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CDC reminds clinicians to use standard precautions, recommends isolating patients with coronavirus symptoms

In light of the “emerging, rapidly evolving” outbreak of the novel coronavirus 2019-nCoV, the Centers for Disease Control and Prevention is reminding clinicians to use standard precautions consistently and advising they isolate patients who show signs and symptoms of the virus.




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ADA releases coronavirus handout for dentists based on CDC guidelines

The handout covers strategies for helping prevent the transmission of suspected respiratory disease in the dental health care setting and answers frequently asked questions related to the virus, based on guidelines from the Centers for Disease Control and Prevention.




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ADA technical report on age assessment by dental analysis available for review

The ADA Standards Committee on Dental Informatics has approved the technical report for circulation and comment.




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Wisconsin faces wave of anti-fluoridation efforts

The ADA and the Wisconsin Dental Association are partnering up with other fluoridated water proponents to address February anti-fluoridation movements in three Wisconsin municipalities: Lake Delton, Berlin and Hayward.




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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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Connecticut Foundation for Dental Outreach postpones Mission of Mercy dental clinic amid coronavirus concerns

The Connecticut Foundation for Dental Outreach has postponed the Connecticut Mission of Mercy Free Dental Clinic scheduled for March 20-21 in Danbury, Connecticut, "out of abundant caution" amid the coronavirus disease outbreak.




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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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ADA adds frequently asked questions from dentists to coronavirus resources

With the coronavirus disease now deemed a pandemic by the World Health Organization, the American Dental Association updated its webpage on the disease March 11 to include a link to frequently asked questions from member dentists covering topics such as personal protective equipment and patient communications.




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ADA to Congress: Include dentists, patients in coronavirus legislation

The American Dental Association is urging Congress to include oral health care providers and their patients in any legislation proposed to confront 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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Association warns members on potential coronavirus-related phishing emails

The Association is asking member dentists and their dental teams to increase their vigilance over phishing emails as a result of the coronavirus, known as COVID-19.
Attackers often use emergencies as an opportunity to send fake emails tailored to that situation, the association said.




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ADA lobbies Congress’ coronavirus legislative package

As Congress works on legislation in response to the coronavirus disease outbreak, the ADA is working to ensure that those bills include provisions that are beneficial to dentists — particularly dental practice owners — and their patients.




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Association provides coronavirus infection control resources for dentists

The ADA is sharing with members the CDC guidelines on the use of personal protective equipment on its website dedicated to COVID-19.




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Senate passes coronavirus legislative package

The Senate and House have passed a coronavirus legislation package that includes three issues important to dentistry that will next head to the White House where President Donald Trump is expected to sign it into law.




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Infection control webinar from ADA, OSAP available late March 20

On March 20, the ADA will release an on-demand webinar offering answers to frequently asked questions about infection control protocol and procedures related to COVID-19.




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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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ADA will share Paycheck Protection Program information as soon as it becomes available

The Association is waiting for clear guidance from the Small Business Administration on the best way to help dentists considering applying for Paycheck Protection Program 7(a) loans.




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Webinar on Small Business Administration loans available online

The ADA webinar, Small Business Administration Loans: Understanding the Options for Dentist Owners, is available online.




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SBA announces funding no longer available for Economic Injury Disaster Loans, Paycheck Protection Program

The Small Business Administration said that as of April 16, the agency is unable to accept any new applications for the Paycheck Protection Program or the Economic Injury Disaster Loans due to a lack of funding.




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ADA advises dentists to follow science-backed guidance regarding COVID-19 testing, avoid 'gray market'

The ADA is urging dentists to be cautious about using novel coronavirus diagnostic tests before they have been properly evaluated and made available for dentists.




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Labor ends temporary nonenforcement of paid leave protections

The U.S. Department of Labor announced April 20 that it is ending the temporary period of non-enforcement of paid leave protections under the Families First Coronavirus Response Act.




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Third wave of HPI polling shows dentists’ response to COVID-19

The third round of results from the ADA Health Policy Institute poll on the impact of COVID-19 on dental practices was released April 27, with 79% of dentists reporting their practices are closed except for emergencies and 17% are closed completely.




