Meanings and Mechanisms of One Health Partnerships: Insights from a Critical Review of Literature on Cross-government Collaborations

Key messages Multisector collaborations are complex political enterprises, which incorporate within themselves, different visions around, objectives, mandates, function and success. Collaborations can take various forms which allow practitioners to choose the form of collaboration that is most relevant to their requirements. Most collaborations consist of partners who pursue different individual and institutional agenda and who exercise different amounts of influence. Collaborations should learn how to manage rather than minimize these differences. While there are no fixed parameters for success, given the dynamic contexts within which multisector collaborations function, they can result in unintended outcomes. Collaborations that are responsive to changing internal and external dynamics are more likely to thrive.Complex health policy challenges such as antimicrobial resistance and other emerging infections are driven by activities in multiple sectors. Therefore, addressing these also requires joint efforts from multiple sectors as exemplified in the One Health approach. We undertake a critical review to examine the different ways in which multisector partnerships have been conceptualized across multiple disciplines and thematic areas. We started with a set of six articles from the disciplines of health, nutrition and public administration that reviewed conceptual frameworks within their respective fields. We conducted backward citation tracing using the bibliography of the six articles to identify other articles in the same and related fields that conceptualized multisector partnerships. We identified 58 articles published from 1967 to 2018 from the fields of global health, infectious diseases, management, nutrition and sustainability sciences indicating that multisector partnerships have been a topic of study across different fields for several decades. A thematic analysis of the 58 articles revealed that multisector partnerships assume a variety of forms and have been described in different ways. Partnerships can be categorized by scope, scale, formality and strength. Multisector partnerships emerge in conditions of dynamic uncertainty and sector failure when the information and resources required are beyond the capacities of any individual sector. Such partnerships are inherently political in nature and subsume multiple competing agendas of collaborating actors. Sustaining collaborations over a long period of time will require collaborative approaches like One Health to accommodate competing political perspectives and include flexibility to allow multisector partnerships to respond to changing external dynamics

Meanings and mechanisms of One Health partnerships: insights from a critical review of literature on cross-government collaborations

Complex health policy challenges such as antimicrobial resistance and other emerging infections are driven by activities in multiple sectors. Therefore, addressing these also requires joint efforts from multiple sectors as exemplified in the One Health approach. We undertake a critical review to examine the different ways in which multisector partnerships have been conceptualized across multiple disciplines and thematic areas. We started with a set of six articles from the disciplines of health, nutrition and public administration that reviewed conceptual frameworks within their respective fields. We conducted backward citation tracing using the bibliography of the six articles to identify other articles in the same and related fields that conceptualized multisector partnerships. We identified 58 articles published from 1967 to 2018 from the fields of global health, infectious diseases, management, nutrition and sustainability sciences indicating that multisector partnerships have been a topic of study across different fields for several decades. A thematic analysis of the 58 articles revealed that multisector partnerships assume a variety of forms and have been described in different ways. Partnerships can be categorized by scope, scale, formality and strength. Multisector partnerships emerge in conditions of dynamic uncertainty and sector failure when the information and resources required are beyond the capacities of any individual sector. Such partnerships are inherently political in nature and subsume multiple competing agendas of collaborating actors. Sustaining collaborations over a long period of time will require collaborative approaches like One Health to accommodate competing political perspectives and include flexibility to allow multisector partnerships to respond to changing external dynamics

Developing Jungle Perch Fingerling Production to Improve Fishing Opportunities

This project has for the first time demonstrated the feasibility of hatchery production of jungle perch fingerlings. The research on jungle perch production has enabled a hatchery production manual with accompanying videos to be produced. This has given private commercial hatcheries the information needed to produce jungle perch fingerlings. Several hatcheries have already indicated an interest in producing jungle perch and will be assisted to do so in 2016. Currently jungle perch are not a permitted stocking species, so cannot be sold to fish stocking groups. However, hatcheries will be able to sell fingerlings to the aquarium trade or supply grow out facilities that could produce jungle perch for human consumption. Should jungle perch become a permitted species for stocking, this will provide hatcheries with a major new product option to sell to fish stocking groups. It would also benefit anglers by providing another iconic species for impoundment stocking programs. This could have flow-on benefits to regional economies through angler tourism. Should the pilot reintroductions of jungle perch into streams result in self-sustaining jungle perch populations, then there will be three restored jungle perch populations close to major population centres. This will create a new opportunity for anglers not normally able to target jungle perch. Since the majority of anglers who target jungle perch are catch and release fishers, angling is expected to have minimal impact on recovery of the populations. This project led to the development of a hatchery manual for jungle perch production and to a summary brochure. In late 2014 and in 2015 researchers were able to make the first ever releases of jungle perch fingerlings back into rivers and streams within their historical range

