Psychometric documentation of a quality-of-life questionnaire for patients undergoing antireflux surgery (QOLARS).

BACKGROUND: The purpose of our study was to develop a quality-of-life (QoL) questionnaire for patients with gastroesophageal reflux disease (GERD) who have undergone laparoscopic fundoplication. This questionnaire was developed to be more comprehensive than existing measures. METHODS: Between 1994 and 2002, 252 patients underwent laparoscopic fundoplication for GERD in the 1st Department of Surgery, Semmelweis University. We undertook a retrospective analysis: each of 252 operated patients was given a questionnaire and was requested to complete it and return it in an enclosed envelope. A total of 116 patients returned completed questionnaires. The patients included 55 men and 61 women, with a mean age of 46 years (range 14-77). These patients were used in the psychometric evaluation. The questionnaire consisted of 50 questions (including the Visick score, EORTC-QLQ-C30, and a modified GERD-HRQL). RESULTS: Internal consistency reliability was high (alpha value overall, 0.95, range, 0.74-0.96). Using convergent and divergent validity, construct validity was evaluated by examining Pearson correlation coefficients between items and scales. Construct validity was demonstrated based on observed correlations. Known groups validity was upheld because patients who experienced more symptoms and patients who has higher Visick scores reported worse QoL than those with less symptoms or lower Visick scores. CONCLUSIONS: Our questionnaire is a short and user-friendly instrument with excellent psychometric properties. It has been found to be valid and reliable.

Adjustment and coping in epilepsy.

Our study investigated interrelationships between problems in psychosocial adjustment, coping and epilepsy variables. Establishing the cross-cultural applicability of the Washington Psychosocial Seizure Inventory (WPSI) was an additional objective. The WPSI, Ways of Coping Scale, Modified Version, as well as scales measuring depression and anxiety were administered to 310 outpatients with epilepsy. When the scores of patients with high Lie scores were eliminated, the WPSI profiles were found to be similar to former studies, with some score elevations in emotional adjustment and interpersonal adjustment. When relationships between adjustment variables and coping were modelled, coping was found to be a mediator between the effects of interpersonal and emotional adjustment and integration to the broader social context (vocational adjustment). Family background was found to be a significant predictor of the emotional well-being and interpersonal adjustment scores of the patients. Results support the central role of coping and emotional well-being and emphasize the importance of family factors in adjustment to epilepsy. Psychotherapy and psychological interventions could support coping with illness, primarily through elimination of negative family and social effects and treatment of emotional problems.

Comparative analysis of differences by gender in sudden infant death syndrome in Hungary and Japan.

We examined the sex ratio in sudden infant death syndrome (SIDS) cases in Hungary, in Tokyo and Japan between 1985 and 1996. From all the infant death cases in Hungary 395 (240 male, 155 female) were SIDS (odds ratio (OR)=1.179, with 95% confidence interval (CI)=0.961, 1.446), in Japan 4348 (2550 male, 1798 female) were SIDS (OR=1.145, with 95% CI=1.076, 1.218) and in Tokyo 307 (178 male, 129 female) were SIDS (OR=1.128, with 95% CI=0.894, 1.423). Male infants showed a significantly higher birth rate than females. The male infants are more vulnerable (p<0.005), however, higher mortality among male infants should not be considered a characteristic feature for SIDS.

Family- and school-related stresses in depressed Hungarian children.

The aim of the study was 1) to identify recent and past life stresses as having a significant differential risk of childhood depression versus other childhood psychiatric illnesses, and 2) to establish if life stresses shared with other family members had a greater impact on the depression of the child than events of only personal relevance. Using a recently developed semi-structured interview (Diagnostic Evaluation Schedule for Children and Adolescents - Hungarian version, DESCA-H ), 68 life events of a total sample of 526 children were investigated. Two hundred and fifteen depressed preadolescents (mean age 12.73 years, SD 2.58) were compared with identical variables of 311 nondepressed mixed clinical controls (mean age: 10.91 years, SD 2.46) referred to child psychiatry care with other psychiatric symptomatology than depression. The life event questionnaire part of the DESCA-H was administered separately by means of lists of recent (within 1 year) and past stresses (events prior to 1 year before the assessment). With the two series of life stresses, two separate logistic regression analyses were performed. Of past stressors, physical punishment of the child by teachers, serious financial problems of the family and mental health problems of family members were found to be significant predictors of depression. From the series of recent stresses, moving to a new school, somatic illness, death of relatives and mental health disorders of family members were proved to be independent risk factors of depression for the children. The findings suggest that significant stresses of the child shared with other family members dominate in demarcating depressed children from nondepressed ones. School-related stresses are critically discussed.

Adaptation and major chromosomal changes in populations of Saccharomyces cerevisiae.

Thirteen independent populations of Saccharomyces cerevisiae (nine haploid and four diploid) were maintained in continuous culture for up to approximately 1000 generations, with growth limited by the concentration of organic phosphates in medium buffered at pH 6. Analysis of clones isolated from these populations showed that a number (17) of large-scale chromosomal-length variants and rearrangements were present in the populations at their termination. Nine of the 16 yeast chromosomes were involved in such changes. Few of the changes could be explained by copy-number increases in the structural loci for acid phosphatase. Several considerations concerning the nature and frequency of the chromosome-length variants observed lead us to conclude that they are selectively advantageous.

Genetic changes accompanying increased fitness in evolving populations of Escherichia coli.

Two populations of Escherichia coli, each initiated with a single clone containing a derivative of the plasmid pBR322, were maintained for long periods in glucose-limited continuous culture. In both populations, after an extensive number of generations had elapsed, clones were isolated in which the transposon Tn3 from the plasmid had integrated into the bacterial chromosome. In both cases examined, the transpositions were shown to increase relative fitness approximately 6-7%, in the environment in which the populations were maintained. The loci of integration were mapped to approximately 13.2 min (population 1) and approximately 32.8 min (population 2).