Safeguarding the Welfare of Fish in Aquaculture : Physiological Assessments of Stress and Welfare During Handling, Transport and Slaughter

The increased demand of fish for human consumption has led to a rapid expansion of aquaculture. However, there are major knowledge gaps regarding species-specific needs, which entails an increased risk that fish are exposed to various aquaculture practices that have negative effects on their welfare. The purpose of this thesis has been to gain knowledge that can be used to assess the welfare of fish in aquaculture. To do so I have investigated various physiological indicators of fish welfare during handling, transport, and slaughter. First, the long-term effect of implantation of a heart rate bio-logger in the rainbow trout (Oncorhynchus mykiss) was investigated. I found no indications of impaired health three weeks after surgery, and concluded that these individuals can be assumed to represent a healthy population. The same type of bio-logger was then used, in combination with other biochemical stress indicators, to investigate the effect of repeated stress from handling, transport and slaughter in European whitefish (Coregonus lavaretus). The results clearly showed that the animals were stressed during crowding and brailing prior to transportation and during subsequent stunning before killing. To evaluate the reliability of a range of practical visual indicators of unconsciousness, measurements of Electroencephalogram was used, where changes in brain activity of rainbow trout before and after stunning with carbon dioxide, bolt-gun and electricity were investigated. Unfortunately, the result showed that the practical visual indicators used to assess unconsciousness was in poor agreement with the assessment based on brain activity. In summary, several important findings are presented here that can be used to improve fish welfare in aquaculture, and which can form the basis for future regulations and general advice on how fish should be handled, kept, cared for, and stunned and killed

A balancing act : work life and childcare among parents of children with cancer

Aim: The overall aim of this thesis was to investigate the socioeconomic consequences for parents of children with cancer in Sweden. The specific aims were to increase the knowledge of (I) risk of sick leave, (II) division of childcare leave, (III) balancing work and family roles, and (IV) facilitators and barriers to return to work and meet financial needs. Methods: The thesis comprises four studies. The first two studies were based on quantitative methods. The data were derived from a sample of 3,626 parents of 1,899 children who were diagnosed with cancer during 2004-2009, and a matched reference cohort of 34,874 parents from the general population. National registry data were utilized to analyze sick leave and childcare leave longitudinally. Logistic, negative binomial, beta, and linear regression analyses were conducted. The final two studies were based on qualitative methods. Nine focus group interviews with 22 mothers and 11 fathers of children with cancer were conducted. The interviews were audio-recorded and transcribed verbatim. The data were analyzed using inductive content analysis in study III, and deductive content analysis in study IV. Results: In studies I and II, we found that parents of children with cancer were on sick leave and childcare leave for statistically significantly more days than reference parents from the year of the child’s diagnosis and up to six years after diagnosis. Bereaved parents were at particularly high risk of sick leave. Mothers were overall on sick leave and childcare leave for more days than fathers. The division of childcare leave within a parental couple (i.e. fathers’ share of the couple’s total childcare leave days) was not substantially associated with the division of income within the couple (i.e. fathers’ share of the couple’s total income). Moreover, parents’ income development was not affected by extent of childcare leave. In study III, we found that parents experienced changed perspectives and priorities after a child’s cancer diagnosis. Their ability to balance work and parent roles were affected by context and conditions regarding work, economy and gender roles. Furthermore, parents described a long-term unbalance of roles. In study IV, we found that facilitators for return to work were flexibility and understanding from employers and social services, while barriers were pressures to return without consideration of the consequences. Facilitators to meet financial needs were available public, private and employer support, while barriers were a lack of organized and efficient support from employers and social services. Conclusions: Parents experience considerable work disruptions for several years after a child’s cancer diagnosis, due to both the child’s increased care demands, as well as their own ill health. Parents ability to balance work and family was affected for a long time, while the understanding and support from employers and social services declined over time. For parents to be able to meet financial needs and return to work, more coordinated and efficient support is needed from healthcare and social services, as well as flexibility from employers

Use of electroencephalogram (EEG) to optimize stunning efficiency and animal welfare in commercial catfish production

