The Effect of a Sunday Liquor-Sales Ban Repeal on Crime: A Triple-Difference Analysis.

PubMed

Han, SeungHoon; Branas, Charles C; MacDonald, John M

2016-05-01

This study investigates whether alcohol availability in state-run liquor stores affects crime nearby. In 2003, Pennsylvania repealed its Sunday alcohol-sales ban for a portion of its state-run liquor stores. We capitalize on this change in alcohol policy to assess the effect of alcohol availability on crime occurring within the vicinity of liquor stores that opened on Sundays in Philadelphia. We employed a difference-in-difference-in-differences model that compared reported crime before versus after the change in alcohol policy, Sundays versus other days of the week, and the fraction of liquor stores affected versus not affected by the repeal. We used crime incident data in Philadelphia between 1998 and 2011. The repeal was associated with a significant increase in total and property-crime incidents occurring around Sunday-open state liquor stores in low-socioeconomic-status neighborhoods. We found no evidence of the displacement of crime to nearby areas. This is the first triple-difference alcohol study that attempts to isolate the micro-spatial effects of a shift in alcohol availability on local crime patterns, and shows that the repeal of Sunday alcohol-sales restrictions may increase crime in poor urban areas. Copyright © 2016 by the Research Society on Alcoholism.

The Effect of a Sunday Liquor Sales Ban Repeal on Crime: A Triple Difference Analysis

PubMed Central

Han, SeungHoon; Branas, Charles C.; MacDonald, John M.

2017-01-01

Background This paper investigates whether alcohol availability in state-run liquor stores affects crime nearby. In 2003, Pennsylvania repealed its Sunday alcohol sales ban for a portion of its state-run liquor stores. We capitalize on this change in alcohol policy to assess the effect of alcohol availability on crime occurring within the vicinity of liquor stores that opened on Sundays in Philadelphia. Methods We employed a difference-in-difference-in-differences model that compared reported crime before versus after the change in alcohol policy, Sundays versus other days of the week, and the fraction of liquor stores affected versus not affected by the repeal. We used crime incident data in Philadelphia between 1998 and 2011. Results The repeal was associated with a significant increase in total and property crime incidents occurring around Sunday-open state liquor stores in low socioeconomic status neighborhoods. We found no evidence of the displacement of crime to nearby areas. Conclusions This is the first triple-difference alcohol study that attempts to isolate the micro-spatial effects of a shift in alcohol availability on local crime patterns, and shows that the repeal of Sunday alcohol sales restrictions may increase crime in poor urban areas. PMID:27080017

Vehicle speed considerations in traffic management : development of a new speed monitoring program

DOT National Transportation Integrated Search

2000-12-01

The federal speed monitoring program, established in 1974 and repealed in 1995, was primarily intended to provide reliable data for inclusion in states' annual certification for Federal Aid Highway Projects. The repeal of the program not only authori...

78 FR 15869 - Repeal of Disclosure Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-13

...) with respect to the entities regulated by OFHEO and by the Finance Board. The regulations being repealed govern public financial disclosures made by the entities with respect to certain federal... Government to regulate and oversee the Federal National Mortgage Association, the Federal Home Loan Mortgage...

Evaluation of motorcycle helmet law repeal in Arkansas and Texas

DOT National Transportation Integrated Search

2000-09-01

In 1997, Arkansas and Texas became the first states since 1983 to repeal "universal" laws requiring all motorcycle riders to wear helmets. Helmet use under the universal law was 97 percent in statewide surveys (1996 in Arkansas and 1997 in Texas). By...

Effects of the repeal of Missouri's handgun purchaser licensing law on homicides.

PubMed

Webster, Daniel; Crifasi, Cassandra Kercher; Vernick, Jon S

2014-04-01

In the USA, homicide is a leading cause of death for young males and a major cause of racial disparities in life expectancy for men. There are intense debate and little rigorous research on the effects of firearm sales regulation on homicides. This study estimates the impact of Missouri's 2007 repeal of its permit-to-purchase (PTP) handgun law on states' homicide rates and controls for changes in poverty, unemployment, crime, incarceration, policing levels, and other policies that could potentially affect homicides. Using death certificate data available through 2010, the repeal of Missouri's PTP law was associated with an increase in annual firearm homicides rates of 1.09 per 100,000 (+23%) but was unrelated to changes in non-firearm homicide rates. Using Uniform Crime Reporting data from police through 2012, the law's repeal was associated with increased annual murders rates of 0.93 per 100,000 (+16%). These estimated effects translate to increases of between 55 and 63 homicides per year in Missouri.

The Hatch Act and Inflation.

ERIC Educational Resources Information Center

Baird, Charles W.

1980-01-01

Repeal of the Hatch Act would worsen inflation and make effective controls over government much more difficult to achieve. Repeal of the Hatch Act would serve the interests of no one except those who seek to gain increasing political power at the expense of the general public. (Author/IRT)

Repeal and modification of mandatory motorcycle helmet legislation : a review of available information : final report.

DOT National Transportation Integrated Search

1978-01-01

In 1975, Congress relieved the Secretary of Transportation of the power to impose sanctions upon states for not having a law requiring the use of helmets by motorcyclists. Shortly afterward, the states having such laws began repealing or modifying th...

76 FR 74648 - Repeal of Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-01

... the manner of calculating the Resolution Funding Corporation (RefCorp) obligations of the Federal Home Loan Banks (Banks), respectively. FHFA is also repealing certain parts of the Office of Federal Housing... Banks and the Office of Finance (OF) (which acts as the Banks' fiscal agent) and certain functions of...

29 CFR 1601.35 - Petitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 4 2010-07-01 2010-07-01 false Petitions. 1601.35 Section 1601.35 Labor Regulations..., Amendment, or Repeal of Rules § 1601.35 Petitions. Any interested person may petition the Commission, in writing, for the issuance, amendment, or repeal of a rule or regulation. Such petition shall be filed with...

75 FR 13207 - Proposed Collection; Comment Request for Regulation Project

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-18

... Respect to Certain Debt Obligations; Application of Repeal of 30 Percent Withholding by the Tax Reform [email protected] . SUPPLEMENTARY INFORMATION: Title: Registration Requirements With Respect to Certain Debt Obligations; Application of Repeal of 30 Percent Withholding by the Tax Reform Act of 1984. OMB Number: 1545...

Mixed Signals.

ERIC Educational Resources Information Center

Danforth, Eric L.

2003-01-01

According to the Education Commission of the States, 14 states prohibit pagers and/or cell phones in schools, 8 states have repealed bans, and the rest have no statutes on the issue. Ten states, including some that have repealed bans, grant policymaking authority to local boards. Presents arguments pro and con on cell phones and school district…

Alaska Community Transit

Science.gov Websites

Grant Information Human Services Funding 5310 5316 (Repealed) 5317 (Repealed) Alaska Mental Health Trust . Transit News, Events, & Highlights SFY2019 Public Transit and Human Service Grant Recommendations pdf icon ( 134 KB) SFY2020 Human Service Intent to Apply opens 8/1/2018. Human Service agencies must sumbit

78 FR 75633 - Self-Regulatory Organizations; Boston Stock Exchange Clearing Corporation; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-12

.... Article Fifth, Paragraph D provides that, except for directors elected by the holders of any series of... together as a single class. Adoption, Alteration, Amendment and Repeal of By-Laws. Article Eighth... Repeal of Certain Charter Provisions. Article Ninth, Paragraph A provides that the affirmative vote of...

The Impact of Repealing Sunday Closing Laws on Educational Attainment

ERIC Educational Resources Information Center

Lee, Dara N.

2013-01-01

Adolescents face daily tradeoffs between human capital investment, labor, and leisure. This paper exploits state variation in the repeal of Sunday closing laws to examine the impact of a distinct and plausibly exogenous rise in the quantity of competing diversions available to youth on their educational attainment. The results suggest that the…

12 CFR 1102.308 - Right to petition for issuance, amendment and repeal of rules of general application.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Right to petition for issuance, amendment and repeal of rules of general application. 1102.308 Section 1102.308 Banks and Banking FEDERAL FINANCIAL INSTITUTIONS EXAMINATION COUNCIL APPRAISER REGULATION Description of Office, Procedures, Public Information...

29 CFR 1910.3 - Petitions for the issuance, amendment, or repeal of a standard.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 5 2011-07-01 2011-07-01 false Petitions for the issuance, amendment, or repeal of a standard. 1910.3 Section 1910.3 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR OCCUPATIONAL SAFETY AND HEALTH STANDARDS General § 1910.3...

29 CFR 1910.3 - Petitions for the issuance, amendment, or repeal of a standard.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 5 2012-07-01 2012-07-01 false Petitions for the issuance, amendment, or repeal of a standard. 1910.3 Section 1910.3 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR OCCUPATIONAL SAFETY AND HEALTH STANDARDS General § 1910.3...

75 FR 17456 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Order Approving...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-06

... To Repeal Incorporated NYSE Rule 405(4) (Common Sales Accounts) March 31, 2010. On January 21, 2010...''),\\4\\ FINRA proposed to repeal NYSE Rule 405(4) (Common Sales Accounts).\\5\\ \\4\\ The current FINRA... as the ``NYSE Rules.'' NYSE Rule 405(4) (Common Sales Accounts) required proper supervision of...

Medicaid Expansion and ACA Repeal: Evidence From Ohio.

PubMed

Seiber, Eric E; Berman, Micah L

2017-06-01

To examine the health insurance coverage options for Medicaid expansion enrollees if the Affordable Care Act (ACA) is repealed, using evidence from Ohio, where more than half a million adults have enrolled in the state's Medicaid program through the ACA expansion. The Ohio Medicaid Assessment Survey interviewed 42 000 households in 2015. We report data from a unique battery of questions designed to identify insurance coverage immediately prior to Medicaid enrollment. Ninety-five percent of new Medicaid enrollees in Ohio did not have a private health insurance option immediately before enrollment. These new enrollees are predominantly older, low-income Whites with a high school education or less. Only 5% of new Medicaid enrollees were eligible for an employer-sponsored insurance plan to which they could potentially return in the case of repeal of the ACA. The vast majority of Medicaid expansion enrollees would have no plausible pathway to obtaining private-sector insurance if the ACA were repealed. Demographic similarities between the expansion population and 2016 exit polls suggest that coverage losses would fall disproportionately on members of the winning Republican coalition.

The Danish tax on saturated fat: why it did not survive.

PubMed

Vallgårda, S; Holm, L; Jensen, J D

2015-02-01

Health promoters have repeatedly proposed using economic policy tools, taxes and subsidies, as a means of changing consumer behaviour. As the first country in the world, Denmark introduced a tax on saturated fat in 2011. It was repealed in 2012. In this paper, we present arguments and themes involved in the debates surrounding the introduction and the repeal. An analysis of parliamentary debates, expert reports and media coverage; key informant interviews; and a review of studies about the effects of the tax on consumer behaviour. A tax on saturated fat had been suggested by two expert committees and was introduced with a majority in parliament, as a part of a larger economic reform package. Many actors, including representatives from the food industry and nutrition researchers, opposed the tax both before and after its introduction, claiming that it harmed the economy and had no positive influence on health, rather the contrary. Few policy actors defended the tax. Public health had a prominent role in the politicians' arguments for introducing the tax but was barely mentioned in the debate about the repeal. Shortly after the repeal of the tax, research was published showing that consumption of saturated fat had declined in Denmark. The analysis indicates that the Danish tax on fat was introduced mainly to increase public revenue. As the tax had no strong proponents and many influential adversaries, it was repealed. New research indicates that the tax was effective in changing consumer behaviour.

29 CFR 1910.3 - Petitions for the issuance, amendment, or repeal of a standard.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 5 2010-07-01 2010-07-01 false Petitions for the issuance, amendment, or repeal of a... major sources of national consensus standards. National consensus standards adopted on May 29, 1971... itself a producer of national consensus standards, within the meaning of section 3(9) of the Act, is...

38 CFR 4.89 - Ratings for inactive nonpulmonary tuberculosis in effect on August 19, 1968.

Code of Federal Regulations, 2010 CFR

2010-07-01

... nonpulmonary tuberculosis in effect on August 19, 1968. 4.89 Section 4.89 Pensions, Bonuses, and Veterans... tuberculosis in effect on August 19, 1968. Public Law 90-493 repealed section 356 of title 38, United States Code which provided graduated ratings for inactive tuberculosis. The repealed section, however, still...

38 CFR 4.89 - Ratings for inactive nonpulmonary tuberculosis in effect on August 19, 1968.

Code of Federal Regulations, 2013 CFR

2013-07-01

... nonpulmonary tuberculosis in effect on August 19, 1968. 4.89 Section 4.89 Pensions, Bonuses, and Veterans... tuberculosis in effect on August 19, 1968. Public Law 90-493 repealed section 356 of title 38, United States Code which provided graduated ratings for inactive tuberculosis. The repealed section, however, still...

38 CFR 4.89 - Ratings for inactive nonpulmonary tuberculosis in effect on August 19, 1968.

Code of Federal Regulations, 2011 CFR

2011-07-01

... nonpulmonary tuberculosis in effect on August 19, 1968. 4.89 Section 4.89 Pensions, Bonuses, and Veterans... tuberculosis in effect on August 19, 1968. Public Law 90-493 repealed section 356 of title 38, United States Code which provided graduated ratings for inactive tuberculosis. The repealed section, however, still...

38 CFR 4.89 - Ratings for inactive nonpulmonary tuberculosis in effect on August 19, 1968.

Code of Federal Regulations, 2012 CFR

2012-07-01

... nonpulmonary tuberculosis in effect on August 19, 1968. 4.89 Section 4.89 Pensions, Bonuses, and Veterans... tuberculosis in effect on August 19, 1968. Public Law 90-493 repealed section 356 of title 38, United States Code which provided graduated ratings for inactive tuberculosis. The repealed section, however, still...

38 CFR 4.89 - Ratings for inactive nonpulmonary tuberculosis in effect on August 19, 1968.

Code of Federal Regulations, 2014 CFR

2014-07-01

... nonpulmonary tuberculosis in effect on August 19, 1968. 4.89 Section 4.89 Pensions, Bonuses, and Veterans... tuberculosis in effect on August 19, 1968. Public Law 90-493 repealed section 356 of title 38, United States Code which provided graduated ratings for inactive tuberculosis. The repealed section, however, still...

The President's pleasant surprise: how LGBT advocates ended Don't Ask, Don't Tell.

PubMed

Frank, Nathaniel

2013-01-01

This study assesses the role of LGBT advocates in repealing the military's Don't Ask, Don't Tell policy in the U.S. Congress. It draws on the author's direct involvement with that effort as well as personal interviews and media evidence to consider the contributions of the Obama Administration, members of Congress, the media, and individuals and pressure groups in the repeal process. It argues that repeal succeeded not because of the effective implementation of a White House plan but because the pressure of LGBT advocates ultimately shattered several key obstacles including inadequate messaging and dysfunction and inertia among both politicians and interest groups in Washington. The article offers insight into the role of public pressure in forwarding social change.

Changing the Price of Marriage: Evidence from Blood Test Requirements

ERIC Educational Resources Information Center

Buckles, Kasey; Guldi, Melanie; Price, Joseph

2011-01-01

We use state repeals of blood test requirements (BTRs) for a marriage license that occurred between 1980 and 2008 to examine the impact of changes in the price of marriage on the marriage decision. Using a within-group estimator that holds constant state and year effects and exploits variation in the repeal dates of BTRs across states, we find…

The success and repeal of the Medicare Catastrophic Coverage Act: a paradoxical lesson for health care reform.

PubMed

Aaronson, W E; Zinn, J S; Rosko, M D

1994-01-01

Congress intended the Medicare Catastrophic Coverage Act (MCCA) of 1988 to reduce the risk for illness-related catastrophic financial losses in the elderly. The act was short-lived, facing repeal just one year after passage. Many elderly persons were convinced that the costs of the program outweighed the benefits. However nursing home payment provisions of the MCCA may have affected out-of-pocket expenses paid by the elderly for long-term care more than consumers realized at the time of repeal. A transmittal memorandum, issued by the Health Care Financing Administration independent of Congressional action, enhanced consumers' ability to qualify for Medicare nursing home benefits. We investigated the effects of the Medicare policy change on nursing home payer mix and out-of-pocket expenses in 489 Pennsylvania nursing homes. We found that substantial shifts in payer mix from self-pay to Medicare payment sources occurred, reducing out-of-pocket expenses. Unfortunately the debate over the MCCA's repeal did not include discussion of the improved nursing home benefit structure. These findings, and the fate of the MCCA legislation, reinforce the importance of comprehensive information and clear communication in promoting health care reform.

Repealing Federal Health Reform: Economic and Employment Consequences for States.

PubMed

Ku, Leighton; Steinmetz, Erika; Brantley, Erin; Bruen, Brian

2017-01-01

Issue: The incoming Trump administration and Republicans in Congress are seeking to repeal the Affordable Care Act (ACA), likely beginning with the law’s insurance premium tax credits and expansion of Medicaid eligibility. Research shows that the loss of these two provisions would lead to a doubling of the number of uninsured, higher uncompensated care costs for providers, and higher taxes for low-income Americans. Goal: To determine the state-by-state effect of repeal on employment and economic activity. Methods: A multistate economic forecasting model (PI+ from Regional Economic Models, Inc.) was used to quantify for each state the effects of the federal spending cuts. Findings and Conclusions: Repeal results in a $140 billion loss in federal funding for health care in 2019, leading to the loss of 2.6 million jobs (mostly in the private sector) that year across all states. A third of lost jobs are in health care, with the majority in other industries. If replacement policies are not in place, there will be a cumulative $1.5 trillion loss in gross state products and a $2.6 trillion reduction in business output from 2019 to 2023. States and health care providers will be particularly hard hit by the funding cuts.

26 CFR 25.2523(i)-2 - Treatment of spousal joint tenancy property where one spouse is not a United States citizen.

Code of Federal Regulations, 2010 CFR

2010-04-01

... governed by the principles of sections 2515 and 2515A (as such sections were in effect before their repeal by the Economic Recovery Tax Act of 1981). However, in applying these principles, the donor spouse... 2515(c) (prior to its repeal by the Economic Recovery Tax Act of 1981, Pub. L. 97-34, 95 Stat. 172). (b...

26 CFR 1.871-14 - Rules relating to repeal of tax on interest of nonresident alien individuals and foreign...

Code of Federal Regulations, 2010 CFR

2010-04-01

...) Application of 10-percent shareholder test to interest paid to a simple trust or grantor trust. Whether interest paid to a simple trust or grantor trust and distributed to or included in the gross income of a... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Rules relating to repeal of tax on interest of...

Contextualizing the first-round failure of the AHCA: down but not out.

PubMed

Hirsch, Joshua A; Rosenkrantz, Andrew B; Nicola, Greg N; Harvey, H Benjamin; Duszak, Richard; Silva, Ezequiel; Barr, Robert M; Klucznik, Richard P; Brook, Allan L; Manchikanti, Laxmaiah

2017-06-01

On 8 November 2016 the American electorate voted Donald Trump into the Presidency and a majority of Republicans into both houses of Congress. Since many Republicans ran for elected office on the promise to 'repeal and replace' Obamacare, this election result came with an expectation that campaign rhetoric would result in legislative action on healthcare. The American Health Care Act (AHCA) represented the Republican effort to repeal and replace the Affordable Care Act (ACA). Key elements of the AHCA included modifications of Medicaid expansion, repeal of the individual mandate, replacement of ACA subsidies with tax credits, and a broadening of the opportunity to use healthcare savings accounts. Details of the bill and the political issues which ultimately impeded its passage are discussed here. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Repeal of the Sustainable Growth Rate: an overview for surgeons.

PubMed

Sangji, Naveen F

2014-10-01

The Medicare sustainable growth rate (SGR) formula is used to control Medicare spending on physician services. Under the current SGR formula, physicians face an almost 24% cut to the Medicare fee schedule on April 1, 2015. The US House Way & Means and Energy & Commerce Committees and the Senate Finance Committee released jointly proposed legislation to permanently repeal the SGR, and transition Medicare physician payment to a value-based payment method. This review summarizes the key components of the proposed legislation, and discusses some of the political challenges ahead. House Committees on Energy & Commerce and Ways & Means, and the Senate Committee on Finance staff write-ups. Physician Medicare reimbursement will move from a volume-based model to a value-based model over the next decade. Surgeons should remain engaged with the political process to ensure repeal of the SGR. Copyright © 2014 Elsevier Inc. All rights reserved.

HIV in the military.

PubMed

1996-04-05

A stopgap spending bill that would repeal a recently enacted provision discharging members of the armed services who test positive for HIV was approved in the Senate. The provision, inserted into the bill by Rep. Robert K. Dornan (R-CA), was part of a $256 defense authorization bill that forces the Pentagon to discharge all HIV-positive service members within 6 months of diagnosis. Dornan promises to insert the same language into next year's defense bill if the repeal stands.

Repeal of Comprehensive Background Check Policies and Firearm Homicide and Suicide.

PubMed

Kagawa, Rose M C; Castillo-Carniglia, Alvaro; Vernick, Jon S; Webster, Daniel; Crifasi, Cassandra; Rudolph, Kara E; Cerdá, Magdalena; Shev, Aaron; Wintemute, Garen J

2018-04-02

In 2016, firearms killed 38,658 people in the United States. Federal law requires licensed gun dealers, but not private parties, to conduct background checks on prospective firearm purchasers with the goal of preventing prohibited persons from obtaining firearms. Our objective was to estimate the effect of the repeal of comprehensive background check laws - requiring a background check for all handgun sales, not just sales by licensed dealers - on firearm homicide and suicide rates in Indiana and Tennessee. We compared age-adjusted firearm homicide and suicide rates, measured annually from 1981-2008 and 1994-2008 in Indiana and Tennessee, respectively, to rates in control groups constructed using the synthetic control method. The average rates of firearm homicide and suicide in Indiana and Tennessee following repeal were within the range of what could be expected given natural variation (differences = 0.7 firearm homicides and 0.5 firearm suicides per 100,000 residents in Indiana and 0.4 firearm homicides and 0.3 firearm suicides per 100,000 residents in Tennessee). Sensitivity analyses resulted in similar findings. We found no evidence of an association between the repeal of comprehensive background check policies and firearm homicide and suicide rates in Indiana and Tennessee. In order to understand whether comprehensive background check policies reduce firearm deaths in the United States generally, more evidence on the impact of such policies from other states is needed.

Universal coverage reforms in the USA: From Obamacare through Trump.

PubMed

Rice, Thomas; Unruh, Lynn Y; van Ginneken, Ewout; Rosenau, Pauline; Barnes, Andrew J

2018-05-22

Since the election of Donald Trump as President, momentum towards universal health care coverage in the United States has stalled, although efforts to repeal the Affordable Care Act (ACA) in its entirety failed. The ACA resulted in almost a halving of the percentage of the population under age 65 who are uninsured. In lieu of total repeal, the Republican-led Congress repealed the individual mandate to purchase health insurance, beginning in 2019. Moreover, the Trump administration is using its administrative authority to undo many of the requirements in the health insurance exchanges. Partly as a result, premium increases for the most popular plans will rise an average of 34% in 2018 and are likely to rise further after the mandate repeal goes into effect. Moreover, the administration is proposing other changes that, in providing states with more flexibility, may lead to the sale of cheaper and less comprehensive policies. In this volatile environment it is difficult to anticipate what will occur next. In the short-term there is proposed compromise legislation, where Republicans agree to provide funding for the cost-sharing subsidies if the Democrats agree to increase state flexibility in some areas and provide relief to small employers. Much will depend on the 2018 and 2020 elections. In the meantime, the prospects are that the number of uninsured will grow. Copyright © 2018 The Author(s). Published by Elsevier B.V. All rights reserved.

Ready or Not? Repeal of Don’t Ask, Don’t Tell

DTIC Science & Technology

2010-01-01

number . 1. REPORT DATE 2010 2. REPORT TYPE 3. DATES COVERED 4. TITLE AND SUBTITLE Ready or Not? Repeal of Don’t Ask, Don’t Tell 5a. CONTRACT... NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING...ORGANIZATION NAME(S) AND ADDRESS(ES) USAF Air War College,325 Chennault Circle,Maxwell AFB,AL,36112 8. PERFORMING ORGANIZATION REPORT NUMBER 9. SPONSORING

An Analysis of Opinion of the Impact of Don’t Ask Don’t Tell, Its Repeal, and the Proposed Plan to Implement the Repeal

DTIC Science & Technology

2011-06-05

progress, quarterly, research, special, group study , etc. 3. DATES COVERED. Indicate the time during which the work was performed and the report was...the General/Flag officers’ Study Group . Palm Center White Paper, University of California, 2008. Center for Military Readiness, Open Letter to...of Military Studies Research Paper September 2010- May 2011 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER An Analysis of Opinion of the Impact of Don’t

Veterans' Health Insurance Coverage Under the Affordable Care Act and Implications of Repeal for the Department of Veterans Affairs

PubMed Central

Dworsky, Michael; Farmer, Carrie M.; Shen, Mimi

2018-01-01

Abstract This article describes the Affordable Care Act's (ACA's) effects on nonelderly veterans' insurance coverage and demand for Department of Veterans Affairs (VA) health care and assesses the coverage and VA utilization changes that could result from repealing the ACA. Although prior research has shown that the number of uninsured veterans fell after the ACA took effect, the implications of ACA repeal for veterans and, especially, for VA have received less attention. Besides providing a new coverage option to veterans who are not enrolled in VA, the ACA also had the potential to affect health care use among VA patients. Findings include the following: In 2013, prior to the major coverage expansions under the ACA, nearly one in ten nonelderly veterans were uninsured, lacking access to both VA coverage and non-VA health insurance. Uninsurance among nonelderly veterans fell by an adjusted 36 percent (3.3 percentage points) after implementation of the ACA, from 9.1 percent in 2013 to 5.8 percent in 2015. By increasing non-VA health insurance coverage for VA patients, the ACA likely reduced demand for VA care; the authors estimate that, if the gains in insurance coverage that occurred between 2013 and 2015 had not occurred, nonelderly veterans would have used about 1 percent more VA health care in 2015: 125,000 more office visits, 1,500 more inpatient surgeries, and 375,000 more prescriptions. Recent congressional proposals to repeal and replace the ACA would increase the number of uninsured nonelderly veterans and further increase demand for VA health care. PMID:29607249

Outing the costs of civil deference to the military.

PubMed

Hillman, Elizabeth L

2013-01-01

Placing the costs and process of repeal into the framework of U.S. civil governance and military power reveals the faltering state of civilian control over, and understanding of, contemporary military institutions. The excessive delays, repetitive studies, and lack of judicial oversight that characterized the process of repeal expose a military unmoored from the constitutional and democratic constraints of civilian control. The end of Don't Ask, Don't Tell is more than a civil rights triumph. It is also a lesson in the steep costs and troubling consequences of excessive civilian deference to the armed forces.

Menominee Restoration Act: H.R. 7421--To Repeal the Act Terminating Federal Supervision Over the Property and Members of the Menominee Tribe of Wisconsin as a Federally Recognized, Sovereign Indian Tribe; and to Restore to the Menominee Tribe of Wisconsin Those Federal Services Furnished to American Indians Because of Their Status as American Indians; and for Other Purposes. Hearings Before..., 93d Congress, 1st Session....

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Interior and Insular Affairs.

Presenting reports, statements, letters, and additional information, these hearings of the Menominee Restoration Act (HR 7421) deal with restoration of Federal services to the Menominee tribe via repeal of the 83d Congress' (1953) termination policy. Testimony includes statements from representatives of the: Federal Government, National Congress…

To amend the Internal Revenue Code of 1986 to repeal the new carryover basis rules in order to prevent tax increases and the imposition of compliance burdens on many more estates than would benefit from repeal, to retain the estate tax with a $3,500,000 exemption, to reinstitute and update the Pay-As-You-Go requirement of budget neutrality on new tax and mandatory spending legislation, enforced by the threat of annual, automatic sequestration, and for other purposes.

THOMAS, 111th Congress

Rep. Pomeroy, Earl [D-ND-At Large

2009-11-19

Senate - 01/20/2010 Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 253. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

"We Now Have a Patient and Not a Criminal": An Exploratory Study of Judges and Lawyers' Views on Suicide Attempters and the Law in Ghana.

PubMed

Osafo, Joseph; Akotia, Charity S; Andoh-Arthur, Johnny; Boakye, Kofi E; N-B Quarshie, Emmanuel

2018-05-01

This study explored the views of judges and lawyers of the superior courts of Ghana on the law criminalizing attempted suicide. Qualitative data were collected from 12 experienced legal practitioners of the superior courts (five judges and seven lawyers) using a semi-structured interview schedule. Thematic analysis of the data yielded three main perspectives: In defence of the Law, Advocating a Repeal, and Pro-Health Orientation. Although exploratory, the findings of this study offer cues for stepping up suicide literacy and advocacy programmes toward either a repeal of the law or a reform.

How did the Elimination of the Earnings Test above the Normal Retirement Age affect Retirement Expectations?1

PubMed Central

Michaud, Pierre-Carl

2010-01-01

We look at the effect of the 2000 repeal of the earnings test above the normal retirement age on retirement expectations of workers in the Health and Retirement Study, aged 51 to 61 in 1992. For men, we find that those whose marginal wage rate increased when the earnings test was repealed, had the largest increase in the probability to work full-time past normal retirement age. We do not find significant evidence of effects of the repeal of the earnings test on the probability to work past age 62 or the expected claiming age. On the other hand, for those reaching the normal retirement age, deviations between the age at which Social Security benefits are actually claimed and the previously reported expected age are more negative in 2000 than in 1998. Since our calculations show that the tax introduced by the earnings test was small when accounting for actuarial benefit adjustments and differential mortality, our results suggest that although male workers form expectations in a way consistent with forward-looking behavior, they misperceive the complicated rules of the earnings test. Results for females suggest similar patterns but estimates are imprecise. PMID:21037938

The effect of the 1997 Texas motorcycle helmet law on motorcycle crash fatalities.

PubMed

Bavon, Al; Standerfer, Christina

2010-01-01

This study seeks to determine the effect of the Texas motorcycle helmet law on fatalities since the repeal of the universal helmet law in 1997. Texas monthly motorcycle accident data between 1994 and 2004 were obtained from the National Highway Transportation Safety Administration's Fatality Analysis Reporting System (FARS) and supplemented with motorcycle registration data from the Texas Department of Transportation. An ARIMA model was used to estimate the impact of the law. A sharp increase in fatality rates occurred immediately following the implementation of the law in September 1997. Deaths increased by 30%, fatality rates per motorcycle registrations increased by 15.2%, and fatality rates per vehicle miles traveled increased by 25% after repeal. Helmet use decreased from 77% in 1996 to 63% in 1997 and 36% in 1998 and thereafter. The parameter estimates of the ARIMA model (0,0,0) (0,1,1) show that the change in the law led to statistically significant increases of 2.3 fatalities and 1.18 fatality rate per 100 billion vehicle miles traveled. The repeal of the universal helmet law in Texas in 1997 has had a significant adverse effect on motorcyclist fatalities in Texas.

The impact of medical tourism and the code of medical ethics on advertisement in Nigeria

PubMed Central

Makinde, Olusesan Ayodeji; Brown, Brandon; Olaleye, Olalekan

2014-01-01

Advances in management of clinical conditions are being made in several resource poor countries including Nigeria. Yet, the code of medical ethics which bars physician and health practices from advertising the kind of services they render deters these practices. This is worsened by the incursion of medical tourism facilitators (MTF) who continue to market healthcare services across countries over the internet and social media thereby raising ethical questions. A significant review of the advertisement ban in the code of ethics is long overdue. Limited knowledge about advances in medical practice among physicians and the populace, the growing medical tourism industry and its attendant effects, and the possibility of driving brain gain provide evidence to repeal the code. Ethical issues, resistance to change and elitist ideas are mitigating factors working in the opposite direction. The repeal of the code of medical ethics against advertising will undoubtedly favor health facilities in the country that currently cannot advertise the kind of services they render. A repeal or review of this code of medical ethics is necessary with properly laid down guidelines on how advertisements can be and cannot be done. PMID:25722776

The impact of medical tourism and the code of medical ethics on advertisement in Nigeria.

PubMed

Makinde, Olusesan Ayodeji; Brown, Brandon; Olaleye, Olalekan

2014-01-01

Advances in management of clinical conditions are being made in several resource poor countries including Nigeria. Yet, the code of medical ethics which bars physician and health practices from advertising the kind of services they render deters these practices. This is worsened by the incursion of medical tourism facilitators (MTF) who continue to market healthcare services across countries over the internet and social media thereby raising ethical questions. A significant review of the advertisement ban in the code of ethics is long overdue. Limited knowledge about advances in medical practice among physicians and the populace, the growing medical tourism industry and its attendant effects, and the possibility of driving brain gain provide evidence to repeal the code. Ethical issues, resistance to change and elitist ideas are mitigating factors working in the opposite direction. The repeal of the code of medical ethics against advertising will undoubtedly favor health facilities in the country that currently cannot advertise the kind of services they render. A repeal or review of this code of medical ethics is necessary with properly laid down guidelines on how advertisements can be and cannot be done.

77 FR 10351 - Regulatory Review Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-22

... regulation inefficient, obsolete, contrary to controlling legal precedent, or unduly burdensome; (2... what steps may be necessary to relieve any unnecessary burden, including amendment to or repeal of...

Surreptitious surgery on Long Island Sound: The oral cancer surgeries of President Grover Cleveland.

PubMed

Maloney, William

2010-01-01

Grover Cleveland rose from being the mayor of Buffalo to the governor of New York to the president of the United States. At the start of Cleveland's second term as president, the nation was involved in a severe financial crisis, the extent of which was not known by the general public. President Cleveland was to make a strong appeal to Congress in the coming months to repeal the Sherman Silver Purchase Act of 1890. He thought this would set the nation on the road to fiscal recovery. However, his vice president, Adlai Stevenson, strongly opposed repeal of the Sherman Act. Prior to scheduling his appearance before Congress, President Cleveland noticed a rough spot on his palate. A biopsy confirmed that it was cancer, and it was determined that surgery was needed. Cleveland and his advisors thought the nation would be thrown into a panic if the President's health did not remain a secret. A surgical team, which included a dentist, performed the surgery in secrecy while traveling aboard a yacht. A prosthetic obturator was fabricated by a New York prosthodontist to close the surgical defect. Cleveland recovered well, made a forceful speech before Congress, had the Sherman Act repealed and lived without a recurrence of his oral cancer for the rest of his life. The public remained unaware, for the most part, of the gravity of President Cleveland's health for decades.

Tiahrt Restrictions Repeal Act

THOMAS, 113th Congress

Rep. Lee, Barbara [D-CA-13

2013-02-13

House - 04/15/2013 Referred to the Subcommittee on Crime, Terrorism, Homeland Security, And Investigations. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

76 FR 41585 - Regulation and Independent Regulatory Agencies

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-14

..., competitiveness, and job creation.'' Independent regulatory agencies, no less than executive agencies, should..., streamline, expand, or repeal them in accordance with what has been learned. Such retrospective analyses...

Presidential Elections and HIV-Related National Policies and Programs.

PubMed

Holtgrave, David R; Bonacci, Robert A; Valdiserri, Ronald O

2017-03-01

The November 2016 general election and subsequent voting of the Electoral College resulted in the selection of Donald Trump as President of the United States. The incoming Administration ran a campaign that indicated a desire for substantial change in health policy, including the repeal of the Affordable Care Act (ACA). President Trump has said very little directly about HIV programs and policies, but some campaign positions (such as the repeal of the ACA) would clearly and substantially impact the lives of persons living with HIV. In this editorial, we highlight important HIV-related goals to which we must recommit ourselves, and we underscore several key points about evidence-based advocacy that are important to revisit at any time (but most especially when there is a change in Administration).

Repeal ID Act of 2014

THOMAS, 113th Congress

Rep. Daines, Steve [R-MT-At Large

2014-02-21

House - 03/20/2014 Referred to the Subcommittee on Crime, Terrorism, Homeland Security, and Investigations. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

12 CFR 174.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

...(q), as in effect immediately prior to its repeal by the Financial Institutions Reform, Recovery, and... determine to be operating in substantially the same manner as a savings association. (q) [Reserved] (r...

12 CFR 174.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

...(q), as in effect immediately prior to its repeal by the Financial Institutions Reform, Recovery, and... determine to be operating in substantially the same manner as a savings association. (q) [Reserved] (r...

12 CFR 174.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

...(q), as in effect immediately prior to its repeal by the Financial Institutions Reform, Recovery, and... determine to be operating in substantially the same manner as a savings association. (q) [Reserved] (r...

Auto Enroll Repeal Act

THOMAS, 113th Congress

Sen. Isakson, Johnny [R-GA

2014-06-26

Senate - 06/26/2014 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Repeal REAL ID Act

THOMAS, 113th Congress

Sen. Walsh, John E. [D-MT

2014-03-12

Senate - 03/12/2014 Read twice and referred to the Committee on Homeland Security and Governmental Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Davis-Bacon Repeal Act

THOMAS, 113th Congress

Sen. Lee, Mike [R-UT

2014-07-16

Senate - 07/16/2014 Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

An analysis of the Illinois Retail Rate Law and the Cook County waste-to-energy siting battles, 1987--2001

NASA Astrophysics Data System (ADS)

Sendzik, Mark Edward

2002-01-01

The analysis explores the environmental justice impacts of the 1998 Illinois Retail Rate Law and Cook County waste-to-energy siting proposals on the Chicago metropolitan area. Particular attention is given to the dynamics of the grassroots environmental organizations which emerged to fight the siting proposals. The organizations are examined in the context of NIMBYism, the antitoxic movement, the environmental justice movement, and mainstream environmentalism. In addition, the underlying causes for the unintended consequences of the Retail Rate Law are analyzed against the backdrop of market and government failure. Face-to-face and telephone interviews were conducted with forty-one persons familiar with the battles over the Cook County siting proposals and the efforts to repeal the Retail Rate Law. The term "environmental justice" became controversial as siting opponents and supporters both appropriated the issue to support dueling positions on the proposed sitings. However, environmental justice did not play an instrumental role in repealing the Retail Rate Law or the siting proposals. Economic concerns led to the repeal of the legislation and demise of the original siting proposals. The circumstances of the siting battles and opposition groups raise questions about the future effectiveness of the environmental justice movement. A combination of market and government failure led to the unintended consequences from the retail Rate Law. Strategic maneuvering by state legislative leaders delayed the repeal of the legislation by several years. The resulting delay placed considerable cost on individuals, communities, corporations, and the State of Illinois. A bivariate analysis was conducted to examine whether the distribution patterns of ground level concentrations from the proposed facilities would have had a disproportionate distribution in lower-income and minority populations in the Chicago metropolitan area. The statistical analysis did discover evidence that ground level concentrations from the proposed Cook County facilities would have had a disproportionate distribution in poor and minority communities. The exposure level from only one pollutant examined in the analysis would have exceeded health benchmark standards. However, the evidence supports the need for cumulative impact analyses to determine a more through impact of projects in some circumstances.

To repeal the Legal Services Corporation Act.

THOMAS, 113th Congress

Rep. Scott, Austin [R-GA-8

2013-01-22

House - 02/28/2013 Referred to the Subcommittee on Regulatory Reform, Commercial And Antitrust Law. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

HAMP Repeal and Deficit Reduction Act of 2011

THOMAS, 112th Congress

Rep. Jordan, Jim [R-OH-4

2011-01-25

House - 03/23/2011 Referred to the Subcommittee on Insurance, Housing and Community Opportunity. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

75 FR 16666 - Liquor Dealer Recordkeeping and Registration, and Repeal of Certain Special (Occupational) Taxes

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-02

... recordkeeping requirements, Spices and flavorings, Surety bonds, Virgin Islands. 27 CFR Part 19 Administrative..., Reporting and recordkeeping requirements, Research, Scientific equipment, Spices and flavoring, Surety bonds...

ObamaCare Repeal Act

THOMAS, 113th Congress

Sen. Cruz, Ted [R-TX

2013-01-29

Senate - 01/30/2013 Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 9. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Dodd-Frank Repeal Act of 2011

THOMAS, 112th Congress

Sen. Shelby, Richard C. [R-AL

2011-04-06

Senate - 04/06/2011 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Repeal of Obamacare Act

THOMAS, 112th Congress

Rep. Cantor, Eric [R-VA-7

2012-07-09

Senate - 07/16/2012 Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 451. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

REAL ID Repeal and Identification Security Enhancement Act of 2009

THOMAS, 111th Congress

Rep. Cohen, Steve [D-TN-9

2009-07-31

House - 10/23/2009 Referred to the Subcommittee on Information Policy, Census, and National Archives. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Ethanol Subsidy and Tariff Repeal Act

THOMAS, 112th Congress

Sen. Coburn, Tom [R-OK

2011-05-24

Senate - 05/25/2011 Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 69. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

12 CFR 574.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Loan Control Act, 12 U.S.C. 1730(q), as in effect immediately prior to its repeal by the Financial... paragraph (q) of this section. (q) Savings and loan holding company means any company that directly or...

12 CFR 574.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Loan Control Act, 12 U.S.C. 1730(q), as in effect immediately prior to its repeal by the Financial... paragraph (q) of this section. (q) Savings and loan holding company means any company that directly or...

12 CFR 574.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Loan Control Act, 12 U.S.C. 1730(q), as in effect immediately prior to its repeal by the Financial... paragraph (q) of this section. (q) Savings and loan holding company means any company that directly or...

OAR Regulatory Reform

EPA Pesticide Factsheets

The U.S. EPA's Office of Air and Radiation is hosting a public teleconference to solicit input on specific air and radiation actions that should be considered for “repeal, replacement, or modification” to reduce regulatory burden consistent with EO 13777.

Repealing the Job-Killing Health Care Law Act

THOMAS, 112th Congress

Sen. DeMint, Jim [R-SC

2011-01-26

Senate - 01/27/2011 Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 4. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

78 FR 23818 - Urbanized Area Formula Program: Proposed Circular

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-22

... that MAP-21 has had on the State Safety Oversight (SSO) Program and the requirements of 49 CFR 659. Section 5330, which authorizes the SSO Program, will be repealed three years from the effective date of...

SGR Repeal and Medicare Beneficiary Access Act of 2013

THOMAS, 113th Congress

Sen. Baucus, Max [D-MT

2013-12-19

Senate - 01/16/2014 By Senator Baucus from Committee on Finance filed written report. Report No. 113-135. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

3 CFR 13579 - Executive Order 13579 of July 11, 2011. Regulation and Independent Regulatory Agencies

Code of Federal Regulations, 2012 CFR

2012-01-01

..., streamline, expand, or repeal them in accordance with what has been learned. Such retrospective analyses... agency's regulatory program more effective or less burdensome in achieving the regulatory objectives. Sec...

To repeal a requirement with respect to the procurement and acquisition of alternative fuels.

THOMAS, 111th Congress

Rep. Hensarling, Jeb [R-TX-5

2009-02-13

House - 05/04/2009 Referred to the Subcommittee on Government Management, Organization, and Procurement. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

To repeal a limitation on Federal procurement of certain fuels.

THOMAS, 112th Congress

Rep. Conaway, K. Michael [R-TX-11

2011-10-05

House - 11/02/2011 Referred to the Subcommittee on Technology, Information Policy, Intergovernmental Relations and Procurement Reform . (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Repeal Big Oil Tax Subsidies Act

THOMAS, 112th Congress

Sen. Menendez, Robert [D-NJ

2012-03-19

Senate - 03/29/2012 Cloture on the measure not invoked in Senate by Yea-Nay Vote. 51 - 47. Record Vote Number: 63. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

A legacy of struggle: the OSHA ergonomics standard and beyond, Part II.

PubMed

Delp, Linda; Mojtahedi, Zahra; Sheikh, Hina; Lemus, Jackie

2014-11-01

The OSHA ergonomics standard issued in 2000 was repealed within four months through a Congressional resolution that limits future ergonomics rulemaking. This section continues the conversation initiated in Part I, documenting a legacy of struggle for an ergonomics standard through the voices of eight labor, academic, and government key informants. Part I summarized important components of the standard; described the convergence of labor activism, research, and government action that laid the foundation for a standard; and highlighted the debates that characterized the rulemaking process. Part II explores the anti-regulatory political landscape of the 1990s, as well as the key opponents, power dynamics, and legal maneuvers that led to repeal of the standard. This section also describes the impact of the ergonomics struggle beyond the standard itself and ends with a discussion of creative state-level policy initiatives and coalition approaches to prevent work-related musculoskeletal disorders (WMSDs) in today's sociopolitical context.

Protecting Adolescents' Right to Seek Treatment for Sexually Transmitted Diseases without Parental Consent: The Arizona Experience with Senate Bill 1309

PubMed Central

Goodwin, Kimberly D.; Taylor, Melanie M.; Brown, Erin C. Fuse; Winscott, Michelle; Scanlon, Megan; Hodge, James G.; Mickey, Tom; England, Bob

2012-01-01

In 2010, Senate Bill 1309 included language to repeal an existing Arizona law that enables minors younger than 18 years of age to seek diagnosis and treatment of sexually transmitted diseases (STDs) without parental consent. Numerous implications were identified that would have stemmed from parental consent provisions originally proffered in Senate Bill 1309. These implications included diminished access to essential health services among minors, exacerbated existing health disparities, increased health-care spending costs, and thwarted efforts to curb the spread of STDs. Lastly, minors would have been deprived of existing privacy protections concerning their STD-related medical information. This case study describes how collaborative advocacy efforts resulted in the successful amendment of Senate Bill 1309 to avert the negative sexual and reproductive health outcomes among adolescents stemming from the potential repeal of their existing legal right to seek STD treatment without parental consent. PMID:22547855

Protecting adolescents' right to seek treatment for sexually transmitted diseases without parental consent: the Arizona experience with Senate Bill 1309.

PubMed

Goodwin, Kimberly D; Taylor, Melanie M; Brown, Erin C Fuse; Winscott, Michelle; Scanlon, Megan; Hodge, James G; Mickey, Tom; England, Bob

2012-01-01

In 2010, Senate Bill 1309 included language to repeal an existing Arizona law that enables minors younger than 18 years of age to seek diagnosis and treatment of sexually transmitted diseases (STDs) without parental consent. Numerous implications were identified that would have stemmed from parental consent provisions originally proffered in Senate Bill 1309. These implications included diminished access to essential health services among minors, exacerbated existing health disparities, increased health-care spending costs, and thwarted efforts to curb the spread of STDs. Lastly, minors would have been deprived of existing privacy protections concerning their STD-related medical information. This case study describes how collaborative advocacy efforts resulted in the successful amendment of Senate Bill 1309 to avert the negative sexual and reproductive health outcomes among adolescents stemming from the potential repeal of their existing legal right to seek STD treatment without parental consent.

Commonsense Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014

THOMAS, 113th Congress

Sen. Wyden, Ron [D-OR

2014-03-25

Senate - 03/26/2014 Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 336. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Responsible Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014

THOMAS, 113th Congress

Sen. Hatch, Orrin G. [R-UT

2014-03-12

Senate - 03/13/2014 Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 330. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Medicare SGR Repeal and Beneficiary Access Improvement Act of 2014

THOMAS, 113th Congress

Sen. Wyden, Ron [D-OR

2014-03-11

Senate - 03/12/2014 Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 327. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Enforcing Job Safety: A Managerial View

ERIC Educational Resources Information Center

Barnako, Frank R.

1975-01-01

The views of management or of employees regarding enforcement of the job safety law range from general satisfaction to calls for repeal of the act. The complexity of standards, statistics and recordkeeping, and enforcement procedures are major areas of concern. (MW)

To repeal the Dodd-Frank Wall Street Reform and Consumer Protection Act.

THOMAS, 112th Congress

Rep. Bachmann, Michele [R-MN-6

2011-01-05

House - 02/08/2011 Referred to the Subcommittee on Technology, Information Policy, Intergovernmental Relations and Procurement Reform . (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

A bill to repeal the Patient Protection and Affordable Care Act.

THOMAS, 111th Congress

Sen. DeMint, Jim [R-SC

2010-03-23

Senate - 03/23/2010 Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 332. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

To repeal the Prevention and Public Health Fund.

THOMAS, 112th Congress

Rep. Pitts, Joseph R. [R-PA-16

2011-03-29

Senate - 04/14/2011 Received in the Senate and Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

A bill to repeal the American Recovery Capital loan program of the Small Business Administration.

THOMAS, 111th Congress

Sen. Snowe, Olympia J. [R-ME

2009-11-16

Senate - 11/16/2009 Read twice and referred to the Committee on Small Business and Entrepreneurship. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Proposed Rule for Repeal of Emission Requirements for Glider Vehicles, Glider Engines, and Glider Kits

EPA Pesticide Factsheets

Rule to finalize standards for medium- and heavy-duty vehicles that would improve fuel efficiency and cut carbon pollution to reduce the impacts of climate change, while bolstering energy security and spurring manufacturing innovation.

29 CFR 1206.8 - Amendment or rescission of rules in this part.

Code of Federal Regulations, 2010 CFR

2010-07-01

... interested person may petition the Board, in writing, for the issuance, amendment, or repeal of a rule or... denied in whole or in part, prompt notice shall be given of the denial, accompanied by a simple statement...

First Amendment Protects Tobacco Advertising.

ERIC Educational Resources Information Center

Fein, Bruce

1988-01-01

Argues that the U.S. government suppression of tobacco advertising is inconsistent with the First Amendment. Cites court decisions declaring that truthful commercial speech concerning lawful activity can be suppressed only if restraint directly advances a substantial government interest. Concludes that Congress should repeal prohibition on…

Proposing an amendment to the Constitution of the United States to repeal the sixteenth article of amendment.

THOMAS, 111th Congress

Rep. King, Steve [R-IA-5

2009-01-08

House - 02/09/2009 Referred to the Subcommittee on the Constitution, Civil Rights, and Civil Liberties. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

To repeal mandatory funding for school-based health center construction.

THOMAS, 112th Congress

Rep. Burgess, Michael C. [R-TX-26

2011-03-29

Senate - 05/05/2011 Received in the Senate and Read twice and referred to the Committee on Health, Education, Labor, and Pensions. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

A bill to repeal the provision of law that provides automatic pay adjustments for Members of Congress.

