[The value of dynamic contrast-enhanced MRI in the differentiation between benign and malignant lacrimal epithelial tumors].

Objective: To investigate the diagnostic performance of multiparametric dynamic contrast-enhanced MRI(DCE-MRI) for the differentiation between benign and malignant larcrimal gland epithelial tumors. Methods: The clinical and imaging data of 104 patients with epithelial tumors of the lacrimal gland who underwent orbital MRI scan and met the inclusion criteria in Beijing Tongren Hospital from January 2011 to December 2017 were retrospectively collected, including 48 males and 56 females, aged from 12 to 77 (43±7) years. Sixty-three cases of benign epithelial tumors and 41 cases of malignant epithelial tumors were examined by DCE-MRI. The parameters of semiquantitative analysis including: time to peak enhancement (Tpeak), maximum enhancement ratio (ERmax), Slope, washout ratio (WR) and time-signal intensity curve (TIC) types. The parameters of quantitative analysis including: volume transfer constant (Ktrans), the extravascular extracellular volume fraction (Ve) and rate constant (Kep). Receiver operating characteristic (ROC) curve analysis was performed for DCE-MRI parameters with statistically significant differences, the area under the curve (AUC) was calculated, the diagnostic threshold was determined, and the diagnostic performance was evaluated. Logistic regression analysis was used to determine the best parameters for differential diagnosis of benign and malignant epithelial tumors of the lacrimal gland. Results: For the semiquantitative analysis of DCE-MRI, malignant lacrimal gland epithelial tumor had a significantly shorter Tpeak than benign masses [(103.77±57.87) s vs (187.80±77.01) s,P<0.001)], while had a higher value in ERmax, Slope [M(Q1,Q3)] and WR in malignant masses compared with benign one [1.55±0.39 vs 1.36±0.33; 1.76 (0.97,2.27) vs 0.62 (0.50,0.93); 7.70%(1.40%, 21.60%)% vs 0(0, 0),all P<0.05)].The TICs of benign lacrimal tumors mainly showed a persistent type (49/63),while most malignant lacrimal tumors mainly showed a plateau type (25/41). For the quantitative analysis of DCE-MRI, the values of Ktrans and Kep[M(Q1,Q3)] in malignant tumors were significantly greater than those of benign tumors (0.99±0.52/min vs 0.43±0.23/min, P<0.001; 1.33(0.83, 1.55)/min vs 0.55(0.46, 0.68)/min, P<0.001). No significant difference in Ve was found between the groups (0.76±0.20 vs 0.73±0.22,P=0.467). Through the statistical analysis, TIC types (OR=3.887,95%CI: 1.409-10.725) and Ktrans(OR=50.979,95%CI: 6.046-429.830) can provide superior diagnostic performance for predicting malignant lacrimal gland epithelial tumors, with a sensitivity of 78.05%, specificity of 77.78%,and sensitivity of 70.73%, specificity of 95.24%, respevtively. Furthermore, the comprehensive diagnostic performance of Ktrans in AUC was proven to be significantly better than that of TIC [0.875 (0.796-0.932) vs 0.798 (0.708-0.870),P=0.049]. Conclusions: Multiparametric DCE-MRI is helpful for the differential diagnosis of benign and malignant epithelial tumors of lacrimal gland. TIC type and Ktrans have higher diagnostic value, and the diagnostic performance of Ktrans is better than that of TIC.

