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Effects of alpha-2-adrenoceptor agonism and antagonism on equine blood insulin and glucose concentrations after oral carbohydrate load.
Veterinary journal (London, England : 1997)    February 14, 2024   Volume 304 106080 doi: 10.1016/j.tvjl.2024.106080
Hallman IAM, Raekallio MR, Koho N, Weckman MJ, Karikoski NP.Alpha-2-adrenoceptor agonist detomidine is a commonly used sedative agent in horses. In addition to the sedative effect, detomidine has been reported to elicit changes in energy metabolism such as hypoinsulinaemia and hyperglycaemia. This study aimed to investigate the effects of detomidine with and without peripherally acting alpha-2-adrenoceptor antagonist vatinoxan on insulin and blood glucose (BG) concentrations in horses after a standard dose of oral carbohydrates. Sixteen horses were assigned to four intravenous treatments in a randomised cross-over design: saline (SAL), detomidine (0.02...
Evaluation of stability and safety of equine mesenchymal stem cells derived from amniotic fluid for clinical application.
Frontiers in veterinary science    February 14, 2024   Volume 11 1330009 doi: 10.3389/fvets.2024.1330009
Kim EY, Lee EJ, Kim RE, Kil TY, Kim MK.Amniotic fluid mesenchymal stem cells (AF-MSCs), which can be obtained from fetal tissue, reportedly have self-renewal capacity and multi-lineage differentiation potential. The aim of this study was to identify the biological characteristics of AF-MSCs and evaluate their stability and safety in long-term culture. To confirm the biological characteristics of AF-MSCs, morphology, proliferation capacity, karyotype, differentiation capacity, gene expression level, and immunophenotype were analyzed after isolating AF-MSCs from equine amniotic fluid. AF-MSCs were differentiated into adipocytes, chon...
The potential risks of equine serum therapy in transmitting new infectious diseases: lessons from a post-pandemic era.
Frontiers in public health    February 14, 2024   Volume 12 1366929 doi: 10.3389/fpubh.2024.1366929
Pucca MB, Camphora AL.No abstract available
Identification of the Reference Genes for Relative qRT-PCR Assay in Two Experimental Models of Rabbit and Horse Subcutaneous ASCs.
International journal of molecular sciences    February 14, 2024   Volume 25, Issue 4 2292 doi: 10.3390/ijms25042292
Ivanova Z, Petrova V, Grigorova N, Vachkova E.Obtaining accurate and reliable gene expression results in real-time RT-PCR (qRT-PCR) data analysis requires appropriate normalization by carefully selected reference genes, either a single or a combination of multiple housekeeping genes (HKGs). The optimal reference gene/s for normalization should demonstrate stable expression across varying conditions to diminish potential influences on the results. Despite the extensive database available, research data are lacking regarding the most appropriate HKGs for qRT-PCR data analysis in rabbit and horse adipose-derived stem cells (ASCs). Therefore,...
Efficacy of hippotherapy simulator exercise program in patients with stroke: a randomized single-blind clinical trial.
Topics in stroke rehabilitation    February 14, 2024   Volume 31, Issue 6 576-584 doi: 10.1080/10749357.2024.2310425
Öztürk S, Aydoğdu O, Sari Z.The aim of this study was to investigate the effect of hippotherapy simulator on balance, postural control, mobility, functional capacity and independence level in people with stroke. This study involved 26 people with stroke aged 18-65, who were randomly assigned to a Hippotherapy Simulator Group (HSG;  = 13) and a Conventional Exercise Group (CEG;  = 13). Patients underwent assessments using the Berg Balance Scale (BBS), Postural Assessment Scale for Stroke (PAS-S), Timed Up and Go Test (TUG), Rivermead Mobility Index (RMI), 2-Minute Walking Test (2-MWT), and Barthel Daily Living Act...
A Relaxed Horse-A Relaxed Client? An Experimental Investigation of the Effects of Therapy Horses’ Stress on Clients’ Stress, Mood, and Anxiety.
