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  • Book
    Harry P. Selker, June S. Wasser, editors.
    Summary: This book examines the landmark 2010 Patient Protection and Affordable Care Act (ACA) from the perspective that health policy innovation is translational research directed at improving health. It delineates a new perspective about the creation and potential impact of the ACA and guides the development of health policy that is supported by best evidence that, in turn, transforms into practice, policy, and public benefit. Told by those involved in the creation and implementation of the ACA, the book reviews the history and impact of this ground-breaking legislation and recommends priorities, objectives, and next steps for translational research as the ACA is implemented. Featuring contributions from nationally renowned leaders in healthcare policy, this book adds to the public conversation about the ACA and its role in shaping health policy and contributes to a more realistic, nuanced, and productive understanding of this ground-breaking legislation by physicians, policy makers, and the public. It also provides a framework for next steps in continuing to improve U.S. health policy.

    Contents:
    Introduction: The Affordable Care Act as a National Experiment
    Objectives of the ACA
    Delivering on the Promise of the Affordable Care Act
    What We Got (and What Might Have Been): A Distinctively American Approach
    Commentary to Section II: Conducting the Experiment
    The Affordable Care Act as an Experiment: Data We Have, Expect to Have, and Should Have, from a Vermont Pilot Study
    The Center for Medicare and Medicaid Innovation: Its Purpose, Processes, and Desired Outcomes
    The Dream of a National Health Information Technology Infrastructure
    Results from a Massachusetts Pilot Study
    Commentary to Section III: Engaging the Public
    The Value Proposition for Individuals and the Public
    Messaging, Medicine, and Obamacare
    Commentary to Section IV: From Personal to Political to Policy: What Next?
    Supreme Court Review of the ACA and Political Gamesmanship
    Medicaid Expansion Challenges States
    Next Experiments in ACA Legislation and Policy
    Epilogue.
    Digital Access Springer 2014
  • Article
    Granoff DM, Basden M, Rockwell R.
    West J Med. 1978 Feb;128(2):101-5.
    Ampicillin-resistant Hemophilus influenzae had not been identified in Fresno, California, before June 1976. In the 12 months that followed, eight resistant type B strains and three resistant nontypable isolates were cultured from patients treated at two hospitals that provide nearly all of the acute pediatric inpatient care for the area. Two of the resistant strains were obtained from patients with invasive infections and represented 4.2 percent of Hemophilus influenzae isolated from blood, cerebrospinal fluid or joint aspirates during the 12 months. The remaining six resistant type B strains were obtained from 117 patients, and were the predominant organism in cultures of other sites, primarily respiratory secretions. In two of three patients infected with nontypable organisms, resistance appeared to emerge during therapy with ampicillin. Measurement of beta lactamase was a practical and accurate method for differentiating between ampicillin-sensitive and resistant strains. All ten of the beta lactamase-positive isolates tested had minimal inhibitory concentrations (MIC) for ampicillin of 15 mug per ml, or less. In contrast 30 beta lactamase-negative strains had MIC's of 1.5 mug per ml, or less, of ampicillin. Our results indicate that ampicillin resistance has become a significant problem in the Central Valley of California and probably the entire state.
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