Measurement of the

The ^{18}O(α,γ)^{22}Ne reaction is critical for AGB star nucleosynthesis due to its connection to the abundances of several key isotopes, such as ^{21}Ne and ^{22}Ne. However, the ambiguous resonance energy and spin-parity of the dominant 470 keV resonance leads to substantial uncertainty in the ^{18}O(α,γ)^{22}Ne reaction rate for the temperature of interest. We have measured the resonance energies and strengths of the low-energy resonances in ^{18}O(α,γ)^{22}Ne at the Jinping Underground Nuclear Astrophysics experimental facility (JUNA) with improved precision. The key 470 keV resonance energy has been measured to be E_{α}=474.0±1.1 keV, with such high precision achieved for the first time. The spin-parity of this resonance state is determined to be 1^{-}, removing discrepancies in the resonance strengths in earlier studies. The results significantly improve the precision of the ^{18}O(α,γ)^{22}Ne reaction rates by up to about 10 times compared with the previous data at typical AGB temperatures of 0.1-0.3 GK. We demonstrate that such improvement leads to precise ^{21}Ne abundance predictions, with an impact on probing the origin of meteoritic stardust SiC grains from AGB stars.

Direct Measurement of the Astrophysical

Fluorine is one of the most interesting elements in nuclear astrophysics, where the ^{19}F(p,α)^{16}O reaction is of crucial importance for Galactic ^{19}F abundances and CNO cycle loss in first generation Population III stars. As a day-one campaign at the Jinping Underground Nuclear Astrophysics experimental facility, we report direct measurements of the essential ^{19}F(p,αγ)^{16}O reaction channel. The γ-ray yields were measured over E_{c.m.}=72.4-344 keV, covering the Gamow window; our energy of 72.4 keV is unprecedentedly low, reported here for the first time. The experiment was performed under the extremely low cosmic-ray-induced background environment of the China JinPing Underground Laboratory, one of the deepest underground laboratories in the world. The present low-energy S factors deviate significantly from previous theoretical predictions, and the uncertainties are significantly reduced. The thermonuclear ^{19}F(p,αγ)^{16}O reaction rate has been determined directly at the relevant astrophysical energies.

[Outline of Song's works on the gynecology of traditional Chinese medicine].

Because of long history and excellent medical skills, the Song gynecology is regarded as one of the "four great masters" of the gynecology in Zhejiang province. The monographs survived of Song gynecology are at least four, besides the earliest one Songshi Nüke Cuoyao(, Synopsis of Song's Gynecology)(1612), there is Songshi Bochuan Chanke Quanshu(, Complete Treatise on Gynecology of Song Bochuan), Songshi Nüke Chanhou Pian(, Chapter of Puerperal Disease from Song's Gynecology), which are formed in Qing dynasty, and Linzheng Lu(, Clinical Records) formed in the Republic of China era.And Jingli Songshi Nüke(, Meticulously Sort Out Song's Gynecology), which might belong to School of Song's gynecology, and Nüke Milu(, Secretive Records of Gynecology) were found in records. This paper excavates and sorts these 6 Song's gynecological monographs, carries out in-depth research on the changes of editions, spread and origins, and clarify the general situation of song's gynecological monographs.

[Value of the apparent diffusion coefficient in diffusion weighted imaging at 3.0T MR for differentiating lacrimal gland tumors].

Objective: To investigate the diagnostic value of apparent diffusion coefficient in diffusion weighted imaging at 3.0 T MR for the differentiation in the larcrimal gland tumors. Methods: A total of 73 cases, 36 males and 37 female; mean age 14-81(44±15)years, with lacrimal gland tumors confirmed by pathology in Beijing Tongren Hospital were retrospectively analyzed between January 2011 and April 2016.All cases underwent the preoperative routine MRI and DWI scan, the ADC values were measured in region of interest within the solid zone. The cases were divided into benign and malignant group by the histopathology, according the different pathological categories, the malignant cases were further divided into the epithelial and non-epithelial malignacy. The receiver operating characteristic curve (ROC) was constructed using various cut points of ADC for different parameters to confirm the diagnostic threshold value and evaluate the diagnostic efficacy. Results: There were totally 77 lesions in 73 cases, of which 69 involved unilateral lacrimal gland,4 bilateral lacrimal glands. The mean ADC value of malignant and benign masses in lacrimal gland was (1.36±0.16) and (0.90±0.30)×10(-3) mm(2)/s respectively. There was significantly statistical difference between the both(t=-8.319, P<0.01). The mean ADC value of epithelial and non-epithelial malignacy in lacrimal gland was (1.08±0.18) and (0.54±0.09)×10(-3) mm(2)/s respectively. There was significantly statistical difference between the both(t=11.988, P<0.01). The area under the ROC for distinguishing malignant from benign lesions was 0.940. Using an ADC value of 1.275×10(-3) mm(2)/s as the threshold value, the best result obtained had a sensitivity of 94.4%(34/36), specificity of 82.9%(34/41), accuracy of 88.3%(68/77). The area under the ROC for differentiating non-epithelial from epithelial malignacy was 1.0. Using an ADC value of 0.736×10(-3) mm(2)/s as the threshold value, the best result obtained had a sensitivity of 100%, specificity of 100%, accuracy of 100%. Conclusion: The ADC value is helpful in differentiation among different kinds of tumors in lacrimal masses.

