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Overfishing is the primary cause of marine defaunation, yet declines in and increasing extinction risks of individual species are difficult to measure, particularly for the largest predators found in the high seas 1 – 3 . Here we calculate two well-established indicators to track progress towards Aichi Biodiversity Targets and Sustainable Development Goals 4 , 5 : the Living Planet Index (a measure of changes in abundance aggregated from 57 abundance time-series datasets for 18 oceanic shark and ray species) and the Red List Index (a measure of change in extinction risk calculated for all 31 oceanic species of sharks and rays). We find that, since 1970, the global abundance of oceanic sharks and rays has declined by 71% owing to an 18-fold increase in relative fishing pressure. This depletion has increased the global extinction risk to the point at which three-quarters of the species comprising this functionally important assemblage are threatened with extinction. Strict prohibitions and precautionary science-based catch limits are urgently needed to avert population collapse 6 , 7 , avoid the disruption of ecological functions and promote species recovery 8 , 9 . The global abundance of oceanic sharks and rays has decreased by 71% since 1970 and 24 species are threatened with extinction owing to a concomitant increase in fishing pressure.

Manta rays (Genus Manta) are economically important for fisheries and tourism in Indonesia. These species have been listed by the International Union for the Conservation of Nature Red List as Vulnerable to extinction; therefore, human exploitation of manta rays must be regulated. A better understanding of the habitat use and movement patterns of manta rays in Indonesia is needed in order to employ effective conservation measures. To gain better insight into the movements of Manta alfredi we used 'Manta Matcher', an online database with an integrated automated matching algorithm, to compare photographs from 2,604 encounters of M. alfredi collected by recreational divers and dive operators throughout Indonesia over a nine-year period. This photographic comparison revealed that manta rays migrated between regional sanctuaries such as Nusa Penida, the Gili Islands, and the Komodo National Park (up to 450 km straight-line distance). The areas between these sanctuaries are heavily fished and trafficked by ships, and when manta rays travel through these regions they risk being fished and injured by ship strikes. These long-range manta ray movements suggest connectivity between M. alfredi populations in neighboring islands and raise concerns about the future management of regional populations. It is recommended that a national conservation strategy be developed to protect the remaining populations in the country.

Objective : To assess healthcare professionals’ perceptions of patient safety culture and to examine variations across clinical units in Eastern Ethiopian public hospitals. Methods : A cross-sectional study was conducted using the Hospital Survey on Patient Safety Culture (HSoPSC 2.0) tool. Analysis of variance and ordinal logistic regression analyses were performed. Results were presented as mean differences and an adjusted odds ratio (AOR) with a 95% confidence interval (CI), and statistical significance was set at a p-value < 0.05. Content analysis was performed for data provided through the open-ended response option. Results : A total of 582 questionnaires were returned, yielding a response rate of 85%. Overall positive patient safety culture score was 47% (95% CI: 41–53%). Intensive care units (ICUs) scored significantly lower on patient safety culture dimensions compared to other clinical units. Factors contributing to the patient safety ratings included Midwives (AOR = 0.20, 95% CI: 0.06–0.71, p = 0.013), Organisational learning and continuous improvement (AOR = 1.35, 95% CI: 1.04–1.76, p = 0.025), Supervisor, manager, or clinical leader support for patient safety (AOR = 1.41, 95% CI: 1.06–1.89, p = 0.02), and Hospital management support for patient safety (AOR = 1.28, 95% CI: 1.00–1.63, p = 0.049). The challenges in ensuring patient safety included the absence of patient safety incident reporting systems, severe resource constraints, limited awareness regarding patient safety, ineffective communication, poor management support, and a blame-oriented organisational culture. Conclusions : Significant improvement in patient safety culture in Ethiopian public hospitals, especially in the ICU, is critically needed to mitigate healthcare risks and ensure patient safety. Addressing these issues requires targeted patient safety training, strong leadership support, and adequate resource allocation. Further exploration of ICU-specific patient safety insights and validation of the HSoPSC 2.0 tool within the Ethiopian healthcare context should be undertaken to ensure cultural and contextual relevance.

The structures and functions of organelles are highly interdependent. Using paired 3D electron microscopy and multi-omics, a study now shows how other organelles affect mitochondrial structure and function: peroxisome-derived lipids reverse mitochondrial stress, highlighting the importance of organelle interconnectivity.

