Publications by authors named "Michael McNeil"
Background: Integrating pediatric palliative care (PPC) into pediatric oncology standard care is essential. Therefore, it is important to assess physicians' knowledge and perceptions of PPC to optimize its practice.
Objective: To evaluate the knowledge, comfort levels, and perspectives of physicians regarding the timing and perceived barriers to integrating PPC into pediatric cancer care across Europe.
Importance: Quadrivalent adjuvanted inactivated influenza vaccine (aIIV4) and adjuvanted recombinant zoster vaccine (RZV) contain novel adjuvants. Data are limited on the comparative safety, reactogenicity, and health-related quality of life (HRQOL) effects of the simultaneous administration of these vaccines.
Objective: To compare the safety and reactogenicity after simultaneous doses of RZV and aIIV4 administration (opposite arms) with simultaneous doses of RZV with quadrivalent high-dose inactivated influenza vaccine [HD-IIV4]).
Article Synopsis
- A study evaluated the participation rates of the Kaiser Permanente Side Effect Monitor (KPSEM), a self-reporting system for vaccine side effects, among patients receiving COVID-19 vaccinations from April 2021 to July 2023.
- Out of over 2 million vaccinated patients, only about 8% participated, with significant variations based on age and race; younger parents had the lowest rates, while older adults participated the most.
- The findings indicate that socio-economic factors influenced participation, as individuals in lower deprivation areas and certain racial groups were less likely to engage with the system.
Article Synopsis
- The study analyzes COVID-19 vaccination rates across a diverse population in the U.S. using data from OCHIN, a network of community healthcare organizations, focusing on patients aged 6 months and older.
- It found that vaccination rates increased with age, with only 11.7% of the youngest group vaccinated, compared to 72.3% of those 65 and older, and identified factors influencing higher vaccination rates like prior influenza vaccination and private insurance.
- The research revealed racial disparities, noting that Hispanic and NH Asian patients had higher vaccination rates compared to NH Black and NH Native Hawaiian/Other Pacific Islander groups in the youngest age category.
Purpose: Vaccine-associated enhanced disease (VAED) is a theoretical concern with new vaccines, although trials of authorized vaccines against SARS-CoV-2 have not identified markers for VAED. The purpose of this study was to detect any signals for VAED among adults vaccinated against coronavirus disease 2019 (COVID-19).
Methods: In this cross-sectional study, we assessed COVID-19 severity as a proxy for VAED among 400 adults hospitalized for COVID-19 from March through October 2021 at eight US healthcare systems.
Implementation of a hospital-based end-of-life and bereavement care program in a latin American middle-income country. A source of light and compassion in the midst of cloudy times.
BMC Palliat Care
July 2024
Background: The death of a child is one of the most devastating events a family can face, resulting in significant physical and psychosocial morbidity. Bereavement support programs have been developed in high-income contexts to address this need. However, little is known about implementing bereavement programs in low-and middle-income countries (LMICs).
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- The U.S. COVID-19 vaccination program started in December 2020 and has played a crucial role in reducing illness and death caused by the virus, with safety monitoring being a key part of this effort.
- The government established multiple safety monitoring systems, utilizing both passive and active surveillance to track potential adverse events, especially focusing on vulnerable groups like pregnant individuals.
- The report highlights how systems worked together to quickly identify and manage issues like myocarditis after mRNA vaccinations, ensuring effective communication of safety data to healthcare providers and the public.
Importance: Pregnant people and infants are at high risk of severe COVID-19 outcomes. Understanding changes in attitudes toward COVID-19 vaccines among pregnant and recently pregnant people is important for public health messaging.
Objective: To assess attitudinal trends regarding COVID-19 vaccines by (1) vaccination status and (2) race, ethnicity, and language among samples of pregnant and recently pregnant Vaccine Safety Datalink (VSD) members from 2021 to 2023.