Ligand-assisted mechanochemical synthesis of ceria-based catalysts for the selective catalytic reduction of NO by NH3.

CeO2/TiO2 catalysts were fabricated by dry ball milling in the presence or absence of an organic ligand. It was found that the catalysts prepared by ligand-assisted ball milling exhibited high NH3-SCR activities due to the interaction between cerium ions and ligand molecules resulting in good dispersion, a high Ce3+ ratio and high reducibility of cerium species.

[Clinical outcomes of early repair for open orbital fracture].

OBJECTIVE: To investigate the clinical outcomes following early repair for orbital fracture and soft tissue simultaneously for open orbital fractures. METHODS: Retrospective clinical study. This study comprised of 19 patients(20 eyes) with open orbital fracture who underwent surgery within 48 hours in the Second Hospital of Dalian Medical University between August 2011 and August 2014. The wounds were evaluated at the same time and the surgical debridement was done. The surgical exposure was achieved through direct approach and auxiliary cosmetic incisions. Titanium mesh and plate was used for orbital reconstruction. Local flaps or island flaps were used for soft tissue repair. With the post-operative CT scan, the condition of the soft tissue which was herniated, the orbital rim and orbital wall were observed. The measurement of the exophthalmos of both eyes was performed using Hertel exophthalmometer. Compared with the intact eye, the globe displacement (upward or downward) of the reconstructed eye was measured. The follow up duration was 12-24 months. The eye movement, diplopia, restriction of mouth opening, depression of midface, the condition of soft tissue and scar as well as post-operative complications were recorded. Comparison of the reconstructed eye's globe displacement before and after operation were analyzed with wilcoxon signed ranks test. Comparison of the exophthalmos of the reconstructed eye relative to the intact eye were analyzed with t-paired test. RESULTS: In all 19 cases (20 eyes), fractures were anatomically reconstructed, and no cases of infection, titanium mesh and plate migration and rejection occured during the follow-up. Seven cases had eyeball hypoglobus with median 3.0 mm (min 2.0 mm, max 4.0 mm) pre-operatively. The Reconstructed eye globe were corrected in 6 cases and 1 case had residual hypoglobus of 1.0 mm ,median 0.0 mm (min 0.0 mm, max 1.0 mm). The amount of the eye globe displacement between pre-and post-operation was statistically significant(z=-2.40, P<0.05). Enophthalmos was corrected in 16 cases (the mean of posterior globe displacement in reconstructed orbit relative to intact orbit was less than or equal to 2.0mm), but in 2 patients the residual enophthalmos was 3.0 mm. The difference of the exophthalmos of both eyes was not obvious (t=-0.46,P>0.05). Among 20 eyes, 16 patients had restrictive eye movement. After 12 months follow-up, 13 eyes with restrictive eye movement were corrected while the other 3 showed improvement. Eight patients of restriction of mouth opening or midface depression were corrected and no infection complications were noted. There was no flap necrosis in 13 patients of soft tissue defect. CONCLUSION: Surgical treatment of open orbital fractures with simultaneous repair of orbital fracture and soft tissue within 48 hours after trauma could correct enophthalmos, hypoglobus and eye movement function effectively and improve periorbital aesthetics. (Chin J Ophthalmol, 2016, 52: 273-277).

