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• Families support antibiotic stewardship but feel responsible for RACF resident's best interests. • If infection is suspected, regular communication and evidence of high-quality care reassures relatives. • Antibiotics are not viewed as a life-sustaining treatment for resistant and refractory infections. • Advanced care planning involving families should be promoted with antibiotic use a specific focus. Antimicrobial resistance makes the misuse of antibiotics in residential aged care facilities (RACFs) a significant concern. Family members influence antibiotic prescribing for RACF residents, but there is limited understanding of the beliefs and knowledge that drive their involvement. Drawing on a fictional scenario, forty-six participants with a parent aged 75 or over took part in eight dialogue groups exploring family members' perspectives on antibiotic use and risks in older relatives. Main themes were identified using framework analysis. Participants supported judicious use of antibiotics in RACFs, but perceived vulnerabilities of older people, both structural and physiological prompt family pressure for antibiotics. Empirical antibiotic use became more acceptable when pathways to a prompt diagnosis are not apparent or confidence in RACF monitoring and care is lacking. The role of antibiotics in end-of-life decision-making was significantly under-recognised. Overall, elevation of discussion around antibiotics and end of life care are required. [ABSTRACT FROM AUTHOR]

The popularity of equestrian sports provides an increasing market for horse gear or tack. While manufacturers have launched new designs to enhance the safety, comfort, effectiveness and esthetics of their products, few items of tack have been evaluated quantitatively. Nosebands are not an essential component of a bridle, but are widely used across equestrian sport. Despite this, little is known about factors which influence rider decision-making when selecting what noseband to use for their horse. A 41-question online survey was distributed via equestrian social media sites to provide insight into how riders select and fit nosebands, what factors influence decision-making, and sources of information that inform practice. Frequency analysis combined with Kruskal-Wallis analyses identified if differences in noseband selection, use and fit existed between recreational and competitive riders. Thematic analysis analysed open questions to evaluate riders' decision-making in more detail. A total of 1,381 respondents completed the survey. Horse performance, comfort and control, customary habit to use and appearance were key factors that informed rider decision-making when selecting which noseband to use for their horse. The use of cavesson (34%) and flash (20%) nosebands was prevalent across riders in the UK and North America, for recreational riding, flatwork and jumping; these nosebands were perceived as kind and comfortable for the horse. Differences in the use of crank nosebands (P <0.01) and additional padding under the noseband (P <0.02) were found between disciplines. Most respondents (79%) had changed their horse's noseband at least once; when more control was required, riders used nosebands incorporating a strap passing below the bit (e.g., flash and grackle nosebands). If the bridle or noseband was thought to be causing pain or injury to the horse, the majority of respondents (95%) would change the noseband. Preferred sources of information in this regard were veterinarians, equine dentists and coaches or trainers, with less than 25% consulting a qualified bridle fitter. Most respondents agreed with the recommendation that there should be room for 2-3 fingers beneath a correctly adjusted noseband; 44% had experienced the tightness of their horse's noseband being checked at competition, however only 14% recognised the ISES taper gauge. Increased communication of the value of using trained bit and bridle fitters and the ISES taper gauge to assess noseband fit to riders is warranted. [ABSTRACT FROM AUTHOR]

Safe and effective care transitions require interprofessional collaboration, but there is limited literature on interprofessional strategies to teach care transitions. The objective was to evaluate student pharmacist and nurse readiness for change towards interprofessional collaborative practice during care transitions. Interprofessional teams were instructed to collaborate and provide care for their patient throughout multiple healthcare transitions. Students were asked to complete the Interprofessional Socialization and Valuing Scale (ISVS) 9A/9B, the nine-item set version, prior to implementation of the case conference series and after the activity debrief. There was an increase across six items from the ISVS scale for pharmacy students and eight of nine for nursing students. There were significant changes in two of nine items for the pharmacy groups and three of nine in the nursing group. An interprofessional case conference series demonstrated a significant increase in student pharmacist and student nurse awareness of the importance of working within a team during care transitions, as well as an appreciation towards their role within the interprofessional team. [ABSTRACT FROM AUTHOR]

