全健康(One Health)视角下绿色健康社区景观设计体系构建

以全健康(OneHealth)视角为出发点,保障人、环境和动物的健康对于社区健康环境规划与设计具有重要意义。在现有健康社区景观设计体系中,人、环境、物种三者关系虽被提及,但未被系统探究,健康社区建设实践也需要系统性的景观设计体系支持。基于全健康理念中人、环境和物种的相互关系,结合生态系统服务功能、康复景观理论和园艺疗法,进一步探讨人、环境、物种健康之间的关联途径。通过对全健康理念视角下的3个层次进行演绎发展,归纳总结了人的健康、环境健康和物种健康的组成要素及内容,构建了以人的健康需求为导向的社区健康设计框架,提出了以人与人际、人与环境和人与物种为三大圈层的健康社区景观设计体系。全健康视角为社区健康环境设计提供了一个系统性、整合性且具有操作性的框架,未来应重视健康社区体系中各类疗愈空间的设计与使用,以增进社区居民共享的健康福祉。

世界动物卫生组织One Health总体框架及最新关注方向

近年来,人兽共患病在全球越来越多的地方影响人类和动物的健康。在此背景下,由联合国粮食及农业组织(FAO)、世界卫生组织(WHO)和世界动物卫生组织(WOAH)三方国际组织提出了“One Health”的概念。2021年底,FAO、WOAH、WHO和联合国环境规划署(UNEP)共同成立了One Health高级别委员会(One Health High Level Expert Panel,OHHLEP),并将“One Health”重新定义。论文就“One Health”的概念、提出的背景、重要发展进程、总体框架和协调机制以及未来应用展望进行了全面的介绍和阐述,为我国进一步深入了解“One Health”理念,实践并更好地应用“One Health”方法,从而解决我国人兽共患病、抗生素耐药等对人类、动物和环境危害严重的问题提供思路和参考。

Global Strategies to Combat Antimicrobial Resistance: A One Health Perspective

Background: Antimicrobial resistance (AMR) is a global health challenge that has escalated due to the inappropriate use of antimicrobials in humans, animals, and the environment. Developing and implementing strategies to reduce and combat AMR is critical. Purpose: This study aimed to highlight some global strategies that can be implemented to address AMR using a One Health approach. Methods: This study employed a narrative review design that included studies published from January 2002 to July 2023. The study searched for literature on AMR and antimicrobial stewardship (AMS) in PubMed and Google Scholar using the 2020 PRISMA guidelines. Results: This study reveals that AMR remains a significant global public health problem. Its severity has been markedly exacerbated by inappropriate use of antimicrobials in humans, animals, and the broader ecological environment. Several strategies have been developed to address AMR, including the Global Action Plan (GAP), National Action Plans (NAPs), AMS programs, and implementation of the AWaRe classification of antimicrobials. These strategies also involve strengthening surveillance of antimicrobial consumption and resistance, encouraging the development of new antimicrobials, and enhancing regulations around antimicrobial prescribing, dispensing, and usage. Additional measures include promoting global partnerships, combating substandard and falsified antimicrobials, advocating for vaccinations, sanitation, hygiene and biosecurity, as well as exploring alternatives to antimicrobials. However, the implementation of these strategies faces various challenges. These challenges include low awareness and knowledge of AMR, a shortage of human resources and capacity building for AMR and AMS, in adequate funding for AMR and AMS initiatives, limited laboratory capacities for surveillance, behavioural change issues, and ineffective leadership and multidisciplinary teams. Conclusion: In conclusion, this study established that AMR is prevalent among humans, animals, and the environment. Successfully addressing AMR calls for a collaborative, multifaceted One Health approach. Despite this, some gaps remain effectively implementing strategies currently recommended to combat AMR. As a result, it is essential to reinforce the strategies that are deployed to counter AMR across the human, animal, and environmental sectors.

浅谈“One health”和“成果导向教育”双理念应用于医学开放创新实验项目管理的实践与探索

“One health”理念是从“人类-动物-环境”的整体视角解决复杂健康问题,凸显了人类文化与自然之间的联系,旨在指导人们在日常生活中秉持一种“万物一体、万物健康”的观念和行为准则。“成果导向教育(OBE)”理念,强调以学生学习成果为导向,制定教学目标和教学设计。开放创新实验教学的过程不仅在于传授基础医学知识,更需要将“One health”及“OBE”理念贯穿于理论及实验教学中,同时培养学生主动性,从群体角度解决医学问题,建立“健康一体化”的人文理念。本文主要以开放创新实验项目为切入点,浅谈将“One health”“OBE”理念融入开放创新实验项目中的方法及重难点。