Utilization of lightflecks by seedlings of five dominant tree species of different subtropical forest successional stages under low-light growth conditions.

We selected five typical tree species, including one early-successional species (ES) Pinus massoniana Lamb., two mid-successional species (MS) Schima superba Gardn. et Champ. and Castanopsis fissa (Champ. ex Benth.) Rehd. et Wils. and two late-successional species (LS) Cryptocarya concinna Hance. and Acmena acuminatissima (BI.) Merr et Perry., which represent the plants at three successional periods in Dinghushan subtropical forest succession of southern China. Potted seedlings of the five species were grown under 12% of full sunlight for 36 months. The ES and MS showed the slowest and fastest responses to lightflecks, respectively, which correlated with the rate of stomatal opening. In contrast to P. massoniana and C. concinna, the other three species exhibited a high induction loss. Early-successional species showed the lowest specific leaf area and chlorophyll content, the highest photosynthetic capacity (A(max)) and respiratory carbon losses (R(d)). Compared with ES and MS, LS showed lower A(max) and R(d). The five tree species showed a similar chlorophyll a/b ratio after long-term low-light adaptations. On the other hand, LS had a relatively higher de-epoxidation state to protect themselves from excess light during lightflecks. Our results indicated that (i) slower responses to lightflecks could partially explain why ES species could not achieve seedling regeneration in low-light conditions; (ii) fast responses to lightflecks could partially explain why MS species could achieve seedling regeneration in low-light conditions; and (iii) smaller respiratory carbon losses might confer on the LS species a competitive advantage in low-light conditions.

The performance and application of fly ash modified by PDMDAAC.

Fly ash modification by polydimethydiallylammonium chloride (PDMDAAC) in laboratory scale was explored in this work and the adsorption performance of modified fly ash and its application in dyeing wastewater treatment were also studied. The key factors (concentration and temperature) for PDMDAAC to affect the adsorption properties of fly ash (FA) were revealed using the orthogonal test with four factors. The results indicated that the adsorption magnitude of fly ash to PDMDAAC increased due to its favorable specific surface causing the change of the surface charge nature. Hence, adsorption performance of modified fly ash on organic molecules and its ion exchange capacity are strengthened. The maximum color removal efficiency was obtained as 88.2% by modified fly ash with 2.0 g/100 mL dosage in dyeing wastewater, which is much higher than 12.5% color removal efficiency by raw fly ash with the same dosage. And, the used modified fly ash could be used for cement production as additive agent. The intensity of cement produced with 15% the modified fly ash in weight reached the Chinese Cement Standard (GB/T17671-1999), blazing a promising novel way in fly ash utilization.

Symbiosis of Mycoplasma hominis in Trichomonas vaginalis may link metronidazole resistance in vitro.

Fourteen of 28 Trichomonas vaginalis isolates collected from patients in Guangzhou, China from 2003 to 2004 were found to be naturally infected with Mycoplasma hominis, as determined by PCR using specific primers. In vitro metronidazole sensitivity assay of the 28 isolates revealed four displaying low susceptibility [minimum lethal concentration (MLC)= approximately 13-25 microg/ml] and another four displaying high resistance (MLC=50-100 microg/ml). The overwhelming majority of these resistant isolates (7/8) were mycoplasma-infected. The mean of MLCs of mycoplasma-infected isolates is approximately 10-fold higher than the mean of noninfected isolates (p=0.029). Sequence analyses of PCR-amplified small subunit-large subunit rRNA interspacer regions (ITS1/5.8S/ITS2) revealed that 23 of the 28 samples are identical, the remaining five being separable into two groups, each with a single point mutation. These internal transcribed spacer sequence variants are associated neither with mycoplasma infection nor with drug resistance. In contrast, random amplified polymorphic DNA analyses of DNAs using 10 different primers showed that the drug-resistant isolates are clustered together in association with mycoplasma infection, albeit more loosely. Taken together, the results obtained from this study suggest that in vitro metronidazole resistance of T. vaginalis is related to mycoplasma infection of this protozoan.

