Caught in the environmental discourse—Coastal fisheries under pressure

For decades, the Norwegian coastal fisheries have been defined as the most sustainable, compared to industrial, offshore fisheries. This is due to the low fuel costs involved in the nearshore fisheries, the relatively low investments required and the fact that the coastal fleet is decentralized, providing work opportunities along the entire coast. However, over time new actors, outside the fisheries domain, have brought new sustainability attributes to the environmental discourse. The new agenda goes beyond the traditional sustainability concept, which was closely related to single stock management. Today, reduction of greenhouse gas emissions, ghost fishing, plastic pollution at sea and a stricter quota control regime, have become central topics in the sustainability debate. Furthermore, sustainability labels from private certifying agencies have gained a strong position in defining sustainable fisheries, and hence, access to the best paying fish markets. Finally, the coastal fleet has been locked into a quota management regime which makes it difficult to utilize new green technologies. The new order puts considerable pressure on the traditional coastal fisheries. How the coastal fishers and the fisheries administration answer these challenges, will largely determine the future of this fleet. As described in the article, the answers have so far not been very convincing. This could turn the tables, favouring the offshore fleet, which so far has been more responsive to the new challenges.publishedVersio

Cesarean sections in Georgia and Norway - What contributes to too much, too little, or just right? The role of maternal risk factors and efforts to reduce high cesarean section rates

High rates of cesarean section are associated with increased mortality and morbidity. To decrease cesarean sections without medical indication is complex and requires in-depth knowledge of local context and which groups to target for possible interventions. Our aim was to assess the role of maternal risk factors in relation to cesarean section in Georgia and Norway, two countries with diverging rates of cesarean sections. In addition, we wanted to assess the impact of a financial punitive policy with the aim to curb the high cesarean section rate in Georgia. The thesis consists of three studies, all of which used data from national birth registries. The first study assessed the relationship between maternal factors and cesarean section among primiparous women in Georgia. The second study assessed the prevalence of maternal risk factors for cesarean section over time and their relationship with the observed increase in cesarean sections in Norway. The third study assessed the impact of a financially punitive policy on rates of CS and perinatal outcomes in Georgia. Among primiparous women in Georgia, age ≥35 years, obesity, and birthweight ≥4000 g were strongly associated with cesarean section, while the proportion of women with risk factors for cesarean section was not unusually high. In Norway, the proportion of women with risk factors for cesarean section increased over time. Despite this development, the national cesarean section rate has remained stable since 2005. The financial policy did reduce the cesarean section rate in Georgia, mainly among primiparous women. We could not find that the policy impacted transfer to neonatal intensive care units or perinatal mortality. Our findings from Georgia and Norway indicate that maternal risk factors are not an important contributor to the increasing proportions of cesarean section. Financial regulations may play a role in reducing high rates of cesarean section but should be implemented with caution

Illegal fishing: A challenge to fisheries management in Norway

The management of the Norwegian Northeast Atlantic cod fishery has in many ways been a success story; quotas have been high (but now declining), profitability has been higher than most other industries and there is great interest among young recruits to enter the fishery. However, over the last decade illegal fishing of allocated quotas and black-market transactions throughout the value chain have become a significant of the political debate in the fishey, especially in northern Norway. Fisheries crime has been described as a priority area for law enforcement. To combat illegal overfishing the introduction of new automatic catch monitoring technologies onboard fishing vessels is considered a key strategy by the Norwegian Directorate of Fisheries. However, the new quota control measures are met with considerable resistance by the fishermen. This paper outlines the key elements of modern fisheries management to address sustainability goals, how the institutional subsystems connect with each other, and how illegal overfishing may threaten the stability of the entire management system. The gravity of illegal overfishing supports the authorities' new strategies to increase catch- and quota control. Nevertheless, the implementation of new control technologies may not be straightforward. Especially small-scale fishermen have presented a number of valid arguments against the proposed control measures. Thus, this study outlines how the implementation process may gain increased support from the fishermen.publishedVersio

Between Plan and Market - The Quota Allocation System in Norwegian Fisheries

Norway has been characterized as a “hesitant reformer” regarding fisheries management. Instead of introducing a fully fledged ITQ-system after the crisis in the coastal fisheries in 1990, a new Individual Vessel Quota (IVQ) system was introduced. Later a structural policy was introduced, whereby fishing rights (and adjoining quotas) may be bought and sold together with the vessel. This system in turn necessitated a quota allocation system, and the article traces this system, its origins, structure and logic. Different allocation keys prescribe how all important commercial species are allocated to different fleet groups and down to the individual vessel. Having worked for nearly 20 years, the allocation system has been heavily institionalized and hence difficult to change. Several reforms have been suggested, but for the time being Norwegian fishers seem largely satisfied with the overall system, although fisheries administrators have ended up being more involved with detailed allocation issues, instead of less which was part of the idea behind the new system

