Development of Transdisciplinarity Among Students Placed with a Sustainability for Health Research Project

Transdisciplinary education on sustainability for health has been primarily developed in high-income countries, yet the need in countries with limited research and human resource investments remains urgent. Little empiric documentation of the facilitators and barriers to transdisciplinary learning in such countries has been described. We assessed transdisciplinary learning among students of different disciplines collaborating with an Ecuadorian sustainability for health research project. Six undergraduate students from four different disciplinary backgrounds were incorporated through work–study agreements with provincial university academic supervisors. Learning was fostered and monitored through participant observations by a field supervisor. Students’ learning was evaluated through subsequent in-depth interviews and visualization methods. Academic supervisor key informant and co-investigator observations aided triangulation. Qualitative data were analyzed using indicators of transdisciplinary thinking. Principal factors facilitating transdisciplinary learning were interaction with social actors, the integration of work with other disciplines, the use of alternative research techniques and methods, and the constant support of the field supervisor. Inhibiting factors included the existence of rigid academic rules, lack of training of the academic supervisors in diverse research methods, and social pressures to implement unidisciplinary foci. At the end of their link with the project, students had developed both cognitive outcomes and attitudinal values relevant to sustainable development for health. In countries with limited investments in research and human resources development, transdisciplinary approaches with social actors and engaged researchers can sensitize new professionals training in traditional academic contexts to the ecological–social–health problems faced by poor majorities and encourage their subsequent work on sustainability for human health.     

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.     

'Changing climate, changing health, changing stories' profile: using an EcoHealth approach to explore impacts of climate change on inuit health

Global climate change and its impact on public health exemplify the challenge of managing complexity and uncertainty in health research. The Canadian North is currently experiencing dramatic shifts in climate, resulting in environmental changes which impact Inuit livelihoods, cultural practices, and health. For researchers investigating potential climate change impacts on Inuit health, it has become clear that comprehensive and meaningful research outcomes depend on taking a systemic and transdisciplinary approach that engages local citizens in project design, data collection, and analysis. While it is increasingly recognised that using approaches that embrace complexity is a necessity in public health, mobilizing such approaches from theory into practice can be challenging. In 2009, the Rigolet Inuit Community Government in Rigolet, Nunatsiavut, Canada partnered with a transdisciplinary team of researchers, health practitioners, and community storytelling facilitators to create the Changing Climate, Changing Health, Changing Stories project, aimed at developing a multi-media participatory, community-run methodological strategy to gather locally appropriate and meaningful data to explore climate-health relationships. The goal of this profile paper is to describe how an EcoHealth approach guided by principles of transdisciplinarity, community participation, and social equity was used to plan and implement this climate-health research project. An overview of the project, including project development, research methods, project outcomes to date, and challenges encountered, is presented. Though introduced in this one case study, the processes, methods, and lessons learned are broadly applicable to researchers and communities interested in implementing EcoHealth approaches in community-based research.     

Ecosystem Health in Professional Curriculum: Experience to Date

In order to present a holistic view of defining problems and exploring long-term solutions for health-related issues, several colleges and universities are adopting an ecosystem health approach. While these curricular offerings are varied in nature, a number of common themes appear to be emerging. The case study is the preferred method for introducing the subject matter as this provides immediate relevance to the student studying within a specific discipline but, when carefully designed, promotes systems thinking and allows exploration of a number of features common to all complex systems. These include: interdependence of system components, complexity, uncertainty, and the need for transdisciplinary thinking when analyzing the issues. The articles appearing in this supplement are examples of how this approach has been introduced into a variety of curricula pertaining to human health, animal health, and other related fields.     

Challenges Facing the Adoption of Ecosystem Health as a Core Component in Professional Curricula

While there has been considerable success in introducing ecosystem health into professional curricula at a number of universities, there have been significant challenges to its introduction. There are difficulties relating to pervading attitudes within universities. Ecosystem health deals with uncertainty whereas most other disciplines cherish certainty. Ecosystem health is often considered a “soft science” lacking in specifics. The enormity and complexity of ecosystem health problems are often perceived as discouraging and impossible to solve. The university structure can present challenges in that transdisciplinary problem solving requires the participation of many different departments, with several levels of approval required. There are also challenges in the teaching of ecosystem health given its extremely broad focus, limited experience in ecosystem health curricula, and almost no experience in effective evaluation of a field that emphasizes attitudes as much as it does information. This article describes each of these challenges, draws on the experience of the conference, and provides potential solutions to overcoming these challenges.     

