Epidemiological Panel Studies of Older Adults: New Frontiers in the Research on Human– Animal Interaction

ABSTRACT

This paper discusses epidemiological studies of older adults and human–animal interaction (HAI), and potential relevance to future research on HAI and animal-assisted interventions (AAI) in aging populations. Key issues in epidemiological work are discussed, including target populations, treatment/exposures, follow up, and endpoint measures as they relate to interacting with or owning companion animals. In outlining the limits in our current state of knowledge, we also make recommendations for the design and analysis of epidemiological studies to advance research on HAI and aging.     

Research on animal-assisted intervention and autism spectrum disorder, 2012–2015

Including animals in autism intervention is growing in both research and practice. A systematic literature review was conducted to collate and synthesize all empirical research on animal-assisted intervention (AAI) for autism published from 2012 to 2015. Findings from 28 included studies revealed that AAI programs generally include one animal per participant with a total contact time of approximately 10 hours over the course of 8 to 12 weeks. Research methodology is diverse and though limited in many cases, has improved over the last few years. The most commonly reported outcome was increased social interaction, which was unanimously significant across 22 studies. The need for further research is highlighted, calling for a focus on refining AAI techniques, identifying optimal circumstances for positive change as well as individuals who may not benefit, and independent replication of high quality studies to move AAI from an enrichment activity to an evidence-based practice for autism.     

The Effect of an Animal-Assisted Intervention on Anxiety and Pain in Hospitalized Children

ABSTRACT

Forty children between the ages of 8 and 18 years, who were admitted to a hospital pediatric unit, were randomly assigned to an animal-assisted intervention (AAI) or an active control condition (working on an age-appropriate jigsaw puzzle). Ratings of pain and anxiety were taken both pre- and post-condition. The attachment Questionnaire and Family Life Space Diagram (FLSD) also were administered, and information on medications taken was recorded. A significant post-condition difference was found between groups for anxiety, with the aaI group having lower anxiety scores. However, no significant within- or between-group pre-post changes in either pain or anxiety were detected. Nearly two-thirds of the children (64%) reporting pain at baseline were receiving some type of analgesic, which may have influenced outcomes. Findings demonstrate some support that attachment may be a moderating variable: children with a secure attachment style reported lower pain and anxiety at baseline, with large effect sizes for differences in both anxiety (g = 1.34) and pain (g = 1.23). Although the aaI did not significantly reduce anxiety and pain in these hospitalized children, further investigation of the influence of analgesic use and the moderating effect of attachment style is indicated.     

Strategies to improve the evidence base of animal-assisted interventions

Animal-assisted interventions (AAIs) reflect an extraordinary opportunity to improve mental health given the special role that animals (pets) occupy in everyday life and general public receptivity to animals. To enhance the evidence-base for AAIs, four recommendations are discussed: (a) conduct more well-designed studies, including the use of a broader array of methodologies; (b) make explicit “small theories” about precisely why and how human-animal interaction changes health and well-being; (c) increase laboratory-based studies of processes likely to underlie therapeutic applications; and (d) develop a strategic plan to guide AAI research, a means of implementing that plan, and ways of monitoring progress to ensure implementation has had impact on AAI research. There is enormous potential for AAI to overcome many obstacles of more traditional physical and mental health services, but developing that potential depends on establishing a stronger evidence base.     

A Systematic Review of Research on Pet Ownership and Animal Interactions among Older Adults

ABSTRACT

Research on the impact of companion animals in the lives of older adults is considered from two perspectives: pet ownership and in animal-assisted interventions (AAI). This paper first presents a discussion of potential theoretical explanations of the impact of animals on human health and wellbeing among older adults, and then provides a systematic review and evaluation of existing research on the topics of human–animal interaction (HAI) and physical health and exercise, depression and anxiety, and loneliness and social functioning. Each of the studies in this review (n = 145) are rated according to modified Oxford Center for Evidence Based Medicine (OCEBM) levels and the role of theory, in conceptualizing the study or interpreting outcomes, is discussed. The quality of evidence for each topical area of HAI and aging research is summarized, and recommendations are made for future research directions that will increase our knowledge of the relationship between HAI and health outcomes for older adults in different settings.     

