Assistance Dogs: Historic Patterns and Roles of Dogs Placed by ADI or IGDF Accredited Facilities and by Non-Accredited U.S. Facilities

Rabies incidence and burden in three cities of Cameroon (2004-2013)

Rabies is a fatal disease occurring worldwide and especially in almost all the countries in Asia and Africa including Cameroon. Though animal and human rabies is prevalent in Cameroon, the epidemiology and socio-economic burden of the disease in the country is not known. Therefore, a 10-year (October 2004-April 2013) retrospective study on the incidence of animal and human rabies and its burden in Garoua, Ngaoundéré and Yaoundé in Cameroon was carried out. Records of human cases were extracted from the database of the regional hospitals, and animal cases from the databases of Centre Pasteur and National Veterinary Laboratory. The burden of the disease was assessed through the estimation of costs linked to preventive measures (vaccination), corrective procedures (Post Exposure Treatment), Disability-Adjusted Life Year (DALY) and overall societal cost of the disease. Overall, 56 rabies-suspected human deaths, corresponding to an incidence of 0.02 ± 0.00 ‱ and Animal Rabies Incidence (ARI) of 0.37 ± 0.00 % among 1844 suspected animal cases were recorded. The economic loss due to preventive measures of 326,046 ± 28,130.85 USD, related to corrective procedures of 806,741.25 ± 2,466.08 USD, and DALY of 1690.28 ± 4.76 years were estimated. This is the first study that highlights the enormous socio-economic burden associated with animal and human rabies in endemic parts of Cameroon and emphasizes on enhancing rabies eradication strategy focusing on the One Health approach.

Examining the relationship between different naturally-occurring maxillary beak shapes and their ability to cause damage in commercial laying hens

1. Using chicken models to avoid unnecessary harm, this study examined the relationship between naturally-occurring maxillary (top) beak shapes and their ability to cause pecking damage.2. A selection of 24 Lohmann Brown laying hens from a total population of 100 were sorted into two groups based on their maxillary beak shape, where 12 were classified as having sharp beaks (SB) and 12 as having blunt beaks (BB).3. All hens were recorded six times in a test pen which contained a chicken model (foam block covered with feathered chicken skin) and a video camera. During each test session, the number of feathers removed from the model, the change in skin and block weight (proxies for tissue damage) and the percentage of successful pecks (resulting in feather and/or tissue removal) were recorded.4. SB hens removed more feathers from the model and had a greater change in skin weight than BB hens. The mean number of pecks made at the model did not differ between the beak shape groups; however, SB hens had a greater percentage of successful pecks, resulting in feather and/or tissue removal, compared to BB hens.5. In conclusion, SB hens were more capable of removing feathers and causing damage. Birds performed more successful pecks resulting in feather and/or tissue removal as they gained experience pecking at the model.

The effects of service dogs for children with autism spectrum disorder and their caregivers: a cross-sectional study

Introduction

Service dogs are an increasingly popular complementary intervention for children with autism spectrum disorder. However, despite increasing demand, there remains a lack of empirical research on their potential benefits. The purpose of this study was to evaluate the effects of service dogs on children with autism and their caregivers.

Methods

A total of N = 75 families of children with autism were recruited from a non-profit service dog provider in the US, including n = 39 families previously placed with a service dog and n = 36 families engaging in usual care while on the waitlist. Caregivers completed an online survey containing both self- and proxy-report standardized measures of child, caregiver, and family functioning. Linear regressions modeled the relationship between service dog presence and survey outcomes, controlling for relevant child and caregiver covariates.

Results

Results indicated that having a service dog was associated with significantly better child sleep behaviors, including better sleep initiation and duration and less sleep anxiety/co-sleeping with medium effect sizes. However, service dog presence was not significantly related to child withdrawal, negative emotionality, emotional self-control, hyperactivity, irritability, and lethargy with small effect sizes. For caregivers, having a service dog was not significantly related to standardized measures of caregiver strain, sleep disturbance, depression, or the impact of the child's condition on family functioning with small effect sizes. Supplemental matched case-control analyses confirmed these findings.

Discussion

In conclusion, service dogs were found to positively impact sleep behaviors among children with autism, but may not uniformly relate to other areas of child and caregiver wellbeing. Prospective longitudinal designs, larger sample sizes able to detect small effects, and studies that measure sleep using objective methods are needed to build on these findings.

Benefits and challenges of mobility and medical alert service dogs for caregivers of service dog recipients

PURPOSE

Mobility and medical alert service dogs are an assistive technology for individuals with disabilities or chronic conditions. Informal caregivers of individuals with disabilities are subject to physical and emotional stress due to their responsibilities. Understanding how service dogs, an increasingly common assistive technology, may add to or subtract from caregiver stress is crucial for promoting caregiver well-being. The purpose of this study was to analyze caregiver accounts to understand their perspective on benefits and challenges they face with mobility and medical alert service dogs.

MATERIALS AND METHODS

Open ended survey responses from 117 caregivers of service dog recipients (N = 72 with a service dog, N = 45 on the waitlist) were analysed through a conventional content analysis.

RESULTS

Four major themes were found regarding caregiver and service dog: Family Benefits, Caregiver Benefits, Assistance Through Service Dog's Training, and Drawbacks.

CONCLUSIONS

Findings suggest that benefits and challenges of mobility and medical service dogs extend beyond the service dog recipient, affecting the caregiver and other family members as well. Future studies should further explore this interaction to determine the best way to support caregivers of individuals with disabilities.IMPLICATIONS FOR REHABILITATIONMobility and medical alert service dogs are increasingly partnered with individuals with disabilities or chronic diseases as an assistive technology but few studies have focussed on the experience of the caregivers of service dog recipients. Caregivers of individuals with disabilities or chronic diseases may be subject to both psychological and physiological stressors as a result of their caregiver duties.Results found that caregivers perceive both benefits to themselves and to their families in terms building a bond with the animal that helps to reduce worry and offers emotional support. The most commonly mentioned drawbacks include general maintenance of the service dog, grooming needs and travel restrictions.This research is important in order to offer appropriate support to caregivers of individuals with disabilities.

Service dogs for autistic children and family system functioning: a constant comparative analysis

Introduction

Service dog placements for autistic children are growing in popularity, yet findings to date are mixed. Moreover, no study to date has examined these placements through the lens of a recognized theoretical model. The purpose of this study is twofold: to explore experiences reported by caretakers of autistic children involved in a service dog program, and to contextualize findings within an established theoretical framework.

Methods

A total of n = 50 caretakers of autistic children (n = 38 with and n = 12 without a service dog) were recruited through the national non-profit service dog provider Canine Companions. Participants completed an online survey through Qualtrics which asked open-ended questions about their experiences, both negative and positive.

Results

Constant comparative analysis identified two high level themes, nested within a family systems approach framework: (1) Enhancing social functioning of the family system unit and (2) Fostering stability and strength within family system subunits. These themes interacted holistically to foster and reinforce family system resilience. Placements led to greater social inclusion for children and their families, acted as a highly individualized intervention, and decreased experiences of judgement and stigma. Perceived as members of the family, service dogs may coregulate with the autistic child and family members and can be a source of joyful connection within the family.

