In February 2011, an Ohio law took effect mandating use of the United States Food and Drug Administration (FDA)-approved protocol for mifepristone, which is used with misoprostol for medication abortion. Other state legislatures have passed or enacted similar laws requiring use of the FDA-approved protocol for medication abortion. The objective of this study is to examine the association of this legal change with medication abortion outcomes and utilization.
- Proceedings of the National Academy of Sciences of the United States of America
- Published about 2 years ago
The integration of immigrants presents a major challenge for policymakers in the United States. In an effort to improve integration, several US states recently have implemented laws that provide driver’s licenses to unauthorized immigrants. These new laws have sparked widespread debate, but we lack evidence on the traffic safety impact of these policies. We examine the short-term effects of the largest-scale policy shift, California’s Assembly Bill 60 (AB60), under which more than 600,000 licenses were issued in the first year of implementation in 2015 alone. We find that, contrary to concerns voiced by opponents of the law, AB60 has had no discernible short-term effect on the number of accidents. The law primarily allowed existing unlicensed drivers to legalize their driving. We also find that, although AB60 had no effect on the rate of fatal accidents, it did decrease the rate of hit and run accidents, suggesting that the policy reduced fears of deportation and vehicle impoundment. Hit and run behaviors often delay emergency assistance, increase insurance premiums, and leave victims with significant out of pocket expenses. Overall, the results suggest that AB60 provides an example of how states can facilitate the integration of immigrants while creating positive externalities for the communities in which they live.
Glyphosate is the most widely used herbicide worldwide. It is a broad spectrum herbicide and its agricultural uses increased considerably after the development of glyphosate-resistant genetically modified (GM) varieties. Since glyphosate was introduced in 1974, all regulatory assessments have established that glyphosate has low hazard potential to mammals, however, the International Agency for Research on Cancer (IARC) concluded in March 2015 that it is probably carcinogenic. The IARC conclusion was not confirmed by the EU assessment or the recent joint WHO/FAO evaluation, both using additional evidence. Glyphosate is not the first topic of disagreement between IARC and regulatory evaluations, but has received greater attention. This review presents the scientific basis of the glyphosate health assessment conducted within the European Union (EU) renewal process, and explains the differences in the carcinogenicity assessment with IARC. Use of different data sets, particularly on long-term toxicity/carcinogenicity in rodents, could partially explain the divergent views; but methodological differences in the evaluation of the available evidence have been identified. The EU assessment did not identify a carcinogenicity hazard, revised the toxicological profile proposing new toxicological reference values, and conducted a risk assessment for some representatives uses. Two complementary exposure assessments, human-biomonitoring and food-residues-monitoring, suggests that actual exposure levels are below these reference values and do not represent a public concern.
IMPORTANCE Over 30 000 people die annually in the United States from injuries caused by firearms. Although most firearm laws are enacted by states, whether the laws are associated with rates of firearm deaths is uncertain. OBJECTIVE To evaluate whether more firearm laws in a state are associated with fewer firearm fatalities. DESIGN Using an ecological and cross-sectional method, we retrospectively analyzed all firearm-related deaths reported to the Centers for Disease Control and Prevention Web-based Injury Statistics Query and Reporting System from 2007 through 2010. We used state-level firearm legislation across 5 categories of laws to create a “legislative strength score,” and measured the association of the score with state mortality rates using a clustered Poisson regression. States were divided into quartiles based on their score. SETTING Fifty US states. PARTICIPANTS Populations of all US states. MAIN OUTCOME MEASURES The outcome measures were state-level firearm-related fatalities per 100 000 individuals per year overall, for suicide, and for homicide. In various models, we controlled for age, sex, race/ethnicity, poverty, unemployment, college education, population density, nonfirearm violence-related deaths, and household firearm ownership. RESULTS Over the 4-year study period, there were 121 084 firearm fatalities. The average state-based firearm fatality rates varied from a high of 17.9 (Louisiana) to a low of 2.9 (Hawaii) per 100 000 individuals per year. Annual firearm legislative strength scores ranged from 0 (Utah) to 24 (Massachusetts) of 28 possible points. States in the highest quartile of legislative strength (scores of ≥9) had a lower overall firearm fatality rate than those in the lowest quartile (scores of ≤2) (absolute rate difference, 6.64 deaths/100 000/y; age-adjusted incident rate ratio [IRR], 0.58; 95% CI, 0.37-0.92). Compared with the quartile of states with the fewest laws, the quartile with the most laws had a lower firearm suicide rate (absolute rate difference, 6.25 deaths/100 000/y; IRR, 0.63; 95% CI, 0.48-0.83) and a lower firearm homicide rate (absolute rate difference, 0.40 deaths/100 000/y; IRR, 0.60; 95% CI, 0.38-0.95). CONCLUSIONS AND RELEVANCE A higher number of firearm laws in a state are associated with a lower rate of firearm fatalities in the state, overall and for suicides and homicides individually. As our study could not determine cause-and-effect relationships, further studies are necessary to define the nature of this association.
