A theoretical explanation for how a nutrition counseling and medically tailored meal delivery program benefitted participants living with lung cancer.

Purpose: The purpose of this study was to assess participants' perceptions and experiences while participating in a Food is Medicine medically tailored meal plus intensive nutrition counseling intervention to create a theoretical explanation about how the intervention worked.

Methods: This interpretive qualitative study included the use of semi-structured interviews with active participants in a randomized controlled trial aimed at understanding how a medically tailored meal plus nutrition counseling intervention worked for vulnerable individuals with lung cancer treated at four cancer centers across the USA. During the 8-month long study, participants in the intervention arm were asked to be interviewed, which were recorded, transcribed verbatim, and analyzed using conventional content analysis with principles of grounded theory.

How a Medically Tailored Meal Intervention with Intensive Nutrition Counseling Created Active Coping with Behavior Change for Vulnerable Patients with Lung Cancer.

Purpose: The purpose of this study was to assess participants' perceptions and experiences while participating in a Food is Medicine medically tailored meal plus nutrition counseling intervention to create a theoretical explanation about the intervention worked.

Methods: This interpretive qualitative study included the use of semi-structured interviews with active intervention participants. Purposeful sampling included vulnerable (uninsured, rural zip code residency, racial/ethnic minority, 65 years old, and/or low-income) individuals with lung cancer treated at four cancer centers across the United States.

HIV Psychiatry: The Missing Link to HIV Prevention and Comprehensive Care.

HIV psychiatry may be the missing link to HIV prevention and care. Although HIV has been transformed from a fatal illness to a chronic and manageable illness, morbidity and mortality from HIV and AIDS continue to persist despite advances in prevention and care. In the 42 years since the HIV pandemic began in 1981, >84 million people were infected with HIV and 40 million people with HIV have died.

The Participation of Trans Women in Competitive Fencing and Implications on Fairness: A Physiological Perspective Narrative Review.

Debate has surrounded whether the participation of trans women in female sporting categories is fair, specifically the retained male physiological advantage due to increased testosterone compared to cisgender females. Recently, individual sporting organisations have been investigating and assessing policies regarding trans women athlete participation in female categories, resulting in several banning participation. This review aims to discuss the scientific evidence and provide appropriate guidance for the inclusion of trans women in elite competitive female fencing categories.

Burnout and Moral Injury Among Consultation-Liaison Psychiatry Trainees.

Burnout and moral injury within medicine have steadily increased over the last decades, especially among those providing care during the COVID-19 pandemic. The term has been used to describe clinician distress and a syndrome of emotional exhaustion, a diminished sense of personal accomplishment, and depersonalization. Burnout has a significant impact on both job performance and patient care.

Decisional and Dispositional Capacity Determinations: Neuropsychiatric Illness and an Integrated Clinical Paradigm.

Background: Assessment of decisional capacity requires thorough clinical review of a patient's current psychiatric symptoms and cognitive processes. The assessment to determine the patient's capacity for self-management postdischarge is a different clinical concept from decisional capacity.

Objectives: Standardized guidelines for capacity determinations (both for informed consent and for disposition) would be helpful to clinicians, patients, and their caregivers.

Updates in Psychosomatic Medicine: 2014.

Background: The amount of literature published annually related to psychosomatic medicine is vast; this poses a challenge for practitioners to keep up-to-date in all but a small area of expertise.

Objectives: To introduce how a group process using volunteer experts can be harnessed to provide clinicians with a manageable selection of important publications in psychosomatic medicine, organized by specialty area, for 2014.

Methods: We used quarterly annotated abstracts selected by experts from the Academy of Psychosomatic Medicine and the European Association of Psychosomatic Medicine in 15 subspecialties to create a list of important articles.

Caring for persons with early childhood trauma, PTSD, and HIV: a curriculum for clinicians.

Access and adherence to medical care enable persons with HIV to live longer and healthier lives. Adherence to care improves quality of life, prevents progression to AIDS, and also has significant public health implications. Early childhood trauma-induced posttraumatic stress disorder (PTSD) is one factor that has been identified as an obstacle to adherence to both risk reduction and HIV care.

Early childhood trauma, posttraumatic stress disorder, and non-adherence in persons with AIDS: a psychodynamic perspective.

Non-adherence to treatment and risk-reduction measures not only leads to increased morbidity and mortality in patients with HIV/AIDS but is also a major public health hazard. While there are multiple determinants of non-adherence, one that is particularly complex and refractory to intervention appears to be the history of childhood trauma and the development of post-traumatic stress disorder (PTSD). While behavioral intervention is occasionally helpful in increasing a patient's commitment to self-care, it is our view that the use of a more psychoanalytic framework, as well as the development of a psychodynamic understanding of the patient's history and struggles, may provide both patient and clinician with a more profound understanding of the forces that perpetuate non-adherence, thus facilitating a more cohesive and empathic approach to treatment.

