Production, fasting and delousing of triploid and diploid salmon in Northern Norway - Report for the 2020-generation

This report is an investigation into the 2020 generation of triploid salmon in Northern Norway and their diploid comparators. The trajectory of 16 fish groups comprising more than 10 million fish is described throughout their production cycles. The commercially cultivated fish vary in origin and rearing environment, and experience different disease and treatment events. The acquired dataset provides a uniquely whole description of the aquaculture production cycle but is challenged by the many confounding factors. Rather than make isolated analyses we evaluated the motivations of farmers within the complex system of management regimes, commercial structures, and animal health. We find that farmers and fish health personnel make decisions which balance welfare needs with production goals, but their decisions are constrained and often forced by regulations. Furthermore, a repeated pattern has emerged in which farmers choose to apply riskier handing operations on fish which are perceived to be stronger while reserving gentler operations for those that are perceived to be weaker, which more often are triploid fish. This was also shown in that they typically chose to fast the triploid fish longer than the diploid before delousing operations. The movement of fish between farms and applying delousing treatments increases mortality in the weeks after the operation compared to before, regardless of ploidy. Mortality especially increased after thermal and mechanical treatments even though these were preferentially applied to fish perceived to be stronger. The susceptibility of triploid fish to health problems was demonstrated by higher prevalence of winter ulcers and mortality during the winter for triploid compared to diploids, especially when the fish were transferred to sea that Autumn. Overall, the triploids were also inferior in their economic prospect for the farmer, compared to diploids they had lower product quality at harvest, required more feed per kg produced, and had a higher cumulative mortality by the time of harvest despite being harvested earlier and at lower weight.Production, fasting and delousing of triploid and diploid salmon in Northern Norway - Report for the 2020-generationpublishedVersio

Tredje samlerapport: Velferd for triploid laks i Nord-Norge - Sluttrapport, utsett 2019

Denne rapporten tar for seg velferden til 14 grupper av triploid laks satt ut i Nord-Norge vår, sommer og høst 2019. To av gruppene satt ut om våren hadde perfekt utgangspunkt med god smoltkvalitet og feilfri transport. Disse fikk begge lav dødelighet, men i ett av tilfellene ble ILA påvist mot slutten av produksjonen. Det ble også påvist ILA på en av gruppene satt ut om sommeren. Parasitten Parvicapsula pseudobranchicola angriper typisk smolt satt ut august-oktober og gir høy dødelighet hos triploid laks. For 2019-generasjonen ble flere av sommer- og høstutsettene, og også ett av vårutsettene smittet av denne parasitten. På den positive siden så fikk ett av høstutsettene kun moderat dødelighet fra vintersår første vinter i sjø. Totalt sett var imidlertid velferden til 2019-generasjonen et tilbakeslag etter til dels lovende resultat for særlig 2017- og 2018-generasjonene.publishedVersio

Lithium in drinking water and incidence of suicide:A nationwide individual-level cohort study with 22 years of follow-up

Suicide is a major public health concern. High-dose lithium is used to stabilize mood and prevent suicide in patients with affective disorders. Lithium occurs naturally in drinking water worldwide in much lower doses, but with large geographical variation. Several studies conducted at an aggregate level have suggested an association between lithium in drinking water and a reduced risk of suicide; however, a causal relation is uncertain. Individual-level register-based data on the entire Danish adult population (3.7 million individuals) from 1991 to 2012 were linked with a moving five-year time-weighted average (TWA) lithium exposure level from drinking water hypothesizing an inverse relationship. The mean lithium level was 11.6 μg/L ranging from 0.6 to 30.7 μg/L. The suicide rate decreased from 29.7 per 100,000 person-years at risk in 1991 to 18.4 per 100,000 person-years in 2012. We found no significant indication of an association between increasing five-year TWA lithium exposure level and decreasing suicide rate. The comprehensiveness of using individual-level data and spatial analyses with 22 years of follow-up makes a pronounced contribution to previous findings. Our findings demonstrate that there does not seem to be a protective effect of exposure to lithium on the incidence of suicide with levels below 31 μg/L in drinking water

