Biomedical subjects

C F Finch

Publications and source records attributed to C F Finch.

At least 55 records · Page 3Linked to original sources

PubMed2001

Balancing the risk of injury to gymnasts: how effective are the counter measures?

BACKGROUND: To minimise injury risk and maximise gymnastics performance, coaches, parents, and health professionals working with young gymnasts need to understand and practise safe gymnastics. AIMS: To (a) identify the various injury counter measures specific to gymnastics, (b) critically review the literature describing each injury prevention measure, and (c) assess, using available risk factor and injury data, the weight of evidence to support each of these counter measures. Specific recommendations for further research and implementation strategies to prevent injury and improve safety are also given. METHODS: The relevant literature was identified through the use of Medline (1966 to May 1998) and SPORT Discus (1975 to May 1998) searches, hand searching of journals and reference lists, and discussions with key Australian gymnastics organisations. RESULTS: The key gymnastics injury counter measures identified in this review include coaching (physical preparation, education, spotting, and performance technique), equipment, and the health support system (medical screening, treatment, and rehabilitation). Categorisation of the type of evidence for the effectiveness of each of these counter measures in preventing injury showed that most of it is based on informal opinion/anecdotal evidence, uncontrolled data based studies, and several prospective epidemiological studies. There is no evidence from formally controlled trials or specific evaluation studies of counter measures for gymnastics. CONCLUSIONS: Although gymnastics is a sport associated with young participants and frequent high volume, high impact training, there is a paucity of information on injury risk factors and the effectiveness of injury practices. Further controlled trials are needed to examine the extent to which injury prevention counter measures can prevent or reduce the occurrence of injury and re-injury. Particular attention should be devoted to improving training facilities, the design and testing of apparatus and personal equipment used by gymnasts, and coaching and the role of spotting in preventing injury.

Athletic Injuries↗

PubMed2001

Warm up practices of golfers: are they adequate?

BACKGROUND: Although it is widely recommended that golfers warm up before play or practice to enhance their physical performance and reduce their injury risk, it is not known to what extent they actually undertake such warm up procedures. OBJECTIVE: To collect information about the proportion of golfers who actively warm up and to determine the types of warm up behaviours. METHODS: This study was conducted over three weeks at three different golfing venues: a private golf course, a public golf course, and a golf driving range. Golfers' warm up behaviours, defined as any form of preparative exercise, were recorded by direct observation by two independent observers. RESULTS: The sample consisted of 1040 amateur golfers (852 men and 188 women) aged at least 18 years. Only 54.3% (95% confidence interval 49.8 to 58.8) performed some form of warm up activity. Air swings on the tee were the most commonly observed warm up activity, with 88.7% (95% confidence interval 85.9 to 91.5) of golfers who warmed up performing these. CONCLUSIONS: Only a small proportion of amateur golfers perform appropriate warm up exercises. To improve on this, golfers should be educated about the possible benefits of warming up and be shown how to perform an appropriate warm up routine.

Golf↗

PubMed2001

What do under 15 year old schoolboy rugby union players think about protective headgear?

OBJECTIVES: When protective headgear is designed, the attitudes of the intended users needs to be taken into account, as well as safety performance criteria. The aim of this study was therefore to determine the attitudes of schoolboy rugby union players towards protective headgear. METHODS: A survey of 140 rugby union players (82.4% response rate) from 10 randomly selected school teams in metropolitan Sydney was conducted at the end of the 1999 playing season. All players were aged 14-16 years. All teams had participated in a trial of headgear during the 1999 season in which six of the teams had been assigned to a headgear trial arm and four teams to a control arm. Players completed a self report questionnaire during a supervised session at school. The questionnaire collected information on recent head injuries, use of protective equipment, and attitudes towards headgear. RESULTS: Some form of protective equipment was always worn by 76.1% of players: 93.6% reported using a mouthguard and 79.3% a helmet/headgear during the 1999 season. The two most important reasons for wearing headgear were related to safety concerns. Players with no recent head/neck injury were more likely to report that they felt safer when wearing headgear (p<0.001) and less likely to cite a previous injury as a motivating factor for wearing headgear (p<0.001) than those who had sustained a recent head/neck injury. Of the players who wore headgear during the 1999 season, 67% said that they played more confidently when they wore headgear, but 63% said that their head was hotter. Few players reported that their head was uncomfortable (15%) or that it was hard to communicate (3%) when they wore headgear. The main reasons for not wearing headgear were related to its design features: uncomfortable (61%) and it was hot (57%). CONCLUSIONS: The primary reason cited by players for wearing headgear is safety. Receiving an injury would also motivate non-wearers to wear headgear. Players report that they are more confident and able to tackle harder if they wear headgear, suggesting that a belief in its protective capabilities may influence behaviour. These attitudes need to be addressed in the design of effective headgear as well as in strategies to promote its use.