Discussion

Results highlighted the service dog's influence on the entire family (beyond the autistic child). Implications for service dog organizations suggest it may be helpful to account for family-wide impacts throughout the placement process. High standards on the part of provider organizations may minimize negatives, optimizing outcomes for both humans and canines. Ultimately, findings enrich our understanding of service dog interventions for autistic children.

Psychiatric service dog placements are associated with better daily psychosocial functioning for military veterans with posttraumatic stress disorder

OBJECTIVE

Psychiatric service dog placements may benefit psychosocial functioning for veterans with posttraumatic stress disorder (PTSD), however, these effects have never been examined directly in daily life. This nonrandomized longitudinal clinical trial quantified the efficacy of psychiatric service dogs for daily psychosocial functioning among N = 168 veterans with PTSD using ecological momentary assessment (EMA).

METHOD

EMA data were collected twice daily for 2 weeks at each assessment period (0 and 3 months), totaling 9,408 survey responses (2 Assessments × 14 Days × 2 Prompts × 168 Participants).

RESULTS

At follow-up, regression analysis identified associations between service dog placement and better perceived social interaction quality (β = 0.42, p < .05), better affect (negative affect: β = -2.64, p < .001; positive affect: β = 2.44, p < .001), and lower odds of panic attacks (OR = 0.68, p < .05). Social participation results were mixed: placements were associated with greater activity participation (β = 3.21, p < .001) but lower odds of being away from home (OR = 0.77, p < .05), indicating possible support for anecdotes that public stigma is an obstacle to community participation.

CONCLUSIONS

Results further revealed that the service dog's trained tasks may be particularly important for social functioning outcomes, and the service dog's presence for emotional functioning outcomes. Findings highlight a need for education surrounding service dog etiquette and reveal potential mechanisms underlying psychiatric service dog placements. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Decision-Making on Recommended Age of Spay/Neuter for a Specific Dog: General Principles and Cultural Complexities

Many dogs and cats were euthanized in US animal shelters through the 1940s, sharply declining in the 1980s. Early age neutering of young cats and dogs grew frequent in the 1990s; adoptions from shelters increased, leading to a decline in shelter euthanasia of dogs. Several publications, beginning in 2013, revealed heightened risks of joint disorders and some cancers for some dog breeds when neutered at young ages. These risks are breed-, gender-, and body-size specific and related to neutering age. Current guidelines suggest making a personalized decision for each dog's neutering age. Recommendations are presented for 40 breeds and mixed-breed weight classes.

Current Perspectives on the Challenges of Implementing Assistance Dogs in Human Mental Health Care

The prevalence of mental health disorders, driven by current global crises, is notably high. During the past decades, the popularity of dogs assisting humans with a wide spectrum of mental health disorders has significantly increased. Notwithstanding these dogs' doubtless value, research on their legal status, certification processes, training and management practices, as well as their welfare status, has been scarce. This scoping review highlights that in contrast to other assistance dogs such as guide dogs, there exists no consistent terminology to mark dogs that assist humans with impaired mental health. Legal authorities monitoring the accreditation process, training and tracking of mental health supporting dogs are broadly lacking, with only few exceptions. This review emphasizes the need to address several topics in the promotion of progress in legal and welfare issues related to assistance dogs as well as emotional support dogs for humans with a mental health disorder. The current body of knowledge was assessed in three different areas of focus: (1) the legal dimension including definitions and certification processes; (2) the dimension of performed tasks; and (3) the dog welfare dimension including aspects of the relationship with the handler and risks associated with children recipients. Considering the challenges associated with a mental health diagnosis, collaborations of dog provider organizations and health care professionals would be desirable to continuously assess the efficiency of the human-dog dyad regarding their overall compatibility, general satisfaction and mutual well-being.

Assistance dogs for military veterans with PTSD: A systematic review, meta-analysis, and meta-synthesis

Psychiatric assistance dogs for military veterans with posttraumatic stress disorder (PTSD) currently make up over 19% of assistance dog partnerships globally. We conducted a systematic review of the literature relating to these partnerships, with specific aims to (1) summarize their characteristics, (2) evaluate the quality of existing evidence, and (3) summarize outcomes. A total of 432 records were independently screened (Cohen’s kappa = 0.90). Of these, 41 articles (29 peer-reviewed publications and 12 unpublished dissertations) met inclusion criteria. Data extraction was conducted to address the research aims, including a meta-analysis (quantitative outcomes) and meta-synthesis (qualitative outcomes). All peer-reviewed publications on the topic of psychiatric assistance dogs for veterans with PTSD were published within the last five years. The majority of included articles were quantitative (53%), 41% were qualitative, and 6% employed mixed methods. Mean methodological rigor scores were 80% for peer reviewed articles and 71% for dissertations, where higher scores represent more rigorous methodology. Quantitative articles reported significant improvements in the domains of PTSD severity, mental health, and social health. Impacts on physical health and global quality of life appear inconclusive. Meta-analysis (9 articles) revealed that partnership with an assistance dog had a clinically meaningful, significant, and large effect on PTSD severity scores (g = −1.129; p<0.0001). Qualitative meta-synthesis identified two third order constructs: (1) Impact on the individual: mental & physical health and (2) Impact beyond the individual: building relationships & connection. This synthesis of increasingly prevalent research on assistance dogs for veterans with PTSD provides support for the impact of this complementary and integrative health intervention on PTSD symptom severity, and signs of meaningful improvements in adjacent domains including mental and social health. Gaps between quantitative and qualitative findings, along with the need to report greater demographic detail, highlight key opportunities for future research.

Application of a modified Poisson model in identifying factors associated with prevalence of pregnancy termination among women aged 15 - 49 years in Uganda

Background

Abortion in Uganda is illegal, only permitted when it places the pregnant mother at risk. This study aimed to apply the modified Poisson model in identifying factors associated with the prevalence of pregnancy termination among women of reproductive age in Uganda.

Methods

The 2016 Uganda Demographic Health Survey (UDHS) data were used in this study. More than 18,000 women of the age of 15 - 49 years participated in this study. A modified Poisson model that incorporated sampling weights was used to establish the factors associated with pregnancy termination.

Results

In Uganda, 18,506 (18.1%) had ever had a pregnancy terminated. The results revealed that, the woman's age [APR = 3.15, 95% CI: 2.72-3.63], being married [APR = 1.55, 95% CI: 1.40-1.71], mass media exposure [APR = 1.18, 95% CI: 1.08-1.29], working status [APR = 1.21, 95% CI: 1.09-1.35], and having visited a health facility [APR = 1.20, 95% CI: 1.10-1.31] were positively significantly associated with likelihood of pregnancy termination.

Conclusion

There exists a significant proportion of women who have had their pregnancies terminated in Uganda. It is observed that woman's age, marital status, mass media exposure, having visited a health facility in the last 12 months and working status were main predictors. Based on these results, researchers concluded that the emphasis should be put on improving access to post-abortion care, contraceptive use and media exposure.