Objective: To assess the validity of electronic health record (EHR)-based influenza vaccination data among adults in a multistate network.
Methods: Following the 2018-2019 and 2019-2020 influenza seasons, surveys were conducted among a random sample of adults who did or did not appear influenza-vaccinated (per EHR data) during the influenza season. Participants were asked to report their influenza vaccination status; self-report was treated as the criterion standard.
: Children with cancer experience significant pain and anxiety during needle-based procedures. Undertreated pain in children has long-lasting consequences and reduces the efficacy of subsequent analgesic efforts. A validated quality improvement (QI) intervention, known as the "Children's Comfort Promise", includes (1) topical anesthetics, (2) sucrose or breastfeeding for infants, (3) comfort positioning, and (4) distraction techniques, and has been shown to be highly effective in decreasing procedural pain and anxiety in children.
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- * The CDC formed an independent group called the ACIP COVID-19 Vaccine Safety Technical Work Group (VaST) to monitor vaccine safety and address any concerns that arose post-authorization.
- * VaST met regularly from November 2020 to April 2023, collaborating with federal agencies to review safety data and inform vaccination policies while ensuring the effective assessment of safety during the rollout of multiple COVID-19 vaccines.
Background: In 2020, the Global Cancer Observatory reported 280,000 cases of childhood cancer worldwide, with a higher burden of disease and mortality rates in low- and middle-income countries. In 2022, the National Institute of Health reported 1708 new cases of childhood cancer in Colombia and an overall survival rate of approximately 55%. The aim of this study is to compare outcomes in children with cancer in the hospital setting during the last 72 h of life who received concurrent Pediatric Palliative Care (PPC) versus oncology care alone.
View Article and Find Full Text PDFIntroduction: The death of a child may be the most traumatic event a family can experience. Bereavement care for parents is essential for their physical and mental well-being and is a psychosocial standard of care. Childhood mortality is higher in low- or middle-income countries (LMICs); however, little is known regarding bereavement support or interventions for parents in LMICs.
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- A study explored racial and ethnic disparities in influenza vaccination coverage among pregnant women in the U.S., finding that non-Hispanic White women had higher vaccination rates than Hispanic and non-Hispanic Black women.
- The research involved surveys conducted after the 2019-2020 and 2020-2021 flu seasons, with significant oversampling of non-Hispanic Black and unvaccinated women to assess vaccine-related attitudes influencing vaccination coverage.
- The study concluded that attitudes towards the vaccine (like safety concerns) significantly contributed to the observed disparities in vaccination rates, even in a context where overall vaccination coverage was relatively high among pregnant women.
We report on the existence of two phosphatidic acid biosynthetic pathways in mycobacteria, a classical one wherein the acylation of the sn-1 position of glycerol-3-phosphate (G3P) precedes that of sn-2 and another wherein acylations proceed in the reverse order. Two unique acyltransferases, PlsM and PlsB2, participate in both pathways and hold the key to the unusual positional distribution of acyl chains typifying mycobacterial glycerolipids wherein unsaturated substituents principally esterify position sn-1 and palmitoyl principally occupies position sn-2. While PlsM selectively transfers a palmitoyl chain to the sn-2 position of G3P and sn-1-lysophosphatidic acid (LPA), PlsB2 preferentially transfers a stearoyl or oleoyl chain to the sn-1 position of G3P and an oleyl chain to sn-2-LPA.
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- - The Global Initiative for Childhood Cancer (GICC) focuses on improving cure rates for kids with cancer worldwide by enhancing healthcare quality and access, particularly in Latin America and the Caribbean (LAC) through collaboration with organizations like PAHO and St. Jude Children's Research Hospital.
- - In 2021, PAHO established regional working groups to tackle various aspects of childhood cancer care, resulting in seven focus areas: early detection, nursing, psychosocial support, nutrition, supportive care, treatment abandonment, and palliative care.
