Pramipexole versus Levodopa in Patients with Early Parkinson''s Disease: Effect on Generic and Disease-Specific Quality of Life

OBJECTIVE: Although health-related quality of life (HRQOL) has been included in multiple Parkinson's disease (PD) clinical trials, little is known about how HRQOL responds to treatments over time. Here we assess the effect of therapy on HRQOL and explore factors that influence the HRQOL profiles and subdomains. METHOD: A total of 301 subjects with early PD were randomized to either initial pramipexole or initial levodopa and followed every 3 months over a 4-year period. To estimate health outcomes, we used EQ-5D and PDQUALIF. We calculated the incremental effectiveness as the accumulated difference in the total HRQOL over time between treatments. The subgroup analyses (by sex, race, age, baseline patient characteristics, and occurrence of adverse events) were conducted using the same approach. Sensitivity analysis was performed to test the effect of missing data imputation on the results. RESULTS: All three HRQOL measures resulted in similar profiles over time characterized by initial improvement over the first 3 to 6 months and followed by a gradual decline in years 2, 3, and 4. The difference in HRQOL between the treatment arms widened in favor of pramipexole in years 3 and 4 for all HRQOL measures used (EQ-5D: Y3 0.048, P = 0.03; Y4 0.071, P = 0.04). Our analyses suggested that the effect of pramipexole on HRQOL was mediated through nonmotor functions, whereas levodopa improved primarily motor domains of HRQOL. CONCLUSION: Our results suggest that pramipexole and levodopa affect patient HRQOL via improvement on different domains of well-being: nonmotor effect for pramipexole and mobility improvement for levodopa.     

Cross-Cultural Validation of the Scales for Outcomes in Parkinson's Disease-Psychosocial Questionnaire (SCOPA-PS) in Four Latin American Countries

ObjectiveTo conduct a cross-national validation of the Scales for Outcomes in Parkinson's Disease-PsychoSocial questionnaire (SCOPA-PS) in four Latin American Countries.MethodsData quality (missing items), scale assumptions (item–test correlation), internal consistency (Cronbach's alpha, item homogeneity), factor structure, content validity, and precision (standard error of measurement, SEM) of the scale were explored, as was convergent validity with motor symptoms (Clinical Impression of Severity Index [CISI-PD], Scales for Outcomes in Parkinson's Disease-Motor Scale), emotional status (Hospital Anxiety and Depression Scale) and health-related quality of life (Parkinson Disease Questionnaire-39). Known-groups validity was studied by category of severity, based on Hoehn and Yahr staging (HY), CISI-PD, and disease duration.ResultsThree hundred thirty-one Parkinson's disease (PD) patients with usable data participated (mean age 64.7 years; 42.3% female; mean PD duration 8.5 years; HY, 1 to 5). Data quality (missing items <10%), scale assumptions (item–total correlation = 0.43 ? 0.71) and internal consistency of SCOPA-PS (Cronbach's alpha = 0.87; item homogeneity = 0.38) were satisfactory. Factor analysis suggested a unifactorial structure. High convergent validity was found for depression (r_S = 0.61), anxiety (r_S = 0.62), and health-related quality of life (r_S = 0.82). Known-groups validity analyses indicated a gradual influence of severity category and disease duration on SCOPA-PS scores (P < 0.0001). SEM value was 8.24 (7 to 12 in previous studies). These magnitudes may be indicative of the threshold for a real change and a minimum important difference.ConclusionsThe Latin American versions of the SCOPA-PS displayed appropriate psychometric attributes.     

Constant Transmission Properties of Variant Creutzfeldt-Jakob Disease in 5 Countries

Variant Creutzfeldt-Jakob disease (vCJD) has been reported in 12 countries. We hypothesized that a common strain of agent is responsible for all vCJD cases, regardless of geographic origin. To test this hypothesis, we inoculated strain-typing panels of wild-type mice with brain material from human vCJD case-patients from France, the Netherlands, Italy, and the United States. Mice were assessed for clinical disease, neuropathologic changes, and glycoform profile; results were compared with those for 2 reference vCJD cases from the United Kingdom. Transmission to mice occurred from each sample tested, and data were similar between non-UK and UK cases, with the exception of the ranking of mean clinical incubation times of mouse lines. These findings support the hypothesis that a single strain of infectious agent is responsible for all vCJD infections. However, differences in incubation times require further subpassage in mice to establish any true differences in strain properties between cases.     

