Studies of fish responses to the antifoulant medetomidine

ABSTRACT Growth of marine organisms, fouling, on man-made constructions submerged in the water is regarded as a major problem. For vessels, fouling increases drag and thereby fuel consumption, wherefore antifouling paints are used. Traditionally, they contain toxic compounds, and several of these have unwanted effects in the environment. Today the search for environmentally acceptable and efficient alternatives is intense. Medetomidine, originally used as a veterinary sedative, inhibits barnacle settling at nanomolar concentrations. It is presently under evaluation for use as an antifouling agent. The studies within this thesis were performed to investigate medetomidine responses in fish. The focus was to identify early effects, occurring from low concentrations. Studies have been performed in the species rainbow trout, Atlantic cod, turbot, Atlantic salmon and three spined stickleback. Exposure time vary from 1 up to 54 days, and a set of parameters have been investigated including biochemical biomarkers, growth and related parameters, behaviour and large scale gene expression. Paleness is the most obvious effect of medetomidine in fish and appears from 0.5 to 50 nM, depending on species. Colour was observed and quantified, and the function of melanophores (pigment cells) after long term exposure to medetomidine was investigated. It is suggested that melanophores are functional after treatment, and thus the colour change may be reversible. Although not lethal per-see, paleness may have consequences for fish predator-prey interactions (camouflage), social signalling and UV protection. Medetomidine also showed to affect the activity of the hepatic enzyme Cytochrome P4501A (CYP1A), measured as EROD activity. A minor increase in activity was observed in vivo in several of the investigated species. In vitro, medetomidine showed instead to be a potent inhibitor of EROD activity with median inhibition values (IC50) in the nanomolar range. An inhibited CYP1A activity may interfere with fish detoxification of toxicants abundant in the aquatic environment. No significant effects were found on growth rate, but the results indicate lowered blood glucose levels and decreased liver size after medetomidine treatment and thus a shift in carbohydrate metabolism. The large scale gene expression study revealed no significant differences among treatments. We found no effects on glutathione or glutathione dependent enzymes in any of the studies. In the behavioural studies, fish were less active and had less appetite in medetomidine treatments compared to control. Medetomidine had no effects on investigated antioxidant enzymes and showed no cytotoxicity. Among the responses studied within this thesis, paleness and inhibition of EROD activity are perhaps the most important. These effects appear early and are clear and consistent among several species

Organisational challenges in the United Kingdom's post-disaster 'crisis-support' work

Local authorities in the United Kingdom are required to ‘lead’ multi-agency humanitarian responses to major disasters. Concerns mounted in the late twentieth century that responses to people bereaved in the immediate aftermath of such events at best failed to meet their needs and at worst compounded their distress. Subsequent reviews and reforms reframed some victim needs as ‘rights’ and established legal, administrative, and practice frameworks to improve matters. Local authority ‘crisis support’, provided in partnership with other actors, lies at the heart of the UK’s contemporary emergency response to the bereaved. Drawing on primary research on the development and deployment of crisis support in a local authority, and while acknowledging incident- and context-related challenges, this paper considers the significance of challenges with their origins in organisational factors. Recent developments within and between responders may exacerbate these challenges. This paper argues, therefore, that further research into such developments is necessary

Transitioning the chemical market

Chemicals are everywhere in our everyday products. Many of them have proven to be hazardous and threaten our health as well as the environment. Scientists and chemical researchers have led many studies demonstrating the devastating effects from the widespread use of manmade hazardous chemicals (risks of cancers, diabetes, respiratory disorders, disruption of ecosystems, soil contamination, etc.). While awareness among society and consumers is slowly increasing, much remains to be done to set the chemical industry’s transition in motion. This shift is not impossible, and is in fact achievable given that many toxic substances are replaceable with safer and more sustainable alternatives. Driving the switch to safer alternatives requires all stakeholders, from govemnments to businesses and investors, to adopt far more proactive policies in this area. Chemicals and their impacts should not be underestimated on our path toward a green transition

The civilian validation of the Modified Physiological Triage Tool (MPTT): an evidence-based approach to primary major incident triage

