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Making the Global Compact on Migration a Reality: Ideas for Enhancing Regular Migration Pathways at All Skill Levels

As the final phase of preparations for the historic adoption of a Global Compact for Safe, Orderly, and Regular Migration approaches, this webinar explores two central objectives of the compact: enhancing the availability and flexibility of pathways for regular migration, and investing in skills development.




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Balancing Acts: Policy Frameworks for Migrant Return and Reintegration

In recent years, questions of whether, when, and how to return failed asylum seekers and other migrants to their origin countries have dominated migration debates in many countries. These issues were also taken up in the negotiation of the Global Compact for Safe, Orderly, and Regular Migration, moving the discussion beyond the typical bilateral one. This policy brief outlines how states might more constructively work together on returns and reintegration programs.




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Migration in the Netherlands: Rhetoric and Perceived Reality Challenge Dutch Tolerance

The Netherlands has witnessed a rise in far-right populism, challenging its reputation as a humanitarian haven. Yet, public fears equating immigration with a rise in religious extremism do not necessarily reflect the facts. This profile explores historical and contemporary migration in a country where population growth relies largely on immigration, and analyzes to what extent policymaking has been shaped by rising populism.




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Improving the Governance of International Migration

This volume from MPI's Transatlantic Council on Migration aims to fill the analytical gap regarding the question of what greater global cooperation on governing the flow of international migrants could achieve. The book focuses on a set of fundamental questions: What are the key steps to building a better, more cooperative system of governance? What are the goals that can be achieved through greater international cooperation? And, most fundamentally, who (or what) is to be governed?




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Social Distancing

Social Distancing (date: 5/9/2020 - Rank: 6)




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Superior Long-term Survival for Simultaneous Pancreas-Kidney Transplantation as Renal Replacement Therapy: 30-Year Follow-up of a Nationwide Cohort

OBJECTIVE

In patients with type 1 diabetes and end-stage renal disease, it is controversial whether a simultaneous pancreas-kidney (SPK) transplantation improves survival compared with kidney transplantation alone. We compared long-term survival in SPK and living- or deceased-donor kidney transplant recipients.

RESEARCH DESIGN AND METHODS

We included all 2,796 patients with type 1 diabetes in the Netherlands who started renal replacement therapy between 1986 and 2016. We used multivariable Cox regression analyses adjusted for recipient age and sex, dialysis modality and vintage, transplantation era, and donor age to compare all-cause mortality between deceased- or living-donor kidney and SPK transplant recipients. Separately, we analyzed mortality between regions where SPK transplant was the preferred intervention (80% SPK) versus regions where a kidney transplant alone was favored (30% SPK).

RESULTS

Of 996 transplanted patients, 42%, 16%, and 42% received a deceased- or living-donor kidney or SPK transplant, respectively. Mean (SD) age at transplantation was 50 (11), 48 (11), and 42 (8) years, respectively. Median (95% CI) survival time was 7.3 (6.2; 8.3), 10.5 (7.2; 13.7), and 16.5 (15.1; 17.9) years, respectively. SPK recipients with a functioning pancreas graft at 1 year (91%) had the highest survival (median 17.4 years). Compared with deceased-donor kidney transplant recipients, adjusted hazard ratios (95% CI) for 10- and 20-year all-cause mortality were 0.79 (0.49; 1.29) and 0.98 (0.69; 1.39) for living-donor kidney and 0.67 (0.46; 0.98) and 0.79 (0.60; 1.05) for SPK recipients, respectively. A treatment strategy favoring SPK over kidney transplantation alone showed 10- and 20-year mortality hazard ratios of 0.56 (0.40; 0.78) and 0.69 (0.52; 0.90), respectively.

CONCLUSIONS

Compared with living- or deceased-donor kidney transplantation, SPK transplant was associated with improved patient survival, especially in recipients with a long-term functioning pancreatic graft, and resulted in an almost twofold lower 10-year mortality rate.




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Targeting CXCR1/2 Does Not Improve Insulin Secretion After Pancreatic Islet Transplantation: A Phase 3, Double-Blind, Randomized, Placebo-Controlled Trial in Type 1 Diabetes

OBJECTIVE

Reparixin is an inhibitor of CXCR1/2 chemokine receptor shown to be an effective anti-inflammatory adjuvant in a pilot clinical trial in allotransplant recipients.

