Intrapartum Analgesia—Have Women’s Preferences Changed over the Last Decade?

Background: Global access to social media has supposedly changed women’s awareness about the pharmacological and alternative methods of pain relief during vaginal delivery. The purpose of the study was to analyze changes in women’s preference and opinion about different forms of labor analgesia over the past decade. Materials and methods: The study was designed as an anonymous survey with questions about women’s knowledge and preference of different forms of pain relief in labor. The survey was conducted in 2010 and 2020, with data collected from 1175 women in 2010 and 1033 in 2020. Results: There were no differences between 2010 and 2020 in the proportion of women who wanted to receive analgesia in labor, at, respectively 67.9% of women in 2010 and 73.9% in 2020. About 50% of women chose epidural analgesia as the only efficacious method of pain relief in labor both in 2010 and 2020. There were no differences between the two time-points in the distribution of chosen methods of pain relief. In total, 92.3% of women in 2010 and 94.9% in 2020 thought that they should have the possibility of independent choice of analgesia method before the delivery (p < 0.04). Conclusions: A high proportion of Polish women choose EDA over other pharmacological and nonpharmacological methods of pain relief in labor, and this preference has not changed over the last decade. Increasing women’s knowledge about different methods of intrapartum pain relief may lead to wider use of nonpharmacological methods of pain relief.

Expert Views on COVAX and Equitable Global Access to COVID-19 Vaccines

Objectives: We face the impossibility of having enough COVID-19 vaccines for everyone in the near future. This study aims to contribute to the debate on equitable global access to COVID-19 vaccines, tackling key ethical discussions and policy challenges regarding early phases of COVAX, the global cooperation mechanism for supporting fair vaccine allocation.Methods: We conducted in-depth interviews with twelve experts and a literature research on academic articles, media sources and public statements. We built a data analysis matrix and conducted a thematic analysis.Results: Our findings show, first, that interviewed experts who hold different views on vaccine allocation, including moderate nationalist perspectives, agree on joining a global cooperation mechanism. Second, incentives to join COVAX vary greatly among countries. Third, specific barriers to COVAX emerged in the early implementation phase. And fourth, countries might be trapped in a zero-sum game regarding the global vaccine supply.Conclusion: We present findings that enrich analyses of early phases of COVAX (April 2020–21), we introduce three ethical discussions that provide a common ground for equitable access to COVID-19 vaccines, and we highlight policy challenges.

When spider webs unite, they can tie up a lion1: NLM’s work in Information Technology and Health in Africa, 1997–2011

In 1997, Donald A.B. Lindberg M.D., Director, U.S. National Library of Medicine (NLM) agreed to address the request of African malaria researchers for access to the Internet and medical journals as part of the U.S. National Institutes of Health’s (NIH) contribution to the Multilateral Initiative on Malaria (MIM). This challenge matched my interests and previous experience in Africa. I joined NLM in 1997 to help establish the MIM Communications Network (MIMCom) in partnership with several NIH components and more than 30 other partners in Africa, the U.S., the United Kingdom (U.K.), and Europe. After a successful launch of MIMCom, NLM worked with African partners to create a series of innovative programs to build capacity in Africa and enhance global access to indigenous African research.

Diplomasi Vaksin Covid-19 dan Budaya Anarki dalam Sistem Internasional [Covid-19 Vaccine Diplomacy and Cultures of Anarchy in The International System]

To fight the Covid-19 pandemic, several countries, through their pharmaceutical companies, conduct research and production of vaccines. Efforts to invent a vaccine are racing with the rapid mutation of Covid-19. The World Health Organization with GAVI (Global Alliance for Vaccines and Immunization) and CEPI (Coalition for Epidemic Preparedness Innovations) initiated a collaborative forum called Covid-19 Vaccine Global Access (COVAX). The goal there is justice and equity in the distribution of vaccines throughout the world. Although strategic efforts to deal with the Covid-19 pandemic are carried out multilaterally through COVAX, many countries have also taken bilateral steps to get their vaccine needs. On the other hand, the Covid-19 vaccine diplomacy that took place in an anarchic international system showed three different cultural patterns, namely Hobbesian (conflictual), Lockean (competitive), and Kantian (cooperative). By using a qualitative approach, this study analyzes three cultural patterns of anarchy in vaccine diplomacy. Data collection techniques in this research are based on library research. The theory used in this research is diplomacy and cultures of Anarchy in Constructivism approach. From this research, it was found that the COVAX is a representation of the cooperative pattern carried out by countries in overcoming the Covid-19 pandemic. But apart from that, there is also Hobbesian or conflictual diplomacy between the United States and China. Meanwhile, competitive diplomacy can be seen in the competition among vaccine-producing countries.AbstrakUntuk mengatasi pandemi Covid-19, sejumlah negara melalui perusahaan farmasinya melakukan penelitian dan produksi vaksin. Upaya pencarian vaksin berlomba dengan mutasi Covid-19 yang cepat. Organisasi Kesehatan Dunia (World Health Organization) bersama GAVI (Global Alliance for Vaccines and Immunization) dan CEPI (Coalition for Epidemic Preparedness Innovations) menginisiasi wadah kolaboratif bernama Covid-19 Vaccine Global Access (COVAX). Tujuannya, agar terjadi keadilan dan pemerataan dalam distribusi vaksin ke seluruh dunia. Meski upaya strategis menghadapi pandemik Covid-19 dilakukan secara multilateral melalui COVAX, tapi langkah-langkah bilateral juga banyak dilakukan negaranegara dalam memenuhi kebutuhan vaksinnya. Pada sisi lain, diplomasi vaksin Covid-19 yang terjadi dalam sistem internasional yang anarki menunjukkan tiga pola budaya yang berbeda, yaitu Hobbesian (konfliktual), Lockian (kompetitif), dan Kantian (kooperatif). Dengan menggunakan pendekatan kualitatif, penelitian ini menganalisis tiga pola budaya anarki dalam diplomasi vaksin yang terjadi saat ini. Tekni pengumpulan data pada penelitian berdasarkan riset kepustakaan (library research). Teori yang digunakan dalam penelitian ini adalah Diplomasi dan Budaya Anarki dalam Konstruktivisme yang dikembangkan Alexander Wendt. Dari penelitian ini, ditemukan wadah COVAX merupakan representasi pola kooperatif yang dilakukan negara-negara dalam mengatasi pandemik Covid-19. Namun selain itu, terjadi juga diplomasi ala Hobbesian atau konfliktual seperti yang terjadi antara Amerika Serikat dan China. Sedangkan diplomasi yang bersifat kompetitif terlihat pada persaingan di antara negara-negara produsen vaksin.