A novel approach to studying early knee osteoarthritis illustrates that bilateral medial tibiofemoral osteoarthritis is a heritable phenotype: an offspring study.

To assess the potential of studying offspring of people with and without knee osteoarthritis to understand the risk factors and heritability for knee osteoarthritis. We selected two groups of Osteoarthritis Initiative (OAI) participants from one clinical site: (1) participants with bilateral radiographic medial tibiofemoral osteoarthritis and (2) those without tibiofemoral osteoarthritis. We then invited biological offspring ≥ 18 years old to complete an online survey that inquired about osteoarthritis risk factors and symptoms. Among the survey respondents, we recruited ten offspring of members from each group for a clinic visit with bilateral knee posterior-anterior radiographs and magnetic resonance imaging of the right knee. We established contact with 269/413 (65%) eligible OAI participants. Most (227/269, 84%) had ≥ 1 eligible biological offspring, and 213 (94%) were willing to share information about the new family study with their offspring. Our survey was completed by 188 offspring from 110 OAI participants: mean age of 43.0 (10.4) years, mean body mass index of 23.7 (5.9) kg/m2, 65% female. Offspring obesity (OR = 2.7, 95% CI 1.0-7.3), hypertension (OR = 3.7, 95% CI 1.2-11.3), and Heberden's nodes (OR = 3.6, 95% CI 1.0-13.2) were associated with parental osteoarthritis status; however, adjusted models were not statistically significant. Radiographic tibiofemoral osteoarthritis (16/18 knees vs. 2/20 knees) and meniscal abnormalities (7/9 vs. 2/10 index knees) were more common among offspring with parental osteoarthritis status than not. We established the potential of a novel offspring study design within the OAI, and our results are consistent with bilateral radiographic medial tibiofemoral osteoarthritis being a heritable phenotype of osteoarthritis.

Serious mental illness-Psychology's call to action: If not us, who? If not now, when?

While psychology has much to contribute to the care of individuals living with a serious mental illness (SMI), psychologists have been and continue to be underrepresented as their treatment providers. However, serving those living with an SMI presents an urgent public health need. In this article, we provide an overview of the historical role of psychology in the care of individuals with SMIs, and we argue that a confluence of factors renders this a propitious time for psychologists to increase their commitment to the care of those living with an SMI. These factors include (a) the availability of strengths-based and/or functional assessment tools and effective psychosocial interventions, often created or empirically tested and enhanced by psychologists, (b) the continuing evolution of a recovery movement which brings more optimism to the field, and (c) the establishment, over the past 15 years, of an APA recognized and approved infrastructure to provide and recognize formal SMI Psychology training and expertise. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Training guidelines and competencies for serious mental illness (SMI) psychology.

Individuals with serious mental illness (SMI) face unique and significant challenges that require evidence-based practices and clinicians who have advanced, comprehensive training to provide them. SMI affects about 5.5% of the U.S. population and results in serious health, social, and economic burdens. Despite advancements in treatment over the past 50 years, training programs for psychologists and other mental health providers have failed to keep up with these advances, underutilizing evidence-based assessments and interventions developed specifically for this population and found to be efficacious. To address this, the SMI Psychology Specialty has developed Training Guidelines to establish consistent, high-quality, and evidence-based training for postdoctoral psychologists. This article highlights selected features of the Training Guidelines for SMI Psychology. Although these were developed for postdoctoral training programs in SMI Psychology, they are applicable to training programs at all levels, and we hope that training programs in psychology and other mental health disciplines will incorporate these advances into their curricula. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Fred J. Frese III (1940-2018).

Fred J. Frese III, called a "national treasure" by Mike Hogan, Chair of the President's New Freedom Commission on Mental Health, died July 16, 2018, at his home in Hudson, Ohio, surrounded by his family. Fred was an extraordinary human being who was diagnosed with paranoid schizophrenia and rose to become an influential and accomplished psychologist who inspired all he met. Fred presented Congressional testimony to both Houses of Congress, appeared on several national TV and radio broadcasts, and spoke worldwide. Fred was a fellow of the APA and received the Association's Distinguished Service Award in 1987 and a Presidential Citation in 2005. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Psychosocial Services for Individuals With Serious Mental Illness/Severe Emotional Disturbance: Clinical Practice Guideline Toolkit.

This article presents a short, easy-to-use guideline for clinicians working with people with serious mental illness, particularly those with schizophrenia, schizoaffective disorder, delusional disorders, other psychotic disorders, or depression with significant impact on functioning, and may be of use for those working with individuals with bipolar disorder. This guideline is not meant to supplant the more detailed, excellent clinical practice guidelines that have been developed and published. Rather, the charts and explanation presented here are designed as a step-by-step tool that clinicians can use to ensure they are following the most appropriate course of action and providing the best psychosocial rehabilitation services possible for persons with these disorders. Program managers can use this tool to evaluate the processes used in their system to ensure that appropriate services are offered for the individuals in their care. This guideline is also not meant as a substitute for comprehensive training in the practice of assessment and treatment for individuals with serious mental illness. Very little detail is provided about the disorders, appropriate assessments, and interventions because clinicians providing services to people with these disorders should have received the specialized training necessary to appropriately deliver the services needed by these individuals.

The knee pain map: reliability of a method to identify knee pain location and pattern.

OBJECTIVE: To describe the location and pattern of knee pain in patients with chronic, frequent knee pain using the Knee Pain Map, and to evaluate the inter- and intrarater reliability of the map. METHODS: A cohort of 799 participants from the University of Pittsburgh Osteoarthritis Initiative Clinical Center who had knee pain in the last 12 months were studied. Trained interviewers assessed and recorded participant-reported knee pain patterns into 8 local areas, 4 regional areas, or as diffuse. Inter- and intrarater reliability were assessed using Fleiss' kappa. RESULTS: Participants most often reported localized (69%) followed by regional (14%) or diffuse (10%) knee pain. In those with localized pain, the most commonly reported locations were the medial (56%) and lateral (43%) joint lines. In those with regional pain, the most commonly reported regions were the patella (44%) and medial region (38%). There was excellent interrater reliability for the identification of localized and regional pain patterns (kappa = 0.7-0.9 and 0.7-0.8, respectively). The interrater reliability for specific locations was also excellent (kappa = 0.7-1.0) when the number of participants with pain in a location was >4. For regional pain, the kappa for specific regions varied from 0.7-1.0. CONCLUSION: The majority of participants could identify the location of their knee pain, and trained interviewers could reliably record those locations. The variation in locations suggests that there are multiple sources of pain in knee OA. Additional studies are needed to determine whether specific knee pain patterns correlate with discrete pathologic findings on radiographs or magnetic resonance images.

Downregulation of death-associated protein kinase 1 (DAPK1) in chronic lymphocytic leukemia.

The heritability of B cell chronic lymphocytic leukemia (CLL) is relatively high; however, no predisposing mutation has been convincingly identified. We show that loss or reduced expression of death-associated protein kinase 1 (DAPK1) underlies cases of heritable predisposition to CLL and the majority of sporadic CLL. Epigenetic silencing of DAPK1 by promoter methylation occurs in almost all sporadic CLL cases. Furthermore, we defined a disease haplotype, which segregates with the CLL phenotype in a large family. DAPK1 expression of the CLL allele is downregulated by 75% in germline cells due to increased HOXB7 binding. In the blood cells from affected family members, promoter methylation results in additional loss of DAPK1 expression. Thus, reduced expression of DAPK1 can result from germline predisposition, as well as epigenetic or somatic events causing or contributing to the CLL phenotype.