Designing graduate training programs in conservation medicine-producing the right professionals with the right tools.

New challenges to human, animal, and ecosystem health demand novel solutions: New diseases are emerging from new configurations of humans, their domestic animals and wildlife; new pressures on once robust and resilient ecosystems are compromising their integrity; synthetic compounds and engineered organisms, new to the natural world, are spreading unpredictably around the globe. Globalization provides opportunities for infectious organisms to gain access to new hosts, changing in distribution and virulence. What type of training should be developed to provide professionals with the right tools to meet these challenges? In this article, we offer recommendations for developing academic programs in conservation medicine. We discuss the need for, and the advantages to, using a conservation medicine approach to address real world situations and present illustrations of how this is applied today. We suggest a core set of skills that are needed in a conservation medicine practitioner, and recommend key considerations for designing new conservation medicine training programs. We review existing programs that offer conservation medicine content, and provide examples of where opportunities exist for those interested in pursuing a conservation medicine career

Preparing society to create the world we need through“One Health”education

A previous concept paperpublished in this journal and a Press Release in June 2016 focused on the importance of raising awareness about the UN-2030 Sustainable Development Goals (SDGs) and, in particular, developing a better understanding about the critical need to ensure the sustainability of people and the planet in this decade and beyond. A recurring theme that weaves through the literature and practical realities is that education presents the best option for ensuring a sustainable future– one that encompasses the health and well-being of humans, animals and the environment (One Health!). To this end, the One Health Education Task Force (OHETF), led by the One Health Commission in association with the One Health Initiative, agreed to conduct an online survey and conference in the fall of 2016to engage interested colleagues in a discussion about the possible application of One Health in K-12 (or equivalent) educational settings. Seventy-six people from around the world participated in the survey which focused on basic concepts, values and principles associated with One Health and Well-Being.  Input was sought on the various ways that One Health intersects with the UN Sustainable Development Goals and how they might work together toward common objectives.Questions also explored the why, how, and where One Health could be incorporated into K-12 curricula, and who should be involved in creating this new curriculum.  The survey also addressed the challenges that might be encountered in gaining support, funding and implementing a One Health and Well-Being curriculum globally. Overall, there was a great deal of agreement among participants as to the priorities and major challenges that would be encountered in moving this initiative forward and, most importantly, that this type of initiative is greatly needed. The online conference involved twenty-five participants, including ten who had also participatedin the survey, and others who had shown interest in previous publications and presentations on this topic.  The conference was designed to present the results of the survey and conduct a more in depth discussion about potential curriculum development designs, funding sources, and implementation challenges.  Five strategies were presented for K-12 One Health curriculum innovation, from teacher training programs and grants, to the development of a digital sharing network and knowledgebase.  Funding options were discussed and included multi-national organizations such as the United Nations and World Bank as well as large foundations that have funded major change initiatives in the past.  Critical points were made regarding the scope of this initiative and the need to integrate any curriculum with the diverse needs of local people, their cultures, and the particular One Health challenges facing their region. Importantly, a “Community of Practice” model was put forward as a means to support and promote the goals of One Health teaching and learning in a meaningful and supportive way for the benefit of all involved. This survey and conference provided valuable external input and support for the OHETF’s proposal to develop a global K-12 One Health -themed educational initiative. The perspectives reported here are also a useful account of the progress we have made as a One Health community in consolidating our values and principles so that they can drive meaningful change initiatives such as that being proposed. &nbsp

Preparing society to create the world we need through“One Health”education

A previous concept paperpublished in this journal and a Press Release in June 2016 focused on the importance of raising awareness about the UN-2030 Sustainable Development Goals (SDGs) and, in particular, developing a better understanding about the critical need to ensure the sustainability of people and the planet in this decade and beyond. A recurring theme that weaves through the literature and practical realities is that education presents the best option for ensuring a sustainable future– one that encompasses the health and well-being of humans, animals and the environment (One Health!). To this end, the One Health Education Task Force (OHETF), led by the One Health Commission in association with the One Health Initiative, agreed to conduct an online survey and conference in the fall of 2016to engage interested colleagues in a discussion about the possible application of One Health in K-12 (or equivalent) educational settings.Seventy-six people from around the world participated in the survey which focused on basic concepts, values and principles associated with One Health and Well-Being.  Input was sought on the various ways that One Health intersects with the UN Sustainable Development Goals and how they might work together toward common objectives.Questions also explored the why, how, and where One Health could be incorporated into K-12 curricula, and who should be involved in creating this new curriculum.  The survey also addressed the challenges that might be encountered in gaining support, funding and implementing a One Health and Well-Being curriculum globally. Overall, there was a great deal of agreement among participants as to the priorities and major challenges that would be encountered in moving this initiative forward and, most importantly, that this type of initiative is greatly needed.The online conference involved twenty-five participants, including ten who had also participatedin the survey, and others who had shown interest in previous publications and presentations on this topic.  The conference was designed to present the results of the survey and conduct a more in depth discussion about potential curriculum development designs, funding sources, and implementation challenges.  Five strategies were presented for K-12 One Health curriculum innovation, from teacher training programs and grants, to the development of a digital sharing network and knowledgebase.  Funding options were discussed and included multi-national organizations such as the United Nations and World Bank as well as large foundations that have funded major change initiatives in the past.  Critical points were made regarding the scope of this initiative and the need to integrate any curriculum with the diverse needs of local people, their cultures, and the particular One Health challenges facing their region. Importantly, a “Community of Practice” model was put forward as a means to support and promote the goals of One Health teaching and learning in a meaningful and supportive way for the benefit of all involved.This survey and conference provided valuable external input and support for the OHETF’s proposal to develop a global K-12 One Health -themed educational initiative. The perspectives reported here are also a useful account of the progress we have made as a One Health community in consolidating our values and principles so that they can drive meaningful change initiatives such as that being proposed. 

