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The importance of fish for the medieval and early modern economy in the Baltic Sea is known through separate studies by historians and archaeologists. This article aims to combine zooarchaeological data with account books from castles in Kastelholm (Åland Islands) and Raseborg (south-western coast of Finland) in order to understand the processing and transport of fish in the area. Fish was paid as tax by the peasants but was also fished by the castle fishermen and brought to the castles to be consumed there. Here, the preserved fish products are primarily studied through pike and cod, which represent the main economically important larger fish species in the Baltic Sea. The study reveals some differences between the castles studied and the importance of fish for the castle economy.
Infants born with undiagnosed transposition of the great arteries continue to be born in district general hospitals despite the improvements made in antenatal scanning. Evidence indicates improved outcomes with early definitive treatment after birth, hence the recommendation of delivery in a tertiary centre. The role of specialist paediatric and neonatal transport teams, to advise, stabilise, and transport the infants to a tertiary centre in a timely manner, is critical for those infants born in a district general hospital. This pilot study aims to compare outcomes between infants born in district general hospitals and those who were born in a tertiary maternity unit in South West England and South Wales.
This was a secondary data analysis of data collected from the local Paediatric Intensive Care Audit Network and the local transport database. Infants born with a confirmed diagnosis of transposition of the great arteries, that required an arterial switch operation as the definitive procedure between April, 2012 and March 2018 were included.
Forty-five infants with a confirmed diagnosis of transposition of the great arteries were included. Statistical analysis demonstrated there were no significant differences in the time to balloon atrial septostomy (p = 0.095), time to arterial switch operation (p = 0.461), length of paediatric ICU stay (p = 0.353), and hospital stay (p = 0.095) or mortality between the two groups.
We found no significant differences in outcomes between infants delivered outside the specialist centre, who were transferred in by a specialist team.
Three states and one county now allow Emergency Medical Services (EMS) providers to transport injured law enforcement K9s (LEK9s) as long as no human needs the ambulance at the time. Several other states either have pending legislation or are in discussions about this topic. As additional states ponder these laws, it is likely that the EMS transport of LEK9s will become legal in many states. In the wake of this legislation, a significant void was created. Currently, there are no published protocols for the safe transport of LEK9s by EMS providers. Additionally, the transport destination for these LEK9s is unlikely to be programmed into vehicle Global Positioning Systems. The authors of this report convened a Joint Task Force on Working Dog Care, consisting of veterinarians, EMS directors, EMS physicians, and LEK9 handlers, who met to develop a protocol for LEK9s being transported to a veterinary facility. The protocol covers the logistics of getting the LEK9 into the ambulance (eg, when the handler is or is not available), appropriate restraint, and the importance of prior arrangements with a veterinary emergency facility. A LEK9 hand-off form and a Transport Policy Form are provided, downloadable, and customizable for each EMS provider. This protocol provides essential information on safety and transport logistics for injured LEK9s. The hope is that this protocol will assist EMS providers to streamline the transport of an injured LEK9 to an appropriate veterinary facility.
Chapter 1, “Horizons,” recovers the vanquished plan that preceded Milton Keynes, North Bucks New City. In the early 1960s, Buckinghamshire county council’s chief architect and planner, Fred Pooley, peered into the future. Like other planners at the time, he foresaw a post-industrial world of affluence, leisure, and new mobilities, if also one still organized around familiar gender roles and urban forms. Pooley designed a city for a quarter-million residents, with a monorail ensuring free and equal access to the city center. This social democratic vision sought to use the powers of the state to distribute the benefits of affluence. Pooley also wanted North Bucks New City to send a message to the world, expressing a nationalist urbanism that promised to secure Britain’s post-imperial status as an urban innovator. While the new town that eventually emerged, in the form of Milton Keynes, rejected Pooley’s monorail, its location – indeed, its existence – resulted from a contested process that cannot be understood without attending to this unrealized vision.
We begin our consideration of Brahms’s politics and religion with the great historical turn that occurred in the centre of Europe in the year 1870. With the decisive German military defeat of France and proclamation of King Wilhelm I of Prussia as German Emperor, the German Question was at last given its definitive Prussian-dominated Smaller German solution. Brahms probably would have preferred a Larger German solution that included Austria, Prussia’s traditional rival for leadership in the loosely bound German Confederation that was established by the Congress of Vienna following Napoleon’s final defeat in 1815. But what mattered most was that Germany had at last emerged from its political impotence to become a nation-state possessed of power and influence in the world commensurate with its long-recognised achievements in the cultural sphere.