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EIA sees fuel prices below 2018 average for the next two years

U.S. retail fuel prices will drop this year and in 2020 from 2018, but in both cases higher than January levels due to mandated lower sulfur in marine fuel.




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IEA: Greater use of rail would save energy, lower emissions

Increased railway use would save energy, help the environment, and also be safer, according to reports prepared by international environmental experts.




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Analysis suggests states need to plan for second wave of COVID-19

Leaders across the United States should plan for a worst-case scenario, second wave to the COVID-19 pandemic, including no vaccine availability or herd immunity, say experts at the University of Minnesota.




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Commercially Available Insulin Products Demonstrate Stability Throughout the Cold Supply Chain Across the U.S.

OBJECTIVE

A recent publication questioned the integrity of insulin purchased from U.S. retail pharmacies. We sought to independently validate the method used, isotope dilution solid-phase extraction (SPE) liquid chromatography mass spectrometry (LC-MS), and expand analysis to two U.S. Pharmacopeia (USP) methods (high-performance LC with ultraviolet detection and LC-MS).

RESEARCH DESIGN AND METHODS

Each method was used to evaluate nine insulin formulations, purchased at four pharmacies, within five geographic locations in the U.S.

RESULTS

All human and analog insulins measured by the USP methods (n = 174) contained the expected quantity of active insulin (100 ± 5 units/mL). When using isotope dilution SPE-LC-MS, units-per-milliliter values were well below product labeling due to unequal recovery of the internal standard compared with target insulin.

CONCLUSIONS

Insulin purchased from U.S. pharmacies is consistent with product labeling.




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Use of Glucagon-Like Peptide 1 Receptor Agonists and Risk of Serious Renal Events: Scandinavian Cohort Study

OBJECTIVE

To assess the association between use of glucagon-like peptide 1 (GLP-1) receptor agonists and risk of serious renal events in routine clinical practice.

RESEARCH DESIGN AND METHODS

This was a cohort study using an active-comparator, new-user design and nationwide register data from Sweden, Denmark, and Norway during 2010–2016. The cohort included 38,731 new users of GLP-1 receptor agonists (liraglutide 92.5%, exenatide 6.2%, lixisenatide 0.7%, and dulaglutide 0.6%), matched 1:1 on age, sex, and propensity score to a new user of the active comparator, dipeptidyl peptidase 4 (DPP-4) inhibitors. The main outcome was serious renal events, a composite including renal replacement therapy, death from renal causes, and hospitalization for renal events. Secondary outcomes were the individual components of the main outcome. Hazard ratios (HRs) were estimated using Cox models and an intention-to-treat exposure definition. Mean (SD) follow-up time was 3.0 (1.7) years.

RESULTS

Mean (SD) age of the study population was 59 (10) years, and 18% had cardiovascular disease. A serious renal event occurred in 570 users of GLP-1 receptor agonists (incidence rate 4.8 events per 1,000 person-years) and in 722 users of DPP-4 inhibitors (6.3 events per 1,000 person-years, HR 0.76 [95% CI 0.68–0.85], absolute difference –1.5 events per 1,000 person-years [–2.1 to –0.9]). Use of GLP-1 receptor agonists was associated with a significantly lower risk of renal replacement therapy (HR 0.73 [0.62–0.87]) and hospitalization for renal events (HR 0.73 [0.65–0.83]) but not death from renal causes (HR 0.72 [0.48–1.10]). When we used an as treated exposure definition in which patients were censored at treatment cessation or switch to the other study drug, the HR for the primary outcome was 0.60 (0.49–0.74).

CONCLUSIONS

In this large cohort of patients seen in routine clinical practice in three countries, use of GLP-1 receptor agonists, as compared with DPP-4 inhibitors, was associated with a reduced risk of serious renal events.