Defining Terms Used for Animals Working in Support Roles for People with Support Needs

Simple Summary

Although animals are being employed for a growing number of roles to support people, the terms used to describe those animals (e.g., “therapy animal” and “emotional support animal”) can be confusing. The same term may be used to describe different types of work, or the same role can be described with different terms. This paper presents the results of a collaboration between over 100 researchers, practitioners, and end users of animal-based supports from all over the world. We created working definitions for the following nine terms: “assistance animal”, “companion animal”, “educational/school support animal”, “emotional support animal”, “facility animal”, “service animal”, “skilled companion animal”, “therapy animal”, and “visiting/visitation animal”. In this paper, we describe the defining characteristics of each animal type and how it is different from the other types. We recommend phasing out the terms “skilled companion animal” and “service animal”, because they are similar to other terms. We discuss how our definitions may be received in different parts of the world.

Abstract

The nomenclature used to describe animals working in roles supporting people can be confusing. The same term may be used to describe different roles, or two terms may mean the same thing. This confusion is evident among researchers, practitioners, and end users. Because certain animal roles are provided with legal protections and/or government-funding support in some jurisdictions, it is necessary to clearly define the existing terms to avoid confusion. The aim of this paper is to provide operationalized definitions for nine terms, which would be useful in many world regions: “assistance animal”, “companion animal”, “educational/school support animal”, “emotional support animal”, “facility animal”, “service animal”, “skilled companion animal”, “therapy animal”, and “visiting/visitation animal”. At the International Society for Anthrozoology (ISAZ) conferences in 2018 and 2020, over 100 delegates participated in workshops to define these terms, many of whom co-authored this paper. Through an iterative process, we have defined the nine terms and explained how they differ from each other. We recommend phasing out two terms (i.e., “skilled companion animal” and “service animal”) due to overlap with other terms that could potentially exacerbate confusion. The implications for several regions of the world are discussed.

Dog Behaviour Prediction Testing

Dogs exhibit behavioural heterogeneity as a result of their close proximity to people as pets, working animals, or research animals. This variability stems from their natural talents as well as contextual effects. This document examines the several types of dog behavioural tests, including those that are used to evaluate dogs and others that are used to categorize individual animals. This study revealed a lack of agreement on all of these testing procedures. Individual variations in behaviour, or personality differences, may now be quantified and described in the working dog literature. The predictive association between certain dog behavioural features (if any) and crucial working results is less well-known.

A Scoping Review of the Benefits and Challenges of Using Service Dogs for Finding and Maintaining Employment

Purpose Having a service dog can help increase the independence of people with disabilities and they are considered a reasonable accommodation within employment settings. The objective of this scoping review was to understand the benefits and challenges of using a service dog in gaining and maintaining employment. Methods Systematic searches of seven international databases led to 19 studies meeting our inclusion criteria. Using a narrative review approach, we analyzed these studies regarding their sample characteristics, methods, results and quality of evidence. Results Nineteen studies were included in the review, which spanned across 6 countries over a 24-year period. Our findings showed that the benefits of having a service dog included improvements in employment status, employers' recognition of service dogs as a workplace accommodation, lower absenteeism, ability to travel to work, and other career-related benefits. Challenges with having a service dog included discrimination and exclusion, and lack of employers' awareness of service dogs and people with disabilities. Conclusions Our findings highlight several benefits and challenges of having a service dog in the workplace. More research is needed to explore the impact of service dogs on employment, health and productivity in the workplace and how this may vary by type of disability and service dog.

2021 AAHA Working, Assistance, and Therapy Dog Guidelines

The guidelines are the first comprehensive consensus report on veterinary healthcare recommendations for working, assistance, and therapy dogs. This category of canine patients includes a broad assortment of animals, some with well-defined functions and others that provide a more generalized support role. The guidelines discuss recommendations for dogs trained for protection, odor/scent detection, service functions for people with diagnosed disabilities or physical limitations, emotional support, and therapeutic intervention. Although the term is often used to describe dogs providing animal-assisted activities, true therapy dogs provide goal-directed therapy, often under the supervision of a healthcare professional such as an occupational therapist or psychologist. Many working dogs undergo extensive training and have rigorous physical demands placed upon them. These factors make working, assistance, and therapy dogs inherently valuable and impose a need for a high level of primary veterinary care as described in the guidelines. Because working dogs have a particularly close relationship with their handlers, a trust relationship between the practice team and the working-dog client is imperative.

Hearing dogs for people with severe and profound hearing loss: a wait-list design randomised controlled trial investigating their effectiveness and cost-effectiveness

Background

Hearing loss increases the risk of poor outcomes across a range of life domains. Where hearing loss is severe or profound, audiological interventions and rehabilitation have limited impact. Hearing dogs offer an alternative, or additional, intervention. They live permanently with recipients, providing sound support and companionship.

Methods

A single-centre, randomised controlled trial (RCT) evaluated the impacts of a hearing dog on mental well-being, anxiety, depression, problems associated with hearing loss (responding to sounds, fearfulness/social isolation), and perceived dependency on others. Participants were applicants to the UK charity ‘Hearing Dogs for Deaf People’. Eligibility criteria were as follows: first-time applicant; applying for a hearing dog (as opposed to other support provided by the charity). Participants were randomised 1:1 to the following: receive a hearing dog sooner than usual [HD], or within the usual application timeframe (wait-list [WL] comparator). The primary outcome was mental well-being (Short Warwick-Edinburgh Mental Well-Being Scale) 6 months (T1) after HD received a hearing dog. The cost-effectiveness analysis took a health and social care perspective.

Results

In total, 165 participants were randomised (HD n = 83, WL n = 82). A total of 112 (67.9%) were included in the primary analysis (HD n = 55, WL n = 57). At T1, mental well-being was significantly higher in the HD arm (adjusted mean difference 2.53, 95% CI 1.27 to 3.79, p < 0.001). Significant improvements in anxiety, depression, functioning, fearfulness/social isolation, and perceived dependency, favouring the HD arm, were also observed. On average, HD participants had used fewer statutory health and social care resources. In a scenario whereby costs of provision were borne by the public sector, hearing dogs do not appear to be value for money. If the public sector made a partial contribution, it is possible that hearing dogs would be cost-effective from a public sector perspective.

Conclusions

Hearing dogs appear to benefit recipients across a number of life domains, at least in the short term. Within the current funding model (costs entirely borne by the charity), hearing dogs are cost-effective from the public sector perspective. Whilst it would not be cost-effective to fully fund the provision of hearing dogs by the public sector, a partial contribution could be explored.

Trial registration

The trial was retrospectively registered with the International Standard Randomised Controlled Trial Number (ISRCTN) registry on 28.1.2019: ISRCTN36452009.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-021-05607-9.

Visual Exploration and Observation of Real-Life Interactions Between Children with ASD and Service Dogs

Two original studies explored relationships between visual attention of children with ASD (candidates for receiving a service dog) and their behaviors during their first interaction with a service dog. The first study consisted in video behavioural analyses of 16 children with ASD interacting with a service dog. During the interaction with a service dog, the time children with ASD spent looking towards social items vs objects was associated with how they interacted with the service dog. The second study was exploratory (i.e. 6 children), using the same behavioural approach but coupled with eye-tracking data. The more children with ASD looked at both their parent and the evaluator, as opposed to inanimate items, the more they interacted with the service dog.

Assistance, Service, Emotional Support, and Therapy Dogs

This article focuses on the areas where harnessing the canine's trainability, mobility, and sociability enables their use for aiding and augmenting humans. This area, which is rapidly expanding, has provided life-changing solutions for persons affected by various impairments and disabilities (eg, visual, hearing, physical, mental).