Animals : an open access journal from MDPI    February 13, 2024   Volume 14, Issue 4 604 doi: 10.3390/ani14040604
Müller-Klein A, Braun MN, Ferreira de Sá DS, Michael T, Link-Dorner U, Lass-Hennemann J.Equine-assisted therapies are becoming increasingly popular for addressing physical and psychological disabilities in clients. The role of the horse's welfare in equine-assisted service receives increasing attention in research. Several studies have shown that horses are able to perceive human emotions and respond to human stress responses. However, no research has yet looked at the other side of the coin-whether and how humans perceive and react to equine stress levels during equine-assisted services. To fill this gap in the research, we employed a within-subjects design, in which horse-naïv...
Refinement and revalidation of the Equine Ophthalmic Pain Scale: R-EOPS a new scale for ocular pain assessment in horses.
Veterinary journal (London, England : 1997)    February 13, 2024   106079 doi: 10.1016/j.tvjl.2024.106079
Nannarone S, Ortolani F, Scilimati N, Gialletti R, Menchetti L.This study addresses the refinement and revalidation of a composite pain scale that focuses on equine facial expressions and behavioural indicators as exhibitions of ophthalmic pain. This scale included only Behavioural and Facial and Ocular expression indicators and, compared to the first version of Equine Ophthalmic Pain Scale (EOPS), item descriptors and related ratings were changed. Thirteen horses with ocular diseases that required medical or surgical treatment were enrolled (group P). In each animal, the refined EOPS (R-EOPS) was applied prior to any treatment (T0) and one week later (T7...
Veterinarians and zoonotic pathogens, infections and diseases – questionnaire study and case series, Finland.
Infectious diseases (London, England)    February 12, 2024   Volume 56, Issue 5 384-392 doi: 10.1080/23744235.2024.2313662
Jokelainen P, Virtala AK, Raulo S, Kantele A, Vapalahti O, Kinnunen PM.Veterinarians are at risk for numerous zoonotic infections. In this paper, we summarise descriptions of zoonotic infections from a questionnaire study and a series of work-related zoonotic cases, aiming to add to the knowledge on occupational zoonotic risks of veterinarians. Unassigned: We collected data on zoonotic infections contracted by veterinarians in Finland in two studies:1) using a questionnaire in 2009, and 2) inviting veterinarians who had encountered an occupational zoonosis to report it in structured interviews in 2019. Unassigned: In the questionnaire study in 2009, of 306 veteri...
Retrospective Study of 25 Cases of Acorn Intoxication Colitis in Horses between 2011 and 2018 and Factors Associated with Non-Survival.
Animals : an open access journal from MDPI    February 12, 2024   Volume 14, Issue 4 599 doi: 10.3390/ani14040599
Hermange T, Ruault B, Couroucé A.The aim of this study is to describe clinical data associated with acorn intoxication and to find variables associated with survival. Data from horses presented at CISCO-ONIRIS from 2011 to 2018 with a diagnosis of acorn intoxication were included. Diagnosis was based on the following: season, the presence of acorns in the environment, clinical and hemato-biochemical parameters suggestive of a digestive/renal disease, the co-morbidity of companion animals, and post-mortem findings. Statistical analysis was completed using Student's t-test for mean comparisons and a Chi-square test for group co...
First Reported Circulation of Equine Influenza H3N8 Florida Clade 1 Virus in Horses in Italy.
Animals : an open access journal from MDPI    February 12, 2024   Volume 14, Issue 4 598 doi: 10.3390/ani14040598
Equine influenza (EI) is a highly contagious viral disease of equids characterized by pyrexia and respiratory signs. Like other influenza A viruses, antigenic drift or shift could lead to a vaccine-induced immunity breakdown if vaccine strains are not updated. The aim of this study was to genetically characterize EIV strains circulating in Italy, detected in PCR-positive samples collected from suspected cases, especially in the absence of formal active surveillance. Methods: Between February and April 2019, blood samples and nasal swabs collected from each of the 20 symptomatic horses from Nor...
Determination of sweetener specificity of horse gut-expressed sweet taste receptor T1R2-T1R3 and its significance for energy provision and hydration.
