Ecological Time Research Articles

Existential Well-Being in Nature: A Cross-Cultural and Descriptive Phenomenological Approach.

Exploring the putative role of nature in human well-being has typically been operationalized and measured within a quantitative paradigm of research. However, such approaches are limited in the extent to which they can capture the full range of how natural experiences support well-being. The aim of the study was to explore personal experiences in nature and consider how they might be important to human health and well-being. Based on a descriptive phenomenological analysis of fifty descriptions of memorable moments in nature from England, Indonesia, and Norway, our findings illustrate a common structure presented under three themes: 1. serenity that gives rise to a growing awareness of how the body is stimulated by the senses; 2. admiration and appreciation for the sensation of beauty; 3. an emerging sense of togetherness and deep emotional bonding. The findings are discussed using the concepts of ecological time and the ecological body, which foreground being in nature as constituted as an interdependent and dynamic human process. We conclude by understanding well-being in terms of human responsiveness to their surroundings and thus as rooted in the human condition.

Mortality from cerebral stroke in the State of Pernambuco, Brazil: an ecological study

Introduction: cerebrovascular accident (CVA) is the second leading cause of death globally, characterized by cerebrovascular events due to dysfunctions in the cerebral blood supply. It can be ischemic or hemorrhagic and has high morbidity and mortality rates. In Brazil, it is the main cause of death, disabling many over 50 years of age and leading to around 40% of early retirements. Despite advances in initial treatment, mortality rates remain high, indicating flaws in prevention and treatment strategies. Therefore, the World Health Organization (WHO) emphasizes the need for immediate implementation of preventive and treatment measures for this condition. Objective: to evaluate the trend in the mortality coefficient and proportional mortality from stroke in the population of Pernambuco, from 2000 to 2021. Methods: This is an ecological time series study with data from the population of the state of Pernambuco, located in northeast region of Brazil, from 2000 to 2021. The eligibility criteria were deaths with a stroke occurring in the state of Pernambuco. Information on mortality, population estimates and number of deaths by sex and age group were extracted from the database of the Department of Informatics of the Unified Health System (DATASUS). For statistical analysis, it was calculated the mortality coefficient, proportional mortality, mean, standard deviation, skewness and kurtosis. The temporal trend of stroke was assessed by jointpoint regression. Results: Between 2000 and 2021, there were 39,410 deaths from stroke. Around 49.0% were male and 51.0% female. The female sex had an average of 913.45 in the number of deaths, being quantitatively higher than the average identified for the male sex of 877.04 deaths. The years with the highest number of deaths were 2006, 2007 and 2008, while 2018 had the lowest number. There was a progressive increase in the number of deaths from stroke from 2018 to 2021. There was a decline in the average annual percentage variation in the mortality rate for stroke in all groups studied, in addition to a drop in the average annual percentage of proportional mortality for stroke in the entire population. Throughout the period, there was a decline in the average annual percentage of proportional mortality from stroke in the entire population studied. Conclusion: In the period from 2000 to 2021 there was a greater number of deaths due to stroke in women in contrast to men in the population of Pernambuco, Brazil. Furthermore, there was a downward trend in stroke rates in both the mortality rate and proportional mortality. In the period from 2018 to 2021 there was a progressive increase in the mortality rate and proportional mortality from stroke.

AIR POLLUTION BY FINE PARTICULATE MATERIAL ON HOSPITALIZATION FOR RESPIRATORY DISEASES IN THE ELDERLY

Objective: To analyze the effects of air pollution exposure on hospitalizations for respiratory diseases in the elderly. Methods: this was an ecological time series study in Cuiabá, Mato Grosso, during the years 2015 and 2016. Daily levels of fine particulate matter PM2.5 and carbon monoxide were estimated and made available by the National Institute for Space Research. Variables related to temperature, relative humidity and adjustments for temporal trend, seasonality and calendar effects were included in the stochastic model of the ARIMA class (integrated autoregressive moving averages). Results: During the period selected for data collection, there were 1556 hospitalizations for respiratory diseases in Cuiabá. It was verified with this study that the number of cases of respiratory hospitalizations in the elderly was higher between the months of May and September 2015, despite a smaller number of occurrences, in the same period of 2016. As for the monthly average number of hospitalizations of elderly people aged 60 or over, these ranged from 41 hospitalizations in December 2016 to 103 hospitalizations in May 2015. Conclusion: The present study found an association between an increase in PM2.5 and a greater number of hospitalizations of elderly people with 60 years or older due to respiratory diseases. These results are consistent with some other studies found in other investigations on the subject.

