Biomedical subjects

L Stallone

Publications and source records attributed to L Stallone.

3 recordsLinked to original sources

PubMed2001

Studying the epidemiology of attention-deficit hyperactivity disorder: screening method and pilot results.

OBJECTIVE: As part of a larger epidemiologic study of risk factors for attention-deficit hyperactivity disorder (ADHD), this pilot study combined parent and teacher information to estimate ADHD prevalence among elementary school children in a North Carolina county. The methods developed for this study and the pitfalls we encountered illustrate the challenges involved in conducting population-based studies of ADHD. METHODS: We employed 2-stage screening using DSM-IV criteria. Teachers completed behaviour-rating scales for all children. We then administered a structured telephone interview to parents of potential cases. We screened 362 of 424 (85%) children in grades 1 to 5 in 4 schools. RESULTS: According to parent reports, 43 children (12%) had previously been diagnosed with ADHD by a health professional. Thirty-four children (9%) were taking ADHD medication. Forty-six children (12.7%) met study case criteria for ADHD, based on combined teacher and parent reports. Of the 46 cases, 18 (39%) had not been previously identified. Eight previously diagnosed children, however, did not meet case criteria. After we adjusted for nonresponse, the estimated prevalence was 16% (95%CI, 12% to 20%). CONCLUSIONS: These data suggest that the DSM-IV prevalence of ADHD has been substantially underestimated, although the true prevalence in this population may be less than the 16% estimated here. Population-based studies of ADHD are feasible and may provide important information about practice and treatment patterns in community settings, as well as a broader understanding of the etiology and life course of this common disorder.

Attention Deficit Disorder with Hyperactivity↗

PubMed2001

Recruiting a community sample in collaboration with farmworkers.

Few studies have examined health effects of pesticides in farmworkers, possibly because researchers perceive this population to be relatively inaccessible. We conducted an epidemiologic study of health effects among farmworkers in two towns in central Florida--Apopka and Pierson. Apopka is a suburb of Orlando with a diffuse farmworker community working in many crops, whereas Pierson is a small rural town with a tightly knit farmworker community working mainly in ferns. We collaborated with the Farmworker Association of Florida, a grassroots organization representing 6,700 farmworker families. We identified potential participants using membership lists of the Community Trust Federal Credit Union. Members of the Farmworker Association served as recruiters for the study, locating randomly selected Credit Union members and administering a screening interview to determine eligibility. In Apopka 90% of contacted workers were screened, and 79% of eligible workers participated in the study; corresponding proportions in Pierson were 94 and 85%. Farmworkers who had worked for 6-15 years and those who worked in a defined type of agriculture (nursery, citrus, or ferns) were more likely to enroll than others. Thus, while the response rate was good for a multistage recruiting process, study participants had a slightly different work history from those who chose not to enroll. We conclude that it is possible to conduct a study of health outcomes in farmworkers with a defined population and good response rates. Collaboration with the community is essential to the success of such a project, and community characteristics can affect response rates.

Adult↗

PubMedDate not supplied

Semistructured interview for seizure classification: agreement with physicians' diagnoses.

A semi-structured interview was developed for classification of seizures in accordance with the 1981 International League Against Epilepsy (ILAE) criteria. The interview was administered over the telephone by trained lay interviewers. Interview-based diagnoses for 50 patients were compared with independent diagnoses by neurologists who also use the ILAE system for seizure classification. Interview diagnoses agreed with those of physicians for broad seizure-type classifications (i.e., partial vs. generalized onset) in 88% of patients and for detailed combinations of seizure type in 64% of patients. Nonchance agreement between the two sources, assessed by the kappa statistic, was excellent for any partial onset (kappa = 0.83), secondarily generalized (kappa = 0.81), and primary generalized tonic-clonic (kappa = 0.76) seizures. Agreement was fair to good for any generalized onset (kappa = 0.70), simple partial (kappa = 0.56), complex partial (kappa = 0.54), and generalized nonconvulsive (kappa = 0.56) seizures. Sensitivity ranged from 0.60 to 1.0 for partial onset seizures, and from 0.43 to 0.67 for generalized onset seizures. Specificity ranged from 0.60 to 0.87 for partial onset seizures, and was 1.0 for generalized onset seizures. Positive predictive value was 0.95 for any partial onset and 1.0 for any generalized onset seizure. These results suggest that this interview can produce accurate diagnoses of major seizure categories. Use of this instrument for clinical epilepsy research should facilitate conduct of large studies at a significant saving of both time and money.

Humans↗