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Developmental delays/disorders in young children are identified as a public health priority. WHO and Autism Speaks co-designed a training programme titled “WHO-Caregiver Skills Training” (WHO-CST) which aims at providing training for caregivers whose children are with possible symptoms of Autism spectrum disorder (ASD) symptoms and pervasive developmental disorders (PDD), so that they can learn better strategies on managing the daily lives of their children and foster better communication between the parent-children dyad. The WHO-CST programme is currently implemented in more than 30 regions worldwide and it started in Hong Kong from 2018. As the programme is newly developed, only a few studies tried to evaluate the effectiveness of the programme in qualitative approaches, or in quantitative approach with relatively small sample (e.g. n < 10). In the present study, our team, who is responsible for the implementation and evaluation of the WHO-CST programme in Hong Kong, attempt to assess the effectiveness of the training in WHO-CST under a randomized controlled trial (RCT) design with about 120 eligible caregivers who will be randomly assigned in experimental and control groups. Our measurement will include the Joint Engagement Rating Inventory (JERI) developed by experts in WHO to gauge how parents engage their children in a 10-minute video recording their dyadic interaction and behaviors in a defined play setting. A set of other measurements on the caregiver’s experience of using intervention skills and their enhancement of knowledges will also be measured. We hypothesize that caregivers in treatment group will have better growth in scores of both JERI and measurements of other outcome than the wait-list control group’s after the 12-week WHO-CST training, and also persistence of skill and knowledge level should also be found after a 30-day follow-up test.

Self-determination is viewed as an important ingredient of successful recovery in psychiatric rehabilitation. The concept of autonomy, a key component of self-determination, may be of less importance in Chinese cultures, whereby an individual's choices may be in conflict with the family's expectations. This study aimed to develop an instrument to measure opinions about self-determination among Chinese consumers and their family members.A 27-item questionnaire, the Consumer and Family Decision Making Scale (CFDMS), was constructed to measure consumers' and family members' views of self-determination in various aspects of daily life. A total of 364 (182 consumers of psychiatric services with a diagnosis of schizophrenia and 182 of their family members) participated in the study.The CFDMS was found to possess good psychometric properties and appears to be a reliable and valid instrument for assessment of consumers' decision making. (The Cronbach's alphas of psychiatric care and treatment factor, personal and social function factor, community and daily living factor, and money management factor were as follows: .86, .89, .87 and .76. The respective test-retest reliabilities were as follows: .81, .89, .80, and .88). Chinese consumers preferred autonomous decision making in regard to personal and social functioning and community and daily living but preferred to defer decisions regarding psychiatric care and treatment and money management to others. Family members and consumers had similar views.Deferring decisions to family members is common in Chinese families. The emphasis on autonomy in Western health care may need to be reconsidered in the treatment of Chinese consumers. Chinese families have a strong influence on treatment decisions, and providers must respect this style and remain nonjudgmental when dealing with situations or decisions that may be contradictory to their own culture and values.

SummaryMacrophages play a dynamic role in tissue repair following injury. Here we found that following streptozotocin (STZ)-induced beta-cell death, mouse islet macrophages expressed increasedIgf1, decreased proinflammatory cytokine expression, and transcriptome changes consistent with macrophages undergoing efferocytosis and having an enhanced state of metabolism. Macrophages were the major, if not sole, contributors to islet IGF-1 production. Adoptive transfer experiments showed that macrophages can maintain insulin secretionin vivofollowing beta-cell death with no effects on islet-cell turnover. IGF-1 neutralization during STZ-treatment decreased insulin secretion without affecting islet-cell apoptosis or proliferation. Interestingly, high fat diet (HFD) combined with STZ further skewed islet macrophages to a reparative state. Finally, islet macrophages fromdb/dbmice also expressed decreased proinflammatory cytokines and increasedIgf1mRNA. These data have important implications for islet biology and pathology and show that islet macrophages preserve their reparative state following beta-cell death even during HFD feeding and severe hyperglycemia.

