scholarly journals Two Threats to Precision Medicine Equity

2019 ◽  
Vol 29 (Supp) ◽  
pp. 629-640
Author(s):  
Dayna Bowen Matthew
Keyword(s):  
United States ◽  
Precision Medicine ◽  
Care Delivery ◽  
Research Effort ◽  
The United States ◽  
Medical Product ◽  
Great Promise ◽  
Sequencing Technologies ◽  
Legal Duty ◽  
Precision Medicine Initiative

In January 2015, President Barack Obama unveiled the “Precision Medicine Initiative,” a nationwide research effort to help bring an effective, preventive, and therapeutic approach to medicine. The purpose of the initiative is to bring a precise understanding of the genetic and environmental determi­nants of disease into clinical settings across the United States.1 The announcement was coupled with $216 million provided in the President’s proposed budget for a million-person national research cohort including public and private partnerships with academic medical centers, research­ers, foundations, privacy experts, medical ethicists, and medical product innovators. The Initiative promises to expand the use of precision medicine in cancer research and modernize regulatory approval processes for genome sequencing technologies. In response, Congress passed the 21st Century Cures Act in December 2016, authorizing a total of $1.5 billion over 10 years for the program.2 Although the Precision Medicine Initiative heralds great promise for the future of disease treatment and eradication, its implementation and development must be carefully guided to ensure that the millions of federal dollars expended will be spent equitably. This commentary discusses two key threats to the Precision Medicine Initia­tive’s ability to proceed in a manner consis­tent with the United States Constitutional requirement that the federal government shall not “deny to any person . . . the equal protection of the laws.”3 In short, this com­mentary sounds two cautionary notes, in order to advance precision medicine equity. First, achieving precision medicine equity will require scientists and clinicians to fulfill their intellectual, moral, and indeed legal duty to work against abusive uses of preci­sion medicine science to advance distorted views of racial group variation.Precision medicine scientists must decisively denounce and distinguish this Initiative from the pseudo-science of eugenics – the im­moral and deadly pseudo-science that gave racist and nationalist ideologies what Troy Duster called a “halo of legitimacy” during the first half of the 20th century.4 Second, to combat the social threat to precision medicine, scientists must incorporate a comprehensive, ecological understanding of the fundamental social and environ­mental determinants of health outcomes in all research. Only then will the Precision Medicine Initiative live up to its potential to improve and indeed transform health care delivery for all patients, regardless of race, color, or national origin.Ethn Dis: 2019;29(Suppl 3):629-640; doi:10.18865/ed.29.S3.629

Hamas and Civil Society in Gaza

2013 ◽  
Author(s):  
Sara Roy
Keyword(s):  
United States ◽  
Political Violence ◽  
West Bank ◽  
Gaza Strip ◽  
Social Institutions ◽  
The United States ◽  
Great Promise ◽  
Religious Congregations ◽  
Regional Dynamics ◽  
Second Intifada

Many in the United States and Israel believe that Hamas is nothing but a terrorist organization, and that its social sector serves merely to recruit new supporters for its violent agenda. Based on extensive fieldwork in the Gaza Strip and West Bank during the critical period of the Oslo peace process, this book shows how the social service activities sponsored by the Islamist group emphasized not political violence but rather community development and civic restoration. The book demonstrates how Islamic social institutions in Gaza and the West Bank advocated a moderate approach to change that valued order and stability, not disorder and instability; were less dogmatically Islamic than is often assumed; and served people who had a range of political outlooks and no history of acting collectively in support of radical Islam. These institutions attempted to create civic communities, not religious congregations. They reflected a deep commitment to stimulate a social, cultural, and moral renewal of the Muslim community, one couched not only—or even primarily—in religious terms. Vividly illustrating Hamas's unrecognized potential for moderation, accommodation, and change, the book also traces critical developments in Hamas' social and political sectors through the Second Intifada to today, and offers an assessment of the current, more adverse situation in the occupied territories. The Oslo period held great promise that has since been squandered. This book argues for more enlightened policies by the United States and Israel, ones that reflect Hamas' proven record of nonviolent community building. A new afterword discusses how Hamas has been affected by changing regional dynamics and by recent economic and political events in Gaza, including failed attempts at reconciliation with Fatah.