Adolescent↗

PubMed2001

A profile of patients attending sports medicine clinics.

OBJECTIVES: To describe the sociodemographic profile of sports injury patients who attend sports medicine clinics for treatment and to describe their reasons for choosing to attend such clinics. METHOD: Data were collected as part of a fully audited injury surveillance system implemented within sports medicine clinics. The study was conducted within five allied multidisciplinary sports medicine clinics in metropolitan Melbourne, Australia. All patients initially presenting for treatment of a new sports or active recreation injury over the period August 1997 to August 1998 were eligible for this study, irrespective of the practitioner providing the treatment. Data were obtained on 6476 patients. RESULTS: The median age of the patients was 25.4 years (range 6.8--81.6) and most were male (69.8% of cases; 95% confidence interval (95% CI) 68.7 to 70.9). Patients had both professional and non-professional backgrounds and were not just local suburb residents. Many patients had insurance cover for their injury treatment: 59.0% (95% CI 58.6 to 59.4) had some private health insurance and 46.6% (95% CI 45.4 to 47.8) had club/association insurance. The most common reasons for attending a clinic was its location (36.8%; 95% CI 36.5 to 37.1) and referral/recommendation (31.0%; 95% CI 30.7 to 31.3). CONCLUSION: Sports medicine clinics provide treatment for a broad spectrum of injured sports participants across a variety of sporting/recreation contexts. Although these clinics mainly serve the immediate geographic community, the sports speciality and expertise of a particular clinic can attract patients from further afield. This information can help sports medicine clinics to market their services more efficiently to meet the needs of their potential patients.

Adolescent↗

PubMed2000

The safety practices of sporting clubs/centres in the city of Hume.

Sports injuries are a significant public health problem in Australia. However, little information is available about community level sports injuries, or about the sports safety policies and practices of community level sports organisations in Australia. The aim of this paper is to present the results of a survey of local clubs and sporting centres in the City of Hume, a local council in Victoria. This is the first reported survey of safety practices of sporting clubs/centres at the community level in Australia. Sixty-four clubs/centres participated in the survey, which involved face-to-face interviews with representatives from the participating clubs/centres. A major finding was that whilst sports bodies perform certain activities typically associated with preventing sports injuries, they often do not have formal policies or written objectives which recognise the safety of their participants as an important goal. The sports safety measures reported to be adopted by the surveyed clubs/centres included use of protective equipment, accredited coaches, sports trainers, encouraging warm-ups, modified rules for juniors and checking of playing areas and facilities for environmental hazards. The provision of first aid services (including personnel and equipment) varied across the sporting clubs/centres. The major barriers towards improving sports safety were reported to be a lack of funds, the media's attitude towards sports injuries and the role of the local council as the owner of sporting facilities. There is also a clear role for researchers to improve the dissemination of key findings from their injury prevention research in a form that can be readily used at the grass roots of sports participation.

Athletic Injuries↗

PubMed2000

Preventing injuries to competitive and recreational adult golfers: what is the evidence?

Although injuries to golfers are not common, both survey studies and hospital emergency department records have provided objective evidence that golfers are sometimes at risk of injury. While many golf injury studies describe the associated mechanisms and types of injuries, less attention has been given to research relating to the various injury prevention measures for this sport. This paper provides a critical review of the range of countermeasures to prevent golf injuries and highlights areas to be considered for future research, development, and implementation. In particular, it focuses on the strength of the evidence for the effectiveness of these measures. This review concludes that there needs to be more formal evaluation of the suggested countermeasures to prevent golf injuries. Particular attention should be given to evaluations of the golf swing and its relationship to particular injuries such as low-back, wrist, and shoulder problems. These countermeasures and associated strategies are recommended to reduce the incidence of injury in this popular and accessible sport.

Adult↗

PubMed2000

Sport, age, and sex specific incidence of sports injuries in Western Australia.