Disorders of mineral metabolism, including secondary hyperparathyroidism, are thought to contribute to extraskeletal (including vascular) calcification among patients with chronic kidney disease. It has been hypothesized that treatment with the calcimimetic agent cinacalcet might reduce the risk of death or nonfatal cardiovascular events in such patients.In this clinical trial, we randomly assigned 3883 patients with moderate-to-severe secondary hyperparathyroidism (median level of intact parathyroid hormone, 693 pg per milliliter [10th to 90th percentile, 363 to 1694]) who were undergoing hemodialysis to receive either cinacalcet or placebo. All patients were eligible to receive conventional therapy, including phosphate binders, vitamin D sterols, or both. The patients were followed for up to 64 months. The primary composite end point was the time until death, myocardial infarction, hospitalization for unstable angina, heart failure, or a peripheral vascular event. The primary analysis was performed on the basis of the intention-to-treat principle.The median duration of study-drug exposure was 21.2 months in the cinacalcet group, versus 17.5 months in the placebo group. The primary composite end point was reached in 938 of 1948 patients (48.2%) in the cinacalcet group and 952 of 1935 patients (49.2%) in the placebo group (relative hazard in the cinacalcet group vs. the placebo group, 0.93; 95% confidence interval, 0.85 to 1.02; P=0.11). Hypocalcemia and gastrointestinal adverse events were significantly more frequent in patients receiving cinacalcet.In an unadjusted intention-to-treat analysis, cinacalcet did not significantly reduce the risk of death or major cardiovascular events in patients with moderate-to-severe secondary hyperparathyroidism who were undergoing dialysis. (Funded by Amgen; EVOLVE ClinicalTrials.gov number, NCT00345839.).

This monograph, written by the pioneers of IVF and reproductive medicine, celebrates the history, achievements, and medical advancements made over the last 40 years in this rapidly growing field. (C) 2018 by American Society for Reproductive Medicine.

A single specimen of giant leptocephalus Thalassenchelys foliaceus Castle & Raju 1975 was caught in subtropical waters of the western North Pacific. Mitochondrial COI gene sequence divergence between T. foliaceus and Congriscus maldivensis (Norman, 1939) (0.64 ± 0.27%), coupled with differences in myomere and vertebral counts, indicate that T. foliaceus is a junior synonym of C. maldivensis.

This study explored the roles of perceived social support and depression in acceptance of disability among Chinese individuals with spinal cord injuries (SCI). Design: An exploratory and cross-sectional study was conducted in an outpatient rehabilitation center in Guangzhou, China. One hundred Chinese individuals with SCI completed the Multidimensional Scale of Perceived Social Support, Center for Epidemiological Studies Short Depression Scale, and Acceptance of Disability Scale. Results: In general, there was low acceptance of disability and a high prevalence of depression among Chinese individuals with SCI. Higher acceptance of disability was associated with less depressive symptoms and higher level of perceived social support. Furthermore, depression was shown to mediate the relationship between perceived social support and acceptance of disability. Conclusion: Depression is an essential factor in the process of acceptance of disability. Cross-cultural studies are needed to facilitate a better understanding of the adjustment process following disabilities and apply culturally sensitive interventions to promote acceptance of disability.

Work opportunities for people with behaviorally driven health conditions such as HIV/AIDS, drug abuse, alcohol abuse, and psychosis are directly impacted by employer perspectives. To investigate this issue, we report findings from a mixed method design involving qualitative interviews followed by a quantitative survey of employers from Chicago (U.S.), Beijing (China), and Hong Kong (China). Findings from qualitative interviews of 100 employers were used to create 27 items measuring employer perspectives (the Employer Perspective Scale: EPS) about hiring people with health conditions. These perspectives reflect reasons for or against discrimination. In the quantitative phase of the study, representative samples of approximately 300 employers per city were administered the EPS in addition to measures of stigma, including attributions about disease onset and offset. The EPS and stigma scales were completed in the context of one of five randomly assigned health conditions. We weighted data with ratios of key demographics between the sample and the corresponding employer population data. Analyses showed that both onset and offset responsibility varied by behaviorally driven condition. Analyses also showed that employer perspectives were more negative for health conditions that are seen as more behaviorally driven, e.g., drug and alcohol abuse. Chicago employers endorsed onset and offset attributions less strongly compared to those in Hong Kong and Beijing. Chicago employers also recognized more benefits of hiring people with various health conditions. The implications of these findings for better understanding stigma and stigma change among employers are considered.