第24届世界大冬会传染病防控系统的建立与应用

目的通过对大冬会传染病预防控制保障模式的研究,为实现保障目标和大冬会的顺利举办保驾护航,为科学开展大型冬季赛事疾病控制保障工作提供参考依据。方法通过科学评估和综合分析传染病防控基础能力以及对重大传染病疫情、突发公共卫生事件风险识别和评价,明确赛会期传染病控制保障的工作方向和目标。结果通过探索保障工作的运行模式,建立了多部门联动机制、重大事项会商制度,信息通报制度和技术、物资储备制度;同时建立了传染病询(巡)诊和症状监控系统、不明原因疾病及症候群监控系统、重点疾病监控系统。形成了点面结合,赛区中心和外围全面兼顾的防控模式。结论由于此系统的建立和应用,2009年第24届世界大冬会的疾病预防控制保障目标圆满实现。保障系统和运行模式将为其他大型会议和赛事提供直接的参考决策依据和指导建议。     

疾控机构综合效益评价指标权重的研究

目的探索疾控机构综合效益评价指标权重判定的方法，使各疾病控机构综合效益值的计算更具有科学性和可比性。方法建立疾控机构综合效益评价体系的层次结构模型，采用调查表对疾病预防控制系统领域的专家进行指标重要性的问卷调查，运用层次分析法进行权重系数的计算。结果得出各评价指标的权重系数，其中三个大类指标投入、利用和效果的权重系数分别为0．10、0．26和0．64。结论层次分析法是一种较为准确、实用的权重系数判定的方法。     

疾病预防控制中心现代化建设的探索及思考

疾病预防控制中心现代化建设是顺应时代发展的需要。地处经济发达地区的苏州工业园区疾病防治中心积极探索疾控机构现代化建设．着力推进管理现代化、技术现代化和设施现代化。疾控中心在进行现代化建设的过程中,应把握三点：管理现代化关键在于理念创新;技术现代化关键在于人才培养;设施现代化关键在于经费投入。     

广州市疾病预防控制机构人力资源现状分析

目的了解广州市市级和县区级疾病预防控制机构卫生人力资源配置现状,为合理配置人力资源提供依据。方法通过调查表法对2010年广州市市级和县区级疾控机构人力资源现状进行调查,对现有人员的性别、年龄、学历、工龄、职称等情况进行统计分析,并与2005年人力资源配置情况进行比较。结果广州市各级疾控机构在编人员以中青年为主,人员较稳定,人员总量增加,但增长幅度明显低于服务人口的变化;专业技术人员占总人数比例增加,但未达到标准;学历层次有所提高,但县级市疾控机构仍有待优化;中、高级职称技术人员增加,但职称比例仍不理想。结论广州市各级疾控机构人员数量不足,人员结构不平衡,需制订科学的人力资源配置计划。     

深圳市疾控机构2008-2009年度绩效评估结果分析

目的通过分析深圳市2008-2009年度疾病预防控制机构的绩效评估结果,发现存在的问题,为今后疾病预防控制工作的可持续发展提供重要的参考依据。方法回顾性分析深圳市2008-2009年度的区域和市级机构绩效评估指标的完成度水平。结果深圳市2008-2009年度的区域和市级机构绩效评估结果均超过900分,属于优秀水平。区域绩效评估中的慢性病病人规范管理率、居民健康教育与健康促进与基础设施和仪器设备达标单位比例的完成度较低;市级机构绩效评估中的"疾病预防与控制"和"综合指标"的完成度较低。结论根据绩效评估结果,深圳市的疾病预防控制工作属于优秀水平,但同时发现存在的问题和不足,需进一步加强和完善。     

Comparing specialist early years provision for speech and language impaired children with mainstream nursery provision in the UK - an application of the Early Childhood Environment Rating Scale (ECERS)

BACKGROUND: This study examines the application of the Early Childhood Environment Rating Scale (ECERS) to specialist early years provision for children with developmental speech and language impairment. The scale, which has been used in the national Effective Provision of Pre-school Education (EPPE) study in the UK comprises seven subscales describing the quality of provision along a continuum centred on the following areas: 'space and furnishings', 'personal care routines', 'language reasoning', 'activities', 'interaction', 'program structure', and 'parents and staff'. METHODS: The ECERS was applied to two nurseries funded by the UK charity I CAN by two researchers with inter-rater-reliability coefficients ranging from 0.91 to 0.96. RESULTS: There were notable differences between the specialist early years provision and 'average' nursery provision in the UK. On 7/8 measures the early years centre scores are markedly higher than average pre-school provisions. The standard of education and care for the pre-school provisions included in the EPPE project ranged from below minimal (for the diversity subscale, ECERS-E) to approaching good (for the space and furnishings subscale). In contrast, the early years centres were rated as between minimal to good on areas such as space and furnishings and good to excellent on all other areas. CONCLUSIONS: Clearly specialist services such as those described offer something different from the average. Given results which suggest the positive effects on the children's language abilities of such services it is quite possible that the distinctive characteristics of the nursery environment are responsible for the positive impact. There is a good case for extending the application of the ECERS as a way of helping those providing specialist services start to detect the active ingredients of the provision.     

