The drivers of sea lice management policies and how best to integrate them into a risk management strategy: An ecosystem approach to sea lice management.

The control of sea lice infestations on cultivated Atlantic salmon is a major issue in many regions of the world. The numerous drivers which shape the priorities and objectives of the control strategies vary for different regions/jurisdictions. These range from the animal welfare and economic priorities of the producers, to the mitigation of any potential impacts on wild stocks. Veterinary ethics, environmental impacts of therapeutants, and impacts for organic certification of the produce are, amongst others, additional sets of factors which should be considered. Current best practice in both EU and international environmental law advocates a holistic ecosystem approach to assessment of impacts and risks. The issues of biosecurity and ethics, including the impacts on the stocks of species used as cleaner fish, are areas for inclusion in such a holistic ecosystem assessment. The Drivers, Pressures, State, Impacts, Responses (DPSIR) process is examined as a decision-making framework and potential applications to sea lice management are outlined. It is argued that this is required to underpin any integrated sea lice management (ISLM) strategy to balance pressures and outcomes and ensure a holistic approach to managing the issue of sea lice infestations on farmed stock on a medium to long-term basis.

Sensitivity assessment of sea lice to chemotherapeutants: Current bioassays and best practices.

Traditional bioassays are still necessary to test sensitivity of sea lice species to chemotherapeutants, but the methodology applied by the different scientists has varied over time in respect to that proposed in "Sea lice resistance to chemotherapeutants: A handbook in resistance management" (2006). These divergences motivated the organization of a workshop during the Sea Lice 2016 conference "Standardization of traditional bioassay process by sharing best practices." There was an agreement by the attendants to update the handbook. The objective of this article is to provide a baseline analysis of the methodology for traditional bioassays and to identify procedures that need to be addressed to standardize the protocol. The methodology was divided into the following steps: bioassay design; material and equipment; sea lice collection, transportation and laboratory reception; preparation of dilution; parasite exposure; response evaluation; data analysis; and reporting. Information from the presentations of the workshop, and also from other studies, allowed for the identification of procedures inside a given step that need to be standardized as they were reported to be performed differently by the different working groups. Bioassay design and response evaluation were the targeted steps where more procedures need to be analysed and agreed upon.

Sea lice levels on wild Atlantic salmon, Salmo salar L., returning to the coast of Ireland.

The sea lice population structure, prevalence and intensity of Lepeophtheirus salmonis have been studied over a period extending from 2004 to 2011. Infestation data were collected from the interceptor drift net fishery from 2004 until it was closed in 2006. From 2010, data were collected from the inshore draft net fishery. In all, 34 samples from the drift and draft net fisheries have been analysed to date. Prevalence of infestation with L. salmonis regularly approached 100% in samples of hosts recovered from the offshore drift net fishery. Abundance was variable both within and between years with a maximum mean abundance of 25.8 lice per fish recorded in 2004. The population structure of L. salmonis on hosts recovered in the inshore and estuarine draft net fisheries was different from that observed in the more offshore drift net samples. There is clear evidence of recent infestation with L. salmonis in the draft net samples.

Impact of Lepeophtheirus salmonis infestations on migrating Atlantic salmon , Salmo salar L., smolts at eight locations in Ireland with an analysis of lice-induced marine mortality.

Sea lice infestation as a source of marine mortality of outwardly migrating Atlantic salmon smolts has been investigated by treating groups of ranched salmon, prior to release, with a prophylactic sea lice treatment conferring protection from sea lice infestation. A number of studies have been carried out in Ireland using both established ranched populations and groups of hatchery reared fish imprinted for 5-8 weeks in the sites of experimental releases. In this study, data on 352 142 migrating salmon from twenty-eight releases, at eight locations along Ireland's South and West coasts covering a 9-year period (2001 to 2009) are reviewed. Both published and new data are presented including a previously unpublished time series. The results of a meta-analysis of the combined data suggest that while sea lice-induced mortality on outwardly migrating smolts can be significant, it is a minor and irregular component of marine mortality in the stocks studied and is unlikely to be a significant factor influencing conservation status of salmon stocks.

Clinical, paraclinical and genetic aspects of autosomal recessive cerebellar ataxias (ARCA) in Mali.

