Evaluating a natural horsemanship program in relation to the ISES first principles of horse training

The ISES training principles provide an excellent starting point for professionals and horse owners. Currently, there does not seem to be an accepted protocol for evaluating horse training programs against the ISES principles. We suggest an approach to this, using Parelli Natural Horsemanship as our subject for evaluation. This initial pilot study (single-subject / n=1), trials two analytical methods, as applied to the current, video-based teaching materials from Parelli (latest DVD set, published and commercially available from 2015, supplied by Parelli for use in this study). The two methods used were: (i) ethology-based video observation / logging and (ii) discourse analysis of the language used to teach. The ethology-based approach uses an ethogram, which lists the behavioural characteristics of a human trainer adhering to the ISES principles. Computer-based ‘continuous sampling’ of Parelli video clips was used to log the frequencies of ISES principles. Inter Observer Reliability of the analysis to date was assessed using a two-way, mixed, absolute agreement, average-measures ICC (Intra Class Correlation). This evaluated observer agreement in the frequency count ratings for the ISES principles. Discourse analysis is a qualitative research methodology, applied across many domains including politics and health. Discourse analysis allows us to study transcripts of horse training materials, codifying the words, phrases and linguistic structures. Understanding the context within which training language is used, and its meaning to both the speaker and audience, makes it possible to evaluate compatibility with the ISES principles. Results for the ethology-based observations found all ISES principles present (1-10). High frequency counts for principles 2 & 10. Low counts for principles 5 & 7. Inter Observer Reliability (2 observers) was in the ‘excellent’ range (ICC=0.79). The high ICC value suggests that a minimal amount of measurement error was introduced by the independent observers, and therefore statistical power is not substantially reduced. At this stage (without an ICC value closer to 1.0 or further calibrating observers), increasing the evidence against random effects would require more extensive trials (p=0.16). The interim results from the discourse analysis shows consistent congruence between the Parelli materials and the ISES principles, particularly in the areas of: training according to the horse’s ethology and cognition, using learning theory appropriately, forming consistent habits, avoiding flight responses and ensuring that the horse should always be as calm as possible (1, 2, 7, 9 and 10)

Temporal trends and patterns in heart failure incidence: a population-based study of 4 million individuals

Background: Large-scale and contemporary population-based studies of heart failure incidence are needed to inform resource planning and research prioritisation but current evidence is scarce. We aimed to assess temporal trends in incidence and prevalence of heart failure in a large general population cohort from the UK, between 2002 and 2014. Methods: For this population-based study, we used linked primary and secondary electronic health records of 4 million individuals from the Clinical Practice Research Datalink (CPRD), a cohort that is representative of the UK population in terms of age and sex. Eligible patients were aged 16 years and older, had contributed data between Jan 1, 2002, and Dec 31, 2014, had an acceptable record according to CPRD quality control, were approved for CPRD and Hospital Episodes Statistics linkage, and were registered with their general practice for at least 12 months. For patients with incident heart failure, we extracted the most recent measurement of baseline characteristics (within 2 years of diagnosis) from electronic health records, as well as information about comorbidities, socioeconomic status, ethnicity, and region. We calculated standardised rates by applying direct age and sex standardisation to the 2013 European Standard Population, and we inferred crude rates by applying year-specific, age-specific, and sex-specific incidence to UK census mid-year population estimates. We assumed no heart failure for patients aged 15 years or younger and report total incidence and prevalence for all ages (>0 years). Findings: From 2002 to 2014, heart failure incidence (standardised by age and sex) decreased, similarly for men and women, by 7% (from 358 to 332 per 100 000 person-years; adjusted incidence ratio 0·93, 95% CI 0·91–0·94). However, the estimated absolute number of individuals with newly diagnosed heart failure in the UK increased by 12% (from 170 727 in 2002 to 190 798 in 2014), largely due to an increase in population size and age. The estimated absolute number of prevalent heart failure cases in the UK increased even more, by 23% (from 750 127 to 920 616). Over the study period, patient age and multi-morbidity at first presentation of heart failure increased (mean age 76·5 years [SD 12·0] to 77·0 years [12·9], adjusted difference 0·79 years, 95% CI 0·37–1·20; mean number of comorbidities 3·4 [SD 1·9] vs 5·4 [2·5]; adjusted difference 2·0, 95% CI 1·9–2·1). Socioeconomically deprived individuals were more likely to develop heart failure than were affluent individuals (incidence rate ratio 1·61, 95% CI 1·58–1·64), and did so earlier in life than those from the most affluent group (adjusted difference −3·51 years, 95% CI −3·77 to −3·25). From 2002 to 2014, the socioeconomic gradient in age at first presentation with heart failure widened. Socioeconomically deprived individuals also had more comorbidities, despite their younger age. Interpretation: Despite a moderate decline in standardised incidence of heart failure, the burden of heart failure in the UK is increasing, and is now similar to the four most common causes of cancer combined. The observed socioeconomic disparities in disease incidence and age at onset within the same nation point to a potentially preventable nature of heart failure that still needs to be tackled. Funding: British Heart Foundation and National Institute for Health Research

