Enhancing inter-organizational collaboration for wildlife disease surveillance in Sri Lanka.

Management of zoonotic infectious diseases is an urgent global heath imperative. Interdisciplinary approaches for zoonosis management exist in literature, but collaboratively implementing them is a pervasive challenge. The Sri Lanka Wildlife Health Centre (SLWHC) was created in 2011 to coordinate wildlife disease surveillance and response among government agencies. We interviewed SLWHC-affiliated personnel about existing communication and collaboration channels to identify operational needs as well as potential enhancements for the SLWHC's operations. We used the Policy Sciences' analytical framework to identify opportunities and challenges for the SLWHC. Study participants held both human and animal health as the utmost priorities. However, their observations indicate that inter-organizational communication barriers and intra-organizational hierarchies still need to be overcome for the Centre's partnering organizations to collaborate to their fullest potential. Any interventions to enhance the SLWHC's collaborative capacity for detecting and managing zoonotic disease outbreaks could be strengthened by appealing to participants' shared value orientations towards enlightenment and respect. A common interest was the desire to collaborate and combine resources, knowledge and personnel to detect, reduce and prevent the incidence of zoonotic disease outbreaks in Sri Lanka. These lessons about institutionalizing communication have considerable relevance for organizational responses to the current SARS-CoV2 pandemic and other zoonoses.

A Practical Methodology for Disaggregating the Drivers of Drug Costs Using Administrative Data.

BACKGROUND: Prescription drug expenditures represent a significant component of health care costs in Canada, with estimates of $28.8 billion spent in 2014. Identifying the major cost drivers and the effect they have on prescription drug expenditures allows policy makers and researchers to interpret current cost pressures and anticipate future expenditure levels. OBJECTIVES: To identify the major drivers of prescription drug costs and to develop a methodology to disaggregate the impact of each of the individual drivers. METHODS: The methodology proposed in this study uses the Laspeyres approach for cost decomposition. This approach isolates the effect of the change in a specific factor (e.g., price) by holding the other factor(s) (e.g., quantity) constant at the base-period value. The Laspeyres approach is expanded to a multi-factorial framework to isolate and quantify several factors that drive prescription drug cost. Three broad categories of effects are considered: volume, price and drug-mix effects. For each category, important sub-effects are quantified. RESULTS: This study presents a new and comprehensive methodology for decomposing the change in prescription drug costs over time including step-by-step demonstrations of how the formulas were derived. CONCLUSIONS: This methodology has practical applications for health policy decision makers and can aid researchers in conducting cost driver analyses. The methodology can be adjusted depending on the purpose and analytical depth of the research and data availability.

Mainstreaming the social sciences in conservation.

Despite broad recognition of the value of social sciences and increasingly vocal calls for better engagement with the human element of conservation, the conservation social sciences remain misunderstood and underutilized in practice. The conservation social sciences can provide unique and important contributions to society's understanding of the relationships between humans and nature and to improving conservation practice and outcomes. There are 4 barriers-ideological, institutional, knowledge, and capacity-to meaningful integration of the social sciences into conservation. We provide practical guidance on overcoming these barriers to mainstream the social sciences in conservation science, practice, and policy. Broadly, we recommend fostering knowledge on the scope and contributions of the social sciences to conservation, including social scientists from the inception of interdisciplinary research projects, incorporating social science research and insights during all stages of conservation planning and implementation, building social science capacity at all scales in conservation organizations and agencies, and promoting engagement with the social sciences in and through global conservation policy-influencing organizations. Conservation social scientists, too, need to be willing to engage with natural science knowledge and to communicate insights and recommendations clearly. We urge the conservation community to move beyond superficial engagement with the conservation social sciences. A more inclusive and integrative conservation science-one that includes the natural and social sciences-will enable more ecologically effective and socially just conservation. Better collaboration among social scientists, natural scientists, practitioners, and policy makers will facilitate a renewed and more robust conservation. Mainstreaming the conservation social sciences will facilitate the uptake of the full range of insights and contributions from these fields into conservation policy and practice.

