One Health operations: a critical component in the International Health Regulations Monitoring and Evaluation Framework.

Under the International Health Regulations (IHR, 2005), a legally binding document adopted by 196 States Parties, countries are required to develop their capacity to rapidly detect, assess, notify and respond to unusual health events of potential international concern. To support countries in monitoring and enhancing their capacities and complying with the IHR (2005), the World Health Organization (WHO) developed the IHR Monitoring and Evaluation Framework (IHR MEF). This framework comprises four complementary components: the State Party Annual Report, the Joint External Evaluation, after-action reviews and simulation exercises. The first two are used to review capacities and the second two to help to explore their functionality. The contribution of different disciplines, sectors, and areas of work, joining forces through a One Health approach, is essential for the implementation of the IHR (2005). Therefore, WHO, in partnership with the Food and Agriculture Organization of the United Nations (FAO), the World Organisation for Animal Health (OIE), and other international and national partners, has actively worked on facilitating the inclusion of the relevant sectors, in particular the animal health sector, in each of the four components of the IHR MEF. Other tools complement the IHR MEF, such as the WHO/OIE IHR-PVS [Performance of Veterinary Services] National Bridging Workshops, which facilitate the optimal use of the results of the IHR MEF and the OIE Performance of Veterinary Services Pathway and create an opportunity for stakeholders from animal health and human health services to work on the coordination of their efforts. The results of these various tools are used in countries' planning processes and are incorporated in their National Action Plan for Health Security to accelerate the implementation of IHR core capacities. The present article describes how One Health is incorporated in all components of the IHR MEF.

En vertu du Règlement sanitaire international (RSI, 2005), instrument juridique ayant force obligatoire pour les 196 États Parties dans le monde, les pays s'engagent à renforcer leurs capacités de détection, d'évaluation, de notification et de réaction en cas d'événements sanitaires inhabituels ou présentant une dimension internationale inquiétante. Le Cadre de suivi et d'évaluation du RSI (2005) a été élaboré par l'Organisation mondiale de la santé (OMS) afin de soutenir les pays souhaitant évaluer et améliorer leurs capacités et leur niveau de conformité avec le RSI (2005). Ce cadre comprend quatre composantes complémentaires : le rapport annuel de l'État Partie, l'Évaluation extérieure conjointe, les examens « après action¼ et les exercices de simulation. Les deux premières composantes permettent de faire le point sur les capacités tandis que les deux dernières visent une connaissance détaillée de leur fonctionnement. La mise en oeuvre du RSI (2005) demande aux différentes disciplines, secteurs et domaines d'activités de fédérer leurs forces dans une approche Une seule santé. Par conséquent, en partenariat avec l'Organisation des Nations Unies pour l'alimentation et l'agriculture (FAO), avec l'Organisation mondiale de la santé animale (OIE) et avec d'autres partenaires internationaux et nationaux, l'OMS a fait en sorte de faciliter l'intégration de tous les secteurs concernés, en particulier celui de la santé animale, dans les diverses composantes du Cadre d'évaluation du RSI. D'autres outils complètent celui-ci, en particulier les ateliers de liaison nationaux OMS/OIE sur le RSI et le Processus d'évaluation des performances des Services vétérinaires (PVS), dont le but est de faciliter l'utilisation optimale des résultats du Cadre d'évaluation du RSI et du Processus PVS de l'OIE et de fournir aux acteurs des services de santé animale et de santé publique la possibilité de se concerter sur les modalités d'une synergie de leur action. Les résultats de ces outils sont ensuite pris en compte par les pays lors des procédures de planification et intégrés dans les Plans d'action nationaux pour la sécurité sanitaire afin d'accélérer la mise en oeuvre des capacités fondamentales décrites dans le RSI. Les auteurs décrivent l'intégration du concept Une seule santé dans chacune des composantes du Cadre d'évaluation du RSI.

Según lo dispuesto en el Reglamento Sanitario Internacional (RSI, 2005), documento jurídicamente vinculante suscrito por 196 Estados Partes, los países están obligados a dotarse de la capacidad necesaria para detectar, evaluar, notificar y afrontar con rapidez todo evento sanitario inusual que pueda revestir importancia internacional. Para ayudar a los países a dotarse de mejores capacidades, a seguir de cerca su evolución al respecto y a dar cumplimiento al RSI (2005), la Organización Mundial de la Salud (OMS) elaboró el marco de seguimiento y evaluación del RSI, que consta de cuatro elementos complementarios: el informe anual que debe presentar cada Estado Parte; la evaluación externa conjunta; exámenes posteriores a las intervenciones; y ejercicios de simulación. Los dos primeros sirven para examinar las capacidades, y los dos segundos para ayudar a estudiar su funcionalidad. Para la aplicación del RSI (2005) es fundamental la contribución de diferentes disciplinas, sectores y ámbitos de trabajo, que aúnen esfuerzos actuando desde los postulados de Una sola salud. Por ello la OMS, en colaboración con la Organización de las Naciones Unidas para la Alimentación y la Agricultura (FAO), la Organización Mundial de Sanidad Animal (OIE) y otros asociados internacionales y nacionales, ha trabajado activamente para facilitar la integración de los sectores pertinentes, en particular el de la sanidad animal, en cada uno de los cuatro componentes del marco de seguimiento y evaluación del RSI. Hay otros dispositivos que vienen a complementar este marco, por ejemplo los talleres nacionales dedicados a la creación de nexos entre el RSI y el proceso PVS (Prestaciones de los Servicios Veterinarios) de la OIE, organizados conjuntamente por la OMS y la OIE, que facilitan un uso idóneo de los resultados del marco de seguimiento y evaluación del RSI y del proceso PVS y brindan a las partes interesadas de los servicios sanitarios y zoosanitarios la oportunidad de trabajar sobre la coordinación de sus respectivas actividades. Los resultados de estas diversas herramientas alimentan después los procesos de planificación de los países y son incorporados a su Plan de acción nacional de seguridad sanitaria para acelerar la implantación de las capacidades básicas prescritas en el RSI. Los autores explican cómo se incorpora la filosofía de Una sola salud a todos los componentes del marco de seguimiento y evaluación del RSI.