Ecological baselines in the Eastern Mediterranean Sea shifted long before the availability of observational time series.

Native biodiversity loss and invasions by nonindigenous species (NIS) have massively altered ecosystems worldwide, but trajectories of taxonomic and functional reorganization remain poorly understood due to the scarcity of long-term data. Where ecological time series are available, their temporal coverage is often shorter than the history of anthropogenic changes, posing the risk of drawing misleading conclusions on systems' current states and future development. Focusing on the Eastern Mediterranean Sea, a region affected by massive biological invasions and the largest climate change-driven collapse of native marine biodiversity ever documented, we followed the taxonomic and functional evolution of an emerging "novel ecosystem", using a unique dataset on shelled mollusks sampled in 2005-2022 on the Israeli shelf. To quantify the alteration of observed assemblages relative to historical times, we also analyzed decades- to centuries-old ecological baselines reconstructed from radiometrically dated death assemblages, time-averaged accumulations of shells on the seafloor that constitute natural archives of past community states. Against expectations, we found no major loss of native biodiversity in the past two decades, suggesting that its collapse had occurred even earlier than 2005. Instead, assemblage taxonomic and functional richness increased, reflecting the diversification of NIS whose trait structure was, and has remained, different from the native one. The comparison with the death assemblage, however, revealed that modern assemblages are taxonomically and functionally much impoverished compared to historical communities. This implies that NIS did not compensate for the functional loss of native taxa, and that even the most complete observational dataset available for the region represents a shifted baseline that does not reflect the actual magnitude of anthropogenic changes. While highlighting the great value of observational time series, our results call for the integration of multiple information sources on past ecosystem states to better understand patterns of biodiversity loss in the Anthropocene.

An ecological analysis of socio-economic determinants associated with paediatric vaccination coverage in the Campania Region: A population-based study, years 2003–2017

IntroductionVaccines are the most cost-effective and straightforward intervention against severe infectious diseases. However, in Europe and in Italy, paediatric vaccination coverage for certain vaccines remains suboptimal, with considerable regional differences in Italy. Vaccine coverage varies significantly due to socio-economic and organisational factors. Aim of this study was to assess the influence of the Deprivation Index, the density of General Practitioners and General Paediatricians per inhabitants on the coverage of both mandatory and non-mandatory paediatric vaccinations across local health authorities and health districts in the Campania Region for birth cohorts from 2001 to 2015. Materials and methodsPopulation-based, ecological time series analysis focusing on the Campania Region, most populous region in the south of Italy. Vaccination coverage data were extracted from the regional immunization database, whilst information on the Deprivation Index and number of primary care doctors and primary care paediatricians per local health district were extracted from public health records. Univariate descriptive statistics were employed to describe study characteristics, as appropriate, whilst and mixed-effect linear regression models were employed to assess the associations between variables of interest and vaccination coverage. ResultsOverall vaccination coverage has generally increased, except for the MMR vaccine, which showed coverage fluctuations. An increase in the Deprivation Index, indicative of less favourable socio-economic conditions, was associated with decreased vaccination coverage in the 24-month age group for some mandatory vaccines (DTaP: Coef −0.97, 95% CI −1.77 | −0.17; Poliomyelitis: Coef −0.98, 95% CI −1.78 | −0.17; Hepatitis B: Coef −0.90, 95% CI −1.71 | −0.10). Moreover, areas with a greater density of General Paediatricians per inhabitants saw increased coverage for Haemophilus influenzae type b in the 6-year age group (Coef 9.78, 95% CI 1.00 | 18.56). ConclusionsIt is necessary to target public health policies to address vaccination inequalities. These efforts should include expanding vaccination campaigns, enhancing catch-up programs, and increase resource allocation in primary care settings to facilitate the role of General Practitioners and Paediatricians in fostering awareness and adherence.