Regulation of p21 and p27 expression by the hepatitis B virus X protein and the alternate initiation site X proteins, AUG2 and AUG3.

BACKGROUND: The hepatitis B virus X gene has three in-frame start codons encoding the pX, AUG2 and AUG3 proteins. The AUG2 and AUG3 genes are 5'-truncated in respect to the full-length pX gene; however, all three genes terminate at the same stop codon. The activity of pX as an oncogene is well characterized; however, less is known about the AUG2 and AUG3 proteins. METHODS: The effects of pX, AUG2 and AUG3 on p21Cip,1/WAF,1/MDA6 and p27Kip-1 cyclin kinase inhibitor (CKI) protein expression, and the impact they have on proliferation, were investigated in CHO K-1 cells. CHO K-1 cells were chosen because they can be transfected at 100% efficiency. RESULTS: p21- and p27-luciferase reporter expression is modulated by increasing doses of the hepatitis B X proteins. At low concentrations of pX or AUG2, p21- and p27-luciferase activity was increased, and at high concentrations, p21- and p27-luciferase activity was decreased. Expression of the AUG3 gene showed a different profile: it was increasingly stimulatory with dose for both promoters. Western blot analyses demonstrated that p21 and p27 protein levels were modulated as predicted based on data generated in the promoter-luciferase experiments. Tritiated thymidine labeling of DNA showed biphasic kinetics of incorporation in the presence of varying pX and AUG2 concentrations, whereas labeling decreased with AUG3 concentration. The growth inhibitory effect of pX expression was reduced by antisense ablation of either p21 or p27. CONCLUSIONS: The relative expression level of pX, AUG2, and AUG3 impacts on CKI expression and cell proliferation. Our findings may explain why divergent effects of pX expression on growth have been observed by different groups, which may be related to relative pX expression levels.

Characterization of the inhibitory effect of PEG-lipid conjugates on the intracellular delivery of plasmid and antisense DNA mediated by cationic lipid liposomes.

Poly(ethylene glycol)-lipid (PEG-lipid) conjugates are widely used in the field of liposomal drug delivery to provide a polymer coat that can confer favorable pharmacokinetic characteristics on particles in the circulation. More recently these lipids have been employed as an essential component in the self-assembly of cationic and neutral lipids with polynucleic acids to form small, stable lipid/DNA complexes that exhibit long circulation times in vivo and accumulate at sites of disease. However, the presence of a steric barrier lipid might be expected to inhibit the transfection activity of lipid/DNA complexes by reducing particle-membrane contact. In this study we examine what effect varying the size of the hydrophobic anchor and hydrophilic head group of PEG-lipids has on both gene and antisense delivery into cells in culture. Lipid/DNA complexes were made using unilamellar vesicles composed of 5 mole% PEG-lipids in combination with equimolar dioleoylphosphatidylethanolamine and the cationic lipid dioleyldimethylammonium chloride. Using HeLa and HepG2 cells we show that under the conditions employed PEG-lipids had a minimal effect on the binding and subsequent endocytosis of lipid/DNA complexes but they severely inhibited active gene transfer and the endosomal release of antisense oligodeoxynucleotides into the cytoplasm. Decreasing the size of the hydrophobic anchor or the size of the grafted hydrophilic PEG moiety enhanced DNA transfer by the complexes.

The social functioning of persons with chronic mental illness: an empirical typology of consumers and correlates of social functioning.