- - Over the course of several months, experts participated in meetings to create important resources, including educational materials for parents and virtual courses, and ongoing cooperation among health organizations is crucial for the successful implementation of GICC strategies.*
Objective: To describe the development of educational materials for parents and other caregivers of children with cancer, which utilized a culturally sensitive approach to reduce acceptance barriers to palliative care (PC).
Methods: The Pan American Health Organization (PAHO), St. Jude Children's Research Hospital, and partners in Latin America and the Caribbean collaborated in a three-phase project, beginning with a needs assessment survey of caregivers of children with cancer in Peru.
Article Synopsis
- The covalent modification of bacterial polysaccharides may influence their production, export, and biological functions, but it's unclear how mycobacteria, like Mycobacterium tuberculosis (Mtb), utilize similar mechanisms.
- Research shows that specific succinyl groups on Mtb's lipoarabinomannan play a key role in determining the mannose-capping of this molecule, affecting its overall biological activity.
- The absence of succinyl groups on Mtb's primary cell envelope polysaccharides results in heightened pro-inflammatory responses in both murine and human macrophages, highlighting succinylation as a vital factor in Mtb's regulation of inflammation.
Purpose: Early integration of pediatric palliative care (PPC) for children with cancer is critical to improving the quality of life of both the patient and family. Understanding physician perceptions of palliative care and perceived barriers to early integration is necessary to develop PPC in Brazil.
Methods: The Assessing Doctors' Attitudes on Palliative Treatment survey was modified for use in Brazil.
Purpose: In this scoping review, we evaluated existing literature related to factors influencing treatment decision-making for patients diagnosed with cancer in low- and middle-income countries, noting factors that influence decisions to pursue treatment with curative versus non-curative intent. We identified an existing framework for adult cancer developed in a high-income country (HIC) context and described similar and novel factors relevant to low-and middle-income country settings.
Methods: We used scoping review methodology to identify and synthesize existing literature on factors influencing decision-making for pediatric and adult cancer in these settings.
Background: Approximately 90% of children with cancer live in low-income and middle-income countries (LMICs), where 5-year survival is lower than 20%. Treatment-related mortality in high-income countries is approximately 3-5%; however, in LMICs, treatment-related mortality has been reported in up to 45% of children with cancer. This study aimed to systematically explore the burden of treatment-related mortality in children with cancer in LMICs and to explore the association between country income level and treatment-related mortality.
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- The FDA authorized the Janssen COVID-19 Vaccine for adults on 2/27/2021, with safety monitored through VAERS and a smartphone system called v-safe.
- An analysis of VAERS and v-safe data from February 2021 to February 2022 showed that out of over 17 million doses given, 67,995 adverse events (AEs) were reported, primarily non-serious and similar to clinical trial results.
- Serious AEs included conditions like COVID-19 disease and Guillain-Barré syndrome, with notable reporting rates for myopericarditis being elevated shortly after vaccination among younger adults.
Background: The opioid epidemic in the US continues to worsen. Opioid-only and polysubstance-involved opioid overdose deaths are increasing among adolescents and young adults, who have limited knowledge of opioid overdose prevention, including recognition and response. College campuses have infrastructure to support national-level implementation of evidence-based public health strategies for providing opioid overdose prevention and naloxone training programs among this priority population.
View Article and Find Full Text PDFOur institution's annual bereaved family event was modified to a virtual format during the COVID-19 pandemic. While necessary to comply with physical distancing directives, the transition also provided greater accessibility for families. Virtual events were feasible and appreciated by attendees.
View Article and Find Full Text PDFPediatric palliative care (PPC) programs vary widely in structure, staffing, funding, and patient census, resulting in inconsistency in service provision. Improving the quality of palliative care for children living with serious illness and their families requires measuring care quality, ensuring that quality measurement is embedded into day-to-day clinical practice, and aligning quality measurement with healthcare policy priorities. Yet, numerous challenges exist in measuring PPC quality.
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