Frontiers in veterinary science    February 12, 2024   Volume 11 1325135 doi: 10.3389/fvets.2024.1325135
Smith L, Moran AW, Al-Rammahi M, Daly K, Shirazi-Beechey SP.Studies carried out in several species have demonstrated that detection of low-calorie sweeteners in the lumen of the intestine, by the sweet receptor, T1R2-T1R3, initiates a signaling pathway leading to enhanced expression and activity of intestinal Na/glucose cotransporter 1, SGLT1. This results in an increased gut capacity to absorb glucose, sodium chloride and water, the basis for oral rehydration therapy. Horses express T1R2, T1R3 and downstream signaling elements in the intestinal tissue. As such, the potential of sweetener-stimulation of T1R2-T1R3 leading to upregulation of SGLT1 allows...
Pharmacokinetics/pharmacodynamics cut-off determination for fosfomycin using Monte Carlo simulation in healthy horses.
The Journal of veterinary medical science    February 12, 2024   doi: 10.1292/jvms.23-0476
Kuroda T, Minamijima Y, Niwa H, Mita H, Tamura N, Fukuda K, Toutain PL, Ohta M.Fosfomycin (FOM) is an approved veterinary medicinal product for large animals in Japan, but Clinical breakpoint (CBP) for antimicrobial susceptibility test (AST) is not defined for animals. This study aimed at conducting a pharmacokinetics/pharmacodynamics (PK/PD) analysis to determine the PK/PD cutoff for the CBP in horses. Drug concentrations following single intravenous administration (IV) of 20 mg/kg body weight (BW) FOM in nine horses were measured using liquid chromatography/mass spectrometry. The data were modelled using a nonlinear mixed-effects model, followed by Monte Carlo simulati...
Low levels of microRNA-21 in neutrophil-derived exosomes may contribute to airway smooth muscle hyperproliferation in horses with severe asthma.
American journal of veterinary research    February 12, 2024   1-8 doi: 10.2460/ajvr.23.11.0267
Vargas A, Mainguy-Seers S, Boivin R, Lavoie JP.Neutrophilic inflammation is associated with the degree of airway obstruction in severe equine asthma (SEA), but the contribution of these leukocytes to bronchial remodeling remains ill defined. Neutrophils could cause structural alterations of the airways by the release of exosomes, a type of cell-derived nanoparticles that can modify the biology of local and distant cells. Neutrophil-derived exosomes have been shown to increase airway smooth muscle (ASM) cell proliferation in humans and horses. Therefore, this study aimed to identify neutrophil exosomal microRNAs (miRs) implicated in the reg...
A profile of occupational tasks performed by mounted police officers.
Work (Reading, Mass.)    February 10, 2024   Volume 77, Issue 4 1235-1244 doi: 10.3233/WOR-230283
Canetti EFD, Gersbach-Seib A, Moore R, Schram B, Orr R.Within individual policing organisations, there are a wide variety of units and job roles. Unassigned: To profile the occupational tasks performed by Australian mounted police officers, aiming to offer conditioning insight into this unique job role. Unassigned: Thirteen fully qualified and operational mounted police officers (n = 11 females), who served in the mounted police unit for ∼3.3 (±2.3) years, participated in this observational cohort study. Participants completed a survey outlining common occupational tasks and were monitored throughout four consecutive shifts. Participants' h...
Relationships between antral follicle count and reproductive characteristics of embryo-recipient mares.
Journal of equine veterinary science    February 10, 2024   Volume 134 105029 doi: 10.1016/j.jevs.2024.105029
Delchiaro SB, Oliveira PVLF, Júnior RJP, Gonçalves GD, Morotti F, Seneda MM.Mares (n = 77) were evaluated by antral follicle count (AFC) and selected as embryo recipients. Cyclic recipients received embryos between days 4-6 after ovulation. The acyclic recipients received an intramuscular (i.m.) protocol with 5mg of estradiol benzoate (EB) on the day of donor ovulation (D0; D-4 recipient), 3mg of EB on the following day (D1; D-3 recipient), and 3mg of EB (D2; D-2 recipient). Furthermore, 1500mg of progesterone (P4) i.m. given on D0 of the recipient (D4 donor) followed by 1500mg of P4 on the day of ET (D4-6 recipient). On the ET day, the AFC and animals' weight, body c...
Chicory (Cichorium intybus) reduces cyathostomin egg excretion and larval development in grazing horses.
