1
|
Crozet G, Cliquet F, Robardet E. What would be the impact on the rabies risk of reducing the waiting period before dogs are imported? A modelling study based on the European Union legislation. Zoonoses Public Health 2024. [PMID: 38317287 DOI: 10.1111/zph.13113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 01/19/2024] [Accepted: 01/25/2024] [Indexed: 02/07/2024]
Abstract
AIMS Lyssavirus rabies (RABV) is responsible for a major zoonotic infection that is almost always lethal once clinical signs appear. Rabies can be (re)introduced into rabies-free areas through transboundary dog movements, thus compromising animal and human health. A number of measures have been implemented to prevent this happening, one of which is the waiting period (WP) after anti-rabies vaccination and serological testing. This WP ensures that antibodies assessed through the serological test are due to the vaccine, not to infection. Indeed, if antibodies are due to RABV infection, the dog should display clinical signs within this WP and would not therefore be imported. METHODS AND RESULTS Within a framework of quantitative risk assessment, we used modelling approaches to evaluate the impact of this WP and its duration on the risk of introducing rabies via the importation of dogs into the European Union. Two types of models were used, a classical stochastic scenario tree model and an individual-based model, both parameterised using scientific literature or data specifically applicable to the EU. Results showed that, assuming perfect compliance, the current 3-month waiting period was associated with a median annual number of 0.04 infected dogs imported into the EU. When the WP was reduced, the risk increased. For example, for a 1-month WP, the median annual number of infected dogs imported was 0.17 or 0.15 depending on the model, which corresponds to a four-fold increase. CONCLUSION This in silico study, particularly suitable for evaluating rare events such as rabies infections in rabies-free areas, provided results that can directly inform policymakers in order to adapt regulations linked to rabies and animal movements.
Collapse
Affiliation(s)
- Guillaume Crozet
- Laboratoire de Santé Animale USC EPIMAI, ANSES, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Florence Cliquet
- Nancy Laboratory for Rabies and Wildlife, ANSES, Malzéville, France
| | | |
Collapse
|
2
|
Arora KS, Chua A, Miller E, Boozer M, Serna T, Bullington BW, White K, Gunzler DD, Bailit JL, Berg K. Medicaid and Fulfillment of Postpartum Permanent Contraception Requests. Obstet Gynecol 2023; 141:918-925. [PMID: 37103533 PMCID: PMC10154035 DOI: 10.1097/aog.0000000000005130] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 01/12/2023] [Indexed: 04/28/2023]
Abstract
OBJECTIVE To evaluate the association between Medicaid insurance and fulfillment of postpartum permanent contraception requests. METHODS We conducted a retrospective cohort study of 43,915 patients across four study sites in four states, of whom 3,013 (7.1%) had a documented contraceptive plan of permanent contraception at the time of postpartum discharge and either Medicaid insurance or private insurance. Our primary outcome was permanent contraception fulfillment before hospital discharge; we compared individuals with private insurance with individuals with Medicaid insurance. Secondary outcomes were permanent contraception fulfillment within 42 and 365 days of delivery, as well as the rate of subsequent pregnancy after nonfulfillment. Bivariable and multivariable logistic regression analyses were used. RESULTS Patients with Medicaid insurance (1,096/2,076, 52.8%), compared with those with private insurance (663/937, 70.8%), were less likely to receive desired permanent contraception before hospital discharge (P≤.001). After adjustment for age, parity, weeks of gestation, mode of delivery, adequacy of prenatal care, race, ethnicity, marital status, and body mass index, private insurance status was associated with higher odds of fulfillment at discharge (adjusted odds ratio [aOR] 1.48, 95% CI 1.17-1.87) and 42 days (aOR 1.43, 95% CI 1.13-1.80) and 365 days (aOR 1.36, 95% CI 1.08-1.71) postpartum. Of the 980 patients with Medicaid insurance who did not receive postpartum permanent contraception, 42.2% had valid Medicaid sterilization consent forms at the time of delivery. CONCLUSION Differences in fulfillment rates of postpartum permanent contraception are observable between patients with Medicaid insurance and patients with private insurance after adjustment for clinical and demographic factors. The disparities associated with the federally mandated Medicaid sterilization consent form and waiting period necessitate policy reassessment to promote reproductive autonomy and to ensure equity.