Introduction: Autosomal recessive cerebellar ataxias (ARCA) are a group of rare and heterogynous neurodegenerative diseases mainly characterized by unbalance and walking difficulty and movement incoordination. Objectives: To clinically and paraclinically characterize ARCA in the department of Neurology at the Teaching Hospital of Point G and identify the underlying genetic defect. Patients and method: We have conducted a longitudinal and prospective study from January 2018 to December 2020. Patients with ARCA phenotype seen in the Department of Neurology at the Teaching Hospital of Point "G" were enrolled. Results: We have enrolled 7 families totaling 13 patients after giving an informed verbal and written consent. The sex ratio was 2.2 in favor of males, Kayes region and Fulani ethnic group were respectively the most represented region and ethnic group.Walking difficulty represented the major symptom followed by loss of vibration and joint sense, nystagmus, dysarthria and skeletal deformities. Alpha-foetoprotein level was high in one patient. Genetic testing confirmed Friedreich ataxia in one family and was not conclusive in 4 families. Conclusion: This study showed that ARCA are not uncommon in Mali and genetic testing is crucial to confirm the diagnosis.

Introduction: Les ataxies cérébelleuses autosomiques récessives (ACAR) constituent un groupe de maladies neurodégénératives rares et hétérogènes caractérisées essentiellement par un trouble de l'équilibre et de la marche, et un trouble de la coordination des mouvements. Objectifs: Caractériser les signes cliniques, paracliniques et génétiques des ataxies cérébelleuses autosomiques récessives au Service de Neurologie du CHU du Point "G". Patients et méthodes: Nous avons réalisé une étude de cas enrôlé dans le cadre d'une étude longitudinale et prospective allant de Janvier 2018 à Décembre 2020, portant sur des patients présentant des symptômes d'ACAR et ayant donné leur consentement éclairé. Résultats: Nous avons enrôlé sept familles totalisant 13 patients. Le sexe ratio était de 2,2 en faveur des hommes, la région de Kayes était la plus représentée et l'ethnie peulh était majoritaire. Les troubles de la marche ont représenté les signes majeurs suivis de troubles de la sensibilité profonde, de nystagmus, de dysarthrie, et des déformations ostéoarticulaires. L'alpha-foetoprotéine était élevée chez une patiente. Le test génétique a retrouvé l'ataxie de Friedreich dans une famille et n'a pas été concluant dans quatre autres. Conclusion: Cette étude montre que les ACAR ne sont pas rares au Mali et l'exploration génétique constitue un outil indispensable pour leur diagnostic de certitude.

[Factors associated with mental disorders in the psychiatric department of the university hospital centre of Point G in Mali.] / FACTEURS ASSOCIÉS AUX TROUBLES MENTAUX DANS LE SERVICE DE PSYCHIATRIE DU CENTRE HOSPITALIER UNIVERSITAIRE DU POINT G AU MALI.

INTRODUCTION: Mental health is a state of equilibrium and well-being, any alteration of which leads to the appearance of a state of distress and/or mental disorder. OBJECTIVE: The objective of this work was to study familial and environmental factors associated with mental disorders. MATERIALS AND METHODS: A cross-sectional study was conducted in the Psychiatry Department of the Point G University Hospital Center from April 1, 2016 to March 31, 2017 among outpatients with a psychiatric disorder in whom factors associated with psychiatric disorders were studied. RESULTS: We included 288 patients. The median age was 33.0 years. The sex ratio was 1.88 in favor of males. Married patients accounted for 45.5%. First born uterine siblings accounted for 26.7%. Patients born of an inbreeding alliance accounted for 25.7%. Cases with a family history of a psychiatric disorder represented 59.0% and those who spent their childhood with their parents accounted for 64.2%. Cases of psychoactive substance use prior to the onset of the mental disorder accounted for 42.7%. The main psychosocial stress factors that preceded the onset of the mental disorder were grief (46.2%) and family conflict (22.6%). Psychotic disorders accounted for 77.8%. CONCLUSION: Our results show an association of mental disorders with family history of psychiatric disorder among patients followed in psychiatry. Further studies, such as genetic association may prove useful.

