Beyond the surface: Seabirds and plastics as indicators in a large, remote marine protected area.

Marine protected areas (MPAs) are an important conservation tool for species and habitats; however, they are not a panacea solution. For example, MPAs provide little protection from plastic pollution which travels vast distances on ocean currents. Here we document exposure of juvenile Christmas Shearwaters (Puffinus nativitatis) to plastics on uninhabited Ducie Atoll in the remote South Pacific. Despite being surrounded by the very large Pitcairn Islands MPA, most birds (68.7 %; n = 16) contained 3.8 ± 4.1 pieces of ingested plastic. Unexpectedly, the number, mass and frequency of occurrence of plastic in two age classes (young downy chicks and fledglings) was similar. While the reason for this is unknown, it may suggest birds do not acquire new plastic items, or are able to rid themselves of plastics, beyond a certain age. We discuss the potential health consequences of plastic ingestion in Christmas Shearwaters and call for further research of this poorly studied species.

Evaluating the impact of landscape configuration, patterns and composition on land surface temperature: an urban heat island study in the Megacity Lahore, Pakistan.

The urban heat island (UHI) phenomenon is negatively impacted by rapid urbanization, which significantly affects people's everyday lives, socioeconomic activities, and the urban thermal environment. This study focuses on the impact of composition, configuration, and landscape patterns on land surface temperature (LST) in Lahore, Pakistan. The study uses Landsat 5-TM and Landsat 8-OLI/TIRS data acquired over the years 2000, 2010 and 2020 to derive detailed information on land use, normalized difference vegetation index, LST, urban cooling islands (UCI), green cooling islands (GCI) and landscape metrics at the class and landscape level such as percentage of the landscape (PLAND), patch density (PD), class area (CA), largest patch index (LPI), number of patches (NP), aggregation index (AI), Landscape Shape Index (LSI), patch richness (PR), and mean patch shape index (SHAPE_MN). The study's results show that from the years 2000 to 2020, the built-up area increased by 17.57%, whereas vacant land, vegetation, and water bodies declined by 03.79%, 13.32% and 0.4% respectively. Furthermore, landscape metrics at the class level (PLAND, LSI, LPI, PD, AI, and NP) show that the landscape of Lahore is becoming increasingly heterogeneous and fragmented over time. The mean LST in the study area exhibited an increasing trend i.e. 18.87°C in 2000, 20.93°C in 2010, and 22.54°C in 2020. The significant contribution of green spaces is vital for reducing the effects of UHI and is highlighted by the fact that the mean LST of impervious surfaces is, on average, roughly 3°C higher than that of urban green spaces. The findings also demonstrate that there is a strong correlation between mean LST and both the amount of green space (which is negative) and impermeable surface (which is positive). The increasing trend of fragmentation and shape complexity highlighted a positive correlation with LST, while all area-related matrices including PLAND, CA and LPI displayed a negative correlation with LST. The mean LST was significantly correlated with the size, complexity of the shape, and aggregation of the patches of impervious surface and green space, although aggregation demonstrated the most constant and robust correlation. The results indicate that to create healthier and more comfortable environments in cities, the configuration and composition of urban impermeable surfaces and green spaces should be important considerations during the landscape planning and urban design processes.

How urban heat island magnifies hot day exposure: Global unevenness derived from differences in built landscape.

Urban heat-islands reportedly expose densely populated areas to higher temperatures. However, the magnitude of the impact of extra hot-day exposure (EHDE) and its association with the effects of urbanization on a global scale remain unclear. As local climate zones (LCZs) refine the impact of differences in urban built-type on heat-island effects, this study aimed to quantify the global EHDE caused by the urban heat-island effect based on LCZs and explored the joint impacts of low gross-domestic product and an increasing vulnerable-age population on EHDE. The results showed that EHDE accounted for 48.01 % of overall hot-day exposure. Additionally, despite a significant geographic differentiation among LCZ types with the highest EHDE intensity, they are almost typically building-intensive LCZs. Furthermore, our study revealed regional differences in the structure of the EHDE share in LCZs, which support the adoption of targeted EHDE mitigation strategies.

