Health care utilisation in patients with non-cardiac chest pain: A longitudinal analysis of chest pain,anxiety and interoceptive fear

Chest pain can be a frightening experience that leads many to seek medical evaluation. The symptom results in costly health care utilisation. Over half of patients referred for cardiac evaluations of chest pain do not obtain definitive medical explanations for their symptoms; these cases are described as non-cardiac chest pain (NCCP). Some patients with NCCP are not reassured after being informed their chest pain is non-cardiac in origin and seek repeated medical evaluation. Co-morbid anxiety and mood disorders often coexist with NCCP and are associated with health care utilisation. The current study examined chest pain, general anxiety, interoceptive fear and health care utilisation in a sample of 196 chest pain patients near the time of cardiac evaluation (Time 1), and 70 of these patients one year later (Time 2). Results indicate that anxiety and interoceptive fear were significantly associated with health care utilisation at Time 1, and only interoceptive fear (at Time 1) predicted health care utilisation at Time 2. This study develops research in this area by examining the relation of anxiety and health care utilisation longitudinally in patients with NCCP.     

Differential Diagnosis with the Bender Gestalt Test

Forty-two patients, 18 of whom were diagnosed as organic and 24 as having a functional psychiatric disorder, were given the Bender Gestalt test. Both the Hain (1964) and the Pascal and Suttell (1951) scoring systems gave mean scores for the two groups which were different at beyond the .001 level of significance. The Pascal-Suttell also gave a significant difference between means when either patient group was compared with normals. Using a previously established cutoff score for the Hain, 76% of the patients were correctly classified, as compared with 81% by a clinical expert on the Bender.     

Education for Vocation in Public Life USA1

Abstract : The Lutheran sensibility is that life is a paradox, a dialectical tension, in the midst of which one must act and live. This sensibility informs an open and dialectical educational model for liberal arts education, which encourages a dynamic interaction of faith and learning. It supports a vocational understanding of public life that cultivates critical analysis while seeking to encourage citizenship for the common good.     

Promoting Healing and Restoring Trust: Policy Recommendations for Improving Behavioral Health Care for American Indian/Alaska Native Adolescents

American Indian/Alaska Native youth represent the strength and continued survival of many Nations and Tribes. However, they currently experience numerous health disparities and challenges, including the highest rate of suicide among 15–24 year-olds in the United States. Our comprehensive review of the literature on the mental health of AI/AN youth highlighted seven focal causes of behavioral health disparities: (1) high levels of violence and trauma exposure and traumatic loss, (2) past and current oppression, racism, and discrimination, (3) underfunded systems of care, (4) disregard for effective indigenous practices in service provision, policy, and funding, (5) overreliance on evidence-based practices, (6) lack of cultural competence among systems of care and providers, and (7) barriers to care. Seven policy recommendations that recognize the importance of moving beyond exclusive reliance on western models of care and that seek to foster transformation of individuals, families, communities, behavioral health service systems of care, and social structures are presented, supported, and discussed.     

Impulsivity and Paced Tapping

The purpose of this study was to test the hypothesis that impulsivity is positively related to both the intraindividual variability and the rate of performance of a paced tapping task. Selected experimental conditions which have been demonstrated to influence paced tapping were included in the experimental design of the tapping task. The independent variables in the tapping task were: feedback vs. no feedback; tempo; concurrent cognitive task (counting) vs. no concurrent cognitive task. Three measures of tapping performance were computed: absolute or total error of tapping, tapping rate, and the intraindividual variability of tapping. The results confirm the hypothesis that impulsivity is positively related to rate of paced tapping, although the degree of relationship varied under different experimental conditions within the paced tapping task. Intraindividual variability of tapping was not significantly related to impulsivity, but the results were suggestive of a positive relationship.     

The Numinosum and the brain: The weaving thread of consciousness

The world bangs on a thin thread and that is the psyche of man —C. G.Jung, A Matter of Heart (the film)