The Lam Assessment on Stages of Employment Readiness (LASER) was developed to assess welfare recipients' employment readiness. The LASER consists of 14 items corresponding to Prochaska's stages of change model (Prochaska, DiClemente and Norcross, 1992). A sample of 149 welfare recipients from a work training program participated in the study. The Confirmatory Factor Analysis (CFA) supported the three factors structure corresponding to Prochaska's Pre-Contemplation, Contemplation, and Action stages. A cluster analysis classified the sample into three groups according to their LASER scores. A six months follow-up on employment outcomes showed that those who were in Pre-contemplation stage had the poorest employment outcome (25%), those who were in the Action stage had the best outcome (56%) and those in the Contemplation stage were in between (38%). Implications for work rehabilitation and treatment matching were discussed.

This study investigated certified rehabilitation counselors’ (CRCs) attitudes, knowledge, and comfort in addressing disability and sexuality issues. One hundred ninety-nine CRCs completed a modified version of the Knowledge, Comfort, Approach and Attitudes toward Sexuality Scale to determine the effect of knowledge and attitudes on level of comfort in addressing sexuality issues with consumers. Counseling and education-type comfort and comfort with sexual solicitations or discovering consumers in sexual situations (approach) were assessed separately. Participants demonstrated low discomfort on the education and counseling-related comfort scale ( M = 1.84, SD = .82) and medium discomfort on the approach-related comfort scale ( M = 2.78, SD = .96), positive attitudes ( M = 1.53, SD = .74), and average knowledge ( M = 2.40, SD = .842). Results of regression analyses indicated that 17% ( R 2 = .172) of the variance on comfort and 19% ( R2 = .189) of the variance on approach could be accounted for by CRCs’ knowledge and attitude, indicating that these were contributing to CRC comfort levels in addressing sexuality with consumers. Implications include the need for continued research concerning factors affecting CRC comfort in addressing sexuality-related issues with consumers, and the need for increased CRC education and training in sexuality and disability.

Employer attitudes about individuals with disabilities vary with the amount of familiarity and type of disability. This study examined three experience factors of intimacy: experience, culture of employer, and type of disability. One hundred employers (Beijing = 30, Chicago = 40, Hong Kong = 30) were recruited to participate in qualitative interviews about their experiences with disabilities. Researchers coded responses according to employer report of disability experience with a family member, with an acquaintance, or not having experience. Results demonstrated that experiences varied by city. Chicago employers were more likely to report experience with family members than did those from Beijing or Hong Kong. Beijing employers reported more experience with acquaintances than did those from Chicago or Hong Kong. Hong Kong employers were more likely to report no experience with people with disabilities. This paper discusses the results in the context of cultural differences among the three cities.

Employers are primary and necessary agents in the return of people with disabilities to the work force. In this study, employment attitudes about two key constructs for vocational rehabilitation are examined: hiring the person with a disability and accommodating the person with disabilities at work. One hundred employers from Beijing, Hong Kong, and Chicago were surveyed regarding their attitudes. Results showed employers from Beijing were less likely to endorse hiring people with disabilities compared with those from Chicago and Hong Kong. In addition, people with psychiatric disabilities were less likely to be hired compared with those with physical disabilities. No clear pattern by city emerged for accommodations. Reasons why this pattern of attitudes emerged are discussed. Implications of these findings for attitude change are also considered.

We investigated the long-term effects of an information and communication technology (ICT) training programme for people with intellectual disabilities (ID). A community-based ICT training programme was designed to enhance the computer skills of people with ID and prepare them to make use of ICT in their daily life. Of the 100 who had participated in the original ICT training programme, 59 of them and their caregivers agreed to participate in the follow-up interview. A computer skills checklist was used to assess the ICT competence of the participants before training, after training, and at the 6-month follow-up assessment. All caregivers were interviewed at the 6-month follow-up session to explore the use of ICT by people with ID and their needs for further training. Results from repeated measures ANOVA showed that participants maintained at the 6-month follow-up the basic ICT skills that they acquired during training [F=13.86, p0.001]. Caregivers reported that participants spent more time in using the computers, but still needed occasional guidance. They also reported a need to advance their ICT skills beyond the basic computer training. We concluded that ICT training for people with ID would help them in maximizing the benefits of information technology via computers.