120-years of ecological monitoring data shows that the risk of overhunting is increased by environmental degradation for an isolated marine mammal population: The Baltic grey seal.

The Baltic Sea is home to a genetically isolated and morphologically distinct grey seal population. This population has been the subject of 120-years of careful documentation, from detailed records of bounty statistics to annual monitoring of health and abundance. It has also been exposed to a range of well-documented stressors, including hunting, pollution and climate change. To investigate the vulnerability of marine mammal populations to multiple stressors, data series relating to the Baltic grey seal population size, hunt and health were compiled, vital demographic rates were estimated, and a detailed population model was constructed. The Baltic grey seal population fell from approximately 90,000 to as few as 3000 individuals during the 1900s as the result of hunting and pollution. Subsequently, the population has recovered to approximately 55,000 individuals. Fertility levels for mature females have increased from 9% in the 1970s to 86% at present. The recovery of the population has led to demands for increased hunting, resulting in a sudden increase in annual quotas from a few hundred to 3550 in 2020. Simultaneously, environmental changes, such as warmer winters and reduced prey availability due to overfishing, are likely impacting fecundity and health. Future population development is projected for a range of hunting and environmental stress scenarios, illustrating how hunting, in combination with environmental degradation, can lead to population collapse. The current combined hunting quotas of all Baltic Nations caused a 10% population decline within three generations in 100% of simulations. To enable continued recovery of the population, combined annual quotas of less than 1900 are needed, although this quota should be re-evaluated annually as monitoring of population size and seal health continues. Sustainable management of long-lived slowly growing species requires an understanding of the drivers of population growth and the repercussions of management decisions over many decades. The case of the Baltic grey seal illustrates how long-term ecological time series are pivotal in establishing historical baselines in population abundance and demography to inform sustainable management.

[Trend in breast cancer mortality rate among women aged 20 years or older in Brazil, 2005-2019].

The aim is to analyze the trend in breast cancer mortality rates and its correlation with the socioeconomic development status in Brazil. It involved an ecological time series study carried out in the 26 units of the federation, Federal District and regions of Brazil. Data sources included the Mortality Information System (number of deaths), the Brazilian Institute of Geography and Statistics (resident population) and the study of the Global Burden of Disease (Socio-demographic Index - SDI). Data from 2005 to 2019 were used. The trend was analyzed using Prais-Winsten regression models. The relationship between the mortality rate and the SDI was analyzed using Spearman's correlation coefficient. During the study period, 207,683 deaths from breast cancer occurred. The average standardized mortality rate was 19.95 deaths per 100,000 women in Brazil. All the regions of Brazil showed an increasing trend in mortality. Of the total federative units, 22 showed an increasing trend. There was a positive relationship between the mortality rate and the SDI. The standardized mortality rate for breast cancer showed an increasing trend in Brazil, in all regions and in most states. There was a direct association between mortality and SDI, indicating a greater magnitude in more developed regions.

The rehabilitation workforce in Brazil

BackgroundThe surge in individuals facing functional impairments has heightened the demand for rehabilitation services. Understanding the distribution of the rehabilitation workforce is pivotal for effective health system planning to address the population’s health needs.ObjectiveTo investigate the spatial and temporal dispersion of physical therapists, speech therapists, psychologists and occupational therapists across various tiers of care within Brazil’s Unified Health System and its regions.MethodThis is an ecological time series study on the supply of rehabilitation professionals. Data were obtained from the National Register of Health Establishments from 2007 to 2020. The density of professionals was calculated per 10,000 inhabitants annually for Brazil and its five regions. The Joinpoint regression model was used to analyze the temporal trends of the density of professionals, considering a 95% confidence interval.ResultsIn 2020, the most notable concentrations of psychologists, speech therapists, and occupational therapists in Brazil were observed in the domain of Specialized Health Care, with densities of 0.60, 0.20, and 0.16 professionals per 10,000 inhabitants, respectively. Conversely, the highest density of physical therapists was found within Hospital Health Care, with a density of 1.19 professionals per 10,000 inhabitants. Notably, variations in professional dispersion across different regions were apparent. Primary Health Care exhibited the highest density of professionals in the Northeast region, while the Southern region accounted for the highest densities in all professional categories within Specialized Health Care. The southeast region exhibited the largest workforce within Hospital Health Care. A marked upsurge in professional availability was noted across all categories, notably in the occupational therapy sector within hospital care (AAPC: 30.8), despite its initial low density.ConclusionThe implementation of public health policies played a significant role in the expansion of the rehabilitation workforce at all three levels of care in Brazil and its various regions from 2007 to 2020. Consequently, regional disparities and densities of professionals have emerged, mirroring patterns observed in low-income countries.

