Imaging and mapping the impact of clouds on skyglow with all-sky photometry.

Artificial skyglow is constantly growing on a global scale, with potential ecological consequences ranging up to affecting biodiversity. To understand these consequences, worldwide mapping of skyglow for all weather conditions is urgently required. In particular, the amplification of skyglow by clouds needs to be studied, as clouds can extend the reach of skyglow into remote areas not affected by light pollution on clear nights. Here we use commercial digital single lens reflex cameras with fisheye lenses for all-sky photometry. We track the reach of skyglow from a peri-urban into a remote area on a clear and a partly cloudy night by performing transects from the Spanish town of Balaguer towards Montsec Astronomical Park. From one single all-sky image, we extract zenith luminance, horizontal and scalar illuminance. While zenith luminance reaches near-natural levels at 5 km distance from the town on the clear night, similar levels are only reached at 27 km on the partly cloudy night. Our results show the dramatic increase of the reach of skyglow even for moderate cloud coverage at this site. The powerful and easy-to-use method promises to be widely applicable for studies of ecological light pollution on a global scale also by non-specialists in photometry.

Landscape genetics highlights the role of bank vole metapopulation dynamics in the epidemiology of Puumala hantavirus.

Rodent host dynamics and dispersal are thought to be critical for hantavirus epidemiology as they determine pathogen persistence and transmission within and between host populations. We used landscape genetics to investigate how the population dynamics of the bank vole Myodes glareolus, the host of Puumala hantavirus (PUUV), vary with forest fragmentation and influence PUUV epidemiology. We sampled vole populations within the Ardennes, a French PUUV endemic area. We inferred demographic features such as population size, isolation and migration with regard to landscape configuration. We next analysed the influence of M. glareolus population dynamics on PUUV spatial distribution. Our results revealed that the global metapopulation dynamics of bank voles were strongly shaped by landscape features, including suitable patch size and connectivity. Large effective size in forest might therefore contribute to the higher observed levels of PUUV prevalence. By contrast, populations from hedge networks highly suffered from genetic drift and appeared strongly isolated from all other populations. This might result in high probabilities of local extinction for both M. glareolus and PUUV. Besides, we detected signatures of asymmetric bank vole migration from forests to hedges. These movements were likely to sustain PUUV in fragmented landscapes. In conclusion, our study provided arguments in favour of source-sink dynamics shaping PUUV persistence and spread in heterogeneous, Western European temperate landscapes. It illustrated the potential contribution of landscape genetics to the understanding of the epidemiological processes occurring at this local scale.

Multiple parasites mediate balancing selection at two MHC class II genes in the fossorial water vole: insights from multivariate analyses and population genetics.

We investigated the factors mediating selection acting on two MHC class II genes (DQA and DRB) in water vole (Arvicola scherman) natural populations in the French Jura Mountains. Population genetics showed significant homogeneity in allelic frequencies at the DQA1 locus as opposed to neutral markers (nine microsatellites), indicating balancing selection acting on this gene. Moreover, almost exhaustive screening for parasites, including gastrointestinal helminths, brain coccidia and antibodies against viruses responsible for zoonoses, was carried out. We applied a co-inertia approach to the genetic and parasitological data sets to avoid statistical problems related to multiple testing. Two alleles, Arte-DRB-11 and Arte-DRB-15, displayed antagonistic associations with the nematode Trichuris arvicolae, revealing the potential parasite-mediated selection acting on DRB locus. Selection mechanisms acting on the two MHC class II genes thus appeared different. Moreover, overdominance as balancing selection mechanism was showed highly unlikely in this system.

Competencias de los comités de ética asistencial y autoevaluación de sus componentes. Estudio CEA-CAT (2) / Assistential ethics committees competency and autoevaluation of its components. CEA-CAT (2) study

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La toma de decisiones éticas en una sociedad confuciana. Un modelo de participación mutua / Ethical decision-making in a Confucian society. A model of mutual participation

La familia, más que el individuo, es el centro de la sociedad en Asia, aunque cada individuo sea reconocido como un ser independiente. No obstante, él y ella no son más que una entidad más pequeña en comparación con la entidad mayor que es la familia. ¿Quién toma decisiones cuando se busca tratamiento médico en una situación terminal? La familia será quien tome la decisión en la sociedad confuciana, y no el paciente. El papel de la familia es esencial en el proceso de toma de decisiones. Aunque la influencia del pensamiento bioético occidental en el proceso de deliberación asiático es innegable, Asia ha desarrollado gradualmente su propia bioética, que se ha visto enriquecida por sus culturas tradicionales. Uno de los logros es el modelo de toma de decisiones de participación mutua

