Understanding variation in impacts from private protected areas across regions and protection mechanisms to inform organizational practices.

Private land protection is an important and growing tool to address biodiversity loss and climate change. Thus, better empirical evidence on the effectiveness of private land protection and organizational practices, such as targeting of lands for protection and choice of protection mechanism (i.e., fee simple land acquisition and conservation easements), is needed. We addressed this gap by estimating the impacts of The Nature Conservancy's (TNC) (a large nongovernmental organization with relatively decentralized management) conservation land acquisitions and easements from 1988 to 2016 in three regions of the United States (Mid-Atlantic, New England and New York, and California). We estimated impact in terms of avoided conversion by comparing natural land cover on 3179 protected parcels with matched unprotected parcels. Nineteen of 21 ecoregional plans used threats of agriculture and development to identify priorities for protection. When regions and protection mechanisms were pooled, on average there was no evidence of avoided conversion from 1988 to 2016. Accounting for mechanisms, TNC land acquisitions avoided conversion and easements did not. TNC's easements on parcels acquired by conservation partners did avoid conversion. Limitations of these results include focus on a single measure of impact, inability to capture future avoided conversion, and low land cover change accuracy in California. Our results suggest that private land protection managers who seek to avoid land conversion in the near to medium term should increase focus on areas with higher threats. Special attention should be paid to strengthening accountability and the role of partners, improving or clarifying how easements are used, and facilitating the flow of resources to work with the greatest potential impact.

Comprensión de la variación en el impacto de las áreas protegidas privadas sobre las regiones y los mecanismos de protección para guiar las prácticas organizativas Resumen La protección de terreno privado es una herramienta importante, aunque su naturaleza voluntaria puede sesgar la protección hacia parcelas menos amenazadas­lo que resulta en que la conversión no se evite o se evite muy poco. Además, muchos programas de protección privada tienen una supervisión limitada y pocos reportes de sus resultados. Por lo tanto, se necesitan mejores evidencias empíricas de la efectividad de la protección en suelo privado y las prácticas organizativas, como el enfoque en tierras para protección y la selección de los mecanismos de protección (adquisición de terrenos a título oneroso y servidumbres de conservación). Abordamos esta brecha con la estimación de impactos de las adquisiciones de suelo de The Nature Conservancy (TNC, una gran organización no gubernamental con un manejo relativamente descentralizado) y las servidumbres implementadas entre 1988 y 2016 en tres regiones de los Estados Unidos: Atlántico Medio, Nueva Inglaterra y Nueva York, y California. Estimamos el impacto en términos de la conversión que se evitó al comparar la cobertura de suelo en 3,179 parcelas protegidas con parcelas desprotegidas equivalentes. Diecinueve de los 21 planes eco­regionales usaron las amenazas a la agricultura y al desarrollo para identificar las prioridades de protección. Cuando agrupamos las regiones y los mecanismos de protección, en promedio no hubo impacto alguno. Si se consideran los mecanismos, las adquisiciones de suelo de la TNC tuvieron un impacto mientras que las servidumbres no. Las servidumbres de la TNC en las parcelas adquiridas por socios de conservación sí tuvieron un impacto, aunque esta manera de proteger sólo se presentó en las regiones del Atlántico Medio y de Nueva Inglaterra y Nueva York. Nuestros resultados sugieren que la protección privada, especialmente mediante servidumbres, puede estar sesgada hacia suelos no amenazados. Los gestores que buscan evitar la conversión del suelo a mediano o corto plazo deberían enfocarse más en las áreas con más amenazas. Se debería prestar especial atención al fortalecimiento del papel y las responsabilidades de los socios, a la mejora o aclaración de cómo se usan las servidumbres y la facilitación del flujo de recursos para trabajar con el mayor impacto potencial.

Effects of climate and land-cover change on the conservation status of gibbons.

Species shift their distribution in response to climate and land-cover change, which may result in a spatial mismatch between currently protected areas (PAs) and priority conservation areas (PCAs). We examined the effects of climate and land-cover change on potential range of gibbons and sought to identify PCAs that would conserve them effectively. We collected global gibbon occurrence points and modeled (ecological niche model) their current and potential 2050s ranges under climate-change and different land-cover-change scenarios. We examined change in range and PA coverage between the current and future ranges of each gibbon species. We applied spatial conservation prioritization to identify the top 30% PCAs for each species. We then determined how much of the PCAs are conserved in each country within the global range of gibbons. On average, 31% (SD 22) of each species' current range was covered in PAs. PA coverage of the current range of 9 species was <30%. Nine species lost on average 46% (SD 29) of their potential range due to climate change. Under climate-change with an optimistic land-cover-change scenario (B1), 12 species lost 39% (SD 28) of their range. In a pessimistic land-cover-change scenario (A2), 15 species lost 36% (SD 28) of their range. Five species lost significantly more range under the A2 scenario than the B1 scenario (p = 0.01, SD 0.01), suggesting that gibbons will benefit from effective management of land cover. PA coverage of future range was <30% for 11 species. On average, 32% (SD 25) of PCAs were covered by PAs. Indonesia contained more species and PCAs and thus has the greatest responsibility for gibbon conservation. Indonesia, India, and Myanmar need to expand their PAs to fulfill their responsibility to gibbon conservation. Our results provide a baseline for global gibbon conservation, particularly for countries lacking gibbon research capacity.