Hospitalizations for conditions sensitive to primary care and sustainable development objectives

Hospitalizations for Primary Care Sensitive Conditions (ICSAP) are widely recognized as an indicator of health system performance. Considering that the evaluation of health practices is mandatory, monitoring these indicators becomes relevant, with a view to directing actions that can contribute to the Sustainable Development Goals. The objective of this study was to analyze the profile of ICSAP that occurred in the Federal District (DF) in the period from 2018 to 2022. This is an ecological time series study, using Hospital Admission Authorizations as a data source, via the Information System Hospital of the Unified Health System. Data collection was carried out in November 2022 and covered the period from 2018 to 2022. Descriptive statistical analysis was carried out. It was possible to identify the profile of ICSAP in DF. The elderly population and children aged 1 to 14 years were predominant, as well as diagnoses related to anemia, ear, nose and throat infections and asthma. The main causes of deaths and expenses were cerebrovascular diseases, heart failure and bacterial pneumonia.

Impact of primary care coverage on hospital admissions for conditions sensitive to primary care in the municipality of Rio Verde – GO

The indicator Hospitalizations for Causes Sensitive to Primary Care (ICSAP) has been used as an indicator of access and quality of primary health care, and its high rates have been correlated with deficiencies in service coverage or an inadequate resolution capacity of primary care for certain basic health problems, The study was carried out with the objective of characterizing the rates of hospital admissions for causes sensitive to primary care in the city of Rio Verde – GO, as well as describing its historical series and verifying the impact of Primary Care coverage, in period from 2008 to 2018. Ecological time series study, whose data were collected from the Hospital Admissions System of the Unified Health System, based on the Brazilian List of Admissions for Conditions Sensitive to Primary Care. For data analysis, the research was divided into two axes: clinical-epidemiological and demographic aspects. The causes of hospitalizations for conditions sensitive to primary care were based on the list from the Ministry of Health. It was concluded that hospitalizations for conditions sensitive to primary care showed a reduction, while the coverage of primary care and the health strategy teams of the family, an increase was observed throughout the period analyzed. The three main groups with the highest percentage of hospitalizations for conditions sensitive to primary care were infectious gastroenteritis, followed by heart failure and lung diseases.

Temporal Trends in the Completeness of Epidemiological Variables in a Hospital-Based Cancer Registry of a Pediatric Oncology Center in Brazil.

This ecological time series study aimed to examine the temporal trends in the completeness of epidemiological variables from a hospital-based cancer registry (HbCR) of a reference center for pediatric oncology in Brazil from 2010 to 2016. Completeness categories were based on the percentage of missing data, with the categories excellent (<5%), good (5-10%), regular (11-20%), poor (21-50%), and very poor (>50%). Descriptive and bivariate analyses were performed using R.4.1.0; a Mann-Kendall trend test was performed to examine the temporal trends. Variables with the highest incompleteness included race/color (17.24% in 2016), level of education (51.40% in 2015), TNM (56.88% in 2012), disease status at the end of the first treatment (12.09% in 2013), cancer family history (79.12% in 2013), history of alcoholic consumption (39.25% in 2015), history of tobacco consumption (38.32% in 2015), and type of admission clinic (10.28% in 2015). Nevertheless, most variables achieved 100% completeness and were classified as excellent across the time series. A significant trend was observed for race/color, TNM, and history of tobacco consumption. While most variables maintained excellent completeness, the increasing incompleteness trend in race/color and decreasing trend in TNM underscore the importance of reliable and complete HbCRs for personalized cancer care, for planning public policies, and for conducting research on cancer control.