INTRODUCTION: Triage is a key principle in the effective management of a major incident. Existing triage tools have demonstrated limited performance at predicting need for life-saving intervention (LSI). Derived on a military cohort, the Modified Physiological Triage Tool (MPTT) has demonstrated improved performance. Using a civilian trauma registry, this study aimed to validate the MPTT in a civilian environment. METHODS: Retrospective database review of the Trauma Audit and Research Network (TARN) database for all adult patients (>18 years) between 2006 and 2014. Patients were defined as Priority One if they received one or more LSIs from a previously defined list. Only patients with complete physiological data were included. Patients were categorised by the MPTT and existing triage tools using first recorded hospital physiology. Performance characteristics were evaluated using sensitivity, specificity and area under receiver operating characteristic (AUROC). RESULTS: During the study period, 218 985 adult patients were included in the TARN database. 127 233 (58.1%) had complete data: 55.6% male, aged 61.4 (IQR 43.1-80.0) years, Injury Severity Score 9 (IQR 9-16), 96.5% suffered blunt trauma and 24 791 (19.5%) were Priority One. The MPTT (sensitivity 57.6%, specificity 71.5%) outperformed all existing triage methods with a 44.7% absolute reduction in undertriage compared with existing UK civilian methods. AUROC comparison supported the use of the MPTT over other tools (p<0.001.) CONCLUSION: Within a civilian trauma registry population, the MPTT demonstrates improved performance at predicting need for LSI, with the lowest rates of undertriage and an appropriate level of overtriage. We suggest the MPTT be considered as an alternative to existing triage tools

Advancing the scientific study of prehospital mass casualty response through a Translational Science process: the T1 scoping literature review stage

PurposeThe European Union Horizon 2020 research and innovation funding program awarded the NIGHTINGALE grant to develop a toolkit to support first responders engaged in prehospital (PH) mass casualty incident (MCI) response. To reach the projects' objectives, the NIGHTINGALE consortium used a Translational Science (TS) process. The present work is the first TS stage (T1) aimed to extract data relevant for the subsequent modified Delphi study (T2) statements.MethodsThe authors were divided into three work groups (WGs) MCI Triage, PH Life Support and Damage Control (PHLSDC), and PH Processes (PHP). Each WG conducted simultaneous literature searches following the PRISMA extension for scoping reviews. Relevant data were extracted from the included articles and indexed using pre-identified PH MCI response themes and subthemes.ResultsThe initial search yielded 925 total references to be considered for title and abstract review (MCI Triage 311, PHLSDC 329, PHP 285), then 483 articles for full reference review (MCI Triage 111, PHLSDC 216, PHP 156), and finally 152 articles for the database extraction process (MCI Triage 27, PHLSDC 37, PHP 88). Most frequent subthemes and novel concepts have been identified as a basis for the elaboration of draft statements for the T2 modified Delphi study.ConclusionThe three simultaneous scoping reviews allowed the extraction of relevant PH MCI subthemes and novel concepts that will enable the NIGHTINGALE consortium to create scientifically anchored statements in the T2 modified Delphi study

A concept for major incident triage: full-scaled simulation feasibility study

<p>Abstract</p> <p>Background</p> <p>Efficient management of major incidents involves triage, treatment and transport. In the absence of a standardised interdisciplinary major incident management approach, the Norwegian Air Ambulance Foundation developed Interdisciplinary Emergency Service Cooperation Course (TAS). The TAS-program was established in 1998 and by 2009, approximately 15 500 emergency service professionals have participated in one of more than 500 no-cost courses. The TAS-triage concept is based on the established triage Sieve and Paediatric Triage Tape models but modified with slap-wrap reflective triage tags and paediatric triage stretchers. We evaluated the feasibility and accuracy of the TAS-triage concept in full-scale simulated major incidents.</p> <p>Methods</p> <p>The learners participated in two standardised bus crash simulations: without and with competence of TAS-triage and access to TAS-triage equipment. The instructors calculated triage accuracy and measured time consumption while the learners participated in a self-reported before-after study. Each question was scored on a 7-point Likert scale with points labelled "Did not work" (1) through "Worked excellent" (7).</p> <p>Results</p> <p>Among the 93 (85%) participating emergency service professionals, 48% confirmed the existence of a major incident triage system in their service, whereas 27% had access to triage tags. The simulations without TAS-triage resulted in a mean over- and undertriage of 12%. When TAS-Triage was used, no mistriage was found. The average time from "scene secured to all patients triaged" was 22 minutes (range 15-32) without TAS-triage vs. 10 minutes (range 5-21) with TAS-triage. The participants replied to "How did interdisciplinary cooperation of triage work?" with mean 4,9 (95% CI 4,7-5,2) before the course vs. mean 5,8 (95% CI 5,6-6,0) after the course, p < 0,001.</p> <p>Conclusions</p> <p>Our modified triage Sieve tool is feasible, time-efficient and accurate in allocating priority during simulated bus accidents and may serve as a candidate for a future national standard for major incident triage.</p