Information science

Emily Dickinson

Arjun von Caemmerer MB BS(Hons), FRACGP

It is a pleasure to announce the winner of the MJA, MDA National Prize for Excellence in Medical Research 2011. This $10 000 award honours the authors of the best original clinical research article published in the Medical Journal of Australia in each calendar year. The Journal’s Content Review Committee has awarded the 2011 prize to a team of seven authors led by Nola Olsen and Professor Bill Musk ...

Annette Katelaris

Rachel Nowak explains why improving communication standards will be essential in the drive to speed research translationPssst ... Want your research findings or health guidelines to change how doctors treat patients? Then take a tip from an ex-journo: Use plain English. Keep it short. Tell stories. Journalists have, for centuries, used these tools first to hook ...

Rachel E Nowak BSc, MA, PhD

To the Editor: An important and controversial article authored by Haines and Lowenthal1 was recently published in the Internal Medicine Journal. The authors challenged evidence used by Ian Gawler on his website (iangawler.com) and in his book2 to support meditation and dietary interventions as cancer therapy. Publication of the article was subsequent to initial submission ...

Emma S McBryde

In reply: The article referred to by McBryde was submitted to the MJA in 2011. Patient consent was requested, following standard MJA practice for all manuscripts containing potentially identifying patient data or images, but this was not provided by the authors. We agree that all the information was already publicly available, and it was for ...

Annette G Katelaris

The winners of the MJA Dr Eric Dark Creative Writing Prize were announced at the inaugural Dr Eric Dark Memorial Dinner, held at the Fairmont Resort in Leura, New South Wales, on Saturday 10 March 2012. The prize is sponsored by Varuna, the Writers’ House and “Doctors Who ...”, a Varuna initiative to nurture creativity, innovation and advocacy in the medical profession. Named in memory of Dr Eric Dark (1889–1987), Australian general practitioner and public health activist, the MJA’s new writing competition obviously inspired many of our readers: there were 110 entries based on the theme of “splendid isolation”, with a very high overall standard. We needed all the help we could get from the creative writing experts at Varuna and our new literary editor, Dr Leah Kaminsky, to come to a final decision! The winners were Dr Susan Fox, a GP from Daylesford, Victoria, in the medical practitioners category, and Australian National University medical student Paulina Wojciechowska in the medical students category. Both winners attended a 2-day writing workshop at Varuna, led by Dr Hilton Koppe and Dr Kaminsky, on the same weekend as the dinner. The medical practitioners prize also includes a 1-week residential writing retreat at Varuna. We thank our external judges and, of course, those of you who shared your stories and insights with us. Keep writing and watch out for the announcement of next year’s competition. MJA editorial staff congratulate the winners: (L-R) Dr Tania Janusic, Dr Annette Katelaris, Dr Susan Fox, Paulina Wojciechowska, Dr Ruth Armstrong, Dr Astika Kappagoda. Eric Dark (painting): inspiring doctors to create, innovate and advocate; pictured with “Doctors Who ...” panel members Dr Michelle Cahill and Dr Hilton Koppe.

