Levels of metals in hair of young children as an indicator of environmental pollution

In 1982 the levels of lead (Pb), cadmium (Cd), vanadium (V), copper (Cu), and selenium (Se) were determined in hair of 231 four- to five-year-old children. The objective was to explore the feasibility of using metal-in-hair levels in groups of children as an indicator of environmental pollution. The study was carried out in four areas, which were assumed to differ in ambient pollution by metals. A questionnaire on personal data, socioeconomic status, intake of beverages, and life-style was completed by the parents. The metal-in-hair levels covered a large range. The variables pertaining to location together with sex, presence of a garden, and drinking of coffee and/or tea explained 32% of the variance of Pb, 24% of the variance of Cd, and 21% of the variance of V. The total variance explained by all measured questionnaire items was at best 38%. The location was the most important factor. Cu and Se levels did not differ between the locations.     

Recall of medication during pregnancy: Validity and accuracy of an adjusted questionnaire

Objective — To study the validity and accuracy of an adjusted questionnaire on medical drug use during pregnancy eight years after the pregnancy. Methods — The ability of a questionnaire on medication during pregnancy to detect actual use (= sensitivity) was tested against information collected 8 years previously (in 1983–1984) from 473 women with high-risk pregnancies who delivered at the University Hospital Nijmegen, the Netherlands. Results — For separate drug groups, the sensitivity varied between 5% and 91%. The timing of use was recalled moderately well. Although specific questions on drug groups did improve the sensitivity as compared to an earlier questionnaire, the improvement was not enough to make the questionnaire valid. High maternal education, low birth weight, low gestational age and a low 5-min Apgar score were related to better recall. The sensitivity of the questionnaire depended on the behavioural score of the child, implying recall bias. Conclusion — Questionnaire data on drug use during pregnancy obtained eight years after delivery are not a valid source of information.     

Validity and reliability of a questionnaire on fecundability.

The validity of a short questionnaire on fertility problems was tested on a group of 151 moderately educated women who had participated in a prospective study on early pregnancy failure some years before. Part of this group was approached by a personal interview, another part by telephone interviews and a third part was sent a questionnaire by mail. Reliability was tested on another population of 89 women with at least one child. The questionnaire was presented to these women twice with an interval of 3-5 weeks. The validity study showed no systematic errors for either of the approaches. Random errors were fairly large except for the personal interviews. The reliability showed great stability for the telephone interviews as well as for the mailed questionnaire. It is concluded that the questionnaire performs reasonably well, but on some items the draft questionnaire should be rephrased. The choice of a specific approach to the study population depends on the research question.     

A randomized controlled trial of electromagnetic therapy in the primary care management of venous leg ulceration

OBJECTIVE: The aim was to establish the potential efficacy, tolerabilityand side-effect profile of electromagnetic therapy as an adjunctto conventional dressings in the treatment of venous leg ulcers. METHOD: A prospective, randomized, double blind controlled clinicaltrial was carried out in a dedicated leg ulcer clinic basedin one urban general practice. Nineteen patients with leg ulcersof confirmed venous aetiology were assessed. The main outcomemeasures were rate and scale of venous leg ulcer healing, changesin patient-reported pain levels, quality of life, degree ofmobility, side effect profile and acceptability to patientsand staff. RESULTS: Sixty-eight per cent of patients attending this dedicated clinicachieved improvements in the size of their ulcer (4, 21%, healedfully) and in reduced pain levels (P < 0.05) during the trial,despite the chronicity of ulcer histories. Patients treatedwith electromagnetic therapy at 800 Hz were found at day 50to have significantly greater healing (P < 0.05) and paincontrol (P < 0.05) than placebo therapy or treatment with600 Hz. All patients reported improved mobility at the end ofthe study. The electromagnetic therapy was well tolerated bypatients, with no differences between groups in reporting adverseevents, and proved acceptable to staff. CONCLUSION: Despite the small numbers in this pilot study, electromagnetictherapy provided significant gains in the healing of venousleg ulcers and reduction in pain. Keywords. Electromagnetic therapy, RCT, leg ulcers, primary care.