Motor vehicle crashes (MVCs) continue to be a leading cause of death in the United States, although broad adoption of seatbelt use has markedly reduced fatality. New Hampshire remains the only state without a mandatory adult seatbelt law and has the lowest seatbelt usage rate at 78%, compared with the national average of 91%. This study investigates the association between seatbelt legislation and unrestrained MVC fatalities, focusing specifically on crashes occurring in New Hampshire and occupants with New Hampshire driver's licenses. This retrospective cross-sectional study analyzed all fatal MVCs in the United States from 2017 to 2023 using the National Highway Traffic Safety Administration's Fatality Analysis Reporting System data. The primary outcome was unrestrained MVC mortality. Exposures included crash state and state driver's license, categorized into New Hampshire, primary enforcement states, and secondary enforcement states. Multivariable logistic regression was adjusted for demographic, environmental, vehicle, and driver-related factors. Secondary analyses evaluated New Hampshire-licensed drivers outside the state and non-New Hampshire-licensed occupants within New Hampshire. Among 146,655 fatal MVCs eligible for analysis, 474 occurred in New Hampshire and 485 involved New Hampshire license holders. The proportion of unrestrained fatal MVCs was highest for MVCs geographically within New Hampshire (71.5%) and for occupants with New Hampshire driver's licenses (68.7%). MVCs in New Hampshire (OR, 2.80; 95% CI, 2.15-3.65) and possessing a New Hampshire license (OR, 2.74; 95% CI, 2.13-3.52) were significantly associated with increased odds of unrestrained MVC fatality. Notably, New Hampshire-licensed drivers exhibited increased unrestrained fatality risk even when traveling outside their home state (OR, 2.06; 95% CI, 1.28-3.33). Our findings underscore the strong association between New Hampshire's absence of an adult seatbelt law and elevated unrestrained MVC fatality risk. These data highlight the urgent need for policy interventions to enhance occupant safety through mandatory seatbelt legislation in New Hampshire. ( J Trauma Acute Care Surg . 2026;101: 80-88. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved.). Level IV.

Do social networks and peer influence shape major life decisions in polarized settings? We explore this question by examining how peers influenced the allegiances of West Point cadets during the American Civil War. Leveraging quasi-random variations in the proportion of cadets from Free States, we analyze how cadets' decisions about which army to join depended on the composition of their peers. We have three main findings. First, there was a strong and significant peer effect: a higher proportion of classmates from Free States significantly increased the likelihood that cadets from Slave States joined the Union Army. Second, the peer effect varies with geography, most notably with the slave population share in cadets' home states or counties, and with cadets' own slave ownership in 1860. Third, peer effects were amplified by shared experiences such as having served together in the Mexican-American War, continuous military service, and belonging to the same cohort, suggesting that sustained interaction is important.

With the migration of arthroplasty to the ambulatory surgery center (ASC) setting, it is critical to understand the impact of certificate-of-need (CON) laws limiting ASC construction on the manner patients receive care. This study examined location of care within a practice that straddles the border of a CON state (Illinois) and non-CON state (Indiana) to determine the proportion of patients traveling away from their home state for surgery. The cost of care for cases that migrated out-of-state was investigated. Patients who had a home address in Illinois or Indiana and underwent primary hip or knee arthroplasty at ASCs affiliated with our institution from 2016 to 2024 were retrospectively reviewed. Patients who underwent surgery outside of Illinois or Indiana, or at a non-ASC facility, were excluded. Location of surgery, facility fee reimbursement, and driving distance between patients' home addresses and ASC locations were compared. Patients were treated at eight ASCs, four in Illinois and four in Indiana. Of the 7,503 patients included, 6,505 (86.7%) were from Illinois and 998 (13.3%) from Indiana. Patients from Illinois (CON state) were 3.7 times more likely to have surgery out-of-state than those from Indiana (non-CON state) (28.4 versus 7.7%, P < 0.001). Of the patients who had surgery out-of-state, 67.3% from Illinois and 100% from Indiana had a closer in-state option (P < 0.001). Using national average Medicare facility fee data, there was a net migration of approximately $18,085,000 out of Illinois in facility fee reimbursement. Patients living in a state with CON laws restricting ASC construction were more likely to travel out-of-state for outpatient primary arthroplasty, leading to a migration of revenue away from CON states. Given the lack of evidence suggesting CON laws improve outcomes, combined with the potential for state-level financial loss incurred by limiting ASC construction, we suggest that the current CON legislative regulatory framework be reevaluated.

Telles, R. (Director). Heffernan, J. &amp; Feinberg, M. (Executive Producers). (2024). American Agitators. Video Project. 94 mins. Most people have probably never heard of Fred Ross. Yet he was a major force in the second half of the 20th century. Ross had a gift for organizing people at the grassroots level and he shared that gift by training others to do the same. He actually began his work as the supervisor in the migrant camps of the Great Depression in his home state of California. He taught those people how to organize themselves so that everyone could have a better life. During WWII, he supervised a Japanese relocation camp and, again, taught them to organize. After the war, he continued to work with ethnic groups and labor groups. He helped found the Community Service Organization which focused on these grassroots efforts to improve people’s lives in areas such as equal education and safety in the workplace. This resulted in achievements like the founding of the Farm Workers Union. Up until then, the traditional way of organizing people was the ‘hate the boss’ method: make people as angry as possible and it usually ended in a physical fight between the two sides. Ross rejected this; he was a man of peace. He knew that the real power of the people lay in the ballot box. If you get enough people on your side to vote, then the politicians will start to pay attention to you. That is when change happens. This film is much like Ross himself. It is rather quiet in its presentation. It presents a lot of facts and history. Yet, watching it will leave many feeling inspired to get out there and do something to make the world a better place. He died in 1992 but his legacy continues. Workers are still organizing and still fighting. The film does run long at 94 minutes. There is also a one hour version available that may be more suitable for the classroom. This is an excellent film. I would encourage showing it to young people in particular to show them what can be accomplished when people work together toward a common goal. Fred Ross’ favorite quote was “A good organizer is a social arsonist who goes around setting people on fire.” What might the next generation achieve if they, too, have that fire within them? Awards won include: Best Documentary, Cinequest Film Festival

State-level abortion restrictions in the US enforced after the June 2022 Dobbs v Jackson Women's Health Organization Supreme Court decision have worsened geographic, racial, and socioeconomic inequities in abortion access, warranting investigation of experiences for individuals who travel out of state to seek abortion care. To highlight the obstacles abortion seekers must overcome to obtain care, to identify common barriers and facilitators of interstate abortion travel, and to offer recommendations for abortion organizations, policymakers, and advocates to expand access for individuals living in states with abortion bans. This qualitative study analyzed data obtained from out-of-state participants collected as part of a larger cross-sectional, mixed-methods study. All English- and Spanish-speaking patients from out of state who were at least 16 years of age and medically cleared for research attending 2 abortion clinics in Illinois between September and November 2023 were eligible. Participants completed a self-administered survey and a semistructured interview. Directed content analysis was used to identify emergent and crosscutting themes. In total, 33 individuals (all self-identified as female or a woman) completed the survey and interview. Most participants were between 20 and 24 years of age (n = 12 [36%]) or 30 years or older (n = 12 [36%]), and from southern US states with a total abortion ban (n = 25 [76%]). From the time participants decided to terminate their pregnancy to the day of the abortion appointment, they experienced a median of 14.0 days of delay, with a mean (SD) of 29.6 (36.5) days of delay. Patient journeys of seeking abortion were categorized into 3 phases: information gathering, planning finances and travel, and traveling and completing the appointment. Participants reflected on how restrictive policies in their home states deepened abortion stigma and stifled access to accurate information. Most participants encountered their longest delays in the information-gathering phase, as they had to find legitimate clinics, often without any referrals, and navigate the complex web of laws between states. When patients had personal financial security, strong social support, or were in geographic proximity to a state in which abortion was legal, their journeys were facilitated. In this cross-sectional qualitative study of participants traveling across state lines for abortion, the policy landscape and abortion stigma of the home state, information and resource availability, and interpersonal support shaped their journeys in the post-Dobbs landscape. To improve cross-state abortion access for individuals in states with abortion restrictions or bans, policy change should be coupled with increased visibility of accurate information, charitable funding, and abortion stigma reduction. Abortion support organizations and the public should continue to enable access through social support services, such as volunteer drivers and abortion doulas.

