Conceptions of Contraception: Awareness and Access to Emergency Contraception Among Young Adults in Albuquerque

Background: Family planning has enormous societal, economic, and interpersonal implications. The United States, NM is no exception, has a much higher rate of unintended pregnancies (50%) than other developed countries. This is associated with poor health outcomes for the mother and the child. Emergency contraception (EC) provides a safe back up method. NM had tried to increase access to EC by licensing pharmacists to dispense it without a prescription. In addition, the FDA agreed to make it OTC for people \u3e18 years old. Objective: To assess young adults knowledge and access to EC in the Albuquerque area. Our goal is that this information will provide a better understanding of EC use in this population and thereby make EC more available. Methods: Anonymous, self-report, survey administered in university classrooms to individuals who were 18-25 years old and willing to participate. Results: Total 339 participants (female 199, male 140). The majority knew about EC and that it was available (95% and 96% respectively). However where it could be obtained and what exactly it was seemed unclear for the majority of participants. These results did not change based on age. Participants who discussed EC with their HCP were more likely to have used EC (p\u3c0.0001) and know that it was different from \u27the abortion pill\u27 (p=0.005). In total 33% of female participants had used EC. Women who had used EC were only slightly more likely to know that EC was available directly from a pharmacist (Fisher\u27s Exact Test p=0.01). Otherwise, their responses were statistically similar to the other participants. Summary: Emergency contraception is a valuable tool in the arsenal of socially, economically, and individually important campaign of family planning. Young adults\u27 knowledge about EC has improved in some areas (availability from pharmacist, OCT, and the distinction between it and RU 486). Despite the change in status to OTC, public health and Planned Parenthood clinics are still the most common access point. Further study to assess the access of individuals \u3c18 years old, actual use when women have EC on hand, and its correlation with conception is recommended. Lastly, HCP should to continue to inform patients about EC to be used as it was intended —as Plan B for when Plan A —a consistent, reliable, birth control method fails.\u2

Learning to Share: Explaining the Conditions under Which States Delegate Governance

A potential solution for weak or failing states is to enact a delegation agreement whereby a host relinquishes authority over some governance function to an external actor. Through case studies in Melanesia, I find that these arrangements can be implemented as treaties, rather than contracts, so that the external actor remains somewhat exempt from the normal procedure or law of the host state. I also generate hypotheses about the conditions under which host states and external actors enact these self-enforcing equilibria: host states request these agreements either where a major law and order problem leads to a loss of monopoly on the use of force, or where extortion or corruption leads to budgetary crisis. External actors agree to them only under the latter circumstances since this makes the reputational and actual costs of the mission lower, as judged against alternative methods for resolving the problem, and where that state also poses a specific transnational security threat.weak states; fragile states; sovereignty; governance; Melanesia; external actors; delegation; intervention

Living in Fear: The Dynamics of Extortion in Mexico’s Drug War

Why do drug trafficking organizations (DTOs) sometimes prey on the communities in which they operate but sometimes provide assistance to these communities? What explains their strategies of extortion and co-optation toward civil society? Using new survey data from Mexico, including list experiments to elicit responses about potentially illegal behavior, this article measures the prevalence of extortion and assistance among DTOs. In support of our theory, these data show that territorial contestation among rival organizations produces more extortion and, in contrast, DTOs provide more assistance when they have monopoly control over a turf. The article uncovers other factors that also shape DTOs’ strategies toward the population, including the degree of collaboration with the state, leadership stability and DTO organization, and the value and logistics of the local criminal enterprise

Recommended adult immunization schedule, United States, 2020

In October 2019, the Advisory Committee on Immunization Practices (ACIP) voted to approve the Recommended Adult Immunization Schedule for Ages 19 Years or Older, United States, 2020. The 2020 adult immunization schedule, available at www.cdc.gov/vaccines /schedules/hcp/imz/adult.html, summarizes ACIP recommendations in 2 tables and accompanying notes (Figure). The full ACIP recommendations for each vaccine are available at www.cdc.gov/vaccines/hcp/acip-recs/index.html. The 2020 schedule has also been approved by the director of the Centers for Disease Control and Prevention (CDC) and by the American College of Physicians (www .acponline.org), American Academy of Family Physicians (www.aafp.org), American College of Obstetricians and Gynecologists (www.acog.org), and American College of Nurse-Midwives (www.midwife.org)

Governance delegation agreements: Shared sovereignty as a substitute for limited statehood

Governance delegation agreements-international treaties allowing external actors legal authority within host states for fixed terms-succeed in simple and, under certain conditions, complex state-building tasks. These deals are well institutionalized and have input legitimacy because ratification requires sufficient domestic support from a ruling coalition. In order to obtain that input legitimacy, however, host states constrain external actors commensurate with their level of statehood: Stronger states delegate less legal authority. This article argues that these constraints, which produce joint rather than complete authority, require external actors to work within state structures rather than substituting for them, and thus make coordination of complex tasks more difficult. A quantitative overview of data on consent-based peacekeeping missions complements a qualitative analysis focused on comparative case studies in Melanesia and Central America to test the theory. The results support the theory and suggest that these deals hold promise particularly for accomplishing complex tasks in especially weak states

Bullets for ballots: Electoral participation provisions and enduring peace after civil conflict

Why does fighting recur following some civil conflict peace settlements, but not others? What kind of agreements are associated with more enduring peace? Post-conflict elections can often complicate and even undermine peace agreements. Agreements that contain “electoral participation provisions,” however, may help stabilize settlements and produce more enduring peace. Electoral participation provisions mandate that rebel groups be allowed to compete alongside the government in post-conflict elections. Such provisions encourage external actors, such as intergovernmental organizations and foreign donors, to become engaged in post-conflict elections. As part of this engagement, they can provide incentives to the parties to adhere to the terms of the settlement, as well as detect and sanction instances of noncompliance. New cross-national data suggest that conflict after peace settlements recurs less often when electoral participation provisions are included than when they are not. The data also suggest that this pacifying relationship holds when combatants expect international engagement

How International Actors Help Enforce Domestic Deals

International actors at times seek to help bring peace, democracy, and human rights. Studies of how international actors help enforce political bargains between incumbent governments and their domestic opponents are proliferating. They show that opposition groups have trouble trusting incumbents to adhere to the political bargains they strike because incumbents can use their familiarity with state institutions and can use their asymmetric hold on power during bargain implementation to violate terms by retaining more of the status quo than agreed. International actors can overcome these ¤quot¤reversion problems,¤quot¤ however, by using monitoring mechanisms (often focused on electoral campaigns) and incentives conditioned on compliance. Reversion problems, and enforcement by international actors as a solution, are common across issue areas¤mdash¤arising when domestic actors try to end civil conflict, open elections, and reduce repression¤mdash¤but the literatures in these issue areas have largely remained segregated. This review proposes advancing this research agenda by unifying them and (re)examining the conditions under which this solution works best