Female age and reproductive stage influence copulation patterns in mountain gorillas’ variable mating system

Variation in mating systems and in individuals’ copulation patterns can have important consequences for the genetic structure of a population and ultimately its evolution. Whilst most gorilla sub-species form single-male, polygynous reproductive groups, mountain gorillas have both single-male and multimale reproductive groups. Considerable research has investigated the mating patterns of males in these multimale groups, but comparatively little is known about females. We investigated the copulation patterns of 71 female mountain gorillas over 13 years. We found that most sexually active, fecundable females in multimale groups had multiple mating partners. Females’ copulation patterns varied based on their reproductive stage, mating most often and with the greatest number of partners when they were pregnant, and least often when they had young dependent offspring. Females copulated throughout pregnancy, with pregnant females copulating more frequently in single-male groups than in multimale groups. Mating also varied with age, with older females mating less often and with fewer partners. Our findings confirm that when females transfer between single-male and multimale groups, they predominantly switch from copulating with one male to copulating with multiple males, and that females are also flexibly adjusting their copulation patterns across their lifetimes. This highlights the considerable variability of the mountain gorillas mating system, particularly from the female perspective, and the importance of accounting for within-species variation in copulation patterns. Significance statement Patterns of mating can vary both between individuals of the same species and within individuals across their lives. These patterns influence the genetic structure of a population. By examining copulation patterns in female mountain gorillas, we demonstrate that whilst females in single-male groups have only one mating partner, females in multi-male groups predominantly have multiple partners across a year. They also alter their copulation patterns across their lifetimes, copulating less often and with fewer partners as they age, and copulating most when pregnant. Our results highlight the flexibility with which female mountain gorillas can adjust their copulation patterns across their lifetimes, as the costs and benefits of copulation shift

Dominance rank but not body size influences female reproductive success in mountain gorillas

According to life history theory, natural selection has shaped trade-offs for allocating energy among growth, reproduction and maintenance to maximize individual fitness. In social mammals body size and dominance rank are two key variables believed to influence female reproductive success. However, few studies have examined these variables together, particularly in long-lived species. Previous studies found that female dominance rank correlates with reproductive success in mountain gorillas (Gorilla beringei beringei), which is surprising given they have weak dominance relationships and experience seemingly low levels of feeding competition. It is not currently known whether this relationship is primarily driven by a positive correlation between rank and body size. We used the non-invasive parallel laser method to measure two body size variables (back breadth and body length) of 34 wild adult female mountain gorillas, together with long-term dominance and demography data to investigate the interrelationships among body size, dominance rank and two measures of female reproductive success (inter-birth interval N = 29 and infant mortality N = 64). Using linear mixed models, we found no support for body size to be significantly correlated with dominance rank or female reproductive success. Higher-ranking females had significantly shorter inter-birth intervals than lower-ranking ones, but dominance rank was not significantly correlated with infant mortality. Our results suggest that female dominance rank is primarily determined by factors other than linear body dimensions and that high rank provides benefits even in species with weak dominance relationships and abundant year-round food resources. Future studies should focus on the mechanisms behind heterogeneity in female body size in relation to trade-offs in allocating energy to growth, maintenance and lifetime reproductive success

An updated atlas of human helminth infections: the example of East Africa.

BACKGROUND: Reliable and updated maps of helminth (worm) infection distributions are essential to target control strategies to those populations in greatest need. Although many surveys have been conducted in endemic countries, the data are rarely available in a form that is accessible to policy makers and the managers of public health programmes. This is especially true in sub-Saharan Africa, where empirical data are seldom in the public domain. In an attempt to address the paucity of geographical information on helminth risk, this article describes the development of an updated global atlas of human helminth infection, showing the example of East Africa. METHODS: Empirical, cross-sectional estimates of infection prevalence conducted since 1980 were identified using electronic and manual search strategies of published and unpublished sources. A number of inclusion criteria were imposed for identified information, which was extracted into a standardized database. Details of survey population, diagnostic methods, sample size and numbers infected with schistosomes and soil-transmitted helminths were recorded. A unique identifier linked each record to an electronic copy of the source document, in portable document format. An attempt was made to identify the geographical location of each record using standardized geolocation procedures and the assembled data were incorporated into a geographical information system. RESULTS: At the time of writing, over 2,748 prevalence surveys were identified through multiple search strategies. Of these, 2,612 were able to be geolocated and mapped. More than half (58%) of included surveys were from grey literature or unpublished sources, underlining the importance of reviewing in-country sources. 66% of all surveys were conducted since 2000. Comprehensive, countrywide data are available for Burundi, Rwanda and Uganda. In contrast, information for Kenya and Tanzania is typically clustered in specific regions of the country, with few records from areas with very low population density and/or environmental conditions which are unfavourable for helminth transmission. Information is presented on the prevalence and geographical distribution for the major helminth species. CONCLUSION: For all five countries, the information assembled in the current atlas provides the most reliable, up-to-date and comprehensive source of data on the distribution of common helminth infections to guide the rational implementation of control efforts