Las especies modifican su distribución como respuesta a los cambios en el clima y el uso de suelo, lo que puede derivar en una disparidad espacial entre las áreas protegidas (AP) y las áreas de conservación prioritarias (ACP). Analizamos los efectos del cambio en el clima y el uso de suelo sobre la distribución potencial de los gibones para identificar las ACP que lograrían su conservación exitosa. Recopilamos puntos globales de presencia de gibones y modelamos (modelo de nicho ecológico) su distribución actual y potencial para la década de 2050 bajo diferentes escenarios de cambio climático y de uso de suelo. Después exploramos los cambios en la distribución y la cobertura de las AP entre la distribución actual y a futuro de cada especie de gibón y aplicamos la priorización de la conservación espacial para identificar el mejor 30% de ACP para cada especie. Posteriormente determinamos la extensión conservada de las ACP en cada país dentro de la distribución mundial de gibones. En promedio, el 31% (DS 22) de la distribución actual de cada especie está cubierta en las AP. La distribución actual de nueve especies tiene una cobertura de áreas protegidas menor al 30%. Como promedio, nueve especies perdieron el 46% (DS 29) de su rango potencial debido al cambio climático. Bajo un escenario de cambio climático con un cambio de suelo optimista (B1), doce especies perdieron el 39% (DS 28) de su distribución. Con un escenario pesimista (A2), 15 especies perdieron el 36% (DS 28) de su distribución. Cinco especies perdieron considerablemente más distribución bajo el escenario A2 en relación con el B1 (p = 0.01, SD 0.01), lo que sugiere que los gibones se beneficiarán con la gestión efectiva de la cobertura terrestre. La cobertura dentro de las AP de la distribución futura fue < 30% para once especies. En promedio, el 32% (DS 25) de las ACP estuvo cubierto dentro de las AP. Indonesia albergó más especies y más ACP, por lo que tuvo la mayor responsabilidad en la conservación de los gibones. Indonesia, India y Myanmar necesitan expandir sus AP para cumplir con su responsabilidad en la conservación de los gibones. Nuestros resultados proporcionan una línea base para la conservación mundial de los gibones, particularmente para aquellos países que carecen de los recursos para investigarlos.

[Evaluation of a community-based intervention to increase influenza vaccination coverage in pregnant women]. / Evaluación de una intervención comunitaria para incrementar la cobertura vacunal de la gripe en mujeres embarazadas.

OBJECTIVE: To know the impact of the educational intervention carried out on the professionals of a basic health area and their community participation group, which make up the intervention group (IG), and to analyze its repercussion on the vaccination coverage achieved for influenza in the risk group (pregnant and puerperal women) comparing it with its neighboring basic zone, which makes up the control group (CG), during the 2019/20 vaccination season. DESIGN: Quasi-experimental study of community intervention. SITE: Two basic health zones belonging to the Elche-Crevillente health department, Spain. PARTICIPANTS: Pregnant and postpartum women from 2 basic health areas and the community participation group. Health professionals directly related to the flu vaccination campaign. INTERVENTIONS: Training session for the IG prior to the 2019/20 flu campaign. MAIN MEASUREMENTS: Attitudes towards influenza vaccination in health professionals through the validated CAPSVA questionnaire and the vaccination coverage of pregnant and postpartum women through the Nominal Vaccine Registry and their acceptance of the vaccine in the midwife's office. RESULTS: The influenza vaccination coverage data recorded in Nominal Vaccine Registry for pregnant and puerperal women was 26.4% (n=207) in the IG and 19.7% (n=144) in the CG (p=0.001), with an incidence ratio of 1.34, thus achieving 34% more vaccination in the IG. Acceptance for vaccination in the midwife's office was also high, with 96.5% immunization in IG vs. 89.0% in CG, with a RR=1.09 (95% CI 1.01-1.62). CONCLUSIONS: Joint training strategies for professionals and community assets improve the results of vaccination coverage.

Using interview surveys and multispecies occupancy models to inform vertebrate conservation.

Species distribution data are an essential biodiversity variable requiring robust monitoring to inform wildlife conservation. Yet, such data remain inherently sparse because of the logistical challenges of monitoring biodiversity across broad geographic extents. Surveys of people knowledgeable about the occurrence of wildlife provide an opportunity to evaluate species distributions and the ecology of wildlife communities across large spatial scales. We analyzed detection histories of 30 vertebrate species across the Western Ghats biodiversity hotspot in India, obtained from a large-scale interview survey of 2318 people who live and work in the forests of this region. We developed a multispecies occupancy model that simultaneously corrected for false-negative (non-detection) and false-positive (misidentification) errors that interview surveys can be prone to. Using this model, we integrated data across species in composite analyses of the responses of functional species groups (based on disturbance tolerance, diet, and body mass traits) to spatial variation in environmental variables, protection, and anthropogenic pressures. We observed a positive association between forest cover and the occurrence of species with low tolerance of human disturbance. Protected areas were associated with higher occurrence for species across different functional groups compared with unprotected lands. We also observed the occurrence of species with low disturbance tolerance, herbivores, and large-bodied species was negatively associated with developmental pressures, such as human settlements, energy production and mining, and demographic pressures, such as biological resource extraction. For the conservation of threatened vertebrates, our work underscores the importance of maintaining forest cover and reducing deforestation within and outside protected areas, respectively. In addition, mitigating a suite of pervasive human pressures is also crucial for wildlife conservation in one of the world's most densely populated biodiversity hotspots.

Uso de Encuestas y Modelos de Ocupación Multiespecies para Orientar la Conservación de Vertebrados Resumen Los datos de distribución de especies son una variable esencial de la biodiversidad que requieren de un monitoreo sólido para orientar la conservación de la fauna. Aun así, dichos datos permanecen inherentemente escasos debido a los obstáculos logísticos del monitoreo de la biodiversidad a lo largo de extensiones geográficas generalizadas. Las encuestas realizadas a personas conocedoras de la incidencia de fauna proporcionan una oportunidad para evaluar la distribución de las especies y la ecología de las comunidades de fauna en escalas espaciales grandes. Analizamos las historias de detección de 30 especies de vertebrados en los Ghats Occidentales de la India obtenidos a partir de una encuesta a gran escala realizada por entrevistas a 2318 personas que viven y trabajan en los bosques de esta región. Desarrollamos un modelo de ocupación multiespecies que corrigió simultáneamente los errores falsos negativos (no detección) y los falsos positivos (identificación correcta) a los que están propensos las encuestas por entrevista. Con este modelo, integramos los datos de todas las especies a un análisis compuesto de las respuestas de los grupos funcionales de especies (con base en la tolerancia a la perturbación, dieta y características de masa corporal) para la variación espacial en las variables ambientales, protección y presiones antropogénicas. Observamos una asociación positiva entre la incidencia de especies con la baja tolerancia a la perturbación humana y a la cobertura forestal. Las áreas protegidas estuvieron asociadas con una incidencia mayor para las especies ubicadas en diferentes grupos funcionales comparadas con las áreas desprotegidas. También observamos que la incidencia de especies con una tolerancia baja a las perturbaciones, herbívoros y especies de mayor tamaño estaba asociada negativamente con las presiones de desarrollo, como los asentamientos humanos, la producción de energías y minería, y las presiones demográficas, como la extracción de recursos biológicos. Para la conservación de vertebrados amenazados, nuestro trabajo hace hincapié en la importancia de mantener la cobertura forestal y reducir la deforestación dentro y fuera de las áreas protegidas, respectivamente. Además, la mitigación de un conjunto de presiones humanas dominantes también es crucial para la conservación de la naturaleza en uno de los puntos calientes de biodiversidad con una de las mayores densidades poblacionales del mundo.

