From "one medicine" to "one health" and systemic approaches to health and well-being.
From "one medicine" to "one health" and systemic approaches to health and well-being.
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DOI：
10.1016/j.prevetmed.2010.07.003
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发表时间：
2011-09-01
影响因子：
2.6
通讯作者：
Tanner M
中科院分区：
文献类型：
--
作者：
Zinsstag J;Schelling E;Waltner-Toews D;Tanner M
面对复杂的全球变化模式，人类、宠物、牲畜和野生动物及其社会和生态环境之间不可分割的相互联系是显而易见的，需要对人类和动物的健康及其各自的社会和环境背景采取综合办法。本文简要回顾了人类和动物健康综合思想的历史，从早期的历史时期，到欧洲大学的建立，再到世纪末比较医学的兴起。世纪，卡尔文施瓦贝提出了“一药”的概念。它认识到人类医学和兽医学之间没有范式差异，两个学科都可以促进彼此的发展。考虑到对社会的健康和福祉采取更广泛的做法，通过在不同环境中的实际实施和认真验证，将“一种药物”的最初概念扩展为“一种健康”。鉴于近几十年来的全球健康思想，已经出现了生态系统健康方法。这些方法基于超越人类和动物的复杂生态思维，考虑到生态系统与健康之间不可分割的联系，称为“生态系统健康”。尽管有这些综合性的概念和方法的发展，大部分的人类和动物健康的思想和行动仍然停留在单独的学科筒仓。然而，与分散的部门思维相比，现在有越来越多的证据表明，连贯一致地应用“一个健康”具有附加值。学术课程、临床实践、卫生部和畜牧/农业部以及国际组织越来越多地考虑综合思维。挑战仍然存在，重点围绕关键问题，如“一个健康”如何演变，以及现代健康理论的要素是什么？人类和动物在其社会和生态背景下的密切相互依存关系涉及“人类-环境系统”的概念，也称为“社会-生态系统”。在社会生态系统背景下理解和管理人类活动的理论和实践已由复原力联盟成员完善发展，并在千年生态系统评估中得到广泛使用，包括其关于人类福祉成果的工作。这反过来又需要将系统理论应用于人类和动物健康。成功的公共卫生系统方法的例子显示出意想不到的结果。类似于“系统生物学”，主要集中在蛋白质和分子在亚细胞水平上的相互作用，社会生态系统（HSES）中的健康系统方法是对所有健康相关领域中复杂相互作用的跨学科和跨学科研究。HSES超越了“一个健康”和“生态健康”，期望确定新出现的健康特性和决定因素，这些特性和决定因素可能来自从分子到生态和社会文化背景的系统观点，以及与不同疾病地方性和卫生系统结构的比较。
Faced with complex patterns of global change, the inextricable interconnection of humans, pet animals, livestock and wildlife and their social and ecological environment is evident and requires integrated approaches to human and animal health and their respective social and environmental contexts. The history of integrative thinking of human and animal health is briefly reviewed from early historical times, to the foundation of universities in Europe, up to the beginning of comparative medicine at the end of the 19th century. In the 20th century, Calvin Schwabe coined the concept of “one medicine”. It recognises that there is no difference of paradigm between human and veterinary medicine and both disciplines can contribute to the development of each other. Considering a broader approach to health and well-being of societies, the original concept of “one medicine” was extended to “one health” through practical implementations and careful validations in different settings. Given the global health thinking in recent decades, ecosystem approaches to health have emerged. Based on complex ecological thinking that goes beyond humans and animals, these approaches consider inextricable linkages between ecosystems and health, known as “ecosystem health”. Despite these integrative conceptual and methodological developments, large portions of human and animal health thinking and actions still remain in separate disciplinary silos. Evidence for added value of a coherent application of “one health” compared to separated sectorial thinking is, however, now growing. Integrative thinking is increasingly being considered in academic curricula, clinical practice, ministries of health and livestock/agriculture and international organizations. Challenges remain, focusing around key questions such as how does “one health” evolve and what are the elements of a modern theory of health? The close interdependence of humans and animals in their social and ecological context relates to the concept of “human-environmental systems”, also called “social-ecological systems”. The theory and practice of understanding and managing human activities in the context of social-ecological systems has been well-developed by members of The Resilience Alliance and was used extensively in the Millennium Ecosystem Assessment, including its work on human well-being outcomes. This in turn entails systems theory applied to human and animal health. Examples of successful systems approaches to public health show unexpected results. Analogous to “systems biology” which focuses mostly on the interplay of proteins and molecules at a sub-cellular level, a systemic approach to health in social-ecological systems (HSES) is an inter- and trans-disciplinary study of complex interactions in all health-related fields. HSES moves beyond “one health” and “eco-health”, expecting to identify emerging properties and determinants of health that may arise from a systemic view ranging across scales from molecules to the ecological and socio-cultural context, as well from the comparison with different disease endemicities and health systems structures.
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影响因子：
11.8
作者：
Kahn, LH
通讯作者：
Kahn, LH
DOI：
10.1073/pnas.0702288104
发表时间：
2007-09-25
影响因子：
11.1
作者：
Ostrom, Elinor
通讯作者：
Ostrom, Elinor
影响因子：
3.3
作者：
Graham, Jay P.;Leibler, Jessica H.;Silbergeld, Ellen K.
通讯作者：
Silbergeld, Ellen K.
影响因子：
5.4
作者：
Rock, Melanie;Buntain, Bonnie J.;Hallgrimsson, Benedikt
通讯作者：
Hallgrimsson, Benedikt
影响因子：
5.5
作者：
Mabry, Patricia L.;Olster, Deborah H.;Morgan, Glen D.;Abrams, David B.
通讯作者：
Abrams, David B.