Collapse
Affiliation(s)
- Kavita Shah Arora
- Department of Obstetrics and Gynecology, the Department of Epidemiology, Gillings School of Global Public Health, and the Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; the Department of Obstetrics and Gynecology and the Center for Health Care Research and Policy, Population Health Research Institute, MetroHealth Medical System, Cleveland, Ohio; the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Providence, Rhode Island; the Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama; the Department of Obstetrics and Gynecology, University of California, San Francisco, San Francisco, California; and the Department of Sociology, Steve Hicks School of Social Work, University of Texas at Austin, Austin, Texas
| | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Takeuchi H, Maezawa T, Hagiwara K, Horage Y, Hanada T, Haipeng H, Sakamoto M, Nishioka M, Takayama E, Terada K, Kondo E, Takai Y, Suzuki N, Ikeda T. Investigation of an efficient method of oocyte retrieval by dual stimulation for patients with cancer. Reprod Med Biol 2023; 22:e12534. [PMID: 37601482 PMCID: PMC10433114 DOI: 10.1002/rmb2.12534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 07/25/2023] [Accepted: 08/01/2023] [Indexed: 08/22/2023] Open
Abstract
Purpose To examine the optimal timing of second ovarian stimulation using the dual stimulation method for good ovarian responders with cancer undergoing oocyte retrieval for fertility preservation. Methods A retrospective analysis was conducted using data from 69 patients with cancer who underwent oocyte retrieval for fertility preservation at four Japanese institutions during 2010-2021. Twenty-two patients underwent two oocyte retrievals for fertility preservation. We studied the relationship between the initial number of oocytes retrieved via dual stimulation and risk of ovarian enlargement as well as the appropriate waiting interval between the end of the first ovarian stimulation and beginning of the second ovarian stimulation. Results The risk of ovarian enlargement was high when the initial number of oocytes retrieved via dual stimulation was ≥5. An 8-day waiting interval may be more effective for performing a second ovarian stimulation oocyte retrieval in these cases, although the difference was not significant. Conclusions This study provides one policy for effectively managing ovarian enlargement and timing of second ovarian stimulation during oocyte retrieval via the dual stimulation method for patients with cancer undergoing fertility preservation. If more facilities implement this procedure, more oocytes may be obtained in a short period for fertility preservation purposes.
Collapse
Affiliation(s)
- Hiroki Takeuchi
- Department of Obstetrics and Gynecology, Graduate School of MedicineMie UniversityTsuJapan
| | - Tadashi Maezawa
- Department of Obstetrics and Gynecology, Graduate School of MedicineMie UniversityTsuJapan
| | | | - Yuki Horage
- Department of Obstetrics and GynecologySt. Marianna University School of MedicineKawasakiJapan
| | - Tetsuro Hanada
- Department of Obstetrics and GynecologyShiga University of Medical ScienceOtsuJapan
| | - Huang Haipeng
- Department of Obstetrics and Gynecology, Saitama Medical CenterSaitama Medical UniversityKawagoeJapan
| | - Mito Sakamoto
- Department of Obstetrics and Gynecology, Graduate School of MedicineMie UniversityTsuJapan
| | - Mikiko Nishioka
- Department of Obstetrics and Gynecology, Graduate School of MedicineMie UniversityTsuJapan
| | - Erina Takayama
- Department of Obstetrics and Gynecology, Graduate School of MedicineMie UniversityTsuJapan
| | - Kento Terada
- Advanced Reproductive Medical CenterMie‐University HospitalTsuJapan
| | - Eiji Kondo
- Department of Obstetrics and Gynecology, Graduate School of MedicineMie UniversityTsuJapan
| | - Yasushi Takai
- Department of Obstetrics and Gynecology, Saitama Medical CenterSaitama Medical UniversityKawagoeJapan
| | - Nao Suzuki
- Department of Obstetrics and GynecologySt. Marianna University School of MedicineKawasakiJapan
| | - Tomoaki Ikeda
- Department of Obstetrics and Gynecology, Graduate School of MedicineMie UniversityTsuJapan
| |
Collapse
|
4
|
Alvarez J, Nielsen SS, Robardet E, Stegeman A, Van Gucht S, Vuta V, Antoniou SE, Aznar I, Papanikolaou A, Roberts HC. Risks related to a possible reduction of the waiting period for dogs after rabies antibody titration to 30 days compared with 90 days of the current EU legislative regime. EFSA J 2022; 20:e07350. [PMID: 35662806 PMCID: PMC9161159 DOI: 10.2903/j.efsa.2022.7350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
