scholarly journals Risks Associated with Animal-Assisted Intervention Programs: A Literature Review

Author(s):  
Kathryn R. Dalton ◽  
Kaitlin B. Waite ◽  
Kathy Ruble ◽  
Karen C. Carroll ◽  
Alexandra DeLone ◽  
...  

AbstractThe benefits of animal-assisted interventions (AAI), to utilize companion animals as an adjunctive treatment modality, is well-established and a burgeoning research field. However, few studies have evaluated the potential hazards of these programs, such as the potential for therapy animals to transfer hospital-associated pathogens between individuals and the hospital environment. Here we review the current literature on the possible risks of hospital-based AAI programs, including zoonotic pathogen transmission. We identified twenty-nine articles encompassing reviews of infection control guidelines and epidemiological studies on zoonotic pathogen prevalence in AAI. We observed substantial heterogeneity in infection control practices among hospital AAI programs. Few data confirmed pathogen transmission between therapy animals and patients. Given AAI’s known benefits, we recommend that future research utilize a One Health framework to evaluate microbial dynamics among therapy animals, patients, and hospital environments. This framework may best promote safe practices to ensure the sustainability of these valuable AAI programs.HighlightsDespite the many benefits of animal-assisted interventions (AAI) for patients, there is a risk of therapy animals becoming vectors of hospital pathogens.There is an absence of literature on transmission of hospital pathogens between patients and therapy animals during an AAI session.More research is needed to improve the safety and utilization of this important adjunctive therapy.

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S14-S14 ◽  
Author(s):  
Kathryn Dalton ◽  
Kathy Ruble ◽  
Alexandra DeLone ◽  
Pam Frankenfield ◽  
Destiny Walker ◽  
...  

Abstract Background Animal-assisted interventions (AAI), the use of animals as a complementary therapy in holistic patient care, has shown many positive outcomes. However, therapy animals can serve as mechanical vectors of hospital-associated infections (HAI), e.g., methicillin-resistant Staphylococcus aureus (MRSA). This pilot study assessed for transmission of HAIs among therapy animals, patients, and the hospital environment. We tested the effectiveness of a novel decolonization protocol for therapy dogs to reduce the risk of transmission of HAIs and enhance AAI program sustainability. Our hypothesis was that HAI transmission occurs from positive child to child, with the dog as an intermediary fomite. Methods Before and after child–animal interaction, we sampled patients, dogs, and the environment, and collected vital statistics and survey data from patients. MRSA was detected in samples by culture and molecular testing. Therapy dog handlers performed normal pre-visit practices for 2 control visits, then switched to a decolonization protocol (chlorhexidine-based shampoo prior to the visit, and chlorhexidine wipes on the fur during the visit) for 2 intervention visits. Results We evaluated 45 children and 4 therapy dogs over 13 visits. Children had decreased blood pressure and heart rate, and reported improved mental health scores post visit. MRSA conversion was identified from 10.2% of the children and 38.5% of the dogs, while 93% of the environmental samples were MRSA positive both pre and post. Patients that interacted closely with the dog had 8.01 times higher odds (95% CI 1.1–15.2) of MRSA conversion compared with patients who barely interacted with the dog. When stratified by intervention group, the MRSA conversation odds ratio of close interaction was 0.93 (95% CI 0.1–10.8) when the dog was decolonized versus 9.72 (0.9–99) when not decolonized. Conclusion This study showed the potential for AAI visits to improve physiological and mental health of pediatric outpatients. A risk of HAI exposure to patients from interaction with the dog was found, but this effect was nullified by the decolonization procedure. Future research is needed to increase the safety of this valuable alternative therapy. Disclosures All authors: No reported disclosures.


Animals ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 2769
Author(s):  
Zenithson Ng ◽  
Taylor Chastain Griffin ◽  
Lindsey Braun

Access to human–animal interactions (HAI) have been influenced by the COVID-19 pandemic. Service animals that were trained and accustomed to daily access to public places had to adjust to staying at home. Therapy animals and their handlers who previously visited with many of the populations most vulnerable to the virus have had to halt their programming. Professionals who utilize animal-assisted interventions (AAI) have had to develop new strategies for providing goal-oriented care. Even the landscape for companion animals has been significantly altered, leading to behavioral changes and new practices for pet owners and veterinarians. While animals and their human companions face new challenges, our recognition of the power of the human–animal bond (HAB) has grown, as it provides a vital need for connection during this time of isolation. In this paper, we will not only focus on describing the new status quo related to various kinds of animals and the public’s access to HAI, but will also offer suggestions for sharing the human–animal bond during a time in which physical connections are limited. Organizational insights from the service and therapy animal fields will be explored, and findings related to the auspiciousness of new initiatives, such as animal-related engagement (ARE), will be presented. Recommendations for people who share their lives with any of these kinds of animals will be made to ensure both human and animal welfare. Finally, future research and best practices will be suggested, so we can empirically understand and develop these revised offerings to ultimately bring HAI to a wider audience than ever before.


