Horse owners seek the advice and support of a number of equestrian professionals in carrying out their duty of care for their animal. In some instances, these professionals form a multi-disciplinary team (MDT). The aim of this study was to explore the experiences of the Society of Master Saddlers\' qualified saddle fitters (SMSQSFs) working with other professionals and to understand the nature of inter-disciplinary working from an SMSQSF perspective. Semi-structured, one-to-one online interviews with fourteen SMSQSFs were completed. Areas explored included the nature of the participant\'s client base; the frequency and nature of their interactions with other professionals; their perceptions of horse owner expectations of an MDT approach; and any benefits, challenges, and barriers to an MDT approach within an equestrian setting. Interviews were video and audio recorded (MS Teams), transcribed verbatim (Otter ai), and imported into qualitative data analysis software (NVivo, version 12). Data were analysed using thematic analysis. Six themes were identified: (1) effective communication; (2) multidisciplinary expectations; (3) horse welfare; (4) professionalism; (5) relationships; (6) working together. Communication was recognised as a crucial component of an effective MDT. Most participants valued and desired an MDT approach. They felt they had a key role to play within the equestrian MDT, not only in the prevention of deterioration in horse welfare but also in improving the functionality and performance of the horse-rider partnership. Effective MDT working was also seen as having benefits to SMSQSFs and other professional stakeholders alike, although time and financial constraints were identified as barriers to MTD working. The role of the horse owner within the MDT was unclear and potentially complex, and this and other factors such as the professional identity of the SMSQSF, personal relationships, and input from others outside of the MDT team were identified as challenges to effective MDT working. This present study found that SMSQSFs experience similar benefits and challenges to an MDT approach as seen in human healthcare settings. The role of the horse owner, communication, and professional recognition are indicated as pivotal to MDT effectiveness in achieving optimal saddle fit.

The importance of wearing a facemask during a pandemic has been widely discussed, and a number of studies have been undertaken to provide evidence of a reduced infectious virus dose because of wearing facemasks. Here, one aspect that has received little attention is the fraction of breathing flow that is not filtered because it passes as leak flow between the mask and face. Its reduction would be beneficial in reducing the dose response. The results of the present study include the filter material pressure loss parameters, pressure distributions under masks, and the fraction of breathing flow leaked versus steady breathing flow in the range of 5 to 30 L min-1, for two commonly used facemasks mounted on mannequins, in the usual \'casual\' way and in a \'tight\' way by means of three different fitters placed over the mask to improve the seals. For the \'casual\' mount, leaks were high: 83% to 99% for both masks at both exhalation and inhalation flows. For the \'tight\' mount with different fitters, the masks showed different lower levels in the range of 18 to 66% of leakage, which, for exhalation, were nearly independent of flow rate, while for inhalation, were decreasing with increasing rates of respiration flows, probably because suction improved the sealing. In practice, masks are worn in a \'casual\' mount, which would imply that nearly all contagious viruses found in aerosols small enough to follow air streams would be exhaled to and inhaled from the ambient air.

Background Insulin therapy is a major part of diabetes treatment. The insulin injection technique must be done accurately and needs a professional process for diabetes mellitus (DM) patients. The aim of this research is to evaluate the relationship of education level pertaining to the accuracy of insulin injection techniques through HbA1c values. Methods We used a cross-sectional study with sampling using a purposive technique according to the inclusion criteria: diagnosed with DM and using insulin therapy with/without a combination of oral antidiabetic drugs, having HbA1c levels of data ± 3 months from the time of study, willing to become research respondents by signing informed consent. The study was conducted by filling out the questionnaire Forum for Injection Technique and Therapy Expert Recommendation (FITTER) and interviews. Results Fifty subjects with primary education were able to perform insulin injection techniques with 20% accuracy while subjects with secondary education level showed 14% accuracy, and higher education 2%. All of these results had HbA1c values > 6.5%. 100 % of the subjects were provided with educational resources and 78% had a care-giver at home. Statistical analysis of correlation between levels of education with the accuracy of the insulin injection technique was carried out through the Somers\' correlation test (p = 0.81, r = -0.03). This study shows there is no relationship between the level of education and the accuracy of insulin injection techniques through HbA1c values. This might occur due to several factors such as information sources and caregiver\'s practice.