'It's all about money! Implementation of South Africaís new fisheries policy

This paper was originally written as part of an economics study commissioned by the Chief Directorate: Marine and Coastal Management (MCM) of the South African Department of Environmental Affairs and Tourism (DEAT). Since the 1994 ‘negotiated revolution’, South Africa’s fishing industry has been under pressure to ‘become transformed’, just like most other industries and administrative institutions. The broad goals of the new dispensation were gradually spelt out, starting with an initiative in late 1994 which led to the establishment of the Fisheries Policy Development Committee (FPDC), via a White Paper on fisheries policy in 1997, and finally on to the passing of new legislation at the end of 1998 ñ the Marine Living Resources Act (MLRA). Although the Act is clearly a compromise between the existing industry owners and the political representatives of previously disadvantaged groups, it nevertheless opened a considerable ‘action space’ by insisting on ‘the need to restructure the fishing industry to address historical imbalances and to achieve equity within all branches of the fishing industry’ (MLRA section 2(j)). And reform was urgently needed. Just like the rest of South African society, the fishing industry was extremely racially skewed in terms of ownership of existing vessels and factories, as well as the allocation of quotas and fishing rights (Hersoug 1998; Hersoug & Holm 2000). The same pattern applied to industry leadership and fisheries administration ñ it was predominantly white. However, after years of discussions and planning, the high hopes pinned on implementing the proposed reforms have not borne fruit. More than two years after having passed the new MLRA, there is a high level of confusion about what is expected of the established industry and what is possible (in terms of redistributing quotas and fishing rights) for the new prospective entrants. In spite of having produced the long-awaited new framework for fisheries, production is falling, distribution conflicts seem to be endemic, litigation is becoming more common and huge human as well as economic resources are being expended on all kinds of ‘rent-seeking’ behaviour. What went wrong and why

Local empowerment through the creation of coastal space?

Developments in national fisheries and marine environmental policies during the last 30 years have changed the relationship between coastal communities and the marine resources that people in these communities traditionally harvested. In Norway, for example, when the state authorities have made decisions to defend what they regard as national interests, the local level has been left with authority over minor issues related to area planning in the coastal zone. Although coastal planning until recently was about sharing fishing areas between different users, we now see a spatial dimension emerging in planning, giving it a much broader scope. The processes of defining spatial properties and creating coastal space as a governable object have the potential to empower local communities. These processes contribute to enhanced local control and improved local participation in the governance of natural resources. In Norway, the 2008 Planning and Building Act strengthened the role of municipalities in local planning. In addition, the application of a new three-dimensional, spatial approach to coastal planning may create opportunities for new control over local resources. In marine spatial planning (MSP) the natural resources are seen as part of coastal spatial properties; thus, governing of sea space implies resource governance. As our examples illustrate, considerable power is associated with the ability to identify and define the properties of coastal space. MSP could become an important tool for controlling local resources, rebuilding collapsed fisheries, and managing them sustainably at the level of municipalities

Effect of improved home ventilation on asthma control and house dust mite allergen levels

The warm, humid environment in modern homes favours the dust mite population, but the effect of improved home ventilation on asthma control has not been established. We tested the hypothesis that a domestic mechanical heat recovery ventilation system (MHRV), in addition to allergen avoidance measures, can improve asthma control by attenuating re-colonization rates. We conducted a randomized double-blind placebo-controlled parallel group trial of the installation of MHRV activated in half the homes of 120 adults with asthma, allergic to Dermatophagoides pteronyssinus. All homes had carpets steam cleaned and new bedding and mattress covers at baseline. The primary outcome was morning peak expiratory flow (PEF) at 12 months. At 12 months, the primary end-point; change in mean morning PEF as compared with baseline, did not differ between the MHRV group and the control group (mean difference 13.5 l/min, 95% CI: −2.6 to 29.8, P = 0.10). However, a secondary end-point; evening mean PEF, was significantly improved in the MHRV group (mean difference 24.5 l/min, 95% CI: 8.9-40.1, P = 0.002). Indoor relative humidity was reduced in MHRV homes, but there was no difference between the groups in Der p 1 levels, compared with baseline. The addition of MHRV to house dust mite eradication strategies did not achieve a reduction in mite allergen levels, but did improve evening PEF

Factors Associated with Cesarean Section among Primiparous Women in Georgia: A Registry-based Study

