Search

Copyright of Conservation Biology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To evaluate parental mental health monitoring during follow-up care for very preterm (VPT) infants, describe symptoms of anxiety and depression and risk factors for mothers and fathers at 1 and 12 months of corrected age.Methods: Parents completed the Hospital Anxiety and Depression Scale (HADS). Psychological symptoms and risk factors were analysed within and between mothers and fathers.Results: In 4 years, the monitoring reached 1260 (48%) families. Of these, 693 mothers and 340 fathers (300 couples) completed the HADS twice. At 1 month, 22% and 15% of the mothers and 10% and 9% of the fathers, respectively, reported elevated symptoms of anxiety and depression. At 12 months, these rates were significantly reduced to 14% and 9% for mothers and 5% and 4% for fathers respectively. Within couples, anxiety and depression were positively associated. At 12 months, in 20% of the couples, one or both parents reported elevated symptoms. Risk factors were length of hospital stay, migration background, educational level and employment status.Conclusion: The mental health of parents of VPT infants improved, but elevated symptoms were still observed in 17% of included families after one year. Acknowledging and remediating parental mental health remain essential during follow-up care. [ABSTRACT FROM AUTHOR]

We calculate the first distributional statistics for municipal water use with 14.9 million monthly billing records for a half million households in Cape Town, South Africa, from 2014 to 2018. These years span a historic drought and a multi‐faceted package of conservation programs that achieved a 50% citywide drop in consumption. We find that the top 10% of households consumed 31% of water before the drought, with the Gini coefficient showing clear seasonal peaks driven by outdoor water use. Matching billing records to fine‐grained census data from 2011, we find that the correlation between income and water use in the winter was 0.08 but rose to 0.36 during outdoor watering seasons. This correlation declines before switching signs by the end of the drought. The city's increasing block tariff implied that the top 10% of users generate 50%–60% of utility revenues. Although before the drought these top users were more likely to be high income, the composition of top water users changed during the drought. Average income of top users during the drought was 35% lower than the average income of top users before the drought. Our results suggest that Cape Town's policy of providing a free allowance of 10.5 kL (m3) per month to qualify indigent households helped protect many, but not all, from multiple steep tariff increases. Key Points: We calculate the first distributional statistics for municipal water supply deliveries and show how they can inform policyDuring Cape Town's historic drought, we showed that the correlation between income and water changed from positive to negativeThe city's policy of providing a free allowance to indigent households helped protect many, but not all, from steep tariff increases [ABSTRACT FROM AUTHOR]

A previous randomized controlled trial has suggested the effectiveness of a Dutch postdischarge responsive parenting program for very preterm (VPT) infants, indicating that nationwide implementation was justified. This paper describes the development and nationwide implementation of the intervention, known as the TOP program, which consisted of three phases. In the preparation phase (2006–2010), a theory of change and the structure of the TOP program were developed, and funding for phase two, based on a positive Business Case, was obtained. In the pilot implementation phase (2010–2014), intervention strategies were developed for a real‐world setting, capacity and adoption were increased, systematic evaluations were incorporated, and sustained funding was obtained. In the full‐implementation phase (2014–2019), all Dutch Healthcare Insurers reimbursed the TOP program, enabling VPT infants to participate in the program without charge. By 2018, the number of interventionists that provided the TOP program had increased from 37 to 91, and all level III hospitals and 65% of regional hospitals in the Netherlands referred VPT infants. Currently, the program reaches 70% of the Dutch target population and parental satisfaction with the TOP program is high. After a 12‐year implementation period, the TOP program forms part of routine care in the Netherlands. [ABSTRACT FROM AUTHOR]

Pervasive threats of climate change and land degradation have compounded the inherent low farm productivity problem in sub‐Saharan Africa. Though sustainable agricultural intensification practices have been shown to improve the resilience of farm production in the face of these emerging threats, they suffer low adoption rates typical of any technology adoption in these regions. Recent evidence points to an emergence of large traders in smallholder grain markets of countries in sub‐Saharan Africa. Given their big financial and operational capacities, the hypothesis is that they can drive the elusive transformation in agri‐food systems by enhancing sustainable production and marketing for smallholder farmers. This study tests this hypothesis using a decade‐long large‐panel dataset from Kenya. A dynamic random effects Probit model and a control function approach are used to evaluate the dynamism in adopting sustainable agricultural inputs and the effect of large grain traders in enhancing the adoption of these inputs at the farm level. Results indicate that sales to large grain traders lead to higher adoption of inorganic fertilizer and improved seed, key agricultural intensification inputs. Land ownership is also shown to be a key success factor for entry into large‐grain‐trader markets. Lastly, the adoption of improved seed and organic manure is persistent across time, indicating state dependence in using these inputs. These results suggest that strategies to foster engagements between large grain traders and farmers can enhance the uptake of sustainable intensification inputs. Such strategies should be accompanied by efforts to improve access to these markets by resource‐poor farmers who are primarily smallholders. [ABSTRACT FROM AUTHOR]

