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2022 ◽  
Mathai Mammen ◽  
Vas Narasimhan ◽  
Richard Kuntz ◽  
Freda Lewis-Hall ◽  

United States health care spending consumes nearly a fifth of the GDP [1]. While, in many respects, the U.S. health care system is enviable and highly innovative, it is also characterized by elements of ineffectiveness, inefficiency, and inequity. These aspects, resulting from pre-existing vulnerabilities within the system and interactions between the various stakeholders, were acutely highlighted by the COVID-19 pandemic. As health product manufacturers and innovators (HPMI) took steps to mitigate the immediate crisis and simultaneously begin to develop a longer-term sustainable solution, six common themes arose as areas for transformational change: support for science, data sharing, supply chain resiliency, stockpiling, and surge capacity, regulatory and reimbursement clarity and flexibility, public- and private-sector coordination and communication, and minimizing substandard care offerings. Within these categories, the authors of this paper suggest policy priorities to increase the effectiveness, efficiency, and equity of the HPMI sector and writ large across the U.S. health care system. These priorities call for increased scientific funding to diversify the pipeline for research and development, strengthening the nation’s public health infrastructure, building and maintaining “ever warm” manufacturing capacity and related stockpiles, instituting efficient and effective regulatory and reimbursement frameworks that promote innovation and creativity, devising structures and processes that enable more efficient collaboration and more effective communication to the public, and implementing rewards that incentivize desired behaviors among stakeholders. This assessment draws from the collective experience of the authors to provide a perspective for the diagnostics, hospital supplies and equipment, medical devices, therapeutics, and vaccines segments. While the authors of this paper agree on a common set of key policies, sub-sector-specific nuances are important to consider when putting any action priority into effect. With thoughtful implementation, these policies will enable a quicker, more robust response to future pandemics and enhance the overall performance of the U.S. health care system.

2022 ◽  
Cornell University Library
Viet Nam ◽  

The U.S. Library of Congress Holding: Kinh tế Việt Nam - Thăng trầm và đột phá (Asia) by NXB Chính trị Quốc gia Sự thật (2009).

Tasha L. Golden ◽  
Richard Sima ◽  
Grace Roebuck ◽  
Sonakshi Gupta ◽  
Susan Magsamen

Mutale Chileshe ◽  
Emma Bunkley ◽  
Jean Hunleth

The recent focus on rural–urban cancer disparities in the United States (U.S.) requires a comprehensive understanding of the processes and relations that influence cancer care seeking and decision making. This is of particular importance for Black, Latino, and Native populations living in rural areas in the U.S., who remain marginalized in health care spaces. In this article, we describe the household production of health approach (HHPH) as a contextually-sensitive approach to examining health care seeking and treatment decisions and actions. The HHPH approach is based on several decades of research and grounded in anthropological theory on the household, gender, and therapy management. This approach directs analytical attention to how time, money, and social resources are secured and allocated within the household, sometimes in highly unequal ways that reflect and refract broader social structures. To demonstrate the benefits of such an approach to the study of cancer in rural populations in the U.S., we take lessons from our extensive HHPH research in Zambia. Using a case study of a rural household, in which household members had to seek care in a distant urban hospital, we map out what we call a rural HHPH approach to bring into focus the relations, negotiations, and interactions that are central to individual and familial health care seeking behaviors and clinical treatment particular to rural regions. Our aim is to show how such an approach might offer alternative interpretations of existing rural cancer research in the U.S. and also present new avenues for questions and for developing interventions that are more sensitive to people’s realities.

Anastasia S. Lambrou ◽  
John T. Redd ◽  
Miles A. Stewart ◽  
Kaitlin Rainwater-Lovett ◽  
Jonathan K. Thornhill ◽  

Abstract Monoclonal antibody therapeutics to treat COVID-19 have been authorized by the U.S. Food and Drug Administration under Emergency Use Authorization (EUA). Many barriers exist when deploying a novel therapeutic during an ongoing pandemic, and it is critical to assess the needs of incorporating monoclonal antibody infusions into pandemic response activities. We examined the monoclonal antibody infusion site process during the COVID-19 pandemic and conducted a descriptive analysis using data from three sites at medical centers in the U.S. supported by the National Disaster Medical System. Monoclonal antibody implementation success factors included engagement with local medical providers, therapy batch preparation, placing the infusion center in proximity to emergency services, and creating procedures resilient to EUA changes. Infusion process challenges included confirming patient SARS-CoV-2 positivity, strained staff, scheduling, and pharmacy coordination. Infusion sites are effective when integrated into pre-existing pandemic response ecosystems and can be implemented with limited staff and physical resources.

2022 ◽  
Steven P. Rowe ◽  
Andreas Buck ◽  
Ralph A. Bundschuh ◽  
Constantin Lapa ◽  
Sebastian E. Serfling ◽  

AbstractProstate-specific membrane antigen (PSMA)-directed positron emission tomography (PET) has gained increasing interest for imaging of men affected by prostate cancer (PC). In recent years, 68Ga-labeled PSMA compounds have been widely utilized, although there is a trend towards increased utilization of 18F-labeled agents. Among others, [18F]DCFPyL (piflufolastat F 18, PYLARIFY) has been tested in multiple major trials, such as OSPREY and CONDOR, which provided robust evidence on the clinical utility of this compound for staging, restaging, and change in management. Recent explorative prospective trials have also utilized [18F]DCFPyL PET/CT for response assessment, e.g., in patients under abiraterone or enzalutamide, rendering this 18F-labeled PSMA radiotracer as an attractive biomarker for image-guided strategies in men with PC. After recent approval by the U.S. Food and Drug Administration, one may expect more widespread use, not only in the U.S., but also in Europe in the long term. In the present review, we will provide an overview of the current clinical utility of [18F]DCFPyL in various clinical settings for men with PC.

Rumya S. Putcha

Abstract Using methods from country music studies, performance studies, hashtag ethnography, and Black Feminist Thought (BFT), this article employs sonic, discursive, and social media analysis to examine performances of White masculinity known as “country boys.” In the opening sections, I describe examples of country boys that emerge from Texas A&M University (College Station), bringing together confederate statues and the men who identify with and defend such statues. I then turn my focus to critical analysis of one country boy in particular: county music singer, brand progenitor, and Texas icon, Granger Smith a.k.a. Earl Dibbles Jr. Highlighting the importance of country boys to the cultural identity of Texas A&M University, I argue that White publics aggregate and accrue racialized and gendered meaning in social media spaces through signs associated with Smith like the hashtag #yeeyeenation. Such signs are predicated on and normalize a rhetoric—in this case, that something or someone “is not racist”—even in the face of evidence to the contrary. Extending the insights of scholarship on the former Confederacy to contemporary country music cultures and to the present political moment, this article interrogates how White identities and related genealogies in the U.S. context are not simply established to sanitize and excuse expressions of racist, gendered, and exclusionary thought, but are sustained by aestheticized deceptions. I refer to these deceptions as mythopoetics. In this article I demonstrate how Smith’s success, particularly since he is best known for his “redneck” alter-ego, Earl Dibbles Jr., is a testament to the power and reach of mythopoetics in a hegemonic White and heteropatriarchal society. I argue that mythopoetics are not only essential to majoritarian cultural formations today, but also normalize White supremacy to such a point that its violence can circulate without consequence and in plain sight.

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