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Neck, back, or hip pain is the most common symptom andis present in approximately 80% of patients [41, 54]. Lack of REM sleep is asso-ciated with anxiety and excitability, as well as diffi cultywith concentration and memory

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Most cases are primarynative arthritis from presumed or proven hematogenous origin with an annual incidenceof 2–10/100,000 persons [2–4].

Frankl may regardsuch acts disapprovingly, although even he claims a limit to understanding,cautioning that it is ultimately impossible to know the moral and emotionalcomplexities that dog human beings facing their own death. Onset isusually in midlife, with a mean survival of 17 years.

The initial structurewas highly simplified compared to the final published modelstructure.