Releases Saturday 28 October 2000
No 7268 Volume 321

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(1) CYCLE HELMETS DO PROTECT AGAINST HEAD
INJURIES

(2) ADVICE ON DRIVING AFTER GROIN HERNIA
SURGERY IS INCONSISTENT

(3) RAPE: INTERNATIONAL ACTION IS NOT ENOUGH



(1) CYCLE HELMETS DO PROTECT AGAINST HEAD
INJURIES

(Trends in serious head injuries among cyclists in England:
analysis of routinely collected data)
http://bmj.com/cgi/content/full/321/7268/1055

(Editorial: Bicycle helmets: it's time to use them)
http://bmj.com/cgi/content/full/321/7268/1035

The number of serious head injuries among cyclists of all ages
has fallen as a result of increasing helmet use, despite doubts
about the effectiveness of helmets, particularly for adults,
finds a study in this week's BMJ.

Researchers at Imperial College London calculated the
number of cyclists admitted to hospital with head injuries, as a
percentage of total monthly admissions, between April 1991
and March 1995. The patients were divided into three age
categories: junior (6-10 years), secondary (11-15 years), and
adult (16 years and over). The authors found that numbers of
emergency admissions among cyclists changed little over the
four-year study period. However, the number admitted with
head injuries fell from 40% to 28%. Each age group showed
a significant reduction, add the authors: 9% among junior,
11% among secondary and 13% among adults.

These findings indicate that helmets are of benefit both to
children and, contrary to popular belief, to adults, say the
authors. Local publicity campaigns encouraging the voluntary
wearing of helmets have been effective and should
accompany national drives to promote cycling, they conclude.

Contact:

Adrian Cook, Department of Primary Health Care and
General Practice, Imperial College School of Medicine,
London, UK
Email: a.d.cook@ic.ac.uk

(2) ADVICE ON DRIVING AFTER GROIN HERNIA
SURGERY IS INCONSISTENT

(Advice on driving after groin hernia surgery in the United
Kingdom: questionnaire survey)
http://bmj.com/cgi/content/full/321/7268/1056

(Editorial: Driving after repair of groin hernia)
http://bmj.com/cgi/content/full/321/7268/1033

Advice given to patients on when to drive after groin hernia
surgery is inconsistent, varying from the day of surgery to two
months after surgery, according to a study in this week's
BMJ, highlighting the need for national guidelines to be
developed.

Ismail and colleagues, from Harold Wood Hospital in
Romford, Essex, surveyed 200 consultant general surgeons
and managers of 30 day surgery units in the UK about advice
they give to patients on driving after groin hernia repair.
Advice ranged from it was all right for patients to drive the
same day, to patients should wait six to eight weeks before
driving. The most common response, given by 38 surgeons,
was that patients should wait two weeks.

Eighty-five surgeons based their advice on common sense
and traditional practice, and 16 relied on published data. Yet
even these 16 gave variable advice, say the authors.
Furthermore, many day units did not provide written
information on driving after hernia repair or failed to
document what information had been given, they add.

Given the potential safety, financial and social implications of
driving after hernia surgery, surgeons and day surgery units
should be able to provide patients with consistent,
evidence-based information on driving different types of
vehicles, say the authors. They stress the points which should
be taken into consideration when advising patients when they
may safely drive after groin hernia surgery and call for
national guidelines on this issue to be developed.

Contact:

Wael Ismail, Locum Consultant Surgeon, Harold Wood
Hospital, Romford, UK
Email: Wael@ismail.com

(3) RAPE: INTERNATIONAL ACTION IS NOT ENOUGH

(Editorial: Time to talk about rape)
http://bmj.com/cgi/content/full/321/7268/1034

(Personal View: The day my life changed)
http://bmj.com/cgi/content/full/321/7268/1089

At least one in every five women experiences rape or
attempted rape during her lifetime, yet international efforts to
prevent sexual violence are failing because the judicial system
is so often stacked against women, according to an editorial
in this week's BMJ.

A Human Rights Watch report recently concluded that sexual
violence is increasing and women in many countries are
becoming worse off. It identifies issues that need to be
addressed - such as eliminating police bias, providing
protection from further violence and ensuring that
perpetrators are brought to justice. Yet such high level
measures are often hard to implement because they involve
changing attitudes and power relationships, so perhaps it is
not surprising that a purely "top-down" approach is
ineffective, argues the author.

A strong, coordinated "bottom-up" approach is also required,
with healthcare professionals as advocates for women -
providing support and care for both the physical and
emotional consequences of sexual violence. "We need to
brush aside the taboos and talk more openly about this huge
problem and the practical ways of tackling it," concludes the
author.

The importance of health professionals as advocates is also
emphasised in a personal view, written anonymously for the
BMJ, which reveals how counselling sessions enabled one
woman to come to terms with her ordeal.

Contact:

Rhona MacDonald, Editorial Registrar, British Medical
Journal, London, UK
Email: Rmacdonald@bmj.com


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