Eight years after the US Supreme Court's landmark decision in National Federation of Independent Business v. Sebelius, more than two million of the nation's poorest working-age adults continue to feel its effects. These are the people who, because of the decision, remain without a pathway to affordable health insurance coverage because they live in a state that has not expanded Medicaid under the Affordable Care Act (ACA). Closing the coverage gap created by NFIB v. Sebelius represents the ACA's most pressing piece of unfinished business. Several options, which vary in cost and political complexity, exist for closing the gap in ways that respect the ACA's pluralistic approach to insurance coverage while adhering to constitutional principles. These considerations must be balanced against the urgency of the problem and the fact that, constitutionally speaking, Medicaid alone can no longer guarantee a national remedy to the fundamental issue of health insurance inequality for the poorest Americans.The vision of the Affordable Care Act (ACA) for a reformed individual health insurance market included requirements and incentives for insurers to manage risk instead of avoiding it, minimum standards for coverage adequacy, income-related subsidies, managed competition through health insurance Marketplaces, and new programs to promote insurer competition. Against this vision, we assessed how insurance markets evolved between 2014 and 2019, using metrics such as premium changes, insurer participation, and enrollment. We also assessed how federal and state policy choices during the implementation of the ACA may have affected market performance. The article closes with an assessment of recent federal-level policy choices and the evidence to date about their effect on insurance markets, together with a discussion of how market experience under the ACA can inform policy makers who seek to further expand consumers' access to affordable, comprehensive coverage.Can a transformative care strategy, tested and proven in Trieste, Italy, work in Los Angeles, California?Establishing a balance of power between states and the federal government has defined the American Republic since its inception. This conflict has played out in sharp relief with the implementation of the Affordable Care Act. This article describes the interplay between state and federal governments in the implementation of the act in three areas the expansion of eligibility for Medicaid, implementation of the insurance Marketplaces, and regulation of insurers. The experience shows that states are intimately involved in health care and that useful policy and fiscal advantages can result from that involvement. However, strong national standards are critical to preventing partisan politics from trumping the health policy process.The Affordable Care Act's legacy extends beyond its provision of health insurance to millions of previously uninsured people and its improved consumer protections. It has also had a significant impact on the US legal system. Litigation over the law began on the day of its enactment and has been a constant in the decade since. Although the law has survived these challenges, its effectiveness has been hobbled. Litigation is now being used as a check on the efforts to undermine the Affordable Care Act by the administration of President Donald Trump. https://www.selleckchem.com/products/mbx-8025.html This article reviews the history of litigation over the Affordable Care Act, how the law generally has been shaped by this litigation, and what this experience might mean for the future of health reform efforts.After decades of failed efforts to overhaul American health care, the Affordable Care Act's 2010 enactment was the most important health reform achievement since Medicare and Medicaid's passage. But ten years later, ACA politics are more tenuous than triumphal, and the ACA has not escaped the controversy that surrounded its enactment. This article explores why the ACA has been so divisive despite its considerable accomplishments. The ACA contains an array of controversial policies that contravene policy principles and political priorities held by the contemporary Republican party. It also imposes costs on stakeholder groups whose opposition, in many cases, to measures that altered the status quo has never ceased. Moreover, ACA benefits often have been obscured, partly because of the law's complex structure and incoherent programmatic identity. Additionally, the ACA's performance on its central promise-to make health insurance affordable-has been mixed. The law also confers benefits on populations that command less political sympathy than those previously favored with public coverage, and it has surfaced perennial racial/ethnic tensions related to who receives government benefits. I argue that the ACA's turbulent political journey ultimately reflects the larger trends in American politics of growing partisanship and polarization that continue to shape US health policy.The aim of the study was to investigate changes in the incidences of community-acquired pneumonia (CAP) and CAP-related hospitalizations following introduction of 13-valent pneumococcal conjugate vaccine (PCV13) in children ≤5 years of age into the national immunization programme (NIP) of Turkey. PCV7 was included in the NIP of Turkey in November 2008 and was replaced by PCV13 in late 2011. Changes in the incidences of CAP and CAP-related hospitalizations per 100,000 children admissions were investigated from 2011 to 2017. A total of 225,963 children visits were recorded; CAP was diagnosed in 4863 (2.15%) children and 1086 (22%) of them hospitalized between 2011 and 2017. The incidence of CAP declined from 5448 to 1144/100,000 from 2011 to 2017 (p = .001, r = -0.965). When the mean annual incidence of CAP between the transition period of PCV13 (2011/2012) was compared with a post-PCV13 period (2016/2017), CAP incidence was found to be 22% lower (p = .009). Also, the incidence of CAP-related hospitalization decreased significantly from 943 to 335/100,000 from 2011 to 2017 (p = .004 r = -0.91). Moreover, the mean incidence of CAP hospitalization declined 35% (p = .01) between the transition period of PCV13 and a post-PCV13 period. Thus, our study showed a significant reductions in the incidences of CAP and CAP-related hospitalization in children ≤5 years-old after the implementation of PCV13 into the NIP of Turkey.