Background Patient safety incidents, defined as deviations from standard healthcare practices, contribute to significant mortality and financial burdens for healthcare systems globally each year. In response, international agencies advocate for patient safety incident reporting and learning systems to prevent the recurrence of safety incidents and promote learning. The effective design and implementation of these systems require the identification of factors that influence incident reporting practices. Therefore, the aim of this review was to systematically appraise and synthesise the current literature on factors influencing patient safety incident reporting practices in African healthcare organisations. Methods A systematic integrative review was conducted. Five electronic databases, including PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCO host, Scopus, Web of Science, and Excerpta Medica Database (Embase), were searched to identify relevant articles. Peer-reviewed articles published in English were included in this review. Two independent reviewers screened the identified articles first by title and abstract, followed by full text evaluation. Quality appraisal was conducted using the Joanna Briggs Institute and the Quality Assessment with Diverse Studies tool. A thematic synthesis approach was used to analyse the data. The themes were presented with narrative descriptions. Results A literature search identified 9,265 articles, of which 51 were included in the review, representing the perspectives of 15,089 healthcare professionals. Of the included articles, 88% were rated as moderate to high quality. Five descriptive themes were identified as barriers and facilitators that influenced patient safety incident reporting practices, including fear of reprisal within the prevailing patient safety culture, attitudes and perceptions towards patient safety incident reporting, the extent of knowledge and skills regarding patient safety incidents and reporting, the availability and attributes of reporting systems and processes, and the level of support from managers and rapport with staff. Conclusion The identified barriers and facilitators influencing patient safety incident reporting should be addressed to effectively design, implement, and improve patient safety incident reporting systems and practices. Protocol registration The review protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42023455168.

Two separate sightings, two years apart, of the mimic octopus Thaumoctopus mimicus Norman & Hochberg, 2005 are reported from the Inhambane Province of southern Mozambique within the protected waters of the Vilanculos Coastal Wildlife Sanctuary. Individuals were encountered in May 2020 and 2022 in shallow waters, at a depth of less than 30 cm. Both individuals were fully exposed moving along a sandy substrate at the water's edge in a tidal flat. These represent the first documented sightings of T. mimicus in Mozambique, confirming the occurrence of the species along the eastern coast of Africa and extending this species' known range west from the Arabian Sea and south from the Red Sea.

Purpose Patient participation is characterized by dyadic patient–nurse interactions that enable patients to passively or actively participate in communicative and physical care activities. Less research has been conducted on nonparticipation. Examining this phenomenon may highlight issues to address and identify strategies that may ultimately promote patient participation and move the rhetoric of patient participation to a reality. The aim of this secondary analysis was to explore hospital patients’ and nurses’ perceptions of nonparticipation in nursing care specifically focused on communication and self‐care. Design Secondary supplementary analysis of qualitative data. We collated original transcripts from one dataset that included 20 patient and 20 nurse interviews conducted at two hospitals in Australia, in November 2013 to March 2014. Methods Interviews were arranged into units of analysis dependent on group (patient/nurse) and setting (public/private hospital) and were reanalyzed using manifest, inductive content analysis. Findings Two categories were found: (a) nurses impeding two‐way clinical communication; and (b) patients and nurses disregarding patients’ self‐care efforts. These categories describe that nonparticipation occurred when nurses inhibited communication, and when patients were not involved in self‐care while hospitalized or during discharge planning. Conclusions Perceptions of nonparticipation differ across settings, having implications for how patient participation recommendations are enacted in different contexts. Clinical Relevance There is no one‐size‐fits‐all approach; nurses need to identify common instances of nonparticipation within their setting and develop and implement strategies to promote patient participation that are suited to their context.