Undetection of vector-borne viruses in equids of Galapagos Islands.

Domestic species, including equids, were introduced in the Galapagos Islands in the XIX century. Equine vector-borne diseases are circulating in South America but their occurrence in the Galapagos Island was unknown. The objective of this study was to detect the occurrence of West Nile virus (WNV), Usutu virus (USUV) and equine infectious anemia virus (EIAV) in the four Galapagos Islands raising equids if they were present at a prevalence >1%. Serum samples were collected from 411 equids belonging to 124 owners from April to July 2019. All the results were negative to the ELISA tests used suggesting that WNV, USUV and EIAV are not circulating in the equine population of the Galapagos Islands.

Metal concentrations in echinoderms: Assessing bioindicator potential and ecological implications.

This study investigates the concentrations of heavy metals and trace elements in five echinoderm species: Holothuria (Platyperona) sanctori, Arbacia lixula, Coscinasterias tenuispina, Ophioderma longicaudum, and Antedon bifida. Given their ecological significance and potential as a food source, understanding the presence and transfer of heavy metals in these species is crucial. Sampling was conducted in 2022 in Canary Islands. Analysis using ICP-OES revealed concentrations of Zn, Cd, Pb, Cu, Ni, Cr, and Fe in mg/kg. The results showed a consistent sequence of metals across all species, with Fe > Zn > Cu > Ni > Cr > Pb > Cd. Holothurians exhibiting the highest levels, followed by sea urchins. Starfish and brittle stars showed similar, lower concentrations, while crinoids exhibited the lowest levels, consistent with their filter-feeding behavior. The findings highlight the potential of holothurians as bioindicators for environmental pollutants. Understanding the role of these echinoderms as bioindicators is essential for assessing ecosystem health and informing conservation efforts in subtropical marine environments.

Mortality of Patients With Inflammatory Bowel Disease in the Faroe Islands From 1966-2020.

BACKGROUND: Increased mortality rates have been found in patients suffering from inflammatory bowel disease (IBD). The Faroe Islands have the highest occurrence of IBD, mainly ulcerative colitis (UC). This study investigated mortality of patients with IBD compared with the general Faroese population. METHODS: All patients diagnosed with IBD from 1966-2020 were included, as well as population mortality data. All-cause and cause-specific mortality in the IBD cohort was compared with the population by standardized incidence ratios (SIRs). Risk factors for death within the cohort were assessed by hazard ratios (HRs) using Cox regression. RESULTS: Overall mortality was not increased in patients with Crohn's disease (CD; SIR 0.9; 95% confidence interval [CI], 0.56-1.35) or UC (SIR 1.0; 95% CI, 0.83-1.25). However, patients with UC had an elevated risk of dying from digestive diseases (SIR 4.3; 95% CI, 2.16-7.74). Patients with IBD had lower risk of death of cardiovascular diseases compared with the background population (SIR 0.7; 95% CI, 0.50-0.93). Risk factors for mortality included male gender, age at diagnosis, and use of steroids. Protective factors were use of 5-aminosalicylic acid (5-ASA), thiopurines, and biological treatment. CONCLUSIONS: No increased risk of all-cause mortality in patients with CD or UC was found in this nationwide study compared with the entire Faroese population over more than 5 decades. The risk of death due to digestive diseases was, however, increased in patients with UC, while mortality risk of cardiovascular diseases was lower in patients with IBD.

Increased mortality exists in IBD patients. The Faroe Islands have the highest occurrence in the world, though mortality risk in Faroese patients compared with the population is unknown. No increased overall risk was found, while mortality risk of digestive diseases was elevated.

Cestode diversity in shrews from islands in the Sea of Japan and the Sea of Okhotsk.