EFSA received a mandate from the European Commission to assess the risks related to a possible reduction of the waiting period after rabies antibody titration test to 30 days compared with 90 days of the current EU legislation, for dogs moving from certain non-EU countries to the EU. This Scientific Report assessed the probability of introduction of rabies into the EU through commercial and non-commercial movements of vaccinated dogs with a positive titration test (≥ 0.5 IU/mL) if the waiting period decreases from 90 to 30 days. Assuming that all the legal requirements are complied with, the risk of transmission of rabies through the movement of a vaccinated dog is related to the risk of introducing an animal incubating rabies that was infected before the day of vaccination or shortly after vaccination but before the development of immunity (21 days post-vaccination). Using published data on the incubation period for experimental and field cases in dogs and considering the rabies incidence data in certain countries, the aggregated probability for the annual introduction of rabies through dogs was assessed. Considering the uncertainty related to the duration of the incubation period, the number of imported dogs, and the disease incidence in some countries it was concluded with a 95% certainty that the maximum number of rabies-infected imported dogs complying with the regulations in a 20-year period could increase from 5 to 20 when decreasing the waiting period from 90 to 30 days. Nevertheless, the potential impact of even a small increase in probability means the risk is increased for a region like the EU where rabies has long been a focus for eradication, to protect human and animal health.
Collapse
|
5
|
Souames S, Berrama Z. Factors affecting conception rate after the first artificial insemination in a private dairy cattle farm in North Algeria. Vet World 2020; 13:2608-2611. [PMID: 33487977 PMCID: PMC7811532 DOI: 10.14202/vetworld.2020.2608-2611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 10/23/2020] [Indexed: 11/16/2022] Open
Abstract
Aim This study analyzed risk factors influencing the conception rate at the first artificial insemination (CR1) in dairy cows reared in the plain of Mitidja, which is considered a major dairy region in North Algeria. Materials and Methods A total of 1054 lactations were used in the relational study of fertility conducted using the multivariable logistic regression model using the odds ratio (OR). Results The breeding season had a specific effect on fertility; the first service was often followed by pregnancy when performed during autumn (AUT) (OR=1.67, p<0.05) and spring (SPR) (OR=1.65, p<0.05). The chances of obtaining conception during the first service increased significantly for a waiting period (WP) (interval between calving and time to first service) of 50-100 days postpartum (DPP) (OR=1.67, p<0.05). Conclusion From this study, it can be concluded that no specific effect was observed relative to the breed and parity. Furthermore, CR1 significantly increased after summer calving when the first services were performed during SPR and AUT and a WP after 50 DPP.
Collapse
Affiliation(s)
- Samir Souames
- Laboratory of Animal Health and Production, Higher National Veterinary School, Issad Abbes, Oued Smar Algiers, Algeria
| | - Zahra Berrama
- Laboratory of Animal Health and Production, Higher National Veterinary School, Issad Abbes, Oued Smar Algiers, Algeria
| |
Collapse
|
6
|
Rowlands S, Thomas K. Mandatory Waiting Periods Before Abortion and Sterilization: Theory and Practice. Int J Womens Health 2020; 12:577-586. [PMID: 32801935 PMCID: PMC7402852 DOI: 10.2147/ijwh.s257178] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/14/2020] [Indexed: 11/23/2022] Open
Abstract
Some laws insist on a fixed, compulsory waiting period between the time of obtaining consent and when abortions or sterilizations are carried out. Waiting periods are designed to allow for reflection on the decision and to minimize regret. In fact, the cognitive processing needed for these important decisions takes place relatively rapidly. Clinicians are used to handling cases individually and tailoring care appropriately, including giving more time for decision-making. Psychological considerations in relation to the role of emotion in decision-making, eg, regret, raise the possibility that waiting periods could have a detrimental impact on the emotional wellbeing of those concerned which might interfere with decision-making. Having an extended period of time to consider how much regret one might feel as a consequence of the decision one is faced with may make a person revisit a stable decision. In abortion care, waiting periods often result in an extra appointment being needed, delays in securing a procedure and personal distress for the applicant. Some women end up being beyond the gestational limit for abortion. Those requesting sterilization in a situation of active conflict in their relationship will do well to postpone a decision on sterilization. Otherwise, applicants for sterilization should not be forced to wait. Forced waiting undermines people's agency and autonomous decision-making ability. Low-income groups are particularly disadvantaged. It may be discriminatory when applied to marginalized groups. Concern about the validity of consent is best addressed by protective clinical guidelines rather than through rigid legislation. Waiting periods breach reproductive rights. Policymakers and politicians in countries that have waiting periods in sexual and reproductive health regulation should review relevant laws and policies and bring them into line with scientific and ethical evidence and international human rights law.