Developing Jungle Perch Fingerling Production to Improve Fishing Opportunities

This project has for the first time demonstrated the feasibility of hatchery production of jungle perch fingerlings. The research on jungle perch production has enabled a hatchery production manual with accompanying videos to be produced. This has given private commercial hatcheries the information needed to produce jungle perch fingerlings. Several hatcheries have already indicated an interest in producing jungle perch and will be assisted to do so in 2016. Currently jungle perch are not a permitted stocking species, so cannot be sold to fish stocking groups. However, hatcheries will be able to sell fingerlings to the aquarium trade or supply grow out facilities that could produce jungle perch for human consumption. Should jungle perch become a permitted species for stocking, this will provide hatcheries with a major new product option to sell to fish stocking groups. It would also benefit anglers by providing another iconic species for impoundment stocking programs. This could have flow-on benefits to regional economies through angler tourism. Should the pilot reintroductions of jungle perch into streams result in self-sustaining jungle perch populations, then there will be three restored jungle perch populations close to major population centres. This will create a new opportunity for anglers not normally able to target jungle perch. Since the majority of anglers who target jungle perch are catch and release fishers, angling is expected to have minimal impact on recovery of the populations. This project led to the development of a hatchery manual for jungle perch production and to a summary brochure. In late 2014 and in 2015 researchers were able to make the first ever releases of jungle perch fingerlings back into rivers and streams within their historical range

Pain after upper limb surgery under peripheral nerve block is associated with gut microbiome composition and diversity

peer-reviewedGut microbiota play a role in certain pain states. Hence, these microbiota also influence somatic pain. We aimed to determine if there was an association between gut microbiota (composition and diversity) and postoperative pain. Patients (n = 20) undergoing surgical fixation of distal radius fracture under axillary brachial plexus block were studied. Gut microbiota diversity and abundance were analysed for association with: (i) a verbal pain rating scale of < 4/10 throughout the first 24 h after surgery (ii) a level of pain deemed “acceptable” by the patient during the first 24 h following surgery (iii) a maximum self-reported pain score during the first 24 h postoperatively and (iv) analgesic consumption during the first postoperative week. Analgesic consumption was inversely correlated with the Shannon index of alpha diversity. There were also significant differences, at the genus level (including Lachnospira), with respect to pain being “not acceptable” at 24 h postoperatively. Porphyromonas was more abundant in the group reporting an acceptable pain level at 24 h. An inverse correlation was noted between abundance of Collinsella and maximum self-reported pain score with movement. We have demonstrated for the first time that postoperative pain is associated with gut microbiota composition and diversity. Further work on the relationship between the gut microbiome and somatic pain may offer new therapeutic targets

The International Health Partnership Plus: rhetoric or real change? Results of a self-reported survey in the context of the 4th High Level Forum on Aid Effectiveness in Busan.

