137 Optimizing Animal Welfare in a Socially Acceptable and Sustainable Manner: The ASAS Grand Challenge That Requires Moral Self-reflection and Scientific Calibration

Sentience and animal welfare: Affirming the science and addressing the skepticism

Reducing the Burden of Pain From Vaccination: Updated Recommendations for All Age Groups.

Introduction: Adequate control of pain and anxiety during intravenous cannula (IV) placement improves patient satisfaction and reduces medical traumatic stress in children. We aimed to improve the overall experience of needle sticks in children by implementing a year-long multidisciplinary quality improvement project (“The Poke Plan”). Our primary aim was to increase the involvement of child life and use of pediatric pain mitigation strategies by 60% in all hospitalized children. Our secondary aim was to improve patient and parental satisfaction. Methods: A multidisciplinary team was assembled to improve our screening process for difficult IV access in patients on admission and the development of a poke plan pathway. 9 PDSA cycles focused on extensive nursing education, improved documentation, easy access to local pain medication, family involvement and feedback with child life, and weekly updates. Our process measure was the use of poke plan pathway. Balancing measures included increased workload for PIV placement experts. Results: During the study period, 773 patient charts were reviewed (78 pre-intervention [12/20 -04/21] and 695 post-intervention [04/21-07/22]). Compliance with the pain mitigation and distraction strategies increased from 16 – 20% in preintervention phase to > 60% in post implementation phase. The utilization of expert staff increased from 2% to 6%. HCAHPS scores for pain control improved from an average of 73.78% in 2020 to 82.6% in 2021/2022. Process stability of pain mitigation strategies was measured using a control chart. During the first 4 PDSA cycles, there was a significant shift above the center line which was transiently sustained (p=0.001). These cycles included nursing education, ultrasound training, and implementation of a poke plan algorithm. There was then a downward trend back below the center line. Further strategies included weekly huddles and a competition between the units to encourage poke plan usage. Another significant trend upward was observed (p=0.002) following resident education, update of the order sets, and EMR integration. Conclusions: Standardized poke plan pathway including early evaluation, timely team communication, proper preparation and targeted approach can lead to reduction in discomfort with IV access with better patient satisfaction.