The welfare of farmed fish has gained increasing attention during recent decades, and as technological advances have facilitated measurements of brain activity in fish, the slaughter process has been highlighted as an area for assessment and potential improvement. Here, we used electroencephalograms (EEG) to assess brain activity in channel catfish (Ictalurus punctatus), and used commercial slaughter practices to guide optimization of stunning conditions in a laboratory setting. Following in-air electro-stunning at processing plants, individual fish responses to the shock varied based on EEG and corresponding ventilation measurements prior to physical euthanasia. Results from laboratory experiments showed stunning efficacy is dependent on shock duration and the location where electrodes contact fish. Electrodes contacting the head for 1 s using 50 Hz 132 AC V-RMS, with a current >380 mA(RMS), caused immediate loss of consciousness lasting 10-40 s. When the exposure period was prolonged to 6 s, recovery time was significantly longer, ranging from 45 to 240 s (mean 125 s). If the electrodes contacted the body instead of the head, shock delivered for 6 s resulted in a shorter recovery time of 0-100 s (mean 48 s). These findings highlight that shock duration and electrode position are important when stunning channel catfish and presumably other fishes, and indicate the time from stunning to killing should be kept as short as possible

The experience of pregnancy resulting from ART (Assisted Reproductive Technology) treatment : a qualitative Brazilian study

Background: Pregnancies achieved through medical treatments following a period of infertility may demand extra emotional and practical investment from women. Aim: This paper aims at understanding the experience of pregnancy after Assisted Reproductive Technology (ART), and exploring whether this experience is affected by previous failed infertility treatments. Methods: This paper uses a qualitative approach. Participants were nineteen expectant first-time mothers from Brazil who conceived through ART treatment. During the third trimester of gestation, a semi-structured interview was administered to assess perceptions of and feelings about treatment and pregnancy. Interview transcripts were analyzed using thematic analysis, and the sample was divided into two groups according to whether it was the participant’s first treatment (FT) or not (NFT). Findings: Themes identified include: Tolerance of the demands of treatment and pregnancy, Consideration of the mechanics of treatment and pregnancy, and Emotionally painful aspects of treatment and pregnancy. Pregnancy itself was regarded as a reward or compensation for the difficulties undergone. Perspectives differed according to whether pregnancy followed the first ART treatment; those who had undergone previously unsuccessful treatments focused less on the mechanical aspects of the process but were more concerned about possible physical problems. Conclusion: The similarities and differences found according to number of treatments attempted should be taken into consideration when providing psychological support for expectant ART mothers

First-time mothers’ experiences of pregnancy and birth following assisted reproductive technology treatment in Taiwan

Background Assisted Reproductive Technology (ART) treatment tends to involve significant physical and emotional commitments that can impact maternal, infant and family health and well-being. An in-depth understanding of experiences is necessary to provide adequate support for women and their families during pregnancy and transition to parenthood following ART treatment. The aim of this study was to explore first-time mothers’ experiences of pregnancy and transition to parenthood following successful ART treatment in Taiwan. Method Twelve first-time mothers who conceived and gave live birth using ART treatment were purposively selected from a fertility centre in Taipei, Taiwan. Women’s experiences in pregnancy and in their transition to motherhood were explored using semi-structured in-depth interviews. All interviews were recorded, transcribed, and analysed using the Colaizzi strategy. Results The mothers’ accounts reflected three main themes: ‘being different from mothers who became pregnant naturally’; ‘ensuring health and safety of the foetus’; and ‘welcoming new lives with excitement’. The difference mothers felt about themselves was evident in four subthemes: becoming pregnant after a long wait, feeling vulnerable during pregnancy, relying on family’s assistance and support, and worrying about the impact of ART on health. The theme on ‘ensuring health and safety of the foetus’ encompassed three subthemes: activities to protect the unborn baby, monitoring foetal movement constantly to maintain peace of mind, and receiving foetal reduction for the sake of the pregnancy. Narratives around ‘welcoming new lives with excitement’ reflected four subthemes: overcoming hardship for worthwhile results, realising one’s life and dreams, proving to be fertile enough to give birth, and return to normal life track. Conclusion Findings indicate the need for educational and psychosocial interventions to support women and their families physically and psychologically during ART treatment. The stigma related to infertility and the psychosocial support from family are aspects to consider while planning intervention programmes

