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HIV Basics and Diagnosis: Knowledge and Awareness for All

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Having the basic knowledge of HIV has become crucial for everyone. Awareness often helps you take precaution. HIV or otherwise known as human immunodeficiency virus is responsible for causing HIV infection, a condition in which a person’s immune system gets weakened as the virus attacks and destroys the important cells in the body which fight infection and keep us healthy. Even though there is no complete cure for HIV, with proper medical care and lifestyle improvement, the infection can be effectively controlled.

It is noted that people in the US are more prone to HIV infection than others due to many factors as the choice of sex partners, risky behaviors, and lifestyle. At the first point, diagnosing the condition is crucial through the right methods.

HIV is primarily diagnosed by testing the blood or saliva of the patient for development of any antibodies to the virus. Once being infected, the body may take about 12 weeks to develop these antibodies, so the testing needs to be done accordingly to confirm.

Methods of diagnosis

At the latest, there is a test that checks for the ‘HIV antigen’, which is a protein produced by the infected virus soon after the infection. This is now considered to be the fastest and earliest method for diagnosing HIV. An early diagnosis can surely prompt people to take additional precautions to prevent any transmission.

Elisa Test

ELISA stands for enzyme-linked immunosorbent assay, which is the most popularly used method for diagnosing HIV infection. If the ELISA application test is positive, next the Western Blot Test may be administered to reconfirm the presence of virus. If you doubt you have HIV despite finding the ELISA test negative, you need to do the testing again in a couple of months to get reassured.

Other tests

There are a few other tests which are approved for diagnosing HIV infection, and the results of these tests need to be reconfirmed by a doctor or medical professional.

  • Home test – The only approved home test by U.S. FDA (Food and Drug Administration) is the ‘Home Access Express Test’, for which you can buy the kit from the pharmacies.
  • Saliva test – In this, a cotton pad will be used to take saliva from the inner part of the cheek. It will be tested in a laboratory and it may take three days to get results. Even if the result is positive, it needs to be confirmed with a blood test.
  • Western Blot — This is a secondary blood test, which is very sensitive and is used to confirm the positive results of an ELISA test.
  • Viral Load test — This test is used to assess the volume of HIV in the blood. This test is used for early detection of HIV as well as during the treatment of HIV to analyze the progress of treatment. HIV gets detected by checking the DNA sequences which bind to those on the virus.

If you are diagnosed as HIV positive and start with the treatment, there are various types of tests administered by the doctors to determine the stages of the disease to implement adequate treatment modalities. The most common tests are CD4 count, viral load test, drug resistance test etc

Walter Moore is a healthcare specialist with many years of experience in Oncology with specialization in ELISA application for early detection of HIV and effective treatment modalities.

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Disability

New Study Looks at End-of-Life Decision-Making for People with Intellectual Disabilities

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A new study by researchers at the University at Buffalo provides a groundbreaking look at how advance care planning medical orders inform emergency medical service (EMS) providers’ experiences involving people with intellectual disabilities.

Most states in the U.S. have programs that allow terminally ill patients to document their end-of-life decisions.  In New York, the Medical Orders for Life-Sustaining Treatment form (MOLST) allows individuals to document what measures health care providers, including EMS providers, should take near the end of a patient’s life.

Studies suggest that this approach to person-centered advance care planning can alleviate a dying patient’s pain and suffering, according Deborah Waldrop, a professor in the UB School of Social Work and an expert on end-of-life care. Yet little research on end-of-life decision-making has been done on the growing population of older Americans with intellectual disabilities, which the American Association on Intellectual and Developmental Disabilities defines as a disability characterized by significant limitations in learning, reasoning, problem solving, and a collection of conceptual, social and practical skills.

Waldrop and Brian Clemency an associate professor of emergency medicine in the Jacobs School of Medicine and Biomedical Sciences, authored one of the first scholarly examinations of how pre-hospital providers assess and manage emergency calls for patients who do not wish to be resuscitated or intubated.  Jacqueline McGinley, a doctoral candidate in UB’s School of Social Work, joined their research team and served as first author for their most recent work.

Through a series of interviews with five different emergency medical service agencies in upstate New York, the researchers asked EMS providers specifically how forms like the MOLST shape what they do in the case of someone with an intellectual disability.

“The best available research before our study suggested that as of the late 1990s, fewer than 1 percent of people with intellectual disabilities had ever documented or discussed their end-of-life wishes,” says McGinley. “But with this study, we found that about 62 percent of the EMS providers we surveyed had treated someone with an intellectual or developmental disability who had these forms.”

That disparity points to the need to illuminate this understudied area of how people with intellectual disabilities are engaging in end-of-life discussions, according to McGinley.

She says the EMS providers’ charge is to follow protocol by honoring the documents, their directions and organizational procedures. The MOLST, as its name implies, is a medical order that providers are professionally bound to respect.  Their procedures are identical for all emergency calls involving someone who is imminently dying regardless of a pre-existing disability, the study’s results suggested.

But questions remained.

“We heard from providers who wrestled with the unique issues that impact this population, including organizational barriers when working across systems of care and decision-making for individuals who may lack capacity” says McGinley.

There are approximately 650,000 adults age 60 and older in the U.S. with intellectual disabilities, according to Census Bureau figures from 2000. Demographers expect that figure to double by 2030, and triple within the foreseeable future.

Person-centered advance care planning specifically involves the individual in discussions about their health history, possible changes to their current health status and what future options might be available in order to best inform that person’s end-of-life decision-making.

The results, published in the Journal of Applied Research in Intellectual Disabilities, suggest that medical orders largely favor efforts to prolong life. This may be due to a reluctance to discuss advanced care planning in this population.  Still, this sociocultural context must be strongly considered as future research explores how people with intellectual disabilities engage in end-of-life discussions.