Ruth M Armstrong BMed

“The baby’s breech, come quickly.” The midwife’s voice was sharp and squeaky. She had already hung up the phone. My head, muddled with sleep, began to pound. I staggered out of bed, stripped off my pyjamas and dragged on an old shirt and jeans, pulling my straggly hair into a rough ponytail. I grabbed my jacket on the way out the door. Outside, the mist enveloped me in stillness. An early morning frost had coated the windscreen with ice. I scraped it with my hand, but it was stuck tight. I turned the car’s heater on full, put the windscreen wipers on to maximum and pulled out of the driveway. With my head out the window, I could just negotiate my way between the gum trees lining the road. The mist swirled kaleidoscopically in the headlight beams. My eyes began to water, and I wiped them with fingers numb from the cold. As I finally reached the highway, I pushed down harder on the accelerator, trying not to spin my tyres on the icy bitumen. In the birth room of the tiny rural hospital, Matildhe was emitting short, low moans in between loud pants. Julie had got Matildhe’s legs up in stirrups, but she was lopsided on the bed. I pulled her buttocks to straighten her up. I noticed my hands were shaking as I took up position between Matildhe’s legs. She smiled briefly at me with her mouth but her eyes were fixed on the wall behind me. The baby’s buttocks were visible, with thick bottle-green meconium oozing out of the anus. There was no one else to call for help; the other GP in town was on holiday. Julie was the only nurse on duty for our small country hospital, and this baby was coming soon. Julie was an experienced midwife but I doubted she had delivered many vaginal breech babies in the past 20 years or so. The only breech birth I’d ever seen was when I’d been called in to observe as a medical student; I had been one of twenty or so people in the room. I shuddered. “You can push, Matildhe”, I said, trying to stop my voice from trembling. My mind was a muddy puddle. My eyes were fixed solely on Matildhe’s perineum; everything in my peripheral vision was blackness. I could hear Julie murmuring words of encouragement to Matildhe, but I couldn’t see her. Phrases came to me from deep within, the voices of professors and tutors long gone: Hands off the breech Keep the back up Let the body hang when you see the nape of the neck I heard each of these slowly and clearly intoned in a deep and authoritative voice. I uncurled my thumbs from where I was clenching them under my fingers. Matildhe continued to pant and moan as I coaxed her through the birth. I followed the voices in my head, leaving my hands off except to assist the delivery of the baby’s arms, and ensuring its back was uppermost in the birth canal. At one point, I heard Julie murmur to me, “I can’t find the heartbeat”, as Matildhe pushed, shrieking. I clamped my teeth together, biting down hard. I now held the baby’s legs in my hands, with its head still inside Matildhe. Its blue feet hung down limply over my wrists, lolling to each side. “Come on”, I said to Matildhe. “Another push.” I placed forceps on the baby’s head, but an image came to me of a different manoeuvre I remembered from the textbooks. I placed my hand tightly over the baby’s face, my middle finger in its little mouth, my ring and index fingers on its cheeks. “Come on baby”, I cried. Finally the baby’s head slipped free of Matildhe’s vagina. I held it in my hands, willing it to take a breath. “We have to take your baby for a bit of breathing help”, I said to Matildhe. She nodded, her eyes closed, her face still. The baby was cold in my hands and rapidly turning white. I wiped it down with a towel and began the resuscitation. My hands were shiny with sweat and vernix; it was hard to get a good seal on the facemask. “Is Matildhe okay?” I called to Julie. “Bit of bleeding over here”, Julie replied. “Can I give some extra oxytocin?” I took a shallow breath before I began to bark orders at Julie for more drugs. “Your baby’s a bit flat”, I said gently to Matildhe as I continued the resuscitation. I had already started pumping the baby’s tiny chest with my index and middle fingers, trying not to break its ribs as I pressed down quickly, again and again. With the ventilation mask slipping off the baby’s tiny face with every puff of oxygen, I grabbed a small tube to insert into its lungs. My hands were shaking so much, it was hard to hold the baby’s head still to see the vocal cords. I tried once, twice, three times. Each time, the baby’s chest failed to rise as I pumped oxygen down the tube. I tried for a fourth time. My fingers felt numb. My chest was heavy. I could feel Matildhe’s eyes on us. Please, I willed. Finally, the tube was through the cords. Something shifted in the room. A flick of the baby’s eyelid. A slight movement of a tiny fingernail against the resuscitation cot. The baby had a heartbeat again. “The bleeding’s slowing”, called Julie. “Matildhe’s blood pressure is holding and her pulse is settling.” I breathed out the air I’d been holding in tight against my heart. “You have a baby boy”, I said finally to Matildhe. She smiled. “Will he be okay?” she asked, craning her head towards the resuscitation cot. “We need to wait”, I said quietly. “But he’s okay for now.” At the nurses’ station, I struggled to write my notes. Despite the blood pumping hard through my arteries at my wrist, the pen wouldn’t move on the page and my sentences didn’t make sense. I found myself staring into space on several occasions. The retrieval team were kind on the phone, asking me to repeat myself over and over. They said it would be three hours until they arrived. I paced back along the long, empty corridor to the birth room, with the sound of my footsteps bouncing off the sterile walls. Matildhe was cradling her son’s head in her hands. He was lying peacefully. “Thank you”, she said. “Thank you for everything.” As I walked outside the hospital entrance into the morning, the air opened up around me. The sun was shining through the clouds, sending rays of light high into the sky. Magpies cawed to each other across the bitumen. The window of my car was still open. I wound it up and drove home, watching the sunlight dance over the defrosting ice crystals on the windscreen.

