STUDY QUESTION
How do the different forms of regulation and public financing of IVF affect utilization in otherwise similar European welfare state systems?
SUMMARY ANSWER
Countries with more liberal ...social eligibility regulations had higher levels of IVF utilization, which diminished as the countries' policies became more restrictive.
WHAT IS KNOWN ALREADY
Europe is a world leader in the development and utilization of IVF, yet surveillance reveals significant differences in uptake among countries which have adopted different approaches to the regulation and and public financing of IVF.
STUDY DESIGN, SIZE, DURATION
A descriptive and comparative analysis of legal restrictions on access to IVF in 13 of the EU15 countries that affirmatively regulate and publicly finance IVF.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Using 2009 data from the European Society of Human Reproduction and Embryology study of regulatory frameworks in Europe and additional legislative research, we examined and described restrictions on access to IVF in terms of general eligibility, public financing and the scope of available services. Multiple correspondence analysis was used to identify patterns of regulation and groups of countries with similar regulatory patterns and to explore the effects on utilization of IVF, using data from the most recent European and international IVF monitoring reports.
MAIN RESULTS AND THE ROLE OF CHANCE
Regulations based on social characteristics of treatment seekers who are not applicable to other medical treatments, including relationship status and sexual orientation, appear to have the greatest impact on utilization. Countries with the most generous public financing schemes tend to restrict access to covered IVF to a greater degree. However, no link could be established between IVF utilization and the manner in which coverage was regulated or the level of public financing.
LIMITATIONS, REASONS FOR CAUTION
Owing to the lack of data regarding the actual level of public versus private financing of IVF it is impossible to draw conclusions regarding equity of access. Moreover, the regulatory and utilization data were not completely temporally matched in what can be a quickly changing regulatory landscape.
WIDER IMPLICATIONS OF THE FINDINGS
Whether motivated by cost, eligility restrictions or the availability of particular services, cross-border treatment seeking is driven by regulatory policies, underscoring the extra-territorial implications of in-country political decisions regarding access to IVF.
STUDY FUNDING/COMPETING INTEREST(S)
There was no funding source for this study. The authors have no conflicts of interest to declare.
We present an approach coupling a limited experimental number of tests with numerical simulations regarding the design of radiation-hardened (RH) rare earth (RE)-doped fiber amplifiers. Radiation ...tests are done on RE-doped fiber samples in order to measure and assess the values of the principal input parameters requested by the simulation tool based on particle swarm optimization (PSO) approach. The proposed simulation procedure is validated by comparing the calculation results with the measured degradations of two amplifiers made with standard and RH RE-doped optical fibers, respectively. After validation, the numerical code is used to theoretically investigate the influence of some amplifier design parameters on its sensitivity to radiations. Simulations show that the RE-doped fiber length used in the amplifier needs to be adjusted to optimize the amplifier performance over the whole space mission profile rather than to obtain the maximal amplification efficiency before its integration in the harsh environment. By combining this coupled approach with the newly-developed RH RE-doped fibers, fiber-based amplifiers nearly insensitive to space environment may be designed in the future.
A fully fibered microwave-optical source at 1.5 µm is studied experimentally. It is shown that the beat note between two orthogonally polarized modes of a distributed-feedback fiber laser can be ...efficiently stabilized using an optical phase-locked loop. The pump-power-induced birefringence serves as the actuator. Beat notes at 1 GHz and 10 GHz are successfully stabilized to a reference synthesizer, passing from the 3 kHz free-running linewidth to a stabilized sub-Hz linewidth, with a phase noise as low as -75 dBc/Hz at 100 Hz offset from the carrier. Such dual-frequency stabilized lasers could provide compact integrated components for RF and microwave photonics applications.
The temperature dependence of the emission and absorption cross sections of Er and Yb ions in rare-earth-doped aluminosilicate optical fibers is experimentally investigated. The obtained results ...demonstrate that the McCumber theory accurately predicts the temperature-induced changes of the emission cross section spectrum up to 500 °C when the absorption spectra measured at the considered temperature is used for the calculations instead of the one acquired at ambient temperature. Finally, we also demonstrate that the various heating steps up to 500 °C are not affecting the fiber guiding properties and no permanent effect is observed on the emission and absorption cross section spectra measured at room temperature.
Fiber Bragg Grating (FBG) based sensors are nowadays used for several applications, but, even if they present advantages for their incorporation into radiation environments, commercial-off-the-shelf ...devices cannot still be used in harsh conditions. We recently reported a procedure for fabricating FBGs resistant to severe constraints combining both high radiation doses up to MGy levels and operation temperatures exceeding 200°C (RadHard FBGs). Following these results, the European project HOBAN was granted by Kic InnoEnergy with the aim of developing and marketing FBG-based temperature and strain monitoring systems suitable for harsh nuclear environments (350°C temperature and MGy dose levels), with their associated instrumentation devices. In this framework, we present an accurate study about the robustness of the radiation-response of these RadHard FBGs against the main grating inscription parameters. Up to the accumulated X-ray dose of 1 MGy(SiO 2 ), no significant radiation induced Bragg wavelength shift is observed meaning that radiations induce errors below ± 0.4°C in the temperature estimation. Moreover, a study about the dose-rate dependence (1 to 50 Gy/s) of the gratings response is also reported and confirms the high radiation hardness of our RadHard FBGs at all dose rates.
In the framework of the HOBAN collaborative project funded by KIC InnoEnergy, radiation-hardened fiber Bragg gratings (FBGs) are developed to withstand high levels of radiation dose at high ...temperatures for their implementation in temperature and strain sensors for nuclear facilities, accelerators or space. This paper presents Gamma radiation test results obtained at room and elevated temperature in hardened FBGs as well as in the optical fibers used for their production. It is shown that radiation-induced Bragg wavelength shift is below ±2 pm corresponding to ±0.2 °C and does not influence the sensor performance even after a total dose of 200 kGy(SiO2) and operating temperature up to 350 °C.
We evaluate the potential of a new architecture of distributed optical fiber sensor (DOFS) to discriminate between the temperature and strain changes along a single optical fiber exposed to ...radiation. This DOFS exploits the measurements of both the Landau-Placzek ratio (LPR) and the Brillouin frequency shift (BFS) to achieve the discrimination between the two parameters on up to 10 km of fiber with a spatial resolution of 1 m. We demonstrate that the LPR remains unaffected up to MGy(SiO 2 ) dose levels, whereas the BFS is only slightly shifted by the radiation. The measured radiation-induced BFS is strongly reduced in radiation-hardened fluorine-doped single-mode optical fibers. Combining the DOFS architecture and the fiber allows discriminating temperature and strain using a single optical fiber up to megagray dose levels.
We investigated the behavior of a new class of erbium-doped fiber amplifier (EDFA) when exposed to 63 MeV protons. The EDFA is designed with a radiation hardened hole-assisted carbon coated (HACC) Er ...3 + -doped optical fiber. The particular structure of this HACC fiber allows to permanently incorporate an optimal amount of D 2 or H 2 gases into its core, reducing its radiation sensitivity without degrading the EDFA performances. Irradiations up to a fluence of 7.5 ×10 11 p/cm 2 confirm the excellent tolerance of this HACC-EDFA component. It exhibits a limited decrease of ~ 0.6 dB of its ~ 27 dB gain for this fluence corresponding to an ionization dose of 100 krad(Si). Such a device can then survive to the radiative environments associated with both today's space missions and future more challenging applications.
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