OBJECTIVE: To describe the trends in recreational sports injury in Perth, Western Australia. DESIGN: A prospective cohort study of sports injuries during the 1997 winter season (May to September). SETTING: Sample of Australian football, field hockey, basketball, and netball players from the Perth metropolitan area, Western Australia. METHODS: A cohort of sports participants was followed over the five month winter sports season. Before the season, participants completed a baseline questionnaire and during the season were interviewed every four weeks by telephone. RESULTS: Overall, 92% of participants (n = 1391) who completed a baseline questionnaire completed at least one follow up telephone interview. About half (51%) of the cohort sustained one or more injuries during the winter season accounting for a total of 1034 injuries. Most injuries were of moderate (58%, n = 598) or minor (40%, n = 412) severity, with only 3% (n = 24) requiring emergency department treatment or a hospital stay. The injury incidence rate was greatest for football (20.3/1000 hours of participation), similar for field hockey and basketball (15.2/1000 hours and 15.1/1000 hours respectively), and lowest for netball (12.1/1000 hours). The incidence of injury was greatest in the first four weeks of the season, and participants aged between 26 and 30 years had about a 55% greater risk of injury than those aged less than 18 years. CONCLUSIONS: This is one of the first studies to show that recreational sports are safe. Although the likelihood of injury was greatest in the first month of the season, few injuries required admission to hospital or emergency department treatment. A greater emphasis on prevention in the early part of the season should help to reduce the elevated incidence of injury found at this time.

Adolescent↗

PubMed1999

Injury surveillance during medical coverage of sporting events--development and testing of a standardised data collection form.

Medical coverage services have the potential to play a key role in sports injury surveillance activities. Provided that injury surveillance activities are fully coordinated and a standardised data collection procedure is implemented, valuable sports injury information can be obtained by medical coverage personnel. This paper describes the development of a standardised injury data collection form for use by medical coverage personnel during large sporting events. The form was trialed during two large sporting events in Melbourne, Australia in 1995. A range of sports medicine and sports first aid personnel was involved in the trial and injury details were collected on all persons receiving treatment from the coverage team, irrespective of injury severity. The final sports injury data collection form is easy to use, can be used by all types of medical coverage personnel and can provide valuable data in a timely manner. The form has since been adopted as the injury data collection standard at a number of major Australian sporting events. Recommendations for incorporating injury surveillance activities when organising sporting events and planning medical coverage services are given. Suggestions for maximising compliance with data collection procedures are also discussed.

Algorithms↗

PubMed1999

Relationship of hydrolase activities to epithelial cell turnover in distal colonic mucosa of normal rats.

BACKGROUND: The relationships between changes induced by diet in colonic epithelial kinetics and in the activities of brush border hydrolases are poorly defined. The aims of this study are to define these relationships, as changes in kinetics would be expected to influence differentiation, and to determine whether the type of ingested dietary indigestible carbohydrates influences hydrolase activities. METHODS: Groups of eight rats were fed a low fibre diet +/- supplements of different types of indigestible carbohydrates for 4 weeks. Alkaline phosphatase (ALP) and dipeptidyl peptidase IV (DPPIV) activities and epithelial kinetics were measured in distal colonic mucosa. RESULTS: Median ALP activities correlated positively and DPPIV activity negatively with the median proportion of cells entering metaphase (r = 0.58 and -0.58, respectively; P < 0.05) and number of metaphase arrests per crypt column across the diets (r = 0.59 and 0.58, respectively; P < 0.05). Stepwise regression analysis showed that both hydrolases independently predicted these kinetic indices (R2 > 63% for each). Mucosal ALP activities were markedly elevated during consumption of raw potato starch, guar gum and methylcellulose, while only potato starch caused a significant elevation of DPPIV activities. CONCLUSIONS: The type of indigestible carbohydrate in the diet influences colonic mucosal hydrolase activities. The opposite relationship between kinetics and each of the two hydrolases indicates that these hydrolases do not reflect the same event; dipeptidyl peptidase IV might relate to differentiation status while ALP could also be influenced by epithelial irritation due to changes in luminal conditions.

Alkaline Phosphatase↗

PubMed1999

Measures to prevent cricket injuries: an overview.

