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National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0–42·8) in 1990 to 53·7 (52·2–55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Bill & Melinda Gates Foundation.

Vixotrigine (BIIB074) is a voltage- and use-dependent sodium channel blocker. These studies will evaluate the efficacy and safety of vixotrigine in treating pain experienced by patients with trigeminal neuralgia (TN) using enriched enrollment randomized withdrawal trial designs. Two double-blind randomized withdrawal studies are planned to evaluate the efficacy and safety of vixotrigine compared with placebo in participants with TN (NCT03070132 and NCT03637387). Participant criteria include ≥18 years old who have classical, purely paroxysmal TN diagnosed ≥3 months prior to study entry, who experience ≥3 paroxysms of pain/day. The two studies will include a screening period, 7-day run-in period, a 4- or 6-week single-dose-blind dose-optimization period (Study 1) or 4-week open-label period (Study 2), and 14-week double-blind period. Participants will receive vixotrigine 150 mg orally three times daily in the dose-optimization and open-label periods. The primary endpoint of both studies is the proportion of participants classified as responders at Week 12 of the double-blind period. Secondary endpoints include safety measures, quality of life, and evaluation of vixotrigine population pharmacokinetics. There is a need for an effective, well-tolerated, noninvasive treatment for the neuropathic pain associated with TN. The proposed studies will evaluate the efficacy and safety of vixotrigine in treating pain experienced by patients with TN.

By turns evident and invisible, the legacy of Jewishness in the Caribbean manifests variously in the Cuban cultural imagination: through recognition of a distant Sephardic ancestry; through the presence of Jewish characters in literature written by non-Jews; and through the enduring influence of the cultural production of early twentieth-century Jewish immigrants. The article evinces the complexities of this legacy through its analysis of, among other works, a 2017 operatic production of Hatuey : Memoria del fuego , a künstlerroman that tells the story of Ukrainian Yiddish poet Asher Penn and the writing of his 1931 epic poem about Hatuey, a sixteenth-century indigenous leader. The analysis proceeds from multiple vantages: histories of Cuban Jewry; an analysis of the Passover narrative; and theories of Cuban Creole and Black cultural formation such as Peréz-Firmat’s allegory of the Cuban ajiaco and Tavia Nyong’o’s afro-fabulation. From within this polyvalence, the article argues that the story of Jewishness and Cuba is one that resists available categories—a story that is and was always-already multidirectional, dynamic, and emergent.

The Gullah people of St. Helena Island still relate that their people wanted to \"catch the learning\" after northern abolitionists founded Penn School in 1862, less than six months after the Union army captured the South Carolina sea islands. In this broad history Orville Vernon Burton and Wilbur Cross range across the past 150 years to reacquaint us with the far-reaching impact of a place where many daring and innovative social justice endeavors had their beginnings. Penn Center's earliest incarnation was as a refuge where escaped and liberated enslaved people could obtain formal liberal arts schooling, even as the Civil War raged on sometimes just miles away. Penn Center then earned a place in the history of education by providing agricultural and industrial arts training for African Americans after Reconstruction and through the Jim Crow era, the Great Depression, and two world wars. Later, during the civil rights movement, Penn Center made history as a safe meeting place for organizations like Martin Luther King Jr.'s Southern Christian Leadership Conference and the Peace Corps. Today, Penn Center continues to build on its long tradition of leadership in progressive causes. As a social services hub for local residents and as a museum, conference, and education complex, Penn Center is a showcase for activism in such areas as cultural, material, and environmental preservation; economic sustainability; and access to health care and early learning. Here is all of Penn Center's rich past and present, as told through the experiences of its longtime Gullah inhabitants and countless visitors. Including forty-two extraordinary photographs that show Penn as it was and is now, this book recounts Penn Center's many achievements and its many challenges, reflected in the momentous events it both experienced and helped to shape.

Long recognized as one of America's foremost men of letters, Robert Penn Warren continues to dazzle us with his many-sided genius. In the haunting images of his poetry, the narrative power of his fiction, the revealing insights of his essays, we find literary achievement of the highest order. Warren's writing has merited the close attention of literary critics. In this book Neil Nakadate brings together the most important critical essays, including a new essay written for this volume, to give a comprehensive view of the range of Warren's work. A list of Warren's published works, 1929-1980, and a useful checklist of critical works on Warren's writing supplement this rich and balanced collection of essays. Contributors: A.L. Clements, Chester E. Eisinger, Norton R. Girault, Robert B. Heilman, H.P. Heseltine, James H. Justus, Richard Law, Frederick P.W. McDowell, Neil Nakadate, Ladell Payne, M. Bernetta Quinn, John Crowe Ransom, Victor Strandberg, Walter Sullivan, William Tjenos, Simone Vauthier, and Robert Penn Warren

Perhaps I was the last to know how rich is the capital of the South—in history, in culture, in food (just no longer in pandas.) If ever a city demanded a return visit, it is Atlanta. In order to optimize the wisdom and experience of so many of CEA’s seasoned scholars and to serve the next generation of teacher-scholars, the CEA introduced in Atlanta its Mentors Program. From the daily schedule to one’s own personal session selections, from presentation abstracts to a list of featured speakers and their biographies, from local eateries to directions from the airport the C4ME site is pretty unbeatable.