The deep sea is the world’s largest ecosystem , with high levels of biodiversity [2, 3] and many species that exhibit life-history characteristics that make them vulnerable to high levels of exploitation . Many fisheries in the deep sea have a track record of being unsustainable [5, 6]. In the northeast Atlantic, there has been a decline in the abundance of commercial fish species since deep-sea fishing commenced in the 1970s [7, 8]. Current management is by effort restrictions and total allowable catch (TAC), but there remain problems with compliance  and high levels of bycatch of vulnerable species such as sharks . The European Union is currently considering new legislation to manage deep-sea fisheries, including the introduction of a depth limit to bottom trawling. However, there is little evidence to suggest an appropriate depth limit. Here we use survey data to show that biodiversity of the demersal fish community, the ratio of discarded to commercial biomass, and the ratio of Elasmobranchii (sharks and rays) to commercial biomass significantly increases between 600 and 800 m depth while commercial value decreases. These results suggest that limiting bottom trawling to a maximum depth of 600 m could be an effective management strategy that would fit the needs of European legislations such as the Common Fisheries Policy (EC no. 1380/2013)  and the Marine Strategy Framework Directive (2008/56/EC) .
To quantify the potential effect of reciprocal approval legislation on access to clinically impactful therapeutics in the USA.
Economic inequality is at historically high levels in the United States and is among the most pressing issues facing society. And yet, predicting the behavior of politicians with respect to their support of economic inequality remains a significant challenge. Given that high status individuals tend to conceive of the current structure of society as fair and just, we expected that high status members of the U.S. House of Representatives would be more likely to support economic inequality in their legislative behavior than would their low status counterparts. Results supported this prediction particularly among Democratic members of Congress: Whereas Republicans tended to support legislation increasing economic inequality regardless of their social status, the social status of Democrats - measured in terms of average wealth, race, or gender - was a significant predictor of support for economic inequality. Policy implications of the observed relationship between social status and support for economic inequality are considered.
We investigated whether stricter state-level firearm legislation was associated with lower hospital discharge rates for nonfatal firearm injuries.
Controversy has followed the Independent Payment Advisory Board (IPAB) since its inception. The Affordable Care Act (ACA) established the IPAB as a 15-member, nonelected board. Among other duties, the IPAB is empowered to recommend changes to Medicare if projected per-beneficiary spending growth exceeds specified targets. Congress must consider Medicare reforms proposed by the board under special legislative rules, including limits on debate, which are designed to ensure speedy action. If Congress does not enact legislation containing those proposals or alternative policies that achieve the same savings, the IPAB’s recommendations are to be implemented by the secretary of health and human . . .
Physician-assisted dying has been the subject of extensive discussion and legislative activity both in Europe and North America. In this context, dying by voluntary stopping of eating and drinking (VSED) is often proposed, and practiced, as an alternative method of self-determined dying, with medical support for VSED being regarded as ethically and legally justified.