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Investigates whether a system of no-take marine reserves generates consistent biodiversity outcomes, based on systematic Reef Life Survey censuses of rocky reef fishes, invertebrates and macroalgae at eight marine reserves across northern NZ and the Kermadec Islands. Assesses ecological responses of reef assemblages to protection from fishing, including potential trophic cascades, using a control-impact design for the six marine reserves studied with associated reference sites, and also by comparing observations at reserve sites with predictions from random forest models that assume reserve locations are fished. Source: National Library of New Zealand Te Puna Matauranga o Aotearoa, licensed by the Department of Internal Affairs for re-use under the Creative Commons Attribution 3.0 New Zealand Licence.

Cancer survival rates vary significantly between low and high-income areas. By leveraging community assets, healthcare inequities may be addressed. Nationally, Macmillan Cancer Support (Macmillan) (a national cancer charity) is working with local Voluntary and Community Sector (VCS) organisations to improve cancer care.In Plymouth, where cancer mortality is above average, Macmillan has partnered with the Zebra Collective (Zebra) (a community cooperative), Age UK Plymouth (a local charity), The Wolseley Trust (Social Prescribing team), and General Practice (GP) surgeries. In Spring 2024, the Plymouth Cancer Champions' Project (PCCP) launched to address these inequities through community-led approaches via peer-to-peer community engagement and volunteer recruitment. This Integrated Care Case is a practice-based account of how through an embedded ethnographic action research approach, a small community cooperative (Zebra) is influencing its' local low-income community's understanding of and engagement with cancer care services from an asset-based community development approach. The PCCP prioritises involving individuals with lived experience, including those from lower socio-economic status backgrounds, minoritised ethnic groups, and cancer-affected backgrounds, in leadership roles. This collaborative, community-driven approach fosters inclusivity, empowerment, and engagement, and a deep contextual understanding of the community context including barriers and strengths. Through an innovative asset-based community development approach, the deficit narrative is countered- enabling people-led change, influence and learning within cancer care inequity and integrated care.

To support ongoing marine spatial planning in New Zealand, a numerical environmental classification using Gradient Forest models was developed using a broad suite of biotic and high-resolution environmental predictor variables. Gradient Forest modeling uses species distribution data to control the selection, weighting and transformation of environmental predictors to maximise their correlation with species compositional turnover. A total of 630,997 records (39,766 unique locations) of 1,716 taxa living on or near the seafloor were used to inform the transformation of 20 gridded environmental variables to represent spatial patterns of compositional turnover in four biotic groups and the overall seafloor community. Compositional turnover of the overall community was classified using a hierarchical procedure to define groups at different levels of classification detail. The 75-group level classification was assessed as representing the highest number of groups that captured the majority of the variation across the New Zealand marine environment. We refer to this classification as the New Zealand “Seafloor Community Classification” (SCC). Associated uncertainty estimates of compositional turnover for each of the biotic groups and overall community were also produced, and an added measure of uncertainty – coverage of the environmental space – was developed to further highlight geographic areas where predictions may be less certain owing to low sampling effort. Environmental differences among the deep-water New Zealand SCC groups were relatively muted, but greater environmental differences were evident among groups at intermediate depths in line with well-defined oceanographic patterns observed in New Zealand’s oceans. Environmental differences became even more pronounced at shallow depths, where variation in more localised environmental conditions such as productivity, seafloor topography, seabed disturbance and tidal currents were important differentiating factors. Environmental similarities in New Zealand SCC groups were mirrored by their biological compositions. The New Zealand SCC is a significant advance on previous numerical classifications and includes a substantially wider range of biological and environmental data than has been attempted previously. The classification is critically appraised and considerations for use in spatial management are discussed.

Research has shown that during the 2003 SARS pandemic, emergency department (ED) visits among the pediatric population decreased. We set out to investigate if this was also true for injury-related ED visits during the COVID-19 pandemic. Using data from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), we looked at 28 years of injury-related ED visits at the Montreal Children's Hospital, a provincially designated Pediatric Trauma Centre. We compared data from a two-month period during the COVID-19 lockdown (16 March to 15 May) to the same period in previous years (1993-2019) to determine whether the 2020 decrease in ED visit numbers was unprecedented (i.e. a similar decrease had never occurred) for different age groups, nature of injuries, mechanisms and severity. The 2020 decrease was unprecedented across all age groups between 1993 and 2019. When compared with the 2015 to 2019 average, the decrease was smallest in children aged 2 to 5 years (a 35% decrease), and greatest in the group aged 12 to 17 years (83%). Motor vehicle collisions and sports-related injuries practically vanished during the COVID-19 lockdown. Surprisingly, more children aged 6 to 17 years presented with less urgent injuries during the COVID-19 lockdown than in previous years. As was the case with SARS in 2003, COVID-19 acted as a deterrent for pediatric ED visits. The lockdown in particular had a profound impact on injury-related visits. The de-confinement period will be monitored to determine the impact in both the short and the long term.

