A One Health Research Framework for Animal-Assisted Interventions

Animal-assisted interventions in adult hospital rehabilitation settings: A scoping review

Animal-assisted interventions (AAIs) have the potential to enhance people's well-being and function and are increasingly being implemented across a range of settings. This scoping review explored how AAIs have been used in adult hospital rehabilitative care. Using JBI and PRISMA-ScR guidelines, a systematic search of four databases was undertaken. Inclusion criteria involved adults, aged >18 years, who had received AAIs in the hospital rehabilitation setting. Twenty-two articles met the inclusion criteria. Results identified two intervention types: visitation activities (n = 8 studies) and structured therapeutic interventions (n = 14 studies). Dogs were the most common animal species. Improvements in social and emotional well-being were reported across both types of interventions, with improvements in ambulation, motor skills, and verbal communication reported by those engaged in structured therapeutic interventions. Implementation challenges included a dependency on volunteer dog-handlers; the need for better recording of interventions in medical records to enable evaluation; and cost, safety, infection control, and animal welfare considerations. Strengthening the planning of AAIs is fundamental for the realization of potential outcomes from human-animal interactions in hospital rehabilitative care.

Participation in a Prison-Based Training Programme Is Beneficial for Rescue Dogs

Dogs are often relinquished because of behavioural issues which may be exacerbated in rehoming centres. Prison-based dog training programmes (DTPs) may enhance outcomes for rescue dogs by providing socialisation and training opportunities to improve behaviour, welfare and likelihood of rehoming. We assessed whether dogs benefitted from participation, 1-3 times per week, in a prison-based DTP in which male young offenders learn how to train and care for dogs waiting to be rehomed. Within DTP sessions, there was significant improvement on a range of training tasks (n = 42 dogs). Analyses of videos (n = 17 dogs) in the kennels and a training barn pre- and post-DTP participation showed improvement in some positive behaviours, but no significant change in other behaviours. Subjective ratings by staff of the dogs' behaviour were made (n = 20 dogs). Desirable behaviours (e.g., playful/friendly) increased, and most undesirable behaviours (e.g., frustrated and noisy) decreased. Participation in the DTP did not mitigate all negative behaviours. However, improvements are consistent with enhanced welfare and likelihood of successful rehoming. Prison-based DTPs can be effective in supporting the work of animal rescue organisations to improve outcomes for dogs, while offering people in custody an opportunity to engage in purposeful activity and provide a community service.

Guidance on Minimum Standards for Canine-Assisted Psychotherapy in Adolescent Mental Health: Delphi Expert Consensus on Health, Safety, and Canine Welfare

As interest in animal-assisted therapy (AAT) and canine-assisted psychotherapy (CAP) grows, there are increasing calls for the management of related health, safety, and welfare concerns for canines, providers, and clients. Existing health and safety guidelines lack empirical support and are, at times, contradictory. Welfare is increasingly prioritized; however, tools to monitor and manage welfare are underutilized and under-reported. The aim of this study was to provide expert consensus on the minimum health, safety, and welfare standards required to develop and deliver a CAP group program to adolescents experiencing common mental health disorders. Diverse AAT experts were recruited globally. Using Delphi methodology, over two rounds, 40 panelists reached a consensus agreement to include 32 items from a possible 49 into the minimum standards. Health and safety measures included risk assessment, veterinary screening, preventative medicine, training in infection control, and first aid. Welfare measures included training in welfare assessment, documentation of welfare, and flexible, individualized responses to promote wellbeing. Intestinal screening for parasites and the prohibition of raw food were not supported. Flexible and individualized assessment and management of canine welfare were supported over fixed and time-limited work schedules. Clinical practice implications are discussed, and recommendations are made.

A Relaxed Horse-A Relaxed Client? An Experimental Investigation of the Effects of Therapy Horses' Stress on Clients' Stress, Mood, and Anxiety

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-naïve participants had a standardized interaction with both an experimentally stressed horse and an experimentally relaxed horse. We assessed physiological indicators of stress (heart rate, heart rate variability, and salivary cortisol) in participants and horses, as well as psychological indicators of stress (state anxiety and positive and negative affect) in participants. Although our stress and relaxation manipulations were successful (indicated by horses' physiological indicators of stress), we did not find any difference in the participants' physiological or psychological indicators of stress between the interaction with a stressed and the interaction with a relaxed horse. Together with results from previous studies, this suggests that humans cannot intuitively recognize the (physiological) stress level of horses, which has important implications for effective communication and bonding between humans and horses and for the safety of equine activities.