Brahms witnessed a period of staggering scientific and technological advances throughout Europe and the burgeoning USA. The nineteenth century offered new modes of transportation: musicians could now travel to distant cities to perform. With this mobility came the need for standardisation, both of technological devices as well as musical parameters, such as concert pitch, which varied considerably among cities. Brahms was both interested in, and delighted by, advances which related to music and its performance, from train travel to new research in the natural sciences. Indeed, he became an interlocutor with a number of leading natural scientists of the period.
By the 1830s, the Industrial Revolution was in full swing in Britain, and German cities were slowly experiencing the effects of mechanisation. A crucial development in both production and communications was the steam engine, which powered factory machinery, facilitating mass production.
Bovine trichomoniasis is a notifiable, reproductive disease of cattle caused by the parasite Tritrichomonas foetus. Culturing with modified Diamond's medium (MDM) is required to increase the low number of organisms received from a preputial sample, but is limited in application to remote areas as it requires continuous cold chain storage. This study utilized lyophilization to sustain the viability of MDM during transport in lieu of a continuous cold chain. All lyophilized MDM was able to sustain T. foetus after storage for 42 days at 24 °C, and the results demonstrated that lyophilized MDM was equally as viable as refrigerated liquid MDM. Storage of lyophilized MDM at room temperature for 1 and 7 days did not impact T. foetus yield, both with and without exposure to light. A limitation of the lyophilized MDM was demonstrated with a significant decrease in T. foetus yield when the media was stored at 37 and 58 °C. The lyophilization of MDM provides a robust method of transporting and storing medium prior to reconstitution and inoculation, for use in T. foetus diagnosis and surveillance in remote areas.
The goal of this review is to present a concise and critical assessment of the literature related to physiologic responses in cattle that are subjected to transportation. Over two-thirds of US cattle are transported. Understanding trends in circulating physiologic parameters is an important part of mitigating the negative effects of transportation. For the producer, linking these effects after transportation to morbidity outcomes within the first 45 days on feed (i.e. especially development of bovine respiratory disease) is critical. Physiologic parameters in circulation are of primary importance and may have value for prediction of bovine respiratory disease on arrival and for the understanding of disease pathogenesis. The results of our literature survey indicated that post-transportation immune function, increased acute phase proteins, glucocorticoids, and inflammation are a pivotal starting point for understanding disease. These potential biomarkers may have utility in identifying disease for targeted therapeutics so that traditional protocols that rely heavily on metaphylaxis can be avoided. Additional research is needed to develop strategies for physiological marker identification, treatment methods, or predictive behaviors to prevent respiratory disease before and after transport. This review examines the significant deleterious effects of transportation handling and stress, and current immune system translation and non-antimicrobial mitigation strategies.
The effect of transportation and lairage on the faecal shedding and post-slaughter contamination of carcasses with Escherichia coli O157 and O26 in young calves (4–7-day-old) was assessed in a cohort study at a regional calf-processing plant in the North Island of New Zealand, following 60 calves as cohorts from six dairy farms to slaughter. Multiple samples from each animal at pre-slaughter (recto-anal mucosal swab) and carcass at post-slaughter (sponge swab) were collected and screened using real-time PCR and culture isolation methods for the presence of E. coli O157 and O26 (Shiga toxin-producing E. coli (STEC) and non-STEC). Genotype analysis of E. coli O157 and O26 isolates provided little evidence of faecal–oral transmission of infection between calves during transportation and lairage. Increased cross-contamination of hides and carcasses with E. coli O157 and O26 between co-transported calves was confirmed at pre-hide removal and post-evisceration stages but not at pre-boning (at the end of dressing prior to chilling), indicating that good hygiene practices and application of an approved intervention effectively controlled carcass contamination. This study was the first of its kind to assess the impact of transportation and lairage on the faecal carriage and post-harvest contamination of carcasses with E. coli O157 and O26 in very young calves.