THOMAS, 112th Congress

Sen. McCaskill, Claire [D-MO

2011-01-25

Senate - 01/25/2011 Read twice and referred to the Committee on Homeland Security and Governmental Affairs. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

21 CFR 589.1 - Substances prohibited from use in animal food or feed.

Code of Federal Regulations, 2010 CFR

2010-04-01

... establish, amend, or repeal a regulation under this part on the basis of new scientific evaluation or... the form set forth in § 571.1 of this chapter, and will be published in the Federal Register for...

Price trends for federal-aid highway construction : 1987 base, second quarter 1999

DOT National Transportation Integrated Search

1997-04-01

This plan is part of the continuing commitment by the National Highway Traffic Safety Administration and the Federal Highway Administration to reduce the number of speed-related fatalities and injuries occurring on our highways. Since the repeal of t...

To repeal the provision of law that provides for automatic pay adjustments for Members of Congress.

THOMAS, 112th Congress

Rep. Platts, Todd Russell [R-PA-19

2011-01-07

House - 02/08/2011 Referred to the Subcommittee on Federal Workforce, U.S. Postal Service, and Labor Policy . (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Evaluation of the reinstatement of the helmet law in Louisiana

DOT National Transportation Integrated Search

2008-05-01

Louisiana has enacted and repealed motorcycle helmet laws many times. Louisiana first adopted an all-rider motorcycle helmet law in 1968, amended it in 1976 to require helmet use only by riders under the age of 18, and reenacted a universal helmet la...

A Seer of Trump's Coming Parses Repeal and Replace.

PubMed

Kirkner, Richard Mark

2017-03-01

Diana Furchtgott-Roth, a senior fellow at the Manhattan Institute, a freemarket think tank, confidently predicted back in October what few people saw coming-Donald Trump's electoral victory. Now she gives her take on the dismantling of the ACA and what might come after.

43 CFR 29.13 - Termination.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Termination. Upon termination of operations of the Pipeline, the full disposition of all claims, and the... shall request that Congress provide for final disposition of the Fund. If Congress at any time establishes a comprehensive oil pollution liability fund which supersedes or repeals the Fund, the Fund assets...

24 CFR 10.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-04-01

... Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development... formulating the issuance, modification, or repeal of a rule. (c) Secretary means the Secretary or the Under Secretary of Housing and Urban Development, or an official to whom the Secretary has expressly delegated...

24 CFR 10.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-04-01

... Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development... formulating the issuance, modification, or repeal of a rule. (c) Secretary means the Secretary or the Under Secretary of Housing and Urban Development, or an official to whom the Secretary has expressly delegated...

24 CFR 10.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development... formulating the issuance, modification, or repeal of a rule. (c) Secretary means the Secretary or the Under Secretary of Housing and Urban Development, or an official to whom the Secretary has expressly delegated...

24 CFR 10.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development... formulating the issuance, modification, or repeal of a rule. (c) Secretary means the Secretary or the Under Secretary of Housing and Urban Development, or an official to whom the Secretary has expressly delegated...

24 CFR 10.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-04-01

... Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development... formulating the issuance, modification, or repeal of a rule. (c) Secretary means the Secretary or the Under Secretary of Housing and Urban Development, or an official to whom the Secretary has expressly delegated...

30 CFR 700.12 - Petitions to initiate rulemaking.

Code of Federal Regulations, 2010 CFR

2010-07-01

... statement of the facts, technical justification, and law which require issuance, amendment, or repeal of a... of the petition, the Director shall determine if the petition sets forth facts, technical.... Facts, technical justification or law previously considered in a petition or rulemaking on the same...

1999 update of the Arizona highway cost allocation study

DOT National Transportation Integrated Search

1999-08-01

The purpose of this report was to update the Arizona highway cost allocation study and to evaluate the alternative of using the new FHWA cost allocation model as a replacement The update revealed that the repeal of Arizona's weight-distance tas has l...

Legal, Ethical, Social and Economic Issues in Sickle Cell Program

ERIC Educational Resources Information Center

Bowman, James E.

1973-01-01

Urges that mandatory sickle cell screening laws be repealed, and that all screening programs be voluntary; bogus sickle cell organizations are a major crisis in black communities and must be eliminated; research and education in sickle cell disease is badly needed. (Author/JM)

Effects of Affordable Care Act Marketplaces and Medicaid Eligibility Expansion on Access to Cancer Care.

PubMed

Graves, John A; Swartz, Katherine

The aim of this study was to inform oncologists about how repealing the Affordable Care Act (ACA) may affect their ability to provide cancer therapies for people with cancer enrolled in ACA health plans and why proposals to change Medicaid funding may make it even more difficult for Medicaid beneficiaries to access cancer treatments. We examined the regulations and provisions of the ACA related to how health insurance impacts access to diagnostic testing and treatments for people with cancer, including access to clinical trials. Similarly, we examined federal and state rules affecting Medicaid beneficiaries' access to cancer treatments. Repealing various provisions of the ACA will restrict who has access to both current and new cancer treatments. Such changes also will impact oncology research that depends on having heterogeneous people in clinical trials. Significant changes to the ACA will affect oncology treatment choices of everyone with health insurance-not only the 10 million people newly covered by ACA health plans and the 70 million people with Medicaid coverage.

Brief Report: Sexual Risk Behaviors of HIV Seroconverters in the US Army, 2012-2014.

PubMed

Hakre, Shilpa; Scoville, Stephanie L; Pacha, Laura A; Peel, Sheila A; Kim, Jerome H; Michael, Nelson L; Cersovsky, Steven B; Scott, Paul T

2015-12-01

The United States (US) Army implemented a comprehensive HIV characterization program in 2012 following repeal of the Don't Ask, Don't Tell policy banning openly homosexual individuals from serving in the US military. Program staff administered a standardized case report form to soldiers newly diagnosed with HIV from 2012 to 2014 in compliance with new program requirements. The case report form documented sociodemographic, sexual, and other risk behavior information elicited from US Army regulation-mandated epidemiologic interviews at initial HIV notification. A majority of HIV-infected soldiers were male and of black/African American racial origin. In the HIV risk period, male soldiers commonly reported male-male sexual contact, civilian partners, online partner-seeking, unprotected anal sex, and expressed surprise at having a positive HIV result. Don't Ask, Don't Tell repeal allows for risk screening and reduction interventions targeting a newly identifiable risk category in the US Army. At-risk populations need to be identified and assessed for possible unmet health needs.

Brief Report: Sexual Risk Behaviors of HIV Seroconverters in the US Army, 2012–2014

PubMed Central

Scoville, Stephanie L.; Pacha, Laura A.; Peel, Sheila A.; Kim, Jerome H.; Michael, Nelson L.; Cersovsky, Steven B.; Scott, Paul T.

2015-01-01

Abstract: The United States (US) Army implemented a comprehensive HIV characterization program in 2012 following repeal of the Don't Ask, Don't Tell policy banning openly homosexual individuals from serving in the US military. Program staff administered a standardized case report form to soldiers newly diagnosed with HIV from 2012 to 2014 in compliance with new program requirements. The case report form documented sociodemographic, sexual, and other risk behavior information elicited from US Army regulation-mandated epidemiologic interviews at initial HIV notification. A majority of HIV-infected soldiers were male and of black/African American racial origin. In the HIV risk period, male soldiers commonly reported male–male sexual contact, civilian partners, online partner-seeking, unprotected anal sex, and expressed surprise at having a positive HIV result. Don't Ask, Don't Tell repeal allows for risk screening and reduction interventions targeting a newly identifiable risk category in the US Army. At-risk populations need to be identified and assessed for possible unmet health needs. PMID:26247893

Effects of Affordable Care Act Marketplaces and Medicaid Eligibility Expansion on Access to Cancer Care

PubMed Central

Graves, John A.; Swartz, Katherine

2017-01-01

Purpose To inform oncologists about how repealing the ACA may affect their ability to provide cancer therapies for people with cancer enrolled in ACA health plans, and why proposals to change Medicaid funding may make it even more difficult for Medicaid beneficiaries to access cancer treatments. Methods We examined the regulations and provisions of the ACA related to how health insurance impacts access to diagnostic testing and treatments for people with cancer, including access to clinical trials. Similarly, we examined federal and state rules affecting Medicaid beneficiaries’ access to cancer treatments. Results Repealing various provisions of the ACA will restrict who has access to both current and new cancer treatments. Such changes also will impact oncology research that depends on having heterogeneous people in clinical trials. Discussion Significant changes to the ACA will affect oncology treatment choices of everyone with health insurance – not just the 10 million people newly covered by ACA health plans and the 70 million people with Medicaid coverage. PMID:28537962

Outlook. Number 371

ERIC Educational Resources Information Center

Council for American Private Education, 2012

2012-01-01

Council for American Private Education (CAPE) is a coalition of national associations serving private schools K-12. "Outlook" is published monthly by CAPE. This issue contains the following articles: (1) Repeal of Blaine Amendment on Florida Ballot in November; (2) Top Private Education Events of 2011; (3) New Guidance Issued on ESEA…

A bill to amend the Food, Conservation, and Energy Act to repeal a duplicative program relating to inspection and grading of catfish.

THOMAS, 112th Congress

Sen. McCain, John [R-AZ

2011-03-07

Senate - 03/07/2011 Read twice and referred to the Committee on Agriculture, Nutrition, and Forestry. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

76 FR 15859 - Reducing Regulatory Burden; Retrospective Review under E.O. 13563

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-22

... Management, at (202) 501- 1777. SUPPLEMENTARY INFORMATION: A. Background Executive Order 13563 directs each..., ineffective, insufficient, or excessively burdensome.'' The EO calls on every agency to develop ``a... modified, streamlined, expanded or repealed to make the agency's regulatory program more effective and or...

Indiana and the Kansas-Nebraska Act of 1854.

ERIC Educational Resources Information Center

Medland, William J.; Rosenberg, Morton M.

1984-01-01

The Kansas-Nebraska Act, which repealed the ban against slavery in the North, served as a catalyst to activate numerous groups which were unhappy with the Indiana Democratic Party. From this period emerged the new Republican party and also a revitalized Democratic party with new leadership. (IS)

77 FR 65477 - Repeal of Regulations on Marriages

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-29

... outdated and duplicative of other authorities that detail procedures for authentications and documentation... authentication of marriage documents. This section is unnecessary because the laws and regulations that apply to authentications in general also apply to marriage documents, and these functions are already covered in 22 CFR 92...

75 FR 5697 - Employee Protection Program; Removal

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-04

... DEPARTMENT OF TRANSPORTATION Office of the Secretary 14 CFR Part 314 RIN 2105-AD94 Employee... Employee Protection Program. These regulations are removed because the underlying program was repealed by... Employee Protection Program, to be administered by the U.S. Department of Transportation. Section 43 of the...

43 CFR 3430.0-7 - Scope.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Scope. Section 4 of the Federal Coal Leasing Amendments Act of 1976, amending 30 U.S.C. 201(b), repealed the Secretary's authority to issue or extend a coal prospecting permit on Federal lands. Therefore... Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT...

43 CFR 3430.0-7 - Scope.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Scope. Section 4 of the Federal Coal Leasing Amendments Act of 1976, amending 30 U.S.C. 201(b), repealed the Secretary's authority to issue or extend a coal prospecting permit on Federal lands. Therefore... Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT...

43 CFR 3430.0-7 - Scope.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Scope. Section 4 of the Federal Coal Leasing Amendments Act of 1976, amending 30 U.S.C. 201(b), repealed the Secretary's authority to issue or extend a coal prospecting permit on Federal lands. Therefore... Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT...

43 CFR 3430.0-7 - Scope.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Scope. Section 4 of the Federal Coal Leasing Amendments Act of 1976, amending 30 U.S.C. 201(b), repealed the Secretary's authority to issue or extend a coal prospecting permit on Federal lands. Therefore... Lands: Interior Regulations Relating to Public Lands (Continued) BUREAU OF LAND MANAGEMENT, DEPARTMENT...

75 FR 42579 - Energy Conservation Program for Consumer Products: Test Procedure for Microwave Ovens; Repeal of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-22

... the usable baking space. If there is a selector switch for selecting the mode of operation of the oven, set it for normal baking. If an oven permits baking by either forced convection by using a fan, or...

78 FR 9353 - Designation of Offenses

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-08

... November 26, 1998, provided for notification of sex offender release and certain related functions to facilitate effective sex offender registration and tracking. Notifications were required to be made for... for the purposes of this subsection.'' However, 18 U.S.C. 4042(c)(4) was repealed by the Sex Offender...

Human Capital Challenges: Taking Us Into the 21st Century

DTIC Science & Technology

2011-01-24

Defense Health Headquarters (DHHQ)  JTF CapMed and related joint initiatives  Federal workers paid too much?  NSPS Repeal 2010 Military Health...For Succession Planning  Workforce planning (Mission Critical Occs) – Competency Development  “Growing Our Own” – Legislative Initiatives

3 CFR 8989 - Proclamation 8989 of May 31, 2013. Lesbian, Gay, Bisexual, and Transgender Pride Month, 2013

Code of Federal Regulations, 2014 CFR

2014-01-01

... identity and repealed “Don't Ask, Don't Tell.” We lifted the HIV entry ban and ensured hospital visitation..., as well as the National HIV/AIDS Strategy, which addresses the disparate impact of the HIV epidemic...

49 CFR 211.7 - Filing requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... petition the Administrator for issuance, amendment, repeal or permanent or temporary waiver of any rule or regulation. A petition for waiver must be submitted at least 3 months before the proposed effective date, unless good cause is shown for not doing so. (b)(1) All petitions and applications subject to this part...

Deceptive Business Practices: State Regulations.

ERIC Educational Resources Information Center

Rohrer, Daniel Morgan

Although much has been done at the federal level to control deceptive advertising practices, many states have no criminal laws designed to regulate advertising, and several states recently repealed such laws. This paper examines states' efforts to balance the advertiser's freedom of speech with the consumer's need for information about products by…

A bill to amend the Food, Conservation, and Energy Act of 2008 to repeal a duplicative program relating to inspection and grading of catfish.

THOMAS, 113th Congress

Sen. McCain, John [R-AZ

2013-03-21

Senate - 03/21/2013 Read twice and referred to the Committee on Agriculture, Nutrition, and Forestry. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

76 FR 19358 - Sunshine Act Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-07

... Corporation's Board of Directors will meet in open session at 10 a.m. on Tuesday, April 12, 2011, to consider.... These matters will be resolved with a single vote unless a member of the Board of Directors requests...: Proposed Rule Reflecting Repeal of Prohibition on Paying Interest on Demand Deposits. Discussion Agenda...

77 FR 1883 - Suspension of Community Eligibility for Repealing Its Floodplain Management Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-12

... the National Flood Insurance Program (NFIP). If documentation is received from the community before... compliance with the NFIP requirements, FEMA will withdraw the suspension by publication in the Federal.... SUPPLEMENTARY INFORMATION: The National Flood Insurance Program (NFIP) enables property owners to purchase flood...

76 FR 65631 - Energy Conservation Program: Test Procedures for Microwave Ovens

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-24

... Conservation Program: Test Procedures for Microwave Ovens AGENCY: Office of Energy Efficiency and Renewable... (DOE) has initiated a test procedure rulemaking to develop active mode testing methodologies for... Federal Register a final rule for the microwave oven test procedure rulemaking (July TP repeal final rule...

A bill to repeal a prohibition on the use of certain funds for the termination of the Constellation program of the National Aeronautics and Space Administration.

THOMAS, 112th Congress

Sen. Nelson, Bill [D-FL

2011-02-08

Senate - 02/08/2011 Read twice and referred to the Committee on Commerce, Science, and Transportation. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

To repeal mandatory funding provided to States in the Patient Protection and Affordable Care Act to establish American Health Benefit Exchanges.

THOMAS, 112th Congress

Rep. Upton, Fred [R-MI-6

2011-03-29

Senate - 05/05/2011 Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 39. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

Military Construction, Veterans Affairs, and Related Agencies: FY2009 Appropriations

DTIC Science & Technology

2008-09-17

Defense Posture Realignment ( GDPR ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Repealing the BRAC Commission Mechanism... GDPR One-Time Implementation Costs . . . . . . . . . . . . . . . . . . 12 Table 4. Department of Veterans Affairs Appropriations, FY2002-FY2008...IGPBS) has been renamed the Global Defense Posture Realignment ( GDPR ). 17 Office of the Under Secretary of Defense (Comptroller), National Defense

29 CFR 779.381 - Establishments within special exceptions or exemptions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... sick, the aged, the mentally ill or defective, and schools for physically or mentally handicapped or... the first part of section 13(b)(8). Hospitals, residential care establishments, and schools for... primarily engaged in the business of selling automobiles, trucks, or farm implements was repealed by the...

29 CFR 779.381 - Establishments within special exceptions or exemptions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... sick, the aged, the mentally ill or defective, and schools for physically or mentally handicapped or... the first part of section 13(b)(8). Hospitals, residential care establishments, and schools for... primarily engaged in the business of selling automobiles, trucks, or farm implements was repealed by the...

29 CFR 779.381 - Establishments within special exceptions or exemptions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... sick, the aged, the mentally ill or defective, and schools for physically or mentally handicapped or... the first part of section 13(b)(8). Hospitals, residential care establishments, and schools for... primarily engaged in the business of selling automobiles, trucks, or farm implements was repealed by the...

75 FR 34707 - Information Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-18

... the working group the Secretary of Defense directed to examine the issues associated with a repeal of... its report on ``Sexual Orientation and U.S. Military Personnel Policy: Options and Assessment.'' A... different sources in a range of locations throughout the country and world, it is necessary to begin data...

Don't Ask, Don't Tell Repeal Act of 2010

THOMAS, 111th Congress

Sen. Lieberman, Joseph I. [ID-CT

2010-12-09

Senate - 12/09/2010 Read twice and referred to the Committee on Armed Services. (All Actions) Notes: For further action, see H.R.2965, which became Public Law 111-321 on 12/22/2010. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Don't Ask, Don't Tell Repeal Act of 2010

THOMAS, 111th Congress

Rep. Murphy, Patrick J. [D-PA-8

2010-12-14

House - 12/23/2010 Referred to the Subcommittee on Military Personnel. (All Actions) Notes: For further action, see H.R.2965, which became Public Law 111-321 on 12/22/2010. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Rating Teacher-Preparation Programs

ERIC Educational Resources Information Center

Von Hippel, Paul T.; Bellows, Laura

2018-01-01

Recent policies intended to improve teacher quality have focused on the preparation that teachers receive before entering the classroom. A short-lived federal rule would have required every state to assess and rank teacher-preparation programs by their graduates' impact on student learning. Though the federal rule was repealed, last year some 21…

78 FR 63379 - Registration of Mortgage Loan Originators; Effective Date

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-24

... FARM CREDIT ADMINISTRATION 12 CFR Part 610 RIN 3052-AC78 Registration of Mortgage Loan Originators... loan originators employed by Farm Credit System (FCS or System) institutions. We repealed these... Enforcement for Mortgage Licensing Act (S.A.F.E. Act), which require residential mortgage loan originators at...

How Has the Affordable Care Act Affected Work and Wages?

PubMed

Abraham, Jean; Royalty, Anne Beeson

2017-01-01

In a review of the evidence, the authors find that the ACA had minimal effect on employment, hours of work, and compensation. This brief provides critical perspective on the effects of reforms on labor markets for federal and state policymakers as they consider changing or repealing the law.

76 FR 45403 - Disclosure to Participants

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-29

... regulation on Disclosure to Participants. The regulation is obsolete as a result of the Pension Protection... Benefit Guaranty Corporation's guarantee. The Pension Protection Act of 2006 repealed section 4011 for..., DC 20005, 202-326-4024. (TTY/TDD users may call the Federal relay service toll-free at 1-800- 877...

75 FR 82567 - Federal Acquisition Regulation; Repeal of the Small Business Competitiveness Demonstration Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-30

... Competitiveness Demonstration Program AGENCY: Department of Defense (DoD), General Services Administration (GSA... of the Small Business Competitiveness Demonstration Program, to meet the requirements of section 1335... (15 U.S.C. 644 note), the Small Business Competitiveness Demonstration Program. In accordance with the...

76 FR 42015 - Prohibition Against Payment of Interest on Demand Deposits

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-18

... also sought comment on four specific issues related to the proposal: 1. Does the repeal of Regulation Q..., consumer lending and small business lending. Commenters argued that smaller institutions, as they lose... received from smaller banks because the business model of smaller banks focuses on relationships and...

To Smack or Not to Smack?

ERIC Educational Resources Information Center

Keown, Robin

2006-01-01

The issue of physical punishment is a particularly controversial one at the moment as child advocates are engaged in a struggle to persuade the New Zealand government to repeal a defence in law (section 59 of the 1961 "Crimes Act") which justifies parents hitting their children provided the force used is "reasonable in the…

77 FR 25893 - Federal Pell Grant Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-02

... Program regulations to make them consistent with recent changes in the law that prohibit a student from... should make any changes in these regulations. We invite your comments. We will consider these comments in... change in the law that repealed section 401(b)(5) of the HEA. We have retained most of current Sec. 690...

77 FR 59321 - Approval and Promulgation of Implementation Plans; Revisions to the Nevada State Implementation...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-27

... includes a rescission of one definition from the existing SIP (the definition of ``special mobile equipment... mobile equipment'' 10/05/10 (repealed) 01/24/11 defined. NAC 445B.187 ``Stationary source'' defined... permit'' defined........ 49 FR 11626; (March 27, 1984). NAQR article 1.182--Special mobile equipment...

To repeal an obsolete provision in title 49, United States Code, requiring motor vehicle insurance cost reporting.

THOMAS, 112th Congress

Rep. Owens, William L. [D-NY-23

2012-05-08

House - 05/11/2012 Referred to the Subcommittee on Health. (All Actions) Notes: For further action, see H.R.5859, which became Public Law 112-252 on 1/10/2013. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

40 CFR 52.1770 - Identification of plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... FR 61213 Sect .0507 Particulates from Chemical Fertilizer Manufacturing Plants 04/01/03 09/17/03, 68... Organic Compounds Sect .0901 Definitions 07/01/96 08/01/97, 62 FR 41277 Sect .0902 Applicability 07/01/00... FR 61213 Repealed. Sect .0939 Determination of Volatile Organic Compounds Emissions 07/01/88 01/16/90...

Alternative Fuels Data Center: State Alternative Fuel and Advanced Vehicle

Science.gov Websites

2014 to 2015, the number of tax incentives decreased. Significantly, Georgia repealed its successful tax incentive program. Aside from political and budgetary drivers, the decrease in new tax incentives see their savings more immediately (e.g., rebates, vouchers), rather than waiting until tax season

West Europe Report

DTIC Science & Technology

1987-05-14

denying that he, in any way, has become alienated from the ideals of the party. Opposing Porno and Abortions The dispute between the left wing and...the right wing of the party goes back to 1970, when the Christian People’s Party first emerged in reaction to the repeal of the ban on porno and the

May 31, 1918 Act Repeal Act

THOMAS, 113th Congress

Sen. Crapo, Mike [R-ID

2014-02-25

Senate - 11/13/2014 By Senator Tester from Committee on Indian Affairs filed written report. Report No. 113-271. (All Actions) Notes: For further action, see H.R.5050, which became Public Law 113-262 on 12/18/2014. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

47 CFR 1.413 - Content of notice.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Content of notice. 1.413 Section 1.413 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE Rulemaking Proceedings Rulemaking Proceedings § 1.413 Content of notice. A notice of the proposed issuance, amendment, or repeal of a rule will include the following: (a) A...

7 CFR 1.28 - Petitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 7 Agriculture 1 2013-01-01 2013-01-01 false Petitions. 1.28 Section 1.28 Agriculture Office of the Secretary of Agriculture ADMINISTRATIVE REGULATIONS Departmental Proceedings § 1.28 Petitions. Petitions by interested persons in accordance with 5 U.S.C. 553(e) for the issuance, amendment or repeal of a rule may be...

77 FR 19533 - Changes in the Statutory Authority for Petitions for Relief

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-02

... corrections to reflect the repeal of one of the underlying statutory authorities regarding petitions for.... Administrative petitioning rights are not affected by removal of this authority because CBP has other existing..., which is currently cited as one of the underlying statutory authorities. Title 46 U.S.C. Appendix...

To repeal the Patient Protection and Affordable Care Act and health care-related provisions in the Health Care and Education Reconciliation Act of 2010.

THOMAS, 113th Congress

Rep. Bachmann, Michele [R-MN-6

2013-01-03

Senate - 05/22/2013 Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 78. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

22 CFR 401.9 - Suspension or amendment of rules.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Suspension or amendment of rules. 401.9 Section 401.9 Foreign Relations INTERNATIONAL JOINT COMMISSION, UNITED STATES AND CANADA RULES OF PROCEDURE General § 401.9 Suspension or amendment of rules. The commission may suspend, repeal, or amend all or any...

76 FR 32853 - Lesbian, Gay, Bisexual, And Transgender Pride Month, 2011

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-07

..., Gay, Bisexual, And Transgender Pride Month, 2011 By the President of the United States of America A Proclamation The story of America's Lesbian, Gay, Bisexual, and Transgender (LGBT) community is the story of..., Don't Tell'' policy. With this repeal, gay and lesbian Americans will be able to serve openly in our...

12 CFR 250.260 - Miscellaneous interpretations; gold coin and bullion.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 4 2013-01-01 2013-01-01 false Miscellaneous interpretations; gold coin and... Miscellaneous interpretations; gold coin and bullion. The Board has received numerous inquiries from member banks relating to the repeal of the ban on ownership of gold by United States citizens. Listed below are...

12 CFR 250.260 - Miscellaneous interpretations; gold coin and bullion.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 3 2011-01-01 2011-01-01 false Miscellaneous interpretations; gold coin and... interpretations; gold coin and bullion. The Board has received numerous inquiries from member banks relating to the repeal of the ban on ownership of gold by United States citizens. Listed below are questions and...

12 CFR 250.260 - Miscellaneous interpretations; gold coin and bullion.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 4 2014-01-01 2014-01-01 false Miscellaneous interpretations; gold coin and... Miscellaneous interpretations; gold coin and bullion. The Board has received numerous inquiries from member banks relating to the repeal of the ban on ownership of gold by United States citizens. Listed below are...

12 CFR 250.260 - Miscellaneous interpretations; gold coin and bullion.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Miscellaneous interpretations; gold coin and... interpretations; gold coin and bullion. The Board has received numerous inquiries from member banks relating to the repeal of the ban on ownership of gold by United States citizens. Listed below are questions and...

12 CFR 250.260 - Miscellaneous interpretations; gold coin and bullion.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 4 2012-01-01 2012-01-01 false Miscellaneous interpretations; gold coin and... Miscellaneous interpretations; gold coin and bullion. The Board has received numerous inquiries from member banks relating to the repeal of the ban on ownership of gold by United States citizens. Listed below are...

Preventing Child and Adolescent Firearm Injuries. Firearm Facts.

ERIC Educational Resources Information Center

Duker, Laurie

In an effort to reduce the current epidemic of gun violence among children and adolescents in the United States, this fact sheet presents various approaches to reducing access to and interest in carrying firearms. Suggested approaches to reducing access include: (1) urging parents to turn in their guns to police; (2) repealing anti-gun control…

78 FR 79652 - Approval and Promulgation of Implementation Plans; Washington: State Implementation Plan...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-31

... Department of Ecology (Ecology) dated November 20, 2013. This SIP revision updates ambient air quality... May 22, 1996. See 75 FR 35520 and 61 FR 25580. Lastly, Ecology requested EPA approval of the state..., particulate matter, and sulfur dioxide. Secondly, Ecology repealed Chapter 173-470 WAC that contained outdated...

To repeal section 10(f) of Public Law 93-531, commonly known as the "Bennett Freeze".

THOMAS, 111th Congress

Rep. Kirkpatrick, Ann [D-AZ-1

2009-03-26

House - 03/26/2009 Referred to the House Committee on Natural Resources. (All Actions) Notes: For further action, see S.39, which became Public Law 111-18 on 5/8/2009. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

39 CFR 255.9 - Other postal regulations; authority of postal managers and employees.

Code of Federal Regulations, 2010 CFR

2010-07-01

... managers and employees. 255.9 Section 255.9 Postal Service UNITED STATES POSTAL SERVICE ORGANIZATION AND... ELECTRONIC AND INFORMATION TECHNOLOGY § 255.9 Other postal regulations; authority of postal managers and... repeal, modify, or amend any other postal regulation, to authorize any postal manager or employee to...

21 CFR 25.34 - Devices and electronic products.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Devices and electronic products. 25.34 Section 25... ENVIRONMENTAL IMPACT CONSIDERATIONS Categorical Exclusions § 25.34 Devices and electronic products. The classes... substitutes. (c) Issuance, amendment, or repeal of a standard for a class II medical device or an electronic...

21 CFR 25.34 - Devices and electronic products.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Devices and electronic products. 25.34 Section 25... ENVIRONMENTAL IMPACT CONSIDERATIONS Categorical Exclusions § 25.34 Devices and electronic products. The classes... substitutes. (c) Issuance, amendment, or repeal of a standard for a class II medical device or an electronic...

21 CFR 25.34 - Devices and electronic products.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Devices and electronic products. 25.34 Section 25... ENVIRONMENTAL IMPACT CONSIDERATIONS Categorical Exclusions § 25.34 Devices and electronic products. The classes... substitutes. (c) Issuance, amendment, or repeal of a standard for a class II medical device or an electronic...

21 CFR 25.34 - Devices and electronic products.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Devices and electronic products. 25.34 Section 25... ENVIRONMENTAL IMPACT CONSIDERATIONS Categorical Exclusions § 25.34 Devices and electronic products. The classes... substitutes. (c) Issuance, amendment, or repeal of a standard for a class II medical device or an electronic...

21 CFR 25.34 - Devices and electronic products.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Devices and electronic products. 25.34 Section 25... ENVIRONMENTAL IMPACT CONSIDERATIONS Categorical Exclusions § 25.34 Devices and electronic products. The classes... substitutes. (c) Issuance, amendment, or repeal of a standard for a class II medical device or an electronic...

Legislative Actions to Repeal, Defund, or Delay the Affordable Care Act

DTIC Science & Technology

2013-11-22

Public Health Sciences Track, pursuant to ACA Section 5315. • Removed the maintenance of effort requirement for use of monies in the Community Health...Office (GAO) study of the costs and processes of ACA implementation, and a Medicare actuarial analysis of the impact of the ACA’s private insurance

Military Construction, Veterans Affairs, and Related Agencies: FY2009 Appropriations

DTIC Science & Technology

2008-10-09

Global Presence and Basing Strategy (IGPBS)/Global Defense Posture Realignment ( GDPR ) . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Repealing...Second FY2008 Supplemental (P.L. 110-252) . . . . . . . . . . . . . . . . . . . . 6 Table 3. IGPBS/ GDPR One-Time Implementation Costs...report. CRS-10 17 The DOD Integrated Global Presence and Basing Strategy (IGPBS) has been renamed the Global Defense Posture Realignment ( GDPR ). 18

Summary Report for Online Schools and Programs

ERIC Educational Resources Information Center

Colorado Department of Education, 2014

2014-01-01

Pursuant to State Law, the Colorado Department of Education, Office of Blended and Online Learning is required to prepare an annual summary report for submission. The passage of a later State House Bill repealed the annual requirement for the Summary Report and also the annual reporting mandates that were required of all online schools and…

The Effects of an Adversarial Process on Adoption Decisions.

ERIC Educational Resources Information Center

Ryburn, Murray

1993-01-01

Examines the legal and social work process in contested adoption proceedings, and argues that there are moral grounds for repealing provisions in British legislation on forced adoption. Considers the adversarial process that characterizes adoption hearings, the role of poverty in the lives of families whose children are admitted to foster care,…

Medical malpractice reform and employer-sponsored health insurance premiums.

PubMed

Morrisey, Michael A; Kilgore, Meredith L; Nelson, Leonard Jack

2008-12-01

Tort reform may affect health insurance premiums both by reducing medical malpractice premiums and by reducing the extent of defensive medicine. The objective of this study is to estimate the effects of noneconomic damage caps on the premiums for employer-sponsored health insurance. Employer premium data and plan/establishment characteristics were obtained from the 1999 through 2004 Kaiser/HRET Employer Health Insurance Surveys. Damage caps were obtained and dated based on state annotated codes, statutes, and judicial decisions. Fixed effects regression models were run to estimate the effects of the size of inflation-adjusted damage caps on the weighted average single premiums. State tort reform laws were identified using Westlaw, LEXIS, and statutory compilations. Legislative repeal and amendment of statutes and court decisions resulting in the overturning or repealing state statutes were also identified using LEXIS. Using a variety of empirical specifications, there was no statistically significant evidence that noneconomic damage caps exerted any meaningful influence on the cost of employer-sponsored health insurance. The findings suggest that tort reforms have not translated into insurance savings.

Healthcare Reform and the Next Generation: United States Medical Student Attitudes toward the Patient Protection and Affordable Care Act

PubMed Central

Huntoon, Kristin M.; McCluney, Colin J.; Scannell, Christopher A.; Wiley, Elizabeth A.; Bruno, Richard; Andrews, Allen; Gorman, Paul

2011-01-01

Context Over one year after passage of the Patient Protection and Affordable Care Act (PPACA), legislators, healthcare experts, physicians, and the general public continue to debate the implications of the law and its repeal. The PPACA will have a significant impact on future physicians, yet medical student perspectives on the legislation have not been well documented. Objective To evaluate medical students' understanding of and attitudes toward healthcare reform and the PPACA including issues of quality, access and cost. Design, Setting, and Participants An anonymous electronic survey was sent to medical students at 10 medical schools (total of 6982 students) between October–December 2010, with 1232 students responding and a response rate of 18%. Main Outcome Measures Medical students' views and attitudes regarding the PPACA and related topics, measured with Likert scale and open response items. Results Of medical students surveyed, 94.8% agreed that the existing United States healthcare system needs to be reformed, 31.4% believed the PPACA will improve healthcare quality, while 20.9% disagreed and almost half (47.7%) were unsure if quality will be improved. Two thirds (67.6%) believed that the PPACA will increase access, 6.5% disagreed and the remaining 25.9% were unsure. With regard to containing healthcare costs, 45.4% of participants indicated that they are unsure if the provisions of the PPACA will do so. Overall, 80.1% of respondents indicated that they support the PPACA, and 78.3% also indicated that they did not feel that reform efforts had gone far enough. A majority of respondents (58.8%) opposed repeal of the PPACA, while 15.0% supported repeal, and 26.1% were undecided. Conclusion The overwhelming majority of medical students recognized healthcare reform is needed and expressed support for the PPACA but echoed concerns about whether it will address issues of quality or cost containment. PMID:21931604

Past Informing Present: Parallels Between Racial Integration in the Armed Forces and Repeal of Don’t Ask, Don’t Tell

DTIC Science & Technology

2011-02-15

Military (pp. 121- 133). New York, New York: Aldine de Gruyter. Schiefer, M. (2010, October 21). Email Correspondence: Race on OSB . San Antonio TX...M. (2010, October 21). Email Correspondence: Race on OSB . San Antonio TX. 73 Military Leadership Diversity Commission. (n.d.). Recent Enlisted

78 FR 69789 - Policy and Procedures Concerning the Use of Airport Revenue; Proceeds From Taxes on Aviation Fuel

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-21

... two general categories of fuel used in aircraft: aviation gasoline, or ``avgas,'' used in... aircraft fuel from the sales tax. The Nebraska Legislature considered repealing that exemption and proposed to make the aircraft fuel tax proceeds payable to the state general fund. An opinion was sought on...

Proposing an amendment to the Constitution of the United States to give citizens of the United States the right to enact and repeal laws by voting on legislation in a national election.

THOMAS, 111th Congress

Rep. Hoekstra, Peter [R-MI-2

2010-01-21

House - 03/01/2010 Referred to the Subcommittee on the Constitution, Civil Rights, and Civil Liberties. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

77 FR 70686 - Rules Governing Hearings Before the Agency of Original Jurisdiction and the Board of Veterans...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-27

... the Agency of Original Jurisdiction and the Board of Veterans' Appeals; Repeal of Prior Rule Change... hearings before the Agency of Original Jurisdiction (AOJ) do not apply to hearings before the Board of... Governing Hearings Before the Agency of Original Jurisdiction and the Board of Veterans' Appeals...

75 FR 8770 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-25

... Change To Repeal Incorporated NYSE Rule 405(4) (Common Sales Accounts) February 18, 2010. Pursuant to...) (Common Sales Accounts) as part of the process to develop the consolidated FINRA rulebook. The text of the... NYSE Rule 405(4) (Common Sales Accounts).\\4\\ \\3\\ The current FINRA rulebook consists of (1) FINRA Rules...

Proposing an amendment to the Constitution of the United States to repeal the twenty-second article of amendment, thereby removing the limitation on the number of terms an individual may serve as President.

THOMAS, 111th Congress

Rep. Serrano, Jose E. [D-NY-16

2009-01-06

House - 02/09/2009 Referred to the Subcommittee on the Constitution, Civil Rights, and Civil Liberties. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

78 FR 75661 - Self-Regulatory Organizations; NASDAQ OMX PHLX LLC; Notice of Filing of Proposed Rule Change To...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-12

... following three supermajority voting requirements. Removal of Directors. Article Fifth, Paragraph D provides... class. Adoption, Alteration, Amendment and Repeal of By-Laws. Article Eighth, Paragraph A provides that... Provisions. Article Ninth, Paragraph A provides that the affirmative vote of the holders of at least 66\\2/3...

78 FR 75598 - Self-Regulatory Organizations; Stock Clearing Corporation of Philadelphia; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-12

... Directors. Article Fifth, Paragraph D provides that, except for directors elected by the holders of any.... Article Eighth, Paragraph A provides that the affirmative vote of the holders of at least 66\\2/3\\% of the..., Amendment and Repeal of Certain Charter Provisions. Article Ninth, Paragraph A provides that the affirmative...

Ready or Not Repeal of Don’t Ask, Don’t Tell

DTIC Science & Technology

2010-02-17

the DoD with enough power and vision to lead the change, The key was the Code avoided dealing with attitudes and beliefs, which are often...Additionally, in Israel, rather than alter facilities, “gay soldiers are assigned to open bases, allowing them to commute to and from home and sleep at

76 FR 71260 - Approval and Promulgation of Implementation Plans; Texas; Revisions to the New Source Review (NSR...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-17

... natural gas 7/22/1998 6/17/1998 Repeal and readoption disapproval. processing, as Section treating, or 116... for Changes at Certain Natural Gas Processing, Treating, or Compression Facilities 1. What is the... the following grounds: This definition exempts changes at certain natural gas processing, treating, or...

PUHCA's Repeal Appeal: Analogies to Banking and Telecom

DOE Office of Scientific and Technical Information (OSTI.GOV)

Higgins, Mark D.

There are many possible scenarios for the future of electric utility consolidation, but experiences in banking and telecommunications deregulation and consolidation suggest one as the most likely: larger players will continue to consolidate, smaller players will be acquired or focus on niche markets, and new, non-utility investors will enter utility markets, with varying degrees of success.

75 FR 17037 - Federal Home Loan Bank Directors' Eligibility, Elections, Compensation and Expenses

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-05

... 2590-AA03, 2590-AA31 and 2590-AA34 Federal Home Loan Bank Directors' Eligibility, Elections... that implements two separate proposed rules, which relate to Federal Home Loan Bank (Bank) director... amended section 7(i) of the Federal Home Loan Bank Act (Bank Act) by repealing the statutory caps on the...

26 CFR 1.963-0 - Repeal of section 963; effective dates.

Code of Federal Regulations, 2012 CFR

2012-04-01

... after December 31, 1975, then a foreign corporation shall be includible in such election only if— (i) It... (i) of this paragraph from a chain or group election of a United States shareholder for its taxable.... The application of this paragraph may be illustrated by the following example: Example. (a) M is a...

26 CFR 1.872-2 - Exclusions from gross income of nonresident alien individuals.

Code of Federal Regulations, 2011 CFR

2011-04-01

... certain exchange or training programs—(1) Exclusion from income. Compensation paid to a nonresident alien... “exchange visitor” under section 201 of the U.S. Information and Educational Exchange Act of 1948 (22 U.S.C. 1446), which section was repealed by section 111 of the Mutual Education and Cultural Exchange Act of...

26 CFR 1.872-2 - Exclusions from gross income of nonresident alien individuals.

Code of Federal Regulations, 2013 CFR

2013-04-01

... certain exchange or training programs—(1) Exclusion from income. Compensation paid to a nonresident alien... “exchange visitor” under section 201 of the U.S. Information and Educational Exchange Act of 1948 (22 U.S.C. 1446), which section was repealed by section 111 of the Mutual Education and Cultural Exchange Act of...

26 CFR 1.872-2 - Exclusions from gross income of nonresident alien individuals.

Code of Federal Regulations, 2012 CFR

2012-04-01

... certain exchange or training programs—(1) Exclusion from income. Compensation paid to a nonresident alien... “exchange visitor” under section 201 of the U.S. Information and Educational Exchange Act of 1948 (22 U.S.C. 1446), which section was repealed by section 111 of the Mutual Education and Cultural Exchange Act of...

Corporate Structure Events Involving Regulated Utilities: The Need for a Multidisciplinary, Multijurisdictional Approach

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hempling, Scott

2006-08-15

The repeal of PUHCA has occasioned important questions on the appropriate role for regulation in the area of utility corporate structure, including complex process and jurisdictional issues. There is a disproportionality between the importance of these questions and the lack of attention that has been given them by our regulatory and political communities. (author)

LJ Best Consumer Health Books 2010

ERIC Educational Resources Information Center

Bibel, Barbara

2011-01-01

The year 2010 is historic because it marks the passage of a U.S. health-care reform bill as well as midterm elections that sent to Congress people looking to repeal it. Meanwhile, the public is waiting to see what it all means. It also saw the rise of personalized medicine, with genetics and electronic health records promising a more…

Proposing an amendment to the Constitution of the United States to give States the right to repeal Federal laws and regulations when ratified by the Legislatures of two thirds of the several States.

THOMAS, 111th Congress

Rep. Bishop, Rob [R-UT-1

2010-11-30

House - 12/20/2010 Referred to the Subcommittee on the Constitution, Civil Rights, and Civil Liberties. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

75 FR 34706 - Information Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-18

... Reduction Act (44 U.S.C. chapter 35). A shortened comment period of twelve days is necessary because the... a 2 month field period, it is necessary to begin data collection procedures no later than mid-July... associated with a repeal of the law known as ``Don't Ask, Don't Tell.'' The CRWG is studying what impact, if...

Don't Ask, Don't Tell Repeal Act of 2010

THOMAS, 111th Congress

Sen. Lieberman, Joseph I. [ID-CT

2010-12-10

Senate - 12/13/2010 Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 688. (All Actions) Notes: For further action, see H.R.2965, which became Public Law 111-321 on 12/22/2010. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

75 FR 16706 - Approval and Promulgation of Implementation Plans; Texas; Revisions to Voiding of Permits and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-02

... Promulgation of Implementation Plans; Texas; Revisions to Voiding of Permits and Extension of Permits AGENCY... Implementation Plan (SIP). Within this SIP submittal, the State repealed a paragraph of the SIP rule pertaining... met, including a health effects review. EPA is proposing to approve the new replacement rule for this...

The NEA Supports Substantial Overhaul, Not Repeal, of NCLB

ERIC Educational Resources Information Center

Packer, Joel

2007-01-01

The National Education Association (NEA) agrees that No Child Left Behind (NCLB) Act is flawed but believes it can be salvaged. The association believes that several substantive changes that overhaul the statute would produce a far better result. The NEA is not alone in calling for fundamental changes in the law. A coalition of more than 129…

16 CFR 3.13 - Adjudicative hearing on issues arising in rulemaking proceedings under the Fair Packaging and...

Code of Federal Regulations, 2010 CFR

2010-01-01

... material to the issues raised by such objections or other issues specified by the Commission. In such case...) Parties. Any person who petitions for issuance, amendment, or repeal of a rule or order, and any person... filed in the proceeding. Upon written application to the Administrative Law Judge and a showing of good...

A bill to repeal an obsolete provision in title 49, United States Code, requiring motor vehicle insurance cost reporting.

THOMAS, 112th Congress

Sen. Klobuchar, Amy [D-MN

2012-12-04

Senate - 12/04/2012 Read twice and referred to the Committee on Commerce, Science, and Transportation. (All Actions) Notes: For further action, see H.R.5859, which became Public Law 112-252 on 1/10/2013. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

14 CFR 11.23 - Does FAA follow the same procedures in issuing all types of rules?

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 1 2012-01-01 2012-01-01 false Does FAA follow the same procedures in issuing all types of rules? 11.23 Section 11.23 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... authority to issue each type, and where you send petitions for FAA to adopt, amend, or repeal each type...

14 CFR 11.23 - Does FAA follow the same procedures in issuing all types of rules?

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Does FAA follow the same procedures in issuing all types of rules? 11.23 Section 11.23 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... authority to issue each type, and where you send petitions for FAA to adopt, amend, or repeal each type...

78 FR 40011 - Approval and Promulgation of Air Quality Implementation Plans; Virginia; Removal of Consumer and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

... four articles located in chapter 9VAC5-40 (Existing Stationary Sources) from the Virginia SIP. These articles are being removed from the Virginia SIP because they were repealed in their entirety and have been replaced by the updated corresponding articles in chapter 9VAC5-45 (Consumer and Commercial Products). The...

Big Dreams, Serious Implications: How the DREAM Act can Help America Meet its Workforce Demands

ERIC Educational Resources Information Center

Hermes, James

2008-01-01

This article describes how the Development, Relief and Education for Alien Minors (DREAM) Act will help undocumented students by: (1) establishing a path to legal status and eventually earn legal residency through two years of higher education or military service; and (2) repealing a provision of federal law that bars states from granting in-state…

To repeal the expansion of information reporting requirements for payments of $600 or more to corporations, and for other purposes.

THOMAS, 112th Congress

Rep. Scalise, Steve [R-LA-1

2011-01-05

House - 01/05/2011 Referred to the House Committee on Ways and Means. (All Actions) Notes: For further action, see H.R.4, which became Public Law 112-9 on 4/14/2011. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

78 FR 46792 - Federal Acquisition Regulation; Repeal of Sunset for Certain Protests of Task or Delivery Order...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-01

... Defense Authorization Act (NDAA) for Fiscal Year 2013. This section removes the sunset date for protests against certain orders under a task-order contract or delivery-order contract for title 10 agencies only... agencies covered by title 10 of the United States Code, namely DoD, NASA, and Coast Guard. This section...

Russia and Moldova Jackson-Vanik Repeal and Magnitsky Rule of Law Accountability Act of 2012

THOMAS, 112th Congress

Sen. Baucus, Max [D-MT

2012-07-19

Senate - 09/20/2012 By Senator Baucus from Committee on Finance filed written report. Report No. 112-226. Additional views filed. (All Actions) Notes: For further action, see H.R.6156, which became Public Law 112-208 on 12/14/2012. Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

A Reconsideration of "College English," November 1974: Separatists Unite! (But Has the Assimilation Begun?)

ERIC Educational Resources Information Center

Pruitt, John

2011-01-01

In 1974, Ohio repealed its sodomy laws; Massachusetts Representative Elaine Noble became the first openly gay individual elected to a state legislature; and the National Gay Task Force collaborated with US Representatives Bella Abzug (D-NY) and Edward Koch (D-NY) to introduce the Equality Act of 1974 to ban discrimination against lesbians, gay…

75 FR 67970 - Notice of Inquiry; An Analysis of the European Union Repeal of the Liner Conference Block Exemption

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-04

... the E.U.'s policy decision on U.S. trades, and will be incorporated into the Commission's research for... concerning the parameters of the study, the proposed research methods, and the possibility of future... particular. NOI Participation The Commission's research efforts, under the E.U. Study, are intended to...

The Repeal of Section 28: It Ain't over 'til It's over

ERIC Educational Resources Information Center

Greenland, Katy; Nunney, Rosalind

2008-01-01

Section 28 (part of the Local Government Act of 1988) was a notorious piece of legislation that sought to prevent local education authorities in the UK from "promoting homosexuality". The effect of Section 28 was to create uncertainty and fear among teachers as to what was (and what was not) permitted in schools. Over time practitioners…

To repeal the War Powers Resolution.

THOMAS, 113th Congress

Rep. Garrett, Scott [R-NJ-5

2013-09-09

House - 09/09/2013 Referred to the Committee on Foreign Affairs, and in addition to the Committee on Rules, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Health Education as an Arena for Adult Educators' Engagement in Social Justice

ERIC Educational Resources Information Center

Hill, Lilian H.

2011-01-01

As American political discussion of health care access and costs escalated in view of the November 2010 election, it is clear that access to health care is inequitable. The acrimonious public debate and calls for the health care reform bill to be repealed echo the defeat of the 1993 health care reform bill, which also advocated universal health…

38 CFR 3.953 - Pub. L. 85-56 and Pub. L. 85-857.

Code of Federal Regulations, 2010 CFR

2010-07-01

... privileges or benefits as a retired emergency officer of World War I, on December 31, 1958, under the laws in... laws, repealed by Pub. L. 85-56, including those service connected under the second proviso of section 200 of the World War Veterans' Act, 1924, as amended, are protected by section 2316(b), Pub. L. 85-56...

The Impact of Short-Term Food Regulations in New Zealand Schools

ERIC Educational Resources Information Center

Cushman, Penni

2012-01-01

Purpose: In New Zealand, legislation was introduced to regulate the types of food sold and promoted in schools but 15 months later, part of the legislation was repealed. The purpose of this paper is to determine the extent to which a sample of schools implemented positive changes when the legislation was introduced and the extent to which they…

28 CFR 572.40 - Compassionate release under 18 U.S.C. 4205(g).

Code of Federal Regulations, 2011 CFR

2011-07-01

.... 4205(g)) § 572.40 Compassionate release under 18 U.S.C. 4205(g). 18 U.S.C. 4205(g) was repealed... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Compassionate release under 18 U.S.C. 4205(g). 572.40 Section 572.40 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE...

28 CFR 572.40 - Compassionate release under 18 U.S.C. 4205(g).

Code of Federal Regulations, 2010 CFR

2010-07-01

.... 4205(g)) § 572.40 Compassionate release under 18 U.S.C. 4205(g). 18 U.S.C. 4205(g) was repealed... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Compassionate release under 18 U.S.C. 4205(g). 572.40 Section 572.40 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE...

28 CFR 572.40 - Compassionate release under 18 U.S.C. 4205(g).

Code of Federal Regulations, 2014 CFR

2014-07-01

.... 4205(g)) § 572.40 Compassionate release under 18 U.S.C. 4205(g). 18 U.S.C. 4205(g) was repealed... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Compassionate release under 18 U.S.C. 4205(g). 572.40 Section 572.40 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE...