How to Measure Human-Dog Interaction in Dog Assisted Interventions? A Scoping Review

Human-dog interaction is the working tool through which the therapeutic, educational and recreational goals of dog-assisted interventions (DAIs) are achieved. A better understanding of the characteristics of this interaction could improve the effectiveness of DAIs. This scoping review addresses the question: how has the human-dog connection been measured in the context of DAIs? After searching the Web of Science and Scopus platforms, only peer-reviewed, primary research studies reporting measures of therapy dog-human interaction, relationship and bond were included. A total of 70 included articles provided information on what was measured (interaction, relationship or bond) and how, as well as the general context (DAIs or experimental situations with therapy dogs). While the majority of the articles identified use behavioural analysis methods to analyse the interaction between the participant/recipient and the therapy dog during DAIs, it was possible to identify some more structured tools that assess the participant/recipient's interaction, relationship or bond with the therapy dog, as well as tools that consider the animal's perspective or focus on the dog-handler dyad, indicating growing areas of research. The tools and methods identified can be used by both practitioners and researchers to further explore aspects of human-dog interaction in the field of DAIs.

Going to the office - What's in it for the dog?

Benefits and challenges of dogs being present at the office were analyzed from three perspectives: the company view, the dog owner (employee) and the dog view. For companies, office dogs may serve as a branding symbol, leading to higher employee satisfaction and productivity, increased stress resilience and fewer turnover intentions. Yet, companies need to apply pet policies, risk management strategies and mitigate nuisance such as barking, loose fur or excrement. Additional breaks to walk the dogs are required and other employees or customers may be irritated. Employees take advantage of stress reduction, social support, higher job satisfaction, not having to leave their animal at home. Still, an office dog is an added responsibility in terms well-being, safety, distraction from work and emotional involvement. Although the animal perspective has not yet been scientifically addressed, we propose potential benefits such as less separation distress by having the owner nearby, higher social engagement and additional walks during breaks. Challenges for dogs may involve unwanted attention, aversive environmental stimulation, being restrained via leash or crate, irritation caused by conspecifics, emotional contagion or individual requirements.

Developing and Planning a Protocol for Implementing Health Promoting Animal Assisted Interventions (AAI) in a Tertiary Health Setting

The Ottawa Charter identifies that multiple levels of government, non-government, community, and other organizations should work together to facilitate health promotion, including in acute settings such as hospitals. We outline a method and protocol to achieve this, namely an Action Research (AR) framework for an Animal Assisted Intervention (AAI) in a tertiary health setting. Dogs Offering Support after Stroke (DOgSS) is an AR study at a major tertiary referral hospital. AAI has been reported to improve mood and quality of life for patients in hospitals. Our project objectives included applying for funding, developing a hospital dog visiting Action Research project, and, subsequent to ethics and governance approvals and finance, undertaking and reporting on the Action Research findings. The Action Research project aimed to investigate whether AAI (dog-visiting) makes a difference to the expressed mood of stroke patients and their informal supports (visiting carers/family/friends), and also the impact these visits have on hospital staff and volunteers, as well as the dog handler and dog involved. We provide our protocol for project management and operations, setting out how the project is conducted from conception to assess human and animal wellbeing and assist subsequent decision-making about introducing dog-visiting to the Stroke Unit. The protocol can be used or adapted by other organizations to try to avoid pitfalls and support health promotion in one of the five important action areas of the Ottawa Charter, namely that of reorienting health services.

Human-Animal Interaction in Animal-Assisted Interventions (AAI)s: Zoonosis Risks, Benefits, and Future Directions-A One Health Approach

Animal-assisted interventions (AAI)s represent the expression of integrated medicine, according to the One Health approach. Actually, animal-assisted therapies and animal-assisted activities are implemented in hospitals, rehabilitation centers, etc. The efficacy of AAIs is based on interspecific interactions and would be impacted by different factors, such as the characters of both the animal and the handler, a suitable selection of animal species, an appropriate animal educational protocol, the relationship between the handler and the animal, and mutual relationship among the animal, the patients, and members of the working team. AAIs produce many advantages for the patients but could expose them to zoonotic-pathogens transmission. Therefore, positive animal welfare, as preventative medicine to avoid incidents or transmission of zoonosis, is a relevant aspect with implications for human and animal health and wellbeing. This review aims to summarize the current published knowledge regarding the occurrence of pathogens in AAIs and to discuss their relevance in light of health and safety in AAIs participants. In addition, this review will contribute to defining the state of the art of AAIs through a careful benefits/challenges analysis and offers discussion points on the possible future developments according to the One Health approach.

The Promotion and Development of One Health at Swiss TPH and Its Greater Potential