A comparative analysis of taxonomic diversity on shrew cestodes among four islands in the Sea of Japan and the Sea of Okhotsk (Sakhalin, Kunashir, Hokkaido, and Moneron) was performed. Cestode species shared among the islands were identified and their host specificity was investigated. On Sakhalin Island, 33 species of the families Hymenolepididae, Dilepididae and Mesocestoididae were recorded in four shrew species (Sorex caecutiens, S. gracillimus, S. minutissimus and S. unguiculatus). In S. caecutiens, S. gracillimus, and S. unguiculatus on Kunashir Island, 22 species of the same families were found and, on Hokkaido Island, 23 species of the families Hymenolepididae and Dilepididae were recorded. On Moneron Island, three species of cestodes were registered in S. tundrensis. The Sakhalin-Hokkaido-Kunashir complex of shrew cestodes includes eastern-Palearctic, trans-Palearctic and endemic species. High endemism (~22%) of shrew tapeworms in the Sakhalin-Kunashir-Hokkaido Islands was noted as compared to continental territories. The different numbers of cestode species in S. unguiculatus (31), S. caecutiens (29), S. gracillimus (19) and S. minutissimus (1) were found. It was concluded that the cestodes species diversity of shrews of Sakhalin-Kunashir-Hokkaido depended primarily on the history of island formation, their modern physical and geographical features, the abundance of definitive and intermediate cestodes hosts and, to a lesser extent, on the size and remoteness of the islands from the mainland and the diversity of host species.

Investigating the effects of underwater noise from two vessels on the behaviour of short-finned pilot whales.

Multiple whale-watching vessels may operate around cetaceans at any one time, and targeted animals may experience underwater noise effects. We hypothesised that the cumulative noise of two vessels with low source levels (SLs) will elicit lower behavioural disturbance in short-finned pilot whales (Globicephala macrorhynchus) compared to a single vessel with a higher SL. We measured the behaviour of whales during 26 controls (stationary vessel >300 m) and 44 treatments off Tenerife (Canary Islands, Spain). Treatments consisted of vessel approaches mimicking whale-watch scenarios (distance ∼60 m, speed 1.5 kn). Approaches with two simultaneous vessels, with maximum cumulative mid and low-frequency (0.2-110 kHz) weighted source levels (SLsMF-LF) 137-143 dB, did not affect mother-calf pairs' resting, nursing, diving, respiration rate or inter-breath interval. However, a louder single vessel approach with twin petrol engines at SLsMF-LF 139-151 dB significantly decreased the proportion of time resting for the mother. The results suggest that if a single or two vessels are present, if the cumulative SL is < 143 dB, the behavioural disturbance on the whales will be negligible. By examining noise effects from multiple vessels on the behaviour of pilot whales, the importance of incorporating a noise threshold into whale-watching guidelines was emphasised.

Complete genome sequence of Vibrio parahaemolyticus ST36 strain MAVP-26, a clinical isolate from an oyster-borne human gastric infection.

A Pacific native lineage of Vibrio parahaemolyticus ST36 serotype O4:K12 was introduced into the Atlantic, which increased local source illnesses. To identify genetic determinants of virulence and ecological resiliency and track their transfer into endemic populations, we constructed a complete genome of a 2013 Atlantic-traced clinical isolate by hybrid assembly.

The effect of terrain on the fine-scale genetic diversity of sub-Antarctic Collembola: A landscape genetics approach.