28 CFR 572.40 - Compassionate release under 18 U.S.C. 4205(g).

Code of Federal Regulations, 2013 CFR

2013-07-01

.... 4205(g)) § 572.40 Compassionate release under 18 U.S.C. 4205(g). 18 U.S.C. 4205(g) was repealed... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Compassionate release under 18 U.S.C. 4205(g). 572.40 Section 572.40 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE...

28 CFR 572.40 - Compassionate release under 18 U.S.C. 4205(g).

Code of Federal Regulations, 2012 CFR

2012-07-01

.... 4205(g)) § 572.40 Compassionate release under 18 U.S.C. 4205(g). 18 U.S.C. 4205(g) was repealed... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Compassionate release under 18 U.S.C. 4205(g). 572.40 Section 572.40 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE...

How Will Repealing the ACA Affect Medicaid? Impact on Health Care Coverage, Delivery, and Payment.

PubMed

Rosenbaum, Sara; Rothenberg, Sara; Schmucker, Sara; Gunsalus, Rachel; Beckerman, J. Zoë

2017-03-01

ISSUE: The Affordable Care Act enhanced Medicaid's role as a health care purchaser by expanding eligibility and broadening the range of tools and strategies available to states. All states have embraced delivery and payment reform as basic elements of their programs. GOAL: To examine the effects of reducing the size and scope of Medicaid under legislation to repeal the ACA. FINDINGS AND CONCLUSIONS: Were the ACA's Medicaid expansion to be eliminated and were federal Medicaid funding to experience major reductions through block grants or per capita caps, the effects on system transformation would be significant. Over 70 percent of Medicaid spending is driven by enrollment in a program that covers 74 million people; on a per capita basis Medicaid costs less than Medicare or commercial insurance. States would need to absorb major financial losses by reducing the number of people served, reducing the scope of services covered, introducing higher cost-sharing, or further reducing already low payments. Far from improving quality and efficiency, these changes would cause the number of uninsured to rise while depriving health care providers and health plans of the resources needed to care for patients and invest in the tools that are essential to system transformation

Legalization of Sunday alcohol sales and alcohol consumption in the United States.

PubMed

Yörük, Barış K

2014-01-01

To investigate the relationship between legalization of Sunday alcohol sales and alcohol consumption in the United States. State-level per capita consumption of beer, wine and spirits was analyzed using difference-in-differences econometric methods. United States. Five treatment states that repealed their laws restricting Sunday alcohol sales during 1990-2007 and 12 control states that retained their Sunday alcohol laws during the same period. Outcome measures are state-level per capita consumption of overall alcohol, beer, wine and spirits. Among the states that legalized Sunday sales of alcoholic beverages, Delaware, Pennsylvania and New Mexico experienced significant increases in overall alcohol consumption (P < 0.05). However, the effect of the legalization of Sunday alcohol sales in Massachusetts and Rhode Island on per capita alcohol consumption was insignificant (P = 0.964 and P = 0.367). Three out of five states in the United States that repealed their laws restricting Sunday sale of alcoholic beverages during 1990-2007 experienced significant increases in per capita alcohol consumption. This finding implies that increased alcohol availability leads to an increase in alcohol consumption. © 2013 Society for the Study of Addiction.

Medical Malpractice Reform and Employer-Sponsored Health Insurance Premiums

PubMed Central

Morrisey, Michael A; Kilgore, Meredith L; Nelson, Leonard (Jack)

2008-01-01

Objective Tort reform may affect health insurance premiums both by reducing medical malpractice premiums and by reducing the extent of defensive medicine. The objective of this study is to estimate the effects of noneconomic damage caps on the premiums for employer-sponsored health insurance. Data Sources/Study Setting Employer premium data and plan/establishment characteristics were obtained from the 1999 through 2004 Kaiser/HRET Employer Health Insurance Surveys. Damage caps were obtained and dated based on state annotated codes, statutes, and judicial decisions. Study Design Fixed effects regression models were run to estimate the effects of the size of inflation-adjusted damage caps on the weighted average single premiums. Data Collection/Extraction Methods State tort reform laws were identified using Westlaw, LEXIS, and statutory compilations. Legislative repeal and amendment of statutes and court decisions resulting in the overturning or repealing state statutes were also identified using LEXIS. Principal Findings Using a variety of empirical specifications, there was no statistically significant evidence that noneconomic damage caps exerted any meaningful influence on the cost of employer-sponsored health insurance. Conclusions The findings suggest that tort reforms have not translated into insurance savings. PMID:18522666

Corporal punishment and child maltreatment in New Zealand.

PubMed

Kelly, Patrick

2011-01-01

On 2 May, 2007, the New Zealand Parliament passed a law repealing Section 59 of the Crimes Act. In so doing, New Zealand became the first English-speaking nation in the world to make corporal punishment of a child illegal. The passage of this legislation was surrounded by intense and persistent public debate, and supporters of corporal punishment continue to advocate against the law change to the present day. In Sweden, where the first stage of similar repeal took place in 1957, it may be difficult for many to understand the strength of the public opposition to this change in New Zealand. This article will present a viewpoint on the evolution of the debate in New Zealand, review the wider context of child maltreatment and family violence in New Zealand and summarize a range of attempts to prevent or intervene effectively in the cycle of dysfunction. Child maltreatment and family violence are public health issues of great importance, and a stain on all societies. While corporal punishment may be a significant contributing factor, there is no single 'solution'. Change must occur on multiple levels (political, economic, cultural, familial and professional) before the tide will turn.

Legalization of Sunday alcohol sales and alcohol consumption in the United States

PubMed Central

Yörük, Barış K.

2013-01-01

Aims To investigate the relationship between legalization of Sunday alcohol sales and alcohol consumption in the United States. Design State-level per capita consumption of beer, wine, and spirits was analyzed using difference-in-differences econometric methods. Setting United States. Participants 5 treatment states that repealed their laws restricting Sunday alcohol sales during 1990–2007 and 12 control states that retained their Sunday alcohol laws during the same period. Measurements Outcome measures are state-level per capita consumption of overall alcohol, beer, wine, and spirits. Findings Among the states that legalized Sunday sales of alcoholic beverages, Delaware, Pennsylvania, and New Mexico experienced significant increases in overall alcohol consumption (P<0.05). However, the effect of the legalization of Sunday alcohol sales in Massachusetts and Rhode Island on per capita alcohol consumption was insignificant (P=0.964 and P=0.367). Conclusions Three out of five states in the USA that repealed their laws restricting Sunday sale of alcoholic beverages during 1990–2007, experienced significant increases in per capita alcohol consumption. This finding implies that increased alcohol availability leads to an increase in alcohol consumption. PMID:24103041

The Impact of Location and Proximity on Consumers' Willingness to Pay for Green Electricity: The Case of West Virginia

NASA Astrophysics Data System (ADS)

Nkansah, Kofi

During the 2015 legislative session, West Virginia lawmakers passed a bill to repeal the Renewable and Alternative Energy Portfolio Standards Act of 2009 (ARPS). Legislators stated concerns about ARPS's impacts on coal industry related jobs in the state as the major factor driving this repeal. However, no comprehensive study on public acceptance, opinions, or willingness to pay (WTP) for renewable/and or alternative sources of electricity within West Virginia was used to inform this repeal decision. As the state of West Virginia struggles to find the right path to expand its renewable energy portfolio, public acceptance of renewable electricity is crucial to establishing a viable market for these forms of energy and also ensure the long-term sustainability of any RPS policy that may be enacted in the future. This study sought to assess consumers' preferences, attitudes and WTP for renewable and alternative electricity in West Virginia. The monetary values that consumers placed on proximity as an attribute of a renewable and alternative electricity generation source were also estimated. Two counties in West Virginia were selected as study areas based on the types of electricity generation facility that already exist in each county -one county with coal-fired power plants (Monongalia County) and another with both a coal-fired power plant and a wind farm (Grant County). A forced choice experiment survey was used with attributes that varied in source of energy (wind versus natural gas), proximity of the generation source relative to the respondent's residence (near, moderate or far) and an additional premium per month on the electric bill (varying from 1 to 15). Respondents were asked to choose between generating 10% of the electricity supplied to them from wind or natural gas. Random samples of 1500 residents from each county were sent surveys and response rates were 27.0% (Monongalia) and 35.3% (Grant). A Mixed logit econometric models were used to analyze consumer choices with utility models. WTP for energy source and proximity attribute levels were computed using parameter estimates from these utility models. Statistically different models were developed for each county. Results from the study showed that respondents in both counties had preferences for electricity generated from wind compared to natural gas. A majority of the sampled populations chose the wind option, 62.0% in Monongalia County and 60.0% in Grant County. The sampled populations in Monongalia and Grant Counties were willing to pay a weighted mean of 21.59 and 9.87 per month, respectively, for 10% of their electricity to be generated from wind over natural gas. Despite this large difference, county level means were not statistically different. On aggregate, a positive social benefit per year would be derived from generating 10% of electricity supplied to consumers in Monongalia County (2.5 million) and Grant County (186 thousand) from wind relative to natural gas. Similarly, the most social benefit would be derived from siting wind turbines at "far" locations from residents in both counties. Both county level sampled populations were willing to pay a higher premium to site wind turbines or a natural gas-fired power plant at the farthest location relative to the baseline location (near a respondent's current residence). Grant County respondents were willing to pay a slightly higher positive premium (mean of 11.71 per month) to site wind turbines at the farthest location than respondents in Monongalia County (mean of 10.14 per month). The mean WTP to site a natural gas-fired power plant at the farthest location in Monongalia County (13.06) and Grant County (13.47) were not statistically different from each other. Results from this study suggest that the decision for an outright repeal of the ARPS bill was flawed. Based on Monongalia and Grant County populations, there are social benefits derived from generating 10% of the electricity supplied to consumers in West Virginia from renewable and alternative energy sources, and wind is preferred to natural gas. This repeal implies there are few, if any, benefits. Given this repeal, I suggest that a voluntary green pricing program with a focus on wind energy serve as an alternative renewable energy policy in West Virginia. Under such a policy, consumers who are concerned about the environment and are willing to pay a positive premium for renewable electricity would be able to opt into the program. Premiums paid by participants of such a program can be used to increase the renewable energy share in West Virginia's energy portfolio.

A bill to repeal the authority to provide certain loans to the International Monetary Fund, the increase in the United States quota to the Fund, and certain other related authorities, to rescind related appropriated amounts, and for other purposes.

THOMAS, 112th Congress

Sen. DeMint, Jim [R-SC

2011-06-23

Senate - 06/27/2011 Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 85. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

AHCA's Medicaid Cuts Would Harm Students and Threaten State Funding for Postsecondary Education

ERIC Educational Resources Information Center

Pham, Duy; Socolow, David

2017-01-01

On May 4, 2017, the United States House of Representatives narrowly passed the American Health Care Act (AHCA) as a repeal and replacement of the Affordable Care Act (ACA). Independent analyses of the AHCA show that it would leave 23 million more people uninsured by 2026, and make coverage less comprehensive and affordable for millions more. Many…

Do Blue Laws Save Lives? The Effect of Sunday Alcohol Sales Bans on Fatal Vehicle Accidents

ERIC Educational Resources Information Center

Lovenheim, Michael F.; Steefel, Daniel P.

2011-01-01

This paper analyzes the effect of state-level Sunday alcohol sales restrictions ("blue laws") on fatal vehicle accidents, which is an important parameter in assessing the desirability of these laws. Using a panel data set of all fatal vehicle accidents in the U.S. between 1990 and 2009 combined with 15 state repeals of blue laws, we show that…

76 FR 20892 - Prohibition Against Payment of Interest on Demand Deposits

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-14

... comments may also be viewed electronically or in paper in Room MP-500 of the Board's Martin Building (20th... Dodd-Frank Act repeals Section 19(i) of the Act in its entirety, effective one year from the date of... typeface with a font size of 10 or 12; this will enable the Board to convert text submitted in paper form...

McREL Leadership Responsibilities through the Lens of Data: The Critical Nine

ERIC Educational Resources Information Center

James-Ward, Cheryl; Abuyen, Joy

2015-01-01

At the onset of the 21st century, the United States ushered in a new era of school accountability and reform with the No Child Left Behind Act [NCLB] (United States Department of Education, 2010). Until and unless it is repealed or replaced, this law continues in effect today, with many states now applying to renew their NCLB waivers (Klein,…

A bill to amend title 38, United States Code, to repeal the prohibition on collective bargaining with respect to matters and questions regarding compensation of employees of the Department of Veterans Affairs other than rates of basic pay, and for other purposes.

THOMAS, 111th Congress

Sen. Brown, Sherrod [D-OH

2010-06-15

Senate - 09/02/2010 Placed on Senate Legislative Calendar under General Orders. Calendar No. 558. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

A bill to amend title 38, United States Code, to repeal the prohibition on collective bargaining with respect to matters and questions regarding compensation of employees of the Department of Veterans Affairs other than rates of basic pay, and for other purposes.

THOMAS, 112th Congress

Sen. Brown, Sherrod [D-OH

2011-03-14

Senate - 09/06/2011 Placed on Senate Legislative Calendar under General Orders. Calendar No. 148. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

77 FR 59747 - Repeal of the Final Rule Imposing Special Measures and Withdrawal of the Findings of Primary...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-01

... Money Laundering Concern of November 25, 2003, issued pursuant to 31 U.S.C. 5318A of the Bank Secrecy... amends the anti-money laundering provisions of the BSA, codified at 12 U.S.C. 1829b, 12 U.S.C. 1951-1959..., or type of account is of ``primary money laundering concern,'' to require domestic financial...

76 FR 45689 - Financial Crimes Enforcement Network; Repeal of the Final Rule and Withdrawal of the Finding of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-01

... Money Laundering Concern Against VEF Banka AGENCY: Financial Crimes Enforcement Network (``FinCEN... Institution of Primary Money Laundering Concern of April 26, 2005, issued pursuant to 31 U.S.C. 5318A of the... PATRIOT Act amends the anti-money laundering provisions of the BSA, codified at 12 U.S.C. 1829b, 12 U.S.C...

Latin America Report, No. 2755.

DTIC Science & Technology

1983-10-21

1982 Production, Economic Activity (LA PRESSE DE GUYANE, 9, 10 Aug 83) 48 Illegal Immigration Called Number One Problem (LA PRESSE DE GUYANE...DIARIO GRAFICO , 9 Sep 83).. 59 ’Equicrats’ Recommend Limitations CEDEP Recommends Repeal GUYANA Reportage on PNC Congress Deliberations...reminders dating back to April, 1983 for such as en - actment, from the Citizens’ Carnival Celebrations Com- mittee, now known an the Citizens

Repealing Don’t Ask, Don’t Tell: Addressing the Ripple Effects

DTIC Science & Technology

2010-02-25

and lesbians as a minority group who are fighting against discrimination . Transgender individuals are considered a “group,” and although there does...study stated transgender people in the military experience discrimination and that the Veteran’s Administration denied assistance when approached by a...integrated blacks, there was initial resistance based on discrimination .24 Prior to the integration, whites opposed the policy with vehement hostility

To Punish or to Treat: Substance Abuse within the Context of Oscillating Attitudes toward Correctional Rehabilitation

ERIC Educational Resources Information Center

Pallone, Nathaniel J.; Hennessy, James J.

2003-01-01

Although its remote origins can be traced to the end of prohibition with the repeal of the Volstead Act in 1933, the nation's "war on drugs" gathered massive strength in the early days of the Reagan administration. During the 1980s and 1990s, the decision of the nation, expressed through its legislators, seemed to be to "criminalize" drug use or…

A Holistic Approach to Repealing Don’t Ask Don’t Tell

DTIC Science & Technology

2010-03-17

Lesbian, Gay, Bisexual, Transgender, ( LGBT ) rights debate.”31 Five months into his Presidency, President Obama held a LGBT White House reception... LGBT reception, the first of its kind at the White House, sharply contrasted from President Bush‟s position on homosexual issues. President Bush...never issued a LGBT proclamation during his presidential tenure. Pro-family groups criticized President Obama‟s homosexual political agenda as

Potential Impact of Repeal of the Defense of Marriage Act

DTIC Science & Technology

2013-04-01

lesbian, gay, bisexual, and transgender ( LGBT ) community.11 Congress believed that couples who traveled to Hawaii to get married would be imposing...acceptability aside, however, homosexuals continue to be treated poorly because of their sexual orientation. Even though the LGBT community has...one’s identity. Finally, the Court found that even with recent political advances of the LGBT community, they still lack "meaningful" political power

Ergonomics and regulatory politics: the Washington State case.

PubMed

Silverstein, Michael

2007-05-01

Every year in the State of Washington more than 50,000 workers experience a work related musculoskeletal disorder (WMSD), making up more than 30% of all worker compensation cases. In 2000, the Washington State Department of Labor and Industries (L&I) adopted a workplace ergonomics rule requiring employers to reduce worker exposure to hazards that cause or contribute to WMSDs. In 2003, the ergonomics rule was repealed by a margin of 53.5-46.5 in a statewide voter initiative. The official rulemaking record of approximately 100,000 pages, along with supplementary published and unpublished material, was reviewed. The relationship between scientific deliberation and the public policy process in adopting and repealing the ergonomics rule was assessed and described. The deliberative features of the regulatory, judicial, legislative, and ballot processes were compared. The ergonomics rule was successful in the regulatory and legal arenas where the process was most transparent and open to public involvement, differing views could be presented fully, and decision makers were expected to explain their decisions in light of the record. The rule fared most poorly in the legislature and at the ballot box when these features were lost and where considered deliberation was replaced by unconstrained political conflict. Additional checks and balances are needed.

The Impact of the ACA's Medicaid Expansion on Hospitals' Uncompensated Care Burden and the Potential Effects of Repeal.

PubMed

Dranove, David; Gartwaite, Craig; Ody, Christopher

2017-05-01

ISSUE: By increasing health insurance coverage, the Affordable Care Act's Medicaid eligibility expansion was also expected to lessen the uncompensated care burden on hospitals. The expansion currently faces an uncertain future. GOAL: To compare the change in hospitals' uncompensated care burden in the 31 states (plus the District of Columbia) that chose to expand Medicaid to the changes in states that did not, and to estimate how these expenses would be affected by repeal or further expansion. METHODS: Analysis of uncompensated care data from Medicare Hospital Cost Reports from 2011 to 2015. FINDINGS AND CONCLUSIONS: Uncompensated care burdens fell sharply in expansion states between 2013 and 2015, from 3.9 percent to 2.3 percent of operating costs. Estimated savings across all hospitals in Medicaid expansion states totaled $6.2 billion. The largest reductions in uncompensated care were found for hospitals in expansion states that care for the highest proportion of low-income and uninsured patients. Legislation that scales back or eliminates Medicaid expansion is likely to expose these safety-net hospitals to large cost increases. Conversely, if the 19 states that chose not to expand Medicaid were to adopt expansion, their uncompensated care costs also would decrease by an estimated $6.2 billion.

Patient Protection and Affordable Care Act of 2010: reforming the health care reform for the new decade.

PubMed

Manchikanti, Laxmaiah; Caraway, David L; Parr, Allan T; Fellows, Bert; Hirsch, Joshua A

2011-01-01

The Patient Protection and Affordable Care Act (the ACA, for short) became law with President Obama's signature on March 23, 2010. It represents the most significant transformation of the American health care system since Medicare and Medicaid. It is argued that it will fundamentally change nearly every aspect of health care, from insurance to the final delivery of care. The length and complexity of the legislation and divisive and heated debates have led to massive confusion about the impact of ACA. It also became one of the centerpieces of 2010 congressional campaigns. Essentials of ACA include: 1) a mandate for individuals and businesses requiring as a matter of law that nearly every American have an approved level of health insurance or pay a penalty; 2) a system of federal subsidies to completely or partially pay for the now required health insurance for about 34 million Americans who are currently uninsured - subsidized through Medicaid and exchanges; 3) extensive new requirements on the health insurance industry; and 4) numerous regulations on the practice of medicine. The act is divided into 10 titles. It contains provisions that went into effect starting on June 21, 2010, with the majority of provisions going into effect in 2014 and later. The perceived major impact on practicing physicians in the ACA is related to growing regulatory authority with the Independent Payment Advisory Board (IPAB) and the Patient Centered Outcomes Research Institute (PCORI). In addition to these specifics is a growth of the regulatory regime in association with further discounts in physician reimbursement. With regards to cost controls and projections, many believe that the ACA does not fix the finances of our health care system - neither public nor private. It has been suggested that the Congressional Budget Office (CBO) and the administration have used creative accounting to arrive at an alleged deficit reduction; however, if everything is included appropriately and accounted for, we will be facing a significant increase in deficits rather than a reduction. When posed as a global question, polls suggest that public opinion continues to be against the health insurance reform. The newly elected Republican congress is poised to pass a bill aimed at repealing health care reform. However, advocates of the repeal of health care reform have been criticized for not providing a meaningful alternative approach. Those criticisms make clear that it is not sufficient to provide vague arguments against the ACA without addressing core issues embedded in health care reform. It is the opinion of the authors that while some parts of the ACA may be reformed, it is unlikely to be repealed. Indeed, the ACA already is growing roots. Consequently, it will be extremely difficult to repeal. In this manuscript, we look at reducing the regulatory burden on the public and providers and elimination of IPAB and PCORI. The major solution lies in controlling the drug and durable medical supply costs with appropriate negotiating capacity for Medicare, and consequently for other insurers.

Women in Combat- A Policy Paradox for Commanders

DTIC Science & Technology

2010-03-01

Women’s Studies Home Page at, http:// feminism ,eserver.org/ workplace /professions/ women -in-the-military.txt. (accessed March 16, 2010) 61 Women in...serving in combat, the Secretary of Defense’s combat exclusion policy restricts the use of women in the military. Commanders are at risk of violating...current combat exclusion policy restricts the effective use of women in the military. Specifically Title 10, U.S.C. 85491 was repealed in 1991 that

76 FR 28646 - Implementation of the New Source Review (NSR) Program for Particulate Matter Less Than 2.5...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-18

... Program B. Fine PM and the NAAQS for PM 2.5 C. How is the PSD program for PM 2.5 implemented? IV... ? B. Why did EPA propose to repeal the grandfather provision for PM 2.5 ? C. Summary of Comments and... maintain the NAAQS and to meet the other requirements of section 110(a) of the Act. Part C of title I of...

NAFTA and Farm Subsidies: A Recipe for Poor Regional Security

DTIC Science & Technology

2011-10-31

the repeal of farm subsidies in New Zealand, the number of sheep dropped to about 40 million from 58 million, dairy cows have risen over five...fruit, vegetables, beef , and poultry, all of which thrive without farm subsidies.45 If any of these justifications were valid, these farmers would be...impoverished, near bankruptcy or replaced by imports and both the supplies and prices of fruit, vegetables, beef , and poultry would fluctuate wildly

Defense.gov - Special Report: Policy Review - 'Don't Ask, Don't Tell'

Science.gov Websites

updated and may no longer be applicable as a result of changes in law, regulation and/or administration Tell” law “fairer and more appropriate.” On Feb. 2, Gates announced he’d ordered a review to understand the implications of a possible repeal of the 17-year-old law that bans gays and lesbians from

To repeal the Tax Cuts and Jobs Act, forgive all outstanding Federal student loans, and for other purposes.

THOMAS, 111th Congress

Rep. Polis, Jared [D-CO-2

2018-05-23

House - 05/23/2018 Referred to the Committee on Ways and Means, and in addition to the Committees on Education and the Workforce, Natural Resources, and Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions... (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

To repeal the annual fee on health insurance providers enacted by the Patient Protection and Affordable Care Act.

THOMAS, 113th Congress

Rep. Boustany, Charles W., Jr. [R-LA-3

2013-02-15

House - 04/24/2013 Rereferred to the Committee on Ways and Means, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee... (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Support to the DoD Comprehensive Review Working Group Analyzing the Impact of Repealing ’Don’t Ask, Don’t Tell’. Volume 1: Findings From the Surveys

DTIC Science & Technology

2010-11-01

Table 5.8). When Service members (both married and unmarried ) were asked this same question, job satisfaction was most often selected (by 30.5% of...said they were in the Service member survey. When married Service members were asked how their Retention and Referrals Findings at a Glance...49  Retention

To impose a limitation on the maximum amount of crop insurance premiums paid by the Federal Crop Insurance Corporation, to repeal the authority to provide direct payments for producers of certain major agricultural commodities and peanuts, to prohibit the Secretary of Agriculture from making payments to the Brazilian Cotton Institute, and for other purposes.

THOMAS, 113th Congress

Rep. Kind, Ron [D-WI-3

2013-04-18

House - 05/03/2013 Referred to the Subcommittee on General Farm Commodities and Risk Management. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Navy and Marine Corps Officers’ Attitudes Toward the Don’t Ask, Don’t Tell Policy

DTIC Science & Technology

2011-03-01

the 48 percent agreed with the statement, “In the event of a draft, gay men should be drafted the same as...that has continued to emerge in studies over the years among researchers is the concept of unit cohesion and how it might be affected by the repeal of...suggest that interpersonal conflicts would be minimal, and the key to stopping insignificant disruptive acts is through commander

Study of Scientists and Engineers in DoD Laboratories

DTIC Science & Technology

1982-09-01

LABORATORY PERSONNEL CEILINGS - REPEAL HIGH GRADE CEILINGS AND CREATE DEFENSE S&T SERVICE - ADJUST S&E PAY SCALE TO MEET MARKET COMPETITION - REMOVE...with an June 1980 examination of the dynamics of the S&E labor NSF-80-316 market -- i.e., the flows into and out of science and engineering. National...at all degreeand beyond Science and levels and tight markets at all degree levels inOct, 1980 Engineerinp, most engineering fields. Engineering and

PURPA: The spur to competition and utility restructuring

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hirsh, R.F.

Without discussing the merits or deficiencies of the arguments made by contesting parties, this article explores the history of PURPA and its intended and unintended consequences. The article will serve as a background for discussion of the repeal or reform of PURPA so that participants in the debate will understand the profound consequences of this important law. Most notably, PURPA helped establish the free-market, competitive principles that many people hope to extend further in the utility system.

Navigating the Repeal of Don’t Ask, Don’t Tell

DTIC Science & Technology

2011-03-24

different categories, except for non-heterosexuals. They serve in the U.S. Armed Forces now and they will continue to serve in the future. Legal ...categories, except for non-heterosexuals. They serve in the U.S. Armed Forces now and they will continue to serve in the future. Legal integration... homosexuals . This shortlist can be boiled down to sex, race, religion, ethnicity, age and sexual orientation. Over the years, the U.S. military

Foreign Affairs, Defense, and Trade: Key Issues for the 110th Congress

DTIC Science & Technology

2006-12-20

granting Mexican trucks access to U.S. highways. Another long running dispute related to sugar and high - fructose corn syrup imports was recently resolved...and Mexico has agreed to repeal its 20% tax on soft drinks made with high - fructose corn syrup (HFCS). CRS Report RL32724, Mexico-U.S. Relations: Issues...reconstruction in those countries. After Iraq, other high priorities will be the continuing fight against terrorism and efforts to dissuade or restrain

George Washington and the Politics of War and Revolution

DTIC Science & Technology

2015-05-23

upon.… No Conditional Resolutions, which may be formed at the time, should be published until it is known, that the Petition has had no Effect ...Fairfax summarized his position that “There are two Methods proposed to effect a Repeal [of the remaining intolerable acts]; the one by Petition, the...disposal or shall be wantonly wrested from us by a set of luxurious , abandoned, and piratical hirelings to be appropriated by them to increase the

An Analysis of the President’s February Budgetary Proposals

DTIC Science & Technology

1993-03-01

recent trends in corporate income tax collections explain more than half of this difference. Second, both the amount and timing of spending for deposit...percent of the increase in revenue in 1994 through 1998 comes from increases in individual and corporate income tax rates, repeal of the wage cap on the...federal unemployment insurance payroll taxes, and the corporate income tax . For purposes of ranking by adjusted family income (API), income for each family

Moral Blow to the Marine Corps: The Repeal of the Don’t Ask Don’t Tell Policy

DTIC Science & Technology

2011-04-08

else individually has to accept homosexual acts as acceptable (based on freedom of speech and freedom of religion). The DOD report stated that of...free speech rights being curtailed would lead them to withdraw their endorsement.൞ The issuebere is really freedom of speech . Chaplains already...effects regardless of the intent. Freedom of speech and religion are our most important rights as Americans. By trying to protect one group are we

Health Professions and Nurse Education. Hearing before the Subcommittee on Health and the Environment of the Committee on Energy and Commerce, House of Representatives, One Hundred Second Congress, First Session, on H.R. 2405.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. House Committee on Energy and Commerce.

The Subcommittee on Health and the Environment met to receive testimony on federal health professions programs authorized by Titles VII and VIII of the Public Health Service Act. These programs are slated for repeal by the Bush Administration in 1992. In particular the subcommittee heard testimony on the subject of critical shortages in training…

The evolution of U.S. temperance movements since repeal: a comparison of two campaigns to control alcoholic beverage marketing, 1950s and 1980s.

PubMed

Pennock, Penny

2005-01-01

This paper compares the politics of a failed religious movement to ban alcohol advertising in the 1950s with the politics of a more secular, and partially successful, movement to regulate alcohol marketing in the 1970s and 1980s. Although the contexts of the two marketing control movements were quite different, the continuities were equally striking. Both employed arguments about youth, social order, and the power of mass media.

To repeal the Patient Protection and Affordable Care Act.

THOMAS, 111th Congress

Rep. King, Steve [R-IA-5

2010-03-25

House - 06/16/2010 Motion to Discharge Committee filed by Mr. King (IA). Petition No: 111-11. (All Actions) Notes: On 6/16/2010, a motion was filed to discharge the Committees on Energy and Commerce, Ways and Means, Education and Labor, the Judiciary, Natural Resources, Rules, House Administration, and Appropriations from consideration of H.R.4972. A discharge petition requires 218 signatures for... Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

30 CFR 938.15 - Approval of Pennsylvania regulatory program amendments.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Subsidence and Land 2001 Conservation Act: Repeal of Section 4 (52 P.S. 1406.4); 5(b)(partial approval); 5.1...)); 5.2(a)(1), (2), and (3) (52 P.S. 1406.5b(a)(1), (2), and (3)); 5.2(b)(1) (52 P.S. 1406.5b(b)(1)); 5... approval); 5.4(a)(1), (2) and (4) (52 P.S. 1406.5d(a)(1), (2) and (4)); 5.4(b) (52 P.S. 1406.5d(b)); 5.5(a...

30 CFR 938.15 - Approval of Pennsylvania regulatory program amendments.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Subsidence and Land 2001 Conservation Act: Repeal of Section 4 (52 P.S. 1406.4); 5(b)(partial approval); 5.1...)); 5.2(a)(1), (2), and (3) (52 P.S. 1406.5b(a)(1), (2), and (3)); 5.2(b)(1) (52 P.S. 1406.5b(b)(1)); 5... approval); 5.4(a)(1), (2) and (4) (52 P.S. 1406.5d(a)(1), (2) and (4)); 5.4(b) (52 P.S. 1406.5d(b)); 5.5(a...

30 CFR 938.15 - Approval of Pennsylvania regulatory program amendments.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Subsidence and Land 2001 Conservation Act: Repeal of Section 4 (52 P.S. 1406.4); 5(b)(partial approval); 5.1...)); 5.2(a)(1), (2), and (3) (52 P.S. 1406.5b(a)(1), (2), and (3)); 5.2(b)(1) (52 P.S. 1406.5b(b)(1)); 5... approval); 5.4(a)(1), (2) and (4) (52 P.S. 1406.5d(a)(1), (2) and (4)); 5.4(b) (52 P.S. 1406.5d(b)); 5.5(a...

30 CFR 938.15 - Approval of Pennsylvania regulatory program amendments.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Subsidence and Land 2001 Conservation Act: Repeal of Section 4 (52 P.S. 1406.4); 5(b)(partial approval); 5.1...)); 5.2(a)(1), (2), and (3) (52 P.S. 1406.5b(a)(1), (2), and (3)); 5.2(b)(1) (52 P.S. 1406.5b(b)(1)); 5... approval); 5.4(a)(1), (2) and (4) (52 P.S. 1406.5d(a)(1), (2) and (4)); 5.4(b) (52 P.S. 1406.5d(b)); 5.5(a...

Device-tax repeal surfaces as key in budget stalemate. White House says it's unwilling to compromise until shutdown ends.

PubMed

Lee, Jaimy; Zigmond, Jessica

2013-10-14

As lawmakers in D.C. continue to wrangle over how to solve the government shutdown and debt ceiling impasse, the Affordable Care Act's medical device tax is emerging as a likely bargaining chip. But many wonder how the tax's $29.1 billion in funding for coverage expansion will be replaced. Minnesota GOP Rep. Erik Paulsen, says he's encouraged that there is a strong chance the device tax could be overturned.

Streamlining Defense Acquisition Laws. Executive Summary: Report of the DoD Acquisition Law Advisory Panel

DTIC Science & Technology

1993-03-01

procurement into a single, 1 The Defense Systems Management College is a DOD educational institution which has, since 1971, trained prgram managers and...greater butis prevented by numerous statutory require- use of commercial items. The Panel has re- ments from buying those products like any other...purchases of an item from one particular source. prevent inadvertent repeal and defines the rela- This is a "lose-lose situation" for commercial tionship of

A New Authorization for Use of Military Force Against the Islamic State: Issues and Current Proposals

DTIC Science & Technology

2016-01-15

three months, and it would repeal the 2002 AUMF. Senators Tim Kaine and Jeff Flake introduced another proposed IS AUMF (S. 1587 ) on June 16, 2015...and appropriate” against the Islamic State and associated persons or forces. S. 1587 defines “associated persons or forces,” however, as not only...the Islamic State of Iraq and the Levant Representative Adam Kinzinger February 13, 2015 S. 1587 Authority for the Use of Military Force Against

Unit Cohesion and the Impact of DADT

DTIC Science & Technology

2010-01-01

law that denies gay Americans the right to serve the country they love because of who they are.”1 So said president of the United States and...to defend their fellow citizens,” said Admiral Mullen, who further stated that it was his personal belief that “allowing gays and lesbians to serve...knowing that a mem- ber of a unit is gay or lesbian had no effect on their judgments of unit cohesion.9 Thus, the argument hinges on whether repealing

Marine Corps Officer Attitudes Toward the Repeal of Don’t Ask, Don’t Tell

DTIC Science & Technology

2013-03-01

are quite different, since conceptions of morality may be normative or descriptive and refer to some distinct notion of “right” and “wrong” behavior...of respondents, with the broader concept of tolerance by society rather moral correctness, and this is apparent in the responses by Marine Corps... moral relativism .” While this term has been defined in numerous ways, perhaps the best definition is provided by Stanford University’s Encyclopedia of

Universal Motorcycle Helmet Laws to Reduce Injuries: A Community Guide Systematic Review.

PubMed

Peng, Yinan; Vaidya, Namita; Finnie, Ramona; Reynolds, Jeffrey; Dumitru, Cristian; Njie, Gibril; Elder, Randy; Ivers, Rebecca; Sakashita, Chika; Shults, Ruth A; Sleet, David A; Compton, Richard P

2017-06-01

Motorcycle crashes account for a disproportionate number of motor vehicle deaths and injuries in the U.S. Motorcycle helmet use can lead to an estimated 42% reduction in risk for fatal injuries and a 69% reduction in risk for head injuries. However, helmet use in the U.S. has been declining and was at 60% in 2013. The current review examines the effectiveness of motorcycle helmet laws in increasing helmet use and reducing motorcycle-related deaths and injuries. Databases relevant to health or transportation were searched from database inception to August 2012. Reference lists of reviews, reports, and gray literature were also searched. Analysis of the data was completed in 2014. A total of 60 U.S. studies qualified for inclusion in the review. Implementing universal helmet laws increased helmet use (median, 47 percentage points); reduced total deaths (median, -32%) and deaths per registered motorcycle (median, -29%); and reduced total injuries (median, -32%) and injuries per registered motorcycle (median, -24%). Repealing universal helmet laws decreased helmet use (median, -39 percentage points); increased total deaths (median, 42%) and deaths per registered motorcycle (median, 24%); and increased total injuries (median, 41%) and injuries per registered motorcycle (median, 8%). Universal helmet laws are effective in increasing motorcycle helmet use and reducing deaths and injuries. These laws are effective for motorcyclists of all ages, including younger operators and passengers who would have already been covered by partial helmet laws. Repealing universal helmet laws decreased helmet use and increased deaths and injuries. Published by Elsevier Inc.

Response to Letter Requesting the EPA Repeal the Alternative Fuels Exemption in the PSD Regulations

EPA Pesticide Factsheets

This document may be of assistance in applying the New Source Review (NSR) air permitting regulations including the Prevention of Significant Deterioration (PSD) requirements. This document is part of the NSR Policy and Guidance Database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

Support Plan for Implementation: Report of the Comprehensive Review of the Issues Associated with a Repeal of ’Don’t Ask, Don’t Tell’

DTIC Science & Technology

2010-11-30

regarding.discrimination.based.on.“sex.stereotyping”.and/or.“harassment.” 5. Collection and Retention of Sexual Orientation Data The. Working. Group...someone.other.than.a.person.in.the.priority.list.set.by.law...This.could.include. an. unmarried . partner,. significant. other,. friend,. or. distant. relative.. . . Service. members.must. be...take.action.on.complaints.that.allege.discrimination.based.on.sexual.orientation.. 5. Collection and Retention of Sexual Orientation Data

Challenges to validity in single-group interrupted time series analysis.

PubMed

Linden, Ariel

2017-04-01

Single-group interrupted time series analysis (ITSA) is a popular evaluation methodology in which a single unit of observation is studied; the outcome variable is serially ordered as a time series, and the intervention is expected to "interrupt" the level and/or trend of the time series, subsequent to its introduction. The most common threat to validity is history-the possibility that some other event caused the observed effect in the time series. Although history limits the ability to draw causal inferences from single ITSA models, it can be controlled for by using a comparable control group to serve as the counterfactual. Time series data from 2 natural experiments (effect of Florida's 2000 repeal of its motorcycle helmet law on motorcycle fatalities and California's 1988 Proposition 99 to reduce cigarette sales) are used to illustrate how history biases results of single-group ITSA results-as opposed to when that group's results are contrasted to those of a comparable control group. In the first example, an external event occurring at the same time as the helmet repeal appeared to be the cause of a rise in motorcycle deaths, but was only revealed when Florida was contrasted with comparable control states. Conversely, in the second example, a decreasing trend in cigarette sales prior to the intervention raised question about a treatment effect attributed to Proposition 99, but was reinforced when California was contrasted with comparable control states. Results of single-group ITSA should be considered preliminary, and interpreted with caution, until a more robust study design can be implemented. © 2016 John Wiley & Sons, Ltd.

Effects of state-level policy changes on homicide and nonfatal shootings of law enforcement officers.

PubMed

Crifasi, Cassandra K; Pollack, Keshia M; Webster, Daniel W

2016-08-01

To evaluate the impact of state-level policy changes on assaults on law enforcement officers (LEOs) in the USA. Pooled time series and cross-sections with negative binomial regression were used to estimate the impact of state-level changes of right-to-carry (RTC), three-strikes and permit-to-purchase (PTP) handgun laws on fatal and non-fatal assaults of LEOs. LEO assaults were stratified by weapon type (all methods, handgun and non-handgun) and whether or not the assault was fatal. Data were collected from the Federal Bureau of Investigation's Law Enforcement Officers Killed and Assaulted database and analysed for the period 1984-2013 for fatal assaults and 1998-2013 for non-fatal assaults. RTC laws showed no association with fatal (p>0.4) or non-fatal (p>0.15) assaults on LEOs. Three-strikes laws were associated with a 33% increase in the risk of fatal assaults on LEOs. Connecticut's PTP law was not associated with fatal (p>0.16) or non-fatal (p>0.13) assaults. Missouri's repeal of its PTP legislation was marginally associated with a twofold increased risk of non-fatal handgun assaults (p=0.089). This research indicates that three-strikes laws increase the risk of fatal assaults. RTC laws are not associated with increased risk of assault. Missouri's PTP repeal may increase the risk of non-fatal handgun assaults. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Medicaid nursing home payment and the role of provider taxes.

PubMed

Grabowski, David C; Zhanlian Feng; Mor, Vincent

2008-08-01

In the context of recent state budget shortfalls and the repeal of the Boren Amendment, state Medicaid expenditures for nursing home care were considered a potential target for payment cuts. The authors examine this issue using data from a survey of state nursing home payment policies. Results indicate that aggregate inflation-adjusted Medicaid payment rates steadily increased through 2004, and this growth is partly attributable to the adoption of nursing home provider taxes in many states. A recent proposal to cap provider taxes, if enacted, may lead to a decrease in Medicaid payment rates for nursing home care.

Support to the DoD Comprehensive Review Working Group Analyzing the Impact of Repealing ’Don’t Ask, Don’t Tell’. Volume 2: Findings from the Qualitative Research Tasks

DTIC Science & Technology

2010-11-01

Tell military.” (male) “You must consider that most of your troops come from small town America , and while in the city and other progressive areas...in the country, it may be acceptable to be gay, it is generally not acceptable in small town America . Therefore, you are creating a situation in...state favors the demands of the homosexual activists over the First Amendment, it is only a matter of time before the military censors the religious

Medicaid Nursing Home Payment and the Role of Provider Taxes

PubMed Central

Feng, Zhanlian; Intrator, Orna; Mor, Vincent

2009-01-01

In the context of recent state budget shortfalls and the repeal of the Boren amendment, state Medicaid expenditures for nursing home care were considered a potential target for payment cuts. We examine this issue using data from a survey of state nursing home payment policies. Our results indicate aggregate inflation-adjusted Medicaid payment rates increased steadily through 2004, and this growth was partly attributable to the adoption of nursing home provider taxes in many states. A recent proposal to cap provider taxes, if enacted, may lead to a decrease in Medicaid payment rates for nursing home care. PMID:18369236

Persistent threats to validity in single-group interrupted time series analysis with a cross over design.

PubMed

Linden, Ariel

2017-04-01

The basic single-group interrupted time series analysis (ITSA) design has been shown to be susceptible to the most common threat to validity-history-the possibility that some other event caused the observed effect in the time series. A single-group ITSA with a crossover design (in which the intervention is introduced and withdrawn 1 or more times) should be more robust. In this paper, we describe and empirically assess the susceptibility of this design to bias from history. Time series data from 2 natural experiments (the effect of multiple repeals and reinstatements of Louisiana's motorcycle helmet law on motorcycle fatalities and the association between the implementation and withdrawal of Gorbachev's antialcohol campaign with Russia's mortality crisis) are used to illustrate that history remains a threat to ITSA validity, even in a crossover design. Both empirical examples reveal that the single-group ITSA with a crossover design may be biased because of history. In the case of motorcycle fatalities, helmet laws appeared effective in reducing mortality (while repealing the law increased mortality), but when a control group was added, it was shown that this trend was similar in both groups. In the case of Gorbachev's antialcohol campaign, only when contrasting the results against those of a control group was the withdrawal of the campaign found to be the more likely culprit in explaining the Russian mortality crisis than the collapse of the Soviet Union. Even with a robust crossover design, single-group ITSA models remain susceptible to bias from history. Therefore, a comparable control group design should be included, whenever possible. © 2016 John Wiley & Sons, Ltd.

Anti-choice groups target reproductive rights in Congress.

PubMed

1995-06-16

In a May 3 memo, the GOP "Family Caucus" presented its legislative agenda for the remainder of the 104th Congress. Chaired by Representative Tom Coburn (R-OK), the anti-choice caucus promotes family and social issues, and emphasizes religious liberty and parental rights. It is seeking to eliminate funding for Title X of the Public Health Service Act, which provides grants to domestic family planning providers; repeal the Freedom of Access to Clinic Entrances Act (FACE); curtail fetal tissue research; restrict the production and sale of RU486; reduce funding for the US Agency for International Development (USAID); and hinder US representation at the UN Fourth World Conference on Women. On May 17, the Virginia-based Christian Coalition unveiled a ten-point "Contract with the American Family," which targets reproductive health care by restricting late-term abortions, reversing the Medicaid requirement that states cover abortions in cases of rape or incest, and eliminating funding for Title X and international family planning. Director Ralph Reed was joined at the group's press conference in the Capitol by Speaker of the House Newt Gingrich (R-GA) and Senator Phil Gramm (R-TX), both of whom are anti-abortion. Senate Majority Leader Robert Dole (R-KS), who is also anti-choice, met with Reed in his office later that day. Anti-choice representatives and senators met with some success in the last month in restricting US funding for family planning programs abroad, US participation in international meetings, and the performance of abortions at military facilities. Representative Charles Canady (R-FL) has introduced a bill banning modified dilation and evacuation abortions, and Representative Robert Dornan (R-CA) has introduced the "Family Planning Programs Repeal Act" (HR 1623).

From DTCA-PD to patient information to health information: the complex politics and semantics of EU health policy.

PubMed

Brooks, Eleanor; Geyer, Robert

2012-12-01

Between 2001 and 2011 the pharmaceutical industry, supported by DG Enterprise, was engaged in an ongoing campaign to repeal/amend the European Union (EU) ban on direct-to-consumer advertising of prescription drugs (DTCA-PD). As it became increasingly clear that the ban would not be repealed, DTCA-PD supporters tried to shift the debate away from advertising and towards the provision of 'patient information' and the rights of patients to access such information. Meanwhile, a variety of national and European health organizations, supported by DG SANCO, sought to maintain the ban and oppose the industry-supported 'patient information' campaign. Instead, they promoted a concept of 'health information' that included all aspects of citizens' health, not just pharmaceuticals. This article aims to analyse the transition from DTCA-PD to patient information to health information and examine its implications for EU health policy as a complex policy space. The article examines the emergence and development of EU health policy and the evolution of the DTCA-PD debate through the lens of complexity theory. It analyses the nature of the semantic, political and policy transition and asks why it occurred, what it tells us about EU health policy and future EU health legislation and how it may be understood from a complexity perspective. The article concludes that the complexity framework is ideally suited for the field of public health and, in particular, the DTCA-PD debate. Having successfully shifted the policy-focus of the debate to patients' rights and health information, opponents of the legislation are likely to face their next battle in the realm of cyberspace, where regulatory issues change the nature of advertising. © 2012 Blackwell Publishing Ltd.

Paternalism and its discontents: motorcycle helmet laws, libertarian values, and public health.

PubMed

Jones, Marian Moser; Bayer, Ronald

2007-02-01

The history of motorcycle helmet legislation in the United States reflects the extent to which concerns about individual liberties have shaped the public health debate. Despite overwhelming epidemiological evidence that motorcycle helmet laws reduce fatalities and serious injuries, only 20 states currently require all riders to wear helmets. During the past 3 decades, federal government efforts to push states toward enactment of universal helmet laws have faltered, and motorcyclists' advocacy groups have been successful at repealing state helmet laws. This history raises questions about the possibilities for articulating an ethics of public health that would call upon government to protect citizens from their own choices that result in needless morbidity and suffering.

Paternalism & Its Discontents: Motorcycle Helmet Laws, Libertarian Values, and Public Health

PubMed Central

Jones, Marian Moser; Bayer, Ronald

2007-01-01

The history of motorcycle helmet legislation in the United States reflects the extent to which concerns about individual liberties have shaped the public health debate. Despite overwhelming epidemiological evidence that motorcycle helmet laws reduce fatalities and serious injuries, only 20 states currently require all riders to wear helmets. During the past 3 decades, federal government efforts to push states toward enactment of universal helmet laws have faltered, and motorcyclists’ advocacy groups have been successful at repealing state helmet laws. This history raises questions about the possibilities for articulating an ethics of public health that would call upon government to protect citizens from their own choices that result in needless morbidity and suffering. PMID:17194856

MTBE, ethanol rules come under fire

DOE Office of Scientific and Technical Information (OSTI.GOV)

Begley, R.

EPA is facing stiff challenges to the mandates for methyl tert-butyl ether (MTBE) and ethanol in its reformulated gasoline (RFG) program. Wisconsin officials are receiving hundreds of complaints about the alleged health effects and other problems with MTBE added to gasoline, and Gov. Tommy Thompson is demanding that EPA suspend the RFG program until April 1. Rep. James Sensenbrenner (R., WI) is threatening to introduce a bill to repeal the program in Wisconsin if EPA does not comply. However, EPA administrator Carol Browner says the agency will {open_quotes}defer any decision{close_quotes} on the request. EPA has sent technical experts to Milwaukeemore » to respond to and monitor citizens` complaints.« less

SGR reform and nephrology: difficult problems, potential solutions.

PubMed

Velez, Ruben; Singer, Dale; Blaser, Robert

2012-09-01

In light of the massive uncertainty with both the federal government in general and health policy priorities specifically, it is probably constructive to focus on the things we know for sure. In Medicare Part B reimbursement, the SGR system is fundamentally flawed, and must be replaced. All of Congress has recognized this fact, and there is legislation in the House that would move the ball forward on SGR repeal and replacement. Likewise, coordinated care models like ACOs offer a logical process for achieving a triple aim: improving individual health care, improving population health, and promoting cost efficiency in health care. Hopefully, policy makers in Washington will recognize and act on these truths as well.

Rethinking Roe v. Wade: defending the abortion right in the face of contemporary opposition.

PubMed

Manninen, Bertha Alvarez

2010-12-01

In 2008, many states sought to pass Human Life Amendments, which would extend the definition of personhood to encompass newly fertilized eggs. If such an amendment were to pass, Roe v. Wade, as currently defended by the Supreme Court, may be repealed. Consequently, it is necessary to defend the right to an abortion in a manner that succeeds even if a Human Life Amendment successfully passes. J.J. Thomson's argument in "A Defense of Abortion" successfully achieves this. Her argument is especially strong when one considers that her central thesis-that one person's right to life does not entail the right to use another's person's body for continued sustenance-is pervasive in legal policies in the U.S.A.

"Democracy was never intended for degenerates": Alberta's flirtation with eugenics comes back to haunt it.