Author(s):  
Kathryn R. Dalton ◽  
Kathy Ruble ◽  
Laurel E. Redding ◽  
Daniel O. Morris ◽  
Noel T. Mueller ◽  
...  

AbstractBackgroundMicrobial sharing between humans and animals has been demonstrated in a variety of settings. However, the extent of microbial sharing that occurs within the healthcare setting during animal-assisted intervention programs, a validated and valuable part of holistic patient wellness, is unknown. Understanding microbial transmission between patients and therapy animals can provide important insights into potential health benefits for patients, in addition to addressing concerns regarding potential pathogen transmission that limits program utilization. This study evaluated the potential for microbial sharing between pediatric patients and therapy dogs, and tested whether patient-dog contact level and a dog decolonization protocol modified this sharing.Methods and ResultsPatients, therapy animals, and the hospital environment were sampled before and after every group therapy session and samples underwent 16S rRNA sequencing to characterize microbial communities. Both patients and animals experienced changes in the relative abundance and overall diversity of their nasal microbiome, suggesting that exchange of microorganisms had occurred. Increased contact was associated with greater sharing between patients and therapy animals, as well as between patients. A topical chlorhexidine-based dog decolonization intervention was associated with decreased microbial sharing between therapy dogs and patients, particularly from the removal of rarer microbiota from the dog, but did not significantly affect sharing between patients.ConclusionThese data suggest that the therapy animal is both a potential source of and a vehicle for the transfer of microorganisms to patients but not necessarily the only source. The relative contribution of other potential sources (e.g., other patients, the hospital environment) should be further explored to determine their relative importance.


Author(s):  
Lars-Christer Hydén ◽  
Mattias Forsblad

In this chapter we consider collaborative remembering and joint activates in everyday life in the case of people living with dementia. First, we review past research of practices that scaffolds the participation of persons with dementia in everyday chores under different stages of dementia diseases. We do so by suggesting three analytical types of scaffolding: when the scaffolding practices (i) frame the activity, (ii) guide actions, or (iii) are part of repair activities. Second, we review two aspects of collaborative remembering that are especially important in the case of dementia: training of scaffolding practices, and the sustaining and presentation of identities through collaborative storytelling. Finally, theoretical and methodological tendencies of the research field are summarized and future research needs are formulated.


Games ◽  
2021 ◽  
Vol 12 (2) ◽  
pp. 45
Author(s):  
Tiziana Ciano ◽  
Massimiliano Ferrara ◽  
Mariangela Gangemi ◽  
Domenica Stefania Merenda ◽  
Bruno Antonio Pansera

This work aims to provide different perspectives on the relationships between cooperative game theory and the research field concerning climate change dynamics. New results are obtained in the framework of competitive bargaining solutions and related issues, moving from a cooperative approach to a competitive one. Furthermore, the dynamics of balanced and super-balanced games are exposed, with particular reference to coalitions. Some open problems are presented to aid future research in this area.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1738.3-1738
Author(s):  
F. Eymard ◽  
P. Ornetti ◽  
J. Maillet ◽  
E. Noel ◽  
P. Adam ◽  
...  