Attitudes toward Animals among Kindergarten Children: Species Preferences

ABSTRACT

Attitudes toward animals are influenced by both animal traits (e.g., similarity to humans, aesthetic quality, size) and individual human attributes (e.g., gender, age, educational level, cultural factors). Although the examination of children's interest in animals, and their preference for different species, may evidence specific trends and help explain the development of attitudes, the vast majority of research has not considered children younger than 6 years. The present study was aimed at assessing preferences for a variety of animal species in a sample of 3–6 year-old Italian children, using a forced-choice task and visual aids (images of the animals). Pictures of 48 animal species, ranging from mammals to invertebrates, were presented to the children. Two photographic stimuli were simultaneously displayed and participants were asked to indicate their preference. Results show that the children preferred higher-order species, and domestic over wild animals. Apart from a few exceptions, invertebrates were the most disliked group of species among the children. Girls showed more negative and fear-related attitudes than the boys. Results are discussed taking into account different factors that may affect children's preferences for various animal species, that is, similarity to humans and aesthetical appeal. Greater knowledge on early attitudes toward animals has implications for promoting interest in animals and for building educational interventions for kindergarten children. This is particularly important in light of the growing use of different animals in educational and therapeutic contexts, as well as from an animal welfare perspective.     

Dolphin-Assisted Therapy with Parental Involvement for Children with Severe Disabilities: Further Evidence for a Family-Centered Theory for Effectiveness

Dolphin-assisted therapy has frequently been criticized for a lack of empirical results and theoretical foundation. In this study, results from an innovative dolphin-assisted therapy program for children with disabilities are presented. The therapeutic program is based on a sophisticated framework and developed with reference to previous findings about special education interventions. Parental involvement was integrated purposefully into the dolphin–child interaction to initiate an improvement in parent–child interactions. The effectiveness of this approach was supported in a controlled pretest-posttest design with matched samples. Pre-testing was conducted 4 weeks before dolphin-assisted therapy commenced, and post-testing occurred 4 weeks and 6 months after it finished. In total, 47 children with disabilities (Down syndrome, physical or mental retardation) and their parents and pedagogic-therapeutic staff participated in the study. The results of the parental questionnaires showed stable, positive changes in children's communicative abilities and social-emotional behavior and in parental quality of life, with mainly large effect sizes. These results exceed previously published effects from animal-assisted therapy and likewise of dolphin-assisted therapy. Data derived from staff questionnaires showed a moderate therapeutic effect on one of the three factors tested in relation to children's communicative abilities, but not on the social-emotional behavior of the child. Possible explanations for these findings are discussed.     

Effects of Having Pets at Home on Children's Attitudes toward Popular and Unpopular Animals

ABSTRACT

Having pets at home provides various social, health, and educational benefits to children. The question of how keeping pets at home affects the attitudes of children toward wild animals still has not been answered, due to various methodological issues, such as ignorance of some attitude dimensions and/or questionnaires that include items focused on very different animals. We conducted three independent research surveys (using three independent samples) of Slovakian primary school children aged 10 to 15 years (n = 1297). These surveys focused on the effects of keeping pets on the attitudes of children towards, and knowledge of, three unpopular animals in Slovakia. These animals were pests (potato beetle) (Study 1), predators (wolf) (Study 2), and those that pose a threat of disease to humans (mouse) (Study 3). Each survey also included a popular animal (ladybird beetle, rabbit, and squirrel, respectively), which served as a “control”; these were compared by pair-wise statistics. Results consistently showed that children had better knowledge of, but less favorable attitudes towards, unpopular animals compared with popular ones. Having pets at home was associated with more positive attitudes to, and better knowledge of, both popular and unpopular animals. Girls were less favorably inclined than boys to animals that may pose a threat, danger, or disease to them. Implications for humane education are discussed, especially in terms of keeping pets, the link between knowledge and attitudes, and children's understanding of ecological adaptations.     

Intussusception in the older child.

During its first 6 years of operation a large pediatric unit in a suburban general hospital treated 13 children over the age of 2 years for confirmed intussesception. During the same period 14 infants under the age of 2 years were treated for intussusception. It is suggested that the true age incidence of the disease is reflected more accurately by these figures than by those reported by large children''s hospitals. The clinical course was often less acute in the older child and hydrostatic reduction was usually effective (in 11 of 12 attempts). Prompt operation is recommended when the condition recurs more than 1 week after reduction because of the increased risk of an underlying intestinal lesion. Practitioners are urged to keep intussusception in mind when assessing an older child with intestinal colic.     

Children'S Attitudes About the Humane Treatment of Animals and Empathy: One-Year Follow up of a School-Based Intervention

ABSTRACT

This study assessed the maintenance of the effect of a year-long school-based humane education program on fourth grade children's attitudes toward animals. Generalization to human-directed empathy was also measured. Using a pretest-posttest (Year 1) follow-up (Year 2) design and ANCOVA, we found that the experimental group (children who experienced the program) humane attitudes mean was greater than the control group mean at initial posttesting and at the Year 2 follow up. At both Year 1 and Year 2 posttesting, the enhancement of attitudes toward animals generalized to human-directed empathy, especially when the quality of the children's relations with their pets was considered as a covariate. The results contribute to the growing literature on the significance of the relations between children and animals, and serve to encourage humane education efforts.     