Prevalence and severity of cardiac abnormalities and arteriosclerosis in farmed rainbow trout (Oncorhynchus mykiss)

Cardiovascular disease may pose a major threat to the health and welfare of farmed fish. By investigating a range of established cardiovascular disease indicators, we aimed to determine the prevalence, severity and consequences of this affliction in farmed rainbow trout (Oncorhynchus mykiss) from an open cage farm in the Baltic Sea, an open cage farm in a freshwater lake, and a land-based recirculating aquaculture system. We also aimed to identify environmental, anthropogenic and physiological factors contributing towards the development of the disease. The majority of trout possessed enlarged hearts with rounded ventricles (mean height:width ratios of 1.0-1.1 c.f. similar to 1.3 in wild fish) and a high degree of vessel misalignment (mean angles between the longitudinal ventricular axis and the axis of the bulbus arteriosus of 28-31 degrees c.f. similar to 23 degrees in wild fish). The prevalence and severity of coronary arteriosclerosis was also high, as 92-100% of fish from the different aquaculture facilities exhibited coronary lesions. Mean lesion incidence and severity indices were 67-95% and 3.1-3.9, respectively, which resulted in mean coronary arterial blockages of 19-32%. To evaluate the functional significance of these findings, we modelled the effects of arterial blockages on coronary blood flow and experimentally tested the effects of coronary occlusion in a sub-sample of fish. The observed coronary blockages were estimated to reduce coronary blood flow by 34-54% while experimental coronary occlusion adversely affected the electrocardiogram of trout. Across a range of environmental (water current, predation), anthropogenic (boat traffic intensity, hatchery of origin, brand of feed pellets) and physiological factors (condition factor, haematological and plasma indices), the hatchery of origin was the main factor contributing towards the observed variation in the development of cardiovascular disease. Therefore, further research on the effects of selective breeding programs and rearing strategies on the development of cardiovascular disease is needed to improve the welfare and health of farmed fish

Health care workers' experiences of managing foetal distress and birth asphyxia at health facilities in Northern Uganda.

BACKGROUND: Birth asphyxia is one of the leading causes of intrapartum stillbirth and neonatal mortality worldwide. We sought to explore the experiences of health care workers in managing foetal distress and birth asphyxia to gain an understanding of the challenges in a low-income setting. METHODS: We conducted in-depth interviews with 12 midwives and 4 doctors working in maternity units from different health facilities in Northern Uganda in 2018. We used a semi-structured interview guide which included questions related to; health care workers' experiences of maternity care, care for foetal distress and birth asphyxia, views on possible preventive actions and perspectives of the community. Audio recorded interviews were transcribed verbatim and analysed using inductive content analysis. RESULTS: Four categories emerged: (i) Understanding of and actions for foetal distress and birth asphyxia including knowledge, misconception and interventions; (ii) Challenges of managing foetal distress and birth asphyxia such as complexities of the referral system, refusal of referral, lack of equipment, and human resource problems, (iii) Expectations and blame from the community, and finally (iv) Health care worker' insights into prevention of foetal distress and birth asphyxia. CONCLUSION: Health care workers described management of foetal distress and birth asphyxia as complex and challenging. Thus, guidelines to manage foetal distress and birth asphyxia that are specifically tailored to the different levels of health facilities to ensure high quality of care and reduction of need for referral are called for. Innovative ways to operationalise transportation for referral and community dialogues could lead to improved birth experiences and outcomes

Factors associated with birth asphyxia among term singleton births at two referral hospitals in Northern Uganda: a cross sectional study