从“One Health”视角应对抗微生物药物耐药性

作为一场席卷全球的卫生危机,抗生素长期使用所带来的抗微生物药物耐药性(antimicrobial resistance,AMR)日趋严重,耐药病原菌、多重耐药菌、“超级细菌”等问题逐步成为公共卫生、畜牧兽医、环境卫生等领域共同面对的严峻挑战。近年来,随着“One Health”理念的兴起和探索实践,该理念逐步成为应对AMR挑战、实现人-动物-环境共同健康的共识。本文从“One Health”视角看待AMR问题,综述了“One Health”及AMR的发展历程,总结了国内外应用“One Health”理念遏制AMR问题的方法策略,提出了应对AMR问题的未来发展方向,为共同应对AMR挑战提供了参考。

One Health——我国人兽共患病防控新思考

近年来,随着新型冠状病毒肺炎(新冠肺炎)等重大公共卫生事件的发生,One Health(全健康)理念也不断更新发展,已获得越来越多的国际认可,在指导解决公共卫生事件,尤其在指导人兽共患病防控方面起着举足轻重的作用。其中,人兽共患病是公共卫生领域的一大痛点,对我国的民生健康、社会安定、农业和畜牧业的发展影响深远。文章从One Health理念出发,主要介绍我国人兽共患病防控工作现状,以期为我国进行跨学科、跨部门、跨领域的交流合作提供科学指导,以实现人类、动物与环境三者的最佳健康。

One Health视角下抗菌药物管理策略国际经验与启示

抗菌药物耐药性问题近年来得到国际组织和各国政府的高度重视,各国已达成遏制抗菌药物耐药需要卫生、农业、环保领域共同努力,开展多部门联合治理行动的共识。本文基于One Health视角,从战略计划、监测工具、组织架构等方面归纳分析了国际组织、欧盟、英国及美国在卫生、农业和环保领域的抗菌药物管理策略,总结可供中国借鉴的抗菌药物管理国际经验。

人与动物的共同健康:One Health--浅谈从动物实验室安全管理到全民健康

"同一健康"(One Health)理念是一种旨在通过地方,国家和全球范围内的多学科的共同努力,来实现人、动物和环境共同健康的健康理念。其雏形最早出现于十八世纪欧洲的比较医学,经历百余年的发展在二十一世纪逐渐成熟。在该理念的指导下,多国家和地区对含抗生素的动物促生长剂的使用政策以及人兽共患病的预防方案上进行了不同程度的调整,并取得了一定成效,这证明了One Health对解决公共卫生问题,实现全民健康的积极影响。此外,实验动物由于其特殊性,其使用不当所引起的生物实验室安全事故会对公众健康构成威胁,因此杜绝动物实验室安全隐患必然是实现全民健康的重要一环。本文梳理了One Health理念的发展历史和内涵,就其在公共卫生问题和动物实验室安全管理的发展现状做一综述。

One Health理念视域下体育的使命与担当

与传统健康观念重点关注医药产业、倾向于有病治病的理念不同,One Health更多的是强调整体的健康,是人类--动物--环境健康的协调和平衡,倾向于治未病、少得病、主动健康的理念。该理念旨在通过多学科、多部门的联合,去克服当前复杂的人类健康问题。One Health与当前“推进健康中国建设”战略决策和体育强国战略下的体医融合、体卫融合的理念不谋而合,但作为人体健康四大基石之一的运动与健康促进方面,在One Health领域尚未被广泛关注。因此,基于One Health理念视域下系统性梳理体育的使命与担当,对丰富和完善One Health的价值内涵,充实生态文明建设,构建人类健康命运共同体有着现实而长远的意义。

“One Health”理念及其在兽医领域的发展应用

“One Health”是通过跨学科、跨部门协作,在地区、国家及全球层面,提高人类、动物和环境健康水平的整体战略。近年来,人兽共患病、新发传染病、食品安全和抗生素耐药等问题日趋凸显,对人类、动物和生态环境均构成了极大威胁。为了应对这些不断出现的公共卫生危机,全球很多国家和地区开始关注“One Health”理念并将其应用于解决这一系列问题,已取得初步成效。本文简要介绍了“One Health”概念的由来及其在中国的发展,列举了该理念在我国兽医领域的实践与成效,呼吁应在“One Health”理念的引导下,携手合作、共同应对,保障人-动物-环境的共同健康。

