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(2) ADVICE
ON DRIVING AFTER GROIN HERNIA
SURGERY IS
INCONSISTENT
(3) RAPE:
INTERNATIONAL ACTION IS NOT ENOUGH
(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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