The third Chinese veterinary conference was held in Suzhou, China, from 28 to 30 October ([ 1 ][1]). For the first time at a Chinese national conference, a forum on Animal Welfare Development was included on the schedule. The addition of this topic reflects the growing recognition of the importance of animal welfare issues among the Chinese academic community. At the forum, Chinese veterinarians and international experts agreed that improving animal welfare in China will require the development and enforcement of a national code of animal welfare, and that reference texts and educational materials in Chinese will be needed to standardize teaching and to make the issue broadly accessible. Animal protection and welfare issues are also gaining increasing attention in mainstream Chinese society. Take, for example, the recent public support for banning the practice of medicinal bear farming, which involves repeatedly extracting bile from live, captive animals ([ 2 ][2]). Popular figures are also promoting animal welfare issues: For example, the legendary basketball star Yao Ming is the face of a new WildAid campaign, which is combating the ivory trade by targeting potential consumers ([ 3 ][3]). A suite of other animal advocacy nongovernmental organizations (NGOs) such as the World Society for the Protection of Animals (WSPA) ([ 4 ][4]), Animals Asia ([ 5 ][5]), and the International Fund for Animal Welfare (IFAW) ([ 6 ][6]) also operate within China. Despite this growing awareness, however, China has a long way to go in developing and implementing animal welfare standards at an international level. We offer the following suggestions to facilitate this process. China must develop and enact national animal welfare legislation and policies. Although related legislation has been in preparation for years, there are still only fragmentary professional requirements and no national laws dealing directly with animal welfare. The legislation has been delayed by a range of issues, including the need for measurable animal welfare criteria, and the potential for conflict between policy supporters and commercial interests. These issues must be resolved and the legislation process completed as a matter of urgency, in order to provide a stable basis for the improvement of animal welfare across China. Effective implementation of such legislation will require the establishment of government institutions as a platform for the assessment and monitoring of the welfare of farmed, captive, and pet animals across China. Such institutions will require the participation and cooperation of relevant government departments, the academic community, commercial interests, and consumers. Together, these stakeholders can develop and enforce effective and sustainable animal welfare procedures and standards. To accurately convey the concepts of animal welfare and the need for animal welfare standards, community education will be critical. These activities should be targeted especially to professionals who work closely with animals—veterinaries, animal keepers, and researchers—who, by changing their own behaviors, can influence the behavior of the communities in which they work. Relevant educational materials should also be distributed through collaborations with schools and community groups in an effort to educate and influence the largest possible cross section of society. Animal welfare research in China has been limited, in large part due to a lack of funding. This is in turn partly due to the lack of enforced animal welfare standards for animals-related industries, and also to the perception that introducing animal welfare standards can only negatively affect production and profits. Relevant research should therefore be supported and encouraged. Collaborations among Chinese researchers, NGOs, and the international academic communities will result in the incorporation of the most effective international policies, industry standards, and research into the development of Chinese education programs and standards. 1. [↵][7] The Third Chinese Veterinary Conference ([www.cnvc.org.cn/en][8]). 2. [↵][9] 1. X. Sheng 2. et al ., Nature 484, 455 (2012). [OpenUrl][10][PubMed][11] 3. [↵][12] WildAid, “Yao Ming Heads to Africa to Document Rhino and Elephant Poaching Crisis,” 10 August 2012 ([www.wildaid.org/yaomingblog][13]). 4. [↵][14] World Society for the Protection of Animals, China ([www.wspa.org.cn/][15]). 5. [↵][16] Animals Asia ([www.animalsasia.org][17]). 6. [↵][18] International Fund for Animal Welfare ([www.ifaw.org/china][19]). [1]: #ref-1 [2]: #ref-2 [3]: #ref-3 [4]: #ref-4 [5]: #ref-5 [6]: #ref-6 [7]: #xref-ref-1-1 View reference 1 in text [8]: http://www.cnvc.org.cn/en [9]: #xref-ref-2-1 View reference 2 in text [10]: {openurl}?query=rft.jtitle%253DNature%253B%2BPhysical%2BScience%2B%2528London%2529%26rft.stitle%253DNature%253B%2BPhysical%2BScience%2B%2528London%2529%26rft.aulast%253DBuffett%26rft.auinit1%253DH.%2BG.%26rft.volume%253D484%26rft.issue%253D7395%26rft.spage%253D455%26rft.epage%253D455%26rft.atitle%253DIndian%2Bscience%253A%2BEnhance%2Bvisibility%2Bof%2BIndia%2527s%2Bacademies.%26rft_id%253Dinfo%253Apmid%252F22538600%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [11]: /lookup/external-ref?access_num=22538600&link_type=MED&atom=%2Fsci%2F338%2F6111%2F1150.atom [12]: #xref-ref-3-1 View reference 3 in text [13]: http://www.wildaid.org/yaomingblog [14]: #xref-ref-4-1 View reference 4 in text [15]: http://www.wspa.org.cn/ [16]: #xref-ref-5-1 View reference 5 in text [17]: http://www.animalsasia.org [18]: #xref-ref-6-1 View reference 6 in text [19]: http://www.ifaw.org/china

It is well documented that castration, regardless of age or method (surgical or band) causes pain in beef cattle. At the same time, consumer concern and awareness regarding painful routine management procedures in livestock is at an all-time high. Developing pain mitigation strategies that are practical and cost effective for producers is also important to facilitate their adoption by the beef industry. The goal of this paper is to review current pain assessment and mitigation strategies for knife and band castration in pre-weaned calves with focus on the influence of the age and method of castration, including a summary of recent studies assessing the effects of meloxicam in controlling calf pain and improving calf comfort.

The implementation of on-farm pain mitigation strategies is dependent on feasibility and importance to producers. Currently, there is a lack of information regarding adoption of management practices associated with pain in cattle within the Canadian beef industry. The objective of this mixed methods study was to describe pain-associated practices implemented on farm and producer perceptions toward pain mitigation strategies. A questionnaire about calving management and calf processing was delivered to 109 cow-calf producers in western Canada. In addition, 15 respondents were purposively selected based on questionnaire responses to participate in individual semistructured, on-farm interviews. The prevalence of pain mitigation strategies used for dystocia and cesarean section by respondents were 46 and 100%, respectively. The majority of operations reported castrating and dehorning calves before 3 mo of age (95 and 89%, respectively). The majority of operations did not use pain mitigation strategies for castration and dehorning (90 and 85%, respectively). Branding was practiced by 57% of respondents, 4% of which used pain mitigation. Thematic content analysis revealed that producers' perception of pain were influenced by what they referred to as "common sense," relatability to cattle, visual evidence of pain, and age of the animal. Factors that influenced participant rationale for the implementation of pain mitigation practices included access to information and resources, age of the animal, benefit to the operation, cost and logistics, market demands, and personal conscience. Overall, management practices were generally in compliance with published Canadian guidelines. Results of this study may provide direction for future policy making, research, and extension efforts to encourage the adoption of pain mitigation strategies.

