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This report aims to describe the U.S. blood system, identify and discuss potential threats to the functioning and sustainability of the blood system, and describe recommendations with the potential to improve the sustainability of the blood system.
Los Angeles Times Book Prize Finalist: A “compelling chronicle” of the science, politics, and business of blood (The Wall Street Journal). Blood carries life, yet the sight of it makes people faint. It is a waste product and a commodity pricier than oil. It can save lives and transmit deadly infections. Each one of us has roughly nine pints of it, yet many don’t even know their own blood type. And for all its ubiquitousness, the few tablespoons of blood discharged by 800 million women are still regarded as taboo: menstruation is perhaps the single most demonized biological event. Rose George, author of The Big Necessity, takes us from ancient practices of bloodletting to the breakthrough of the “liquid biopsy,” which promises to diagnose cancer and other diseases with a simple blood test. She introduces Janet Vaughan, who set up the world’s first system of mass blood donation during the Blitz, and Arunachalam Muruganantham, known as “Menstrual Man” for his work on sanitary pads for developing countries. She probes the lucrative business of plasma transfusions, in which the US is known as the “OPEC of plasma.” And she looks to the future, as researchers seek to bring synthetic blood to a hospital near you. Spanning science and politics, individual’s stories and global epidemics, Nine Pints reveals our life’s blood in an entirely new light. One of Bill Gates’ Recommended Summer Reading Titles “Stellar . . . An informative, elegant, and provocative exploration of the life-giving substance . . . A wondrously well-written work.” —Booklist (starred review) Both fascinating and informative . . . George packs her book with the kinds of provocative, witty, and rigorously reported facts and stories sure to make readers view the integral fluid coursing through our veins in a whole new way.” —Kirkus Reviews (starred review) “George charges down wholly unexpected avenues of medical history and global injustice, leaving the reader by turns giddy and appalled. And always, always in awe of the writing.” —Mary Roach, author of Grunt: The Curious Science of Humans at War “A very good book.” —The New York Times
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
Ensuring that blood remains available and safe for the Joint military community requires sophisticated logistical support and a dependable supply chain. The authors explore approaches to improving the resiliency of the blood supply chain.
This presentation describes various aspects of the regulation of tissue oxygenation, including the roles of the circulatory system, respiratory system, and blood, the carrier of oxygen within these components of the cardiorespiratory system. The respiratory system takes oxygen from the atmosphere and transports it by diffusion from the air in the alveoli to the blood flowing through the pulmonary capillaries. The cardiovascular system then moves the oxygenated blood from the heart to the microcirculation of the various organs by convection, where oxygen is released from hemoglobin in the red blood cells and moves to the parenchymal cells of each tissue by diffusion. Oxygen that has diffused into cells is then utilized in the mitochondria to produce adenosine triphosphate (ATP), the energy currency of all cells. The mitochondria are able to produce ATP until the oxygen tension or PO2 on the cell surface falls to a critical level of about 4–5 mm Hg. Thus, in order to meet the energetic needs of cells, it is important to maintain a continuous supply of oxygen to the mitochondria at or above the critical PO2 . In order to accomplish this desired outcome, the cardiorespiratory system, including the blood, must be capable of regulation to ensure survival of all tissues under a wide range of circumstances. The purpose of this presentation is to provide basic information about the operation and regulation of the cardiovascular and respiratory systems, as well as the properties of the blood and parenchymal cells, so that a fundamental understanding of the regulation of tissue oxygenation is achieved.
This comprehensive book is written to inform and improve outcomes of patients in need of blood management during surgical procedures. Information is presented in an accessible format, allowing for immediate use in clinical practice. Beginning with an overview of the history of blood transfusions, early chapters present the foundational information needed to comprehend information in later chapters. Nuanced procedures, drugs, and techniques are covered, including new biologicals to assist clotting and blood substitutes. Further discussions focus on potential complications seen in blood transfusions, such as diseases of the coagulation system, pathogen transmissions, and acute lung injuries. Chapters also examine the complexities of treating specific demographics, of which include the geriatric patient and patients suffering from substance abuse. Essentials of Blood Product Management in Anesthesia Practice is an invaluable guide for anesthesiologists, surgeons, trauma physicians, and solid organ transplant providers.
When does epidemic disease disrupt society to the point where it becomes a political crisis? In the early 1980s, almost unnoticed in the larger drama that was AIDS, over half of hemophiliacs and a large number of blood transfusion recipients were infected with toxic blood contaminated with HIV. The French public's "discovery" of this catastrophe in the early 1990s created a transformative political crisis; this same discovery in the United States went largely unnoticed. In The Social Production of Crisis, Constance A. Nathanson and Henri Bergeron focus on a profoundly troubling story to present a detailed case comparative analysis not only of the catastrophe itself and its multiple retrospective interpretations but also of its intimate connection to the history and organization of blood as a consumer product in each country. They draw on secondary sources, archival research, and interviews with key players to provide a historical, political, and social reconstruction of the HIV contamination of the blood supply to answer the question of how and why disease morphed into crisis in France and not in the United States. They also raise questions about the curious immunity to human suffering as a policy engine in the United States, about the often reiterated weakness of civil society in France, and about theorizing alternative epidemic trajectories. Investigating a series of morally shocking events, this book develops a sociological theory of how political crises are socially produced and raises questions about disease policy and politics in the US and France.
The WHO guidelines on assessing donor suitability for blood donation have been developed to assist blood transfusion services in countries that are establishing or strengthening national systems for the selection of blood donors. They are designed for use by policy makers in national blood programmes in ministries of health, national advisory bodies such as national blood commissions or councils, and blood transfusion services.
Scores of talented and dedicated people serve the forensic science community, performing vitally important work. However, they are often constrained by lack of adequate resources, sound policies, and national support. It is clear that change and advancements, both systematic and scientific, are needed in a number of forensic science disciplines to ensure the reliability of work, establish enforceable standards, and promote best practices with consistent application. Strengthening Forensic Science in the United States: A Path Forward provides a detailed plan for addressing these needs and suggests the creation of a new government entity, the National Institute of Forensic Science, to establish and enforce standards within the forensic science community. The benefits of improving and regulating the forensic science disciplines are clear: assisting law enforcement officials, enhancing homeland security, and reducing the risk of wrongful conviction and exoneration. Strengthening Forensic Science in the United States gives a full account of what is needed to advance the forensic science disciplines, including upgrading of systems and organizational structures, better training, widespread adoption of uniform and enforceable best practices, and mandatory certification and accreditation programs. While this book provides an essential call-to-action for congress and policy makers, it also serves as a vital tool for law enforcement agencies, criminal prosecutors and attorneys, and forensic science educators.