Socioeconomic determinants of health and COVID-19 in Mexico.

INTRODUCTION: The population living in conditions of poorness has a heavier pathological burden than social strata with better economic possibilities. OBJECTIVE: To determine the influence of socioeconomic and demographic factors on COVID-19 morbidity, mortality and lethality in municipalities and states of Mexico. METHODS: Morbidity, mortality and lethality associated with COVID-19 were analyzed according to the human development index and its indicators, and type of population. Descriptive statistical analyses, correlations between developmental variables and morbidity, mortality and lethality, association tests and hierarchical groupings were carried out. RESULTS: Positive correlations were observed between morbidity and mortality and the human development index; COVID-19 fatality increased as the values of said index decreased. There was a significantly higher risk of elevated mortality in localities with moderate and low development, and in those with less than 49,999 inhabitants. The main factors associated with fatality were lack of access to health services, income vulnerability and social deprivation. CONCLUSIONS: The evidence generated should lead to decisions aimed at improving the quality of life of the population with social deprivations and vulnerabilities, which needs to be protected against the consequences of current COVID-19 pandemic.

INTRODUCCIÓN: La población en situación de pobreza presenta una carga patológica mayor que los estratos sociales con mejores posibilidades económicas. OBJETIVO: Determinar la influencia de los factores socioeconómicos y demográficos en la morbilidad, mortalidad y letalidad de COVID-19 en municipios y estados de México. MÉTODOS: Se analizó la morbilidad, mortalidad y letalidad asociadas a COVID-19 conforme el índice de desarrollo humano y sus indicadores, así como el tipo de población. Se realizaron análisis estadísticos descriptivos, de correlación entre variables de desarrollo versus morbilidad, mortalidad y letalidad, pruebas de asociación y agrupaciones jerárquicas. RESULTADOS: Se observaron correlaciones positivas entre la morbilidad y mortalidad y el índice de desarrollo humano; la letalidad por COVID-19 aumentó conforme disminuyó dicho índice. Existió riesgo significativamente superior de alta letalidad en las localidades con moderado y bajo desarrollo, así como en aquellas con menos de 49 999 habitantes. Los principales factores asociados a la letalidad fueron la falta de acceso a los servicios de salud, la vulnerabilidad por ingreso y la carencia social. CONCLUSIONES: La evidencia generada debe llevar a decisiones tendentes al mejoramiento de la calidad de vida de la población con carencias y vulnerabilidades sociales, que necesita ser protegida contra las consecuencias de la actual pandemia de COVID-19.

Supporting habitat conservation with automated change detection in Google Earth Engine.

A significant limitation in biodiversity conservation has been the effective implementation of laws and regulations that protect species' habitats from degradation. Flexible, efficient, and effective monitoring and enforcement methods are needed to help conservation policies realize their full benefit. As remote sensing data become more numerous and accessible, they can be used to identify and quantify land-cover changes and habitat loss. However, these data remain underused for systematic conservation monitoring in part because of a lack of simple tools. We adapted 2 algorithms that automatically identify differences between pairs of images. We used free, publicly available satellite data to evaluate their ability to rapidly detect land-cover changes in a variety of land-cover types. We compared algorithm predictions with ground-truthed results at 100 sites of known change in the United States. We also compared algorithm predictions to manually created polygons delineating anthropogenic change in 4 case studies involving imperiled species' habitat: oil and gas development in the range of the Greater Sage Grouse (Centrocercus urophasianus); sand mining operations in the range of the dunes sagebrush lizard (Sceloporus arenicolus); loss of Piping Plover (Charadrius melodus) coastal habitat after Hurricane Michael (2018); and residential development in St. Andrew beach mouse (Peromyscus polionotus peninsularis) habitat. Both algorithms effectively discriminated between pixels corresponding to land-cover change and unchanged pixels as indicated by area under a receiver operating characteristic curve >0.90. The algorithm that was most effective differed among the case-study habitat types, and both effectively delineated habitat loss as indicated by low omission (min. = 0.0) and commission (min. = 0.0) rates, and moderate polygon overlap (max. = 47%). Our results showed how these algorithms can be used to help close the implementation gap of monitoring and enforcement in biodiversity conservation. We provide a free online tool that can be used to run these analyses (https://conservationist.io/habitatpatrol).