One Health, an integrated health concept, is now an integral part of health research and development. One Health overlaps with other integrated approaches to health such as EcoHealth or Planetary Health, which not only consider the patient or population groups but include them in the social-ecological context. One Health has gained the widest foothold politically, institutionally, and in operational implementation. Increasingly, One Health is becoming part of reporting under the International Health Legislation (IHR 2005). The Swiss Tropical and Public Health Institute (Swiss TPH) has played a part in these developments with one of the first mentions of One Health in the biomedical literature. Here, we summarise the history of ideas and processes that led to the development of One Health research and development at the Swiss TPH, clarify its theoretical and methodological foundations, and explore its larger societal potential as an integrated approach to thinking. The history of ideas and processes leading to the development of One Health research at the Swiss TPH were inspired by far-sighted and open ideas of the directors and heads of departments, without exerting too much influence. They followed the progressing work and supported it with further ideas. These in turn were taken up and further developed by a growing number of individual scientists. These ideas were related to other strands of knowledge from economics, molecular biology, anthropology, sociology, theology, and linguistics. We endeavour to relate Western biomedical forms of knowledge generation with other forms, such as Mayan medicine. One Health, in its present form, has been influenced by African mobile pastoralists’ integrated thinking that have been taken up into Western epistemologies. The intercultural nature of global and regional One Health approaches will inevitably undergo further scrutiny of successful ways fostering inter-epistemic interaction. Now theoretically well grounded, the One Health approach of seeking benefits for all through better and more equitable cooperation can clearly be applied to engagement in solving major societal problems such as social inequality, animal protection and welfare, environmental protection, climate change mitigation, biodiversity conservation, and conflict transformation.

Animal-Assisted Counseling for Young Children: Evidence Base, Best Practices, and Future Prospects

Increasing numbers of young children are experiencing mild to moderate mental health issues that require support in addition to that typically provided by family members and teachers. The services of professional counselors can be particularly useful when children need help adjusting to and coping with various stressors and situations. Many school counselors and other mental health professionals have found that carefully planned interactions between young children and animals (e.g., guinea pigs, rabbits, dogs, horses) represent an effective alternative/complementary therapeutic modality. Animals may provide an accepting, nonjudgmental presence that focuses young children's attention, motivates them to learn, and encourages participation in planned intervention activities. This article begins by describing the general purposes for counseling with young children and the role that early childhood educators can play in increasing families' awareness of and access to these services in their communities. Next, it defines animal-assisted counseling and reviews the relevant research to build a rationale for including carefully selected animals in mental health support services for children. The third section discusses caveats about involving animals in individual and small group counseling sessions, in classrooms, and in other facilities/programs that work with young children. The article then summarizes best practices in animal-assisted counseling and how they are influenced by variables within the child, animal welfare considerations, different contexts, availability of resources, and interagency collaborations. The conclusion is a statement on the future of animal-assisted counseling for young children and how it supports the goals of humane education.

Role of social, cultural and symbolic capital for youth and community wellbeing in a rural Alaska Native community

Health promotion programs by and for Indigenous Peoples increasingly use strength-based Indigenous approaches aimed at reinforcing protective factors rooted in their cultures and traditions. These protective factors can counteract the deleterious effects induced by the rapid social changes related to colonization. Western social scientists defined cultural, social and symbolic capital as assets akin to social strengths that can promote health. It is important to understand Indigenous perspectives on these social and cultural capitals, and the ways their interplay can promote wellness. Using the qualitative methods photovoice and digital storytelling, we elicited the perspectives of Athabascan middle and high school students participating in the Frank Attla Youth and Sled Dog Care-Mushing Program in their home community of Huslia in Interior Alaska. Subsequently, we disseminated the stories and preliminary findings in Huslia, and conducted focus groups with adults to triangulate with the youth perspectives. Deductive and inductive thematic content analysis of youth stories and photos revealed the impacts of the program on them and their community. Youth reported gains in cultural, social and symbolic capital and shared what these forms of capital mean in their cultural context. Cultural capital gains were mostly in its embodied form, e.g. in work ethics, perseverance and the value of cultural traditions; social capital gains revolved around relations with peers, adults and Elders, nature and animals, as well as social cohesion and sense of belonging in Huslia; Symbolic capital was reflected through pride and spirituality. The students' stories also illustrated their perspectives on how the program affected their wellbeing, through physical activity, healing relations with dogs, increased self-esteem and visions of a bright future. Adults corroborated youth perspectives and shared their observations of program impacts on discipline, academic and life skills and resilience. These findings could be used to guide development and assessment of culturally-based wellbeing promoting interventions.

Evidence of Animal-Assisted Therapy in Neurological Diseases in Adults: A Systematic Review

BACKGROUND

In recent years, the possibility of intervening humans with animal-assisted therapy (AAT) has been growing due to numerous physical, psychological, and social benefits provided to humanity, enabling them to maintain or improve their quality of life. There exist different animals through which this therapy can be performed. The purpose of this systematic review will focus on the effects of AAT in several neurological diseases.

METHODS

The search of clinical trials was carried out in the PubMed, Scielo, Embase and PEDro databases. The selection of articles was made according to the different inclusion and exclusion criteria, incorporating those that approached neurological diseases to be reviewed.

RESULTS

Twenty-five clinical trials were identified, seventeen of which were finally included in the review. The results indicate that animal-assisted therapy (AAT) in different neurological diseases has many benefits in several areas, for example, in motor and physical ability as well as in mental and behavioural health.

CONCLUSIONS

This systematic review provides occupational therapy practitioners with evidence on the use of activity based on animal-assisted therapy as a novel field of intervention that can complement other therapies and obtain benefits in different populations.