The Cape Town Water Map is an innovative and somewhat controversial behavior‐modification tool implemented to reduce water use in a drought‐stricken region. [ABSTRACT FROM AUTHOR]

Post-discharge preventive intervention programmes with involvement of the parent may support the resilience and developmental outcomes of infants born very preterm. Randomized controlled trials of home-based family-centred intervention programmes in very preterm infants that aimed to improve cognitive outcome, at least at age two, were selected and updated on the basis of a recent systematic review to compare their content and effect over time to form the basis of a narrative review. Six programmes were included in this narrative review. Four of the six programmes led to improved child cognitive and/or motor development. Two programmes, which focused primarily on responsive parenting and development, demonstrated improved cognitive outcome up till 5 years after completion of the programme. The programmes that also focused on maternal anxiety remediation led to improved maternal mental well-being, along with improved child behaviour, in one study - even at 3 years after completion of the programme. The magnitude of the effects was modest. Family-centred preventive intervention programmes that aim at improvement of child development should be continued after discharge home to improve the preterm child's resilience. Programmes may be most effective when they support the evolvement of a responsive parent-infant relationship over time, as well as the parent's well-being. [ABSTRACT FROM AUTHOR]

Aim: To elucidate the relation between motor impairment and other developmental deficits in very preterm-born children without disabling cerebral palsy and term-born comparison children at 5 years of (corrected) age.Method: In a prospective cohort study, 165 children (81 very preterm-born and 84 term-born)were assessed with the Movement Assessment Battery for Children - 2nd edition, Touwen’s neurological examination, the Wechsler Preschool and Primary Scale of Intelligence, processing speed and visuomotor coordination tasks of the Amsterdam Neuropsychological Tasks, and the Strengths and Difficulties Questionnaire.Results: Motor impairment (≤15th centile) occurred in 32% of the very preterm-born children compared with 11% of their term-born peers (p=0.001). Of the very preterm-born children with motor impairment, 58% had complex minor neurological dysfunctions, 54% had low IQ, 69% had slow processing speed, 58% had visuomotor coordination problems, and 27%, 50%,and 46% had conduct, emotional, and hyperactivity problems respectively. Neurological outcome (odds ratio [OR]=41.7, 95% confidence intervals [CI] 7.5–232.5) and Full-scale IQ(OR=7.3, 95% CI 1.9–27.3) were significantly and independently associated with motor impairment. Processing speed (OR=4.6, 95% CI 1.8–11.6) and attention (OR=3.2, 95% CI1.3–7.9) were additional variables associated with impaired manual dexterity. These four developmental deficits mediated the relation between preterm birth and motor impairment.Interpretation: Complex minor neurological dysfunctions, low IQ, slow processing speed,and hyperactivity/inattention should be taken into account when very preterm-born children are referred for motor impairment. [ABSTRACT FROM AUTHOR]

This paper explores the collective action problem as it relates to climate change and develops two models that capture the mitigation-adaptation trade-off. The first model presents climate change as a disaster that will occur with certainty, and where both mitigation and adaptation reduce the size of the loss associated with the disaster (the so-called deterministic model). The second model presents climate change as an uncertain event, where mitigation affects the probability of disaster while adaptation again reduces the size of the loss (this is the so-called stochastic model). Comparing the two models in a one-shot public goods experiment with students, we find no significant differences in subjects' choice to mitigate. The experiments also reveal a relatively low rate of mitigation for both models compared with earlier studies. [ABSTRACT FROM AUTHOR]

