The demographic history of Madagascan micro-endemics: have rare species always been rare?

Extinction has increased as human activities impact ecosystems, yet relatively few species have conservation assessments. Novel approaches are needed to highlight threatened species that are currently data-deficient. Many Madagascan plant species have extremely narrow ranges, but this may not have always been the case-it is unclear how the island's diverse flora evolved. To assess this, we generated restriction-site associated DNA sequence data for 10 Madagascan plant species, estimated effective population size (Ne) for each species and compared this to census (Nc) sizes. In each case, Ne was an order of magnitude larger than Nc-signifying rapid, recent population decline. We then estimated species' demographic history, tracking changes in Ne over time. We show that it is possible to predict extinction risk, particularly in the most threatened species. Furthermore, simulations showed that our approach has the power to detect population decline during the Anthropocene. Our analyses reveal that Madagascar's micro-endemics were not always rare, having experienced a rapid decline in their recent history. This casts further uncertainty over the processes that generated Madagascar's exceptional biodiversity. Our approach targets data-deficient species in need of conservation assessment, particularly in regions where human modification of the environment has been rapid.

Fire and grazing determined grasslands of central Madagascar represent ancient assemblages.

The ecology of Madagascar's grasslands is under-investigated and the dearth of ecological understanding of how disturbance by fire and grazing shapes these grasslands stems from a perception that disturbance shaped Malagasy grasslands only after human arrival. However, worldwide, fire and grazing shape tropical grasslands over ecological and evolutionary timescales, and it is curious Madagascar should be a global anomaly. We examined the functional and community ecology of Madagascar's grasslands across 71 communities in the Central Highlands. Combining multivariate abundance models of community composition and clustering of grass functional traits, we identified distinct grass assemblages each shaped by fire or grazing. The fire-maintained assemblage is primarily composed of tall caespitose species with narrow leaves and low bulk density. By contrast, the grazer-maintained assemblage is characterized by mat-forming, high bulk density grasses with wide leaves. Within each assemblage, levels of endemism, diversity and grass ages support these as ancient assemblages. Grazer-dependent grasses can only have co-evolved with a now-extinct megafauna. Ironically, the human introduction of cattle probably introduced a megafaunal substitute facilitating modern day persistence of a grazer-maintained grass assemblage in an otherwise defaunated landscape, where these landscapes now support the livelihoods of millions of people.

"Leading Better Care": An evaluation of an accelerated coaching intervention for clinical nursing leadership development.

AIM: Outcomes of an accelerated co-active coaching intervention for senior clinical nursing leadership development. BACKGROUND: Co-active coaching is characterized by a whole person approach, commitment to deep learning and conscious action through supportive compassionate and courageous coach-coachee partnership. The national leadership capabilities framework, "Step into Leadership", was used for development and evaluation. METHODS: 116 senior clinical nurse leaders attended one face-to-face induction day and received a total of 3 hours of one-to-one telephone coaching and two virtual peer group facilitated sessions. Evaluation used primarily qualitative descriptive methods with iterative review of emerging themes. RESULTS: Capability mapping indicated self-leadership development as the most frequently cited need. Improvements in self-confidence, capacity for reflection and bringing whole self into the work were reported to deliver enhancement in team and service performance. CONCLUSIONS: Co-active coaching supported deep analysis by individuals. Focus on self, rather than behaviours provoked reflection on perspectives, mindsets, beliefs and approaches which can lead to more sustainable behaviour and support service change. IMPLICATIONS FOR NURSING MANAGEMENT: Investment in a co-active coaching approach offers bespoke support for clinical leaders to develop self-leadership capability, a precursor to delivering positive impacts on care.

A Qualitative Study of Medical Students' Perspectives on Distance Learning During COVID-19.

Introduction: With the Coronavirus disease 2019 [COVID-19] pandemic, changes were undertaken out of necessity to allow medical students to continue their education. The aim of this study is to create key themes for educators to consider when implementing distance learning strategies into the curriculum based on 2nd year graduate entry medical students experience of learning and engagement with the use of distance learning during the COVID-19 pandemic. Materials and Methods: A qualitative study with a phenomenological methodology was set within a constructivist paradigm. A volunteer sampling strategy was used to recruit participants. Nine semi-structured, audio-recorded interviews were undertaken and transcribed verbatim. A thematic analysis was undertaken of the transcripts using the Braun and Clarke framework with an open-coded approach. Results: Exploration of the student experience generated an understanding of the learning process. The concept of adaptability emerged based on the themes of technology, environment, study skills and human interaction. Discussion: Necessary changes to the formal curriculum affected medical students learning and experience that demanded adaptability. The 'new normal' generated a context within which students were communicating and interacting in ways creating individual challenges for students and educators. Conclusion: With the advancements in information, communication and technology, distance learning is likely to be further incorporated in undergraduate training long term. Its position should be one that is harmonious within the wider educational realm that engages and meets the needs of the students. The rich understanding exposes adaptations and considerations for educators to improve the student experience.