Recommendations for Transdisciplinary Professional Competencies and Ethics for Animal-Assisted Therapies and Interventions

AAI is a transdisciplinary field that has grown exponentially in recent decades. This growth has not always been synergistic across fields, creating a need for more consistent language and standards, a call for which many professionals in the field have made. Under the umbrella of human–animal interactions (HAI) is animal-assisted interventions (AAIs), which have a more goal-directed intention with animals who have been assessed for therapeutic, educational, or vocational work. The current article offers a brief history and efficacy of HAI, describes the limitations and gaps within the field and recommends a new set of competencies and guidelines that seek to create some of the needed common language and standards for AAI work to address these limitations.

Therapy Dog Welfare Revisited: A Review of the Literature

During the past decade, the field of human-animal interaction(s) research has been characterized by a significant increase in scientific findings. These data have contributed to our current understanding of how humans may benefit from contact with animals. However, the animal experience of these interactions is still an under-researched area. This paper addresses the welfare of dogs who participate in animal-assisted interventions (AAIs) to improve health in human recipients. This paper builds on previous work by Glenk (2017) and provides an updated review of the literature on therapy dog welfare published from 2017-2021. New advances in scientific methodology, such as the determination of salivary oxytocin, breath rate and tympanic membrane temperature, are analyzed regarding their value and limitations for research in AAIs. Moreover, welfare-related social and environmental factors (e.g., freedom of choice, exploration of novel environments, inequity aversion, individual development, working experience, relationship with handler and handler skills) that profoundly influence dog perception and well-being are reviewed and discussed. Accounting for the globally increasing interest and the number of dogs utilized in AAIs, safeguarding therapy dog well-being, and identifying situations, circumstances and protocols that may challenge animal welfare remains an emerging and crucial area of scientific effort.

Zoonotic Risk of Encephalitozoon cuniculi in Animal-Assisted Interventions: Laboratory Strategies for the Diagnosis of Infections in Humans and Animals

The involvement of animals for therapeutic purposes has very ancient roots. To date, it is clear that animal-assisted interventions (AAIs), in addition to ensuring the replacement of missing or deficient affects, improves psychophysiological parameters connected to human health. However, AAI could potentially present risks related to the transmission of infectious agents from animals to humans. Among these microorganisms, E. cuniculi is a microspore which induces pathological effects (fever, headache, nausea, vomiting, diarrhea, breathlessness, respiratory symptoms, and weakness) in both humans and animals. Consequently, an accurate and fast diagnosis of E. cuniculi infection, as well as the identification of new diagnostic approaches, is of fundamental importance. This literature review was carried out to provide an extensive and comprehensive analysis of the most recent diagnostic techniques to prevent and care for E. cuniculi-associated risks in the AAI field.

Providing Humans With Practical, Best Practice Handling Guidelines During Human-Cat Interactions Increases Cats' Affiliative Behaviour and Reduces Aggression and Signs of Conflict

The importance of animals' experiences and associated comfort during Human-Animal Interactions (HAI), and particularly Animal Assisted Interventions (AAI), are increasingly recognised. However, there remains a paucity of published research, particularly concerning less formal but frequent HAIs to which companion animals are typically exposed, such as stroking or petting. Additionally, few practical evidence-based guides to facilitate humans' optimal animal handling and interaction in these contexts exist. A simple set of Human-Cat Interaction (HCI) guidelines were therefore created, with the aim to enhance domestic cats' comfort during generic HCI contexts. Based around a “CAT” acronym, guidelines focused on providing the cat with choice and control (“C”), paying attention (“A”) to the cats' behaviour and body language and limiting touch (“T”), primarily to their temporal regions. Guidelines were presented to human participants during a brief training intervention, and guideline efficacy was subsequently assessed. Domestic cats available for rehoming at Battersea Dogs and Cats Home, UK (n = 100) were filmed during interactions with novel members of the public (n = 120). Cats were exposed to a maximum of six, 5-min interaction sessions, balanced across “control” (interactions with humans pre-training) and “intervention” conditions (interactions with humans post-training). For each observation, cat behaviour and posture were coded and humans' cat-directed behaviour rated on the degree to which it reflected best practice principles. Data were extracted from a total of 535 observations and average human interaction ratings and cat behaviour values compared between control and intervention conditions via paired Wilcoxon tests. Compared to the control, humans' interaction styles were rated as significantly more closely aligned with best practice principles in the intervention condition. Cats also displayed significantly greater frequencies and/or durations of affiliative and positively-valenced behaviours in the intervention. In contrast, cats in the control displayed significantly greater frequencies of human-directed aggression, in addition to greater frequencies and/or durations of behaviours associated with conflict and negative valence. Results demonstrate the positive impact of practical interaction guidelines on cats' social behaviour and comfort during HCI, with the potential to improve cats' general experiences during interactions, reduce human-directed aggression and ultimately improve cat-human relationships.