Studies have investigated the kinematics of the healthy canine thoracic limb (TL), but there is currently no research to the authors' knowledge investigating the influence of the working harness on TL kinematics. The aim of this study was to compare the TL stride length (SL) and shoulder, elbow and carpal joint range of movement (ROM) of assistance dogs when wearing three different harnesses (H1 and H2 Y-shaped harnesses; H3 the dog's original harness) with differing handle designs (A and B type handles; all dogs used an A type handle with H3, their original harness), in comparison to a standard collar at walk. Thirteen dogs were analyzed at walk in each condition: Harness 1, H1 (B-handle); Harness 2, H2 (A-handle); Harness 3, H3 (A-handle, and the dog's original working harness); and the Collar with the lead held between 20 and 40cm. A series of Friedman's analyses with post-hoc Wilcoxon Signed Rank tests compared SL and joint ROM at peak protraction and retraction of the TL. Results: The results show significant TL kinematic changes in H1 (B-handle): SL in H1 was significantly reduced in comparison to the Collar (6%; P = 0.008). In TL protraction, a significant reduction in shoulder extension was recorded for H1 in comparison to H3 (6%; P = 0.005). In TL retraction, a significant reduction in carpal extension was observed in H1 in comparison to the collar (4%; P = 0.008), H2 (2%; P = 0.005), and H3 (4%; P = 0.005). Conclusions: Differences in canine locomotion were observed between conditions in comparison to when the dog was at walk in the collar. Our findings suggest the harness handle type may result in the TL kinematic changes observed. Significant TL SL and ROM restrictions were noted in H1, the only harness in the study with a specific handle design (B-handle type). The increase in proximal TL joint ROM and a subsequent reduction in distal TL joint ROM suggests an alteration to the energy efficiency of locomotion when compared to previous literature. These results were seen only in H1 and not H2, a similar design of harness, therefore suggesting the B-handle type may be the key factor in the kinematic changes observed. [ABSTRACT FROM AUTHOR]

Bioelectrical impedance analysis (BIA) is widely considered a body composition technique suitable for routine application. However, its utility in sick or malnourished children is complicated by variability in hydration. A BIA variant termed vector analysis (BIVA) aims to resolve this, by differentiating hydration from cell mass. However, the model was only partially supported by children's data. To improve accuracy, further adjustment for body shape variability has been proposed, known as specific BIVA (BIVA specific). We re-analysed body composition data from 281 children and adolescents (46% male) aged 4–20 years of European ancestry. Measurements included anthropometry, conventional BIA, BIVA outcomes adjusted either for height (BIVA conventional), or for height and body cross-sectional area (BIVA specific), and fat-free mass (FFM) and fat mass (FM) by the criterion 4-component model. Graphic analysis and regression analysis were used to evaluate different BIA models for predicting FFM and FM. Age was strongly correlated with BIVA conventional parameters, but weakly with BIVA specific parameters. FFM correlated more strongly with BIVA conventional than with BIVA specific parameters, whereas the opposite pattern was found for FM. In multiple regression analyses, the best prediction models combined conventional BIA with BIVA specific parameters, explaining 97.0% and 89.8% of the variance in FFM and FM respectively. These models could be further improved by incorporating body weight. The prediction of body composition can be improved by combining two different theoretical models, each of which appears to provide different information about the two components FFM and FM. Further work should test the utility of this approach in pediatric patients. [ABSTRACT FROM AUTHOR]

With scientific and molecular advancements related to disease pathogenesis, advances in gene and stem cell therapies, and the promise of lucrative markets for biopharmaceutical companies, there has been a rapid expansion in the number of potential new muscular dystrophy (MD) treatments. The first champion for a newly diagnosed MD patient and their caregivers is typically an MD-specific patient advocacy group (PAG). Muscular dystrophy PAGs have been among the most active in the rare disease drug development space. Notable achievements in the last decade include promulgating the first U.S. clinical research guidance, setting up registries and natural history studies, and investing in companies—some of which have brought potentially disease-modifying products to the market. This paper will discuss five key strategies that have been successfully employed by MD PAGs to advance treatments: (1) creating a national registry, (2) understanding the barriers to identifying patients with certain subtypes of muscular dystrophy to participate in clinical trials, (3) partnering with the biopharmaceutical industry, (4) collaborating with the regulators, and (5) incorporating market access and use insights early in clinical development. While clearly helpful within the MD community, these tactics could also be employed by PAGs representing other types of rare diseases. [ABSTRACT FROM AUTHOR]