RESEARCH DESIGN AND METHODS

A phase 3, multicenter, randomized, double-blind, parallel-assignment study (NCT01817959) was conducted in recipients of islet allotransplants randomized (2:1) to reparixin or placebo in addition to immunosuppression. Primary outcome was the area under the curve (AUC) for C-peptide during the mixed-meal tolerance test at day 75 ± 5 after the first and day 365 ± 14 after the last transplant. Secondary end points included insulin independence and standard measures of glycemic control.

RESULTS

The intention-to-treat analysis did not show a significant difference in C-peptide AUC at both day 75 (27 on reparixin vs. 18 on placebo, P = 0.99) and day 365 (24 on reparixin vs. 15 on placebo, P = 0.71). There was no statistically significant difference between treatment groups at any time point for any secondary variable. Analysis of patient subsets showed a trend for a higher percentage of subjects retaining insulin independence for 1 year after a single islet infusion in patients receiving reparixin as compared with patients receiving placebo (26.7% vs. 0%, P = 0.09) when antithymocyte globulin was used as induction immunosuppression.

CONCLUSIONS

In this first double-blind randomized trial, islet transplantation data obtained with reparixin do not support a role of CXCR1/2 inhibition in preventing islet inflammation-mediated damage.




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Glucose, Advanced Glycation End Products, and Diabetes Complications: What Is New and What Works

Melpomeni Peppa
Oct 1, 2003; 21:
Council's Voice




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Treatment Approach to Patients With Severe Insulin Resistance

Timothy J. Church
Apr 1, 2016; 34:97-104
Feature Articles




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Plasma Lipidome and Prediction of Type 2 Diabetes in the Population-Based Malmö Diet and Cancer Cohort

OBJECTIVE

Type 2 diabetes mellitus (T2DM) is associated with dyslipidemia, but the detailed alterations in lipid species preceding the disease are largely unknown. We aimed to identify plasma lipids associated with development of T2DM and investigate their associations with lifestyle.

RESEARCH DESIGN AND METHODS

At baseline, 178 lipids were measured by mass spectrometry in 3,668 participants without diabetes from the Malmö Diet and Cancer Study. The population was randomly split into discovery (n = 1,868, including 257 incident cases) and replication (n = 1,800, including 249 incident cases) sets. We used orthogonal projections to latent structures discriminant analyses, extracted a predictive component for T2DM incidence (lipid-PCDM), and assessed its association with T2DM incidence using Cox regression and lifestyle factors using general linear models.

RESULTS

A T2DM-predictive lipid-PCDM derived from the discovery set was independently associated with T2DM incidence in the replication set, with hazard ratio (HR) among subjects in the fifth versus first quintile of lipid-PCDM of 3.7 (95% CI 2.2–6.5). In comparison, the HR of T2DM among obese versus normal weight subjects was 1.8 (95% CI 1.2–2.6). Clinical lipids did not improve T2DM risk prediction, but adding the lipid-PCDM to all conventional T2DM risk factors increased the area under the receiver operating characteristics curve by 3%. The lipid-PCDM was also associated with a dietary risk score for T2DM incidence and lower level of physical activity.

CONCLUSIONS

A lifestyle-related lipidomic profile strongly predicts T2DM development beyond current risk factors. Further studies are warranted to test if lifestyle interventions modifying this lipidomic profile can prevent T2DM.




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Similar Breast Cancer Risk in Women Older Than 65 Years Initiating Glargine, Detemir, and NPH Insulins

OBJECTIVE

To assess whether initiation of insulin glargine (glargine), compared with initiation of NPH or insulin detemir (detemir), was associated with an increased risk of breast cancer in women with diabetes.

RESEARCH DESIGN AND METHODS

This was a retrospective new-user cohort study of female Medicare beneficiaries aged ≥65 years initiating glargine (203,159), detemir (67,012), or NPH (47,388) from September 2006 to September 2015, with follow-up through May 2017. Weighted Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% CIs for incidence of breast cancer according to ever use, cumulative duration of use, cumulative dose of insulin, length of follow-up time, and a combination of dose and length of follow-up time.

RESULTS

Ever use of glargine was not associated with an increased risk of breast cancer compared with NPH (HR 0.97; 95% CI 0.88–1.06) or detemir (HR 0.98; 95% CI 0.92–1.05). No increased risk was seen with glargine use compared with either NPH or detemir by duration of insulin use, length of follow-up, or cumulative dose of insulin. No increased risk of breast cancer was observed in medium- or high-dose glargine users compared with low-dose users.