BACKGROUND: Birth asphyxia is one of the leading causes of neonatal mortality worldwide. In Uganda, it accounts for 28.9% of all neonatal deaths. With a view to inform policy and practice interventions to reduce adverse neonatal outcomes, we aimed to determine the prevalence and factors associated with birth asphyxia at two referral hospitals in Northern Uganda. METHODS: This was a cross-sectional study, involving women who gave birth at two referral hospitals. Women in labour were consecutively enrolled by the research assistants, who also attended the births and determined Apgar scores. Data on socio-demographic characteristics, pregnancy history and care during labour, were obtained using a structured questionnaire. Participants were tested for; i) malaria (peripheral and placental blood samples), ii) syphilis, iii) white blood cell counts (WBC), and iv) haemoglobin levels. The prevalence of birth asphyxia was determined as the number of newborns with Apgar scores < 7 at 5 min out of the total population of study participants. Factors independently associated with birth asphyxia were determined using multivariable logistic regression analysis and a p-value < 0.05 was considered statistically significant. RESULTS: A total of 2,930 mother-newborn pairs were included, and the prevalence of birth asphyxia was 154 [5.3% (95% confidence interval: 4.5- 6.1)]. Factors associated with birth asphyxia were; maternal age ≤ 19 years [adjusted odds ratio (aOR) 1.92 (1.27-2.91)], syphilis infection [aOR 2.45(1.08-5.57)], and a high white blood cell count [aOR 2.26 (1.26-4.06)], while employment [aOR 0.43 (0.22-0.83)] was protective. Additionally, referral [aOR1.75 (1.10-2.79)], induction/augmentation of labour [aOR 2.70 (1.62-4.50)], prolonged labour [aOR 1.88 (1.25-2.83)], obstructed labour [aOR 3.40 (1.70-6.83)], malpresentation/ malposition [aOR 3.00 (1.44-6.27)] and assisted vaginal delivery [aOR 5.54 (2.30-13.30)] were associated with birth asphyxia. Male newborns [aOR 1.92 (1.28-2.88)] and those with a low birth weight [aOR 2.20 (1.07-4.50)], were also more likely to develop birth asphyxia. CONCLUSION: The prevalence of birth asphyxia was 5.3%. In addition to the known intrapartum complications, teenage motherhood, syphilis and a raised white blood cell count were associated with birth asphyxia. This indicates that for sustained reduction of birth asphyxia, appropriate management of maternal infections and improved intrapartum quality of care are essential

“Living each week as unique” : maternal fears in Assisted Reproductive Technology pregnancies

Objective: to explore women's fears during pregnancy following conception via assisted reproductive technology (ART). Methods: 19 expectant first-time mothers were interviewed during the third trimester of pregnancy using a semi-structured schedule. Perceptions of and feelings about pregnancy were assessed. Content analysis was used to identify themes and subthemes. Findings: four overarching themes emerged: the baby's survival, the health of the baby, the efficacy of the mother and childbirth. Of these, the most commonly reported fears were related to miscarriage or fetal death, and the baby being born with an abnormality. Conclusions and implications: in addition to fears that are experienced by some women who conceived spontaneously, the women in this study who conceived via ART reported other fears, such as miscarriage or fetal death, that are more specific to this context. This suggests that these concerns should be taken into consideration when providing psychological support for ART mothers

Clinical and biochemical prediction of early fatal outcome following hip fracture in the elderly

Hip fracture, a moderate musculoskeletal trauma, is associated with a high postoperative mortality. Most patients are elderly, with comorbid conditions and often with heart disease. The objective of this study was to find out if clinical parameters and analyses of specific muscle enzymes could predict three month postoperative mortality. A total of 302 patients above 75 years of age with hip fracture were consecutively enrolled. Baseline information on age, sex and comorbidity assessed with the American Society of Anesthesiologists (ASA) score was obtained before surgery. Creatine kinase (CK), myocardium-specific creatine kinase (CK-MB) and troponin T (TnT) were analysed from venous blood, collected the day before surgery (−1) and postoperatively, within 24 hours (0) and on days one (+1) and four (+4). The overall three month mortality was 19.5%. Multivariate analyses showed that age, male sex and comorbidity (ASA) correlated with mortality (p = 0.027, p = 0.002, p < 0.001, respectively). Surgery induced a two- to threefold increase of CK and CK-MB but without any correlation with mortality. However, high TnT levels >0.04 μg/l correlated significantly with death (days −1, +1 and +4, p = 0.003, p = 0.005 and p = 0.003, respectively). Multivariate analyses, adjusted for age, sex and ASA category, confirmed this correlation (day +4, p = 0.008). Thus, in elderly patients with comorbidities undergoing hip fracture surgery information on sex, age, ASA category and postoperative laboratory analyses on TnT provide the clinicians with useful information on patients at risk of fatal outcome