Enhancing the Selection and Performance of Working Dogs

Dogs perform a variety of integral roles in our society, engaging in work ranging from assistance (e.g., service dogs, guide dogs) and therapy to detection (e.g., search-and-rescue dogs, explosive detection dogs) and protection (e.g., military and law enforcement dogs). However, success in these roles, which requires dogs to meet challenging behavioral criteria and to undergo extensive training, is far from guaranteed. Therefore, enhancing the selection process is critical for the effectiveness and efficiency of working dog programs and has the potential to optimize how resources are invested in these programs, increase the number of available working dogs, and improve working dog welfare. In this paper, we review two main approaches for achieving this goal: (1) developing selection tests and criteria that can efficiently and effectively identify ideal candidates from the overall pool of candidate dogs, and (2) developing approaches to enhance performance, both at the individual and population level, via improvements in rearing, training, and breeding. We summarize key findings from the empirical literature regarding best practices for assessing, selecting, and improving working dogs, and conclude with future steps and recommendations for working dog organizations, breeders, trainers, and researchers.

The Effect of a PTSD Service Dog on Military Veterans' Medication Regimens: A Cross-Sectional Pilot Study

Recent research suggests that service dogs may have clinically-relevant benefits for military veterans with posttraumatic stress disorder (PTSD). However, the effects of PTSD service dogs on veterans' medication use has been largely unexplored. The objective of this study was to quantify the effect of PTSD service dogs on medication use among a population of military veterans with PTSD. In a cross-sectional design, United States post-9/11 military veterans with PTSD were recruited from a single service dog provider including veterans living with a PTSD service dog (n = 52) and veterans on the waitlist (n = 44). Both populations of veterans received treatment as usual. Participants completed an online survey of self-reported medication regimens and medication changes. Regression models quantified the effect of having a service dog on physical health, mental health, pain, and sleep medications while controlling for confounding variables (age, sex, relationship status, traumatic brain injuries, and physical health). Results indicated that there were no significant effects of having a service dog on overall self-reported medication use nor any specific medication category (p's > 0.06). However, veterans with a service dog were more likely than those on the waitlist to report that their doctor had decreased dosage or removed medications since getting their service dog. The results of this preliminary cross-sectional research should be interpreted with caution, as future within-subject and pharmacy-verified research is necessary to understand the causality of these findings.

The End of the Partnership With a Guide Dog: Emotional Responses, Effects on Quality of Life and Relationships With Subsequent Dogs

Guide dogs are mobility aids that facilitate independent travel of people who are blind or visually impaired. Additional benefits imparted to the guide dog handler include companionship, and increased: social-function, self-esteem and confidence. Some evidence shows that the end of the guide dog partnership can result in reduced mobility, and may have profound psychosocial effects on the handler due to feelings of bereavement and loss of self-esteem. However, this evidence is limited. This study examined the experiences and feelings of 36 people across New Zealand, who experienced the ending of at least one partnership with a guide dog (77 pairings), to explore issues arising at the end of the partnership and how this may impact on relationships with subsequent dogs. Results indicate that the majority of handlers experienced a reduction in their quality of life due to a decrease in independent mobility followed by the loss of a friend and companion, curtailment of social interactions, and loss of self-esteem/confidence. The end of the partnership affected people in different ways. Most handlers “accepted” the partnership had ended, but some felt guilty or angry with the guide dog school. Most applied for another dog immediately, as the need for mobility was high, while others preferred to wait and a smaller number did not reapply. Feelings at this time also affected the handlers' relationships with subsequent guide dogs, with over a quarter expressing a negative effect. Retiring a guide dog (for whatever reason) is not only difficult for the handler, but also for the handler's family, friends, co-workers, and doubtlessly, the dog. The majority of handlers expressed feelings of extreme grief when the partnership ended, whether it was successful or not. Feelings of extreme grief were more common for first than subsequent dogs. The depth of emotion was compared to losing a family member or other loved one, which has been reported in some person and pet relationships. A better understanding of issues surrounding the end of the partnership, including the human-animal bond, will help inform the guide dog industry of how best to support their clients during this time and when transitioning to another dog. Findings may be applied to other service/assistance dog users and the pet owning community.

A survey on health professionals' understanding of federal protections regarding service dogs in clinical settings

Context

Research has been scarce on health professionals' knowledge about guidelines regulating service dogs in a clinical setting. Gaining insight into health professionals' understanding of Americans with Disabilities Act (ADA) regulations concerning service dogs is critical for navigating compliance and reducing risk. Misinformation about service dogs could influence decisions affecting policy and care, leading to poor treatment and suboptimal health outcomes for patients with service animals.

Objectives

To assess health professionals' knowledge about ADA regulations and beliefs about workplace protocols and training related to service dogs.

Methods

The study used snowball sampling to distribute surveys to health professionals from around the United States. Initial outreach occurred using mailing lists, investigators' personal networks, and social media. The survey contained 24 items. True and false questions were used to test ADA knowledge and then coded as correct or incorrect. Most closed-end questions were measured on a 5-point Likert scale using frequencies and descriptive statistics. A one-way analysis of variance (ANOVA) was conducted to test whether variables, such as encounters to service dogs, affected knowledge of ADA requirements.

Results

The survey was completed by 441 health professionals from around the country. Most (234; 53.1%) worked in a hospital and came from a range of professional backgrounds (nurses, 155 [35.2%]; physicians, 71 [16.1%]). While nearly three-quarters (318 [73.1%]) of participants said their workplace had a policy on service animals, 113 (34.9%) of those said they were unfamiliar with the policy and 236 (54.5%) said they had not received adequate training on the topic. Most participants did not know basic ADA policy requirements related to service dogs. Only those who were extremely familiar with policy (F=4.613; p=0.001) and those who strongly agreed that they knew the differences between service dogs and other classes of animals (F=5.906; p=0.000) scored higher on the knowledge test than those who disagreed.

Conclusions

Our results suggest that increased familiarity and training leads to higher knowledge about service dogs and ADA policy. Health professionals need additional education on ADA service dog regulations and hospital policy in order to minimize risk and ensure patients with service dogs receive optimal care.

The effects of assistance dogs on psychosocial health and wellbeing: A systematic literature review

Beyond the functional tasks that assistance dogs are trained for, there is growing literature describing their benefits on the psychosocial health and wellbeing of their handlers. However, this research is not only widely disparate but, despite its growth, has not been reviewed since 2012. Our objective was to identify, summarize, and methodologically evaluate studies quantifying the psychosocial effects of assistance dogs for individuals with physical disabilities. Following PRISMA guidelines, a systematic review was conducted across seven electronic databases. Records were independently screened by two authors. Studies were eligible for inclusion if they assessed outcomes from guide, hearing, medical, or mobility service dogs, if they collected original data on handlers' psychosocial functioning, and if the outcome was measured quantitatively with a validated, standardized measure. Studies on psychiatric service dogs, emotional support dogs, and pet dogs were excluded. Of 1,830 records screened, 24 articles were identified (12 publications, 12 theses) containing 27 studies (15 cross-sectional, 12 longitudinal). Studies assessed the effects of mobility (18), hearing (7), guide (4), and medical (2) assistance dog partnerships with an average sample size of N = 83. An analysis of 147 statistical comparisons across the domains of psychological health, quality of life, social health, and vitality found that 68% of comparisons were null, 30% were positive in the hypothesized direction, and 2% were negative. Positive outcomes included significant effects of having an assistance dog on psychological wellbeing, emotional functioning, self-esteem, and vitality. However, it is of note that several methodological weaknesses of the studies make it difficult to draw any definitive conclusions, including inadequate reporting and a failure to account for moderating or confounding variables. Future research will benefit from stronger methodological rigor and reporting to account for heterogeneity in both humans and assistance dogs as well as continued high-quality replication.