Biodiversity patterns are shaped by the interplay between geodiversity and organismal characteristics. Superimposing genetic structure onto landscape heterogeneity (i.e., landscape genetics) can help to disentangle their interactions and better understand population dynamics. Previous studies on the sub-Antarctic Prince Edward Islands (located midway between Antarctica and Africa) have highlighted the importance of landscape and climatic barriers in shaping spatial genetic patterns and have drawn attention to the value of these islands as natural laboratories for studying fundamental concepts in biology. Here, we assessed the fine-scale spatial genetic structure of the springtail, Cryptopygus antarcticus travei, which is endemic to Marion Island, in tandem with high-resolution geological data. Using a species-specific suite of microsatellite markers, a fine-scale sampling design incorporating landscape complexity and generalised linear models (GLMs), we examined genetic patterns overlaid onto high-resolution digital surface models and surface geology data across two 1-km sampling transects. The GLMs revealed that genetic patterns across the landscape closely track landscape resistance data in concert with landscape discontinuities and barriers to gene flow identified at a scale of a few metres. These results show that the island's geodiversity plays an important role in shaping biodiversity patterns and intraspecific genetic diversity. This study illustrates that fine-scale genetic patterns in soil arthropods are markedly more structured than anticipated, given that previous studies have reported high levels of genetic diversity and evidence of genetic structing linked to landscape changes for springtail species and considering the homogeneity of the vegetation complexes characteristic of the island at the scale of tens to hundreds of metres. By incorporating fine-scale and high-resolution landscape features into our study, we were able to explain much of the observed spatial genetic patterns. Our study highlights geodiversity as a driver of spatial complexity. More widely, it holds important implications for the conservation and management of the sub-Antarctic islands.

CpG island turnover events predict evolutionary changes in enhancer activity.

BACKGROUND: Genetic changes that modify the function of transcriptional enhancers have been linked to the evolution of biological diversity across species. Multiple studies have focused on the role of nucleotide substitutions, transposition, and insertions and deletions in altering enhancer function. CpG islands (CGIs) have recently been shown to influence enhancer activity, and here we test how their turnover across species contributes to enhancer evolution. RESULTS: We integrate maps of CGIs and enhancer activity-associated histone modifications obtained from multiple tissues in nine mammalian species and find that CGI content in enhancers is strongly associated with increased histone modification levels. CGIs show widespread turnover across species and species-specific CGIs are strongly enriched for enhancers exhibiting species-specific activity across all tissues and species. Genes associated with enhancers with species-specific CGIs show concordant biases in their expression, supporting that CGI turnover contributes to gene regulatory innovation. Our results also implicate CGI turnover in the evolution of Human Gain Enhancers (HGEs), which show increased activity in human embryonic development and may have contributed to the evolution of uniquely human traits. Using a humanized mouse model, we show that a highly conserved HGE with a large CGI absent from the mouse ortholog shows increased activity at the human CGI in the humanized mouse diencephalon. CONCLUSIONS: Collectively, our results point to CGI turnover as a mechanism driving gene regulatory changes potentially underlying trait evolution in mammals.

Drivers of barrier Island water-table fluctuations and groundwater salinization.

Barrier islands are threatened by climate change as sea-level rise and higher frequency storm surge lead to more flooding and saltwater intrusion. Vegetation plays a vital role in preventing erosion of barrier islands due to aeolian and hydrological forces. However, vegetation on barrier islands is threatened by rising water tables causing hypoxic conditions and storm-surge overwash introducing saline water in the root zone. To better protect barrier island ecosystems, it is critical to identify the relative influence of different hydrological drivers and understand how this influence varies spatially and temporally. In this study, three barrier island sites were instrumented with groundwater wells monitoring water level and specific conductance. Using these data, a set of transfer function noise models were calibrated and used to determine the relative influence of hydrologic drivers including precipitation, evapotranspiration, bay and ocean water levels, and wave height on groundwater levels and specific conductance. We found that drivers of water-level change and specific conductance vary strongly among sites, depending primarily on the surface water connectivity and the geology of the island. Sites with close connection to inlets showed more salinization and responded to a larger number of drivers, while sites that were poorly connected to the ocean responded to fewer drivers.

Comparing trophic position estimates using bulk and compound specific stable isotope analyses: applying new approaches to mackerel icefish Champsocephalus gunnari.

