One Health (OH) recognizes the interconnectedness of humans, animals, and their shared environment and mobilizes multiple sectors to achieve sustainable and optimal health outcomes. We synthesized current OH implementations at global, regional, national, and local community levels using the OH Joint Plan of Action (OH JPA) developed to enhance best practices in OH implementation. We applied the OH JPA Theory of Change, supported by three pathways mapped out across six action tracks to guide our review. Searches were conducted in PubMed, Embase and Scopus. Eligibility of studies was based on implementation of OH undertaken across two or more sectors within the human-animal-environment interface. Selection was guided by the PRISMA-ScR. Of the 54 studies, 77 unique programs reported OH implementations, and of these, 42 (54.5 %) involved human and animal sectors only. No studies involved the environment sector and its impact on human-environment or animal-environment. The majority (90.9 %) of programs incorporated at least one aspect of policy, legislation, advocacy and financing (Pathway 1). Capacity development, community engagement, multisectoral coordination, collaboration or communication was identified in 96.1 % of programs (Pathway 2). Data, evidence and knowledge featured in 60 % of OH initiatives (Pathway 3). Pathway 2 was the most engaged pathway building the foundation for OH implementation and action. There is opportunity for further growth concerning community engagement, monitoring and evaluation strategies with enhanced future investment for implementation of community-centric and risk-based solutions. Furthermore, it is important to foster better understanding of environmental issues and to build capacity for the environment sector to be better represented in the implementation of OH.

The study evaluated individual and setting-specific factors that moderate clinicians’ perception regarding use of clinical decision support systems (CDSS) for antibiotic management. A cross-sectional online survey examined clinicians’ perceptions about CDSS implementation for antibiotic management in Australia. Multivariable logistic regression determined the association between drivers of CDSS adoption and different moderators. Clinical experience, CDSS use and care setting were important predictors of clinicians’ perception concerning CDSS adoption. Compared to nonusers, CDSS users were less likely to lack confidence in CDSS (OR = 0.63, 95%, CI = 0.32, 0.94) and consider it a threat to professional autonomy (OR = 0.47, 95%, CI = 0.08, 0.83). Conversely, there was higher likelihood in experienced clinicians (>20 years) to distrust CDSS (OR = 1.58, 95%, CI = 1.08, 2.23) due to fear of comprising their clinical judgement (OR = 1.68, 95%, CI = 1.27, 2.85). In primary care, clinicians were more likely to perceive time constraints (OR = 1.96, 95%, CI = 1.04, 3.70) and patient preference (OR = 1.84, 95%, CI = 1.19, 2.78) as barriers to CDSS adoption for antibiotic prescribing. Our findings provide differentiated understanding of the CDSS implementation landscape by identifying different individual, organisational and system-level factors that influence system adoption. The individual and setting characteristics can help understand the variability in CDSS adoption for antibiotic management in different clinicians.

SUMMARY: Changing trends in foodborne disease are influenced by many factors, including temperature. Globally and in Australia, warmer ambient temperatures are projected to rise if climate change continues.Salmonellaspp. are a temperature-sensitive pathogen and rising temperature can have a substantial effect on disease burden affecting human health. We examined the relationship between temperature andSalmonellaspp. and serotype notifications in Adelaide, Australia. Time-series Poisson regression models were fit to estimate the effect of temperature during warmer months onSalmonellaspp. and serotype cases notified from 1990 to 2012. Long-term trends, seasonality, autocorrelation and lagged effects were included in the statistical models. DailySalmonellaspp. counts increased by 1·3% [incidence rate ratio (IRR) 1·013, 95% confidence interval (CI) 1·008–1·019] per 1 °C rise in temperature in the warm season with greater increases observed in specific serotype and phage-type cases ranging from 3·4% (IRR 1·034, 95% CI 1·008–1·061) to 4·4% (IRR 1·044, 95% CI 1·024–1·064). We observed increased cases ofS. Typhimurium PT9 andS. Typhimurium PT108 notifications above a threshold of 39 °C. This study has identified the impact of warm season temperature on differentSalmonellaspp. strains and confirms higher temperature has a greater effect on phage-type notifications. The findings will contribute targeted information for public health policy interventions, including food safety programmes during warmer weather.

Q fever, a zoonotic disease transmitted from animals to humans, is a significant public health problem with a potential for outbreaks to occur. Q fever prevention strategies should incorporate human, animal, and environmental domains. A One Health approach, which engages cross-sectoral collaboration among multiple stakeholders, may be an appropriate framework and has the underlying principles to control Q fever holistically. To assess whether components of One Health for Q fever prevention and control have been applied, a comprehensive literature review was undertaken. We found 16 studies that had practiced or recommended a One Health approach. Seven emerging themes were identified: Human risk assessment, human and animal serology, integrated human–animal surveillance, vaccination for at-risk groups, environmental management, multi-sectoral collaboration, and education and training. Within the multi-sectoral theme, we identified five subthemes: Policy and practice guidelines, information sharing and intelligence exchange, risk communication, joint intervention, and evaluation. One Health practices varied between studies possibly due to differences in intercountry policy, practice, and feasibility. However, the key issue of the need for multi-sectoral collaboration was highlighted across most of the studies. Further research is warranted to explore the barriers and opportunities of adopting a One Health approach in Q fever prevention and control.

SUMMARY: Campylobacterspp. is a commonly reported food-borne disease with major consequences for morbidity. In conjunction with predicted increases in temperature, proliferation in the survival of microorganisms in hotter environments is expected. This is likely to lead, in turn, to an increase in contamination of food and water and a rise in numbers of cases of infectious gastroenteritis. This study assessed the relationship ofCampylobacterspp. with temperature and heatwaves, in Adelaide, South Australia.We estimated the effect of (i) maximum temperature and (ii) heatwaves on dailyCampylobactercases during the warm seasons (1 October to 31 March) from 1990 to 2012 using Poisson regression models.There was no evidence of a substantive effect of maximum temperature per 1 °C rise (incidence rate ratio (IRR) 0·995, 95% confidence interval (95% CI) 0·993–0·997) nor heatwaves (IRR 0·906, 95% CI 0·800–1·026) onCampylobactercases. In relation to heatwave intensity, which is the daily maximum temperature during a heatwave, notifications decreased by 19% within a temperature range of 39–40·9 °C (IRR 0·811, 95% CI 0·692–0·952). We found little evidence of an increase in risk and lack of association betweenCampylobactercases and temperature or heatwaves in the warm seasons. Heatwave intensity may play a role in that notifications decreased with higher temperatures. Further examination of the role of behavioural and environmental factors in an effort to reduce the risk of increasedCampylobactercases is warranted.