One Health拟适用的国际法原则

One Health框架早被运用于公共卫生领域,指导国际社会通过“跨学科、跨专业”的合作以应对公共卫生事件。为规范国际社会在该框架的指引下行事,需要从国际法层面为One Health找到相关可适用的法律原则。现有法学领域的公平互利原则、审慎原则、风险预防原则、适当顾及原则与One Health的核心要义相契合,且能为国际社会共同应对公共卫生事件提供原则性指导,弥补了该框架法律原则的缺位。但在适用这些原则时,要注重结合公共卫生事件的特点,也要正视各国应对能力的差异,为各国应对公共卫生事件提供一般性的指导方针。

We Should Apply a “One Health” Approach to Understand and Treat Alzheimer’s Disease

Despite many decades of researches and large numbers of clinical trials, there remain no effective treatments for Alzheimer’s disease, a major degenerative ageing brain disorder. The potential treatments have focused on targeting the accumulation of amyloid beta-peptide in the brains of patients, but without success in slowing the disease. Many studies have now identified a large range of pathological changes (i.e. altered immune activity, mitochondrial impairment, abnormal microbiome), and links to the external environment (i.e. associations with infections, the influence of air pollution). While the concept of One Health (which considers links between the environment and human disease) has traditionally been applied to the understanding of the human infectious disease, it is argued here that the One Health approach should be adopted for Alzheimer’s disease. This would provide a far more holistic understanding of the disease, and its relationship to a growing number of exogenous factors, as well as could potentially lead to new treatment options targeted at the confluence of external influences, and internal molecular pathways.

Spontaneous Rabies in a Stray Bitch after Parturition Induced Immunosuppression —Investigating an Impending Outbreak of Rabies with One Health Approach

Background: Rabies is endemic in India and every half an hour a person dies of this dreaded disease. Stray roaming dogs, mostly unvaccinated, are most dangerous host in spread of rabies in India and in our state of Himachal Pradesh. Timely prophylaxis is the only method to save animal bite victims, including that of rabid dog bite patients. Objectives: Objective of this study was to investigate an impending outbreak of rabies in Shimla town in the absence of life saving rabies immunoglobulins (RIGs) in the market, and to know the source of infection by using one health approach and using epidemiological tools. Methods: On April 7, 2015, there was a sudden surge in cases of suspected rabid dog bites. Impending rabies outbreak was suspected as there were no RIGs available in the market. A rapid Response Team (RRT) consisting of the author, veterinary doctor, dog squad of Municipal Corporation (MC) Shimla along with the vehicles to impound rabid dogs was constituted to investigate the terror spread by two rabid dogs on biting spree in the Shimla Municipality. Results: A total of 18 people were bitten by suspected rabid dogs within three days period. A black bitch and a brown dog, on the identity of affected people, were captured by the dog squad of Municipality next day on April 8, 2015 and taken to Dog Sterilization Centre, Animal Birth Control (ABC) programme, MC Shimla for observation. The most furious Black bitch died of clinically confirmed symptoms of furious rabies after three days. The second rabid dog, brown in color, died after a month of observation due to paralytic dumb rabies. The brain of the brown dog was extracted for Fluorescent Antibody Testing (FAT) at central research Institute (CRI) Kasauli and was found to be positive for FAT. Follow up of patients was 100% by house to house visit and over telephone and no casualty was reported. Conclusion: While we were working on hypothesis of rabid dogs getting the infection from nearby forest about 8 - 10 KM away but on follow up of the patients, they reported that both the dog and bitch used to stay in the compound of their colony since the bitch was pregnant and there was no history of the bitch moving for away to forests neither any outside dog which was seen near them in the compound. This led us to think of other causes of what must had happened to the bitch that caused her to be rabid as for the past 9 years we had observed bitches becoming rabid after litter birth (Whelping) and making their pups rabid due to licking. Since the carrier state for rabies virus in bitches/dogs is known and a state of immunosuppression after whelping/parturition is also known, therefore there is a possibility of latent rabies virus getting activated due to immunosuppression after litter birth and it is thought to be as one of the probable causes of black bitch getting rabid and inflicting the infection to accompanying brown dog. We need to do further studies to ascertain this phenomenon before coming to a definite conclusion and suspect such a possibility in case a dam suddenly becomes rabid among a pack of stray dogs in rabies endemic countries like ours.