Arboviruses epidemic associates with Guillain-Barre syndrome: temporal series in northeast Brazil

Arboviruses cause public health problems in several countries, and records show thatthey can generate central and peripheral neurological complications with permanent sequelae. However, it is not certain which arbovirus is responsible for outbreaks of the Guillain-Barré Syndrome (GBS), especially in Brazil. Thus, the objective of this study is to verify if there is a coincidence between the GBS outbreak and the most common arboviruses in Northeastern Brazil, as well as their relationship. An ecological time series study was designed with the federative units of Northeastern Brazil, using hospitalizations for Guillain-Barré syndrome and notifications of arbovirus infections between 2014 and 2019 as a data source. Distribution incidence curves were constructed for the conditions studied, and generalized estimating equations (GEE) models were applied to estimate the relationship between arboviruses and Guillain-Barré. The results showed a similar distribution for the incidences of Chikungunya virus (z=7.82; p=0.001), Zika virus (z=3.69; p=0.03), and Guillain-Barré syndrome (z=2.98; p=0.05) from 2014 to 2019. The GEE model revealed that the distribution of Chikungunya incidence is associated with the distribution of GBS incidence in each year (x2Wald=3,969; p=0.046). This pattern was repeated in seven of the nine states, while the Zika virus had a significant relationship with GBS in only two states. The outbreak of GBS in Northeastern Brazil appears to be probabilistically related to outbreaks of the Chikungunya virus.

Gender and homicides in Paraná: a descriptive analysis from an ecological perspective (2018-2021)

Violence is considered a public health issue as it is one of the main causes of premature mortality in the world, resulting in several impacts that affect the population. This is an ecological time series study on homicides between 2018 and 2021 carried out in the State of Paraná. Data were extracted from the Mortality Information System (SIM) by categories: gender, age, race/color, marital status, place of occurrence and IDC (X85 to Y09 and Y35 to Y36). Data analysis shows that 9,169 violent deaths occurred in the state during the period, 91.2% (8,365) of which were male and 8.7% (801) were female. Considering only the age group, the majority of homicides are between the ages of 20 and 29, totaling 3,349 deaths in the last 4 years, 93.3% (3,123) of male gender and 6.7% (226) of female gender. In this same age group, there is the largest percentage difference between genders. A greater similarity was observed between 5 and 9 years old, with the percentage of both genders equal to 50% (7). The data shows that the highest rate of female homicides, 36.1% (289) occurred at home, while 42.7% (3,572) of male deaths occurred on public roads. Firearm discharge (ICD: X93, X94 and X95) is the main cause of death for both genders, with males accounting for 61.5% (5,142) and females 43.6% (349) of the cases. Better understanding the categories that lead to homicide is a fundamental step towards creating more effective public policies to minimize homicides in Brazil and around the world.

Hanseníase em menores de quinze anos no município mais hiperendêmico do Brasil

ABSTRACT Objective: To describe leprosy involvement and physical disability profiles in children and adolescents under 15 years old. Methods: Ecological time series study, based on data from the Brazilian Notifiable Diseases Information System, including new cases of leprosy residing in Palmas (TO), from 2001 to 2020. Results: A total of 471 notified cases in children and adolescents under 15 years of age were evaluated, resulting in a detection coefficient of 26.5 per 100,000 inhabitants. Of these, 52% (n=243) were women, 5% (n=24) corresponded to grade two disability, and 36% (n=168) were diagnosed through spontaneous demand. The temporal trend analysis showed a 0.5% reduction in the detection coefficient. There was a significant decrease in the diagnosis of the undetermined and tuberculoid clinical forms and a significant increase in the dimorphous form. Diagnosis through contact examination increased significantly by 13.1% and that through spontaneous demand decreased by 4.9%. The detection coefficient of cases with grade two disability reduced significantly by 7.4% while those with grade one increased by 16.8%. Conclusions: Despite the downward trend in the detection coefficient in children and adolescents under 15 years of age and in cases with grade two disability, other factors indicate failure in the adequate management of leprosy in Palmas.

