Is it time for integration of surgical skills simulation into the United Kingdom undergraduate medical curriculum? A perspective from King’s College London School of Medicine

PURPOSE: Changes in undergraduate medical curricula, combined with reforms in postgraduate education, have training implications for surgical skills acquisition in a climate of reduced clinical exposure. Confidence and prior experience influences the educational impact of learning. Currently there is no basic surgical skills (BSS) programme integrated into undergraduate curricula in the United Kingdom. We explored the role of a dedicated BSS programme for undergraduates in improving confidence and influencing careers in King's College London School of Medicine, and the programme was evaluated. METHODS: A programme was designed in-line with the established Royal College of Surgeons course. Undergraduates were taught four key skills over four weeks: knot-tying, basic-suturing, tying-at-depth and chest-drain insertion, using low-fidelity bench-top models. A Likert-style questionnaire was designed to determine educational value and influence on career choice. Qualitative data was collected. RESULTS: Only 29% and 42% of students had undertaken previous practice in knot-tying and basic suturing, respectively. 96% agreed that skills exposure prior to starting surgical rotations was essential and felt a dedicated course would augment undergraduate training. There was a significant increase in confidence in the practice and knowledge of all skills taught (p<0.01), with a greater motivation to be actively involved in the surgical firm and theatres. CONCLUSION: A simple, structured BSS programme can increase the confidence and motivation of students. Early surgical skills targeting is valuable for students entering surgical, related allied, and even traditionally non-surgical specialties such as general practice. Such experience can increase the confidence of future junior doctors and trainees. We advocate the introduction of a BSS programme into United Kingdom undergraduate curricula

Biology of Parrotfishes

Parrotfish are found on almost every coral reef in the world. This ubiquity and uniqueness of their feeding action make them one of the most important groups of fishes within coral reef ecosystems. But why, exactly, are parrotfish so important to reefs? Can the evolution of a particular jaw morphology and feeding action really have had such a large impact on the health and functioning of the world's coral reefs? This book introduces the reader to this fascinating group of fishes (Labridae, Scarinae), from the morphological innovation of a jaw that has the power to bite through solid calcium carbonate, to the threats currently faced by parrotfish populations around the world. It contains new insights into their diet and food processing ability, and lifehistories, and concludes with an overview of emerging and future research directions

Variation in the parasite communities of three co-occurring herbivorous coral reef fishes

Parasites are important, diverse, and abundant components of natural ecosystems and can influence the behaviour and health of their hosts, inter- and intraspecific interactions, and ultimately community structure. Coral reefs are one of the world's most biodiverse ecosystems, yet our understanding of the abundance, diversity, and composition of parasite communities of coral reef fishes is limited. Here, the authors aimed to compare the abundance, richness and composition of parasite communities among three co-occurring herbivorous coral reef fishes (the barred rabbitfish Siganus doliatus, Ward's damsel Pomacentrus wardi and the obscure damsel Pomacentrus adelus) from an inshore reef of the Great Barrier Reef (GBR). In total, 3978 parasites (3869 endoparasites and 109 ectoparasites) from 17 families were recovered from 30 individuals of each of the three fish species (mean = 44 ± 22 s.e. parasites per fish; range = 0–1947 parasites per fish). The parasite communities of P. wardi and P. adelus were characterised by pennellid copepods, derogenid and lecithasterid digeneans and were distinct from those of S. doliatus that were characterised by a higher abundance of atractotrematid and gyliauchenid digeneans. The abundance and family richness of all parasites were greatest in S. doliatus (abundance: 22.1 ± 5.0 parasites per fish; richness: 3.2 ± 0.3 families per fish), intermediate in P. wardi (abundance: 4.8 ± 1.1 parasites per fish; richness: 2.3 ± 0.3 families per fish) and lowest in P. adelus (abundance: 1.4 ± 0.4 parasites per fish; richness: 0.9 ± 0.2 families per fish). Similarly, the abundance of endoparasites was greatest in S. doliatus (19.7 ± 5.1 endoparasites per fish), intermediate in P. wardi (2.6 ± 0.7 endoparasites per fish) and lowest in P. adelus (1.2 ± 0.4 endoparasites per fish). Ectoparasite abundances were also lowest for P. adelus (0.2 ± 0.1 ectoparasites per fish), and S. doliatus and P. wardi had comparable abundances of ectoparasites (1.3 ± 0.3 and 2.1 ± 0.5 parasites per fish, respectively). Similarities between the parasite assemblages of the two pomacentrids may be related to their similar behaviours and/or diets vs. those of the larger-bodied and more mobile rabbitfish. Investigating the causes and consequences of variation in parasite communities across a broader range of fish species will be critical to understand the potential role of parasites in coral reef ecosystems