Using non-lethal tissue sampling for stable isotope analysis has become standard in many fields, but not for fishes, despite being desirable when species are rare or protected, when repeated sampling of individuals is required or where removal may bias other analyses. Here, we examine the utility of fish dorsal fin membrane as an alternative to muscle for analyzing δ 13 C and δ 15 N ratios in two reef fish species (blue cod Parapercis colias and spotty Notolabrus celidotus ) that have differing feeding modes. Both species exhibited evidence of size-based feeding from fin δ 15 N values, but not from muscle. Blue cod fin δ 15 N increased steadily throughout the sampled size range (213–412 mm fork length), whereas spotty exhibited a distinct ontogenetic diet shift at approximately 120–140 mm fork length after which size-based feeding did not occur. Fin membrane was higher than muscle in δ 13 C in both species and in δ 15 N for blue cod, but fin δ 15 N was lower than muscle in spotty. The δ 13 C and δ 15 N fin–muscle offsets were constant in spotty regardless of size, while in blue cod, δ 13 C was constant with fish size, but δ 15 N offsets increased with increasing fish size. Non-lethal sampling utilizing fin tissue can be employed to estimate stable isotope values of muscle in fishes, but it is necessary to assess relationships among tissues and the effects of fish size on isotope values a priori for each species studied. Our data indicated that fin membrane may be a more sensitive tissue than muscle for detecting size-based feeding in some fish species using stable isotopes. A critical literature review revealed inconsistencies in tissue types tested, little understanding of tissue-specific trophic shift or turnover rates, and pseudo-replicated analyses leading to erroneous postulating of 1:1 relationships between tissues.

Monitoring species’ response in marine protected areas is important for informing both the management of those areas and the establishment of additional protected areas. Populations of spiny lobsters Jasus edwardsii were monitored in eight New Zealand marine reserves for up to 34 years. The populations displayed highly variable responses to protection. While a few showed rapid (within 1–2 years of protection) increases in abundance, others showed little response even after a decade of protection. Some reserves displayed little initial recovery, then a sudden increase following several years of protection, while others displayed significant declines in abundance following initial recovery. Marine reserves located in areas with initially high densities of juveniles tended to have rapid recovery, but aspects of reserve design had no significant influence on the recovery rate. Variability among recovery trajectories also suggests that supply-side dynamics may be a key driver of lobster recovery. Densities of legal-sized lobsters were positively correlated with reserve age, but the abundance of juvenile lobsters increased in all but one reserve, indicating enhanced recruitment, survival and/or movement of juvenile lobsters into reserves. It is important to consider the placement of reserves, with respect to potential levels of larval supply, when establishing marine reserves for either conservation or fisheries management purposes and for evaluating their effectiveness.

The spatial configuration of marine reserves should reflect management objectives. If reserves are intended to conserve 'natural' biological communities, then reserve boundaries should follow barriers to species movement, but if cross-boundary movement of harvestable individuals associated with certain habitat is desired for fisheries purposes, then boundaries should intersect that habitat. We relate movement patterns of the reef-associated spiny lobster Jasus edwardsii (Palinuridae) to the relative positions of habitat and reserve boundaries in a 24.5 km super(2) marine reserve on the temperate northeast coast of New Zealand by tagging >5000 individuals and recapturing a subset over 3 yr using pots. Lobster movement patterns were sex- and size-dependent, but nearly all recaptured individuals were found on the same rocky reef on which they were tagged, indicating that lobsters were reluctant to cross the muddy sediments between reefs. Lobsters became increasingly likely to migrate from the reserve into the heavily fished adjacent coast as the proportion of their reef that was unprotected increased. Corresponding changes in average catch per unit effort (CPUE) and size of all lobsters (tagged and untagged) occurred within the protected parts of the reefs, with lobster densities on a fully protected reef being 8-fold higher than densities on the protected part of a reef that was 91% unprotected.

