Testing for hybridisation of the Critically Endangered Iguana delicatissima on Anguilla to inform conservation efforts

The Caribbean Island of Anguilla in the north-eastern Lesser Antilles is home to one of the last populations of the Critically Endangered Lesser Antillean iguana Iguana delicatissima. This population is highly threatened primarily because of hybridisation with non-native Iguana iguana. This study assesses the degree of hybridisation between Anguilla’s Iguana species firstly using morphological characteristics and then genetic analysis to validate the genetic integrity of morphologically identified I. delicatissima. We also examined the genetic diversity of Anguilla’s I. delicatissima population, and that of a population on the nearby island of Îlet Fourchue, St Barthélemy. Forty-five iguanas were captured in Anguilla and 10 in St Barthélemy, and sequences from 3 nuclear and 1 mtDNA genes were obtained for each. Of the 45 iguanas captured in Anguilla, 22 were morphologically identified as I. delicatissima, 12 as I. iguana and the remainder were identified as hybrids. Morphological assignments were all confirmed by genetic analyses except for one I. iguana and one hybrid individual. These two individuals appeared likely to have originated following ancestral hybridisation events several generations ago. A significant paucity of genetic diversity was found within Anguillan and St Barthélemy I. delicatissima populations, with a single haplotype being identified for each of the three nuclear genes and the mtDNA sequence. This study highlights the urgency for immediate action to conserve Anguilla’s remnant I. delicatissima population. Protection from hybridisation will require translocation to I. iguana-free offshore cays, with supplementary individuals being sourced from neighbouring islands to enhance the genetic diversity of the population

Maria Auxiliadora Hospital in Lima, Peru as a model for neurosurgical outreach to international charity hospitals

A myriad of geopolitical and financial obstacles have kept modern neurosurgery from effectively reaching the citizens of the developing world. Targeted neurosurgical outreach by academic neurosurgeons to equip neurosurgical operating theaters and train local neurosurgeons is one method to efficiently and cost effectively improve sustainable care provided by international charity hospitals. The International Neurosurgical Children’s Association (INCA) effectively improved the available neurosurgical care in the Maria Auxiliadora Hospital of Lima, Peru through the advancement of local specialist education and training. Neurosurgical equipment and training were provided for the local neurosurgeons by a mission team from the University of California at San Diego. At the end of 3 years, with one intensive week trip per year, the host neurosurgeons were proficiently and independently applying microsurgical techniques to previously performed operations, and performing newly learned operations such as neuroendoscopy and minimally invasive neurosurgery. Our experiences may serve as a successful template for the execution of other small scale, sustainable neurosurgery missions worldwide

67. Loving your child to death: Considerations of the care of chronically-ill children and euthanasia in Emil Sher's Mourning Dove and implications for medical educations

How do parents cope when their child is ill or dying, when he or she experiences constant pain or suffering? What do parents think of the contributions that medical professionals make to the care of their chronically or terminally ill child? Is it possible for a parent to love a child so much that the child is wished dead? The purpose of this paper is to explore those questions and aspects of the care of chronically or terminally ill children using Mourning Dove’s portrayal of one family’s attempt to care for their ill daughter. A play written by Canadian playwright Emil Sher, Mourning Dove is based on the case of Saskatchewan wheat farmer Robert Latimer who killed his 12 year old daughter Tracy who suffered with cerebral palsy and lived in tremendous pain. Rather than focusing on the medical or legal aspects of the care of a chronically ill child, the play offers a glimpse into how a family copes with the care of such a child and the effects the child’s illness has on a family. Reading and examination of non-medical literature, such as Mourning Dove, therefore serve as a useful means for medical professionals to better understand how illness affects and is responded to by patients and their families. This understanding is a prerequisite for them to be able to provide complete care of children with chronic or terminal illnesses and their families. Nuutila L, Salanterä S. Children with long-term illness: parents’ experiences of care. J Pediatr Nurs 2006; 21(2):153-160. Sharman M, Meert KL, Sarnaik AP. What influences parents’ decisions to limit or withdraw life support? Pediatr Crit Care Med 2005; 6(5):513-518. Steele R. Strategies used by families to navigate uncharted territory when a child is dying. J Palliat Care 2005; 21(2):103-110

Saving the sea turtles of Anguilla: Combining scientific data with community perspectives to inform policy decisions

Historic over-exploitation and the more recent threats caused by fisheries by-catch, disease and climate change have left sea turtle populations in the Wider Caribbean at risk of extinction. In 1995, following regional declines in nesting and foraging populations, the island of Anguilla implemented a moratorium on the hunting of turtles. At the request of the Government of Anguilla for scientific data to either support or remove the moratorium, comprehensive population estimates were obtained, and foraging, nesting and migratory movements were examined. In addition, community perspectives on turtles and their protection were assessed. Between 2015 and 18 surveys of 30 nesting beaches estimated low nesting activity with a maximum of 41 hawksbill, 15 green, and 1–2 leatherback turtles nesting in Anguilla annually. The inter-nesting range of hawksbills exhibited high levels of geographic overlap and occurred within 1.5 km of nesting beaches. Migratory tracks of hawksbill turtles traversed through seven exclusive economic zones, two of which allow a legal turtle fishery. Site fidelity was observed in foraging areas of green turtles and genetic analysis revealed population differentiation between green turtle foraging sites in Anguilla and between hawksbill rookeries in Anguilla compared to other Leeward Islands, indicating the individual importance of each foraging and nesting site. The Anguillan public (n = 302) overwhelmingly agreed with the current ban on harvesting sea turtles and considered turtles important for ecotourism. Our work provides a case-study, that can be applied globally, of how scientific research combined with community perspectives can effectively inform policy and ultimately protect endangered species, and highlights that local Governments provided with high quality data in a timely fashion for their policy making timetable are more likely to integrate findings into their decision-making process

Opportunity mapping for nature-based solutions: Mitigating storm surge and land erosion in the Caribbean

The islands of the Caribbean are particularly susceptible to the effects of climate change due to their low-lying coastal areas and location within the Atlantic basin's hurricane belt. The UK Overseas Territory of Anguilla is one such island. The predicted increase in the severity of hurricanes and sea-level rise is highly likely to increase the flood risk of already vulnerable island communities. In this study, flood risk and erosion models are used to prioritise opportunity areas for nature-based restoration and to identify those that would have the greatest impact on coastal and in-land flood risk reduction. Two study sites in Anguilla were selected to highlight this ecologically-based modelling approach; Cove Bay and Pond, a degraded sand dune system and brackish pond, and the East End Pond, an Important Bird and Biodiversity Area that floods following heavy rainfall events. At the coastal site, the restoration of mangroves, sand dunes and coral reefs have the potential to provide flood risk reduction up to 500 m inland and protect homes, infrastructure and tourism developments. For the in-land East End Pond, areas of high erosion risk were predominately identified as bare or disturbed land within 1 km of the pond's basin. Habitat restoration of these areas was identified as having the greatest impact on reducing flood risk. The creation of flood risk, opportunity and impact models are invaluable tools that can be used to inform, advocate and justify the implementation of nature-based solutions to a range of stakeholders from policy-makers to local communties