Multilevel correlates of domain-specific physical activity among rural adults - a cross-sectional study.

BACKGROUND: Increasing physical activity (PA) in rural communities is a vital prevention tactic in multiple chronic diseases; however, little is known on the multilevel correlates of PA rural areas. A better understanding of domain-specific PA adds context for promoting PA in rural communities. The current study sought to determine factors associated with domain-specific and overall moderate-vigorous physical activity (MVPA) in rural communities. METHODS: Surveys were conducted across 14 rural mid-Western communities, with the final analytical sample including 1241 adults (ages 19-96, M = 57.0 [SD = 16.7], 67.8% female, 83.8% white). Generalized linear models with negative binomial distributions examined the relation between demographics, trail use, and perceptions of the neighborhood environment, with domain-specific and overall MVPA, measured via the Global Physical Activity Questionnaire. RESULTS: Rural residents reported an average of 617 total minutes of weekly MVPA (SD = 1141), with 58.5% meeting MVPA guidelines. Higher age, female gender, and higher educated individuals had lower levels of overall and occupational MVPA. Females, higher education, and perceived indoor recreational access were associated with lower levels of transportation-related MVPA, while trail use was associated with increased transportation MVPA. Higher age and female gender respondents had lower levels of recreational MVPA, while trail users and those who perceived favorable indoor recreational access had higher levels of recreational MVPA. CONCLUSIONS: PA primarily occurred in the occupational domain among this sample of rural mid-Western adults. Findings highlight the need for multilevel interventions to address PA across multiple domains in rural communities, especially among females and older adults.

A multilevel approach for promoting physical activity in rural communities: a cluster randomized controlled trial.

BACKGROUND: Physical activity (PA) has demonstrated a decreased risk in various cancers and other chronic diseases; however, rural residents are less likely to attain recommended levels of PA compared to urban and suburban counterparts. Given rural residents make up 15% of the United States population, there is a need for novel approaches to increase PA among this population. The goal of the present study is to investigate the effectiveness of a multilevel intervention to increase PA rates among rural residents. METHODS/DESIGN: Guided by an ecological framework, a group-randomized design will be used to evaluate the effects of a three-level intervention for increasing PA among adult residents residing in 6 rural communities (n = 600) along with 6 control communities (n = 600). The intervention includes components at the individual (short message service [SMS] text messages), interpersonal (social support in walking groups), and community levels (events at existing trails). Innovative methods to encourage participation will be employed as well as a focus on life priorities (family, recreation, hobbies) other than health. Aim 1 includes a literature review and key informant interviews to determine the local contexts for intervention adaptation. Aim 2 will employ a set of interventions at the individual, interpersonal, and community-levels to evaluate their impact on moderate-to-vigorous PA as measured by self-reported (telephone survey) and objectively assessed (accelerometry) measures. These data are supplemented by location based on Global Positioning System and community audits, which provide information on recreational amenities, programs/policies, and street segments. DISCUSSION: This study is among the first of its kind to test a multilevel intervention in a rural setting, address life priorities that compliment health outcomes, and examine moderation between behavioral interventions and the natural environments where people are physically active. Our results will influence the field by enhancing the ability to scale-up innovative, PA interventions with the potential to reach high-risk, rural populations. TRIAL REGISTRATION: Clinical Trials NCT03683173 , September 25, 2018.

Animals may act as social buffers: Skin conductance arousal in children with autism spectrum disorder in a social context.

Children with autism spectrum disorder (ASD) experience high rates of social stress and anxious arousal. Preliminary evidence suggests that companion animals can act as buffers against the adverse effects of social stress in adults. We measured continuous physiological arousal in children with ASD and typically developing (TD) children in a social context during four conditions: (a) a baseline of reading silently, (b) a scripted classroom activity involving reading aloud, (c) free play with peers and toys, and (d) free play with peers and animals (guinea pigs). Our results confirmed heightened arousal among children with ASD compared to TD children in all conditions, except when the animals were present. Children with ASD showed a 43% decrease in skin conductance responses during free play with peers in the presence of animals, compared to toys. Thus, animals may act as social buffers for children with ASD, conferring unique anxiolytic effects.

