Jerry C. Parker

To evaluate the capabilities and resources of free and charitable clinics in the United States to deliver musculoskeletal care to an indigent population.

Over the past seven years, the Air Force Research Laboratory in Albuquerque, NM has been working in close collaboration with Los Alamos National Laboratory on their field-reversed configuration (FRC) experiment, FRX-L. Through these joint efforts a second experiment has been designed and is now being assembled and tested at the AFRL. This new experiment, which is referred to as the FRC Heating Experiment (FRCHX), has the goal of not only forming a plasma in a field-reversed configuration but of also translating it into an aluminum flux conserving shell (solid liner), where it will be subsequently heated through rapid compression of the liner. The FRC formation portion of FRCHX has been designed to closely match the electrical properties of FRX-L so that FRCs of similar parameters can be formed. Likewise, the translation portion of FRCHX, which has been designed and fabricated concurrently with the new translation section of FRX-L, also closely matches that of FRX-L. The design approach being taken to compressively heat the FRC in the final portion of FRCHX relies on the experimental setup used during two earlier “deformable-contact” vacuum liner experiments that were performed with the Shiva Star Capacitor Bank. In these experiments the liner electrodes had 8-cm-diameter holes on their axes, and both tests were found to be successful in that the ends of the 10-cm diameter, 30-cm long aluminum liner stretched and maintained contact with the electrodes while the body of the liner glided radially inward to implode uniformly. This presentation focuses on the system design and integration of the first two portions of the FRCHX experiment, the FRC formation and translation sections. The measured and/or intended performance of each are discussed, along with the various magnetic and plasma diagnostics that are being fielded in both sections. The remaining tasks to be accomplished before a complete FRC formation, translation, and compression experiment can be performed are also outlined at the end.

Objective: The purpose was to examine the relationship of pre-existing psychiatric history to pain reports in a cohort of persons with RA and concomitant major depression who were receiving a trial of antidepressant medication. Method: RA patients (n = 41) with a current episode of major depression were divided into two subgroups comprised of those with a previous psychiatric history (PSY+) (n = 20) and those without a previous psychiatric history (PSY-) (n = 21). The groups were compared with regard to their responsiveness to a regimen of antidepressive medication on measures of depression, pain, coping, and life stress over a period of 15 months. Results: Although depression scores for both the PSY+ and the PSY- groups decreased significantly from baseline to 15-month follow-up, the composite pain score was found to be significantly decreased only for the PSY- group. Conclusion: Psychiatric history appears to predispose persons with concomitant RA and major depression to report less pain reduction following antidepressive treatment than those persons without a psychiatric history.

Objective: To examine several methods of determining reliability of change constructs in depressive symptoms in patients with rheumatoid arthritis (RA) and to demonstrate the strengths, weaknesses, and uses of each method.Methods: Data were analyzed from a cohort of 54 persons with RA who participated in a combined behavioral/pharmacologic intervention of 15 months duration. These longitudinal data were used to examine 3 methodologies for assessing the reliability of change for various measures of depression. The specific methodologies involved the calculations of reliable change, sensitivity to change, and reliability of the change score.Results: The analyses demonstrated differences in reliability of change performance across the various depression measures, which suggest that no single measure of depression for persons with RA should be considered superior in all contexts.Conclusion: The findings highlight the value of utilizing reliability of change constructs when examining changes in depressive symptoms over time.

Research has established a link between health status and symptoms of depression in persons with rheumatoid arthritis (RA), but the effects of "cognitive coping" variables have not been extensively studied. We examined the mediator effect of a cognitive coping variable (Pain Control and Rational Thinking factor score from the Coping Strategies Questionnaire) over the course of a pharmacological intervention. Data were analyzed from 54 persons with RA, all of whom met diagnostic criteria for major depression. Measures of depression, health status, and cognitive coping were collected at 4 different stages of a pharmacological (antidepressant) study as follows: (1) at baseline, (2) postintervention, (3) 6 month followup, and (4) 15 month followup. Results indicated that a direct relationship existed between health status and depression at all 4 time periods. However, this relationship was mediated by cognitive coping only at the postintervention and the 6 month followup. A cognitive coping variable was found to mediate the relationship between health status and depression, but only at moderate levels of depression.

An experiment to form, translate, and adiabatically compress plasmas in field-reversed configurations (FRC's) is now being designed at the Air Force Research Laboratory in Albuquerque, NM. This experiment is referred to as "F-LINCX", for Formation, LINer Compression experiment. Over the past six years, the AFRL has been working in close collaboration with Los Alamos National Laboratory's FRC formation experiment, FRX-L. The AFRL experiment will reproduce the electrical properties of FRX-L to ensure that FRC's of similar parameters are formed. After formation, the FRC will be translated into the interior of a 10-cm diameter, 30-cm long aluminum solid liner, and the Shiva Star Capacitor Bank will be used to implode the liner and compress the FRC to magnetized target fusion (MTF) relevant densities and temperatures. Based upon FRX-L's present configuration, the FRC formation will require four separate capacitor banks. These banks include two slow rise-time banks to first establish a bias magnetic field in a 10-cm diameter, 36-to- 45-cm long theta discharge region and higher-intensity cusp fields at both ends of this region. Inside the theta discharge region will be a 50 to 100 mTorr deuterium pre- fill; a fast bank will pre-ionize this gas with an oscillating field comparable to the bias field. The last bank will drive a reverse-field in the theta discharge region with an amplitude approximately 10 times greater than the initial bias field. This bank will be crowbarred to lengthen decay time and FRC lifetime. To translate the FRC from the theta discharge region to the liner, one or two additional slow banks are needed to set up a guide field and a mirror field at the opposite end of the liner. The status of the F-LINCX experiment is discussed, along with relevant circuit and hardware designs for the capacitor banks. A proposed design for the integrated theta discharge, translation, and liner implosion regions is also presented.

Objective: To examine the level of anxiety experienced by individuals with rheumatoid arthritis (RA).Methods: Data from 2 previous studies were used to compare the level of anxiety (measured by the State‐Trait Anxiety Inventory) in the following 4 subgroups: a general RA sample, a general osteoarthritis sample, a sample with both RA and major depression, and a normative sample of age‐equivalent, working adults. Canonical correlations were used to examine associations between measures of anxiety and measures of both stress and depression. The relationship between anxiety and duration of RA was also explored.Results: The general RA sample had state anxiety levels that were comparable to the normative sample, although trait anxiety levels were significantly higher (P < 0.001). In addition, individuals with RA who also met criteria for depression exhibited significantly higher levels of both state anxiety (P < 0.0001) and trait anxiety (P < 0.0001) than was observed in the normative sample. Canonical correlations revealed that measures of anxiety were correlated with both measures of depression (r = 0.83) and measures of stress (r = 0.50). Anxiety was not found to be significantly related to RA disease duration.Conclusion: These findings demonstrated that individuals with RA, especially if concomitantly depressed, tend to exhibit levels of anxiety that are generally higher than a normative group of age‐equivalent, working adults. The substantial canonical correlations between anxiety and both depression and stress revealed that anxiety shares variance with these more frequently studied variables in RA. However, anxiety was not found to be related to RA disease duration.