Cultural Considerations for Psychologists in Primary Care

Many health concerns in the United States (e.g., diabetes) are routinely managed in primary care settings. Regardless of the medical condition, patients’ health is directly influenced by factors such as healthcare providers and cultural background. Training related to how behaviors influence health, coupled with training on how cultural diversity intersects with mental health, allows psychologists to have the relevant expertise to assist in the development of primary care behavioral health interventions. However, many psychologists in primary care struggle with how to integrate a culture-centered paradigm into their roles as behavioral health providers. This paper provides an introduction on how three culture-centered concepts (providers’ cultural sensitivity, patient–provider cultural congruency, and patients’ health literacy) can be applied in primary care using the Five A’s Organizational Construct and a model of cultural competence. In addition, the paper includes a section on integration of cultural considerations into consultation and training and concludes with a discussion of how the three culture-centered concepts have implications for health equity.     

Memory as a Property of Nature

Prerequisite to memory is a past distinct from present. Because wave evolution is both continuous and time-reversible, the undisturbed quantum system lacks a distinct past and therefore the possibility of memory. With the quantum transition, a reversibly evolving superposition of values yields to an irreversible emergence of definite values in a distinct and transient moment of time. The succession of such moments generates an irretrievable past and thus the possibility of memory. Bohm’s notion of implicate and explicate order provides a conceptual basis for memory as a general feature of nature akin to gravity and electromagnetism. I propose that natural memory is an outcome of the continuity of implicate time in the context of discontinuous explicate time. Among the ramifications of natural memory are that laws of nature can propagate through time much like habits and that personal memory does not require neural information storage.     

Science and Religion: Ten Models of War,Truce, and Partnership

Public discourse today continues to propagate the simplistic idea that science and religion are engaged in a hopelessly unwinnable war. This is misleading. Science and religion interact at so many different junctures and in so many different ways that any simple generalization misguides us. This essay provides an updated inventory of ten popular conceptual models for relating science and theology, when theology is understood as rational reflection on religion. Four influential models assume that a war is taking place: (1) scientism; (2) scientific imperialism; (3) theological authoritarianism; and (4) the evolution controversy. Six additional preferred models assume a truce or even more, a partnership: (5) the Two Books; (6) the Two Languages; (7) ethical alliance; (8) dialogue accompanied by creative mutual interaction; (9) naturalism; and (10) theology of nature. Special attention will be given to creative mutual interaction within a framework of a theology of nature.     

Chronically increased Gsalpha signaling disrupts associative and spatial learning

The cAMP/PKA pathway plays a critical role in learning and memory systems in animals ranging from mice to Drosophila to Aplysia. Studies of olfactory learning in Drosophila suggest that altered expression of either positive or negative regulators of the cAMP/PKA signaling pathway beyond a certain optimum range may be deleterious. Here we provide genetic evidence of the behavioral and physiological effects of increased signaling through the cAMP/PKA pathway in mice. We have generated transgenic mice in which the expression of a constitutively active form of Gsalpha (Gsalpha* Q227L), the G protein that stimulates adenylyl cyclase activity, is driven in neurons within the forebrain by the promoter from the CaMKIIalpha gene. Despite significantly increased adenylyl cyclase activity, Gsalpha* transgenic mice exhibit PKA-dependent decreases in levels of cAMP due to a compensatory up-regulation in phosphodiesterase activity. Interestingly, Gsalpha* transgenic mice also exhibit enhanced basal synaptic transmission. Consistent with a role for the cAMP/PKA pathway in learning and memory, Gsalpha* transgenic mice show impairments in spatial learning in the Morris water maze and in contextual and cued fear conditioning tasks. The learning deficits observed in these transgenic mice suggest that associative and spatial learning requires regulated Gsalpha protein signaling, much as does olfactory learning in Drosophila.     

Variation in cue duration reveals top-down modulation of involuntary orienting to uninformative symbolic cues

This article reports three experiments in which the effects of cue duration on involuntary orienting to uninformative symbolic cues (arrows presented at fixation) were investigated. Experiment 1 showed that symbolic cues had less effect on involuntary orienting when they were presented for only 25 msec than when they were presented for 200 msec across a range of stimulus onset asynchronies. Experiment 2 suggested that the effect of cue duration on involuntary orienting was due primarily to top-down strategic factors, rather than to bottom-up stimulus factors, and Experiment 3 suggested that these strategic factors may involve differences in how the cue is processed. Altogether, the present findings are important because they emphasize the distinction between cue processing and the putative involuntary orienting that results from such processing in the symbolic-cuing paradigm. In so doing, the present results help resolve discrepant findings that have been reported across previous studies.     

Environmental toxicants and developmental disabilities: a challenge for psychologists

Developmental, learning, and behavioral disabilities are a significant public health problem. Environmental chemicals can interfere with brain development during critical periods, thereby impacting sensory, motor, and cognitive function. Because regulation in the United States is based on limited testing protocols and essentially requires proof of harm rather than proof of lack of harm, some undefined fraction of these disabilities may reflect adverse impacts of this "vast toxicological experiment" (H. L. Needleman, as quoted in B. Weiss & P. J. Landrigan, 2000, p. 373). Yet the hazards of environmental pollutants are inherently preventable. Psychologists can help prevent developmental disabilities by mobilizing and affecting public policy, educating and informing consumers, contributing to interdisciplinary research efforts, and taking action within their own homes and communities to reduce the toxic threat to children.     

Happiness and health: environmental and genetic contributions to the relationship between subjective well-being, perceived health, and somatic illness

The aim was to identify genetic and environmental influences on the covariances between subjective well-being (SWB), perceived health, and somatic illness. Analyses were based on 6576 Norwegian twins aged 18-31. Heritabilities ranged from .24 to.66. SWB correlated .50 with perceived health, -.25 with musculoskeletal pain, and -.07 with allergy. Common genetic factors accounted for 45%-60% of associations. SWB and perceived health was to a high extent influenced by the same genes (r(g)=.72 and.82 for males and females, respectively). For SWB and musculoskeletal pain, r-sub(g) =-.29 and -.42 for males and females, respectively. Effects were partly sex specific. Environmental factors shared by twins did not affect the covariances. Results support a differentiated view of SWB-health relations, and imply that both genes and environment play important roles in the associations between well-being and health.