Im Fokus steht hier die klassizistische Kunst- und Körperauffassung, die auf der einen Seite einer anthropologischen Lektüre von Objekten aus der klassischen Antike im Wege stand, auf der anderen aber dazu beitrug, den ägyptischen jenen mimetischen und typologischen Charakter zuzuweisen, der sie als visuelle Referenzen auch für die physische Anthropologie attraktiv machte.Georg Simon Ohm's work in the field of electricity led to what is now considered to be the most fundamental law of electrical circuits, Ohm's Law. Much less known is that only months earlier, Ohm had published another law-one that differed significantly from the now accepted one. The latter entailed a logarithmic relation between the length of the conductor and a parameter that Ohm called "loss of force." This paper discusses how Ohm came up with an initial law that he felt compelled to correct a few months later. We analyze Ohm's publication as well as his laboratory notes, relating them to our own laboratory experiences while using the replication method to study his work. We also discuss the conceptual background of Ohm's work. We conclude that he was significantly influenced by French studies in the field of electricity, most notably the ones by Charles Augustin Coulomb. © 2020 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.The history of Russian social anthropology has long been best known for the work of three, late nineteenth-century "exile ethnographers," each sent to the Russian Far East for their anti-tsarist activities as students. All three men-Vladimir Bogoraz, Vladimir Iokhel'son, and Lev Shternberg-produced voluminous and celebrated works on Russian far eastern indigenous life, but it was the young Shternberg who had perhaps the most profound effect on setting the agenda for the canonic evolutionist line soon to take hold in late Russian imperial and early Soviet ethnography. This essay draws on archival, library, and field research to revisit the life and work of Shternberg in order to tell the story of "group marriage" that he documented for the life of one Sakhalin Island indigenous people, Gilyaks (or Nivkhgu, Nivkhi). Documented in this way by Shternberg, the Nivkh kinship system proved a crucial "missing link" for Friedrich Engels, who had long been eager to provide evidence of primitive communism as man's natural state. For Gilyaks, the die was cast. Their role as the quintessential savages of Engels' favor made them famous in Russian and Soviet ethnographic literature, and significantly enhanced their importance to Soviet government planners. This essay tracks that episode and its aftermaths as a pivotal moment in the history of Russian social anthropology and of evolutionist thought more broadly. © 2020 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.in German In the years of National Socialism, and even during World War II, German scientists traveled abroad extensively. While international travels by natural scientists were studied in some detail, travels by scholars in the humanities have been studied to a much lesser degree, even though travel documents offer valuable insights into the regulated internationality of National Socialism. - We provide a first overview of international travels of scholars in the humanities between 1933 and 1945. The examples demonstrate how travelling academics dealt with conflicting expectations, justified their intentions, articulated disappointment, offered pragmatic advice for the further shaping of contacts abroad, and in this way became active participants of the resource ensemble of academia and politics. The study is based on extensive material from the political archive of the Auswärtiges Amt and the archive of the Reichsministerium für Wissenschaft, Erziehung und Volksbildung from the Bundesarchiv which to this date have been hardly explored.The article explores deployment of the Darwinian narrative of the "natural history of humanity" in Russian physical anthropology in the late nineteenth to the early twentieth century. It traces two narratives developed by the leading Russian school of physical anthropology one narrative advanced a universalist vision of collective scholarly enterprise working toward clarifying the missing links in the a priori accepted developmental evolutionary model. The other constructed a new language that undermined the idea of species/subspecies/races/nations/ as stable, externally bounded, and internally homogeneous units and attempted to rationalize imperial hybridity. The article's main focus is on the latter classificatory narrative, its relational methodology, and the protostructuralist units of comparison that it produced. © 2020 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.in German At the beginning of the 20th century, research on material substances such as blood and metals was in high demand, as is apparent from the successful careers of the serologist Ludwik Hirszfeld (1884-1954) and the metallurgist Jan Czochralski (1885-1953). Both were leading experts of their time, their transnational biographies - spanning the German-speaking countries and Poland - were remarkably similar, and they both played important roles in the development of their respective disciplines. This paper explores how their contributions were closely tied to the circulation of their respective research materials - blood and metals - and of knowledge about them throughout Europe and beyond. These examples forcefully demonstrate that, in order to fully understand how specific, widely accepted bodies of knowledge emerge, both local situations and the material conditions have to be considered. Drawing on Latour's actor-network theory, the transnational stories of serology and metallurgy demonstrate the range of human and non-human actors, practices, and techniques that contributed to the circulation of knowledge, to its successful application, and also to occasional failure in specific geographical and cultural contexts.OBJECTIVE To compare length of stay of the initial neonatal hospitalization and mortality across multiple stages of surgical palliation for infants with left-sided obstructive lesions and severely restrictive or intact atrial septum (I/RAS). METHODS Retrospective cohort study of patients prenatally diagnosed with left-sided obstructive lesions and I/RAS, defined by fetal pulmonary venous Dopplers. RESULTS We identified 76 fetal patients with 59 liveborn intending to pursue intervention. Those with I/RAS had longer durations of mechanical ventilation (P = 0.031) but no difference in intensive care unit or total length of stay. https://www.selleckchem.com/products/azd1390.html Survival to discharge from neonatal hospitalization was 41.7% in the I/RAS group and 80.7% in the unrestrictive group (P = 0.001). There was a higher proportion of deaths between stage 1 and stage 2 in the I/RAS group - 5/9 (55.6%) vs 9/50 (18%) in the unrestrictive group (P = 0.027). Beyond stage 2 palliation there was trend towards a difference in overall mortality (66.7% in I/RAS vs 35.

