Swedish horse owner’s experiences towards loading horses

Studies have shown that struggle during loading of horses is a well-known problem. Horses are flight animals who usually avoid dark and narrow places where the view of their surroundings are limited. Horses are also naturally neophobic, which can cause problems when loading and training horses to load. The risk of injuries caused by the horse’s flight response are burn marks and fractures on humans as well as wounds and fractures on horses. Studies have shown that different vehicles cause different physiological and behavioral responses in horses, something that can affect the horses will to load. Most horse owners train their horses to load by using negative- or positive reinforcement, positive- or negative punishment or habituation, which has different purposes and effects on the horse. This study aimed to get an understanding for how horse owners assess their horse experience of loading, which vehicles and training methods horse owners use when loading. By distributing a 23-question survey to horse centers and in Facebook groups. The method used was able to reach out to a great number of people during limited time. However, an intern dropout occurred because the respondent was not obligated to answer every question. A total of 49 answers were received. The results showed that a that a majority of horses were easy to load and often tend load without the owners help. Most horses travel 1-2 times a week to mostly competitions and training. The most frequently used vehicle was a two-horse trailer where the horse walks in and out from the back of the trailer. When they train to load, horse owners used most frequently positive reinforcement by giving the horse feed. Owners who do not train explained that the horse loads by itself followed by using negative reinforcement. However, studies have shown that training methods are often used unknowingly by owners, which leads to believe that training with habituation has occurred more than the owners are aware of. When experiencing problems during loading, they tend to use negative reinforcement by using lunge lines behind the horse’s hindlegs. Horse owners considered that if a horse once has learnt to load, the knowledge of loading sticks with them even after a longer break from transporting. Something that studies agree with. Studies do not however agree with positive reinforcement being the most common training method, rather it being negative reinforcement. Previous studies have shown that vehicles where the horse stands against the direction of travel is preferred by horses, something that horse owners agreed with. However, the most common vehicle according to studies is the same as was found in this survey. New questions for future studies were shaped to deeper investigate the teaching of loading horses to owners, how experiences change over time and finally how vehicles should be constructed to further facilitate loading

Oral Health Care Reform in Finland – aiming to reduce inequity in care provision

<p>Abstract</p> <p>Background</p> <p>In Finland, dental services are provided by a public (PDS) and a private sector. In the past, children, young adults and special needs groups were entitled to care and treatment from the public dental services (PDS). A major reform in 2001 – 2002 opened the PDS and extended subsidies for private dental services to all adults. It aimed to increase equity by improving adults' access to oral health care and reducing cost barriers. The aim of this study was to assess the impacts of the reform on the utilization of publicly funded and private dental services, numbers and distribution of personnel and costs in 2000 and in 2004, before and after the oral health care reform. An evaluation was made of how the health political goals of the reform: integrating oral health care into general health care, improving adults' access to care and lowering cost barriers had been fulfilled during the study period.</p> <p>Methods</p> <p>National registers were used as data sources for the study. Use of dental services, personnel resources and costs in 2000 (before the reform) and in 2004 (after the reform) were compared.</p> <p>Results</p> <p>In 2000, when access to publicly subsidised dental services was restricted to those born in 1956 or later, every third adult used the PDS or subsidised private services. By 2004, when subsidies had been extended to the whole adult population, this increased to almost every second adult. The PDS reported having seen 118 076 more adult patients in 2004 than in 2000. The private sector had the same number of patients but 542 656 of them had not previously been entitled to partial reimbursement of fees.</p> <p>The use of both public and subsidised private services increased most in big cities and urban municipalities where access to the PDS had been poor and the number of private practitioners was high. The PDS employed more dentists (6.5%) and the number of private practitioners fell by 6.9%. The total dental care expenditure (PDS plus private) increased by 21% during the study period. Private patients who had previously not been entitled to reimbursements seemed to gain most from the reform.</p> <p>Conclusion</p> <p>The results of this study indicate that implementation of a substantial reform, that changes the traditionally defined tasks of the public and private sectors in an established oral health care provision system, proceeds slowly, is expensive and probably requires more stringent steering than was the case in Finland 2001 – 2004. However, the equity and fairness of the oral health care provision system improved and access to services and cost-sharing improved slightly.</p

Inflammatory parameters after pleurodesis in recurrent malignant pleural effusions and their predictive value

AbstractRecurrent pleural malignant effusion is a common problem which can be treated by inducing symphysis of the pleural sheets. Many different drugs administered into the pleural space can be used to achieve this. The drugs cause an inflammatory response, which in turn is believed to cause the symphysis. Comparatively little has been published on the degree of pleural inflammation and the systemic response and whether this will affect the outcome.The aim of this study was to describe the systemic inflammatory reaction following instillation of a chemical agent into the pleura and to investigate whether this had any predictive value for the outcome (i.e. the pleurodesis). The markers investigated were simple ones: erythrocyte sedimentation rate, C-reactive protein, and leukocyte count from venous blood samples, and the fever reaction.Eighty-nine prospective patients with malignant pleural effusion who underwent pleurodesis with either talc (48 patients) or quinacrine (41 patients) were included in the study. Symphysis was achieved in 82 patients (92 per cent) and all had a prominent transitional elevation of the inflammatory parameters. The unsuccessful attempts caused negligible or very small elevations, but due to the small numbers only the degree of fever after 8 and 48h showed a statistically significant difference.In conclusion, pleurodesis causes a systemic inflammation and there is a tendency to a correlation between the success of pleurodesis and the degree of inflammation. High fever and high inflammatory parameters including CRP are due to this inflammatory response and do not indicate infection

The impact of pleurodesis in malignant effusion on respiratory function

AbstractPleurodesis of malignant pleural effusion provides for a substantially better quality of life compared to onging exudation with the need for repeated evacuation of fluid. Successful pleurodesis leads to permanent cessation of fluid production as a result of the formation of fibrous adhesion between the lung and costal pleura which in theory, however, might restrict lung mobility. In patients with poor lung function, or with need for bilateral pleurodesis, the apprehension of further impairment of lung function often arises. The aim of this study was to evaluate the effects of pleurodesis on lung function. Therefore 10 patients with malignant pleurisy with very limited tumour were investigated. They were without radiological signs of tumour infiltration in the lung parenchyma, without visible tumour growth in the pleural space during thoracoscopy and had undergone a successful one-sided pleurodesis. Respiratory function tests were performed at different times, 1–102 months after pleurodesis. The assessment consisted of: static and dynamic spirometry, exercise testing with blood gas determination and radiospirometry.Spirometric values were slightly low, but in general within the reference limits. Blood gas determination showed no signs of alveolar hypoventilation. Radiospirometry showed a slight attenuation of activity in the treated lung but similar turnover of gas of the treated vs. the untreated side. The study showed that pleurodesis in malignant pleurisy has only minor impact on respiratory function