Presence of Campylobacterjejuni and C. coli in Dogs under Training for Animal-Assisted Therapies

This study was conducted to evaluate the presence of Campylobacter (C.) jejuni and C. coli in dogs at five dog training centers in Southern Italy. A total of 550 animals were sampled by collecting rectal swabs. The samples were processed to detect thermotolerant Campylobacter spp. by culture and molecular methods. Campylobacter spp. were isolated from 135/550 (24.5-95% confidence interval) dogs. A total of 84 C. jejuni (62.2%) and 51 C. coli (37.8%) isolates were identified using conventional PCR. The dog data (age, sex, breed, and eating habits) were examined by two statistical analyses using the C. jejuni and C. coli status (positive or negative) as dependent variables. Dogs fed home-cooked food showed a higher risk of being positive for C. jejuni than dogs fed dry or canned meat for dogs (50.0%; p < 0.01). Moreover, purebred dogs had a significantly higher risk than crossbred dogs for C. coli positivity (16.4%; p < 0.01). This is the first study on the prevalence of C. jejuni and C. coli in dogs frequenting dog training centers for animal-assisted therapies (AATs). Our findings emphasize the potential zoonotic risk for patients and users involved in AATs settings and highlight the need to carry out ad hoc health checks and to pay attention to the choice of the dog, as well as eating habits, in order to minimize the risk of infection.

Occurrence of Pasteurella multocida in Dogs Being Trained for Animal-Assisted Therapy

Animal-assisted therapy (AAT) is a non-pharmacological therapy aimed at people with physical and/or mental disabilities. Therefore, it is necessary to carry out interventions that guarantee its benefits for patients while also avoiding the risk of zoonoses due to contact with the animals or their mucous membranes. The present study aimed to detect the occurrence of Pasteurella multocida in the oral cavity of dogs attending a “dog educational centre” and training for AAT interventions. In addition, some of the potential predictable factors of infection (i.e., age, sex, breed, and living conditions) were analyzed. In total, 25/200 dogs examined (12.5%; 95% confidence interval = 8.4–18.1%) were positive for P. multocida, as confirmed by PCR. Sex, breed, and living conditions were risk factors associated with P. multocida as revealed by the logistic regression analysis. Specifically, cross-bred female dogs living prevalently outdoors were significantly associated with the presence of P. multocida (p < 0.05). This study represents the first epidemiological survey of the prevalence of P. multocida in the oral cavity of dogs involved subsequently in AAT interventions, highlighting the potential risk of P. multocida infection in patients, often belonging to risk categories (e.g., children, the elderly, and immunocompromised individuals). Therefore, healthcare guidelines could be suggested to integrate the current literature related to the health check of dogs involved in AAT. In this way, it could be ensured that, even with bodily contact during AAT, the risk of pathogen transmission by the co-therapist dog can be avoided.

The influence of human interaction on guinea pigs: Behavioral and thermographic changes during animal-assisted therapy

Guinea pigs are often involved in animal-assisted therapy (AAT) but there is little knowledge about the effects of human contact on guinea pigs involved in AAT. The aim of this study was to investigate effects of availability of a retreat, presence of conspecifics, prior experience with AAT, and human interaction on indicators of welfare in guinea pigs involved in AAT. Guinea pigs of both sexes and different ages (n=20) were assigned to a randomized, controlled within-subject trial with repeated measurements. Each guinea pig was tested in four settings: (I) therapy with retreat possibility with conspecifics, (II) therapy with retreat possibility without conspecifics, (III) therapy without retreat possibility, and (IV) setting without human interaction. We measured changes in eye temperature, as a proxy to infer stress levels, at 5-s intervals with a thermographic camera. All sessions were video recorded and the guinea pigs' behavior was coded using continuous recording and focal animal sampling. For the statistical analysis we used generalized linear mixed models, with therapy setting as a fixed effect and individual guinea pig as a random effect. We observed a temperature increase relative to baseline in settings (I) therapy with retreat with conspecifics present and (III) therapy without retreat. The percentage of time a guinea pig was petted was positively correlated with a rise in the eye temperature independent of the setting. Time spent eating was reduced in all therapy settings (I-III) compared to the setting without HAI (human animal interaction) (IV). In the setting with retreat (I), guinea pigs showed more active behaviors such as locomotive behavior or startling compared to the setting without retreat (III) and the setting without HAI (IV). When no retreat was available (III), they showed more passive behaviors, such as standing still or freezing compared to therapy with retreat (I). Based on our results we identified the behaviors "reduced eating", "increased startle" and "increased freezing" as indicators of an increased stress level. Petting the guinea pigs was correlated with a rise in the eye temperature and might be a factor which can cause stress. Our results support the suggestion that guinea pigs involved in AAT should have a retreat possibility, should have access to conspecifics, and should be given time to adapt to a new setting. In this way, stress might be reduced.

