Methods: Validity and utility of community health workers' estimation of kava use

Clough, Alan R.; Bailie, Ross; Burns, C. B.; Guyula, Terrence; Wunungmurra, Roslyn; Wanybarrnga, Sylvia Rrepula

doi:10.1111/j.1467-842x.2002.tb00271.x

Cited by 29 publications

(39 citation statements)

References 11 publications

(10 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In brief, group classifications were verified according to the consensual methodology that required corroborating information from the participant, local community health workers, paid indigenous research assistants from the same clan, and local health records (Burns et al, 1995a, b;Maruff et al, 1998;Clough et al, 2002;Cairney et al, 2003). Blood samples were taken from each participant and analyzed to determine the concentration of lead.…”

Section: Methodsmentioning

confidence: 99%

Neurological and Cognitive Recovery Following Abstinence from Petrol Sniffing

Cairney

Maruff

Burns

et al. 2005

Neuropsychopharmacol

View full text Add to dashboard Cite

Anecdotal observations suggest that neurological impairments associated with petrol (gasoline) sniffing resolve with abstinence, although these effects have not been proven empirically. Severe exposure to leaded petrol may induce a lead encephalopathy that extends beyond any acute intoxication and requires emergency hospital treatment. Previously, in chronic petrol sniffers, we showed neurological, saccadic, and cognitive abnormalities that were more severe in petrol sniffers with a history of hospitalization for lead encephalopathy, and that correlated with blood lead levels and the length of time of sniffing petrol. Ex-petrol sniffers showed a qualitatively similar but quantitatively less severe pattern of impairment. Petrol sniffing was stopped completely in one of the study communities by modifying social, occupational, and recreational opportunities. After 2 years, we obtained biochemical and neurobehavioral (neurological, saccade, and cognitive) data from all available participants of the earlier study including 10 nonsniffers and 29 chronic petrol sniffers, with six of these individuals previously receiving hospital treatment for lead encephalopathy. Here, we report that blood lead was reduced and that neurobehavioral impairments improved, and in many cases normalized completely. The most severe petrol-related neurobehavioral impairment was observed among individuals who had longer histories of abuse and higher blood lead levels, and among petrol sniffers with a history of lead encephalopathy. Those with the greatest extent of neurobehavioral impairment showed the greatest degree of improvement with abstinence, but were less likely to recover completely. This is the first direct evidence that neurological and cognitive impairment from chronic petrol sniffing ameliorates with abstinence and may recover completely.

show abstract

Section: Methodsmentioning

confidence: 99%

Neurological and Cognitive Recovery Following Abstinence from Petrol Sniffing

Cairney

Maruff

Burns

et al. 2005

Neuropsychopharmacol

View full text Add to dashboard Cite

show abstract

“…Similar methods were used to estimate exposure to other substance use and other related data. These methods for assessing exposure to kava use have been validated in an earlier study [21] and the data collection procedures described in detail therein. To summarize, health workers concurred about an individual's history of kava use (k=0 .…”

Section: Data Collectionmentioning

confidence: 99%

“…Controls (n=431, up to four per case) were matched with 120 cases for home locality, sex and age, in 5-year groupings. The methods for selection of controls have been described elsewhere [21]. Each community health centre in the region maintains a paper record of the medical history of local patients which is stored in files held in the health centre.…”

Section: Controlsmentioning

confidence: 99%

“…These factors combined with the mobility of the region's population across the communities and nearby major centres in the ' Top End ' of the NT, made interviewing of cases and controls infeasible. In order to overcome these difficulties, it was necessary to collect data by proxy using interviews with knowledgeable Aboriginal health workers combined with documentary sources [21].…”

Section: Data Collectionmentioning

confidence: 99%

“…For each case and control, consensus classification by health workers was used as already described [21]. Data collection faced peculiar constraints.…”

Section: Data Collectionmentioning

confidence: 99%

See 2 more Smart Citations

Case–control study of the association between kava use and pneumonia in eastern Arnhem Land Aboriginal communities (Northern Territory, Australia)

et al. 2003

View full text Add to dashboard Cite

Pneumonia causes significant morbidity and mortality in Aboriginal populations in Australia's Northern Territory (NT). Kava, consumed in Arnhem Land since 1982, may be a risk factor for infectious disease including pneumonia. A case–control study (n=115 cases; n=415 controls) was conducted in 7001 Aboriginal people (4217 over 15 years). Odds ratios (OR) were calculated by conditional logistic regression with substance use and social factors as confounders. Pneumonia was not associated with kava use. Crude OR=1·26 (0·74–2·14, P=0·386), increased after controlling for confounders (OR=1·98, 0·63–6·23, P=0·237) but was not significant. Adjusted OR for pneumonia cases involving kava and alcohol users was 1·19 (0·39–3·62, P=0·756). In communities with longer kava-using histories, adjusted OR was 2·19 (0·67–7·14, P=0·187). There was no kava dose–response relationship. Crude ORs for associations between pneumonia and cannabis use (OR=2·27, 1·18–4·37, P=0·014) and alcohol use (OR=1·95, 1·07–3·53, P=0·026) were statistically significant and approached significance for petrol sniffing (OR=1·98, 0·99–3·95, P=0·056).

show abstract

Saccade and cognitive impairment associated with kava intoxication

Cairney

Maruff

Clough

et al. 2003

Human Psychopharmacology

Self Cite

View full text Add to dashboard Cite

Kava is an extract from the Piper methysticum Forst. f. plant that has social and spiritual importance in Pacific islands societies. Herbal remedies that contain kava are used for the psychiatric treatment of anxiety and insomnia. Laboratory studies have found only subtle, if any, changes on cognitive or motor functions from the acute effects of consuming small clinical doses of kava products. Intoxication from recreational doses of kava has not been studied. The performance of individuals intoxicated from drinking kava (n=11) was compared with a control group (n=17) using saccade and cognitive tests. On average, intoxicated individuals had consumed 205 g of kava powder each (approximately 150 times clinical doses) in a group session that went for 14.4 h and ended 8 h prior to testing. Intoxicated kava drinkers showed ataxia, tremors, sedation, blepharospasm and elevated liver enzymes (GGT and ALP), together with saccadic dysmetria, saccadic slowing and reduced accuracy performing a visual search task that only became evident as the task complexity increased. Kava intoxication is characterized by specific abnormalities of movement coordination and visual attention but normal performance of complex cognitive functions. Saccade abnormalities suggest disruption of cerebellar and GABAergic functions.

show abstract

Methods: Validity and utility of community health workers' estimation of kava use

Abstract: Objective: Estimating illicit substance use in epidemiological studies is challenging, particularly across ethical, cultural and language barriers. While developing the methods for a case-control study of the

Cited by 29 publications

References 11 publications

Neurological and Cognitive Recovery Following Abstinence from Petrol Sniffing

Neurological and Cognitive Recovery Following Abstinence from Petrol Sniffing

Case–control study of the association between kava use and pneumonia in eastern Arnhem Land Aboriginal communities (Northern Territory, Australia)

Saccade and cognitive impairment associated with kava intoxication

Contact Info

Product

Resources

About