The value of screening for psychiatric disorders in rheumatology referrals

BACKGROUND: Musculoskeletal complaints are common and often unexplained and often lead to rheumatology referrals. The prevalence of psychiatric disease in patients with musculoskeletal complaints is unknown. OBJECTIVES: To determine the prevalence of common psychiatric disorders among patients referred to a rheumatology clinic and the likelihood of establishing a rheumatic diagnosis if a psychiatric disorder is present. DESIGN: Prospective diagnostic survey. SETTING: Two hospital-based rheumatology clinics and a general medicine clinic. PARTICIPANTS: A consecutive sample of newly referred patients (n = 185) and their rheumatologists (n = 9). INTERVENTION: Before their visit, all patients filled out a self-administered version of PRIME-MD (Primary Care Evaluation of Mental Disorders), a questionnaire that makes Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition: Primary Care Version, diagnoses of depressive, anxiety, and somatoform disorders. After the visit, the study rheumatologists, who were unaware of the PRIME-MD results, completed a questionnaire regarding their diagnostic assessment. These patients were compared with 210 patients with musculoskeletal complaints who were cared for in a general medicine clinic. MAIN OUTCOME MEASURES: Psychiatric and rheumatic disorders. RESULTS: Compared with patients with musculoskeletal complaints in a general medicine clinic, patients referred to a rheumatology clinic had a higher prevalence of psychiatric disease (40% vs 29%; P = .008), had an almost 2-fold higher prevalence of anxiety disorders, and were more likely to have multiple psychiatric disorders (odds ratio = 2.70, 95% confidence interval = 1.50-5.00). The likelihood of a psychiatric disorder differed among patients with connective tissue disease, nonsystemic articular or periarticular disorders, and nonarticular disorders (27%, 38%, 55%, respectively; P = .006). In a best-fitting logistic regression model, psychiatric disorders markedly decreased the likelihood of a connective tissue disease (odds ratio = 0.24, 95% confidence interval = 0.09-0.62). CONCLUSIONS: Forty percent of patients referred to a rheumatology clinic in this study had a psychiatric disorder, and its presence predicted a lower likelihood of a connective tissue disease. Prospective studies are needed to determine if screening for psychiatric disease before referring patients with unexplained musculoskeletal complaints would reduce costs or improve recognition of potentially treatable psychiatric disorders.     

Latent structure of strategies used to cope with nociceptive stimulation.

Investigated the latent cognitive structure of 32 undergraduates' perceptions of coping strategies used by 50 college students exposed to a cold pressor test or a muscle ischemia task, using multidimensional scaling (MDS). The resulting strategy clusters (e.g., behavioral activity, pleasant imaginings) were grouped into sensation acknowledging, coping relevance, and cognitive/behavioral dimensions. Using different methodology and MDS analysis, 22 undergraduates' perceptions of the 3 coping strategies were examined. There was close correspondence between the resulting dimensions and those of the 1st sample. Results show that Ss preferred strategies that ignored pain sensations and suggest a method for assessing relative efficiency of coping strategies for pain. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of factor structures and criterion-related validity coefficients for two measures of personality based on the five factor model.

The factor structure and criterion-related validity for 2 types of personality measures that are based on 5 factor models were studied. Confirmatory factor analysis was used to compare a 5 versus 6 factor model in an applied setting. In addition, criterion-related validity coefficients were examined for the 2 inventories. Two Big Five measures were used—1 was an adjective-based bipolar inventory and the other was a questionnaire (NEO-Personality Inventory; PI)—to shed light on the relationships between inventory characteristics, factor structure, and criterion-related validity. The sample consisted of 423 flight attendant trainees. Results indicated that the 6 factor model provided a better fit for both measures compared with the 5 factor model. Scales from the NEO-PI were significantly correlated with measures of training success, whereas scales from the bipolar inventory were not. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Radial temperature differences during the melt spinning of fibers

In this investigation, a numerical model was developed to predict the temperature distribution in a fiber during melt spinning. This model uses the implicit Crank–Nicolson method to solve the governing differential equation for the problem. The model was applied to a series of numerical experiments on a liquid crystalline fiber which is melt-spun. These simulations used typical sets of operating conditions to determine the effect of various operating parameters on the predicted radius profile, spinline tension, and temperature distribution. The effects of spinneret capillary diameter, mass flow rate, ambient air temperature, spinning temperature, and elongational viscosity were investigated. The results of the various runs showed that ambient air temperature and mass flow rate had a significant effect on the predicted radius profile, spinline tension, and temperature distribution. The spinning temperature was an important parameter, but its only significant effect was on the spinline tension. Spinneret capillary diameter and elongational viscosity had little effect on the predicted results.     