Behavioral problems in the domestic dog (Canis familiaris) increase the likelihood of the dog being rehomed or relinquished to a rescue shelter. Problem behaviors that result in relinquishment include unwanted elimination, destructive behavior, and excessive vocalization when owners are absent. Dog appeasing pheromone (DAP) is currently marketed via veterinarians as a stress relief product and purported to help dogs cope in stressful situations and as a potential solution to reduce anxiety. This study investigated whether a DAP diffuser affected behavioral and physiological stress parameters in 10 dogs in a laboratory environment. A repeated measures design with and without the use of DAP and in the presence and absence of the owner was used. Behavioral responses, such as barking, passive behavior, scratching, whining, orienting behavior, exploration, and locomotion, were recorded in real time and video recorded using a focal instantaneous sampling technique. To control for potential bias, 10% of the videos were scored using a second blinded scorer to assess interrater reliability. Heart rate (HR), heart rate variability using standard deviation of normal to normal beats, and eye temperature and ear temperature (°C) were also collected to assess dogs' physiological state. When dogs were separated from their owner, there was a significant increase in orienting behavior during both the DAP and without DAP application trial phase, suggesting arousal due to owner absence rather than any discernible effect of DAP. A significant increase was recorded in core eye temperature when the owner was absent and the DAP diffuser was not switched on; however, eye temperature also increased when the owners were present after the DAP condition, suggesting that it may be the owner's presence and the dog's arousal levels that affect core eye temperature rather than any effect of DAP. There was no significant effect of DAP on HR or ear temperature. Overall, our results suggest that the application of a DAP diffuser did not markedly influence the behavior, HR, and eye or ear temperature of dogs. [ABSTRACT FROM AUTHOR]

Fostering a sense of belonging and a personal connection is seen as fundamental by many educational researchers, regardless of the learning environment. Online learning certainly provides flexible learning opportunities but comes with notable issues. For online learners, nurturing a sense of belonging may present a way of improving their experiences and attainment, as well as reducing attrition rates. Research specifically exploring sense of belonging and online learning is limited. This article addresses that gap and reports on a small-scale exploratory study using qualitative data-collection and analysis methods to investigate the importance, or not, of sense of belonging for postgraduates' online education by exploring the origins and nature of their lived experience of online learning and their sense of belonging therein. Our initial findings emphasise its importance for them as online learners and have identified three significant themes: interaction/engagement, the culture of the learning, and support. These early findings highlight the importance of these three themes in promoting a sense of belonging and in ensuring that there are opportunities for meaningful group and peer interactions; they will be of interest to all engaged in online education. [ABSTRACT FROM AUTHOR]

The United Nation created the World Programme for Human Rights Education to advance implementation of human rights education (HRE). This study is an exploration of some aspects of the Second Phase of the Programme as it pertains to the incorporation of human rights education into higher education settings. It concludes that there is a global attempt to integrate HRE into higher education, particularly at the course level in medical, legal, and political departments. Content and pedagogical approaches vary significantly. The role of higher education in stimulating HRE research is under-developed. Higher education has a powerful opportunity to do much more to integrate and advance HRE in the future.

Objective: Usage of and views concerning alternative therapies in the DS community are not well documented. Some positive effects of green tea extracts (GTE) containing Epigallocathechin-3-gallate (EGCG) have been reported in individuals with DS and DS mouse models, but minimal improvements or detrimental effects of pure EGCG treatment have been reported in DS mouse models. Given the uncertainty about the effectiveness of these supplements, the goal of this study was to determine the relative prevalence of and attitudes about GTE/EGCG treatments among DS caregivers.Methods: An anonymous survey about attitudes and usage of GTE/EGCG in individuals with DS was completed by caregivers of these individuals.Results: GTE/EGCG treatment was provided by 18% of responding caregivers who were mostly younger, highly educated, and utilized scientific sources and other parents to influence their decision to use GTE/EGCG. Individuals with DS who received GTE/EGCG were characterized as less severely disabled. Most caregivers who did not give GTE/EGCG reported concerns about potential side effects and lack of effectiveness. Few caregivers consulted with medical providers about GTE/EGCG usage.Conclusions: These results demonstrate a need for communication between caregivers, medical providers, and scientists about potential benefits and risks for adverse effects of GTE, EGCG, and other nutritional supplements in individuals with DS. [ABSTRACT FROM AUTHOR]