Cricket is a major international sport, generally played in British Common-wealth nations. Although strictly a non-contact sport, injuries in cricket can result in a number of ways. In high level cricket, overuse injuries are common and related to the physical demands of the sport, particularly in the delivery of the ball. The bowling action involves repetitive twisting, extension and rotation of the trunk at the same time as absorption of large ground reaction forces over a short period of time. These movements, if performed incorrectly or too frequently, can lead to overuse injuries of the back, particularly in elite and high level cricketers. Cross-sectional studies have demonstrated that spinal overuse injuries occur more frequently to cricketers adopting a mixed bowling action than to those who favour a front- or side-on bowling technique. Strategies to ensure that cricketers do not adopt the mixed action or bowl too fast for extended periods can prevent these back injuries. Injuries resulting from impacts, generally from the cricket ball, can also occur and are more common during low level competition or informal participation. Because of the potential severity of these impacts, a range of protective equipment ranging from body padding to gloves and face protectors are now common features of standard cricket equipment. Although a number of measures to prevent cricket injuries have been widely suggested in the literature, there have been very few studies that have formally assessed their effectiveness in preventing injury. Further research is needed to gain a greater understanding of the biomechanics of cricket actions, the mechanisms of resultant injuries and the role of various risk factors in injury causation.

Adolescent↗

PubMed1998

Effect of topical butyrate on rectal epithelial kinetics and mucosal enzyme activities.

1. This study aimed to determine the effect of luminal butyrate on proliferative kinetics, a differentiation marker (alkaline phosphatase), and a molecule that controls cell-substratum adhesion (urokinase) in histologically normal human rectal mucosa. 2. Ten subjects with a colonoscopically normal colon (seven had previous adenomas) were given either butyrate or saline enemas for 4 days in a double-blind cross-over manner. Rectal biopsies were taken before and after each course of enemas. Epithelial proliferative kinetics were measured immunohistochemically using antibodies to proliferating cell nuclear antigen. Urokinase and alkaline phosphatase activities were measured spectrophotometrically in biopsy homogenates. 3. Both saline and butyrate enemas were well tolerated and induced no histological change except for a significant increase in crypt length (P < 0.05). The number of proliferating cells per crypt also increased significantly after butyrate (P = 0.018). 4. Compared with saline enemas, butyrate did not affect kinetic indices nor alkaline phosphatase activities. However, mucosal urokinase activities were significantly lower in butyrate-treated patients (9.5 +/- 2.0 i.u./g) than in saline-treated patients (12.8 +/- 2.0 i.u./g; P = 0.045). 5. Delivering of extra butyrate to the distal colon in healthy subjects may stabilize cell-substratum adhesion in surface epithelium and therefore offer a potential mechanism by which elevating distal colonic luminal butyrate concentrations might be beneficial in patients with colitis or hyperproliferative large bowel epithelium.

Adult↗

PubMed1998

Urokinase and the intestinal mucosa: evidence for a role in epithelial cell turnover.

BACKGROUND: The functions of urokinase in intestinal epithelia are unknown. AIMS: To determine the relation of urokinase expressed by intestinal epithelial cells to their position in the crypt-villus/surface axis and of mucosal urokinase activity to epithelial proliferative kinetics in the distal colon. METHODS: Urokinase expression was examined immunohistochemically in human intestinal mucosa. Urokinase activity was measured colorimetrically in epithelial cells isolated sequentially from the crypt-villus axis of the rat small intestine. In separate experiments, urokinase activity and epithelial kinetics (measured stathmokinetically) were measured in homogenates of distal colonic mucosa of 14 groups of eight rats fed diets known to alter epithelial turnover. RESULTS: From the crypt base, an ascending gradient of expression and activity of urokinase was associated with the epithelial cells. Median mucosal urokinase activities in each of the dietary groups of rats correlated positively with autologous median number of metaphase arrests per crypt (r=0.68; p<0.005) and per 100 crypt cells (r=0.75; p<0.001), but not with crypt column height. CONCLUSIONS: Localisation of an enzyme capable of leading to digestion of cell substratum in the region where cells are loosely attached to their basement membrane, and the association of its activity with indexes of cell turnover, suggest a role for urokinase in facilitating epithelial cell loss in the intestine.

Animals↗

PubMed1998

The effectiveness of ski bindings and their professional adjustment for preventing alpine skiing injuries.

This article presents a critical review of the extent to which alpine ski bindings and their adjustment have been formally demonstrated to prevent injuries. It considers a range of evidence, from anecdotal evidence and informed opinion to biomechanical studies, testing of equipment, epidemiological studies and controlled field evaluations. A total of 15 published studies examining the effectiveness of bindings and their adjustment were identified. All of these included anecdotal or informed opinion, and all but one focused on equipment design. Seven studies involved the testing of bindings or binding prototypes, 2 studies presented biomechanical models of the forces involved in binding operation, 6 reported an epidemiological evaluation of ski bindings and 2 considered skiers' behaviours towards binding adjustment. Some of the reviewed articles relate to the study of the biomechanics of ski bindings and their release in response to various loads and loading patterns. Other studies examined the contribution of bindings and binding-release to lower extremity, equipment-related injuries, the effect of various methods of binding adjustment on injury risk and the determinants of skiers' behaviour relating to professional binding adjustment. Most of the evidence suggests that currently used bindings are insufficient for the multidirectional release required to reduce the risk of injury to the lower limb, especially at the knee. This evidence suggests that further technical developments and innovations are required. The standard of the manufacture of bindings and boots also needs to be considered. The optimal adjustment of bindings using a testing device has been shown to be associated with a reduced risk of lower extremity injury. Generally, however, the adjustment of bindings has been shown to be inadequate, especially for children's bindings. Recommendations for further research, development and implementation with respect to ski binding and their adjustment are given in this article.

Athletic Injuries↗

PubMed1997

An overview of some definitional issues for sports injury surveillance.

Injury surveillance is the ongoing collection of data describing the occurrence of, and factors associated with, injury. The success of any sports injury surveillance system and its wide scale applicability is dependent upon valid and reliable definitions of sports injury, injury severity and sports participation. Published sports injury reports are often difficult to interpret and compare with other published data because of different data collection and/or analysis methods. Standardised data collection methodologies including definitions are crucial for improving the comparability and interpretation of published data. Attention needs to be directed towards the definition of both risk and exposure factors since the validity and usefulness of the outcomes of research activities, data collection and surveillance systems rely on these. International consensus on appropriate definitions would greatly assist the collection of comparable and reliable sports injury data. Standardised definitions are also needed to answer questions such as: 'what is a sport? When should an activity be considered to be recreational rather than sport? Who is a sports participant? How should sports participation be measured? What is a meaningful measure of exposure to injury risk? What is a sports injury? How should sports injury severity be measured? How severe must an injury be before it should be considered to be a sports injury for surveillance purposes?' Agreed definitions and answers to these questions are essential before injury surveillance is established. Sports injury data is needed to guide injury prevention activities, to set and monitor sports safety policies and interventions, and as the basis of sports injury prevention research. All sports injury surveillance systems should therefore collect information about the epidemiology of sports injuries and their outcomes in a form that is of relevance across a broad range of potential users of the data.

Athletic Injuries↗

PubMed1996

Chronic hepatitis C and interferon alfa therapy: predictors of long term response.

OBJECTIVE: To identify independent patient, disease and viral characteristics that predict a sustained biochemical or viral response to interferon alfa therapy in patients with chronic hepatitis C. DESIGN: Comparison of interferon responders and non-responders by univariate and multivariate analysis. SETTING: The hepatitis clinic of the Alfred Hospital, Melbourne (a tertiary referral hospital), between July 1989 and June 1994. SUBJECTS: All patients with chronic hepatitis C who were treated with interferon alfa (IFN-alpha; 3 million IU, three times a week or more) for at least 12 weeks. OUTCOME MEASURES: Patient demographic and epidemiologic characteristics, pretreatment serum alanine aminotransferase (ALT) and 2-gamma-glutamyl transpeptidase (GGT) levels, histological grading of hepatic steatosis, necroinflammatory activity and fibrosis, serum hepatitis C virus (HCV) RNA titres and genotype and post-treatment serum ALT levels and presence of HCV RNA. RESULTS: Of 58 patients, 13 (22%) had a sustained (six months or longer) biochemical response to IFN-alpha therapy, including 12 (21%) with a sustained viral response. Univariate analysis showed that young patients with a normal serum GGT level, grade 0-1 steatosis and fibrosis, low viral titre and infection with genotypes 3a and 2a were more likely to have a sustained response. Infection with genotypes other than 1a and 1b was the only independent variable associated with both a sustained biochemical and viral response. After adjusting for genotype, a hepatic fibrosis grade of 0-1 was also independently associated with viral response. This logistic regression model accurately predicted the virological response in 80% of cases. CONCLUSION: In Australian patients with chronic hepatitis C, a sustained viral response to IFN-alpha therapy is most likely in those infected with a genotype other than 1a or 1b and with minimal hepatic fibrosis.

