, Melissa Yssel, MB ChB, FC Path(SA) Chem 139, and Wendy M. Zakowicz, BS 79 Purpose: To achieve clinical validation of cutoff values for newborn screening by tandem mass spectrometry through a worldwide collaborative effort. Methods: Cumulative percentiles of amino acids and acylcarnitines in dried blood spots of approximately 25-30 million normal newborns and 10,742 deidentified true positive cases are compared to assign clinical significance, which is achieved when the median of a disorder range is, and usually markedly outside, either the 99th or the 1st percentile of the normal population. The cutoff target ranges of analytes and ratios are then defined as the interval between selected percentiles of the two populations. When overlaps occur, adjustments are made to maximize sensitivity and specificity taking all available factors into consideration.

Depression was studied in a community sample of 962 males and 1555 females aged 55 years and over living in Kentucky in 1981. The sample was representative of the population in Kentucky in that age group and quite similar to that US population. The Center for Epidemiologic Studies Depression Scale was used as a measure of depression, and 13.7% of the males and 18.2% of the females were at or above a previously established cutpoint of 20 for adults over age 55 years. Significant relationships to depression were found in both sexes for age, education, income, housing quality, marital status, and health. For females, the age-depression relationship was not linear. By far the strongest relationship was with self-reported physical health. Significant proportions of those with self-reported kidney or bladder disease, heart trouble, lung trouble, hardening of the arteries, and stroke were above the depression cutpoint. For those conditions, physicians could expect high levels of concomitant depression in about one fourth of males and at least one third of females. These levels of depression were not found for those with high blood pressure, stomach ulcers, cancer, or diabetes. Over half of the sample reported taking prescribed medication and over half had needed a physician's care in the previous six months. Only 3.9% of the males and 3.2% of the females admitted to needing help for mental health problems. Thus, older adults with depression would probably be more likely to seek help from physicians than from services or professionals with explicit mental health labels.

The feasibility and efficacy of Virtual Reality Job Interview Training (VR-JIT) was assessed in a single-blinded randomized controlled trial. Adults with autism spectrum disorder were randomized to VR-JIT (n=16) or treatment as usual (TAU) (n=10) groups. VR-JIT consisted of simulated job interviews with a virtual character and didactic training. Participants attended 90% of lab-based training sessions and found VR-JIT easy-to-use, enjoyable, and they felt prepared for future interviews. VR-JIT participants had greater improvement during live standardized job interview role-play performances than TAU participants (p=0.046). A similar pattern was observed for self-reported self-confidence at a trend level (p=0.060). VR-JIT simulation performance scores increased over time (R-Squared=0.83). Results indicate preliminary support for the feasibility and efficacy of VR-JIT, which can be administered using computer software or via the internet.

This study tested the separate and combined effects of spouse-assisted pain coping skills training (SA-CST) and exercise training (ET) in a sample of patients having persistent osteoarthritic knee pain. Seventy-two married osteoarthritis (OA) patients with persistent knee pain and their spouses were randomly assigned to: SA-CST alone, SA-CST plus ET, ET alone, or standard care (SC). Patients in SA-CST alone, together with their spouses, attended 12 weekly, 2-h group sessions for training in pain coping and couples skills. Patients in SA-CST + ET received spouse-assisted coping skills training and attended 12-weeks supervised ET. Patients in the ET alone condition received just an exercise program. Data analyses revealed: (1) physical fitness and strength: the SA-CST + ET and ET alone groups had significant improvements in physical fitness compared to SA-CST alone and patients in SA-CST + ET and ET alone had significant improvements in leg flexion and extension compared to SA-CST alone and SC, (2) pain coping: patients in SA-CST + ET and SA-CST alone groups had significant improvements in coping attempts compared to ET alone or SC and spouses in SA-CST + ET rated their partners as showing significant improvements in coping attempts compared to ET alone or SC, and (3) self-efficacy: patients in SA-CST + ET reported significant improvements in self-efficacy and their spouses rated them as showing significant improvements in self-efficacy compared to ET alone or SC. Patients receiving SA-CST + ET who showed increased self-efficacy were more likely to have improvements in psychological disability. An intervention that combines spouse-assisted coping skills training and exercise training can improve physical fitness, strength, pain coping, and self-efficacy in patients suffering from pain due to osteoarthritis.