Dog Welfare, Well-Being and Behavior: Considerations for Selection, Evaluation and Suitability for Animal-Assisted Therapy

Simple Summary

Benefits for humans participating in animal-assisted therapy (AAT) have been long documented; however, welfare considerations for the animal counterparts are still quite non-specific, often relating to more general concerns associated with animal-assisted interventions (AAIs). Providers of AAT have a moral and ethical obligation to extend the “Do No Harm” tenet to the animals with whom they work. Companion animals do not ask or voluntarily sign up to be a part of a therapeutic team and their natural traits of love and sociability can easily be misinterpreted and exploited. This article reviews the current state of animal-assisted interventions; it highlights the lack of sufficient evaluation processes for dogs working with AAT professionals, as well as the risks associated with not protecting the dogs’ welfare. Finally, the authors make recommendations for determining the suitability of specific dogs in the clinical setting and ensuring that the population, environment, and context of the work is amenable to the dogs’ welfare and well-being.

Abstract

Health care and human service providers may include dogs in formal intervention settings to positively impact human physical, cognitive and psychosocial domains. Dogs working within this context are asked to cope with a multitude of variables including settings, populations, activities, and schedules. In this article, the authors highlight how both the preparation and operation of dogs within animal-assisted therapy (AAT) differs from less structured animal-assisted activities (AAA) and more exclusive assistance animal work; the authors highlight the gaps in our knowledge in this regard, and propose an ethically sound framework for pragmatic solutions. This framework also emphasizes the need for good dog welfare to safeguard all participants. If dogs are not properly matched to a job or handler, they may be subjected to unnecessary stress, anxiety, and miscommunication that can lead to disinterest in the work, overt problematic behavioral or health outcomes, or general unsuitability. Such issues can have catastrophic outcomes for the AAT. The authors propose standards for best practices for selection, humane-based preparation and training, and ongoing evaluation to ensure the health, welfare and well-being of dogs working in AAT, which will have concomitant benefits for clients and the professionalism of the field.

Defining the PTSD Service Dog Intervention: Perceived Importance, Usage, and Symptom Specificity of Psychiatric Service Dogs for Military Veterans

Research suggests that psychiatric service dogs may be an effective complementary treatment option for military veterans with posttraumatic stress disorder (PTSD). Although this practice continues to increase in popularity and research has reached the rigor of clinical trials, the components of the PTSD service dog intervention remain largely undefined. This research aimed to (1) quantify the importance, usage, and PTSD symptom specificity of service dog trained and untrained behaviors, (2) explore how PTSD severity, time since receiving the service dog, and the veteran-dog relationship relate to outcomes, and (3) compare expectations of veterans on the waitlist to experiences of veterans with service dogs. In a cross-sectional design, 217 post-9/11 military veterans with PTSD were recruited from a national service dog provider, including n = 134 with a service dog and n = 83 on the waitlist. Results showed that the service dog's trained tasks of calming and interrupting anxiety were perceived as the most important for veterans' PTSD, the most frequently used in a typical day, and as helping the most PTSD symptoms. Trained tasks were most helpful to the PTSD symptoms of hypervigilance and intrusion, and least helpful toward the symptoms of amnesia and risk-taking. Although all trained tasks were helpful toward PTSD symptoms, veterans rated the service dog's untrained behaviors on average as more important for their PTSD. After controlling for covariates, there was no relationship between a veteran's PTSD severity and perceived importance or frequency of task use. However, veterans who reported feeling closer to their service dogs reported using trained tasks more often, and veterans who had their service dogs for longer reported using trained tasks less often. Finally, veterans on the waitlist reported higher expectations regarding task use and importance than described by veterans with a service dog. In conclusion, findings describe the core components of the PTSD service dog intervention by quantifying the use and value of trained and untrained dog behaviors. Overall, this study helps explain the PTSD service dog's clinically relevant value while contributing to the scientific understanding of this emerging practice.

Mobility and medical service dogs: a qualitative analysis of expectations and experiences

Purpose: To qualitatively describe and compare the expectations and experiences of living with a mobility or medical service dog among those with a physical disability or chronic condition.Materials and methods: A total of 64 participants living with a service dog and 27 on the waitlist to receive a service dog participated in a cross-sectional open-ended survey. Qualitative content analysis was used to identify themes and sub-themes.Results: A total of 101 codes were summarized into themes of Physical Benefits, Psychosocial Benefits, and Drawbacks to having a service dog. Psychosocial benefits included the human-animal relationship as well as emotional, quality of life, and social benefits. Drawbacks included service dog care, public access and education, lifestyle adjustments, and dog behaviour. While participants on the waitlist were more likely to anticipate physical benefits of having a service dog, those with a service dog largely described psychosocial benefits. Findings also suggest that some drawbacks, such as public discrimination, may be unanticipated by the waitlist.Conclusions: A comparison of expectations and experiences of service dog ownership highlights both the positive and negative aspects of the service dog-owner relationship and identifies potential aspects of having a service dog that may be unanticipated or overestimated by those on the waitlist.Implications for RehabilitationWhen asked about helpful and important aspects of having a service dog, 98% of service dog owners described the psychosocial benefits of their dog's assistance and companionship.The human-animal relationship was the most discussed psychosocial benefit from both current owners as well as those on the waitlist, demonstrating the unique strength of the service dog-owner bond in this population.Those on the waitlist to receive a service dog did not anticipate as many drawbacks as current owners described. In particular, difficulties with public access and education as well as dog behaviour were commonly experienced, but not expected, drawbacks to service dog ownership.Findings identify aspects of having a service dog that may be unanticipated or overestimated by those on the waitlist, providing rehabilitation professionals with a basis for preparing those who may be considering incorporating a service dog into their lives.

Is there a Profile of Spontaneous Seizure-Alert Pet Dogs? A Survey of French People with Epilepsy

Simple Summary

Very little is known about dogs that could alert their owner of an impending epileptic seizure. Here, we explored the profiles of untrained dogs that spontaneously show seizure-related behaviors. Using a self-reporting questionnaire, we found that these dogs do not have a particular profile (e.g., sex, breed, age, epilepsy of the owner), but bonding is perceived as better when the dog alerts compared to a dog who does not alert. Personality traits helped discriminate between these two types of dogs; seizure-alert dogs were scored higher for Motivation, Training Focus and lower in Neuroticism than non-alerting dogs. In addition, we reported alert-related behavior characteristics (e.g., the dogs that alerted the more frequently stayed close and stared at their owner when he/she had a seizure). Our results are in line with the existing literature and help further the understanding of seizure-alert dogs. In particular, we suggest that some personality traits could be a basis for the selection of future assistance dogs.