This study examined the typology of consumers and correlates of their social functioning using the Social Functioning Scale (SFS). Data were obtained from 244 outpatients of two psychiatric hospitals and psychiatric ward inpatients in two general hospitals through a structured in-person interview. The typology was generated using Cluster Analysis, and the profile of each group was further examined. The results indicated that there were four distinct groups of consumers. Multiple regression analysis revealed that consumers' sex, age, education, diagnosis, behavioral problems, family caregivers' age, employment status, and overall social support were significantly associated with consumers' social functioning. The implications for previous research findings and psychiatric rehabilitation service are discussed.

Effect of combination therapy including protease inhibitors on mortality among children and adolescents infected with HIV-1.

BACKGROUND: Combination therapy including protease inhibitors has been shown to be effective in treating adults infected with human immunodeficiency virus type 1 (HIV-1), but there are only limited data regarding the treatment of children and adolescents. METHODS: A cohort of 1028 HIV-1-infected children and adolescents, from birth through 20 years of age, who were enrolled in research clinics in the United States before 1996 was followed prospectively through 1999. We used proportional-hazards regression models to estimate the effect on mortality of combination therapy including protease inhibitors. RESULTS: Seven percent of the subjects were receiving combination therapy including protease inhibitors in 1996; by 1999, 73 percent were receiving such therapy. In univariate analyses, a higher base-line percentage of lymphocytes that were CD4-positive, a higher weight for age, a higher height for age, black race, Hispanic ethnic background, younger age, and perinatally acquired infection were associated with a longer median time to the initiation of this type of therapy (P<0.001). After adjustment for covariates, the differences among racial and ethnic groups in the time to initiation were not statistically significant. Mortality declined from 5.3 percent in 1996 to 2.1 percent in 1997, 0.9 percent in 1998, and 0.7 percent in 1999 (P for trend <0.001). There were reductions in mortality in all subgroups defined according to age, sex, percentage of CD4+ lymphocytes, educational level of the parent or guardian, and race or ethnic background. In adjusted analyses, the initiation of combination therapy including protease inhibitors was independently associated with reduced mortality (hazard ratio for death, 0.33; 95 percent confidence interval, 0.19 to 0.58; P<0.001). CONCLUSIONS: The use of combination therapy including protease inhibitors has markedly reduced mortality among children and adolescents infected with HIV-1.

Violence exposure and emotional trauma as contributors to adolescents' violent behaviors.

OBJECTIVE: To investigate the degree to which violence exposure and symptoms of psychological trauma are related to adolescents' own violent behaviors. DESIGN AND SETTING: Anonymous self-report questionnaire administered to students in 6 public high schools (grades 9-12). PARTICIPANTS: Sixty-eight percent of the students attending the participating schools during the survey participated in the study (N=3735). Ages ranged from 14 to 19 years; 52% were female; and 35% were African American, 33% white, and 23% Hispanic. RESULTS: Multiple regression analysis determined that violence exposure and symptoms of psychological trauma together explained more than 50% of the variance in both male and female self-reported violent behavior. The independent effects of exposure to violence explained about one quarter of the variance in both male and female adolescents' violent behaviors. Anger was found to be the leading trauma symptom. CONCLUSION: Our findings suggest that health clinicians and other professionals who encounter adolescents should routinely screen them for both exposure to violence and symptoms of anger.

Functional binding between Gbeta and the LIM domain of Ste5 is required to activate the MEKK Ste11.