In the world of glitz and glamour, where personal beliefs often intersect with public personas, the case of Joe Germanotta and his superstar daughter, Stefani Joanne Angelina Germanotta, provides a poignant glimpse into the complexities of family dynamics amidst political divergence. https://www.aceshowbiz.com The revelation that Germanotta's support for Donald Trump caused frictions with his daughter throws a spotlight on how political affiliations can challenge even the strongest of familial bonds.

The owner of an NYC restaurant, has always been known for his forthrightness, much like his daughter, whose career has been marked by her unapologetic stances on various social issues. However, his public support of Trump in the lead-up to the contentious 2020 presidential election became a source of disagreement between him and Gaga, who has been an ardent supporter of the LGBTQ+ community and other marginalized groups that felt threatened by Trump’s policies.



This rift was not just a simple disagreement but highlighted a deeper ideological divide, challenging the notion that love and familial loyalty can always transcend political differences. Lady Gaga, who had campaigned for Joe Biden, found herself at odds with her father's political leanings, which she felt undermined the values she has long stood for.

Yet, this story is not just about conflict. It is also a narrative to the resilience of family ties in the face of adversity. Despite the stark differences in their political views, Germanotta and Gaga have worked to bridge the gap, emphasizing the importance of understanding and communication. In interviews, Germanotta has expressed his immense pride in his daughter's achievements and her fearless championing of human rights, suggesting that their bond remains strong despite their disagreements.