PubMed

Cairney, R

1996-09-15

An Alberta woman recently won a lawsuit against the government of Alberta for wrongful sterilization that took place when she was a 14-year-old ward at the Provincial Training School for Mental Defectives. It was the first time the province has been held accountable for actions taken under the Sexual Sterilization Act, a 1927 law that promoted the theory of eugenics and led to the sterilization of more than 2800 people. It has since been repealed. A physician who served on the province's Eugenics Board said the decisions were based on the best scientific advice and medical techniques available at the time. Today, she added, eugenics is being practised in a different way through prenatal diagnosis and therapeutic abortion.

Employment Act 1989 (No. 38 of 1989), 16 November 1989.

PubMed

1989-01-01

Among other things, this Act amends the law of the UK to conform to the requirements of European Communities Council Directive 76/207/EEC, which calls for the equal treatment of men and women in employment and vocational training. It repeals most legislation that makes distinctions in such areas, including pre-1975 legislation, which was exempted from the provisions of the Sex Discrimination Act 1975. Provisions discriminating in favor of women with respect to pregnancy, maternity, or other risks particularly affecting them are not changed, however. The Act also sets the age that women are eligible to receive statutory redundancy pay at 65, the same age as for men, and removes most restrictions on women working in certain fields once deemed dangerous for them.

HIV in military.

PubMed

1996-05-31

The House of Representatives approved a defense authorization bill that requires the Pentagon to discharge service members who test positive for HIV antibodies. This is the second measure of its kind. Last year, Rep. Robert K. Dornan (R-CA) pushed through Congress a similar measure that was repealed after encountering public opposition. President Clinton said he will veto the defense bill in its current form. The bill provides $13 billion in spending beyond the amount the Pentagon requested, resurrects plans for the Star Wars missile defense system, and rescinds Clinton's don't ask, don't tell policy toward gay men and lesbians in the military. Rep. Peter Torkildsen (R-MA) is confident that the HIV provision can be stricken when the bill goes to a House-Senate conference committee in a few weeks.

Let's Get Real About Health Care Reform.

PubMed

Karpf, Michael

2017-09-01

In light of the ongoing debate about health care policy in the United States, including efforts to repeal and replace the Affordable Care Act, it will be critically important for the academic community to engage in the dialogue. Developing a viable approach to health care reform requires an understanding of the interaction and interdependence between choice, cost, and coverage in a competitive and functional market-based system. Some institutions have implemented models that indicate the feasibility of providing high-quality, efficient patient care while working within fixed budgets. The academic community must stay engaged in these conversations because of its moral commitment to equitable access to health care for all. Academic medical centers will also have to define and protect their roles in an evolving health care delivery system in the United States.

[Public water supply fluoridation in Brazil according to health sector leaders].

PubMed

Ferreira, Regina Glaucia Lucena Aguiar; Bógus, Cláudia Maria; Marques, Regina Auxiliadora de Amorim; Menezes, Léa Maria Bezerra de; Narvai, Paulo Capel

2014-09-01

Various groups have opposed water supply fluoridation in Brazil, while others have supported the measure based on scientific evidence. This article describes the perceptions of delegates to the 13th National Health Conference on mandatory fluoridation of the country's public water supply. Interviews were processed using collective subject discourse analysis. A certain degree of misinformation persists regarding basic characteristics of water fluoridation, which is frequently confused with chlorination. The delegates' discourses showed a continuing need for public awareness-raising regarding fluoridation and the delegates' desire that the National Congress not take measures impacting public health without consulting society's stakeholders. However, most of the interviewees agreed that to repeal mandatory water fluoridation or loosen the control of its implementation could increase the incidence of tooth decay in the population.

“They’re Going to Die Anyway”: Smoking Shelters at Veterans’ Facilities

PubMed Central

Smith, Elizabeth A.; Malone, Ruth E.

2013-01-01

Military personnel and veterans are disadvantaged by inadequate tobacco control policies. We conducted a case study of a Department of Veterans Affairs (VA) effort to disallow smoking and tobacco sales in VA facilities. Despite strong VA support, the tobacco industry created a public relations–focused grassroots veterans’ opposition group, eventually pushing the US Congress to pass a law requiring smoking areas in every VA health facility. Arguing that it would be unpatriotic to deny veterans this “freedom” they had ostensibly fought for and that banning smoking could even harm veterans’ health, industry consultants exploited veterans’ organizations to protect tobacco industry profits. Civilian public health advocates should collaborate with veterans to expose the industry’s manipulation, reframe the debate, and repeal the law. PMID:23409899

Analysis & commentary. Health reform: only a cease-fire in a political hundred years' war.

PubMed

Miller, Thomas P

2010-06-01

Four dominant political forces drove the process and product of national health reform during the past two years: federal budget constraints; public concerns about the size and reach of the federal government; the time pressure of the congressional calendar; and the political parties' high-stakes, all-or-nothing bets on what became President Barack Obama's defining policy priority. Republican congressional leaders saw little advantage in offering more detailed alternatives. Congressional Democrats calculated that they had even more to lose politically by abandoning health reform legislation than by pushing it through Congress. This essay argues that passage of the legislation merely represents a cease-fire in a long-standing war and that more battles between forces for "implementation" and those for "repeal and replace" are to come.

"Democracy was never intended for degenerates": Alberta's flirtation with eugenics comes back to haunt it.

PubMed Central

Cairney, R

1996-01-01

An Alberta woman recently won a lawsuit against the government of Alberta for wrongful sterilization that took place when she was a 14-year-old ward at the Provincial Training School for Mental Defectives. It was the first time the province has been held accountable for actions taken under the Sexual Sterilization Act, a 1927 law that promoted the theory of eugenics and led to the sterilization of more than 2800 people. It has since been repealed. A physician who served on the province's Eugenics Board said the decisions were based on the best scientific advice and medical techniques available at the time. Today, she added, eugenics is being practised in a different way through prenatal diagnosis and therapeutic abortion. Images p790-a PMID:8823227

Did prohibition really work? Alcohol prohibition as a public health innovation.

PubMed

Blocker, Jack S

2006-02-01

The conventional view that National Prohibition failed rests upon an historically flimsy base. The successful campaign to enact National Prohibition was the fruit of a century-long temperance campaign, experience of which led prohibitionists to conclude that a nationwide ban on alcohol was the most promising of the many strategies tried thus far. A sharp rise in consumption during the early 20th century seemed to confirm the bankruptcy of alternative alcohol-control programs. The stringent prohibition imposed by the Volstead Act, however, represented a more drastic action than many Americans expected. Nevertheless, National Prohibition succeeded both in lowering consumption and in retaining political support until the onset of the Great Depression altered voters' priorities. Repeal resulted more from this contextual shift than from characteristics of the innovation itself.

State laws and the practice of lay midwifery.

PubMed Central

Butter, I H; Kay, B J

1988-01-01

A national survey was conducted to assess the current status and characteristics of state legislation regulating the practice of lay midwives. As of July 1987, 10 states have prohibitory laws, five states have grandmother clauses authorizing practicing midwives under repealed statutes, five states have enabling laws which are not used, and 10 states explicitly permit lay midwives to practice. In the 21 remaining states, the legal status of midwives is unclear. Much of the enabling legislation restricts midwifery practice often resulting in situations similar to those in states with prohibitory laws. Given the growth of an extensive grassroots movement of lay midwives committed to quality of care, this outcome suggests that 21 states with no legislation may provide better opportunities for midwifery practice than states with enabling laws. PMID:3407812

Implications of the 2017 Tax Cuts and Jobs Act for Public Health.

PubMed

Glied, Sherry

2018-06-01

The recently passed Tax Cuts and Jobs Act will reduce total federal revenues by about 4% between 2018 and 2027. The law makes multiple changes to the taxation of individuals and corporations. It also repeals the Affordable Care Act's (ACA's) individual mandate penalties, which will erase some of the gains in insurance coverage achieved since implementation of the ACA's coverage expansions. The resulting increases in rates of uninsurance will likely lead to increased uncompensated care and deflect hospitals and health departments from addressing other prevention and public health needs. In addition, the law is expected to lead to substantial increases in the federal debt and, consequently, to calls for reductions in spending on entitlement programs, particularly Medicare, and on discretionary programs, including public health. Many other provisions of the law could also have second-order effects on public health.

Fewer and better children: race, class, religion, and birth control reform in America.

PubMed

Wilde, Melissa J; Danielsen, Sabrina

2014-05-01

In the early 20th century, contraceptives were illegal and, for many, especially religious groups, taboo. But, in the span of just two years, between 1929 and 1931, many of the United States' most prominent religious groups pronounced contraceptives to be moral and began advocating for the laws restricting them to be repealed. Met with everything from support, to silence, to outright condemnation by other religious groups, these pronouncements and the debates they caused divided the American religious field by an issue of sex and gender for the first time. This article explains why America's religious groups took the positions they did at this crucial moment in history. In doing so, it demonstrates that the politics of sex and gender that divide American religion today is deeply rooted in century-old inequalities of race and class.

Fifty Years of Family Planning: New Evidence on the Long-Run Effects of Increasing Access to Contraception

PubMed Central

Bailey, Martha J.

2014-01-01

This paper assembles new evidence on some of the longer-term consequences of U.S. family planning policies, defined in this paper as those increasing legal or financial access to modern contraceptives. The analysis leverages two large policy changes that occurred during the 1960s and 1970s: first, the interaction of the birth control pill’s introduction with Comstock-era restrictions on the sale of contraceptives and the repeal of these laws after Griswold v. Connecticut in 1965; and second, the expansion of federal funding for local family planning programs from 1964 to 1973. Building on previous research that demonstrates both policies’ effects on fertility rates, I find suggestive evidence that individuals’ access to contraceptives increased their children’s college completion, labor force participation, wages, and family incomes decades later. PMID:25339778

Conflicts between religious or spiritual beliefs and pediatric care: informed refusal, exemptions, and public funding.

PubMed

2013-11-01

Although respect for parents' decision-making authority is an important principle, pediatricians should report suspected cases of medical neglect, and the state should, at times, intervene to require medical treatment of children. Some parents' reasons for refusing medical treatment are based on their religious or spiritual beliefs. In cases in which treatment is likely to prevent death or serious disability or relieve severe pain, children's health and future autonomy should be protected. Because religious exemptions to child abuse and neglect laws do not equally protect all children and may harm some children by causing confusion about the duty to provide medical treatment, these exemptions should be repealed. Furthermore, public health care funds should not cover alternative unproven religious or spiritual healing practices. Such payments may inappropriately legitimize these practices as appropriate medical treatment.

Evidence Europe 2017. London, UK - February 22-23, 2017.

PubMed

Kibble, A

2017-03-01

As the political backdrop changes in both the U.S. and Europe, volatility in the pharma industry is beginning to be felt as the sector becomes sensitive to the uncertainty. U.S. President Trump has stated he will pursue an agenda against high U.S. drug prices and is expected to seek to repeal the Affordable Care Act, while in Europe, Brexit casts further unknowns in regulatory authorization procedures, trade and external reference pricing. With these factors in mind, Terrapin's Evidence Europe meeting provided for a very topical discussion on the use of evidence to define and communicate value in healthcare. With a particular focus on real-world evidence, the conference used presentations, panel briefings and roundtable discussions to foster debate on the challenges faced by industry as it negotiates the current fragile environment. Copyright 2017 Clarivate Analytics.

Coroners and death certification law reform: the Coroners and Justice Act 2009 and its aftermath.

PubMed

Luce, Tom

2010-10-01

After considering various different options for half a decade, the last Government legislated in 2009 to reform the England and Wales coroner and death certification systems. The Coroners and Justice Act 2009 provides for the creation of a new Chief Coroner post to lead the jurisdiction and for local medical examiners to oversee a new death certification scheme applicable equally to burial and cremation cases. In October 2010 the new Government announced that it judges the main coroner reform to be unaffordable, will not proceed with it and plans to repeal the provisions. It intends to implement the new death certification arrangements, which is welcome. The decision to abort the main coroner reform in spite of longstanding and widespread recognition of the need for major change is deplorable though in line with other failures over the last century to properly modernise this neglected service.

Death - whose decision? Euthanasia and the terminally ill

PubMed Central

Fraser, S.; Walters, J.

2000-01-01

In Australia and Oregon, USA, legislation to permit statutory sanctioned physician-assisted dying was enacted. However, opponents, many of whom held strong religious views, were successful with repeal in Australia. Similar opposition in Oregon was formidable, but ultimately lost in a 60-40% vote reaffirming physician-assisted dying. This paper examines the human dilemma which arises when technological advances in end-of-life medicine conflict with traditional and religious sanctity-of-life values. Society places high value on personal autonomy, particularly in the United States. We compare the potential for inherent contradictions and arbitrary decisions where patient autonomy is either permitted or forbidden. The broader implications for human experience resulting from new legislation in both Australia and Oregon are discussed. We conclude that allowing autonomy for the terminally ill, within circumscribed options, results in fewer ethical contradictions and greater preservation of dignity. Key Words: Physician-assisted suicide • voluntary euthanasia • patient autonomy • religious belief PMID:10786323

Externalities in the Workplace: A Response to a Rejoinder to a Response to a Response to a Paper

PubMed Central

Alamar, Benjamin C.; Glantz, Stanton A.

2009-01-01

Professor Henderson has simply repeated the same two points he made in his earlier critique (Henderson 2007) of our article “Smoke-free Ordinances Increase Restaurant Profit and Value” (Alamar and Glantz 2004). He argues 1.) that secondhand smoke is not an externality, therefore no government intervention is required to protect workers and customers in restaurants and bars, and 2.) the empirical results in the paper are not conclusive because the data are cross-sectional. Henderson also issues a challenge for us to advocate for the repeal of the California law on smoke-free restaurants. While we enjoy a good debate and do not mind adding another publication to our CVs, we do hope that Prof. Henderson will not find the burning desire to restate his position again, after we respond this last time. PMID:19756237

Solidarity as a national health care strategy.

PubMed

West-Oram, Peter

2018-05-02

The Trump Administration's recent attempts to repeal the Affordable Care Act have reignited long-running debates surrounding the nature of justice in health care provision, the extent of our obligations to others, and the most effective ways of funding and delivering quality health care. In this article, I respond to arguments that individualist systems of health care provision deliver higher-quality health care and promote liberty more effectively than the cooperative, solidaristic approaches that characterize health care provision in most wealthy countries apart from the United States. I argue that these claims are mistaken and suggest one way of rejecting the implied criticisms of solidaristic practices in health care provision they represent. This defence of solidarity is phrased in terms of the advantages solidaristic approaches to health care provision have over individualist alternatives in promoting certain important personal liberties, and delivering high-quality, affordable health care. © 2018 John Wiley & Sons Ltd.

Implications of the 2017 Tax Cuts and Jobs Act for Public Health

PubMed Central

2018-01-01

The recently passed Tax Cuts and Jobs Act will reduce total federal revenues by about 4% between 2018 and 2027. The law makes multiple changes to the taxation of individuals and corporations. It also repeals the Affordable Care Act’s (ACA’s) individual mandate penalties, which will erase some of the gains in insurance coverage achieved since implementation of the ACA’s coverage expansions. The resulting increases in rates of uninsurance will likely lead to increased uncompensated care and deflect hospitals and health departments from addressing other prevention and public health needs. In addition, the law is expected to lead to substantial increases in the federal debt and, consequently, to calls for reductions in spending on entitlement programs, particularly Medicare, and on discretionary programs, including public health. Many other provisions of the law could also have second-order effects on public health. PMID:29565668

Regression away from the mean: Theory and examples.

PubMed

Schwarz, Wolf; Reike, Dennis

2018-02-01

Using a standard repeated measures model with arbitrary true score distribution and normal error variables, we present some fundamental closed-form results which explicitly indicate the conditions under which regression effects towards (RTM) and away from the mean are expected. Specifically, we show that for skewed and bimodal distributions many or even most cases will show a regression effect that is in expectation away from the mean, or that is not just towards but actually beyond the mean. We illustrate our results in quantitative detail with typical examples from experimental and biometric applications, which exhibit a clear regression away from the mean ('egression from the mean') signature. We aim not to repeal cautionary advice against potential RTM effects, but to present a balanced view of regression effects, based on a clear identification of the conditions governing the form that regression effects take in repeated measures designs. © 2017 The British Psychological Society.

The Supreme Court's spring term: abortion, the right to die, and the decline of privacy rights.

PubMed

Wing, K R

1990-01-01

Wing analyzes the constitutional significance and the important long-term implications for health policy of three 1990 U.S. Supreme Court decisions: Hodgson v. Minnesota, Ohio v. Akron Center for Reproductive Health, and Cruzan v. Director, Missouri Department of Health. Hodgson and Ohio upheld state statutes requiring parental notification of a minor's impending abortion. Cruzan upheld a state court decision refusing to allow the family of a patient in a persistent vegetative state to discontinue life-sustaining treatment. Wing argues that these decisions reach far beyond "the abortion issue" or "the right to die." Not only have they narrowed the constitutional protection of individual privacy, but they allow states to regulate activities like abortion in a manner that indicates that the Court is prepared to repeal the notion that individual privacy is entitled to enhanced judicial protection.

Matrimonial Causes (Amendment) Act, 1986 (No. 15 of 1986), 31 December 1986.

PubMed

1987-01-01

Among other things, this Act makes the following changes in the Matrimonial Causes Act (Chapter 48): a) it lowers the waiting period after a marriage has occurred before a petition of divorce can be presented to the Supreme Court to two years; b) it lowers the waiting period for obtaining a divorce on the ground of desertion to two years; c) it prohibits persons from claiming damages on account of adultery; d) it repeals provisions allowing a Court to order settlement of a wife's property by possession by or reversion to her spouse or children if a divorce or separation is granted by reason of the wife's adultery, desertion, or cruelty; and e) it provides that "the Matrimonial Causes Rules 1937, of England in so far as they are not inconsistent with this Act, shall apply to any proceedings under this Act." full text

Defining child exposure to domestic violence as neglect: Minnesota's difficult experience.

PubMed

Edleson, Jeffrey L; Gassman-Pines, Jenny; Hill, Marissa B

2006-04-01

Policymakers are increasingly focusing on children exposed to domestic violence. The 1999 Minnesota legislature amended the definition of child neglect to include a child's exposure to family violence. What was initially seen as a simple change to bring more attention to children exposed to domestic violence resulted in great turmoil across Minnesota's county-run child protection system. Referrals to county child protection agencies expanded rapidly in the months following the law change, and no new state funding was provided to implement the legislation. A coalition of child welfare administrators and battered women's advocates successfully lobbied for the repeal of this change in definition. Many were dissatisfied with both the impact of the legislation and the fact that exposed children and their families were left without badly needed services. This article reconstructs how Minnesota's legislature made this change, its consequences, and the lessons that may be drawn from this experience.

Undermining the ACA through the executive branch and federalism: what the Trump administration's approach to health reform means for older Americans.

PubMed

Jones, David K; Gusmano, Michael K; Nadash, Pamela; Miller, Edward Alan

2018-04-12

The ACA has survived multiple existential threats in the legislative and judicial branches, including dozens of congressional attempts at repeal and two major Supreme Court cases. Even as it seems that the ACA is here to stay, what the law accomplishes is far from settled. The Trump administration is using executive powers to weaken the law, in many cases using the same powers that President Obama used to strengthen the effects of the reform. States have responded by seeking flexibility to pursue reforms, such as work requirements, that could not pass Congress and that were not allowed by the Obama administration. There is no indication that the ACA is imploding as President Trump has predicted and seems to desire, although these changes have a real and substantial impact on the lives of many Americans, including the near-elderly in unique ways.

Lesbian, Gay, Bisexual, and Transgender (LGBT) Service Members: Life After Don't Ask, Don't Tell.

PubMed

Goldbach, Jeremy T; Castro, Carl Andrew

2016-06-01

Lesbian, gay, and bisexual service members can serve openly in the military with the repeal of the Don't Ask, Don't Tell policy. The fate of transgender service members remains uncertain as the policy preventing them from serving in the military remains under review. The health care needs of these populations remain for the most part unknown, with total acceptance and integration in the military yet to be achieved. In this paper, we review the literature on the health care needs of lesbian, gay, bisexual, and transgender (LGBT) service members, relying heavily on what is known about LGBT civilian and veteran populations. Significant research gaps about the health care needs of LGBT service members are identified, along with recommendations for closing those gaps. In addition, recommendations for improving LGBT acceptance and integration within the military are provided.

Disaster Averted, For Now: How the American Health Care Act Would Have Affected Californians.

PubMed

Rasmussen, Petra W

2017-03-01

Although the American Health Care Act (AHCA) was recently defeated, the policies in the bill represented a mix of ideas long favored by conservatives. If enacted, this repeal-and-replace bill would have had devastating consequences for most of the 5 million Californians currently receiving direct benefits from the Affordable Care Act (ACA), including more than 1 million who receive subsidies through Covered California and almost 4 million who have enrolled in the Medi-Cal expansion. Although the bill failed to garner enough votes for passage, it is likely that efforts to chip away at the ACA will continue and that some of the ideas contained within the AHCA will be revisited. This policy brief summarizes some of the most significant reversals that would have occurred under the Republican plan in the individual and small group insurance markets.

Rules regarding the health insurance premium tax credit. Final and temporary regulations.

PubMed

2014-07-28

This document contains final and temporary regulations relating to the health insurance premium tax credit enacted by the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010, as amended by the Medicare and Medicaid Extenders Act of 2010, the Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011, and the Department of Defense and Full-Year Continuing Appropriations Act of 2011 and the 3% Withholding Repeal and Job Creation Act. These regulations affect individuals who enroll in qualified health plans through Affordable Insurance Exchanges (Exchanges) and claim the premium tax credit, and Exchanges that make qualified health plans available to individuals. The text of the temporary regulations in this document also serves as the text of proposed regulations set forth in a notice of proposed rulemaking (REG-104579-13) on this subject in the Proposed Rules section in this issue of the Federal Register.

The politics of paranoia.

PubMed

Belkin, Aaron

2013-01-01

For almost 20 years, gay rights advocates and defenders of military anti-gay discrimination engaged in a phony debate about whether allowing open service would undermine unit cohesion. To be sure, a preponderance of evidence showed that open service would not undermine cohesion, and the repeal of don't ask, don't tell (DADT) required advocates to prevail on that point in the court of public opinion. But concerns about cohesion were never the basis of opposition to open service. Rather, opposition was a modern incarnation of the politics of paranoia, a dangerous tradition in American history. Acknowledging that DADT had nothing to do with cohesion and that military leaders allowed the armed forces to be implicated in the politics of paranoia could facilitate disabling paranoia as the basis for other political projects such as anti-immigrant xenophobia. For a video on DADT and paranoia, search for "Donnelly Belkin DADT" on YoutTube.

Laws prohibiting over-the-counter syringe sales to injection drug users: relations to population density, HIV prevalence, and HIV incidence.

PubMed

Friedman, S R; Perlis, T; Des Jarlais, D C

2001-05-01

This study sought to assess relations of laws prohibiting over-the-counter syringe sales (anti-OTC laws) to population prevalence of injection drug users and HIV prevalence or incidence among 96 US metropolitan areas. A cross-sectional analysis was used. Metropolitan areas with anti-OTC laws had a higher mean HIV prevalence (13.8% vs 6.7%) than other metropolitan areas (pseudo-P < .001). In 83 metropolitan areas with HIV prevalence of less than 20%, anti-OTC laws were associated with HIV incidence rates of 1% or greater (pseudo-P < .001). Population proportions of injection drug users did not vary by presence of anti-OTC laws. Anti-OTC laws are not associated with lower population proportions of injection drug users. Laws restricting syringe access are associated with HIV transmission and should be repealed.

Collision course? Donald Trump, Paul Ryan, and the fate of Medicare.

PubMed

Oberlander, Jonathan

2018-04-10

The election of Donald Trump as president of the United States raises questions about the future of Medicare. How will Medicare fare under Republican-led government? There are several compelling reasons that the Trump administration and Congressional Republicans might avoid Medicare reform, including the political risks of taking on a popular program, the difficulties the party has encountered in trying to dismantle the Patient Protection and Affordable Care Act (ACA), the importance of older Americans to the GOP coalition, and President Trump's views about Medicare. However, because of fiscal pressures and the commitment of Speaker of the House Paul Ryan and other Republicans to entitlement reform, the GOP nonetheless could end up attempting to make major changes in Medicare. Alternatively, Republican efforts to repeal and undermine the ACA could unintentionally enhance the political fortunes of proposals to expand Medicare. Consequently, the fate of Medicare during the Trump administration remains highly uncertain.

The introduction of dram shop legislation in the United States and the advent of server training.

PubMed

Saltz, R F

1993-01-01

This paper discusses the relationship of research to policy in the matter of dram shop liability and server training in the USA. The discussion is made difficult by the apparent lack of any such relationship. While research in the area has only just been published, dram shop liability in the USA actually dates to the nineteenth century, with its current form shaped by the repeal of prohibition in 1933. Because liability law and liability insurance vary from state to state, current movements for reform and server training arise somewhat spontaneously in different localities and with different emphases. Research constitutes only a minor influence among several others more salient to the political process of policy formation. The advent of mandatory server training in the state of Oregon is used to illustrate the somewhat capricious nature of progress in responsible beverage service.

One giant leap for mankind? A cost-utility analysis of abolishing the law of gravity

PubMed Central

Cyr, Claude; Lanthier, Luc

2007-01-01

Background Canada's Neo Rhino Party, a joke political party created in 2006 as a successor to the Parti Rhinocéros, is planning a new regulation to repeal the law of gravity, which could have an important impact on diseases attributable to gravity on earth. Methods We sought to estimate the number of quality-adjusted life-years that would be saved if the proposed regulation is passed and determine the cost-effectiveness of adapting Boris Volfson's antigravity machine1 for use on earth. We performed an economic analysis using a hidden Markov model. Results Our results suggest that a microgravity environment would save over 2 million quality-adjusted life-years. The cost for every quality-adjusted life-year saved is estimated to be $328. Interpretation Microgravity is the solution to the health care crisis in Canada. In addition, using technological, statistical and medical jargon gives us the opportunity to defy the laws of physics, mathematics and medicine. PMID:18056617

Health Physics Society Comments to U.S. Environmental Protection Agency Regulatory Reform Task Force.

PubMed

Ring, Joseph; Tupin, Edward; Elder, Deirdre; Hiatt, Jerry; Sheetz, Michael; Kirner, Nancy; Little, Craig

2018-05-01

The Health Physics Society (HPS) provided comment to the U.S. Environmental Protection Agency (EPA) on options to consider when developing an action plan for President Trump's Executive Order to evaluate regulations for repeal, replacement, or modification. The HPS recommended that the EPA reconsider their adherence to the linear no-threshold (LNT) model for radiation risk calculations and improve several documents by better addressing uncertainties in low-dose, low dose-rate (LDDR) radiation exposure environments. The authors point out that use of the LNT model near background levels cannot provide reliable risk projections, use of the LNT model and collective-dose calculations in some EPA documents is inconsistent with the recommendations of international organizations, and some EPA documents have not been exposed to the public comment rule-making process. To assist in establishing a better scientific basis for the risks of low dose rate and low dose radiation exposure, the EPA should continue to support the "Million Worker Study," led by the National Council on Radiation Protection and Measurement.

[Euthanasia outside Europe].

PubMed

Julesz, Máté

2014-08-10

The passive form of euthanasia is legalized almost in every civilized country. Its active form is not a generally accepted legal institution. In Europe, active euthanasia is legalized only in The Netherlands, Belgium, Luxembourg and Switzerland. In Australia, the Act on the Rights of the Terminally Ill of 1995 legalized the institution of assisted suicide, which is not identical to active euthanasia. The difference lies in the fact that legalized active euthanasia means that the author of a murder is not punishable (under certain circumstances), whilst assisted suicide is not about murder, rather about suicide. In the first case, the patient is killed on his or her request by someone else. In the second case, the patient himself or herself executes the act of self-killing (by the assistance of a healthcare worker). In Australia, the institution of assisted suicide was repealed in 1997. Assisted suicide is legal in four USA member states: in Vermont, Washington, Montana and Oregon. In Uruguay, the active form of euthanasia has been legal since 1932.

What will Donald Trump's presidency mean for health? A scorecard.

PubMed

McKee, Martin; Greer, Scott L; Stuckler, David

2017-02-18

US Presidents make their mark on health, for better or worse. Donald Trump campaigned on a populist platform to "make America great again". While the actual policies his administration will pursue-and the priority he will place on each of them-remain in many ways uncertain, both his statements and his nominations for key government posts suggest that his presidency could have profound implications for health. His proposal to repeal and replace the Affordable Care Act with a "better reform", his stance on reproductive rights, and his approaches to other areas, such as science policy and climate change, coupled with his stated intention to put "America first" are creating anxiety and uncertainty about America's domestic health policies and its global leadership role in areas such as security and development. We propose criteria on which the global health community can judge the success or failure of a Trump presidency, based on a selection of the 17 Sustainable Development Goals that apply to health. Copyright © 2017 Elsevier Ltd. All rights reserved.

Social security financing.

PubMed

1980-05-01

After nearly 2 years of study, the 1979 Advisory Council on Social Security submitted its findings and recommendations in December. In February the Bulletin published the Executive Summary of the Council's report. Because of the continuing wide public interest in the future of social security financing, the Council's detailed findings and recommendations on that subject are published below. The Council unanimously reports that all current and future beneficiaries can count on receiving the payments to which they are entitled. Among the recommendations it calls for are partial financing with nonpayroll-tax revenues. Suggested changes include hospital insurance (HI) financed through portins of personal and corporate income taxes and a part of the HI insurance payroll tax diverted to cash benefits with the balance of this tax repealed. The Council also recommends that the social security cash benefits program be brought into long-run actuarial balance--with a payroll-tax rate increase in the year 2005. It rejects the idea of a value-added tax as being inflationary. Parenthetical remarks represent additional views of the Council members cited.

The case to ban sugary food and drink from schools: these products are addictive, and kids will learn best without them.

PubMed

Thornley, S; Sundborn, G

2014-03-01

In New Zealand, schools have been a battleground as a setting to address the obesity epidemic, with successive governments enforcing, and then repealing laws to ban junk food from canteen menus. Just what is considered 'junk food' remains controversial, but recently sugar sweetened beverages have become a target of public health groups. The adverse health consequences of their intake have been the principal arguments to reduce their availability. Here, we argue that the advantages of reducing intake of sugar in schools are very likely to lead to educational and other social benefits. Indices of sugar intake have been associated with aggressive behaviour, attention deficit, dysphoria and suicidal thoughts in cross-sectional studies. Longitudinal studies have also linked soft drink intake with impaired cognitive development. We believe that banning sugary drinks from schools will assist teachers and students to better achieve their learning goals, with a side effect of improving their health status.

The Sex Discrimination (Northern Ireland) Order 1988 (S.I. No. 1988/1303 [N.I. 13]), 26 July 1988.

PubMed

1989-01-01

Among other things, this Northern Ireland Sex Discrimination Order amends the 1976 Sex Discrimination Order to do the following: 1) repeal the exemption of private households and small "undertakings" and partnerships from compliance with the Order; 2) restrict the exemptions allowed in the Order and in the Equal Pay Act 1970 with respect to retirement; 3) provide for common age limits for men and women in unfair dismissal cases; 4) extend exemptions to the Order for training bodies to include any person providing training; 5) authorize the Equal Opportunities Commission to issue codes of practice containing practical guidance on the elimination of discrimination in employment and the promotion of equality of opportunity for men and women; such codes of practice shall be admissible in evidence in proceedings under the Order; 6) apply provisions relating to void and unenforceable contracts to collective agreements and rules of "undertakings"; and 7) remove certain restrictions on the working hours and conditions of women.

Pakistan: Frontline state again. Master`s thesis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rivard, D.S.

1995-12-01

The objective of this study is to determine Pakistan`s place in contemporary U.S. national security strategy. Today, U.S.-Pakistan relations are strained due to the Pressler Amendment to the Foreign Assistance Act. The Pressler Amendment prohibits arms transfers from the United States to Pakistan in response to Pakistani efforts to develop a nuclear weapon capability. This thesis provides a historical background to the current impasse by examining Pakistani foreign policy since 1947. Next, the study examines the evolution of U.S. interests and security objectives in South and Southwest Asia. Current security objectives analyzed are the U.S. strategies to contain Iran andmore » Iraq and to prevent nuclear proliferation in the region. In order to attain security objectives in the region, the author concludes that the U.S. needs a close cooperative relationship with Pakistan. Since the Pressler Amendment stands as the greatest obstacle to improved U.S.-Pakistan relations, the amendment should be repealed.« less

A legacy of struggle: the OSHA ergonomics standard and beyond, Part I.

PubMed

Delp, Linda; Mojtahedi, Zahra; Sheikh, Hina; Lemus, Jackie

2014-11-01

In November 2000, the Occupational Safety and Health Administration (OSHA) issued an ergonomics standard to prevent debilitating work-related musculoskeletal disorders (WMSDs). It was rescinded by Congress within four months. We explore how this story unfolded over two decades of collaboration and conflict. Part I provides an overview of the historical context of the struggle for a standard, followed by interviews with key players from labor, academia and government. They provide a snapshot of the standard; discuss the prevalence of WMSDs in the context of changing work organization; give insight into the role of unions and of scientific debate within the context of rulemaking; and uncover the basis for the groundbreaking OSHA citations that laid the foundation for a standard. Part II interviews further explore the anti-regulatory political landscape of the 1990s that led to repeal of the standard, discuss the impact of the struggle beyond the standard, and describe creative approaches for the future.

Healthy by Design: Using a Gender Focus to Influence Complete Streets Policy.

PubMed

Keippel, April Ennis; Henderson, Melissa A; Golbeck, Amanda L; Gallup, TommiLee; Duin, Diane K; Hayes, Stephen; Alexander, Stephanie; Ciemins, Elizabeth L

2017-10-17

Public health leaders in Yellowstone County, Montana, formed an alliance to address community-wide issues. One such issue is Complete Streets, with its vision of safe streets for all. This case study focuses on development and adoption of a Complete Streets policy. It examines how a community coalition, Healthy By Design, infused a gender focus into the policymaking process. An incremental and nonlinear policymaking process was aided by a focus on gender and health equity. The focus on a large constituency helped to frame advocacy in terms of a broad population's needs, not just special interests. The city council unanimously adopted a Complete Streets resolution, informed by a gender lens. Healthy By Design further used gender information to successfully mobilize the community in response to threats of repeal of the policy, and then influenced the adoption of a revised policy. Policies developed with a focus on equity, including gender equity, may have broader impact on the community. Such policies may pave the way for future policies that seek to transform gender norms toward building a healthier community for all residents. Published by Elsevier Inc.

Forest Elephant Crisis in the Congo Basin

PubMed Central

Blake, Stephen; Strindberg, Samantha; Boudjan, Patrick; Makombo, Calixte; Bila-Isia, Inogwabini; Ilambu, Omari; Grossmann, Falk; Bene-Bene, Lambert; de Semboli, Bruno; Mbenzo, Valentin; S'hwa, Dino; Bayogo, Rosine; Williamson, Liz; Fay, Mike; Hart, John; Maisels, Fiona

2007-01-01

Debate over repealing the ivory trade ban dominates conferences of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES). Resolving this controversy requires accurate estimates of elephant population trends and rates of illegal killing. Most African savannah elephant populations are well known; however, the status of forest elephants, perhaps a distinct species, in the vast Congo Basin is unclear. We assessed population status and incidence of poaching from line-transect and reconnaissance surveys conducted on foot in sites throughout the Congo Basin. Results indicate that the abundance and range of forest elephants are threatened from poaching that is most intense close to roads. The probability of elephant presence increased with distance to roads, whereas that of human signs declined. At all distances from roads, the probability of elephant occurrence was always higher inside, compared to outside, protected areas, whereas that of humans was always lower. Inside protected areas, forest elephant density was correlated with the size of remote forest core, but not with size of protected area. Forest elephants must be prioritised in elephant management planning at the continental scale. PMID:17407383

From exclusion to acceptance: a case history of homosexuality in the U.S. Court of Military Appeals.

PubMed

Wilson-Buford, Kellie

2013-01-01

Policing the legality and normalcy of service members' sexual lives was a contentious process for military courts throughout the 1950s, 1960s, and early 1970s that resulted in the inconsistent enforcement of the homosexual exclusion policy. Military personnel of all ranks and occupations harbored a variety of attitudes and beliefs about homosexuality that challenged the legitimacy and uniformity of the military's legal assault on sexual deviance. Over half of the active duty personnel originally accused of homosexual tendencies received either sentence reductions or sentence reversals as a result of this highly contested process by which official military policy was translated into practice via courts-martial. Paradoxically, the very policies that discriminated against alleged homosexual service members generated legal avenues through which gays and lesbians exercised their rights to due process, and, ultimately, their rights as American citizens embodied in the repeal of the Don't Ask, Don't Tell policy. Rather than being an ideologically homophobic monolith, the Cold War American military rocked with contestation over an exclusion policy that attempted--unsuccessfully--to eliminate all gay and lesbian service members.

The impact of asbestos in Illinois public schools

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marucco, T.E.

The Asbestos Hazard Emergency Response Act (AHERA) was signed into law providing a framework for addressing asbestos problems in secondary and elementary schools. This study examines the perceived attitudes of Illinois School personnel relative to the impact of asbestos in their buildings. Conclusions are: (1) All districts regardless of size, type, and enrollment have the largest concentration of non-friable asbestos in floor tile. (2) All school districts are surveying their asbestos and report that they are managing it properly following AHERA and state guidelines; removal is the most accepted method of abatement. (3) Administrators, schools boards, teachers, and maintenance staffmore » in general showed a high concern about asbestos abatement. (4) Governmental agencies have exerted the greatest pressure on school districts to manage existing asbestos properly. (5) External pressure does not appear to influence school districts regarding asbestos abatement. (6) Current attitudes and activities would change little if AHERA were repealed. (7) Asbestos abatement activities have taken place when schools are vacated. (8) Most administrators regard radon, leaded water, toxic chemicals, indoor air quality, and air pollution equal to or more threatening than asbestos.« less

Suicide Rates and State Laws Regulating Access and Exposure to Handguns

PubMed Central

Anestis, Joye C.

2015-01-01

Objectives. Using previous research, we examined the impact of 4 handgun laws (waiting periods, universal background checks, gun locks, and open carrying regulations) on suicide rates. Methods. We used publicly available databases to collect information on statewide laws, suicide rates, and demographic characteristics for 2013. Results. Each law was associated with significantly lower firearm suicide rates and the proportion of suicides resulting from firearms. In addition, each law, except for that which required a waiting period, was associated with a lower overall suicide rate. Follow-up analyses showed a significant indirect effect on overall suicide rates through the proportion of suicides by firearms, indicating that the reduced overall suicide rate was attributable to fewer suicide attempts, fewer handguns in the home, suicide attempts using less lethal means, or a combination of these factors. States that implemented any of these laws saw a decreased suicide rate in subsequent years, whereas the only state that repealed 1 of these laws saw an increased suicide rate. Conclusions. Our results were supportive of a potentially vital role in suicide prevention for state legislation that limits access and exposure to handguns. PMID:26270305

Scientists, bioethics and democracy: the Italian case and its meanings

PubMed Central

Corbellini, Gilberto

2007-01-01

In June 2005, Italy held a referendum on repealing the law on medically assisted fertilization (Law 40/2004), which limits access to artificial reproduction to infertile couples, and prohibits the donation of gametes, the cryopreservation of embryos, preimplantation genetic diagnosis (PDG), and research on human embryos. The referendum was invalidated, and the law remained unchanged. The Italian political e bioethical debate on assisted reproduction was manipulated by the Catholic Church, which distorted scientific data and issues at stake with the help of Catholic politicians and bioethicists. What happened in Italy shows that some perverse socio‐cultural e political mechanisms are spreading the absurd and anti‐historical view that scientific and technological advancements are threatening democracy and personal freedom. Scientists should not only contrast the political attempts at limiting freedom of scientific research, but also tell politicians, humanists and citizens that the invention of Western science with its view of scientific community as an “open society”, contributed and still contributes, through scientific education, to the construction and maintaining of the moral and political values underlying Western democracies. PMID:17526686

Forest elephant crisis in the Congo Basin.

PubMed

Blake, Stephen; Strindberg, Samantha; Boudjan, Patrick; Makombo, Calixte; Bila-Isia, Inogwabini; Ilambu, Omari; Grossmann, Falk; Bene-Bene, Lambert; de Semboli, Bruno; Mbenzo, Valentin; S'hwa, Dino; Bayogo, Rosine; Williamson, Liz; Fay, Mike; Hart, John; Maisels, Fiona

2007-04-01

Debate over repealing the ivory trade ban dominates conferences of the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES). Resolving this controversy requires accurate estimates of elephant population trends and rates of illegal killing. Most African savannah elephant populations are well known; however, the status of forest elephants, perhaps a distinct species, in the vast Congo Basin is unclear. We assessed population status and incidence of poaching from line-transect and reconnaissance surveys conducted on foot in sites throughout the Congo Basin. Results indicate that the abundance and range of forest elephants are threatened from poaching that is most intense close to roads. The probability of elephant presence increased with distance to roads, whereas that of human signs declined. At all distances from roads, the probability of elephant occurrence was always higher inside, compared to outside, protected areas, whereas that of humans was always lower. Inside protected areas, forest elephant density was correlated with the size of remote forest core, but not with size of protected area. Forest elephants must be prioritised in elephant management planning at the continental scale.

The Post-Repeal Eclipse in Knowledge About The Harmful Effects of Alcohol

PubMed Central

Katcher, Brian S.

2014-01-01

National Prohibition in the USA (1919 to 1933) was followed by an era in which medical scientists played an important role in minimizing the harmful effects of alcohol. Cirrhosis, cardiomyopathy, adverse fetal effects, and esophageal cancer are examples of alcohol-related health problems that were well known at the beginning of the 20th century but were dismissed during the late 1930’s and early 1940’s, only to be rediscovered during the 1960’s and afterwards. This eclipse in knowledge occurred because of skepticism about earlier claims that had been made in the name of scientific temperance and, most importantly, because of changing standards for medical evidence. The paradigm for disease causation that gave birth to modern medicine was based on microbiology and reinforced by hormone and nutrition discoveries. Most alcohol-related health problems are poorly explained by this paradigm. The more recent epidemiologic paradigm for noninfectious disease is more applicable to the health risks associated with heavy drinking. A transformation of knowledge about alcohol’s relationship to disease has occurred. PMID:8329965

Mistrust in Medicine: The Rise and Fall of America's First Vaccine Institute.

PubMed

Lanzarotta, Tess; Ramos, Marco A

2018-06-01

In 1813, the American government passed An Act to Encourage Vaccination, the first federal endorsement of a medical practice in American history. The law tasked a federal agent with maintaining a supply of the smallpox vaccine and distributing it nationwide. James Smith, a well-respected physician and proponent of vaccination, was appointed as vaccine agent. Smith was skeptical of claims that only well-trained physicians should be allowed to perform vaccination; he felt it was a simple procedure that should be available to all American citizens. In 1822, he made a tragic error that caused several deaths and left him vulnerable to criticism from political opponents and his medical peers. This ended Smith's professional career and led to the repeal of the act itself. In this article, we use the rise and fall of James Smith to provide a historical perspective on contemporary debates surrounding delayed vaccination schedules. We explain how physicians-in the 19th century and today-have worked to build public trust in vaccination in an American culture suspicious of medical expertise.

Efficiency of energy recovery from waste incineration, in the light of the new Waste Framework Directive.

PubMed

Grosso, Mario; Motta, Astrid; Rigamonti, Lucia

2010-07-01

This paper deals with a key issue related to municipal waste incineration, which is the efficiency of energy recovery. A strong driver for improving the energy performances of waste-to-energy plants is the recent Waste Framework Directive (Directive 2008/98/EC of the European Parliament and of the Council of 19 November 2008 on waste and repealing certain Directives), which allows high efficiency installations to benefit from a status of "recovery" rather than "disposal". The change in designation means a step up in the waste hierarchy, where the lowest level of priority is now restricted to landfilling and low efficiency wastes incineration. The so-called "R1 formula" reported in the Directive, which counts for both production of power and heat, is critically analyzed and correlated to the more scientific-based approach of exergy efficiency. The results obtained for waste-to-energy plants currently operating in Europe reveal some significant differences in their performance, mainly related to the average size and to the availability of a heat market (district heating). Copyright (c) 2010 Elsevier Ltd. All rights reserved.

[Leprosy and human rights: trends in Japan and in the world].

PubMed

Yokota, Yozo

2014-12-01

Leprosy, or Hansen's disease, has long been regarded as an incurable and dreadful contagious disease. The patients have been forcefully hospitalized and deprived of many basic human rights. Their family members have often been discriminated against due to stigma associated with this disease. Soon after the Second World War, a specific remedy called "multi-drug therapy" (MDT) was discovered and leprosy became a relatively easily curable disease. Despite this medical development, it took time to change the policy and legislation of forceful hospitalization of leprosy patients. The stigma surrounding leprosy and consequent discrimination have continued. In Japan, it was only in 1996 that the legislation requiring forceful hospitalization of leprosy patients was repealed. The Government decided to provide remedies to the former patients who had suffered from this policy. At the United Nations, the General Assembly adopted a resolution to eradicate discrimination against persons affected by leprosy and their family members. It is hoped that discrimination associated with Hansen's disease will soon be overcome by the efforts of all concerned, particularly doctors and nurses who are specialists of this disease.

Unintended Consequences of US Immigration Policy: Explaining the Post-1965 Surge from Latin America

PubMed Central

Massey, Douglas S; Pren, Karen A.

2012-01-01

The year 1965 is often cited as a turning point in the history of US immigration, but what happened in the ensuing years is not well understood. Amendments to the Immigration and Nationality Act passed in that year repealed the national origins quotas, which had been enacted during the 1920s in a deliberate attempt to limit the entry of Southern and Eastern European immigrants—or more specifically Jews from the Russian Pale and Catholics from Poland and Italy, groups at the time deemed “unassimilable.” The quotas supplemented prohibitions already in place that effectively banned the entry of Asians and Africans. The 1965 amendments were intended to purge immigration law of its racist legacy by replacing the old quotas with a new system that allocated residence visas according to a neutral preference system based on family reunification and labor force needs. The new system is widely credited with having sparked a shift in the composition of immigration away from Europe toward Asia and Latin America, along with a substantial increase in the number of immigrants. PMID:22833862

US Traffic Fatalities, 1985–2014, and Their Relationship to Medical Marijuana Laws

PubMed Central

Mauro, Christine M.; Wall, Melanie M.; Kim, June H.; Cerdá, Magdalena; Keyes, Katherine M.; Hasin, Deborah S.; Galea, Sandro; Martins, Silvia S.

2017-01-01

Objectives. To determine the association of medical marijuana laws (MMLs) with traffic fatality rates. Methods. Using data from the 1985–2014 Fatality Analysis Reporting System, we examined the association between MMLs and traffic fatalities in multilevel regression models while controlling for contemporaneous secular trends. We examined this association separately for each state enacting MMLs. We also evaluated the association between marijuana dispensaries and traffic fatalities. Results. On average, MML states had lower traffic fatality rates than non-MML states. Medical marijuana laws were associated with immediate reductions in traffic fatalities in those aged 15 to 24 and 25 to 44 years, and with additional yearly gradual reductions in those aged 25 to 44 years. However, state-specific results showed that only 7 states experienced post-MML reductions. Dispensaries were also associated with traffic fatality reductions in those aged 25 to 44 years. Conclusions. Both MMLs and dispensaries were associated with reductions in traffic fatalities, especially among those aged 25 to 44 years. State-specific analysis showed heterogeneity of the MML–traffic fatalities association, suggesting moderation by other local factors. These findings could influence policy decisions on the enactment or repealing of MMLs and how they are implemented. PMID:27997245

Unit Support Protects Against Sexual Harassment and Assault among National Guard Soldiers

PubMed Central

Walsh, Kate; Galea, Sandro; Cerda, Magdalena; Richards, Catherine; Liberzon, Israel; Tamburrino, Marijo B.; Calabrese, Joseph; Koenen, Karestan C.

2014-01-01

Objective Despite concerns about increased sexual harassment and assault following 2013 legislation repealing the ban on women in combat, little research has examined military factors that could prevent sexual harassment and assault during deployment. This study examined whether unit support, which reflects the quality of service members’ relationships within their unit, protects against sexual harassment and assault during deployment. Methods Participants were 1674 Ohio Army National Guard service members who reported at least one deployment during a telephone survey conducted in 2008-2009. Participants completed measures of sexual harassment/assault, unit support, and psychosocial support. Logistic regression was used to model odds of sexual harassment/assault. Results Approximately 13.2% (n=198) of men and 43.5% (n=74) of women reported sexual harassment, and 1.1% (n=17) of men and 18.8% (n=32) of women reported sexual assault during their most recent deployment. Higher unit support was associated with decreased odds of sexual harassment and assault. Conclusions A substantial proportion of men and women reported sexual harassment/assault. Higher unit support was associated with diminished odds of sexual harassment/assault during deployment. Programming designed to improve unit cohesion has potential to reduce sexual harassment and assault. PMID:25442705

Abortion bills introduced to Western Australian parliament.

PubMed

Loff, B; Cordner, S

1998-03-21

Police charges against two doctors who were involved in an abortion in West Australia in February 1998 prompted the introduction of two bills to the state's Legislative Assembly and Upper House. West Australia's Attorney-General, Peter Foss, introduced a bill to the Legislative Assembly which permits induced abortion if a pregnancy is causing serious danger to the mother's physical or mental health; if serious danger to her physical or mental health will result if the abortion is not performed; if the woman will otherwise experience serious personal, family, social, or economic consequences; or if she gives informed consent. Informed consent is defined as consent given by the woman after she has received counseling about the consequences of an induced abortion. This bill can allow for either no change in the current framework or abortion upon demand since the Attorney has stated that members may accept all or none of the options, or something in between. Debate began on March 17 and will probably be heated. A Private Member's Bill was introduced into the West Australian Upper House which would repeal the sections of the Criminal Code on abortion. As such, abortion would become a matter to be determined by only a woman and her doctor.

The Kantian framework of complementarity

NASA Astrophysics Data System (ADS)

Cuffaro, Michael

A growing number of commentators have, in recent years, noted the important affinities in the views of Immanuel Kant and Niels Bohr. While these commentators are correct, the picture they present of the connections between Bohr and Kant is painted in broad strokes; it is open to the criticism that these affinities are merely superficial. In this essay, I provide a closer, structural, analysis of both Bohr's and Kant's views that makes these connections more explicit. In particular, I demonstrate the similarities between Bohr's argument, on the one hand, that neither the wave nor the particle description of atomic phenomena pick out an object in the ordinary sense of the word, and Kant's requirement, on the other hand, that both 'mathematical' (having to do with magnitude) and 'dynamical' (having to do with an object's interaction with other objects) principles must be applicable to appearances in order for us to determine them as objects of experience. I argue that Bohr's 'complementarity interpretation' of quantum mechanics, which views atomic objects as idealizations, and which licenses the repeal of the principle of causality for the domain of atomic physics, is perfectly compatible with, and indeed follows naturally from a broadly Kantian epistemological framework.