IgG and IgM cooperate in coating of intestinal bacteria in IgA deficiency

Immunoglobulin A (IgA) is acknowledged to play a role in the defence of the mucosal barrier by coating microorganisms. Surprisingly, IgA-deficient humans exhibit few infection-related complications, raising the question if the more specific IgG may help IgM in compensating for the lack of IgA. Here we employ a cohort of IgA-deficient humans, each paired with IgA-sufficient household members, to investigate multi-Ig bacterial coating. In IgA-deficient humans, IgM alone, and together with IgG, recapitulate coating of most bacterial families, despite an overall 3.6-fold lower Ig-coating. Bacterial IgG coating is dominated by IgG1 and IgG4. Single-IgG2 bacterial coating is sparse and linked to enhanced Escherichia coli load and TNF-α. Although single-IgG2 coating is 1.6-fold more prevalent in IgA deficiency than in healthy controls, it is 2-fold less prevalent than in inflammatory bowel disease. Altogether we demonstrate that IgG assists IgM in coating of most bacterial families in the absence of IgA and identify single-IgG2 bacterial coating as an inflammatory marker.</p

Struggle with a gap between intensive care units and general wards

Nursing critically ill patients includes planning and performing safe discharges from Intensive Care Units (ICU) to the general wards. The aim of this study was to obtain a deeper understanding of the main concern in the ICU transitional process—the care before, during, and after the transfer of ICU patients. Interviews were conducted with 35 Swedish nurses and analysed according to grounded theory. The main concern was the nurses' “struggling with a gap.” The “gap” was caused by differences in the altered level of care and contributed to difficulties for nurses encountering an overlap during the transitional care. The categories: sheltering, seeking organizational intertwining and striving for control are related to the core category and were used to generate a theory. The nurses sought improved collaboration, and employed patient-centred routines. They wanted access to necessary tools; they relayed or questioned their own competence and sought assurance of the patients' ability to be transferred. If the nurses felt a loss of control, lack of intertwining and lack of collaboration, they sheltered their patients and themselves. Intertwining was more difficult to perform, but actually even more important to do. With knowledge about ICU transitional care, collaboration, routines, and with an organization that provides an educational environment, the process could be improved

Wanting a Life in Decency! : A Qualitative Study from Experienced Electric Wheelchairs Users’ perspective

Background: The functionality and the safety of the electric wheelchairs were essential for users’ everyday life. Some evidence indicated that the wheelchair Per Se highly influenced users’ occupational life, their personal identity and social life; further, the wheelchair became an extension of the body and more than a technical device. Besides, there was still both environmental and self-efficacy or/and mental health factors obstacles for full social participation. Even so, there was to some extent stigma related to being a wheelchair user. There was a need to reflect users’ perspective on being depended on electric wheelchair. The aim, accordingly, was to describe and to get a deeper insight into electric wheelchairs users’ perspective and experiences of utilizing this device; a qualitative design with an inductive approach was used. Method: Qualitative latent and interpretative content analysis [1] [2] was used after repeated face-to-face semi-structured interviews with three experienced Swedish electric wheelchair users during the autumn 2017. Findings: The findings showed a high degree of dependability of the assistants that supported the users, and of the quality of that working relationship. The findings were formulated, abstracted and interpreted in several steps. It showed one theme of meaning: “Living in a space shifting between potential violation of or respect for human dignity”. Conclusion: The study showed that electric wheelchair users were relatively content with their lives as well as with their devices in turns of mobility and accessibility, but the meaning of their narrations showed a life at constant risk of having the respect of human rights and human respect violated. Besides, the importance of having access to good and high quality devices, good staffing, and environmental support, all in concordance with human rights, the clinical and practical implications of this study narrows down to a question of encountering the other person as a whole and worthy individual.SMART (Smarta system och tjänster för ett effektivt och innovativt samhälle

Features of Swedish municipal elderly and psychiatric group dwelling care after the 1990s healt care reformations