Abstract

Despite controversies and the lack of research, dogs are empirically selected and trained to perform as service dogs, in relation to the dogs’ and future owners’ characteristics. We assessed the characteristics of both humans and dogs in an unbiased population (not selected or trained) of spontaneous seizure-alert by pet dogs and investigated whether we could replicate previous findings. We addressed a self-reporting questionnaire to French people with epilepsy. We analyzed the general characteristics of the humans and pet dogs and their behaviors that could alert their owner before a seizure. In addition, we used the Monash Canine Personality Questionnaire refined to evaluate pet dogs’ personality through five different traits, and the Monash Dog-Owner Relationship scale to assess human–dog relationships. In line with previous reports, we found no particular factor, either pet-, people- or epilepsy-related that could be associated with the presence or absence of alert behaviors. Alert behaviors and circumstances were explored and three different alert patterns emerged. In terms of personality, seizure-alert pet dogs scored significantly higher than non-alerting dogs for the traits “Motivation” and “Training Focus” and lower for “Neuroticism”. The owner–dog bond score was significantly higher for seizure-alert dogs than for non-alerting dogs.

Disaster Preparedness among Service Dog Puppy- Raisers (Human Subject Sample)

Simple Summary

Before service animals are matched with clients, they undergo training programs for increasing the dogs’ ability to navigate public spaces. Increasingly, service dog training programs recruit young adults from universities and college campuses. Little is known, however, how these students prepare for disasters and the ways in which they create plans to keep service dogs in training safe during hazard events. We collected data from service dog puppy raisers in a hurricane-prone region of the United States to understand their concepts and actions of disaster preparedness. People who were raising a service puppy for the first time were more likely to consider evacuating from Hurricane Irma in 2017 than people who had participated in the program before. Additionally, over half of the respondents did not have a disaster preparedness kit. Finally, many respondents in this study indicated that their service dog in training provides a sense of safety and security.

Abstract

Little is known about the ways in which puppy raisers engage in disaster preparedness for their puppies (or “guide dogs in training”). The aim of this research is to understand disaster preparedness among service dog puppy raisers. A web-based survey was distributed to people raising puppies in a service dog training program (n = 53 complete survey responses). Questions in the survey included items about disaster preparedness and plans for canine safety in hazards events. Out of those who said they had an evacuation plan for their puppy in training, 59% stated they would put the dog in their vehicles for evacuating to safety in the event of a hurricane or other disaster. The odds of first-time puppy raisers who considered evacuation for Hurricane Irma in 2017 was 15.3 times the odds of repeat raisers. Over half the raisers reported that they did not have a disaster kit. Additionally, 82% of respondents indicated that having a service puppy in training makes them feel safer. These results can be used as a foundation for service dog organizations in disaster preparedness among their puppy raiser volunteers and in designing recruitment messages for new volunteers.

Geographic Availability of Assistance Dogs: Dogs Placed in 2013-2014 by ADI- or IGDF-Accredited or Candidate Facilities in the United States and Canada, and Non-accredited U.S. Facilities

Assistance dogs' roles have diversified to support people with various disabilities, especially in the U.S. Data presented here are from the U.S. and Canada non-profit facilities (including both accredited and candidate members that fulfilled partial requirements: all here termed “accredited”) of Assistance Dogs International (ADI) and the International Guide Dog Federation (IGDF), and from non-accredited U.S. assistance dog training facilities, on the numbers and types of dogs they placed in 2013 and 2014 with persons who have disabilities. ADI categories of assistance dogs are for guide, hearing, and service (including for assistance with mobility, autism, psychiatric, diabetes, seizure disabilities). Accredited facilities in 28 states and 3 provinces responded; accredited non-responding facilities were in 22 states and 1 province (some in states/provinces with responding accredited facilities). Non-accredited facilities in 16 states responded. U.S./Canada responding accredited facilities (55 of 96: 57%) placed 2,374 dogs; non-accredited U.S. facilities (22 of 133: 16.5%) placed 797 dogs. Accredited facilities placed similar numbers of dogs for guiding (n = 918) or mobility (n = 943), but many more facilities placed mobility service dogs than guide dogs. Autism service dogs were third most for accredited (n = 205 placements) and U.S. non-accredited (n = 72) facilities. Psychiatric service dogs were fourth most common in accredited placements (n = 119) and accounted for most placements (n = 526) in non-accredited facilities. Other accredited placements were for: hearing (n = 109); diabetic alert (n = 69), and seizure response (n = 11). Responding non-accredited facilities placed 17 hearing dogs, 30 diabetic alert dogs, and 18 seizure response dogs. Non-accredited facilities placed many dogs for psychiatric assistance, often for veterans, but ADI accreditation is required for veterans to have financial reimbursement. Twenty states and several provinces had no responding facilities; 17 of these states had no accredited facilities. In regions lacking facilities, some people with disabilities may find it inconvenient living far from any supportive facility, even if travel costs are provided. Despite accelerated U.S./Canada placements, access to well-trained assistance dogs continues to be limited and inconvenient for many people with disabilities, and the numerous sources of expensive, poorly trained dogs add confusion for potential handlers.

Rejections in an non-purpose bred assistance dog population: Reasons, consequences and methods for screening

Assistance dogs aid people with various impairments on a daily basis. To become an assistance dog, a strict selection procedure and intensive training period must be successfully completed. Consequently, not every dog acquired for this purpose, becomes an assistance dog. The purpose of this study was to investigate reasons for failure and the financial consequences thereof for assistance dog associations that do not have a dedicated breeding program for their dogs. Data were collected for a total of 537 dogs enlisted between 2001 and 2015 and purchased out of the general dog population by five Belgian assistance dog associations. Only 60 percent of the dogs actually became an assistance dog and the main reasons for failure were related to undesirable behavioural characteristics and orthopaedic disorders. The estimated average financial loss per rejected dog was found to be 10524 euro. A detailed comparison of the two most popular breeds (Golden Retriever and Labrador Retriever) within the guide dogs and mobility assistance dogs revealed no significant difference in probability of successfully completing the training. However, a comparison of orthopaedic screening methods revealed a higher rejection with computed tomography for elbow dysplasia and laxity-based radiographical techniques for hip dysplasia compared to radiography and the standard ventrodorsal hip extend radiograph alone, respectively. Based on these results, we provide several suggestions to increase the probability of success.

Professionally- and Self-Trained Service Dogs: Benefits and Challenges for Partners With Disabilities

It has been widely reported that service dogs offer benefits to their human partners, however, it is unclear whether the expanding methods of training and roles of service dogs for their partners with various disabilities also provide similar benefits. This study aimed to investigate the self-reported experience of service dog partners to understand whether three different factors influence the benefits and drawbacks associated with partnering with a service dog: (1) different methods of training service dogs; (2) different severities of human partners' disabilities; (3) different roles of service dogs. Partners of service dogs were recruited to the web survey through service dog facilities and networking groups. Answers from 19 men and 147 women participants (91.8% living in the U.S.) were analyzed in this study. Participants experienced the expected benefits of service dogs, including increased independence, social relationships, self-esteem, and life satisfaction, and decreased anxiety, stress, and loneliness. However, the perceived benefits, concerns, and burdens differed depending on the partners' disabilities and the training history of the dogs. When first living with their service dogs, people who had self-trained their service dogs experienced more burdens than those living with professionally trained service dogs. No major reduction in expenses for assistance after acquiring a dog was reported. Personalized team training based on each person's disabilities and situation is required to optimize the benefits and minimize the burdens and concerns of living with service dogs.

