The diaries used in this study were designed to be easy to use and to be suitable for a diverse sample of the population. We first compared them with 24 hour audiotape recordings of the infants' vocalisations. Crying refers to a complex act that includes elements of movement, facial expression, and voice, and is usually interpreted as expressing a negative emotion. In the tape recordings the vocal part of crying is designated as negative vocalisation compared with neutral sounds (such as grunting) and positive sounds (such as cooing).Secondly, the sociodemographic characteristics of parents who returned diaries with readable data were compared with those of parents who did not from a population sample in a prospective cohort study. Thus the findings describe quantitative associations between negative vocalisations and the diary records of crying and fussing, they illustrate the limitations of both techniques in assessing the amount of infant crying, and they indicate the potential limits on the use of diaries for this purpose in the general population. Subjects and methodsTen mothers (who spoke fluent English or French) of normal 6 week old infants, who were in the nursery of a large general hospital associated with the university or a community health unit volunteered to take part in the comparison of diaries and tape recordings. The mean age of the infants was 6-3 weeks (range 5-5-7) at the time of recording; there were five boys and five girls, and seven were exclusively breast fed. The mean (SD) socioeconomic score measured by Green's two factor index8 was 67-8 (11.7), a wide range that is typical of this community.9 Informed consent was obtained before the tape recordings were made.

Objective To determine the effect of helmets on the risk of head and neck injuries in skiers and snowboarders. Design Matched case-control and case crossover study. Setting 19 ski areas in Quebec, Canada, November 2001 to April 2002. Participants 1082 skiers and snowboarders (cases) with head and neck injuries reported by the ski patrol and 3295 skiers and snowboarders (controls) with non-head or non-neck injuries matched to cases at each hill. Main outcome measures Estimates of matched odds ratios for the effect of helmet use on the risk of any head or neck injury and for people requiring evacuation by ambulance. Results The adjusted odds ratio for helmet use in participants with any head injury was 0.71 (95% confidence interval 0.55 to 0.92), indicating a 29% reduction in the risk of head injury. For participants who required evacuation by ambulance for head injuries, the adjusted odds ratio for helmet use was 0.44 (0.24 to 0.81). Similar results occurred with the case crossover design (odds ratio 0.43, 0.09 to 1.83). The adjusted odds ratio for helmet use for participants with any neck injury was 0.62 (0.33 to 1.19) and for participants who required evacuation by ambulance for neck injuries it was 1.29 (0.41 to 4.04). Conclusions Helmets protect skiers and snowboarders against head injuries. We cannot rule out the possibility of an increased risk of neck injury with helmet use, but the estimates on which this assumption is based are imprecise.

An intervention using a single home visit to improve the extent to which families use safety measures was found to be insufficient to influence the long-term adoption of home safety measures, but was effective to decrease the overall occurrence of injuries. Future programs should target a few, well-focused, evidence-based areas including the evaluation of high-risk groups and the effect of repeated visits on outcome.

Except for lower extremity injuries, snowboarders have a higher rate of injuries than skiers. Furthermore, collision-related injury rates have increased over time for snowboarders. Targeted injury prevention strategies in this group seem justified.

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