Factors Associated with Suicide among Police Officers in Brazil: An Integrative Literature Review Study

The study aimed to identify factors associated with suicide among police officers in Brazil. This is an integrative literature review that was based on the following guiding question: "What are the factors associated with suicide among police officers in Brazil?". Searches were performed in November 2023 in the scientific databases Virtual Health Library (VHL) (https:// pesquisa.bvsalud.org/portal/) and PubMed (https://pubmed.ncbi.nlm.nih.gov/), from the search key: ((POLICE) AND (SUICIDE)) and (BRAZIL). The descriptors used were extracted from the Mesh/National Library of Medicine platform. Original articles published in the last 10 years that presented characteristics, profile and risk factors associated with suicide were included. Literature review studies, dissertations, theses, letters to the editor and articles in duplicate were excluded. The studies were published between 2007 and 2022. The sample consisted of quantitative descriptive studies (n=3), retrospective cohort (n=1) and ecological time series (n=1). The surveys had samples mostly composed of military police men; only one study investigated federal highway police. The factors associated with suicide and suicidal ideation among police officers in Brazil were financial complications, psychopathological comorbidities, male sex, young age and incipient career graduation.

HEALTH AND WELL-BEING ACROSS ECOLOGICAL SYSTEMS AND TIME IN MID LIFE AND LATE ADULTHOOD

Abstract Health and well-being are shaped by peoples’ experiences and ecological contexts (Bronfenbrenner, 2005), reflecting the influence of complex person-context relationships. For example, experiences (e.g., daily stressors, early childhood adversity) occur within microlevel (e.g., marital relationships, neighborhoods) and macrolevel (e.g., societal inequalities) contexts, impacting both daily well-being and healthy aging. Further, a robust literature highlights the significance of naturally occurring everyday experiences for a range of health outcomes, underscoring how daily experiences have immediate and lasting effects on individual physical and cognitive health and psychological well-being. Drawing on Bronfenbrenner’s Ecological Model, the current symposium features novel research examining health and well-being outcomes across diverse ecological systems and time scales across midlife and old age, with the goal of articulating how innovative approaches for studying person-context interactions can be leveraged to understand both proximal and long-term health and well-being. Polenick and colleagues will examine associations between daily negative and positive events and well-being among heterosexual married couples living with early-stage dementia. Cichy et al. will examine gender differences in the prospective effects of daily stress processes on long-term chronic disease risk in midlife and later life. Next, Turner and Mogle will examine how positive and negative affect mediate the associations between daily memory lapses and psychological well-being. Finally, Choi, Munoz, Scott, and Sliwinski will examine whether current positive (i.e., neighborhood cohesion) and negative (i.e., neighborhood violence) neighborhood contexts moderate the effect of childhood stress exposure on cognitive function in adulthood. Robert Stawski will synthesize the presentations and offer insights for future research.

Three years of COVID-19 pandemic: comparative analysis of incidence, lethality and mortality among the States of the South Region of Brazil

Introduction: in Brazil, the first case of COVID-19 was confirmed on February 26, 2020 As of March 17, 2023, the Ministry of Health recorded 699,634 deaths from COVID-19, with a fatality rate of 1.9%. The impact of the COVID-19 pandemic in Brazil in socioeconomic and health system spheres and a reflection of major regional differences. Objective: to analyze mortality, incidence and lethality due to COVID-19 in the states of Paraná and Santa Catarina, southern Brazil. Methods: this is an ecological time series study using official Brazilian secondary data for cases and deaths from COVID-19. The data were extracted from the panel of the State Department of Health of the states of Santa Catarina and Paraná. For trend analysis, time series were developed using the Prais-Winsten regression model. Statistical analyzes were performed using STATA 14.0 software (College Station, TX, USA, 2013). Results: in the analysis of rates in the total period analyzed, the trends for mortality, lethality and incidence in the state of Santa Catarina are decreasing, decreasing and stationary, respectively. In the state of Paraná, rates in the total period showed a stationary, decreasing and increasing trend for mortality, lethality and incidence, respectively. Conclusion: COVID-19 had a devastating effect on the states of Santa Catarina and Paraná. Both states suffered from the progress of the COVID-19 pandemic, with higher lethality and mortality rates being observed in the state of Paraná, while Santa Catarina had a higher incidence rate over the three years it was in effect. COVID-19 pandemic.