Fluoridation advocacy in Queensland: a long and winding road.

PubMed

Akers, Harry Francis; Foley, Michael Anthony

2012-10-01

By 1977, all Australian states and mainland territories, with the exception of Queensland, had widely implemented adjusted water fluoridation. This disparity in public health policy persisted until 2008. This study analyses the sociopolitical and socioeconomic backgrounds that underpinned the repeal of the Fluoridation of Public Water Supplies Act (1963) and its replacement with the Water Fluoridation Act (2008). The authors used a literature review and historic method. References are in the public domain. The devolution, without funding, of a discretionary local authority power to fluoridate contributed to the perennial low fluoridation status in Queensland. A window of opportunity for fluoridation advocates opened between 2003 and 2008. Now that 87% of Queenslanders have access to optimally fluoridated water, Queensland premier Anna Bligh has largely delivered on a promise made in 2007 to fluoridate water supplies across the state. The implementation of adjusted water fluoridation requires not only political stability and resolve, but also centralised authority. The last of these factors must embrace the decision, the funding and the indemnity. State control over water-related infrastructure and water treatment enhances prospects for fluoridation. The roles of opinion polls, internal advisers and departmental figures are also confirmed. Political repercussions were minimal. © 2012 FDI World Dental Federation.

Moving Across Boundaries: Migration in South Africa, 1950–2000

PubMed Central

2013-01-01

Existing knowledge about historical patterns of black internal migration in South Africa is incomplete, primarily because of the lack of good life course studies as well as the apartheid government’s suppression and censoring of data. This article provides a comprehensive picture of historical internal migration patterns with an analysis of a unique individual retrospective life history data set. This sample of the black population, collected in 2000, is the only known nationally representative life history data for South Africa; it includes all residential moves for each individual during his/her lifetime. Various mobility outcomes are analyzed: moves within/across provinces, moves within/across rural and urban areas, forced moves, moves with a nuclear family, and individual moves. The results indicate that migration significantly increased among black South Africans during the last half of the twentieth century, and that this increase began before the Pass Laws were repealed in 1986 and well before the official end of apartheid in 1991 or the first free election in 1994. The timing of this increase in migration rates suggests that migration in defiance of the Pass Laws (albeit a dangerous and desperate proposition) was a way of life for many black South Africans. PMID:22956415

The Medicare Access And CHIP Reauthorization Act: Effects On Medicare Payment Policy And Spending.

PubMed

Hussey, Peter S; Liu, Jodi L; White, Chapin

2017-04-01

In 2015, Congress repealed the Sustainable Growth Rate formula for Medicare physician payment, eliminating mandatory payment cuts when spending exceeded what was budgeted. In its place, Congress enacted the Medicare Access and CHIP Reauthorization Act (MACRA), which established a two-track performance-based payment system that encourages physicians to participate in alternative payment models. MACRA could have huge effects on health care delivery, but the nature of those effects is highly uncertain. Using the RAND Corporation's Health Care Payment and Delivery Simulation Model, we estimated the effects of MACRA on Medicare spending and utilization and examined how effects would differ under various scenarios. We estimate that MACRA will decrease Medicare spending on physician services by -$35 to -$106 billion (-2.3 percent to -7.1 percent) and change spending on hospital services by $32 to -$250 billion (0.7 percent to -5.1 percent) in 2015-30. The spending effects are critically dependent on the strength of incentives in the alternative payment models, particularly the incentives for physicians to reduce hospital spending and physician responses to MACRA payment rates. Project HOPE—The People-to-People Health Foundation, Inc.

PURPA: The intersection of competition and regulatory policy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cudahy, R.D.

High on the priority list of matters to be considered by Congress is the reform and possible repeal of section 210 of the Public Utility Regulatory Policies Act of 1978 (PURPA). The values addressed by PURPA are as important today as they were when the legislation was adopted in 1978. This is true even if plans for competition have moved beyond PURPA. No doubt a large part of the generation added in the last fifteen years meets the PURPA objectives. A palusible - but unconvincing - case can therefore be made for reforming PURPA by restricting benefits to alternative energymore » projects, or even foreliminating the PURPA preference entirely. This sort of radical surgery, unless PURPA is supplanted by some equally effective regulatory scheme, will likely result in a major downgrading of PURPA`s primary objectives. However the chips may fall, the essential PURPA objectives - energy conservation and diversification of generating resources - are as worthy today as they were when the statute was enacted. Modifications of PURPA may be in order, and reexamination by the FERC and by Congress may be necessary. This ought not, however, involve abandonment of PURPA`s basic policy objectives.« less

Impact of integrated child development scheme on child malnutrition in West Bengal, India.

PubMed

Dutta, Arijita; Ghosh, Smritikana

2017-10-01

With child malnutrition detected as a persistent problem in most of the developing countries, public policy has been directed towards offering community-based supplementary feeding provision and nutritional information to caregivers. India, being no exception, has initiated these programs as early as 1970s under integrated child development scheme. Using propensity score matching technique on primary data of 390 households in two districts of West Bengal, an Eastern state in India, the study finds that impact of being included in the program and receiving supplementary feeding is insignificant on child stunting measures, though the program can break the intractable barriers of child stunting only when the child successfully receives not only just the supplementary feeding but also his caregiver collects crucial information on nutritional awareness and growth trajectory of the child. Availability of regular eggs in the feeding diet too can reduce protein-related undernutrition. Focusing on just feeding means low depth of other services offered under integrated child development scheme, including pre-school education, nutritional awareness, and hygiene behavior; thus repealing a part of the apparent food-secure population who puts far more importance on the latter services. © 2016 John Wiley & Sons Ltd.

A Standardized Procedure for a Pre-evaluation of the IED Instance

NASA Astrophysics Data System (ADS)

Panepinto, Deborah; Ruffino, Barbara; Zanetti, Mariachiara; Genon, Giuseppe

2016-04-01

This study presents a procedure, called EICS (Enterprise IPPC Compatibility Study) aimed at evaluating, by means of the calculation of three indexes, the compliance of the processes performed in an industrial plant with the guidelines provided by BREFs (BAT References) Documents. In fact, according to European Directive 2010/75/EU (concerning the Integrated Pollution Prevention and Control and repealing European Directive 2008/01/EC), industrial plants must require authorizations to the competent authority stating the conformity of their activity, in order to obtain this conformity they are advised to Best Available Technologies (BAT). The aim of the BATs is to avoid or minimize the impact of an industrial activity on the environment through the prevention of the atmospheric emissions, wastewater discharge and energetic consumption, and the correct waste management thus improving the efficiency of the plant. The procedure shown in the present paper has been tested on several types of industrial plant (cement plants, secondary smelt foundries, paper-mill, and automotive industries as regards their paint lines). In this paper, the application of EICS method to a cement plant is presented: the obtained results highlight a good correlation between the index values and the real situation of the plant.

Moving across boundaries: migration in South Africa, 1950-2000.

PubMed

Reed, Holly E

2013-02-01

Existing knowledge about historical patterns of black internal migration in South Africa is incomplete, primarily because of the lack of good life course studies as well as the apartheid government's suppression and censoring of data. This article provides a comprehensive picture of historical internal migration patterns with an analysis of a unique individual retrospective life history data set. This sample of the black population, collected in 2000, is the only known nationally representative life history data for South Africa; it includes all residential moves for each individual during his/her lifetime. Various mobility outcomes are analyzed: moves within/across provinces, moves within/across rural and urban areas, forced moves, moves with a nuclear family, and individual moves. The results indicate that migration significantly increased among black South Africans during the last half of the twentieth century, and that this increase began before the Pass Laws were repealed in 1986 and well before the official end of apartheid in 1991 or the first free election in 1994. The timing of this increase in migration rates suggests that migration in defiance of the Pass Laws (albeit a dangerous and desperate proposition) was a way of life for many black South Africans.

Is liquor intoxicating? Scientists, prohibition, and the normalization of drinking.

PubMed Central

Pauly, P J

1994-01-01

The reliance of current advocates of recreational drug legalization on parallels between "drug prohibition" and the repudiated experiment of National Prohibition in the 1920s invites renewed attention to the history of the legalization and normalization of drinking. A new scientific conception of the nature and effects of alcohol formed an important element in both the politics of repeal and the ensuing legitimation of alcohol consumption. The industrial toxicologist Yandell Henderson argued that alcohol should be considered analogous to carbon monoxide--clearly a poison, yet a normal part of civilized life and only problematic above a determinable and manageable exposure threshold. This argument had political force in the early 1930s as part of the contention that beer was not an "intoxicating liquor." It was more broadly persuasive because it was consistent with Americans' experience with industrial poisons, for which exposure levels had been set by toxicologists such as Henderson. This historical perspective illuminates the more recent reassessment of the risks of alcohol consumption. It also challenges the applicability of the model of the normalization of drinking to proposals to legalize cocaine and opiates. Images p307-a p309-a PMID:8296962

Unit support protects against sexual harassment and assault among national guard soldiers.

PubMed

Walsh, Kate; Galea, Sandro; Cerda, Magdalena; Richards, Catherine; Liberzon, Israel; Tamburrino, Marijo B; Calabrese, Joseph; Koenen, Karestan C

2014-01-01

Despite concerns about increased sexual harassment and assault after the 2013 legislation repealing the ban on women in combat, little research has examined military factors that could prevent sexual harassment and assault during deployment. This study examined whether unit support, which reflects the quality of service members' relationships within their unit, protects against sexual harassment and assault during deployment. Participants were 1,674 Ohio Army National Guard service members who reported at least one deployment during a telephone survey conducted in 2008 and 2009. Participants completed measures of sexual harassment/assault, unit support, and psychosocial support. Logistic regression was used to model odds of sexual harassment/assault. Approximately 13.2% of men (n = 198) and 43.5% of women (n = 74) reported sexual harassment, and 1.1% of men (n = 17) and 18.8% of women (n = 32) reported sexual assault during their most recent deployment. Greater unit support was associated with decreased odds of sexual harassment and assault. A substantial proportion of men and women reported sexual harassment/assault. Greater unit support was associated with diminished odds of sexual harassment/assault during deployment. Programming designed to improve unit cohesion has the potential to reduce sexual harassment and assault. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Resonance coupling in plasmonic nanomatryoshka homo- and heterodimers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ahmadivand, Arash, E-mail: aahma011@fiu.edu; Sinha, Raju; Pala, Nezih

Here, we examine the electromagnetic (EM) energy coupling and hybridization of plasmon resonances between closely spaced concentric nanoshells known as “nanomatryoshka” (NM) units in symmetric and antisymmetric compositions using the Finite Difference Time Domain (FDTD) analysis. Utilizing plasmon hybridization model, we calculated the energy level diagrams and verified that, in the symmetric dimer (in-phase mode in a homodimer), plasmonic bonding modes are dominant and tunable within the considered bandwidth. In contrast, in the antisymmetric dimer (out-of-phase mode in a heterodimer), due to the lack of the geometrical symmetry, new antibonding modes appear in the extinction profile, and this condition givesmore » rise to repeal of dipolar field coupling. We also studied the extinction spectra and positions of the antibonding and bonding modes excited due to the energy coupling between silver and gold NM units in a heterodimer structure. Our analysis suggest abnormal shifts in the higher energy modes. We propose a method to analyze the behavior of multilayer concentric nanoshell particles in an antisymmetric orientation employing full dielectric function calculations and the Drude model based on interband transitions in metallic components. This study provides a method to predict the behavior of the higher energy plasmon resonant modes in entirely antisymmetric structures such as compositional heterodimers.« less

Amendments to Summary Plan Description regulations. Pension and Welfare Benefits Administration, Labor. Final rule.

PubMed

2000-11-21

This document contains a final rule amending the regulations governing the content of the Summary Plan Description (SPD) required to be furnished to employee benefit plan participants and beneficiaries under the Employee Retirement Income Security Act of 1974, as amended (ERISA). These amendments implement information disclosure recommendations of the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry, as set forth in their November 20, 1997, report, "Consumer Bill of Rights and Responsibilities." Specifically, the amendments clarify benefit, medical provider, and other information required to be disclosed in, or as part of, the SPD of a group health plan and repeal the limited exemption with respect to SPDs of welfare plans providing benefits through qualified health maintenance organizations (HMOs). In addition, this document contains several amendments updating and clarifying provisions relating to the content of SPDs that affect both pension and welfare benefit plans. This document also adopts in final form certain regulations that were effective on an interim basis implementing amendments to ERISA enacted as part of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). This final rule will affect employee pension and welfare benefit plans, including group health plans, as well as administrators, fiduciaries, participants and beneficiaries of such plans.

Science, politics, and the regulation of dietary supplements: it's time to repeal DSHEA.

PubMed

Cohen, Peter J

2005-01-01

Since the turn of the century, resourceful entrepreneurs have advertised a wide variety of purportedly simple and painless cures for cancer, including liniments of turpentine, mustard, oil, eggs, and ammonia; peat moss; arrangements of colored floodlamps; pastes made from glycerine and limburger cheese . . . [T]his historical experience does suggest why Congress could reasonably have determined to protect the terminally ill, no less than other patients, from the vast range of self-styled panaceas that inventive minds can devise. [Individuals have] the right to be treated by a health care practitioner with any medical treatment (including a treatment that is not approved, certified, or licensed by the Secretary of Health and Human Services) that such individual desires or the legal representative of such individual desires. The makers of our Constitution undertook to secure conditions favorable to the pursuit of happiness. They recognized the significance of man's spiritual nature, of his feelings and of his intellect. They knew that only a part of the pain, pleasure and satisfactions of life are to be found in material things. They sought to protect Americans in their beliefs, their thoughts, their emotions and their sensations. They conferred, as against the Government, the right to be left alone--the most comprehensive of rights and the right most valued by civilized men.

Mental capacity and mental health acts part 4: a new framework.

PubMed

Griffith, Richard

The increasingly complex interface between the Mental Health Act 1983 and the Mental Capacity Act 2005 has been discussed in this column over the last three months. The boundaries between the two statutes is becoming increasingly blurred with the Court of Protection, a specialist court that considers cases about people lacking decision-making capacity, commonly being asked to make decisions on mental health law as well. Northern Ireland is proposing to resolve the interface problem by repealing its mental health laws and replacing them with a single statutory framework for mental capacity law. If passed, it will give all adults with capacity the right to consent to or refuse any form of treatment. Physical and mental conditions will be on an equal footing and there would be no compulsory detention or treatment of adults with capacity. For those whose lack capacity, treatment will be available in their best interests with arrangements in place to authorise situations where the care arrangements amount to a deprivation of liberty. In this article Richard Griffith considers the new proposals for Northern Ireland and wonders where these proposals point the way for the other devolved nations to develop their mental health and mental capacity law for a 21st century Britain.

The undue burden of paying for abortion: An exploration of abortion fund cases.

PubMed

Ely, Gretchen E; Hales, Travis; Jackson, D Lynn; Maguin, Eugene; Hamilton, Greer

2017-02-01

The results of a secondary data analysis of 3,999 administrative cases from a national abortion fund, representing patients who received pledges for financial assistance to pay for an abortion from 2010 to 2015, are presented. Case data from the fund's national call center was analyzed to assess the impact of the fund and examine sample demographics which were compared to the demographics of national abortion patients. Procedure costs, patient resources, funding pledges, additional aid, and changes over time in financial pledges for second-trimester procedures were also examined. Results indicate that the fund sample differed from national abortion patients in that fund patients were primarily single, African American, and seeking funding for second trimester abortions. Patients were also seeking to fund expensive procedures, costing an average of over $2,000; patients were receiving over $1,000 per case in pledges and other aid; and funding pledges for second trimester procedures were increasing over time. Abortion funding assistance is essential for women who are not able to afford abortion costs, and it is particularly beneficial for patients of color and those who are younger and single. Repeal of policy banning public funding of abortion would help to eliminate financial barriers that impede abortion access.

A "Cap" on Medicaid: How Block Grants, Per Capita Caps, and Capped Allotments Might Fundamentally Change the Safety Net.

PubMed

Mager-Mardeusz, Haleigh; Lenz, Cosima; Kominski, Gerald F

2017-04-01

Changing the Medicaid program is a top priority for the Republican party. Common themes from GOP proposals include converting Medicaid from a jointly financed entitlement benefit to a form of capped federal financing. While proponents of this reform argue that it would provide greater flexibility and a more predictable budget for state governments, serious consequences would likely result for Medicaid enrollees and state governments. Under all three scenarios promoted by Republicans--block grants, capped allotments, and per capita caps—most states would face increased costs. For all three scenarios, the capped nature of the funding guarantees that the real value of funds would decrease in future years relative to what would be expected from growth under the current program. Although the federal government would undoubtedly realize savings from all three scenarios, the impact might lead states to reduce benefits and services, create waiting lists, impose cost-sharing on a traditionally low-income enrollee population, or impose other obstacles to coverage. Nationally, as many as 20.5 million Americans stand to lose coverage under the proposed Medicaid changes. In California, up to 6 million people could lose coverage if changes to the Medicaid program were coupled with the repeal of coverage for the expansion population.

[Financial and economic sustainability of public spending on health care by local governments: an analysis of data from municipalities in Mato Grosso State, Brazil].

PubMed

Scatena, João Henrique Gurtler; Viana, Ana Luiza d'Avila; Tanaka, Oswaldo Yoshimi

2009-11-01

Brazil's Unified National Health System is financed according to a model known as fiscal federalism, the fund-sharing rules of the Social Security Budget, Ministry of Health norms, and Constitutional Amendment 29 (EC-29), which links Federal, State, and municipal resources to health. This article discusses the sustainability of public spending on health at the municipal level. Twenty-one municipalities were studied, using municipal budget data. From 1996 to 2006, total current per capita revenues increased by 280% above the accumulated inflation and Gross Domestic Product, varying by size of municipality, which also defined the composition of the municipal budgets. Meanwhile, the budget comprising the basis for EC-29 increased less (178%), thus placing limits on the municipal share of health spending. The results observed in these municipalities are believed to reflect the reality in thousands of other Brazilian municipalities, thus jeopardizing the capacity for municipal investment in health, especially beginning in 2008. The situation may become even worse, considering the repeal of the so-called Bank Transaction Tax (CPMF), Bills of Law 306/08 and 233/08 (currently under review in the National Congress), and the world recession stemming from the U.S. financial crisis.

If I were in charge of electric industry restructuring and regulatory reform: A grim fairy tale

DOE Office of Scientific and Technical Information (OSTI.GOV)

Burns, R.E.

1995-12-31

Imagine for a few minutes what it would be like to be made emperor or empress over the current debate on electric industry restructuring. You could cloak yourself with a robe of authority and issue decrees that would be followed. However, a wise ruler would use his or her powers with a light-hand to fashion and move the debate forward. The following shows what I would do if I were emperor {hor_ellipsis}if I were in charge of the electric industry restructuring and regulatory reform. The recommended decrees include: (1) immediate cessation of the debate over retail competition, (2) recognition ofmore » the regulatory authority needed in this period, (3) coordination of federal-state actions to achieve a common goal, (4) abandonment of fuel adjustment clauses, rate base, and rate-of-return regulation for the gnerating sector, (5) FERC will recognize that state commissions are not bound by the Sierra-Mobile doctrine, (6) efficiencies achieved from performance-based regulations may be credited against stranded costs, (7) the debate over standed benefits will cease, (8) state commissions will reward utilities for engaging in cost-effective emission reduction, (9) the repeal of PURPA and PUHCA will go forward, and (10) an end to the poolco-bilateral contract debate.« less

The role played by stakeholders in the public debate that brought Italy out of the club of nuclear energy producers.

PubMed

Cantone, Marie Claire; Sturloni, Giancarlo; Brunelli, Giancarlo

2007-10-01

In 1964, Italy was the fourth largest world producer of electricity generated by nuclear reactors, second in Europe only to United Kingdom. In subsequent years, various controversial political events contributed towards drastically slowing down the development of the Italian national nuclear program. The 1986 Chernobyl Nuclear Power Plant accident, which caused a public outcry all over Europe, had particularly serious repercussions in Italy. In a controversial referendum, held in November 1987, Italian citizens voted to repeal three laws promoting the installation of nuclear power plants (NPP) on Italian soil and allowing the National Institute for Electrical Energy (ENEL) to participate in the construction of NPP's abroad. This work analyzes the reasons for that decision and the communication strategies of the stakeholders that took part in the public debate on nuclear energy during the weeks following the Chernobyl accident. Drawing from the methodologies used in media studies, a quantitative and qualitative analysis of two leading Italian newspapers was performed. The results reveal that a variety of stakeholders, upholding different values and interests, took part in the debate. There being no tradition of a public dialogue and participation in Italy, the debate was polarized to a "yes/no choice," which eventually caused Italy to abandon the production of nuclear power for civilian use.

The impact of the EU general data protection regulation on scientific research.

PubMed

Chassang, Gauthier

2017-01-01

The use of personal data is critical to ensure quality and reliability in scientific research. The new Regulation [European Union (EU)] 2016/679 of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data [general data protection regulation (GDPR)], repealing Directive 95/46/EC, strengthens and harmonises the rules for protecting individuals' privacy rights and freedoms within and, under certain conditions, outside the EU territory. This new and historic legal milestone both prolongs and updates the EU acquis of the previous Data Protection Directive 95/46/EC. The GDPR fixes both general rules applying to any kind of personal data processing and specific rules applying to the processing of special categories of personal data such as health data taking place in the context of scientific research, this including clinical and translational research areas. This article aims to provide an overview of the new rules to consider where scientific projects include the processing of personal health data, genetic data or biometric data and other kinds of sensitive information whose use is strictly regulated by the GDPR in order to give the main key facts to researchers to adapt their practices and ensure compliance to the EU law to be enforced in May 2018.

Unbundling of electric power and energy services

DOE Office of Scientific and Technical Information (OSTI.GOV)

Keith, D.M.; Lewis, B.R.

1996-12-31

The world-wide movement to restructure the electric and power and energy industry is now well underway in the United States. The most recent thrust came this year, with the Federal Energy Regulatory Commission`s (FERC`s) issuance on April 24th of new regulations designed to open the interconnected transmission grid to all qualified wholesale users. Other movements have been in the many forms of earlier statutes and regulations promulgated in 1978 to make more efficient use of fuels burned; utility diversification efforts; utility creation of affiliate and subsidiary organizations and operations; introduction into the market of private non-utility power developers; utilities obtainingmore » clearance from the Securities and Exchange Commission (SEC) to venture in international markets; massive mergers and acquisitions; bankruptcies; the entry into the market of nonutility power marketers and brokers, including entities from the gas and securities industries not previously involved in the electric power and energy industry; additional congressional consideration of outright repeal of Holding Company legislation dating back to 1935; some states entering into an era of abandoning the control past in favor of complete re-regulation of the industry on the basis of performance; the coming of Independent System Operators (ISO`s), Regional Transmission Groups (RTG`s), and the possible coming of Capacity Reservation Tariffs (CRT`s), to name a few.« less

Prevalence of Military Sexual Trauma and Sexual Orientation Discrimination Among Lesbian, Gay, Bisexual, and Transgender Military Personnel: a Descriptive Study.

PubMed

Gurung, Sitaji; Ventuneac, Ana; Rendina, H Jonathon; Savarese, Elizabeth; Grov, Christian; Parsons, Jeffrey T

2018-03-01

Despite the repeal of Don't Ask, Don't Tell, Don't Pursue (DADT) and the update to the Transgender Policy, there remain concerns about the persistence of military sexual trauma (MST) and sexual orientation discrimination against lesbian, gay, bisexual, and transgender (LGBT) service members. A sample of 253 participants (89 women, 164 men) completed an Internet-based survey that assessed the prevalence of sexual orientation discrimination (e.g., offensive speech, physical or discriminatory behaviors) and MST (e.g., sexual harassment and sexual assault). The survey was conducted between April 2012 and October 2013. Women and men reported similar levels of sexual orientation discrimination in the military. Participants reported experiencing more threats and intimation, vandalism, and physical assault outside of the military than inside the military ( p < 0.05). Although the prevalence of MST (both sexual harassment and sexual assault) in the military was high among both genders, women were more likely to report experiences of sexual harassment compared to men ( p < 0.05). Our findings demonstrate the prevalence of MST and sexual orientation discrimination among LGBT service members in the military and point to the need for strong accountability and oversight to protect sexual minority persons while they are serving their country.

Contrary to cost-shift theory, lower Medicare hospital payment rates for inpatient care lead to lower private payment rates.

PubMed

White, Chapin

2013-05-01

Many policy makers believe that when Medicare constrains its payment rates for hospital inpatient care, private insurers end up paying higher rates as a result. I tested this "cost-shifting" theory using a unique new data set that combines MarketScan private claims data with Medicare hospital cost reports. Contrary to the theory, I found that hospital markets with relatively slow growth in Medicare inpatient hospital payment rates also had relatively slow growth in private hospital payment rates during 1995-2009. Using regression analyses, I found that a 10 percent reduction in Medicare payment rates led to an estimated reduction in private payment rates of 3 percent or 8 percent, depending on the statistical model used. These payment rate spillovers may reflect an effort by hospitals to rein in their operating costs in the face of lower Medicare payment rates. Alternatively, hospitals facing cuts in Medicare payment rates may also cut the payment rates they seek from private payers to attract more privately insured patients. My findings indicate that repealing cuts in Medicare payment rates would not slow the growth in spending on hospital care by private insurers and would in fact be likely to accelerate the growth in private insurers' costs and premiums.

The impact of the EU general data protection regulation on scientific research

PubMed Central

Chassang, Gauthier

2017-01-01

The use of personal data is critical to ensure quality and reliability in scientific research. The new Regulation [European Union (EU)] 2016/679 of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data [general data protection regulation (GDPR)], repealing Directive 95/46/EC, strengthens and harmonises the rules for protecting individuals’ privacy rights and freedoms within and, under certain conditions, outside the EU territory. This new and historic legal milestone both prolongs and updates the EU acquis of the previous Data Protection Directive 95/46/EC. The GDPR fixes both general rules applying to any kind of personal data processing and specific rules applying to the processing of special categories of personal data such as health data taking place in the context of scientific research, this including clinical and translational research areas. This article aims to provide an overview of the new rules to consider where scientific projects include the processing of personal health data, genetic data or biometric data and other kinds of sensitive information whose use is strictly regulated by the GDPR in order to give the main key facts to researchers to adapt their practices and ensure compliance to the EU law to be enforced in May 2018. PMID:28144283

Liking Health Reform But Turned Off By Toxic Politics.

PubMed

Jacobs, Lawrence R; Mettler, Suzanne

2016-05-01

Six years after the Affordable Care Act (ACA) became law, the number of nonelderly Americans with health insurance has expanded by twenty million, and the uninsurance rate has declined nearly 9 percentage points. Nevertheless, public opinion about the law remains deeply divided. We investigated how individuals may be experiencing and responding to health reform implementation by analyzing three waves of a panel study we conducted in 2010, 2012, and 2014. While public opinion about the ACA remains split (45.6 percent unfavorable and 36.2 percent favorable), there have been several detectable shifts. The share of respondents believing that reform had little or no impact on access to health insurance or medical care diminished by 18 percentage points from 2010 to 2014, while those considering reform to have some or a great impact increased by 19 percentage points. Among individuals who held unfavorable views toward the law in 2010, the percentage who supported repeal-while still high, at 72 percent-shrank by 9 percentage points from 2010 to 2014. We found that party affiliation and distrust in government were influential factors in explaining the continuing divide over the law. The ACA has delivered discernible benefits, and some Americans are increasingly recognizing that it is improving access to health insurance and medical care. Project HOPE—The People-to-People Health Foundation, Inc.

Brownfields redevelopment: A reality?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rosenberg, D.M.

There have been numerous attempts to reform the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA), also known as Superfund, since its inception. The act originally promulgated $1.6 billion in funding to provide for the rapid cleanup of those sites designated as the most dangerous and placed on the National Priorities List (NPL). In 1986, Congress increased the amount of the Superfund to $8.5 billion and added another $5.1 billion in 1990. Overall, it is estimated that the total amount of money spent on the Superfund program is between 25 and 30 billion dollars. While current Superfund reform continues tomore » unfold, Congress has promised to provide a more sensible approach to environmental cleanup, including the possible repeal of retroactive, strict and joint and several liability up to a fixed point in time. One thing is for certain, there is increased recognition that, despite good intentions, the federal Superfund law has been a dismal failure and a major deterrent to the redevelopment of industrial urban areas and contaminated properties. In need of a fix and with an obsessive desire to remove the stigma long associated with the Superfund program, the EPA will hang its hat on the Brownfields Initiative. This initiative is intended to demonstrate ways to return contaminated, unproductive, abandoned urban sites to productive use and ensure that future development is accomplished in a sustainable, environmentally sound manager.« less

The Neurobiology of Alcohol Consumption and Alcoholism: An Integrative History1

PubMed Central

Tabakoff, Boris; Hoffman, Paula L.

2013-01-01

Studies of the neurobiological predisposition to consume alcohol (ethanol) and to transition to uncontrolled drinking behavior (alcoholism), as well as studies of the effects of alcohol on brain function, started a logarithmic growth phase after the repeal of the 18th Amendment to the United States Constitution. Although the early studies were primitive by current technological standards, they clearly demonstrated the effects of alcohol on brain structure and function, and by the end of the 20th century left little doubt that alcoholism is a “disease” of the brain. This review traces the history of developments in the understanding of ethanol’s effects on the most prominent inhibitory and excitatory systems of brain (GABA and glutamate neurotransmission). This neurobiological information is integrated with knowledge of ethanol’s actions on other neurotransmitter systems to produce an anatomical and functional map of ethanol’s properties. Our intent is limited in scope, but is meant to provide context and integration of the actions of ethanol on the major neurobiologic systems which produce reinforcement for alcohol consumption and changes in brain chemistry that lead to addiction. The developmental history of neurobehavioral theories of the transition from alcohol drinking to alcohol addiction is presented and juxtaposed to the neurobiological findings. Depending on one’s point of view, we may, at this point in history, know more, or less, than we think we know about the neurobiology of alcoholism. PMID:24141171

Maintaining Continuity of Care for Nursing Home Residents: Effect of States’ Medicaid Bed-Hold Policies and Reimbursement Rates

PubMed Central

Intrator, Orna; Schleinitz, Mark; Grabowski, David C; Zinn, Jacqueline; Mor, Vincent

2009-01-01

Objective Recent public concern in response to states’ intended repeal of Medicaid bed-hold policies and report of their association with higher hospitalization rates prompts examination of these policies in ensuring continuity of care within the broader context of Medicaid policies. Data Sources/Study Design Minimum Data Set assessments of long-stay nursing home residents in April–June 2000 linked to Medicare claims enabled tracking residents’ hospitalizations during the ensuing 5 months and determining hospital discharge destination. Multinomial multilevel models estimated the effect of state policies on discharge destination controlling for resident, hospitalization, nursing home, and market characteristics. Results Among 77,955 hospitalizations, 5,797 (7.4 percent) were not discharged back to the baseline nursing home. Bed-hold policies were associated with lower odds of transfer to another nursing home (AOR=0.55, 95 percent CI 0.52–0.58) and higher odds of hospitalization (AOR=1.36), translating to 9.5 fewer nursing home transfers and 77.9 more hospitalizations per 1,000 residents annually, and costing Medicaid programs about $201,311. Higher Medicaid reimbursement rates were associated with lower odds of transfer. Conclusions Bed-hold policies were associated with greater continuity of NH care; however, their high cost compared with their small impact on transfer but large impact on increased hospitalizations suggests that they may not be effective. PMID:18783452

Superfund Reform 1995. Principles for a new Superfund program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bresnick, W.

1995-11-01

Superfund Reform `95 is a broad coalition of small and large businesses and local governments. Superfund Reform `95 believes now is the time for a new law to be drafted based on the principles and programmatic elements described below. Superfund Reform `95 believes that the program they are proposing will generate efficiencies and cost savings that will permit it to be implemented without the need to increase the total amount of taxes currently being levied to support the Superfund. The current federal Superfund program is badly broken and in need of major restructuring. The existing Superfund program must be replacedmore » by a new program in which the benefits justify its cost and which is equitable, cost-effective, and limited in size and scope so that it is targeted to address real, current, and significant risks to human health and environment posed by the past disposal of hazardous substances. The size of the federal National Priorities List (NPL) should be capped so that the remedial response program is phased out over time. Retroactive liability should be repealed and the remedy selection process significantly reformed. States should be given the opportunity to be delegated implementation of the reformed federal Superfund program at NPL sites as well as provided with incentives to implement their own similarly reformed programs in a fair and cost-effective manner.« less

Disparities in Insurance Coverage, Health Services Use, and Access Following Implementation of the Affordable Care Act: A Comparison of Disabled and Nondisabled Working-Age Adults.

PubMed

Kennedy, Jae; Wood, Elizabeth Geneva; Frieden, Lex

2017-01-01

The objective of this study was to assess trends in health insurance coverage, health service utilization, and health care access among working-age adults with and without disabilities before and after full implementation of the Affordable Care Act (ACA), and to identify current disability-based disparities following full implementation of the ACA. The ACA was expected to have a disproportionate impact on working-age adults with disabilities, because of their high health care usage as well as their previously limited insurance options. However, most published research on this population does not systematically look at effects before and after full implementation of the ACA. As the US Congress considers new health policy reforms, current and accurate data on this vulnerable population are essential. Weighted estimates, trend analyses and analytic models were conducted using the 1998-2016 National Health Interview Surveys (NHIS) and the 2014 Medical Expenditure Panel Survey. Compared with working-age adults without disabilities, those with disabilities are less likely to work, more likely to earn below the federal poverty level, and more likely to use public insurance. Average health costs for this population are 3 to 7 times higher, and access problems are far more common. Repeal of key features of the ACA, like Medicaid expansion and marketplace subsidies, would likely diminish health care access for working-age adults with disabilities.

Restaurant volatility and the Iowa City, Iowa, smoke-free restaurant ordinance.

PubMed

Sheffer, Megan A; Squier, Christopher A; Gilmore, Gary D

2013-01-01

To determine the economic impact of the Iowa City, Iowa, smoke-free restaurant ordinance (IC-SFRO) using an immediate and novel approach. In this retrospective study, food permit licensure served as the measure to assess the IC-SFRO impact. The Iowa City experience provided an excellent experimental setting, as the ordinance was enacted March 1, 2002, and repealed May 7, 2003, because of preemption. The city of Coralville served as a natural control, as it is contiguous to Iowa City, has similar population demographics, and has never enacted a smoke-free restaurant ordinance. Food permit licensure data for all Iowa City and Coralville restaurants were obtained from the Johnson County Health Department. Differences in restaurant volatility were assessed using Fisher's exact probability test. The number of restaurants increased in both Iowa City and Coralville throughout the ordinance period. The ratio of the total number of restaurants in Iowa City to the total number of restaurants in the Iowa City-Coralville metropolitan area remained stable. The proportion of restaurants for each city did not differ significantly during the preordinance, ordinance, and postordinance periods. The IC-SFRO did not adversely impact the restaurant industry in terms of restaurant closures. The Iowa legislature was urged to draft evidence-based legislation, such as amending preemption of the IC-SFRO, to protect and promote the health of its communities.

More than a virus: a qualitative study of the social implications of hepatitis B infection in China.

PubMed

Wallace, J; Pitts, M; Liu, C; Lin, V; Hajarizadeh, B; Richmond, J; Locarnini, S

2017-08-01

China has the largest absolute number of people living with hepatitis B with up to 300,000 people estimated to die each year from hepatitis B related diseases. Despite advances in immunisation, clinical management, and health policy, there is still a lack of accessible and affordable health care for people with hepatitis B. Through in-depth interviews, this study identifies the personal, social and economic impact of living with hepatitis B and considers the role of stigma and discrimination as barriers to effective clinical management of the disease. Semi-structured qualitative interviews were held with 41 people living with hepatitis B in five Chinese cities. Participants were recruited through clinical and non-government organisations providing services to people with hepatitis B, with most (n = 32) being under the age of 35 years. People living with hepatitis B experience the disease as a transformative intergenerational chronic infection with multiple personal and social impacts. These include education and employment choices, economic opportunities, and the development of intimate relationships. While regulations reducing access to employment and education for people with hepatitis B have been repealed, stigma and discrimination continue to marginalise people with hepatitis B. Effective public policy to reduce morbidity and mortality associated with hepatitis B needs to address the lived impact of hepatitis B on families, employment and educational choices, finances, and social marginalisation.

U.S. pharmaceutical policy in a global marketplace

PubMed Central

Lakdawalla, Darius; Goldman, Dana P.; Michaud, Pierre-Carl; Sood, Neeraj; Lempert, Robert; Cong, Ze; de Vries, Han; Gutierrez, Italo

2013-01-01

Markets for innovative goods involve significant spillovers in a global economy. When US consumers pay higher prices for drugs, this stimulates innovation that benefits consumers all over the world. Conversely, when large European markets restrict prices and profits, foreign consumers bear some of the long-run cost in the form of less innovation. The result is a free-riding problem at a global level. These incentives are particularly strong for smaller markets, whose policies have relatively little impact on global innovation, but can have relatively large impacts on national pharmaceutical budgets. The result is a system in which the largest countries bear disproportionate burdens for stimulating innovation. Using a microsimulation approach, we estimate the impact of these incentive effects. The model’s baseline estimates demonstrates that the US adoption of European-style price controls would harm consumers in the US and Europe; over a 50-year period, it would cost $8 trillion in the US, and $5 trillion in Europe. Similarly, repealing European price controls would add $10 trillion to the wealth of US society, and $6 trillion to wealth in Europe. Even under the most conservative assumptions, adopting price controls generates at best a small benefit, but risks a large cost. On the other hand, reducing pharmaceutical copayments would increase wealth in both societies, a result which is robust to a wide variety of parameter values. PMID:19088101

Resister's logic: the anti-vaccination arguments of Alfred Russel Wallace and their role in the debates over compulsory vaccination in England, 1870-1907.

PubMed

Fichman, Martin; Keelan, Jennifer E

2007-09-01

In the 1880s, Alfred Russel Wallace, the celebrated co-discoverer of natural selection, launched himself into the centre of a politicised and polarised debate over the unpopular compulsory vaccination laws in England. Wallace never wavered in his belief that smallpox vaccination was useless and likely dangerous. Six years before his death, the anti-vaccinationists successfully secured a conscience clause that effectively dismantled the compulsory vaccination laws. Several other important Victorian scientists joined Wallace in the fight to repeal compulsory vaccination arguing that widely held views on the effectiveness of vaccination and evidence for immunity were inconclusive in the light of (then) contemporary standards of evidence. This article situates Wallace's anti-vaccination logic within the broader matrix of sociopolitical and cultural reform movements of the late Victorian era. Additionally it provides the first detailed analysis of his critique of vaccination science, in particular the role statistics played in his arguments. In this period, both pro-vaccinationists and anti-vaccinationists invested great efforts in collating and analysing statistical data sets that either supported or refuted the claims of vaccination's effectiveness. While each side presented 'controlled' case studies to support their assertions, without an unambiguous test to measure or demonstrate vaccination's effectiveness, the anti-vaccinationists continued to mount credible statistical critiques of vaccination science.

The Workforce Task Force report: clinical implications for neurology.

PubMed

Freeman, William D; Vatz, Kenneth A; Griggs, Robert C; Pedley, Timothy

2013-07-30

The American Academy of Neurology Workforce Task Force (WFTF) report predicts a future shortfall of neurologists in the United States. The WFTF data also suggest that for most states, the current demand for neurologist services already exceeds the supply, and by 2025 the demand for neurologists will be even higher. This future demand is fueled by the aging of the US population, the higher health care utilization rates of neurologic services, and by a greater number of patients gaining access to the health care system due to the Patient Protection and Affordable Care Act. Uncertainties in health care delivery and patient access exist due to looming concerns about further Medicare reimbursement cuts. This uncertainty is set against a backdrop of Congressional volatility on a variety of issues, including the repeal of the sustainable growth rate for physician reimbursement. The impact of these US health care changes on the neurology workforce, future increasing demands, reimbursement, and alternative health care delivery models including accountable care organizations, nonphysician providers such as nurse practitioners and physician assistants, and teleneurology for both stroke and general neurology are discussed. The data lead to the conclusion that neurologists will need to play an even larger role in caring for the aging US population by 2025. We propose solutions to increase the availability of neurologic services in the future and provide other ways of meeting the anticipated increased demand for neurologic care.

The Workforce Task Force Report

PubMed Central

Vatz, Kenneth A.; Griggs, Robert C.; Pedley, Timothy

2013-01-01

The American Academy of Neurology Workforce Task Force (WFTF) report predicts a future shortfall of neurologists in the United States. The WFTF data also suggest that for most states, the current demand for neurologist services already exceeds the supply, and by 2025 the demand for neurologists will be even higher. This future demand is fueled by the aging of the US population, the higher health care utilization rates of neurologic services, and by a greater number of patients gaining access to the health care system due to the Patient Protection and Affordable Care Act. Uncertainties in health care delivery and patient access exist due to looming concerns about further Medicare reimbursement cuts. This uncertainty is set against a backdrop of Congressional volatility on a variety of issues, including the repeal of the sustainable growth rate for physician reimbursement. The impact of these US health care changes on the neurology workforce, future increasing demands, reimbursement, and alternative health care delivery models including accountable care organizations, nonphysician providers such as nurse practitioners and physician assistants, and teleneurology for both stroke and general neurology are discussed. The data lead to the conclusion that neurologists will need to play an even larger role in caring for the aging US population by 2025. We propose solutions to increase the availability of neurologic services in the future and provide other ways of meeting the anticipated increased demand for neurologic care. PMID:23783750

Globalization, pharmaceutical pricing, and South African health policy: managing confrontation with U.S. firms and politicians.

PubMed

Bond, P

1999-01-01

Brewing since the advent of South African democracy in 1994 and promises of health sector transformation, an extraordinary drug war between President Nelson Mandela's African National Congress government and U.S. pharmaceutical manufacturers took on global proportions in 1998-1999. Within months of the passage of South African legislation aimed at lowering drug prices, the U.S. government quickly applied powerful pressure points to repeal a clause allowing potential importation of generic substitutes and imposition of compulsory licensing. At stake were not only local interpretations of patent law and World Trade Organization rules on Trade in Intellectual Property, but international power relations between developing countries and the pharmaceutical industry. In reviewing the ongoing debate, this article considers post-apartheid public health policy, U.S. government pressure to change the law, and pharmaceutical industry interests and links to the U.S. government, and evaluates various kinds of resistance to U.S. corporate and government behavior. The case thus raises--not for the first time--concerns about contemporary imperialism ("globalization"), the role of the profit motive as an incentive in vital pharmaceutical products, and indeed the depth of "democracy" in a country where high-bidding international drug firms have sufficient clout to embarrass Vice President Al Gore by pitting him against the life-and-death interests of millions of consumers of essential drugs in South Africa and other developing countries.

Howard Wilcox Haggard and the Institutionalization of Modern Alcohol Studies.

PubMed

Allred, Nicholas; Bejarano, William; Ward, Judit

2017-03-01

This biographical sketch and accompanying bibliography provide a new look at Howard Wilcox Haggard, M.D., Ph.D., whose career highlights the consolidation of alcohol studies as a field in twentieth-century America. The article relies in large part on the works of Haggard assembled for the bibliography project, supplemented by published and unpublished documents and records from collections at Rutgers University. Haggard began his career in respiratory physiology, influenced by his work on chemical weapons for the Army during the First World War. As his reputation grew, he moved into anesthesiology and supplemented his research with textbooks and popular science bestsellers. Haggard moved into the burgeoning field of alcohol studies after the repeal of National Prohibition and, in 1940, became the inaugural editor and president of the corporation of the Quarterly Journal of Studies on Alcohol, now the Journal of Studies on Alcohol and Drugs. Under the aegis of the Yale Laboratory for Applied Physiology, he also assembled and oversaw what would become the Center of Alcohol Studies. Haggard died in 1959, his legacy established as a central figure in the 20th-century transformation of alcohol studies in the United States. A prolific researcher with a talent for tapping into the public zeitgeist, Haggard helped provide the institutional infrastructure, academic credibility, and broad audience that made the renaissance of alcohol studies in post-Prohibition America possible.

Federal funding for syringe exchange in the US: Explaining a long-term policy failure.

PubMed

Showalter, David

2018-05-01

The United States prohibited federal funding for syringe exchange programs for people who inject drugs nearly continuously from 1988 to 2015, despite growing scientific evidence, diminishing AIDS-related controversy, and tens of thousands of deaths from injection-related AIDS. This study investigates the political and institutional bases of this long-term failure to support lifesaving public policy. This study draws on national, regional, and local media coverage, archival sources, and semi-structured, in-depth interviews with 6 long-time syringe exchange researchers and activists from California. I use case-oriented process tracing methods to explain the persistence and reform of the federal funding ban. Though previous studies focus on the symbolic clash between conservative morality and empirical science, I find that changing demographic and regional inequalities in the effects of the AIDS epidemic and dynamics produced by the federal structure of US government were more important factors in the creation and persistence of the funding ban. The persistence and eventual repeal of the ban on federal funding for syringe exchange was a product of the changing demographic, geographic, and political effects of the AIDS epidemic within the federal structure of US government, rather than a consequence of intractable morality politics. These contextual dynamics continue to shape AIDS and public health policy at all levels of government. Copyright © 2018. Published by Elsevier B.V.

Are gay and lesbian people fading into the history of bioethics?

PubMed

Murphy, Timothy F

2014-09-01

In many ways, we live in propitious times for gay and lesbian people. In 1996, the Supreme Court struck down Colorado law prohibiting any kind of protected status based on sexual orientation. In 2003, the Supreme Court held that states may not criminalize sexual conduct between consenting adults of the same sex in private, so long as no money changes hands. In 2010, the Congress repealed the "Don't Ask, Don't Tell" policy that excluded openly gay men and lesbians from military service. In 2013, the Supreme Court struck down key elements of the Defense of Marriage Act that prohibited any federal recognition of same-sex marriage. Most states do not allow same-sex marriage, but more and more states are joining the fold. Likewise, most U.S. states do not forbid discrimination based on sexual orientation, but the number that does is increasing. Arguably, no other social minority has made as much legal progress in so short a time. Despite these advances, the story of gay and lesbian people and the law is not yet finished, and the meaning of homosexuality for bioethics is still being written too. Concerns about gay and lesbian people remain important to bioethics in key domains, especially in seeing to the conferral of optimal health care benefits and in sorting through the priorities and social effects of research. Progress in these domains still involves lifting certain burdens of medical and social misjudgments about same-sex attraction. © 2014 by The Hastings Center.

Circular DH/8 D/87 on maternity or adoption leave for and authorized absences by career and non-career employees of the establishments referred to in Section 2 of Law No. 86-33 of 9 January 1986 laying down regulations applicable to staff in the public service in the hospital sector, 7 October 1987.

PubMed

1988-01-01

This Circular is addressed by the Minister of Social Affairs and Employment of France to the regional and departmental authorities responsible for health and social affairs and repeals various earlier Circulars on the same subject. It describes a group of measures within the framework of government policy, relating to, among other things: reducing pregnancy-related risks by associating the occupational physician with measures to protect pregnant women, in particular, concerning the fitness of a pregnant woman for her occupation; entitling pregnant women to a leave of absence from the date of declaration of pregnancy in the case of pregnancies with pathological evolution; and improving the arrangements for leave of absence for pregnancy and birth which was hitherto conditional on obtaining the favorable opinion of the occupational physician, in particular with regard to according flexible working hours during pregnancy and leave of absence for prenatal examinations. It is also recalled, in connection with leave of absence, that administrations having appropriate facilities for baby-minding must enable the mother to breast feed her infant, allowing her leave of absence for this purpose for one hour per day, to be taken at two times during the day. full text

Disparities in Insurance Coverage, Health Services Use, and Access Following Implementation of the Affordable Care Act: A Comparison of Disabled and Nondisabled Working-Age Adults

PubMed Central

Kennedy, Jae; Wood, Elizabeth Geneva; Frieden, Lex

2017-01-01

The objective of this study was to assess trends in health insurance coverage, health service utilization, and health care access among working-age adults with and without disabilities before and after full implementation of the Affordable Care Act (ACA), and to identify current disability-based disparities following full implementation of the ACA. The ACA was expected to have a disproportionate impact on working-age adults with disabilities, because of their high health care usage as well as their previously limited insurance options. However, most published research on this population does not systematically look at effects before and after full implementation of the ACA. As the US Congress considers new health policy reforms, current and accurate data on this vulnerable population are essential. Weighted estimates, trend analyses and analytic models were conducted using the 1998-2016 National Health Interview Surveys (NHIS) and the 2014 Medical Expenditure Panel Survey. Compared with working-age adults without disabilities, those with disabilities are less likely to work, more likely to earn below the federal poverty level, and more likely to use public insurance. Average health costs for this population are 3 to 7 times higher, and access problems are far more common. Repeal of key features of the ACA, like Medicaid expansion and marketplace subsidies, would likely diminish health care access for working-age adults with disabilities. PMID:29166812

Medical Experts and Agnotology in the Fumes Controversy of the Huelva Copper Mines (1888–1890)

PubMed Central

Guillem-Llobat, Ximo

2017-01-01

Huelva’s copper mines (Spain) have been active for centuries but in the second half of the nineteenth century extractive activities in Riotinto, Tharsis, and other mines in the region were intensified in order to reach world leadership. The method used in these mines for copper extraction from low grade ores generated continuous emissions of fumes that were extremely controversial. The inhabitants had complained about the fumes for decades but as activity intensified so did complaints. The killing of anti-fumes demonstrators in 1888 led to the passing of a Royal Decree banning the open-air roasting of ore and to the drafting of numerous reports on the hazards of the fumes. Major state and provincial medical institutions, as well as renowned hygienists and engineers, took part in the assessment, contributing to a scientific controversy especially rich in content. In my paper I will analyse the production and circulation of knowledge and ignorance about the impact of fumes on public health, as well as the role of medical experts and expertise in the controversy. The analysis will focus on the reports drafted between the 1888 ban and its 1890 repeal, and will show the changing nature of the expert assessment and the numerous paths followed by experts in producing ignorance. The paper will conclude by considering other stakeholders, who may shed some light on the reasons behind the performance of the medical experts. PMID:28604295

Legal Perspectives on Religion in Public School Science Classes

NASA Astrophysics Data System (ADS)

Gunn, Jeremy

2006-03-01

In the 1920s, state legislatures in the United States became involved in enacting laws prohibiting the teaching of evolution in public schools. The famous Tennessee v. John Scopes trial of 1925 was the most famous test case to determine the constitutionality the first phase of the laws. Scopes was convicted of violating one such law and many of these anti-evolution laws continued to be in effect for the next forty years. During the 1950s, for a number of reasons, the teaching of evolution became more common as the anti-evolution laws were either repealed or ignored. In 1968, the Supreme Court in Epperson v. Arkansas ruled that the prohibition of the teaching of evolution was unconstitutional. Since the Epperson decision, there have been several other federal court decisions that have considered the constitutionality of allowing religious theories to be taught in the science curriculum. For all practical purposes, federal courts since 1968 have prohibited the teaching of creationism. The new current battleground is on the issue of intelligent design. The first court decision on intelligent design, from Dover, Pennsylvania, is expected by January 2006. The significance of this decision, and the fallout from it, will be discussed. In many ways, the current controversy over the teaching of intelligent design may be only the tip of a far larger public controversy involving the roles of science, law, politics, and religion. Suggestions will be made as to how the scientific community can contribute to the legal and cultural issues that underlie this debate.