Reframing the conception of nature conservation management by transdisciplinary methodology: From stakeholders to stakesharers

Nature conservation is concerned with human–nature interface problems. The aim of this article is to examine how the transdisciplinary methodology can help improve community-based conservation approaches. Transdisciplinarity is an extremely promising global movement that promotes a new approach to the creation of human knowledge. It includes dialogue among the natural sciences, social sciences and humanities as well as with civil society, where the problems of the world are lived out on a daily basis. The intent of taking down the walls between the disciplines and civil society is to enable new types of knowledge to emerge through complex and integrated, mutually learned insights. The four pillars (axioms) of the transdisciplinary methodology – multiple levels of Reality (ontology), the logic of the included middle, emergent complexity (epistemology) and integral value constellations (axiology) – are explained as is the role each plays in reframing our conception of the conservation of nature. A transdisciplinary methodology helps everyone involved in a community-based conservational approach feel as if they are stakesharers rather than stakeholders. Almost everyone is familiar with the term stakeholder, referring to someone who can affect, or can be affected by others’, decisions. To have a stake in something means people share or have an involvement in it. We coined the term stakesharer to reflect the idea that, within transdisciplinary work, people share ideas, solutions, threats and opportunities as they try to stake out their collective response to human–nature interface problems.     

On the Even Greater Need for Precaution Under Global Change

The greater the potential for disastrous, large-scale, or catastrophic impacts on health, the greater the case for precaution. The imperative for precautionary action, critical also for downstream determinants of health, is at least as compelling where macro-level concerns about the sustainability of life on Earth are at issue. In this context, I propose that a higher threshold of uncertainty is needed where large-scale harms to health and well-being are possible. Initial efforts must focus on the training of researchers and risk managers for competencies in complexity, and in systems approaches to transdisciplinary enquiry. Revisiting the intent behind Bradford Hill on causation is an essential first step. Focus on the more proximate causes of diseases, such as those related either to occupational exposures or to more downstream environmental exposures, is left to others in this collection.     

Economic and anthropological assessments of the health of children in Maya immigrant families in the US.

Immigration from developing countries to the US generally increases access to health care and clean water, but it also introduces some unhealthy lifestyle patterns, such as diets dense in energy and little regular physical activity. We present a transdisciplinary model of child health and examine the impact of immigration on the physical growth and health of Maya children in Guatemala and the US. Maya-American children are much taller and have longer legs, on average, than their counterparts in Guatemala. This suggests that immigration to the US improves their health. However, the Maya-American children also are much heavier than both Guatemalan Maya and White American children, and have high rates of overweight and obesity. Quantile regression analysis indicates that Maya are shorter except in the upper tail of the stature distribution, and have higher Body Mass Index (BMI) in the tails, but not in the middle of the BMI distribution. Leisure time spent in front of a television or computer monitor tends to raise BMI in the middle and lower tail of the distribution, but not in the upper tail.     

All Hands on Deck: Transdisciplinary Approaches to Emerging Infectious Disease

The increasing burden of emerging infectious diseases worldwide confronts us with numerous challenges, including the imperative to design research and responses that are commensurate to understanding the complex social and ecological contexts in which infectious diseases occur. A diverse group of scientists met in Hawaii in March 2005 to discuss the linked social and ecological contexts in which infectious diseases emerge. A subset of the meeting was a group that focused on “transdisciplinary approaches” to integrating knowledge across and beyond academic disciplines in order to improve prevention and control of emerging infections. This article is based on the discussions of that group. Here, we outline the epidemiological legacy that has dominated infectious disease research and control up until now, and introduce the role of new, transdisciplinary and systems-based approaches to emerging infectious diseases. We describe four cases of transboundary health issues and use them to discuss the potential benefits, as well as the inherent difficulties, in understanding the social–ecological contexts in which infectious diseases occur and of using transdisciplinary approaches to deal with them. The views expressed here by Marian McDonald and Josh Rosenthal are those of the authors and do not represent official views or policies of the U.S. Centers for Disease Control and Prevention or the National Institutes of Health.     

Untangling the Complexity of Liver Fluke Infection and Cholangiocarcinoma in NE Thailand Through Transdisciplinary Learning

This study demonstrates how a transdisciplinary learning approach provided new insights for explaining persistent Opisthorchis viverrini infection in northern Thailand, as well as elucidating problems of focusing solely on the parasite as a means of addressing high prevalence of cholangiocarcinoma. Researchers from diverse backgrounds collaborated to design an investigative homestay program for 72 Singaporean and Thai university students in five northeast Thai villages. The students explored how liver fluke infection and potential cholangiocarcinoma development are influenced by local landscape dynamics, aquatic ecology, livelihoods, food culture and health education. Qualitative fieldwork was guided daily by the researchers in a collaborative, co-learning process that led to viewing this health issue as a complex system, influenced by interlinked multidimensional factors. Our transdisciplinary experience has led us to believe that an incomplete understanding of these linkages may reduce the efficacy of interventions. Further, viewing liver fluke infection and cholangiocarcinoma as the same issue is inadvisable. Although O. viverrini infection is an established risk factor for the development of cholangiocarcinoma, multiple factors are known to influence the likelihood of acquiring either. Understanding the importance of the current livelihood transition, landscape modification and the resulting mismatch between local cultures and new socio-ecological settings on cholangiocarcinoma initiation and liver fluke transmission is of critical importance as it may help readjust our view of the respective role of O. viverrini and other socioeconomic risk factors in cholangiocarcinoma etiology and refine intervention strategies. As demonstrated in this study, transdisciplinary approaches have the potential to yield more nuanced perspectives to complex diseases than research that focuses on specific aspects of their epidemiology. They may therefore be valuable when designing effective solutions to context-sensitive diseases such as liver fluke infection and cholangiocarcinoma.     

