Objective This study is an examination of sleep, pain, depression, and physical functioning at baseline and 1-year followup among patients with fibromyalgia syndrome (FMS). Although it is clear that these symptoms are prevalent among FMS patients and that they are related, the direction of the relationship is unclear. We sought to identify and report sleep problems in this population and to examine their relationship to pain, depression, and physical functioning. Methods Patients diagnosed with fibromyalgia were recruited from a Southern California health maintenance organization and evaluated according to American College of Rheumatology criteria in the research laboratory. Six hundred patients completed the baseline assessment and 492 completed the 1-year assessment. Measures included the Center for Epidemiologic Studies Depression Scale, the McGill Pain Questionnaire, the Pittsburgh Sleep Quality Index, and the Fibromyalgia Impact Questionnaire. Results The majority of the sample (96% at baseline and 94.7% at 1 year) scored within the range of problem sleepers. Path analyses examined the impact of baseline values on 1-year values for each of the 4 variables. No variable of interest predicted sleep, sleep predicted pain (β = 0.13), pain predicted physical functioning (β = −0.13), and physical functioning predicted depression (β = −0.10). Conclusion These findings highlight the high prevalence of sleep problems in this population and suggest that they play a critical role in exacerbating FMS symptoms. Furthermore, they support limited existing findings that sleep predicts subsequent pain in this population, but also extend the literature, suggesting that sleep may be related to depression through pain and physical functioning.

This study compared the language skills in a group of very low-income toddlers with those of a middle-income sample matched on age and sex. The assessment instrument was the MacArthur Communicative Development Inventory (CDI) for toddlers, a parent report form. The scores for the low-income group were strikingly lower on the three key indices evaluated: size of expressive vocabulary, age of appearance of word combinations, and complexity of utterances. The entire lowincome distribution was shifted about 30% toward the lower end of the middle-income distribution for both productive vocabulary and grammatical development. The magnitude of these income/ social class effects was larger than reported in most prior reports for children in this age range. This finding underscores the cautionary note issued by the CDI developers, which states that the published CDI norms, based on a middle-class sample, may not be directly applicable to low-income samples.A considerable body of evidence indicates that a moderate to strong negative relation exists between language skills and socioeconomic status (SES). The literature is much more complete and more definitive for children over 3 or 4 years of age: children from low-SES families perform at a lower level on both language tasks and a variety of cognitive tasks (Allen,

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Of 1,811 individuals sampled in a metropolitan community, 382 reported having a musculoskeletal complaint. Eighty-four percent of them had used an unconventional remedy within the previous 6 months. Most individuals used inexpensive, unharmful remedies such as exercise, prayer, and relaxation. This study indicates that people with musculoskeletal disorders often use unconventional remedies, but raises questions regarding the seriousness of this problem.

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Ⅲ The present study is an examination of the effects of quality and quantity of social support on the psychological and physical well-being of women with fibromyalgia syndrome (FMS

The present study compared the physical and mental health and the health care use of spouses of patients with fibromyalgia syndrome (FS group; n = 135) with that of spouses of healthy individuals (n = 153). FS group participants reported lower health and affective states and scored higher on depression, loneliness, and subjective stress than comparison group participants (p < .017). Husbands in the FS group who reported more illness impact and whose wives reported worse sleep quality and less self-efficacy had more psychological difficulties. No differences were found in health care costs between groups. These findings suggest that chronic illness in a partner may negatively affect an individual's physical and mental health.

Effects of a community-based literacy program on 1-, 2-, and 3-year-old children's language and conceptual development were assessed. University students were trained to teach Head Start parents effective methods for reading to their children. Families were randomly assigned to receive 18, 3, or 0 instructional visits. Results indicated that parents in the 18-instructional-visit program increased their participation in appropriate literacy behaviors such as reading to their children, teaching concepts to their children, and using the library, more than parents in the 0-instructional-visit groups. Children in the 18-instructional-visit program showed greater gains in language and conceptual development than children in the 0-instructional-visit group. Few differences were found between children in the 3-visit and 0-instructional-visit groups. Thus, only a high-intensity community-based intervention designed to train parents was effective in increasing emergent literacy in low-income ethnic children.