Trauma Exposure in Anxious Primary Care Patients

The present study examined rates of trauma exposure, clinical characteristics associated with trauma exposure, and the effect of trauma exposure on treatment outcome in a large sample of primary care patients without posttraumatic stress disorder (PTSD). Individuals without PTSD (N?=?1,263) treated as part of the CALM program (Roy-Byrne et al., Journal of the American Medical Association 303(19)1921–1928, 2010) were assessed for presence of trauma exposure. Those with and without trauma exposure were compared on baseline demographic and diagnostic information, symptom severity, and responder status six months after beginning treatment. Trauma-exposed individuals (N?=?662, 53 %) were more likely to meet diagnostic criteria for Obsessive Compulsive Disorder and had higher levels of somatic symptoms at baseline. Individuals with and without trauma exposure did not differ significantly on severity of anxiety, depression, or mental health functioning at baseline. Trauma exposure did not significantly impact treatment response. Findings suggest that adverse effects of trauma exposure in those without PTSD may include OCD and somatic anxiety symptoms. Treatment did not appear to be adversely impacted by trauma exposure. Thus, although trauma exposure is prevalent in primary care samples, results suggest that treatment of the presenting anxiety disorder is effective irrespective of trauma history.     

The Action of God in the World—A Synthesis of Process Thought in Science and Theology

A foundational belief of monotheistic religions is that God acts in the world. In this paper, the case is made that divine action has its origins in the molecular world. Within a metaphysical framework of process thought, a hypothesis is constructed in which God's action in the world, God's ‘initial aim’ for all actualities, is divine motivation of chemical becoming.     

Perfect visual short-term memory for periodic patterns

Abstract

The short-term memory for spatial frequency information was assessed by measuring the spatial frequency discrimination thresholds for briefly flashed luminance gratings as a function of the time interval between the test and reference gratings, using a computer-controlled two-interval forced-choice procedure. Discrimination thresholds were stable for interstimulus intervals in the range 1–30 sec under all conditions tested. At low contrasts, short exposure times and low spatial frequencies discrimination thresholds increased, but no interactions between stimulus parameters affecting thresholds and interstimulus interval were observed. It is concluded that factors limiting spatial discrimination are associated with the sensory coding stage. Spatial discrimination and visual memory may be based on a common representation, which is perfectly retained in short-term memory. Visual half-field tests revealed no hemispheric differences in the processing and retention of spatial frequency information.     

Latent variable assessment of outcomes in a nurse-managed intervention to increase latent tuberculosis treatment completion in homeless adults.

OBJECTIVE: To assess predictors of latent tuberculosis infection (LTBI) completion by using structural equation modeling (SEM) among homeless adults, a group at great risk for LTBI and active tuberculosis (TB). LTBI therapy is effective in stemming the progression to active TB, yet treatment adherence among homeless persons is difficult to attain. DESIGN: By using SEM, the authors assessed predictors of LTBI completion among a sample of 494 homeless adults in Los Angeles, CA, who received either a nurse case-managed program (NCM) or a usual care program. MAIN OUTCOME MEASURES: Latent variables were created with the baseline variables of site type, age, intervention status, dissatisfaction with health care, depression, TB risk assessment, alcohol use, heroin or cocaine use, and TB knowledge. Outcome variables included many of the same baseline variables as well as treatment completion. RESULTS: LTBI treatment completion (100% adherence) was significantly and positively associated with participation in NCM, older age, and less heroin or cocaine use. NCM also predicted greater TB knowledge, greater ease of treatment, and more satisfaction with treatment (NCM completion rate = 64%, control rate = 42%). CONCLUSION: The culturally competent NCM program, combined with active tracking and incentives, was successful in a difficult-to-treat and highly transient population.     

Neurochemical regulation of feeding in the rat: facilitation by alpha-noradrenergic, but not dopaminergic, receptor stimulants.

Rats ate voraciously after intraventricular injections of the alpha-noradrenergic receptor stimulant clonidine. Intraventricular administration of l-norepinephrine also facilitated feeding, but similar injections of dopamine and apomorphine (a dopamine receptor stimulant) were ineffective and even tended to suppress feeding. Clonidine was 100 times more potent than norepinephrine and increased the intake of both the ordinary diet of powdered food and a highly palatable wet food. The anorexic action of amphetamine was reversed by centrally administered clonidine. These observations suggest "respondent" rather than "operant" regulation of feeding by noradrenergic systems. That is, in relation to noradrenergic mechanisms, feeding appears to be a respondent which is sensitized or disinhibited by activation of alpha-noradrenergic receptors, rather than an operant which is reinforced by the release of norepinephrine.