Despite the likelihood that a horse's mass influences hoof morphology, empirical evidence is lacking. A clearer understanding of factors influencing hoof shape could enable prevention, or better treatment, of foot-based disorders; common causes of equine lameness. The study's aim was to investigate the relationship between horse body size, in terms of mass and height, and fore hoof dimensions. A further aim was to determine changes in the occurrence of hoof asymmetry as body size increases. Height, mass, and fore hoof dimensions; coronet band width (CBW); hoof base width (HBW); dorsal hoof wall angle (DHWA); and hoof spread (HS) of 63 riding school horses were measured within two weeks of routine shoeing. Regression analysis demonstrated positive relationships between body mass and both CBW and HBW in left and right hooves, indicating basic hoof dimensions increased as body mass increased. No relationship between horse height and hoof variables was found, suggesting mass is more influential on hoof morphology. Left and right DHWL were moderately correlated; however, paired t -test results identified a greater right than left DHWA. As left DHWA increased, left HS decreased, indicating development of a more upright hoof geometry. Both left and right HS increased as corresponding HBW increased. Both hooves tended toward a more upright conformation as horse height and body mass increased. However, asymmetries observed suggest a splayed left hoof compared to a "boxy" right hoof. Such morphological adjustments may indicate variation in horn tubule orientation in response to greater structural loading; an important consideration for hoof practitioners. • The mass of the study cohort had a greater influence on hoof conformation than horse height. • Taller horses (>16hh) have more upright "boxy" feet compared to shorter horses. • Paired hooves presented with asymmetry; the left hoof being more acutely angled. • Dorsal hoof wall angle asymmetry increased as horse height and body mass increased. • Right hooves presented as more upright or "boxy" due to a lower hoof spread ratio. [ABSTRACT FROM AUTHOR]

Quantitative assessment of racehorse workload and fitness levels can be achieved through heart rate monitoring (HRM), an established reliable indicator of workload. Using HRM can aid trainers in formulating evidence-based training regimes and evaluating individual horses' progress during training. Despite this, HRM is not used consistently within racehorse training. This study aimed to evaluate how the maintenance workload of racehorses actively engaged in training and racing in the UK and varied across an interval-training regime (6 weeks). Ten thoroughbred racehorses (age: 9.1 ± 1.9 years) of mixed level (British Horseracing Authority Official Rating: 127.2 ± 7.95; career winnings: £34774.6 ± 21548.64) and experience in training (total races: 25 ± 12) were recruited for the study. Equinity Technology™ Ltd HRM systems collected weekly heart rate (HR) data for each horse during a maintenance interval training session (speed: 11 m/s) on a 3 furlong (0.38 m) all-weather gallop (sand, rubber, and wax mixture; 8 cm depth). Maintenance workload levels were determined by the same experienced National Hunt trainer; typical training sessions consisted of a warm up (walk and trot) to the gallop (1000 m) followed by a canter interval run: 0.38 km, after which horses walked 0.38 km back to the start; this process was then repeated a further two times. Mean HR, mean speed, and mean stride frequency (SF) for each run was recorded. Mean HR was used to calculate the mean percentage of HR maximum (%HRmax) for each horse between canter runs for individual training sessions and across the 6-week period. A series of one-way ANOVAs (significance: P < 0.05) with post hoc paired t-tests (Bonferroni-adjusted alpha: P < 0.01) examined if differences in %HRmean, mean speed, and mean SF occurred across the cohort and for individual horses. No significant differences in %HRmax, mean speed, or mean SF were found at the cohort or individual level (P > 0.05). The trainer rated all horses working at maintenance (aerobic) levels; however, descriptive analysis identified that 74%, 43%, and 2% of gallop runs exceeded the anaerobic threshold when set at 75%, 80%, and 85% of HRmax. The results provide evidence that HRM can provide trainers with a more accurate appraisal of racehorse workload compared to visual assessment during training. Increasing industry understanding of how HRM can be used to monitor fitness within training can enhance equine welfare by preparing horses appropriately for the demands of competition. [ABSTRACT FROM AUTHOR]

