128 research outputs found
25 years of the WHO essential medicines lists: progress and challenges.
The first WHO essential drugs list, published in 1977, was described as a peaceful revolution in international public health. The list helped to establish the principle that some medicines were more useful than others and that essential medicines were often inaccessible to many populations. Since then, the essential medicines list (EML) has increased in size; defining an essential medicine has moved from an experience to an evidence-based process, including criteria such as public-health relevance, efficacy, safety, and cost-effectiveness. High priced medicines such as antiretrovirals are now included. Differences exist between the WHO model EML and national EMLs since countries face varying challenges relating to costs, drug effectiveness, morbidity patterns, and rationality of prescribing. Ensuring equitable access to and rational use of essential medicines has been promoted through WHO's revised drug strategy. This approach has required an engagement by WHO on issues such as the effect of international trade agreements on access to essential medicines and research and development to ensure availability of new essential medicines
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Advances in intravesical drug delivery systems to treat bladder cancer
Chemotherapeutic agents administered intravesically to treat bladder cancer have limited efficacy due to periodic dilution and wash-out during urine formation and elimination. This review describes the pathophysiology, prevalence and staging of bladder cancer, and discusses several formulation strategies used to improve drug residence within the bladder. These include the use of amphiphilic copolymers, mucoadhesive formulations, hydrogels, floating systems, and liposomes. Various in vitro and in vivo models recently employed for intravesical drug delivery studies are discussed. Some of the challenges that have prevented the clinical use of some promising formulations are identified
Technological elites, the meritocracy, and postracial myths in Silicon Valley
Entre as modernas elites tecnolĂłgicas digitais, os mitos da meritocracia e da façanha intelectual sĂŁo usados como marcadores de raça e gĂŞnero por uma supremacia branca masculina que consolida recursos de forma desproporcional em relação a pessoas nĂŁo brancas, principalmente negros, latinos e indĂgenas. Os investimentos em mitos meritocráticos suprimem os questionamentos de racismo e discriminação, mesmo quando os produtos das elites digitais sĂŁo infundidos com marcadores de raça, classe e gĂŞnero. As lutas histĂłricas por inclusĂŁo social, polĂtica e econĂ´mica de negros, mulheres e outras classes desprotegidas tĂŞm implicado no reconhecimento da exclusĂŁo sistĂŞmica, do trabalho forçado e da privação de direitos estruturais, alĂ©m de compromissos com polĂticas pĂşblicas dos EUA, como as ações afirmativas, que foram igualmente fundamentais para reformas polĂticas voltadas para participação e oportunidades econĂ´micas. A ascensĂŁo da tecnocracia digital tem sido, em muitos aspectos, antitĂ©tica a esses esforços no sentido de reconhecer raça e gĂŞnero como fatores cruciais para inclusĂŁo e oportunidades tecnocráticas. Este artigo explora algumas das formas pelas quais os discursos das elites tecnocráticas do Vale do SilĂcio reforçam os investimentos no pĂłs racialismo como um pretexto para a re-consolidação do capital em oposição Ă s polĂticas pĂşblicas que prometem acabar com práticas discriminatĂłrias no mundo do trabalho. Por meio de uma análise cuidadosa do surgimento de empresas de tecnologias digitais e de uma discussĂŁo sobre como as elites tecnolĂłgicas trabalham para mascarar tudo, como inscrições algorĂtmicas e genĂ©ticas de raça incorporadas em seus produtos, mostramos como as elites digitais omitem a sua responsabilidade por suas reinscrições pĂłs raciais de (in)visibilidades raciais. A partir do uso de análise histĂłrica e crĂtica do discurso, o artigo revela como os mitos de uma meritocracia digital baseados em um “daltonismo racial” tecnocrático emergem como chave para a manutenção de exclusões de gĂŞnero e raça.Palavras-chave: Tecnologia. Raça. GĂŞnero.Among modern digital technology elites, myths of meritocracy and intellectual prowess are used as racial and gender markers of white male supremacy that disproportionately consolidate resources away from people of color, particularly African Americans, Latino/as and Native Americans. Investments in meritocratic myths suppress interrogations of racism and discrimination even as the products of digital elites are infused with racial, class, and gender markers. Longstanding struggles for social, political, and economic inclusion for African Americans, women, and other legally protected classes have been predicated upon the recognition of systemic exclusion, forced labor, and structural disenfranchisement, and commitments to US public policies like affirmative action have, likewise, been fundamental to political reforms geared to economic opportunity and participation. The rise of the digital technocracy has, in many ways, been antithetical to these sustained efforts to recognize race and gender as salient factors structuring technocratic opportunity and inclusion. This paper explores some of the ways in which discourses of Silicon Valley technocratic elites bolster investments in post-racialism as a pretext for re-consolidations of capital, in opposition to public policy commitments to end discriminatory labor practices. Through a careful analysis of the rise of digital technology companies, and a discussion of how technology elites work to mask everything from algorithmic to genetic inscriptions of race embedded in their products, we show how digital elites elide responsibility for their post-racial re-inscriptions of racial visibilities (and invisibilities). Using historical and critical discourse analysis, the paper reveals how myths of a digital meritocracy premised on a technocratic colorblindness emerge key to perpetuating gender and racial exclusions.Keywords: Technology. Race. Gender
Behavioural and educational outcomes following extremely preterm birth : current controversies and future directions
As a consequence of improved survival rates for extremely preterm (EP; <28 weeks of gestation) births, there is a growing body of evidence detailing the impact of extreme prematurity on outcomes throughout childhood and adolescence. Historically, attention first focused on documenting rates of sensory impairments and severe neurodevelopmental disabilities. However, over recent years, there has been growing interest in the impact of EP birth on long term mental health and educational outcomes. In this chapter we review literature relating to the impact of EP birth on attention, social and emotional problems, psychiatric disorders and educational outcomes. We also outline current controversies in the field. In particular, we present emergent research exploring developmental trajectories to determine whether the sequelae associated with EP birth represent a developmental delay or persistent deficit, and we consider what approaches to intervention may be most fruitful in improving behavioural and educational outcomes in this population
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