The Swansea 6D model: a diagnostic and conversational framework for supervisors, mentors and doctors in training.

Doctors in training are particularly vulnerable to stress and burnout, with the transition into the early parts of training being a period of acute anxiety. Supervisors and mentors have a key role to play in helping trainees make the transition from medical student to practising doctor. This often involves professional conversations, ranging from the relatively routine to difficult issues. The Swansea 6D model has been designed as a guidance tool which provides a simple, memorable framework around which conversations can be structured in terms of identifying meaningful expectations, providing explanations and reframing situations.

Parasitization of juvenile edible crabs (Cancer pagurus) by the dinoflagellate, Hematodinium sp.: pathobiology, seasonality and its potential effects on commercial fisheries.

This study reports on the prevalence and severity of infections caused by the parasitic dinoflagellate, Hematodinium in juvenile edible crabs (Cancer pagurus) found in 2 intertidal survey sites (Mumbles Head and Oxwich Bay) in the Bristol Channel, UK. Crabs were assessed for the presence and severity of Hematodinium infections by the histological examination of infected tissues. Such infections were found to exhibit a seasonal trend in the 2 study areas with high numbers of animals (ca. 30%) infected in the spring to summer but with low severity. Conversely, in November only ca. 10% of crabs were infected but these animals had large numbers of parasites in their haemolymph and other tissues. At this time, the carapace and underlying tissues of infected crabs had the chalky, pinkish-orange appearance that is characteristic of this disease. Hematodinium-infected crabs ranged in size from 12 to 74 mm carapace width. Overall, it is concluded that the high prevalence of infection of juvenile crabs in this area may have implications for the sustainability of the edible crab fishery in the Bristol Channel.

Disease profiles of juvenile edible crabs (Cancer pagurus L.) differ at two geographically-close intertidal sites.

The prevalence of disease in edible crabs (Cancer pagurus) was assessed at two sites in South West Wales; one estuarine (Pembroke Ferry) and another facing open water (Freshwater East). Diseases included pink crab disease caused by Hematodinium sp., an infection of the antennal gland caused by Paramikrocytos canceri and an idiopathic inflammatory condition of the connective tissue surrounding the anterior ganglionic masses. This latter condition was only found in crabs from Pembroke Ferry. There was a significantly higher prevalence of pink crab disease at Freshwater East than Pembroke Ferry, although both sites had similar levels of infection by P. canceri.

Effect of the copepod parasite Nicothoë astaci on haemolymph chemistry of the European lobster Homarus gammarus.

The gills of the European lobster Homarus gammarus (L.) are susceptible to parasitization by the copepod Nicothoë astaci, the lobster louse. This copepod feeds on haemolymph of the host and can damage the gills, potentially affecting gaseous exchange capabilities. To investigate the host response to the parasite, haemolymph levels of total protein, haemocyanin, glucose and ammonia were quantified in adult lobsters carrying varying parasite loads. Parasite loads correlated positively with total haemolymph protein and haemocyanin concentrations but not with glucose or ammonia concentrations. The data suggest that lobsters with gills damaged by the feeding activities of N. astaci respond by producing higher levels of haemocyanin, which is both a key defence response and may compensate for their decreased respiratory functioning.

A comparison of the structure of American (Homarus americanus) and European (Homarus gammarus) lobster cuticle with particular reference to shell disease susceptibility.

The integument of arthropods is an important first-line defence against the invasion of parasites and pathogens. Once damaged, this can be subject to colonisation by microbial agents from the surrounding environment, which in crustaceans can lead to a condition termed shell disease syndrome. This condition has been reported in several crustacean species, including crabs and lobsters. The syndrome is a progressive condition where the outer cuticle becomes pitted and eroded, and in extreme cases is compromised, leaving animals susceptible to septicaemia. This study examined the susceptibility of juvenile American (Homarus americanus) and European (Homarus gammarus) lobsters to shell disease, as a result of mechanical damage. Scanning electron microscopy was used as a method to identify differences in the cuticle structure and consequences of mechanical damage. Claw regions were aseptically punctured, whilst carapaces were abraded using sterile sandpaper, to mimic natural damage. After a period of between 10 and 12 weeks, lobsters were sacrificed, fixed and stored for later examination. The carapace and claws of juvenile American lobsters were shown to be thinner and more vulnerable to abrasion damage than their European counterparts. In addition, the number and distribution of setal pits and pore canal openings also differed between the two species of lobster. Mechanical damage resulted in the formation of shell disease lesions on the claw and carapace of both lobster species. However, American lobsters, unlike their European counterparts, had extensive bacterial colonisation on the margins of these lesions. Overall, it is concluded that the cuticle of the American lobster is more susceptible to damage and resulting microbial colonisation. This may have implications for susceptibility of both species of lobster to shell disease syndrome.

Twelve tips for providing effective student support in undergraduate medical education.

Medical students often require high levels of specialised institutional and personal support to facilitate success. Contributory factors may include personality type, course pressures and financial hardship. Drawing from research literature and the authors' experience, 12 tips are listed under five subheadings: policy and systems; people and resources; students; delivering support; limits of support. The 12 tips provide guidance to organisations and individual providers that encourages implementation of good practice and helps them better visualise their role within the system. By following the tips, medical schools can make more effective provisions for the expected, diverse and sometimes specialist needs of their students. Schools must take a proactive, anticipatory approach to provide appropriately for their entire student body. This ensures that students receive the best quality support, are more likely to succeed and are adequately prepared for their medical careers.

Characterization and molecular epidemiology of a fungal infection of edible crabs (Cancer pagurus) and interaction of the fungus with the dinoflagellate parasite Hematodinium.

This study reports on an emerging fungal disease of the edible crab, Cancer pagurus. Juvenile (prerecruit) crabs were found to be subject to this disease condition during the months of May to September at two intertidal sites in South Wales, United Kingdom. Histopathology revealed that the fungi overwhelm the host response in the tissues, leading to progressive septicemia. The causative agent of this infection was isolated and grown in pure culture and was identified as a member of the Ophiocordyceps clade by sequencing of the small subunit of the fungal ribosomal DNA (rDNA). Of the crabs naturally infected with the fungus, 94% had a coinfection with the parasitic dinoflagellate Hematodinium species. To determine if there was any interaction between the two disease-causing agents, apparently fungus-free crabs, both with and without natural Hematodinium infections, were challenged with the fungal isolate. The presence of Hematodinium caused a significant reduction in fungal multiplication in the hemocoel of the crabs in comparison to that in Hematodinium-free individuals. Histopathology of coinfected crabs showed a systemic multiplication of Hematodinium within host tissues, leading to a rapid death, while Hematodinium-free crabs experimentally infected with the fungal isolate died due to fungal sepsis (septicemia) with the same characteristic pathology as seen in natural infections.

Infection of juvenile edible crabs, Cancer pagurus by a haplosporidian-like parasite.

This study aimed to examine the pathobiology of a haplosporidian-like infection in juvenile (pre-recruit) edible crabs (Cancer pagurus) from two locations in South West Wales, UK. Infected crabs showed no external symptoms of the disease but dissection revealed an infected and hypertrophic antennal gland. Histological examination showed extensive parasitisation of the antennal gland overlying the hepatopancreas. Heavily infected crabs also showed the presence of parasites with morphological similarities to Haplosporidia in the labyrinth of the antennal gland and in the gills. The spread of the infection from the antennal gland to the gills suggests that these parasites are released into the haemolymph. Attempts to characterise the haplosporidian-like organism using several primers previously shown to amplify members of the phylum Haplosporidia failed. The prevalence of infection in juvenile edible crabs varied throughout the sampling period of November 2011 to July 2012 with the lowest level of ca. 15% in November peaking at 70% in March. This parasite may represent a threat to the sustainability of edible crab fisheries in this region if the damage observed in the antennal gland and gills results in host mortality. The identification of these parasites as members of the phylum Haplosporidia based on morphology alone must be seen as tentative in the absence of sequence data.

Morphology and pathology of the ectoparasitic copepod, Nicothoë astaci ('lobster louse') in the European lobster, Homarus gammarus.

Ectoparasitic copepods have been reported in a wide range of aquatic animals, including crustacean shellfish. However, with the exception of the salmon louse, Lepeophtheirus salmonis, our knowledge of such parasites in commercial species is rudimentary. The current study examines the morphology and pathology of the parasitic copepod, Nicothoë astaci (the 'lobster louse') in its host, the European lobster, Homarus gammarus. Lobsters were sampled from waters surrounding Lundy Island (Bristol Channel, UK) and all individuals collected were found to harbour female adult N. astaci in their gills, with a mean of 47·3 parasites/lobster. The majority of N. astaci were found in the basal region of pleurobranch gills. The parasite was found to attach to gill filaments via its oral sucker, maxillae and maxillipeds, and to feed on host haemolymph (blood) through a funnel-like feeding channel. It caused varying degrees of damage to the host gill, including occlusion of gill filaments and disruption to the vascular system in the central axis. Although there was evidence of extensive host response (haemocytic infiltration) to the parasite, it was displaced from the parasite attachment site and thus was observed in the central gill axis below. The region of gill filament immediately underlying the parasite feeding channel was devoid of such activity suggesting that the parasite interferes with the cellular defence and haemostatic mechanisms of the lobster in order to maintain invasion of the host.

Shell disease in crustaceans - just chitin recycling gone wrong?

The exoskeletons of aquatic crustaceans and other arthropods contain chitin, a biopolymer of beta-(1,4)-linked N-acetylglucosamine together with associated proteins. Despite the vast amounts of chitin within such animals little is found in sediments and open water because microorganisms rapidly degrade this following its loss after moulting or upon the animals' death. Shell disease syndrome is a worldwide disease condition that affects a wide range of crustaceans. It comes about as a result of bacterial degradation of the exoskeleton leading to unsightly lesions and even death if the underlying tissues become infected. There are at least two potential forms of the disease; one that appears to centre around chitin degradation and an additional form termed 'epizootic' shell disease, in which chitin degradation is of less significance. This account reviews our current understanding of the causative agents of this syndrome, assesses the potential economic consequences of the disease, and critically examines whether it is associated with anthropogenic disturbances including pollution. Overall, despite extensive studies during the last few decades, the potential links between faecal, heavy metal and insecticide pollution and shell disease are still unclear.

Dynamics of shell disease in the edible crab Cancer pagurus: a comparative study between two sites on the Gower Peninsula, South Wales, UK.

Shell disease syndrome is a degradative condition of the crustacean exoskeleton which results in the formation of black-spot lesions. Field surveys on the edible crab Cancer pagurus (L.) population at 2 sites in the Gower Peninsula of South Wales, UK, namely Langland Bay and Rhossili causeway, revealed similarities in the prevalence of shell disease but differences in the severity. Male crabs from Langland Bay displayed significantly greater severities of the disease on the dorsal carapace and ventral surfaces than those in Rhossili. The greatest severities of the disease in Langland were attributable to sand abrasion injuries during back-burrowing behaviour and prolonged exposure to high numbers of chitinolytic bacteria. Lower severities of shell disease in males from Rhossili were a reflection of the inability to back-burrow due to the nature of the onshore sediment, and hence the crabs were only exposed to low levels of chitinolytic bacteria in the water column. On areas of the causeway that permitted back-burrowing, the chitinase enzyme activities in sediments were significantly lower than those in Langland Bay. It is concluded that the potential for crustacean shell degradation is higher at Langland than Rhossili, but whether the differences in chitinolytic abilities of the sediments at the 2 sites are a result of differences in pollution levels or simply of different substratum types, remains to be determined.

Increased disease calls for a cost-benefits review of marine reserves.

Marine reserves (or No-Take Zones) are implemented to protect species and habitats, with the aim of restoring a balanced ecosystem. Although the benefits of marine reserves are commonly monitored, there is a lack of insight into the potential detriments of such highly protected waters. High population densities attained within reserves may induce negative impacts such as unfavourable trophic cascades and disease outbreaks. Hence, we investigated the health of lobster populations in the UK's Marine Conservation Zone (MCZ) at Lundy Island. Comparisons were made between the fished, Refuge Zone (RZ) and the un-fished, No-Take Zone (NTZ; marine reserve). We show ostensibly positive effects such as increased lobster abundance and size within the NTZ; however, we also demonstrate apparent negative effects such as increased injury and shell disease. Our findings suggest that robust cost-benefit analyses of marine reserves could improve marine reserve efficacy and subsequent management strategies.

Interaction between eicosanoids and the complement system in salmonid fish.

Both eicosanoid generation and the complement system have long evolutionary histories predating the emergence of the vertebrates over 500 myr ago. This study investigated the interplay between these two systems in an example of a bony fish, the rainbow trout (Oncorhynchus mykiss). Specifically, it examined whether purified complement fragments including C3a-1 and zymosan-activated serum, stimulate the biosynthesis of any of these eicosanoids by trout macrophages. Incubation of macrophages with zymosan pre-incubated with normal trout serum resulted in the phagocytosis of such particles and the generation of both intra- and extra-cellularly located lipoxygenase and cyclooxygenase products. Both eicosanoid generation and phagocytosis levels were significantly elevated following incubation of zymosan in trout serum in comparison with heat-inactivated (60°C for 30 min) trout serum and saline alone. A combined mass spectrometry/high performance liquid chromatography approach was employed to conclusively demonstrate the presence of the cyclooxygenase product, prostaglandin E (PGE) in the culture supernatants of ionophore-challenged macrophages. Incubation of trout macrophages with zymosan-activated trout serum (i.e. no zymosan present) failed to stimulate PGE generation. Similarly, incubation of these cells for up to 60 min with C3a-1 (4 or 50 nM) failed to generate significant amounts of PGE or lipoxygenase products such as leukotriene B(4/5) or lipoxin A(4/5). Longer term (6 & 24h) incubation of macrophages with C3a-1 (4 nM) resulted in a time dependent increase in the generation of PGE but not leukotriene B in culture supernatants. No conclusive evidence that the increase in PGE generation was caused by changes in the expression of either cyclooxygenase-1 or -2 was found.

Prostaglandins in non-insectan invertebrates: recent insights and unsolved problems.

Prostaglandins (PG) are oxygenated derivatives of C20 polyunsaturated fatty acids including arachidonic and eicosapentaenoic acids. In mammals, these compounds have been shown to play key roles in haemostasis, sleep-wake regulation, smooth muscle tone, and vaso-, temperature and immune regulation. In invertebrates, PGs have been reported to perform similar roles and are involved in the control of oogenesis and spermatogenesis, ion transport and defence. Although there is often a detailed understanding of the actions of these compounds in invertebrates such as insects, knowledge of their mechanism of biosynthesis is often lacking. This account provides a critical review of our current knowledge on the structure and modes of biosynthesis of PGs in invertebrates, with particular reference to aquatic invertebrates. It emphasises some of the most recent findings, which suggest that some PGs have been misidentified. Prostaglandins in invertebrates can be categorised into two main types; the classical forms, such as PGE2 and PGD2 that are found in mammals, and novel forms including clavulones, bromo- and iodo-vulones and various PGA2 and PGE2 esters. A significant number of reports of PG identification in invertebrates have relied upon methods such as enzyme immunoassay that do not have the necessary specificity to ensure the validity of the identification. For example, in the barnacle Balanus amphitrite, although there are PG-like compounds that bind to antibodies raised against PGE2, mass spectrometric analysis failed to confirm the presence of this and other classical PGs. Therefore, care should be taken in drawing conclusions about what PGs are formed in invertebrates without employing appropriate analytical methods. Finally, the recent publication of the Ciona genome should facilitate studies on the nature and mode of biosynthesis of PGs in this advanced deuterostomate invertebrate.

Shell disease syndrome in the edible crab, Cancer pagurus--isolation, characterization and pathogenicity of chitinolytic bacteria.

Chitinolytic bacteria are believed to be the primary aetiological agents of shell disease syndrome in marine crustaceans. The disease principally results from the breakdown of their chitinous exoskeletons by the shell disease pathogens, but pathogenicity may also manifest internally should a breach of the carapace occur. The current study looks at the pathogenicity of a number of bacteria (predominantly from the genus Vibrio) isolated from the edible crab, Cancer pagurus. All chitinase-producing bacteria investigated were capable of growth in a minimal medium consisting of chitin powder from crab shells, but differed in their speed of growth and nature of chitinolytic activity, suggesting that they have different roles within the lesion community. Two isolates (designated I4 and I7) were chosen for studies on internal pathogenicity, which included the effect of the pathogen on crab tissues, the ability of the host to remove the bacteria from circulation and the antibacterial activity of crab blood. Initially, I4 was rapidly removed from circulation, but began to reappear in the blood after 24 h. By 100 h, 100% of crabs were moribund. The septicaemic effects of the isolate were reflected in the low levels of its killing by blood-cell lysate and serum. By contrast, I7 was only slowly removed from circulation and caused the rapid mortality of all crabs in <3 h. A large decline in the number of circulating blood cells following injection of I7 was mirrored by an accumulation of these cells in the gills. Initial experiments suggest that the death of the crabs following injection with I7 may be caused by toxic extracellular bacterial products that exert their effects on the blood cells and nervous system of the crabs.

Hepoxilins and trioxilins in barnacles: an analysis of their potential roles in egg hatching and larval settlement.

The barnacle life cycle has two key stages at which eicosanoids are believed to be involved in cellular communication pathways, namely the hatching of nauplii and the settlement of cypris larvae. Barnacle egg-hatching activity has previously been reported to reside in a variety of eicosanoids, including 8-hydroxyeicosapentaenoic acid and a number of tri-hydroxylated polyunsaturated fatty acid derivatives, the trioxilins. The production of the eicosapentaenoic acid metabolite trioxilin A4 (8,11,12-trihydroxy-5,9,14,17-eicosatetraenoic acid) by the barnacles Balanus amphitrite and Elminius modestus was confirmed using a combination of high-performance liquid chromatography and gas chromatography, both linked to mass spectrometry. In addition, both species also generated trioxilin A3 (8,11,12-trihydroxy-5,9,14-eicosatrienoic acid; an arachidonic acid-derived product), 8,11,12-trihydroxy-9,14,17-eicosatrienoic acid (a omega3 analogue of trioxilin A3; derived from omega3 arachidonic acid) and 10,13,14-trihydroxy-4,7,11,16,19-docosapentaenoic acid (a docosahexaenoic acid-derived product). In contrast to earlier reports, trioxilin A3 had no E. modestus egg-hatching activity at any of the concentrations tested (10(-9)-10(-6) mol l(-1)). The unstable epoxide precursor hepoxilin A3, however, caused significant levels of hatching at 10(-6) mol l(-1). Furthermore, the stable hepoxilin B3 analogue PBT-3 stimulated hatching at 10(-7) mol l(-1). Neither trioxilin A3, hepoxilin A3 or PBT-3 at 0.25-30 micromol l(-1) served as settlement cues for B. amphitrite cypris larvae.