Local compositional change and regional stability across 3000 years of coral reef development

AbstractAimMeasuring changes in ecological diversity over time is core to understanding and managing human impacts on natural systems. Observational data do not capture pre‐modern community states or multiple generations of long‐lived taxa, so interpretation of current diversity trends requires comparison with the past. We aimed to estimate diversity trends over long time periods in a series of fossil coral terraces.LocationHuon peninsula, Papua New Guinea.Time Period9817–6433 years before 1950 AD.Major Taxa StudiedThirty‐five genera of Sceleractinian coral.MethodsWe estimated trends in standing richness (α diversity) and turnover (temporal β diversity) in palaeoecological time series of fossil reef terraces. We compared taxonomic and functional group composition estimates of α diversity, using Hill numbers, and β diversity, measured both sequentially along each time series and to the earliest community.ResultsWe found regional‐scale trends of slowly increasing α diversity and directional turnover driven by increased evenness over time. These regional trends were averages of local‐scale trends in α and β diversity that were largely synchronous, even as coral composition diverged between spatial clusters. Our two β diversity estimates provided opposing, but complementary, reference frames to understand the magnitude and rate of compositional change in ecological time series.Main ConclusionsWe provide evidence that prior to strong anthropogenic influence, natural communities were experiencing directional diversity and compositional change. Our results provide a valuable perspective of diversity dynamics in the recent geological past, including how choices in the measurement of diversity can occlude and influence results.

Marine reserves promote cycles in fish populations on ecological and evolutionary time scales.

Marine reserves are considered essential for sustainable fisheries, although their effectiveness compared to traditional fisheries management is debated. The effect of marine reserves is mostly studied on short ecological time scales, whereas fisheries-induced evolution is a well-established consequence of harvesting. Using a size-structured population model for an exploited fish population of which individuals spend their early life stages in a nursery habitat, we show that marine reserves will shift the mode of population regulation from low size-selective survival late in life to low, early-life survival due to strong resource competition. This shift promotes the occurrence of rapid ecological cycles driven by density-dependent recruitment as well as much slower evolutionary cycles driven by selection for the optimal body to leave the nursery grounds, especially with larger marine reserves. The evolutionary changes increase harvesting yields in terms of total biomass but cause disproportionately large decreases in yields of larger, adult fish. Our findings highlight the importance of carefully considering the size of marine reserves and the individual life history of fish when managing eco-evolutionary marine systems to ensure both population persistence as well as stable fisheries yields.

Association between hospitalizations for sensitive conditions and quality of primary care.

To analyze the association between municipal rates of ambulatory care sensitive conditions (ACSC) hospitalization and the quality of primary health care (PHC), socioeconomic, and demographic variables and those related to local characteristics of the health system from 2010 to 2019. Ecological time series study in Brazilian municipalities analyzing the correlation of ACSC hospitalization rates with PHC quality measured by the three cycles of the Primary Care Access and Program for improving primary care access and quality (PMAQ-AB). The study included municipalities whose teams participated in 80% or more of at least two PMAQ-AB cycles. The correlation between standardized ACSC hospitalization rates and PHC quality and other variables was analyzed. Spearman's test was used between the response variable and numerical explanatory variables. Generalized equations estimation was used as a multivariate model associating ACSC hospitalization rates with the other variables over the years. A total of 3,500 municipalities were included in the models. The quality of PHC (PMAQ-AB score) showed an inverse association with the variation in ACSC hospitalization rates. Hospitalization rates fell by -2% per year every ten-point increase in the PMAQ-AB score, adjusted by the remaining variables. A one-unit increase in the beds per 1,000 inhabitants variable had an impact of approximately +6.4% on ACSC hospitalization rates. Regarding population size, larger municipalities had lower ACSC hospitalization rates. Increased PHC coverage and lower socioeconomic inequality were also associated with the reduction in hospitalizations. The reduction in ACSC hospitalization rates over time was associated with an increase in the quality of PHC. It was also associated with a reduction in the number of hospital beds and municipalities with better socioeconomic indicators.