The ornamental fish trade is estimated to handle up to 1·5 billion fishes. Transportation and handling of fishes imposes a range of stressors that can result in mortality at rates of up to 73%. These rates vary hugely, however, and can be as low as 2%, because they are generally estimated rather than based on experimental work. Given the numbers of ornamental fishes traded, any of the estimated mortality rates potentially incur significant financial losses and serious welfare issues. Industry bodies, such as the Ornamental Aquatic Trade Association (OATA), have established standards and codes of best practice for handling fishes, but little scientific research has been conducted to understand the links between stress, health and welfare in ornamental species. In aquaculture, many of the same stressors occur as those in the ornamental trade, including poor water quality, handling, transportation, confinement, poor social and physical environment and disease and in this sector directed research and some resulting interventions have resulted in improved welfare standards. This review considers the concept of welfare in fishes and evaluates reported rates of mortality in the ornamental trade. It assesses how the stress response can be quantified and used as a welfare indicator in fishes. It then analyses whether lessons from aquaculture can be usefully applied to the ornamental fish industry to improve welfare. Finally, this analysis is used to suggest how future research might be directed to help improve welfare in the ornamental trade.

Good practice for the housing and care of laboratory zebrafish Danio rerio is an increasingly discussed topic, with focus on appropriate water quality parameters, stocking densities, feeding regimes, anaesthesia and analgesia practices, methods of humane killing, and more. One area of current attention is around the provision of environmental enrichment. Enrichment is accepted as an essential requirement for meeting the behavioural needs and improving the welfare of many laboratory animal species, but in general, provision for zebrafish is minimal. Some of those involved in the care and use of zebrafish suggest there is a ‘lack of evidence’ that enrichment has welfare benefits for this species, or cite a belief that zebrafish do not ‘need’ enrichment. Concerns are also sometimes raised around the practical challenges of providing enrichments, or that they may impact on the science being undertaken. However, there is a growing body of evidence suggesting that various forms of enrichment are preferred by zebrafish over a barren tank, and that enriched conditions can improve welfare by reducing stress and anxiety. This review explores the effects that enrichment can have on zebrafish behaviour, physiology and welfare, and considers the challenges to facilities of providing more enrichment for the zebrafish they house.

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To evaluate the status of UK undergraduate urology teaching against the British Association of Urological Surgeons (BAUS) Undergraduate Syllabus for Urology. Secondary objectives included evaluating the type and quantity of teaching provided, the reported performance rate of General Medical Council (GMC)-mandated urological procedures, and the proportion of undergraduates considering urology as a career. Subjects and MethodsThe uroLogical tEAching in bRitish medical schools Nationally (LEARN) study was a national multicentre cross-sectional evaluation. Year 2 to Year 5 medical students and Foundation Year (FY) 1 doctors were invited to complete a survey between 3 October and 20 December 2020, retrospectively assessing the urology teaching received to date. Results are reported according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). ResultsIn all, 7063/8346 (84.6%) responses from all 39 UK medical schools were included; 1127/7063 (16.0%) were from FY1 doctors who reported that the most frequently taught topics in undergraduate training were on urinary tract infection (96.5%), acute kidney injury (95.9%) and haematuria (94.4%). The most infrequently taught topics were male urinary incontinence (59.4%), male infertility (52.4%) and erectile dysfunction (43.8%). Male and female catheterisation on patients as undergraduates was performed by 92.1% and 73.0% of FY1 doctors respectively, and 16.9% had considered a career in urology. Theory-based teaching was mainly prevalent in the early years of medical school, with clinical skills teaching, and

Background/Aims Prior to each treatment of zoledronate (ZA) or denosumab, it is routine clinical practice to test for vitamin D. If vitamin D levels are low, patients must be started on replacement therapy prior to treatment. Other studies suggest that osteoporosis patients not taking vitamin D supplementation are likely to have subtherapeutic vitamin D levels. Awaiting vitamin D levels can delay timely treatment and organising these tests is labour intensive. In this service evaluation, we examined whether patients could have been treated empirically with vitamin D without testing. Methods We included all 542 patients from the New Cross Hospital osteoporosis treatment clinic lists between November 2021 to June 2022. The only patients excluded were those not taking ZA or denosumab. Data collected included demographics, medication history, and vitamin D levels. Vitamin D levels were measured as follows: <15 nmol/L: severe deficiency, 15-30 nmol/L: deficiency, >30-50 nmol/L: insufficiency, >50-250 nmol/L: adequate, >250 nmol/L: potential toxicity. Results 484 patients were included of which 88.6% were female. The mean age was 76.8. 90.0% were either on vitamin D and calcium supplementation, or on vitamin D supplementation alone. Of these patients on supplementation, vitamin D levels were adequate in 79.8%, insufficient in 7.8%, deficient in 0.4%, severely deficient in 0.2% and not available for the remaining patients. Of those not on supplementation, vitamin D levels were adequate in 45.9%, insufficient in 16.2%, deficient in 10.8% and severely deficient in 4%, and not available for the remaining patients. None of the patients had toxic levels of vitamin D. On contacting the 3 patients prescribed vitamin D supplementation but with deficient or severely deficient vitamin D levels, 2 were not taking the supplements and 1 was taking alfacalcidol (which is not measured in the standard trust vitamin D test). Therefore, of those patients taking vitamin D supplementation as prescribed, their vitamin D levels were all above 30 nmol/L. Conclusion This service evaluation therefore supports an approach of not testing vitamin D levels in patients who are due to receive either ZA or denosumab and are taking vitamin D supplementation. A small number of patients taking vitamin D supplementation still had insufficient levels of vitamin D; therefore, it could be recommended to treat all patients on vitamin D supplementation with a short course of high does vitamin D prior to ZA or denosumab treatment. In addition, any patients not taking vitamin D supplementation could also be treated with a course of high dose vitamin D prior to treatment without testing vitamin D levels. This will ensure safe levels of vitamin D and timely treatment of osteoporosis. This will save time and money and reduce waste. Disclosure J. Keasley: None. C. Stevens: None. A. Kumar: None. H. Sapkota: None.