Multiculturalism in healthcare in Finland : literature review

Multiculturalism is both a challenge and a concern in the 21st century healthcare environment. The ever-increasing immigration and demand for foreign labor, has both positive and negative effects on the daily lives of health professionals. In their work, they encounter people from different religions, different ethnic groups, and different geographical backgrounds. In multicultural nursing, health professionals must respect and value cultural diversity. An open and receptive approach to people’s diversity, promotes professional growth and leads to a greater understanding of the specificities of different cultures. The internalisation of social structures and diversity also provides a basis for accepting the differences of the broad human spectrum. Gender roles, sexuality, and social status are examples of these. This literature review addresses the work-related challenges and benefits faced by healthcare professionals in a multicultural work environment. The thesis also presents solutions to these challenges. The literature review has been based on scientific publications as well as other reliable academic sources and databases, such as EBSCO, PUBMED, Sage Journals, GOOGLE Scholar, Science direct and Cinahl andmaster’s Literature Review, 2011-2021. The thesis on multicultural health care covers most aspects of the health care system for citizens and immigrants (health care personnel) and solutions to a global nursing phenomenon

Human-Wildlife Conflict in Golden Monkeys (Cercopithecus mitis kandti) of the Volcanoes National Park, Rwanda

This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s10764-023-00365-8Human-wildlife conflict, in particular crop-foraging, challenges conservationists worldwide. Endangered golden monkeys (Cercopithecus mitis kandti) are frequent crop-foragers around Volcanoes National Park (VNP), Rwanda. To evaluate the impact of crop-foraging behaviour on monkeys and farmers, we interviewed 45 farmers near VNP using a structured questionnaire and organised a workshop for local and regional actors to discuss mitigation measures. To investigate differences in monkey behaviour when foraging inside versus outside VNP, and to inform mitigation strategies, we collected ad libitum behavioural data from one habituated golden monkey group for 11 weeks. We tested the feasibility of a taste aversion technique to deter monkeys, by placing chilli-laced potatoes in harvested potato fields adjacent to the study group’s home range, but found that experimental aversion techniques were logistically challenging. Of 38 farmers, 95% experienced potato loss to monkeys and 36% of 44 farmers threw objects at/chased monkeys in the previous farming season. Farmers and workshop participants judged the most effective way to mitigate crop-foraging to be through improvement of existing crop-guarding. Behavioural observations indicated increased vigilance behaviour and decreased social behaviour when in farmland. Monkeys (N=9) that visited the experimental area avoided chilli-laced potatoes but continued to forage on nearby crops. In conclusion, our results indicate that crop-foraging can negatively impact farmers' livelihoods and attitudes and can increase vigilance behaviour of monkeys. Our multi-faceted approach enabled the involvement of a wide range of stakeholders, highlighted the urgent need to improve existing management measures and explored alternatives to facilitate positive coexistence between monkeys and farmers

Multiple mechanisms for inbreeding avoidance used simultaneously in a wild ape

Mating with close kin can have considerable negative fitness consequences, which are expected to result in selective pressure for inbreeding avoidance mechanisms, such as dispersal, mate choice and post-copulatory biases. Captive studies have suggested that inbreeding avoidance through mate choice is far less widespread than expected and may be absent where other mechanisms already limit inbreeding. However, few studies have examined multiple mechanisms of inbreeding avoidance simultaneously, particularly in the wild. We use 13 years of detailed dispersal, copulation and paternity data from mountain gorillas to examine inbreeding avoidance. We find that partial dispersal of both sexes results in high kinship in multimale groups, but that copulations between close kin occur 40% less than expected. We find strong kin discrimination in mate choice, with significant avoidance of maternal kin but more limited avoidance of paternal kin. We find no evidence for post-copulatory inbreeding avoidance. Our analyses support familiarity-based mechanisms of kin identification and age-based avoidance that limits mating between fathers and daughters in their natal group. Our findings demonstrate that multiple complementary mechanisms for inbreeding avoidance can evolve in a single species and suggest that inbreeding avoidance through mate choice may enable more flexible dispersal systems to evolve

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit