Investigating Helmet Promotion for Cyclists: Results from a Randomised Study with Observation of Behaviour, Using a Semi-Automatic Video System

INTRODUCTION: Half of fatal injuries among bicyclists are head injuries. While helmet use is likely to provide protection, their use often remains rare. We assessed the influence of strategies for promotion of helmet use with direct observation of behaviour by a semi-automatic video system. METHODS: We performed a single-centre randomised controlled study, with 4 balanced randomisation groups. Participants were non-helmet users, aged 18–75 years, recruited at a loan facility in the city of Bordeaux, France. After completing a questionnaire investigating their attitudes towards road safety and helmet use, participants were randomly assigned to three groups with the provision of “helmet only”, “helmet and information” or “information only”, and to a fourth control group. Bikes were labelled with a colour code designed to enable observation of helmet use by participants while cycling, using a 7-spot semi-automatic video system located in the city. A total of 1557 participants were included in the study. RESULTS: Between October 15th 2009 and September 28th 2010, 2621 cyclists' movements, made by 587 participants, were captured by the video system. Participants seen at least once with a helmet amounted to 6.6% of all observed participants, with higher rates in the two groups that received a helmet at baseline. The likelihood of observed helmet use was significantly increased among participants of the “helmet only” group (OR = 7.73 [2.09–28.5]) and this impact faded within six months following the intervention. No effect of information delivery was found. CONCLUSION: Providing a helmet may be of value, but will not be sufficient to achieve high rates of helmet wearing among adult cyclists. Integrated and repeated prevention programmes will be needed, including free provision of helmets, but also information on the protective effect of helmets and strategies to increase peer and parental pressure

Botulinum toxin to improve results in cleft lip repair: a double-blinded, randomized, vehicle-controlled clinical trial.

Most patients with facial scarring would value even a slight improvement in scar quality. Botulinum toxin A is widely used to alleviate facial dynamic rhytides but is also believed to improve scar quality by reducing wound tension during healing. The main objective was to assess the effect of Botulinum toxin on scars resultant from standardized upper lip wounds.This article is freely available via Open Access. Click on the 'Additional Link' to access the full-text

Review: Bucephalus minimus, a deleterious trematode parasite of cockles Cerastoderma spp.

Trematodes are the most prevalent and abundant macroparasites in coastal waters. They display a complex life cycle with alternation of free-living and parasitic stages generally involving three host species. The most deleterious stage is in the first intermediate host (a mollusc) where the parasite penetrates as miracidium larvae and asexually multiplicates in sporocysts/rediae to provide cercariae larvae. However, due to basic low prevalence in ecosystems, this system remains difficult to study. Taking the example of the cockle (Cerastoderma edule), an exploited bivalve along North-Eastern Atlantic coasts, and Bucephalus minimus, its most prevalent parasite as first intermediate host, we summarised the 51 most relevant papers (1887-2015). Besides, a 16-year monthly monitoring was performed at Banc d'Arguin (Atlantic coast of France), and allowed to obtain a sufficient number of infected cockles (276 out of 5,420 individuals) in order to provide new information concerning this parasite/host system. Sporocysts (diameter 80-500 μm) and developing cercariae (length 300-500 μm) are not visible before cockle reaches 16-mm shell length and then prevalence increases with host size. Seasonality of infection was not observed but variation of prevalence was significant among years and negatively correlated to the temperature of the former year, which could correspond to the period of infection by miracidium. Seven other species of trematode were identified in cockles as second intermediate host. For six of them, metacercariae abundance per individual was 2 to 12 folds higher in B. minimus-infected cockles, exacerbating the potential negative impact on host. From the parasite point of view, metacercariae can be considered as hitchhikers, taking advantage of the abnormal migration of B. minimus-infected cockles to the sediment surface where they become more vulnerable to predators that are also the final hosts of many of these parasites