This study examined the effects of meiosis inhibition during bovine oocyte transportation on developmental competence and quality of produced embryos. The transportation medium was supplemented with: 100 μM butyrolactone I (BL), 500 μM IBMX + 100 μM forskolin (mSPOM), 100 μM milrinone (MR) or follicular fluid (bFF), and was carried out in a portable incubator for 6 h. Next, oocytes were in vitro matured (IVM) for 18 h, without the meiotic inhibitors, with the exception of mSPOM group, in which was added 20 μM cilostamide. The three control groups were IVM with 10% fetal calf serum (FCS) (Control Lab FCS) or 0.6% bovine serum albumin (BSA) (Control Lab BSA) in a CO2 in air incubator or in the portable incubator with 0.6% BSA (Control Transp BSA). Higher cleavage rates (P < 0.05) were obtained in the Control Lab FCS group (84.5 ± 5.3%) compared with the other groups (59.6 ± 3.4% to 70.9 ± 2.3%). Embryonic development was higher (P < 0.05) in the Control Lab FCS group (39.8 ± 4.7%) than in the Control Transp BSA (22.7 ± 3.4%) and MR (21.6 ± 2.3%) groups. However, they were similar (P > 0.05) to the other groups (23.6 ± 3.3% to 28.8 ± 2.7%). The total number of blastomeres was higher (P < 0.05) in the Control Lab FCS group (85.2 ± 5.6) than in Control Lab BSA (53.6 ± 2.9), Control Transp BSA (55.5 ± 4.4), BL (58.2 ± 3.0), mSPOM (57.9 ± 4.9) and MR (59.2 ± 3.9), but all these treatments did not differ (P > 0.05) from bFF (67.7 ± 4.2). No differences (P > 0.05) were found in apoptosis by the activity of caspases (139.0 ± 3.2 to 152.4 ± 6.5, expressed in fluorescence intensity) as well as the percentage of TUNEL-positive cells (12.3 ± 2.0% to 15.7 ± 1.7%). In conclusion, the transportation of oocytes over 6 h with BL, mSPOM or bFF enabled the acquisition of developmental competence at similar rates to the Control Lab FCS group.
Introduction: Medical transport services are essential in the regionalization of trauma care. Given the limited number of designated trauma centers, transport times can be prolonged, with patient care managed by paramedics for the duration of their transfer. Pain management is a paramount component, but oligoanalgesia can occur. The primary objective of this study was to evaluate pain management practices during transport of trauma patients by air. Methods: We conducted a 12-month review of ORNGE electronic paramedic records. ORNGE is the exclusive provider of air and land transport in Ontario, Canada. Cases from 1 January 2015 to 31 December 2015 were screened. Patients were identified according to inclusion (≥18 years old requiring transportation to designated trauma center) and exclusion criteria (GCS<14; intubation; accompanied by a nurse or physician). Information was collected in a standardized, piloted data form used by a single trained data extractor. Demographics, injury description, and transportation parameters were recorded. Outcomes included pain assessment according to changes on a 10-point numeric rating scale (NRS), patterns of analgesia administration, and analgesia-related adverse events (AEs). Results were reported as mean, (standard deviation), [range], or percentage. Results: Of 600 potential records, 372 patients met our inclusion criteria with the following characteristics: age 47.0 [19-92] years; 70.4% male; 97.0% blunt injury. Duration of transport was 82.4 (46.3) minutes. Pain was initially assessed in 90.0% of patients. Overall, NRS at baseline was 4.9 (2.8). Of the 62.4% who received analgesia, NRS at baseline was 5.9 (2.5). Fentanyl was most commonly administered (78.5%) at 44.3 [25-60] mcg. NRS after the first dose of analgesia decreased by 1.1 (1.6) points. A total of 73.7% of patients received further analgesia, equal to 2.4 [1-19] additional doses. While 23.4% of patients had no change in NRS after the first dose of analgesia, subsequent doses resulted in no change in NRS in over 65% [65.4-71.3] of patients. A total of 43 AEs (6.7%) were recorded after 638 doses of analgesia, and the most common AE was nausea (39.5%). Conclusion: The majority of patients were assessed for pain. Although the first analgesia administration had minimal effect on NRS, subsequent doses appeared to have even less of an impact. AEs were infrequent.