腕肘类职业病的保健器具研究与设计

目的通过对腕肘类职业病及其现有技术中的保健器具研究，提出新型设计，减缓和制止这些职业病症的上升和年轻化趋势。方法基于腕肘关节韧带是一个高度分化的复杂连接体系，通过对腕肘关节进行有效活动锻炼，降低腕肘关节韧带的刚度，增加腕肘关节的松弛度，起到病征预防和保健的功效。结果通过有效锻炼可以减少非健康工作、剧烈运动、意外事故引起的损伤，并且对腕类、肘类病症有较好的保健和治疗作用。结论该保健器具可以有效缓解与降低鼠标手、学生肘、键盘腕等新“职业病”症状，同时对大众的疾病预防与身体保健具有良好功效。     

浙江省疾控机构实验室仪器设备配置及检验能力分析

目的了解浙江省疾控机构实验室仪器设备配置情况及检验能力。方法通过多阶段分层随机抽样方法,抽取32个县（市、区）疾控机构连同省、市疾控机构作为样本机构,调查设备投入情况、设备资产总额、实验室仪器设备配置以及检验能力分析。结果2007年省、市、县级疾控机构设备资产额分别为6920．0万元、1097．1万元和266．0万元。省级疾控机构A、B、C三类仪器设备的种类配置率分别为93．O％、90．0％和50．6％,市级分别为64．6％、60．6％和32．1％,县级分别为54．1％、48．2％和27．3％。省、市、县A类检验项目开展率依次为95．2％、84．6％和74．7％,较2005年提高19．7％、8．2％和4．4％。结论省、市、县疾控机构设备投入及实验室检验能力均较2001年较大提高,总体呈上升趋势。但区域发展不平衡,部分县级疾控机构均距离标准仍有一定差距。     

2000-2008年黄浦区疾病预防控制中心经费配置情况分析

目的评价2000-2008年黄浦区疾病预防控制中心(以下简称黄浦区CDC)的经费配置情况。方法通过问卷调查,了解9年间地方政府对黄浦区CDC的财政投入总量及其分配。结果 2008年,政府对黄浦区CDC的财政投入总量较2000年增长了501.1%,其中,公用经费和经常性业务经费、防治专项经费、仪器设备投入分别增长了341.3%、58.5%、100.0%,人员经费较2001年增长122.4%。结论 2000-2008年,黄浦区CDC的政府财政投入显著增加,但投入结构仍需改善。其中,公用和经常性业务经费增幅最为显著,但仍显不足;人员经费、防治专项经费、仪器设备投入的合理性和稳定性仍需改善。     

一步RT-PCR方法在黑龙江省手足口病病原检测中的应用

目的了解核酸检测方法在黑龙江省手足口病病原谱调查中的应用价值,为疾病防控提供依据。方法在全省范围内收集2009年和2010年疑似手足口病病人疱疹液、咽拭子或肛拭子标本,使用人肠道病毒通用引物、肠道病毒71型(EV71)引物和萨奇病毒A组16型(CVA16)引物,采用一步RT-PCR方法进行病原核酸检测,进而分析病原构成,并对部分核酸检测阳性标本进行病毒分离。结果 2009年检测标本985份,其中EV71阳性226份、CVA16阳性191份、EV71和CVA16合并阳性3份,其他肠道病毒阳性100份。2010年检测标本1696份,其中EV71阳性354份、CVA16阳性356份、其他肠道病毒阳性188份。两年标本肠道病毒阳性率平均为52.87%,其中EV71和CVA16占阳性标本中病原总数的79.69%。选取353份核酸检测阳性标本进行病毒分离,共获得毒株265株。结论一步RT-PCR方法用于手足口病病原检测稳定、特异、快捷、易于分型,EV71和CVA16是黑龙江省近两年手足口病的主要病原体。     

西藏自治区国家突发急性传染病防控队装备的研制

目的：研制一套用于西藏特殊地域突发急性传染病防控的机动卫生装备。方法：整套系统采用车辆与帐篷的技术形式,综合集成疾病预防控制与功效保障技术。结果：构建了一套机动、快速、安全、高效的突发急性传染病防控平台。结论：该套装备整体设计合理,达到了设计技术指标的要求,有助于提升西藏自治区国家突发急性传染病防控保障能力．     

2007～2009年山东省疾病预防控制机构检验人力资源分析

[目的]了解山东省疾病预防控制机构检验人员情况,为政府管理部门制定决策提供依据。[方法]2010年,对山东省三级疾控机构2007～2009年检验人力资源情况进行调查。[结果]2007～2009年,省级、市级检验人员数量略有增加。50岁以上人员所占比例不断下降,40岁以下人员所占比例呈上升趋势;专科及以下学历人员所占比例不断下降,本科及以上学历人员所占比例从33.70%增加到42.43%;高级职称人员所占比例逐年增加,中级职称人员所占比例逐年减少;省级其他检验人员所占比例最大,市级和县级微生物检验人员所占比例最大。[结论]2007～2009年山东省疾控机构检验人力资源配置有所优化,年龄结构年轻化,学历水平得到提高,但职称结构和专业结构还有待改善。     