Avian influenza and gut microbiome in poultry and humans:A“One Health”perspective

A gradual increase in avian influenza outbreaks has been found in recent years.It is highly possible to trigger the next human pandemic due to the characteristics of antigenic drift and antigenic shift in avian influenza virus(AIV).Although great improvements in understanding influenza viruses and the associated diseases have been unraveled,our knowledge of how these viruses impact the gut microbiome of both poultry and humans,as well as the underlying mechanisms,is still improving.The“One Health”approach shows better vitality in monitoring and mitigating the risk of avian influenza,which requires a multi-sectoral effort and highlights the interconnection of human health with environmental sustainability and animal health.Therefore,monitoring the gut microbiome may serve as a sentinel for protecting the common health of the environment,animals,and humans.This review summarizes the interactions between AIV infection and the gut microbiome of poultry and humans and their potential mechanisms.With the presented suggestions,we hope to address the current major challenges in the surveillance and prevention of microbiome-related avian influenza with the“One Health”approach.

A One Health approach to fight antimicrobial resistance in Uganda: Implementation experience, results, and lessons learned

Uganda has been implementing the Global Health Security Agenda(GHSA)since 2015 to build its capacity according to World Health Organization(WHO)Benchmarks on International Health Regulations Capacities.The country remains prone to outbreaks,with more than 20 disease outbreaks reported in the past five years,including Ebola virus disease,Crimean-Congo haemorrhagic fever,Marburg haemorrhagic fever,measles,yellow fever,coronavirus disease 2019(COVID-19),and cholera.Antimicrobial resistance(AMR)is an ongoing challenge.Uganda scored capacity level 3 on infection prevention and control(IPC)and antimicrobial stewardship(AMS)in the 2017 Joint External Evaluation(JEE)assessment.Identified gaps were being addressed after a self-assessment in 2021.This paper describes the technical assistance approaches provided to Uganda by the Medicines,Technologies,and Pharmaceutical Services Program,funded by the United States(U.S.)Agency for International Development,and implemented by Management Sciences for Health.The program,through a One Health approach,supported systematic capacity strengthening based on the JEE's capacity advancement framework for global health security,specifically relating to AMR.The program's interventions impacted 32 WHO benchmark actions(7 for AMR multisectoral coordination,16 for IPC,and 9 for AMS),contributing to Uganda's strengthened GHSA capacity.Leveraging success built on the AMR platform,the program trained 745 health workers in IPC for the Ebola virus and provided support for simulation exercises by eight district IPC teams.The program also worked with the Ministry of Health to coordinate IPC for the COVID-19 response in five health regions,covering 45 districts and reaching 5,452 health workers at 858 health facilities.

One Health视角下细菌耐药产生传播影响驱动因素及其机制研究进展

细菌耐药对公共健康构成严重威胁,是全球共同面对的重大挑战之一。随着全球社会、经济、环境变化导致人群对抗生素的暴露机会及程度增加,加速了病原菌对抗生素耐药性的产生和传播,致使药物临床感染治疗效果减弱。本文基于One Health视角综述细菌耐药性产生传播的主要机制及其驱动因素,多层面探讨控制细菌耐药性的方法及策略,并对耐药研究及防控的前景进行了展望,旨在探索基于One Health的细菌耐药防控策略。

Gut microbiota research nexus:One Health relationshipbetween human,animal,and environmental resistomes

The emergence and rapid spread of antimicrobial resistance is of global public health concern.The gut microbiota harboring diverse commensal and opportunistic bacteria that can acquire resistance via horizontal and vertical gene transfers is considered an important reservoir and sink of antibiotic resistance genes(ARGs).In this review,we describe the reservoirs of gut ARGs and their dynamics in both animals and humans,use the One Health perspective to track the transmission of ARG-containing bacteria between humans,animals,and the environment,and assess the impact of antimicrobial resistance on human health and socioeconomic development.The gut resistome can evolve in an environment subject to various selective pressures,including antibiotic administration and environmental and lifestyle factors(e.g.,diet,age,gender,and living conditions),and interventions through probiotics.Strategies to reduce the abundance of clinically relevant antibiotic-resistant bacteria and their resistance determinants in various environmental niches are needed to ensure the mitigation of acquired antibiotic resistance.With the help of effective measures taken at the national,local,personal,and intestinal management,it will also result in preventing or minimizing the spread of infectious diseases.This review aims to improve our understanding of the correlations between intestinal microbiota and antimicrobial resistance and provide a basis for the development of management strategies to mitigate the antimicrobial resistance crisis.