I document a new fact about mobility within the United States. County-to-county migration and commuting drop discretely at state borders. People are three times as likely to move to a county 15 miles away, but in the same state, than to an equally-distant county across state lines. Standard economic explanations, like differences in amenities or moving costs, have little explanatory power. Experimental evidence suggests many people experience "home state bias" and discount out-of-state moves, independent of whether social ties are present. This pattern has real economic costs, resulting in local labor markets that are less dynamic after negative economic shocks.

ABSTRACT Diasporas and their transnational ties to homelands and other networks often generate heightened suspicion in countries of residence. They are perceived as non-state actors forming non-transparent connections, fostering long-distance nationalism and potential dual loyalties. Diasporas are also viewed as possible sources of tension, as homeland conflicts may be transported across borders, producing public unrest and security concerns. Countries of origin frequently share these anxieties. While harnessing diaspora potential has become a global trend, home states may still regard diasporas as conflict perpetuators, regime destabilizers or dissidents requiring control. Whether embraced or securitized, diaspora members are defined through presumed geographic, racial, cultural, ethnic and religious origins, reinforcing the cultural and political unity of the nation-state. This article examines how diasporas, particularly from conflict regions, are constructed as security threats despite narratives celebrating them as agents of peace, arguing that diaspora securitization works as a way to reaffirm national unity and safety.

Exposure to fine particulate matter (PM2.5) is associated with the development of diseases and premature death. However, little is known about the potential PM2.5 exposure of incarcerated populations. In this paper, we used satellite-derived data to assess outdoor PM2.5 concentrations at 1,593 prisons in the contiguous U.S. from 1998 to 2022. Across our study period, despite overall national decreases in PM2.5 concentrations and disparities, prisons on average experienced higher pollution than the nonincarcerated U.S. population. In 2022, over 500 prisons had spatially averaged concentrations higher than the population-weighted concentrations of their home states. We also found evidence that in 12 states, state and federal prison populations systematically had higher PM2.5 than the nonincarcerated populations in those states; similar findings were obtained for national analyses stratified by degree of urbanicity. In 2022, about 7% of prisons were above federal air quality standards, with over 50% of these prisons located in California. Collectively, the contributions of this study in finding health-relevant disparities in outdoor PM2.5 concentrations for prisons across several different metrics may highlight an urgent public health crisis that requires deeper inquiry and interventions from government officials. Decarceration would work to immediately reduce the population of people vulnerable to air pollution in prisons.

The COVID-19 pandemic presented unprecedented challenges to hospital system and critical care resources, leading to significant changes to operations and patient care. There are limited national data on these changes and instances of unsanctioned deviations from patient care, yet understanding the COVID response is key to future preparedness efforts. We sought to understand how hospitals and states navigated scarcity during COVID-19, particularly in the absence of a declaration of crisis standards of care. Between February 2022 and September 2022 we conducted 34 interviews with 36 leaders of U.S. states' COVID-19 planning and response efforts. Interviews were transcribed verbatim and verified. We analyzed interviews using iterative inductive thematic analysis for descriptions of resource scarcity and changes to policies and procedures to prevent rationing lifesaving care. Nearly all participants described equipment and personnel scarcity in their home institution or state during COVID-19. Hospitals across regions and states developed formal and informal coordination processes for load and resource sharing in response to influxes of high-acuity patients, avoiding formal rationing of lifesaving resources in many regions. Participants also described unsanctioned patient triage, early discharge, and patients counseled to accept less aggressive care (e.g., premature transition to hospice) in states that had not declared crisis standards of care. Extending limited resources and inter-institutional collaboration helped avoid formal rationing. Yet, patient care was unquestionably impacted due to scarcity, both real and perceived. Reports of using hospital triage protocols to deny patients lifesaving care outside of formally recognized crisis conditions and attempts to nudge patients to accept less-resource-intensive care are concerning. This may have had disproportionate effects on older adults, individuals with disabilities, and racial and ethnic minoritized groups. To avoid unsanctioned deviations from standard practice in future health emergencies, we recommend that transparent and equitable triage protocols are implemented with robust oversight.