Susan E Fox MB BS(Hons)/BA, FRACGP, FACRRM

Every morning I wake just to hear him get up and head for the bathroom. Then I fall back to sleep. Somewhat later, I wake up again. I hear him leave the bathroom and go down the stairs. Slowly. No reason to rush. Like on thin ice of a lake, one step after another. Just to make it to the other side. I fall back to sleep. When I wake again, I know it’s time for him to leave the kitchen. He does. I can hear the clonking of the dishes as he clears the table, and then the door slightly creaks. Steps across the hallway. Another creaking door opens and closes. He’s in the lounge: it’s time for the news. Later, after I have finally emerged from my bedroom, he will enumerate to me the famous people who died last night. But now I fall back to sleep and continue along twisting hospital corridors, through half-open hospital rooms. I burst into one after another. Where is she? She was here just a second ago, just then, before I woke up! I look for her in the empty beds and gurneys. Sometimes I find her. But she’s there less and less often. They say it is normal. She will be nearest for the first six months. And then not. I am still in my dream, bubbled in, when the phone starts. I pretend I’m asleep. He pretends he cannot hear it. It rings for a few minutes. When it ceases, I know there have been too many interruptions and I will no longer meet her today. Leaving behind the rusty twilight of the corridors, I struggle out of bed. When I see him, we both choose not to mention the phone. In an undertone, we make remarks about recent political unrest in some faraway countries. “What will it be?” we ask, trying to avert eyes from her picture on the left, just by the vase with pansies. Then it’s the phone again. We knew we would not be able to get away for long. It is now like some new law of nature. They ring us. A procession of acquaintances, friends and relatives. They check on us, give advice we never asked for, enquire about our daily routine. Some of them behave like they are bringing a special message. They say, “She came to me in a dream last night. She looked well. Your mother looked happy”. I know they mean unlike that day in the chapel, supine and dressed up by foreign hands from the funeral home because it is no longer our tradition to prepare our loved ones ourselves for their last journey. They tell me things as if they were some long forgotten details. What a great nurse she was. Not the fastest but so well organised that she’d always finish everything before everyone else. How patients wanted her to be their nurse. How they said, “Sister, I hope you are making my injections today”. And how she stayed in a boarding house and was afraid of mice. “I know, I know”, I answer. But what I really want is to be able to smell her hair. I go and sniff her pillow, but every day the scent becomes vaguer and vaguer. The phone rings again. He and I look at each other. “Why don’t you answer, this is your house now”, my father tells me. It is. The phone angrily buzzes as I walk out of the room. When he isn’t there, I sieve through clutter assembled on her side of their bed. There is a small urn with ambers, because they’re supposed to take away any pain you have. I try warming up a few golden pebbles in my hands but everything stays the same. There is also a basket with dried petals for better sleep. I sneak them out to my room — if I could dream for longer, I might get to see her more often. Then there is a porcelain elephant with a lifted trunk. It seems incredible that it’s no longer needed. I catch him dusting it when he thinks I’m out. I too wait. I feel that if only I could stay motionless for long enough, she will change her mind and come back. “The human was not meant for inaction”, voices in the receiver tell me. “To survive, one needs to keep