SciCombinator

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Concept: United States Congress

125

In May 2015, the 21st Century Cures Act was introduced in the U.S. House of Representatives, with the goal of promoting the development and speeding the approval of new drugs and devices.(1) Championed by the pharmaceutical, biotechnology, and device industries, the bill was approved unanimously (51 to 0) in committee and continues to be debated. If enacted into law, some of its provisions could have a profound effect on what is known about the safety and efficacy of medical products, as well as which ones become available for use. Some aspects of the bill could indeed enhance the development of . . .

Concepts: Pharmacology, Medicine, United States, United States Congress, Pharmaceutical drug, 21st century, Democratic Party, United States House of Representatives

120

It’s not often that California, West Virginia, and Mississippi are politically aligned, but that unlikely trio formed on June 25, 2015, when California Governor Jerry Brown signed into law Senate Bill (SB) 277, substantially narrowing exceptions to school-entry vaccination mandates. With that law, California becomes the third state to disallow exemptions based on both religious and philosophical beliefs; only medical exemptions remain. The move represents a stunning victory for public health that affects not only California schoolchildren but also the prospects for strengthening vaccination requirements nationwide. In 2014, California tightened its personal-belief exemption by requiring parents seeking such exemptions to obtain . . .

Concepts: United States, United States Congress, United States Constitution, Religion, Bill, Veto, Bill Clinton, Jerry Brown

117

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.

Concepts: United States, United States Congress, U.S. state, Law, California, Policy, Implementation, Legislature

99

In February 2015, Senators Orrin Hatch (R-UT) and Richard Burr (R-NC), along with Representative Fred Upton (R-MI), unveiled the Patient Choice, Affordability, Responsibility, and Empowerment Act (Patient CARE Act).(1) Although its terms remain sketchy, the proposal deserves serious attention. The Budget Resolutions passed by each House of Congress in late March, though nonbinding, assume enactment of some version of the proposal, and Hatch and Upton chair the Senate Finance Committee and the House Energy and Commerce Committee, respectively, two of Congress’s most powerful health committees. The Patient CARE Act would repeal the insurance reforms of the Affordable Care Act (ACA) . . .

Concepts: Patient, United States Congress, United States House of Representatives, United States Senate, Legislatures, Senate, United States Senate Committee on Finance, Orrin Hatch

72

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.

Concepts: Demography, United States, United States Congress, U.S. state, State, Suicide, Common law, Legislature

43

On November 19, 2013, New York City Mayor Michael Bloomberg signed into law the “Tobacco 21” bill, imposing the strictest age restriction on tobacco sales of any major U.S. city.(1) Beginning in May 2014, it will be illegal to sell tobacco products and electronic cigarettes to persons younger than 21 years of age. The law stops short of making possession of tobacco products by persons under 21 a crime, placing the responsibility on retailers under penalty of civil fines. Regulations issued by the Food and Drug Administration (FDA) set the national minimum tobacco-sales age at 18 but allow states and . . .

Concepts: Tobacco, Cigarette, Nicotine, United States Congress, New York City, New York, Michael Bloomberg, Mayor of New York City

38

On January 20, 2016, New Jersey Governor Chris Christie vetoed a bill passed with strong bipartisan support by his state legislature that would have raised New Jersey’s minimum age of sale for tobacco products to 21. The veto is a setback in an otherwise accelerating movement toward dissemination of “Tobacco 21” laws as a new tool for reducing young people’s access to cigarettes and e-cigarettes. In 2013, only 8 U.S. localities had adopted Tobacco 21 laws. By March 2016, at least 125 localities and the state of Hawaii had done so, and California was on the cusp of following suit. . . .

Concepts: United States, Tobacco, United States Congress, United States Constitution, New Jersey, Asian American, Kentucky, Filipino American

34

As Zika virus continues to spread, decisions regarding resource allocations to control the outbreak underscore the need for a tool to weigh policies according to their cost and the health burden they could avert. For example, to combat the current Zika outbreak the US President requested the allocation of $1.8 billion from Congress in February 2016.

Concepts: President of the United States, United States Congress, United States Constitution, Ronald Reagan, Resource allocation, Franklin D. Roosevelt, George H. W. Bush, Bill Clinton

32

India is known as the “pharmacy of the developing world,” because it supplies much of the world’s demand for affordable, generic drugs. So when the Supreme Court of India issued a landmark ruling in April adopting a strict interpretation of the country’s new patent law, advocates for global access to medicines celebrated. In fact, the decision in Novartis v. Union of India & Others provides an important model for other countries around the world - a step toward a “patent law 2.0” that not only helps to ensure access to medicines but might also help better align pharmaceutical innovation with . . .

Concepts: Pharmacology, Supreme Court of the United States, United States Congress, Pharmaceutical drug, Pharmacy, Food and Drug Administration, Jury, Public domain

28

We investigated whether stricter state-level firearm legislation was associated with lower hospital discharge rates for nonfatal firearm injuries.

Concepts: Surgery, United States Congress, Legislature