[Clinical and laboratory features of recessive Limb Girdle Muscular dystrophies in the Department Neurology of University Hospital of Point G]. / Aspects Cliniques et Paracliniques des Myopathies des Ceintures Récessives au Service de Neurologie du CHU Point G.

INTRODUCTION: Limb-Girdle Muscular dystrophies (LGMD) is a group of inherited diseases characterized by predominantly proximal and limb muscle weakness. These are rare diseases that have not been well studied in sub-saharan Africa. The aim of our was the clinical and paraclinical characterization of patients with recessive LGMD at the Department of Neurology of the Teaching Hospital of Point G. PATIENTS AND METHODS: We conducted a longitudinal prospective study which took place from March 2014 to May 2019. Patients with recessive LGMD phenotype were enrolled. Sociodemographic, clinical and laboratory data were analyzed. RESULTS: We enrolled 46 families (67 patients), i.e. a frequency of 16.7% among the neurodegenerative diseases seen in the service. Among them, 45.6% came from the Sikasso region. Autosomal recessive inheritance pattern was suspected in 67.4% of the families. Symptoms appeared mainly in the first decade of life. Proximal muscle weakness was found in almost all patients. Cardiac examination showed dilated cardiomyopathy in 4.5% of cases. CONCLUSION: Limb-Girdle muscular dystrophy is a disabling disease that is found in Mali. Further study of these cases could elucidate the underlying genetic defects.

Core neuropsychological characteristics of children and adolescents with 22q11.2 deletion.

BACKGROUND: The 22q11.2 deletion syndrome (22qDS) confers high risk for intellectual disability and neuropsychological/academic impairment, although a minority of patients show average intelligence. Intellectual heterogeneity and the high prevalence of psychiatric diagnoses in earlier studies may have obscured the prototypical neuropsychological profile in 22qDS. METHODS: We examined intelligence, memory, reading and mathematical processes in 31 children/adolescents with 22qDS, selected for educational underachievement and an absence of psychiatric diagnoses, using standardised, psychometrically matched instruments that specify how typical a score is for a given intelligence quotient (IQ). RESULTS: Corroborating earlier findings, verbal IQ was significantly superior to performance IQ; verbal memory and basic reading were relative strengths; and visual/spatial memory was a relative weakness. All four findings transcended performance characteristics that are typical of low-IQ individuals. Rote learning yielded the highest score; reading comprehension, numerical operations and mathematical reasoning were among the lowest-performed academic domains. Albeit in the expected direction, performance in the respective components could not be clearly differentiated from what is IQ-appropriate. CONCLUSIONS: A superiority of verbal intelligence over non-verbal intelligence, relative strengths in verbal memory and basic reading, and a relative weakness in visual/spatial memory are likely to be core characteristics of children/adolescents with 22qDS, transcending performance features that are typical of individuals with low IQ.

Temporary expatriation is related to HIV-1 infection in rural Senegal.

OBJECTIVES: To assess temporary expatriation as a risk factor for HIV infection in a rural area of Senegal and to examine the transmission of HIV from expatriates to their families. DESIGN: Cross-sectional study in identified expatriates and in a representative cluster sample of the general population from the same geographical area in northern Senegal. METHODS: In 1989, a survey (including questionnaire and serological tests for HIV-1 and HIV-2) was conducted in all expatriates currently living in 11 villages in northern Senegal and spouses of all expatriates (present or not) from this area ('expatriate' group, n = 258). In parallel, a cluster sample of 600 adults was drawn from eight villages of the same area, of whom 414 were selected as the control group since they and their spouses had not travelled outside Senegal in the last 10 years. RESULTS: In the 'expatriate' group, sera from 39 subjects were confirmed as HIV-positive by Western blot [17 out of 63 men (27.0%) and 22 out of 195 women (11.3%)]. Of these subjects, 33 were infected by HIV-1, four by HIV-2 and two had a dual HIV-1/2 profile. In contrast, only two subjects (one man and one woman) from the control group were infected by HIV-2 and none by HIV-1. In men, HIV-1 seroprevalence was associated with age < 40 years [odds ratio (OR), 7.4; P = 0.03] and previous sexually transmitted disease (STD) symptoms (OR, 13.5; P = 0.03), whereas the risk factors in women were age < 25 years (OR, 3.7; P = 0.04), being a widow (OR, 30.4; P < 0.01) and presence of sexual activity over the last 2 years (OR, 21.3; P < 0.01). CONCLUSIONS: Penetration of HIV-1 infection in a country where HIV-2 is endemic shows that the HIV-1 epidemic is currently spreading to rural West Africa. Migrant workers appear to play a major role in this epidemic.

