scholarly journals Psychosocial impact of HIV/aids diagnosis on elderly persons receiving care from a public healthcare service

2015 ◽  
Vol 18 (4) ◽  
pp. 821-833 ◽  
Author(s):  
Leandro César da Silva ◽  
Ezequiel Elias Azevedo Alves Felício ◽  
Júnia Brunelli Cassétte ◽  
Lissa Araújo Soares ◽  
Rhariany Alves de Morais ◽  
...  
Keyword(s):  
Healthcare Service ◽  
Psychosocial Impact ◽  
Sexual Practices ◽  
Public Healthcare ◽  
Elderly Persons ◽  
Current Increase ◽  
Fear Of Rejection ◽  
Aids Diagnosis ◽  
The Impact ◽  
Hiv Aids

The current increase in the number of elderly people infected with the human immunodeficiency virus (HIV) represents a major challenge to healthcare professionals, public policies and the general population, in terms of the need to discuss the role of sexuality and sexual practices in the aging process and the impact of these issues on health promotion for the elderly. The aim of the present study was to identify the psychosocial impact of HIV/Aids diagnosis on elderly persons receiving care in a public healthcare service, based on the perception of the individuals themselves. A qualitative research study of an exploratory nature was performed, based on individual semi-structured interviews with HIV-positive elderly patients, living in the mid-west macro-region of Minas Gerais. Analysis of the results suggested that, according to the 14 patients interviewed, HIV diagnosis involves changes in the way they relate to people; in self-care; in sexual practices; in the performance of daily activities and in the possibility of continuing to participate in social groups. The patients reported embarrassment, fear of rejection and discrimination, and experiences of isolation and facing prejudice. Based on the results, it can be concluded that most of the problems faced by older people are linked to socially constructed stigmas and stereotypes associated with the disease and the efforts made by such individuals to keep the diagnosis a secret.

scholarly journals Examining ‘institutional entrepreneurship’ in healthcare redesign and improvement through comparative case study research: a study protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e020807 ◽  
Author(s):  
Angela Melder ◽  
Prue Burns ◽  
Ian Mcloughlin ◽  
Helena Teede
Keyword(s):  
Health Service ◽  
Study Protocol ◽  
Healthcare Service ◽  
Healthcare Delivery ◽  
Comparative Case Study ◽  
Public Healthcare ◽  
Service Improvement ◽  
Institutional Entrepreneurship ◽  
Doctoral Research ◽  
The Impact

IntroductionHealthcare service redesign and improvement has become an important activity that health system leaders and clinicians realise must be nurtured and mastered, if the capacity issues that constrain healthcare delivery are to be solved. However, little is known about the critical success factors that are essential for sustaining and scaling up improvement initiatives. This situation limits the impact of these initiatives and undermines the general standing of redesign and improvement activity within healthcare systems. The conduct of the doctoral research detailed in this study protocol will be nested within a broader parent study that seeks to address this problem by drawing on the theory of ‘institutional entrepreneurship’. The doctoral research will apply this idea to understanding the capacities and capabilities required at the organisation level to bring about transformational change in healthcare services.Methods and analysisThe parent study is predominantly qualitative, is multilevel in nature and has been codesigned with five partner healthcare organisations. The focus is a sector-wide attempt in an Australian state jurisdiction to transfer new redesign and improvement knowledge into the public healthcare system. The doctoral research will focus on the implementation of the sector-wide approach in one healthcare service in the jurisdiction. This research involves interviews with project team members and stakeholders involved in two improvement initiatives undertaken by the health service. It will involve interviews with redesign and improvement leaders and senior managers responsible for the overall health service improvement approach. The methods will also include immersive fieldwork, interviews and focus groups. Appropriate methods for coding and thematic extraction will be applied to the qualitative data.Ethics and disseminationEthical approval has been granted by the health service and Monash University Human Research Ethics Committee. Dissemination will be facilitated via academic publication, industry reports and workshops and dissemination events as part of the broader project.

scholarly journals Shifting consciousness and challenging power: Women activists and the provision of HIV/AIDS services

2020 ◽  
Vol 24 ◽  
Author(s):  
Shauna Mottiar ◽  
Vuyiseka Dubula
Keyword(s):  
Women Activists ◽  
Hiv Treatment ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
Civil Society Organisations ◽  
Public Healthcare Sector ◽  
Keywords Hiv ◽  
The Impact ◽  
Roll Out ◽  
Hiv Aids