This paper investigates the use of charges and standards in dealing with a common externality, plastic litter from shopping bags in Botswana. The country passed a plastic bag legislation (effective 2007) to curb the plastic bag demand. Uniquely, the act does not stipulate the amount that the retailers had to charge for plastic bags, they, independently from one another, set different prices. We assessed the environmental effectiveness and efficiency of the plastic bag legislation by analysing consumers' sensitivity to the improvement of the plastic bag and related price charges. The introduction of the plastic bag legislation led to a significant decline in the consumption of plastic bags per 1,000 Botswana pulas of shopping. The partial success of the charges levied in Botswana was due to the constantly high prices of the bags. [ABSTRACT FROM AUTHOR]

We estimate the risk attitudes of a large sample of individuals from various fishing communities along the west coast of South Africa. Female fishers and rights holders are found to be more risk averse than their male counterparts, while rights holders are found to be less risk averse relative to subjects without fishing rights. Risk attitudes are found to be correlated with compliance with fisheries regulations. In particular, a greater degree of risk aversion translates into a reduction in compliance. Furthermore, in the case of gender, female fishers and rights holders are more likely to comply with fisheries regulations. [ABSTRACT FROM AUTHOR]

Health-related quality of life is an important patient-reported outcome used in intervention trials and for monitoring the consequences of health status on physical, mental, and social domains. Parkinson's disease is a complex disorder that strongly affects patients' quality of life. Several health-related quality of life tools have been used in Parkinson's disease. A Movement Disorder Society Task Force was commissioned to rate the psychometric quality of available health-related quality of life scales as applied to Parkinson's disease. Following the methodology adopted by previous work of the Movement Disorder Society Task Force, a review of generic and specific health-related quality of life scales applied in studies on Parkinson's disease was completed. Considering the scales from 3 perspectives-use in Parkinson's disease, use by multiple research groups, and clinimetric properties-a final classification as 'recommended,' 'suggested,' or 'listed' was applied to each reviewed instrument. Four generic scales (EuroQoL, Nottingham Health Profile, 36-Item Short-Form Health Survey, and Sickness Impact Profile) and 5 specific scales (39-Item Parkinson's Disease Questionnaire, Parkinson's Disease Questionnaire Short Form, Parkinson's Disease Quality of Life Questionnaire, Parkinson's Impact Scale, and Scales for Outcomes in Parkinson's Disease-Psychosocial) reached the level of 'recommended.' The 39-item Parkinson's Disease Questionnaire is the most thoroughly tested and applied questionnaire. Three other generic measures (Quality of Life Questionnaire 15D, Schedule for the Evaluation of Individual Quality of Life-Direct Weighting, and World Health Organization Quality of Life Assessment Short Version) and the specific Parkinson's Disease Quality of Life Scale are 'suggested.' With a little additional effort in completing the stipulated requirements, they could reach the 'recommended' level. At present there is a wide variety of health-related quality of life measures for application in the Parkinson's disease setting, and the task force does not recommend the development of a new scale. Selection of the most appropriate instrument for a particular objective requires consideration of the characteristics of each scale and the goals of the assessment. © 2011 Movement Disorder Society [ABSTRACT FROM AUTHOR]

The SCOPA-Cognition is a reliable and valid test to evaluate cognitive functioning in Parkinson's disease and is widely used in clinical and research settings. Recently, the Movement Disorder Society introduced criteria for Parkinson's disease dementia. The objective of the present study was to use these criteria to determine SCOPA-Cognition cutoffs for maximum accuracy, screening, and diagnosing of Parkinson's disease dementia. A total of 282 patients with Parkinson's disease were assessed with the SCOPA-Cognition and the Movement Disorder Society's Parkinson's disease dementia criteria. From the 275 patients with a complete assessment of the dementia criteria, 12% (n = 32) fulfilled the criteria. Data from 268 patients with complete assessments of both the dementia criteria and the SCOPA-Cognition were used to determine cutoffs for maximum accuracy, screening, and diagnosing of Parkinson's disease dementia. The area under the curve was 0.91 (95% confidence interval, 0.85-0.97), showing a strong association between the dementia criteria and the SCOPA-Cognition. The cutoff for maximum accuracy was 22/23, based on the highest sum of sensitivity (0.80) and specificity (0.87), with positive and negative predictive values of 0.43 and 0.97, respectively. The optimal screening cutoff was 24/25, and the optimal diagnostic cutoff was 17/18. Using the recently published Parkinson's disease dementia criteria as a reference, the current study presents SCOPA-Cognition cutoffs for maximum accuracy, screening, and diagnosing of Parkinson's disease dementia. The availability of SCOPA-Cognition cutoffs for Parkinson's disease dementia may contribute to the scale's usefulness and promote its further use in both clinical and research settings. © 2011 Movement Disorder Society [ABSTRACT FROM AUTHOR]