scholarly journals Complementary and Integrative Health Knowledge and Practice in Primary Care Settings: A Survey of Primary Care Providers in the Northwestern United States

2021 ◽  
Vol 10 ◽  
pp. 216495612110233
Author(s):  
Malaika R Schwartz ◽  
Allison M Cole ◽  
Gina A Keppel ◽  
Ryan Gilles ◽  
John Holmes ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Health Knowledge ◽  
Care Delivery ◽  
Primary Care Providers ◽  
The United States ◽  
Research Network ◽  
Care Providers ◽  
Integrative Health ◽  
And Training

Background The demand for complementary and integrative health (CIH) is increasing by patients who want to receive more CIH referrals, in-clinic services, and overall care delivery. To promote CIH within the context of primary care, it is critical that providers have sufficient knowledge of CIH, access to CIH-trained providers for referral purposes, and are comfortable either providing services or co-managing patients who favor a CIH approach to their healthcare. Objective The main objective was to gather primary care providers’ perspectives across the northwestern region of the United States on their CIH familiarity and knowledge, clinic barriers and opportunities, and education and training needs. Methods We conducted an online, quantitative survey through an email invitation to all primary care providers (n = 483) at 11 primary care organizations from the WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region Practice and Research Network (WPRN). The survey questions covered talking about CIH with patients, co-managing care with CIH providers, familiarity with and training in CIH modalities, clinic barriers to CIH integration, and interest in learning more about CIH modalities. Results 218 primary care providers completed the survey (45% response rate). Familiarity with individual CIH methods ranged from 73% (chiropracty) to 8% (curanderismo). Most respondents discussed CIH with their patients (88%), and many thought that their patients could benefit from CIH (41%). The majority (89%) were willing to co-manage a patient with a CIH provider. Approximately one-third of respondents had some expertise in at least one CIH modality. Over 78% were interested in learning more about the safety and efficacy of at least one CIH modality. Conclusion Primary care providers in the Northwestern United States are generally familiar with CIH modalities, are interested in referring and co-managing care with CIH providers, and would like to have more learning opportunities to increase knowledge of CIH.

The Current Status of Hearing Care: Can We Change the Status Quo?

2005 ◽  
Vol 16 (07) ◽  
pp. 410-418 ◽  
Author(s):  
Dennis Van Vliet
Keyword(s):  
United States ◽  
Hearing Loss ◽  
Care Delivery ◽  
The United States ◽  
Status Quo ◽  
Hearing Impaired ◽  
Current Status ◽  
High Quality ◽  
Scientific Database ◽  
The Status

The members of the profession of audiology often express concern that the services and products that have been developed to provide benefit to the hearing impaired are not sought after or delivered to the majority of those diagnosed with hearing loss. A critical look at the status quo of hearing care delivery in the United States is needed to verify this assumption and to develop strategies to improve the situation. A key concern is the lack of a comprehensive high-quality scientific database upon which to build continuous improvements in the effectiveness of the services and products that are provided to the hearing impaired.

The Managed Health Care Market

1992 ◽  
Vol 5 (2) ◽  
pp. 67-71
Author(s):  
William A. Hemberger
Keyword(s):  
United States ◽  
Health Care ◽  
Managed Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
The United States ◽  
Health Care Market ◽  
Managed Health Care ◽  
Program Benefit

Health care delivery and benefits in the United States are changing. This article provides a basic description of the present-day components, managed care constructs, and impact of medical/hospital program/ benefit designs on pharmacy programs.

Revising the ERDs for the 21st Century

2021 ◽  
Vol 46 (8) ◽  
pp. 1-2
Author(s):  
John F. Brehany ◽  
Keyword(s):  
United States ◽  
Health Care ◽  
21St Century ◽  
Health Care Services ◽  
Care Delivery ◽  
The United States ◽  
Care Services ◽  
Moral Tradition ◽  
Modern Health Care ◽  
Catholic Health Care

Since their inception in 1948, The Ethical and Religious Directives for Catholic Health Care Services (ERDs) have guided Catholic health care ministries in the United States, aiding in the application of Catholic moral tradition to modern health care delivery. The ERDs have undergone two major revisions in that time, with about twenty years separating each revision. The first came in 1971 and the second came twenty-six years ago, in 1995. As such, a third major revision is due and will likely be undertaken soon.

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