Background: Children less than five years of age comprised approximately 30% in 2020 of foster care entries in the United States, and they are consistently the largest foster care entry group. Very young children can respond differently to the same adverse life events. Detection of complex interpersonal traumas is core to providing appropriate interventions and prevention of reoccurring negative outcomes in these children. Methods: Children who (1) were identified as having experienced complex interpersonal trauma, but (2) who did not have traumatic stress symptoms were identified using Child and Adolescent Needs and Strengths data in a large midwestern state from 2010 to 2021. A logistic model was fit to determine the effect of cumulative traumatic exposures (e.g., adverse childhood experiences such that increased events were hypothesized to predict an increased likelihood of symptomatic detection. We conducted a latent class analysis to understand the relationship between traumatic experiences, asset-based factors, and the detection of traumatic stress in children aged five years and under who had exposure to traumatic events but did not have detectable traumatic stress symptoms. Results: We detected three classes within this population of very young children, who were described as “resilient” (demonstrating asset-based resilience when faced with traumatic experiences), “missed” (those who exhibit behavioral and mental health types like those with detected traumatic stress symptoms but who were not detected as such), and “unfolding”. Very young children do demonstrate asset-based resilience when faced with traumatic experiences. Conclusions: Detection of traumatic stress may be more difficult in young children. It is important to assess both traumatic stress and strengths to ensure that children who are resilient after exposure to traumatic experiences (i.e., do not demonstrate traumatic stress symptoms) are not referred to unnecessary interventions. Additional educational approaches are needed to help caseworkers identify symptoms of traumatic stress that mirror symptoms of other behavioral and emotional challenges. Precision medicine approaches are required to best match the interventions to specific needs of young children. Recognition of resilience in very young children is critical for designing systems that customize approaches of trauma-informed care.

Background: Over 75% of American adults are not meeting aerobic and muscular physical activity recommendations, with the majority being females. Equestrian activities are a potential avenue to increase physical activity, especially in females who account for approximately 90% of sport participants. This study describes perceptions of equestrian activities and establishes the patterns of self-reported equestrian, barn work, and nonequestrian physical activity engagement to understand participation in activities that may sustain physical activity across the lifespan. Methods: American equestrians (n = 2551) completed an anonymous online survey with questions about perceptions and benefits of equestrian activities, demographics, and engagement in equestrian activities, barn work, and nonequestrian activities. Results: There were 2039 completed responses, (95.6% female), with representation from all regions of the United States. Professionals (20.6%), amateurs (39.1%), and recreational (40.3%) comprised participation status. Significantly fewer recreational participants perceived equestrian as physical activity and as a sport than amateurs (P < .05) and professionals (P < .05). Engagement in equestrian and barn work physical activity was significantly higher in professionals (P < .0001), followed by amateurs (P < .0001), with the lowest in recreational equestrians (P = .001). Professional and amateur equestrians engaged in significantly more nonequestrian physical activity than recreational participants (P < .05). Conclusions: Equestrian physical activity engagement is dependent on the status of participation. Equestrian, barn work, and nonequestrian physical activity do meet physical activity aerobic and muscular recommendations and should be encouraged as a physical activity for females across the lifespan.

The foundation of healthy workplace design is an understanding of work practices. Volunteers comprise the majority of the workforce in care centers using horses to address human health issues. Documentation is lacking on protections for worker well-being in equestrian microenvironments which are known to have the potential for dust exposures. Climate acts as a master variable in equestrian facility design and ventilation usage to address dust and temperature concerns. Using climate as an independent variable, our objective was to characterize space usage, safety, environmental control, and organizational practices through a national survey of equine assisted programs. We found that more fully enclosed indoor arena spaces were in cold/very cold and mixed-humid climates (p = 0.0114). Annually more volunteers (p = 0.0073) work in these two climate groups averaging 100 volunteers per location. A total of 34% of all facilities, regardless of climate, do not use mechanical ventilation systems (e.g., fans). As volunteer worker time in the arena increased, time in the barn microenvironment tended to decrease (p = 0.0538). We identified facility designs, ventilation usage, and worker arrangements to refine the scalability of future air contaminant monitoring and to provide frameworks for education, workplace design, and prevention of exposure to dust.