Psychiatric treatment of persons with HIV/AIDS: an HIV-psychiatry consensus survey of current practices.

Background: Only sparse evidence from controlled clinical trials is available to guide the psychiatric treatment of persons with HIV/AIDS.

Objective: The authors assessed and determined current treatment trends in AIDS psychiatry.

Method: Members of the Organization of AIDS Psychiatry (OAP) participated in a web-based survey.

Impact of bereavement on progression of AIDS and HIV infection: a review.

Background: Human immunodeficiency virus (HIV) disease is associated with bereavement and grief reactions brought about by the disease process itself and by the losses of loved ones.

Objective: The goal of this review is to assess the current literature regarding grief, HIV, and immunity.

Method: The authors reviewed applicable articles retrieved from a MEDLINE literature search with the search terms "bereavement/HIV," "grief/HIV," and "immunity/grief/HIV.

DNR versus DNT: clinical implications of a conceptual ambiguity: a case analysis.

Psychiatrists who practice psychosomatic medicine are routinely called upon to help resolve ethical dilemmas that arise in the care of patients near the end of their lives. Psychosomatic-medicine psychiatrists may be of unique value in these situations because of the clinical insights that we bring to the care of the dying patient. In particular, our subspecialty brings expertise related to the evaluation of decisional capacity of patients who are faced with accepting or declining end-of-life clinical interventions, such as resuscitation and intubation.

The role of psychosomatic-medicine psychiatrists in bioethics: a survey study of members of the academy of psychosomatic medicine.

The Bioethics Subcommittee of The Academy of Psychosomatic Medicine developed a survey to assess the involvement of psychosomatic-medicine psychiatrists in bioethics and the extent of their participation on bioethics committees and in the teaching of bioethics. Of 599 Academy members surveyed, 122 (20.4%) responded.

Consultation-liaison psychiatrists on bioethics committees: opportunities for academic leadership.

Objective: This article briefly reviews the history of the relationship between psychiatry and the leadership of ethics committees as a background for examining appropriate educational initiatives to adequately prepare residents and early career psychiatrists to serve as leaders of ethics committees.

Method: A Medline review of literature on psychiatry and ethics committees and consultation as well as recent survey data from the Academy of Psychosomatic Medicine indicate that psychosomatic medicine psychiatrists are particularly qualified and interested in serving as chairs of ethics committees. The authors compare knowledge and skills obtained in psychiatric training with the Society for Heath and Human Values and the Society for Bioethics Consultation Task Force on standards for ethics consultation proposed as core competencies for ethics committee leadership.

Preserving a sense of wonder: the integration of an ego-supportive psychodynamic approach to supervision in an AIDS psychiatry fellowship.

The challenges of working with medically and mentally ill persons with a paucity of resources, inadequate networks of social support, and multiple stresses and losses maybe daunting to even the most seasoned of caregivers. A psychiatric trainee may be overwhelmed by the despair, sorrow, and desperation en-countered in the day-to-day care of the complex severely ill patient with lethalmedical and lethal psychiatric diagnoses. Individuals who are infected with HIV and hepatitis C, who are polysubstance users, and who are benzodiazepine dependent present with inordinate demands for prescribed substances to use or to sell in the street.

A new technique of "midline anchoring" in spinal cord stimulation dramatically reduces lead migration.

Spinal cord stimulation (SCS) is a popular method of treatment of chronic pain. Unfortunately, migration of the lead continues to be a serious complication of this therapy. In an attempt to reduce lateral migration of the SCS lead, we performed a retrospective assessment of a new technique of percutaneous lead placement.

The association between schizophrenia and cancer: a population-based mortality study.

Background: For most of this century there has been speculation that persons diagnosed with schizophrenia have a reduced incidence of cancer.

Objective: To determine if a history of cancer was more common in persons diagnosed with schizophrenia when compared with the general population, controlling for known risk and demographic factors.

Design: We used the 1986 National Mortality Followback Survey (NMFS) which sampled 1% of all deaths in the US from that year.

Understanding the psychodynamics of non-adherence to medical treatment in persons with HIV infection.

We present this medical-psychiatric case discussion to illustrate the psychodynamic aspects of nonadherence in a woman with AIDS. Our patient sustained severe, repeated abandonment and brutal emotional, physical and sexual trauma throughout her early and later childhood and adult life. Her care was considerably complicated by the sequelae of trauma including difficulty with trust and posttraumatic stress disorder.