The influence of aquariums on weight in individuals with dementia.

This study assessed whether individuals with dementia who observe aquariums increase the amount of food they consume and maintain body weight. The sample included 70 residents in dementia units within 3 extended care facilities in 2 states. The intervention included the introduction of an aquarium into each common dining area. A total increase of 196.9 g of daily food intake (25.0%) was noted from baseline to the end of the 10-week study. Resident body weight increased an average of 2.2 pounds during the study. Eight of 70 residents experienced a weight loss ((Equation is included in full-text article.)=1.89 lbs). People with advanced dementia responded to aquariums in their environment documenting that attraction to the natural environment is so innate that it survives dementia.

"Dying alone and being eaten": dog scavenging on the remains of an elderly animal hoarder-a case report.

Animal hoarding and human consumption by dogs have been important but often understudied aspects of the human-animal bond that can be addressed within a One Health framework. No scientific report has focused on dog scavenging on animal hoarders to date, despite isolated reports of dog scavenging on human remains, mostly due to starvation. The phenomenon has been approached as a confounding factor for human forensics. In 2014, the Animal Protection Department of Curitiba City was called to rescue and handle ten small dogs which had scavenged for a week on the human remains of their elderly owner, a potential animal hoarder. At inspection, three dead dogs in early putrefaction were also found in the household. Human autopsy revealed body putrefaction and lack of soft organs. Along with the dental arch, DNA testing was performed on the remains for official deceased identification. Due to the potential public health risks of aggression toward frail human beings and for the control of zoonotic diseases, all ten dogs were euthanized. Subsequent investigations by the crime scene police, homicide police, and autopsy services were unable to establish or rule out natural death, criminal or suicidal poisoning, zoonotic disease (rabies), fatal dog attack, or fatal accidental trauma. A general protocol has been proposed for future approaches to dog scavenging and suspicious killing of animal hoarders, as well an assessment for the potential adoption or euthanasia of animals owned by hoarders in these circumstances.

Perceptions of COVID-19 Mitigation Strategies between Rural and Non-Rural Adults in the US: How Public Health Nurses Can Fill the Gap.

The purpose of this study was to capture the perceptions of COVID-19 mitigations' efficacy of rural and non-rural participants, using the health belief model (HBM), as well as to describe where public health nursing may be able to fill behavior gaps in rural communities. Rural and non-rural participants completed electronic surveys. Surveys collected demographic information and perceptions of various mitigation strategies' effectiveness. Rurality was significantly associated with perceptions of the effectiveness of public health mitigation strategies including wearing facemasks, limiting time indoors, avoiding gatherings, non-essential business closure, and staying home. Our findings suggest people in rural areas perceive mitigations to be effective. Other researchers have consistently shown rural residents are least likely to partake in the same mitigations. Rural public health nurses on the front line serve as the key to closing the aforementioned gap. Understanding where their community's perceptions lie is pivotal in creating educational programs to continue mitigation efforts as we embark on the second year of this pandemic.

Demographics and outcome of dogs and cats enrolled in the PetSafe program at the Purdue University College of Veterinary Medicine: 2004-2019.