College and university environmental programs as a policy problem (part 2): strategies for improvement.

Environmental studies and environmental sciences programs in American and Canadian colleges and universities seek to ameliorate environmental problems through empirical enquiry and analytic judgment. In a companion article (Part 1) we describe the environmental program movement (EPM) and discuss factors that have hindered its performance. Here, we complete our analysis by proposing strategies for improvement. We recommend that environmental programs re-organize around three principles. First, adopt as an overriding goal the concept of human dignity-defined as freedom and social justice in healthy, sustainable environments. This clear higher-order goal captures the human and environmental aspirations of the EPM and would provide a more coherent direction for the efforts of diverse participants. Second, employ an explicit, genuinely interdisciplinary analytical framework that facilitates the use of multiple methods to investigate and address environmental and social problems in context. Third, develop educational programs and applied experiences that provide students with the technical knowledge, powers of observation, critical thinking skills and management acumen required for them to become effective professionals and leaders. Organizing around these three principles would build unity in the EPM while at the same time capitalizing on the strengths of the many disciplines and diverse local conditions involved.

College and university environmental programs as a policy problem (part 1): integrating knowledge, education, and action for a better world?

The environmental sciences/studies movement, with more than 1000 programs at colleges and universities in the United States and Canada, is unified by a common interest-ameliorating environmental problems through empirical enquiry and analytic judgment. Unfortunately, environmental programs have struggled in their efforts to integrate knowledge across disciplines and educate students to become sound problem solvers and leaders. We examine the environmental program movement as a policy problem, looking at overall goals, mapping trends in relation to those goals, identifying the underlying factors contributing to trends, and projecting the future. We argue that despite its shared common interest, the environmental program movement is disparate and fragmented by goal ambiguity, positivistic disciplinary approaches, and poorly rationalized curricula, pedagogies, and educational philosophies. We discuss these challenges and the nature of the changes that are needed in order to overcome them. In a subsequent article (Part 2) we propose specific strategies for improvement.

Production of eosinophil chemoattractant activity by ovine gastrointestinal nematodes.

Eosinophilia is a well documented feature of helminth infections but the precise nature of the interaction between parasite and eosinophil remains an enigma. This paper describes experiments demonstrating that ruminant gastrointestinal trichostrongyles produce potent chemoattractant activity for ovine bone marrow-derived eosinophils in vitro. This activity was initially identified as a constituent of whole worm extracts of third and fourth larval (L3, L4), and adult stages of Teladorsagia circumcincta, and adult Haemonchus contortus. Similar activity was detected in excretory/secretory (E/S) material derived from live T. circumcincta L3. Subsequently, by adapting the assay technique to incorporate live worms directly into the system, it was shown that L3 of both T. circumcincta and H. contortus produced eosinophil chemoattractant activity. In contrast, neither whole worm extracts, or E/S preparations from mixed stages of the free-living nematode Caenorhabditis elegans contained eosinophil chemoattractant activity, and there was no evidence of chemoattractant production by live C. elegans. The results described are challenging to the traditional dogma that eosinophils are host-protective effector cells, and raise the intriguing possibility that ovine nematodes actively encourage recruitment of eosinophils. Local eosinophil-mediated mucosal damage, comparable to that seen in the asthmatic lung, may then provide a permissive local microenvironment for the parasite. Moreover, if they prove important for pathogenicity, nematode chemoattractants could offer future potential as novel therapeutic targets.

Anaplastic large cell lymphoma arising in a silicone breast implant capsule: a case report and review of the literature.

Anaplastic large cell lymphoma is a rare type of primary breast lymphoma. We report a case of anaplastic large cell lymphoma, T-cell phenotype, occurring in the periprosthetic capsule of a silicone breast prosthesis 9 years after implantation for augmentation mammoplasty. This case is unique for its unusual presentation.