Respaldo a la Conservación de Hábitat con la Detección Automatizada de Cambio en Google Earth Resumen Una limitación significativa en la conservación de la biodiversidad ha sido la implementación efectiva de las leyes y regulaciones que protegen los hábitats de las especies de la degradación. El monitoreo flexible, eficiente y efectivo y los métodos de aplicación son necesarios para que las normas de conservación puedan llevar a cabo su potencial completo. Conforme los datos de telemetría se vuelven cada vez más numerosos y accesibles, su uso puede extenderse a la identificación y cuantificación de los cambios en la cobertura del suelo y la pérdida del hábitat. Sin embargo, estos datos todavía están subutilizados en cuanto al monitoreo sistemático de la conservación en parte debido a la falta de herramientas simples y sencillas. Adaptamos dos algoritmos que identifican automáticamente las diferencias entre pares de imágenes. Utilizamos datos satelitales gratuitos y disponibles para el público para con ellos evaluar la habilidad que tienen los algoritmos para detectar rápidamente los cambios en la cobertura del suelo dentro de una variedad de tipos de cobertura de suelo. Comparamos las predicciones algorítmicas con los resultados de algunas investigaciones en 100 sitios con cambios conocidos en los Estados Unidos. También comparamos las predicciones algorítmicas con polígonos creados manualmente que delinean el cambio antropogénico en cuatro estudios de caso que involucran al hábitat de una especie en peligro: desarrollos de petróleo y gas en la distribución de Centrocercus urophasianus; minas de arena en la distribución de Sceloporus arenicolus; la pérdida del hábitat costero de Charadrius melodus después del huracán Michael (2018); y los desarrollos residenciales en el hábitat de Peromyscus polionotus peninsularis. Ambos algoritmos discriminaron efectivamente entre los píxeles que correspondían al cambio en la cobertura del suelo y los píxeles sin cambio así indicados por el área bajo la curva de característica de receptor operante >0.90. El algoritmo más efectivo difirió entre los tipos de hábitat para los estudios de caso, mientras que ambos algoritmos delinearon efectivamente la pérdida de hábitat así indicada por la baja tasa de omisión (min. = 0.0) y comisión (min. = 0.0) y el traslape moderado de polígonos (max. = 47%). Nuestros resultados mostraron cómo pueden usarse estos algoritmos para ayudar a cerrar la brecha en la implementación del monitoreo y aplicación en la conservación de la biodiversidad. Proporcionamos una herramienta gratuita en línea que puede usarse para realizar estos análisis: https://conservationist.io/habitatpatrol.

Subjective modeling choices and the robustness of impact evaluations in conservation science.

Arbitrary modeling choices are inevitable in scientific studies. Yet, few empirical studies in conservation science report the effects these arbitrary choices have on estimated results. I explored the effects of subjective modeling choices in the context of counterfactual impact evaluations. Over 5000 candidate models based on reasonable changes in the choice of statistical matching algorithms (e.g., genetic and nearest distance mahalanobis matching), the parametrization of these algorithms (e.g., number of matches), and the inclusion of specific covariates (e.g., distance to nearest city, slope, or rainfall) were valid for studying the effect of Virunga National Park in Democratic Republic of the Congo on changes in tree cover loss and carbon storage over time. I randomly picked 2000 of the 5000 candidate models to determine how much and which subjective modeling choices affected the results the most. All valid models indicated that tree cover loss decreased and carbon storage increased in Virunga National Park from 2000 to 2019. Nonetheless, the order of magnitude of the estimates varied by a factor of 3 (from -4.78 to -13.12 percentage points decrease in tree cover loss and from 20 to 46 t Ce/ha for carbon storage). My results highlight that modeling choices, notably the choice of the matching algorithm, can have significant effects on point estimates and suggest that more structured robustness checks are a key step toward more credible findings in conservation science.

Selecciones Subjetivas de Modelos y la Contundencia de las Evaluaciones de Impacto en las Ciencias de la Conservación Resumen Las selecciones arbitrarias de modelos son inevitables en los estudios científicos. Sin embargo, pocos estudios empíricos en las ciencias de la conservación reportan los efectos de estas selecciones arbitrarias sobre los resultados estimados. Exploré los efectos de las selecciones subjetivas de modelos en el contexto de las evaluaciones de impacto contrafactuales. Más de 5000 modelos candidatos basados en cambios razonables en la elección de los algoritmos de emparejamiento estadístico (p. ej.: emparejamiento genético y de distancia más cercana mahalanobis), la parametrización de estos algoritmos (p. ej.: número de parejas) y la inclusión de covariados específicos (p. ej.: distancia a la ciudad más cercana, inclinación, precipitación) fueron válidos para estudiar el efecto del Parque Nacional Virunga en la República Democrática del Congo sobre la pérdida de cobertura arbórea y el almacenamiento de carbono a través del tiempo. Escogí al azar 2000 de los 5000 modelos candidatos para determinar cuántos y cuáles selecciones subjetivas de los modelos afectaron más al resultado. Todos los modelos válidos indicaron que la pérdida de la cobertura arbórea disminuyó y el almacenamiento de carbono incrementó en el Parque Nacional Virunga desde entre el año 2000 y el 2019. No obstante, el orden de magnitud de las estimaciones varió con un factor de 3 (una disminución de -4.78 hasta -13.12 puntos porcentuales en la pérdida de la cobertura arbórea y de 20 hasta 46 t Ce/ha para el almacenamiento de carbono). Mis resultados resaltan que la selección de los modelos, notablemente la elección del algoritmo de emparejamiento, puede tener efectos significativos sobre las estimaciones de puntos y sugieren que las revisiones más estructuradas de la contundencia son un paso importante hacia descubrimientos más creíbles en las ciencias de la conservación.

Conservation planning on China's borders with Myanmar, Laos, and Vietnam.

Transboundary conservation is playing an increasingly important role in maintaining ecosystem integrity and halting biodiversity loss caused by anthropogenic activities. However, lack of information on species distributions in transboundary regions and understanding of the threats in these areas impairs conservation. We developed a spatial conservation plan for the transboundary areas between Yunnan province, southwestern China, and neighboring Myanmar, Laos, and Vietnam in the Indo-Burma biodiversity hotspot. To identify priority areas for conservation and restoration, we determined species distribution patterns and recent land-use changes and examined the spatiotemporal dynamics of the connected natural forest, which supports most species. We assessed connectivity with equivalent connected area (ECA), which is the amount of reachable habitat for a species. An ECA incorporates the presence of habitat in a patch and the amount of habitat in other patches within dispersal distance. We analyzed 197,845 locality records from specimen collections and monographs for 21,004 plant and vertebrate species. The region of Yunnan immediately adjacent to the international borders had the highest species richness, with 61% of recorded species and 56% of threatened vertebrates, which suggests high conservation value. Satellite imagery showed the area of natural forest in the border zone declined by 5.2% (13,255 km2 ) from 1995 to 2018 and monoculture plantations increased 92.4%, shrubland 10.1%, and other cropland 6.2%. The resulting decline in connected natural forest reduced the amount of habitat, especially for forest specialists with limited dispersal abilities. The most severe decline in connectivity was along the Sino-Vietnamese border. Many priority areas straddle international boundaries, indicating demand and potential for establishing transboundary protected areas. Our results illustrate the importance of bi- and multilateral cooperation to protect biodiversity in this region and provide guidance for future conservation planning and practice.