OBJECTIVE: To determine the number and species of animals cared for by the PetSafe program at the Purdue University College of Veterinary Medicine (a community service offered to meet the short-term housing needs of pets, especially pets owned by victims of intimate partner violence) from 2004 through 2019 and collect information on duration of stay, outcome, health problems, and expenses. ANIMALS: 229 animals cared for by the PetSafe program. PROCEDURES: Medical records were reviewed for information on species, breed, age, duration of stay, outcome of stay, client referral source, whether the animal had been cared for previously, health problems, medical interventions, and expenses incurred. RESULTS: There were 124 dogs, 95 cats, 6 ferrets, and 4 sugar gliders; 187 of the animals were returned to their owners, 37 were rehomed, and 5 were euthanized because of medical conditions. The most common health problems were dental disease and dermatological complaints (eg, flea infestation and resulting fleabite dermatitis). None of the animals had physical evidence of abuse. Mean duration of stay was 22 days (range, 1 to 93 days), and mean ± SD cost per animal was $368 ± $341. CLINICAL RELEVANCE: Over the 16-year period of the study, the number and species of animals cared for by the PetSafe program at Purdue and the health problems encountered in those animals were relatively stable, and the program was able to meet the relatively predictable financial costs incurred through existing sources of funding.

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

[This corrects the article DOI: 10.1371/journal.pone.0243302.].

A Cross-Sectional Comparison of Physical Activity during COVID-19 in a Sample of Rural and Non-Rural Participants in the US.

Physical activity (PA) pre-COVID-19 was lower in rural areas compared to non-rural areas. The purpose of this study was to determine COVID-19's impact on PA in rural and non-rural residents. A cross-sectional study consisting of a convenience sample of 278 participants (50% rural, 50% non-rural) from 25 states completed an online survey describing their PA behaviors and perceptions during COVID-19. The global physical activity questionnaire was used to determine PA in various domains and summed to determine if the participant met the PA guidelines. Rural participants had a significantly higher body mass index, lower income, and a lower educational attainment. Conversely, non-rural participants reported more barriers to PA. There was no difference in the perception of COVID-19's impact on PA, specifically; however, rural participants were significantly less likely to meet cardiorespiratory PA recommendations compared to non-rural participants. Conclusions: This study demonstrates the continued disparity in PA between rural and non-rural residents, despite the supposition of COVID-19 being less impactful in rural areas due to sparse populations. Efforts should be pursued to close the PA gap between rural and non-rural residents.

Physical Activity Surveillance in the United States for Work and Commuting: Understanding the Impact on Population Health and Well-being.

OBJECTIVE: To summarize and describe the current US surveillance systems that assess physical activity (PA) for work and commuting. METHODS: An expert group conducted an environmental scan, generating a list (n = 18) which was ultimately reduced to 12, based on the inclusion of PA and/or sedentary behavior data. RESULTS: The 12 surveys or surveillance systems summarized provide nationally representative data on occupational-level PA or individual-level PA at work, data on active commuting, some are scorecards that summarize workplace health best practices and allow benchmarking, and one is a comprehensive nationally representative survey of employers assessing programs and practices in different worksites. CONCLUSIONS: The various surveillance systems and surveys/scorecards are disparate and need to be better analyzed and summarized to understand the impact of occupational-level PA and commuting on population health and well-being, life expectancy, and workforce productivity.

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

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

Randomized Trial of Therapy Dogs Versus Deliberative Coloring (Art Therapy) to Reduce Stress in Emergency Medicine Providers.

OBJECTIVE: Cognitive stress during shift work contributes to burnout in emergency department (ED) workers. We hypothesize that if physicians and nurses interact with a therapy dog for 5 minutes while on ED shift, both their perceived and their manifested stress levels will decrease. METHODS: In this single-center, prospective, randomized controlled clinical trial (NCT03628820), we tested the effectiveness of therapy dogs versus coloring a mandala and versus no intervention (control) on provider stress. Consenting emergency medicine physicians and nurses provided three self-reported assessments of stress and saliva samples at the start (T1), at the middle (T2), and near the end (T3) of shift. Thirty minutes prior to T2, participants were randomized to either interacting with a therapy dog or coloring for 5 minutes; controls had neither. Stress was assessed on visual analog scale (VAS, 0-100 mm) and with salivary cortisol (Salimetrics) and the modified Perceived Stress Scale (mPSS-10). To assess potential change in participant behavior, patients of providers in either group were asked to complete an internally derived survey of empathic behaviors displayed by providers at T1 and T3. RESULTS: We enrolled 122 providers (n = 39 control, n = 40 coloring, n = 43 dog); 48% were residents, and 60% enrolled on an evening shift. At T1, mean (±SD) VAS score was not different between groups (18.2 [±17.8] mm). At T3, VAS tended to increase with coloring (24.5 mm), remain unchanged in controls (20 mm), and decreased slightly with dogs (13.6 mm, p = 0.018 vs. coloring, Tukey's post hoc). Salivary cortisol levels were consistently highest at the beginning of each providers' shift and were significantly decreased versus control in both the dog and the coloring groups (p < 0.05, Tukey's). We observed no difference between groups for the mPSS-10 nor in patient reported survey of empathic behaviors. CONCLUSION: This randomized controlled clinical trial demonstrates preliminary evidence that a 5-minute therapy dog interaction while on shift can reduce provider stress in ED physicians and nurses.

