A Multimodal Ayurveda and Mind-Body Therapeutic Intervention for Chronic Symptoms Attributed to a Postinfectious Syndrome: A Pilot Study.

Evaluate feasibility and impact of a multimodal integrative therapeutic intervention in patients presenting with chronic symptoms attributed to a postinfectious syndrome. This was a prospective longitudinal single-center pilot study conducted from January 2019 to December 2020. University of Maryland Lyme Program, Baltimore Maryland.

"I got so much on my plate": Understanding care discontinuity for HIV and HCV among formerly incarcerated persons.

Objective: To explore barriers to care continuity among formerly incarcerated persons with HIV and/or hepatitis C.

Data Sources And Study Setting: We draw on data from semi-structured interviews conducted in 2018-2019 with 30 formerly incarcerated persons and 10 care providers. Data were collected across two clinics in Baltimore, Maryland, and Washington, D.

Young Same-Gender-Loving Men (SGLM) Living with HIV Continue to Experience Symptoms that May Impair Their Retention in Care.

Over half of HIV infections in the U.S. are among young gay, bisexual, and other same-gender-loving men (SGLM).

Early Use of the Palliative Approach to Improve Patient Outcomes in HIV Disease: Insights and Findings From the Care and Support Access (CASA) Study 2013-2019.

Young men of color who have sex with men (yMSM) living with human immunodeficiency virus (HIV) in syndemic environments have been difficult-to-retain in care resulting in their being at-risk for poor health outcomes despite availability of effective once-daily antiretroviral treatment (ART). Multiple methods have been implemented to improve outcomes for this cohort; none with sustainable results. Outpatient HIV staff themselves may be a contributing factor.

What Matters Most at the End-of-Life for Chinese Americans?

To provide optimal end-of-life (EOL) care in the Chinese American population, we need to have a better understanding of what matters most at EOL from their perspective. Experiencing a "good death" at the EOL is the optimal goal of palliative care. Studies show that the meaning and description of good death varies across cultures in different populations.

Challenges to advance care planning among multidisciplinary health professionals in China.

Background: Advance care planning (ACP) is a critical component of quality end-of-life care. Little is known regarding the cultural influences on health professionals' attitudes toward the discussion of ACP in China.

Objective: To better understand attitudes toward ACP among Chinese healthcare professionals in China and the influence of cultural factors such as filial piety, or xiào.

2017 HIV Medicine Association of Infectious Diseases Society of America Clinical Practice Guideline for the Management of Chronic Pain in Patients Living With Human Immunodeficiency Virus.

Pain has always been an important part of human immunodeficiency virus (HIV) disease and its experience for patients. In this guideline, we review the types of chronic pain commonly seen among persons living with HIV (PLWH) and review the limited evidence base for treatment of chronic noncancer pain in this population. We also review the management of chronic pain in special populations of PLWH, including persons with substance use and mental health disorders.

2017 HIVMA of IDSA Clinical Practice Guideline for the Management of Chronic Pain in Patients Living With HIV.

Pain has always been an important part of human immunodeficiency virus (HIV) disease and its experience for patients. In this guideline, we review the types of chronic pain commonly seen among persons living with HIV (PLWH) and review the limited evidence base for treatment of chronic noncancer pain in this population. We also review the management of chronic pain in special populations of PLWH, including persons with substance use and mental health disorders.

Mortality Among Hardmetal Production Workers: UK Cohort and Nested Case-Control Studies.

Objective: The aim of this study was to characterize the mortality at two hardmetal production factories in the United Kingdom as part of an international study.

Methods: Standardized mortality ratios (SMRs) were calculated on the basis of mortality rates for England and Wales, and local rates. A nested case-control study of lung cancer was undertaken.

Review of measurement techniques and methods for assessing personal exposure to airborne nanomaterials in workplaces.

Exposure to airborne agents needs to be assessed in the personal breathing zone by the use of personal measurement equipment. Specific measurement devices for assessing personal exposure to airborne nanomaterials have only become available in the recent years. They can be differentiated into direct-reading personal monitors and personal samplers that collect the airborne nanomaterials for subsequent analyses.

Occupational Exposure to Respirable Dust, Respirable Crystalline Silica and Diesel Engine Exhaust Emissions in the London Tunnelling Environment.

Personal 8-h shift exposure to respirable dust, diesel engine exhaust emissions (DEEE) (as respirable elemental carbon), and respirable crystalline silica of workers involved in constructing an underground metro railway tunnel was assessed. Black carbon (BC) concentrations were also assessed using a MicroAeth AE51. During sprayed concrete lining (SCL) activities in the tunnel, the geometric mean (GM) respirable dust exposure level was 0.

Implementation of HIV Palliative Care: Interprofessional Education to Improve Patient Outcomes in Resource-Constrained Settings, 2004-2012.

Palliative care (PC), introduced early in the management of chronic illness, improves patient outcomes. Early integration of a palliative approach for persons with HIV has been documented to be effective in identifying and managing patient-level concerns over the past decade in African settings. The experience of implementing PC in multiple African and other resource-constrained settings (RCSs) emphasizes the need for essential palliative competencies that can be integrated with chronic disease management for patients and their families facing life-limiting illness.

