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Quinn K, John S, Hirshfield S, Algiers O, O'Neil A, Petroll A, Walsh J. Challenges to meeting the HIV care needs of older adults in the rural South. SSM Qual Res Health 2022; 2:100113. [PMID: 36620181 PMCID: PMC9815493 DOI: 10.1016/j.ssmqr.2022.100113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
People living with HIV in rural parts of the Southern United States face poor outcomes along the HIV care continuum. Additionally, over half of people with diagnosed HIV are age 50 and older. Older adults living with HIV in the rural South often have complex health and social needs associated with HIV, aging, and the rural environment. Research is needed to understand what support organizations and clinics need in providing care to this population. This qualitative study examines the challenges health and social service providers face in caring for older patients living with HIV. In 2020-2021, we interviewed 27 key informants who work in organizations that provide care to older adults with HIV in the seven states with high rural HIV burden: Alabama, Arkansas, Kentucky, Mississippi, Missouri, Oklahoma, and South Carolina. Our findings highlight how racism and poverty; culture, politics, and religion; and a lack of healthcare infrastructure collectively shape access to HIV care for older adults in the South. Rural health and social service providers need structural-level changes to improve their care and services.
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Affiliation(s)
- K.G. Quinn
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, 2071 N. Summit Ave., Milwaukee, WI, 53202, United States
| | - S.A. John
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, 2071 N. Summit Ave., Milwaukee, WI, 53202, United States
| | - S. Hirshfield
- SUNY Downstate Health Sciences University, 450 Clarkson Ave., Brooklyn, NY, 11203, United States
| | - O. Algiers
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, 2071 N. Summit Ave., Milwaukee, WI, 53202, United States
| | - A. O'Neil
- Institute for Health and Equity, Medical College of Wisconsin, 8701 W. Watertown Plank Road, Wauwatosa, WI, 53226, United States
| | - A.E. Petroll
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, 2071 N. Summit Ave., Milwaukee, WI, 53202, United States
| | - J.L. Walsh
- Department of Psychiatry and Behavioral Medicine, Center for AIDS Intervention Research, Medical College of Wisconsin, 2071 N. Summit Ave., Milwaukee, WI, 53202, United States
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Cartledge S, Driscoll A, Dinh D, O'Neil A, Thomas E, Brennan A, Lefkovits J, Stub D. High Risk PCI Patients Still Missing Out on Cardiac Rehabilitation Referral – a Prospective, Multisite Study of 41,739 Patients From the Victorian Cardiac Outcomes Registry. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Scovelle AJ, King T, Shields M, O'Neil A, Lallukka T, Hewitt B, Milner A. Do psychosocial job stressors differentially affect the sleep quality of men and women? A study using the HILDA Survey. Eur J Public Health 2021; 31:736-738. [PMID: 33963842 DOI: 10.1093/eurpub/ckab056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The aim of this study was to investigate whether gender was an effect modifier of the relationship between three psychosocial job stressors and sleep quality, in a representative sample of 7280 employed Australians. We conducted linear regressions and effect measure modification analyses. Low job control, high job demands and low job security were associated with poorer sleep quality. There was evidence of effect modification of the relationship between job security and sleep quality by gender on the additive scale, indicating that the combined effect of being male and having low job security is greater than the summed interactive effect.