Psychiatric Assistance Dog Use for People Living With Mental Health Disorders

A psychiatric assistance dog (PAD) is a service dog that is trained to assist its handler (owner) who has been diagnosed with a mental health condition such as post-traumatic stress disorder (PTSD), schizophrenia, depression, anxiety, or bipolar disorder. Literature searches reveal that little is known about the population of people who own PADs, the types of dogs used or the functions they provide. One third (n = 199) of PAD owners in Australia registered with the charity “mindDog” participated in an online survey designed to better understand the person and dog team. Participants learned about PADs through the internet (37%), health care practitioners (32%), or family/friends (30%). The dogs in the sample were of varying age, gender and breed. The most common reasons for people to choose a dog to be a PAD were temperament (60%) and size/weight (48%). Just under half (48%) of the dogs had been acquired by the owner specifically to be trained as a PAD, and the rest were existing pets. All the dogs were trained by the owner or a combination of the owner and a qualified trainer; none were trained exclusively by assistance/service dog provider organizations. The median age of the participants at the time of data collection was 47 years, ranging from 10 to 75 years. Most (77%) identified as female. Depression (84%), anxiety (social 61%; generalized 60%), PTSD (62%), and panic attacks (57%) were the most reported mental health diagnoses. Tasks the dogs performed for their owners included: reduction of anxiety through tactile stimulation (94%); nudging/pawing to bring back to the present (71%); interrupting undesirable behavior (51%); constant body contact (50%); deep pressure stimulation (45%) and blocking contact from other people (42%). PAD usage decreased (46%), increased (30%) or did not change (24%) participants' use of psychiatric or other health care services. Decrease in service use was mainly due to reduced suicide attempts, and less requirement for hospitalization and medication; increased use was mainly due to enhanced ability to attend appointments. Results of this study show that PAD owners have differing mental health diagnoses, and their dogs perform different tasks to support them in daily life. Every participant described the relationship with his/her PAD as positive, suggesting that a successful working partnership does not require the dog to have been bred or raised specifically for the role. A better understanding of this population and the person-dog relationship will inform the appropriate choice, training and use of PADs for people living with mental health problems.

The experience of acquiring an assistance dog: examination of the transition process for first-time handlers

PURPOSE

As the popularity of using dogs to assist individuals with disability grows, there is a need for increased understanding of assistance dog handlers' experiences of living and working with their dog. This is particularly pertinent to first-time handlers and during the initial placement period, where the handler and assistance dog, and the relationship forming between them, may be extremely vulnerable. The aim of this study was to better understand first-time assistance dog handlers' experience of the placement period, especially any challenges that they experience.

MATERIALS AND METHODS

Semi-structured interviews were conducted with two youth and five adult handlers, and one parent of a young handler, recruited from three Australian assistance dog organizations. Interviews were conducted 1 month following the initial acquisition of an assistance dog. Meleis' transitions theory was used to develop a better understanding of the transition process for first-time handlers.

RESULTS

Inductive content analysis identified various challenges that first-time handlers experience throughout the transition period. These included: the initial response to living with the assistance dog; renegotiating relationships and social interactions; and, adjusting expectations regarding the assistance dog's behavior and capabilities.

CONCLUSION

First-time handler experiences indicate a need for assistance dog organizations to develop initiatives to further assist their handlers through a smooth transition into assistance dog ownership. Implications for rehabilitation Integrating an assistance dog into a first-time handler's life is a long process full of challenges. Provider organizations and other support members markedly impact the ease of transitioning an assistance dog into a handler's life. Organizations should be aware of the role they have and employ strategies to create as smooth a transition as possible. Support from other support members is crucial to ease the challenges experienced.

An Owner-Independent Investigation of Diabetes Alert Dog Performance

Objective: To quantify Diabetes Alert Dog (DAD) performance by using owner-independent measures.

Research Design and Methods: Eight owners of accredited DADs used a FreeStyle Libre Flash Glucose Monitoring System (FGMS). Concurrent Closed Circuit Television (CCTV) footage was collected for between 5 and 14 days in each owner's home or workplace. The footage was blind-coded for dogs' alerting behaviors. The sensitivity, False Positive Rate and Positive Predictive Values (PPV) of dogs' alerts to out-of-range (OOR) episodes were calculated. Ratings for 11 attributes describing participant's lifestyle and compliance (taken from each dog's instructor) and the percentage of DAD alerts responded to by the owner as per training protocol (taken from CCTV footage) were assessed for association with dog performance.

Results: Dogs alerted more often when their owners' glucose levels were outside vs. inside target range (hypoglycaemic 2.80-fold, p = 0.001; hyperglycaemic 2.29-fold, p = 0.005). Sensitivity to hypoglycaemic episodes ranged from 33.3 to 91.7%, the mean was 55.9%. Mean PPV for OOR episodes was 69.7%. Sensitivity and PPV were associated with aspects of the dog and owner's behavior, and the owner's adherence to training protocol.

Conclusions: Owner-independent methods support that some dogs alert to hypo- and hyperglycaemic events accurately, but performance varies between dogs. We find that DAD performance is affected by traits and behaviors of both the dog and owner. Combined with existing research showing the perceived psychosocial value and reduced critical health care needs of DAD users, this study supports the value of a DAD as part of a diabetes care plan. It also highlights the importance of ongoing training and continued monitoring to ensure optimal performance.

Enhancing Success of Veterinary Visits for Clients With Disabilities and an Assistance Dog or Companion Animal: A Review

Despite increasing information on enhancing client communication and compliance/adherence in veterinary medicine, literature focusing on special cases remains limited: working with clients with special needs, challenges or disabilities, or when the patient is an assistance or emotional support animal. This paper summarizes current recommendations on how best to build successful working relationships with these clients, including action items to implement in practice. In addition, this paper reviews current literature on important considerations for care of assistance dogs as patients.

Applying Machine Learning Techniques to Identify Undiagnosed Patients with Exocrine Pancreatic Insufficiency

BACKGROUND

Exocrine pancreatic insufficiency (EPI) is a serious condition characterized by a lack of functional exocrine pancreatic enzymes and the resultant inability to properly digest nutrients. EPI can be caused by a variety of disorders, including chronic pancreatitis, pancreatic cancer, and celiac disease. EPI remains underdiagnosed because of the nonspecific nature of clinical symptoms, lack of an ideal diagnostic test, and the inability to easily identify affected patients using administrative claims data.

OBJECTIVES

To develop a machine learning model that identifies patients in a commercial medical claims database who likely have EPI but are undiagnosed.

METHODS

A machine learning algorithm was developed in Scikit-learn, a Python module. The study population, selected from the 2014 Truven MarketScan® Commercial Claims Database, consisted of patients with EPI-prone conditions. Patients were labeled with 290 condition category flags and split into actual positive EPI cases, actual negative EPI cases, and unlabeled cases. The study population was then randomly divided into a training subset and a testing subset. The training subset was used to determine the performance metrics of 27 models and to select the highest performing model, and the testing subset was used to evaluate performance of the best machine learning model.