Abstracts

Abstract

Exposure to pets and wildlife can help children develop positive attitudes toward animals, which can foster the development of empathy and ecological stewardship. However, geographical, logistical and economic restrictions limit opportunities for many youth to interact directly with live animals. Thus, educational interventions that utilize imitation animal artifacts rather than live animals, and which are effective in helping children develop an understanding of animals, present an important resource for educators. In the current study, the impact of a curriculum that employs imitation animal artifacts on children's perceptions of their relationships to animals was assessed. Third grade children's (n = 96) perceptions of their relationships to animals were analyzed by means of a drawing assessment tool. An analytic scoring rubric was used to assess three features of the drawings: Interactivity, Affect, and Realism. The combination of these elements was defined as the construct Self–Animal Perception. Change in Self–Animal Perception was assessed over time using repeated measures ANOVA. The curriculum intervention resulted in significant improvement in Self–Animal Perception scores relative to controls. The Self–Animal Perception construct and the drawing assessment tool utilized for measuring children's perceived relationships to animals are discussed.     

Assessing Effectiveness of a Nonhuman Animal Welfare Education Program for Primary School Children

Nonhuman animal welfare education aims to promote positive relationships between children and animals and thus improve animal welfare, yet few scientific evaluations of these programs exist. This study aimed to evaluate the effectiveness of an education program developed by the Scottish Society for the Prevention of Cruelty to Animals (SPCA) that included 4 interventions focusing on pets (companion animals), wild animals, farm animals, and general animal rescues. Knowledge, attachment to pets, and attitudes and beliefs about animal minds were assessed at pretest, posttest, and delayed posttest using a questionnaire administered to 1,217 Scottish children aged 7 to 13 years old. Results showed a significant positive impact of the program on knowledge about animals and the Scottish SPCA for all interventions. The pet and farming interventions significantly impacted children’s beliefs about animal minds. There were trends toward improvements in a range of other measures. This study highlights the importance of teaching animal welfare education to children for early prevention of animal cruelty, discusses the need to base this education on theory and research to find effective change, and demonstrates how evidence-based practice can inform future education programs.     

Pediatric Post-Discharge Mortality in Resource Poor Countries: A Systematic Review

Objectives

Mortality following hospital discharge is an important and under-recognized contributor to overall child mortality in developing countries. The primary objective of this systematic review was to identify all studies reporting post-discharge mortality in children, estimate likelihood of death, and determine the most important risk factors for death.

Search Strategy

MEDLINE and EMBASE were systematically searched using MeSH terms and keywords from the inception date to October, 2012. Key word searches using Google Scholar™ and hand searching of references of retrieved articles was also performed. Studies from developing countries reporting mortality following hospital discharge among a pediatric population were considered for inclusion.

Results

Thirteen studies that reported mortality rates following discharge were identified. Studies varied significantly according to design, underlying characteristics of study population and duration of follow-up. Mortality rates following discharge varied significantly between studies (1%–18%). When reported, post-discharge mortality rates often exceeded in-hospital mortality rates. The most important baseline variables associated with post-discharge mortality were young age, malnutrition, multiple previous hospitalizations, HIV infection and pneumonia. Most post-discharge deaths occurred early during the post-discharge period. Follow-up care was examined in only one study examining malaria prophylaxis in children discharged following an admission secondary to malaria, which showed no significant benefit on post-discharge mortality.

Conclusions

The months following hospital discharge carry significant risk for morbidity and mortality. While several characteristics are strongly associated with post-discharge mortality, no validated tools are available to aid health workers or policy makers in the systematic identification of children at high risk of post-discharge mortality. Future research must focus on both the creation of tools to aid in defining groups of children most likely to benefit from post-discharge interventions, and formal assessment of the effectiveness of such interventions in reducing morbidity and mortality in the first few months following hospital discharge.     

Does benefit justify research with children?

The inclusion of children in research gives rise to a difficult ethical question: What justifies children's research participation and exposure to research risks when they cannot provide informed consent? This question arises out of the tension between the moral requirement to obtain a subject's informed consent for research participation, on the one hand, and the limited capacity of most children to provide informed consent, on the other. Most agree that children's participation in clinical research can be justified. But the ethical justification for exposing children to research risks in the absence of consent remains unclear. One prevalent group of arguments aims to justify children's risk exposure by appealing to the concept of benefit. I call these ‘benefit arguments’. Prominent versions of this argument defend the idea that broadening our understanding of the notion of benefit to include non‐medical benefits (such as the benefit of a moral education) helps to justify children's research participation. I argue that existing benefit arguments are not persuasive and raise problems with the strategy of appealing to broader notions of benefit to justify children's exposure to research risk.     