Studies aimed to assess up to what extent farming and transport previous to slaughtering might affect physiology and meat quality in young goat kids are needed, with the ultimate purpose of promoting practices that minimize stress in these animals. In this regard the effects of on-farm management and transport duration on some physiological responses and meat quality parameters in goat kids were assessed. Two farms representing ‘high’ and ‘low’ welfare-friendly management practices were selected. In total, 32 suckling kids were withdrawn from each farm, transported by road for 2 or 6 h, and then slaughtered. Blood samples were collected both on-farm and in the slaughterhouse, and biochemistry, cell counts and haematocrit were determined. After slaughtering, carcass quality parameters were measured. Longissimus dorsi muscle was dissected and pH, colour parameters, water holding capacity and shear force were measured throughout 8-day ageing period. Results indicate that, regardless its duration, transport caused significant effects on some blood parameters suggesting stress in live animals, like glucose, cortisol or creatine kinase. Despite the marked stress status in animals, this condition was not decisively reflected on L. dorsi quality parameters, but some effects were observed regarding fat cover in carcasses and colour parameters. The results suggest that postmortem changes throughout ageing were more decisive in terms of meat quality than stressful management either on-farm or during transport.
The association between transportation and the occurrence of the bovine respiratory disease complex (BRDC) has long been recognised. Many hypotheses regarding this association have been declared through the past decades, and it is agreed upon by most researchers that the multiple stressors that calves experience during transportation result in an overall immunosuppression that allows the respiratory tract to be invaded by numerous opportunistic pathogens. Furthermore, the innate immune cells, neutrophils, may be trapped in a paradox whereby their crucial defence and pathogen-killing activities are counteracted by excessive inflammation and tissue damage that may exacerbate disease, including the BRDC. Neutrophilia in response to glucocorticoids has been attributed to an influx of immature neutrophils newly released from the bone marrow, a decrease in neutrophil margination along endothelial walls, and a decrease in neutrophil apoptosis. Several of these explanations have been confirmed by altered expression of genes and proteins important for neutrophil margination and apoptosis.
Introduction: Rural emergency departments (EDs) are important safety nets for 20% of Canadian citizens. In Quebec, the province’s 26 rural EDs treat an average of 19,000 patients/year and are on average 300 km from levels 1 and 2 trauma centers. These distances signify that Emergency Medical Services (EMS) play a considerable role in the care of rural patients. EMS in Quebec province are private local services. There are no published reports on EMS in rural Quebec. As part of a larger study on rural emergency care, this descriptive study aimed at offering a comprehensive portrait of EMS. Methods: We conducted semi-structured interviews with managers of all paramedic services in rural Quebec. Interview questions focused on number of transports, training, availability of telemetry, GPS technologies, and work schedules. Results: Fifty managers of the 51 private companies serving the 26 rural EDs in Quebec were interviewed (response rate 98%). All were primary care paramedics (PCP). In 2010, EMS transported 40,671 patients, with 10,228 emergency transports to the rural EDs. A total of 7956 inter-facility transfers were conducted, 1499 of them emergency. Each ED required between 88 and 700 inter-facility transfers. A total of 60% (n=31/51) had GPS technology, only 25% (n=13/51) had telemetry features. Work schedules varied with 13% (n=7/51) of companies offering shifts of less than 12 hours, 28% (n=14/51) 24/7 weekly shifts, and 56% (n=29/51) a combination. Conclusion: This is the first study to describe rural EMS in Quebec. The finding that Quebec’s rural EDs are served by 51 privately-owned companies is unique in Canada. The considerable number of EMS transports, including inter-facility transfers, may reflect lack of local resources in rural EDs, the vulnerable population served, or the increased trauma risk in rural areas. Future studies should examine inter-facility transport reasons, costs, times and adequate training/scope of EMS practice.
