The conservation significance of natural hybridisation in Mediterranean plants: from a case study on Cyclamen (Primulaceae) to a general perspective.

Hybridisation plays a prominent role in plant evolution due to its influence on genetic diversity, fitness and adaptive potential. We identify a case of on-going hybrid evolution of floral phenotypes in disjunct populations of Cyclamen balearicum and C. repandum subsp. repandum on Corsica and Sardinia. Hybrid populations on the two islands contain similar patterns of variation in flower colour and size but are probably at different stages in the evolutionary process of hybridisation, and differences in the frequency of floral types and flower size suggest hybrid vigour that may contribute to the dynamics and maintenance of hybrid forms. In a review of cases of hybridisation in Mediterranean plants we found an equivalent number of cases for the contemporary occurrence of mixed hybrid populations, as there are cases of homoploid hybrid species differentiation. We argue for the development of a conservation strategy for Mediterranean plants that integrates the need to protect not just pure endemic species (some of hybrid origin) but also mixed populations where adaptive variation and new species are evolving due to contemporary hybridisation.

Have patients become impatient to act in our healthcare system?

For some 40 years now, in France, the progressive recognition of the knowledge and experience of patients has been accompanied by an institutionalization of their participation and a diversification of the spaces in which they act. In this contribution, we offer an analytic look at the different forms of patient participation in the health world, in France and abroad. This non exhaustive overview underlines the need to pay particular attention to the conditions required if the shared experiences of care providers and patients are to serve as an occasion to optimize and revitalize the approach to medical care.

Type 2 diabetes patient education in Reunion Island: perceptions and needs of professionals in advance of the initiation of a primary care management network.

AIM: This study focused on issues in the education of type 2 diabetes patients in primary care on Reunion Island which, in a medical context, is broadly similar to metropolitan France, but with a much greater prevalence of diabetes. The aim was to assess the perceptions, training, reported practices and needs of health care providers in the field of patient education in advance of the initiation of a health care management network for diabetic patients. METHODS: A total of 74 physicians and 63 nurses completed a detailed questionnaire comprising 52 items divided into six parts: professional activity, initial and postgraduate training, educational practices, objectives of patient education, perceived barriers and prospects for optimization. RESULTS: Educational activities for patients are almost nonexistent. Information and explanations given during a face-to-face encounter with the physician or nurse that combine technical and caring approaches are the main reasons reported for patient education. The obstacles reported by professionals that need to be overcome are limited available time, patient passivity and inadequate staff training. Practitioners and nurses are poorly taught as regards patient education and self-management of chronic diseases. The suggested improvements include professional acknowledgement, more convenient and available tools and improved postgraduate training. CONCLUSION: Patient education in primary care is still mostly an illusion, with many gaps that hinder education for both patients and professionals. The training of health professionals needs to meet the challenge of chronic diseases by integrating aspects from the fields of education and the social sciences.

Evidence for local outbreeding depression in the Mediterranean island endemic Anchusa crispa Viv. (Boraginaceae).

In this study we examined the relative effects of inbreeding and outbreeding on offspring fitness over two generations in Anchusa crispa Viv., a rare species which on Corsica (France) occurs in small populations composed of patches of few individuals. Self- and outcross-pollinations were carried out in a single population and F(1) progeny grown to flowering. Plants grown from selfing and outcrossing were then selfed or outcrossed to produce F(2) individuals in four combinations of pollination treatments over two generations, i.e. self + self, self + outcross, outcross + self and outcross + outcross. In the F(1) generation, selfed progeny had a significantly greater number of cymes per plant than outcrossed progeny (P=0.006). Plants from two generations of selfing had fewer seeds per fruit (P=0.06) but a significantly greater survival rate (P < 0.001) and a greater number of cymes (P=0.06) than those from two generations of outcrossing. Selfed F(2) from outcrossed F(1) had a significantly greater number of cymes (P < 0.01) than outcrossed F(2) from outcrossed F(1). In the comparison between selfed and outcrossed F(2) from selfed F(1) the former had a significantly greater survival rate (P < 0.001), but the latter significantly more flowers per cyme (P < 0.05). Together, these results indicate that outbreeding depression may occur on a very local scale within populations of this rare endemic species, with important implications for the conservation of rare plants.

Genetic structure of continental and island populations of the Mediterranean endemic Cyclamen balearicum (Primulaceae).

Cyclamen balearicum is a self-compatible perennial herb endemic to the western Mediterranean Basin. This species occurs in five geographically isolated terrestrial islands in southern France and on four Balearic islands. In this study, we compare genetic variability and differentiation within and among 11 terrestrial island populations and 17 true island populations. Of nine readable enzyme loci, five were polymorphic in both terrestrial and true islands. F statistics showed a significant heterozygote deficiency in all populations, probably due to high levels of autonomous selfing, restricted gene flow, and subsequent genetic drift. Genetic diversity was higher in terrestrial islands than on the Balearic islands, suggesting that the Balearic islands were colonized when they were in contact with the continent. Population differentiation was greater among terrestrial islands (Fst = 0.417 and Gst = 0.344) than among true islands (Fst = 0.112 and Gst = 0.093). Furthermore, differentiation among populations on the Basses Cévennes terrestrial island was greater (Fst = 0.254) than among populations on the true island of Mallorca (Fst = 0.163). The greater genetic differentiation among terrestrial islands could have been caused by genetic bottlenecks associated with changes in climate and human land use that may have reduced population sizes more severely in terrestrial islands in southern France than on the Balearic islands.