Background: There are well-documented differences in cancer survival between people from low and high-income areas but despite initiatives to improve mortality these inequities prevail (1). By capitalising on the assets of those living within lower-income communities, healthcare inequities may be reduced (2).  Macmillan Cancer Support, a national cancer charity, has partnered with local Voluntary and Community Sector (VCS) organisations in the United Kingdom to reduce the drivers of inequity in cancer care specifically relating to knowledge of cancer, equitable experiences, timely diagnosis and access to treatment (3).  In Plymouth, a low-income city in the South-West of England, cancer mortality rates are significantly higher than the national average (4). Here, Macmillan has partnered with Zebra (a Plymouth community collective working toward social and environmental justice), Age UK Plymouth (a charity working in the community to support individuals over 50), and The Wolseley Trust (a Community Development Trust fostering community involvement including social prescribing), as well as local General Practice (GP) surgeries to explore an asset-based community development approach to tackle cancer care inequity in low-income areas of Plymouth (5,6,7). Approach: The project launched in Summer 2023, and the project team was recruited by April 2024. To date they have hosted seven community cancer awareness and support events to address these inequities through community-led approaches. The Principal Investigator (PI) is a General Practitioner in training, with Zebra they are taking an embedded ethnographic action-research approach to explore how the PCCP influences Plymouth communities’ engagement with cancer services. The University of Plymouth has ethically approved this project. Twelve PCCP stakeholders have been recruited as participants. Data from naturally occurring events such as meetings, cancer awareness events, and participant reflective logs have been collected, and focus groups will be facilitated in late 2024. The PI has delivered training on cancer, health equity and primary care. Results and implications: The PCCP has begun to unearth barriers to cancer care for local people facing mental health issues, financial difficulties, substance dependence, homelessness, as well as those from minority groups. Following decades of community work, Zebra’s longstanding relationship with their community has enabled them to engage with local citizens in a rapid yet deep manner alongside the PCCP partners. Zebra is acting as a web, connecting healthcare providers, community resources, and citizens, forming a network to address cancer inequities and foster deeper community connection through meaningful engagement via an asset-based community development approach. References 1.Baker, C., Mansfield, Z. Cancer statistics for England. 2023. London: House of Commons Library. 2.Edwards-Smith, L., Hayes, J. (2023). Community Asset Network - addressing Disparities in Outcomes. Available at:  https://www.plymouth.ac.uk/research/primarycare/public-health/devon-community-assets-research-collaborative. (Accessed 23rd September 2024).  3.Macmillan Community Cancer Champions. Available at: https://www.macmillan.org.uk/donate/philanthropy/our-funding-priorities/macmillan-community-cancer-champions. (Accessed 23rd September 2024).  4.Office for Health Improvements and Disparities. (2021). Health Profile of the South-West of England 2021. Available at: www.gov.uk/government/publications/health-profiles-for-english-regions-2021. (Accessed 19th January 2024).   5.Zebra. Available at: https://www.zebra.coop/. (Accessed 23rd September 2024).  6.Age UK Plymouth. Available at: https://www.ageuk.org.uk/plymouth/. (Accessed 23rd September 2024).  7.Wolseley Trust. Available at: https://www.wolseley-trust.org/index.php?option=com_k2&view=item&layout=item&id=24. (Accessed 23rd September 2024).   

Early recognition of left ventricular hypertrophy is important because antihypertensive treatment decreases morbidity and mortality. The ideal screening method for left ventricular hypertrophy in hypertensive emergency department (ED) patients has not been identified. Our objective was to determine the diagnostic accuracies of electrocardiogram (ECG) and N-terminal Pro–B-type natriuretic peptide (pro-BNP) for left ventricular hypertrophy individually and in combination in hypertensive ED patients. Prospective diagnostic study in an academic urban tertiary care hospital ED with annual census of 65 000 visits. Inclusion criteria are as follows: adult ED patients with systolic blood pressure greater than or equal to 160 mm Hg or diastolic blood pressure greater than or equal to 100 mm Hg on 2 or more measurements taken 60 minutes apart. Exclusion criteria are as follows: patients with heart failure, renal insufficiency/failure, acute myocardial infarction, or without recent or scheduled echocardiograms. All patients received echocardiograms and had pro-BNP levels measured using a RAMP point-of-care device (Response Biomedical, Vancouver, BC, Canada). We calculated diagnostic test characteristics with 95% confidence intervals (CIs). A total of 49 patients were enrolled. The average age was 57.9 years, 26.5% were male, and 63.3% were African American. Thirty-two patients (65%) had left ventricular hypertrophy by echocardiogram. Twenty-one (43%) had ECG evidence of left ventricular hypertrophy. Median pro-BNP level was 268 pg/mL. The combination of the 2 tests provided the greatest specificity (94%; 95% CI, 69%-99.7%) and positive predictive value (94%; 95% CI, (68%-99.7%). The combination of ECG and pro-BNP is a promising screening algorithm for identification of hypertensive ED patients with left ventricular hypertrophy.

We updated the Illinois historical (1905–December 2017) distribution and status (not reported, reported or established) maps for Amblyomma americanum (L.) (Acari: Ixodidae), Dermacentor variabilis (Say) (Acari: Ixodidae), and Ixodes scapularis (Say) (Acari: Ixodidae) by compiling publicly available, previously unexplored or newly identified published and unpublished data (untapped data). Primary data sources offered specific tick-level information, followed by secondary and tertiary data sources. For A. americanum, D. variabilis, and I. scapularis, primary data contributed to 90% (4,045/4,482), 80% (2,124/2,640), and 32% (3,490/10,898) tick records vs 10%, 20%, and 68%, respectively from secondary data; primary data updated status in 95% (62/65), 94% (51/54) and in 90% (9/10) of the updated counties for each of these tick species; by 1985 there were tick records in 6%, 68%, and 0% of the counties, compared to 20%, 72%, and 58% by 2004, and 77%, 96%, and 75% of the counties by 2017, respectively for A. americanum, D. variabilis, and I. scapularis. We document the loss of tick records due to unidentified, not cataloged tick collections, unidentified ticks in tick collections, unpublished data or manuscripts without specific county location, and tick-level information, to determine distribution and status. In light of the increase in tick-borne illnesses, updates in historical distributions and status maps help researchers and health officials to identify risk areas for a tick encounter and suggest targeted areas for public outreach and surveillance efforts for ticks and tick-borne diseases. There is a need for a systematic, national vector surveillance program to support research and public health responses to tick expansions and tick-borne diseases.