Abstract The use of pressure via a bit in the horse's mouth is part of training methods throughout equine disciplines. Rein tension refers to the force exerted on the reins between the horse and human during ridden and in-hand training. Understanding the effects of these forces has the potential to inform both rider performance and equine welfare research. The methodological protocols of current rein tension research appear inconsistent, and to date, a review on rein tension has not been published. This study uses a systematic literature review to evaluate the tools and methods used to measure rein tension within current literature to establish whether their findings were reliable. The review also suggests improvements to study protocols, where appropriate, to enable the standardized measurement of rein tension. A search protocol was developed and inclusion criteria defined with the aid of independent subject specialists, including 2 published equestrian authors, an equine industry professional and a librarian. Inclusion criteria determined that only full peer-reviewed articles available via Google Scholar and published in the previous 15 years were included in the review. Articles also had to include the following key words: rein tension AND "horse/s" OR "rider/s" OR "equine/s" OR "equestrian." The literature search returned 154 initial results, and the inclusion criteria rejected 137 results. Seventeen primary research articles (after 2002) from peer-reviewed journals were subsequently reviewed. The articles reviewed found rein tension to be influenced by the horse, the rider, and the training equipment used. Rein tension studies have multivariable foci and methodological limitations and frequently report their methods and results inconsistently. Future rein tension research should aim to improve the consistency of reporting horse-related, rider-related, and performance-related factors that may affect rein tension, as well as reporting data handling and analysis approaches to increase comparability between studies. [ABSTRACT FROM AUTHOR]

Race pace strategy has been extensively studied in human sports such as running, cycling, and swimming. In contrast, pacing strategy appears to have been virtually ignored in equestrian sport despite its potential to contribute to performance optimization. Previously, we have demonstrated that there are significant differences in pacing strategy between finishers and nonfinishers in 120-km single-day endurance races. The aim of the present study was to further analyze the same dataset of electronically timed Federation Equestre Internationale (FEI) 120-km (single day) Concours de Raid d’Endurance International (CEI) ∗∗ ∗∗ All rides between 120 km and 139 km in one day or between 70 km and 89 km per day over two days. Maximum Pulse at Vet Gates: 64 bpm within 20 minutes. endurance races that took place in Europe and the Middle East in 2016 and 2017. The competition records of 218 horses that finished (average completion rate: 56%) in 24 races, each consisting of 4 loops (laps), were evaluated. Final loop speed was significantly increased for horses placed in the top 3 who recorded 12% faster mean speed ( P = .011) compared with horses that finished outside of the top 3. Top 3–finishing horses also significantly increase the speed with which they complete loop 3 ( P = .040; 3% increase in percentage of loop 1 speed) and the final loop ( P = .008; 8% increase in percentage of loop 1 speed) of races compared with horses who achieve lower placings and completed loop 1 at a 3% lower percentage of their average race speed ( P = .008) and those who finished fourth or higher. These results suggest that horses that are placed in the top 3 are ridden more consistently. [ABSTRACT FROM AUTHOR]