Modern slavery in capture fisheries persists not only through abusive practices on board fishing vessels, but also through a wider network of corporate actors that sustain such operations, notably those engaged in offshore transshipment. In Asia, where these actors operate across jurisdictional boundaries, many fall outside the reach of existing legal frameworks. This article examines the role of home state jurisdiction in regulating corporate involvement in modern slavery at sea, focusing on transshipment and other fishing-related activities. It argues that the current law of the sea regime, anchored in flag and coastal state jurisdiction, leaves accountability gaps when those states fail to act. The article contends that home states have a duty to protect against human rights abuses committed by their nationals abroad, and that this duty extends extraterritorially in its prescriptive reach, is assessed through a due diligence standard, and is operationalized through domestic enforcement measures.

This case report highlights an unusual scenario of a conjoined twin pregnancy resulting from intrauterine insemination in a state with restrictive abortion laws. Despite a diagnosis deemed not compatible with life, the patient faced legal barriers preventing termination within their home state. Forced to seek care out-of-state, the patient underwent a successful termination at ten weeks and three days after lengthy and expensive travel. This case stresses the complex challenges posed by restrictive abortion laws, impacting patient access to essential medical interventions. The case demonstrates the critical intersections between medical care, medical ethics, legal constraints, and patient outcomes in managing complicated pregnancies in a post-Dobbs world.

Superintending the City: An Administrative Law for Home Rule

Does the Home State Political Alignment Influence MNE Internationalization Strategy? The Role of Home State Political Alignment on MNE Foreign Entry Mode

Naming, Praising, and Shaming Firms: Online Activism and the Russo-Ukrainian War

ABSTRACT: The Left Front, a coalition of parties led by the Communist Party of India (Marxist), was elected in my home state of West Bengal in 1977 and stayed in power for thirty-four years. When I was growing up, its permanence seemed no less solid than the stars and the moon. As late as 2004 Communist parties held fifty-three of 545 seats in the Indian parliament. Twenty years later, in the 2024 election, the three Communist parties together won eight seats. As their vote share shrank, the Hindu nationalist Bharatiya Janata Party rose, and the center-left Congress became largely indistinguishable from the BJP on economic questions. Both parties worked to privatize state assets, remove licensing restrictions on domestic businesses, and woo multinational capital in a global race to attract foreign corporations. In Bengal, the Left Front’s economic policies in the 2000s followed a similar path, and it used eminent domain laws to seize agricultural land from sharecroppers to give to domestic and international firms. Violent confrontations over land rights in Singur and Nandigram led millions of the Left Front’s traditional voters—from street vendors and auto-rickshaw drivers to small farmers and sharecroppers—to abandon the coalition, culminating in its defeat in 2011.

To understand if patients who travel out-of-state for abortion care are aware of medications by mail options for medication abortion and explore predictors of awareness. We recruited patients at family planning clinics in three western states (OR, UT, and WA) between September 2024 and February 2025. Individuals who traveled to a clinic outside of their home state, were 18 years of age or older, and spoke English or Spanish were eligible for participation in the cross-sectional survey. Participants self-reported data on socio-demographics, gestational age, reason for travel, and awareness of medication abortion pills-by-mail options. We assessed differences in, and predictors of awareness of pills-by-mail using chi squared test for categorical data and logistic regression. The final analytic sample included 113 unique individuals. Most participants, 82 (73%), identified their gestational age to be <11 weeks. Just over a third (n=41, 37%) were aware of pills-by-mail. Among those who were aware, 21 (51%) learned about the pills-by-mail option online, 10 (24%) from social media, and 5 (12%) learned from a healthcare provider. Participants provided no dominant reason for traveling. Seven (17%) participants who were previously aware of pills-by-mail options indicated that they traveled because they desired a procedural abortion over a medication abortion. Individuals who completed the survey in Spanish (OR 3.66, 95% CI 1.03-13.10), and those with public health insurance (OR 3.85, 95% CI 1.25-11.86) were more likely to be aware of medications by mail options. Most participants traveling out of state for abortion were unaware of medications by mail options despite being <11 weeks. These findings represent a lack of awareness of medications by mail options and warrant additional research. Increasing awareness of safe and legal abortion options, particularly medications by mail options, may increase access for individuals who may otherwise travel.