Wildlife Tuberculosis: An Emerging Threat for Conservation in South Asia

Wildlife tuberculosis (TB) is becoming one of the emerging challenges for conservation globally. South Asian region is home to many endangered species like Asian elephants, rhinoceros, and Bengal tigers. Although it carries more than one‐third of global burden of human TB, TB in livestock and wildlife has not been adequately studied. This chapter reviews the present knowledge and information about animal‐adapted members of Mycobacterium tuberculosis complex and wildlife TB in South Asia. Recent studies of TB from different wild animals in Nepal and Bangladesh have found that M.orygis is an emerging threat of wildlife TB in the region. These studies have demonstrated wide diversity of M. orygis strains circulating in the region indicating its endemic distribution. M. orygis–associated TB was discovered from a free‐ranging rhinoceros in Nepal and the finding could signify threat of TB in other wild animals, including a possibility of unknown maintenance host. Recent studies also revealed an emerging challenge caused by TB to elephants in different South Asian countries like Nepal, India, and Sri Lanka. Wildlife TB is becoming a conservation challenge in South Asia, but given the paucity of research in this area, it is overlooked and underexplored

Treatment of Cryptococcal Meningitis with Combination Amphotericin B and Flucytosine for Four as Compared with Six Weeks

Abstract One hundred ninety-four patients with cryptococcal meningitis were enrolled in a multicenter, prospective, randomized clinical trial to compare the efficacy and toxicity of four as compared with six weeks of combination amphotericin B and flucytosine therapy. Among 91 patients who met preestablished criteria for randomization, cure or improvement was noted in 75 percent of those treated for four weeks and in 85 percent of those treated for six weeks. The estimated relapse rate for the four-week regimen was higher — 27 as compared with 16 percent — whereas the incidence of toxic effects for the two regimens was similar — 44 as compared with 43 percent. Among 23 transplant recipients, 4 of 5 treated for four weeks relapsed, leading to the decision to treat the rest of the group for six weeks. Only 3 of the 18 treated for six weeks relapsed. In a third group of 80 patients, the protocol was not followed during the initial four weeks, and these patients were not randomized. Thirty-eight died or relapsed. Multifactorial analysis of pretreatment factors for all 194 patients identified three significant predictors (P These and other findings in this study are consistent with the view that the four-week regimen should be reserved for patients who have meningitis without neurologic complications, underlying disease, or immunosuppressive therapy; a pretreatment cerebrospinal fluid white-cell count above 20 per cubic millimeter and a serum cryptococcal antigen titer below 1:32; and at four weeks of therapy, a negative cerebrospinal fluid India ink preparation and serum and cerebrospinal fluid cryptococcal-antigen titers below 1:8. Patients who do not meet these criteria should receive at least six weeks of therapy. (N Engl J Med 1987; 317:334–41.

Designing graduate training programs in conservation medicine-producing the right professionals with the right tools.

New challenges to human, animal, and ecosystem health demand novel solutions: New diseases are emerging from new configurations of humans, their domestic animals and wildlife; new pressures on once robust and resilient ecosystems are compromising their integrity; synthetic compounds and engineered organisms, new to the natural world, are spreading unpredictably around the globe. Globalization provides opportunities for infectious organisms to gain access to new hosts, changing in distribution and virulence. What type of training should be developed to provide professionals with the right tools to meet these challenges? In this article, we offer recommendations for developing academic programs in conservation medicine. We discuss the need for, and the advantages to, using a conservation medicine approach to address real world situations and present illustrations of how this is applied today. We suggest a core set of skills that are needed in a conservation medicine practitioner, and recommend key considerations for designing new conservation medicine training programs. We review existing programs that offer conservation medicine content, and provide examples of where opportunities exist for those interested in pursuing a conservation medicine career

Curriculum Asset Mapping for One Health Education

The major premise of One Health is engagement of multiple disciplines to address shared problems spanning human, animal, and ecosystem health. The current model of academic specialization encourages development of isolated disciplines within the university setting, thereby creating barriers to resource sharing and academic collaboration. The aim of this project was to develop a systematic approach to mapping university assets that could be harnessed to advance One Health education. Asset in this context was defined as a course, program, or faculty expertise relevant to a particular One Health problem. The approach adopted comprised the following steps: (1) identify a current problem that would benefit from an integrated, interdisciplinary perspective (e.g., EIDs [emerging infectious diseases]); (2) identify individual disciplinary teaching areas pertinent to the problem (e.g., health communication, wildlife ecology); (3) identify competencies expected to be attained by graduates who will address the problem (e.g., respond to outbreaks); (4) survey faculty members on their teaching areas and curricular offerings that address these competencies; and (5) compile responses in a database that is searchable by teaching area and competency. We discuss our recent experiences mapping the assets at Tufts University that are relevant to the problem of EIDs with emphasis on zoonotic-disease surveillance, outbreak investigation, and outbreak response. Using 13 teaching areas and 16 competencies relevant to applied epidemiology, we identified and characterized previously untapped resources across the university. Asset mapping is thus a useful tool for identifying university resources and opportunities that can be leveraged to support interdisciplinary education for One Health. </jats:p