Simple SummaryDisbudding is a routine procedure performed in goat kids at an early age, especially the ones in the dairy industry. The procedure is mainly done to increase safety for other animals and workers in intensive dairy farms. Disbudding is a painful procedure that affects the welfare of the kids. Effective and practical pain mitigation strategies to reduce the suffering of goat kids due to disbudding have not yet been found. We studied two different pain mitigation strategies for this procedure and concluded that they were not entirely effective. Consumers are increasingly aware of animal farming practices, especially the ones that can lead to suffering and pain, such as disbudding. It is crucial that pain mitigation strategies as well as possible alternative solutions to disbudding continue to be investigated. Nowadays, most of the goat milk production in developed countries is done in intensive indoors production systems. In these systems, procedures such as disbudding are performed routinely. Disbudding is done in young goat kids and is a recognised as a painful procedure. Pain mitigation strategies have been extensively researched, but a method that is effective in mitigating pain as well as being safe and practical has not yet been found. In this paper we used three treatment groups: one control and two groups with pain mitigation strategies for cautery disbudding, one using local anaesthesia (lidocaine) and a second one using local anaesthesia (lidocaine) plus an analgesic (flunixin meglumine). The behaviour of twenty-seven goat kids was recorded for three hours after disbudding. Overall, the goat kids that received both pain mitigation treatments dedicated more time performing active and positive behaviours. Nevertheless, the incidence of behaviours related to pain and discomfort was not consistently reduced. Research is still needed to find a practical and effective pain mitigation strategy for disbudding. A solution to this challenge would improve animal welfare as well as address societal concerns linked to the suffering of farm animals.

With the publication of this editorial Animal Welfare enters a new era in a new format: the Journal is now Gold Open Access with continuous online-only publication of high-quality animal welfare research. Animal Welfare, the longest continuously published animal welfare journal is the scientific journal of the Universities Federation for Animal Welfare (www.ufaw.org.uk)(UFAW), a nonprofit society dedicated to the promotion of animal welfare science. As a society journal, Animal Welfare is dedicated to the dissemination of evidence-based animal welfare information, which is central to UFAW's mission. The transition to Gold Open Access means the Journal will now do an even better job of fulfilling that mission. Like UFAW, our new publishing partner Cambridge University Press https://www.cambridge.org/ (CUP) is a non-profit organisation, and together we have transitioned the Journal to a sustainable, fully open access model that serves the unique needs of the animal welfare science community. This means we can continue to publish high quality animal welfare research whilst ensuring that it is accessible to everyone as quickly and widely as possible. Since the mission of UFAW and the Journal is to bring about improvements in animal welfare via a better understanding of animal welfare problems and their solutions, it is crucial that anyone who can make use of the research we publish can access it freely. We are delighted that this is now the case. The transition from a printed journal to online-only publication will also reduce our environmental impact, whilst reducing the delay between acceptance of papers and publication. The editorial team https://www.cambridge.org/core/journals/animal-welfare/information/ about-this-journal/editorial-board are very excited about the move to open access, online publishing. Following the transition, we will continue to work on improving the submission and publishing process. As well as a brand-new cover design, one recent development is a change to format-neutral initial submissions of manuscripts. This means that authors do not need to format their article to the journal style at this initial stage, and figures and tables can be kept in their original locations in the text, which also makes reviewing easier. This is just one example of how we are working to make the Journal user-friendly and accessible to improve the experience for authors and reviewers. Another change is an expansion of the section on ethical considerations, included in all experimental papers, where we encourage authors to describe in detail the ethical considerations concerning of their use of animals (or humans) in research. Whether or not an ethics committee has approved the study, we would like to hear more about the harm-benefit assessments made by the researchers, and a description of how the 3Rs and other ethical principles were implemented. For more details on this, see the section on Ethical Considerations in the author instructions https://www.cambridge.org/core/journals/animal-welfare/ information/author-instructions. At UFAW, as well as ensuring that anyone who needs to can access the latest animal welfare research we also want to make sure that everyone has the chance to publish their research in Animal Welfare, regardless of their ability to pay Article Processing Charges https://www.cambridge.org/ core/journals/animal-welfare/information/author-instructions/fees-and-pricing (APCs). Some authors will be covered by one of CUP's Transformative Agreements https://www.cambridge.org/ core/services/open-access-policies/read-and-publish-agreements (sometimes known as Read-and-Publish deals) allowing academics at many institutions to publish without directly paying an APC. For authors who are not covered by a transformative agreement, and do not have funding for APCs, the Journal can offer discretionary waivers of the APC as well as automatic full or partial geographic waivers to authors based in a lower income country which is on the Research4Life https://www. research4life.org/access/eligibility/ list. As before, any profits made by the Journal will continue to be ploughed back into the animal welfare work carried out by UFAW, in the form of support for research and dissemination of new knowledge. Alongside this editorial we are publishing the first papers under our new publishing model. These include studies on highly topical areas, that have been the subject of debate for decades such as the control of rats and mice when they come into conflict with humans and emerging areas such as the animal welfare challenges of farming insects for food (Barrett & Fischer 2023; De Ruyver et al. 2023. As a society journal, we hope that you will continue to support Animal Welfare in its new format, as authors, reviewers, members of the editorial boardand as readers.