busy. This is the only way.” In the evenings, we sit in front of the TV. He dozes off and wakes up to the sound of his own snoring. I work through a pile of photocopies from my Anatomy colouring book. Over and over again, like a madman, I colour the brain, the parts that failed her when we needed them to work. The parts where the blood leaked out and gave her a big scare, and neither of us were with her. The parts that gave her such a headache. The headache so big that they call it “thunderclap”. Like a loud clap of some large hands from above to announce that your time has come. Days are always fine. It’s like she went to work. At night I’m back in there again, when we hovered at her ICU bed like scared birds whose hatchling had fallen out of the nest. “Let us leave her rosary in case she wakes up when we aren’t there.” “Let us leave her some cookies in case she wakes up hungry.” “And the eyeglasses, why didn’t we think of that, if she wakes up and cannot see, she’ll be petrified.” One morning I fall asleep to wade through the brown dusk of a cave. I feel she’s somewhere around, but cannot tell her apart from the other silhouettes that populate it. They corner me in and stare. Then they drag me inside a cube as dark as a fucking Rosetta Stone: “You have to stay here. You are not meant to wander around”. I fight them tooth and nail. I will not be locked up! Never will it happen! The muddy darkness around me shifts with uncertainty, and then I feel her by me and can smell her hair. As if I had any bargaining power, I declare, “I will stay put as long as I have to, providing she holds my hand through all this time”. It is allowed. They put me in the cube but I get to clutch my fingers around hers. I sit in complete darkness. My senses tell me nothing except that my hand is out there with her, in a brownish grotto. “I don’t even get to dream”, he says when I tell him. It’s the phone again. They ask me about my dreams. I fear they will be like him, a bit envious of my little dark box. “I wish there was something to tell”, I reply. “How is he?” they ask. “He walks”, I answer. Kilometres of footpaths daily. I know he is trying to remember. He had no way of tearing her away from the cold claws of the other side; he had no way of stopping her from slipping through, all blue on her lips, and face, and arms. But now he will save her. He will pick up every memory of her that lingers in the parks and cul-de-sacs, pin the pieces together and turn them over in his head so many times that they will finally hold strong. He will close his eyes when the spring wind blows from the mountains, and she will be in it just the same as years ago when he would meet her on her way back from work, shivering from cold in an unbuttoned trench coat. He will listen to footsteps echoing on the pavement; a slightly uneven gait, yes, just like hers when she was in a hurry. He will labour like an ant in the infinity of mazes; he will not forego any avenue, will check every nook, collect every grain of sand and drag it back home. The doctors may have had to let her go, and it was not up to him to do anything. But this is the part that rests in his hands. And this time it will be different. She will not end as long as he goes on. I sometimes see him meandering around alleys of the cemetery and trails of neighbouring hills. I now know it. We are both dragging our own stones on our own ropes attached to our own necks. These are our private stones; we will guard them with our lives. Only we and no one else can rid us of them. When I look at him through the knots of twigs and their fresh sprouts, I know he sees me. He knows I see him. We gently alter our routes so that they don’t intersect. The weather is clear. Wind caresses my cheeks. I close my eyes and test how far I can walk without seeing. In the darkness I create.