Planeación de la Conservación en las Fronteras de China con Myanmar, Laos y Vietnam Resumen La conservación transfronteriza cada vez juega un papel más importante en la preservación de la integridad del ecosistema y en el freno a la pérdida local de la biodiversidad causada por las actividades antropogénicas. Sin embargo, la falta de información sobre la distribución de las especies en las regiones transfronterizas y de la comprensión de las amenazas en estas áreas obstaculiza la conservación. Desarrollamos un plan de conservación espacial para las áreas transfronterizas entre la provincia de Yunnan, al suroeste de China, y los países vecinos Myanmar, Laos y Vietnam localizadas en el punto caliente de biodiversidad Indo-Burma. Para identificar las áreas prioritarias para la conservación y la restauración, determinamos los patrones de distribución de las especies y los recientes cambios en el uso de suelo y examinamos las dinámicas espaciotemporales del bosque natural conectado, el cual mantiene a la mayoría de las especies. Evaluamos la conectividad con el área equivalente conectada (AEC), que es la cantidad de hábitat accesible para una especie. Un AEC incorpora la presencia del hábitat en un fragmento y la cantidad de hábitat en otros fragmentos dentro de la distancia de dispersión. Analizamos 197,845 registros de localidades desde colecciones de especímenes y monografías para 21,004 especies de plantas y de vertebrados. La región de Yunnan inmediatamente adyacente a las fronteras internacionales tuvo la riqueza de especies más alta con el 61% de las especies registradas y el 56% de los vertebrados amenazados, lo que sugiere un elevado valor de conservación. Las imágenes satelitales mostraron que el área del bosque natural en la zona fronteriza declinó en un 5.2% (13,255 km2 ) entre 1995 y 2018 y que los sembradíos de monocultivos incrementaron en un 92.4%, los matorrales en un 10.1% y otras tierras de cultivo en un 6.2%. La declinación resultante en el bosque natural conectado redujo la cantidad del hábitat, especialmente para los especialistas del bosque con habilidades limitadas de dispersión. La declinación más grave en la conectividad ocurrió a lo largo de la frontera entre China y Vietnam. Muchas áreas prioritarias atraviesan las fronteras internacionales, lo que indica una demanda y un potencial para el establecimiento de áreas protegidas transfronterizas. Nuestros resultados ejemplifican la importancia de la cooperación bi- y multilateral para proteger la biodiversidad en esta región y proporciona información para la planeación y práctica de la conservación en el futuro.

Intestinal parasites in child and youth populations of Argentina: Environmental factors determining geographic distribution.

The transmission of intestinal parasites is generally considered to be "mediated by the environment" which suggests that they are particularly sensitive to the changes that occur in it. The aim of the present study was to evaluate the environmental variables that act as risk factors for intestinal parasitosis in children and youths in Argentina. The association between environmental variables related to temperature, precipitation and soil and parasitosis found in children and youths from different provinces was evaluated, including land use/cover classes obtained from satellite images. Of the total population analyzed, 66.9% of the participants were parasitized. The total number of identified parasite species was 17 and the most prevalent were Blastocystis sp. (42.2%), Enterobius vermicularis (33.6%) and Giardia lamblia (17.0%). Infection by protozoa, and by G. lamblia in particular, was greater when the mean summer temperature was higher (OR=1.2 for both). Blastocystis sp. and geohelminths were greater due to an increase in isothermality (OR=1.1 and 1.2, respectively). The risk of infection with Ascaris lumbricoides was associated with an increase in the temperature in the wettest quarter (OR=1.2). Hookworm infection was associated with an increase in the normalized difference vegetation index (OR=32.5). Most of participants infected with hookworms lived in areas with abundant arboreal-shrubby and agropastoral use vegetation. The heterogeneous distribution of enteric parasites is indicative of the wide environmental variability of Argentina.

[The Global Patient Safety Action Plan 2021-2030: Identifying actions for safer primary health care]. / El Plan de acción mundial para la seguridad del paciente 2021-2030: identificando acciones para una atención primaria más segura.

The 74th World Health Assembly adopted in May 2021 the "Global Patient Safety Action Plan: 2021-2030" to enhance patient safety as an essential component in the design, procedures and performance evaluation of health systems worldwide. It is a strategic plan that guides country governments, health sector entities, health organisations and the World Health Organisation secretariat on how to implement the assembly's patient safety resolution. Deployment of the plan will strengthen the quality and safety of health systems worldwide by spanning the entire continuum of people's health care from diagnosis to treatment and care, reducing the likelihood of harm in the course of care. The Declaration on Primary Health Care during the Global Conference on Primary Health Care in Astana, 2018, urged countries to strengthen their primary health care systems as an essential step towards achieving universal health coverage and providing access to safe, quality care without financial loss. The deployment of the Global Patient Safety Action Plan in primary care is therefore a high-priority health policy action. The Action Plan is structured into 6 strategic objectives with 35 strategic actions. We present an analysis of the strategic actions regarding healthcare organizations and the challenges ahead for their particular deployment in primary health care settings.

Mediation of area and edge effects in forest fragments by adjacent land use.

Habitat loss, fragmentation, and degradation have pervasive detrimental effects on tropical forest biodiversity, but the role of the surrounding land use (i.e., matrix) in determining the severity of these impacts remains poorly understood. We surveyed bird species across an interior-edge-matrix gradient to assess the effects of matrix type on biodiversity at 49 different sites with varying levels of landscape fragmentation in the Brazilian Atlantic Forest-a highly threatened biodiversity hotspot. Both area and edge effects were more pronounced in forest patches bordering pasture matrix, whereas patches bordering Eucalyptus plantation maintained compositionally similar bird communities between the edge and the interior and exhibited reduced effects of patch size. These results suggest the type of matrix in which forest fragments are situated can explain a substantial amount of the widely reported variability in biodiversity responses to forest loss and fragmentation.