International journal for parasitology. Drugs and drug resistance    February 9, 2024   Volume 24 100523 doi: 10.1016/j.ijpddr.2024.100523
Malsa J, Boudesocque-Delaye L, Wimel L, Auclair-Ronzaud J, Dumont B, Mach N, Reigner F, Guégnard F, Chereau A, Serreau D, Théry-Koné I, Sallé G....Cyathostomins are the most prevalent parasitic nematodes of grazing horses. They are responsible for colic and diarrhea in their hosts. After several decades of exposure to synthetic anthelmintics, they have evolved to become resistant to most compounds. In addition, the drug-associated environmental side-effects question their use in the field. Alternative control strategies, like bioactive forages, are needed to face these challenges. Among these, chicory (Cichorium intybus, Puna II cultivar (cv.)) is known to convey anthelmintic compounds and may control cyathostomins in grazing horses. To ...
Treatment of lidocaine-refractory ventricular tachycardia using procainamide in an anesthetized horse.
Journal of the American Veterinary Medical Association    February 9, 2024   Volume 262, Issue 5 1-3 doi: 10.2460/javma.23.09.0535
Fernandez-Barrientos MA, Flynn H, Ratliff B, Kilcoyne I.To highlight the use of procainamide as a potential alternative treatment modality in cases of ventricular tachycardia that are refractory to lidocaine and magnesium sulfate. Methods: 1 adult horse weighing 380 kg. Unassigned: A 25-year-old Arabian gelding presented with severe colic signs. Due to persistent pain, it was elected to carry out an exploratory laparotomy. During the procedure a diagnosis of severe, unstable ventricular tachycardia was made based on the ECG findings, with an initial heart rate of 195 beats per minute and severe hypotension. Results: Initial treatment consisted of d...
The Welfare of Horses Competing in Three-Barrel Race Events Is Shown to Be Not Inhibited by Short Intervals between Starts.
Animals : an open access journal from MDPI    February 9, 2024   Volume 14, Issue 4 583 doi: 10.3390/ani14040583
Filho HCM, Trindade KLG, Silva CJFL, Cruz RKS, Vilela CF, Coelho CS, Filho JDR, Manso HECCC.Equestrian sports require precise animal welfare and health evaluations. To test the hypothesis that horses maintain their welfare when subjected to two three-barrel (3TB) races with 2 min intervals, an experiment was designed to evaluate their surface temperature using infrared thermography (IRT) in regions of interest (barrel, flank, neck, jaw, corner of the mouth, and ocular caruncle) and also measure blood biomarkers (hemogram, total plasma protein, fibrinogen, urea, creatinine, GGT, CK, cortisol, IL-6, and IL-1β). Ten Quarter Horses were monitored through thermography (pre-race, +1, +4, ...
Detection of Crimean-Congo haemorrhagic fever virus in Hyalomma marginatum ticks, southern France, May 2022 and April 2023.
Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin    February 9, 2024   Volume 29, Issue 6 2400023 doi: 10.2807/1560-7917.ES.2024.29.6.2400023
Bernard C, Joly Kukla C, Rakotoarivony I, Duhayon M, Stachurski F, Huber K, Giupponi C, Zortman I, Holzmuller P, Pollet T, Jeanneau M, Mercey A....Crimean-Congo haemorrhagic fever (CCHF), a potentially severe zoonotic viral disease causing fever and haemorrhagic manifestations in humans. As the Crimean-Congo haemorrhagic fever virus (CCHFV) has been detected in ticks in Spain and antibodies against the virus in ruminant sera in Corsica, it was necessary to know more about the situation in France. In 2022-2023, CCHFV was detected in 155 ticks collected from horses and cattle in southern France.
The effects of food on the pharmacokinetics of mycophenolate mofetil in healthy horses.
Journal of veterinary pharmacology and therapeutics    February 9, 2024   doi: 10.1111/jvp.13430
Bello K, Lorch G, Papich MG, Kim K, Toribio RE, Yan L, Xie Z, Hill K, Phelps MA.Additional immunomodulatory treatment is needed for the management of immune-mediated disease in horses. Mycophenolate mofetil (MMF) is an immunomodulatory agent used in human and veterinary medicine for the prevention of graft rejection and the management of autoimmune diseases. Few studies exist investigating the pharmacokinetics of MMF in horses. The aim of this study was to evaluate the pharmacokinetics of a single dose of MMF in healthy horses in the fed vs. fasted state. Six healthy Standardbred mares were administered MMF 10 mg/kg by a nasogastric (NG) tube in a fed and fasted state. ...