Results of the Utah-Arizona stage-by-stage migrations

USGS Publications Warehouse

Ellis, D.H.; Mellon, C.; Kinloch, M.; Dolbeare, T.; Ossi, D.P.

2001-01-01

In an effort to find a safer means of teaching cranes new migration routes, each year (in 1998 and 1999) we transported a group of greater sandhill cranes (Grus canadensis tabida) stage-by-stage, in a horse trailer, with stops for brief flights at about 30-km intervals, along a 1300-1400-km fall migration route from Fish Springs National Wildlife Refuge (Fish Springs) in west-central Utah to the vicinity of Gila Bend, Arizona. Thereafter, we released them into a wild flock of sandhill cranes. All stage-by-stage birds were hand-reared with both a plastic crane decoy (to encourage them to roost in water) and a costume-draped humanoid form (called a scare-eagle and used for its namesake purpose). When these 2 teaching aids were placed in water, our cranes readily roosted nearby. All but 4 of our cranes proved cooperative (i.e., catchable at each of the ca 25-36 stops) during the migration. All were efficiently released into a wild flock and experienced good survival. The stage-by-stage method proved to be a safe means of transporting cranes south and giving them experience along the route. Some cranes apparently learned their route from the limited experience afforded by releasing them at intervals, and the 1999 cranes have made repealed migrations to or near our chosen northern terminus. However, after 1 winter in our chosen area, the birds have moved elsewhere to winter.

[Focus on planning the supply of physicians in Belgium].

PubMed

Benahmed, N; Alexander, S; De Wever, A; Deliège, D

2013-01-01

The planning of human medical resources has been in progress since 1996. The aim of this paper is to describe the process which occurred in Belgium and to point out its assets and limits. Literature review, analysis of the Belgian legislation at national and community (Flemish and French-speaking) level and analysis of the projection model. In Belgium, planniing is performed at two different levels of power. Firstly, the federal State determines the number of physicians who will access to the professional titles enabling them to obtain reimbursement of care by Health Funds. It is sustained by a supply projection type " stock and flows", an assessment of the number of required physicians (including healthcare expenditures by age and sex) and the purpose of equalizing Dutch-speaking and French-speaking medical densities. Secondly, Communities, are responsible for training and, as such, are organizing the selection at this level : entrance examination in the North and various selection procedures (now repealed) in the South. Worldwide, the managers of medical planning are faced with decisions related to appropriate numbers for human resources, given population needs, use of services and professional productivity. They have to address concerns from medical surplus to shortage. The case study of Belgium provides insight of various parameters which should be taken into account for national planning of physicians. It also shows the difficulty to assess a complex future and the factors which often hinder the implementation of evidence-based decisions.

European experience of regulating distance selling of medicines for Ukraine.

PubMed

Pashkov, Vitalii; Hrekov, Yevhen; Hrekova, Maryna

Some countries have already tried and tested mechanisms of regulating distance sales as form of distribution of medicines that have been used more or less effectively for a fairly long time. Herewith, so far, the approach of the competent authorities of some countries including Ukraine can be called prevailing in quantitative terms under which the official prohibition on distance sales of medicines is set. The aim of this study is a detailed examination of the nature of the prohibition of the medicines distance selling in Ukraine, namely the an analysis of advantages and disadvantages of this form of distribution of medicines and identification of appropriate ways for gradual repeal of the prohibition in terms of regulatory reform in Ukraine in the sphere of circulation of medicines due to the process of adaptation of statutory regulation in this area to the EU legislation. This study is based on Ukrainian regulation acts, Council Directives 97/7/EC, 2000/31/EC, 2001/83/EC, scientific works and opinions of progressiveminded people in this sphere. Such methods as dialectical, comparative, analytic, synthetic and comprehensive have been used in the article. Reception of the described experience of regulation in EU will allow a further review of the principles of regulation in Ukraine in the sphere of medicines with a shift in the main emphasis in the direction of ensuring adequate consumer rights in this area and preventing the risks of patients' and public health.

European Federation of Organisations for Medical Physics (EFOMP) policy statement 12.1: Recommendations on medical physics education and training in Europe 2014.

PubMed

Caruana, C J; Christofides, S; Hartmann, G H

2014-09-01

In 2010, EFOMP issued Policy Statement No. 12: "The present status of Medical Physics Education and Training in Europe. New perspectives and EFOMP recommendations" to be applied to education and training in Medical Physics within the context of the developments in the European Higher Education Area arising from the Bologna Declaration and with a view to facilitate the free movement of Medical Physics professionals within Europe. Concurrently, new recommendations regarding qualifications frameworks were published by the European Parliament and Council which introduced new terminology and a new qualifications framework - the European Qualifications Framework (EQF) for lifelong learning. In addition, a new European directive involving the medical use of ionizing radiations and set to replace previous directives in this area was in the process of development. This has now been realized as Council Directive 2013/59/Euratom of 5 December 2013 which has repealed directive 97/43/Euratom. In this regard, a new document was developed in the context of the EC financed project "European Guidelines on the Medical Physics Expert" and published as RP174. Among other items, these guidelines refer to the mission statement, key activities, qualification framework and curricula for the specialty areas of Medical Physics relating to radiological devices and protection from ionizing radiation. These developments have made necessary an update of PS12; this policy statement provides the necessary update. Copyright © 2014. Published by Elsevier Ltd.

Case closed: research evidence on the positive public health impact of the age 21 minimum legal drinking age in the United States.

PubMed

DeJong, William; Blanchette, Jason

2014-01-01

In 2006, the nonprofit organization Choose Responsibility called for repealing the 1984 National Minimum Drinking Age Act, which had led all 50 states to establish a minimum legal drinking age (MLDA) of 21 years, and allowing the states to lower their MLDA to 18 years. Two years later, the organization assembled a small group of college and university presidents (the Amethyst Initiative) to call publicly for a critical reexamination of the law. Public health and traffic safety experts responded to these efforts by generating new research on the age 21 MLDA, thus warranting an updated review of the literature. This review focuses primarily on research published since 2006, when Choose Responsibility began its public relations campaign to lower the MLDA. Recent research on the age 21 MLDA has reinforced the position that the current law has served the nation well by reducing alcohol-related traffic crashes and alcohol consumption among youths, while also protecting drinkers from long-term negative outcomes they might experience in adulthood, including alcohol and other drug dependence, adverse birth outcomes, and suicide and homicide. The age 21 law saves lives and is unlikely to be overturned. College and university leaders need to put into effect workable policies, stricter enforcement, and other evidence-based prevention efforts that have been demonstrated to reduce underage drinking and alcohol-related problems on campus and are being applied successfully at prominent academic institutions.

Harassment and Violence Among Men Who Have Sex with Men (MSM) and Hijras After Reinstatement of India's "Sodomy Law".

PubMed

Li, Dennis H; Rawat, Shruta; Rhoton, Jayson; Patankar, Pallav; Ekstrand, Maria L; Simon Rosser, B R; Wilkerson, J Michael

2017-09-01

On December 11, 2013, the Indian Supreme Court recriminalized non-peno-vaginal sex under Sec. 377 of the Indian Penal Code (IPC), overturning a 2009 ruling that deemed IPC Sec. 377 unconstitutional. Similar "sodomy laws" in other countries have been associated with increased violence, harassment, and other discrimination against men who have sex with men (MSM) and transgender women. However, few studies have looked at the effects of such a law in an Indian context. This study examined experiences of victimization among MSM and hijra/transgender women (MSM-H) in the State of Maharashtra using a mixed-method approach. Data came from a quantitative survey and qualitative focus groups and interviews from an HIV prevention study as well as qualitative media and case reports from a local MSM-H-serving community-based organization. MSM-H in Maharashtra reported experiencing a high frequency of harassment, violence, and extortion, particularly from male sex partners met online and police. IPC Sec. 377 was implicated across qualitative sources as creating a culture of protection for harassment against MSM-H by being used directly as a tool for harassment, hindering victims of harassment from seeking legal recourse, and adversely impacting HIV and healthcare services. The reinstated IPC Sec. 377 may directly and indirectly facilitate negative health outcomes among MSM-H. Health agencies and advocates should continue to monitor the impact of IPC Sec. 377, incorporate rights-based approaches to protect MSM-H identities while addressing their health and well-being, and explore avenues to initiate discussions with the government to work toward repealing the law.

Dietary supplements: What's in a name? What's in the bottle?

PubMed

Marcus, Donald M

2016-01-01

The Dietary Supplement Health and Education Act of 1994 (DSHEA), which arbitrarily classified herbals and other medicinal products as dietary supplements, obscured fundamental differences between two classes of products. Authentic supplements to the diet, such as multivitamins or calcium, have nutritional value and are safe. Herbals are used worldwide as medicines, they do not supplement the diet, they may cause severe adverse events, and they should be regulated as medicines. DSHEA also prevented the Food and Drug Administration (FDA) from effectively regulating herbal supplements as medicines. One consequence of weak FDA regulatory oversight is the poor quality of herbals. FDA inspections of manufacturing facilities have revealed violations of good manufacturing practices in over half of facilities inspected, including unsanitary conditions and lack of product specifications. Moreover, many "all natural" herbals marketed for weight loss, enhancement of sexual health and improving sports performance are adulterated with prescription and over-the-counter medications that have caused adverse cardiovascular events. New procedures to authenticate the identity of plants used in herbals will neither detect adulteration by medications nor provide assurance of appropriate pharmacological activity or safety. Nonvitamin, nonmineral "supplements" should be regulated as medicines, but revision or repeal of DSHEA faces strong opposition in Congress. The marketing of botanical supplements is based on unfounded claims that they are safe and effective. Health professionals need to inform patients and the public that there is no reason to take herbal medicines whose composition and benefits are unknown, and whose risks are evident. Copyright © 2015 John Wiley & Sons, Ltd.

MEK inhibition prevents tumour-shed transforming growth factor-β-induced T-regulatory cell augmentation in tumour milieu.

PubMed

Hossain, Dewan M S; Panda, Abir K; Chakrabarty, Sreeparna; Bhattacharjee, Pushpak; Kajal, Kirti; Mohanty, Suchismita; Sarkar, Irene; Sarkar, Diptendra K; Kar, Santosh K; Sa, Gaurisankar

2015-04-01

Tumour progression is associated with immune-suppressive conditions that facilitate the escape of tumour cells from the regimen of immune cells, subsequently paralysing the host defence mechanisms. Induction of CD4(+)  CD25(+)  FoxP3(+) T regulatory (Treg) cells has been implicated in the tumour immune escape mechanism, although the novel anti-cancer treatment strategies targeting Treg cells remain unknown. The focus of this study is to define the interaction between tumour and immune system, i.e. how immune tolerance starts and gradually leads to the induction of adaptive Treg cells in the tumour microenvironment. Our study identified hyperactivated mitogen-activated protein kinase kinase (MEK)/extracellular signal-regulated kinase (ERK) -signalling as a potential target for reversing Treg cell augmentation in breast cancer patients. In more mechanistic detail, pharmacological inhibitors of MEK/ERK signalling inhibited transforming growth factor-β (TGF-β) production in tumour cells that essentially blocked TGF-β-SMAD3/SMAD4-mediated induction of CD25/interleukin-2 receptor α on CD4(+) T-cell surface. As a result high-affinity binding of interleukin-2 on those cells was prohibited, causing lack of Janus kinase 1 (JAK1)/JAK3-mediated signal transducer and activator of transcription 3 (STAT3)/STAT5 activation required for FoxP3 expression. Finally, for a more radical approach towards a safe MEK inhibitor, we validate the potential of multi-kinase inhibitor curcumin, especially the nano-curcumin made out of pure curcumin with greater bioavailability; in repealing tumour-shed TGF-β-induced Treg cell augmentation. © 2014 Bose Institute.

MEK inhibition prevents tumour-shed transforming growth factor-β-induced T-regulatory cell augmentation in tumour milieu

PubMed Central

Hossain, Dewan M S; Panda, Abir K; Chakrabarty, Sreeparna; Bhattacharjee, Pushpak; Kajal, Kirti; Mohanty, Suchismita; Sarkar, Irene; Sarkar, Diptendra K; Kar, Santosh K; Sa, Gaurisankar

2015-01-01

Tumour progression is associated with immune-suppressive conditions that facilitate the escape of tumour cells from the regimen of immune cells, subsequently paralysing the host defence mechanisms. Induction of CD4+ CD25+ FoxP3+ T regulatory (Treg) cells has been implicated in the tumour immune escape mechanism, although the novel anti-cancer treatment strategies targeting Treg cells remain unknown. The focus of this study is to define the interaction between tumour and immune system, i.e. how immune tolerance starts and gradually leads to the induction of adaptive Treg cells in the tumour microenvironment. Our study identified hyperactivated mitogen-activated protein kinase kinase (MEK)/extracellular signal-regulated kinase (ERK) -signalling as a potential target for reversing Treg cell augmentation in breast cancer patients. In more mechanistic detail, pharmacological inhibitors of MEK/ERK signalling inhibited transforming growth factor-β (TGF-β) production in tumour cells that essentially blocked TGF-β-SMAD3/SMAD4-mediated induction of CD25/interleukin-2 receptor α on CD4+ T-cell surface. As a result high-affinity binding of interleukin-2 on those cells was prohibited, causing lack of Janus kinase 1 (JAK1)/JAK3-mediated signal transducer and activator of transcription 3 (STAT3)/STAT5 activation required for FoxP3 expression. Finally, for a more radical approach towards a safe MEK inhibitor, we validate the potential of multi-kinase inhibitor curcumin, especially the nano-curcumin made out of pure curcumin with greater bioavailability; in repealing tumour-shed TGF-β-induced Treg cell augmentation. PMID:25284464

Does Question Wording Predict Support for the Affordable Care Act? An Analysis of Polling During the Implementation Period, 2010-2016.

PubMed

Holl, Kristen; Niederdeppe, Jeff; Schuldt, Jonathon P

2018-07-01

The Patient Protection and Affordable Care Act (ACA) continues to be the subject of fierce political debate in the United States. Drawing on issue framing theory, together with research on wording effects in survey responding, we tested how common differences in the wording of ACA surveys relate to apparent public support for the law. We report on a content analysis of N = 376 U.S. national opinion surveys fielded during a more than six-year period, beginning 23 March 2010 (when President Obama signed the bill into law) and ending 8 November 2016 (Election Day), and use ordinary least squares (OLS) regression models to predict public support for the law as a function of variation in question wording. We coded questions gauging general sentiment toward the law for differences in issue labeling (e.g., Obamacare, Affordable Care Act), whether or not they referenced particular political entities (e.g., President Obama, Congress) or segments of the public (e.g., You, Your Family), various opinion metrics (e.g., Support, Favor), and different response options (e.g., Repeal, Expand) which we used to model aggregate levels of support. The results revealed several key differences in question wording-for example, generic references to the Healthcare Law were employed much more frequently than Obamacare or Affordable Care Act-a number of which reliably predicted aggregate levels of public support. The discussion considers possible explanations for these patterns and reiterates the value of attending to questionnaire design features when interpreting survey data about politically contentious health policy issues.

The Thomsonian movement, the regular profession, and the state in antebellum Connecticut: a case study of the repeal of early medical licensing laws.

PubMed

Appel, Toby A

2010-04-01

The Thomsonian movement, founded by Samuel Thomson, was the first major challenge to the therapies and the social and economic standing of the orthodox medical profession in the United States. In the late-eighteenth or early-nineteenth century, many states chartered a state medical society with power to administer a licensing law that placed at least a nominal penalty on practicing without a license. However, in the 1830s and 1840s, under pressure by proponents of the Thomsonian system, almost all legislatures reversed themselves and removed all restrictions on medical practice. This paper reexamines the rise and fall of medical licensing using Connecticut as a case study. Antebellum legislative controversies over licensing have never been described in detail at the state level--where the drama took place--integrating the perspectives of both the medical regulars and Thomsonian botanical physicians, and state politics. Connecticut is a particularly useful case study because, except for New York, its seven-year battle from 1836 to 1842 over the medical society's charter was the most protracted in the country. How was the campaign structured? To what extent did the licensing restrictions matter? What role did the state-level Democratic party play? Thomsonianism in Connecticut, I suggest, was more professionalized and conservative than historians have often portrayed this movement. This account shows that the state's Thomsonian physicians were not anti-professional or opposed to education, but rather used the politics of the antebellum era to challenge the medical law and legitimize themselves as an alternative form of practice.

Commentary: preparing for health care reform: ten recommendations for academic health centers.

PubMed

Shomaker, T Samuel

2011-05-01

Health care reform, the subject of intense national debate and discussion during the presidential campaign and the first year of the Obama presidency, is now reality. The Patient Protection and Affordable Care Act of 2010 (PPACA) became law in March 2010. Despite efforts by the new Republican majority in the House of Representatives of the 112th Congress to repeal the bill, some aspects of PPACA have already taken effect, and the majority of the remainder are scheduled to be implemented by 2014. PPACA will change the U.S. health care system in fundamental ways. Perhaps more than other entities in the U.S. health care system, academic health centers (AHCs) will bear the impact of the struggle to care for 32 million new, primarily low-income insurance beneficiaries. A large influx of new patients trying to access the health care system through AHCs will coincide with major changes in the financing of health care, the training of health professions students, and the conduct of biomedical research. Although many of the sweeping changes coming through PPACA will not happen until later in this decade, AHCs must begin planning for the future now if they are to prosper, or even survive, in the brave new world of health care reform. The author of this commentary first briefly analyzes some of the most important effects PPACA will have on AHCs and then makes recommendations for how AHCs can prepare to take advantage of the opportunities and mitigate the challenges inherent in implementing PPACA. Copyright © by the Association of American medical Colleges.

The drug regulatory and review process in Guyana.

PubMed

Woo-Ming, R B

1993-01-01

After the old "Sale of Food and Drugs" Ordinance, Cap. 144 was repealed, the new Food and Drugs Act was enacted in 1971. This new Act has considerable flexibility and gives the Minister extensive authority to make Regulations (for carrying out the purposes and provisions of the Act). The Act controls the manufacture, importation, sale, advertising, labeling, packaging, and distribution of drug samples, and the testing of drugs. The Act also controls raw materials and finished products of drugs at the point of entry into the country, with a single agency coordinating both the inspection and analytical services. Developing countries could ensure the procurement of safe, good quality, and effective drugs and devices with the enactment of a similar Food and Drugs Act only. Rapid assessment of Drug Safety, Quality and Efficacy is done through Guyana's participation in the WHO Certification Scheme on the Quality of Pharmaceutical Products moving in International Commerce. This certification scheme is highly commendable especially to third-world countries. The Food and Drug Regulations (1977) have several unique features for drug, cosmetic and device control and they allow for a system of centralized control with limited staff to enforce the legislation. In summary, enforcement of legislative control of imported pharmaceuticals and product evaluation can be considered strong points in the drug regulatory and review process in Guyana. A cautious attitude is observed so as to ensure efficacy, safety, and quality of drugs entering the market. This Drug Regulatory and Review Process is recommended for implementation by third-world countries with outdated drug legislation.(ABSTRACT TRUNCATED AT 250 WORDS)

Riotous assemblage and the materials of regulation.

PubMed

Bulstrode, Jenny

2018-06-01

In the stores of the British Museum are three exquisite springs, made in the late 1820s and 1830s, to regulate the most precise timepieces in the world. Barely the thickness of a hair, they are exquisite because they are made entirely of glass. Combining new documentary evidence, funded by the Antiquarian Horological Society, with the first technical analysis of the springs, undertaken in collaboration with the British Museum, the research presented here uncovers their extraordinary significance to the global extension of nineteenth century capitalism through the repeal of the Corn Laws. In the 1830s and 1840s the Astronomer Royal, George Biddell Airy; the Hydrographer to the Admiralty, Francis Beaufort; and the Prime Minister, Sir Robert Peel, collaborated with the virtuoso chronometer-maker, Edward John Dent, to mobilize the specificity of particular forms of glass, the salience of the Glass Tax, and the significance of state standards, as means to reform. These protagonists looked to glass and its properties to transform the fiscal military state into an exquisitely regulated machine with the appearance of automation and the gloss of the free-trade liberal ideal. Surprising but significant connections, linking Newcastle mobs to tales of Cinderella and the use of small change, demonstrate why historians must attend to materials and how such attention exposes claims to knowledge, the interests behind such claims, and the impact they have had upon the design and architecture of the modern world. Through the pivotal role of glass, this paper reveals the entangled emergence of state and market capitalism, and how the means of production was transformed in vitreous proportions.

Rules for processing genetic data for research purposes in view of the new EU General Data Protection Regulation.

PubMed

Shabani, Mahsa; Borry, Pascal

2018-02-01

Genetic data contain sensitive health and non-health-related information about the individuals and their family members. Therefore, adopting adequate privacy safeguards is paramount when processing genetic data for research or clinical purposes. One of the major legal instruments for personal data protection in the EU is the new General Data Protection Regulation (GDPR), which has entered into force in May 2016 and repealed the Directive 95/46/EC, with an ultimate goal of enhancing effectiveness and harmonization of personal data protection in the EU. This paper explores the major provisions of the new Regulation with regard to processing genetic data, and assesses the influence of such provisions on reinforcing the legal safeguards when sharing genetic data for research purposes. The new Regulation attempts to elucidate the scope of personal data, by recognizing pseudonymized data as personal (identifiable) data, and including genetic data in the catalog of special categories of data (sensitive data). Moreover, a set of new rules is laid out in the Regulation for processing personal data under the scientific research exemption. For instance, further use of genetic data for scientific research purposes, without obtaining additional consent will be allowed, if the specific conditions is met. The new Regulation has already fueled concerns among various stakeholders, owing to the challenges that may emerge when implementing the Regulation across the countries. Notably, the provided definition for pseudonymized data has been criticized because it leaves too much room for interpretations, and it might undermine the harmonization of the data protection across the countries.

Evolution of European Union legislation on emergency research.

PubMed

Mentzelopoulos, Spyros D; Mantzanas, Michail; van Belle, Gerald; Nichol, Graham

2015-06-01

Emergency research is necessary to prevent exposure of patients to unvalidated clinical practice (nonmaleficence), and to improve the dismal prognosis of disorders requiring emergent treatment such as cardiac arrest (beneficence). Regulations that govern clinical research should conform to bioethical principles of respect for nonmaleficence, beneficence, autonomy, and justice. Our objectives are to review the evolution of European Union (EU) legislation on emergency research, and to identify potentially remaining problems. EU legislative sources on clinical research and medical literature describing the impact of EU Regulations on emergency research. Article 5 of EU Directive 2001/20/EC required consent before enrolment in a research study to ensure the autonomy of potentially incapacitated research subjects. However, obtaining such consent is often impossible in emergency situations. Directive 2001/20/EC was criticized for potentially preventing emergency research. Several EU Member States addressed this problem by permitting deferred consent. International ethical guidelines supporting deferred consent were also cited by Good Clinical Practice Directive 2005/28/EC. However, Directive 2001/20/EC was not revised to achieve harmonization of EU emergency research, thus resulting in ongoing "ambiguity" as regards to emergency research legitimacy. This will be definitively addressed by applying EU Regulation No. 536/2014 and repealing Directive 2001/20/EC. The new EU Regulation permits using deferred consent under clearly specified conditions, and may foster emergency research that evaluates interventions posing minimal risk relative to standard practice. Legislation related to emergency research in Europe has evolved to increase concordance with bioethical principles so as to increase evidence-based improvements in emergency care. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Did abortion legalization reduce the number of unwanted children? Evidence from adoptions.

PubMed

Bitler, Marianne; Madeline, Zavodny

2002-01-01

The legalization of abortion in the United States led to well-known changes in reproductive behavior, but its effect on adoptions has not been investigated. Variation across states in the timing and extent of abortion legalization is used to identify the effects of changes in the legal status of abortion on adoption rates from 1961 to 1975. These effects are estimated in regression analyses that control for states' economic, demographic and political characteristics, as well as for health care availability within states. The rate of adoptions of children born to white women declined by 34-37% in states that repealed restrictive abortion laws before Roe v. Wade. The effect was concentrated among adoptions by petitioners not related to the child. Legal reforms resulting in small increases in access, such as in cases of rape and incest, were associated with a 15-18% decline in adoptions of children born to nonwhite women; however, this decline may have been due to other changes in the policy environment for such adoptions. Rates of adoption of children born to white women appear to have declined after Roe v. Wade, but this association is not statistically significant. The estimated effect of abortion legalization on adoption rates is sizable and can account for much of the decline in adoptions, particularly of children born to white women, during the early 1970s. These findings support previous studies' conclusions that abortion legalization led to a reduction in the number of "unwanted" children; such a reduction may have improved average infant health and children's living conditions.

Changing the navigator's course: How the increasing rationalization of healthcare influences access for undocumented immigrants under the Affordable Care Act.

PubMed

López-Sanders, Laura

2017-04-01

A number of researchers have shown that brokers (e.g., navigators and street-level bureaucrats) bridge access to healthcare services and information for immigrant patients through rich personal relationships and a mission of ethical care. An open question remains concerning how the increasing rationalization of healthcare over the past few decades influences brokerage for undocumented immigrant patients. Drawing from fieldwork and interviews conducted in California, as the Affordable Care Act (ACA) was implemented, I develop the concept of the "double-embedded-liaison." While other studies treat brokers as acting either as gatekeepers or patient representatives, this study explains how brokers simultaneously operate on multiple planes when new roles are added. I argue that with more formalization and scrutiny at health centers, the impact of brokerage is destabilized and, subsequently, diminished. Two consequences of the double-embedded-liaison brokerage form are: (1) some brokers become disillusioned and exit -resulting in the loss of valuable resources at the health centers, and (2) immigrants move away from the health centers that historically served them. In looking at brokers' simultaneous performance as gatekeepers and representatives, this research extends brokerage typologies and street-level bureaucracy arguments that largely treat brokerage in a mono-planar rather than in a bi-planar mode. Furthermore, in examining the risks and opportunities brokerage brings to addressing health disparities, the study provides insights into the effects of replacing the ACA or repealing it all together in the Post-Obama era. Copyright © 2017 Elsevier Ltd. All rights reserved.

Implementation of the Energy Efficiency Directive: Opportunities and Challenges

NASA Astrophysics Data System (ADS)

Zīgurs, A.; Sarma, U.

2015-12-01

Discussions in Latvia are ongoing regarding the optimum solution to implementing Directive 2012/27/EU of the European Parliament and of the Council of 25 October 2012 on energy efficiency, amending Directives 2009/125/EC and 2010/30/EU and repealing Directives 2004/8/EC and 2006/32/EC (Directive 2012/27/EU). Without a doubt, increased energy efficiency contributes significantly to energy supply security, competitive performance, increased quality of life, reduced energy dependence and greenhouse gas (GHG) emissions. However, Directive 2012/27/EU should be implemented with careful planning, evaluating every aspect of the process. This study analyses a scenario, where a significant fraction of target energy efficiency is achieved by obliging energy utilities to implement user-end energy efficiency measures. With implementation of this scheme towards energy end-use savings, user payments for energy should be reduced; on the other hand, these measures will require considerable investment. The energy efficiency obligation scheme stipulates that these investments must be paid by energy utilities; however, they will actually be covered by users, because the source of energy utilities' income is user payments for energy. Thus, expenses on such measures will be included in energy prices and service tariffs. The authors analyse the ways to achieve a balance between user gains from energy end-use savings and increased energy prices and tariffs as a result of obligations imposed upon energy utilities. Similarly, the suitability of the current regulatory regime for effective implementation of Directive 2012/27/EU is analysed in the energy supply sectors, where supply tariffs are regulated.

The Impact of State Tort Reforms on Imaging Utilization.

PubMed

Li, Suhui; Dor, Avi; Deyo, Darwyyn; Hughes, Danny R

2017-02-01

Defensive medicine, broadly defined as medical practices that protect physicians from malpractice lawsuits without providing benefits to patients, can lead to wasteful use of health care resources and higher cost. Although physicians cite malpractice liability as an important factor driving their decisions to order imaging tests, little research has been done to examine the systematic impact of liability pressure on overall imaging. The authors examined the extent to which radiography use is influenced by malpractice liability pressure among office-based physicians. Using National Ambulatory Medical Care Survey data from 1999 to 2010, the authors used multivariate difference-in-difference logistic regression to examine the effects of different types of state tort reforms on the probability of radiography orders by primary care physicians (PCPs) and specialists. The probability that a PCP ordered radiography decreased when states enacted permanent caps on noneconomic damages (-1.0%, P < .01), periodic payment reforms (-1.6%, P < .05), and the total number of tort reforms (-0.5%, P < .05). Specialist physicians were responsive to two reforms: caps on punitive damages (-6.1%, P < .01) and the total number of medical tort laws (-1.2%, P < .01). The passage of new indirect reforms was found to reduce radiography orders for PCPs (-1.8%, P < .05), and the repeal of indirect reforms was found to increase radiography orders for specialists (+3.4%, P < .01). State tort reform seems to reduce physicians' ordering of radiography. This analysis also suggests that reforms that make it harder to sue physicians have a stronger impact than reforms that directly reduce physicians' malpractice claim payments. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

What Do We Know About the Association Between Firearm Legislation and Firearm-Related Injuries?

PubMed

Santaella-Tenorio, Julian; Cerdá, Magdalena; Villaveces, Andrés; Galea, Sandro

2016-01-01

Firearms account for a substantial proportion of external causes of death, injury, and disability across the world. Legislation to regulate firearms has often been passed with the intent of reducing problems related to their use. However, lack of clarity around which interventions are effective remains a major challenge for policy development. Aiming to meet this challenge, we systematically reviewed studies exploring the associations between firearm-related laws and firearm homicides, suicides, and unintentional injuries/deaths. We restricted our search to studies published from 1950 to 2014. Evidence from 130 studies in 10 countries suggests that in certain nations the simultaneous implementation of laws targeting multiple firearms restrictions is associated with reductions in firearm deaths. Laws restricting the purchase of (e.g., background checks) and access to (e.g., safer storage) firearms are also associated with lower rates of intimate partner homicides and firearm unintentional deaths in children, respectively. Limitations of studies include challenges inherent to their ecological design, their execution, and the lack of robustness of findings to model specifications. High quality research on the association between the implementation or repeal of firearm legislation (rather than the evaluation of existing laws) and firearm injuries would lead to a better understanding of what interventions are likely to work given local contexts. This information is key to move this field forward and for the development of effective policies that may counteract the burden that firearm injuries pose on populations. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Observation of motorcycle helmet use rates in Michigan after partial repeal of the universal motorcycle helmet law.

PubMed

Buckley, Lisa; Bingham, C Raymond; Flannagan, Carol A; Carter, Patrick M; Almani, Farideh; Cicchino, Jessica B

2016-10-01

Motorcycle crashes result in a significant health burden, including many fatal injuries and serious non-fatal head injuries. Helmets are highly effective in preventing such trauma, and jurisdictions that require helmet use of all motorcyclists have higher rates of helmet use and lower rates of head injuries among motorcyclists. The current study examines helmet use and characteristics of helmeted operators and their riding conditions in Michigan, following a weakening of the state's universal motorcycle helmet use law in April 2012. Data on police-reported crashes occurring during 2012-14 and from a stratified roadside observational survey undertaken in Southeast Michigan during May-September 2014 were used to estimate statewide helmet use rates. Observed helmet use was more common among operators of sports motorcycles, on freeways, and in the morning, and least common among operators of cruisers, on minor arterials, and in the afternoon. The rate of helmet use across the state was estimated at 75%, adjusted for roadway type, motorcycle class, and time of day. Similarly, the helmet use rate found from examination of crash records was 73%. In the observation survey, 47% of operators wore jackets, 94% wore long pants, 54% wore boots, and 80% wore gloves. Protective clothing of jackets and gloves was most often worn by sport motorcycle operators and long pants and boots most often by riders of touring motorcycles. Findings highlight the much lower rate of helmet use in Michigan compared with states that have a universal helmet use law, although the rate is higher than observed in many states with partial helmet laws. Targeted interventions aimed at specific groups of motorcyclists and situations where helmet use rates are particularly low should be considered to increase helmet use. Copyright © 2016 Elsevier Ltd. All rights reserved.

After CLASS--Is a voluntary public insurance program a realistic way to meet the long-term support and service needs of adults with disabilities?

PubMed

Kennedy, Jae; Gimm, Gilbert; Glazier, Raymond

2016-04-01

The CLASS Act, which was part of the Affordable Care Act of 2010, established a voluntary personal assistance services (PAS) insurance program. However, concerns about enrollment and adverse selection led to repeal of the CLASS Act in 2013. To estimate the number of middle-aged adults interested in purchasing PAS insurance, the sociodemographic, socioeconomic and disability attributes of this population, and the maximum monthly premium they would be willing to pay for such coverage. A total of 13,384 adults aged 40-65 answered questions about their interest in PAS insurance in the 2011 Sample Adult National Health Interview Survey. We applied survey weights for the U.S. population and conducted logistic regression analyses to identify personal factors associated with interest in paying for the CLASS program. An estimated 25.8 million adults aged 40-65 (26.7%) said they would be interested in paying for a public insurance program to cover PAS benefits. However, interest in PAS insurance varied by age, race, ethnicity, region, income, disability status, and family experience with ADL assistance. Only 1.6 million adults aged 40-65 (1.8%) said they would be willing to pay $100 per month or more for coverage. While more than a quarter of the middle-aged adult population said they were interested in PAS insurance, actual participation would be highly dependent on premium rates. The current lack of publicly subsidized insurance for long-term care and personal assistance services remains a serious gap in the disability service system. Copyright © 2016 Elsevier Inc. All rights reserved.

Health policies on dialysis modality selection: a nationwide population cohort study

PubMed Central

Lin, Yi-Chun; Lin, Yen-Chung; Kao, Chih-Chin; Chen, Hsi-Hsien; Hsu, Chih-Cheng; Wu, Mai-Szu

2017-01-01

Objectives In Taiwan, peritoneal dialysis (PD) and haemodialysis are fully accessible to patients with end-stage renal disease. However, the usage of PD is considered low in Taiwan. Since 2005, 4 major policies have been implemented by Taiwan's Ministry of Health and Welfare, namely a multidisciplinary predialysis care programme and usage increasing the PD incidence as a key performance indicator (KPI) for hospital accreditation, both of which were implemented in 2006; reimbursement of the glucose-free dialysate, icodextrin that was implemented in 2007; and insurance reimbursement for renting automated PD machines that was implemented in 2008. The aim of this study was to analyse the associations between the PD promotional policies and the actual PD selection rates. Setting We analysed data within the Taiwan Renal Registry Data System from 2006 to 2013, focusing on the PD incidence in relation to the timings of the 4 PD promotional policies; then we stratified the results according to age, sex and the presence of diabetes mellitus. Participants From 2006 to 2013, 115 565 patients were enrolled in this study. The mean (SD) age of patients on PD was 54.6 (15.7) years. Results During the time frame in which the 4 PD promotional policies were implemented, the PD incidence increased from 12.8% in 2006 to 15.1% in 2009. The PD incidence started to decline in 2010 (13.8%) when the hospital accreditation policy was repealed. The 3 remaining policies were weakly associated with the PD incidence. The observational analysis determined that the patients' ages, sexes and diabetes mellitus incidence rates were relatively stable from 2006 to 2013. Conclusions Of the 4 health policies intended to promote PD usage, using increasing the PD incidence as a KPI for hospital accreditation had the strongest association with the PD incidence. PMID:28077410

Reproductive rights on firmer ground with prochoice White House, Congress. Special report -- abortion and the 1992 elections.

PubMed

1992-11-12

After 12 years, the US citizens elected a pro-choice president and preserved the already pro-choice Congress even though new people constitute 25% of the House of Representatives. The Congress gained even more pro-choice members. The abortion issue played an important secondary role (preceded by the economy) in the national elections, but was more important at the state level in many states. For example, voters overwhelmingly chose to preserve access to legal abortion in Arizona (69.31%) and Maryland (62.38%). In addition, 4 new women Senators and a Senator-elect from Colorado publicly proclaimed their pro-choice stance. The states of Missouri, North Carolina, and North Dakota elected pro-choice governors resulting in 30 pro-choice US governors and 20 antiabortion governors. President-elect Clinton can unilaterally repeal 2 of Bush's executive orders: the gag rule and the ban on fetal tissue transplantation research. He will need Congress' support to renew the Title X family planning program, to grant public funding for medically necessary abortions for poor women again, and the pass of the Freedom of Choice Act. Congress and the new president face the obstacle of convincing the public of the damage to basic rights done by the Supreme Court as evidenced by abortion rulings. They also need to lead the pro-choice groups to begin concentrating on how to prevent unwanted pregnancies so as to reduce the number of abortions and the needs of all women who want and need access to safe abortion. The Republican party's great hostility toward abortion and its intolerance for a variety of beliefs and life styles alienated most US citizens. Recent political losses are motivating the Republican party to reorganize but it depends on the moderates' ability and willingness to reclaim the party.

AIDS and the law: opportunities and limitations.

PubMed

Kirby, M

1995-01-01

Laws can only partially succeed in modifying behavior, especially with regard to sex, drug use, and other human pleasures. Effective and just laws to slow the spread of AIDS must therefore be based upon a thorough knowledge of the issues, not upon ignorance, fear, political expediency, or to meet the emotional demands of an often ignorant general population. Good laws, like good ethics, are founded in good data. The most effective response to the AIDS epidemic is neither prohibition nor punishment of individual behavior, but laws designed to truly affect human behavior and shape a society in which the spread of HIV is minimized. Central to an appropriate legislative response is the imperative of protecting the basic rights of individuals infected with HIV. An example of an enlightened, rational, and nondiscriminatory approach to checking the spread of HIV/AIDS while guaranteeing individual freedoms and rights is found in a report commissioned for the State Government of New South Wales. The following measures are recommended to bring state laws into harmony with the national HIV/AIDS strategy: decriminalize brothels, set regulations and public health standards for sex workers, cover sex workers under the Industrial Relations Act, ensure the privacy of HIV/AIDS patients and improve their redress against discrimination in the workplace, repeal laws which make it illegal to possess and administer drugs to oneself, investigate the therapeutic use of marijuana as a prescribed treatment for HIV/AIDS and other terminal illnesses, abandon compulsory testing for HIV in prisons, make condoms available to prisoners and sexually active children, establish a Natural Death Act to allow terminally ill patients to die with dignity, and give legal status to permanent relationships between homosexual couples.

Value-Based Payment Reform and the Medicare Access and Children's Health Insurance Program Reauthorization Act of 2015: A Primer for Plastic Surgeons.

PubMed

Squitieri, Lee; Chung, Kevin C

2017-07-01

In 2015, the U.S. Congress passed the Medicare Access and Children's Health Insurance Program Reauthorization Act, which effectively repealed the Centers for Medicare and Medicaid Services sustainable growth rate formula and established the Centers for Medicare and Medicaid Services Quality Payment Program. The Medicare Access and Children's Health Insurance Program Reauthorization Act represents an unparalleled acceleration toward value-based payment models and a departure from traditional volume-driven fee-for-service reimbursement. The Quality Payment Program includes two paths for provider participation: the Merit-Based Incentive Payment System and Advanced Alternative Payment Models. The Merit-Based Incentive Payment System pathway replaces existing quality reporting programs and adds several new measures to create a composite performance score for each provider (or provider group) that will be used to adjust reimbursed payment. The advanced alternative payment model pathway is available to providers who participate in qualifying Advanced Alternative Payment Models and is associated with an initial 5 percent payment incentive. The first performance period for the Merit-Based Incentive Payment System opens January 1, 2017, and closes on December 31, 2017, and is associated with payment adjustments in January of 2019. The Centers for Medicare and Medicaid Services estimates that the majority of providers will begin participation in 2017 through the Merit-Based Incentive Payment System pathway, but aims to have 50 percent of payments tied to quality or value through Advanced Alternative Payment Models by 2018. In this article, the authors describe key components of the Medicare Access and Children's Health Insurance Program Reauthorization Act to providers navigating through the Quality Payment Program and discuss how plastic surgeons may optimize their performance in this new value-based payment program.

House again passes ban on abortions at military facilities.

PubMed

1996-05-31

Voting 192-225 on May 14, the House defeated an effort to reverse the current prohibition on privately funded abortions at military facilities except in cases of life endangerment, rape, or incest. Introduced by pro-choice Representatives Rosa DeLauro (D-CT), Jane Harman (D-CA), and Mike Ward (D-KY) and mixed record Representative Peter Torkildsen (R-MA), the amendment to the National Defense Authorization Act (HR 3230) would have repealed restrictive language in the statute that governs the Department of Defense (DOD). Floor action on the provision of non-government-funded abortions mirrored Representative DeLauro's failed attempts to strike the onerous provision during the mark-up process for HR 3230, which received final House approval in a 272-153 vote on May 15. The House National Security Committee voted 26-20 against removing the abortion restriction on May 1, six days after a similar 11-5 vote by the Subcommittee on Military Personnel. The near ban on abortion services has been in effect since December of last year, when the DOD spending bill was implemented; President Clinton signed the legislation permanently encoding the restriction into law in February (see RFN IV/22, V/3-4). Upon taking office in January 1993, President Clinton had issued an executive memorandum directing the Secretary of Defense to reverse the ban on the performance of non-lifesaving, privately funded abortions at military facilities, which had been instituted through agency action in mid-1988 (see RFN II/3, IV/13). The DOD authorization statute has prohibited the use of federal funds for abortions except in cases of life endangerment for more than a decade. full text

Sexual Identity, Stigma, and Depression: the Role of the "Anti-gay Propaganda Law" in Mental Health among Men Who Have Sex with Men in Moscow, Russia.

PubMed

Hylton, Emily; Wirtz, Andrea L; Zelaya, Carla E; Latkin, Carl; Peryshkina, Alena; Mogilnyi, Vladmir; Dzhigun, Petr; Kostetskaya, Irina; Galai, Noya; Beyrer, Chris

2017-06-01

Depression is a major public health problem in the Russian Federation and is particularly of concern for men who have sex with men (MSM). MSM living in Moscow City were recruited via respondent-driven sampling and participated in a cross-sectional survey from October 2010 to April 2013. Multiple logistic regression models compared the relationship between sexual identity, recent stigma, and probable depression, defined as a score of ≥23 on the Center for Epidemiological Studies Depression scale. We investigated the interactive effect of stigma and participation in the study after the passage of multiple "anti-gay propaganda laws" in Russian provinces, municipalities, and in neighboring Ukraine on depression among MSM. Among 1367 MSM, 36.7% (n = 505) qualified as probably depressed. Fifty-five percent identified as homosexual (n = 741) and 42.9% identified as bisexual (n = 578). Bisexual identity had a protective association against probable depression (reference: homosexual identity AOR 0.71; 95%CI 0.52-0.97; p < 0.01). Those who experienced recent stigma (last 12 months) were more likely to report probable depression (reference: no stigma; AOR 1.75; 95%CI 1.20-2.56; p < 0.01). The interaction between stigma and the propaganda laws was significant. Among participants with stigma, probable depression increased 1.67-fold after the passage of the anti-gay laws AOR 1.67; 95%CI 1.04-2.68; p < 0.01). Depressive symptoms are common among MSM in Russia and exacerbated by stigma and laws that deny homosexual identities. Repeal of Russia's federal anti-gay propaganda law is urgent but other social interventions may address depression and stigma in the current context.

Efficient Use of Cogeneration and Fuel Diversification

NASA Astrophysics Data System (ADS)

Kunickis, M.; Balodis, M.; Sarma, U.; Cers, A.; Linkevics, O.

2015-12-01

Energy policy of the European Community is implemented by setting various goals in directives and developing support mechanisms to achieve them. However, very often these policies and legislation come into contradiction with each other, for example Directive 2009/28/EC on the promotion of the use of energy from renewable sources and Directive 2012/27/EU on energy efficiency, repealing Directive 2004/8/EC on the promotion of cogeneration based on a useful heat demand. In this paper, the authors attempt to assess the potential conflicts between policy political objectives to increase the share of high-efficiency co-generation and renewable energy sources (RES), based on the example of Riga district heating system (DHS). If a new heat source using biomass is built on the right bank of Riga DHS to increase the share of RES, the society could overpay for additional heat production capacities, such as a decrease in the loading of existing generating units, thereby contributing to an inefficient use of existing capacity. As a result, the following negative consequences may arise: 1) a decrease in primary energy savings (PES) from high-efficiency cogeneration in Riga DHS, 2) an increase in greenhouse gas (GHG) emissions in the Baltic region, 3) the worsening security situation of electricity supply in the Latvian power system, 4) an increase in the electricity market price in the Lithuanian and Latvian price areas of Nord Pool power exchange. Within the framework of the research, calculations of PES and GHG emission volumes have been performed for the existing situation and for the situation with heat source, using biomass. The effect of construction of biomass heat source on power capacity balances and Nord Pool electricity prices has been evaluated.

Medicare Program; Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive Under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models. Final rule with comment period.

PubMed

2016-11-04

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) repeals the Medicare sustainable growth rate (SGR) methodology for updates to the physician fee schedule (PFS) and replaces it with a new approach to payment called the Quality Payment Program that rewards the delivery of high-quality patient care through two avenues: Advanced Alternative Payment Models (Advanced APMs) and the Merit-based Incentive Payment System (MIPS) for eligible clinicians or groups under the PFS. This final rule with comment period establishes incentives for participation in certain alternative payment models (APMs) and includes the criteria for use by the Physician-Focused Payment Model Technical Advisory Committee (PTAC) in making comments and recommendations on physician-focused payment models (PFPMs). Alternative Payment Models are payment approaches, developed in partnership with the clinician community, that provide added incentives to deliver high-quality and cost-efficient care. APMs can apply to a specific clinical condition, a care episode, or a population. This final rule with comment period also establishes the MIPS, a new program for certain Medicare-enrolled practitioners. MIPS will consolidate components of three existing programs, the Physician Quality Reporting System (PQRS), the Physician Value-based Payment Modifier (VM), and the Medicare Electronic Health Record (EHR) Incentive Program for Eligible Professionals (EPs), and will continue the focus on quality, cost, and use of certified EHR technology (CEHRT) in a cohesive program that avoids redundancies. In this final rule with comment period we have rebranded key terminology based on feedback from stakeholders, with the goal of selecting terms that will be more easily identified and understood by our stakeholders.

Observation of motorcycle helmet use rates in Michigan after partial repeal of the universal motorcycle helmet law

PubMed Central

Buckley, Lisa; Bingham, C. Raymond; Flannagan, Carol A.; Carter, Patrick M.; Almani, Farideh; Cicchino, Jessica B.

2017-01-01

Motorcycle crashes result in a significant health burden, including many fatal injuries and serious non-fatal head injuries. Helmets are highly effective in preventing such trauma, and jurisdictions that require helmet use of all motorcyclists have higher rates of helmet use and lower rates of head injuries among motorcyclists. The current study examines helmet use and characteristics of helmeted operators and their riding conditions in Michigan, following a weakening of the state's universal motorcycle helmet use law in April 2012. Data on police-reported crashes occurring during 2012–14 and from a stratified roadside observational survey undertaken in Southeast Michigan during May-September 2014 were used to estimate statewide helmet use rates. Observed helmet use was more common among operators of sports motorcycles, on freeways, and in the morning, and least common among operators of cruisers, on minor arterials, and in the afternoon. The rate of helmet use across the state was estimated at 75%, adjusted for roadway type, motorcycle class, and time of day. Similarly, the helmet use rate found from examination of crash records was 73%. In the observation survey, 47% of operators wore jackets, 94% wore long pants, 54% wore boots, and 80% wore gloves. Protective clothing of jackets and gloves was most often worn by sport motorcycle operators and long pants and boots most often by riders of touring motorcycles. Findings highlight the much lower rate of helmet use in Michigan compared with states that have a universal helmet use law, although the rate is higher than observed in many states with partial helmet laws. Targeted interventions aimed at specific groups of motorcyclists and situations where helmet use rates are particularly low should be considered to increase helmet use. PMID:27448519

[The population questions in Rumania].

PubMed

Birzea, C

1993-03-01

Several months after Romania's dictator, Ceausescu, came to power in 1966, he made abortion the sole method of fertility control, illegal. Births grew in Romania 200% between enactment of this law and 1967. Some other pronatalist actions included taxes on singles and childless couples, assistance to families with many children, discouragement of divorces, and required gynecological exams at large women collectives (e.g. schools and businesses). The population adapted every quickly to these coercive pronatalist measures, however. By 1970, fertility fell steadily. By 1985, it was at the same level as it was pre-Ceausescu (1965). After Ceausescu's fall, repeal of the antiabortion law was one of the first actions taken by the new government, resulting in a 10-fold increase in legal abortions after several months. It also introduced free contraceptive methods which were not available during the Ceausescu years, e.g.. oral contraceptives. This new situation placed the responsibility to make decisions about procreation on people's shoulders. The government chose a population education strategy that emphasizes couples' responsibilities towards upcoming generations and towards improvement of the quality of life. Thus, education networks concerning family life and population grew, principally in 1991. The government created most family life and population education programs in schools, public health institutions and social service agencies, particularly those in large cities. It also called for the media and nongovernmental organizations to also promote programs which encourage parental responsibility, raise the demographic conscience of each person, and explain the moral, social, and economic context of fertility decisions. These education programs have replaced political indoctrination programs and have been integrated into a variety of disciplines. They stress prevention education, including sexual health, prevention of AIDS, drug and alcohol abuse, environmental protection, and human rights.

