Assessment of autonomic dysfunction in Parkinson's disease: the SCOPA-AUT.

We developed a questionnaire to assess autonomic symptoms in patients with Parkinson's disease (PD) and evaluated its reliability and validity. Based on the results of a postal survey in 46 PD patients, 21 multiple system atrophy patients, and 8 movement disorders specialists, items were included according to their frequency, burden, and clinical relevance. The questionnaire was evaluated in 140 PD patients and 100 controls, and test-retest reliability was established in a sample of 55 PD patients. The SCOPA-AUT consists of 25 items assessing the following regions: gastrointestinal (7), urinary (6), cardiovascular (3), thermoregulatory (4), pupillomotor (1), and sexual (2 items for men and 2 items for women) dysfunction. Test-retest reliability was good. Autonomic problems increased significantly with increasing disease severity for all autonomic regions, except sexual dysfunction. We conclude that SCOPA-AUT is a reliable and valid questionnaire that evaluates autonomic dysfunction in PD.     

三峡地区大学生膳食调查与分析

目的：为开展大学生膳食营养教育提供依据。方法：采用记录和询问相结合的方法对301名大学生进行膳食调查。结果：男生的膳食营养状况比女生好。男生对热能、磷、铁、维生素A和维生素B1的摄入量均超过推荐量（Recommended Nutrient Intake，RNI），蛋白质达到RNI的94％，但钙、维生素B2和维生素C摄入不足，分别达到RNI的54％、71％、69％。女生磷、铁、维生素B1的摄取量超过RNI，维生素A达到RNI的90％，基本满足需要，但蛋白质、能量、钙、维生素B2和维生素C分别达到RNI量的76％、78％、57％和54％。男女生摄入的优质蛋白质均达到总摄入量的41％。男女生均有早上餐能量过低，晚餐量过高的现象。结论：大学生的膳营养水平比以往有所提高，但某些营养素仍严重缺乏，应加强对大学生的膳食营养教育。     

Measurement of quality of life in bone marrow transplantation survivors

This study was designed to assess the reliability and validity of a Quality of Life (QOL) instrument on a sample of 179 allogeneic Bone Marrow Transplant (BMT) survivors. The QOL-BMT tool was developed specifically for this population and was based on the investigators' prior research and a conceptual model of Quality of Life. Patients who were at least 100 days post BMT completed the 30 item visual analogue questionnaire. The instrument measured physical symptoms (e.g., weight loss, frequent colds, skin changes, cataracts, sexual problems), psychological to illness, social concerns (e.g., relationship adjustment, return to work), and spiritual well-being (e.g., sense of control, future goals). Psychometric analysis of the instrument included measures of reliability and validity. The study findings demonstrate the unique aspects of QOL dimensions in BMT survivors and the value of QOL assessment in clinical practice and research.This study was supported by the City of Hope National Medical Center, NCI Cancer Center Core Grant, R30 CA 33572 and the City of Hope BRSG Grant Support.     

女性服刑人员精神创伤的特征

目的调查女性服刑人员精神创伤的特征。方法在湖南新路职业学校中,采用多级随机整群抽样的原则抽取471个女性服刑人员,分青少年组（年龄≤25岁）和成年组（〉25岁）。运用创伤性生活事件问卷（TLEQ）和访谈相结合的技术评估她们的精神创伤经历。结果（1）90.4%的女性服刑人员至少经历1件创伤性事件,63.7%至少经历3件或以上的多重创伤。青少年组的事件数量多于成年组（平均为4和3件,P〈0.01）。暴力和毒品相关犯罪组的事件数量相当（平均4件）,都多于经济犯罪组（2件）;中学或相当教育程度者的事件数量最多（4件）,大专或以上者最少（2件）;未婚、离婚/丧偶2组经历的事件数量最多（4件）,已婚组最少（2件）,均差异有显著性（P〈0.05）。（2）最多见的创伤类型是机动车祸（46.9%）、目睹家庭暴力（46.1%）和被抢劫（38.9%）。16.7%的女犯在18岁以前遭遇过性虐待。与成年组相比,青少年组经历了更多的创伤类型为被抢劫、目睹被惨打、目睹家庭暴力,以及儿童期性虐待。结论我国文化背景下,女性服刑人员的精神创伤经历相当普遍,是精神创伤的潜在受害者。     

抑郁症常见中医证候类型第一轮专家问卷分析

目的 :调查抑郁症常见中医证候类型。方法 :根据文献资料和预试结果 ,编制抑郁症常见中医证候类型专家问卷 ,向全国范围内遴选出的 10 2位专家发放问卷调查。结果 :在回收的 92份问卷中 ,5 0 %以上的专家认定五类常见证候。结论 :肝郁气滞证、肝郁脾虚证、肝郁痰阻证、心脾两虚证、肝郁血瘀证是抑郁症的备选常见中医证候。     