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Using the BRAVO Risk Engine to Predict Cardiovascular Outcomes in Clinical Trials With Sodium-Glucose Transporter 2 Inhibitors

OBJECTIVE

This study evaluated the ability of the Building, Relating, Assessing, and Validating Outcomes (BRAVO) risk engine to accurately project cardiovascular outcomes in three major clinical trials—BI 10773 (Empagliflozin) Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME), Canagliflozin Cardiovascular Assessment Study (CANVAS), and Dapagliflozin Effect on Cardiovascular Events–Thrombolysis in Myocardial Infarction (DECLARE-TIMI 58) trial—on sodium–glucose cotransporter 2 inhibitors (SGLT2is) to treat patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS

Baseline data from the publications of the three trials were obtained and entered into the BRAVO model to predict cardiovascular outcomes. Projected benefits of reducing risk factors of interest (A1C, systolic blood pressure [SBP], LDL, or BMI) on cardiovascular events were evaluated, and simulated outcomes were compared with those observed in each trial.

RESULTS

BRAVO achieved the best prediction accuracy when simulating outcomes of the CANVAS and DECLARE-TIMI 58 trials. For the EMPA-REG OUTCOME trial, a mild bias was observed (~20%) in the prediction of mortality and angina. The effect of risk reduction on outcomes in treatment versus placebo groups predicted by the BRAVO model strongly correlated with the observed effect of risk reduction on the trial outcomes as published. Finally, the BRAVO engine revealed that most of the clinical benefits associated with SGLT2i treatment are through A1C control, although reductions in SBP and BMI explain a proportion of the observed decline in cardiovascular events.

CONCLUSIONS

The BRAVO risk engine was effective in predicting the benefits of SGLT2is on cardiovascular health through improvements in commonly measured risk factors, including A1C, SBP, and BMI. Since these benefits are individually small, the use of the complex, dynamic BRAVO model is ideal to explain the cardiovascular outcome trial results.




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Do I Have to Sign?

Parents are asked to sign paperwork when services begin, when changes are made, and if services end. Let's not stop there. Parents must sign before any assessments begin. Parents must sign that they attended meetings. Parents sign that they received a copy of special education rights. The reasoning is to protect everyone involved. It gives documentation to show who attended the meetings, shows parental consent for what is outlined in the plan, and documents what has occurred at the meeting.


Should I sign if I don't agree?
You do not have to sign what you do not agree with. That being said- if you attended the meeting, please sign where it says to sign that you attended the meeting. If you received paperwork, please sign that you received it. If you do not agree with the findings or do not agree with the services offered, then do not sign where it asks if you are in agreement. There may also be an area to sign that you do not agree with the findings and you may have an opportunity to write a dissenting opinion.

What will happen if I don't sign?
In general, the answer is nothing. Literally nothing will happen if you don't sign. Services can not begin until the parent signs. Changes can not take place until the parents sign. Services can not end (in most states) until the parent signs. In most cases if the parent refuses to sign, everything will remain basically the same. Laws vary between states on this issue, so make sure to check your own state laws.

Is it okay to think about it overnight before signing?
Absolutely. If you aren't sure, take some time to think things over or check in with an advocate. However, please do so in a timely manner, for the sake of everyone involved.

What if we do not come to an agreement?
There are times when parents and the school system do not agree. Usually, when all parties stop and listen to each other, an agreement can be made that is in the best interest of the child. Remember that schools have very strict guidelines that must be followed and there are restrictions to what a school can do.

Think about exactly what it is you disagree with. If you do not agree with the guidelines the school is following, then there is not much that can be done unless you are willing to go through an expensive and drawn out process in court that will still likely amount to no changes. In this case, it would be my best advice to work with the school to determine what can be done for your child within the guidelines.

If you disagree because you feel the school is not following state or federal guidelines, there are steps you can take. Start by discussing the area you feel is not being followed with the school or the special education administrator. Usually a resolution can be made by providing a second opinion at the cost of the school system or through the use of a mediator.

What is Erin's advice?
Try to reach an agreement, where you can feel comfortable signing as quickly as possible. You don't want to leave this open. If you need time to take it in to discuss it and then suggest some changes, that is within your right. However, I do not suggest refusing to sign for long periods of time. Those battles rarely end well for parents, the school, or the child.