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Affiliation(s)
- A J Scovelle
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - T King
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - M Shields
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - A O'Neil
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.,Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - T Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - B Hewitt
- School of Social and Political Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - A Milner
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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O'Neil A, Davis J, Mohebbi M, Voutilainen A, Virtanen J, Tuomainen T, Atherton J, Amerena J, Driscoll A, Hare D, Wittert G. 190 Urinary Sodium Concentration Predicts Time-to-Event Outcomes in Men With Heart Failure Over a 33-Year Period. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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5
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O'Neil A, Taylor C, Hare D, Oldroyd J, Rangani W, Dheerasinghe D, Fisher A, Oldenburg B. P1529Poor mental health is accompanied by reduced autonomic functioning in the month following acute coronary syndrome. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p1529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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O'Neil A, Thomas E, Poffley A, Grace S. P3412A global perspective of cardiac rehabilitation registries: a systematic review. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Bhatt NR, Morris M, O'Neil A, Gillis A, Ridgway PF. When should surgeons retire? Br J Surg 2015; 103:35-42. [PMID: 26577951 DOI: 10.1002/bjs.9925] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 05/30/2015] [Accepted: 07/31/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND Retirement policies for surgeons differ worldwide. A range of normal human functional abilities decline as part of the ageing process. As life expectancy and their population increases, the performance ability of ageing surgeons is now a growing concern in relation to patient care. The aim was to explore the effects of ageing on surgeons' performance, and to identify current practical methods for transitioning surgeons out of practice at the appropriate time and age. METHODS A narrative review was performed in MEDLINE using the terms 'ageing' and 'surgeon'. Additional articles were hand-picked. Modified PRISMA guidelines informed the selection of articles for inclusion. Articles were included only if they explored age-related changes in brain biology and the effect of ageing on surgeons' performance. RESULTS The literature search yielded 1811 articles; of these, 36 articles were included in the final review. Wide variation in ability was observed across ageing individuals (both surgical and lay). Considerable variation in the effects of the surgeon's age on patient mortality and postoperative complications was noted. A lack of neuroimaging research exploring the ageing of surgeons' brains specifically, and lack of real markers available for measuring surgical performance, both hinder further investigation. Standard retirement policies in accordance with age-related surgical ability are lacking in most countries around the world. CONCLUSION Competence should be assessed at an individual level, focusing on functional ability over chronological age; this should inform retirement policies for surgeons.
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Affiliation(s)
- N R Bhatt
- Department of Surgery, University of Dublin, Trinity College, at the Adelaide and Meath Hospital, Tallaght, Ireland
| | - M Morris
- Department of Surgery, University of Dublin, Trinity College, at the Adelaide and Meath Hospital, Tallaght, Ireland.,Education Division, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - A O'Neil
- Education Division, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - A Gillis
- Department of Surgery, University of Dublin, Trinity College, at the Adelaide and Meath Hospital, Tallaght, Ireland
| | - P F Ridgway
- Department of Surgery, University of Dublin, Trinity College, at the Adelaide and Meath Hospital, Tallaght, Ireland.,Education Division, School of Medicine, Trinity College Dublin, Dublin, Ireland
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Zea AH, Atkins MB, McDermont D, O'Neil A, Regan M, Hernandez C, Youmans A, Desalvo J, Ochoa A. Role of CD3ζ expression and arginase activity in predicting response and survival in metastatic renal cell carcinoma (mRCC) patients receiving IL-2. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.2535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- A. H. Zea
- Louisiana State University, New Orleans, LA; Beth Israel Deaconess Cancer Center, Boston, MA
| | - M. B. Atkins
- Louisiana State University, New Orleans, LA; Beth Israel Deaconess Cancer Center, Boston, MA
| | - D. McDermont
- Louisiana State University, New Orleans, LA; Beth Israel Deaconess Cancer Center, Boston, MA
| | - A. O'Neil
- Louisiana State University, New Orleans, LA; Beth Israel Deaconess Cancer Center, Boston, MA
| | - M. Regan
- Louisiana State University, New Orleans, LA; Beth Israel Deaconess Cancer Center, Boston, MA
| | - C. Hernandez
- Louisiana State University, New Orleans, LA; Beth Israel Deaconess Cancer Center, Boston, MA
| | - A. Youmans
- Louisiana State University, New Orleans, LA; Beth Israel Deaconess Cancer Center, Boston, MA
| | - J. Desalvo
- Louisiana State University, New Orleans, LA; Beth Israel Deaconess Cancer Center, Boston, MA
| | - A. Ochoa
- Louisiana State University, New Orleans, LA; Beth Israel Deaconess Cancer Center, Boston, MA
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Garnick DW, Luft HS, Gardner LB, Morrison EM, Barrett M, O'Neil A, Harvey B. Services and charges by PPO physicians for PPO and indemnity patients. An episode of care comparison. Med Care 1990; 28:894-906. [PMID: 2232920 DOI: 10.1097/00005650-199010000-00004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Physicians who participate in preferred provider organizations (PPOs) usually agree to various types of utilization review and sometimes discount their charges or agree to accept lower fees. This study was performed to determine whether they provided more or fewer services to their PPO patients than to their indemnity patients and whether the discounting resulted in lower expenditures for each episode of illness. In 1984, Metropolitan Life offered PPO coverage to Dade County (Florida) school board employees and dependents but only a standard indemnity plan to Dade County government employees and dependents. Episodes of care were examined for patients with chest pain, hypertension, joint pain, gastrointestinal or liver disorders, and lower back pain cared for by physicians who treated patients in both the PPO and indemnity employee groups. For PPO patients, charges per physician service were the same or lower, but total physician charges during an episode were higher. For services such as laboratory tests, diagnostic x-rays, and room and board, PPO and indemnity patients' charges were not significantly different.
