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Meeting international commitments to protect 17% of terrestrial ecosystems worldwide will require >3 million square kilometers of new protected areas and strategies to create those areas in a way that respects local communities and land use. In 2000-2016, biological and social scientists worked to increase the protected proportion of Peru's largest department via 14 interdisciplinary inventories covering >9 million hectares of this megadiverse corner of the Amazon basin. In each landscape, the strategy was the same: convene diverse partners, identify biological and sociocultural assets, document residents' use of natural resources, and tailor the findings to the needs of decision-makers. Nine of the 14 landscapes have since been protected (5.7 million hectares of new protected areas), contributing to a quadrupling of conservation coverage in Loreto (from 6 to 23%). We outline the methods and enabling conditions most crucial for successfully applying similar campaigns elsewhere on Earth.
ABSTRACT
INTRODUCCIÓN: El suicidio es un importante problema de salud, cuyas razones subyacentes y patrones de riesgo espaciotemporales no se conocen bien. Este estudio ecológico tuvo como objetivo describir y caracterizar los patrones espaciotemporales del suicidio en la España peninsular durante el período 1999-2018. MÉTODOS: Los datos de mortalidad por suicidios y de población a nivel provincial se obtuvieron del Instituto Nacional de Estadística. Para cada año, provincia y sexo, analizamos los riesgos relativos suavizados (RRs) de mortalidad por suicidio utilizando modelos jerárquicos bayesianos. RESULTADOS: Durante el período de estudio se produjeron 63.307 muertes por suicidio, 47.849 en hombres y 15.458 en mujeres. El riesgo de suicidio durante todo el período de estudio estuvo por encima del promedio nacional para ambos sexos en las provincias de Granada, La Coruña, Lugo y Asturias. En los hombres, esto también ocurrió en Jaén. Los hombres en Madrid y Cantabria, y las mujeres en Madrid, Toledo y Badajoz, mostraron RRs menores de 1 (PP<0,05) durante los 20 años del estudio. El mapa de probabilidades posteriores indica que la mayoría de las provincias en la zona noroeste (Pontevedra, La Coruña, Lugo y Asturias en ambos sexos y León y Orense en mujeres) y el sudeste (Jaén, Málaga, Granada, Almería en ambos sexos, y Córdoba y Ciudad Real en hombres) presentaron riesgos significativamente altos (probabilidades posteriores mayores de 0,95). CONCLUSIONES: Nuestros hallazgos, al identificar áreas donde dirigir programas o estrategias para reducir o eliminar el riesgo de mortalidad por suicidio, muestran la importancia de este tipo de análisis para abordar los problemas de salud pública relacionados con este fenómeno
BACKGROUND: Suicide is a major health problem, whose underlying reasons and spatial-temporal risk patterns are not well understood. This ecological study aims to describe and characterize the spatiotemporal patterns of suicide in mainland Spain during the period 1999-2018. METHODS: Data on mortality from suicide and population at the provincial level were obtained from the National Institute of Statistics. For each year, province, and sex, we analysed the smoothed relative risks (RRs) of suicide mortality using Bayesian hierarchical models. RESULTS: During the study period there were 63,307 suicide deaths, 47,849 in men and 15,458 in women.The risk of suicide throughout the study period is above the national average for both sexes in the provinces of Granada, La Coruña, Lugo and Asturias. In men, this also happens in Jaen. Men in Madrid and Cantabria and women in Madrid, Toledo and Badajoz showed RRs less than 1 (PP<0.05) during the 20 years of the study. The posterior probabilities map indicates that most of the provinces in the Northwest zone (Pontevedra, La Coruña, Lugo and Asturias in both sexes and Leon and Orense in women) and Southeast (Jaen, Malaga, Granada, Almería in both sexes, and Cordoba and Ciudad Real in men) present significantly high risks (posterior probabilities greater than 0.95). CONCLUSIONS: Our findings, identifying areas where to direct programs or strategies to reduce or eliminate the risk of mortality by suicide, show the importance of this type of analysis in addressing public health problems
Subject(s)
Humans , Suicide/statistics & numerical data , 50207 , Time Series Studies , Bayes Theorem , Spatial Analysis , Preventive Health Services/organization & administration , Suicide/prevention & control , Suicide, Attempted/prevention & control , Risk Map , Ecological StudiesABSTRACT
BACKGROUND: Sepsis, a life-threatening organ dysfunction caused by a dysregulated systemic immune response to infection, associates with reduced responsiveness to subsequent infections. How such tolerance is acquired is not well understood but is known to involve epigenetic and transcriptional dysregulation. METHODS: Bead arrays were used to compare global DNA methylation changes in patients with sepsis, non-infectious systemic inflammatory response syndrome, and healthy controls. Bioinformatic analyses were performed to dissect functional reprogramming and signaling pathways related to the acquisition of these specific DNA methylation alterations. Finally, in vitro experiments using human monocytes were performed to test the induction of similar DNA methylation reprogramming. RESULTS: Here, we focused on DNA methylation changes associated with sepsis, given their potential role in stabilizing altered phenotypes. Tolerized monocytes from patients with sepsis display changes in their DNA methylomes with respect to those from healthy controls, affecting critical monocyte-related genes. DNA methylation profiles correlate with IL-10 and IL-6 levels, significantly increased in monocytes in sepsis, as well as with the Sequential Organ Failure Assessment score; the observed changes associate with TFs and pathways downstream to toll-like receptors and inflammatory cytokines. In fact, in vitro stimulation of toll-like receptors in monocytes results in similar gains and losses of methylation together with the acquisition of tolerance. CONCLUSION: We have identified a DNA methylation signature associated with sepsis that is downstream to the response of monocytes to inflammatory signals associated with the acquisition of a tolerized phenotype and organic dysfunction.