The use of trauma databases for epidemiological study of equestrian injuries is well established. However, such databases fail to capture minor injuries or injuries when medical attention is not sought. Additionally, concerns about chronic pain in equestrians have only been explored in small samples. The current study is the first nationwide survey of American equestrians 12 years and older participating in all equestrian disciplines. This study aimed to evaluate the patterns of self-reported acute injuries, behaviours of seeking medical attention for acute injuries, and chronic pain. A convenience sample of 2,573 American equestrians completed an anonymous online survey with questions on acute injury anatomical region, type, and if they sought medical attention. Additional questions identified frequency and location of chronic pain. In total, 2,049 survey responses were complete, with 96% female and representation from all regions of the United States. Participation status (PS) was categorised as professionals (19%), amateurs (43%), and recreational (38%). PS was associated with acute injury and chronic pain frequency. Only 3.9% had never experienced an acute injury from equestrian activity. Of all injuries, foot injuries were most reported (13% of all injuries; 52% of participants) with only 39% seeking medical attention. Professionals had higher odds of experiencing acute injuries in most anatomical regions. 42% indicated they had encountered a concussion; of those, 71% sought medical assistance due to a suspected concussion. Chronic back pain frequency was reported at 27.5%. This study is the first to evaluate self-reported injury in a large convenience sample of American equestrians. The current study found a higher rate of lower extremity injuries in equestrians than previously captured in trauma databases. Prior concussion and acute injury increased the odds of individuals experiencing regional chronic pain, suggesting that future studies and interventions should focus on improving preventative and rehabilitative care. The use of trauma databases for epidemiological study of equestrian injuries is well established. However, such databases fail to capture minor injuries or injuries when medical attention is not sought. Additionally, concerns about chronic pain in equestrians have only been explored in small samples. The current study is the first nationwide survey of American equestrians 12 years and older participating in all equestrian disciplines. This study aimed to evaluate the patterns of self-reported acute injuries, behaviours of seeking medical attention for acute injuries, and chronic pain. A convenience sample of 2,573 American equestrians completed an anonymous online survey with questions on acute injury anatomical region, type, and if they sought medical attention. Additional questions identified frequency and location of chronic pain. In total, 2,049 survey responses were complete, with 96% female and representation from all regions of the United States. Participation status (PS) was categorised as professionals (19%), amateurs (43%), and recreational (38%). PS was associated with acute injury and chronic pain frequency. Only 3.9% had never experienced an acute injury from equestrian activity. Of all injuries, foot injuries were most reported (13% of all injuries; 52% of participants) with only 39% seeking medical attention. Professionals had higher odds of experiencing acute injuries in most anatomical regions. 42% indicated they had encountered a concussion; of those, 71% sought medical assistance due to a suspected concussion. Chronic back pain frequency was reported at 27.5%. This study is the first to evaluate self-reported injury in a large convenience sample of American equestrians. The current study found a higher rate of lower extremity injuries in equestrians than previously captured in trauma databases. Prior concussion and acute injury increased the odds of individuals experiencing regional chronic pain, suggesting that future studies and interventions should focus on improving preventative and rehabilitative care. The use of trauma databases for epidemiological study of equestrian injuries is well established. However, such databases fail to capture minor injuries or injuries when medical attention is not sought. Additionally, concerns about chronic pain in equestrians have only been explored in small samples. The current study is the first nationwide survey of American equestrians 12 years and older participating in all equestrian disciplines. This study aimed to evaluate the patterns of self-reported acute injuries, behaviours of seeking medical attention for acute injuries, and chronic pain. A convenience sample of 2,573 American equestrians completed an anonymous online survey with questions on acute injury anatomical region, type, and if they sought medical attention. Additional questions identified frequency and location of chronic pain. In total, 2,049 survey responses were complete, with 96% female and representation from all regions of the United States. Participation status (PS) was categorised as professionals (19%), amateurs (43%), and recreational (38%). PS was associated with acute injury and chronic pain frequency. Only 3.9% had never experienced an acute injury from equestrian activity. Of all injuries, foot injuries were most reported (13% of all injuries; 52% of participants) with only 39% seeking medical attention. Professionals had higher odds of experiencing acute injuries in most anatomical regions. 42% indicated they had encountered a concussion; of those, 71% sought medical assistance due to a suspected concussion. Chronic back pain frequency was reported at 27.5%. This study is the first to evaluate self-reported injury in a large convenience sample of American equestrians. The current study found a higher rate of lower extremity injuries in equestrians than previously captured in trauma databases. Prior concussion and acute...

Equestrian sport has various welfare issues and educational needs. To address these complex interactions, we propose an integrated approach called the Triple-E Model, which focuses on the equine, equestrian, and environmental triad. A literature review of existing models suggests that complexities of these interactions are overlooked, despite the significant impact of equine industries on economics, healthcare, and animal welfare. This paper discusses current models and theories used to evaluate equine–equestrian–environmental interactions and introduces the Triple-E Model to foster multidisciplinary collaboration. Unlike the One Health triad, which focuses on disease emergence, transmission, and zoonosis, the Triple-E Model extends to non-infectious research, such as musculoskeletal injury. It promotes collaborative care and rehabilitation within the equestrian community by engaging multidisciplinary, multi-setting, and multi-sectoral teams. Given the nature of human–animal interaction and welfare considerations, this model fills the gap in understanding human–horse interactions. The paper highlights the limitations of existing models and explains how the Triple-E Model guides and encourages holistic team collaboration in the equestrian community.

"Corrigendum on: Self-reported acute injury and chronic pain in American equestrian athletes" published on 16 Jan 2024 by Wageningen Academic.