Complexity by Subtraction

The eye and brain: standard thinking is that these devices are both complex and functional. They are complex in the sense of having many different types of parts, and functional in the sense of having capacities that promote survival and reproduction. Standard thinking says that the evolution of complex functionality proceeds by the addition of new parts, and that this build-up of complexity is driven by selection, by the functional advantages of complex design. The standard thinking could be right, even in general. But alternatives have not been much discussed or investigated, and the possibility remains open that other routes may not only exist but may be the norm. Our purpose here is to introduce a new route to functional complexity, a route in which complexity starts high, rising perhaps on account of the spontaneous tendency for parts to differentiate. Then, driven by selection for effective and efficient function, complexity decreases over time. Eventually, the result is a system that is highly functional and retains considerable residual complexity, enough to impress us. We try to raise this alternative route to the level of plausibility as a general mechanism in evolution by describing two cases, one from a computational model and one from the history of life.     

Biodiversity on the brink: Evaluating a transdisciplinary research collaboration

Global biodiversity is facing an extinction crisis. Australia has one of the highest terrestrial species extinction rates in the world. Scientists, policy advisors and governments have recommended that the issue be addressed at a landscape-scale, while noting that there are significant knowledge gaps that are hampering implementation of such an approach. From 2011–2015, the Australian Government funded a transdisciplinary research program, the Landscapes and Policy Hub, to meet this need. Transdisciplinary research is widely acknowledged as essential to address the complexity of contemporary environmental problems. Given that such research programs are in their infancy, it is important to evaluate their efficacy and provide an empirical basis for improving their design. This paper presents an evaluation of the strategies fostering transdisciplinarity adopted by the Landscapes and Policy Hub. A heavy emphasis on communication, with skilled knowledge brokering, regular face-to-face meetings using participatory activities and shared field engagements enhanced transdisciplinary interaction between researchers and research users. However, establishing a fully integrated interdisciplinary research program remained a challenge. Efforts to enable shared conceptual frameworks to emerge through adaptive application of theory in practice could have been balanced with increased effort at the outset for researchers and research users to collaboratively formulate shared research questions, leading to the establishment of teams that could address these questions through cross-mobilisation of interdisciplinary expertise.     

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.     

Understanding Land Use, Livelihoods, and Health Transitions among Tibetan Nomads: A Case from Gangga Township, Dingri County, Tibetan Autonomous Region of China

Tibetan nomads in the Tibetan Autonomous Region of China have experienced profound transitions in recent decades with important implications for land use, livelihoods, and health development. The change from being traditional nomads to agropastoralists engaged in permanent agriculture, a sedentary village life (known as “sedentarization”), has been associated with a remarkable change in diet and lifestyle, decline in spatial mobility, increase in food production, and emerging infectious and noncommunicable diseases. The overarching response of the government has been to emphasize infrastructure and technological solutions. The local adaptation strategies of Tibetan nomads through maintaining balanced mobile herding, reindeer husbandry, as well as off-farm labor and trade could address both the cause of environmental degradation and improve the well-being of local people. Drawing on transdisciplinary, preliminary field work in Gangga Township of Dingri County in the foothills of Mt. Everest, we identify pertinent linkages between land use and health, and spatial and temporal mismatch of livelihoods and health care services, in the transition to sedentary village life. We suggest emerging imperatives in Ecohealth to help restore Tibetan livelihoods in transition to a sedentary lifestyle.     

Author Credit for Transdisciplinary Collaboration

Transdisciplinary collaboration is the key for innovation. An evaluation mechanism is necessary to ensure that academic credit for this costly process can be allocated fairly among coauthors. This paper proposes a set of quantitative measures (e.g., t_credit and t_index) to reflect authors’ transdisciplinary contributions to publications. These measures are based on paper-topic probability distributions and author-topic probability distributions. We conduct an empirical analysis of the information retrieval domain which demonstrates that these measures effectively improve the results of harmonic_credit and h_index measures by taking into account the transdisciplinary contributions of authors. The definitions of t_credit and t_index provide a fair and effective way for research organizations to assign credit to authors of transdisciplinary publications.     