Employment discrimination is considered as a major impediment to community integration for people with serious mental illness, yet little is known about how the problem manifests differently across western and non-western societies. We developed a lay model based on Chinese beliefs and values in terms of Confucianism, Taoism, Buddhism, and folk religions which may be used to explain cross-cultural variation in mental illness stigma, particularly in the arena of employment discrimination. In this study, we tested this lay approach by comparing employers' concerns about hiring people with psychotic disorder for entry-level jobs in US and China.One hundred employers (40 from Chicago, 30 from Hong Kong, and 30 from Beijing) were randomly recruited from small size firms and interviewed by certified interviewers using a semi-structured interview guide designed for this study. Content analysis was used to derive themes, which in turn were compared across the three sites using chi-square tests.Analyses reveal that employers express a range of concerns about hiring an employee with mental illness. Although some concerns were raised with equal frequency across sites, comparisons showed that, relative to US employers, Chinese employers were significantly more likely to perceive that people with mental illness would exhibit a weaker work ethic and less loyalty to the company. Comparison of themes also suggests that employers in China were more people-oriented while employers in US were more task-oriented.Cultural differences existed among employers which supported the lay theory of mental illness.

In China, the lifespan of many buildings is short even by modern standards. The high turnover rate has resulted in an existing building stock that is fairly young. Zhu & Lin (2004) projected that by 2015, half of China’s existing building stock will have been built after 2000. In 2010, Chen Huai, director of the policy research centre at the Ministry of Housing and Urban-Rural Development, stated that “Only those homes built after 1999 are likely to be preserved in the longer term” due to perceived safety and functionality deficits in older buildings (Qian 2010).

A reading test for Spanish speakers in the United States was developed called the Word Accentuation Test-Chicago. The construction and validation of this 40 item test was modeled after reading tests developed in Spain and Argentina, and is based on irregular accentuation of words. The Word Accentuation Test-Chicago was validated on 45 community participants using the Wechsler Adult Intelligence Scale-III in Spanish. Better reading performance was associated with higher intelligence test performance, with an additional 5% of the variation in intelligence score accounted for by reading performance after controlling for age and education. These results indicate that the Word Accentuation Test-Chicago is a psychometrically sound measure of Spanish reading ability that is robustly related to general cognitive ability.

This article reports the results of a survey conducted in order to determine the professional disclosure practices of rehabilitation counselors in both the public and the private sector. Counselors were surveyed regarding the content, the circumstances, the timing, and the format of their disclosure. They were also asked to share their opinions about the use of written forms and about professional disclosure in general. A descriptive analysis revealed that although some information is routinely disclosed, many kinds of information (e.g., treatment risks, limits of confidentiality) that are generally considered very important in the disclosure process are not disclosed to all clients and/or are not disclosed at the outset of the counseling relationship. Several differences in practice between counselors in the public and private sectors were identified. Implications for ethical practice and risk management related to professional disclosure were discussed.

This article examined factors influencing rehabilitation counseling students' attitudes toward people with disabilities in three social contexts, using a conjoint analysis design. A total of 98 graduate students participated in this study. A conjoint measurement of 38 cards (representing people with varying disability type, gender, ethnicity, age, education, and employment status) was used. The authors found that (a) disability-related factors were heavily involved in the preference-making process, (b) attitude or preference formation was also significantly affected by other client characteristics unrelated to disability, and (c) factors influencing attitude/preference formation were similar across the three social contexts. Conjoint analysis could increase our ability to understand factors contributing to the formation of attitudes/preferences in multiple social contexts.

OBJECTIVE: To describe the quality of life (QOL) and psychosocial outcomes of a sample of adults with traumatic brain injury in 50 community dwelling adults with traumatic brain injury and examine the associations among these variables. DESIGN: Cross-sectional. RESULTS: Mean QOL rating was low average. Standardized measures had acceptable internal reliability and normal distributions in this sample. Subjects had significantly lower QOL and social support, higher negative affect, and similar positive affect and spirituality compared with standardization and other nondisabled samples. They also had a significantly higher level of community integration than other traumatic brain injury samples. Regression analyses suggested that social support, community integration, and positive affect make a unique and significant contribution to the QOL variance with R of 0.492. The addition of spirituality reduced their respective unique variance, reducing positive affect to nonsignificant levels due to their high intercorrelation. CONCLUSIONS: Findings suggest that this sample experiences a wide range of QOL. Factors significantly associated with good QOL include community integration, positive affect, and social support; demographic variables had virtually no association with QOL. Evaluation of the sample's response to standardized scales not designed for a traumatic brain injury population support their use in similar QOL investigations. Language: en

