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Post-racing thoroughbreds (TBs) are increasingly being considered for Equine Assisted Services (EAS), but their use has not yet been widely characterised. This study aimed to generate detailed data on TBs and other breeds (OBs) of horses in EAS via an online survey. The survey was completed by 129 EAS practitioners from 15 countries and reported detailed data on 427 EAS equids, including 57 TBs. Most of the EAS horses were housed collectively, had access to free exercise over 12 h per day and had unrestricted access to forage. The most commonly recorded selection criteria for EAS horses consisted of: demonstrating a good personality; enjoying the work; absence of propensity to kick/bite. Detailed data gathered on individual horses showed that in comparison to OBs, TBs were younger, more likely to be a gelding, less likely to be used in ridden programmes, and tended to present more behavioural issues than OBs. The majority of the participants agreed that TBs have specific assets of particular interest to EAS programmes, such as sensitivity, body/movement characteristics or responsiveness/flight response. Finally, a large majority of participants reported that they believe TBs to be suitable for EAS programmes and some would consider working with them. These results showed TBs to already be in use in various EAS programmes and more could be incorporated in the future. In terms of animal welfare and beneficiaries’ safety, a selection process could therefore be designed and implemented to choose the most adapted horses for each EAS centre, according to living conditions and EAS activities practised (ridden or not ridden).
A testing rate for measles above 80% is required by the WHO European Region Measles Elimination strategy to verify elimination. To comply with this rate, we explored factors associated with the return of oral fluid kits (OFK) by suspected measles cases. We described the cases and conducted a mixed-effects analysis to assess the relationship between socio-demographic and public health management characteristics and the likelihood of returning an OFK to the reference laboratory. Of 3,929 cases who were sent a postal OFK, 2,513 (67%) returned the kit. Adjusting for confounding, registration with a general practitioner (GP) (aOR:1.48, 95%CI:1.23–1.76) and living in a less deprived area (aOR:1.35, 95%CI:1.04–1.74) were associated with an increased likelihood of returning the OFK. The odds of returning the OFK also increased if the HPT contacted the parents/guardians of all cases prior to sending the kit and confirmed their address (aOR:2.01, 95%CI:1.17–3.42). Cases notified by a hospital (aOR:1.94, 95%CI:1.31–2.87) or GP (aOR:1.52; 95%CI:1.06–2.16) also had higher odds of returning the OFK. HPTs may want to consider these factors when managing suspected cases of measles since this may help in increasing the testing rates to the WHO-recommended level.
Policymakers, practitioners and the public all have a role in health emergency and disaster risk management (Health EDRM). They need to access, understand and use evidence from research to take actions to reduce health risks and harm. They need the best available evidence to maximize their ability to save lives and reduce suffering. Evidence Aid seeks to meet this need through collections of specially prepared plain-language summaries of systematic reviews, freely available online in multiple languages (www.EvidenceAid.org). The summaries and webpages can be linked to reference management software and embedded in other websites.
Method:
Evidence Aid has added a substantial number of summaries to its collections since 2020, for example, adding a collection for reviews of relevance to the COVID-19 pandemic and its associated measures. From 2021, Evidence Aid built on its partnership with the Pan American Health Organization (PAHO/WHO) to identify and summarize reviews relevant to building resilience into health systems. This included enhancements enriching the content of each summary with the authors’ implications for practice and research, equity considerations and funding sources.
Results:
In November 2022, the Resilient Health Systems collection contained more than 200 summaries relevant to ensuring that health systems are resilient to emergencies, disasters and related challenges. There were also 600 summaries relevant to the COVID-19 pandemic, 150 on the health of refugees and asylum seekers, more than 100 on physical and mental health impacts of disasters and 110 on preventing and treating acute malnutrition.
Conclusion:
Evidence Aid’s 1000+ summaries of systematic reviews relevant to Health EDRM provide a unique gateway into this evidence base for policymakers, practitioners and the public wishing to ensure that disaster preparedness, response, recovery and rehabilitation are effective and efficient. It should be a key component in helping people and organizations to care, cope and overcome in an increasingly challenging world.
The Tailored Activity Program (TAP) is an evidence-based occupational therapist-led intervention for people living with dementia and their care partners at home, developed in the USA. This study sought to understand its acceptability to people living with dementia, their care partners, and health professionals, and factors that might influence willingness to participate prior to its implementation in Australia.