Use of quantitative mass spectrometry-based proteomics and ELISA to compare the alpha 2 macroglobulin concentration in equine blood-based products processed by three different orthobiologic devices.
Frontiers in veterinary science    February 9, 2024   Volume 11 1335972 doi: 10.3389/fvets.2024.1335972
Ortved KF, Alward L, Cowles B, Linardi R, Barot D, Usimaki A, Fedie JR, Amodie D, Goodrich LR.Alpha 2 macroglobulin (A2M), a multi-functional protein in the plasma protease inhibitor class, regulates proinflammatory cytokines and the clearance of chondrodestructive enzymes in cases of joint injury and osteoarthritis (OA). The purpose of this study was to compare A2M concentrations in equine plasma samples processed by three commercial devices developed for stall-side regenerative joint therapy. Unassigned: Plasma samples were obtained from healthy adult horses ( = 13). Mass spectrometry analysis was used to determine the concentration of protein analytes in each sample. Selected re...
Prevalence and potential risk factors for Cryptosporidium spp. infection in horses from Egypt.
Comparative immunology, microbiology and infectious diseases    February 9, 2024   Volume 106 102140 doi: 10.1016/j.cimid.2024.102140
Alruhaili MH, Marzok M, Gattan HS, Salem M, Kandeel M, Selim A.Cryptosporidium is an intestinal protozoan that cause diarrhea in livestock all over the world and have zoonotic importance. The present study aimed to determine the prevalence of Cryptosporidium spp. in horses in Egypt and evaluate the associated risk factors. A total of 420 fecal samples were collected from three governorates (Giza, Kafr ElSheikh and Qalyubia) and examined microscopically using Ziehl-Neelsen staining method. The overall prevalence of Cryptosporidium spp. was 29% and Kafr ElSheikh governorate had the highest rate in comparison to other areas. The prevalence of Cryptosporidium...
Consensus guidelines for nomenclature of companion animal inherited retinal disorders.
Veterinary ophthalmology    February 9, 2024   doi: 10.1111/vop.13185
Mowat FM, Iwabe S, Aguirre GD, Petersen-Jones SM.Companion animals, namely dogs, cats, and horses, can be affected with many forms of hereditary retinal disease. The number of such diseases characterized in the last decade has increased substantially, and nomenclature is nonstandardized, heterogenous, and confusing. We provide in this viewpoint article consensus guidelines for naming of companion animal hereditary retinal diseases, either prospectively or retrospectively. These consensus guidelines have been developed with the purpose of standardizing nomenclature. We provide examples for the iterative nomenclature process and a comprehensiv...
Effectiveness of photo-ozone therapy against equine Pythium insidiosum.
Journal of equine veterinary science    February 9, 2024   Volume 134 105030 doi: 10.1016/j.jevs.2024.105030
Rodrigues VS, Trevisan LAC, Cintra BS, Pires RH, Ribeiro AB, Tavares DC, Oberhaus E, Ferreira JC.Cutaneous pythiosis is a life-threatening infectious disease. Low-level laser therapy (LLLT) and ozone (O3) have been used individually in the treatment of infected wounds. The goals of the study were a) to characterize the antimicrobial action of the photo-ozone therapy (LLLT-O3) against equine Pythium insidiosum, and b) to assess the cytotoxic potential of the LLLT-O3 in keratinocytes. Specimens of pathogen were isolated from 10 horses. After culturing, 120 hyphae plugs were distributed among four groups (n=30 hyphae plugs/group): LLLT (laser irradiation for 160 sec;), O3 (exposition to O3 f...
Methicillin-resistant Staphylococcus spp. investigation in hospitalized horses and contacting personnel in a teaching veterinary hospital.