Ecosystem Health in Professional Education: The Path Ahead

This supplement shows that ecosystem health has become a vital part of the curriculum in a small number of medical, veterinary, and public health schools. This limited, but important, experience provides the groundwork for further expansion into other professional schools and into other universities. Although ecosystem health has defined underlying principles, previous experience has shown that each professional faculty should define what ecosystem health means for the institution and for its students. Based on this definition, it is important that detailed learning objectives be defined for ecosystem health as it pertains to the profession. A model for further development is proposed in this editorial. This model focuses on developing the necessary skill sets for ecosystem health education, the expansion of ecosystem health into earlier and later stages of learning (high school through undergraduate, through postgraduate, and onto practicing professional levels), and raising the awareness of ecosystem health in the local community and at national and international levels. Once comprehensive, transdisciplinary, continuous ecosystem health programs become mainstream, one can expect a “sea change” in the attention given to the interrelationship between humans and their environments, and a more concerted effort to restore the health of our planetary ecosystems.     

The Metabolic Syndrome - a global challenge for prevention.

In the last years we have learned a lot about the pathopysiology of a cluster of the diseases called Metabolic Syndrome but currently an exciting discussion debates the Metabolic Syndrome in a light of a mystery of medicine or a clinical paradigm with a controversary about diagnostic, treatment or preventive procedure. There is now convincing evidence that prevention is the most important and effective way to reduce the personal and socio-economic burden of the Metabolic Syndrome and its associated complications. Still, it is currently not clear how to implement preventive interventions into clinical practice but will require an integrated and transdisciplinary approach on an international level in order to efficiently reduce premature morbidity and mortality. Nevertheless, global strategies are still lacking but are needed to tackle inequalities in health between industrialized countries and the developing world. A global health strategy has to take into account political, epidemiological, environmental, infrastructural and genetic aspects. The Metabolic Syndrome is not a mystery - it is a clinical paradigm and global challenge.     

What are definitions of life good for? Transdisciplinary and other definitions in astrobiology

The attempt to define life has gained new momentum in the wake of novel fields such as synthetic biology, astrobiology, and artificial life. In a series of articles, Cleland, Chyba, and Machery claim that definitions of life seek to provide necessary and sufficient conditions for applying the concept of life—something that such definitions cannot, and should not do. We argue that this criticism is largely unwarranted. Cleland, Chyba, and Machery approach definitions of life as classifying devices, thereby neglecting their other epistemic roles. We identify within the discussions of the nature and origin of life three other types of definitions: theoretical, transdisciplinary, and diagnostic definitions. The primary aim of these definitions is not to distinguish life from nonlife, although they can also be used for classificatory purposes. We focus on the definitions of life within the budding field of astrobiology, paying particular attention to transdisciplinary definitions, and diagnostic definitions in the search for biosignatures from other planets.     

Consensus statement understanding health and malnutrition through a systems approach: the ENOUGH program for early life

Nutrition research, like most biomedical disciplines, adopted and often uses experimental approaches based on Beadle and Tatum’s one gene—one polypeptide hypothesis, thereby reducing biological processes to single reactions or pathways. Systems thinking is needed to understand the complexity of health and disease processes requiring measurements of physiological processes, as well as environmental and social factors, which may alter the expression of genetic information. Analysis of physiological processes with omics technologies to assess systems’ responses has only become available over the past decade and remains costly. Studies of environmental and social conditions known to alter health are often not connected to biomedical research. While these facts are widely accepted, developing and conducting comprehensive research programs for health are often beyond financial and human resources of single research groups. We propose a new research program on essential nutrients for optimal underpinning of growth and health (ENOUGH) that will use systems approaches with more comprehensive measurements and biostatistical analysis of the many biological and environmental factors that influence undernutrition. Creating a knowledge base for nutrition and health is a necessary first step toward developing solutions targeted to different populations in diverse social and physical environments for the two billion undernourished people in developed and developing economies.     

Nutrient dynamics in the deep blue sea

For more than a century, oceanographers have studied the interactions between the photosynthetic production of organic matter and nutrient dynamics in the sea. This research has been field-oriented and transdisciplinary, occurring at the intersections of research in microbiology, physics, analytical chemistry, cell physiology and ecology. The global database derived from this collective effort established a sound scientific understanding of nutrient dynamics and the vital role of microorganisms, both autotrophic and heterotrophic, in the coupled organic-matter production and decomposition cycles in the sea. However, novel approaches used over the past two decades, including new designs for field experiments, repeat field observations and remote-sensing capabilities, together with updated methods of sample analysis, have led to a revolution in our thinking about the mechanisms and controls of nutrient dynamics in the deep blue sea. Contemporary paradigms bear only partial resemblance to the dogma of the past, and are likely to evolve further as new data and new ideas are presented for open discussion and debate.