Collapse
Affiliation(s)
- Sam Rowlands
- Department of Medical Sciences and Public Health, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Kevin Thomas
- Department of Psychology, Faculty of Science and Technology, Bournemouth University, Bournemouth, UK
| |
Collapse
|
7
|
Schick M, Roesner S, Germeyer A, Moessner M, Bauer S, Ditzen B, Wischmann T. Smartphone-supported Positive Adjustment Coping Intervention (PACI) for couples undergoing fertility treatment: a randomised controlled trial protocol. BMJ Open 2019; 9:e025288. [PMID: 31289056 PMCID: PMC6629398 DOI: 10.1136/bmjopen-2018-025288] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Infertility generally counts as a profound crisis in the lives of couples and as an emotionally stressful experience. For couples undergoing fertility treatment, this is especially true of the waiting period following embryo transfer, which couples say is the most stressful period during treatment. However, at this specific phase, psychosocial counselling is not always available on the spot. The aim of this randomised controlled trial (RCT) study was to test the Positive Adjustment Coping Intervention (PACI), a low-dose, smartphone-supported psychological intervention for women and men undergoing fertility treatment. METHODS AND ANALYSIS The effectiveness of PACI is tested by means of a prospective two-arm RCT. During the 14-day waiting period between oocyte puncture/oocyte thawing and pregnancy test, participants are randomly assigned to one of the two groups, and both women and men receive daily text messages on their smartphones. One group receives text messages with statements reflecting positive-adjustment coping attitudes, the other group messages containing cognitive distractions. The primary outcome of this study is the reduction of psychosocial burden during the waiting period of reproductive treatment. Furthermore, we want to assess whether there are differences between the interventions in a pre-post assessment. The secondary outcomes are information on perceived effectiveness and practicability of the intervention one month after the waiting period. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Ethics Committee of Heidelberg University Faculty of Medicine (S-074/2017). Study findings are planned for dissemination via peer-reviewed journal articles and at national and international conferences. TRIAL REGISTRATION NUMBER NCT03118219; Pre-results. PROTOCOL VERSION Version 2.0 dated 18/02/2019.
Collapse
Affiliation(s)
- Maren Schick
- Institute of Medical Psychology, University Hospital Heidelberg, Center for Psychosocial Medicine, Heidelberg, Germany
| | - Sabine Roesner
- Department of Gynecologic Endocrinology and Fertility Disorders, University Women's Hospital Heidelberg, Heidelberg, Germany
| | - Ariane Germeyer
- Department of Gynecologic Endocrinology and Fertility Disorders, University Women's Hospital Heidelberg, Heidelberg, Germany
| | - Markus Moessner
- Center for Psychotherapy Research, University Hospital Heidelberg, Center for Psychosocial Medicine, Heidelberg, Germany
| | - Stephanie Bauer
- Center for Psychotherapy Research, University Hospital Heidelberg, Center for Psychosocial Medicine, Heidelberg, Germany
| | - Beate Ditzen
- Institute of Medical Psychology, University Hospital Heidelberg, Center for Psychosocial Medicine, Heidelberg, Germany
| | - Tewes Wischmann
- Institute of Medical Psychology, University Hospital Heidelberg, Center for Psychosocial Medicine, Heidelberg, Germany
| |
Collapse
|
8
|
Abstract
Handgun waiting periods are laws that impose a delay between the initiation of a purchase and final acquisition of a firearm. We show that waiting periods, which create a "cooling off" period among buyers, significantly reduce the incidence of gun violence. We estimate the impact of waiting periods on gun deaths, exploiting all changes to state-level policies in the Unites States since 1970. We find that waiting periods reduce gun homicides by roughly 17%. We provide further support for the causal impact of waiting periods on homicides by exploiting a natural experiment resulting from a federal law in 1994 that imposed a temporary waiting period on a subset of states.
