Livia is standing on a table in the small room at the University Hospital while Helena Odenrick is drying her coat. In a while they will visit Kåre, 6 years old, one of many seriously ill children who have undergone an operation. Helena rarely knows in advance who they will meet or the child's illness profile. She tells them that it can be good to have it that way because they can both concentrate on one thing – having fun together with Livia.

- I usually ask the patients if they have pain somewhere or if they have difficulty moving. Then I know the conditions for what we can do, says dog handler Helena Odenrick.

Kåre and Livia playing together.

Dogs are believed to have a positive effect on sick children, can help seriously ill children

Dogs as a form of rehabilitation are said to have positive effects on both patients, such as seriously ill children, and their relatives. Therefore, an extensive research study is now being launched that will investigate the effects of dogs in a care environment. There are no previous medical scientific studies where these effects have been measured, making it unique in its kind. The database consists of 50 patients and the registrations are expected to be ready by the turn of next year. In addition, the presence of allergens and bacteria, in connection with the dog's participation, will be investigated. The allergy study is expected to be completed sometime in 2016.

The dog handler Helena Odenrick, Livia and Kåre.

Regular washing necessary for allergy sufferers

Two days a week, Helena and Livia meet a couple of research patients; seriously ill children. Before each patient visit, Livia is bathed with him Allergenius® Dog Special Shampoo to reduce the amount of allergen during the stay with the children. Before and after each wash, brush samples are taken Allergenius ® Dog Allergen Test which captures allergens from the skin and fur. The samples are then sent in for analysis to the Karolinska Institutet. The purpose of these samples is to investigate how much allergen is in the fur when Livia plays with the children. Although Livia is a labradoodle, which was long considered to be low-allergenic, her test results before the study were within the normal range. That is to say, she was neither highly nor low-allergenic compared to other dogs. There are no studies that show that there are specific dog breeds that are so-called "allergenic". The test results from the brush samples on Livia have shown that the allergen content in the fur has decreased by more than 90 percent after washing. In some measurements, the presence of allergen has even been below a measurable level.

Livia in her room before the work shift.

An interruption in everyday life at the hospital

There is a lot of preparation before the meeting. Livia is properly bathed with The special shampoo to minimize the amount of allergens that Livia brings with her in her fur. At present, however, no children with documented allergies participate in the study. When Livia is bathed, brushed and her claws cut, she is finally ready to start working and meet patients, seriously ill children. Helena tells us that Livia is very willing to work and that she loves being at work. We go to the ward together. Everyone we meet along the way, both patients and hospital staff, shines with their presence. However, no one is allowed to pet her when she is at work. Livia has worked in healthcare for just over three years and it is appreciated by both relatives and patients.

We enter the room and Livia acts focused. An element that is always included is a moment of cuddling and cozying up together both before and after the visit. Livia lies down next to Kåre in bed and it's just as if they already know each other. The game together with Kåre takes 30 minutes and is largely controlled by what he himself wants and can do. Today there was a dice roll, where Livia and Kåre competed to see who got the most points. Also hiding treats, where Livia sniffed out dog treats that Kåre had hidden. On a few occasions, Livia and Kåre "high fived" each other. In the meantime, PhD student Maria Lindström Nilsson was present, who recorded and read the data using the electrodes that were attached to Kåre and connected to a number of machines.

After the visit, both Kåre and Livia seemed happy, but noticeably tired. On the way out of the ward, after the last brush sample was taken, it was now free for everyone in the hospital to greet her. Some were familiar with her from before and she seemed to be well liked by all who caught sight of her. The working day is over for this time and Livia gets a chance to rest in her own room at the hospital. In a couple of days it will be time for more play.

Helena Odenrick together with Livia.

Animals in pediatric care less common

Dogs as a form of therapy are common in many social institutions such as correctional services, psychiatry and care for the elderly. For seriously ill children who are cared for in hospital, however, it occurs to a more limited extent. This despite the fact that it is said to have very good physiological effects. The reason is that there are restrictions on hygiene, bacteria and allergies that are governed by the Health Care Act. When all the allergen tests are completed, it is possible to prove that the allergen content can be influenced, so that everyone can have the chance to spend time with a dog when they are in hospital.

The pediatrician, and Livia's mother, Ann Edner is happy about Livia's low allergen levels after washing.

- We hope that she will set the standard for how clean dogs in a care environment must be. It is important and good that the test answers look so nice. It might mean that more dogs can stay in care, says Ann Edner.

Facts:

The study in brief

• The research study aims to investigate the physiological and psychological effects of dogs in pediatric healthcare. Previous research has been able to show that complementary treatment, so-called non-pharmacological treatment, gives children a more positive experience of the hospital stay. What is examined is the presence of certain hormones as well as stress levels and heart rate. The study will also measure the experiences of the children, parents and care staff. An ethologist examines how Livia feels during working hours.
• A total of 50 patients aged 3–18 participate with the consent of their guardian.
• The presence of allergens and bacteria in Livia's fur will be investigated.

Dogs in care and welfare

• Today, there are dog teams in care and social care in around 70 municipalities. Mainly in elderly care. (Source: svt.se/nyheter, 2014)
• Livia is the first trained dog to work in children's healthcare.