Discourses of art and social interests: the representation of landscape in Britain c.1800-1830

This thesis is concerned with the functions of naturalistic landscape painting in Britain c. 1800-1830, and with its status as a modern imagery. The introductory chapter explains the usage of the categories 'ideology' and 'naturalism*. Part One offers a model of the political forms taken by class interests in the period, and situates artists as a social fraction with distinct interests of its own. On the presupposition that production of meaning depends on the interaction between verbal and visual systems, Part Two provides an ideology critique of the three forms of writing which represented the visual arts: (i) philosophical criticism, (ii) academic theory, and (iii) art criticism. In relation to two types of landscape subject, coastal and river scenes, Part Three investigates how artists dealt with the problems of representing the modern, and the probable meanings of different image types. The thesis attempts to show that: (a) the category of art was the object of a struggle within critical discourse, which represented a conflict of class Interests - this struggle centred around the cultural responsibilities of the state, patronage, and control of art institutions, (b) some artists attempted to adapt the recalcitrant modes of landscape painting to the representation of modernity, (c) the emergence of naturalism was linked with a Romantic aesthetic of originality, which helped license a form of modernity, (d) while there was no genetic relationship between naturalistic landscape painting and a particular class interest, in the context of the overall system of contemporary painting, its mode of address lent it to appropriation by bourgeois Ideologues and (e) despite a brief moment of critical insight into the social functions of culture, the bourgeois intelligensia failed to produce a critique of the mythologies of English landscape, which had a predominantly (but not exclusively) conservative function

The influence of low job control on ambulatory blood pressure and perceived stress over the working day in men and women from the Whitehall II cohort.

Objective: Work stress contributes to risk of coronary heart disease and hypertension. This study tested the influence of job control on ambulatory blood pressure, and ratings of perceived stress and happiness in men and women systematically sampled by socio-economic status from the Whitehall II epidemiological cohort. Participants: A total of 227 men and women aged 47-59 years sampled from higher, intermediate and lower employment grades. Outcome measures: Ambulatory blood pressure and ratings of stress, perceived control and happiness. Methods: Participants completed standard measures of job demands and job control, and undertook ambulatory monitoring with measures of blood pressure and subjective state every 20 min from early in the working day until going to bed. Results: Systolic and diastolic blood pressure were greater in participants reporting low rather than high job control (means 125.7/81.5 versus 122.4/78.6 mmHg, P < 0.05), independently of gender, employment grade, body mass index, age, smoking status, and physical activity. Differences persisted into the evening after work. Job demands and job strain (high demand/low control) were not associated with blood pressure. Participants reporting low job control experienced stress more frequently over the working day than did those with high job control. Higher socio-economic status participants and women were more stressed by low job control than were men and people of lower socio-economic status. Conclusions: Job control plays an important role in modulating cardiovascular and affective responses over the working day, and these responses may contribute to increased cardiovascular disease risk. © 2004 Lippincott Williams & Wilkins

Adrenocortical, autonomic, and inflammatory causes of the metabolic syndrome: nested case-control study.

BACKGROUND: The causes of metabolic syndrome (MS), which may be a precursor of coronary disease, are uncertain. We hypothesize that disturbances in neuroendocrine and cardiac autonomic activity (CAA) contribute to development of MS. We examine reversibility and the power of psychosocial and behavioral factors to explain the neuroendocrine adaptations that accompany MS. METHODS AND RESULTS: This was a double-blind case-control study of working men aged 45 to 63 years drawn from the Whitehall II cohort. MS cases (n=30) were compared with healthy controls (n=153). Cortisol secretion, sensitivity, and 24-hour cortisol metabolite and catecholamine output were measured over 2 days. CAA was obtained from power spectral analysis of heart rate variability (HRV) recordings. Twenty-four-hour cortisol metabolite and normetanephrine (3-methoxynorepinephrine) outputs were higher among cases than controls (+ 0.49, +0.45 SD, respectively). HRV and total power were lower among cases (both -0.72 SD). Serum interleukin-6, plasma C-reactive protein, and viscosity were higher among cases (+0.89, +0.51, and +0.72 SD). Lower HRV was associated with higher normetanephrine output (r=-0.19; P=0.03). Among former cases (MS 5 years previously, n=23), cortisol output, heart rate, and interleukin-6 were at the level of controls. Psychosocial factors accounted for 37% of the link between MS and normetanephrine output, and 7% to 19% for CAA. Health-related behaviors accounted for 5% to 18% of neuroendocrine differences. CONCLUSIONS: Neuroendocrine stress axes are activated in MS. There is relative cardiac sympathetic predominance. The neuroendocrine changes may be reversible. This case-control study provides the first evidence that chronic stress may be a cause of MS. Confirmatory prospective studies are required