Simple SummaryAnimal welfare is an important issue for citizens in North America and Europe, but much less is known about how citizens from emergent countries, such as Brazil, view this topic. Our aim was to explore attitudes of urban Brazilian citizens about dairy production and, in particular, how they view four routine husbandry practices: early cow-calf separation; zero-grazing; culling of the newborn male calf; and dehorning without pain mitigation. Through in-depth interviews and a questionnaire using open-ended questions, we can conclude that animal welfare was a major issue for our participants, especially in terms of its perceived relation with milk quality. Although participants were initially unaware about any of the four management practices, they were all viewed as contentious and not supported. This study provides some insights that farmers and others working in the Brazilian dairy supply chain should take into consideration, particularly in terms of social sustainability.The primary aim of this study was to explore attitudes of urban Brazilian citizens about dairy production. A secondary aim was to determine their knowledge and attitudes about four potentially contentious routine dairy cattle management practices: early cow-calf separation; zero-grazing; culling of newborn male calves; and dehorning without pain mitigation. To address the first aim 40 participants were interviewed using open-ended semi-structured questions designed to probe their views and attitudes about dairy production in Brazil, and 300 participants answered a questionnaire that included an open-ended question about the welfare of dairy cattle. Primary concerns reported by the participants centered on milk quality, which included the rejection of any chemical additives, but also animal welfare, environmental and social issues. The interviewees rarely mentioned animal welfare directly but, when probed, expressed several concerns related to this topic. In particular, participants commented on factors that they perceived to influence milk quality, such as good animal health, feeding, clean facilities, and the need to avoid or reduce the use of drugs, hormones and pesticides, the avoidance of pain, frustration and suffering, and the ability of the animals to perform natural behaviors. To address our second aim, participants were asked questions about the four routine management practices. Although they self-reported being largely unaware of these practices, the majority of the participants rejected these practices outright. These data provide insight that animal welfare may be an important issue for members of the public. Failure to consider this information may increase the risk that certain dairy production practices may not be socially sustainable once lay citizens become aware of them.