New editor, new print journal, new website If you’re reading this in the print Journal, you’ll know that the MJA has changed. If you’re reading this online, you might not yet be aware that the print MJA was relaunched in September with a clean new look, easier-to-read page designs and an expanded menu of articles (including medical news, investigative features, educational series, and an increased focus on the medical humanities). We urge you to open a print Journal and have a look. But rest assured we have not forgotten our online readers. Redeveloping our ageing website is a huge task, but it’s well underway, and the new electronic version of the MJA is scheduled to go live with our next issue in January. The trifecta? New print Journal, new website — and new Editor. Dr Annette Katelaris took over as MJA Editor in February, and has already wrought sweeping changes. The MJA is the only Australian journal for the whole medical profession, and driving Dr Katelaris’ changes is the goal of providing an inclusive interactive forum of the best medical information for all doctors, whatever their field of practice. As a peer-reviewed research journal, attracting the highest quality of research is paramount. In a relatively small medical community such as Australia, this is not without difficulty. We already have our Content Review Committee (CRC), an external group of eminent clinicians who meet monthly by teleconference to advise on difficult manuscript decisions and provide input to improving Journal content. We have recently recruited an additional team of experts in several disciplines to become Specialist Editorial Advisers. These advisers will help us less formally, to expedite manuscript assessment, keep us informed about important specialty issues as they arise, and encourage high-quality submissions from a broader range of contributors. The CRC members and our new advisers are listed on the next page — we are very grateful for their dedication and commitment. Also listed in the following pages are all those who have reviewed manuscripts for us this year — we thank them very much for their time and effort in helping to ensure that the MJA publishes the best possible manuscripts in the best possible format. One of the things that matters most to contributors is rapid manuscript handling and timely publication. We’ve recently changed a number of our internal processes so that we can communicate our decisions faster and get your articles published sooner. Some delays in manuscript handling will always be beyond our control, but we anticipate being able to report better results from now on (Box). Our new website will allow us to increase the number of articles published “online first”, further removing publication delay. The new website will also, at long last, offer an option to comment on articles. While letters to the Editor provide an excellent quality of postpublication review and additional insights, the process has major limitations and the immediate debate of important issues is missing. We look forward to hearing from you often, when our online rapid-response option opens for business. There are more changes in the pipeline for 2012. In April, the MJA will hold its inaugural Research Summit to promote excellence in research, translation of research to practice, and knowledge sharing between major research bodies. We also hope that the Summit will identify priorities for lobbying government and other stakeholders to improve the landscape of clinical research. In addition to our prestigious prize for the best research article published in the MJA, and the Dr Ross Ingram Memorial Prize, now extended to include artworks as well as essays about Indigenous health, we will be offering new MJA awards for excellence in research or writing. These include a Global Health prize, for an article about personal experience working in a developing community (the prize will include a Public Health Leadership course at the Nossal Institute), a research prize for medical students, and the MJA Dr Eric Dark creative writing prize, in conjunction with Varuna, the Writers’ House (with prizes including a writing retreat and workshops). While we’re giving away awards, we have managed to win some ourselves. At the Publishers Australia Excellence Awards in November, the MJA was runner-up in two categories: “Relaunch of the Year” and “Custom Magazine of the Year”. We hope you’ve taken advantage of the informal news and opinion forum offered by our free online newsletter, MJA InSight (www.mjainsight.com.au) this year. If not, be sure to sign up in the new year and add your voice to what has become a very lively weekly conversation. MJA Careers, which has now moved to the back of the print Journal and is freely available online as an e-mag, has become a valuable resource for junior doctors needing information to help them choose a career path, and for those contemplating a sea change or just wanting to know what other doctors actually do. As always, we