Purpose This study evaluated psychometric properties of the Patient Health Questionnaire-9 (PHQ-9), the Center for Epidemiological Studies Depression Scale-10 (CESD-10), and the eight-item PROMIS Depression Short Form (PROMIS-D-8; 8b short form) in a sample of individuals living with multiple sclerosis (MS). Research Method Data were collected by a self-reported mailed survey of a community sample of people living with MS (n=455). Factor structure, inter-item reliability, convergent/discriminant validity and assignment to categories of depression severity were examined. Results A one factor, confirmatory factor analytic model had adequate fit for all instruments. Scores on the depression scales were more highly correlated with one another than with scores on measures of pain, sleep disturbance, and fatigue. The CESD-10 categorized about 37% of participants as having significant depressive symptoms. At least moderate depression was indicated for 24% of participants by PHQ-9. PROMIS-D-8 identified 19% of participants as having at least moderate depressive symptoms and about 7% having at least moderately-severe depression. None of the examined scales had ceiling effects, but the PROMIS-D-8 had a floor effect. Conclusions Overall, scores on all three scales demonstrated essential unidimensionality and had acceptable inter-item reliability and convergent/discriminant validity. Researchers and clinicians can choose any of these scales to measure depressive symptoms in individuals living with MS. The PHQ-9 offers validated cut off scores for diagnosing clinical depression. The PROMIS-D-8 measure minimizes the impact of somatic features on the assessment of depression and allows for flexible administration, including Computerize Adaptive Testing (CAT). The CESD-10 measures two aspects of depression, depressed mood and lack of positive affect, while still providing an interpretable total score.

Background-Sleep disturbance in multiple sclerosis has received little research attention despite the potential influence it may have on disease impact.

Large-scale changes in climate may have many unexpected effects on ecosystems, given the importance of climate as a control over almost all ecosystem attributes and their many internal feedbacks. In particular, the interactions among energy flux, plant dynamics, and soil carbon and nutrient cycling are poorly known. In this study, we examined biotic controls over soil temperature and evapotranspiration (ET) in a climate change experiment in two peatlands, a bog and a fen. Bogs are isolated from groundwater inputs (i.e., ombrogenous) and are acidic, whereas fens receive groundwater inputs (i.e., minerogenous) and are more alkaline. They also have many associated differences in soil chemistry, nutrient availability, and plant communities.We removed 27 intact peat monoliths each from a bog and a fen in northern Minnesota to construct a large mesocosm facility that allows for direct manipulation of climatic variables in a replicated experimental design. The treatment design was a fully crossed factorial with three infrared-loading treatments, three water table treatments, and two ecosystem types (bogs and fens), with three replicates of all treatment combinations. Heating was achieved with overhead infrared lamps, so soil temperature was a dependent variable.Increased infrared loading caused mean monthly soil temperature to increase by 1.6Њ-4.1ЊC at 15 cm depth during the growing season (May-October). The soil temperature response was strongly seasonal, with much greater effects during the growing season than during the winter. Within the growing season, heating caused greater increases in soil temperature in May-June in the bog plots and in May-June and September-October in the fen plots. Occasionally during the winter, increased infrared loading cooled the soil by up to 5.1ЊC, probably due to melting of the insulating snow cover. Fen plots were on average 0.8Њ-1.0ЊC warmer than bog plots during the growing season, although bog plots had a steeper soil temperature gradient with depth. Water level had no effect on soil temperature.Annual ET was 12-23% greater in the bog plots than in the fen plots, at least partially explaining the cooler soil temperatures in the bog plots due to latent heat of evaporation. Additionally, warmer, wetter conditions increased ET. In the fen plots, ET was more sensitive to water table depth than in the bog plots. Differences in the composition and seasonality of the plant canopies accounted for much of the observed differences in ET between bog and fen mesocosms, and hence soil temperature. We present a conceptual model of how above-and belowground ecosystem processes control energy fluxes in northern peatlands and suggest that such controls represent a general phenomenon that should be incorporated into climate change models that include biotic feedbacks.

The themes derived from this study can be used to help occupational rehabilitation professionals develop educational and marketing interventions to improve employers' attitudes toward hiring and retaining individuals with disabilities.

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Background/Objective: To determine the information needs, level of Internet access, and current and preferred formats and sources of information of adults with spinal cord injuries (SCIs). Individuals with SCIs have a high lifetime risk for medical complications and other health conditions secondary to their injury. Many secondary conditions can be prevented or mitigated through appropriate self-care and/or selfmanagement. People with SCIs need timely, high-quality information about health and medical issues after discharge and throughout their lifetime to improve self-care and maximize quality of life. Methods: A survey was administered as part of the third time point of a longitudinal research study on individuals with SCI. Results: A total of 80.2% of the 277 respondents reported having Internet access. The most frequently selected format used currently and preferred by respondents for receiving SCI information was ''Web pages/ Internet.'' The top-ranked current and preferred source of SCI information was from a ''Physician: SCI Expert/ Rehabilitation Specialist.'' Respondents reported needing information on medical issues the most. Significantly higher percentages of individuals identified as ''white'' and with higher education levels had access to the Internet and ranked the selection of Web pages/Internet as their top choice. Conclusions: Results confirm that, although people with SCI prefer to receive SCI information from SCI experts, the Internet is a more accessible and more currently used source. Educational level and race predicted current and preferred use of the Internet for obtaining SCI information, suggesting that Internet distribution of SCI information will exclude subgroups.

Background/Objective: Depression has been studied extensively among people with spinal cord injury (SCI). However, basic questions persist regarding the reliability and validity of depression measurement in the context of SCI. The objective of this study was to evaluate the state of knowledge of depression measurement in persons with SCI. Methods: English-language peer-reviewed citations from MEDLINE, CINAHL, PsycINFO, ProQuest, Google Scholar, and Web of Science from 1980 to present. Two reviewers screened 377 abstracts on SCI and depression topics to identify 144 containing classifiable psychometric data. All 144 were reviewed by 6 reviewers. Twenty-four studies reporting psychometric data on 7 depression measures in SCI samples were identified, including 7 validity studies. Results: Reliability data were limited to internal consistency and were consistently good to excellent across 19 studies. Validity data were limited to concurrent validity, construct validity, and/or clinical utility in 10 studies. Measures were comparable with respect to internal consistency, factor structure, and clinical utility. Results are limited to peer-reviewed, English literature, and studies were not judged for quality. Conclusions: Greater attention should be paid to the psychometric evaluation of established measures. Although existing evidence may not justify universal screening, we recommend depression screening in clinical practice when patients may be seen by nonpsychology personnel. There is insufficient evidence to recommend one screening measure over another. Therefore, selection of measures will depend on clinician preferences. Psychometric studies are needed to show test-retest reliability, criterion validity, and sensitivity to change to improve depression recognition and treatment.

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