The effect of nature exposure on the mental health of patients: a systematic review.

BACKGROUND: The effect of nature-based interventions on self-reported mental well-being in patients with physical disease is gaining increasing attention. However, there is a lack of randomized controlled trials investigating this area. Due to the massive costs in health care systems, there is a need for new strategies to address these issues and an urgent need for attention to this field. Nature-based interventions are low cost, easy to implement, and should get attention within the health care field. Therefore, the objective was to find the impact of nature interventions on mental well-being in humans with a physical disease. METHODS: In four major databases (PubMed, Cinahl, PsycINFO, and Cochrane Library), a systematic review of quantitative studies of nature's impact on self-reported mental health in patients with physical disease was performed. A total of 1909 articles were retrieved but only five met the inclusion criteria and were summarized. RESULTS: All five studies were quantitative, with a control group and a nature-based intervention. A source of heterogeneity was identified: the patients in one of the five studies were psychosomatic. In the four studies with somatic patients, significant benefit of nature on self-reported mental health outcomes was found; the only study that failed to show a significant benefit was the one with psychosomatic patients. CONCLUSION: A significant effect of nature on mental well-being of patients with somatic disease was found. The result in patients with psychosomatic disease is inconclusive, and more studies in this category are needed. Further research on the effect of nature on mental health is merited, with special attention to standardizing intervention type and dose as well as outcome measures within each medical discipline.

First detection of Macrorhabdus ornithogaster in wild Eurasian Siskins (Carduelis spinus) in Germany. A case study.

OBJECTIVE: The colonization of the gastric ascomycetous yeast Macrorhabdus (M.) ornithogaster could be associated with a chronic wasting disease in several bird species in captivity. The prevalence and clinical relevance of M. ornithogaster in wild birds is unknown in detail. MATERIAL AND METHODS: In the wintering season 2012/13 injured Eurasian Siskins (Carduelis spinus, n = 8) from the area of Hannover, Lower Saxony, Germany were examined microbiologically and pathologically. RESULTS: In six out of eight injured Eurasian Siskins M. ornithogaster were detected. The yeast was diagnosed microscopically in wet smears from the gastric isthmus and/or in faecal samples. Histopathological examination (n = 4) of the macroscopically slightly enlarged proventriculus in infected birds demonstrated the growth of M. ornithogaster in the mucosal surface and in the ducts of the glands without an inflammatory reaction. As a possible sign of a lowered fitness, all six infected siskins had a reduced body weight (mean: 11.8 ± 1.64 g) in the lower normal weight range compared to the two injured Eurasian Siskins without M. ornithogaster (15.0 g) as well as to data from the literature. Concurrent intestinal bacterial infections comprised Escherichia coli, Clostridium perfringens or Salmonella Typhimurium, that are regarded as an abnormal bacterial flora for Eurasian Siskins. CONCLUSION AND CLINICAL RELEVANCE: Infections with M. ornithogaster can be found in the wild population of Eurasian Siskins in Germany. The frequent occurrence of secondary bacterial infections associated with M. ornithogaster infections should be considered in the treatment and rehabilitation of finches.

Experiencing flow in different types of physical activity intervention programs: three randomized studies.

This study explores whether inactive individuals can experience flow, a rewarding, psychological state, during an exercise intervention and if there are differences according to the type of intervention they perform. Furthermore, the study investigates if experiencing flow is connected to physiological improvements attained during the exercise intervention. The 12- to 16-week interventions included six randomized intervention groups, two female and four male groups performing continuous running, football, interval running and strength training. The results indicate that all six randomized exercise intervention groups experience rather high levels of flow regardless of whether the intervention is a team or individual sport. Differences in experiencing flow, worry and exertion as well as physiological improvements could be found for the different types of sports and the two genders, with the male football group having the highest score for physiological improvement and the lowest score for worry. A connection between experiencing flow and physiological improvement could not be found. Future research should investigate the influence that the participant's gender and also the type of sport have on experiencing flow, worry and perceived exertion. Furthermore, it should be investigated whether experiencing flow is linked to the long-term compliance of regular physical activity.

The group matters: an explorative study of group cohesion and quality of life in cancer patients participating in physical exercise intervention during treatment.

A series of studies have shown that physical activity improves cancer patients functional capacity and quality of life (QOL). Few of these studies have included physical exercise carried out in a group setting. However, patient's experience with the in-group processes remains unexplored. This study investigated group cohesion and changes in QOL in 55 cancer patients undergoing chemotherapy who participated in a 9 h weekly group exercise programme for 6 weeks. The study used a method triangulation component design. Seven qualitative group interviews were conducted post-intervention. QOL (SF-36; EORTC QLQ-C30) was assessed at baseline and after Week 6. The interviews revealed that group cohesion was an interim goal aimed to maximize peak performance potential by patients. Group cohesion was characterized by a special 'esprit de corps' and enabled the group members to feel like sport teams. The programme made purposeful togetherness possible while allowing the patients an opportunity to let their illness fade into the background. Questionnaire data showed significant improvements in mental health, social and emotional functioning. This study identified a conceptualization of group cohesion that forms a valuable basis for a larger randomized controlled trial to conclude whether the observed changes are a result of this specific intervention.