Use of the 10-Group Classification System to analyze how the population control policy change in China has affected cesarean delivery.

OBJECTIVE: To analyze the initial effect following the relaxation of China's population control policy on the cesarean delivery (CD) rate using the 10-Group Classification System (TGCS). METHODS: A retrospective study included all deliveries at a center in Nanjing, China, during 2014-2015. The deliveries were classified using the TGCS. The obstetric populations and the CD rates in each group were compared between 2014 and 2015. RESULTS: Overall, 11 006 deliveries were analyzed. The overall CD rate increased from 28.3% (1623/5737) in 2014 to 33.8% (1782/5269) in 2015 (P<0.001). The largest contributor to the overall CD rate-accounting for approximately one-third of all CDs-were nulliparous women with a single cephalic term pregnancy and induced labor or prelabor CD (group 2); the CD rate in this group increased from 27.2% to 31.4%. Moreover, the proportion of women with a single cephalic term pregnancy with previous CD (group 5) steeply increased from 6.4% to 10.4% of all deliveries; the CD rate in this group during 2014-2015 was 76.6%. CONCLUSION: With China ending its one-child policy, the characteristics of the obstetric population changed. Women with a single cephalic term pregnancy with previous CD were the largest contributor to the CD rate increase.

The effects of China's universal two-child policy.

In October, 2015, China's one-child policy was replaced by a universal two-child policy. The effects of the new policy are inevitably speculative, but predictions can be made based on recent trends. The population increase will be relatively small, peaking at 1·45 billion in 2029 (compared with a peak of 1·4 billion in 2023 if the one-child policy continued). The new policy will allow almost all Chinese people to have their preferred number of children. The benefits of the new policy include: a large reduction in abortions of unapproved pregnancies, virtual elimination of the problem of unregistered children, and a more normal sex ratio. All of these effects should improve health outcomes. Effects of the new policy on the shrinking workforce and rapid population ageing will not be evident for two decades. In the meantime, more sound policy actions are needed to meet the social, health, and care needs of the elderly population.

Midwife and Public Health Nurse Tatsuyo Amari and a State-Endorsed Birth Control Campaign in 1950s Japan.

Mrs. Tatsuyo Amari, a qualified midwife and nurse, served Japan's state-endorsed birth control campaign as a "birth control field instructor" in rural Minamoto Village of Yamanashi Prefecture just west of Tokyo. Her work sheds light on the role of female health-care workers in health and population governance in 1950s Japan. Amari not only facilitated the "top-down" transfer of the state-sanctioned idea of birth control and contraceptives, as did other birth control field instructors, but also enabled the "bottom-up" flow of knowledge about people's reproductive lives through her participation in the policy-oriented birth control research called the "three model-village study." Contextualizing Amari's engagement with the study elucidates how the state relied on the established role of female health-care workers as intermediaries between the state and the people. Finally, Amari's contribution to the scientific aspect of the campaign may motivate historians to recognize the politics around the participation of female health-care workers in the science of birth control.

Put a label (claim) on it: Getting non-surgical contraceptives approved for use in cats and dogs.

RELEVANCE: Non-surgical contraceptives or sterilants need regulatory approval to be sold for that use. This approval process gives veterinarians the information required to assess the benefits and risks of each product, and to provide comprehensive information on the required dose, method and duration of use, safety and effectiveness. AIM: This article reviews the information that must be developed and provided to regulatory agencies worldwide, with a focus on the European Union and the United States, in order to achieve regulatory approval. PROCESSES: The main components of developing a drug include developing extensive information on the safety and effectiveness of the product, and also the safety to the environment and to humans handling and administering the drug. Most importantly, a robust method of manufacturing both the drug itself and the formulated drug product (pill, liquid implant or injection) must be developed to assure quality and consistency in each batch. This information is then compiled and submitted to regulatory agencies; in the United States, this includes the Food and Drug Administration, the United States Department of Agriculture and the Environmental Protection Agency, and, in Europe, the European Medicines Agency. CHALLENGES: Because of the unique nature of non-surgical contraceptives for use in cats and dogs, particularly the desire to have these products last over multiple years, there are special challenges to their regulatory approval that are discussed in this review.

Horse impoundments under Control of Horses legislation in the Munster region of Ireland: factors affecting euthanasia.

Recently, considerable international attention has been paid to the problem of unwanted horses. In Ireland, stray horses, particularly in urban areas, are a further problem. The Control of Horses Act 1996 was enacted in response to an ongoing problem of uncontrolled horses in public places. As yet, no research work has been conducted focusing on stray horses in Ireland. This paper describes horses impounded under the Act in the Munster region of Ireland during 2005-2012 and the factors influencing decisions regarding their disposal. A logistic regression model was developed to investigate factors influencing the probability that a horse was euthanised during impoundment. In total, 3625 seizure events were recorded, most towards the end of the study period. Predictors for euthanasia during 2010-2012 included seizure location, sex, age, colour, body condition score and year. This study highlights the problem of stray horses in Ireland, particularly in urban areas. There is a need for rigorous enforcement of newly enacted horse identification legislation, allowing a fully integrated traceability system. More is required to manage the long-established societal problems of stray horses in urban settings, with a uniform approach by all Local Authorities being long overdue.