Pig behaviour during crowding

Rearing in organic pig production differs from conventional rearing; pigs have outdoor access and larger space allowances. Regardless of production system all pigs are transported before slaughter and during transport pigs are crowded together in a new environment and in a space smaller than they are used to. As pigs in organic herds are reared at even larger space allowances than conventional pigs, such crowding could possibly have a stronger impact on pig behaviour and well-being. Six pig producing herds, three conventional and three organic, were visited and pigs from each herd were enclosed during 12 minutes in a test area corresponding to the crowding on a transport vehicle. During the crowding, pigs‟ behaviour was observed, before and after enclosure in the test area skin lesion scores were recorded, and also measures of heart girth (for weight estimation) was done. The results show that there are differences in how organic and conventional pigs‟ response to a crowded situation. Pigs in organic herds were more active, i.e. standing up (p=0.004), only pigs in conventional herds lied down during the test period. Moreover, organic pigs were more engaged in social tactile interactions (0.001>pp<0,006), vokaliserade mer (p=0,002) och klättrade betydligt mer på väggarna till testområdet (p<0,001) jämfört med de konventionella grisarna. Grisarna i de konventionella besättningarna hade mer hudskador än de ekologiska innan studien (p=0,013), men ingen skillnad i förändring efter studien kunde urskiljas. De intervjuade transportörerna upplevde skillnader i beteende mellan ekologiska och konventionella grisar, de ansåg att ekologiska grisar var mer rörliga och stirriga. Huruvida detta ansågs vara positivt eller negativt för deras arbete upplevdes olika. Sammanfattningsvis, grisar i ekologiska besättningar vokaliserade mer, var mer aktiva och utförde mer sociala interaktioner vid trängsel på en liten yta jämfört med grisar i konventionella besättningar. Detta skulle kunna tyda på att grisar från ekologiska besättningar kan ha svårare, än grisar från konventionella besättningar, att hantera trängsel på en liten yta

Factors influencing pig behaviour during unloading from a transport

Transportation of pigs might be a welfare problem. Stress during and after transportation can negatively affect the meat quality or cause carcass damages, which leads to major economic losses every year. The transportation chain can be divided into several stages; loading, transport and unloading. This literature review focuses on unloading of pigs from a transport. When arriving at an abattoir pigs can be fatigued and need to be as smoothly unloaded as possible. The unloading ramp is a major obstacle for pigs and a high angle of slope causes elevated heart rate and longer unloading times. Unloading system, noise, shadows and darkness can cause pigs to stop or hesistate. Pigs refusing to move can lead to rough handling by electric goads from personnel. Electric goad use is very stressful for pigs and cause elevated heart rate and negative changes in blood parameters, which results in carcass damage and bad meat quality. Improvement of pigs´ welfare can be accomplished through design adjustments of unloading systems, unloading facilities or development of new equipment like the container system. Less handling moments together with unloading at ground level implies that the container system is better for pigs´ welfare. In order to develop unloading systems there is a need for further research together with education of personnal to better understand the behaviour of pigs

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research