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Affiliation(s)
- D W Garnick
- Department of Health Policy and Management, Harvard School of Public Health, Boston, MA
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Adler DS, Goldman L, O'Neil A, Cook EF, Mudge GH, Shemin RJ, DiSesa V, Cohn LH, Collins JJ. Long-term survival of more than 2,000 patients after coronary artery bypass grafting. Am J Cardiol 1986; 58:195-202. [PMID: 3488671 DOI: 10.1016/0002-9149(86)90046-9] [Citation(s) in RCA: 97] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Among 2,004 patients who underwent their first coronary artery bypass graft operation between January 1970 and December 1980 without concomitant valve replacement or aneurysmectomy, life-table survival was 89% at 5 years and 80% at 8 years after surgery. In a multivariate Cox model analysis, the independent correlates of long-term survival were emergent operation with cardiogenic shock (multivariate mortality rate ratio [RR] = 14.0), use of a postoperative intraaortic balloon pump (RR = 3.9), ejection fraction less than 50% (RR = 2.4), preoperative history of congestive heart failure (RR = 2.2), cardiopulmonary bypass time (RR = 1.4 for each 30-minute increment), uncorrected mitral regurgitation (RR = 1.5 for each increment of angiographic gradation), left main coronary artery narrowing (RR = 1.7) and diabetes (RR = 1.6). After controlling for these factors, age, sex and the percentage of narrowings that were bypassed were not independent correlates of long-term survival.
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Usher RH, Saigal S, O'Neil A, Surainder Y. Estimation of red blood cell volume in premature infants with and without respiratory distress syndrome. Biol Neonate 1975; 26:241-8. [PMID: 1131385 DOI: 10.1159/000240735] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Red blood cell volume was estimated indirectly from plasma volume and venous hematocrit measurements in 262 consecutively delivered premature infants of less than 37 weeks' gestation. Infants with respiratory distress syndrome averaged lower red cell volumes (P0.02) than those without. Fatal cases had the lowest volumes. There was a 10.3% mortality from RDS (respiratory distress syndrome) among the one third of infants with the smallest red cell volumes, and only a 2.3% mortality among the one third with the largest volumes. Red cell volume was shown to be a direct correlate of time of cord clamping and thereby of the amount of placental transfusion, both in infants with and without RDS. From this study it is probable that delayed cord clamping, by allowing placental transfusion, decreases the risk of death from RDS in premature infants. Delay in clamping the umbilical cord for 1-1.5 min is advised in premature births.
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Abstract
In Phase1 of this study, three breed types (Simmentaler-, Brahman- and Nguni bulls; n = 60 each) were grain-fed and slaughtered at 12 months of age (A-age, fat-class 2). Feed was withdrawn for either three hours or 24 hours pre-slaughter. Within each feed withdrawal group, three electrical stimulation (ES) treatments were applied, viz. ES for 15 seconds, 120 seconds or no stimulation. In Phase 2, the effects of animal age and feeding regime were investigated using of A-age (feedlot and pasture), AB-age (feedlot and pasture) and B-age (pasture) animals. All carcasses were electrically stimulated for 15 seconds. Longer feed withdrawal increased dark-firm-dry (DFD) meat occurrence (pHu >6) in the Nguni and Simmentaler-cross. Brahman-cross longissimus (LL) tended to be more tender with paler colour and higher drip loss when 120 ES was applied. Longer feed withdrawal recorded higher Warner Bratzler shear force (WBSF) than three hour feed withdrawal. However, ES neutralized the effect of stress on tenderness. On average the AB-age feedlot animals produced the most tender LL followed by the B-age pasture and A-age feedlot which was similar to the AB-age pasture. A-age pasture animals produced the least tender LL steaks. The calpain proteolytic system played a pivotal role in determining the ultimate meat tenderness and although connective tissue becomes less soluble in older animals it did not play the determinant role in tenderness in this study. The intramuscular fat (< 3%) played an important role in the tenderness outcome of Nguni LL which marbled well at AB-age.Keywords: Meat tenderness, pH and temperature decline profile, pre- and post-slaughter conditions, production systems
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