Methods:
This study used qualitative descriptive methods. Semi-structured interviews were conducted with people living with dementia in the community (n = 4), their care partners (n = 13), and health professionals (n = 12). People living with dementia were asked about health professionals coming to their home to help them engage in activities they enjoy, whereas care partners’ and health professionals’ perspectives of TAP were sought, after it was described to them. Interviews were conducted face-to-face or via telephone. All interviews were recorded and transcribed. Framework analysis was used to identify key themes.
Results:
Analysis identified four key themes labelled: (i) TAP sounds like a good idea; (ii) the importance of enjoyable activities; (iii) benefits for care partners; and (iv) weighing things up. Findings suggest the broad, conditional acceptability of TAP from care partners and health professionals, who also recognised challenges to its use. People living with dementia expressed willingness to receive help to continue engaging in enjoyable activities, if offered.
Discussion:
While TAP appeared generally acceptable, a number of barriers were identified that must be considered prior to, and during its implementation. This study may inform implementation of non-pharmacological interventions more broadly.
Stop the Bleed (STB) is a national initiative that provides lifesaving hemorrhagic control education. In 2019, pharmacists were added as health-care personnel eligible to become STB instructors. This study was conducted to evaluate the efficacy of pharmacist-led STB trainings for school employees in South Texas.
Methods:
Pharmacist-led STB trainings were provided to teachers and staff in Laredo, Texas. The 60-min trainings included a presentation followed by hands-on practice of tourniquet application, wound-packing, and direct pressure application. Training efficacy was assessed through anonymous pre- and postevent surveys, which evaluated changes in knowledge, comfort level, and willingness to assist in hemorrhage control interventions. Student volunteers (predominantly pharmacy and medical students) assisted in leading the hands-on portion, providing a unique interprofessional learning opportunity.
Results:
Participants with previous training (N = 98) were excluded, resulting in a final cohort of 437 (response rate 87.4%). Compared with baseline, comfort level using tourniquets (mean, 3.17/5 vs 4.20/5; P < 0.0001), opinion regarding tourniquet safety (2.59/3 vs 2.94/3; P < 0.0001), and knowledge regarding tourniquets (70.86/100 vs 75.84/100; P < 0.0001) and proper tourniquet placement (2.40/4 vs 3.15/4; P < 0.0001) significantly improved.
Conclusions:
Pharmacist-led STB trainings are efficacious in increasing school worker knowledge and willingness to respond in an emergency hemorrhagic situation.
Disturbances in trait emotions are a predominant feature in schizophrenia. However, less is known about (a) differences in trait emotion across phases of the illness such as the clinical high-risk (CHR) phase and (b) whether abnormalities in trait emotion that are associated with negative symptoms are driven by primary (i.e. idiopathic) or secondary (e.g. depression, anxiety) factors.
Aims
To examine profiles of trait affective disturbance and their clinical correlates in individuals with schizophrenia and individuals at CHR for psychosis.
Method
In two studies (sample 1: 56 out-patients diagnosed with schizophrenia and 34 demographically matched individuals without schizophrenia (controls); sample 2: 50 individuals at CHR and 56 individuals not at CHR (controls)), participants completed self-report trait positive affect and negative affect questionnaires, clinical symptom interviews (positive, negative, disorganised, depression, anxiety) and community-based functional outcome measures.
Results
Both clinical groups reported lower levels of positive affect (specific to joy among individuals with schizophrenia) and higher levels of negative affect compared with controls. For individuals with schizophrenia, links were found between positive affect and negative symptoms (which remained after controlling for secondary factors) and between negative affect and positive symptoms. For individuals at CHR, links were found between both affect dimensions and both types of symptom (which were largely accounted for by secondary factors).
Conclusions
Both clinical groups showed some evidence of reduced trait positive affect and elevated trait negative affect, suggesting that increasing trait positive affect and reducing trait negative affect is an important treatment goal across both populations. Clinical correlates of these emotional abnormalities were more integrally linked to clinical symptoms in individuals with schizophrenia and more closely linked to secondary influences such as depression and anxiety in individuals at CHR.
The need to use evidence in humanitarian settings is recognized, yet utilizing that evidence to make decisions about humanitarian response remains a challenge.