This paper analysed differences in the choice of health-care facility by ill individuals in human immunodeficiency virus (HIV)- and acquired immune deficiency syndrome (AIDS)-affected households in the Free State province of South Africa. Secondary education, access to medical aid and household income were significant determinants of choice as were severity and type of illness, and type of health care required. Ill persons with HIV- and AIDS-related illnesses are significantly more likely to opt for public health care, although the strength of this preference declines as household income increases. Those with severe and particularly severe HIV- and AIDS-related illness, in turn, are significantly more likely to opt for private health care, especially at higher levels of income. The public health care sector therefore is likely to remain the backbone of health-care provision to those infected with and affected by HIV and AIDS, highlighting the need for equitable access to efficient, quality public health services. [ABSTRACT FROM AUTHOR]

To identify patterns of motor disturbances in Parkinson's disease (PD) and evaluate their relation with other PD domains. A cohort of 399 PD patients was randomly divided into two samples. Factors within the motor section of the SPES/SCOPA were identified by exploratory factor analysis on data from the first sample and next tested by confirmatory factor analysis in the second sample. Relations with other PD domains were evaluated by regression analyses. A four factor model was found to be valid. This included a tremor, a bradykinetic-rigid, and two axial factors. One axial factor ('rise', 'gait', 'postural instability') was associated with age and cognition, while the other axial factor ('freezing', 'speech', 'swallowing') was related to dopaminergic medication and complications of therapy. Both other factors showed no relevant associations with demographic and clinical characteristics. The identification of motor factors and their relation with other domains of the disease may help to elucidate the mechanisms responsible for these associations and provide an objective base for further research on subtypes in PD. © 2009 Movement Disorder Society [ABSTRACT FROM AUTHOR]

The objective of this study is to evaluate psychiatric symptoms in Parkinson's disease (PD) patients and to assess their relation with other clinical aspects of PD. Psychotic symptoms (PS) and compulsive symptoms (CS) as well as other nonmotor and motor features were evaluated in 353 PD patients. Psychotic and compulsive symptom scores did not correlate significantly. PS occurred in 65% of patients, with item frequencies ranging from 10% (paranoid ideation) to 55% (altered dream phenomena). Regression analysis showed that autonomic impairment accounted for 20% of the 32% explained variance of PS, whereas cognitive problems, depression, daytime sleepiness, and dopamine agonist (DA) dose explained the rest. CS occurred in 19%, with item frequencies of 10% for both sexual preoccupation and compulsive shopping/gambling. Patients with more severe CS (score ≥ 2 on one or both items) were significantly more often men, had a younger age at onset, a higher DA dose and experienced more motor fluctuations compared to the other patients. PS and CS are common but unrelated psychiatric symptoms in PD. The relations found between PS and cognitive problems, depression, daytime sleepiness, and autonomic impairment suggests a resemblance with Dementia with Lewy Bodies. The prominent association between PS and autonomic impairment may be explained by a shared underlying mechanism. Our results confirm previous reports on the profile of patients developing CS, and mechanisms underlying motor fluctuations may also play a role in the development of CS in PD. © 2009 Movement Disorder Society [ABSTRACT FROM AUTHOR]