Gender Matters: Understanding Transitions in Surgical Education.

Introduction: Diverse transitions are elemental to medical career trajectories. The effective navigation of such transitions influences a sense of belonging and wellbeing, positive relationships, and good engagement and attainment within new contexts. Using Multiple and Multidimensional Transitions (MMT) theory as an analytical lens, this paper aims to answer the research question: "What gendered transitions do female surgeons experience, and how do these gendered transitions impact them?" Methods: We conducted a qualitative study drawing on narrative inquiry, with face-to-face and online semi-structured interviews with 29 female surgeons across nine surgical specialities in Ireland and Scotland. This paper is part of a larger study including male surgeons, other colleagues and patients of female surgeons. The female surgeons in this paper were purposively sampled using maximum variation sampling across several levels (consultants, trainees and middle-grade doctors), as well as six who had transitioned out of surgery. Framework analysis was employed to interrogate the interview data. Results: Five overarching types of transitions were identified across surgical education but only three of these transitions-work, culture and health-were primarily experienced by female surgeons (not male surgeons so were considered gendered), thereby impacting social, academic, and psychological domains. The remaining two types of transition-education and geography-were seemingly experienced equally by female and male surgeons, so are beyond the scope of this paper focused on female surgeons' gendered experiences. Conclusion: This novel qualitative study drawing on MMT theory illustrates how multiple gendered transitions interact and impact female surgeons across the surgical education continuum. Aligned with MMT theory, family members and others are also purportedly affected by female surgeons' transitions. Healthcare educators, leaders and policymakers need to better understand gendered transitions and their impacts to improve support for female surgical trainees on their educational journeys.

Madagascar's extraordinary biodiversity: Evolution, distribution, and use.

Madagascar's biota is hyperdiverse and includes exceptional levels of endemicity. We review the current state of knowledge on Madagascar's past and current terrestrial and freshwater biodiversity by compiling and presenting comprehensive data on species diversity, endemism, and rates of species description and human uses, in addition to presenting an updated and simplified map of vegetation types. We report a substantial increase of records and species new to science in recent years; however, the diversity and evolution of many groups remain practically unknown (e.g., fungi and most invertebrates). Digitization efforts are increasing the resolution of species richness patterns and we highlight the crucial role of field- and collections-based research for advancing biodiversity knowledge and identifying gaps in our understanding, particularly as species richness corresponds closely to collection effort. Phylogenetic diversity patterns mirror that of species richness and endemism in most of the analyzed groups. We highlight humid forests as centers of diversity and endemism because of their role as refugia and centers of recent and rapid radiations. However, the distinct endemism of other areas, such as the grassland-woodland mosaic of the Central Highlands and the spiny forest of the southwest, is also biologically important despite lower species richness. The documented uses of Malagasy biodiversity are manifold, with much potential for the uncovering of new useful traits for food, medicine, and climate mitigation. The data presented here showcase Madagascar as a unique "living laboratory" for our understanding of evolution and the complex interactions between people and nature. The gathering and analysis of biodiversity data must continue and accelerate if we are to fully understand and safeguard this unique subset of Earth's biodiversity.

Madagascar's extraordinary biodiversity: Threats and opportunities.

Madagascar's unique biota is heavily affected by human activity and is under intense threat. Here, we review the current state of knowledge on the conservation status of Madagascar's terrestrial and freshwater biodiversity by presenting data and analyses on documented and predicted species-level conservation statuses, the most prevalent and relevant threats, ex situ collections and programs, and the coverage and comprehensiveness of protected areas. The existing terrestrial protected area network in Madagascar covers 10.4% of its land area and includes at least part of the range of the majority of described native species of vertebrates with known distributions (97.1% of freshwater fishes, amphibians, reptiles, birds, and mammals combined) and plants (67.7%). The overall figures are higher for threatened species (97.7% of threatened vertebrates and 79.6% of threatened plants occurring within at least one protected area). International Union for Conservation of Nature (IUCN) Red List assessments and Bayesian neural network analyses for plants identify overexploitation of biological resources and unsustainable agriculture as the most prominent threats to biodiversity. We highlight five opportunities for action at multiple levels to ensure that conservation and ecological restoration objectives, programs, and activities take account of complex underlying and interacting factors and produce tangible benefits for the biodiversity and people of Madagascar.