The ecological importance of the tube building polychaete <i>Lanice conchilega</i> in the <i>Abra alba-Mysella bidentata</i> community (poster)

The Abra alba - Mysella bidentata community is the most diverse (average: 31 spp. 0.1 m-2) and dense (average: 6500 ind. m-2) macrobenthic community on the Belgian Continental Shelf (BCS), in which densities are dominated by polychaetes and bivalves. Numerous species of the community are an important food resource for demersal fish (e.g. cod Gadus morhua) and sea birds (e.g. common scoter Melanitta nigra). This community is mainly found in fine muddy sediments (median grain size: + 200 µm; mud content: 5-10 %) of the swales and slopes of the Western Coastal Banks and Middelkerke Bank and at some local spots along the eastern coast.Because of their ecological importance within the community, three macrobenthic species were selected for a detailed autecological investigation: (1) the bivalve Spisula subtruncata, important as a food resource for seaducks, (2) Abra alba, a highly dominant bivalve, and (3) Lanice conchilega, a habitat structuring polychaete. At this moment only information about L. conchilega is available.Lanice conchilega (family: Terebellidae) typically occurs within the A. alba - M. bidentata community (Indicator Value: 62). Its fringed tubes, with a length of up to 40 cm and extending up to about 3 cm above the sediment, are built from fine to coarse sand grains and shell fragments. When found in high densities (up to 3000 ind. m-2), the patches of tubes create a hydrodynamically benign microclimate in which suspended material is trapped. Consequently, local and patchy sediment elevations of up to 10 cm with a relatively high organic matter content are formed. The fringed tubes, stabilized sediment and increased organic matter content are illustrating the habitat structuring capacity of L. conchilega. The increased habitat complexity in dense patches of L. conchilega are believed to be responsible for the high macrobenthic diversity and density of the community. A relatively low macrobenthic density (2447 ind. m-2) and diversity (22 spp. 0.1 m-2) is found if L. conchilega is present in low densities (-2). If present in high densities, a much higher macrobenthic density (8000 ind. m-2) and diversity (36 spp. 0.1 m-2) occurs. Furthermore, the occurrence of some species (e.g. Eumida sanguinea, Anaitides mucosa, and Pariambus typicus) is almost exclusively linked to the presence of L. conchilega.At present, some information about the life history of L. conchilega is available through the ongoing macrobenthos and hyperbenthos research. Very high densities of the hyperbenthic aulophora larvae are found early May (670 ind. m-3 on average on the BCS). Settlement of L. conchilega takes place in May and is immediately followed by a fast growth till June-July. Within the framework of a PhD research, the ecological importance of L. conchilega will further be evaluated through detailed spatial and temporal investigations of all life stages (planktonic and hyperbenthic larvae and benthic juveniles and adults) from March 2002 till October 2003

Population dynamics of subtidal <i>Lanice conchilega</i> (Pallas, 1766) populations at the Belgian Continental Shelf

The paper at hand describes population dynamics, recruitment and persistence of the Lanice conchilega populations in subtidal soft - bottom sediments along the Belgian coastline. An intensive sampling campaign (monthly - biweekly from March 2002 untill September 2003), the discrimination of different benthic stages and cohort analysis of the adult population enabled the discrimination of trends in recruitment patterns of L. conchilega. Three recruitment periods were defined based on the occurrence of peaks of aulophore larvae in the water column and peaks of recently settled individuals in the benthos: (1) spring recruitment period (April - July), (2) summer recruitment period (July - September), and (3) autumn recruitment period (September - November). The spring recruitment period was the most intense and was characterized by high densities of recently settled individuals and juveniles. These high densities resulted in an adult population, which consisted of different cohorts and which was characterized by a high turn over. The summer and autumn recruitments were less intense and did not occur at every station or in every year. Spatial and temporal variations in timing and intensity of settlement and recruitment were observed and described. Results indicate that L. conchilega is an opportunistic species, characterized by a long pelagic phase, high settlement of larvae and a high turn over in the adult population. Due to this recruitment strategy and the preferential settling of the larvae in adult patches, the studied L. conchilega population was able to maintain high abundances in moderately stable patches