Maternal evaluation of social reinforcement and time-out: Effects of brief parent training.

28 21–40 yr old middle-class mothers and their noncompliant children, ages 2.6–6.6 yrs, participated in 1 of 3 treatment (social reinforcement, time-out, and social reinforcement plus time-out) conditions or a no-treatment control. Results indicate that in addition to producing greater reductions in noncompliant behavior, time-out is rated as comparable in acceptability to social reinforcement. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Genetic control of male fertility in Arabidopsis thaliana: structural analyses of postmeiotic developmental mutants

Seven new male-sterile mutants (ms7-ms13) of Arabidopsis thaliana (L.) Heynh. (ecotype columbia) are described that show a postmeiotic defect of microspore development. In ms9 mutants, microspores recently released from the tetrad appear irregular in shape and are often without exines. The earliest evidence of abnormality in ms12 mutants is degeneration of microspores that lack normal exine sculpturing, suggesting that the MS12 product is important in the formation of pollen exine. Teratomes (abnormally enlarged microsporocytes) are also occasionally present and each has a poorly developed exine. In ms7 mutant plants, the tapetal cytoplasm disintegrates at the late vacuolate microspore stage, apparently causing the degeneration of microspores and pollen grains. With ms8 mutants, the exine of the microspores appears similar to that of the wild type. However, intine development appears impaired and pollen grains rupture prior to maturity. In ms11 mutants, the first detectable abnormality appears at the mid to late vacuolate stage. The absence of fluorescence in the microspores and tapetal cells after staining with 4',6-diamidino-2-phenylindole (DAPI) and the occasional presence of teratomes indicate degradation of DNA. Viable pollen from ms10 mutant plants is dehisced from anthers but appears to have surface abnormalities affecting interaction with the stigma. Pollen only germinates in high-humidity conditions or during in-vitro germination experiments. Mutant plants also have bright-green stems, suggesting that ms10 belongs to the eceriferum (cer) class of mutants. However, ms10 and cer6 are non-allelic. The ms13 mutant has a similar phenotype to ms10, suggesting is also an eceriferum mutation. Each of these seven mutants had a greater number of flowers than congenic male-fertile plants. The non-allelic nature of these mutants and their different developmental end-points indicate that seven different genes important for the later stages of pollen development have been identified.     

A new, more powerful approach to multitrait-multimethod analyses: Application of second-order confirmatory factor analysis.

The advantages of applying confirmatory factor analysis (CFA) to multitrait–multimethod (MTMM) data are widely recognized. However, because CFA, as traditionally applied to MTMM data, incorporates single indicators of each scale (i.e., each trait–method combination), important weaknesses are the failure to (a) correct appropriately for measurement error in scale scores, (b) separate error due to low internal consistency from uniqueness due to weak trait or method effects, (c) test whether items or subscales accurately reflect the intended factor structure, and (d) test for correlated uniquenesses. However, when the analysis begins with multiple indicators of each scale (i.e., items or subscales), second-order factor analysis can be used to address each of these problems. In this approach, first-order factors defined by multiple items or subscales are posited for each scale, and the method and trait factors are posited as second-order factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact shock and penetration fragmentation in porous media

In this paper, we discuss experimental, analytical, and computational techniques for studying the high velocity interaction of solid bodies with low density media. We assume that the velocity of the interaction is such that compressible effects in the solid are important. We are particularly interested in the dynamic mechanisms of deformation, erosion, and breakup which dominate the solid response at these high velocities. This is a problem of considerable current interest. Applications include the atmospheric propagation of high velocity aerosols, such as those that might be created in certain kinds of nuclear reactor accidents and explosive weapon accidents. An even more novel application is to the study of the impact of astrophysical bodies, such as meteors, asteroids, and comet fragments into planetary atmospheres. There is significant concern over the threats posed by impacts of these kinds on the earth. We will discuss the application of our methodology to understanding these impacts. In particular, we suggest that the experimental technique we present is applicable to scaled laboratory simulations of some of the phenomena that are believed to be important in atmospheric impacts.