The State of Animal-Assisted Interventions: Addressing the Contemporary Issues that will Shape the Future.

As the worldwide popularity of animal-assisted interventions (AAIs) increases, the fieldis quickly approaching a paradigm shift, adjusting its image to incorporate more evidence-basedresearch and aligning its purpose for advancing a new future. Contemporary critical issues thatconfront the field today include, but are not limited, to research, animal welfare, practice guidelines,and public policy. This article will provide an overview of the history of AAI and the majormilestones that the field has undergone. The current state of AAI research will be scrutinized, andthe areas that warrant further study will be recommended. Special attention will be given to thecurrent state of animal welfare in AAI, the research that has been done in the area, and practiceguidelines that safeguard animal wellbeing. This article will then discuss how evidence-basedresearch and animal welfare guidelines inform the development of comprehensive professionalstandards and influence changes in public policy regarding AAI. The authors' perceptions for thefield's future trajectory will be presented, which will include solutions to move the field in thedirection that best advances the human-animal bond in research, practice, and public perception.

Animal-Assisted Intervention and Dementia: A Systematic Review.

This review discusses the relationship between animal-assisted interventions (AAI) and behavioral and psychological symptoms of dementia (BPSD). A systematic search was conducted within CINAHL, Web of Science CAB Abstracts, PubMed, Abstracts in Social Gerontology, Google Scholar, and PsycINFO for primary research articles. A total of 32 studies were included in the final review. Variation was noted in study designs and in study setting. Twenty-seven of 32 studies used dogs as the intervention. Agitation/aggression showed a significant decrease in nine of 15 studies. Eleven of 12 studies demonstrated increased social interaction with AAI. Mood had mixed results in nine studies. Quality of life was increased in three of four studies. Resident activity and nutritional intake were each increased in two studies. Animal assisted activities/interventions showed a strong positive effect on social behaviors, physical activity, and dietary intake in dementia patients and a positive effect on agitation/aggression and quality of life.

A Qualitative Study Identifying Barriers and Facilitators of Physical Activity in Rural Communities.

Background: Physical activity (PA) rates are lower in rural populations, compared to urban and suburban counterparts. Since PA is shown to decrease the risk of cancers and chronic diseases, increasing PA in rural environments is an important disease-prevention strategy. However, in order to develop effective interventions for rural populations, more research is needed. The purpose of the study was to elicit rural residents' thoughts and perceptions related to PA and walking trail use. Methods: Key informant interviews were conducted via telephone, with 62 adults, living in six rural communities in southeast Missouri, who identified as stakeholders, walking trail users, and nontrail users. Participants were recruited through word of mouth and snowball sampling. Interviews were digitally audio-recorded, transcribed, and qualitatively analyzed. Findings: Analysis revealed variation within the rural population, with each town unique in what constituted barriers and facilitators to PA. Life priorities other than physical health were found to be important motivators to PA and also influenced how PA was obtained. Community size was found to impact community resources and infrastructure, although this was mitigated by poverty rates. Conclusion: Rural communities are distinct from one another with different views and approaches to PA. Future interventions designed to increase PA should be mindful of differences at the individual and town levels and avoid a one-size-fits-all approach. Interventions would benefit from insight and support from community members and stakeholders, to facilitate a tailored approach to increase PA.

