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Background. After 2 decades of focused efforts to eradicate polio, the impact of eradication activities on health systems continues to be controversial. This study evaluated the impact of polio eradication activities on routine immunization (RI) and primary healthcare (PHC).Methods. Quantitative analysis assessed the effects of polio eradication campaigns on RI and maternal healthcare coverage. A systematic qualitative analysis in 7 countries in South Asia and sub-Saharan Africa assessed impacts of polio eradication activities on key health system functions, using data from interviews, participant observation, and document review.Results. Our quantitative analysis did not find compelling evidence of widespread and significant effects of polio eradication campaigns, either positive or negative, on measures of RI and maternal healthcare. Our qualitative analysis revealed context-specific positive impacts of polio eradication activities in many of our case studies, particularly disease surveillance and cold chain strengthening. These impacts were dependent on the initiative of policy makers. Negative impacts, including service interruption and public dissatisfaction, were observed primarily in districts with many campaigns per year.Conclusions. Polio eradication activities can provide support for RI and PHC, but many opportunities to do so remain missed. Increased commitment to scaling up best practices could lead to significant positive impacts.

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Few individuals in canopy tree species attain the canopy and reproduce. Understanding why these select few succeed is fundamental to tree population ecology and forest community dynamics. Yet our understanding remains poor, because the time required to reach the canopy is long relative to experimental and demographic studies. We used a simple, yet powerful, approach to examine the long‐term process of canopy recruitment. We compared early growth in proven “winners” (extant canopy trees) with that of “contenders” (extant saplings 75 cm tall to 5 cm dbh). The resulting analyses relate early radial growth (after reaching 50 cm height) to survival, implicit in the long‐term persistence of winners. We focused on the three major tree species of subalpine forests in the northeastern United States: shade‐intolerant mountain birch (Betula cordifolia), shade‐tolerant balsam fir (Abies balsamea), and highly shade‐tolerant red spruce (Picea rubens). For all species, extant canopy trees grew faster than extant saplings at equivalent ages and sizes. For shade‐intolerant B. cordifolia, no surviving canopy trees, or even saplings, had slow early growth. Even in shade‐tolerant A. balsamea and P. rubens, surprisingly few individuals with slow early growth were represented in the canopy, even though both saplings and canopy trees survived slow growth for up to 50 years later in life. Thus, long‐term success in reaching the canopy was strongly determined by fast early growth rates, across all species and life histories. We discuss implications for understanding the physiology of shade tolerance and for modeling forest dynamics. Most current models of forest tree population and community dynamics ignore individual growth history, but our results suggest that failure to account for growth history may overestimate long‐term survival of shade‐tolerant species.

During hospitalizations, medications of older adults change substantially. Despite clear medication reconciliation efforts in the hospital environment, medication errors occur upon discharge to home. Because current standards are yielding suboptimal results, alternate methodologies for promoting medication adherence should also be considered, developed, and studied for effectiveness.