Cesarean section rates remain high in Georgia. As a cesarean section in the first pregnancy generally lead to a cesarean section in subsequent pregnancies, primiparous women should be targeted for prevention strategies. The aim of the study was to assess factors associated with cesarean section among primiparous women. The study comprised 17,065 primiparous women with singleton, cephalic deliveries at 37–43 weeks of gestation registered in the Georgian Birth Registry in 2017. The main outcome was cesarean section. Descriptive statistics and logistic regression analysis were used to identify factors associated with cesarean section. The proportion of cesarean section was 37.1% with regional variations from 14.2% to 57.4%. Increased maternal age, obesity and having a baby weighing ≥4000 g were all associated with higher odds of cesarean section. Of serious concern for newborn well-being is the high proportion of cesarean section at 37–38 weeks of gestation. Further research should focus on organizational and economical aspects of maternity care to uncover the underlying causes of the high cesarean section rate in Georgia

Changes in cesarean section rates after introduction of a punitive financial policy in Georgia: A population-based registry study 2017-2019

Background There is little research on how financial incentives and penalties impact national cesarean section rates. In January 2018, Georgia introduced a national cesarean section reduction policy, which imposes a financial penalty on hospitals that do not meet their reduction targets. The aim of this study was to assess the impact of this policy on cesarean section rates, subgroups of women, and selected perinatal outcomes. Methods We included women who gave birth from 2017 to 2019 registered in the Georgian Birth Registry (n = 150 534, nearly 100% of all births in the country during this time). We then divided the time period into pre-policy (January 1, 2017, to December 31, 2017) and post-policy (January 1, 2018, to December 31, 2019). An interrupted time series analysis was used to compare the cesarean section rates (both overall and stratified by parity), neonatal intensive care unit transfer rates, and perinatal mortality rates in the two time periods. Descriptive statistics were used to assess differences in maternal socio-demographic characteristics. Results The mean cesarean section rate in Georgia decreased from 44.7% in the pre-policy period to 40.8% in the post-policy period, mainly among primiparous women. The largest decrease in cesarean section births was found among women <25 years of age and those with higher education. There were no significant differences in the neonatal intensive care unit transfer rate or the perinatal mortality rate between vaginal and cesarean section births in the post-policy period. Conclusion The cesarean section rate in Georgia decreased during the 2-year post-policy period. The reduction mainly took place among primiparous women. The policy had no impact on the neonatal intensive care unit transfer rate or the perinatal mortality rate. The impact of the national cesarean section reduction policy on other outcomes is not known

Women’s experiences and views on early breastfeeding during the COVID-19 pandemic in Norway: quantitative and qualitative findings from the IMAgiNE EURO study

Background Little is known about women’s experience of care and views on early breastfeeding during the COVID19 pandemic in Norway. Methods Women (n =2922) who gave birth in a facility in Norway between March 2020 and June 2021 were invited to answer an online questionnaire based on World Health Organization (WHO) Standard-based quality measures, exploring their experiences of care and views on early breastfeeding during the COVID-19 pandemic. To examine associations between year of birth (2020, 2021) and early breastfeeding-related factors, we estimated odds ratios (ORs) with 95% confdence intervals (CIs) using multiple logistic regression. Qualitative data were analysed using Systematic Text Condensation. Results Compared to the frst year of the pandemic (2020), women who gave birth in 2021 reported higher odds of experiencing adequate breastfeeding support (adjOR 1.79; 95% CI 1.35, 2.38), immediate attention from healthcare providers when needed (adjOR 1.89; 95% CI 1.49, 2.39), clear communication from healthcare providers (adjOR 1.76; 95% CI 1.39, 2.22), being allowed companion of choice (adjOR 1.47; 95% CI 1.21, 1.79), adequate visiting hours for partner (adjOR 1.35; 95% CI 1.09, 1.68), adequate number of healthcare providers (adjOR 1.24; 95% CI 1.02, 1.52), and adequate professionalism of the healthcare providers (adjOR 1.65; 95% CI 1.32, 2.08). Compared to 2020, in 2021 we found no diference in skin-to-skin contact, early breastfeeding, exclusive breastfeeding at discharge, adequate number of women per room, or women’s satisfaction. In their comments, women described understafed postnatal wards, early discharge and highlighted the importance of breastfeeding support, and concerns about long-term consequences such as postpartum depression. Conclusions In the second year of the pandemic, WHO Standard-based quality measures related to breastfeeding improved for women giving birth in Norway compared to the frst year of the pandemic. Women’s general satisfaction with care during COVID-19 did however not improve signifcantly from 2020 to 2021. Compared to pre-pandemic data, our findings suggest an initial decrease in exclusive breastfeeding at discharge during the COVID-19 pandemic in Norway with little diference comparing 2020 versus 2021. Our findings should alert researchers, policy makers and clinicians in postnatal care services to improve future practices