Abstract In this article, I apply Australian logician and ecofeminist philosopher Val Plumwood's Feminism and the Mastery of Nature, specifically its alternative logic of “the dance of interaction,” to a controversial community-engagement program in my home state of Alabama. At Rural Studio, Auburn University students design free housing and public works for one of the poorest regions in the United States, known as the Black Belt. Through the lens of Plumwood's ecofeminist dancing logic, the marginalized source of Rural Studio's survival is revealed to be the resilience of the disempowered majority-Black community. Inspired thereby, I sketch an ecofeminist choreography with three “dancing” concepts (namely Plumwood's “the master model,” Vandana Shiva's “nature's logic,” and Ariel Salleh's “holding”), acknowledging the resilience of the disempowered as a necessary step toward an ethically sustainable aesthetics.

Telemedicine has emerged as a transformative tool in modern health care, facilitating remote communication between physicians and patients while improving access, operational efficiency, and cost-effectiveness. Its role has been extensively studied in adult primary care and surgery. However, its application in Pediatric Plastic Surgery remains unexplored. This study evaluates the impact of telehealth at a high-volume Pediatric Plastic Surgery center, assessing its efficacy in expanding access and optimizing patient care pathways. An IRB-approved retrospective analysis using Salesforce Data Analytics (Salesforce Inc., San Francisco, CA) was conducted on all patients referred to the plastic surgery department at a tertiary pediatric hospital between January 2020 and December 2024. Data collected included referring location, primary diagnosis, and home state. Key outcomes analyzed included referral-to-visit conversion rates, surgical conversion rates, and time to surgery. Comparative analyses were performed between telehealth and in-person consultations, as well as between in-state and out-of-state referrals. A total of 6369 patients were referred during the study period. The majority (82.5%) resided within 80 miles of the hospital, with 57.3% being in-state and 42.7% out-of-state referrals. The overall referral-to-visit conversion rate was 71%. Among those who underwent consultation, 52.9% proceeded with surgery. Notably, telehealth consultations were associated with a significantly higher surgical conversion rate compared with in-person visits (60.5% versus 47.6%; P <0.001). While consultation rates were comparable between in-state (65.0%) and out-of-state (70.0%) referrals ( P =0.72), out-of-state patients using telehealth had markedly higher surgical conversion rates than those seen in person (70.1% versus 36.9%; P <0.001). In-state patients using telehealth also had significantly higher surgical conversion rates compared with those seen in-person (59.8% versus 36.0%; P <0.001). There was no significant difference in time-to-surgery between the telehealth and the in-person cohorts (167 versus 165d; P >0.05). This study underscores the critical role of telehealth in Pediatric Plastic Surgery, particularly in enhancing access for geographically distant patients. Telehealth consultations were associated with higher surgical conversion rates, particularly among out-of-state patients, suggesting that virtual consultations may facilitate more streamlined surgical planning and reduce unnecessary travel burdens. These findings support the broader integration of telehealth into Pediatric Plastic Surgery practice to improve patient access, optimize resource utilization, and expand care delivery for underserved populations.

The confirmation of lower federal court judges heavily depends on senatorial courtesy and the blue slip. Prior work largely ignores state representation—a norm whereby each judgeship on the U.S. Courts of Appeals is assigned to a particular state in the Circuit. Given this norm, senators expect that the president will nominate someone from the same state as the departing circuit judge. However, presidents fail to follow this norm nearly a quarter of the time. This research analyzes how ignoring state representation increases the level of conflict over a nominee. Our results reveal that (a) the probability of a nominee’s rejection by the Senate and (b) the amount of time for the Senate to take final action both increase as the ideological distance between the previous home state senators and the president grows. Additionally, if the new home state senators reveal public opposition to a nomination, the likelihood of rejection and time to final action increase.

ABSTRACT After feeling silenced by the confluence of the George Floyd murder in 2020 with the overwhelm of the pandemic, I found myself preoccupied with an historical event I had not felt ready previously to reflect on—an insurrection, coup, and massacre in my home state of North Carolina occurring in 1898. I began exploring the history of it and writing a series of poems and found that each poem both responded to historical research and, in turn, led me to seek out more research and to reflect on psychoanalytic contributions to topics like collective reparation. The sequence has been a reminder of the ways we turn to language and are changed in turn by it as we seek to alter our relationship to the various traumatic. It also highlights how both poetry and psychoanalysis involve being called to tell the truth.