Early onset Parkinson's disease (EOPD) has been associated with mutations in the Parkin, DJ-1, PINK1, LRRK2, and SNCA genes. The aim of this study is to assess the contribution of these genes in a Dutch EOPD cohort and the phenotypic characteristics of the mutation carriers. A total of 187 unrelated Dutch EOPD patients (age at onset ≤ 50 years) were phenotyped and screened for mutations in all exons of Parkin, DJ-1, and PINK1 by direct sequencing and gene dosage analysis. Additionally, analysis of the A30P mutation and exon dosage of SNCA and sequencing of exons 19,31,35,38,41, and 48 of LRRK2 was performed. Pathogenic variations could explain disease in 4% (7 of 187) of the patients including five patients carrying homozygous or compound heterozygous mutations in Parkin, one with a novel homozygous deletion in DJ-1 (P158Del) and one with a heterozygous mutation in LRRK2 (T2356I). We found seven novel mutations. The phenotypic characteristics of mutation carriers varied widely, comparable to the variability seen in sporadic EOPD. Parkin is the most frequently mutated gene in this EOPD cohort, followed by DJ-1, PINK1 and LRRK2. The low overall mutation frequency indicates that the extrapolation of mutation frequencies from other populations should be applied with caution. © 2008 Movement Disorder Society [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the characteristics of odor discrimination and odor identification deficits in a large population of patients with Parkinson's disease (PD) and to determine which of these olfactory tests best distinguishes between patients with PD and control subjects. Olfactory performance was assessed in 404 patients with PD and 150 controls, using the odor identification and discrimination parts of the Sniffin' Sticks battery. Mean identification and discrimination scores in patients with PD were significantly lower than in controls. Linear regression analysis using a 95% confidence interval revealed that, relative to the performance of controls, 65.0% of patients with PD had an impairment in odor identification, whereas 42.1% of patients were impaired on the odor discrimination task. ROC curves revealed a higher sensitivity and specificity for odor identification than for odor discrimination in separating patients from controls. In patients with PD, odor discrimination performance decreased with increasing disease duration, whereas odor identification was not correlated with disease stage or duration. In PD, odor identification is more frequently impaired than odor discrimination and allows a better discrimination between patients and controls. Although an odor identification deficit is generally believed to be independent of disease progression, the impairment in odor discrimination appears to increase with disease duration. © 2008 Movement Disorder Society [ABSTRACT FROM AUTHOR]

This study evaluated the comparative validity and usefulness of the Parkinson's Disease Sleep Scale (PDSS) and the Scales for Outcomes in PD-Sleep Scale (SCOPA-S), two disease-specific rating scales for assessing sleep disorders in Parkinson's disease (PD). Hoehn and Yahr staging (HY), SCOPA-Motor, Mini-Mental State Examination, Clinical Impression of Severity Index for PD, Hospital Anxiety and Depression Scale, EuroQoL, and SCOPA-Psychosocial, in addition to PDSS and SCOPA-S (night-time sleep (NS) and daytime sleepiness (DS) subscales), were applied to 187 consecutive PD patients. PDSS and SCOPA-S proved similar in acceptability, scaling assumptions, precision, and internal consistency (Cronbach's α = 0.82-0.84). Factor analysis revealed five separate factors for PDSS (67% of the variance) and one factor for each SCOPA-S subscale (60% of the variance for NS and 57% for DS). Correlation coefficient between PDSS and SCOPA-S NS was −0.60. Sleep scales correlated moderately with mood, low-to-moderate with HRQoL, and low with the rest of measures. PDSS and SCOPA-S DS discriminated between patients grouped by HY severity levels and disease duration. Cutoff points of 82/83 for PDSS and 6/7 for SCOPA-S NS were drawn to identify PD patients with sleep problems. Depression/anxiety scores explained 26% for PDSS and 22% for SCOPA-S NS scores. Both scales provide valid, reliable, and useful means to evaluate sleep disorders in PD. PDSS may be used to obtain a profile about potential causes of 'bad sleep,' but is barely useful to assess DS, whereas SCOPA-S assesses nocturnal sleep disorders and daytime somnolence at a similar extent, without exploring the potential causes. © 2008 Movement Disorder Society [ABSTRACT FROM AUTHOR]

Our objective is to evaluate nighttime sleep problems (NSP) and daytime sleepiness (DS) in patients with Parkinson's disease (PD) compared to controls, and to assess relations with demographic, disease-related, and clinical characteristics in patients. NSP and DS were evaluated with the SCOPA-SLEEP questionnaire in PD patients and controls. In patients, other disease-related and clinical characteristics were also evaluated. Four hundred twenty PD patients [mean (SD) age 61.1 (11.5) years] and 150 controls [mean (SD) age 60.9 (9.9) years] participated in the study. Compared to controls, a significantly greater proportion of patients had excessive DS (EDS) (43 vs. 10%), excessive NSP (ENSP) (27 vs. 9%), or used sleep medication (17 vs. 12%). Difficulties with falling asleep were similar in both groups. In both patients and controls, women experienced more NSP than men. In patients, depressive symptoms accounted for 21% of NSP variance and was the major contributor to the total explained variance (30%). Furthermore, NSP were related to dopamine-agonist and levodopa dose, whereas DS was related to age, dopamine-agonist dose, and disease severity. NSP and DS occur frequently in PD, with EDS being reported more commonly than ENSP. No strong relations were found between DS and demographic or clinical variables. The strong relation between NSP and depressive symptoms in PD calls for future studies to explore the nature of this relation. © 2007 Movement Disorder Society [ABSTRACT FROM AUTHOR]