Mediación de los Efectos de Área y de Borde sobre los Fragmentos de Bosque Causados por el Uso de Suelo Adyacente Resumen La pérdida del hábitat, la fragmentación y la degradación tienen efectos nocivos generalizados sobre la biodiversidad de los bosques tropicales. A pesar de esto, el papel del uso de suelo de los terrenos adyacentes (es decir, la matriz) en la determinación de la gravedad de estos impactos todavía está poco entendido. Censamos las especies de aves a lo largo de un gradiente de borde interno de matriz para evaluar los efectos del tipo de matriz sobre la biodiversidad en al menos 49 sitios con diferentes niveles de fragmentación del paisaje en el Bosque Atlántico Brasileño - un punto caliente de biodiversidad que se encuentra severamente amenazado. Tanto los efectos de área como los de borde estuvieron más pronunciados en los fragmentos de bosque que limitan con la matriz de pasturas, mientras que los fragmentos que limitan con plantaciones de Eucalyptus mantuvieron comunidades de aves similares en composición con aquellas entre el borde y el interior y mostraron efectos reducidos del tamaño de fragmento. Estos resultados sugieren que el tipo de matriz en el cual están situados los fragmentos de bosque puede explicar una cantidad sustancial de la ampliamente reportada variabilidad de respuestas a la pérdida del bosque y a la fragmentación.

Dynamics in the global protected-area estate since 2004.

Nations of the world have committed to a number of goals and targets to address global environmental challenges. Protected areas have for centuries been a key strategy in conservation and play a major role in addressing current challenges. The most important tool used to track progress on protected-area commitments is the World Database on Protected Areas (WDPA). Periodic assessments of the world's protected-area estate show steady growth over the last 2 decades. However, the current method, which uses the latest version of the WDPA, does not show the true dynamic nature of protected areas over time and does not provide information on sites removed from the WDPA. In reality, this method can only show growth or remain stable. We used GIS tools in an approach to assess protected-area change over time based on 12 temporally distinct versions of the WDPA that quantify area added and removed from the WDPA annually from 2004 to 2016. Both the narrative of continual growth of protected area and the counter-narrative of protected area removal were overly simplistic. The former because growth was almost entirely in the marine realm and the latter because some areas removed were reprotected in later years. On average 2.5 million km2 was added to the WDPA annually and 1.1 million km2 was removed. Reasons for the inclusion and removal of protected areas in the WDPA database were in part due to data-quality issues but also to on-the-ground changes. To meet the 17% protected-area component of Aichi Biodiversity Target 11 by 2020, which stood at 14.7% in 2016, either the rate of protected-area removal must decrease or the rate of protected-area designation and addition to the WDPA must increase.

Dinámica de los Bienes de las Áreas Protegidas desde 2004 Resumen Países alrededor del mundo se han comprometido con un número de metas y objetivos para tratar los retos ambientales mundiales. Las áreas protegidas han funcionado durante siglos como una estrategia clave en la conservación y juegan un papel importante en cómo se manejan los retos actuales. La herramienta más importante que se usa para rastrear el progreso de los compromisos con las áreas protegidas es la Base de Datos Mundial de las Áreas Protegidas (WDPA, en inglés). Las evaluaciones periódicas de los bienes de las áreas protegidas muestran un crecimiento constante durante las últimas dos décadas. Sin embargo, el método actual, que usa la versión más reciente de la WDPA, no muestra la verdadera naturaleza dinámica de las áreas protegidas a lo largo del tiempo y no proporciona información sobre sitios que han sido removidos de la WDPA. En realidad este método sólo puede mostrar crecimiento o permanecer estable. Usamos herramientas de SIG en una estrategia para evaluar el cambio de las áreas protegidas a lo largo del tiempo con base en doce versiones temporalmente distintas de la WDPA que cuantifican las áreas añadidas o removidas de la WDPA anualmente desde 2004 hasta 2016. Tanto la narrativa del crecimiento continuo de un área protegida como la contra-narrativa de la eliminación de un área protegida fueron exageradamente simplistas. La primera se debe a que el crecimiento ocurrió casi en su mayoría en el dominio marino y la segunda a que algunas áreas eliminadas fueron reprotegidas años después. En promedio se añadieron 2.5 millones de km2 a la WDPA anualmente y 1.1 millones de km2 fueron removidos. Las razones para la inclusión y la eliminación de las áreas protegidas de la base de datos de la WDPA se debieron en parte a temas de calidad de datos pero también a cambios hechos sobre la marcha. Para lograr el 17% del componente de áreas protegidas del Objetivo 11 de Biodiversidad de Aichi para el 2020, el cual se encontraba al 14.7% en 2016, se debe disminuir la tasa de eliminación de áreas protegidas o se debe incrementar la tasa de designación y suma de áreas protegidas a la WDPA.

Landscape trajectory of natural boreal forest loss as an impediment to green infrastructure.

