ conception of JE risk. People seeking to encourage an ecohealth approach or social change models to JE management in Nepal may benefit from adopting social marketing concepts to encourage and empower local experts to examine JE from a socio-ecological perspective.     

Mental health and well-being in primatology: Breaking the taboos

We hope to raise awareness of mental health and well-being among primatologists. With this aim in mind, we organized a workshop on mental health as part of the main program of the Winter meeting of the Primate Society of Great Britain in December 2021. The workshop was very well received. Here, we review the main issues raised in the workshop, and supplement them with our own observations, reflections, and reading. The information we gathered during the workshop reveals clear hazards to mental health and suggests that we must collectively acknowledge and better manage both the hazards themselves and our ability to cope with them if we are to avert disaster. We call on institutions and learned societies to lead in seeking solutions for the benefit of primatologists and primatology.     

Impact of a one-week intensive ‘training of trainers’ workshop for community health workers in south-west Nigeria

Background There is a huge unmet need for mental health services in low- and middle-in-come countries such as Nigeria. It has been suggested that one way of bridging the service gap is to plan for the effective integration of mental health services into primary care. We present the impact of a one-week training workshop on attitudes to and knowledge of mental health issues among the tutors of community health workers.Method An intensive one-week training workshop was organised for 24 trainers of community health officers from eight Nigerian states. The package was designed for the training of primary care workers in low-income countries by one of the authors (RJ). Participants completed a questionnaire designed to assess knowledge of and attitudes to mental health issues before and on completion of the training.Results There were 24 participants with a mean age of 47 years (SD ± 4.89). Eighteen (75%) of the participants were female. The overall assessment of knowledge of mental health issues increased from a mean score of 60.4% before training to a mean score of 73.7% after the training (t-test = 4.48, P = 0.001).Conclusion We reported a significant improvement in the knowledge and attitudes of tutors of community health workers following an intensive one-week training workshop. This, we believe, should improve the quality of pre-service mental health training for community health workers and hopefully impact on mental health service delivery at the primary healthcare level.     

Evolution of Transdisciplinarity and Ecosystem Health at the University of Newcastle,New South Wales,Australia

Antipodean pioneers of transdisciplinary (TD) thinking at the University of Newcastle, Glenn Albrecht and Nick Higginbotham have applied this perspective to contexts of human health globally and to the development of health social science as an emerging TD field. Nick Higginbotham has successfully championed the cause of TD thinking in international networks such as The International Clinical Epidemiology Network (INCLEN) and the International Forum for Social Sciences (IFSSEH). Glenn Albrecht has connected the Newcastle variety of TD thinking to its independently created doppelganger in the form of TD Ecosystem Health as pioneered by David Rapport in Canada. The convergence of TD thinking and Ecosystem Health at Newcastle has promoted a new curriculum in both undergraduate and postgraduate health and environmental sciences courses. Furthermore, TD research teams have been created and pursue investigations of both health and environmental problems. A successful national conference on transdisciplinary approaches to ecosystem health in Australia was held at Newcastle in April 2003. This article details the history of the evolution and synthesis of transdisciplinarity, ecosystem health, and ecohealth at the University of Newcastle, Australia, over a period from 1988 to the present.     

Aldo Leopold’s Land Health from a Resilience Point of View: Self-renewal Capacity of Social–Ecological Systems

Health approaches to ecology have a strong basis in Aldo Leopold’s thinking, and contemporary ecohealth in turn has a strong philosophical basis in Leopold. To commemorate the 125th anniversary of Leopold’s birth (1887–1948), we revisit his ideas, specifically the notions of stewardship (land ethic), productive use of ecosystems (land), and ecosystem renewal. We focus on Leopold’s perspective on the self-renewal capacity of the land, as understood in terms of integrity and land health, from the contemporary perspective of resilience theory and ecological theory more generally. Using a broad range of literature, we explore insights and implications of Leopold’s work for today’s human–environment relationships (integrated social–ecological systems), concerns for biodiversity, the development of agency with respect to stewardship, and key challenges of his time and of ours. Leopold’s seminal concept of land health can be seen as a triangulation of productive use, self-renewal, and stewardship, and it can be reinterpreted through the resilience lens as the health of social–ecological systems. In contemporary language, this involves the maintenance of biodiversity and ecosystem services, and the ability to exercise agency both for conservation and for environmental justice.     