Roadmap to tackle antibiotic resistance in the environment under the One Health framework

Antibiotic resistance has been recognized as a major challenge worldwide for humans.“One Health”has been recognized as a key concept for containment of antibiotic resistance.Under the framework,the role of the environment in the development of antibiotic resistance genes(ARGs)has become increasingly obvious.Despite numerous efforts,response to antibiotic re-sistance is considered to be inadequate,which is probably due to the lack of a clear roadmap.Here,we propose a“One Health”roadmap to combat antibiotic resistance in the environment through(1)understanding environmental resistome.The environmental gene pool has long been recognized as the single largest reservoir of both known and novel ARGs.(2)Standardizing ARG quantification.Systematic joint efforts based on standardized quantification are urgently needed to un-derstand the true tempospatial profiles of the environmental resistome.(3)Identifying mechanisms of resistome development.Horizontal gene transfer and co-selection have been recognized as the two main mechanisms contributing to the environmental resistome.(4)Establishing a risk-assessment framework.The first critical step for large-scale cost-effective targeted ARG management in the environment is the risk assessment to identify the priority ARGs for control.(5)Formulating regulatory standards.By correlating the environmental ARG profile with public health,we may identify the indicator ARGs that can be integrated into current environmental quality standards.(6)Developing control strategies.Systematic analysis of available control technologies is required to identify the most feasible ones to curtail the spread of ARGs in the environment.The proposed roadmap under the“One Health”framework provides a guide to tackle antibiotic resistance in the environment.

基于One health理念开展广州市花都区禽类养殖产业链沙门菌本底调查

目的基于One health理念,评估广州市花都区禽类养殖、屠宰和销售过程中沙门菌污染的关键环节和潜在的传播风险。方法采集人群鼻拭子、禽类口腔/泄殖腔拭子样品、环境(空气、土壤、污泥等)样品;根据GB4789.4-2016进行沙门菌增菌、选择性培养,阳性样品进行PCR复筛鉴定和统计分析。结果共采集人、动物、环境样品361份,沙门菌总检出率为11.36%,其中屠宰环节沙门菌检出率最高(18.82%),职业人群鼻拭子沙门菌阳性率(35.00%)显著高于普通人群(0.00%)。不同环境样品间沙门菌阳性率差异有统计学意义(P<0.05),其中污泥样品沙门菌污染最严重(55.56%),空气气溶胶次之(37.50%)。此外,鹦鹉样品沙门菌检出率显著高于家禽(29.17%vs.3.33%),差异有统计学意义(χ^(2)=9.411,P<0.05)。结论屠宰场是沙门菌污染的关键环节,应做好污水和空气消杀,防止沙门菌外溢,职业人群应定期体检。此外,应加强对鹦鹉等特种禽类沙门菌的日常监控。

One Health: navigating plague in Madagascar amidst COVID-19

Background Africa sees the surge of plague cases in recent decades,with hotspots in the Democratic Republic of Congo,Madagascar,and Peru.A rodent-borne scourge,the bacterial infection known as plague is transmitted to humans via the sneaky bites of fleas,caused by Yersinia pestis.Bubonic plague has a case fatality rate of 20.8%with treatment,but in places such as Madagascar the mortality rate can increase to 40–70%without treatment.Main text Tragedy strikes in the Ambohidratrimo district as three lives are claimed by the plague outbreak and three more fight for survival in the hospitals,including one man in critical condition,from the Ambohimiadana,Antsaharasty,and Ampanotokana communes,bringing the total plague victims in the area to a grim to five.Presently,the biggest concern is the potential plague spread among humans during the ongoing COVID-19 pandemic.Effective disease control can be achieved through training and empowering local leaders and healthcare providers in rural areas,implementing strategies to reduce human–rodent interactions,promoting water,sanitation and hygiene practices(WASH)practices,and carrying out robust vector,reservoir and pest control,diversified animal surveillance along with human surveillance should be done to more extensively to fill the lacunae of knowledge regarding the animal to human transmission.The lack of diagnostic laboratories equipped represents a major hurdle in the early detection of plague in rural areas.To effectively combat plague,these tests must be made more widely available.Additionally,raising awareness among the general population through various means such as campaigns,posters and social media about the signs,symptoms,prevention,and infection control during funerals would greatly decrease the number of cases.Furthermore,healthcare professionals should be trained on the latest methods of identifying cases,controlling infections and protecting themselves from the disease.Conclusions Despite being endemic to Madagascar,the outbreak’s pace is unparalleled,and it may spread to non-endemic areas.The utilization of a One Health strategy that encompasses various disciplines is crucial for minimizing catastrophe risk,antibiotic resistance,and outbreak readiness.Collaboration across sectors and proper planning ensures efficient and consistent communication,risk management,and credibility during disease outbreaks.