College and university compliance with a required meningococcal vaccination law

OBJECTIVE: Maryland became the first state to pass a vaccination law requiring college and university students living on campus to obtain a meningococcal vaccination or to sign a waiver refusing vaccination because college students are at increased risk for disease. The authors sought to identify how Maryland colleges addressed the law and determine whether schools were in full compliance. PARTICIPANTS: The authors surveyed 32 college/university administrators via a self-administered questionnaire. METHODS: The authors calculated vaccination and waiver rates and assessed compliance with the law overall and with specific law components. RESULTS: Among 28 participating schools, annual vaccination rates and waiver rates among students during 2000-2004 ranged from 66%-76% and 12%-17%, respectively. Two (7%) schools were compliant with all components of the law. CONCLUSIONS: Mandatory vaccination laws do not ensure compliance at the college and university level. Mandatory reporting, increased education, and collaboration between colleges and universities and public health agencies are needed.     

Environmental changes to increase physical activity: perceptions of older urban ethnic-minority women

Despite the numerous benefits of physical activity, older adults continue to be more sedentary than their younger counterparts, and sedentary behavior is more prevalent among older racial and ethnic minorities than among Whites. This study used the nominal group technique (NGT) to examine participants' perceptions of what neighborhood environmental changes would encourage greater physical activity for older African American and Hispanic women. Participants age 50-75 years were recruited from 2 urban community health clinics. Nine NGT sessions (45 participants) were conducted. The women were asked what changes in their neighborhood environment would encourage them to become more physically active. Responses to the research question were tabulated, and qualitative analysis was used to identify themes and categories. Major categories were physical environment changes, safety, and activities/social support. Although the physical environment received the greatest number of points, concerns for personal safety cut across categories. Participants indicated the need for more facilities in which to be active.     

Development and evaluation of the physical activity questionnaire for elderly Japanese: the Nakanojo study

The Physical Activity Questionnaire for Elderly Japanese (PAQ-EJ) is a self-administered physical activity questionnaire for elderly Japanese; the authors report here on its repeatability and direct and indirect validity. Reliability was assessed by repeat administration after 1 month. Direct validation was based on accelerometer data collected every 4 s for 1 month in 147 individuals age 65-85 years. Indirect validation against a 10-item Barthel index (activities of daily living [ADL]) was completed in 3,084 individuals age 65-99 years. The test-retest coefficient was high (r = .64-.71). Total and subtotal scores for lower (transportation, housework, and labor) and higher intensity activities (exercise/sports) were significantly correlated with step counts and durations of physical activity <3 and >or=3 METs (r = .41, .28, .53), respectively. Controlling for age and ADL, scores for transportation, exercise/sports, and labor were greater in men, but women performed more housework. Sex- and ADL- or age-adjusted PAQ-EJ scores were significantly lower in older and dependent people. PAQ-EJ repeatability and validity seem comparable to those of instruments used in Western epidemiological studies.     

Systemic lupus erythematosus and hormone replacement therapy

The indications for hormone replacement therapy (HRT) in postmenopausal women is the treatment of climacteric symptoms and the prevention of osteoporosis. Women with systemic lupus erythematosus (SLE) are more likely to have a premature menopause, osteoporosis and cardiovascular disease. HRT can induce SLE flares and cardiovascular or venous thromboembolic events. Therefore it should not be used in women with active disease or those with antiphospholipid (aPL) antibodies. In general, it should be used only for patients without active disease, a history of thrombosis or aPL antibodies. Non-oral administration of estrogen is recommended because of its lesser effect on coagulation. With regard to the progestogen, progesterone or pregnane derivatives are preferred. Otherwise, non-estrogen-based strategies should be used.     

Advances in the surgical management of prolapse

Prolapse is an extremely common condition, for which 11% of women will have a surgical procedure at some point in their lives. The recurrence rate after most of the traditional surgical procedures is high and upto 29% of women who have had surgery for prolapse will require a further operation. In order to improve the surgical outcome, there is currently much interest in the use of grafts to augment traditional repairs and new procedures have been developed using specifically developed grafts. These have been combined with minimally invasive surgical techniques in an attempt to reduce surgical morbidity. These procedures may improve the outcome of surgery for prolapse. However, there is currently a lack of long-term data from randomized trials to demonstrate their effectiveness and safety.     

Evaluating mission drift in microfinance: lessons for programs with social mission

The article contributes to a better understanding of implications of scaling up on the social mission of microfinance programs. It proposes a methodology to measure the extent, if any, to which a microfinance program with a poverty alleviation mission drifts away from its mission during rapid scaling up and presents findings from a field research using the proposed methodology at Activists for Social Alternatives (ASA), a microfinance organization that serves poor women in rural India. The findings indicate that mission drift is not a result of deliberate decisions by the management or board but rather is a result of the challenges posed by the scaling-up process. At times, changing trends in social outcomes were not obvious, and management was not aware of the changes indicated by the proposed measures of social performance.     

Four criteria to evaluate providers' service-delivery response to new contraceptive introduction

This article presents an evaluation framework developed to assess the first-level effects of introducing the Standard Days Method (SDM) in Peru Ministry of Health clinics. Four questions are asked: 1) To what extent do providers routinely achieve SDM service delivery standards? 2) Is the time invested in SDM delivery consistent with program norms? 3) How does SDM delivery compare with delivery of established methods? and 4) How does SDM introduction affect delivery of established methods? A study at 62 clinics demonstrated the framework's usefulness. The Standard Days Method introduction had positive overall effects on the quality of care but provider training needed adjustments.     

“人新世”和大加速（1780—2021）

“人新世”是环境史最新的前沿理论之一,是作为新纪元被列入地质年代表的一个新议题。20世纪中叶,地球上的水、能源和生物多样性方面发生了巨大变化,因此这一时段被视为“人新世”的起点。关于“人新世”的起源、确立、具体定义、政治性和潜在影响,学界存在争议,我在本文中对此进行了评述,展现了“人新世”概念的跨学科适应性和不同面向,勾画了全球环境史的时空尺度。     

越南战争的足迹：20世纪军事化的环境史

军事化指的是“军事进程”,是在经济、文化和环境的交织过程中实现的。从历史研究的角度看,研究军事化最主要的目的是为了非军事化。本文讨论20世纪全球范围内的军事化问题,重点考察越南军事化的环境史。1975年后越南对军事化的反应较为复杂,构成了当代越南经济复苏的重要背景。