Psychiatric correlates of medical care costs among veterans receiving mental health care

Research on increased medical care costs associated with posttraumatic sequelae has focused on posttraumatic stress disorder (PTSD). However, the provisional diagnosis of Disorders of Extreme Stress Not Otherwise Specified (DESNOS) encompasses broader trauma-related difficulties and may be uniquely related to medical costs. We investigated whether DESNOS severity was associated with greater nonmental health medical care costs in veterans receiving mental health care. Participants were 106 men and 105 women receiving VA outpatient mental health treatment. A standardized interview assessed DESNOS severity. The dependent variables consisted of primary and specialty medical treatment costs. Sequential zero-inflated negative binomial regression was used to evaluate the variance in medical costs accounted for by DESNOS severity, controlling for PTSD severity and established predisposing, enabling, and need-based health care factors. Contrary to our hypothesis, in fully adjusted models, DESNOS severity independently added a significant amount of variance to lower specialty medical care costs, whereas PTSD did not consistently account for significant variance in medical care costs. Greater DESNOS severity appears to be associated with lower specialty medical care costs but not primary care costs. These findings may indicate that patients with DESNOS symptoms are at risk for being underreferred for specialty care.     

“Not Gods But Animals”: Human Dignity and Vulnerable Subjecthood

Drawing on earlier work on the conceptual structure of dignity, this paper will suggest a particular type of connectedness between vulnerability and human dignity; namely, that the “organizing idea” of human dignity is the idea of a particular sort of ethical response to universal human vulnerability. It is common ground among many, if not all, approaches to ethics that vulnerability requires us to respond ethically. Here, I argue that human dignity is distinctive among ethical values in that it values us because of, rather than in spite of, or regardless of, our universal vulnerability. The term “dignity” is used synonymously with “human dignity” here, since an investigation of the dignity of non-human entities forms no part of the present examination.     

Creating an art therapy anger management protocol for male inmates through a collaborative relationship

A training partnership was established with the Florida Department of Corrections in 2003, and over the ensuing years, art therapy graduate student interns from Florida State University's Graduate Art Therapy Program have been placed in local prisons at different times. Recently, the art therapy interns worked closely with the supervising psychologist in one prison to alleviate and redirect aggression by integrating cognitive-behavioral techniques with art therapy directives. The art therapy interns and the psychologist developed a curriculum using a combination of workbook exercises and art tasks to develop and increase the participants' anger management skills, the Art Therapy Anger Management Protocol. This article provides an overview of art therapy in prison, the cognitive-behavioral approach to anger management with prison inmates, and how art therapy was used to support this approach. Examples of completed art tasks designed to correspond with the workbook curriculum are presented. Overall, this article presents the successful collaboration between the psychologist and art therapists and demonstrates how they facilitated improvement in the participants' anger management skills through this program.     

Seniority and anti-competitive restrictions on the legislative common pool: tenure’s impact on the overall production of legislation and the concentration of political benefits

It is well established that geographic areas benefit, in terms of the share of government spending they capture, from having a legislator with longer tenure, holding constant the tenure of other legislators. However, the implications of this literature for how the total production of legislation changes if all members gained seniority is less clear. Increased levels and dispersion of seniority within Congress generate a cartel-like effect, whereby legislators restrict the quantity of legislation enacted and increase the average price of each passed bill. The analysis provides a natural experiment to gauge the impacts of the emergence of the congressional committee system.     

Police Impersonation: Pretenses and Predators

Empirical research on police impersonation is rare. This research employs quantitative and qualitative methodologies on 2002?C2010 police case files describing impersonation incidents from three police agencies to provide an understanding of the individual and situational constructs associated with police impersonation. Research objectives included: exploring incident characteristics, comparing incidents to national violent crime statistics; and identifying common themes. Results show that police impersonation incidents, offenders, and victims are unique, particularly when compared to national data. Qualitative analysis identified three major themes related to tactics, motivations, and typology. The research offers a framework for establishing policy recommendations.     

Assessing and meeting the health needs of Roman Catholic priests in the archdiocese of Chicago

In 1985, the Bishops' Committee on Priestly Life and Ministry recommended bishops form holistic health boards for their priests based on the results of a 1982 U.S. survey of Catholic priests. In 1995, a holistic health committee was formed under the office of the vicar for priests for the archdiocese of Chicago. One of the committee's first actions was to survey the priests of the archdiocese of Chicago to identify baseline health behaviors and needs. Survey results (n = 524; 52% response rate) revealed the need for the committee to promote health education, preventive care, and annual physicals. The committee conducted a series of health fairs, improved the insurance benefit for an annual physical, and conducted a series of health-related talks targeted to priests. A follow-up survey in 2006 (n = 389; 46% response rate) indicated improvements in health behaviors of the priests. Comparisons to statewide and national data indicate that overall, engagement in healthy behaviors is higher for priests than for men who are not priests.     

‘Happiness again’: photographing and narrating the arrival of Hungarian child refugees and their families 1956–1957

Abstract

The Australian government has long been involved in creating, collecting and circulating photographs of newly arrived immigrants, displaced people and refugees. Many of these images have been used for internal and external promotional/propaganda purposes. In this article I use news reports and visual photographic material depicting Hungarian refugee children and their families, alongside an analysis of government agendas and communication strategies, to examine how these ‘new Australians’ were understood and presented to the nation. After the 1956 anti-Communist uprising in Hungary, just over 14,000 Hungarian refugees were resettled in Australia. The federal government specially sought out a number of ‘compassionate cases such as children’, and many groups and individuals within the host population offered support to care for what they imagined would be large numbers of orphaned and unaccompanied Hungarian children. These Hungarian refugees came to Australia in the context of increased government interest in public relations and publicity around immigration. A Public Relations director in the Department of Immigration was appointed in 1955 and a publicity section was also established as part of the Planning and Research Division. Discussions by the Immigration Planning Council during 1956 plainly stated that ‘business’ was now the driving force for immigration rather than ‘the “refugee” concept’. Tasman Heyes, the Secretary of the Department of Immigration, agreed but also felt that these two forces were and could be combined, pointing out that since 1951 Australia had received ‘international credit for contributing to the solution of an international problem’ by achieving the integration of these aims. This article examines how refugee children and families were positioned in relation to the fraught pairing of economic and humanitarian concerns, thus interrogating broader understandings of immigration, children and families within the Australian nation that are revealed in these moments of photographic capture and circulation.