Background:There has been much debate regarding the use of intra-articular injections of platelet-rich plasma (PRP) as symptomatic treatment for knee osteoarthritis. The heterogeneity of the preparation and injection protocols limits the extrapolation of data from randomized controlled trials and meta-analyses.Objectives:The objective of this expert consensus was to develop the first clinical practice recommendations for PRP injections in knee osteoarthritis.Methods:Fifteen physicians (10 rheumatologists, 4 specialists in rehabilitation and sport medicine and 1 interventional radiologist) from different countries were selected given to their expertise in the fields of PRP and osteoarthritis. Twenty-five recommendations were finally retained after several meetings using the modified Delphi method to establish clinical consensus. All experts voted their agreement or not for each recommendation using a score between 1 (totally inappropriate) and 9 (totally appropriate). Depending on the median value and extreme scores, recommendations were judged as appropriated or unappropriated with a strong or relative agreement but could also be judged as uncertain due to indecision or absence of consensus.Results:The main recommendations are listed below:- Intra-articular injections of PRP constitute an efficient treatment of early or moderate symptomatic knee osteoarthritis. Median = 8 [6-9] – Appropriate. Relative agreement.- Intra-articular injections of PRP may be useful in severe knee osteoarthritis (Kellgren-Lawrence grade IV). Median = 7 [6-7] – Appropriate. Relative agreement.- Intra-articular injections of PRP in knee osteoarthritis should be proposed as second-line therapy, after failure of non-pharmacological and pharmacological (oral and topic) symptomatic treatment. Median = 9 [5-9] – Appropriate. Relative agreement.- Intra-articular injections of PRP should not be performed in osteoarthritis flare-up with significant effusion. Median = 7 [5-9] – Appropriate. Relative agreement.- Intra-articular PRP treatment may include 1 to 3 consecutive injections. Median = 9 [7-9] – Appropriate. Strong agreement.- Leukocyte-poor PRP should be preferred for knee OA treatment. Median = 8 [5-9] – Appropriate. Relative agreement.- PRP injections should be performed under ultrasound or fluoroscopic guidance. Median = 8 [3-9] – Uncertain. No consensus.- PRP should not be mixed with injectable anesthetic or corticosteroid. Median = 9 [6-9] – Appropriate. Relative agreement.Conclusion:Twenty-five recommendations were discussed by an international multidisciplinary task force group in order to provide a basis for standardization of clinical practices and future research protocols.Disclosure of Interests:Florent Eymard Consultant of: Regenlab, Paul Ornetti: None declared, Jérémy Maillet Consultant of: Regenlab, Eric Noel Consultant of: Regenlab, Philippe Adam Consultant of: Regenlab, Virginie Legré Boyer Consultant of: Regenlab, Thierry Boyer Consultant of: Regenlab, Fadoua Allali: None declared, Vincent Grémeaux Bader: None declared, Jean-François Kaux: None declared, Karine Louati: None declared, Martin Lamontagne Consultant of: Pendopharm, Fabrice Michel: None declared, Pascal Richette: None declared, Hervé Bard Consultant of: Regenlab


Materials ◽  
2021 ◽  
Vol 14 (13) ◽  
pp. 3444
Author(s):  
Joji Abraham ◽  
Kim Dowling ◽  
Singarayer Florentine

Pathogen transfer and infection in the built environment are globally significant events, leading to the spread of disease and an increase in subsequent morbidity and mortality rates. There are numerous strategies followed in healthcare facilities to minimize pathogen transfer, but complete infection control has not, as yet, been achieved. However, based on traditional use in many cultures, the introduction of copper products and surfaces to significantly and positively retard pathogen transmission invites further investigation. For example, many microbes are rendered unviable upon contact exposure to copper or copper alloys, either immediately or within a short time. In addition, many disease-causing bacteria such as E. coli O157:H7, hospital superbugs, and several viruses (including SARS-CoV-2) are also susceptible to exposure to copper surfaces. It is thus suggested that replacing common touch surfaces in healthcare facilities, food industries, and public places (including public transport) with copper or alloys of copper may substantially contribute to limiting transmission. Subsequent hospital admissions and mortality rates will consequently be lowered, with a concomitant saving of lives and considerable levels of resources. This consideration is very significant in times of the COVID-19 pandemic and the upcoming epidemics, as it is becoming clear that all forms of possible infection control measures should be practiced in order to protect community well-being and promote healthy outcomes.


Author(s):  
Xiaochen Zhang ◽  
Lanxin Hui ◽  
Linchao Wei ◽  
Fuchuan Song ◽  
Fei Hu

Electric power wheelchairs (EPWs) enhance the mobility capability of the elderly and the disabled, while the human-machine interaction (HMI) determines how well the human intention will be precisely delivered and how human-machine system cooperation will be efficiently conducted. A bibliometric quantitative analysis of 1154 publications related to this research field, published between 1998 and 2020, was conducted. We identified the development status, contributors, hot topics, and potential future research directions of this field. We believe that the combination of intelligence and humanization of an EPW HMI system based on human-machine collaboration is an emerging trend in EPW HMI methodology research. Particular attention should be paid to evaluating the applicability and benefits of the EPW HMI methodology for the users, as well as how much it contributes to society. This study offers researchers a comprehensive understanding of EPW HMI studies in the past 22 years and latest trends from the evolutionary footprints and forward-thinking insights regarding future research.