Potency testing of veterinary vaccines: The way from in vivo to in vitro

Current quality control of inactivated animal vaccines still focuses on the potency of final products in a batch-wise manner. Animal welfare concerns as well as scientific considerations have led to the ‘3Rs-concept’ that comprises the refinement of animal procedures, the reduction of animal numbers, and the replacement of animal models. Although the 3Rs-concept has been widely accepted as a fundamental principle, the number of approved alternatives for in vivo tests is still limited. To promote further progress, the international scientific workshop ‘Potency Testing of Veterinary Vaccines: The Way from in vivo to in vitro’ was held at the Paul-Ehrlich-Institut in Langen, Germany, on 01-03 December 2010. More than 130 participants from industry, academia and regulatory authorities discussed the current state of the 3Rs-concept, examples of its successful implementation as well as still existing hurdles. Special emphasis was laid on the ‘consistency approach’ that aims to ensure relevant quality attributes of vaccine batches by in vitro analyses during production rather than by in vivo potency tests on the final product. This report provides an overview of the insights gained, including the recommendations produced at the end of the workshop.     

Zoonotic Emerging Infectious Disease in Selected Countries in Southeast Asia: Insights from Ecohealth

Most emerging diseases of humans originate in animals, and zoonotic emerging infectious diseases (EIDs) threaten human, animal, and environment health. We report on a scoping study to assess actors, linkages, priorities, and needs related to management of these diseases from the perspective of key stakeholders in three countries in Southeast Asia. A comprehensive interview guide was developed and in-depth interviews completed with 21 key stakeholders in Vietnam, Lao People’s Democratic Republic, and Cambodia. We found numerous relevant actors with a predominance of public sector and medical disciplines. More capacity weaknesses than strengths were reported, with risk analysis and research skills most lacking. Social network analysis of information flows showed policy-makers were regarded as mainly information recipients, research institutes as more information providers, and universities as both. Veterinary and livestock disciplines emerged as an important “boundary-spanning” organization with linkages to both human health and rural development. Avian influenza was regarded as the most important zoonotic EID, perhaps reflecting the priority-setting influence of actors outside the region. Stakeholders reported a high awareness of the ecological and socioeconomic drivers of disease emergence and a demand for disease prioritization, epidemiological skills, and economic and qualitative studies. Evaluated from an ecohealth perspective, human health is weakly integrated with socioeconomics, linkages to policy are stronger than to communities, participation occurs mainly at lower levels, and equity considerations are not fully considered. However, stakeholders have awareness of ecological and social determinants of health, and a basis exists on which transdisciplinarity, equity, and participation can be strengthened.     

Utz Wachil: Findings from an International Study of Indigenous Perspectives on Health and Environment

This article reports previously unpublished results of a collaborative study undertaken in 2003 by health workers of the UK-based organisation Health Unlimited, and by researchers of the London School of Hygiene and Tropical Medicine. This study marked the first of a series of collaborative activities aimed at highlighting the situation of Indigenous peoples, some in the most isolated ecosystems of the planet. While many researchers focus on quantitative analysis of the health and environmental conditions of Indigenous peoples, our 2003 study aimed at exploring the views of Indigenous peoples in isolated communities in five countries on their environment and their health. In this article we look closely at the web of knowledge and belief that underpins Indigenous peoples’ concepts of health and well-being, and their relationship to land and the environment. Although many Indigenous people have been forced off their traditional lands and live in rural settlements, towns, and cities, there are still a large number of people living in very small Indigenous communities in remote areas. This article focuses on 20 such communities in six countries. We explore traditional knowledge and practice and its relationship to Western medicine and services. The research findings highlight the importance of Indigenous knowledge systems for the emerging ecohealth community and suggest that we have much to learn from Indigenous peoples in our pursuit of a more holistic science. Utz Wachil is from the K’iche language originating in Totonicapan Department, Guatemala. It translates literally as “fine/well face-ness,” face meaning one’s aspect in general, not only physical appearance.     

The human proteome – a scientific opportunity for transforming diagnostics, therapeutics, and healthcare

A National Institutes of Health (NIH) workshop was convened in Bethesda, MD on September 26?C27, 2011, with representative scientific leaders in the field of proteomics and its applications to clinical settings. The main purpose of this workshop was to articulate ways in which the biomedical research community can capitalize on recent technology advances and synergize with ongoing efforts to advance the field of human proteomics. This executive summary and the following full report describe the main discussions and outcomes of the workshop.     