Since January 2016, Medicare pays for patients to have advance care planning conversations with medical providers. In fact, at least once a year, as part of a service plan through the state, people with intellectual disabilities have face-to-face discussions with their service providers, according to McGinley, who notes the importance of this built-in opportunity to have conversations about serious illness and the end of life.

“What’s most important in all of the work we do is knowing that people can die badly,” says Waldrop. “We know we can make changes that illuminate some of the uncertainties and improve care for people who are dying. Knowing how forms, like the MOLST, are applied in the field is an incredible step in the right direction.”

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Health

CHIP Demise Devastating to Millions of American Children

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Congress allowed the federal Children’s Health Insurance Program (CHIP) to expire Oct. 1, leading to the demise of one of the most successful government programs ever implemented, said an expert on health economics at Washington University in St. Louis.

“CHIP has led to a substantial reduction in the uninsured rate for children, to the point where children now have only a 5 percent uninsured rate — the lowest ever,” said Tim McBride, professor at the Brown School and director of the Center for Health Economics and Policy. He also serves as chair of the oversight committee for Missouri’s Medicaid program called MOHealthNET.

An estimated 9 million children are now covered by the CHIP program across the U.S. In Missouri, more 624,000 children are covered by a combination of CHIP and Medicaid, though most children are covered by Medicaid.

What if funding is not restored?

A move to rescue the program hit a snag in the U.S. House of Representatives this week, lowering hopes that it might be restored quickly.

“In the short run, most states can continue to pay for the program for at least a few weeks if not months, using funds carried forward from previous years,” McBride said. “But at some point, those funds will dry up and states will face cutting the program, which will mean children will lose their health insurance.

“States likely do not have the funds to make up for the loss of federal dollars. The impact of this would be devastating, to say the least, on these children and their families. But it would create a huge financial problem for the health care system — physicians, providers and those who care for them.

It should be obvious that this is a great investment in our future because if medical problems can be avoided when children are young, they are much more likely to do better in school, be more productive members of society.

“It should be obvious that this is a great investment in our future because if medical problems can be avoided when children are young, they are much more likely to do better in school, be more productive members of society,” McBride said. “Also, it would be penny-wise, pound-foolish to not deal with this problem now, since covering children is a lot cheaper than covering anyone else, and it costs more if medical care is delayed.”

The state of Missouri reportedly would not run out of funding to finance the CHIP program until the first quarter of 2018, if not a little later, he said. But, in other states, the end of federal funds for CHIP will come considerably sooner, maybe within weeks.

Will Congress eventually come around?

“I would bet that Congress eventually will do something to reauthorize the program, based on previous experience, and I know they are working on legislation right now,” McBride said. “They have had to reauthorize this program many times before, and it has garnered bipartisan support.

“However, these days there is so much partisanship, and Washington is much less functional, so I am afraid to make any definitive predictions now.”

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Health

Self Help Tips and Advice For Social Workers

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There is no denying the positive impact social workers have on hundreds of families and individuals throughout their career. They will tell you about the rewarding experiences they have helping others in need. Unfortunately, for every success, there is at least one case in which they could not help. Social workers see the best and the worst of society every day, and even the strongest among us can crack under the pressure. That is why self-care is so important. Being mindfully aware of your needs as well as the needs of those around you can keep you healthy and able to be there when you’re needed.

What is Self Care and How Can You Do It Every day?

Self-care is a practice that becomes a lifestyle. Understand and commit to the idea that it is not something you do once, it is something you do every day. The key is to be mindful and aware.

It is important to be mindful of where you are and what you are doing as you go about your day. Whether you are in a meeting or at the grocery store, notice how you are feeling in the moment. This can range from listening to your body and noticing your state of health to recognizing an emotional situation in your life.

Become aware of your breathing. When we are feeling stressed, emotional, or run down, we forget how to breathe. Our breath can become fast and shallow which deprives our bodies of the oxygen it needs. Pay attention to your breathing and focus on slowing it down. Allow the air to fill your abdomen, not just your lungs. You will find that mindful breathing exercises calms your thoughts, allows for greater clarity, and lessens your anxiety.

Now That You Are Aware, How Do You Improve?

It’s one thing to be mindful and aware of how you are feeling, but doing something about it is another matter. Improving your physical and emotional state requires some life changes as well.

Many social workers have the stress relieving habit of smoking or grabbing an unhealthy snack from the vending machine. It makes us feel like we’re taking a moment for ourselves. Instead of grabbing a cigarette or a bag of chips, try an e-cigarette starter kit or grab a granola bar. This gives you a moment away while making healthier choices through controlling the nicotine and sugar you intake. The idea is not to deprive yourself but to make small changes that will make you feel better over time.

Changing the way you approach daily tasks is another life change that will give you some added peace of mind. For decades we have been taught to multitask but all we’ve learned is how to start tasks but not finish them in a timely manner. By focusing on one task at a time you’ll allow yourself to finish a job before moving onto something else. This creates a sense of accomplishment and boosts your confidence at the job you are doing.

Maintaining Your New Found Awareness

Creating a support system is important when attempting to care for yourself. By relying on your friends and family you are willingly accepting love and nurturing that you simply cannot give to yourself. When meditating on an issue in your life doesn’t result in answers, one of the best things we can do is turn to our support system for help. It’s not necessary to face every challenge alone and often times, they can see from a perspective that you cannot. You may also find that the more willing you are to receive care from others, the easier it becomes for you to provide care for the people you’re working to help.

Self-care is difficult for those who spend their lives taking care of others. By allowing yourself the care you need you will find that it not only feeds your soul but it will improve your ability to care for the people around you.

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