Quantifying the tropic position (TP) of an animal species is key to understanding its ecosystem function. While both bulk and compound-specific analyses of stable isotopes are widely used for this purpose, few studies have assessed the consistency between and within such approaches. Champsocephalus gunnari is a specialist teleost that predates almost exclusively on Antarctic krill Euphausia superba. This well-known and nearly constant trophic relationship makes C. gunnari particularly suitable for assessing consistency between TP methods under field conditions. In the present work, we produced and compared TP estimates for C. gunnari and its main prey using a standard bulk and two amino acid-specific stable isotope approaches (CSI-AA). One based on the difference between glutamate and phenylalanine (TPGlx-Phe), and the other on the proline-phenylalanine difference (TPPro-Phe). To do that, samples from C. gunnari, E. superba and four other pelagic invertebrate and fish species, all potential prey for C.gunnari, were collected off the South Orkney Islands between January and March 2019, analyzed using standard isotopic ratio mass spectrometry methods and interpreted following a Bayesian approach. Median estimates (CI95%) for C. gunnari were similar between TPbulk (3.6; CI95%: 3.0-4.8) and TPGlx-Phe(3.4; CI95%:3.2-3.6), and lower for TPPro-Phe (3.1; CI95%:3.0-3.3). TP differences between C. gunnari and E. superba were 1.4, 1.1 and 1.2, all compatible with expectations from the monospecific diet of this predator (ΔTP=1). While these results suggest greater accuracy for Glx-Phe and Pro-Phe, differences observed between both CSI-AA approaches suggests these methods may require further validation before becoming a standard tool for trophic ecology.

Detection of Salmonella Pathogenicity Islands and Antimicrobial-Resistant Genes in Salmonella enterica Serovars Enteritidis and Typhimurium Isolated from Broiler Chickens.

Rapid growth in commercial poultry production is one of the major sources of Salmonella infections that leads to human salmonellosis. The two main Salmonella enterica serovars associated with human salmonellosis are enteritidis and typhimurium. The aim of this study was to determine the prevalence of S. enterica serovars Enteritidis and S. Typhimurium as well as their Salmonella pathogenicity islands (SPI) and antibiotic resistance profiles in broiler chicken feces from slaughterhouses. A total of 480 fecal samples from broiler chickens that were grouped into 96 pooled samples were identified to have Salmonella spp. using the invA gene, whilst the Spy and sdfI genes were used to screen for the presence of S. Enteritidis and S. Typhimurium serovars, respectively, by polymerase chain reaction (PCR) assays. The isolates were also screened for the presence of Salmonella pathogenicity islands (SPIs) using PCR. The disc diffusion assay was performed to determine the antibiotic resistance profiles of the isolates. A total of 36 isolates were confirmed as Salmonella spp. through amplification of the invA gene. Out of 36 confirmed Salmonella spp. a total of 22 isolates were classified as S. Enteritidis (n = 8) and were S. Typhimurium (n = 14) serovars. All (n = 22) S. Enteritidis and S. Typhimurium isolates possessed the hilA (SPI-1), ssrB (SPI-2) and pagC (SPI-11) pathogenicity islands genes. Amongst these serovars, 50% of the isolates (n = 11/22) were resistant to tetracycline and nalidixic acid. Only 22% of the isolates, S. Typhimurium (13.6%) and S. Enteritidis (9.1%) demonstrated resistance against three or more antibiotic classes. The most detected antibiotic resistance genes were tet(K), mcr-1, sulI and strA with 13 (59.1%), 9 (40.9%), 9 (40.9%) and 7 (31.8%), respectively. The findings of this study revealed that S. Typhimurium is the most prevalent serotype detected in chicken feces. To reduce the risk to human health posed by salmonellosis, a stringent public health and food safety policy is required.

Guidelines for the description of rhizobial symbiovars.

