Classical conditioning of the human blood pressure response.

The object of this experiment was to demonstrate that blood pressure responses could be classically conditioned in human subjects and to describe the topography of the conditioned response. Despite clear evidence for classical blood pressure conditioning in animals there is little evidence concerning a clear demonstration of the phenomenon in human subjects, and no description of the form of the conditioned response. A 'neutral' 8-s 70-db tone (CS) was paired with a 500-ms electric shock (UCS) in a delay conditioning paradigm. Conditioned subjects were compared to a control group that received the CS and UCS on a truly random schedule. The subjects in the conditioning group showed a conditioned blood pressure response that emerged during the last 4 s of the 8-s CS. The results differ from those obtained from animals, where the CR typically emerges during the first half of the CS. These data may have implications for the role of learning in hypertensive disorders.

Evaluating strategic change using the microcomputer.

To respond to the many strategic changes in health care, CFOs need to analyze and integrate volumes of information that organizations generate. The microcomputer-based strategic financial planning system brings together all the information that is generated from other decision-support systems with the organization and provides the CFO with concise, timely, and accurate analyses of the changes that are affecting their institutions. This system has been proven to be an efficient and effective means to consolidate and analyze strategic data.

Financial planning: a necessity for the '90s.

The changing face of healthcare demands a long-range strategic financial planning system. Yet who's responsible? The chief information officer or the chief financial officer? Reiff and Nelson provide a framework for CIOs to understand their CFO's needs.

Utilization of medical services by alcoholics participating in an outpatient treatment program.

Utilization of medical services by alcoholics participating in an outpatient alcoholism treatment program was examined, comparing these with alcoholics who chose not to participate.

Comparison of utilization of medical services by alcoholics and non-alcoholics.

To determine whether medical costs for alcoholics are higher than those for non-alcoholics, inpatient and outpatient costs for medical services of 191 alcoholics with 191 non-alcoholic matched controls were compared over four years. Results confirm that alcoholics are higher-cost users of medical services than non-alcoholics. (Am J Public Health 1982; 72:600-602.)

Utilization of medical services by alcoholics participating in a health maintenance organization outpatient treatment program: three-year follow-up.

IN a cumulative 3-yr follow-up study of utilization of medical services by alcoholics participating in a health insurance maintenance organization (HMO) outpatient alcoholism treatment program, expenditures of 59 alcoholics were compared with those of 78 alcoholics who chose not to participate. Results show significant differences in dollar cost per patient per year between groups in inpatient expenditures (p = 0.03). When alcoholism clinic costs were excluded from combined inpatient and outpatient expenditures, significance was maintained over the 3 yr (p = 0.02). In combined inpatient and outpatient expenditures including alcoholism treatment costs, the dollar differential between groups was substantial but not statistically significant.

Psychophysiological characteristics of narcissism during active and passive coping.

This study provides the first psychophysiological analysis of narcissism by measuring autonomic responses during active and passive anticipatory coping in 40 undergraduate men who scored high or low on the Narcissistic Personality Inventory (NPI). Compared to the low NPI group, the high NPI group showed greater preejection period (PEP) shortening, cardiac deceleration, and skin conductance response (SCR) habituation during anticipation of an aversive stimulus (p < .02). As expected, SCR and PEP reactivity were greater during active than passive coping. In the case of PEP, this effect emerged only in the low NPI group; the high NPI group showed the greatest PEP reactivity during the first task, regardless of coping demands. These data support hypothesized relationships among narcissism, psychopathy, and psychological predictors of cardiovascular disease, and suggest that a psychobiological dimension may underlie important features of narcissism.

Prevalence and co-occurrence of health risk behaviors among high-risk drinkers in a primary care population.

BACKGROUND: Approximately 10% of patients seen in the primary care setting meet criteria for high-risk (HR) drinking. Little data are available about the co-occurrence of other risk behaviors (RBs) in this population. This study examines the co-occurrence of smoking, poor diet, and sedentariness, and several change-related variables, among 479 HR drinkers participating in Project Health, a NIAAA-funded study testing the effectiveness of a provider-delivered intervention to reduce HR drinking. METHOD: Data were collected at study entry via standardized interview and questionnaire. RESULTS: The prevalence of additional RBs among HR drinkers was smoking, 35%; poor diet, 28%; and sedentariness, 44%. In addition to HR drinking, 67% of participants had at least one RB, and 61% reported smoking, sedentariness, or both. Perception of drinking as a problem was generally low (20%), as was intention to change drinking. Seventy-two percent of participants with multiple RBs perceived at least one of these RBs as a problem. Younger, unmarried, less-educated, blue-collar, and non-working participants were more likely to have multiple RBs than white-collar workers. CONCLUSION: Additional RBs are common among HR drinkers and may increase their already elevated health risks. Implications of these findings for interventions integrating multiple RBs into primary care settings are discussed.

The ensemble-averaged impedance cardiogram: an evaluation of scoring methods and interrater reliability.

The interrater reliability and concurrent validity of two methods of scoring the ensemble-averaged impedance cardiogram were evaluated. Impedance cardiographic and electrocardiographic signals were recorded from 40 undergraduate men and women during a baseline rest period and a vocal mental arithmetic task period. Recordings were scored by four rates using a conventional method, involving ensemble averaging after careful editing of beat-to-beat waveforms, and a streamlined method, involving ensemble averaging without beat-to-beat editing. Intraclass correlations for interrater reliability exceeded .92, whereas intraclass correlations for concurrent validity exceeded .97, indicating excellent agreement between rates and scoring methods for all cardiac measures. The streamlined method was significantly faster than the conventional method. The results indicate that variations in beat-to-beat editing do not constitute a serious source of error in the ensemble-averaged impedance cardiogram and support the interrater reliability and concurrent validity of the two scoring methods.