A novel thermophilic anaerobic bacteria producing cyclodextrin glycosyltransferase

A novel thermophilic anaerobic, rod-shaped, non-spore forming, gram positive bacterium was isolated from an oil field in Turkey, that produces cyclodextrin glycosyltransferase (CGTase) from starch. According to the some morphological, biochemical and 16S rRNA analysis, the strain belongs to the genus Thermoanaerobacter. The strain mainly utilizes starch and derivatives, glucose and fructose as carbon source between 45 and 75 °C, optimally at 65 °C. Optimum pH for growth is 7.5. 16S RNA studies indicate that the bacterium has a similarity of 98.3% to homoacetogenic Thermoanaerobacter kivui and the main fermentation product is acetic acid as in the case with homoacetogenic bacteria. The main difference between the bacterium and T. kivui concerns the utilization of starch. Based on the phylogenetic and biochemical analysis, it is proposed that the species are a new member of the genus Thermoanaerobacter. The strain has CGTase activity optimum at 80 °C and pH 7.0–8.0.     

Challenges of radiotherapy: Report on the 4D treatment planning workshop 2013

This report, compiled by experts on the treatment of mobile targets with advanced radiotherapy, summarizes the main conclusions and innovations achieved during the 4D treatment planning workshop 2013. This annual workshop focuses on research aiming to advance 4D radiotherapy treatments, including all critical aspects of time resolved delivery, such as in-room imaging, motion detection, motion managing, beam application, and quality assurance techniques. The report aims to revise achievements in the field and to discuss remaining challenges and potential solutions. As main achievements advances in the development of a standardized 4D phantom and in the area of 4D-treatment plan optimization were identified. Furthermore, it was noticed that MR imaging gains importance and high interest for sequential 4DCT/MR data sets was expressed, which represents a general trend of the field towards data covering a longer time period of motion. A new point of attention was work related to dose reconstructions, which may play a major role in verification of 4D treatment deliveries. The experimental validation of results achieved by 4D treatment planning and the systematic evaluation of different deformable image registration methods especially for inter-modality fusions were identified as major remaining challenges. A challenge that was also suggested as focus for future 4D workshops was the adaptation of image guidance approaches from conventional radiotherapy into particle therapy. Besides summarizing the last workshop, the authors also want to point out new evolving demands and give an outlook on the focus of the next workshop.     

When the Cell Stress Society International became South American: meeting report of the IX International Workshop on the Molecular Biology of Stress Responses

The International Workshop on the Molecular Biology of the Stress Response organized by the Cell Stress Society International was held in Porto Alegre, Brazil, on May 27–30, 2012, as part of the development of the Latin American Chapter of the Society, a superb initiative headed by Drs. Antonio De Maio and Larry Hightower. The meeting took place in the wonderful facilities of the Pontifícia Universidade do Rio Grande do Sul (PUCRS) and was warmly chaired by Professor Cristina Bonorino. Thirty-four invited speakers presented their work to more than 200 scientists and, even more importantly, to 150 registered students, who were the main beneficiaries of the meeting. The first day of the workshop was dedicated to an educational program for students, young investigators, and participants who were unfamiliar with the field of molecular chaperones and the stress response. Speakers in this pre-workshop were Dr. Harm Kampinga, Dr. Lea Sistonen, Dr. Larry Hightower, Dr. Ivor Benjamin, Dr. Daniel Ciocca, and Dr. Linda Hendershot. Then, the scientific sessions discussed below followed.     

A Reflective Lens: Applying Critical Systems Thinking and Visual Methods to Ecohealth Research

Critical systems methodology has been advocated as an effective and ethical way to engage with the uncertainty and conflicting values common to ecohealth problems. We use two contrasting case studies, coral reef management in the Philippines and national park management in Australia, to illustrate the value of critical systems approaches in exploring how people respond to environmental threats to their physical and spiritual well-being. In both cases, we used visual methods—participatory modeling and rich picturing, respectively. The critical systems methodology, with its emphasis on reflection, guided an appraisal of the research process. A discussion of these two case studies suggests that visual methods can be usefully applied within a critical systems framework to offer new insights into ecohealth issues across a diverse range of socio-political contexts. With this article, we hope to open up a conversation with other practitioners to expand the use of visual methods in integrated research.     

Monitoring and evaluation of the activities of trainees in the ‘training of trainers’ workshop at Ibadan,south-west Nigeria

Background Like most low- and middle-income countries, Nigeria has a huge treatment gap for mental disorders. The World Health Organization has proposed the integration of mental health care into primary health service delivery as one of the ways to bridge this treatment gap. Studies have shown an immediate positive impact of mental health training for primary care workers. We evaluated the impact of training on the tutors of primary care workers approximately 12 months after the training.Method An intensive five-day training workshop for college teachers of mental health in community health officer (CHO) training institutions in south-west Nigeria was conducted in January 2009. Four of the 24 participants were randomly selected for evaluation of the impact of training on their activities approximately 12 months after the workshop. Qualitative methods were used, namely in-depth interviews, direct observation of classroom teaching by the participants and focus group discussion with their students.Results The participants interviewed reported a positive impact of the ‘training of trainers’ (TOT) workshop on their mental health course teaching. Direct observation of four participants revealed that three of them exhibited a high fidelity with the TOT course material and imbibed the teaching techniques advocated. The tutors'' students also reported an improvement in the quality of their mental health classes.Conclusion The training had an overall positive impact on the activities of the trainees approximately one year after the workshop.     