Aim:
To identify how, when, and why decision makers in humanitarian response use scientific, peer-reviewed evidence to make decisions.
Methods:
An online cross-sectional survey of fifteen open- and closed-ended questions on demographics, experience, and role in humanitarian response was developed by Evidence Aid (EA) and Karolinska Institutet (KI). The online survey was available on the EA website from August 2015 to October 2018. Participants were self-selected, recruited through social media channels and mailing lists of EA and KI. All respondents and responses were anonymized. Responses were analyzed with descriptive statistics and content analysis.
Results:
47 people responded, primarily working in Europe or North America with roles of humanitarian response director/manager, independent consultant, or policymaker. Personal assessment of the quality of information, trust in the source, and information that was contextually relevant or based on field experience were factors for deciding whether information should be considered evidence. Reasons for using evidence when making decisions included adhering to good practice to maximize impact and effectiveness of aid, reassurance that the right decisions were being made, personal or organizational values, and using evidence as a tool to protect beneficiaries and organizations from poor quality decisions and program content.
Discussion:
Using evidence for decision making was common practice during the process of designing implementing and evaluating humanitarian response content, yet reasons for use varied. The importance of evidence developed and validated from field experience and trust in the source reported by this sample suggests that strengthening collaborative efforts between decisionmakers and evidence generators could be one approach to improve evidence and evidence use in humanitarian response.
The subantarctic island of South Georgia provides terrestrial and coastal marine records of climate variability, which are crucial for the understanding of the drivers of Holocene climate changes in the subantarctic region. Here we investigate a sediment core (Co1305) from a coastal inlet on South Georgia using elemental, lipid biomarker, diatom, and stable isotope data to infer changes in environmental conditions and to constrain the timing of late-glacial and Holocene glacier fluctuations. Because of the scarcity of terrestrial macrofossils and the presence of redeposited and relict organic matter in the sediments, age control for the record was obtained by compound-specific radiocarbon dating of mostly marine-derived n-C16 fatty acids. A basal till layer recovered in Little Jason Lagoon was likely deposited during an advance of local glaciers during the Antarctic cold reversal. After glacier retreat, an oligotrophic lake occupied the site, which transitioned to a marine inlet around 8.0±0.9 ka because of relative sea-level rise. From 7.0±0.6 to 4.0±0.4 ka, reduced vegetation coverage in the catchment, as well as high siliciclastic input and deposition of ice-rafted debris, indicates glacier advances in the terrestrial catchment and likely in the adjacent fjord. A second, less extensive period of glacier advances occurred in the late Holocene, after 1.8±0.3 ka.
This paper provides a metric for determining whether a given pair of English words is perceived to be morphologically related, based on objective measurements of the words’ orthographic, phonetic, and semantic similarity to each other. The metric is developed on the basis of results from a behavioural study in which participants were asked to judge the relative similarity of pairs of words. The metric is intended to help researchers determine which forms in a language plausibly have segments that alternate; as an example, it is applied to the lexicon of English to illustrate its utility in calculating the frequency of alternation of [s] and [ʃ].
The Second Evidence Aid Conference took place in Brussels, Belgium, in October 2012, jointly organized by Evidence Aid and the Belgian Red Cross–Flanders. It provided an opportunity to build on the discussions from the 2011 First Evidence Aid Conference in Oxford, England, and prioritize the future work of Evidence Aid. Within the plenary presentations, discussions, and small work groups, the more than 80 international participants addressed issues regarding the need, use, and prioritization of evidence. Three parallel workshops focused on the prioritization of research, systematic reviews, and data to be collected during disasters, leading to a suggested prioritization framework and a commitment to identify key areas for evidence in disasters. Working with a wide variety of people and organizations from the disaster and humanitarian sectors, Evidence Aid will take this framework and develop a list of top priority questions in need of research and systematic reviews. Although Evidence Aid will not be able to address all of the research questions that will be identified in this process, it will collect them for sharing with relevant agencies. (Disaster Med Public Health Preparedness. 2013;7:593-596)
To assess the ability of Medicare claims to identify US hospitals with high rates of surgical site infection (SSI) after hip arthroplasty.
Design.
Retrospective cohort study.
Setting.
Acute care US hospitals.
Participants.
