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    <title>Massive Science - Nechama F. Sammet Moring</title>
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<guid isPermaLink="true">https://massivesci.com/notes/abortion-medicine-access-inclusive-fda-regulations/</guid>
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<pubDate>Wed, 04 Aug 2021 18:38:00 EST</pubDate>
<title>Most patients prefer to access abortion medication from pharmacists instead of clinics</title>
<description>Medication abortion has been around for 20 years, and is a safe alternative to surgical abortion for many pregnant people</description>


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  <media:title>A woman completes a purchase at a pharmacy </media:title>
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    <p><a href="https://www.guttmacher.org/evidence-you-can-use/medication-abortion" target="_blank"><ins>Medication abortio</ins>n</a> has been around for 20 years, and is a safe alternative to surgical abortion for many pregnant people. However, despite their <a href="https://www.nejm.org/doi/full/10.1056/NEJMsb1612526" target="_blank"><ins>relative safety, </ins></a>the U.S. Food and Drug Administration (FDA) has very strict requirements about how and where these pills are accessed; many states also require that the first of the pills, mifepristone, be swallowed in the physical presence of the prescribing clinician. The FDA also mandates that only clinics - and not pharmacists - dispense mifepristone.</p>
<p>Critics of these regulations allege that they create <a href="https://www.sciencedirect.com/science/article/abs/pii/S0010782421001037" target="_blank"><ins>unnecessary barriers</ins></a> to safe abortion, particularly for people in rural areas, people with disabilities and other people who might have trouble getting to a clinic. They point out that<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7592805/" target="_blank"><ins> riskier medications</ins></a> are routinely dispensed in pharmacies. The regulations’ supporters cite safety concerns around pharmacists filling prescriptions for mifepristone, though <a href="https://www.uchicagomedicine.org/forefront/research-and-discoveries-articles/study-finds-hc-workers-support-pharmacy-dispensing-to-expand-medication-abortion-access" target="_blank"><ins>many clinicians</ins></a>, and the <a href="https://www.acog.org/clinical-information/policy-and-position-statements/position-statements/2018/improving-access-to-mifepristone-for-reproductive-health-indications" target="_blank"><ins>American College of Obstetrics and Gynecology</ins></a> support treating it like other drugs.</p>
<p><a href="https://journals.lww.com/greenjournal/fulltext/2021/04000/medication_abortion_with_pharmacist_dispensing_of.8.aspx" target="_blank"><ins>A new study</ins></a> obtained special permission for clinicians at eight trial sites to provide eligible patients with a prescription for mifepristone (and the second medication, misoprostol), which they would then fill at a partnering pharmacy. Patients completed surveys about their experiences two days and two weeks after their abortion.&nbsp;</p>
<p>Over 91 percent of study participants reported that they were somewhat or very satisfied with their pharmacy experience, and, of those who had had previous medication abortions, 81 percent said that getting their medications from the pharmacy was the same or better than getting them from the clinic. Two weeks later, 62 percent of participants said that they would prefer to have abortion medications called into the pharmacy, and 28 percent said that they would be fine with obtaining them at either the pharmacy or clinic. Some participants expressed that the pharmacy gave them more control over their abortion experience, because it let them start the process on their own schedule, rather than the clinic’s.</p>
<p>Overall, this study supports the case for loosening the regulations around medication abortion access, and specifically allowing abortion medication drugs to be dispensed by pharmacists. The FDA <a href="https://www.aclu.org/press-releases/fda-announces-long-sought-after-review-harmful-restrictions-medication-abortion" target="_blank"><ins>recently announced</ins></a> that their plans to reconsider their regulations on mifepristone.&nbsp;</p>
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<guid isPermaLink="true">https://massivesci.com/notes/dogs-chewing-sticks-tool-use/</guid>
<link rel="alternate" type="text/html">https://massivesci.com/notes/dogs-chewing-sticks-tool-use/</link>
<pubDate>Wed, 14 Jul 2021 09:58:00 EST</pubDate>
<title>Your dog&#39;s chewing behavior might be a sign of their intelligence</title>
<description>New research asks whether we should add dogs to the list of animals that use tools</description>


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    <p>If you’ve ever lived with dogs, or raised a puppy, you’ve probably seen them excitedly sink their teeth into a stick. Traditionally, we’ve brushed it off as just another canine instinct or behavior, much like shooting us puppy dog eyes or licking themselves. But what if chewing on sticks is actually a sign of dogs’ intelligence?</p>
<p>For a long time, scientists assumed that just a <a href="https://www.livescience.com/9761-10-animals-tools.html" target="_blank">handful of animals</a>, including many primates and crows, used tools. In fact, tool use was seen as a marker of advanced evolution, a sign that we are smart enough to adapt our environment to our needs. A pair of researchers at Kyoto University want to include dogs among the ranks of toolmakers, and their findings have the potential to change how we think about animal intelligence.</p>
<div class="oembed"><div class="iframely-embed"><div class="iframely-responsive" style="height: 140px; padding-bottom: 0;"><a href="https://massivesci.com/notes/dog-eyebrow-muscle-anatomy-cute-paedomorphism/" data-iframely-url="https://cdn.iframe.ly/api/iframe?url=https%3A%2F%2Fmassivesci.com%2Fnotes%2Fdog-eyebrow-muscle-anatomy-cute-paedomorphism%2F&amp;key=a91f6c63822d2172297a7435cae7a9eb"></a></div></div><script async src="https://cdn.iframe.ly/embed.js" charset="utf-8"></script></div>
<p>James Brooks and Shinya Yamamoto <a href="https://www.frontiersin.org/articles/10.3389/fpsyg.2020.577100/full" target="_blank">carefully observed dogs</a> chewing on sticks, and asked themselves why this behavior is so common. They posit that dogs purposefully use sticks to clean their teeth, and that stick chewing could relieve teething pain in puppies, much like we humans give our babies teething rings, and note that the way dogs hold their sticks in their paws suggests they’re potentially thinking through how to manipulate objects in space. This&nbsp;<a href="https://books.google.com/books?hl=en&amp;lr=&amp;id=Dx7slq__udwC&amp;oi=fnd&amp;pg=PT1&amp;ots=We7MjWEZvP&amp;sig=MUJzirv15bb4TbUZZTRBLr43BFE#v=onepage&amp;q&amp;f=false" target="_blank">fits the definition</a> of tool use.</p>
<p>Brooks and Yamamoto recommend further studies to see if dogs seek out sticks to chew on more often when they have other indicators of tooth pain or after different kinds of meals, and if more frequent stick-chewers have better dental health later in life. They also suggest we view tool use in animals as a spectrum, and their research raises questions about animal behaviors that might otherwise be overlooked as mere instinct.&nbsp;In other words, dogs and their sticks might just be showing us that animals are deliberate in their interactions with their environments.</p>
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