The cortisol awakening response in a 3 month clinical trial of service dogs for veterans with posttraumatic stress disorder.

Recent literature suggests that service dogs may be a valuable complementary intervention option for posttraumatic stress disorder (PTSD) among military veterans due to the potential influence on stress response dysregulation. The aim of this short-term longitudinal study was to quantify the impact of service dogs in US military veterans with PTSD with particular attention to the cortisol awakening response. A sub aim of the study was to empirically evaluate the physiological effects of PTSD service dogs on veteran partners. We conducted a clinical trial (ID: NCT03245814) that assessed the cortisol awakening response for 245 participants at baseline and 3 months follow-up across an intervention group (service dog: veterans n = 88, partners n = 46) and control group (usual care: n = 73, partners n = 38). A total of N = 161 veterans and N = 84 partners collected whole saliva samples via a passive drool collection immediately upon waking, 30 min after waking, and 45 min after waking on three consecutive weekdays at baseline and again at follow-up. Mixed model repeated measures (MMRM) with a fixed effect of the intervention group (service dog or control) were utilized. Covariates considered for the model included time of awakening, sleep duration, sleep efficiency, prior day experiences (measured via ecological momentary assessment), traumatic brain injury, age, gender, race, ethnicity, socioeconomic status, smoking status, alcohol use, physical health, and body mass index. A total of 3951 salivary samples were collected (veterans: 2613, partners: 1338). MMRM results demonstrated that veterans with a service dog had a statistically significant higher cortisol awakening response, including the area under the curve with respect to both increase (AUCi, ß = 1.46, p = 0.046) and absolute increase (AINC, ß = 0.05, p = 0.035). Results were not statistically significant for partners. Findings suggest that veterans with service dogs have a higher, less blunted CAR in comparison to veterans receiving usual care alone. In veterans with a blunted morning cortisol response, service dog placement could help boost their morning cortisol response.

Which one to follow? Service animal policy in the United States.

BACKGROUND: Service animals are an invaluable resource to improving health among individuals with disabilities, and their use is steadily growing. Yet, United States' current federal and state policies surrounding service animals are contradictory and burdensome, and often do not adequately protect the rights of service animal handlers. OBJECTIVE: To review each state's service animal policies surrounding criminal interference, misrepresentation of a service animal, and public accessibility. To also identify inconsistencies among states' individual policies, between state policies, and between state and federal policies, and discuss the implications of these inconsistencies. METHODS: Westlaw legal research database was used to comprehensively review each state's policies regarding the use of a service animal. RESULTS: 26 states have one or more policies that are incongruous with the Americans with Disabilities Act. Further, 34 states have contradictions within their own policies and between other states. 31 states provide protections against fraudulent service animals, and there are variations in the degree of protection and ability to enforce these laws. CONCLUSIONS: Because service animals are a vital resource to this particularly vulnerable population, it is imperative that our policies encourage their use and protect the rights of handlers. Yet, inconsistencies among current policies create confusion and ultimately deter individuals with disabilities from taking full advantage of their service animal. We are in need of clear, cohesive policy at all levels of government in order to improve health literacy and ensure that those with disabilities are able to benefit from the positive health impacts of a service animal.

Profiling guide dog handlers to support guide dog matching decisions.

Purpose: This Australian study piloted a new measure of Orientation and Mobility to better understand the functional mobility of guide dog handlers with low vision or blindness. It is expected that this measure can be used to better match guide dogs to their handlers.Materials and methods: The new Orientation and Mobility Outcomes tool scores a client in Stable/Familiar and Dynamic/Unfamiliar conditions, also considering Travel-Related Wellbeing. Semi-structured interviews were conducted with 51 guide dog handlers, during which travel skills were co-rated with an interviewer.Results: A cluster analysis of the Orientation and Mobility Outcomes data identified four mobility styles: intrepid explorers, social navigators, independent roamers and homebodies. The differences between these clusters had more to do with mental mapping skills than level of vision, and different guide dog characteristics were needed to support the travel styles identified for each cluster.Conclusions: The results confirm the importance of the Orientation and Mobility Outcomes tool as a sensitive, person-centred measure of the impact of Orientation and Mobility and guide dog training. In particular, the four mobility clusters provide a new perspective on matching guide dogs with clients, also suggesting the need for a more personalised look at the guide dog training process.Implications for RehabilitationOrientation and Mobility Outcomes data seem precise enough to support and inform the process of matching guide dogs to handlers.Uniform results cannot be expected from guide dog mobility in handlers - age, stage of life, health and spatial cognition impact the competence and travel style of guide dog handlers, whereas vision is less important.Sharing the work of visual interpretation and decision making with a guide dog makes independent travel more possible.Valuable dog characteristics that are specific to handler requirements might be bred or trained from puppy raising onwards, creating a more diverse pool of dogs to draw upon.