Perspectives on the role of patient-centered medical homes in HIV Care.

To strengthen the quality of HIV care and achieve improved clinical outcomes, payers, providers, and policymakers should encourage the use of patient-centered medical homes (PCMHs), building on the Ryan White CARE Act Program established in the 1990s. The rationale for a PCMH with HIV-specific expertise is rooted in clinical complexity, HIV's social context, and ongoing gaps in HIV care. Existing Ryan White HIV/AIDS Program clinicians are prime candidates to serve HIV PCMHs, and HIV-experienced community-based organizations can play an important role.

Pain Management for Persons Living With HIV Disease: Experience With Interprofessional Education in Nigeria.

Context: Pain management (PM) has not been routinely incorporated into HIV/AIDS care and treatment in resource-constrained settings.

Objectives: We describe training for multidisciplinary teams tasked with integrating care management into HIV clinics to address pain for persons living with HIV in Nigeria.

Methods: Education on PM was provided to mixed-disciplinary teams including didactic and iterative sessions following home and hospital visits.

High cancer-related mortality in an urban, predominantly African-American, HIV-infected population.

Objective: To determine mortality associated with a new cancer diagnosis in an urban, predominantly African-American, HIV-infected population.

Design: Retrospective cohort study.

Methods: All HIV-infected patients diagnosed with cancer between 1 January 2000 and 30 June 2010 were reviewed.

Can palliative care integrated within HIV outpatient settings improve pain and symptom control in a low-income country? A prospective, longitudinal, controlled intervention evaluation.

A high burden of pain, symptoms and other multidimensional problems persist alongside HIV treatment. WHO policy indicates palliative care as essential throughout the disease course. This study aimed to determine whether palliative care delivered from within an existing HIV outpatient setting improves control of pain and symptoms compared to standard care.

Palliative care and support for persons with HIV/AIDS in 7 African countries: implementation experience and future priorities.

To combat morbidity and mortality from the worldwide epidemic of the human immunodeficiency virus (HIV), the United States Congress implemented a President's Emergency Plan for AIDS Relief (PEPFAR) in 30 resource-limited countries to integrate combination antiretroviral therapy (ART) for both prevention and cure. Over 35% of eligible persons have been successfully treated. Initial legislation cited palliative care as an essential aspect of this plan but overall health strengthening became critical to sustainability of programming and funding priorities shifted to assure staffing for care delivery sites; laboratory and pharmaceutical infrastructure; data collection and reporting; and financial management as individual countries are being encouraged to assume control of in-country funding.

Generating an African palliative care evidence base: the context, need, challenges, and strategies.

The enormous burden of progressive, incurable disease in sub-Saharan Africa is reflected in the epidemiology of cancer and HIV. However, there has been little research activity and evidence generated to inform appropriate and effective responses. A collaborative of clinicians, academics and advocates have been active in the design, delivery and reporting of research activities in African palliative care.

Family perspectives on communication with healthcare providers during end-of-life cancer care.

Purpose/objectives: To assess healthcare provider communication about end-of-life (EOL) and hospice care with patients with terminal cancer and their families, from the perspective of the family members.

Design: Exploratory, qualitative study using focus group discussion.

Setting: University of Maryland Greenebaum Cancer Center.

Mental health status of clients from three HIV/AIDS palliative care projects.

Objective: To describe mental health status and its correlates among clients of three palliative care programs targeting underserved populations.

Methods: Mental Health Inventory (MHI-5) scores of clients from programs in Alabama (n = 39), Baltimore (n = 57), and New York City (n = 84) were compared.

Results: Mean MHI-5 scores did not differ among sites and were indicative of poor mental health.

Patient reports of symptoms and their treatment at three palliative care projects servicing individuals with HIV/AIDS.

Self-reports of 32 symptoms and their treatments were obtained from patients of three palliative care programs that provide services to seriously ill HIV patients (>or=95% AIDS) in Alabama (n=47), Baltimore (n=91), and New York City (n=117). On average, patients reported 10.9 (SD=7.

Integrating palliative care into disease management guidelines.

Background: Palliative care should not be reserved for those who are close to dying; as a comprehensive approach to minimizing illness-related suffering, it is appropriate for patients with significant illness from the time of diagnosis on.

Objective: The American Hospice Foundation Guidelines Committee's initiative aims to provide a practical approach for guideline writers and others to integrate palliative care into disease management and care services whenever it is relevant.

Design: A consensus approach was used to design recommendations for upgrading existing disease management and service guidelines to include palliative care.

Management of common symptoms of advanced lung cancer.

Disease-directed treatment of lung cancer reduces the morbidity and extends life for patients. However, as providers we must recognize that treating the symptoms of the disease may be as important as the treatment of the disease itself. This is particularly true in advanced disease and after disease-directed therapies have been exhausted.

Development of required postgraduate palliative care training for internal medicine residents and medical oncology fellows.

Background: The need for better care for terminally ill patients led us to create an educational program to provide internal medicine residents and medical oncology fellows basic competency in palliative and end-of-life care.

Methods: An interdisciplinary team identified educational strategies, course objectives, content, and evaluation instruments.

Results And Conclusions: Our strategy is to use a required Web-based course to establish a knowledge base upon which specific training during clinical rotations build skills.