Collapse
|
9
|
Anthony SJ, Nicholas DB, Regehr C, West LJ. A struggle to survive: the experience of awaiting pediatric heart transplantation. Pediatr Transplant 2014; 18:868-74. [PMID: 25284076 DOI: 10.1111/petr.12368] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/04/2014] [Indexed: 11/27/2022]
Abstract
Despite the establishment of heart transplantation as a life-saving therapy for children and adolescents, little research has focused on the biopsychosocial impact of the transplant process. Few studies have captured the subjective experiences of young heart transplant recipients. This study examined the experiences and perspectives of children and adolescents during the pretransplant phase of waiting for a donor organ. Grounded theory methods guided data collection and analysis. A total of 27 adolescents participated in semistructured qualitative interviews. Findings illuminate the waiting period for pediatric heart transplantation to be a pervasive experience, with consequent impact on physical, psychological, and social well-being. Participants described various biopsychosocial processes and experiences that occurred during this time, with data analysis yielding themes reflecting notions of "struggling to survive," including physical limitations, lethargy, social isolation, discomfort with physical appearance, and academic issues. This research identifies the pretransplant experience as a period framed within a text of debilitation and negative self-perceptions related to health and well-being. Supporting children and their families as they navigate this complex and uncertain journey is merited, and results invite further interventional development and research.
Collapse
Affiliation(s)
- Samantha J Anthony
- Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | | | | |
Collapse
|
10
|
Anthony SJ, Annunziato RA, Fairey E, Kelly VL, So S, Wray J. Waiting for transplant: physical, psychosocial, and nutritional status considerations for pediatric candidates and implications for care. Pediatr Transplant 2014; 18:423-34. [PMID: 25041330 DOI: 10.1111/petr.12305] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/22/2014] [Indexed: 11/28/2022]
Abstract
The waiting period for an organ transplant has been described as a time of tremendous uncertainty and vulnerability, posing unique challenges and stressors for pediatric transplant candidates and their families. It has been identified as the most stressful stage of the transplant journey, yet little attention has been given to the physical, psychological, or social impact of the waiting period in the literature. In this review, we discuss the physical, nutritional, and psychosocial implications of the waiting period for child and adolescent transplant candidates and the impact on their parents and siblings. We identify areas for future research and provide recommendations for clinical practice to support children, adolescents, and families during the waiting period.
Collapse
Affiliation(s)
- Samantha J Anthony
- Transplant and Regenerative Medicine Centre, The Hospital for Sick Children, Toronto, ON, Canada
| | | | | | | | | | | |
Collapse
|
11
|
Wang G, Scott SA. The " waiting period" of sensory and motor axons in early chick hindlimb: its role in axon pathfinding and neuronal maturation. J Neurosci 2000; 20:5358-66. [PMID: 10884320 PMCID: PMC6772340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2000] [Revised: 04/24/2000] [Accepted: 05/01/2000] [Indexed: 02/16/2023] Open
Abstract
During embryonic development motor axons in the chick hindlimb grow out slightly before sensory axons and wait in the plexus region at the base of the limb for approximately 24 hr before invading the limb itself (Tosney and Landmesser, 1985a). We have investigated the role of this waiting period by asking, Is the arrest of growth cones in the plexus region a general property of both sensory and motor axons? Why do axons wait? Does eliminating the waiting period affect the further development of motor and sensory neurons? Here we show that sensory axons, like motor axons, pause in the plexus region and that neither sensory nor motor axons require cues from the other population to wait in or exit from the plexus region. By transplanting older or younger donor limbs to host embryos, we show that host axons innervate donor limbs on a schedule consistent with the age of the grafted limbs. Thus, axons wait in the plexus region for maturational changes to occur in the limb rather than in the neurons themselves. Both sensory and motor axons innervate their appropriate peripheral targets when the waiting period is eliminated by grafting older donor limbs. Therefore, axons do not require a prolonged period in the plexus region to sort out and project appropriately. Eliminating the waiting period does, however, accelerate the onset of naturally occurring cell death, but it does not enhance the development of central projections or the biochemical maturation of sensory neurons.
Collapse
Affiliation(s)
- G Wang
- Department of Neurobiology and Anatomy, University of Utah School of Medicine, Salt Lake City, Utah 84132, USA
| | | |
Collapse
|