This new edition of Ann Bowling's well-known and highly respected text has been thoroughly revised and updated to reflect key methodological developments in health research. It is a comprehensive, easy to read, guide to the range of methods used to study and evaluate health and health services. It describes the concepts and methods used by the main disciplines involved in health research, including: demography, epidemiology, health economics, psychology and sociology.The research methods described cover the assessment of health needs, morbidity and mortality trends and rates, costing health services, sampling for survey research, cross-sectional and longitudinal survey design, experimental methods and techniques of group assignment, questionnaire design, interviewing techniques, coding and analysis of quantitative data, methods and analysis of qualitative observational studies, and types of unstructured interviewing. With new material on topics such as cluster randomization, utility analyses, patients' preferences, and perception of risk, the text is aimed at students and researchers of health and health services. It has also been designed for health professionals and policy makers who have responsibility for applying research findings in practice, and who need to know how to judge the value of that research.

Research Methods in Health. Investigating health and health services

BACKGROUND AND OBJECTIVE: Overdiagnosis and underdiagnosis of attention-deficit/hyperactivity disorder (ADHD) are widely debated, fueled by variations in prevalence estimates across countries, time, and broadening diagnostic criteria. We conducted a meta-analysis to: establish a benchmark pooled prevalence for ADHD; examine whether estimates have increased with publication of different editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM); and explore the effect of study features on prevalence. METHODS: Medline, PsycINFO, CINAHL, Embase, and Web of Science were searched for studies with point prevalence estimates of ADHD. We included studies of children that used the diagnostic criteria from DSM-III, DSM-III-R and DSM-IV in any language. Data were extracted on sampling procedure, sample characteristics, assessors, measures, and whether full or partial criteria were met. RESULTS: The 175 eligible studies included 179 ADHD prevalence estimates with an overall pooled estimate of 7.2% (95% confidence interval: 6.7 to 7.8), and no statistically significant difference between DSM editions. In multivariable analyses, prevalence estimates for ADHD were lower when using the revised third edition of the DSM compared with the fourth edition (P = .03) and when studies were conducted in Europe compared with North America (P = .04). Few studies used population sampling with random selection. Most were from single towns or regions, thus limiting generalizability. CONCLUSIONS: Our review provides a benchmark prevalence estimate for ADHD. If population estimates of ADHD diagnoses exceed our estimate, then overdiagnosis may have occurred for some children. If fewer, then underdiagnosis may have occurred.

Prevalence of attention-deficit/ Hyperactivity disorder: A systematic review and meta-analysis

Statistical Methods in Medical Research.

The Foundations of Statistics By Prof. Leonard J. Savage. (Wiley Publications in Statistics.) Pp. xv + 294. (New York; John Wiley and Sons, Inc.; London: Chapman and Hall, Ltd., 1954.) 48s. net.

Probability and Statistical Inference

American Cancer Society Guidelines for the Early Detection of Cancer

Attention deficit hyperactivity disorder (ADHD) is among the most common, intensely investigated, and yet diagnostically controversial neurobehavioral conditions of childhood. The prevalence of ADHD has been reported with great variations among different studies, ranging from 2.2% to 17.8%. The aim of this review was to investigate the variables that influence the prevalence of ADHD and to derive a best estimate for the prevalence of the disorder. We reviewed all the 39 studies on ADHD prevalence appearing in the Pubmed and published since 1992. These studies indicate that ADHD is more common in boys than girls, in younger than older children and adolescents, in one-setting rather than two-setting screening studies, in studies based on DSM-IV rather than DSM-III-R criteria. Additional factors that may well influence prevalence rates include source of information and assessment of clinical impairment. In conclusion, our findings suggest that population characteristics, methodology features, ethnic and cultural differences and diagnostic criteria involved in studies affect the prevalence of ADHD. Standardized designs may lead to firm conclusions on the true prevalence of ADHD, the estimation of which seems impossible to be achieved by reviewing the already existing literature.

Variations in prevalence of attention deficit hyperactivity disorder worldwide

The Role of Empathy in Health and Social Care Professionals

Background
The aim of the present work was to investigate the relative importance of socio-demographic and physical health status factors for subjective functioning, as well as to examine the role of social support.

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Socio-demographic factors and self-reported funtional status: the significance of social support

Although General Practice (GP) was recognized as a medical specialty in Greece in 1986, the number of GPs is insufficient to cover needs and only few medical graduates choose GP as a career option. In the present study we investigated the profile of medical students in terms of their decisions regarding specialization and the possible association of career choices different from GP with the status of undergraduate training regarding GP. The sample consisted of final year students in the Medical School of the University of Athens, Greece. Students filled in a self-reported questionnaire focusing on medical specialization, and GP in particular. Response rate was 82.5% with 1021 questionnaires collected, out of 1237 eligible medical students. Only 44 out of the 1021 (4.3%) respondents stated that GP is -or could be- among their choices for specialty. The most popular medical specialty was General Surgery (10.9%), followed by Cardiology (9.6%), Endocrinology (8.7%) and Obstetrics-Gynaecology (8.3%). The most common criterion for choosing GP was the guaranteed employment on completion of the residency (54.6%) while a 56.6% of total respondents were positive to the introduction of GP/FM as a curriculum course during University studies. Despite the great needs, GP specialty is currently not a career option among undergraduate students of the greater Medical University in Greece and is still held in low esteem. A university department responsible for undergraduate teaching, promotion and research in GP (where not available) is essential; the status of undergraduate training in general practice/family medicine seems to be one of the most important factors that influence physician career choices regarding primary care specialties.

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General Practice as a career choice among undergraduate medical students in Greece

Previous research has suggested that individuals are mostly prone to loneliness in their later years of life because of exposure to several risk factors typical of old age. The current study aims to examine possible demographic, health and social determinants of loneliness among older adults in Europe. Data on a nationally representative sample of 5074 Europeans aged ≥ 65 years were drawn from the first wave of the Survey of Health, Aging and Retirement in Europe (SHARE, 2004/2005). Frequency of feelings of loneliness was examined according to adverse health conditions, stressful life events and social isolation indicators. Female gender, older age, lower socioeconomic status, living unpartnered, being childless and having no activity involvement were significantly associated with frequent feelings of loneliness (p < 0.001). The proportion of the respondents who declared enduring loneliness most of the time compared with none of the time was significantly higher among Southern Europeans relative to their Northern counterparts (p < 0.001). Recent departure of offspring from the parental nest was a significant predictor of loneliness in both the second (ORs = 2.08; 95% CI 1.24–3.48) and the third (ORs = 1.75; 95% CI 1.03–2.96) multiple regression models. In this sample of older Europeans, several demographic characteristics, specific adverse health conditions, stressful life events and social isolation indicators were associated with feelings of loneliness. Policy initiatives for the alleviation of loneliness in older age should therefore aim at improving psychosocial and health-related difficulties faced by this population.

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Anastas Philalithis

Papers

Variations in prevalence of attention deficit hyperactivity disorder worldwide

The Role of Empathy in Health and Social Care Professionals

Socio-demographic factors and self-reported funtional status: the significance of social support

General Practice as a career choice among undergraduate medical students in Greece

Loneliness among older European adults: results from the survey of health, aging and retirement in Europe