RESULTS

The study population consisted of 2088 actual positive EPI cases, 1077 actual negative EPI cases, and 437 530 unlabeled cases. In the best performing model, the precision, recall, and accuracy were 0.91, 0.80, and 0.86, respectively. The best-performing model estimated that the number of patients likely to have EPI was about 12 times the number of patients directly identified as EPI-positive through a claims analysis in the study population. The most important features in assigning EPI probability were the presence or absence of diagnosis codes related to pancreatic and digestive conditions.

CONCLUSIONS

Machine learning techniques demonstrated high predictive power in identifying patients with EPI and could facilitate an enhanced understanding of its etiology and help to identify patients for possible diagnosis and treatment.

The effects of service dogs on psychosocial health and wellbeing for individuals with physical disabilities or chronic conditions

Purpose: To evaluate the effects of service dogs on psychosocial health and indicators of wellbeing among individuals with physical disabilities or chronic conditions.Materials and methods: A total of 154 individuals participated in a cross-sectional survey including 97 placed with a mobility or medical service dog and 57 on the waitlist to receive one. Hierarchical regression evaluated the effect of having a service dog on standardized measures of psychosocial health (Pediatric Quality of Life Inventory) as well as anger, companionship, and sleep disturbance (Patient Reported Outcome Measurement Information System). Among those with a service dog, the Monash Dog-Owner Relationship Scale quantified the human-animal bond.Results: Results indicated that compared to those on the waitlist, individuals with a service dog exhibited significantly better psychosocial health including higher social, emotional, and work/school functioning. There was no significant effect of having a service dog on anger, companionship, or sleep disturbance. Among those with a service dog, emotional closeness, dog-owner interaction, and amount of time since the service dog was placed were weak correlates of outcomes.Conclusions: Findings suggest that service dogs may have measurable effects on specific aspects of psychosocial health for individuals with physical disabilities or chronic conditions.Implications for rehabilitationHealth care providers should recognize that in addition to the functional benefits service dogs are trained to provide, they can also provide their handlers with psychosocial benefits from their assistance and companionship.Results indicate that having a service dog was related to better emotional functioning, social functioning, and work/school functioning. Areas with no significant relationship with having a service dog included social companionship, sleep, and anger.Although findings are from a large and representative sample of mobility and medical service dogs, there may be individual differences in how service dogs affect the psychosocial health of their handlers.

A Systematic Review of the Reliability and Validity of Behavioural Tests Used to Assess Behavioural Characteristics Important in Working Dogs

Background

Working dogs are selected based on predictions from tests that they will be able to perform specific tasks in often challenging environments. However, withdrawal from service in working dogs is still a big problem, bringing into question the reliability of the selection tests used to make these predictions.

Methods

A systematic review was undertaken aimed at bringing together available information on the reliability and predictive validity of the assessment of behavioural characteristics used with working dogs to establish the quality of selection tests currently available for use to predict success in working dogs.

Results

The search procedures resulted in 16 papers meeting the criteria for inclusion. A large range of behaviour tests and parameters were used in the identified papers, and so behaviour tests and their underpinning constructs were grouped on the basis of their relationship with positive core affect (willingness to work, human-directed social behaviour, object-directed play tendencies) and negative core affect (human-directed aggression, approach withdrawal tendencies, sensitivity to aversives). We then examined the papers for reports of inter-rater reliability, within-session intra-rater reliability, test-retest validity and predictive validity.

Conclusions

The review revealed a widespread lack of information relating to the reliability and validity of measures to assess behaviour and inconsistencies in terminologies, study parameters and indices of success. There is a need to standardise the reporting of these aspects of behavioural tests in order to improve the knowledge base of what characteristics are predictive of optimal performance in working dog roles, improving selection processes and reducing working dog redundancy. We suggest the use of a framework based on explaining the direct or indirect relationship of the test with core affect.

Affectionate Interactions of Cats with Children Having Autism Spectrum Disorder

Mental and physical benefits of dogs have been reported for adults and children with special needs, but less is known about benefits of cats for children. A cat that can be held by a child could provide important therapeutic companionship for children with severe or less severe autism spectrum disorder (ASD) who otherwise may lack prosocial behaviors. Because relatively little is known about the behavior of cats around children, we conducted this study. Phase 1 gathered web-survey data from families having an adult cat and a child with ASD (n = 64). In Phase 2, there were direct telephone interviews of parents having a child with severe ASD (n = 16) or less severe ASD (n = 11), or typical development (n = 17). From the Phase 1 web survey of families with ASD children (full range of severities), affectionate interactions of the cats with children were common. Most parents with ASD children volunteered positive comments regarding the cat, such as calming the child, being a soothing protector or a guardian. In the interviews in Phase 2, for all three groups, most parents characterized cats as at least moderately affectionate toward the child. However, cats living with severe ASD children were reported to exhibit less affection than those living with typically developing children or children with less severe ASD. A minority of cats in each group showed some aggression to the specified child; this was not elevated with ASD children. Responses suggested that the cats adopted as kittens were more affectionate and less aggressive to all categories of children than those adopted as adults. Overall, participants reported that ASD children's behaviors indicated that they valued the relationship with the cat, similar to typically developing children, pointing to the importance and potential usefulness of selecting affectionate and compatible cats for ASD children.

A survey of the impact of owning a service dog on quality of life for individuals with physical and hearing disability: a pilot study

Background

Quality of life refers to a person’s experienced standard of health, comfort and happiness and is typically measured using subjective self-report scales. Despite increasing scientific interest in the value of dogs to human health and the growing demand for trained service dogs, to date no research has reported how service dogs may affect client perceptions of quality of life.

Method

We compared quality of life scores on the 16 item Flanagan quality of life scale from individuals who owned a trained service dog with those who were eligible to receive a dog, but did not yet have one (waiting list control). Data were analysed separately from two groups; those with a service dog trained for individuals with physical disabilities (with physical service dog: n = 72; waiting for a service dog: n = 24; recruited from Dogs for Good database) and those with a hearing service dog (with hearing service dog = 111; waiting for a service dog = 30; recruited from Hearing Dogs for Deaf People database).

Results

When controlling for age and gender individuals scored higher on total quality of life scores if they owned a service dog or a hearing service dog, but this was only statistically significant for those with a service dog. Both groups (physical service dog and hearing service dog) scored significantly higher on items relating to health, working, learning and independence if they owned a service dog, in comparison to those on the waiting list. Those with a physical service dog also scored significantly higher on items relating to recreational activities (including items relating to reading/listening to music, socialising, creative expression), and those involving social interactions (including items relating to participating in organisations, socialising, relationship with relatives). Additionally, those with a physical service dog scored higher on understanding yourself and material comforts than those on the waiting list control. In contrast, those with a hearing service dog appeared to receive fewer benefits on items relating to social activities.

Conclusions

Owning a service dog can bring significant specific and potentially general benefits to the quality of life of individuals with physical disabilities and hearing impairments. These benefits may have considerable implications for individuals with disabilities, society and the economy by promoting independence, learning and working abilities.