Rhizobia are bacteria that form nitrogen-fixing nodules in legume plants. The sets of genes responsible for both nodulation and nitrogen fixation are carried in plasmids or genomic islands that are often mobile. Different strains within a species sometimes have different host specificities, while very similar symbiosis genes may be found in strains of different species. These specificity variants are known as symbiovars, and many of them have been given names, but there are no established guidelines for defining or naming them. Here, we discuss the requirements for guidelines to describe symbiovars, propose a set of guidelines, provide a list of all symbiovars for which descriptions have been published so far, and offer a mechanism to maintain a list in the future.

Comparative analysis of bacterial diversity in accumulated snow and exposed sediments across Antarctic Islands.

The Antarctic continent hosts exceptional niches, making it an ideal environment for studying polyextremophilic microorganisms. These organisms are uniquely shaped by the geographic niches and variations in soil types. Here we present, a culture-independent approach using DNA metabarcoding to assess the bacterial communities associated with accumulated snow and exposed sediments across different Antarctic islands situated in the Larsemann Hills, Antarctica. The exposed sediments (ES) were found to be more diverse than the accumulated snow (AS) sediments as represented by the alpha diversity metrics. Out of the total 303 amplicon sequence variants (ASVs) found at the genus level, 93 were unique to accumulated snow sediments and 97 were unique to exposed sediments. The bacterial community composition in accumulated snow was dominated by the phylum Actinobacteriota (24.7%). However, Pseudonocardia (11.9%), Crossiella (11%), and Rhodanobacter (9.1%) were the predominant genera. In contrast, in the exposed sediments, Bacteroidota (24.6%) was the most prevalent phylum, with Crossiella (17.1%), Rhodanobacter (11.1%), and Blastocatella (10%) as the most abundant genera. Metagenomic imputations revealed the abundance of gene families responsible for carbon metabolism, coping with environmental stresses through DNA repair mechanisms, and carbon fixation.

Environmental DNA recovers fish composition turnover of the coral reefs of West Indian Ocean islands.

Islands have been used as model systems to study ecological and evolutionary processes, and they provide an ideal set-up for validating new biodiversity monitoring methods. The application of environmental DNA metabarcoding for monitoring marine biodiversity requires an understanding of the spatial scale of the eDNA signal, which is best tested in island systems. Here, we investigated the variation in Actinopterygii and Elasmobranchii species composition recovered from eDNA metabarcoding along a gradient of distance-to-reef in four of the five French Scattered Islands in the Western Indian Ocean. We collected surface water samples at an increasing distance from reefs (0 m, 250 m, 500 m, 750 m). We used a metabarcoding protocol based on the 'teleo' primers to target marine reef fishes and classified taxa according to their habitat types (benthic or pelagic). We investigated the effect of distance-to-reef on ß diversity variation using generalised linear mixed models and estimated species-specific distance-to-reef effects using a model-based approach for community data. Environmental DNA metabarcoding analyses recovered distinct fish species compositions across the four inventoried islands and variations along the distance-to-reef gradient. The analysis of ß-diversity variation showed significant taxa turnover between the eDNA samples on and away from the reefs. In agreement with a spatially localised signal from eDNA, benthic species were distributed closer to the reef than pelagic ones. Our findings demonstrate that the combination of eDNA inventories and spatial modelling can provide insights into species habitat preferences related to distance-to-reef gradients at a small scale. As such, eDNA can not only recover large compositional differences among islands but also help understand habitat selection and distribution of marine species at a finer spatial scale.

A review of Nearctic Lathrobium (Coleoptera, Staphylinidae), with revision and descriptions of new flightless species from the mountains of the southeastern U.S.