医学生营养知识与膳食状况调查

①目的了解医学生营养知识的掌握情况及对教育传播方式的需求意见，以加强营养知识教育，改善大学生的健康素质。②方法对762名在校大学生进行问卷调查。③结果医学院在校生对营养知识及常识掌握深度和广度都不够，但渴求得到营养知识的欲望比较高，对营养知识的重要性认识正确。有73．6％的学生认为营养知识对生活很重要。87．2％的学生愿意接受营养知识的教育，对营养知识教育的传播方式也表现出特有的需求意向。大学生的膳食结构不够合理，奶类、薯类、鱼虾禽类、豆制品摄入不足。④结论应加强医学生营养知识教育，使医学生做到科学合理的安排膳食，改善饮食行为，促进身体健康。     

Influence of individually estimated portion size on the assessment of nutritional risk in colorectal cancer in Portugal

We evaluated the influence of individually estimated portion sizes on the estimate of nutrient related risk of colorectal cancer, using data from a Portuguese hospital based case-control study on diet and colorectal cancer. A total of 100 patients with colorectal adenocarcinoma (aged 15-92 years) and 211 controls (aged 36-89 years) were included. Two data sets were created for nutrient analysis, the first one allowed estimates of food intake using data on portion size as collected with visual aids during the interview. The second estimate substituted respondents' estimate with a standard portion size, as used in the semi-quantitative (SQ) food frequency approach. The two analytic approaches yielded similar energy and nutrient intakes in cases and controls. The percent range of concordance is acceptable, in the same quartile varying from 44 to 82% (mean: 56%) and very good in the same or adjacent (+/-1) quartile (mean: 91%, range: 85-97%). The two estimates lead to a similar pattern of multivariate odd's ratio, however the SQ estimates resulted in more significant findings. We conclude that little extra information is gained by including individual portion size information when assessing diet-related risk of colorectal cancer.     

Haemophilia in the developing world: successes,frustrations and opportunities

Summary. There is a need to bridge key gaps between high‐ and low‐income countries and individuals; between health policy and clinical practice; and between producers and users of healthcare technology and scientific evidence. The objective of this report was to perform a diagnosis of the situation in the developing world through a survey. This survey was conducted to gather specific information on various aspects related to haemophilia. Countries were chosen by their comparability in infant and adult mortality rates according to the regionalization proposed by the World Health Organization. These indicators are very sensitive to socioeconomic conditions, and have been widely used to study health inequalities. All regions, except Africa and the East Mediterranean, were represented. Africa was excluded because its indicators were not comparable. The East Mediterranean was not represented because of difficulties in contacting investigators. Twenty‐one country representatives were contacted, and 11 answered the questionnaire. Successes obtained by developing countries are based more on the skills and creativity of the local professionals than on the availability of state‐of‐the‐art technology. Frustrations were related to disease underregistration and the limited availability of treatment products. Haemophilia care in the developing world is not as fair as we would like it to be. Governments do not always cover treatment costs, and a very small percentage of the national health budgets is alotted to haemophilia care. The role of the World Federation of Hemophilia was considered crucial by all the investigators surveyed. Training programmes and supply of factor concentrates were the main contributions identified by the respondents.     

International multicenter pilot study of the first comprehensive self-completed nonmotor symptoms questionnaire for Parkinson's disease: the NMSQuest study.

Nonmotor symptoms (NMS) of Parkinson's disease (PD) are not well recognized in clinical practice, either in primary or in secondary care, and are frequently missed during routine consultations. There is no single instrument (questionnaire or scale) that enables a comprehensive assessment of the range of NMS in PD both for the identification of problems and for the measurement of outcome. Against this background, a multidisciplinary group of experts, including patient group representatives, has developed an NMS screening questionnaire comprising 30 items. This instrument does not provide an overall score of disability and is not a graded or rating instrument. Instead, it is a screening tool designed to draw attention to the presence of NMS and initiate further investigation. In this article, we present the results from an international pilot study assessing feasibility, validity, and acceptability of a nonmotor questionnaire (NMSQuest). Data from 123 PD patients and 96 controls were analyzed. NMS were highly significantly more prevalent in PD compared to controls (PD NMS, median = 9.0, mean = 9.5 vs. control NMS, median = 5.5, mean = 4.0; Mann-Whitney, Kruskal-Wallis, and t test, P < 0.0001), with PD patients reporting at least 10 different NMS on average per patient. In PD, NMS were highly significantly more prevalent across all disease stages and the number of symptoms correlated significantly with advancing disease and duration of disease. Furthermore, frequently, problems such as diplopia, dribbling, apathy, blues, taste and smell problems were never previously disclosed to the health professionals.     

SCL-25 and recognition of mental disorders reported by primary health care physicians

A marked proportion of primary care patients have mental disorders and problems that remain unrecognized by the patients and their general practitioners. There is furthermore a great variation in the physicians’ ability to detect mental disorders. The aim of the present study was to find out the overall prevalence of mental disorders among patients receiving primary health care. The material consisted of 1000 randomly selected adult patients attending primary care facilities in Turku. The mental disorders were assessed by using the Symptom Checklist (SCL-25) and by general practitioners. According to the SCL-25, one fourth of the sample had a mental disorder. Only two fifths of them could be identified by the general practitioners.