Attitudes of cannabis growers to regulation of cannabis cultivation under a non-prohibition cannabis model.

PubMed

Lenton, Simon; Frank, Vibeke A; Barratt, Monica J; Dahl, Helle Vibeke; Potter, Gary R

2015-03-01

How cannabis cultivation is dealt with under various examples of cannabis legalization or regulation is an important consideration in design of such schemes. This study aimed to (i) investigate support among current or recent cannabis growers, for various potential policy options for cannabis cultivation if prohibition were repealed, and (ii) explore the support for these options across countries, scale of growing operations, demographics, drug use and cannabis supply involvement variables. This study utilized data from the online web survey of largely 'small-scale' cannabis cultivators, aged 18yrs and over, in eleven countries conducted by the Global Cannabis Cultivation Research Consortium (GCCRC). Data from 1722 current and recent cannabis growers in Australia, Denmark and the UK, who were all asked about policy, were included in the analysis. It investigated support for various frameworks for cultivation: (no regulation (free market); adult only; growing licenses; restrictions on plant numbers; licensed business-only sale; approved commercial growing; etc.). Among current growers, support for these options were compared across countries, across scale of growing operations, and by demographics, drug use and crime variables. Although there were some between country differences in support for the various policy options, what was striking was the similarity of the proportions for each of the eight most popular policy options. Among current growers, many of these positions were predicted by demographic, drug use and cannabis growing variables which were conceptually congruent with these positions. The results have relevance for the provisions regarding cannabis cultivation in the design of new non-prohibitionist models of cannabis which are increasingly under consideration. It should be of interest to policy makers, drug policy researchers, law enforcement and cannabis cultivators. Copyright © 2014 Elsevier B.V. All rights reserved.

Centralized HIV Program Oversight: An Investigation of a Case Series of New HIV Infections among US Army Soldiers, 2012 to 2013.

PubMed

Pacha, Laura A; Hakre, Shilpa; Myles, Otha; Sanders-Buell, Eric E; Scoville, Stephanie L; Kijak, Gustavo H; Price, Michael W; Mody, Rupal M; Liu, Ying; Miller, Shana L; Pham, Phuc T; Michael, Nelson L; Kim, Jerome H; Peel, Sheila A; Tovanabutra, Sodsai; Jagodzinski, Linda L; Cersovsky, Steven B; Scott, Paul T

2015-11-01

Centralized HIV program oversight and repeal of the Department of Defense policy "Don't Ask Don't Tell" permitted characterization of HIV transmission among soldiers assigned to a large US Army base continental United States from 2012 to 2013. An investigation of a greater than expected number of new HIV infections among soldiers was initiated to characterize transmission and identify opportunities to disrupt transmission and deliver services.All soldiers who were assigned to the base at the time of their first positive HIV test and who had their first positive HIV test in 2012 or in the first 6 months of 2013 and who had a clinical genotype available for analysis were eligible for inclusion in the investigation.All patients (n = 19) were men; most were black (52%) and less than 30 years old (64%). Fifteen of the 19 patients participated in in-depth interviews. Eighty percent were men who have sex with men who reported multiple sex partners having met through social and electronic networks. All were subtype B infections. Significant knowledge gaps and barriers to accessing testing and care in the military healthcare system were identified. Most (58%) belonged to transmission networks involving other soldiers.This investigation represents an important step forward in on-going efforts to develop a comprehensive understanding of transmission networks in the Army that can inform delivery of best practices combination prevention services. The Army is developing plans to directly engage individuals in key affected populations most at risk for HIV infection to identify and address unmet needs and expand delivery and uptake of prevention services. Further investigation is underway and will determine whether these findings are generalizable to the Army.

Aspergillus ficuum phytase activity is inhibited by cereal grain components.

PubMed

Bekalu, Zelalem Eshetu; Madsen, Claus Krogh; Dionisio, Giuseppe; Brinch-Pedersen, Henrik

2017-01-01

In the current study, we report for the first time that grain components of barley, rice, wheat and maize can inhibit the activity of Aspergillus ficuum phytase. The phytase inhibition is dose dependent and varies significantly between cereal species, between cultivars of barley and cultivars of wheat and between Fusarium graminearum infected and non-infected wheat grains. The highest endpoint level of phytase activity inhibition was 90%, observed with grain protein extracts (GPE) from F. graminearum infected wheat. Wheat GPE from grains infected with F. graminearum inhibits phytase activity significantly more than GPE from non-infected grains. For four barley cultivars studied, the IC50 value ranged from 0.978 ± 0.271 to 3.616 ± 0.087 mg×ml-1. For two non-infected wheat cultivars investigated, the IC50 values were varying from 2.478 ± 0.114 to 3.038 ± 0.097 mg×ml-1. The maize and rice cultivars tested gaveIC50 values on 0.983 ± 0.205 and 1.972 ± 0.019 mg×ml-1, respectively. After purifying the inhibitor from barley grains via Superdex G200, an approximately 30-35 kDa protein was identified. No clear trend for the mechanism of inhibition could be identified via Michaelis-Menten kinetics and Lineweaver-Burk plots. However, testing of the purified phytase inhibitor together with the A. ficuum phytase and the specific protease inhibitors pepstatin A, E64, EDTA and PMSF revealed that pepstatin A repealed the phytase inhibition. This indicates that the observed inhibition of A. ficuum phytase by cereal grain extracts is caused by protease activity of the aspartic proteinase type.

Aspergillus ficuum phytase activity is inhibited by cereal grain components

PubMed Central

Bekalu, Zelalem Eshetu; Madsen, Claus Krogh; Dionisio, Giuseppe

2017-01-01

In the current study, we report for the first time that grain components of barley, rice, wheat and maize can inhibit the activity of Aspergillus ficuum phytase. The phytase inhibition is dose dependent and varies significantly between cereal species, between cultivars of barley and cultivars of wheat and between Fusarium graminearum infected and non-infected wheat grains. The highest endpoint level of phytase activity inhibition was 90%, observed with grain protein extracts (GPE) from F. graminearum infected wheat. Wheat GPE from grains infected with F. graminearum inhibits phytase activity significantly more than GPE from non-infected grains. For four barley cultivars studied, the IC50 value ranged from 0.978 ± 0.271 to 3.616 ± 0.087 mg×ml-1. For two non-infected wheat cultivars investigated, the IC50 values were varying from 2.478 ± 0.114 to 3.038 ± 0.097 mg×ml-1. The maize and rice cultivars tested gaveIC50 values on 0.983 ± 0.205 and 1.972 ± 0.019 mg×ml-1, respectively. After purifying the inhibitor from barley grains via Superdex G200, an approximately 30–35 kDa protein was identified. No clear trend for the mechanism of inhibition could be identified via Michaelis-Menten kinetics and Lineweaver-Burk plots. However, testing of the purified phytase inhibitor together with the A. ficuum phytase and the specific protease inhibitors pepstatin A, E64, EDTA and PMSF revealed that pepstatin A repealed the phytase inhibition. This indicates that the observed inhibition of A. ficuum phytase by cereal grain extracts is caused by protease activity of the aspartic proteinase type. PMID:28472144

Competition and dental services.

PubMed

Grytten, J; Sørensen, R

2000-07-01

Dental services for adults are different from all other Norwegian health services in that they are provided by private producers (dentists) who have full freedom to establish a practice. They have had this freedom since the end of World War II. A further liberalization of the market for dental services occurred in November 1995, when the so-called normal tariff was repealed. The system changed from a fixed fee system to a deregulated fee system. In principle, the market for dental services for adults operates as a free competitive market, in which dentists must compete for a market share. The aim of this study was to study the short-term effects of competition. A comprehensive set of data on fees, practice characteristics, treatment profiles and factors that dentists take into account when determining fees was analysed. The main finding was that competition has a weak effect. No support was found for the theory that the level of fees is the result of monopolistic competition or monopoly. The results also provided some evidence against the inducement hypothesis. At this stage, it is interesting to notice that dentists do not seem to exploit the power they have to control the market. One explanation, which is consistent with the more recent literature, is that physicians' behaviour to a large extent is influenced by professional norms and caring concerns about their patients. Financial incentives are important, but these incentives are constrained by norms other than self-interest. The interpretation of the results should also take into account that the deregulation has operated for a short time and that dentists and patients may not yet have adjusted to changes in the characteristics of the market. Copyright 2000 John Wiley & Sons, Ltd.

Smoke Extract Impairs Adenosine Wound Healing. Implications of Smoke-Generated Reactive Oxygen Species

PubMed Central

Zimmerman, Matthew C.; Zhang, Hui; Castellanos, Glenda; O’Malley, Jennifer K.; Alvarez-Ramirez, Horacio; Kharbanda, Kusum; Sisson, Joseph H.; Wyatt, Todd A.

2013-01-01

Adenosine concentrations are elevated in the lungs of patients with asthma and chronic obstructive pulmonary disease, where it balances between tissue repair and excessive airway remodeling. We previously demonstrated that the activation of the adenosine A2A receptor promotes epithelial wound closure. However, the mechanism by which adenosine-mediated wound healing occurs after cigarette smoke exposure has not been investigated. The present study investigates whether cigarette smoke exposure alters adenosine-mediated reparative properties via its ability to induce a shift in the oxidant/antioxidant balance. Using an in vitro wounding model, bronchial epithelial cells were exposed to 5% cigarette smoke extract, were wounded, and were then stimulated with either 10 μM adenosine or the specific A2A receptor agonist, 5′-(N-cyclopropyl)–carboxamido–adenosine (CPCA; 10 μM), and assessed for wound closure. In a subset of experiments, bronchial epithelial cells were infected with adenovirus vectors encoding human superoxide dismutase and/or catalase or control vector. In the presence of 5% smoke extract, significant delay was evident in both adenosine-mediated and CPCA-mediated wound closure. However, cells pretreated with N-acetylcysteine (NAC), a nonspecific antioxidant, reversed smoke extract–mediated inhibition. We found that cells overexpressing mitochondrial catalase repealed the smoke extract inhibition of CPCA-stimulated wound closure, whereas superoxide dismutase overexpression exerted no effect. Kinase experiments revealed that smoke extract significantly reduced the A2A-mediated activation of cyclic adenosine monophosphate–dependent protein kinase. However, pretreatment with NAC reversed this effect. In conclusion, our data suggest that cigarette smoke exposure impairs A2A-stimulated wound repair via a reactive oxygen species–dependent mechanism, thereby providing a better understanding of adenosine signaling that may direct the development of pharmacological tools for the treatment of chronic inflammatory lung disorders. PMID:23371060

A constitution for AIDS.

PubMed

Koshy, L M

1996-01-15

The Indian Health Organization projected the number of deaths per day due to AIDS by the year 2000 at 10,000. An interdisciplinary international conference was held in New Delhi to draft an international law governing the issues related to AIDS. Human freedom and public health policies are the most affected by this disease. In the absence of an international AIDS law, judicial verdicts set precedents and could have serious ramifications. A participant from the John Marshall Law School, Chicago, suggested that instead of making new laws, the existing ones from the colonial past should be repealed. This includes Section 377 of the Indian Penal Code, which provides criminal sanctions against those who indulge in unnatural relations with man, woman, or animal. Penalizing homosexuality will only perpetuate clandestine relations and spread the virus into their families. Another participant seconded this motion stating that even a sex worker must be protected from abuse and indignity. The National AIDS Control Organization responded to the criticism that the government had not utilized all the World Bank funds allocated for anti-AIDS projects. The trends of the epidemic were the most important indicators not just the numbers. In Manipur and Mizoram, infection was almost entirely due to injecting drug use. The Saheli project undertaken in the red-light areas of Bombay encompassed brothel owners and prostitutes, which could be replicated in other areas. Because existing government policies were focusing on prevention, there was no protection of an HIV-infected individual's privacy, one participant from Madras stated. The confidentiality issue was also echoed by a US participant. The New Delhi Declaration and Action Plan on HIV/AIDS was also discussed. It forbids discrimination in employment, education, housing, health care, social security, travel, and marital and reproductive rights. Providing sterile needles and ensuring the safety of the blood supply were other concerns mentioned.

MACRA 2.0: are you ready for MIPS?

PubMed

Hirsch, Joshua A; Rosenkrantz, Andrew B; Ansari, Sameer A; Manchikanti, Laxmaiah; Nicola, Gregory N

2017-07-01

The annual cost of healthcare delivery in the USA now exceeds US$3 trillion. Fee for service methodology is often implicated as a cause of this exceedingly high figure. The Affordable Care Act created the Center for Medicare and Medicaid Innovation (CMMI) to pilot test value based alternative payments for reimbursing physician services. In 2015, the Medicare Access and CHIP Reauthorization Act (MACRA) was passed into law. MACRA has dramatic implications for all US based healthcare providers. MACRA permanently repealed the Medicare Sustainable Growth Rate so as to stabilize physician part B Medicare payments, consolidated pre-existing federal performance programs into the Merit based Incentive Payments System (MIPS), and legislatively mandated new approaches to paying clinicians. Neurointerventionalists will predominantly participate in MIPS. MIPS unifies, updates, and streamlines previously existing federal performance programs, thereby reducing onerous redundancies and overall administrative burden, while consolidating performance based payment adjustments. While MIPS may be perceived as a straightforward continuation of fee for service methodology with performance modifiers, MIPS is better viewed as a stepping stone toward eventually adopting alternative payment models in later years. In October 2016, the Centers for Medicare and Medicaid Services (CMS) released a final rule for MACRA implementation, providing greater clarity regarding 2017 requirements. The final rule provides a range of options for easing MIPS reporting requirements in the first performance year. Nonetheless, taking the newly offered 'minimum possible' approach toward meeting the requirements will still have negative consequences for providers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Social capacity building towards flood risk resilience in England: The impact of shifts in risk governance

NASA Astrophysics Data System (ADS)

Begg, C.; Walker, G.

2012-04-01

CapHaz-Net - capacity building for natural hazards in Europe: towards more resilient societies - sees efforts to reduce vulnerability to natural hazards as a social endeavor. One of the findings from this project is the importance of as well as the advantages and pitfalls of participation within the natural hazard management process. Although participation is seen to be important it is still only a small part of the overall management process. However, as European societies see shifts in risk governance from the state to the local level, how are these participation processes likely to change? This paper takes these findings and looks at England as a case study. This case study focuses on the Big Society which promises to be the change that will remedy what Prime Minister David Cameron sees as a broken society. The idea has been put into practice through the Localism Act. The Act seeks not to totally repeal state control but to make decision-making processes more democratic. This includes less bureaucracy for local government to deal with and more space for innovation when dealing with local issues and support for volunteers, mutuals, co-ops, charities and social enterprises to get involved in decision-making and provision of services. But how is this shift going to be everything that it promises to be? And, what does this shift mean for flood risk management? Moreover, how are local people engaged to become involved in shaping the decisions that affect them? By conducting interviews with key stakeholders, this research aims at gaining an understanding of forms of participation that exist in the British context and the public reaction to such opportunities. In turn, this research aims to understand the boundaries of localism in regards to the delivery of flood risk management.

[Placement of children and adolescents following seclusion and restraint actions–a study on family-court approvals of minors in youth welfare, child and adolescent psychiatry and jail according to Para. 1631 German Civil Code].

PubMed

Kölch, Michael; Vogel, Harald

2016-01-01

According to German law (Para. 1631b German Civil Code), the placement of children and adolescents following seclusion and restraint actions must be approved by a family court. We analyzed the family court data of a court district in Berlin (Tempelhof-Kreuzberg) concerning cases of “placement of minors” between 2008 and 2011. A total of 474 such procedures were discovered. After data clearing and correction of cases (e. g., because of emergency interventions of the youth welfare system taking children into custody according to Para. 42, German Civil Code VIII), 376 cases remained. Of these 376 procedures in the years 2008 to 2011, 127 cases concerned children and adolescents according to Para. 1631b German Civil Code, and 249 procedures were settled either by dismissal, withdrawal or by repealing the initial decision to place the child with restrain or seclusion by means of an interim order or by filing an appeal against the final decision. Of the 127 procedures, 68 concerned girls, who were on average slightly younger than boys (14.5 years vs. 15.1 years). In two thirds of the procedures, the children and adolescents were German citizens. The majority of youths involved were living at home at the time of the procedure, but in 15 % of the case the youths were homeless. Most of the adolescents were treated with restraint in child and adolescent psychiatry. The most frequently quoted reasons for seclusion were substance abuse, suicide risk and running away from home/being homeless.

What's at Stake in U.S. Health Reform: A Guide to the Affordable Care Act and Value-Based Care.

PubMed

Rambur, Betty A

2017-05-01

The U.S. presidential election of 2016 accentuated the divided perspectives on the Patient Protection and Affordable Care Act of 2010, commonly known as Obamacare. The perspectives included a pledge from then candidate Donald J. Trump to "repeal and replace on day one"; Republican congressional leaders' more temperate suggestions in the first weeks of the Trump administration to "repair" the Affordable Care Act (ACA); and President Trump's February 5, 2017 statement-16 days after inauguration-that a Republican replacement for the ACA may not be ready until late 2017 or 2018. The swirling rhetoric, media attention, and the dizzying rate of U.S. health and payment reforms both within and outside of the ACA makes it difficult for nurses, both United States and globally, to discern which health policy issues are grounded in the ACA and which aspects reflect payer-driven "volume to value" reimbursement changes. Moreover, popular and controversial elements of the ACA-for example, the clause that prohibits insurance carriers to deny coverage to those with preexisting health conditions and the more controversial individual mandate that bears Supreme Court support as a constitutional provision-are paired in ways that might be unclear to those unfamiliar with nuances of insurance rate determination. To support nurses' capacity to maximize their impact on health policy, this overview distills the 906-page ACA into major themes and describes payment reform legislation and initiatives that are external to the ACA. Understanding the political and societal forces that affect health care policy and delivery is necessary for nurses to effectively lead and advocate for the best interests of their patients.

Terrorism in South Africa.

PubMed

MacFarlane, Campbell

2003-01-01

The Republic of South Africa lies at the southern tip of the African continent. The population encompasses a variety of races, ethnic groups, religions, and cultural identities. The country has had a turbulent history from early tribal conflicts, colonialisation, the apartheid period, and post-apartheid readjustment. Modern terrorism developed mainly during the apartheid period, both by activities of the state and by the liberation movements that continued to the time of the first democratic elections in 1994, which saw South Africa evolve into a fully representative democratic state with equal rights for all. Since 1994, terrorist acts have been criminal-based, evolving in the Cape Town area to political acts, largely laid at the feet of a predominantly Muslim organisation, People against Gangsterism and Drugs, a vigilant organisation allegedly infiltrated by Muslim fundamentalists. Along with this, has been terrorist activities, mainly bombings by disaffected members of white, right-wing groups. In the apartheid era, a Draconian series of laws was enacted to suppress liberation activities. After 1994, most of these were repealed and new legislation was enacted, particularly after the events of 11 September 2001; this legislation allows the government to act against terrorism within the constraints of a democratic system. Disaster management in South Africa has been largely local authority-based, with input from provincial authorities and Civil Defence. After 1994, attempts were made to improve this situation, and national direction was provided. After 11 September 2001, activity was increased and the Disaster Management Act 2002 was brought into effect. This standardized disaster management system at national, provincial, and local levels, also facilites risk assessment and limitation as well as disaster mitigation. The potential still exists for terrorism, mainly from right-wing and Muslim fundamentalist groups, but the new legislation should stimulate disaster management in South Africa to new and improved levels.

A Prospective Analysis of the Costs, Benefits, and Impacts of U.S. Renewable Portfolio Standards

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mai, Trieu; Wiser, Ryan; Barbose, Galen

As states have gained experience with renewable portfolio standards (RPS) policies, many have made significant revisions to existing programs. In 2015 and 2016, seven states raised and extended their final RPS targets, while another state enacted a new RPS policy (Barbose 2016b). Interest in expanding and strengthening state RPS programs may continue, while efforts like recent proposals in many states to repeal or freeze existing RPS policies may also persist. In either context, questions about the potential costs, benefits, and other impacts of RPS programs are usually central to the decision-making process. This report follows on previous analyses that havemore » focused on the historical costs, benefits, and other impacts of existing state RPS programs (Heeter et al. 2014; Wiser et al. 2016a). This report examines RPS outcomes prospectively, considering both current RPS policies as well as a potential expansion of those policies. The goal of this work is to provide a consistent and independent analytical methodology for that examination. This analysis relies on National Renewable Energy Laboratory’s (NREL’s) Regional Energy Deployment System (ReEDS) model to estimate changes to the U.S. electric power sector across a number of scenarios and sensitivity cases, focusing on the 2015–2050 timeframe. Based on those modeled results, we evaluate the costs, benefits, and other impacts of renewable energy contributing to RPS compliance using the suite of methods employed in a number of recent studies sponsored by the U.S. Department of Energy (DOE): a report examining retrospective benefits and impacts of RPS programs (Wiser et al. 2016a), the Wind Vision report (DOE 2015), the On the Path to SunShot report focusing on environmental benefits (Wiser et al. 2016b), and the Hydropower Vision report (DOE 2016).« less

The Economic Impact of Helmet Use on Motorcycle Accidents: A Systematic Review and Meta-analysis of the Literature from the Past 20 Years.

PubMed

Kim, Chang-Yeon; Wiznia, Daniel H; Averbukh, Leon; Dai, Feng; Leslie, Michael P

2015-01-01

The incidence and cost of motorcycle accidents are projected to increase. Motorcycle helmets are accepted as an effective strategy for reducing the morbidity and therefore the cost of motorcycle accidents. Despite this, states have continued to repeal helmet laws in the past 20 years. In addition, variations in the methodologies and outcomes of published reports have contributed to uncertainty regarding the health care dollars saved due to motorcycle helmet use. The purpose of this systematic review and meta-analysis is to clarify the economic impact of motorcycle helmet use. Our primary source was Medline. Search terms included "motorcycle," "motorbike," "motorcycle helmet," "head protective devices," and "cost and cost analysis." The review only included articles that were primary studies, written in English, evaluations of periods after 1994, and published in a peer-reviewed journal. Two independent authors extracted data using predefined data fields. Meta-analysis was done using the R-metafor package. Twelve papers met the criteria for inclusion. Meta-analysis demonstrated that nonhelmeted patients required $12,239 more in hospital costs per patient. Nonhelmeted patients also required more postdischarge care and were more likely to use publicly funded insurance. Studies also found lower injury severity and better hospital course in the helmeted population. Study limitations included selection bias, unclear statistical assumptions, lack of precision measures, confounding variables, and lack of standardization to a common year. Meta-analysis demonstrated an I2 of 67%, attributing a significant proportion of outcome variation to study differences. Motorcycle helmet use reduces morbidity and contributes to significant health care cost savings. Continuing antihelmet legislation will impose a substantial economic burden to the health care system, the government, and the public.

The actual development of European Aviation Safety Requirements in Aviation Medicine: Prospects of Future EASA Requirements

PubMed Central

Siedenburg, J

2009-01-01

Common Rules for Aviation Safety had been developed under the aegis of the Joint Aviation Authorities in the 1990ies. In 2002 the Basic Regulation 1592/2002 was the founding document of a new entity, the European Aviation Safety Agency. Areas of activity were Certification and Maintenance of aircraft. On 18 March the new Basic Regulation 216/2008, repealing the original Basic Regulation was published and applicable from 08 April on. The included Essential Requirements extended the competencies of EASA inter alia to Pilot Licensing and Flight Operations. The future aeromedical requirements will be included as Annex II in another Implementing Regulation on Personnel Licensing. The detailed provisions will be published as guidance material. The proposals for these provisions have been published on 05 June 2008 as NPA 2008- 17c. After public consultation, processing of comments and final adoption the new proposals may be applicable form the second half of 2009 on. A transition period of four year will apply. Whereas the provisions are based on Joint Awiation Requirement - Flight Crew Licensing (JAR-FCL) 3, a new Light Aircraft Pilot Licence (LAPL) project and the details of the associated medical certification regarding general practitioners will be something new in aviation medicine. This paper consists of 6 sections. The introduction outlines the idea of international aviation safety. The second section describes the development of the Joint Aviation Authorities (JAA), the first step to common rules for aviation safety in Europe. The third section encompasses a major change as next step: the foundation of the European Aviation Safety Agency (EASA) and the development of its rules. In the following section provides an outline of the new medical requirements. Section five emphasizes the new concept of a Leisure Pilot Licence. The last section gives an outlook on ongoing rulemaking activities and the opportunities of the public to participate in them. PMID:19561781

Repeal of the concealed weapons law and its impact on gun-related injuries and deaths.

PubMed

Ginwalla, Rashna; Rhee, Peter; Friese, Randall; Green, Donald J; Gries, Lynn; Joseph, Bellal; Kulvatunyou, Narong; Lubin, Dafney; O'Keeffe, Terence; Vercruysse, Gary; Wynne, Julie; Tang, Andrew

2014-03-01

Senate Bill 1108 (SB-1108) allows adult citizens to carry concealed weapons without a permit and without completion of a training course. It is unclear whether the law creates a "deterrent factor" to criminals or whether it escalates gun-related violence. We hypothesized that the enactment of SB-1108 resulted in an increase in gun-related injuries and deaths (GRIDs) in southern Arizona. We performed a retrospective cohort study spanning 24 months before (prelaw) and after (postlaw) SB-1108. We collected injury and death data and overall crime and accident trends. Injured patients were dichotomized based on whether their injuries were intentional (iGRIDs) or accidental (aGRIDs). The primary outcome was any GRID. To determine proportional differences in GRIDs between the two periods, we performed χ analyses. For each subgroup, we calculated relative risk (RR). The number of national and state background checks for firearms purchases increased in the postlaw period (national and state p < 0.001); that increase was proportionately reflected in a relative increase in state firearm purchase in the postlaw period (1.50% prelaw vs. 1.59% postlaw, p < 0.001). Overall, victims of events potentially involving guns had an 11% increased risk of being injured or killed by a firearm (p = 0.036) The proportion of iGRIDs to overall city violent crime remained the same during the two periods (9.74% prelaw vs. 10.36% postlaw; RR, 1.06; 95% confidence interval, 0.96-1.17). However, in the postlaw period, the proportion of gun-related homicides increased by 27% after SB-1108 (RR, 1.27; 95% confidence interval, 1.02-1.58). Both nationally and statewide, firearm purchases increased after the passage of SB-1108. Although the proportion of iGRIDs to overall city violent crime remained the same, the proportion of gun-related homicides increased. Liberalization of gun access is associated with an increase in fatalities from guns. Epidemiologic study, level III.

[Nonnative guidelines for allocating human resources in child and adolescent psychiatry using average values under convergence conditions instead of price determination - analysis of the data of university hospitals in Germany concerning the costs of calculating day and minute values according to Psych-PV and PEPP-System].

PubMed

Barufka, Steffi; Heller, Michael; Prayon, Valeria; Fegert, Jörg M

2015-11-01

Despite substantial opposition in the practical field, based on an amendment to the Hospital Financing Act (KHG). the so-called PEPP-System was introduced in child and adolescent psychiatry as a new calculation model. The 2-year moratorium, combined with the rescheduling of the repeal of the psychiatry personnel regulation (Psych-PV) and a convergence phase, provided the German Federal Ministry of Health with additional time to enter a structured dialogue with professional associations. Especially the perspective concerning the regulatory framework is presently unclear. In light of this debate, this article provides calculations to illustrate the transformation of the previous personnel regulation into the PEPP-System by means of the data of §21 KHEntgG stemming from the 22 university hospitals of child and adolescent psychiatry and psychotherapy in Germany. In 2013 there was a total of 7,712 cases and 263,694 calculation days. In order to identify a necessary basic reimbursement value th1\\t would guarantee a constant quality of patient care, the authors utilize outcomes, cost structures, calculation days, and minute values for individual professional groups according to both systems (Psych-PV and PEPP) based on data from 2013 and the InEK' s analysis of the calculation datasets. The authors propose a normative agreement on the basic reimbursement value between 270 and 285 EUR. This takes into account the concentration phenomenon and the expansion of services that has occurred since the introduction of the Psych-PV system. Such a normative agreement on structural quality could provide a verifiable framework for the allocation of human resources corresponding to the previous regulations of Psych-PV.

Analysis of the proposed EU regulation concerning biocide products and its opportunities for alternative approaches and a toxicology for the 21st century (t4 report).

PubMed

Ferrario, Daniele; Rabbit, Richard R

2012-01-01

On June 12, 2009, the European Commission adopted a proposal for a Regulation concerning the placement on the market and use of biocidal products, which, when it enters into force on January 1, 2013, will repeal and replace Directive 98/8/EC. The main reason for the revision of the current Directive was to promote best practices for environmental and human health protection, along with implementation of current developments in safety testing in order to create safer biocides. Moreover, the proposed Regulation aims to take into consideration the newest legislation on chemicals. This article evaluates the proposed Regulation in comparison to Directive 98/8/EC. Although the new proposal requires the sharing of vertebrate animal test data, both for product authorization and for newly developed active substances, it misses - in contrast to REACH - the opportunity to recognize the accelerating development of alternative approaches to animal testing, most recently with new momentum provided by "Toxicity Testing for the 21st Century", and to support the evolution of toxicology towards a new approach to testing. The new methods promise not only to decrease animal pain and suffering, but also to provide faster results and better prediction for human risk assessment compared to traditional methods. Unfortunately, methods mandated for human risk assessment in the proposal are still mainly based on traditional animal study extrapolation. We put forward and discuss possible alternative strategies, such as in vitro testing, integrated testing strategies, toxicokinetics, "omics", systems biology, bioinformatics, and computational modeling, all of which could be more encouraged by the proposal. Current opportunities to improve our tools for biocide risk assessment are discussed, delineating advantages, limitations, and development needs. It is suggested to open the proposed Regulation to alternative approaches that are based on human biology more than on extrapolation from animals to humans.

Research on PTSD prevalence in OEF/OIF Veterans: expanding investigation of demographic variables.

PubMed

Averill, Lynnette A; Eubanks Fleming, C J; Holens, Pamela L; Larsen, Sadie E

2015-01-01

A series of recent articles has reported on well-designed studies examining base rates of posttraumatic stress disorder (PTSD) screenings within the Operation Enduring Freedom (Afghanistan conflict)/Operation Iraqi Freedom (Iraq conflict) (OEF/OIF) military population. Although these studies have a number of strengths, this line of research points out several key areas in need of further examination. Many OEF/OIF Veterans do not use available Veterans Affairs (VA) services, especially mental health care. This highlights the need to understand the differences between those who use and do not use the VA, especially as research with pre-OEF/OIF Veterans suggests that these two groups differ in significant ways. The high rates of PTSD-related concerns in non-VA users also points to a need to understand whether-and where-Veterans are seeking care outside the VA and the accessibility of evidence-based, trauma-focused treatments in the community and private sectors. Careful examination of relationship status is also paramount as little research has examined relationship status or other relationship context issues. Social support, especially from a spouse, can buffer the development of PTSD; however, relationship discord has the potential to greatly exacerbate PTSD symptomatology. Furthermore, given the additional risk factors for sexual minority Veterans to be exposed to trauma, the 2011 repeal of the US Military "Don't Ask, Don't Tell" policy, and the emergence of the VA as likely the largest health care provider for sexual minority Veterans, it will be critically important to study the trauma and mental health experiences of this group. Studies that examine prevalence rates of PTSD in the returning cohort contribute significantly to our understanding of the US OEF/OIF military population. Further study of PTSD in relation to demographic variables such as VA and non-VA use, relationship status, and sexual orientation will provide rich data that will enhance our ability to develop policy and practice to provide the best care to this population.

The actual development of European aviation safety requirements in aviation medicine: prospects of future EASA requirements.

PubMed

Siedenburg, J

2009-04-01

Common Rules for Aviation Safety had been developed under the aegis of the Joint Aviation Authorities in the 1990s. In 2002 the Basic Regulation 1592/2002 was the founding document of a new entity, the European Aviation Safety Agency. Areas of activity were Certification and Maintenance of aircraft. On 18 March the new Basic Regulation 216/2008, repealing the original Basic Regulation was published and applicable from 08 April on. The included Essential Requirements extended the competencies of EASA inter alia to Pilot Licensing and Flight Operations. The future aeromedical requirements will be included as Annex II in another Implementing Regulation on Personnel Licensing. The detailed provisions will be published as guidance material. The proposals for these provisions have been published on 05 June 2008 as NPA 2008- 17c. After public consultation, processing of comments and final adoption the new proposals may be applicable form the second half of 2009 on. A transition period of four year will apply. Whereas the provisions are based on Joint Aviation Requirement-Flight Crew Licensing (JAR-FCL) 3, a new Light Aircraft Pilot Licence (LAPL) project and the details of the associated medical certification regarding general practitioners will be something new in aviation medicine. This paper consists of 6 sections. The introduction outlines the idea of international aviation safety. The second section describes the development of the Joint Aviation Authorities (JAA), the first step to common rules for aviation safety in Europe. The third section encompasses a major change as next step: the foundation of the European Aviation Safety Agency (EASA) and the development of its rules. In the following section provides an outline of the new medical requirements. Section five emphasizes the new concept of a Leisure Pilot Licence. The last section gives an outlook on ongoing rulemaking activities and the opportunities of the public to participate in them.

Evolution of US Health Care Reform.

PubMed

Manchikanti, Laxmaiah; Helm Ii, Standiford; Benyamin, Ramsin M; Hirsch, Joshua A

2017-03-01

Major health policy creation or changes, including governmental and private policies affecting health care delivery are based on health care reform(s). Health care reform has been a global issue over the years and the United States has seen proposals for multiple reforms over the years. A successful, health care proposal in the United States with involvement of the federal government was the short-lived establishment of the first system of national medical care in the South. In the 20th century, the United States was influenced by progressivism leading to the initiation of efforts to achieve universal coverage, supported by a Republican presidential candidate, Theodore Roosevelt. In 1933, Franklin D. Roosevelt, a Democrat, included a publicly funded health care program while drafting provisions to Social Security legislation, which was eliminated from the final legislation. Subsequently, multiple proposals were introduced, starting in 1949 with President Harry S Truman who proposed universal health care; the proposal by Lyndon B. Johnson with Social Security Act in 1965 which created Medicare and Medicaid; proposals by Ted Kennedy and President Richard Nixon that promoted variations of universal health care. presidential candidate Jimmy Carter also proposed universal health care. This was followed by an effort by President Bill Clinton and headed by first lady Hillary Clinton in 1993, but was not enacted into law. Finally, the election of President Barack Obama and control of both houses of Congress by the Democrats led to the passage of the Affordable Care Act (ACA), often referred to as "ObamaCare" was signed into law in March 2010. Since then, the ACA, or Obamacare, has become a centerpiece of political campaigning. The Republicans now control the presidency and both houses of Congress and are attempting to repeal and replace the ACA. Key words: Health care reform, Affordable Care Act (ACA), Obamacare, Medicare, Medicaid, American Health Care Act.

Trade challenges at the World Trade Organization to national noncommunicable disease prevention policies: A thematic document analysis of trade and health policy space.

PubMed

Barlow, Pepita; Labonte, Ronald; McKee, Martin; Stuckler, David

2018-06-01

It has long been contested that trade rules and agreements are used to dispute regulations aimed at preventing noncommunicable diseases (NCDs). Yet most analyses of trade rules and agreements focus on trade disputes, potentially overlooking how a challenge to a regulation's consistency with trade rules may lead to 'policy or regulatory chill' effects whereby countries delay, alter, or repeal regulations in order to avoid the costs of a dispute. Systematic empirical analysis of this pathway to impact was previously prevented by a dearth of systematically coded data. Here, we analyse a newly created dataset of trade challenges about food, beverage, and tobacco regulations among 122 World Trade Organization (WTO) members from January 1, 1995 to December 31, 2016. We thematically describe the scope and frequency of trade challenges, analyse economic asymmetries between countries raising and defending them, and summarise 4 cases of their possible influence. Between 1995 and 2016, 93 food, beverage, and tobacco regulations were challenged at the WTO. 'Unnecessary' trade costs were the focus of 16.4% of the challenges. Only one (1.1%) challenge remained unresolved and escalated to a trade dispute. Thirty-nine (41.9%) challenges focussed on labelling regulations, and 18 (19.4%) focussed on quality standards and restrictions on certain products like processed meats and cigarette flavourings. High-income countries raised 77.4% (n = 72) of all challenges raised against low- and lower-middle-income countries. We further identified 4 cases in Indonesia, Chile, Colombia, and Saudi Arabia in which challenges were associated with changes to food and beverage regulations. Data limitations precluded a comprehensive evaluation of policy impact and challenge validity. Policy makers appear to face significant pressure to design food, beverage, and tobacco regulations that other countries will deem consistent with trade rules. Trade-related influence on public health policy is likely to be understated by analyses limited to formal trade disputes.

Does the U.S. biofuels mandate increase the price at the pump?

NASA Astrophysics Data System (ADS)

Bolotin, Stephen R.

The Renewable Fuel Standard (RFS) as amended by the Energy Independence and Security Act of 2007 created a federal mandate for blending conventional biofuels like corn-based ethanol and advanced biofuels like biodiesel and renewable gasoline into the United States transportation fuel supply. The RFS established yearly blending standards for the obligated parties--refiners and importers of petroleum products--that increase progressively until reaching a high of 36 billion gallons by 2022. Each ethanol-equivalent gallon of biofuel blended is assigned a unique Renewable Identification Number (RIN) through the Environmental Protection Agency's (EPA) Moderated Transaction System (EMTS). At year's close, obligated parties must submit their allotted RIN obligations to the EPA to demonstrate compliance. In the case of under-compliance or over-compliance, RINs can be traded between obligated parties freely through the EMTS or carried over for use in the next year. It follows, then, that a RIN carries a market value reflective of the cost of complying with RFS regulations. Indeed, most biofuels cost more than their fossil-based equivalents. When the price of a corn ethanol RIN went from 2-3 cents each in 2012 to nearly $1.50 in July of 2013 due to a perceived shortage in corn ethanol RINs, obligated parties faced the prospect of multimillion-dollar compliance cost increases. Arguing that RFS makes fuel significantly more expensive for consumers, petroleum companies have begun to advocate for the full repeal of the RFS, winning over some allies in Congress. The future of this program is uncertain. In an attempt to quantify the concerns of RFS critics, this thesis estimated the effect that RIN prices have on the wholesale cost of diesel fuel. Using daily price data from January 2011 through August of 2013 on RINs and crude oil, I specified twelve OLS regression models that predict the passthrough of the diesel RIN price to wholesale diesel price. My statistical analysis suggests that the diesel RIN price is a useful predictor of wholesale diesel price; however, my analysis also casts some doubt on the claims of obligated parties that they pass the cost of compliance onto the consumer, thereby increasing fuel prices significantly.

Analyzing 20 years of Black Carbon measurements in Germany

NASA Astrophysics Data System (ADS)

Kutzner, R. D.; Quedenau, J.; Kuik, F.; von Schneidemesser, E.; Schmale, J.

2016-12-01

Black Carbon (BC) is an important short-lived climate-forcing pollutant contributing to global warming through absorption of sunlight. In addition, BC, as a component of particulate matter (PM) exerts adverse health effects. Anthropogenic emission sources of BC include residential heating, transport, and agricultural fires, and the dominant natural emission source is wildfires. Despite the adverse effects of BC, legislation that requires mandatory monitoring of BC concentrations does not currently exist in the European Union (EU). Instead, BC is only indirectly monitored as component of PM10 and PM2.5 (PM with a diameter smaller 10 µm and 2.5 µm, respectively). Before the introduction of mandatory PM10 and PM2.5 monitoring in the EU in 2005 and 2015, respectively, `black smoke' (BS), a surrogate for BC, was a required measurement in Germany from the early 1990s. The annual mean limit value was 14 µg/m3 from 1995 and 8 µg/m³ from 1998. In 2004, many measurements were stopped, with the repeal of the regulations. In most German federal states a limited number BC monitoring stations continued to operate. We present a synthesis of BC data from 213 stations across Germany covering the period between 1994 and 2014. Due to the lack of a standardized method and respective legislation, the data set is very heterogeneous relying on twelve different measurement methods including chemical, optical, and thermal-optical methods. Stations include, among others, urban background, traffic and rural. We highlight results from the year 2009, as it is the year with the largest measurement coverage based on the same measurement method, with 28 stations. Further, we calculated trends in BC concentrations for 13 stations with at least 10 years of data, for median concentrations, as well as 5th percentile (background) and 95th percentile (peak episodes). Preliminary results suggest that concentrations have generally declined, with a larger trend at traffic stations compared to urban background stations between 2005 and 2014. However, preliminary results also show that concentrations are highest during the colder months, likely linked to residential heating.

Legal rights, human rights and AIDS: the first decade. Report from South Africa 2.

PubMed

Cameron, E

1993-01-01

A broad range of coercive measures has been considered internationally and applied in some countries in the interest of controlling the spread of HIV. Although a couple such measures are on the books in South Africa, they have never been invoked and will soon be officially repealed. There is, however, a problem in South Africa with the violation by health care workers, employers, and others of individuals' rights to dignity, privacy, and autonomy. The exaggerated and undue fear that doctors and other health workers have of being infected by patients with HIV has led to widespread and gross human rights abuses in clinical management and treatment. Abuses include the refusal of treatment, testing patients for HIV without their informed or any consent, insisting upon HIV testing devoid of diagnostic or therapeutic justification, and widespread breaches of confidentiality. Persons with AIDS and HIV are also denied access to their fair share of national resources. This latter phenomenon is likely to become the principal form of human rights abuse, with racism and class differences exacerbating the problem. The practice is proliferating and takes many forms including pre-employment HIV testing; exclusionary discrimination in insurance; discrimination between HIV and other life-threatening conditions in corporate medical, pension, and provident funds; and the discriminatory denial of fair and adequate health care to people with HIV or AIDS. Discrimination of all kinds, however, retards preventive efforts. Public health therefore demands the recognition and enforcement of individual human rights and that structures of discrimination be eliminated. Human rights protection may, by limiting the effect of discrimination, play a significant part in fighting the epidemic. Protective measures could include enacting legislation to prohibit pre-employment testing, legislation to regulate the provision of insurance and to prohibit or regulate pre-insurance HIV testing and the wholesale refusal of AIDS-related coverage, and more broadly drafted legislation to prohibit public enterprises from discriminating against persons on the basis of HIV or AIDS and to enshrine the principle of nondiscrimination.

Ministerial Decision No. G2a/ik. 4108 laying down regulations on the operation of State facilities for children and State facilities for young children, 1 August 1988.

PubMed

1989-01-01

This Greek decision repeals all contrary provisions. Sec. 1 lays down that state facilities for children and state facilities for young children have as their objective to ensure, on a day-to-day basis, that young children who cannot obtain the necessary care because their parents work, or for other social reasons, obtain food, education, and recreation. Sec. 15 lays down that the children accepted in such facilities are to have their health monitored by a physician under contract to the facility, unless the facility can obtain the services of the National Health System. The physician is to draw up a detailed record for each child dealing with the various aspects of its health. The staff of the facility are also to be responsible for safeguarding the health of the child, within the various areas of responsibility of the individual staff members; such staff are to take all steps necessary for health and safety and to be responsible for any errors or omissions liable to produce an adverse affect on children's health. Under Sec. 24, the contractual physician is to discharge the following duties: provide health services and visit the facility once every 15 days; carry out a medical examination of every child, monitor its physical and intellectual development, and verify that the compulsory vaccinations have been carried out; keep the health records of the children up to date and indicate to the director and the parents appropriate measures to be taken; propose hygiene measures to be taken concerning children's health and the health conditions in the facility; ensure that the pharmacy of the facility has the necessary first-aid medicaments available; indicate the measures appropriate to the protection of the children against infectious diseases and the measures necessary for the prevention and control of such diseases and carry out surveillance of the implementation of these measures; and devise a program and activities concerning health education for children, staff, and parents.

Vital Directions for Health and Health Care: Priorities From a National Academy of Medicine Initiative.

PubMed

Dzau, Victor J; McClellan, Mark B; McGinnis, J Michael; Burke, Sheila P; Coye, Molly J; Diaz, Angela; Daschle, Thomas A; Frist, William H; Gaines, Martha; Hamburg, Margaret A; Henney, Jane E; Kumanyika, Shiriki; Leavitt, Michael O; Parker, Ruth M; Sandy, Lewis G; Schaeffer, Leonard D; Steele, Glenn D; Thompson, Pamela; Zerhouni, Elias

2017-04-11

Recent discussion has focused on questions related to the repeal and replacement of portions of the Affordable Care Act (ACA). However, issues central to the future of health and health care in the United States transcend the ACA provisions receiving the greatest attention. Initiatives directed to certain strategic and infrastructure priorities are vital to achieve better health at lower cost. To review the most salient health challenges and opportunities facing the United States, to identify practical and achievable priorities essential to health progress, and to present policy initiatives critical to the nation's health and fiscal integrity. Qualitative synthesis of 19 National Academy of Medicine-commissioned white papers, with supplemental review and analysis of publicly available data and published research findings. The US health system faces major challenges. Health care costs remain high at $3.2 trillion spent annually, of which an estimated 30% is related to waste, inefficiencies, and excessive prices; health disparities are persistent and worsening; and the health and financial burdens of chronic illness and disability are straining families and communities. Concurrently, promising opportunities and knowledge to achieve change exist. Across the 19 discussion papers examined, 8 crosscutting policy directions were identified as vital to the nation's health and fiscal future, including 4 action priorities and 4 essential infrastructure needs. The action priorities-pay for value, empower people, activate communities, and connect care-recurred across the articles as direct and strategic opportunities to advance a more efficient, equitable, and patient- and community-focused health system. The essential infrastructure needs-measure what matters most, modernize skills, accelerate real-world evidence, and advance science-were the most commonly cited foundational elements to ensure progress. The action priorities and essential infrastructure needs represent major opportunities to improve health outcomes and increase efficiency and value in the health system. As the new US administration and Congress chart the future of health and health care for the United States, and as health leaders across the country contemplate future directions for their programs and initiatives, their leadership and strategic investment in these priorities will be essential for achieving significant progress.

Health Care Efficiencies: Consolidation and Alternative Models vs. Health Care and Antitrust Regulation - Irreconcilable Differences?

PubMed

King, Michael W

2017-11-01

Despite the U.S. substantially outspending peer high income nations with almost 18% of GDP dedicated to health care, on any number of statistical measurements from life expectancy to birth rates to chronic disease, 1 the U.S. achieves inferior health outcomes. In short, Americans receive a very disappointing return on investment on their health care dollars, causing economic and social strain. 2 Accordingly, the debates rage on: what is the top driver of health care spending? Among the culprits: poor communication and coordination among disparate providers, paperwork required by payors and regulations, well-intentioned physicians overprescribing treatments, drugs and devices, outright fraud and abuse, and medical malpractice litigation. Fundamentally, what is the best way to reduce U.S. health care spending, while improving the patient experience of care in terms of quality and satisfaction, and driving better patient health outcomes? Mergers, partnerships, and consolidation in the health care industry, new care delivery models like Accountable Care Organizations and integrated care systems, bundled payments, information technology, innovation through new drugs and new medical devices, or some combination of the foregoing? More importantly, recent ambitious reform efforts fall short of a cohesive approach, leaving fundamental internal inconsistencies across divergent arms of the federal government, raising the issue of whether the U.S. health care system can drive sufficient efficiencies within the current health care and antitrust regulatory environments. While debate rages on Capitol Hill over "repeal and replace," only limited attention has been directed toward reforming the current "fee-for-service" model pursuant to which providers are paid for volume of care rather than quality or outcomes. Indeed, both the Patient Protection and Affordable Care Act ("ACA") 3 and proposals for its replacement focus primarily on the reach and cost of providing coverage for health care, rather than specifics for the delivery of health care. 4 With the U.S. expenditures on health care producing inferior results, experts see consolidation and alternatives to fee-for-service as fundamental to reducing costs. 5 Integrating care coordination and delivery and increasing scale to drive efficiencies allows organizations to benefit from shared savings and relationships with payors and vendors. 6 Deloitte forecasts that, by 2024, the current health system landscape-which includes roughly 80 national health systems, 275 regional systems, 130 academic medical centers, and 1,300 small community systems-will morph into just over 900 multi-hospital systems. 7 Even though health care market and payment reforms encourage organizations to consolidate and integrate, innovators must proceed with extreme caution. Health care organizations attempting to drive efficiencies and bring down costs through mergers may run afoul of numerous federal and state laws and regulations. 8 Calls for updates or leniency in these laws are growing, including the possible recognition of an "Obamacare defense" to antitrust restrictions 9 and speculation that laws restricting physicians from having financial relationships will be repealed, ostensibly to allow sharing of the rewards reaped from coordinated care. 10 In the meantime, however, absent specific waivers or exemptions, all the usual rules and regulations apply, including antitrust constraints, 11 physician self-referral 12 and anti-kickback laws and regulations, 13 state fraud and abuse restrictions, 14 and more. In short, a maelstrom of conflicting political prescriptions, health care regulations, and antitrust restrictions undermine the ability of innovators to achieve efficiencies through joint ventures, transactions, innovative models, and other structures. This article first considers the conflicting positions taken by the United States government with respect to achieving efficiencies in health care under the ACA and alternative delivery models, on the one hand, and health care regulatory enforcement and antitrust enforcement, on the other. At almost a fifth of the U.S. economy, 15 health care arguably has grown ungovernable, exceeding the ability of any one law or branch of government to create or implement coherent reform. Indeed, the article posits that although the ACA reformed and expanded access to health care, it failed to transform the way health care is delivered beyond limited "demonstration projects", leaving fee-for-service intact. Nonetheless, even with limited rather than revolutionary goals, the ACA still lacks sufficient authority across disparate branches of government to achieve its stated goals. The article then examines the conflicting positions of the various United States regulatory schemes and enforcement agencies governing health care, and whether they can be reconciled with the stated goal of the government, often referred to as the "Triple Aim": 16 improving quality of care, improving population health, and lowering health care costs. It examines fundamental, systemic challenges to achieving the "Triple Aim": longstanding health care regulatory laws that impede adoption of innovative delivery systems beyond their current "demonstration project" status, and antitrust enforcement that promotes waste and duplication in densely populated areas, while preventing necessary consolidation to more efficiently reach rural areas. The article concludes with recommendations for promoting efficiency through modest reconciliation of the conflicting goals and regulations in health care.