The Behavioral Dyscontrol Scale is a measure of executive abilities initially designed to predict functional independence in geriatric populations. The current study examined the utility of two Behavioral Dyscontrol Scale (BDS) scoring systems in a nongeriatric sample. The BDS was administered to 49 TBI patients undergoing inpatient and outpatient rehabilitation. The results demonstrate slightly greater utility of the BDS-II scoring system, and support clinical utility of the instrument with nongeriatric patients. Specifically, the Motor Programming Factor and Environmental Independence Factor were more impaired among patients with severe, as compared to mild to moderate, TBIs. In contrast, the Fluid Intelligence Factor was more impaired among patients with frontal, as compared to nonfrontal, injuries. However, when patients were categorized by severity, lesion location differences on the BDS total score and factors were found only for patients with mild to moderate injuries. Similarly, when patients were categorized by lesion location, severity effects were only present among the nonfrontal group. Receiver Operating Characteristic curves demonstrated sensitivity and specificity rates that ranged from 60% to 100% for clinically meaningful cutting scores.

The clinical utility of the Behavioral Dyscontrol Scale (BDS) was compared to that of verbal fluency, the Trail Making Test, and the Stroop Color-Word Test, as well as measures of processing speed/cognitive efficiency and manual dexterity. The ability of these measures to classify 49 TBI patients into frontal versus nonfrontal and mild to moderate versus severe groups was examined. The results showed that the Fluid Intelligence Factor of the BDS improved classifications above and beyond traditional executive measures, but was particularly successful at classifying patients who sustained mild injuries. In contrast, traditional executive instruments were successful at lesion location classifications only among the patients with severe injuries. Severity classifications were successful both for traditional measures of processing speed/cognitive efficiency and for the Motor Programming Factor of the BDS, but only among patients with nonfrontal injuries. These results demonstrate that severity of injury may be an important moderator of tests' sensitivity to frontal lobe involvement.

Osteoarthritis is the most common joint disorder in the human population.II is characterized by the destruction of articular cartilage and the overgrowth ofmarginal and subchondral bone. The commonest weight bearing joint affected is thatof the knee, affecting over one third of people over the age of 65 years. This articlereviews the recent principles of non surgical management of osteoarthritis. This isdivided into non drug management such as primary prevention, physiotherapy,occupational therapy and patient education. Drug management wilJ include the use ofdifferent types of analgesics. viscosupplementation as well as joint injection.

Primary objective: To explore reasons used by staff and clients to identify depression and examine how each group differs. Research design: A between group comparison on both quantitative and qualitative data. Methods and procedure: Thirty-seven individuals with brain injury and 18 non-psychologist rehabilitation professionals participated in this study. The Inventory for Depressive Symptomatology (IDS), a 28-item instrument of client self-report and clinician ratings was used for comparison. Additionally, qualitative data on presence and reason for identification of depression were collected from both parties. Results: There is substantial disagreement between clinicians and clients with regard to overall identification of depression. However, both groups based diagnoses on mood/cognitive symptoms rather than anxiety or vegetative symptoms. Conclusion: The results point to a discrepancy in client and clinician identification and understanding of depression after brain injury, indicating a potential need for education for both groups.

Objective To explore the construct of complicated daily tasks (CDTs) performed by older Chinese people. Study Design Panel review and face-to-face interview. Setting Community of an urban Chinese city. Participants Forty-six women with no major medical events and living independently in the community. Outcome Measures A structured questionnaire containing 21 tasks rated for perceived complexity, importance and frequency. Results A three-factor structure was revealed: “home maintenance”, “outdoor” and “technological”. The 12 core tasks were somewhat different from those revealed in other common clinical instruments. Conclusion Performance of CDTs demands cognitive and physical capabilities, and technological skills of older people. Tasks specific to the Chinese culture were those related to cuisine, use of gadgets, physical environment and life-style.

The Change Assessment Questionnaire for People with Severe and Persistent Mental Illness (CAQ-SPMI), based on Prochaska's (1992) Stages of Change model, was field tested in order to establish its utility in psychiatric rehabilitation. The CAQ-SPMI was given to a sample of 223 participants from a multifaceted psychiatric rehabilitation program with branches throughout northeastern Illinois. Results support the CAQ-SPMI as a valid measure of readiness for change among people with severe and persistent mental illness in rehabilitation programs. The CAQ-SPMI's component structure is reviewed, and possible clinical, program, and future research implications are discussed.