新型冠状病毒肺炎流行期间居家儿童青少年抑郁情绪调查及影响因素分析

目的 了解新型冠状病毒肺炎(COVID-19)流行期间居家儿童青少年抑郁情绪现状,并分析其影响因素,以期为疫情流行期间本地区儿童的心理干预提供参考。方法 2020年2月6—8日,采用问卷星的调查方式,由8~18岁儿童青少年在线填写一般资料、儿童抑郁障碍自评量表(DSRS)和儿童焦虑性情绪障碍筛查表(SCARED)。采用SPSS 22.0软件,经单因素分析,线性回归以及二分类Logistic回归分析明确DSRS得分的影响因素及抑郁症状的危险因素。结果 共有效回收问卷396份,DSRS 量表平均得分为(7.35±5.10)分。DSRS≥15分,即存在明显抑郁症状者41例(10.4%)。多因素分析显示,焦虑得分、居住地、碰到与疫情相关的事情是否害怕、年龄是DSRS得分的影响因素(P＜0.05)。二元Logistic回归分析显示,存在焦虑症状(OR=4.284,95%CI:2.163~8.486,P＜0.001),居住在乡镇及农村(OR=2.382,95%CI:1.120~5.069,P=0.024),碰到与疫情相关的事情经常害怕(OR=3.312,95%CI:1.210~9.064,P=0.020)是疫情流行期间居家儿童青少年出现抑郁症状的危险因素。结论 家庭-学校-社会应加强对儿童的心理干预,减少儿童在疾病流行期间的恐惧及焦虑,尤其是年龄较大的高年级学生,乡镇及农村儿童等重点人群,从而减少COVID-19流行期间儿童青少年抑郁症状的发生。     

2013-2015年湖北省疾病预防控制机构实验室样品检测量与检测类别

目的 掌握湖北省疾病预防控制机构实验室2013-2015年样品检测量与检测类别动态状况,为完善公共卫生检测和实验室能力建设提供依据.方法 通过“湖北省疾病预防控制机构实验室管理信息网报系统”进行网上填报,利用Excel 2010软件建立数据库进行回顾性分析.结果 全省97个单位2013、2014、2015年实验室样品检测量分别为4 711 929份、5 081 078份、5 352 575份.检测类别分为7大类,健康体检和疾病监测两大类别所占比例最高,分别为48.90％、38.25％.结论 健康体检成为各市、县级疾病预防控制机构实验室的主要任务,疾病监测是检测工作的重要内容.通过合理配置和调整实验室资源,做好公共卫生主要检测项目的质量控制,有利于疾病预防控制机构检测检验的能力建设和可持续发展.     

Accuracy of Herdsmen Reporting versus Serologic Testing for Estimating Foot-and-Mouth Disease Prevalence

Herdsman-reported disease prevalence is widely used in veterinary epidemiologic studies, especially for diseases with visible external lesions; however, the accuracy of such reports is rarely validated. Thus, we used latent class analysis in a Bayesian framework to compare sensitivity and specificity of herdsman reporting with virus neutralization testing and use of 3 nonstructural protein ELISAs for estimates of foot-and-mouth disease (FMD) prevalence on the Adamawa plateau of Cameroon in 2000. Herdsman-reported estimates in this FMD-endemic area were comparable to those obtained from serologic testing. To harness to this cost-effective resource of monitoring emerging infectious diseases, we suggest that estimates of the sensitivity and specificity of herdsmen reporting should be done in parallel with serologic surveys of other animal diseases.     

安徽省疾控系统流感疫苗管理和使用现况调查

目的了解安徽省疾病预防控制机构流感疫苗管理和使用情况,为制定流感大流行防控策略提供依据。方法设计调查表调查全省县（区）级疾控机构,Epidata录入数据,用SPSS12.0软件进行统计分析。结果96家县区级疾控中心中,90家从上级疾控中心购置疫苗,占93.7%。仅2家将流感疫苗接种纳入医保范畴,占4.2%;仅1家制定流感疫苗接种减免政策,占2.1%。疫苗接种对象主要为婴幼儿和中小学生。2008年出库成人型疫苗197 691份,实际接种193 984人份;出库儿童型疫苗259 253份,实际接种258 199份;2008年全省儿童流感疫苗接种率为0.1011%,成人接种率为0.0030%。结论安徽省重点人群流感疫苗接种率低,应提高重点人群的流感疫苗接种率。