BACKGROUND: In the budding yeast Saccharomyces cerevisiae, the pheromones that induce haploid cells of opposite cell types to mate activate the Gbeta and Ggamma subunits of a heterotrimeric G protein. These subunits signal through the PAK kinase Ste20 to activate a mitogen-activated protein (MAP) kinase cascade comprising the MEKK Ste11, the MEK Ste7 and two MAP kinases, Fus3 and Kss1. The pathway requires Ste5, a scaffold protein that tethers the MAP kinase cascade enzymes into a high molecular weight complex. Ste5 is thought to associate with Gbeta in a pheromone-independent manner, but it is not known if this interaction affects signaling. RESULTS: A ste5C180A mutant - which expresses Ste5 disrupted in the LIM domain, a putative metal-binding motif that has been proposed to be essential for Ste5 oligomerization - could not transmit the pheromone signal from Gbeta through Ste20 to Ste11. The Ste5C180A protein was impaired in binding Gbeta, although it could oligomerize, bind Ste11, Ste7 and Fus3, facilitate the basal activation of Ste11, and relay the Ste11 signal to MAP kinases. Ste5 bound to Gbeta in a pheromone-dependent manner and preferentially associated with a phosphorylated form of Gbeta in wild-type and ste20Delta, but not in ste5C180A, strains. CONCLUSIONS: Pheromone induces binding of Gbeta to Ste5 through its LIM domain. This binding is essential for activation of Ste11 and is distinct from the ability of Ste5 to oligomerize or to serve as a scaffold and relay the signal from Ste11 to the MAP kinases. Pheromone also induces Ste5-dependent phosphorylation of Gbeta.

Low initial tau phosphorylation in human brain biopsy samples.

A rapid reversible tau phosphorylation at Ser 396/404 was observed in adult human cortical biopsy tissue and rat primary cortical cell cultures. Tau phosphorylation increased usually during the first 20-30 min in phosphate-buffered saline, followed by a decrease. The time course of tau phosphorylation and dephosphorylation in biopsy tissue could be lengthened by culturing in defined, oxygenated medium, instead of in phosphate-buffered saline. Phosphorylation of total protein in biopsy tissue occurred in two phases, with peaks at 30 and 90 min. The first peak of total protein phosphorylation coincided with the peak of tau phosphorylation, although both the first and second peaks of total protein phosphorylation coincided with the first and second peaks of neurofilament-H phosphorylation.

Predictors of depressive symptomatology among lower social class caregivers of persons with chronic mental illness.

This study examined the predictors of depressive symptomatology among caregivers of persons with chronic mental illness. Data were collected through in-person interviews with family caregivers of 103 adults with chronic mental illness who were served by mental health case management agencies. The results indicated that insufficiency of overall social support was the most powerful predictor of caregiver depressive symptomatology. In addition, caregiver burden had a significant unique contribution to caregiver depressive symptomatology, with higher levels of burden associated with greater levels of caregiver depressive symptomatology. Higher levels of client behavioral problems and insufficient support from family members and mental health professionals related to the caregiving role were associated with higher levels of caregiver depressive symptomatology through their associations with caregiver burden. Caregiver race was not significantly related to caregiver burden or to caregiver depressive symptomatology after controlling for other variables. Over two-fifth of White caregivers and over one-quarter of Black caregivers were at risk for clinical depression. Implications for practice and research are discussed.

Adolescents' exposure to violence and associated symptoms of psychological trauma.

OBJECTIVE: To examine the extent to which adolescents are exposed to various types of violence as either victims or witnesses, and the association of such exposure with trauma symptoms; specifically, the hypotheses that exposure to violence will have a positive and significant association with depression, anger, anxiety, dissociation, posttraumatic stress, and total trauma symptoms. DESIGN AND SETTING: The study employed a survey design using an anonymous self-report questionnaire administered to students (grades 9 through 12) in six public high schools during the 1992-1993 school year. PARTICIPANTS: Sixty-eight percent of the students attending the participating schools during the survey participated in the study (N = 3735). Ages ranged from 14 to 19 years; 52% were female; and 35% were African American, 33% white, and 23% Hispanic. RESULTS: All hypotheses were supported. Multiple regression analyses of the total sample revealed that violence exposure variables (and to a lesser extent, demographic variables) explained a significant portion of variance in all trauma symptom scores, including depression (R2 = .31), anger (R2 = .30), dissociation (R2 = .23), posttraumatic stress (R2 = .31), and total trauma (R2 = .37). CONCLUSIONS: A significant and consistent association was demonstrated linking violence exposure to trauma symptoms within a diverse sample of high school students. Our findings give evidence of the need to identify and provide trauma-related services for adolescents who have been exposed to violence.