Although ecological validity of traditional tests of memory has been questioned, use of these tests remains the standard in clinical practice. More recently, however, standardized measures with more emphasis on ecological relevance have been developed. One hundred and nineteen adults with diagnosed brain injuries completed traditional instruments of memory assessment, the Luria Nebraska Neuropsychological Battery Memory Scale (LNNB-M) and the Wechsler Memory Scale-Revised (WMS-R). Subjects also completed the Rivermead Behavioural Memory Test (RBMT), an instrument designed to measure everyday memory. Additionally, clinicians rated subjects' day-to-day memory functioning at the rehabilitation facility. Results suggest that RBMT is most accurate in classifying severity of memory impairment as rated by clinicians. The LNNB-M and WMS-R were relatively accurate at classifying severely impaired and unimpaired subjects, but were much less accurate at classifying subjects in the mild and moderate impairment ranges. Implications for interpretation and use of these instruments in rehabilitation settings are discussed.

The purpose of this study was to identify factors other than disability which impact job placement success and time spent in job placement activities for workers' compensation claimants. It was found that four of the five factors that predict placement success were non-injury related whereas two of the three factors predicting time in placement activities were injury related. Only one factor was found to predict both outcomes. Rationale and implications of the findings are discussed.

The relationship between performance on neuropsychological measures and the vocational and independent living functioning of individuals with traumatic brain injury was examined. The Wechsler Adult Intelligence Scale-Revised (WAIS-R) IQ and Stroop Color and Word Test scores differentiated individuals who required no assistance with activities of daily living from those requiring some level of assistance. Only the Stroop Color and Word Test scores differentiated individuals who were competitively employed or engaged in degree-oriented education from those who were unemployed or in sheltered or supported employment. Wechsler Memory Scale-Revised (WMS-R) scores did not differentiate these groups.

The purpose of this pilot study was to examine the effects of a social skills training program in helping persons with Multiple Sclerosis (MS) increase socialization skills specifically designed to lessen interaction strain with persons who are not disabled. A second purpose focused on the effects of social skills training on increasing self-esteem, self-efficacy beliefs, and self-referent thoughts of persons with MS. Participants in this study included twenty-six persons with MS who were randomly assigned to either a treatment or control group. While there were no significant differences between the experimental and control groups on any measure, the results suggest that these persons with MS maintained positive self-images and apparently experienced no particular anxiety in social interactions.

This article documents the addition of 277 microsatellite marker loci to the Molecular Ecology Resources Database. Loci were developed for the following species: Ascochyta rabiei, Cambarellus chapalanus, Chionodraco hamatus, Coptis omeiensis, Cynoscion nebulosus, Daphnia magna, Gerbillus nigeriae, Isurus oxyrinchus, Lates calcarifer, Metacarcinus magister, Oplegnathus fasciatus, Pachycondyla verenae, Phaethon lepturus, Pimelodus grosskopfii, Rotylenchulus reniformis, Scomberomorus niphonius, Sepia esculenta, Terapon jarbua, Teratosphaeria cryptica and Thunnus obesus. These loci were cross-tested on the following species: Austropotamobius italicus, Cambarellus montezumae, Cambarellus puer, Cambarellus shufeldtii, Cambarellus texanus, Chionodraco myersi, Chionodraco rastrospinosus, Coptis chinensis, Coptis chinensis var. brevisepala, Coptis deltoidea, Coptis teeta, Orconectes virilis, Pacifastacus leniusculus, Pimelodus bochii, Procambarus clarkii, Pseudopimelodus bufonius, Rhamdia quelen, Sepia andreana, Sepiella maindroni, Thunnus alalunga, Thunnus albacares, Thunnus maccoyii, Thunnus orientalis, Thunnus thynnus and Thunnus tonggol.

A study visit funded by the World Rehabilitation Fund was conducted in 1990. The purpose of the study visit was to understand vocational rehabilitation development in Hong Kong and compare its practices to those of the United States. This article describes current vocational rehabilitation development in Hong Kong with emphasis on social, cultural, and economic factors that shape the development. Implications for the United States in areas of vocational training, rehabilitation personnel preparation, and cross-cultural rehabilitation were provided.

