Search

Research on the correlates of ADHD subtypes has yielded inconsistent findings, perhaps because the procedures used to define subtypes vary across studies. We examined this possibility by investigating whether the ADHD subtype distribution in a community sample was sensitive to different methods for combining informant data. We conducted a study to screen all children in grades 1-5 (N=7847) in a North Carolina County for ADHD. Teachers completed a DSM-IV behavior rating scale and parents completed a structured telephone interview. We found substantial differences in the distribution of ADHD subtypes depending on whether one or both sources were used to define the subtypes. When parent and teacher data were combined, the procedures used substantially influenced subtype distribution. We conclude the ADHD subtype distribution is sensitive to how symptom information is combined and that standardization of the subtyping process is required to advance our understanding of the correlates of different ADHD subtypes.

Objective: To evaluate the impact of changing the response labels of a teacher rating scale in a population-based study of ADHD. Method: For parents, the Diagnostic Interview Schedule for Children, which asks whether each of 18 symptoms occurred "often" in the past year, was used. For teachers, most scales use a 4-point scale, with "often" and "very often" as the two highest categories. To make the two instruments more compatible, the authors created a teacher rating scale with "often" as the highest category. Teachers rated more than 6,000 elementary school students using this instrument. Some teachers completed ratings using both questionnaire formats. Results: The scale's internal consistency, convergent validity, and test-retest reliability are excellent. The factor structure is consistent with established "DSM-IV"-based instruments. Response category choices influence the proportion of children exceeding symptom and impairment thresholds. Conclusion: Altering the response scale does not degrade the psychometric properties of the instrument but makes important differences in the sample. (Contains 6 tables and 4 figures.)

The objectives of this study were to ascertain the prevalence and potential sources of lead exposure among pregnant women residing in a socially-disadvantaged immigrant community in Albuquerque, New Mexico. Pregnant women (n = 140) receiving prenatal care through a community clinic participated in a structured interview and screening to measure their blood lead levels (BLLs). Potential sources of lead exposure were ascertained by the CDC and New Mexico Department of Health questionnaires. Self-reported risk factors were examined as predictors of BLLs using multiple linear regression and partial least squares discriminant analysis. Most patients were Spanish-speaking (88.6%), Latina (95%), foreign-born (87.1%), lacked health insurance (86.4%), and had a high school education or lower (84.3%). While risk factors were prevalent in this population, only three women (2.1%) had BLLs ≥ 3 µg/dL. Results of multivariate analyses demonstrated that pica symptoms in pregnancy, history of elevated BLLs before pregnancy, use of non-commercial pottery, and living in older houses were important predictors of elevated BLLs. Although the prevalence of other risk factors relevant to immigrant communities (i.e., use of traditional/folk remedies and cosmetics, seasonings and food products from Mexico) was high, they were not predictive of elevated BLLs. Clinics providing prenatal care to immigrant Hispanic communities should carefully assess patients' pica symptoms, use of non-commercial pottery, and a history of elevated BLLs. Moreover, additional efforts need to focus on the development of screening questionnaires which better reflect exposures of concern in this population. Keywords Lead * Pregnancy * Hispanics * Immigrants * Environmental exposure * Screening * Questionnaires, Introduction Exposure to lead, a well-established environmental pollutant, is associated with a wide range of multi-systemic adverse effects. Elevated blood lead levels (BLLs) during pregnancy are of particular concern because [...]

Objectives. This study estimated the prevalence of medication treatment for attention deficit-hyperactivity disorder (ADHD) among elementary school children in a North Carolina county. Methods. Parents of 7333 children in grades 1 through 5 in 17 public elementary schools were asked whether their child had ever been given a diagnosis of ADHD by a psychologist or physician and whether their child was currently taking medication to treat ADHD. Parents of 6099 children (83%) responded. Results. By parental report, 607 children (10%) had been given an ADHD diagnosis and 434 (7%) were receiving ADHD medication treatment. Seventy-one % of the diagnosed children were receiving medication. Treatment rates varied by sex, race/ethnicity, and grade. Conclusions. If treatment patterns observed in this study are representative, the public health impact of ADHD may be underestimated.

Women who are exposed to high levels of nitrous oxide in their occupation may have a higher risk of infertility than other women. Nitrous oxide is a gas that is used as a pain killer or as a carrier gas for other anesthetics. Among 418 female dental assistants between 18 and 39 years old who had become pregnant within a four-year period, 28% had become pregnant during the first menstrual cycle of unprotected intercourse. Eighty-seven percent of the women had conceived by the end of 13 menstrual cycles. A longer period of exposure to nitrous oxide was associated with a decreased ability to become pregnant. Nineteen women who were exposed to high levels of nitrous oxide five or more hours per week were less than half as likely to conceive during each menstrual cycle as unexposed women. Exposure to high levels of nitrous oxide may interfere with the secretion of reproductive hormones in women.

Self-reported measures of residential pesticide exposure are commonly used in epidemiological studies, especially when financial and logistical resources are limited. However, self-reporting is prone to misclassification bias. This pilot study assesses the agreement between self-report of residential pesticide exposure with direct observation measures, in an agricultural region of Ecuador, as a cross-validation method in 26 participants (16 rose workers and 10 controls), with percent agreement and kappa statistics calculated. Proximity of homes to nearby flower farms was found to have only fair agreement (kappa =.35). The use of discarded plastics (kappa =.06) and wood (kappa =.13) were found to have little agreement. Results indicate that direct observation or measurement may provide more accurate appraisals of residential exposures, such as proximity to industrial farmland and the use of discarded materials obtained from the flower farms. [ABSTRACT FROM PUBLISHER]