Loss of natural forests by forest clearcutting has been identified as a critical conservation challenge worldwide. This study addressed forest fragmentation and loss in the context of the establishment of a functional green infrastructure as a spatiotemporally connected landscape-scale network of habitats enhancing biodiversity, favorable conservation status, and ecosystem services. Through retrospective analysis of satellite images, we assessed a 50- to 60-year spatiotemporal clearcutting impact trajectory on natural and near-natural boreal forests across a sizable and representative region from the Gulf of Bothnia to the Scandinavian Mountain Range in northern Fennoscandia. This period broadly covers the whole forest clearcutting period; thus, our approach and results can be applied to comprehensive impact assessment of industrial forest management. The entire study region covers close to 46,000 km2 of forest-dominated landscape in a late phase of transition from a natural or near-natural to a land-use modified state. We found a substantial loss of intact forest, in particular of large, contiguous areas, a spatial polarization of remaining forest on regional scale where the inland has been more severely affected than the mountain and coastal zones, and a pronounced impact on interior forest core areas. Salient results were a decrease in area of the largest intact forest patch from 225,853 to 68,714 ha in the mountain zone and from 257,715 to 38,668 ha in the foothills zone, a decrease from 75% to 38% intact forest in the inland zones, a decrease in largest patch core area (assessed by considering 100-m patch edge disturbance) from 6114 to 351 ha in the coastal zone, and a geographic imbalance in protected forest with an evident predominance in the mountain zone. These results demonstrate profound disturbance of configuration of the natural forest landscape and disrupted connectivity, which challenges the establishment of functional green infrastructure. Our approach supports the identification of forests for expanded protection and conservation-oriented forest landscape restoration.

[Effect of influenza vaccination in Primary Healthcare workers and the general population in Gran Canaria: A cross-sectional study]. / Efecto de la vacunación antigripal en trabajadores de atención primaria y población general de Gran Canaria: estudio transversal.

OBJECTIVE: To estimate the effect of the influenza vaccination in Primary Healthcare workers and the general population vaccinated during the 2015/2016 campaign. DESIGN: Cross-sectional study. SETTING: All the Primary Healthcare centres within the Gran Canaria healthcare region. PARTICIPANTS: A total of 1,868 Primary Healthcare workers (33.5% men; 66.5% women) and 795,605 individuals from the general population (49.4% men; 50.6% women). PRINCIPAL MEASUREMENTS: The outcome variables in Primary Healthcare workers were: influenza cases reported to the Epidemiological Surveillance System, and the sick leave days due to illness. In the general population: reported flu cases and vaccination coverage in connection with the vaccination status of the healthcare professional. The magnitude of association between vaccination and morbidity was estimated applying logistic regression models. RESULTS: Although not statistically significant, healthcare professionals that were not vaccinated had 1.7-fold increase in the risk of having influenza than those vaccinated. In the general population the association was significant in the female population (OR: 1.3; 95%CI: 1.1-1.5). Population coverage was significantly higher when both the doctor and nurse were vaccinated (OR: 1.3; 95%CI: 1.3-1.3), and reported flu cases decreased when the nurse was vaccinated (OR: 0.9; 95%CI: 0.9-0.9). CONCLUSION: A possible protective effect of influenza vaccination was observed in the general population, as well as an influence of Primary Healthcare workers on the patients regarding this. Even so, the low coverages registered point to a need to implement measures that may lead to a more favourable attitude towards influenza vaccination.

Use of long-term data to evaluate loss and endangerment status of Natura 2000 habitats and effects of protected areas.

Habitat loss is a key driver of biodiversity loss. However, hardly any long-term time series analyses of habitat loss are available above the local scale for finer-level habitat categories. We analysed, from a long-term perspective, the habitat specificity of habitat-area loss, the change in trends in habitat loss since 1989 (dissolution of the communist state), and the impact of protected areas on habitat loss in Hungary. We studied 20 seminatural habitat types in 5000 randomly selected localities over 7 periods from 1783 to 2013 based on historical maps, archival and recent aerial photos and satellite imagery, botanical descriptions, and field data. We developed a method for estimating habitat types based on information transfer between historical sources (i.e., information from a source was used to interpret or enrich information from another source). Trends in habitat loss over time were habitat specific. We identified 7 types of habitat loss over time regarding functional form: linear, exponential, linear and exponential, delayed, minimum, maximum, and disappearance. Most habitats had continuous loss from period to period. After 1986 the average annual rates of habitat loss increased, but the trend reversed after 2002. Nature conservation measures significantly affected habitat loss; net loss was halted, albeit only inside protected areas. When calculating the degree of endangerment based on short-term data (52 years), we classified only 1 habitat as critically endangered, but based on long-term data (230 years), this increased to 7 (including habitat that no longer existed). Hungary will probably reach the global Convention on Biological Diversity Target 5 but will probably not achieve the EU Biodiversity Strategy target of halting habitat loss by 2020. Long-term trend data were highly useful when we examined recent habitat-loss data in a wider context. Our method could be applied effectively in other countries to augment shorter-term data sets on trends in habitat area.

[Antipneumococcal vaccination in Catalonian adults: Vaccine coverages and adequacy to distinct guideline recommendations]. / Vacunación antineumocócica en adultos de Cataluña: coberturas y grado de adecuación a distintas guías de recomendaciones.

OBJECTIVES: To know antipneumococcal vaccination coverages among Catalonian adults and evaluate the adequacy of vaccine use according to 3 distinct current vaccination guidelines. DESIGN: Population-based cross-sectional study. SETTING: Primary Health Care. Catalonia, Spain. PARTICIPANTS: A total of 2,033,465 individuals≥50 years-old registered in the Catalonian Health Institute. MAIN MEASUREMENTS: Vaccination status for the 23-valent pneumococcal polysaccharide vaccine (PPV23) and/or the 13-valent pneumococcal conjugate vaccine (PCV13) was revised at 1/01/2015. Adequacy of vaccination status was determined according to 3 distinct vaccination recommendation guidelines: Spanish Ministry of Health (basically coinciding with Catalonian Health Institute's recommendations), Spanish Society of Family Physicians (semFYC) and Centers for Disease Control and Prevention (CDC). RESULTS: Overall, 789,098 (38.8%) persons had received PPV23 and 5,031 (0.2%) had received PCV13. PPV23 coverage largely increased with increasing age (4.8% in 50-59 years, 35.5% in 60-69 years, 71.9% in 70-79 years and 79.5% in≥80 years; P<.001), whereas PCV13 coverage was very small in all age groups. Considering the 3 analysed vaccine guidelines a 46.1% of the overall study population were adequacy vaccinated according to Spanish Ministry's recommendations, 19.3% according to semFYC's recommendations and 4.6% according to CDC's recommendations. CONCLUSION: PPV23 coverage among Catalonian adults may be considered as intermediate, but PCV13 coverage is very small. The institutional recommendations (Spanish Ministry) are more followed than corporative (semFYC) or less local (CDC) recommendations in clinical practice.