We examine the degree of social support and quality of life (QOL) among 60 Latinos with mental illness from a Community Mental Health Center of a large metropolitan Midwestern city. Additionally, we assess the relationship of both the quality and quantity of social support, and control for demographic factors as they all relate to QOL. Latinos had an average network of 3 contacts. Despite their small network, participants were satisfied with the quality of support they received. Their QOL was mixed, comparable to reports from non-Latinos with mental illness, and from the general population. Having better quality of social support being male and younger were associated with a higher QOL. Community treatment programs for Latinos with mental illness could benefit from focusing on nurturing existing networks, fostering social skills, and providing additional forms of support for those Latinos in need.

Objectives Pain is identified as the third largest health problem in the world, impacting sleep, physical functioning, and psychologic functioning. Pain has been viewed as a multidimensional experience influenced by biology, psychology, cultural conditioning, expectancies, and social contingencies. The aims of this study were to examine the psychometric properties and the differential item functioning (DIF) of the short-form McGill Pain Questionnaire (SF-MPQ) to test the cultural differences in verbally based pain expression. Methods Data were drawn from the medical records of 134 Hispanic and 134 non-Hispanic White patients with pain. Cases were matched on total SF-MPQ score, sex, and age. Estimates of reliability and validity were assessed. Using a traditional moderated regression approach, each of the 15 items on the SF-MPQ was analyzed for DIF using matched moderated regression methodology. Results Internal consistency was high: Hispanics 0.90 and non-Hispanics 0.89. Factor analysis revealed 2 components for each ethnic group. DIF analyses revealed statistically significant group differences for the 5 items (ie, throbbing, gnawing, aching, tiring-exhausting, and sickening) potentially due to cultural-linguistic factors. The remaining 10 items revealed no significant differences. Group differences were not accounted for by sex, age, marital status, education, pain location, or pain duration. Discussion Test bias was relatively small (0.74) given the entire scale of the SF-MPQ (0 to 45), indicating that this measure seems to be used equivalently across these 2 groups. This study shows 1 method in evaluating the cross-cultural validity of pain assessment instruments, and contributes to the understanding of cross-cultural variability in item reporting on the SF-MPQ.

This study examined differences in gastric bypass surgical outcomes by comparing two groups of female patients: those with a history of sexual abuse (SA) and those without a history of sexual abuse (NSA).Participants who agreed to participate in the study were assessed at either 6-18 months or 19-40 months postsurgery. Outcome measures included body mass index (BMI), level of depression as measured through the Beck Depression Inventory, level of self-esteem as measured through the Rosenberg Self-esteem Scale, and BISS as measured through the Body Image State Scale. Two-by-two analyses of variance (ANOVAs) were conducted for each of the four outcome variables.ANOVA results revealed that BMI was the only variable to be found statistically significant among the four dependent measures. At 6-18 months postsurgery, the SA group had significantly higher BMI than the NSA group. Compared BMI during the two postsurgery time periods, the SA group had a significantly lower BMI at 19-40 months than the SA group at 6-18 months postsurgery.The results suggest that females with a history of sexual abuse did not differ from their counterparts with regard to depression, self-esteem, and body dissatisfaction at baseline, as well as years after surgery. Given the improvement in BMI from the sexual abuse group at 6-18 months postsurgery to 19-40 month postsurgery, patients may not be as concerned with maintaining excess weight as a defense against potential future abuse as originally proposed.

This study translated and validated the Chinese Version of the Self-stigma of Mental Illness Scale (CSSMIS), which may be used to measure self-stigma of mental health consumers in China. We also examined its correlation with self-esteem, self-efficacy and psychosocial treatment compliance. A cross-sectional observational study was implemented. Some 51 males and 57 females who suffered from severe mental illness were recruited from psychiatric settings in Hong Kong. They were required to complete the Chinese Version of the Self-stigma of Mental Illness Scale, the Rosenberg Self-esteem Scale and the Self-efficacy Scale. Their level of compliance during psychosocial treatment and their demographic information were recorded by their case managers. Exploratory factor analysis revealed two homologous factors for the four subscales of the CSSMIS. Factor 1 was related to the negative beliefs and consequences of having mental disorders, whereas Factor 2 was related to positive beliefs. The perceived stigma subscale and the three self-stigma subscales were strongly inter-correlated. Significant correlations were also found between almost all subscales of the CSSMIS and the remaining scales. The psychometric properties of the CSSMIS are statistically acceptable. The results also suggest that stigma played a detrimental role in undermining self-esteem, self-efficacy and psychosocial treatment compliance. Implications for recovery of mental health consumers are discussed.