Current challenges to research on animal-assisted interventions

Studies of the effects of Animal-Assisted Interventions (AAIs) face a number of theoretical and practical challenges. Proposed theoretical processes for the effects of AAIs include those that address primarily the animal’s ability to facilitate human–human social engagement, those that emphasize animals’ apparent capacity to trigger social attachments and provide nonhuman social support, those that categorize certain animals as supernormal stimuli, those that advance a biophilia hypothesis that living organisms have an innate ability to attract and hold human attention, and those that promote an integrative biopsychosocial model. Each of these generates potentially testable hypotheses, and the field would benefit from systematic efforts to address their validity. Practical challenges to AAI research include issues of study design and methodology, the heterogeneity of both AAI recipients and the animals participating in these interventions, the welfare of these animals, and the unusual pressure from the public and media to report and publish positive findings. Such challenges need to be carefully considered in designing and implementing future studies in the field.     

Enhancing Children's Attitudes About the Humane Treatment of Animals: Generalization to Human-Directed Empathy

Abstract

We assessed the impact of a year-long, school-based humane education program on younger (first and second graders) and older (fourth and fifth graders) children's attitudes toward the treatment of animals. Generalization to human-directed empathy was also measured. Using a pretest-posttest design and ANCOVA, we found that the program enhanced the animal-related attitudes of children differentially, depending on grade level. For younger children, there was no significant difference between experimental (E) and control (C) group attitude means; however, qualitative analysis showed that greater enhancement of attitudes occurred for first grade E group children than for C group children at that grade level. No differences were present on the generalization measure of empathy. For older children, there was a significant difference between E and C group attitude means qualified by grade level—there was greater enhancement of humane attitudes for E group than for C group fourth graders but no difference for fifth graders. On the generalization measure of empathy, posttest means for the E group were significantly greater than means for the C group regardless of grade level. The results contribute to the growing literature on the relation between children and animals and serve to encourage and validate the efforts of humane educators to improve children's caring and kindness toward companion and noncompanion animals.     

Conducting Studies with Fathers: Challenges and Opportunities

Traditionally, researchers interested in understanding father involvement in the lives of young children have relied on mothers as proxy respondents for fathers, yet recent research has made noteworthy strides in collecting data from fathers themselves yielding an unprecedented wealth of data on fathers' involvement in their children's lives. Despite this progress, there remain many methodological challenges in conducting studies with fathers and their children. Therefore, this article highlights several methodological challenges, including the identification of fathers, recruitment of fathers as participants, and retention of participants in small-scale studies with longitudinal designs, and discusses the advantages and disadvantages of several strategies our research team and others have used to collect data from fathers. The paper concludes with a set of suggestions for improving methodological approaches in fatherhood research, as well as remaining challenges in this area of study.     

Programas para combatir la soledad en las personas mayores en el ámbito institucionalizado: una revisión de la literatura científica

Loneliness is a problem that affects a very high percentage of older people, and can lead to physical and/or mental illness. This article aims to present a systematic review of programs to combat loneliness directed towards the institutionalised elderly. Experimental and quasi-experimental articles published between 2000 and 2016 were included in the review. An analysis was carried out on the quality of the methodological evidence of each of the articles. The programs analysed included animal-assisted, contacts with families through videoconferencing, gardening and/or horticulture workshops, reminiscence therapies, humour therapies, and cognitive interventions. The results show that intervention programs are effective to reduce the feeling of loneliness. The methodological limitations of the studies are discussed and future research is recommended.     

Anxiety-Reducing Effect: Dog,Fish and Plant in Direct Comparison

Animals have an anxiety-reducing effect on humans. However, in the search for which interventions are the most effective, one notices that studies in this field are not comparable as they all use different designs. Hereby, we investigated the anxiety reducing abilities of different animals and a plant using a public speaking task with identical set-ups and measures in all conditions. After speech anxiety was induced in university students (n = 71), they were presented with either a dog, a fish, a plant, or were left alone (control condition) for an intervention phase of 5 minutes. Anxiety measures were taken at five different points throughout the testing procedure. When comparing the participants' levels of anxiety before and after the intervention, we found that all students showed reduced anxiety levels in the experimental conditions, with no differences among the types of intervention, while no such effect was found for participants in the control condition. Our results not only demonstrate a new perspective in research on animal-assisted activities by presenting a more systematic and analytic approach to research in this field, but more importantly, they confirm the necessity for research guidelines for animal-assisted activities across the different disciplines involved, and question the unique importance and necessity of the involvement of animals in interventional practice.