Amygdaloid self-stimulation: a movable electrode mapping study.

The distribution of electrical self-stimulation foci within the amygdala (AMY) was mapped using movable electrodes in rats. Each barpress delivered a 0.4-s train of cathodal rectangular pulses of fixed intensity and duration and variable frequency. The rate-frequency function was recorded for successive dorsoventral sites. Self-stimulation was found throughout the AMY, except in the lateral nucleus. Depending on the site, maximum rates varied from 3 to 37 barpresses/min, whereas threshold frequencies varied from 9.2 to 40 pulses/train; no correlation between these two aspects of self-stimulation was found. Most threshold frequencies lay within the range of 10 to 20 pulses/train, which suggests a relatively homogeneous distribution of rewarding efficacy within the positive areas. The lowest threshold estimates are comparable to those usually obtained for pontine and medial forebrain bundle areas, which suggests that the AMY is an important focus for self-stimulation.

Interactions between amygdaloid and hypothalamic self-stimulation: a re-examination.

The function relating bar-pressing rate to the frequency of cathodal pulses was obtained in rats self-stimulating with amygdaloid (AMY) and lateral hypothalamic (LH) electrodes. The maximum self-stimulation (SS) rates in the AMY was found to be very low, compared to the LH. Concurrent stimulation with pairs of AMY-LH pulses did not shift the rate-frequency functional laterally, indicating the absence of summation of the two rewarding effects. In a second experiment, concurrent AMY-LH stimulation (using sub-threshold intensity LH pulses) facilitated bar-pressing for AMY stimulation (it increased the slope of the AMY rate-frequency function) without shifting this function laterally. In a third experiment, subjects were given a choice between a pulse frequency yielding maximal AMY rate and a series of higher pulse frequencies. Subjects consistently preferred the higher frequency values, attesting that the maximum AMY rates were not constrained by a saturating reinforcing effect. In a fourth experiment, subjects were given a choice between AMY stimulation and concurrent AMY-LH stimulation, using low intensity LH pulses. Subjects showed no preference for either stimulation condition, although rates were higher for the latter condition. These findings suggest that the maximum rate for AMY stimulation was constrained by factors interfering with bar-pressing and that the effect of these factors was attenuated by co-activation of the LH. In a fifth experiment, pre-treatment with phenobarbital mimicked the rate-enhancing effect of concurrent AMY-LH stimulation for 2 of the 4 subjects tested. This finding suggests that the LH pulses contributed to attenuate seizure activity accompanying AMY SS. In a final experiment, AMY SS rates were also increased by co-activation of rewarding sites in the rostral MFB but not the dorsal raphe, suggesting an anatomical specificity of this effect.

Psychotherapy: past training and current practice.

Our 1988 survey of Texas psychiatrists indicates that hospital work is more common, and long-term psychotherapy less common than it had been in the 1982 APA survey. Almost 85% reported long-term psychotherapy experience as residents. Thirty-nine percent reported multiple patients treated for approximately 2 years. Use of audio techniques by resident and teacher in the post-1970-trained group predicted current long-term therapy activity as did an experience of personal therapy and seeing a patient at least twice weekly in training. Concurrent drug use is widely reported for long-term psychotherapy patients and to a lesser degree in psychoanalysis. Our data suggest a shift to increased hospital work and decreased long-term psychotherapy.

Keeping Elizabeth Bouvia alive for the public good.

The case of Elizabeth Bouvia, a handicapped woman who wanted doctors to assist her in dying, reveals that autonomy is insufficient as the sole or even the most important public policy principle. Where the community is asked to endorse a course of action by granting medical and financial assistance, considerations of autonomy must give way to the broader notion of the public good, which gives primacy to the respect for life.