The objective of this study was to develop a clinimetric sound scale that addresses both psychotic and compulsive complications in Parkinson's disease (PD). The SCales for Outcomes in PArkinson's disease-Psychiatric Complications (SCOPA-PC) was developed by modifying the items of the Parkinson Psychosis Rating Scale (PPRS) and including an item on compulsive behavior in PD. To evaluate the validity of the SCOPA-PC, 106 PD patients were assessed. A subsample of 43 patients was assessed for interrater and test-retest reliability. Construct validity was evaluated using the Neuropsychiatric Inventory (NPI) and the South Oaks Gambling Scale (SOGS). Interrater and test-retest reliability for the total score was 0.95 and 0.91 (intraclass correlation coefficient), respectively. For the items, the interrater reliability ranged from 0.62 to 0.96 (weighted kappa) and the test-retest reliability ranged from 0.54 to 0.88 (weighted kappa). Cronbach's alpha was 0.68. The correlation between the SCOPA-PC total score and the NPI was 0.41. The correlation between SCOPA-PC items and NPI items that addressed similar constructs ranged from 0.34 to 0.68, whereas the correlation between the item on compulsive behavior and the SOGS was 0.49. In conclusion, the SCOPA-PC is a reliable, valid, and easily-administered semistructured questionnaire for both psychotic and compulsive complications in PD. © 2007 Movement Disorder Society [ABSTRACT FROM AUTHOR]

This paper analyses the impact of income inequality on public good provision in an experimental setting. A sample of secondary school students were recruited to participate in a simple linear public goods game where income heterogeneity was introduced by providing participants with unequal token endowments. The results show that endowment heterogeneity does not have any significant impact on contributions to the public good, and that consistent with models of reciprocity, low and high endowment players contribute the same fraction of their endowment to the public pool. Moreover, individuals appear to adjust their contributions in order to maintain a fair share rule. [ABSTRACT FROM AUTHOR]

In May 2003 South Africa introduced legislation intended to decrease plastic bag litter. It combined standards and price-based economic tools in an attempt to reduce the public's demand for plastic bags. This paper analyses the short term effects of the legislation on bag demand. It also provides a background to these regulations and a theoretical overview. The assessment uses bag consumption data from four retailers, each representing a different consumer market. These are analysed, and respective price elasticities calculated. The results suggest that plastic bag demand is relatively price inelastic and imply that instruments utilising price alone, would have limited efficacy. However, the combination of standards and pricing successfully curbed plastic bag use in the short run. Further analysis suggests that the effectiveness of the legislation may be declining over time. [ABSTRACT FROM AUTHOR]

It is often contended that rural development works most effectively when beneficiary communities are active project participants, and not the passive recipients of assistance. This paper analyses participatory development through the lens of public goods theory. South Africa's Community Water Supply & Sanitation Programme is discussed as a case study. Conclusions from our game-theoretic analysis are used to make suggestions for South African development policy. [ABSTRACT FROM AUTHOR]

We evaluated the validity, reliability, and potential responsiveness of the Beck Depression Inventory (BDI) in patients with Parkinson's disease (PD). In part 1 of the study, 92 patients with PD underwent a structured clinical interview for DSM major depression and based on this patients were considered depressed (PD-D) or nondepressed (PD-ND). Subsequently, patients filled in the BDI. In part 2, a postal survey consisting the BDI was performed in 185 PD patients and 112 controls. Test-retest reliability was assessed in 60 PD patients. The factor analysis revealed a cognitive-affective and a somatic factor. Cronbachs α for the BDI was 0.88. Mean BDI indicated significant differences ( P < 0.001) between the PD and control group, between the PD-ND and PD-D group, and between PD-ND and control group. In part 1, the receiver operating characteristic curves showed that the area under the curve for the total BDI was 0.88. A cutoff was calculated for the BDI (14/15) that had the highest sum of sensitivity (0.71) and specificity (0.90). In part 2, the test-retest reliability for the BDI total score was 0.89 (intraclass correlation coefficient). The smallest real difference was 3.3 for the total BDI. The BDI is a valid, reliable, and potential responsive instrument to assess the severity of depression in PD. However, an adjusted cutoff is recommended. © 2006 Movement Disorder Society [ABSTRACT FROM AUTHOR]

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. © 2004 Movement Disorder Society [ABSTRACT FROM AUTHOR]