The over all aim of this thesis, consisting of six studies, was to explore features of the Swedish municipal elderly and psychiatric group dwelling care after the 1990s health care reformation era. Focus is primarily on the municipal psychiatry. The mixed design, used here, employs both quantitative and qualitative methods. In paper I all psychiatric municipal care providers' caring approaches towards a fictitious elderly long-term client with schizophrenia was explored through a questionnaire. Approximately 70 per cent of the nurses had a symptom-orientated approach which focuses on correction of disease-related symptoms towards the clients. If the nurses had been working for less than 10 years they tend to have a more person-centred approach, which indicate that long- term job experience might affect the care providers' attitudes towards the clients negatively. In paper II the existence of a visible pattern in care providers' attitudes and their arguments for the preferred approaches towards a fictitious elderly person (Mrs NN) with a diagnosis of long term schizophrenia was investigated. Fourty-eight (73%) of the respondents (n = 66) emphasized the importance of meeting Mrs NN within the framework of reality and the need as a care provider to focus on the present or the 'here and now' when they communicate with her. Twenty-seven per cent stressed the importance of meeting Mrs NN within the framework of a person-focused approach to the same question. The majority was unable to see the client a as anything else than what the diagnosis said. The purpose of paper III was to investigate twenty care providers' experiences of job satisfaction, whose work involves taking care of clients suffering from dementia and elements of ' aggressiveness' and 'psychomotor agitation'. The individual narrative interviews indicated exposure, insufficiency, a feeling of not being valued and doubt, as well as respect and importance and devotion towards the residents. The interpretation of the narrations showed that an ambiguous and complex core-theme: 'job satisfaction as a process moving between breaking down and occasionally building up the working person'. The care providers experienced that they only got support from each other and the positive relationship with colleagues was mentioned as the primary reason for care providers' continuing to work at the group dwellings. The organisation and resident behaviours were seen as very negative. Just a small degree of support was experienced from the side of the organisation. In paper IV the aim was to investigate how clients at two psychiatric group dwellings spend their time using the Patient Activity Classification (PAC). The clients who displayed a predominant picture of negative symptoms were left alone for 84% of the day. Of this 29.5% could be explained by their illness. The results indicated that, even if the dwellings had a creative climate, there was a negative process in terms of care providers' well-being with a moderate degree of emotional exhaustion, depersonalisation, and personal accomplishment. In paper V the aim was to investigate the connections between the time spent together and the care providers' opinion of client behaviour and social functioning in community-based psychiatry. Twenty nine clients' were assessed by 30 care providers, who answered the Global Assessment of Functioning Scale (GAF) and the Positive and Negative Syndrome Scale (PANSS). The PAC instrument revealed that clients spent, an average of 60.8 per cent of time alone, while only 20 per cent of their daily time was spent with the care providers. Four groups of clients were created based on the GAF scores, high and low, and a PANSS scores, high and low, related factor analysis. The clients in the group judged as having a low level of social functioning in combination with high degrees of psychiatric symptoms, receive less staff attention (18%) and are the clients who spend the most time alone (73.4%). Finally, in paper VI, the professional role of care providers in social psychiatry is in the midst of a period of role re-definition towards a recovery, client-focused perspective. In three focus group interviews 13 care providers discussed their views and experiences of their professional role at a social PGD (Psychiatric Group Dwelling) context when caring for clients suffering from severe mental illness. Thematic content analysis was conducted. Four themes were formulated: 'Being a general human factotum not unlike the role of parents', 'Having a complex and ambiguous view of clients', 'Working in a mainly "strangled" situation', and 'Feeling overwhelming frustration'. The findings showed that when aspects of the care were related to Kari Martinsen's ontological theory of care, including a practical, relational- and moral dimension, the moral dimension seemed to cause the care providers suffering. Furthermore, a figure is presented to illuminate how the findings contributing to different levels of the features of municipal EGD (Elderly Group Dwelling) and PGD care can be understood and related to each other. There is a hope that the results of this research could be used as a foundation to develop educational- and "contact" programs for care providers and others with the interpretation and the power to decide. This might, in a longer perspective, lead to a positive development for all identified levels, with special focus on a higher degree of experienced quality of life for both elderly and psychiatric clients