Introduction: An undefined yet potentially significant risk for Emergency Medical Services (EMS) systems are patients who access 911 with an ambulance response who are not transported to hospital (non-transport). Our objective was to determine the prevalence and associated characteristics of non-transport and potentially clinically adverse non-transports in Nova Scotia. Methods: We conducted a secondary analysis of pooled cross-sectional, population-based administrative data in a provincial EMS system that provides care to 920,000 residents. Electronic patient care record (ePCR) data was retrospectively analyzed for one calendar year (2014). The dependent variables were non-transport status and potentially adverse non-transport status. Potentially adverse non-transports were defined as a repeat call within 48 hours for a related complaint with the outcome of transport or death. Independent variables include patient characteristics, (age, sex, vitals and paramedic clinical impression), operational (crew type and response code) and environmental (time, date, and location). For both objectives we determined the prevalence of the outcome of interest, and associated characteristics. Results: There were 74,471 EMS responses between January to December 2014, 18.9% (n=14, 094/74,471) resulted in a non-transport. The characteristics most associated with non-transport are: age, paramedic clinical impressions, number of co-morbidities, response mode, and incident location type. As age decreased, the likelihood of non-transport increased. Younger non-transported patients (0-15 years old) (OR 2.2, 99.9% CI 1.9-2.5) are more likely to have non-transport. Relative to other paramedic clinical impressions, glycemic issues (OR 4.8; 99.9% CI 3.9-5.7) and wellness checks (OR 6.5; 99.9% CI 5.7-7.3) are more likely to have a non-transport. Non-transports are more likely at a detention facility (OR 4.1; 99.9% CI 3.2-5.1) or a roadway (OR 2.4; 99.9% CI 2.1-2.8). 5.6% (n=798/14094) of non-transport patients were classified as a potentially adverse non-transport. Conclusion: This study demonstrated that a significant portion of patients (18.9%) had a non-transport outcome, but only a small percentage (5.6%) were considered potentially adverse. The results of this study provide timely information to policy makers and healthcare practitioners on the scope of this issue, and suggest potential directions for future study and clinical decision making.
Evidence-based guidelines regarding the optimal mode of transport for trauma patients from scene to trauma centre are lacking. The purpose of this study was to investigate the relationship between trauma patient outcomes and mode of transport at a single Ontario Level I Trauma Centre, and specifically to investigate if the mode of transport confers a mortality benefit.
A historical, observational cohort study was undertaken to compare rotor-wing and ground transported patients. Captured data included demographics, injury severity, temporal and mortality variables. TRISS-L analysis was performed to examine mortality outcomes.
387 rotor-wing transport and 2,759 ground transport patients were analyzed over an 18-year period. Rotor-wing patients were younger, had a higher Injury Severity Score, and had longer prehospital transport times. Mechanism of injury was similarly distributed between groups. After controlling for heterogeneity with TRISS-L analysis, the mortality of rotor-wing patients was found to be lower than predicted mortality, whereas the converse was found with ground patients.
Rotor-wing and ground transported trauma patients represent heterogeneous populations. Accounting for these differences, rotor-wing patients were found to outperform their predicted mortality, whereas ground patients underperformed predictions.
Before slaughter, lambs may experience several stressors such as feed and water deprivation, handling and transport that have the potential to negatively impact welfare and meat quality. The objective of this study was to evaluate the effect of pre-slaughter handling, exercise and the presence of a dog on the behaviour and physiology of lambs and meat quality at slaughter. At 6 months of age, 60 lambs (n=20 lambs/replicate; three replicates) were allocated to one of the two treatment groups (n=30 lambs/treatment): low (LOW) intensive handling or high (HIGH) intensive handling. LOW lambs were moved short distances, quietly and without the use of a dog before transport. HIGH lambs were moved quickly, long distances and with a dog present before transport. Lamb behaviour (standing, lying, rumination and panting) was recorded for 1 h before (post-treatment) and after transport (post-transport), and for 30 min before slaughter (pre-slaughter). Blood samples were collected before (baseline), after transport (post-transport) and at exsanguination (at slaughter) to assess cortisol, lactate and non-esterified fatty acid (NEFA) concentrations. At slaughter, lamb carcases (M. longissimus lumborum) were evaluated for pH levels, drip and cook loss, and tenderness. HIGH lambs spent more time standing (P<0.001) and panting (P<0.001) and less time lying (P<0.001) and ruminating (P<0.001) post-treatment than LOW lambs, but more (P<0.001) time ruminating post-transport. All lambs spent more time standing (P<0.001) and less time lying (P<0.001) and panting (P<0.001) post-transport and pre-slaughter than post-treatment. Cortisol concentrations were greater (P<0.001) in lambs post-transport and at slaughter compared with baseline values. Lactate concentrations were lower (P=0.002) in HIGH than LOW lambs. In addition, NEFA concentrations were higher (P<0.001) post-transport and at slaughter in HIGH compared with LOW lambs. Ultimate pH was higher (P<0.001) in HIGH than LOW lambs and pH declined quicker (P=0.012) in LOW than HIGH lambs. Cook loss, drip loss and shear force were lower (P⩽0.05) in HIGH than LOW lambs. The HIGH intensive pre-slaughter handling regime used in the present study caused stress in lambs and increased ultimate pH that could potentially negatively impact welfare, product quality and consistency.