KIE: A California Superior Court refused the request of Elizabeth Bouvia, a patient severely physically handicapped by cerebral palsy, that she be allowed to starve herself to death while receiving pain-killing drugs and palliative care in a hospital. Kane argues that, although the principle of self determination is a significant one, when public cooperation in suicide is requested it is insufficient and must yield to the principle of the value of life. The author discusses the relevant issues of supporting the conscience of the hospital staff, of the right to refuse treatment, and of balancing quality versus value of life. He concludes that the adoption of the quality of life argument for Ms. Bouvia and other handicapped persons would be a public policy mistake--the community must not participate or assist in taking life.

Adolescent pregnancy: a study of aborters and non-aborters.

PIP: In a June 1970 through January 1971 study of 99 single girls seeking abortion and 33 single girls choosing to complete the pregnancy, knowledge of and/or access to contraceptives were not the problem. Emotional factors such as guilt over sexual activity, acting-out disorders (rebellious attitude, hippie lifestyle, indifference toward others), or severe reactions to loss of a love relationship contributed to pregnancy in both groups. The girls who became pregnant, especially the ones who chose to complete the pregnancy, viewed pregnancy and motherhood as a source of gratification and self-esteem. Research on motivational factors in adolescent pregnancy is needed to prevent high recidivism. The majority of state abortion laws requiring phychiatric deficiencies for abortions are misguided, since the girls who chose not to abort were more psychiatrically disturbed than the ones who had abortions.^ieng

Lipid, apolipoprotein AI and B levels in Ivorian patients with sickle cell anaemia.

Plasma apolipoprotein AI, apolipoprotein B, cholesterol and triglycerides in 114 Ivorian patients with homozygous sickle cell anaemia (HbSS) were compared to 40, age and sex matched controls with normal haemoglobin (HbAA). Except for plasma triglycerides, lipid and apolipoprotein levels were found to be lower in patients with sickle cell anaemia as compared to normal control subjects. The differences between the two groups were found to be statistically significant (p < 0.05 Student's t test). In addition, a highly significant decrease of plasma apolipoprotein AI (p < 0.01) was observed during painful crisis as compared to the steady state (0.78 g.L-1 versus 1.01 g.L-1), whereas triglyceride levels were found to be higher (1.02 g.L-1 versus 0.78 g.L-1). Although the metabolism of lipoproteins is being altered, the results of this cross-sectional study do not suggest that patients with sickle cell anaemia are at higher risk of developing coronary artery disease.

[Evaluation of atherogenic risk in homozygous sickle cell disease: study of lipid and apolipoprotein AI and B plasma levels]. / Evaluation du risque athérogène chez le drépanocytaire homozygote: étude des taux plasmatiques des lipides et apolipoprotéines AI et B.

The main clinical use of measurements of Apo Al and Apo B is to determine a patient's risk status for the development of ischemic heart disease. Apo B is generally accepted as a contributory cause of coronary artery disease, while Apo Al apparently has a protective effect. The present study reports the plasma change of Apo Al and B in sickle cell anaemic subjects. Immunochemical findings revealed that Apo Al and B levels were found to be lower in sickle cell patients as compared with normal subjects (HbAA). The atherogenicity index given by Apo B/Apo Al remained in the normal range during periods of steady state (0.64 +/- 0.28), while subjects in painful crisis had high index values (0.95 +/- 0.35). Therefore, we concluded that epidemiological studies on a large sample of patients are needed to confirm this relationship between painful crisis and risk of developing coronary artery disease.

The analgesic effect of odour and music upon dressing change.

Vascular wounds may require frequent dressing changes over a long period of time, often involving pain, which may not be adequately controlled with conventional analgesia. Complementary analgesia may be beneficial as an adjunctive therapy. This pilot study presented eight patients with two odour therapies, lavender and lemon, two music therapies, relaxing and preferred music and a control condition, during vascular wound dressing changes. Although the therapies did not reduce the pain intensity during the dressing change there was a significant reduction in pain intensity for the lavender therapy and a reduction in pain intensity for the relaxing music therapy after the dressing change. This supports the use of these complementary therapies, which are inexpensive, easy to administer and have no known side effects, as adjunctive analgesia in this patient population. Earlier administration before dressing change may enhance these effects. Further research is required to ascertain why certain complementary therapies are more effective than others at relieving pain.