Current Status of Animal-Assisted Interventions in Scientific Literature: A Critical Comment on Their Internal Validity

Simple Summary

Animal-assisted interventions (AAIs) have been receiving ever-increasing attention from both practitioners (including psychologists, educators, social workers, and physicians) and clients alike. However, despite this interest, the literature does not provide an unanimous support for including dogs, horses, cats, or other animals in interventions. The present work analyzes whether or not this lack of support could be understood as the result of inconsistencies and/or biases present in the literature, analyzing the definition of AAIs, the role of animals in interventions, the relationship among AAIs and the way humans relate to non-human animals, and the way in which researchers study these phenomena. The present comment provides some clues on how to improve the development of the field, including the following: giving more prominence to cultural, anthrozoological aspects of AAIs; considering AAIs as modalities of well-known interventions, avoiding their representation as “alternative”, “new”, or “groundbreaking”; and making changes to the study and intervention of designs, thus making it easier to demonstrate the impact of human–animal interactions on improving outcomes.

Abstract

Many meta-analyses and systematic reviews have tried to assess the efficacy of animal-assisted interventions (AAIs), reaching inconsistent conclusions. The present work posits a critical exploration of the current literature, using some recent meta-analyses to exemplify the presence of unattended threats. The present comment illustrates that the field (1) comprehends inconsistencies regarding the terms and definitions of AAIs; (2) pays more attention to the characteristics of the animals than to the action mechanisms of AAIs; (3) does not provide a clear connection between anthrozoology (how humans and non-human animals interact in communities), benefits of the human–animal interaction (HAI), and the design of AAIs; and (4) implicitly reinforces these phenomena through research designs. Thus, some conclusions extracted from these meta-analyses need further discussion. Increasing the internal validity of AAIs in empirical studies is an urgent task, which can be addressed by (1) developing a better understanding of how anthrozoology, the HAI, and AAIs relate to each other; (2) highlighting the mechanisms that explain the results in an empirical and specific way; and (3) changing the design of interventions, adopting a component-centered approach, and focusing on the incremental efficacy and efficiency of AAI programs.

The Psycho-Social Impact of Human-Animal Interactions

When I was asked by the Journal to guest edit a special issue on the psychosocial impact of human-animal interactions, I was honored to accept the invitation [...].

Systematic Review and Meta-Analysis of the Occurrence of ESKAPE Bacteria Group in Dogs, and the Related Zoonotic Risk in Animal-Assisted Therapy, and in Animal-Assisted Activity in the Health Context

Animal-assisted interventions are widely implemented in different contexts worldwide. Particularly, animal-assisted therapies and animal-assisted activities are often implemented in hospitals, rehabilitation centers, and other health facilities. These interventions bring several benefits to patients but can also expose them to the risk of infection with potentially zoonotic agents. The dog is the main animal species involved used in these interventions. Therefore, we aimed at collecting data regarding the occurrence of the pathogens ESKAPE (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter spp.) in dogs, in order to draft guidelines concerning the possible monitoring of dogs involved in animal-assisted therapies and animal-assisted activities in healthcare facilities. We performed a literature search using the PRISMA guidelines to examine three databases: PubMed, Web of Science, and Scopus. Out of 2604 records found, 52 papers were identified as eligible for inclusion in the review/meta-analysis. Sixteen papers reported data on E. faecium; 16 on S. aureus; nine on K. pneumoniae; four on A. baumannii; eight on P. aeruginosa; and six on Enterobacter spp. This work will contribute to increased awareness to the potential zoonotic risks posed by the involvement of dogs in animal-assisted therapies, and animal-assisted activities in healthcare facilities.

Methodological and Terminological Issues in Animal-Assisted Interventions: An Umbrella Review of Systematic Reviews

Simple Summary

Animal-assisted interventions (AAIs) include a wide range of activities aimed at improving the health and well-being of people with the help of pets. Although there have been many studies on the effects of these interventions on animal and human wellbeing and health, univocal data on the methodological aspects, regarding type and duration of intervention, operators, involved animal species, and so on, are still lacking. In this regard, several systematic reviews in the scientific literature have already explored and outlined some methodological aspects of animal-assisted interventions. Therefore, we developed an umbrella review (UR) which summarizes the data of a set of suitable systematic reviews (SRs), in order to clarify how these Interventions are carried out. From our results, it is shown that there is a widespread heterogeneity in the scientific literature concerning the study and implementation of these interventions. These results highlight the need for the development and, consequently, the diffusion of protocols (not only operational, but also research approaches) providing for a univocal use of globally recognized terminologies and facilitating comparison between the numerous experiences carried out and reported in the field.