Adult↗

PubMed1996

Teenagers' attitudes towards bicycle helmets three years after the introduction of mandatory wearing.

OBJECTIVES AND SETTING: To address helmet wearing by 13-17 year olds this study posed the following research questions: 'Do education programs continue to be necessary even after the community wearing rate has increased?' and 'Are helmet laws more effective in encouraging wearing among certain age groups?' Victoria was the first place in the world to introduce bicycle helmet legislation. Experiences in Victoria therefore provide a good model for the introduction of similar legislation in other areas. This study is the first to examine teenagers' attitudes towards helmet wearing after the introduction of compulsory helmet wearing legislation. METHODS: A survey of 1240 year 9 and year 10 students, aged 13-17 years, from 14 secondary schools in the outer south eastern suburbs of Melbourne, was conducted in September 1993. Information about bicycle use, helmet wearing, and attitudes towards helmets was obtained by a self report questionnaire. RESULTS: Bicycles are a popular form of wheeled recreation/self transport among teenagers. 65% of teenagers reported that they owned a helmet but only one third wore a helmet the last time they rode a bicycle. Fewer than 25% of students always wore a helmet when they rode a bicycle, despite compulsory helmet wearing legislation. Major factors leading to teenagers not wanting to wear a helmet were appearance and comfort. Both safety considerations and parental pressures were factors that influenced a teenager to wear a helmet. CONCLUSIONS: The major areas that need to be addressed are low helmet wearing rates; the low priority given to safety issues compared with comfort and peer acceptance; an ignorance of the need for helmets in all riding situations; and a perception that the legislation would not be enforced.

Adolescent↗

PubMed1996

Preventing equestrian injuries. Locking the stable door.

The medical and sports literature databases were searched for equestrian sports-related injury published in English since 1980, together with conference abstracts and discussions with equestrian sporting bodies. This literature was critically reviewed, with emphasis on measures to prevent or control injury i.e. countermeasures. While there is considerable literature available on the epidemiology of injury incurred in most equestrian sports, there is little on the prevention of these injuries. Case-control or other studies evaluating the effectiveness of the countermeasures suggested by authors do not seem to exist. There is a good body of epidemiology that supports the proper use of approved helmets as a means of preventing injury in these sports. However, protective helmets do not always prevent injury as expected, and many riders do not choose to wear them because of perceived poor design. The search for the ideal equestrian helmet should continue. Ideally the effectiveness of helmets should be assessed scientifically. Among the other countermeasures discussed are the use of rules and regulations for conduct of events, knowledge of horse behaviour, well-conducted lessons, contraindicated medical conditions, public education, rider education, appropriate equipment and clothing, the riding environment, rider experience, safety stirrups, body protectors, falling techniques, and first aid measures. Even though the injury rate for equestrians is relatively low when compared with other sports, the injuries that are incurred are usually severe. prevention is often difficult because the behaviour of the horse is unpredictable. Countermeasures used for prevention should be evaluated for the effectiveness to reduce the frequency and severity of injuries to equestrians.

Animals↗

PubMed1994

Mandatory bicycle helmet use following a decade of helmet promotion in Victoria, Australia--an evaluation.

On July 1, 1990, a law requiring wearing of an approved safety helmet by all bicyclists (unless exempted) came into effect in Victoria, Australia. Some of the more important steps that paved the way for this important initiative (believed to be the first statewide legislation of its type in the world) are described, and the initiative's effects are analysed. There was an immediate increase in average helmet-wearing rates from 31% in March 1990 to 75% in March 1991, although teenagers continued to show lower rates than younger children and adults. The number of insurance claims from bicyclists killed or admitted to hospital after sustaining a head injury decreased by 48% and 70% in the first and second years after the law, respectively. Analysis of the injury data also showed a 23% and 28% reduction in the number of bicyclists killed or admitted to hospital who did not sustain head injuries in the first and second post-law years, respectively. For Melbourne, where regular annual surveys of helmet wearing have been conducted, it was possible to fit a logistic regression model that related the reduction in head injuries to increased helmet wearing. Surveys in Melbourne also indicated a 36% reduction in bicycle use by children during the first year of the law and an estimated increase in adult use of 44%.

Adolescent↗