CONCLUSIONS

Overall, glargine use was not associated with an increased risk of breast cancer compared with NPH or detemir in female Medicare beneficiaries.




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Migration, Development, and Global Governance: From Crisis toward Consolidation

Migration and development policy discussions have edged closer to each other on the international stage. The adoption of the Global Compact for Migration in December 2018 marks an important milestone. As all eyes turn toward the compact’s implementation, this brief examines some of the key topics states have pledged to work more closely on—from labor migration and migrants’ rights, to returns and reintegration.




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Long-term Benefits of Intensive Glucose Control for Preventing End-Stage Kidney Disease: ADVANCE-ON

Muh Geot Wong
May 1, 2016; 39:694-700
Cardiovascular Disease and Diabetes




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Feasibility of Outpatient Fully Integrated Closed-Loop Control: First studies of wearable artificial pancreas

Boris P. Kovatchev
Jul 1, 2013; 36:1851-1858
Diabetes Care Symposium




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Consensus Development Conference on Insulin Resistance: 5-6 November 1997

American Diabetes Association
Feb 1, 1998; 21:310-314
Consensus Development Conference Report




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A Mathematical Model for the Determination of Total Area Under Glucose Tolerance and Other Metabolic Curves

Mary M Tai
Feb 1, 1994; 17:152-154
Short Report




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Diabetes and Obesity in the Offspring of Pima Indian Women With Diabetes During Pregnancy

David J Pettitt
Jan 1, 1993; 16:310-314
Supplement 1: Diabetes in Native Americans




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HbA1c Levels Are Significantly Lower in Early and Late Pregnancy

Lene R. Nielsen
May 1, 2004; 27:1200-1201
Brief Reports




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Psychological Insulin Resistance in Patients With Type 2 Diabetes: The scope of the problem

William H. Polonsky
Oct 1, 2005; 28:2543-2545
BR Epidemiology/Health Services/Psychosocial Research




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Relationship of Glucose Tolerance and Plasma Insulin to the Incidence of Coronary Heart Disease: Results from Two Population Studies in Finland

Kalevi Pyörälä
Mar 1, 1979; 2:131-141
Proceedings of the Kroc Foundation International Conference on Epidemiology of Diabetes and its Macrovascular Complications




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Prevalence and Determinants of Glucose Intolerance in a Dutch Caucasian Population: The Hoorn Study

Johanna M Mooy
Sep 1, 1995; 18:1270-1273
Short Report




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Diabetes and Glucose Tolerance as Risk Factors for Cardiovascular Disease: The Framingham Study

W B Kannel
Mar 1, 1979; 2:120-126
Proceedings of the Kroc Foundation International Conference on Epidemiology of Diabetes and its Macrovascular Complications




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Digitizing financial services key to Africa's post-pandemic growth, experts say

As the COVID-19 pandemic begins to take root in Africa, experts say that digitizing financial services could help keep the continent safe




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Metformin Therapy During Pregnancy: Good for the goose and good for the gosling too?

Denice S. Feig
Oct 1, 2011; 34:2329-2330
Editorial (See Rowan et al., p. 2279)




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HbA1c Levels Are Significantly Lower in Early and Late Pregnancy

Lene R. Nielsen
May 1, 2004; 27:1200-1201
Brief Reports




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Steroid Metabolomic Signature of Insulin Resistance in Childhood Obesity

OBJECTIVE

On the basis of urinary steroidal gas chromatography-mass spectrometry (GC-MS), we previously defined a novel concept of a disease-specific "steroid metabolomic signature" and reclassified childhood obesity into five groups with distinctive signatures. The objective of the current study was to delineate the steroidal signature of insulin resistance (IR) in obese children.

RESEARCH DESIGN AND METHODS

Urinary samples of 87 children (44 girls) aged 8.5–17.9 years with obesity (BMI >97th percentile) were quantified for 31 steroid metabolites by GC-MS. Defined as HOMA-IR >95th percentile and fasting glucose-to-insulin ratio >0.3, IR was diagnosed in 20 (of 87 [23%]) of the examined patients. The steroidal fingerprints of subjects with IR were compared with those of obese children without IR (non-IR). The steroidal signature of IR was created from the product of IR – non-IR for each of the 31 steroids.