Abstract

Recently, animal-assisted interventions (AAIs), which are defined as psychological, educational, and rehabilitation support activities, have become widespread in different contexts. For many years, they have been a subject of interest in the international scientific community and are at the center of an important discussion regarding their effectiveness and the most appropriate practices for their realization. We carried out an umbrella review (UR) of systematic reviews (SRs), created for the purpose of exploring the literature and aimed at deepening the terminological and methodological aspects of AAIs. It is created by exploring the online databases PubMed, Google Scholar, and Cochrane Library. The SRs present in the high-impact indexed search engines Web of Sciences and Scopus are selected. After screening, we selected 15 SRs that met the inclusion criteria. All papers complained of the poor quality of AAIs; some considered articles containing interventions that did not always correspond to the terminology they have explored and whose operating practices were not always comparable. This stresses the need for the development and consequent diffusion of not only operational protocols, but also research protocols which provide for the homogeneous use of universally recognized terminologies, thus facilitating the study, deepening, and comparison between the numerous experiences described.

Effects of Proximity between Companion Dogs and Their Caregivers on Heart Rate Variability Measures in Older Adults: A Pilot Study

Heart rate variability (HRV) is a noninvasive tool used to evaluate autonomic nervous system function and is affected by age, stress, postural changes, and physical activity. Dog ownership has been associated with higher 24-hr HRV and increased physical activity compared to nonowners. The current pilot study was designed to evaluate the effects of proximity to a dog in real time (minute-by-minute) on older dog caregivers’ HRV measures and stress index during normal daily life over a 24-hr period. Eleven caregivers (56–83 years of age) wore ActiGraph GT9X Link accelerometers and camntech electrocardiogram monitors, and 11 dogs wore PetPace Collars and ActiGraph monitors to determine (a) proximity (absence or presence of Received Signal Strength Indicator, RSSI), (b) heart rate and HRV measures, (c) position (lying vs. sitting vs. standing), and (d) physical activity in the 11 dyads. Twenty-four hour HRV (SDNN index) and physical activity in the caregivers and dogs were related. Stress index was lower, and HRV parameters (SDNN, rMSDD, high frequency power (HF)) were higher when an RSSI signal was detected (presence of dog) compared to no RSSI signal (absence of dog) in the caregivers while inactive (lying + sitting + standing combined). HRV parameters (rMSDD and HF) were lower in the caregivers while standing and sitting compared to lying. The results from this pilot study support the hypothesis that spending time in the presence of a companion dog increases caregivers’ HRV throughout the day and suggest that proximity to a dog may contribute to overall improvements in 24-hr HRV and cardiac health in dog caregivers.

Examining the Effects of Rabbit-Assisted Interventions in the Classroom Environment

Simple Summary

At the beginning of the first grade of elementary school, children generally show higher levels of anxiety, which continually decreases due to interactions with teachers. However, anxiety levels in children can also be decreased by using additional methods such as animal-assisted interventions in class. In this study, the efficiency of a rabbit-assisted intervention was examined in two first-grade classes with different backgrounds. In one of the classes, most of the pupils had special education needs. It could be concluded that rabbit-assisted interventions were particularly efficient where the anxiety levels of the children were high. This method seems to be useful in improving the efficacy of the educational ability of teachers.

Abstract

The effect of rabbit-assisted interventions on the anxiety levels of first-grade children at a primary school was analyzed. At the beginning of our research, no rabbit-assisted intervention was applied for 6 weeks in order to establish the level of stress caused by the start of the education period. We then alternated 6-week-long periods with and without rabbit-assisted intervention. The level of anxiety in children was assessed every three weeks both in the assisted and non-assisted periods, using the State–Trait Anxiety Inventory for Children, STAI-C. One of the examined classes did not apply the integrating policy while the other class contained pupils with special education needs (called the integrating class). Rabbit-assisted interventions proved to be efficient, as anxiety level scores were significantly lower during the animal-assisted periods. The rabbits actively initiated encounters with humans, not only in the framework of animal-assisted interventions, but also at other occasions. In cases of discomfort, the rabbit retreated to the cage and stayed inside for a short time. The children displayed signs of pleasure when the rabbits approached them. The favorable effect of animal assistance was more apparent in the integrating class. It could be concluded that rabbit-assisted interventions were suitable for decreasing the anxiety levels of elementary school children, improving the efficacy of the educational ability of teachers.

Integrative concepts and practices of health in transdisciplinary social ecology

Increasing recognition of interdependencies of the health of humans, other organisms and ecosystems, and of their importance to socio-ecological systems, necessitates application of integrative concepts such as One Health and EcoHealth. These concepts open new perspectives for research and practice but also generate confusion and divergent opinion, prompting new theories, and call for empirical clarification and evaluation. Through a semi-systematic evaluation of knowledge generation in scientific publications (comprised of literature reviews, conceptual models and analyses of communities of practice), we show how integrative concepts and approaches to health evolve and are adopted. Our findings indicate that while their contexts, goals and rationales vary, integrative concepts of health essentially arise from shared interests in living systems. Despite recent increased attention to ecological and societal aspects of health including broader sustainability issues, the focus remains anthropocentric and oriented towards biomedicine. Practices reflect and in turn transform these concepts, which together with practices also influence ways of integration. Overarching narratives vary between optimism and pessimism towards integrated health and knowledge. We conclude that there is an urgent need for better, coherent and more deeply integrative health concepts, approaches and practices to foster the well-being of humans, other animals and ecosystems. Consideration of these concepts and practices has methodological and political importance, as it will transform thinking and action on both society and nature and specifically can enrich science and practice, expanding their scope and linking them better. Transdisciplinary efforts are crucial to developing such concepts and practices to properly address the multiple facets of health and to achieve their appropriate integration for the socio-ecological systems at stake. We propose the term “transdisciplinary health” to denote the new approaches needed.

