Back pain is one of the major contributors to disability and loss of productivity in modern populations. However, osteological correlates of back pain are often absent or, as yet, unidentified. As bioarchaeologists depend on osteological evidence to interpret quality of life in the past, back pain, with its profound effects on modern populations, is largely overlooked in archaeological samples. This study addresses this shortcoming in bioarchaeological analysis by exploring the relationship between a defined vertebral osteological lesion, the Schmorl's node, and its effect on quality of life in a clinical population. Using patient insight, healthcare practitioner diagnoses and MR imaging analyses, this study investigates:(1) Schmorl's nodes and sociodemographic factors; (2) the number, location and quantitative aspects (e.g. length, depth, area) of Schmorl's nodes, and how these influence the reporting of pain; (3) the dynamic effects of Schmorl's nodes, in combination with other variables, in the reporting of pain; and (4) the perception and impact of pain that patients attribute to Schmorl's nodes with regard to quality-of-life issues. The results of this study indicate that Schmorl's nodes located in the central portion of the vertebral body are significantly associated with patient reporting of pain, and that the presence of osteophytes, in the affected vertebral region, may increase the likelihood that an individual will report pain. This finding provides bioarchaeologists with an osteological correlate to begin interpreting the presence and impact of pain in archaeological populations, with implications for scoring Schmorl's nodes.

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This article describes the development and pilot testing of the Good-Fit Measure (GFM), a measure that public health nurses and other providers involved with planning multidisciplinary violence prevention efforts can use. Themes derived from a series of focus group discussions from a larger study, including individuals (n = 83) from multiple community sectors, guided development of the measure. Participants in three follow-up focus groups (n = 32 participants) reviewed the measure, which was then pilot tested in two phases. Guided by information from the first phase, in which respondents indicated the measure was too complex, the measure was simplified and field tested in phase two. Results from both phases were similar. The GFM score was significantly higher for the program selected by the respondent before completing the measure than the nonselected program (p < 0.01). Participants indicated that the tool was helpful in articulating the specific factors for their decisions. Participants underscored the utility of the tool in facilitating program planning by individual providers and interdisciplinary or multidisciplinary teams. The GFM provides systematic consideration of multiple factors that motivate public health nurses and other community providers in their decision-making process when planning prevention strategies, increasing the likelihood of successful programs.

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