ABSTRACT In 2003, the South African government shifted AIDS policy making HIV treatment available in the public healthcare sector. The antiretroviral roll out, while hailed as a success, has required continued activism to ensure genuine implementation. Women particularly the poor, traditionally bear the brunt of the impact of HIV/AIDS socially and economically. Very often they do this in most marginalised spaces. This paper draws on theories of participation and empowerment to understand female activism during the period of antiretroviral roll out in South Africa. The paper seeks to understand how processes of empowerment linked with the first stage - access to ARVs impacted on the second stage - ARV roll out .It also considers how female activists understand their empowerment in the context of their role. The focus is grassroots activism females in Lusikisiki and Khayelitsha. This paper draws from a qualitative study on bottom-up policy advocacy utilising participatory observation and in-depth interviews with activists and civil society organisations. The main findings are that during the roll out phase of the HIV/AIDS campaign women activists worked from transformed "ways of thinking and being" in terms of HIV/AIDS and in terms of their role in the struggle for health rights. Their contesting embedded notions of power contributed to the democratisation of HIV/AIDS services. The transformation also caused shifts in the ways women mobilised, framed their understanding of the struggle and accessed participation spaces. Keywords: HIV, AIDS, ARVs, health activism, gender power.

scholarly journals 936. Evaluating the Impact of Polypharmacy on Virologic Success in People with HIV

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S501-S502
Author(s):  
Humberto R Jimenez ◽  
Naana Boachie ◽  
Sangwon Park ◽  
Jin Suh
Keyword(s):  
Hiv Transmission ◽  
Virologic Failure ◽  
Descriptive Analysis ◽  
Virologic Response ◽  
Transmission Risk ◽  
Pill Burden ◽  
Cross Sectional ◽  
Hiv Rna ◽  
Aids Diagnosis ◽  
The Impact

Abstract Background As people with HIV (PWH) have experienced reductions in antiretroviral pill burden, there has been an increase in medications to manage non-AIDS-related co-morbidities. Previous studies have linked virologic failure to an increased pill burden. This study assessed whether polypharmacy and other variables affect success of HIV management in our population. Methods A retrospective, cross-sectional analysis of PWH receiving care at a Ryan White-funded clinic in New Jersey was performed. Eligible patients were ≥18 years old, had ≥2 visits in 2019 and were receiving antiretroviral therapy (ART). The primary endpoints were to determine the effect polypharmacy (defined as 5 or more non-ART pills per day) on virologic response rates (HIV RNA < 200 copies/mL). Secondary endpoints accounted for the impact of age, gender, race/ethnicity, HIV transmission risk factor, and AIDS diagnosis on virologic response. A descriptive analysis of comorbidities and medication classes was also completed. Logistic regression, chi square and student’s t test were used for statistical analysis. Results 964 patients were included in the analysis, with 355 (37%) meeting the criteria for polypharmacy. Most patients were male (60%) and the mean age was 49 years of age. The racial/ethnic breakdown was 46% Hispanic, 45% Black and 8% White. Polypharmacy was associated with higher rates of virologic success compared to those with a lower pill burden: 94% vs 86% had an HIV RNA < 200 copies/mL (P=0.0003), respectively. ART pill burden was statistically, but not clinically higher among those with polypharmacy (1.34 vs 1.45, P=0.025). Virologic response was found to be higher among Hispanics and Whites in comparison to Black patients (OR 2.2, CI 1.4-3.5 and 3.0, CI 1.1-8.2). Patients with an AIDS diagnosis were less likely to achieve virologic response (OR 0.64, CI 0.42-0.99). Conclusion Patients with polypharmacy were more likely to achieve virologic success than paitents with a low pill burden in our population. Disclosures Humberto R. Jimenez, PharmD, BCPS, AAHIVP, Gilead (Speaker’s Bureau)

Assessing antiretroviral therapy success in HIV/AIDS morbidity and mortality trends in Brazil, 1990–2017: an interrupted time series study

2020 ◽  
pp. 095646242095298
Author(s):  
Augusto Cesar Lara de Sousa ◽  
Tatiana de Araujo Eleuterio ◽  
José Victor Afonso Coutinho ◽  
Raphael Mendonça Guimarães
Keyword(s):  
Time Series ◽  
Antiretroviral Therapy ◽  
Burden Of Disease ◽  
Interrupted Time Series ◽  
People Living With Hiv ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
The Impact ◽  
Hiv Aids

