Genetic data suggest a natural prehuman origin of open habitats in northern Madagascar and question the deforestation narrative in this region.

The impact of climate change and anthropogenic deforestation on biodiversity is of growing concern worldwide. Disentangling how past anthropogenic and natural factors contributed to current biome distribution is thus a crucial issue to understand their complex interactions on wider time scales and to improve predictions and conservation strategies. This is particularly important in biodiversity hotspots, such as Madagascar, dominated by large open habitats whose origins are increasingly debated. Although a dominant narrative argues that Madagascar was originally entirely covered by woodlands, which were destroyed by humans, a number of recent studies have suggested that past climatic fluctuations played a major role in shaping current biome distributions well before humans arrived. Here, we address the question of the origin of open habitats in the Daraina region in northern Madagascar, using a multiproxy approach combining population genetics modeling and remote-sensing analyses. We show that (i) contrary to most regions of Madagascar, the forest cover in Daraina remained remarkably stable over the past 60 y, and (ii) the golden-crowned sifaka (Propithecus tattersalli), a forest-dwelling lemur, underwent a strong population contraction before the arrival of the first humans, hence excluding an anthropogenic cause. Prehuman Holocene droughts may have led to a significant increase of grasslands and a reduction in the species' habitat. This contradicts the prevailing narrative that land cover changes are necessarily anthropogenic in Madagascar but does not preclude the later role played by humans in other regions in which recent lemur bottlenecks have been observed.

Use of the Rasch Model for Initial Testing of Fit Statistics and Rating Scale Diagnosis for a General Anesthesia Satisfaction Questionnaire.

BACKGROUND AND PURPOSE: The level of patient satisfaction is a result of a complex set of interactions between the patient and the health care provider. It is important to quantify satisfaction with care because it involves the patient in the care experience and decreases the potential gap between expected and actual care delivered. METHODS: We tested a preliminary 23-item instrument to measure patient satisfaction with general anesthesia care. The rating scale Rasch model was chosen as the framework. RESULTS: There were 10 items found to have sufficient evidence of stable fit statistics. Items included 2 questions related to information provided, 2 questions related to concern and kindness of the provider, and 1 question each for interpersonal skills of the provider, attention by the provider, feeling safe, well-being, privacy, and overall anesthesia satisfaction. CONCLUSION: Such actions as providing enough time to understand the anesthesia plan, answering questions related to the anesthetic, showing kindness and concern for the patient, displaying good interpersonal skills, providing adequate attention to the patient, providing a safe environment that maintains privacy and provides a sense of well-being are important actions that are well within the control of individual anesthesia providers and may lead to improved care from the perception of the patient.