Efficacy of Telephone Information and Advice on Welfare: the Need for Realist Evaluation

In the context of increased marketisation in welfare provision, formal information and advice (I&A) is widely assumed to enable users, as consumers, to make informed choices about services, support and care. There is emerging evidence that telephone I&A services represent important ways of providing such services. This article proposes a framework that identifies key areas of focus delineating the efficacy of I&A, which is then used in a comprehensive literature review to critique existing research on outcomes and/or impact of telephone I&A. Existing, predominately quantitative, research has critical weaknesses. There is a lack of adequate contextual focus, understanding agency, and how I&A is used in different contexts to influence causal processes. The article contends that the efficacy of I&A is not adequately reported and provides much needed theoretical clarity in key areas, including the desirability of further realist evaluation approaches

Prognosis research strategy (PROGRESS) 1: a framework for researching clinical outcomes

Understanding and improving the prognosis of a disease or health condition is a priority in clinical research and practice. In this article, the authors introduce a framework of four interrelated themes in prognosis research, describe the importance of the first of these themes (understanding future outcomes in relation to current diagnostic and treatment practices), and introduce recommendations for the field of prognosis researc

“It can’t really be answered in an information pack…”: A realist evaluation of a telephone housing options service for older people.

Despite calls for better support to aid older people’s decision-making about housing options, two recent literature reviews highlight a paucity of research on the efficacy of such services. This paper reports a qualitative realist evaluation on the efficacy of a UK telephone service providing information to older people concerning specialist housing. The findings of 31 realist interviews with 16 older people are presented. Information provided to social tenants did not add much to what people already knew as social tenants tended to be familiar and knowledgeable about housing options available to them. Information seekers in mainstream housing (typically owner-occupiers), who were less familiar with housing options than social tenants, remained uncertain about their housing issues and tended to desire more substantive discussion and deliberation to become more informed. Information was considered too ‘light touch’, although the widely recognised lack of accessible housing options and reports of non-transparent and unresponsive market practices were also key factors. This study underlines the widely acknowledged need to increase the supply of specialist housing, and in the current UK context recommends that housing options support for older people be more substantive – particularly for those residing in mainstream housing

The origins, development and influence of William Shenstone’s landscape garden design at The Leasowes, Halesowen

William Shenstone was a polymath. He wrote letters, essays, composed poetry, painted water-colours, played musical instruments and indulged in architectural design, but above all he created a landscape garden at The Leasowes in the West Midlands that became a celebrated place to visit in the eighteenth century. Shenstone worked during the early days of the English landscape garden movement, and while others created grounds with political and/or historical themes he fashioned a garden in a 'naturesque' style. He created a version, called a ferme ornée that was a distinctive form of English garden at the time. This thesis is the first detailed study of The Leasowes and presents a re-evaluation of his garden. Though many people have written about the landscape in the past, few have had the opportunity to look at it from a multidisciplinary perspective which marries an exploration of archival and literary material with landscape studies and archaeological evidence. The study evaluates why and how Shenstone created his garden. It explores his cultural networks and influences and what he did to make it distinctive. It looks at the planting regime and the verse and poetry that illuminated the garden. Finally, it discovers other gardeners who were influenced by his work before and after his death

The emergence of insecticide resistance in central Mozambique and potential threat to the successful indoor residual spraying malaria control programme.

BACKGROUND: Malaria vector control by indoor residual spraying was reinitiated in 2006 with DDT in Zambézia province, Mozambique. In 2007, these efforts were strengthened by the President's Malaria Initiative. This manuscript reports on the monitoring and evaluation of this programme as carried out by the Malaria Decision Support Project. METHODS: Mosquitoes were captured daily through a series of 114 window exit traps located at 19 sentinel sites, identified to species and analysed for sporozoites. Anopheles mosquitoes were collected resting indoors and tested for insecticide resistance following the standard WHO protocol. Annual cross sectional household parasite surveys were carried out to monitor the impact of the control programme on prevalence of Plasmodium falciparum in children aged 1 to 15 years. RESULTS: A total of 3,769 and 2,853 Anopheles gambiae s.l. and Anopheles funestus, respectively, were captured from window exit traps throughout the period. In 2010 resistance to the pyrethroids lambda-cyhalothrin and permethrin and the carbamate, bendiocarb was detected in An. funestus. In 2006, the sporozoite rate in An. gambiae s.s. was 4% and this reduced to 1% over 4 rounds of spraying. The sporozoite rate for An. funestus was also reduced from 2% to 0 by 2008. Of the 437 Anopheles arabiensis identified, none were infectious. Overall prevalence of P. falciparum in the sentinel sites fell from 60% to 32% between October 2006 and October 2008. CONCLUSION: Both An. gambiae s.s. and An. funestus were controlled effectively with the DDT-based IRS programme in Zambézia, reducing disease transmission and burden. However, the discovery of pyrethroid resistance in the province and Mozambique's policy change away from DDT to pyrethroids for IRS threatens the gains made here