  • IEP
  • Special Education Law

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Teacher's Role in a Successful Behavior Plan

Over the last few years I have been very busy working with teachers to create individualized behavior plans for several different elementary school students. There have been amazingly successful plans where some of the most significant behavior problems in the school have turned it around. Children who made daily trips to the office are only there now to receive praise from the administration. Teachers previously brought to tears from the behaviors have stopped me in the hall to say "Oh my goodness, he's like a different kid!" Students who were close to being sent to a day placement school are now succeeding in a regular classroom. It's very encouraging if I focus on those students. However, there have also been some plans that have been revised and revised and revised and the student is still struggling and the teacher is still severely frustrated. I have been reflecting on why some behavior plans work and others don't. Of course one of the biggest factors is the student. All students are different and the motivation for the misbehavior or lacking skill is different in each student. While this is important to consider, this particular article does not focus on this. I'm going to focus today on the teacher's role in making the behavior plan successful.




  • Focus on the Positive!!! The behavior plans that have had the most dramatic success are plans that allow the teacher to focus on the positive. Classroom consequences are still in place, but are not connected to the plan. Here is an example: Johnny's teachers will offer positive reinforcement frequently in the classroom by giving Johnny a “warm fuzzy” pom pom when he is caught engaging in a desired behavior. Johnny will chose the bag to keep the “warm fuzzies” in and carry the bag with him to every class. Once the bag is full, he receives an immediate reward. There is no limit to how many “warm fuzzies” he can earn in a day. He does not loose “warm fuzzies” that he has already earned. All teachers and staff who work with Johnny can give him “warm fuzzies” for his bag. This plan works because Johnny who was used to receiving a lot of negative feedback, is now getting positive attention frequently throughout the day. He receives something tangible (the warm fuzzy) that he can put into his bag. This begins to change his perception of himself, which changes his behavior, which changes his teacher's perception of him, which can potentially change his future. Plans that offer positive rewards completely separate from the classroom consequences seem to have the most significant effects.



  • Be Consistent. Teachers who are able to be consistent and are able to follow through every time have the most success with the plan. Oppositional children are excellent at pushing limits to see how far they can push. Consistent teachers have more success because they don't offer the wiggle room.



  • Be Flexible. This is not the opposite of being consistent. This is having flexibility in your expectations and stating them upfront. If the student was able to behave like everyone else in the class she would be. She may need some flexibility in some areas. For example you may need to have area for her to work in the classroom for times she needs to cool down and get away from a stimulus. The teacher may need to allow her extra time to finish projects if it is the transition that sets her off. Being flexible and willing to make acceptable changes for the student sets everyone up for success.



  • Remember that all students are different. The behaviors may be exactly the same as a student you had two years ago. However, that doesn't mean that the motivation for the behavior or the lacking skills are the same. What works for one student may not work for the next. That is the reason for the individualized plan. I strongly recommend doing a formal Functional Behavioral Assessment and a Behavior Intervention Plan.

Teachers have a HUGE part in making the Behavior Plan sucessful. It is the teacher who has to follow through and implement it consistently every day. It is the teacher who has to push forward even when it appears it isn't working at first. It is the teacher who has a tremendous positive impact on the student when the behavior starts turning around. It is the teacher who does the work to change lives!




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House probe: Trump admin failed to adequately screen travelers from South Korea, Italy for COVID-19

The Trump administration failed to conduct effective screening of passengers from South Korea and Italy for the coronavirus when those countries were experiencing rapid expansion in COVID-19 cases.




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Pennsylvania, Texas, California among states lifting coronavirus restrictions Friday

California, Iowa, Pennsylvania and Rhode Island are among states that are loosening coronavirus restrictions Friday to gradually revive their economies.




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Scientists unveil fossil fuel-free jet propulsion that uses microwave air plasmas

Engineers in China have developed a fossil fuel-free jet propulsion prototype design that uses microwave air plasmas.




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Unlike 'Jurassic Park,' real raptors may not have hunted in packs

While the coordinated attacks of Velociraptor dinosaurs depicted in the 1993 blockbuster made for compelling movie viewing, a study published this week claims raptors most likely hunted solo, not in packs.




