Killer whales Orcinus orca are found in all oceans of the world, but most of our knowledge on the species comes from studies conducted at higher latitudes. Studies on killer whales in the Caribbean have been scarce. We compiled 176 records of killer whales from the Caribbean, including 95 previously unreported records and 81 records recovered from the literature, consisting of 27 capture or kill records, 4 stranding records and 145 sighting records. Our results indicate that killer whales are widespread in the Caribbean Sea and can be found year‐round in the region. Mean group size was 3.7 animals. A diversity of prey items was recorded, including sea turtles and marine mammals and possibly fish. We cannot exclude ecotype or morphotype‐specific dietary specialization in the Caribbean population. A preliminary morphological analysis of 10 characters in 52 individuals from 21 different groups suggests that Caribbean killer whales do not represent any of the four Antarctic and subantarctic types, type 1 from the northwest Atlantic, or ‘resident’ and ‘transient’ killer whales from the northwest Pacific. Some Caribbean killer whales share a combination of characters typical of type 2 in the North Atlantic, whereas others share those typical of ‘offshore’ killer whales in the northwest Pacific. The significance of this is unclear. Comparison of Caribbean killer whales to previously described morphotypes and ecotypes is hampered by the lack of detailed, quantitative data on variation within other types, as well as by the lack of comparisons of genetic diversity. Our study adds to the growing knowledge of the diversity of killer whales worldwide but underscores that additional research is warranted in the tropics.

The world's oceans are often perceived as barriers that separate countries. To counter these divisions and improve protection of ocean resources, marine protected area (MPA) managers have formed alliances that bridge jurisdictional boundaries to share strategies and resources with other protected areas. The National Oceanic and Atmospheric Administration's Office of National Marine Sanctuaries has embraced this sister site approach to connect MPA management based on ecological and cultural links. Designed to strengthen the management of ecologically and culturally connected areas, these relationships between protected areas serve as catalysts for effective stewardship of the ocean's biological resources and show the important benefits of transnational cooperation. This paper summarizes the lessons from over a decade of sister site partnerships, including case studies from Stellwagen Bank National Marine Sanctuary and four sites in the Caribbean working together to protect a shared population of humpback whales; the Gulf of Mexico Sister Site Network being developed by the USA, Mexico, and Cuba; Papahānaumokuākea Marine National Monument and Rapa Nui in Chile; and broader collaboration among MPAs in the USA and Chile on the Pacific coast.

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BackgroundActive nursing rounds, also known as intentional, care or comfort rounds were first developed in the USA (Struder Group, 2007) and later introduced into UK hospitals in 2012 alongside other measures to improve the quality of nursing care (www.harmfreecare.org). They have been associated with reductions in pressure ulcers, falls and increased patient and staff satisfaction (Cornwell, 2012). A pressure ulcer audit (Hospice UK, 2016) on a hospice inpatient unit (IPU) highlighted the need to improve nurses’ skills in the prevention, management and documentation of skin integrity.AimTo design a comfort round tool specifically for use within the hospice IPU, implement comfort rounds and evaluate the impact on patients and nurses.MethodNurses on the IPU were consulted regarding the overall concept, naming and design of the tool. Training was provided and following implementation, feedback sought from IPU nurses and patients regarding the impact of comfort rounds on patient care and experience.ResultsNurses’ feedback: Healthcare assistants experienced job satisfaction with their involvement in continuity of patient care and evidencing care they provided. They felt areas for improvement included managing time pressures, patient choice, document design, training and team working. Patient feedback: 14 responses, all of whom were positive about the comfort rounds. They felt areas for improvement included communication about the rounds, patient choice and ensuring these discussions are communicated across the team.ConclusionComfort rounds have enabled our patients to feel less isolated and provided reassurances to family members. They support the consistent nursing care of our patients, including improving the involvement of the healthcare assistant workforce, optimising hydration and the prevention of pressure ulcers and falls. Initial assessment of patients admitted to the IPU needs to include discussion about the comfort rounds and creating individualised plans of care including the patient’s needs and preferences relating to comfort rounds.