2021 ◽  
pp. bmjsrh-2020-200962
Author(s):  
Kristina Gemzell-Danielsson ◽  
Ali Kubba ◽  
Cecilia Caetano ◽  
Thomas Faustmann ◽  
Eeva Lukkari-Lax ◽  
...  

Universal access to sexual and reproductive health services is essential to facilitate the empowerment of women and achievement of gender equality. Increasing access to modern methods of contraception can reduce the incidence of unplanned pregnancy and decrease maternal mortality. Long-acting reversible contraceptives (LARCs) offer high contraceptive efficacy as well as cost-efficacy, providing benefits for both women and healthcare systems. The levonorgestrel-releasing intrauterine system (LNG-IUS) first became available in 1990 with the introduction of Mirena (LNG-IUS 20), a highly effective contraceptive which can reduce menstrual blood loss and provide other therapeutic benefits. The impact of the LNG-IUS on society has been wide ranging, including decreasing the need for abortion, reducing the number of surgical sterilisation procedures performed, as well as reducing the number of hysterectomies carried out for issues such as heavy menstrual bleeding (HMB). In the context of the COVID-19 pandemic, Mirena can provide a treatment option for women with gynaecological issues such as HMB without organic pathology, minimising exposure to the hospital environment and reducing waiting times for surgical appointments. Looking to the future, research and development in the field of the LNG-IUS continues to expand our understanding of these contraceptives in clinical practice and offers the potential to further expand the choices available to women, allowing them to select the option that best meets their needs.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Laura Ruiz-Ripa ◽  
Carmen Simón ◽  
Sara Ceballos ◽  
Carmelo Ortega ◽  
Myriam Zarazaga ◽  
...  

Abstract Background Staphylococcus pseudintermedius (SP) and Staphylococcus aureus (SA) are common colonizers of companion animals, but they are also considered opportunistic pathogens, causing diseases of diverse severity. This study focused on the identification and characterization of 33 coagulase-positive staphylococci isolated from diseased pets (28 dogs and five cats) during 2009–2011 in a veterinary hospital in Spain in order to stablish the circulating lineages and their antimicrobial resistance profile. Results Twenty-eight isolates were identified as SP and five as SA. Nine methicillin-resistant (MR) isolates (27%) carrying the mecA gene were detected (eight MRSP and one MRSA). The 55% of SP and SA isolates were multidrug-resistant (MDR). MRSP strains were typed as ST71-agrIII-SCCmecII/III-(PFGE) A (n=5), ST68-agrIV-SCCmecV-B1/B2 (n=2), and ST258-agrII-SCCmecIV-C (n=1). SP isolates showed resistance to the following antimicrobials [percentage of resistant isolates/resistance genes]: penicillin [82/blaZ], oxacillin [29/mecA] erythromycin/clindamycin [43/erm(B)], aminoglycosides [18–46/aacA-aphD, aphA3, aadE], tetracycline [71/tet(M), tet(K)], ciprofloxacin [29], chloramphenicol [29/catpC221], and trimethoprim-sulfamethoxazole [50/dfrG, dfrK]. The dfrK gene was revealed as part of the radC-integrated Tn559 in two SP isolates. Virulence genes detected among SP isolates were as follow [percentage of isolates]: siet [100], se-int [100], lukS/F-I [100], seccanine [7], and expB [7]. The single MRSA-mecA detected was typed as t011-ST398/CC398-agrI-SCCmecV and was MDR. The methicillin-susceptible SA isolates were typed as t045-ST5/CC5 (n=2), t10576-ST1660 (n=1), and t005-ST22/CC22 (n=1); the t005-ST22 feline isolate was PVL-positive and the two t045-ST45 isolates were ascribed to Immune Evasion Cluster (IEC) type F. Moreover, the t10576-ST1660 isolate, of potential equine origin, harbored the lukPQ and scneq genes. According to animal clinical history and data records, several strains seem to have been acquired from different sources of the hospital environment, while some SA strains appeared to have a human origin. Conclusions The frequent detection of MR and MDR isolates among clinical SP and SA strains with noticeable virulence traits is of veterinary concern, implying limited treatment options available. This is the first description of MRSA-ST398 and MRSP-ST68 in pets in Spain, as well the first report of the dfrK-carrying Tn559 in SP. This evidences that current transmissible lineages with mobilizable resistomes have been circulating as causative agents of infections among pets for years.


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