Many donkeys are kept as companions in the UK and are not ridden or work, therefore dental pain can often go unnoticed by owners. Donkeys suffer from an increased frequency of dental pathology compared with horses and require regular dental treatment (rasping) to optimize their welfare. Fecal fiber length (FFL) has been suggested as a noninvasive method to assess when Equidae require dental treatment. This study aimed to identify FFL prerasping in donkeys requiring dental treatment and to evaluate how this changed over a 6-week period postrasping. Twenty adult donkeys of mixed sex and age, and subject to analogous management regimes were selected from The Donkey Sanctuary. Fecal samples were taken for FFL analysis prerasping (week 0) and postrasping (weeks 1–3 and 6). Mean FFL, determined via laboratory analysis, was recorded for each donkey and the cohort each week. Repeated measures analysis of variance with post hoc Bonferroni analyses and a Bonferroni adjustment ( P ≤ .01) examined if differences occurred in FFL between weeks. The cohort's mean FFL was higher prerasping than for all weeks examined postrasping. Significant reductions in mean FFL for the cohort were reported pre- and postrasping for week 0 to weeks 1–3 and 6, 1 and 3, 1 and 6, 2 and 3, and 2 and 6 ( P < .0001). Prerasping FFLs >3.3 mm were associated with the presence of dental elongations in adult, companion donkeys. This suggests that FFL measurement is a useful noninvasive tool that could be used to assess the dental health of donkeys. [ABSTRACT FROM AUTHOR]

Stereotypical behavior (STB) has been observed in a wide range of species regardless of its classification. Despite extensive research into factors that contribute to the etiology of STB and/or influence the expression of STB, few studies have explicitly evaluated if relationships exist between STB and performance variables in livestock or equine athletes. This review explores the effect of STBs on animal performance, using the horse and production animals as examples, to establish whether their expression should be viewed as a positive or negative attribute by the animal industry. Emergent themes within livestock and equine research suggest that individuals that exhibit STBs also demonstrate impaired performance attributes that support the proposal that STB is a negative characteristic. Much of the available empirical evidence suggests that negative environmental stressors represent a greater risk to the economic value of animals compared with STB. Within equestrianism, stereotypic performing horses appear to react and learn in a different way to nonstereotypic horses, which, in professional hands, could enhance their performance potential and value, but with amateur riders could reinforce the negative associations that exist. However, performance is a complex phenomenon with any species, and multiple endogenous and exogenous factors will contribute to success at any one time. Further research is required that explicitly explores how different STBs influence performance variables alongside consideration of the effect of management systems and environmental stressors and their role in STB expression in both livestock and horses. [ABSTRACT FROM AUTHOR]

Abstract Musculoskeletal assessment of horses includes assessment of conformation, symmetry, and postural alignment of the equine spine; however, objective methods to analyse the spine have high costs and are logistically complex. This study aimed to assess the intrarater and interrater reliability of simple methods designed to objectively measure thoracolumbar (TL) posture from photographs. A sample of horses (n = 190) were photographed with a digital camera in two positions of stance, and also a static image was captured from video at the toe off phase of the right hind in walk. Measurements of TL angle, depth, and area of lordosis were tested for intrarater and interrater reliability. Repeated measures of TL angle showed no significant differences between measurements taken by one observer, but TL depth and surface area measures were not found to be consistently reliable. Interrater reliability was poor for all measurements across three observers. TL angle method of recording thoracolumbar posture in horses has the potential to be used to gain an objective measure of posture when standardized positioning is applied by a single experimenter or clinician. Highlights • Musculoskeletal assessment of horses includes assessment of posture. • Objective, simple measures of equine thoracolumbar posture have not been tested for reliability. • Calculation of equine thoracolumbar angle is reliable with one observer but not with multiple observers. • Calculation of equine thoracolumbar depth or area is not reliable for either one or more observers. • The thoracolumbar angle method could be used to objectively measure outcome of treatment interventions if repeated by a single observer. [ABSTRACT FROM AUTHOR]

The article looks at 20th-century Russian mosaic artist Boris Anrep, focusing on mosaics he created in the Chelsea, London, England, home of American-born artist Ethel Sands. It notes the mosaics included portraits of numerous people including the Russian poet Anna Akhmatova, British painter Dora Carrington, and British author Virginia Woolf. Elements drawn from the style of Byzantine mosaics are described.

In 2007, the 'Aiming High' programme set out to improve outcomes for children with disabilities in the UK. There continues to be a plethora of legislation, acts, guidance and changes in practice but is there any evidence of real change for children with a disability? This article aims to discuss whether the current Children and Families Bill will be the legislation that finally does make a significant difference and facilitate improved interagency working, quicker care plans and simplified and safe transition. [ABSTRACT FROM AUTHOR]