Journal of equine veterinary science    February 8, 2024   Volume 134 105031 doi: 10.1016/j.jevs.2024.105031
Olivo G, Zakia LS, Ribeiro MG, da Cunha MLRS, Riboli DFM, Mello PL, Teixeira NB, de Araújo CET, Oliveira-Filho JP, Borges AS.Staphylococci are well-known opportunistic pathogens associated with suppurative diseases in humans and animals. Antimicrobial resistance is an emergent threat to humans and animals worldwide. This study investigated the prevalence of methicillin-resistant Staphylococcus spp. (MRS) in hospitalized horses and contacting personnel (veterinarians and staff), and assessed possible interspecies transmission in a teaching veterinary hospital. Nasal swabs from horses (n = 131) and humans (n = 35) were collected. The microorganisms were identified by traditional biochemical tests and genotypic methods...
Factors affecting measurement of basal adrenocorticotropic hormone in adult domestic equids: A scoping review.
Veterinary journal (London, England : 1997)    February 8, 2024   106071 doi: 10.1016/j.tvjl.2024.106071
Ireland JL, Lester A, Banse HE.Measurement of basal adrenocorticotropic hormone (ACTH) concentration is the most commonly used diagnostic test for pituitary pars intermedia dysfunction (PPID). Although several pre-analytical and analytical factors have been reported to affect basal ACTH concentrations in equids, the extent to which these have been evaluated in the context of PPID diagnosis is unclear. The objectives of this scoping review were to identify and systematically chart current evidence about pre-analytical and analytical factors affecting basal ACTH concentrations in adult domestic equids. Systematic searches of ...
Equine uveitis: Outcome and adverse effects after one or two intravitreal low-dose gentamicin injections.
Equine veterinary journal    February 8, 2024   Volume 57, Issue 1 160-168 doi: 10.1111/evj.14056
Morén S, Kallberg M, Strom L.Uveitis is common in horses, potentially turning chronic (persistent or recurrent) resulting in impaired vision or blindness. All mainstay therapeutics aims at controlling inflammation, but long-term or lifelong treatment is often needed with possibly severe side effects. Therefore, intravitreal injections with low-dose gentamicin (IVGI) have been used in attempt to give a long-lasting result with potentially less side effects. Objective: To retrospectively assess outcome and long-term complications following one or two low-dose IVGI in Swedish horses with chronic uveitis. Methods: Retrospecti...
Detection of paroxysmal atrial fibrillation preceding persistent atrial fibrillation in a horse using an implantable loop recorder with remote monitoring.
Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology    February 8, 2024   Volume 52 19-27 doi: 10.1016/j.jvc.2024.02.002
Vernemmen I, Van Steenkiste G, Decloedt A, Meert H, Walser U, van Loon G.Implantable loop recorders (ILRs) are increasingly used in equine cardiology to detect arrhythmias in the context of collapse, poor performance or monitoring for recurrence of atrial fibrillation (AF). However to date, the ILR has never been reported to be used with a remote monitoring functionality in horses, therefore the arrhythmia is only discovered when a clinician interrogates the ILR using dedicated equipment, which might delay diagnosis and intervention. This case report describes the use of an ILR with remote monitoring functionality in a horse with recurrent AF. The remote monitoring...
Patterns of Equine Small Strongyle Species Infection after Ivermectin Intervention in Thailand: Egg Reappearance Period and Nemabiome Metabarcoding Approach.
Animals : an open access journal from MDPI    February 8, 2024   Volume 14, Issue 4 574 doi: 10.3390/ani14040574
Hamad MH, Islam SI, Jitsamai W, Chinkangsadarn T, Naraporn D, Ouisuwan S, Taweethavonsawat P.The indiscriminate use of anthelmintics to control parasitic nematodes in horses has led to the emergence of anthelmintic resistance worldwide. However, there are no data available on using ivermectin for treating strongyle infections within domesticated horses in Thailand. Therefore, this study aimed to use the fecal egg count reduction (FECR) test to determine the strongylid egg reappearance period (ERP). Additionally, the nemabiome metabarcoding approach is incorporated to study patterns of strongyle species infection following ivermectin treatment. The study results indicate that, although...
Experiences of Interdisciplinary Working from the Perspective of the Society of Master Saddlers Qualified Saddle Fitters.
Animals : an open access journal from MDPI    February 7, 2024   Volume 14, Issue 4 559 doi: 10.3390/ani14040559
Nankervis K, MacKechnie-Guire R, Maddock C, Pyatt A.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...