The implications of alcohol intoxication and the Uniform Policy Provision Law on trauma centers; a national trauma data bank analysis of minimally injured patients.

PubMed

O'Keeffe, Terence; Shafi, Shahid; Sperry, Jason L; Gentilello, Larry M

2009-02-01

Alcohol intoxication may confound the initial assessment of trauma patients, resulting in increased use of diagnostic and therapeutic procedures, thereby increasing hospital costs. The Uniform Policy Provision Law (UPPL) exists in many states and allows insurance companies to deny payment for medical treatment for alcohol-related injuries. If intoxication increases resource utilization, these denials compound the financial burden of alcohol use on trauma centers. We hypothesized that patients injured while under the influence of alcohol require more diagnostic tests, procedures, and hospital admissions, leading to higher hospital charges. The National Trauma Databank (2000-2004) was analyzed to identify adult trauma patients (age > or = 16 years) who were discharged alive, had a length of stay < or = 1 day and minor injuries (Injury Severity Score < 9), and were tested for blood alcohol. The study was confined to minimally injured patients to facilitate identification of unexpected resource use most likely attributable to alcohol use. Resource utilization was compared among patients who tested positive or negative for alcohol use. Results are presented as odds ratio (OR) with 95% confidence intervals (CI). Sixty-eight thousand eight patients met study criteria, of which 31,020 were positive for alcohol. Despite similar baseline characteristics, alcohol-positive patients required significantly more invasive procedures, including intubation (OR 4.16, 95% CI = 3.56-4.85) and Foley catheter insertion (OR 1.52, 95% CI = 1.39-1.67) as well as diagnostic tests (CT scan OR 1.16, 95% CI = 1.12-1.20). They were also less likely to be discharged from the emergency department (OR 0.61, 95% CI = 0.58-0.64), and more frequently required hospital (OR 1.64, 95% CI = 1.57-1.73) or intensive care unit admission (OR 1.82, 95% CI = 1.71-1.94). Mean hospital charges were $1,833 greater ($10,405 +/- 225 vs. 8,572 +/- 68). A significant amount of trauma center costs are primarily attributable to alcohol use rather than injury severity or outcome. The financial costs associated with alcohol use and UPPL-related cost-shifting to trauma centers is a significant burden to trauma centers. UPPL laws that penalize trauma centers for identifying intoxicated patients should be repealed in states where they exist.

Musculoskeletal, biomechanical, and physiological gender differences in the US military.

PubMed

Allison, Katelyn F; Keenan, Karen A; Sell, Timothy C; Abt, John P; Nagai, Takashi; Deluzio, Jennifer; McGrail, Mark; Lephart, Scott M

2015-01-01

The repeal of the Direct Ground Combat Assignment Rule has renewed focus on examining performance capabilities of female military personnel and their ability to occupy previously restricted military occupational specialties. Previous research has revealed female Soldiers suffer a greater proportion of musculoskeletal injuries compared to males, including a significantly higher proportion of lower extremity, knee, and overuse injuries. Potential differences may also exist in musculoskeletal, biomechanical, and physiological characteristics between male and female Soldiers requiring implementation of gender-specific training in order to mitigate injury risk and enhance performance. To examine differences in musculoskeletal, biomechanical, and physiological characteristics in male and female Soldiers. A total of 406 101st Airborne Division (Air Assault) Soldiers (348 male; 58 female) participated. Subjects underwent testing for flexibility, isokinetic and isometric strength (percent body weight), single-leg balance, lower body biomechanics during a stop jump and drop landing, body composition, anaerobic power/capacity, and aerobic capacity. Independent t tests assessed between-group comparisons. Women demonstrated significantly greater flexibility (P<.01-P<.001) and better balance (P≤.001) than men. Men demonstrated significantly greater strength (P≤.001), aerobic capacity (47.5±7.6 vs 40.3±5.4 ml/kg/min, P<.001), anaerobic power (13.3±2.1 vs 9.5±1.7 W/kg, P<.001), and anaerobic capacity (7.8±1.0 vs 6.1±0.8 W/kg, P<.001) and lower body fat (20.1±7.5 vs 26.7±5.7 (%BF), P<.001). Women demonstrated significantly greater hip flexion and knee valgus at initial contact during both the stop jump and drop landing tasks and greater knee flexion at initial contact during the drop landing task (P<.05-P<.001). Gender differences exist in biomechanical, musculoskeletal, and physiological characteristics. Sex-specific interventions may aid in improving such characteristics to optimize physical readiness and decrease the injury risk during gender-neutral training, and decreasing between-sex variability in performance characteristics may result in enhanced overall unit readiness. Identification of sex-specific differences in injury patterns and characteristics should facilitate adjustments in training in order for both sexes to meet the gender-neutral occupational demands for physically demanding military occupational specialties.

Temporal trends in motor vehicle fatalities in the United States, 1968 to 2010 - a joinpoint regression analysis.

PubMed

Bandi, Priti; Silver, Diana; Mijanovich, Tod; Macinko, James

2015-12-01

In the past 40 years, a variety of factors might have impacted motor vehicle (MV) fatality trends in the US, including public health policies, engineering innovations, trauma care improvements, etc. These factors varied in their timing across states/localities, and many were targeted at particular population subgroups. In order to identify and quantify differential rates of change over time and differences in trend patterns between population subgroups, this study employed a novel analytic method to assess temporal trends in MV fatalities between 1968 and 2010, by age group and sex. Cause-specific MV fatality data from traffic injuries between 1968 and 2010, based on death certificates filed in the 50 states, and DC were obtained from Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER). Long-term (1968 to 2010) and short-term (log-linear piecewise segments) trends in fatality rates were compared for males and females overall and in four separate age groups using joinpoint regression. MV fatalities declined on average by 2.4% per year in males and 2.2% per year in females between 1968 and 2010, with significant declines observed in all age groups and in both sexes. In males overall and those 25 to 64 years, sharp declines between 1968 and mid-to-late 1990s were followed by a stalling until the mid-2000s, but rates in females experienced a long-term steady decline of a lesser magnitude than males during this time. Trends in those aged <1 to 14 years and 15 to 24 years were mostly steady over time, but males had a larger decline than females in the latter age group between 1968 and the mid-2000s. In ages 65+, short-term trends were similar between sexes. Despite significant long-term declines in MV fatalities, the application of Joinpoint Regression found that progress in young adult and middle-aged adult males stalled in recent decades and rates in males declined relatively more than in females in certain age groups. Future research is needed to establish the causes of these observed trends, including the potential role of contemporaneous MV-related policies and their repeal. Such research is needed in order to better inform the design and evaluation of future population interventions addressing MV fatalities nationally.

Act No. 18.802, of 23 May 1989, [amending the Civil Code and the Commercial Code and Act 16.618].

PubMed

1989-01-01

In 1989, Chile passed an Act which amended its Civil Code to change the legal status of married women. The amendments repealed the following provisions: 1) that a nondivorced married woman must keep her husband's domicile, 2) that a woman with parental authority cannot remarry unless a court appoints a guardian for the child, 3) that marital authority gives a husband legal rights over a wife's person and property, 4) that a wife need her husband's permission to enter into financial transactions or act as a guardian, 5) that a wife needs a court order or her husband's authorization to administer gifts or inheritances she received under condition that her husband not have administrative power over them, 6) that a wife's adultery results in loss of all control and profit from communal property, 7) that a wife needs her husband's permission to administer an estate or the approval of a judge to continue to administer her late husband's estate if she remarried, 8) that a married woman has diminished legal capacity, and 9) that a husband is responsible for the conduct of his wife. In addition, the Act replaced language stating that a wife owes her husband obedience and a husband owes a wife protection with language stating that each spouse owes each other respect and protection. Wives are given the unrestricted right to work, the right (shared with husbands) to discipline and educate children, the right (shared with husbands) to support after divorce regardless of fault, the right to parental authority, and the right to manage their children's property. Wives no longer have to live wherever their husbands choose. In cases of divorce, a judge will order irrevocable separation of community property and give physical custody of all minor children (boys and girls) to the wife. The position of surviving spouses in regard to inheritance is improved. Real estate brought to a marriage by a wife or received by either spouse as a gift or inheritance is no longer considered community property. Husbands retain the status of head of the marital community and, in most cases, administer community property and the property of their wives and exercise parental authority over children.

Examination of factors associated with use rates after transition from a universal to partial motorcycle helmet use law.

PubMed

Russo, Brendan J; Barrette, Timothy P; Morden, Jeffery; Savolainen, Peter T; Gates, Timothy J

2017-01-02

Motorcycle riders account for a disproportionately high number of traffic injuries and fatalities compared to occupants of other vehicle types. Though research has demonstrated the benefits of helmet use in preventing serious and fatal injuries in the event of a crash, helmet use has remained relatively stable in the United States, where the most recent national estimates show a 64% use rate. Use rates have been markedly lower among those states that do not have a universal helmet law for all riders. In 2012, the state of Michigan repealed its longstanding mandatory helmet use law. In order to gain insights as to the effects of this legislative change, a study was conducted to examine short-term changes in helmet use and identify factors associated with use rates. A statewide direct observation survey was conducted 1 year after the transition from a universal helmet law to a partial helmet law. A random parameters logistic regression model was estimated to identify motorcyclist, roadway, and environmental characteristics associated with helmet use. This modeling framework accounts for both intravehicle correlation (between riders and passengers on the same motorcycle) as well as unobserved heterogeneity across riders due to important unobserved factors. Helmet use was shown to vary across demographic segments of the motorcyclist population. Use rates were higher among Caucasian riders, as well as among those age 60 and above. No significant difference was observed between male and female riders. Use was also found to vary geographically, temporally, and with respect to various environmental characteristics. Geographically, helmet use rates tended to be correlated with historical restraint use trends, which may be reflective of riding environment and general differences in the riding population. To this end, rates were also highly variable based upon the type of motorcycle and whether the motorcyclist was wearing high-visibility gear. The study results demonstrate the short-term reduction in helmet use following transition from a universal to partial motorcycle helmet law. The reduction in use is somewhat less pronounced than has been experienced in other states, which may be reflective of general differences among Michigan motorcyclists because the state has also generally exhibited higher use rates of seat belts and other forms of occupant protection. The study results also highlight potential target areas for subsequent education and public awareness initiatives aimed at increasing helmet use.

European activities in radiation protection in medicine.

PubMed

Simeonov, Georgi

2015-07-01

The recently published Council Directive 2013/59/Euratom ('new European Basic Safety Standards', EU BSS) modernises and consolidates the European radiation protection legislation by taking into account the latest scientific knowledge, technological progress and experience with implementing the current legislation and by merging five existing Directives into a single piece of legislation. The new European BSS repeal previous European legislation on which the national systems for radiation protection in medicine of the 28 European Union (EU) Member States are based, including the 96/29/Euratom 'BSS' and the 97/43/Euratom 'Medical Exposure' Directives. While most of the elements of the previous legislation have been kept, there are several legal changes that will have important influence over the regulation and practice in the field all over Europe-these include, among others: (i) strengthening the implementation of the justification principle and expanding it to medically exposed asymptomatic individuals, (ii) more attention to interventional radiology, (iii) new requirements for dose recording and reporting, (iv) increased role of the medical physics expert in imaging, (v) new set of requirements for preventing and following up on accidents and (vi) new set of requirements for procedures where radiological equipment is used on people for non-medical purposes (non-medical imaging exposure). The EU Member States have to enforce the new EU BSS before January 2018 and bring into force the laws, regulations and administrative provisions necessary to comply with it. The European Commission has certain legal obligations and powers to verify the compliance of the national measures with the EU laws and, wherever necessary, issue recommendations to, or open infringement cases against, national governments. In order to ensure timely and coordinated implementation of the new European legal requirements for radiation protection, the Commission is launching several actions including promotion and dissemination activities, exchange and discussion fora and provision of guidance. These actions will be based on previous experiences and will rely on the results of recent and ongoing EU-funded projects. Important stakeholders including the Euratom Article 31 Group, the association of the Heads of European Radiological protection Competent Authorities (HERCA) and different European professional and specialty organisations will be involved. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Medical marijuana: the conflict between scientific evidence and political ideology. Part one of two.

PubMed

Cohen, Peter J

2009-01-01

Whether "medical marijuana" (Cannabis sativa used to treat a wide variety of pathologic states) should be accorded the status of a legitimate pharmaceutical agent has long been a contentious issue. Is it a truly effective drug that is arbitrarily stigmatized by many and criminalized by the federal government? Or is it without any medical utility, its advocates hiding behind a screen of misplaced (or deliberately misleading) compassion for the ill? Should Congress repeal its declaration that smoked marijuana is without "current medical benefit"? Should cannabis be approved for medical use by a vote of the people as already has been done in 13 states? Or should medical marijuana be scientifically evaluated for safety and efficacy as any other new investigational drug? How do the competing--and sometimes antagonistic--roles of science, politics and prejudice affect society's attempts to answer this question? This article examines the legal, political, policy, and ethical problems raised by the recognition of medical marijuana by over one-fourth of our states although its use remains illegal under federal law. Although draconian punishment can be imposed for the "recreational" use of marijuana, I will not address the contentious question of whether to legalize or decriminalize the use of marijuana solely for its psychotropic effects, a fascinating and important area of law and policy that is outside the scope of this paper. Instead, the specific focus of this article will be on the conflict between the development of policies based on evidence obtained through the use of scientific methods and those grounded on ideological and political considerations that have repeatedly entered the longstanding debate regarding the legal status of medical marijuana. I will address a basic question: Should the approval of medical marijuana be governed by the same statute that applies to all other drugs or pharmaceutical agents, the Food, Drug, and Cosmetic Act (FD&C Act), after the appropriate regulatory agency, the Food and Drug Administration (FDA), has evaluated its safety and efficacy? If not, should medical marijuana be exempted from scientific review and, instead, be evaluated by the Congress, state legislatures, or popular vote? I will argue that advocacy is a poor substitute for dispassionate analysis, and that popular votes should not be allowed to trump scientific evidence in deciding whether or not marijuana is an appropriate pharmaceutical agent to use in modern medical practice.

Light-duty vehicle fuel economy improvements, 1979--1998: A consumer purchase model of corporate average fuel economy, fuel price, and income effects

NASA Astrophysics Data System (ADS)

Chien, David Michael

2000-10-01

The Energy Policy and Conservation Act of 1975, which created fuel economy standards for automobiles and light trucks, was passed by Congress in response to the rapid rise in world oil prices as a result of the 1973 oil crisis. The standards were first implemented in 1978 for automobiles and 1979 for light trucks, and began with initial standards of 18 MPG for automobiles and 17.2 MPG for light trucks. The current fuel economy standards for 1998 have been held constant at 27.5 MPG for automobiles and 20.5 MPG for light trucks since 1990--1991. While actual new automobile fuel economy has almost doubled from 14 MPG in 1974 to 27.2 MPG in 1994, it is reasonable to ask if the CAFE standards are still needed. Each year Congress attempts to pass another increase in the Corporate Average Fuel Economy (CAFE) standard and fails. Many have called for the abolition of CAFE standards citing the ineffectiveness of the standards in the past. In order to determine whether CAFE standards should be increased, held constant, or repealed, an evaluation of the effectiveness of the CAFE standards to date must be established. Because fuel prices were rising concurrently with the CAFE standards, many authors have attributed the rapid rise in new car fuel economy solely to fuel prices. The purpose of this dissertation is to re-examine the determinants of new car fuel economy via three effects: CAFE regulations, fuel price, and income effects. By measuring the marginal effects of the three fuel economy determinants upon consumers and manufacturers choices, for fuel economy, an estimate was made of the influence of each upon new fuel economy. The conclusions of this dissertation present some clear signals to policymakers: CAFE standards have been very effective in increasing fuel economy from 1979 to 1998. Furthermore, they have been the main cause of fuel economy improvement, with income being a much smaller component. Furthermore, this dissertation has suggested that fuel prices have very limited effects upon fuel economy, ranging from no primary effect on certain size classes to a minimal secondary effect through higher performance or horsepower demanded.

The effects of greenbelt cancellation on land value - The case of Wirye New town, South Korea

NASA Astrophysics Data System (ADS)

Lee, S. G.; Yoon, H.

2017-12-01

In 1971, South Korean government began designating urban growth boundary around the major cities (total 4,294 in 7 metropolitan areas, and total 809 in 7 small and medium sized urban areas) to control the urban sprawl, spurred by the rapid industrialization and urbanization from the 1960s. However, due to the heated development pressure within the cities, and the recognition of its inefficiency for the original purpose, the growth limit, so-called greenbelt, has been gradually canceled since the late 1990s. In response to this change, real estate market around the greenbelt has been also changed. Extant researches suggest that designating greenbelt causes land scarcity and adds amenity value, driving up land and property price within and approaching to the boundary. On the other hand, cancellation of greenbelt consequently increases developable land and eases the land scarcity, thus can be expected to decrease land value. However, when the canceled greenbelt is to be developed, the price again increases within the boundary, while generating externalities outward. Wirye New Town is one of the government-driven housing developments on repealed greenbelt, to meet the great housing demand of the southern part of Seoul. The site area is 6.8km2 , containing 42,947 housing units, and supplementary infrastructures such as new subway lines and transit malls. Its plan was announced in 2005, and the expected completion is 2017. In 2013, after partial completion, 2,949 apartments began to be occupied. 20,810 housing units have been supplied as of 2015, and 22,137 additional units are going to be provided by 2019. This change has increased average land and housing price of the vicinity by the real demand as well as the real estate speculation. While this alteration of greenbelt has affected adjacent real estate market substantially, study has not been conducted to quantify the impact. In this backdrop, this study aims to analyze the changing externalities effect of greenbelt on land price, before and after cancellation, around the Wirye New Town development, using random-coefficient multilevel modeling. The findings of the research will provide urban planners with better understanding on the economic impact of releasing greenbelt on real estate market.

Love and sex in the Swedish media.

PubMed

Boethius, C G

1986-01-01

Attitudes toward teenage sexuality are markedly different in Sweden and the US. The more accepting attitude toward adolescent sexuality and the greater availability of family planning information and services may explain why Sweden has a lower adolescent pregnancy, abortion, and childbirth rate than the US. In contrast to the situation in the US, the Swedish mass media presents a realistic view of sexuality to the youth of the nation. It stresses the responsible use of contraception and the need to protect against sexually transmitted diseases in both its entertainment and educational shows. No commercials are aired on Swedish TV; therefore, Swedish youth are not exposed to the blatant and irresponsible image of sex frequently conveyed by commercials in the US. Moreover, in Sweden, parents accept the fact that their older teenagers will engage in sexual activity and help their children prepare for this activity. As a result, teenagers are reassured that their parents understand their feelings and emotions. These teenagers, in turn, are likely to accept their parents' advice about engaging in responsible sexual behavior. In contrast, in societies like the US, which are nonaccepting of adolescent sexual behavior, teenagers are likely to feel their parents and the larger society do not understand their feelings. These teenagers are likely to reject parental or societal advice on sexual matters. Sweden's accepting attitude toward adolescent sexuality is relatively recent. Prior to the 1960s, attitudes in Sweden were similar to those of present day American society. Eventually the government, the schools, and the parents recognized that they were creating a breach between the generations, and they gradually adopted a more realistic and accepting stance on sexual matters. By 1970, all Swedish children were receiving sex education in school. Television programing in sex education began in the 1960s. The broad distribution of printed sex education materials also began in the 1960s. Young people in Sweden are not totally protected from exposure to negative sexual protrayals. Pornography is common. In 1970, following the parliamentary repeal of an old law prohibiting pornography, mass produced pornography began to appear in Sweden. A broad based campaign against pornography lead to the passage in 1980 of a law prohibiting child pornography. Currently, legislation is being considered which would regulate sexual violence in films, tapes, and television and control the printing of sadistic pornographic pictures. In line with past traditions, Swedes believe it is possible to maintain an open attitude about sexual matters while prohibiting the portrayal of sexual exploitation and sexual violence.

The Politics of Medicaid: Most Americans Are Connected to the Program, Support Its Expansion, and Do Not View It as Stigmatizing.

PubMed

Grogan, Colleen M; Park, Sunggeun Ethan

2017-12-01

Policy Points: More than half of Americans are connected to the Medicaid program-either through their own coverage or that of a family member or close friend-and are significantly more likely to view Medicaid as important and to support increases in spending, even among conservatives. This finding helps explain why Affordable Care Act repeal efforts faced (and will continue to face) strong public backlash. Policymakers should be aware that although renaming programs within Medicaid may have increased enrollment take-up, this destigmatization effort might have also increased program confusion and reduced support for Medicaid even among enrollees who say the program is important to them. Since the 1980s, Medicaid enrollment has expanded so dramatically that by 2015 two-thirds of Americans had some connection to the program in which either they themselves, a family member, or a close friend is currently or was previously enrolled. Utilizing a nationally representative survey-the Kaiser Family Foundation Poll: Medicare and Medicaid at 50 (n = 1,849)-and employing ordinal and logistic regression analyses, our study examines 3 questions: (1) are individuals with a connection to Medicaid more likely to view the program as important, (2) are they more likely to support an increase in Medicaid spending, and (3) are they more likely to support adoption of the Medicaid expansion offered under the Affordable Care Act? For each of these questions we examine whether partisanship and views of stigma also impact support for Medicaid and, if so, whether these factors overwhelm the impact of connection to the program. Controlling for the strong effect of partisanship, people with any connection to the Medicaid program are more likely to view the program as important than those with no connection. However, when it comes to increasing spending or expanding the program, the type of connection to the program matters. In particular, adults with current and previous Medicaid coverage and those with a family member or close friend with Medicaid coverage are more likely to support increases in spending and the Medicaid expansion; but, those connected to Medicaid only through coverage of a child are no more likely to support Medicaid than those with no connection. Future research should probe more deeply into whether people with different types of connection to Medicaid view the program differently, and, if so, how and why. Moreover, future research should also explore whether state-level attempts to destigmatize Medicaid by renaming the program also serves to reduce knowledge and support for Medicaid. © 2017 Milbank Memorial Fund.

Refugee movements and Turkey.

PubMed

Kirisci, K

1991-12-01

There has been a long tradition in the Ottoman Empire and the Turkish Republic of receiving refugees. There were Jewish refugees from the Spanish Inquisition, Hungarians and Poles fleeing revolts in 1848-9, and those of Turkish descent and usually from the Balkans. Concurrent with this trend is the history of refugees and immigrants leaving Turkey, such as many Armenians, Greeks and Jews leaving at the turn of the century, and after 1923 and the Treaty of Lausanne. Little is currently published on the topic. This article defines a refugee; provides an overview of the refugee problems of the 1980's due to Bulgarian, Kurdish, and Turkish refugees; and the legal and political aspects. As a country of origin, there is discussion of the political and economic aspects of Turkish asylum seekers in Europe. The potential refugee flows to and from Turkey are also examined. I) For this study, refugees are victims of political violence and are persecuted for political or religious beliefs, ethnic or racial background, or war. In Turkey, there are national refugees, international refugees outside the Convention, and UNHCR Convention refugees. During the 1980's all 3 groups were arriving: from eastern Europe, Iranian Kurds, Iraqis, and ethnic Turks from Bulgaria and Afghanistan. The Turkish restricted acceptance of the 1951 Convention on Refugees creates serious humanitarian and security consequences for refugees other than those from eastern Europe and of Turkish ethnicity. Political considerations play an important role in treatment where security threats outweigh humanitarian need. The case is given for Kurdish refugees. II) Asylum seekers from Turkey in Western Europe was determined between 1986-90 to be 185,000 from applications. These figures have risen steadily due to the political instability and military activity of areas bordering Iraq and Syria, the Emergency Region. In addition there are economic and employment problems, and there has been a suspension of human rights. Europe in return has tightened legislation and procedures to differentiate economically motivated refugees from authentic political asylum seekers. Further research is needed to investigate refugee problems. Further refugees may come due to the promotion of a Black Sea Cooperation Region and easier crossings of borders to the former Soviet Republics. Ethnic Turks in Moldavia or Romania or Bulgaria may leave due to unrest. Factors affecting asylum seekers are improvements in Turkey's human rights record, repeal of bans of the Kurdish language, completion of the South Eastern Development Project, and the European government policy on asylum.

A Review of the History of Attitudes Toward Drinking in Pregnancy.

PubMed

Warren, Kenneth R

2015-07-01

It is now well accepted in pediatrics and obstetrics that prenatal alcohol is a teratogenic agent and the primary causative factor underlying fetal alcohol spectrum disorders (FASDs), although for the majority of the 20th century that knowledge was either unknown or ignored. At least 2 factors contributed to the delay in recognizing alcohol's role in teratogenicity: the rejection of earlier evidence pertaining to alcohol and pregnancy following the repeal of Prohibition in the United States, Canada, and several European countries; and misinterpretation of earlier research findings in a eugenic rather than toxicological context. The pervasive belief held well into the 1970s that there was no risk to either mother or fetus from prenatal alcohol posed a major challenge to changing physician and public attitudes on alcohol and pregnancy. This review provides insight on key events that occurred in changing physician and public understanding of the risks posed by prenatal alcohol use in pregnancy. Historical review of events primarily in the U.S. federal government, found in referenced documents. The transition in physician and public understanding of the risks posed by prenatal alcohol use was aided by the existence of National Institute on Alcohol Abuse and Alcoholism (NIAAA) which was created in 1971. This government agency was able to support research on alcohol and pregnancy immediately following the 1973 published clinical reports calling attention to a proposed fetal alcohol syndrome (FAS). These early research studies provided the foundation for the first government health advisory on alcohol and pregnancy, issued by NIAAA in 1977. Subsequently, the U.S. Food and Drug Administration (FDA) used this new knowledge on FAS in their effort to add alcoholic beverages to the range of products with ingredient and consumer information labeling. The ensuing hearings and actions resulted in a new health advisory under the auspices of the Surgeon General, encouraging avoidance of alcohol consumption in pregnancy. In subsequent years, Congressional attention to the FAS issue resulted in the Alcoholic Beverage Labeling Law. The pace at which understanding of the risks of prenatal alcohol moved forward from a total misunderstanding to acceptance was aided by both the efforts of the NIAAA in its support of research, and the FDA in its efforts to improve consumer information. Today, many women in the United States as well as other countries continue to ignore advisories on avoiding alcohol consumption in pregnancy, emphasizing the need for persistence in education on these health risks. Copyright © 2015 by the Research Society on Alcoholism.

Ecological Meltdown in the Firth of Clyde, Scotland: Two Centuries of Change in a Coastal Marine Ecosystem

PubMed Central

Thurstan, Ruth H.; Roberts, Callum M.

2010-01-01

Background The Firth of Clyde is a large inlet of the sea that extends over 100 km into Scotland's west coast. Methods We compiled detailed fisheries landings data for this area and combined them with historical accounts to build a picture of change due to fishing activity over the last 200 years. Findings In the early 19th century, prior to the onset of industrial fishing, the Firth of Clyde supported diverse and productive fisheries for species such as herring (Clupea harengus, Clupeidae), cod (Gadus morhua, Gadidae), haddock (Melanogrammus aeglefinus, Gadidae), turbot (Psetta maxima, Scophthalmidae) and flounder (Platichthys flesus, Pleuronectidae). The 19th century saw increased demand for fish, which encouraged more indiscriminate methods of fishing such as bottom trawling. During the 1880s, fish landings began to decline, and upon the recommendation of local fishers and scientists, the Firth of Clyde was closed to large trawling vessels in 1889. This closure remained in place until 1962 when bottom trawling for Norway lobster (Nephrops norvegicus, Nephropidae) was approved in areas more than three nautical miles from the coast. During the 1960s and 1970s, landings of bottomfish increased as trawling intensified. The trawl closure within three nautical miles of the coast was repealed in 1984 under pressure from the industry. Thereafter, bottomfish landings went into terminal decline, with all species collapsing to zero or near zero landings by the early 21st century. Herring fisheries collapsed in the 1970s as more efficient mid-water trawls and fish finders were introduced, while a fishery for mid-water saithe (Pollachius virens, Gadidae) underwent a boom and bust shortly after discovery in the late 1960s. The only commercial fisheries that remain today are for Nephrops and scallops (Pecten maximus, Pectinidae). Significance The Firth of Clyde is a marine ecosystem nearing the endpoint of overfishing, a time when no species remain that are capable of sustaining commercial catches. The evidence suggests that trawl closures helped maintain productive fisheries through the mid-20th century, and their reopening precipitated collapse of bottomfish stocks. We argue that continued intensive bottom trawling for Nephrops with fine mesh nets will prevent the recovery of other species. This once diverse and highly productive environment will only be restored if trawl closures or other protected areas are re-introduced. The Firth of Clyde represents at a small scale a process that is occurring ocean-wide today, and its experience serves as a warning to others. PMID:20686614

Medicare physician payment systems: impact of 2011 schedule on interventional pain management.

PubMed

Manchikanti, Laxmaiah; Singh, Vijay; Caraway, David L; Benyamin, Ramsin M; Hirsch, Joshua A

2011-01-01

Physicians in the United States have been affected by significant changes in the patterns of medical practice evolving over the last several decades. The recently passed affordable health care law, termed the Patient Protection and Affordable Care Act of 2010 (the ACA, for short) affects physicians more than any other law. Physician services are an integral part of health care. Physicians are paid in the United States for their personal services. This payment also includes the overhead expenses for maintaining an office and providing services. The payment system is highly variable in the private insurance market; however, governmental systems have a formula-based payment, mostly based on the Medicare payment system. Physician services are billed under Part B. Since the inception of the Medicare program in 1965, several methods have been used to determine the amounts paid to physicians for each covered service. Initially, the payment systems compensated physicians on the basis of their charges. In 1975, just over 10 years after the inception of the Medicare program, payments changed so as not to exceed the increase in the Medical Economic Index (MEI). Nevertheless, the policy failed to curb increases in costs, leading to the determination of a yearly change in fees by legislation from 1984 to 1991. In 1992, the fee schedule essentially replaced the prior payment system that was based on the physician's charges, which also failed to live up to expectations for operational success. Then, in 1998, the sustainable growth rate (SGR) system was introduced. In 2009, multiple attempts were made by Congress to repeal the formula - rather unsuccessfully. Consequently, the SGR formula continues to hamper physician payments. The mechanism of the SGR includes 3 components that are incorporated into a statutory formula: expenditure targets, growth rate period, and annual adjustments of payment rates for physician services. Further, the relative value of a physician fee schedule is based on 3 components: physician work, practice expense (PE), and malpractice expense that are used to determine a value ranking for each service to which it is applied. On average, the work component represents 53.5% of a service's relative value, the fee component represents 43.6%, and the malpractice component represents 3.9%. The final schedule for physician payment was issued on November 24, 2010. This was based on a total cut of 30.8% with 24.9% of the cut attributed to SGR. However, as usual, with patchwork efficiency, Congress passed a one-year extension of the 0% update, effective through December 2011. Consequently, CMS issued an emergency update of the 2011 Medicare fee schedule, with multiple revisions, resulting in a reduction of the conversion factor of $36.8729 from December 2010 to $33.9764 for 2011.

Capping the tax exclusion for employment-based health coverage: implications for employers and workers.

PubMed

Fronstin, Paul

2009-01-01

HEALTH CARE TAX CAP: With health reform a major priority of the new 111th Congress and President Barack Obama, this Issue Briefexamines the administrative and implementation issues that arise from one of the major reform proposals: Capping the exclusion of employment-based health coverage from workers' taxable income. The amount that employers contribute toward workers' health coverage is generally excluded, without limit, from workers' taxable income. In addition, workers whose employers sponsor flexible spending accounts are able to pay out-of-pocket expenses with pretax dollars. Employers can also make available a premium conversion arrangement, which allows workers to pay their share of the premium for employment-based coverage with pretax dollars. In 2005, a presidential advisory board concluded that limiting the amount of tax-preferred health coverage could lower overall private-sector health spending. The panel recommended a cap on the amount of employment-based health coverage individuals can exclude from their income tax, as a way to reduce health spending. In his 2008 "Call to Action" for health care reform, Sen. Max Baucus (D-MT), chairman of the Senate Finance Committee, states that "Congress should explore ways to restructure the current tax incentives to encourage more efficient spending on health and to target our tax dollars more effectively and fairly." While a tax cap on health coverage sounds simple, for many employers, it could be difficult to administer and results would vary by employer based on the type of health benefit plan, the size and demographics of their work force, and even where the workers live. The change would be especially difficult for self-insured employers that do not pay insurance premiums, since they would have to set the "premium equivalent" for each worker. This would not only be costly for employers, depending upon the requirements set out by law, but could also create fairness and tax issues for many affected workers. For self-insured employers, calculating insurance premium costs under a tax cap could be done fairly easily using the COBRA premium. However, whether self-insured employers would be able to use the least costly method to determine the value of coverage would have to be determined by law and/or regulations. THE SEC. 89 EXPERIENCE: Sec. 89 of the Tax Reform Act of 1986, which attempted to make employee benefits more standard and fair, became so controversial that it was repealed by Congress in 1989--in part because the regulations created regulatory burdens that were so complicated and costly as to be unworkable. Similarly, valuation calculations under a health coverage tax cap could become overly burdensome if the lessons from Sec. 89 are not heeded.

Policy Making While Paradigms Shift: Understanding the Development of Policy Drought in the U.S. Congress 1981-2013

NASA Astrophysics Data System (ADS)

McCurdy, K. M.

2013-12-01

Ronald Reagan famously announced in his 1981 inaugural address that 'government is not the solution to our problem; government is the problem.' For the scientific community and Members of Congress of that time, who were partners in working within the scientific management policy paradigm and the meritocracy on which its technical expertise depended, these words were outside their paradigm of good public service. Despite this announcement of a new paradigm by the incoming President, their policy world continued undisturbed, finding points of agreement to make incremental improvements in policy. Executive branch actions in Reagan's two terms as president were dismissed as peculiar, although they were the beginnings of realizing a policy goal of reducing the size and influence of the federal government. The important parameters influencing policy making in the U.S. Congress, which party holds the majority that sets the agenda and schedules votes, seniority that determines leadership positions in the conference and caucus, specialization on policy by committee jurisdictions, vary little annually and thereby were treated as constants by participants and observers alike. But member replacement has policy consequences that are infrequently noted. Members die in office, retire, and lose re-election bids, while the new members replacing them do not replicate any of their institutional characteristics. The policy process continues seemingly unchanged, but there are changes that become apparent with time. By 2013, scientists are no longer unquestioning partners in shaping federal public policy. They have been ridiculed in congressional hearings and in media attacks. Meanwhile new legislative strategies are being tried, e.g. shutting down government, increasing the use of earmarks instead of peer review, filibuster threats, and repeated attempts to repeal laws are now common tactics in Congress. Science and Congress no longer seem to act as partners in policy making, but as adversaries. The junior members of Congress embracing 'Movement Republican goals' to reduce the size of government by any means, are impatient with their senior colleagues who held pragmatic views for achieving limited government. Tensions arise in the conference from this lack of goal alignment, and increasingly become public. The give and take between the parties that was normal in the New Deal and Great Society eras has been replaced by intense partisanship in the 21st century, as the number of members who came to government embracing Reagan's maxim that government was the problem gradually increased in magnitude and seniority. It is important to recognize that there is a paradigm shift underway in Congress, related to the demographic changes in Congress as the new Republicans implement their policy goal of reducing the size of government, and that the structure of the institution produces a lag effect for that shift, and that the binary party labels may further mask the shift.

Obituary: Franklin Kamney (1925-2011)

NASA Astrophysics Data System (ADS)

Kinne, Richard

2011-12-01

Dr. Franklin E. Kameny died October 11, 2011, at the age of 86 of cardiac arrest. Kameny observed RV Tau stars and yellow semiregular variables from 1952 to1954, and his photoelectric measurements served as the basis of his Harvard Ph.D. thesis. After receiving his Ph.D. in 1956, Kameny taught astronomy for a year at Georgetown University. A US Army veteran during World War II, he was hired as an astronomer by the US Army Mapping Service in 1957. His astronomical career was terminated when he was fired from this position due to the discovery of his sexual orientation. Denied his first occupation as an astronomer, Kameny became a pioneer in the struggle for equal rights and was involved in many issues leading to just and equitable treatment of all people. One of his most most notable achievements was working for the removal of homosexuality from the American Psychiatric Association's manual of mental disorders. One of his most recent achievements was helping to push through the Washington, DC, marriage equality act. After a lonely 40-year struggle, Kameny recently began to receive recognition for all his work. In June of 2009, the Office of Personnel Management formally apologized for Kameny's firing and issued him their highest award. The apology letter, in Kameny's estimation, left open the possibility he'd never actually been fired. In his acceptance of the apology he sent the Office a letter, tongue-in-cheek, requesting that the Office let him know what his back pay was! Kameny was present in the Oval Office for the signing of the repeal of "Don't Ask, Don't Tell" in 2010 and was thanked for his work by both President Obama and Vice President Biden. 17th Street in Washington, DC, between P and R Streets was named "Frank Kameny Way," and Kameny's house is now listed on the National Register of Historic Places. Kameny's astronomical career, as short as it may have been, has not been forgotten. In the summer of 2009, his dissertation was "rediscovered" by AAVSO staff in the McAteer Library and his data - 547 observations of RV Tau type stars and other semiregular yellow variables - were added to the AAVSO International Database. Often these are the only observations of these variables on record during this time period. Kameny's unflagging determination in the face of adversity has also served as inspiration over the last year for Society members organizing the new AAS Working Group on LGBTQ Equality. The Society will award a posthumous certificate of appreciation to Dr. Kameny at the January 2012 meeting in Austin, TX. Denied his place in the scientific community by the social conventions of the day, Dr. Kameny fought back and thereby made the world a more equal place. In that way he remains a star in his own right.

20 years of Black Carbon measurements in Germany

NASA Astrophysics Data System (ADS)

Kutzner, Rebecca; Quedenau, Jörn; Kuik, Friderike; von Schneidemesser, Erika; Schmale, Julia

2016-04-01

Black Carbon (BC) is an important short-lived climate-forcing pollutant contributing to global warming through absorption of sunlight. At the same time, BC, as a component of particulate matter (PM) exerts adverse health effects, like decreased lung function and exacerbated asthma. Globally, anthropogenic emission sources of BC include residential heating, transport, and agricultural fires, while the dominant natural emission sources are wildfires. Despite the various adverse effects of BC, legislation that requires mandatory monitoring of BC concentrations does not currently exist in the European Union. Instead, BC is only indirectly monitored as component of PM10 and PM2.5 (particulate matter with a diameter smaller 10 μm and 2.5 μm). Before the introduction of mandatory PM10 and PM2.5 monitoring in the European Union in 2005 and 2015, respectively, 'black smoke', a surrogate for BC, was a required measurement in Germany from the early 1990s. The annual mean limit value was 14 μg m-3 from 1995 and 8 μg m-3 from 1998 onwards. Many 'black smoke' measurements were stopped in 2004, with the repeal of the regulations obtaining at the time. However, in most German federal states a limited number BC monitoring stations continued to operate. Here we present a synthesis of BC data from 213 stations across Germany covering the period between 1994 and 2014. Due to the lack of a standardized method and respective legislation, the data set is very heterogeneous relying on twelve different measurement methods including chemical, optical, and thermal-optical methods. Stations include locations classified as background, urban-background, industrial and traffic among other types. Raw data in many different formats has been modelled and integrated in a relational database, allowing various options for further data analysis. We highlight results from the year 2009, as it is the year with the largest measurement coverage based on the same measurement method, with 30 stations. In 2009 daily average concentrations at 12 background stations ranged from 0.20 to 9.10 μg m-3 BC, while at traffic sites (15 stations) concentrations ranged from 0.30 to 30.60 μg m-3 BC, and industrial sites (3 stations) showed concentrations ranging between 0.30 and 9.4 μg m-3. The seasonal cycle for the year 2009 shows a similar pattern for industrial and background stations with a tendency of higher concentrations in winter. The concentrations at traffic stations are not as clearly coupled to seasons but have a strong weekly cycle with lower concentrations during weekends. Investigating the trends in BC concentration over at least 10 years was possible for 13 stations. Preliminary results suggest that concentrations have declined at traffic and background stations between 2005 and 2014. This implies that a general reduction of BC has already been achieved. However, preliminary results also show that elevated concentrations still occur during the colder months, most likely linked to residential heating.

Physician Quality Reporting System (PQRS) for Interventional Pain Management Practices: Challenges and Opportunities.

PubMed

Manchikanti, Laxmaiah; Hammer, Marvel; Benyamin, Ramsin M; Hirsch, Joshua A

2016-01-01

Basing their rationale on multiple publications from Institute of Medicine (IOM), specifically Crossing the Quality Chasm, policy makers have focused on a broad range of issues, including assessment of the influence of medical practice organization structures on quality performance and development of quality measures. The 2006 Tax Relief and Health Care Act established the Physician Quality Reporting System (PQRS), to enable eligible professionals to report health care quality and health outcome information that cannot be obtained from standard Medicare claims. However, the Patient Protection and Affordable Care Act (ACA) of 2010 required the Centers for Medicare and Medicaid Services (CMS) to incorporate a combination of cost and quality into the payment systems for health care as a precursor to value-based payments. The final change to PQRS pending initiation after 2018, is based on the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) which has incorporated alternative payment models and merit-based payment systems. Recent publication of quality performance scores by CMS has been less than optimal. When voluntary participation began in July 2007, providers were paid a bonus for reporting quality measures from 2008 through 2014, ranging from 0.5% to 2% of the Medicare Part B allowed charges furnished during the reporting period. Starting in 2015, penalties started for nonparticipation. Eligible professionals and group practices that failed to satisfactorily report data on quality measures during 2014 are subject to a 2% reduction in Medicare fee-for-service amounts for services furnished by the eligible professional or group practice during 2016. The CMS proposed rule for 2016 physician payments contained a number of provisions with proposed updates to the PQRS and Physician Value-Based Payment Modifier among other changes. The proposed rule is the first release since MACRA repealed the sustainable growth rate formula. CMS proposed to continue many existing policies regarding PQRS from 2015 to 2016. In addition, 2016 will be the year that is utilized to determine the 2018 PQRS payment adjustment. However, after 2018 the PQRS payment adjustment will be transitioned to the Merit-Based Incentive Payment System (MIPS), as required by MACRA. Overall, there will be over 280 measures in the 2016 PQRS.Readers might be surprised to find out that despite the cost intensity including time requirements personnel, the negative payment adjustments, are only the tip of the iceberg of cost. Indeed, all of the above may only be one-third or one-fourth of the cost to completely implement the PQRS system. Thus far, data across all specialties shows participation to be around 50%. In addition, penalties for lack of reporting of PQRS measures stands to be controversial to the Supreme Court ruling that unfunded mandates must not be permitted and also lack of significant relationships with improvement in quality in the overall analysis in multiple publications.

Implications of health reform for retiree health benefits.

PubMed

Fronstin, Paul

2010-01-01

This Issue Brief examines how current health reform legislation being debated in Congress will impact the future of retiree health benefits. In general, the proposals' provisions will have a mixed impact on retiree health benefits: In the short term, the reinsurance provisions would help shore up early retiree coverage and Medicare Part D coverage would become more valuable to retirees. In the longer term, insurance reform combined with new subsidies for individuals enrolling for coverage through insurance exchanges, the maintenance-of-effort provision affecting early retiree benefits, increases to the cost of providing drug benefits to retirees, and enhanced Medicare Part D coverage, would all create significant incentives for employers to drop coverage for early retirees and drug coverage for Medicare-eligible retirees. REINSURANCE PROGRAM FOR EARLY RETIREES: Proposed legislation includes a provision to create a temporary reinsurance program for employers providing health benefits to retirees over age 55 and not yet eligible for Medicare. Given the temporary nature of the program, it is intended to provide employers an incentive to maintain benefits until the health insurance exchange is fully operational. At that point, employers will have less incentive to provide health benefits to early retirees, and retirees will have less need for former employers to maintain a program. MEDICARE DRUG BENEFITS: The House-passed bill would initially reduce the coverage gap (the so-called "doughnut hole") for individuals in the Medicare Part D program by $500 and eliminate it altogether by 2019. The bill currently before the Senate would also reduce the coverage gap by $500, but does not call for eliminating it. Both would also provide a 50 percent discount to brand-name drug coverage in the coverage gap. These provisions increase the value of the Medicare Part D drug program to Medicare-eligible beneficiaries relative to drug benefits provided by employers. TAX TREATMENT OF EMPLOYER SUBSIDIES UNDER MMA: The Medicare Modernization Act provides subsidies to employers that continue to offer prescription drug coverage through a retiree health benefits program. This subsidy is currently not counted as taxable income to the employer receiving it. Both the House and Senate bills would effectively repeal this tax exclusion. This would have two effects: The real cost of providing retiree health benefits to Medicare-eligible retirees would increase, and an employer's FAS 106 liability would increase immediately. The increase in the cost of retiree drug benefits will cause employers to re-evaluate the subsidy, compared with other available options. Moving retirees to Medicare Part D may become even more attractive to employers if the coverage gap is reduced and/or eliminated. POSTRETIREMENT BENEFIT CHANGES: With some exceptions, the House-passed legislation would prohibit employers from changing the benefits offered to retirees and their beneficiaries once a person has retired. This provision could have a number of different effects: More employers may move toward capping their contributions; employers that want to maintain retiree health benefits may react by cutting the health benefits of active workers; employers may eliminate retiree health benefits altogether to avoid being locked into providing a permanent benefit; or they may drop benefits if they think there is no need to provide them.

Plague: Modern Preventive Measures in Ships and Ports: (Section of Tropical Diseases and Parasitology).

PubMed

White, C F

1935-03-01

Maritime quarantine, introduced in the fourteenth century in an endeavour to prevent the spread of plague. Though the system failed to achieve its object, and was expensive and restrictive to sea-borne commerce, it survived for over 500 years, presumably because, in the absence of knowledge of the aetiology of plague, no method of procedure more likely to be successful could be devised. This country acknowledged the failure of quarantine as a preventive measure in the middle of last century, and substituted the medical inspection of ships on arrival, though the last Quarantine Act was not repealed till 1896. Nevertheless it was not till the discovery of the rôle of the rat and the rat-flea in the spread of plague that it was possible to establish plague-preventive measures on a sound scientific basis.It is now recognized that a Port Health Authority must not only take steps to detect plague, human or rodent, afloat or ashore, at the earliest possible moment, but must eliminate conditions in ships and in shore premises which are conducive to the development of an epizoötic. Though here, and in other countries with an enlightened Public Health Administration, practice has long been ahead of legislation, the International Sanitary Convention of 1926 has now established throughout the world a large measure of uniformity in measures designed to prevent the spread of the more dangerous epidemic diseases by overseas trade, and the Port Sanitary Regulations 1933 have brought quarantine legislation in this country up to date.For the detection of plague every ship arriving from a plague-infected port is medically inspected on arrival, but even if there is no evidence of plague-infection on board, such ships are examined daily by a rat-officer until the discharge of cargo is complete. Dead rats found and live rats trapped are bacteriologically examined. If a rat is reported to be infected the vessel is fumigated at once. The discharge of cargo is then continued under supervision, and when the ship is empty she is fumigated again. Shore premises, particularly those in the immediate vicinity of the berths of ships from plague-infected ports, are systematically searched for dead rats, and live rats are trapped. If evidence of plague-infection is found, energetic measures of rat destruction are at once instituted over a wide area.The International Sanitary Convention requires all foreign-going ships to be inspected every six months as to the number of rats on board. If a ship is not so maintained as to keep the rat population down to a minimum she must be deratized.If, after deratization, ships are to remain free from rats, they must be rat-proofed. Similarly ashore, rat-proofing is the only rat-repressive measure of permanent value.The measures usually adopted to prevent the passage of rats between ships and shore are of limited value.Finally, a rat-flea survey is of value in estimating the susceptibility of a port to infection.

Plague: Modern Preventive Measures in Ships and Ports

PubMed Central

White, C. F.

1935-01-01

Maritime quarantine, introduced in the fourteenth century in an endeavour to prevent the spread of plague. Though the system failed to achieve its object, and was expensive and restrictive to sea-borne commerce, it survived for over 500 years, presumably because, in the absence of knowledge of the ætiology of plague, no method of procedure more likely to be successful could be devised. This country acknowledged the failure of quarantine as a preventive measure in the middle of last century, and substituted the medical inspection of ships on arrival, though the last Quarantine Act was not repealed till 1896. Nevertheless it was not till the discovery of the rôle of the rat and the rat-flea in the spread of plague that it was possible to establish plague-preventive measures on a sound scientific basis. It is now recognized that a Port Health Authority must not only take steps to detect plague, human or rodent, afloat or ashore, at the earliest possible moment, but must eliminate conditions in ships and in shore premises which are conducive to the development of an epizoötic. Though here, and in other countries with an enlightened Public Health Administration, practice has long been ahead of legislation, the International Sanitary Convention of 1926 has now established throughout the world a large measure of uniformity in measures designed to prevent the spread of the more dangerous epidemic diseases by overseas trade, and the Port Sanitary Regulations 1933 have brought quarantine legislation in this country up to date. For the detection of plague every ship arriving from a plague-infected port is medically inspected on arrival, but even if there is no evidence of plague-infection on board, such ships are examined daily by a rat-officer until the discharge of cargo is complete. Dead rats found and live rats trapped are bacteriologically examined. If a rat is reported to be infected the vessel is fumigated at once. The discharge of cargo is then continued under supervision, and when the ship is empty she is fumigated again. Shore premises, particularly those in the immediate vicinity of the berths of ships from plague-infected ports, are systematically searched for dead rats, and live rats are trapped. If evidence of plague-infection is found, energetic measures of rat destruction are at once instituted over a wide area. The International Sanitary Convention requires all foreign-going ships to be inspected every six months as to the number of rats on board. If a ship is not so maintained as to keep the rat population down to a minimum she must be deratized. If, after deratization, ships are to remain free from rats, they must be rat-proofed. Similarly ashore, rat-proofing is the only rat-repressive measure of permanent value. The measures usually adopted to prevent the passage of rats between ships and shore are of limited value. Finally, a rat-flea survey is of value in estimating the susceptibility of a port to infection. PMID:19990226