Background Increased survival from traumatic injury has led to a higher demand for follow-up care when patients are discharged from hospital. It is currently unclear how follow-up care following major trauma is provided to patients, and how, when, and to whom follow-up services are delivered. The aim of this study was to describe the current follow-up care provided to patients and their families who have experienced major traumatic injury in Australia and New Zealand (ANZ). Methods Informed by Donabedian’s ‘Evaluating the Quality of Medical Care’ model and the Institute of Medicine’s Six Domains of Healthcare Quality, a cross-sectional online survey was developed in conjunction with trauma experts. Their responses informed the final survey which was distributed to key personnel in 71 hospitals in Australia and New Zealand that (i) delivered trauma care to patients, (ii) provided data to the Australasian Trauma Registry, or (iii) were a Trauma Centre. Results Data were received from 38/71 (53.5%) hospitals. Most were Level 1 trauma centres ( n  = 23, 60.5%); 76% ( n  = 16) follow-up services were permanently funded. Follow-up services were led by a range of health professionals with over 60% ( n  = 19) identifying as trauma specialists. Patient inclusion criteria varied; only one service allowed self-referral (3.3%). Follow-up was within two weeks of acute care discharge in 53% ( n  = 16) of services. Care activities focused on physical health; psychosocial assessments were the least common. Most services provided care for adults and paediatric trauma (60.5%, n  = 23); no service incorporated follow-up for family members. Evaluation of follow-up care was largely as part of a health service initiative; only three sites stated evaluation was specific to trauma follow-up. Conclusion Follow-up care is provided by trauma specialists and predominantly focuses on the physical health of the patients affected by major traumatic injury. Variations exist in terms of patient selection, reason for follow-up and care activities delivered with gaps in the provision of psychosocial and family health services identified. Currently, evaluation of trauma follow-up care is limited, indicating a need for further development to ensure that the care delivered is safe, effective and beneficial to patients, families and healthcare organisations.

ObjectivesSurvival following traumatic injury has increased, requiring ongoing patient follow-up. While longitudinal outcomes of trauma patients are reported, little is known about optimal delivery of follow-up service for this group. The aim of this scoping review was to identify and describe the structure, process and outcomes of postdischarge follow-up services for patients who sustained major trauma.Evidence reviewThis scoping review was conducted by searching CINAHL, MEDLINE and EMBASE databases. Articles were screened by three independent reviewers. The data of selected articles were organised in the categories of the Donabedian quality framework: structure, processes and outcomes.ResultsTwenty-six articles were included after screening by title/abstract then full text against the inclusion/exclusion criteria; 92% (n=24) were from the USA.Follow-up services were provided by designated trauma centres and delivered by a mixture of health disciplines. Delivery of follow-up was multimodal (in person/telehealth). Protocols and guidelines helped to deliver follow-up care for non-physician led services.Ongoing health issues including missed injuries, pain and infection were identified. No standardised criteria were established to determine recipients, the timing or frequency of follow-up was identified. Patients who engaged with follow-up services were more likely to participate in other health services. Patients reported satisfaction with follow-up care.ConclusionThere are wide variations in how follow-up services for major trauma patients are provided. Further evaluation should focus on patient, family and organisational outcomes. Identifying who is most likely to benefit, when and how follow-up care is delivered are important next steps in improving outcomes.

Assessing the trophic role and interaction of an animal is key to understanding its general ecology and dynamics. Conventional techniques used to elucidate diet, such as stomach content analysis, are not suitable for large threatened marine species. Non-lethal sampling combined with biochemical methods provides a practical alternative for investigating the feeding ecology of these species. Stable isotope and signature fatty acid analyses of muscle tissue were used for the first time to examine assimilated diet of the reef manta ray Manta alfredi, and were compared with different zooplankton functional groups (i.e. near-surface zooplankton collected during manta ray feeding events and non-feeding periods, epipelagic zooplankton, demersal zooplankton and several different zooplankton taxa). Stable isotope δ(15)N values confirmed that the reef manta ray is a secondary consumer. This species had relatively high levels of docosahexaenoic acid (DHA) indicating a flagellate-based food source in the diet, which likely reflects feeding on DHA-rich near-surface and epipelagic zooplankton. However, high levels of ω6 polyunsaturated fatty acids and slightly enriched δ(13)C values in reef manta ray tissue suggest that they do not feed solely on pelagic zooplankton, but rather obtain part of their diet from another origin. The closest match was with demersal zooplankton, suggesting it is an important component of the reef manta ray diet. The ability to feed on demersal zooplankton is likely linked to the horizontal and vertical movement patterns of this giant planktivore. These new insights into the habitat use and feeding ecology of the reef manta ray will assist in the effective evaluation of its conservation needs.