To determine the factorial structure of the BDI-II in a TBI sample and possible predictor variables of depression following TBI.Principle components analysis with orthogonal rotation and linear regression analyses.Fifty-one individuals with traumatic brain injury (TBI) participated in this study. The factorial structure of the BDI-II, a 21-item self-report measure of depression, was examined with individuals in the early stages following TBI. Time since injury, severity of injury, location of lesion and previous substance abuse were examined as possible predictors of depression following TBI.A three-factor structure of the BDI-II was found for the TBI sample, which included Negative Self-Evaluation, Symptoms of Depression and Vegetative Symptoms of Depression. Time since injury was the only significant predictor of depression following TBI.Using the BDI-II, symptoms of depression after TBI fall into three key categories. With time since injury being the only significant predictor of depression following TBI, it appears that the depression could be more of a result of psychosocial factors than neurobiological factors. It was concluded that BDI-II can be useful in identifying symptoms of depression in the early stages following TBI.

A sharp genetic break separates Atlantic from Indo-Pacific bigeye tuna (Thunnus obesus) populations, as the frequencies of two major mitochondrial (mt) DNA types (alpha and beta) found in this species are different across the tip of southern Africa. The level of nucleotide divergence between mtDNA types alpha and beta is of the same order as that between reproductively isolated taxa. To further investigate the genetic structure of bigeye tuna over its distribution range and in the contact zone off southern Africa, bigeye tuna samples collected between 1992 and 2001 (including samples from a previous mtDNA survey) were characterized for four nuclear DNA loci and for mtDNA. Nuclear markers did not support the hypothesis that alpha and beta mitochondria characterize sibling species. Significant allele-frequency differences at one intronic locus (GH2) and one microsatellite locus (mu 208) were found between Atlantic and Indo-Pacific samples, although the level of nuclear genetic differentiation (Weir and Cockerham's (theta) over cap = 0.025 to 0.042) was much lower than in mtDNA ((theta) over cap = 0.664 to 0.807). Probabilistic Bayesian assignment of individuals to a population confirmed that southern African bigeye tuna samples represent a simple mixture of individuals from Atlantic and Indian stocks that do not interbreed, with a higher contribution from Indian Ocean individuals (about 2/3 vs. 1/3).

We report the ultrafast and large third-order nonlinear optical properties of CdS nanocrystals (NCs) embedded in a polymeric film. The CdS NCs of 2-nm radius are synthesized by an ion exchange method and highly concentrated in the two layers near the surfaces of the polymeric film. The two-photon absorption coefficient and the optical Kerr coefficient are measured with laser pulses of 250-fs duration at 800-nm wavelength. The one-photon and two-photon figures of merit are determined to be 3.1 and 1.3, respectively, at irradiance of 2 GW/cm2. The observed nonlinearities have a recovery time of ~ 1 ps. The two-photon-generated free carrier effects have also been observed and discussed. These results demonstrate that CdS NCs embedded in polymeric film are a promising candidate for optical switching applications., Comment: 18 pages, 4 figures

Sildenafil improves erectile function by inhibiting the cGMP-catalytic activity of phosphodiesterase type V (PDE5). We used rapid amplification of cDNA Ends-polymerase chain reaction (RACE-PCR) to isolate three PDE5 isoforms from human corpus cavernosum. Semiquantitative reverse transcription-polymerase chain reaction (RT-PCR) analysis on eight human cavernous tissue samples showed that all samples expressed the PDE5A1 at a lower level than the PDE5A2 isoform. Five samples expressed the PDE5A3 isoform at various levels while the other three did not. Analysis on non-penile tissues showed that all tissues expressed the A1 and A2 isoforms while only those that have substantial amounts of smooth muscle expressed the A3 isoform. Cloning and sequencing of the PDE5A gene showed that the isoform-specific 5'-ends of the PDE5 mRNAs are encoded from three alternative first exons arranged in the order of A1-A3-A2. Promoter activities were detected upstream from the A1-specific exon and in the intron preceding the A2-specific exon. The upstream PDE5A promoter is expected to direct the expression of all three PDE5 isoforms while the intronic PDE5A2 promoter only the A2 isoform. Both promoters were upregulated by increasing concentrations of either cAMP or cGMP. Several transcription factor AP2 and Sp1-binding sequences identified in the promoters are likely to be the mediators of cAMP/cGMP-responsiveness.