Protecting Great Barrier Reef resilience through effective management of crown-of-thorns starfish outbreaks.

Resilience-based management is essential to protect ecosystems in the Anthropocene. Unlike large-scale climate threats to Great Barrier Reef (GBR) corals, outbreaks of coral-eating crown-of-thorns starfish (COTS; Acanthaster cf. solaris) can be directly managed through targeted culling. Here, we evaluate the outcomes of a decade of strategic COTS management in suppressing outbreaks and protecting corals during the 4th COTS outbreak wave at reef and regional scales (sectors). We compare COTS density and coral cover dynamics during the 3rd and 4th outbreak waves. During the 4th outbreak wave, sectors that received limited to no culling had sustained COTS outbreaks causing significant coral losses. In contrast, in sectors that received timely and sufficient cull effort, coral cover increased substantially, and outbreaks were suppressed with COTS densities up to six-fold lower than in the 3rd outbreak wave. In the Townsville sector for example, despite exposure to comparable disturbance regimes during the 4th outbreak wave, effective outbreak suppression coincided with relative increases in sector-wide coral cover (44%), versus significant coral cover declines (37%) during the 3rd outbreak wave. Importantly, these estimated increases span entire sectors, not just reefs with active COTS control. Outbreaking reefs with higher levels of culling had net increases in coral cover, while the rate of coral loss was more than halved on reefs with lower levels of cull effort. Our results also indicate that outbreak wave progression to adjoining sectors has been delayed, probably via suppression of COTS larval supply. Our findings provide compelling evidence that proactive, targeted, and sustained COTS management can effectively suppress COTS outbreaks and deliver coral growth and recovery benefits at reef and sector-wide scales. The clear coral protection outcomes demonstrate the value of targeted manual culling as both a scalable intervention to mitigate COTS outbreaks, and a potent resilience-based management tool to "buy time" for coral reefs, protecting reef ecosystem functions and biodiversity as the climate changes.

Mortalidad en pacientes en edad reproductiva en la provincia de Las Tunas / Mortality in patients of childbearing age in Las Tunas province

Fundamento: las mujeres en edad fértil constituyen un grupo poblacional que tiene una gran importancia para el país, son las encargadas del aumento de la natalidad y pertenecen al conjunto de personas económicamente activas, que aportan de manera muy significativa a la sociedad.Objetivo: describir las principales causas de muerte de las mujeres en edad fértil en la provincia de Las Tunas, en el año 2013.Método: se realizó un estudio observacional, descriptivo y transversal, con el objetivo de describir las principales causas de muerte de las mujeres con edades comprendidas entre los 12 y 49 años, de la provincia de Las Tunas, en el período de enero a diciembre del año 2013. La población de estudio estuvo constituida por las 104 mujeres con estos criterios, que fallecieron durante ese período. Para la recolección de la información se utilizaron los datos estadísticos del Departamento de Estadística de la Dirección Provincial de Salud. Se procesaron los datos por el método estadístico porcentual y se calcularon tasas.Resultados: en la muestra estudiada predominó el grupo de edades comprendido entre los 35 y 49 años; los municipios de Majibacoa, Puerto Padre, Las Tunas y Jobabo fueron los más afectados, según tasas por su densidad de población. Las principales causas de muerte estuvieron representadas por los tumores malignos, las muertes por causas violentas, enfermedades del corazón y las infecciones, mientras que los tipos de cáncer más frecuentes fueron el de mama, pulmón y útero.Conclusiones: se describieron las principales causas de muerte en mujeres de Las Tunas en edad fértil, con predominio de la muerte por tumores malignos y, entre ellos, el más frecuente fue el cáncer de mama (AU)

Background: women of childbearing age are a population group that has great importance for the country; they are responsible of birth increase and belong to the group of economically active people who provides a significant contribution to society.Objective: to describe the main death causes of women of childbearing age in Las Tunas province in 2013.Method: an observational, descriptive and cross-sectional study was carried out with the objective of describing the main causes of death among women aged between 12 and 49 years in Las Tunas provincefrom January to December, 2013. The study population consisted of 104 women with these criteria who died during that period. To collect the information, the statistical data of the Statistics Department of the Provincial Health Directorate were used. Data were processed by the statistical percentage method and rates were calculated.Results: in the studied sample the age group between 35 and 49 years prevailed; Majibacoa, Puerto Padre, Las Tunas and Jobabo were the most affected municipalities, according to their population density rates. The main causes of death were malignant tumors, violent deaths, heart diseases and infections and the most frequent types of cancer were breast, lung and uterus cancer.Conclusions: the main causes of death in women of childbearing age from Las Tunas province were described; those caused by malignant tumors prevailed, being breast cancer the most common one (AU)

Características de pacientes con cáncer de mama diagnosticado en el año 2013 en el municipio de Las Tunas / Characteristics of patients with breast cancer diagnosed in Las Tunas Municipality in 2013

Fundamento: el cáncer de mama constituye la primera causa de muerte de las mujeres en el mundo. El diagnostico precoz y el tratamiento oportuno de las lesiones mamarias constituyen pilares fundamentales en la evolución y pronóstico de este tipo de cáncer.Objetivo: describir las características clínico-epidemiológicas de las pacientes con cáncer de mama del municipio de Las Tunas, provincia del mismo nombre, Cuba; en el periodo de enero a diciembre de 2013. Métodos: se realizó un estudio observacional-descriptivo y transversal. La población de estudio estuvo constituida por las 59 pacientes que se les diagnosticó cáncer de mama. Se estudiaron los antecedentes patológicos personales, antecedentes patológicos familiares de patología mamaria, menopausia, ingestión de hormonas y otros factores asociados. Se definió el BIRADS (por las siglas en inglés de Breast Imaging reporting and data system) mamográfico y se determinó la etapa clínica en que estaban las pacientes cuando se realizó el diagnóstico. Para la recolección de la información fueron utilizados datos estadísticos, historias clínicas individuales, hojas de cargo y resultados de las biopsias y se procesaron por el método estadístico porcentual.Resultados: en la muestra predominó el grupo de edad entre los 50-59 años, los principales factores de riesgo asociados estuvieron relacionados con los antecedentes familiares de haber padecido esta enfermedad, la categoría mamográfica predominante fue la BIRADS IV y la etapa clínica II.Conclusiones: el mayor por ciento de pacientes se diagnosticó de forma tardía, a pesar de los esfuerzos del sistema nacional de salud para aumentar la pesquisa del cáncer de mama (AU)

Background: breast cancer is the first cause of death among women all over the world. Early diagnosis and appropriate treatment of breast lesions are fundamental mainstays in the evolution and prognosis of this cancer.Objective: to describe the clinical and epidemiological characteristics of patients with breast cancer in Las Tunas municipality in Cuba from January to December, 2013. Method: an observational, descriptive and cross-sectional study was carried out. The population sample consisted of 59 patients who were diagnosed with breast cancer. Their personal medical history and family past history of breast disease, menopause, intake of hormones and other associated factors were studied. The mammography BIRADS (Breast Imaging Reporting and Data System) was defined, and the clinical stage in which the patients were at the time of the diagnosis was determined. For the collection of information, statistical data, medical histories, office documents and biopsy results were compiled and processed by the percentage statistical method. Results: the age group between 50 and 59 years old prevailed in the sample; the main associated risk factors were related to the family past history of breast cancer; the predominant mammographic category was BIRADS IV and the clinical stage was II. Conclusions: the highest percentage of patients was diagnosed belatedly, in spite of the efforts of the national health system to increase search for breast cancer (AU)