In Asia, the family, rather than the individual, is the center of society, although each individual may be recognized as an independent being. Nevertheless, an individual is seen as no more than another, smaller entity in comparison with a larger self that is the family. Who makes the decision when medical treatment is sought, especially if the situation is life threatening? In a Confucian society, the decision will be taken by the family rather than by the patient. The role played by the family is essential in decision-making. Although the influence of western bioethical thinking toward Asian bioethical deliberation is undeniable, Asia has gradually developed its own bioethics enriched by its traditional cultures. One of the results is a decision-making procedure based on mutual participation

Estudio observacional sobre los comités de ética asistencial en Cataluña: el estudio CEA-CAT (1). Estructura y funcionamiento / Observational study of Healthcare Ethics Committees in Catalonia: CEA-CAT Study (1). Structure and functioning

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Identificación de los conflictos éticos en la atención sociosanitaria. Un estudio exploratorio / Identification of ethical conflicts in health and social services. An exploratory study

Objetivo: El objetivo principal de este estudio es identificar y clasificar los conflictos éticos que más comúnmente se plantean y más preocupan a los profesionales de la atención sociosanitaria, tanto en la asistencia domiciliaria como en la asistencia institucionalizada. Material y método: Se obtuvo la opinión de profesionales expertos mediante reuniones semiestructuradas y las opiniones recogidas mediante encuesta después de la sesión de presentación del comité en centros sociosanitarios. Se realizó un estudio exploratorio con un total de 4 grupos de discusión semiestructurados (grupos focales), con la participación de distintos perfiles profesionales de la asistencia domiciliaria e institucionalizada en la atención sociosanitaria con experiencia reconocida. Resultados: Los conflictos más frecuentes y que más inquietud crean a los profesionales de la atención sociosanitaria, la mayoría de ellos comunes, entre los niveles institucional y de atención domiciliaria son la relación entre profesionales, la pertinencia de actividades terapéuticas, la relación con la familia, el respeto por las preferencias del paciente y las derivadas de la gestión de los recursos sociales y organizativos. Conclusiones: La identificación de conflictos éticos mediante estudios exploratorios permite diferenciar los temas con potencial riesgo ético en una especialidad terapéutica como, por ejemplo, la atención sociosanitaria. Que se produzca un conflicto u otro depende, en última instancia, del tipo de asistencia prestada

Objective: The main objective of this study was to identify and classify the most common ethical conflicts faced by health professionals working in outpatient and inpatient services. Material and method: a) Expert opinions gathered through semi-structured meetings; b) opinions gathered through a questionnaire distributed after a presentation by an ethics committee in health and social services' centers; and c) an exploratory study with 4 focus groups in which distinct professionals with recognized experience from home and hospital care services participated. Results: The most frequent conflicts faced by health and social services professionals, most of which were common to outpatient and inpatient care, concerned the relationship among health professionals, the appropriateness of therapeutic activities, the relationship with the patient's family, respect for patients' preferences, and conflicts arising from the management of social resources and organizational issues. Conclusions: Identifying ethical conflicts through exploratory studies allows topics likely to pose ethical dilemmas to be differentiated in a specific therapeutic area such as healthcare. The presence of one type of ethical conflict or another depends on the type of healthcare provided

Assessing satisfaction with pain medication in primary care patients: development and psychometric validation of a new measure.

BACKGROUND: The measurement of patient satisfaction with pain medication (SPM) is a potentially useful aid for health care decision-making, but no validated measures for SPM are known. OBJECTIVE: This study aimed to develop an instrument to assess this patient-reported outcome in primary care and to evaluate whether it satisfactorily fulfilled the required psychometric properties (ie, reliability, validity, and sensitivity to change). METHODS: The measure's content was obtained from literature reviews, focus groups, and expert opinion. A preliminary version of 14 self-administered items was obtained and tested in a prospective study in patients receiving pain medication. Item-total statistics and factor analysis were performed to obtain the final version. The final version was psychometrically validated by assessing feasibility, internal consistency (Cronbach's alpha), convergent validity (multivariant methods), discriminant validity in patients presenting pain relief (receiver operating characteristic curves), test-retest reliability (using the intraclass correlation coefficient [ICC] in patients maintaining medication), and sensitivity to change (in patients changing medication). RESULTS: A total of 1119 patients were recruited (626 women [55.9%]; mean [SD] age, 47.6 [15.36] years; primarily suffering musculoskeletal injury [50.7%]). Four items were deleted from the preliminary version owing to low item-scale correlation and/or factor loadings. The final factor analysis confirmed a 4-factor solution, which explained 81.4% of the variance in questionnaire scores. Adverse events, speed/duration of effect, functional benefit, and overall satisfaction dimensions were identified. Cronbach's alpha and ICC for the 10-item final version were >0.80 for the summary score and all dimensions. Pain-related characteristics (intensity, frequency, and degree of pain relief), but not patient-related characteristics, were independently associated with the summary score. The area under the curve was 0.78 for the summary score. Effect sizes and standardized response mean were > or = 0.84 for the summary score and all dimensions. CONCLUSION: The SPM questionnaire appears to have good acceptability as well as satisfactory psychometric properties, based on these analyses.