Objective To determine if family caregiver involvement in interventions with patients with delirium improves patient outcomes. Methods A search of three databases (Medline‐Ovid, CINAHL and Embase) was conducted. Eligibility criteria included adult patients and involvement of family caregivers in any delirium intervention. Data were extracted from each study (determined by PEDro scale) using a customised form. A meta‐analysis was undertaken which compared the length of hospital stay and duration of delirium. PROSPERO registration number is CRD42017077650. Results Five studies involving 505 participants published over a 5‐year period were suitable for inclusion. Low‐level evidence demonstrated family caregiver involvement may reduce caregiver's anxiety and hospital staff viewed administration of education to family caregivers as efficient. Meta‐analysis suggested family interventions reduce length of hospital stay for patients with delirium. It remains unclear if it affects the duration of delirium. Conclusion Family caregivers providing interventions to patients with delirium can improve patient outcomes.
The broad traits of boldness and independence in domestic horses can affect their usefulness and, indirectly, their welfare. The objective of the current study was to explore associations between attributes that reflect equine boldness and independence with both the age of horses and the age at which they were started under saddle, as well as other variables including breed, colour and primary equestrian discipline. All data were sourced from responses (n = 1940) to the 97-question online Equine Behaviour Assessment and Research Questionnaire (E-BARQ). Twenty E-BARQ items from the dataset were selected to reflect boldness and independence and were tested for univariate significance at p < 0.2. Multivariable modelling of the effect of age on remaining traits was assessed by an ordinal logistic regression, using a cumulative log odds model. This revealed that older horses were bolder (p = 0.012). However, horses started under saddle at an older age were less bold and less independent (p = 0.040 and p = 0.010, respectively). Australian Stock Horses were bolder and more independent (p = 0.014 and p = 0.007, respectively) than crossbreed horses. Horses used for breeding conformation (p = 0.039), working equitation (p = 0.045), eventing (p = 0.044) and traditional working horses (p = 0.034) were bolder than those used for other disciplines. Dressage (p = 0.039) and therapy (p = 0.040) horses were less bold than horses used for other disciplines. Stallions were bolder (p = −0.034) than geldings. Brown (p = 0.049) and chestnut (p = 0.027) horses were less bold than bay horses. Compared to crossbreed horses, Thoroughbreds (p = 0.000) and companion horses (p = 0.017) were less bold whilst heavy horses (p = 0.029) and ponies (p = 0.044) were bolder. Compared to pleasure horses, mounted games horses (p = 0.033) were less independent whereas working equitation horses (p = 0.020) were more independent. Riders with more than eight years’ experience reported more independence in their horses (p = 0.015) than those who had ridden their whole lives. The study findings suggest that boldness and independence are separate traits and only boldness was associated with the age of the horse. Factors that relate to desirable boldness and independence are important in ridden horses because they can affect rider safety. Results from this study should improve horse–rider matching and thereby potentially enhance horse welfare.
Chlamydia was detected in 7.4% of >13,500 pregnant women tested at an academic center in Alabama. Age less than 30 years was strongly associated with infection in adjusted models.
An evidence-based understanding of dangerous or unwelcome behaviour in horses would greatly benefit both horses and humans who interact with them. Using owner-reported data from the Equine Behaviour Assessment and Research Questionnaire (E-BARQ), the current study investigated in-hand behaviours associated with dangerous or unwelcome ridden behaviours, notably bolting, rearing and bucking. Respondents (n = 1584) to the ridden horse section of the E-BARQ answered 42 demographic questions, followed by 268 behavioural items. Parallel analysis was conducted to group individual behaviours into rotated components to create independent and dependent indices. Multivariable general linear modelling and ordinal logistic regression were used to identify behaviours associated with bolting, rearing and bucking. Results revealed that safety-from-bolt increased as social confidence with horses (Odds ratio (OR) = 1.06; 95% confidence interval (cf = 1.02–1.09) and other animals (OR = 1.08; cf = 1.03–1.12), compliance in-hand (OR = 1.10; cf = 1.06–1.16) and tolerance of restraint (OR = 1.05; cf = 1.0–1.11) increased; and decreased as loading problems (OR = 0.95; cf = 0.92–0.99) increased. Safety-from-rear increased as tolerance of restraint (OR = 1.07; cf = 1.02–1.12) and social confidence with other animals (OR = 1.05; cf = 1.01–1.09) increased; and decreased as loading problems (OR = 0.94; cf = 0.91–0.98) increased. Safety-from-buck increased as social confidence with horses (b-value = 0.011, p < 0.001) and other animals (b-value = 0.010, p = 0.002), compliance in-hand (b-value = 0.015, p < 0.001), tolerance of restraint (b-value = 0.009, p = 0.027) and tolerance of haltering/bridling (b-value = 0.016, p = 0.010) increased, and it decreased as loading problems increased (b-value = −0.011, p < 0.001). By revealing, for the first time, that specific behaviours on the ground are associated with particular responses in the same horses when ridden, this study advances equitation science considerably. Identification of risk factors for dangerous behaviour while under saddle can improve safety for horses and riders and highlights the importance of effective and humane in-hand training.
It is logical to assume that horses with multiple riders encounter variation in application of training cues. When training cues are inconsistent, we expect to see a decrease in trained responses or an increase in conflict behaviours. This study investigated the relationship between the number of people that regularly ride or handle a horse and the horse’s response to operant cues. Data on 1819 equids were obtained from the Equine Behavior Assessment and Research Questionnaire (E-BARQ), an online global survey of horse owners and caregivers. Three mutually independent indices (acceleration, deceleration, and responsiveness) were derived from a parallel analysis of E-BARQ items related to acceleration and deceleration cues. These indices were then subjected to multivariable modelling against a range of dependent variables including horse and human demographics, horse management, and the number of riders or handlers. The number of riders or handlers was a significant predictor for two out of three indices. As the number of riders or handlers increased, horses were more difficult to accelerate (regression coefficient = 0.0148 ± 0.0071; p = 0.0366) and less difficult to decelerate (regression coefficient = −0.017 ± 0.008; p = 0.030) than those with fewer riders or handlers. These findings suggest that horses’ responses to rein tension cues are more persistent than their responses to leg pressure or whip cues. Alternatively, horses with these responses may be actively selected for multiple rider roles. Longitudinal studies of this sort should reveal how the number of riders or handlers affects horse behaviour and could lead to safer and more humane equestrian practices.
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