The purpose of the ASAS Public Policy Committee (PPC) is to help ASAS shape public policy and public opinion on current issues affecting farms and companion animals. PPC sets goals to make federal agencies aware of the scientific expertise and resources available within ASAS that could be used to develop science-based federal policies affecting poultry and livestock production. Recent reports point to a poor state of agricultural facilities at public colleges of agriculture which puts research priorities related to adaptation to and mitigation of climate change, food safety, zoonotic disease preparedness, animal populations and their care, diet-health, nutrition, biosecurity, new biobased packaging, energy innovations, and advanced market analysis at risk (APLU, 2021). To ascertain input specific to the Animal Sciences (AS), an IRB approved ‘Survey About Infrastructure in Animal Sciences’ (#22-495) was offered by the PPC to department heads and faculty of Animal Science programs across the country. The survey instrument was constructed to allow open-ended responses as well as 5-point Likert scale questions regarding participants views about infrastructure (IF) and thereby learn what members closest to the animal sciences community perceive to be the strengths, weaknesses, and opportunities for improvement in our research infrastructure. Analysis of coded responses in the open-ended questions among varied disciplinary arenas within AS revealed ‘facilities’ as the largest Grand Challenge. About 98% of respondents affirmed sustainable food and animal production is a critical national asset in terms of economic growth and development and 98% indicated an overlooked maintenance of IF in AS undermines national food security. Additionally, 68% indicated the state of core labs, at least for AS programs are only average or below. All respondents (100%) agreed that without comprehensive investment in infrastructure within AS, the USA will continue to fall behind in competing with other countries in areas of research. Study results provided insight into potential consequences of deferred maintenance which should elevate awareness of urgency to address the deficiencies. Since IF needs included future workforce development and working environments, an eroded IF and consequences of deferred maintenance threatens the capacity of AS to pursue Grand Challenges in research and ability to create future workforce readiness of graduates from AS programs.

The ASAS Public Policy Committee (PPC) provides updates of Grand Challenges (GCs) which clearly articulate research priorities while providing science-based information for shaping public policy and enhancing future funding for research and education programs in animal sciences (AS). Among the GCs is reproduction of domesticated animals (cattle, swine, sheep, goats, poultry, horses, and aquatic species) that is integral to sustain and improve global competitiveness of U.S. animal agriculture, understand and resolve complex animal and human diseases, and advance fundamental research in sciences that are critical to understanding mechanisms of action and identify future targets for interventions. Historically, federal and state budgets have dwindled and funding for the United States Department of Agriculture (USDA) National Institute of Food and Agriculture (NIFA) competitive grants programs remained relatively stagnant from 1985 through 2010. This shortage in critical financial support for basic and applied research, coupled with the underappreciated knowledge of the utility of non-rodent species for biomedical research, has hindered funding opportunities for research involving livestock and limited improvements in both animal agriculture and animal and human health. In 2010, the National Institutes of Health (NIH) and USDA National Institute of Food and Agriculture (NIFA) established an interagency partnership to promote the use of agriculturally important animal species in basic and translational research relevant to both biomedicine and agriculture. The “Dual Purpose with Dual Benefit” program encouraged One Health approaches for comparative medicine studies that use farm animal models that mimic human developmental, physiological, and etiological processes to promote human and animal health, better understand disease origins, interspecies transmission and mitigation strategies, and improve efficiency of assisted reproduction technologies. This presentation will review the successes of the 9-year Dual Purpose effort and highlight opportunities for tackling GC research in reproduction of domesticated agricultural animals.

Animal welfare science has engaged in the studies of how mainly farm animals, but to a lesser extent also sport and pet animals and laboratory animals, are affected by various environmental factors. With philosophers engaging in animal welfare it became obvious that animal welfare cannot be properly improved without addressing ethical values. A new trend in animal welfare research is to focus on animal-based measures of welfare, making use of positive emotions as measures of good animal welfare and a multidisciplinary approach to the subject of animal welfare. In order to help risk managers to set appropriate priorities, the European Food Safety Authority (EFSA) has taken on the task of developing a risk assessment methodology for animal welfare. In the last decade, the engagement in animal welfare has led to two international bodies working globally to bring on the subject of animal welfare as one of their areas of responsibility. It can be concluded that animal welfare research has developed from merely studies on changes in behaviour and physiological parameters to also include studies of affective states. Research has become more interdisciplinary and often social sciences are part of such research. Animal welfare has become a factor to consider for legislation and international trade.

