Press releases Saturday 10 April 2004
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(1) BRIGHT CLOTHING AND WHITE HELMETS CUT MOTORCYCLE DEATHS
(2) ANTIDEPRESSANTS ARE NOT SAFE FOR CHILDREN
(3) ALCOHOL LIMIT FOR DRINK DRIVING SHOULD BE MUCH LOWER
(4)
HIV PREVENTION SCHEMES NEGLECT PARTNER REDUCTION
(1) BRIGHT CLOTHING AND WHITE HELMETS CUT MOTORCYCLE DEATHS
(Motorcycle rider conspicuity
and crash related injury: case-control study)
http://bmj.com/cgi/content/full/328/7444/857
Wearing reflective clothing, a white or light coloured helmet, and using headlights during the day can reduce serious injuries or death from motorcycle crashes by up to one third, according to research from New Zealand in this week's BMJ.
The study included 463 motorcycle drivers involved in crashes leading to hospital treatment or death and a further 1,233 motorcycle drivers randomly selected from roadside surveys in the same region and time period.
Several factors including age, years of on-road riding experience, weather conditions and some risk taking behaviours (such as alcohol consumption) were taken into account.
Drivers wearing reflective or fluorescent clothing had a 37% lower risk of crash related injury than other drivers. Compared with wearing a black helmet, use of a white helmet was associated with a 24% lower risk, and daytime use of headlights was associated with a 27% lower risk.
There was no association between risk of crash related injury and the frontal colour of drivers' clothing or motorcycle.
Increasing the use of reflective or fluorescent clothing, white or light coloured helmets, and daytime headlights are simple, cheap ways to increase the visibility of motorcycle riders on the roads and could considerably reduce motorcycle crash related injury and death, conclude the authors.
Contact:
Susan Wells, Senior Lecturer in Epidemiology,
School of Population Health, University of Auckland, New Zealand
Email: s.wells@auckland.ac.nz
(2) ANTIDEPRESSANTS ARE NOT SAFE FOR CHILDREN
(Efficacy and safety of antidepressants
for children and adolescents)
http://bmj.com/cgi/content/full/328/7444/879
Just how safe and effective are antidepressants in children and adolescents?
Researchers in this week's BMJ uncover disturbing shortcomings in trials of newer antidepressants in this patient group. They conclude that antidepressant drugs cannot confidently be recommended as a treatment option for childhood depression.
They reviewed six published trials of newer antidepressants in children. They analysed each study's methods and the extent to which authors' conclusions were supported by data.
Drug companies paid for the trials and otherwise remunerated the authors of at least three of the four larger studies.
The trials consistently exaggerated the benefits of drugs and downplayed the side effects. Improvement in control groups was strong, while additional benefit from drugs was of doubtful clinical significance, write the authors.
Biased reporting and over-confident recommendations in treatment guidelines may mislead doctors, patients, and families, they say. Many will undervalue non-drug treatments that are probably both safer and more effective.
Trustworthy trial results are a foundation of good medical care. It is vital that authors, reviewers, and editors ensure that published interpretations of data are more reasonable and balanced than is the case in the industry dominated literature on childhood antidepressants, they conclude.
Contact:
Jon Jureidini, Department of Psychological
Medicine, Women's and Children's Hospital, North Adelaide, Australia
Email: jureidinij@wch.sa.gov.au
(3) ALCOHOL LIMIT FOR DRINK DRIVING SHOULD BE MUCH LOWER
(Letter: Alcohol limit for
drink driving should be much lower)
http://bmj.com/cgi/content/full/328/7444/895
The alcohol limit for drink driving should be much lower, argues a researcher in this week's BMJ.
In the United Kingdom, United States, Canada, South Africa, and Sri Lanka the legal blood alcohol limit is 0.08 mg per 100 ml.
This is too high as there is clear evidence that driving skills deteriorate and the risk of becoming involved in a crash increases from a blood alcohol concentration of 0.02 mg per 100 ml, says the author.
Because the legal blood alcohol concentration in most countries is so high, people often mistakenly believe that they may drive up to this limit, overlooking the fact that driving is impaired at lower concentrations, he adds.
To set a blood alcohol limit so high may adversely influence people's estimates of their relative risk of injury or death while driving. Drinking and driving policies and decisions about enforcement need to be hinged on the scientific evidence, he concludes.
Contact:
Ediriweera Desapriya, Research Associate,
Department of Paediatrics, Centre for Community Child Health Research,
Vancouver, Canada
Email: edesap@cw.bc.ca
(4) HIV PREVENTION SCHEMES NEGLECT PARTNER REDUCTION
(Partner reduction is crucial
for balanced "ABC" approach to HIV prevention)
http://bmj.com/cgi/content/full/328/7444/891
(Editorial: Partner reduction
and the prevention of HIV/AIDS)
http://bmj.com/cgi/content/full/328/7444/848
Without multiple sexual partnerships there would be no global AIDS pandemic, yet partner reduction is still overlooked in most HIV prevention programmes, argue researchers in this week's BMJ.
Interest has been growing in an "ABC" approach to HIV prevention in which A stands for abstinence or delay of sexual activity, B for be faithful, and C for condom use.
While most programmes to prevent HIV have focused on promoting abstinence or condom use, partner reduction has been the neglected component of this approach, write James Shelton and colleagues.
However, partner reduction has had an important role in countries that have cut HIV infections. For example, multiple partner behaviour dropped noticeably after a national campaign in Uganda to encourage people to practice fidelity.
The authors believe that it is imperative to begin including (and rigorously evaluating) messages about mutual fidelity and partner reduction in ongoing activities to change sexual behaviour.
"Rather than arguing over the merits of abstinence versus condoms, it is time for the international community to unite around a balanced, evidence based ABC approach," they conclude.
Authors of an accompanying commentary suggest that the ABC approach to changing sexual behaviour could be used to tackle all sexually transmitted infections. They believe that, although partner reduction is critical, encouraging young people to delay sexual intercourse should be the first step in programmes to prevent these infections.
Partner reduction is good epidemiology, not good ideology, adds David Wilson of the World Bank's Global HIV/AIDS Program, in an accompanying editorial. He believes that the key to HIV prevention lies in rapid, inexpensive, and locally led initiatives that rely on simple messages to promote changes in community norms, rather than mass media.
Contacts:
(Paper: Daniel Halperin, Senior Technical
Adviser, Office of HIV-AIDS, US Agency for International Development, Washington
DC, USA
Email: dhalperin@usaid.gov
Commentary: Stephen Genuis, Associate
Professor, University of Alberta, Canada
Email: sgenuis@ualberta.ca
/ sgenuis@incentre.net
Editorial: David Wilson, Senior Monitoring
and Evaluation Specialist, Global HIV/AIDS Program, World Bank, Washington
DC, USA
Email: dwilson@worldbank.org
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