Access to health care continues to be one of the major challenges to individuals, communities, and policy makers. In rural areas, the challenges are especially acute. This article examines the use of digital technology to provide health care services to underserved communities. An experimental telepsychiatry program is used to illustrate the promise and the obstacles to using technology to link communities to advanced health care services.
Alteration in the religious practice of 20 patients hospitalized for treatment of an eating disorder were studied by means of a Religious Attitudes Questionnaire and by psychiatric history. The patients as a group were observant with only one (5%) claiming no religious affiliation. Two‐thirds of the patients who regularly participated in Communion decreased their frequency of reception (p < .01) because of fear of the calories in the Communion elements. Attendance at church or synagogue activities where food was present was significantly decreased (p < .005). In contrast, participation in fasting activities increased. We conclude that (1) religious practice is significantly altered by the presence of an eating disorder requiring hospitalization, (2) the fear of fatness pervades even the existential and spiritual life of eating disorder patients, cutting them off from a potential source of support, structure and comfort, (3) considerations of the religious activity of psychiatric patients are often neglected in history taking and treatment.
Objective:The results of past research have identified changes in brain structure in anorexia nervosa. We observed previously unreported MRI alterations in two cases of anorexia nervosa. Method: For both cases, we reviewed the clinical history, MRI scans and conducted a pertinent literature review. Results: The MRI brain scans of two patients with the diagnosis of anorexia nervosa revealed evidence of subcortical hyperintense changes on T2-weighted images. Discussion: No previous reports of these findings have been described in the literature on anorexia nervosa to date. Clinical and pathologic correlates associated with these brain observations in anorexia nervosa are discussed.
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