To describe the trends of HIV/AIDS metrics related to the burden of disease for Brazil between 1990 and 2017 we conducted a timeseries analysis for HIV/AIDS indicators by extracting data from the Global Burden of Disease study. We calculated traditional prevalence, incidence and mortality rates, the number of years lost by HIV-related deaths (YLL) and disability (YLD), and disability-adjusted life years (DALY). We estimated time series models and assessed the impact of highly active antiretroviral therapy (HAART) on the same indicators. In the set of disability-adjusted life years (DALY), the highest weight of its magnitude was due to YLL. There was a decline, especially after 1996, of DALY, mortality and YLL for HIV/AIDS. However, YLD, incidence, and prevalence increased over the same period. Also, the analysis of interrupted time series showed that the introduction of HAART into health policy had a significant impact on indicators, especially for DALY and YLL. We need to assess the quality of life of people living with HIV, especially among older adults. In addition, we need to focus on primary prevention, emphasizing methods to avoid infection and public policies should reflect this.

scholarly journals Do Public Pensions Improve Mental Wellbeing? Evidence from the New Rural Society Pension Insurance Program

2021 ◽  
Vol 18 (5) ◽  
pp. 2391
Author(s):  
Fang Wang ◽  
Haitao Zheng
Keyword(s):  
Mental Health ◽  
Rural Society ◽  
Rural Elderly ◽  
Public Pensions ◽  
Mental Wellbeing ◽  
Elderly Persons ◽  
Pension Insurance ◽  
Beneficial Effects ◽  
Pension Income ◽  
The Impact

The causal effect of public pensions on the mental wellbeing of the elderly in lower and middle-income countries deserves further investigation. This paper first constructed a theoretical framework for the impact of New Rural Society Pension Insurance pensions in China on the mental wellbeing of the rural elderly, and described potential channels through which pension income may affect mental wellbeing. We then used the fixed effect model and the instrument variable approach to estimate the casual effects of pension income on the mental wellbeing of the rural elderly. The results reveal that pension income improves mental wellbeing by relieving depression of the rural elderly; however, the beneficial effects of pension income are very limited. Pension income has no beneficial effects on the mental health of the rural elderly in the east region, whereas it slightly relieves depression of those in the middle and west regions. We also found that pension income produces small improvements in the mental health of older females, elderly persons living independently, and those with relatively poor economic conditions.

The relationship between patient donation and satisfaction with online healthcare service quality

2019 ◽  
Vol 47 (12) ◽  
pp. 1-10
Author(s):  
Yuanrong Hu ◽  
Shengkang Lu ◽  
Zhongming Tang
Keyword(s):  
Patient Satisfaction ◽  
Healthcare Service ◽  
Outcome Quality ◽  
Healthcare Applications ◽  
Mobile Healthcare ◽  
Process And Outcome ◽  
Patient Consultation ◽  
The Impact ◽  
The Relationship

We explored how donation relates to patient satisfaction with the quality of process and outcome in an online healthcare service. Using a dataset of 496,723 patient consultation records collected from ChunyuDoctor, which is among the largest of the Chinese mobile healthcare applications, we conducted a multiple regression and found that patient satisfaction with both process and outcome jointly influenced their donation. We also found that higher quality satisfaction levels meant paying patients were more likely to donate than were free patients. Our results also showed satisfaction with the quality of the process and the outcome had an equal impact on patient donation for the free patients, but the impact of process quality was greater than that of outcome quality for the paying patients, suggesting the importance of enhancing the quality of the process in an online healthcare service. Implications of the findings are discussed.

scholarly journals The impact of chronic disease and disability on the elderly

1999 ◽  
Vol 55 (3) ◽  
pp. 9-14
Author(s):  
C. J. Eales
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Health Care Systems ◽  
The Elderly ◽  
Therapeutic Interventions ◽  
Elderly Persons ◽  
Care Systems ◽  
And Function ◽  
The Impact

Health care systems for elderly people should aim to delay the onset of illness, reducing the final period of infirmity and illness to the shortest possible time. The most effective way to achieve this is by health education and preventative medicine to maintain mobility and function. Changes in life style even in late life may result in improved health, effectively decreasing the incidence of chronic diseases associated with advancing age. This paper presents the problems experienced by elderly persons with chronic diseases and disabilities with indications for meaningful therapeutic interventions.

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