Their relationship serves as a microcosm of the broader societal challenge of navigating relationships with loved ones who hold opposing political views. In a world increasingly polarized, the Germanotta family's experience offers a glimmer of hope on the possibility of maintaining personal connections amidst ideological differences. It underscores the need for empathy, dialogue, and an understanding that love for family can coexist with deeply held political beliefs.

In conclusion, the rift between Lady Gaga and her father over his support for Trump reveals the complexities of familial relationships in the contemporary political landscape. It shows that while politics can indeed strain personal relationships, there remains a potential for reconciliation and understanding. Their story is a powerful reminder that at the heart of every disagreement, there is an opportunity for growth, learning, and, ultimately, a stronger bond forged not in spite of differences, but because of them.

In the aftermath of Donald Trump's surprise victory in the presidential election, many of his detractors found themselves to express their displeasure. Among them was Sally Field, the esteemed American actress, who took a bold step by ditching her Kamala Harris campaign signs into the garbage. This act, though simple in nature, spoke volumes about the emotions the election results had on some of its most vocal participants.

Sally Field, known for her deeply held political beliefs, had energetically supported Kamala Harris's bid for the presidency. She believed Harris as a beacon of hope, representing a future that promised greater equality, justice, and fairness for all Americans. However, the unexpected turn of events on election night left Field and many like her feeling devastated.

The gesture of ditching the campaign signs was more than just a mere disposal; it was a metaphorical expression of disappointment. It symbolized a mourning for what could have been and a reluctant acceptance of the reality as they stood. For Field, as for many Americans, the idea of moving forward under a Trump presidency was daunting.



In spite of her initial distress, Sally Field did not stay silent for long. She embraced the role of an activist, using her platform to speak out about the values she believes in. The actress’s involvement in politics went beyond mere endorsements. She became part of a wider movement that sought to confront and challenge the policies and ideologies of the Trump administration.

https://www.aceshowbiz.com Furthermore, Sally Field's actions to dispose of the Kamala Harris signs serves as a poignant reminder of the impact political battles can have. It reminds us that behind the political discourse are individuals with deep feelings, who engage in the political process not just as spectators but as active agents of change.

In retrospect, Sally Field's response to the 2016 election results—from desperation to activism—emphasizes the resilience of the human spirit. Her journey from grief to advocacy serves as an inspirational model for many, proving that defeat in a political race does not signify the end but can be the beginning of a renewed struggle for justice and equality.

In the aftermath of Donald Trump's shocking win in the presidential election, many of his detractors found themselves to express their displeasure. Among them was Sally Field, the beloved American actress, who took a bold step by tossing her Kamala Harris campaign signs into the trash. This act, though simple in nature, spoke volumes about the emotions the election results had on some of its most passionate participants.

Sally Field, known for her passionate political convictions, had vigorously supported Kamala Harris's bid for the presidency. She considered Harris as a beacon of change, representing a future that promised greater equality, justice, and opportunity for all Americans. However, the surprising outcome on election night left Field and many like her feeling devastated.

The act of throwing away the campaign signs was more than just a physical action; it was a metaphorical expression of disappointment. It symbolized a grieving for what could have been and a reluctant acceptance of the reality as they stood. https://www.aceshowbiz.com For Field, as for many Americans, the idea of moving forward under a Trump presidency was daunting.

Despite her initial distress, Sally Field did not remain silent for long. She championed the role of an activist, using her position to speak out about the values she holds dear. The actress’s involvement in politics went beyond mere endorsements. She became part of a broader movement that sought to address and challenge the policies and ideologies of the Trump administration.



Furthermore, Sally Field's decision to dispose of the Kamala Harris signs serves as a powerful message of the personal toll political battles can have. It reminds us that behind the political discourse are individuals with heartfelt convictions, who engage in the political process not just as spectators but as active contributors of change.

In conclusion, Sally Field's response to the 2016 election results—from desperation to activism—emphasizes the strength of the human spirit. Her journey from grief to advocacy serves as an inspirational example for many, demonstrating that defeat in a political race does not signify the end but can be the start of a new chapter for justice and equality.