RESULTS

IR and non-IR groups of children had comparable mean age (13.7 ± 1.9 and 14.6 ± 2.4 years, respectively) and z score BMI (2.7 ± 0.5 and 2.7 ± 0.5, respectively). The steroidal signature of IR was characterized by high adrenal androgens, glucocorticoids, and mineralocorticoid metabolites; higher 5α-reductase (An/Et) (P = 0.007) and 21-hydroxylase [(THE + THF + αTHF)/PT] activity (P = 0.006); and lower 11βHSD1 [(THF + αTHF)/THE] activity (P = 0.012).

CONCLUSIONS

The steroidal metabolomic signature of IR in obese children is characterized by enhanced secretion of steroids from all three adrenal pathways. As only the fasciculata and reticularis are stimulated by ACTH, these findings suggest that IR directly affects the adrenals. We suggest a vicious cycle model, whereby glucocorticoids induce IR, which could further stimulate steroidogenesis, even directly. We do not know whether obese children with IR and the new signature may benefit from amelioration of their hyperadrenalism.




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Vasodilatory Actions of Glucagon-Like Peptide 1 Are Preserved in Skeletal and Cardiac Muscle Microvasculature but Not in Conduit Artery in Obese Humans With Vascular Insulin Resistance

OBJECTIVE

Obesity is associated with microvascular insulin resistance, which is characterized by impaired insulin-mediated microvascular recruitment. Glucagon-like peptide 1 (GLP-1) recruits skeletal and cardiac muscle microvasculature, and this action is preserved in insulin-resistant rodents. We aimed to examine whether GLP-1 recruits microvasculature and improves the action of insulin in obese humans.

RESEARCH DESIGN AND METHODS

Fifteen obese adults received intravenous infusion of either saline or GLP-1 (1.2 pmol/kg/min) for 150 min with or without a euglycemic insulin clamp (1 mU/kg/min) superimposed over the last 120 min. Skeletal and cardiac muscle microvascular blood volume (MBV), flow velocity and blood flow, brachial artery diameter and blood flow, and pulse wave velocity (PWV) were determined.

RESULTS

Insulin failed to change MBV or flow in either skeletal or cardiac muscle, confirming the presence of microvascular insulin resistance. GLP-1 infusion alone increased MBV by ~30% and ~40% in skeletal and cardiac muscle, respectively, with no change in flow velocity, leading to a significant increase in microvascular blood flow in both skeletal and cardiac muscle. Superimposition of insulin to GLP-1 infusion did not further increase MBV or flow in either skeletal or cardiac muscle but raised the steady-state glucose infusion rate by ~20%. Insulin, GLP-1, and GLP-1 + insulin infusion did not alter brachial artery diameter and blood flow or PWV. The vasodilatory actions of GLP-1 are preserved in both skeletal and cardiac muscle microvasculature, which may contribute to improving metabolic insulin responses and cardiovascular outcomes.

CONCLUSIONS

In obese humans with microvascular insulin resistance, GLP-1’s vasodilatory actions are preserved in both skeletal and cardiac muscle microvasculature, which may contribute to improving metabolic insulin responses and cardiovascular outcomes.




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As Governments Build Advanced Surveillance Systems to Push Borders Out, Will Travel and Migration Become Unequal for Some Groups?

As governments seek to push their borders out by amassing ever more data on travelers and migrants, their creation of increasingly complex border surveillance systems and use of risk-assessment technologies could ease mobility for some while rendering other groups immobile based on hypothetical risk profiles and decisions that are not publicly known and cannot be challenged, as this article explores.




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ADA seeks nominations for representation on Dental Quality Alliance

The ADA is calling for nominations for two seats to represent the Association in the Dental Quality Alliance.




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Alliance of the ADA offers education, entertainment at Conference 2020

From courses on burnout, vaping and more to golf and a low-country boil, the Alliance of the American Dental Association's upcoming Conference 2020 in Charleston, South Carolina, will offer a variety of educational and entertainment opportunities.




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Tufts University program provides homeless veterans with advanced dental care

Service With A Smile was among 10 programs from nine universities to receive funding this year through the ADA Foundation’s E. “Bud” Tarrson Dental School Student Community Leadership Awards.