Dairy animal welfare is of growing interest around the world, especially in developed countries, which have animal welfare programs and resources to establish optimal management systems for cows and understand that animal welfare is the foundation of innovative dairy farming. The article, based on the analysis, synthesis and generalization of world research and the results of own scientific expert assessment of animal welfare identifies the main problems of animal welfare on dairy farms, considers methods of assessing animal welfare in the world and substantiates the importance of implementing welfare programs and management protocols in dairy farming. Thus, in dairy farming, animal welfare is an important component based on world regulations. The analysis of regulations requires an understanding of the legislative aspects of different levels and examples of best practice: a) EU directives and practices, b) directives and practices of each European country c) national directives of non-EU countries, which must take into account all three legislative features. It has been shown that the EU has implemented a number of animal welfare acts, compromises between dairy producers and consumers on a number of instruments to harmonize law enforcement through audit, training, scientific expertise and consulting, and contributes to the stability of the EU food chain. In Ukraine, it is important to harmonize legislation with European Union norms and create a system for assessing the welfare of dairy animals, as well as information and educational activities and training on animal welfare on dairy farms for stakeholders and practical approaches to implementing animal welfare in production. We launched the European approach "Signals of cows" within the Ukrainian-Dutch project "Dairy farm", which allowed to work out the basic aspects of animal welfare in research farms NULES. In 2021, a new law on veterinary medicine was adopted, which implements 14 EU acts and includes a section on animal welfare, which is already a big step forward and opens new opportunities. However, in addition to the provisions on the welfare of calves (harmonization with Regulation 98/58 EC) do not consider regulations on the welfare of the dairy herd, which is not enough to develop the dairy industry in a global transformation. The article presents the basic indicators of welfare of cows, which are used in European countries and which we use in expert assessments. However, systemic data to assess the welfare of cows is not enough, because it is in the plane of consulting, which does not allow the analysis of the welfare of cows. In the context of globalization, the basic problem of animal welfare on dairy farms is the intensification, so the main welfare assessment programs (FARM, The Code of welfare, Welfare Quality and IDSW), which are widely used in milk production in accordance with current animal welfare standards. Intensification of animal husbandry, which provides greater economic efficiency, poses many threats to animal health and remains one of the biggest problems of animal welfare. The desire for profit reduces the ability to implement the principles of sustainable development. We consider it expedient to develop and implement programs for assessing the welfare of cows in Ukraine. So in the EU there is a voluntary WQ program that certifies producers and aims to meet the needs of society, develop a reliable monitoring system on farms and improve the welfare of cows in general. In New Zealand, the Code of welfare has been implemented, which forms awareness of farmers and care for animal welfare. Almost 98% of US farms are members of the FARM (USA) program, which is positioned as a voluntary program and a number of others. Thus, despite the fact that dairy farming is one of the strategic sectors of animal husbandry in Ukraine, the welfare of dairy farms is insufficiently studied and covered. In the perspective of research, it is important to analyze the experience of other countries in this area and the introduction of a system of welfare assessment, as well as the development and implementation of protocols on animal welfare in Ukraine based on the concept of "Five Freedoms". It is important to raise the awareness of stakeholders and officials to ensure proper compliance with EU animal welfare rules, taking into account national, regional and local networks, different support and understanding of the target audience (both farmers and producers, civil servants, scientists and educators, etc.). Also a priority is research on animal welfare, as well as the development of modern approaches to the legal provision of animal welfare, which will improve animal welfare. Thus, in order to ensure a high level of welfare of cows in relation to world standards of animal welfare, the priority is to assess the welfare of cows, improve the legal framework in Ukraine, further research in this area, implementation of effective programs to control the welfare of dairy animals.

Aims The aim of this study was to evaluate an educational pamphlet that incorporates evidence-based pain mitigation strategies during adult vaccine injections and determine its effect on the knowledge, attitudes, and behaviors toward use of such strategies among adults in the community receiving immunizations. Methods An evidence-based pamphlet about how to reduce pain during vaccination in adults was distributed to a convenience sample of community sites that administer vaccines, including family physician offices, travel clinics, and pharmacies. Providers at the community sites distributed a baseline (pre) questionnaire followed by the pamphlet to study participants. Then participants were vaccinated. Six weeks later, participants were contacted to complete a follow-up (post) questionnaire. Participants’ knowledge, attitudes, and behaviors regarding pain mitigation strategies for vaccine injections were evaluated before and after access to the pamphlet. Results Seventy-four people receiving vaccines participated. Participants were predominantly university educated (69%) and female (66%), with a median age of 44.5 years (range, 18–71). Most participants received an injection at a travel or public health clinic (73%). Twenty-seven percent had prior accurate knowledge of pain mitigation strategies. Self-reported pain or fear of needle pain did not change from before access to the pamphlet to six weeks after. Twenty percent of participants used at least one strategy outlined in the pamphlet and found it helpful and 52% were interested in sharing the pamphlet with others. Conclusions An educational pamphlet about vaccination pain mitigation resulted in a positive change in knowledge and attitudes around pain mitigation strategies. Further research is needed to explore long-term impact.

Attitudes of cattle veterinarians and animal scientists to pain and painful procedures in Brazil