Using Duchscher's Theory of Transition Shock To Inform The Experience Of Newly Graduated Nurses In Qatar: A Qualitative Case Study.

This article was migrated. The article was marked as recommended. Background The transition experience of new graduate nurses (NGN) is a complex and stressful period of adjustment and adaptation. The transition period is often negative leading to job dissatisfaction and increased intent to leave. Literature concerned with transition experiences of NGNs in the Middle East is lacking, where the educational, healthcare and cultural context are dissimilar to those in the published literature. Aim To explore the transition experiences of Qatari NGNs to inform development of a formal transition to practice program at a specialty hospital. Methods A qualitative case study design was conducted to explore the professional role transition experiences of Qatari NGNs. Data was collected through the Casey-Fink Graduate Experience Survey, and an unstructured focus group. Results Qatari NGNs experienced challenges of professional role adaptation and feeling ill-prepared in terms of competency and job-readiness, resulting in self-doubt, frustration and fear. Desires to fit-in were negatively impacted by language, discrimination and lack of social support, and professional identity development. Conclusions Professional role transition of Qatari NGNs involves a complex interplay of intrapersonal, interpersonal, organizational and cultural factors. Experiences can be enhanced by accessible, nurturing, multi-level social support to facilitate socialization and improve clinical practice competency. Managing expectations by preparing students for transition and providing transitional support during their first year of practice will improve their experience. Duchscher's Theory of Transition Shock offers insights into the transition expereinces that can inform this support.

Population modelling and genetics of a critically endangered Madagascan palm Tahina spectabilis.

Madagascar is home to 208 indigenous palm species, almost all of them endemic and >80% of which are endangered. We undertook complete population census and sampling for genetic analysis of a relatively recently discovered giant fan palm, the Critically Endangered Tahina spectablis in 2008 and 2016. Our 2016 study included newly discovered populations and added to our genetic study. We incorporated these new populations into species distribution niche model (SDM) and projected these onto maps of the region. We developed population matrix models based on observed demographic data to model population change and predict the species vulnerability to extinction by undertaking population viability analysis (PVA). We investigated the potential conservation value of reintroduced planted populations within the species potential suitable habitat. We found that the population studied in 2008 had grown in size due to seedling regeneration but had declined in the number of reproductively mature plants, and we were able to estimate that the species reproduces and dies after approximately 70 years. Our models suggest that if the habitat where it resides continues to be protected the species is unlikely to go extinct due to inherent population decline and that it will likely experience significant population growth after approximately 80 years due to the reproductive and life cycle attributes of the species. The newly discovered populations contain more genetic diversity than the first discovered southern population which is genetically depauperate. The species appears to demonstrate a pattern of dispersal leading to isolated founder plants which may eventually lead to population development depending on local establishment opportunities. The conservation efforts currently put in place including the reintroduction of plants within the species potential suitable habitat if maintained are thought likely to enable the species to sustain itself but it remains vulnerable to anthropogenic impacts.

Ambiguity and uncertainty: the ongoing concerns of male partners of women treated for breast cancer.

As the prevalence of breast cancer increases, survival improves and short stay or outpatient care become the norm, greater numbers of men will be involved in providing care and support for their partners at home. This qualitative study explored the experiences of 26 male partners of women who had completed treatment for breast cancer. A questionnaire was developed in order to collect background information and to provide a pool for further qualitative sampling. One hundred and five questionnaires were distributed, 79 returned and 26 one-to-one interviews were conducted. While negotiating a role in their wives' breast cancer experience the men attempted to find a balance between the ambiguity and uncertainty they experienced and their need to maintain normality. They described feeling 'in limbo' when expectations of being able to move on following their wives treatment were not fulfilled. An understanding of the 'liminal' experience of being a male partner of a woman with breast cancer may help health care professionals to address the ongoing difficulties men encounter. This is important as it is often the male partners who are called upon to provide continued care and support beyond the recognised treatment period.

The new Code of Professional Conduct.

The Nursing and Midwifery Council (NMC) has approved a new Code of Professional Conduct (NMC 2002a). This article discusses the main elements of the new code, examines the implications for the profession and encourages you to think about the implications for your own nursing practice. It identifies actions that you should take to comply with the code.

Informed consent.

It is essential that nurses are familiar with the principles and requirements of informed consent. This article examines the rationale and principles behind it and encourages nurses to reflect on how it affects their everyday practice.