Controlled clinical trial of canine therapy versus usual care to reduce patient anxiety in the emergency department.

OBJECTIVE: Test if therapy dogs reduce anxiety in emergency department (ED) patients. METHODS: In this controlled clinical trial (NCT03471429), medically stable, adult patients were approached if the physician believed that the patient had "moderate or greater anxiety." Patients were allocated on a 1:1 ratio to either 15 min exposure to a certified therapy dog and handler (dog), or usual care (control). Patient reported anxiety, pain and depression were assessed using a 0-10 scale (10 = worst). Primary outcome was change in anxiety from baseline (T0) to 30 min and 90 min after exposure to dog or control (T1 and T2 respectively); secondary outcomes were pain, depression and frequency of pain medication. RESULTS: Among 93 patients willing to participate in research, 7 had aversions to dogs, leaving 86 (92%) were willing to see a dog six others met exclusion criteria, leaving 40 patients allocated to each group (dog or control). Median and mean baseline anxiety, pain and depression scores were similar between groups. With dog exposure, median anxiety decreased significantly from T0 to T1: 6 (IQR 4-9.75) to T1: 2 (0-6) compared with 6 (4-8) to 6 (2.5-8) in controls (P<0.001, for T1, Mann-Whitney U and unpaired t-test). Dog exposure was associated with significantly lower anxiety at T2 and a significant overall treatment effect on two-way repeated measures ANOVA for anxiety, pain and depression. After exposure, 1/40 in the dog group needed pain medication, versus 7/40 in controls (P = 0.056, Fisher's exact test). CONCLUSIONS: Exposure to therapy dogs plus handlers significantly reduced anxiety in ED patients.

Current human-animal bond course offerings in veterinary schools.

The human-animal bond (HAB) is viewed as growing in importance for practicing veterinarians, veterinary students, and society in general. The fields and activities concerning the HAB are interdisciplinary and varied. There is widespread belief that HAB programs are important for veterinarians, although many practitioners feel that their instruction on this topic was not as complete as desired. Most activities associated with the HAB are conducted in specific centers, but only about half of the veterinary schools in North America have such centers, and the instructional programs they offer to students show much variation. The purpose of this study was to survey North American veterinary schools and to document the activities related to the HAB and HAB centers that are available to veterinary students.

Improving medication adherence in the pediatric population using integrated care of companion animals.

Medication non-adherence occurs in more than half of children with chronic conditions. Unfortunately, most strategies for improving adherence have had limited success in the pediatric population highlighting the need for novel interventions that establish healthy self-management habits for children and adolescents. In this paper we discuss innovative strategies to improve adherence by embedding a medical regimen within a pet care routine, thereby capitalizing on the benefits of a structured habit while providing opportunities for development of autonomy in children and fostering collaborative parent interactions.

Incorporating Pets into Acute Inpatient Rehabilitation: A Case Study.

PURPOSE: The use of animals in various healthcare settings dates as far back as the 19th century, and is still a widely practiced intervention even today. The use of animals in the acute rehabilitation setting is a common practice that benefits both the patient's therapy progression and allows the opportunity for financial reimbursement for the facility. As acute rehabilitation facilities continue to cope with ever changing rules and guidelines, the use of alternate modalities can help the facility overcome difficult challenges while focusing on the needs of the patients. The use of animal assisted therapy is illustrated with a stroke patient at an acute rehabilitation facility who benefited from implementing a pet therapy regimen when regular therapy modalities were not helping. CLINICAL RELEVANCE: Incorporating animal assisted therapy in acute rehabilitation settings is described to obtain greater satisfaction for patients and staff and to facilitate reimbursement for rehabilitation settings.