Household coverage of Swaziland's national community health worker programme: a cross-sectional population-based study.

OBJECTIVES: To ascertain household coverage achieved by Swaziland's national community health worker (CHW) programme and differences in household coverage across clients' sociodemographic characteristics. METHODS: Household survey from June to September 2015 in two of Swaziland's four administrative regions using two-stage cluster random sampling. Interviewers administered a questionnaire to all household members in 1542 households across 85 census enumeration areas. RESULTS: While the CHW programme aims to cover all households in the country, only 44.5% (95% confidence interval: 38.0% to 51.1%) reported that they had ever been visited by a CHW. In both uni- and multivariable regressions, coverage was negatively associated with household wealth (OR for most vs. least wealthy quartile: 0.30 [0.16 to 0.58], P < 0.001) and education (OR for >secondary schooling vs. no schooling: 0.65 [0.47 to 0.90], P = 0.009), and positively associated with residing in a rural area (OR: 2.95 [1.77 to 4.91], P < 0.001). Coverage varied widely between census enumeration areas. CONCLUSIONS: Swaziland's national CHW programme is falling far short of its coverage goal. To improve coverage, the programme would likely need to recruit additional CHWs and/or assign more households to each CHW. Alternatively, changing the programme's ambitious coverage goal to visiting only certain types of households would likely reduce existing arbitrary differences in coverage between households and communities. This study highlights the need to evaluate and reform large long-standing CHW programmes in sub-Saharan Africa.

Determining the effective coverage of maternal and child health services in Kenya, using demographic and health survey data sets: tracking progress towards universal health coverage.

OBJECTIVES: Effective coverage (EC) is a measure of health systems' performance that combines need, use and quality indicators. This study aimed to assess the extent to which the Kenyan health system provides effective and equitable maternal and child health services, as a means of tracking the country's progress towards universal health coverage. METHODS AND RESULTS: The Demographic Health Surveys (2003, 2008-2009 and 2014) and Service Provision Assessment surveys (2004, 2010) were the main sources of data. Indicators of need, use and quality for eight maternal and child health interventions were aggregated across interventions and economic quintiles to compute EC. EC has increased from 26.7% in 2003 to 50.9% in 2014, but remains low for the majority of interventions. There is a reduction in economic inequalities in EC with the highest to lowest wealth quintile ratio decreasing from 2.41 in 2003 to 1.65 in 2014, but maternal health services remain highly inequitable. CONCLUSIONS: Effective coverage of key maternal and child health services remains low, indicating that individuals are not receiving the maximum possible health gain from existing health services. There is an urgent need to focus on the quality and reach of maternal and child health services in Kenya to achieve the goals of universal health coverage.

Health care-seeking behaviours and health expenditures in adults aged 45 years and older in China, 2011-2013.

OBJECTIVES: To provide an assessment of China's progress to universal health coverage (UHC) from the perspective of people-centred care. METHODS: We obtained data on 28 103 participants from the China Health and Retirement Longitudinal Study (CHALRS) during 2011-2013. We used logistic regressions and generalised linear models to analyse care-seeking behaviours and medical expenditures. RESULTS: We found that 95.5% of the subjects were covered by social health insurance in 2013, and nearly 60% subjects in need of medical care were self-medicated. Health insurance was a strong predictor for the access to outpatient care. Use of pure and mixed self-medication increased by 15% and 32% respectively, while use of pure outpatient care fell by 10% between 2011 and 2013, after adjusting for predisposing, service needs and enabling factors. Such trends were particularly evident for the Urban Resident Basic Medical Insurance and the New Cooperative Medical Scheme, which covered more than 80%. The monthly out-of-pocket medical expenditures and the probability of encountering catastrophic health expenditures for outpatient care were four times larger than that for self-medication. Between 2011 and 2013, outpatient care medical costs rose by nearly 50%, whereas there was no such obvious trend for self-medication. People with insurance schemes offering lower cost sharing incurred consistently higher out-of-pocket outpatient payments. CONCLUSIONS: The monitoring of global progress to UHC should incorporate self-medication. In China, it seems that the current reform and the huge government investment have not resulted in access to affordable quality care. To achieve UHC, not only universal insurance, but system-level efforts are needed.

Comparison of administrative and survey data for estimating vitamin A supplementation and deworming coverage of children under five years of age in Sub-Saharan Africa.

OBJECTIVE: To compare administrative coverage data with results from household coverage surveys for vitamin A supplementation (VAS) and deworming campaigns conducted during 2010-2015 in 12 African countries. METHODS: Paired t-tests examined differences between administrative and survey coverage for 52 VAS and 34 deworming dyads. Independent t-tests measured VAS and deworming coverage differences between data sources for door-to-door and fixed-site delivery strategies and VAS coverage differences between 6- to 11-month and 12- to 59-month age group. RESULTS: For VAS, administrative coverage was higher than survey estimates in 47 of 52 (90%) campaign rounds, with a mean difference of 16.1% (95% CI: 9.5-22.7; P < 0.001). For deworming, administrative coverage exceeded survey estimates in 31 of 34 (91%) comparisons, with a mean difference of 29.8% (95% CI: 16.9-42.6; P < 0.001). Mean ± SD differences in coverage between administrative and survey data were 12.2% ± 22.5% for the door-to-door delivery strategy and 25.9% ± 24.7% for the fixed-site model (P = 0.06). For deworming, mean ± SD differences in coverage between data sources were 28.1% ± 43.5% and 33.1% ± 17.9% for door-to-door and fixed-site distribution, respectively (P = 0.64). VAS administrative coverage was higher than survey estimates in 37 of 49 (76%) comparisons for the 6- to 11-month age group and 45 of 48 (94%) comparisons for the 12- to 59-month age group. CONCLUSION: Reliance on health facility data alone for calculating VAS and deworming coverage may mask low coverage and prevent measures to improve programmes. Countries should periodically validate administrative coverage estimates with population-based methods.