Fee-for-service Medicare patients 65 years of age and older who underwent hip arthroplasty in US hospitals from 2005 through 2007.
Methods.
Hospital rankings were derived from claims codes suggestive of SSI, adjusted for age, sex, and comorbidities, while using generalized linear mixed models to account for hospital volume. Medical records were obtained for validation of infection on a random sample of patients from hospitals ranked in the best and worst deciles of performance. We then calculated the risk-adjusted odds of developing a chart-confirmed SSI after hip arthroplasty in hospitals ranked by claims into worst- versus best-performing deciles.
Results.
Among 524,892 eligible Medicare patients who underwent hip arthroplasty at 3,296 US hospitals, a patient who underwent surgery in a hospital ranked in the worst-performing decile based on claims-based evidence of SSI had 2.9-fold higher odds of developing a chart-confirmed SSI relative to a patient with the same age, sex, and comorbidities in a hospital ranked in the best-performing decile (95% confidence interval, 2.2-3.7).
Conclusions.
Medicare claims successfully distinguished between hospitals with high and low SSI rates following hip arthroplasty. These claims can identify potential outlier hospitals that merit further evaluation. This strategy can also be used to validate the completeness of public reporting of SSI.
This paper provides new observations of volcanic features and hydrological characteristics in and around Southern Thule, the southernmost group of islands in the South Sandwich Islands, including the first high-resolution bathymetric image of the Douglas Strait caldera. The South Sandwich Islands are the summits of several very large subduction-related volcanoes constructed at the eastern boundary of the Scotia Sea. Observations of the islands are scarce owing to their remote location and they are only rarely visited, yet the area is an active volcanic arc that is rapidly changing as a result of eruptions, including one (on Montagu Island) that has been ongoing for six years and is creating new land. The three islands that make up Southern Thule are morphologically different, and they illustrate different stages in the construction and evolution of islands in the South Sandwich group. We present the results of an acoustic and hydrographic survey that resulted in the first high-resolution, multibeam ‘swath’ image of the submarine Douglas Strait caldera. The results confirm the presence of a large sediment mound (c. 1000 m3 in volume) on the floor of the Douglas Strait caldera related to a flank collapse of Thule Island. The image also shows an extensive arcuate fault structure, interpreted as evidence that the caldera is nested, and its geomorphological freshness suggests that it is a very young feature that formed conceivably in the last few decades or centuries. The bathymetric image also reveals at least three cone- or mound-like structures within the caldera that may relate to renewed post-caldera volcanism (as pyroclastic cones and/or pillow mounds). Recently formed cones and faults associated with caldera rims are often associated with hydrothermal activity. However, temperature and salinity data collected within the caldera do not yet show any evidence of hydrothermal venting. The ocean surrounding Southern Thule has a prominent surface layer of low salinity water that is probably caused by a high meltwater flux derived from ice caps on the islands. This flux may have been enhanced by the recent warming trend observed in the Antarctic Peninsula, although volcano-related geothermal melting in the ice-filled Thule Island caldera may also contribute to the meltwater flux.
A small-scale excavation, undertaken in advance of building works at Faraday Road, Newbury, Berkshire, encountered an apparently intact Early Mesolithic layer containing abundant worked flint directly associated with animal bones. The site lay on the floodplain of the River Kennet in an area already well-known for Mesolithic remains and certainly represents an extension of the site found at nearby Greenham Dairy Farm in 1963. The flint assemblage was dominated by obliquely-blunted microlithic forms accompanied by a restricted range of other items. The animal bones were, unusually, dominated by wild pig with clear evidence of both primary butchery and food waste. Spatial analysis of the bone and flint assemblages indicated discrete activity areas, possibly associated with hearths. Both pollen and molluscan data were recovered which, together with the results of soil micromorphological examination, confirmed an Early Holocene date for the formation of the Mesolithic layer. Radiocarbon dates place the site in the late 10th–early 9th millennium BP. The paper re-examines the nature of known Early Mesolithic activity in this part of the Kennet valley, with particular reference to the specific environmental conditions that seem to have prevailed. It is concluded that the Faraday Road site represents one part of a continuum of Early Mesolithic occupation that stretches along a considerable length of the floodplain, with each focus of activity witnessing repeated, but intermittent, occupation spanning a period of more than a millennium.