Complete genome sequence and in silico analysis of L. interrogans Canicola strain DU114: A virulent Brazilian isolate phylogenetically related to serovar Linhai

Canine leptospirosis is often caused by Leptospira interrogans serovar Canicola. Infected dogs may become asymptomatic carriers of the pathogen, which leads to many public health concerns. In this work, we present the complete genome sequencing and in silico analysis from a virulent Brazilian strain of L. interrogans serovar Canicola, previously isolated from a stray dog in Sao Paulo City. Comparative genomic analysis with a reference genome allowed identification of 1031 INDELs and several arrangement variations. Out of 35,361 SNPs identified, 6780 were missense mutations and 16,114 were synonymous mutations. The Gene Ontology terms more affected by mutations were described. Interestingly, phylogenetic analyses indicated a genetic relatedness of the isolate with serovar Linhai strain 56,609. In addition, we found several virulence-related genes and main outer membrane proteins associated with pathogenesis. This genomic information about canine isolates may help to elucidate the molecular diversity and mechanisms of Leptospira spp. pathogenicity.     

Evaluating Communities of Practice and Knowledge Networks: A Systematic Scoping Review of Evaluation Frameworks

Communities of Practice (CoPs) are increasingly considered a part of ecohealth and other sectors such as health care, education, and business. However, there is little agreement on approaches to evaluate the influence and effectiveness of CoPs. The purpose of this review was to understand what frameworks and methods have been proposed or used to evaluate CoPs and/or knowledge networks. The review searched electronic databases in interdisciplinary, health, education, and business fields, and further collected references and forward citations from relevant articles. Nineteen articles with 16 frameworks were included in the synthesis. The purposes of the evaluation frameworks varied; while some focused on assessing the performance of CoPs, several frameworks sought to learn about CoPs and their critical success factors. Nine of the frameworks had been applied or tested in some way, most frequently to guide a case study. With limited applications of the frameworks, strong claims about generalizability could not be made. The review results can inform the development of tailored frameworks. However, there is a need for more detailed and targeted CoP evaluation frameworks, as many imperative CoP evaluation needs would be unmet by the available frameworks.     

Development and Evaluation of ‘Briefing Notes’ as a Novel Knowledge Translation Tool to Aid the Implementation of Sex/Gender Analysis in Systematic Reviews: A Pilot Study

Background

There is increasing recognition of sex/gender differences in health and the importance of identifying differential effects of interventions for men and women. Yet, to whom the research evidence does or does not apply, with regard to sex/gender, is often insufficiently answered. This is also true for systematic reviews which synthesize results of primary studies. A lack of analysis and reporting of evidence on sex/gender raises concerns about the applicability of systematic reviews. To bridge this gap, this pilot study aimed to translate knowledge about sex/gender analysis (SGA) into a user-friendly ‘briefing note’ format and evaluate its potential in aiding the implementation of SGA in systematic reviews.

Methods

Our Sex/Gender Methods Group used an interactive process to translate knowledge about sex/gender into briefing notes, a concise communication tool used by policy and decision makers. The briefing notes were developed in collaboration with three Cochrane Collaboration review groups (HIV/AIDS, Hypertension, and Musculoskeletal) who were also the target knowledge users of the briefing notes. Briefing note development was informed by existing systematic review checklists, literature on sex/gender, in-person and virtual meetings, and consultation with topic experts. Finally, we held a workshop for potential users to evaluate the notes.

Results

Each briefing note provides tailored guidance on considering sex/gender to reviewers who are planning or conducting systematic reviews and includes the rationale for considering sex/gender, with examples specific to each review group’s focus. Review authors found that the briefing notes provided welcome guidance on implementing SGA that was clear and concise, but also identified conceptual and implementation challenges.

Conclusions

Sex/gender briefing notes are a promising knowledge translation tool. By encouraging sex/gender analysis and equity considerations in systematic reviews, the briefing notes can assist systematic reviewers in ensuring the applicability of research evidence, with the goal of improved health outcomes for diverse populations.