The Presence of Toxocara Eggs on Dog's Fur as Potential Zoonotic Risk in Animal-Assisted Interventions: A Systematic Review

Animal-assisted interventions (AAIs) usually contribute to the well-being and health of users/patients, but it is essential that the animals involved in these activities do not represent a source of zoonoses. This systematic review focused on the evaluation of the potential risk of the transmission of Toxocara by dogs' fur, considering their involvement as the main animal species in AAIs. Three databases were considered: MEDLINE/PubMed, Scopus, and Web of Science, and the PRISMA guidelines were used. Out of 162 articles found, 14 papers were identified as eligible for inclusion in the review. Although the findings were very heterogeneous, they showed that regular parasitological surveillance to plan effective control programs is strongly needed to guarantee the health of pets and consequently the public health, according to the concept of One Health. Since AAIs involve patients and/or users potentially susceptible, it is very important to appropriately treat dogs enrolled in these interventions after an accurate diagnosis of parasitic zoonoses.

The Human-Animal Relationship as the Focus of Animal-Assisted Interventions: A One Health Approach

BACKGROUND

Animal-assisted intervention (AAIs) represent an adequate expression of integrated medicine, according to the One Health approach. We argue that AAIs are interventions based on interspecific relationships between humans and animals. Although there are many studies on the effects of AAIs on animal and human health and wellbeing, research is still needed to give us more data. For example, information is still lacking on the aspects characterizing and influencing the interspecific relationships occurring in AAIs. The efficacy of an intervention based on interspecific relationships will be influenced by different factors, such as attachment styles and personalities of both the animal and the handler, an appropriate choice of animal species and their individuality, animal educational training techniques, the relationship between the handler and the animal, and relational reciprocity between animal, the patients, and members of the working team.

METHOD

This article aims to contribute to the study of interspecific relationships in AAIs via theoretical considerations. An interspecific relationship determines the result of safe interventions, which directly influences the welfare of the animal. Results and considerations: AAIs should be evaluated systemically as a network within a process in which every component interacts with and influences other components. Standardized methods using appropriate tests and parameters are needed to better select appropriate animals (i.e., species and individual subjects) using interspecific relational competences as well as appropriate educational training methods and health protocols to assess potential risks.

"There Is a Cat on Our Ward": Inpatient and Staff Member Attitudes toward and Experiences with Cats in a Psychiatric Ward

The aim of this study was to investigate inpatient and staff member attitudes toward and experiences with ward cats, and identify possible mechanisms for how cats affect patient satisfaction in a psychiatric clinic. Thirty-three inpatients diagnosed with depression or psychosis residing on wards with and without cats and 17 staff members working on wards with cats participated in semi-structured interviews using a cross-sectional study design. Data analysis included descriptive statistics and correlations. The results showed that 17 out of 19 inpatients and all the staff members liked having a cat on their ward. Further, 12 out of 14 inpatients on wards without cats would like having a cat on their ward. Inpatient perceptions of the cat’s impact on the ward atmosphere correlated significantly with their emotional relationship with the cat (p = 0.015, r = 0.561), how often they saw the cat (p = 0.002, r = 0.676), and if they liked cats in general (p = 0.041, r = 0.486). Our results highlight the positive attitudes of inpatients and staff members toward ward cats and the potential of ward cats to enhance patient satisfaction. This influence might be mediated by factors such as the frequency of contact, the relationship between each patient and the cat, and each patient’s attitude toward cats in general.

Changes of Oxytocin and Serotonin Values in Dialysis Patients after Animal Assisted Activities (AAAs) with a Dog—A Preliminary Study

Our study aimed to measure the levels of serotonin and oxytocin in patients affected by end-stage renal disease (ESRD), undergoing dialysis and participating in a program of animal-assisted activities (AAAs) with a dog. Ten patients with comparable levels of ESRD were enrolled. A blood sample was taken before the start of the study in order to establish basal levels. Eleven meetings were held once a week for 3 months during the last hour of dialysis, and blood samples were collected before and after AAAs. Two more meetings, one month apart from each other, were held two months later without the dog but with the same veterinarian zootherapist. Blood was drawn at the beginning and at the end of each meeting. The samples were then processed for the measurement of serotonin and oxytocin, and data obtained were analysed using analysis of variance with mixed effect models. The results show an increasing level of both serotonin and oxytocin between subsequent meetings with the dog and an increasing trend of inter-intervention levels. Overall, the results suggest that AAAs lead to modifications of serotonin and oxytocin levels, which are also accompanied by behavioural changes of patients.