BACKGROUND: The Paris Declaration on Aid Effectiveness, which provides an international agreement on how to deliver aid, has recently been reviewed by the Organization for Economic Co-operation and Development (OECD). Health sector aid effectiveness is important, given the volume of financial aid and the number of mechanisms through which health assistance is provided. Recognizing this, the international community created the International Health Partnership (IHP+), to apply the Paris Declaration to the health sector. This paper, which presents findings from an independent monitoring process (IHP+Results), makes a valuable contribution to the literature in the context of the recent 4th High Level Forum on Aid Effectiveness in Busan, Korea. METHODS: IHP+Results monitored commitments made under the IHP + using an agreed framework with twelve measures for IHP + Development Partners and ten for IHP + recipient country governments. Data were collected through self-administered survey tools. IHP+Results analyzed these data, using transparent criteria, to produce Scorecards as a means to highlight progress against commitments and thereby strengthen mutual accountability amongst IHP + signatories. RESULTS: There have been incremental improvements in the strengthening of national planning processes and principles around mutual accountability. There has also been progress in Development Partners aligning their support with national budgets. But there is a lack of progress in the use of countries' financial management and procurement systems, and in the integration of duplicative performance reporting frameworks and information systems. DISCUSSION AND CONCLUSIONS: External, independent monitoring is potentially useful for strengthening accountability in health sector aid. While progress in strengthening country ownership, harmonisation and alignment seems evident, there are ongoing challenges. In spite of some useful findings, there are limitations with IHP + monitoring that need to be addressed. This is not surprising given the challenge of rigorously monitoring Development Partners across multiple recipient countries within complex global systems. The findings presented here suggest that the health sector is ahead of the game--in terms of having an established mechanism to promote alignment and harmonisation, and a relatively advanced monitoring framework and methods. But to capitalise on this, IHP + signatories should: a) reaffirm their commitments to the IHP+; b) actively embrace and participate in monitoring and evaluation processes; and c) strengthen in-country capacity notably amongst civil society organizations

Cyclic Glycine-Proline (cGP) Normalises Insulin-Like Growth Factor-1 (IGF-1) Function: Clinical Significance in the Ageing Brain and in Age-Related Neurological Conditions

Insulin-like growth factor-1 (IGF-1) function declines with age and is associated with brain ageing and the progression of age-related neurological conditions. The reversible binding of IGF-1 to IGF binding protein (IGFBP)-3 regulates the amount of bioavailable, functional IGF-1 in circulation. Cyclic glycine-proline (cGP), a metabolite from the binding site of IGF-1, retains its affinity for IGFBP-3 and competes against IGF-1 for IGFBP-3 binding. Thus, cGP and IGFBP-3 collectively regulate the bioavailability of IGF-1. The molar ratio of cGP/IGF-1 represents the amount of bioavailable and functional IGF-1 in circulation. The cGP/IGF-1 molar ratio is low in patients with age-related conditions, including hypertension, stroke, and neurological disorders with cognitive impairment. Stroke patients with a higher cGP/IGF-1 molar ratio have more favourable clinical outcomes. The elderly with more cGP have better memory retention. An increase in the cGP/IGF-1 molar ratio with age is associated with normal cognition, whereas a decrease in this ratio with age is associated with dementia in Parkinson disease. In addition, cGP administration reduces systolic blood pressure, improves memory, and aids in stroke recovery. These clinical and experimental observations demonstrate the role of cGP in regulating IGF-1 function and its potential clinical applications in age-related brain diseases as a plasma biomarker for—and an intervention to improve—IGF-1 function

Cyclic Glycine-Proline (cGP) Normalises Insulin-Like Growth Factor-1 (IGF-1) Function: Clinical Significance in the Ageing Brain and in Age-Related Neurological Conditions

Insulin-like growth factor-1 (IGF-1) function declines with age and is associated with brain ageing and the progression of age-related neurological conditions. The reversible binding of IGF-1 to IGF binding protein (IGFBP)-3 regulates the amount of bioavailable, functional IGF-1 in circulation. Cyclic glycine-proline (cGP), a metabolite from the binding site of IGF-1, retains its affinity for IGFBP-3 and competes against IGF-1 for IGFBP-3 binding. Thus, cGP and IGFBP-3 collectively regulate the bioavailability of IGF-1. The molar ratio of cGP/IGF-1 represents the amount of bioavailable and functional IGF-1 in circulation. The cGP/IGF-1 molar ratio is low in patients with age-related conditions, including hypertension, stroke, and neurological disorders with cognitive impairment. Stroke patients with a higher cGP/IGF-1 molar ratio have more favourable clinical outcomes. The elderly with more cGP have better memory retention. An increase in the cGP/IGF-1 molar ratio with age is associated with normal cognition, whereas a decrease in this ratio with age is associated with dementia in Parkinson disease. In addition, cGP administration reduces systolic blood pressure, improves memory, and aids in stroke recovery. These clinical and experimental observations demonstrate the role of cGP in regulating IGF-1 function and its potential clinical applications in age-related brain diseases as a plasma biomarker for&mdash;and an intervention to improve&mdash;IGF-1 function