Species of the genus Lathrobium Gravenhorst (Coleoptera: Staphylinidae: Paederinae) from North America north of Mexico are reviewed and 41 species are recognized. Morphology and mitochondrial COI sequence data were used to guide species designations in three flightless lineages endemic to the southern Appalachian Mountains, a biologically diverse region known for cryptic diversity. Using a combination of phylogeny, algorithm-based species delimitation analyses, and genitalic morphology, five new cryptic species are described and possible biogeographic scenarios for their speciation hypothesized: L.balsamense Haberski & Caterino, sp. nov., L.camplyacra Haberski & Caterino, sp. nov., L.islae Haberski & Caterino, sp. nov., L.lividum Haberski & Caterino, sp. nov., L.smokiense Haberski & Caterino, sp. nov. Five additional species are described: L.absconditum Haberski & Caterino, sp. nov., L.hardeni Haberski & Caterino, sp. nov., L.lapidum Haberski & Caterino, sp. nov., L.solum Haberski & Caterino, sp. nov., and L.thompsonorum Haberski & Caterino, sp. nov. Two species are transferred from Lathrobium to Pseudolathra Casey: Pseudolathraparcum (LeConte, 1880), comb. nov. and Pseudolathratexana (Casey, 1905), comb. nov. Twenty-six names are reduced to synonymy. Lectotypes are designated for 47 species. Larvae are described where known, and characters of possible diagnostic value are summarized. Species diagnoses, distributions, illustrations of male and female genitalia, and a key to Lathrobium species known from the Nearctic region (including several introduced species) are provided.

'Microcosm of the Pacific': Colonial encounters at the Central Medical School in Fiji.

While larger British colonies in Africa and Asia generally had their own medical services, the British took a different approach in the South Pacific by working with other colonial administrations. Together, colonial administrations of the South Pacific operated a centralised medical service based on the existing system of Native Medical Practitioners in Fiji. The cornerstone of this system was the Central Medical School, established in 1928. Various actors converged on the school despite its apparent isolation from global centres of power. It was run by the colonial government of Fiji, staffed by British-trained tutors, attended by students from twelve colonies, funded and supervised by the Rockefeller Foundation, and jointly managed by the colonial administrations of Britain, Australia, New Zealand, France and the United States. At the time of its establishment, it was seen as an experiment in international cooperation, to the point that the High Commissioner for the Western Pacific called it a 'microcosm of the Pacific'. Why did the British establish an intercolonial medical school in Oceania, so far from the imperial metropole? How did the medical curriculum at the Central Medical School standardise to meet the imperial norm? And in what ways did colonial encounters occur at the Central Medical School? This article provides answers to these questions by comparing archival documents acquired from five countries. In doing so, this article will pay special attention to the ways in which this medical training institution enabled enduring intercolonial encounters in the Pacific Islands.

Working as a Healthcare Professional at Island Primary Care: An Exploratory Qualitative Study on the Cyclades Islands, Greece.

Improving the quality of and access to healthcare services in rural areas is fundamental to developing sustainable healthcare systems. This research aims to explore the motivations of healthcare professionals to work and settle in rural island areas of Greece with limited access to secondary and tertiary care. The study suggests practical ways to encourage self-motivation and attract more health workers in rural areas. An exploratory qualitative research approach was employed, involving semi-structured interviews with 16 healthcare professionals working in primary-care units that lack direct hospital or hospital-health centre access. The research was conducted specifically in the rural islands of the Cyclades. Thematic analysis was conducted to identify common themes and unique insights from the participants. The analysis revealed three thematic categories. Τhe «attraction¼ thematic was influenced by personal factors, random selection, origin, accommodation factors, professional factors, and obligatoriness. The «recruitment¼ thematic was associated with understaffing, special care issues, an unstable working environment, educational and organisational aspects, and an insular lifestyle. The thematic of «retention¼ highlighted personal issues, accommodation difficulties, economic and work-related issues, and unique challenges posed by an insular lifestyle. This research provides valuable insights into the motivations that drive healthcare professionals to settle, work, and remain in remote island units, as well as the challenges they encounter in making this decision. The study proposes strategies to motivate and attract more healthcare professionals to rural areas. These findings should be considered when formulating or reviewing primary healthcare empowerment policies to ensure equitable healthcare access for all individuals.