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Migration & Coronavirus: A Complicated Nexus Between Migration Management and Public Health

This webinar, organized by MPI and the Zolberg Institute on Migration and Mobility at The New School, discussed the state of play around the globe surrounding COVID-19 and examined where migration management and enforcement tools may be useful and where they may be ill-suited to advancing public health goals. 




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Ask Ariely: On Simple Savings, Better Bonuses, and Revised Resolutions

Here’s my Q&A column from the WSJ this week — and if you have any questions for me, you can tweet them to @danariely with the hashtag #askariely, post a comment on my Ask Ariely Facebook page, or email them to AskAriely@wsj.com. ___________________________________________________ Dear Dan, My partner and I are students,...




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Ask Ariely: On Healthy Handshakes, Bus Behaviors, and Diet Defenses

Here’s my Q&A column from the WSJ this week — and if you have any questions for me, you can tweet them to @danariely with the hashtag #askariely, post a comment on my Ask Ariely Facebook page, or email them to AskAriely@wsj.com. ___________________________________________________ Dear Dan, I know that because of the...




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Mike Pompeo to travel to Israel, meet with Benjamin Netanyahu, Benny Gantz

Secretary of State Mike Pompeo plans to travel to Israel next week to meet with Prime Minister Benjamin Netanyahu in his first international trip since coronavirus-related restrictions were put in place.




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Navy adapts maintenance procedures, strategies for containing COVID-19

The Navy has been particularly hard hit by the coronavirus pandemic and is working to adapt its strategies for maintenance as well as containing outbreaks on ships.




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AAI Corp., a division of Textron, nabs $20.7M contract modification for Navy drone program

Textron was awarded a $20.7 million contract modification Friday for work on the Navy's Unmanned Influence Sweep System and Unmanned Surface Vehicle program.




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USS Montgomery, USNS Cesar Chavez enter South China Sea to support drill ship

The USS Montgomery and the USNS Cesar Chavez sailed into the South China Sea this week in support of the West Capella drill ship, according to U.S. Indo-Pacific Command.




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China offers to help North Korea respond to coronavirus pandemic

China's President XI jinping offered Saturday to help North Korean leader Kim Jong Un respond to the coronavirus pandemic.




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Watch: Pete Davidson says Bill Hader recommended him for 'SNL'

Pete Davidson discussed on "The Tonight Show" how Bill Hader helped him land a spot on "Saturday Night Live."




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How to Stop Waiting for ‘When Coronavirus Ends’

How many times have you thought, “When coronavirus ends, I will ______” — as if you’re putting off everything (or at least the things you most love) until then? They...




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Expanding Personal Limits in the Time of Coronavirus

While our external world begins to shrink during this time of social distancing and shelter-in-place health orders, we are challenged to expand our personal, internal limits and thresholds for almost...




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[ Politics ] Open Question : Is Camp David going to be the new Trump “White House“ since Melania’s White House is at the top of the avoidance list for germaphobes?




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[ Politics ] Open Question : Is Trump going to have to invade California?

The state leads the nation in poverty and homelessness while it's socialist elites live in absolute luxury. It's like some third world nation the US is obligated to invade on the basis of humanitarianism.




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[ Law & Ethics ] Open Question : If a relict population of Neandertals were found to be living in a certain cave, on a certain remote island, or in a certain house on?

Pennsylvania Avenue, would placing some of them in zoos be unethical? Would they be considered human enough to receive human rights?




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[ Politics ] Open Question : IF Cons rewrote the Constitution of the United States would it have less laws, more liberty, & move power from DC to the State Capitals?

Oh would that 'less laws/more liberty/more state capital power' look anything like Mike Pence's Religious Freedom Restoration Act or in other words the 'we Conservative Republican Christians are such oppressed persecuted victims WAAAAA WAAAA' Bill. https://www.youtube.com/watch?v=KIikqPmbgvI 




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[ Politics ] Open Question : Is it true many British and American banks and companies(Bank of England,UIC,Prescott Bush,etc) gave money and goods to Hitler secretly?