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Dental Quality Alliance to help dentists make connection between everyday dentistry, quality measures

The Dental Quality Alliance will help dentists learn more about how quality measure domains can be best used to drive quality improvement at the practice level through a free webinar in March.




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Study clubs ‘enhance the level of care provided’

The Duluth Dental Forum in northeastern Minnesota celebrated its 75th anniversary in late 2019, stating that it was the second-oldest study club of its kind in the United States.




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CDC to offer coronavirus guidance during webinar Jan. 31

The Centers for Disease Control and Prevention will provide interim guidance to clinicians regarding the coronavirus outbreak during a webinar at 2 p.m. EST Jan. 31.




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ADA opposes CMS’ Medicaid block grant guidance

The ADA said it believes a new policy from the Centers for Medicare and Medicaid could be “detrimental” to the millions of adults who rely on Medicaid for dental care.




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ADA to stream dental insurance webinar in April

Trying to navigate the world of dental benefits can be full of choppy seas, and the ADA is holding a free webinar in April to help dentists and their staff find a safe harbor full of information.




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ADEA cancels annual session due to coronavirus concerns

The American Dental Education Association announced March 9 it has cancelled its annual session due to the coronavirus disease, now named COVID-19.




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IADR, AADR cancel general session in light of coronavirus

The International Association for Dental Research and American Association for Dental Research have canceled their general session scheduled for March 18-21 in Washington, D.C., in light of the coronavirus disease outbreak.




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OSHA issues coronavirus guidance

The Occupational Safety and Health Administration has issued new guidance for health care providers to prepare workplaces for COVID-19.




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ADA develops guidance on dental emergency, nonemergency care

The ADA provided its members and their patients detailed guidance on March 18 on what to consider dental emergencies and nonemergencies dental care as part of an effort to curb the spread of the coronavirus disease, COVID-19, and alleviate the burden on hospital and emergency departments.




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Dental Trade Alliance appoints new CEO

Arlington, Va. — The Dental Trade Alliance announced March 10 that it appointed Gregory Chavez as CEO. Mr. Chavez, formerly the executive vice president of operations and membership at The Vision Council, will be taking over for Gary Price.




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ADA urges CDC to provide ‘immediate guidance’ on protecting dental patients, staff from COVID-19 during emergency treatments

The American Dental Association is urging the Centers for Disease Control and Prevention to provide immediate guidance on the best way to protect dental patients and staff from the transmission of COVID-19 during emergency and urgent care situations.




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FDI World Dental Congress canceled

This year’s FDI World Dental Congress, scheduled for September in Shanghai, China, is canceled due to the global COVID-19 outbreak, according to a March 26 news release.




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Two March 27 webinars focus on surviving financial storm caused by pandemic

The ADA is presenting two free webinars March 27, aiming to help dentists financially weather the economic downturn during the COVID-19 outbreak and illustrate how ADA advocacy has helped turn the tide.




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Labor Dept. releases new guidance in response to Families First Coronavirus Response Act

The U.S. Department of Labor Wage and Hour Division released new guidance March 26 to help workers and employers understand provisions included in the Families First Coronavirus Response Act.




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Delta Dental member companies begin offering financial assistance during pandemic

The ADA is calling on third-party payers to support dental practices in the midst of the COVID-19 pandemic.




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ADA releases interim guidance on minimizing COVID-19 transmission risk when treating dental emergencies

The American Dental Association has released interim guidance for dentists on how to minimize the risk of COVID-19 transmission before, during and after treating dental emergencies.




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Code Maintenance Committee approves new codes associated with vaping, teledentistry

On the heels of the ADA’s December interim policy on vaping comes a new CDT code that references counseling services about high-risk substance use including vaping.




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ADA offers free e-books on managing finances, HIPAA training April 8-14

As part of its ongoing efforts to support dentists during the COVID-19 pandemic, the ADA is offering members two free e-books the week of April 8-14: “Managing Finances: Best Practices” and “The ADA Practical Guide to HIPAA Training.”




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ADA council affirms importance of code of ethics during COVID-19 pandemic

The ADA Council on Ethics, Bylaws and Judicial Affairs’ ethics subcommittee authored an online essay as part of its Ethical Moment series in the May issue of The Journal of the American Dental Association, affirming that the ADA Principles of Ethics and Code of Professional Conduct is just as important as ever when making the difficult decisions they encounter on a daily basis.