RESUMO
Our aim was to examine temporal change in alpha and beta diversity of freshwater fish communities in rivers that have urbanized over the same period to understand the influence of changes in land use and river connectivity on community change. We used biological (2001-2018), land use (2000-2015), and connectivity data (1987-2017) from Toronto, Ontario, Canada. We used linear mixed effects models to determine the strength of upstream land use, connectivity, and their changes over time to explain temporal change in alpha and beta diversity indices. We examined beta diversity using the temporal beta diversity index (TBI) to assess site-specific community change. The TBI was partitioned into gains and losses, and species-specific changes in abundance were assessed using paired t-tests. There were more gains than losses across the study sites as measured by TBI. We found little to no significant differences in species-specific abundances at aggregated spatial scales (study region, watershed, stream order). We found different relationships between landscape and connectivity variables with the biodiversity indices tested; however, almost all estimated confidence intervals overlapped with zero and had low goodness-of-fit. More fish biodiversity gains than losses were found across the study region, as measured by TBI. We found TBI to be a useful indicator of change as it identifies key sites to further investigate. We found two high value TBI sites gained non-native species, and one site shifted from a cool-water to warm-water species dominated community, both of which have management implications. Upstream catchment land use and connectivity had poor explanatory power for change in the measured biodiversity indices. Ultimately, such spatial-temporal datasets are invaluable and can reveal trends in biodiversity useful for environmental management when considering competing interests involved with urban sprawl in the ongoing "Decade on Restoration."
RESUMO
The World Health Organisation advocates Digital Health Technologies (DHTs) for advancing population health, yet concerns about inequitable outcomes persist. Differences in access and use of DHTs across different demographic groups can contribute to inequities. Academics and policy makers have acknowledged this issue and called for inclusive digital health strategies. This systematic review synthesizes literature on these strategies and assesses facilitators and barriers to their implementation. We searched four large databases for qualitative studies using terms relevant to digital technology, health inequities, and socio-demographic factors associated with digital exclusion summarised by the CLEARS framework (Culture, Limiting conditions, Education, Age, Residence, Socioeconomic status). Following the PRISMA guidelines, 10,401 articles were screened independently by two reviewers, with ten articles meeting our inclusion criteria. Strategies were grouped into either outreach programmes or co-design approaches. Narrative synthesis of these strategies highlighted three key themes: firstly, using user-friendly designs, which included software and website interfaces that were easy to navigate and compatible with existing devices, culturally appropriate content, and engaging features. Secondly, providing supportive infrastructure to users, which included devices, free connectivity, and non-digital options to help access healthcare. Thirdly, providing educational support from family, friends, or professionals to help individuals develop their digital literacy skills to support the use of DHTs. Recommendations for advancing digital health equity include adopting a collaborative working approach to meet users' needs, and using effective advertising to raise awareness of the available support. Further research is needed to assess the feasibility and impact of these recommendations in practice.