welcome your feedback and suggestions and we look forward to continuing to be a leader in quality scientific and medical communication — whatever that might look like as the digital age continues to transform every facet of our lives. Reviewers Specialist Editorial Advisers Derek Chew Richard Day David Ellwood Paul Fitzgerald Leon Flicker Mark Harris Noel Hayman Michael Horowitz Craig Mellis Martin Tattersall Bruce Waxman Gary Wittert David Wood Content Review Committee Craig S Anderson Leon A Bach Flavia M Cicuttini Jennifer J Conn Marie-Louise B Dick Mark F Harris Tom Kotsimbos Campbell Thompson Tim P Usherwood Elmer V S Villanueva E Haydn Walters Bruce Waxman Jane Young Jeffrey Zajac Reviewers (reviews submitted 01/11/2010 – 31/10/2011) Bizhan Aarabi Max W Abbott Penelope A Abbott Ehtesham A Abdi Sarah J Abrahamson Stephen P Ackland Jason P Acworth Stephen Adelstein Michael A Adena Hairul A Ahmad Sreedevi A Aithal Rebecca M Albury Chris P Alderman Heather G I Alexander Charles Algert Carolyn A Allan Clive C Allcock Katrina J Allen Roger W G Allison Steve J Allsop Lisa H Amir Craig S Anderson Ian P S Anderson Warwick P Anderson James A Angus Nigel R Armfield Bruce K Armstrong Jason M Armstrong Peter C Arnold Constantine N Aroney Michael A Ashby Lisa Askie John J Atherton Philip E G Aylward Oyekoya T Ayonrinde Peter D Baade Leon A Bach Nadia Badawi Christopher J Baggoley Peter A Baghurst Ian J Baguley Michael J Bailey Paul M Bailey Ross S Bailie Peter G Baker Philip R Baker Ross I Baker John I Balla Mohammed S Ballal Zsolt J Balogh Lilon G Bandler Michael P Barbato Amanda Barnard Ross StC Barnetson Adrian G Barnett Fay H Johnston Damien J Jolley D Brian Jones Graham R D Jones Ian S C Jones Mark A Jones Philip D Jones Sandra C Jones Anthony F Jorm Christine M Jorm Matthew D Jose David J L Joske Catherine M Joyce Craig A Juresevic Ian Joseph Kamerman Max Kamien Margaret Patricia Kay Anthony C Keech David Keegan Gerben B Keijzers Marc J N C Keirse Margaret A Kelaher Anne-Maree Kelly Michael J Kelly Patrick J Kelly Andrew S Kemp Michael C Kennedy Lizbeth M Kenny Ross K Kerridge Alison M Kesson Soo Keat Khoo Warren J Kidson Susan W Kim Thomas E Kimber James F King Scott Kinlay Vikki E Knott Simon A Koblar Bogda Koczwara Paul A Komesaroff Steven Kossard Mark A Kotowicz Vicki Kotsirilos Gabor T Kovacs Emma E Kowal Ludwig N Kraus Vicki L Krause Paul A Kubler Dennis L Kuchar Susan E Kurrle Antony R A Lafferty Daniel J Lalor Tai Pong (Daniel) Lam Stephen B Lambert Anthony D LaMontagne Louis I Landau Andrew J Langley Paul E Langton Sarah L Larkins Matthew G Law David M Lawrence Mark K Lawrie Julie Leask Karin S Leder Nicole Lee Warwick Bruce Lee Peter A Leggat James Leigh Nat P Lenzo Christopher R Levi Lucy N Lewis George T Lewith Joel Lexchin Siaw-Teng Liaw Rebecca J Linke Wendy L Lipworth Andrew F Little Mark Little Sing Kai Lo Kah-Seong Loke David F M Looke Ruth Lopert Julie A V Lord Charles W Lott Gregory A Lovell Raymond M Lowenthal Fabio Fabio Luciani Guy L Ludbrook Joanne N Luke Kehui K Luo Karen A Luxford Linda M Luxon Zaza Lyons Ian G Barr Bruce H Barraclough Alexandra L Barratt Christopher A Barton Michael B Barton Roger W Bartrop Robert G Batey Diana Battistutta Louise A Baur Richard Beasley Justin J Beilby Mary K Belfrage Derek Bell John F Beltrame Cino L Bendinelli Aric P Bendorf Carol J Bennett Christine C Bennett David L Bennett Derrick A Bennett Jill Benson David I Ben-Tovim Roy G Beran Lynda B Berends Michael Berk Andrew D Bersten James A Best James Donovan Best John P Best J H Nicholas Bett Barbara E Biggins Beverley-Ann Biggs Sara Bird Frances A Birrell Deborah A Black Peter S Blair Andrew F Bleasel C Leigh Blizzard Jared A Blum Neville Board Felix Bochner Nikolai Bogduk India K Bohanna Terry D Bolin Michael D Bollen Barbara J Booth Clare V Boothroyd Robert Booy Craig S Boutlis Ronaldo J Bova Francis J Bowden Carol I Bower Simon D Bowler John Boyages Ian W Boyd Michael J Boyer Frances M Boyle Michael J Boyle David L Bradford Pamela J Bradshaw George Braitberg Kerry J Breen Joan M Brewster David B Brieger Jo-anne E Brien Esther M Briganti Nancy E Briggs Timothy A Brighton Peter J Bristow Helena C Britt Warwick J Britton Kaye E Brock Carolyn R Broderick Peter M Brooks Julia M L Brotherton Simon G A Brown Wendy A Brown David G Bruce Fiona J Bruinsma Heather A Buchan David J Buckley John F Buckley Nicholas A Buckley Anne E Buist Michael D Buist Jonathan G W Burdon John R Burgess David Burgner Bryan H Burmeister Leslie Burnett Colin D Butler James R G Butler Linda Butler Julie E Byles Petra T Bywood Désirée Mészáros Kristine K Macartney Graham J Macdonald Dorothy E M Mackerras Donald G Maclellan A Roderic MacQueen Finlay A Macrae Richard Madden William (Bill) J Madden Guy J Maddern Ian Maddocks Parker J Magin Graeme Paul Maguire Peter K Maitz Donna B Mak Kathy Malera-Bandjalan Linda Mann Lynette M March Paul D Mark Tania P Markovic Paul G Marks Caroline Marshall Nathaniel Stuart Marshall Robert D Marshall Roger J Marshall Andrew J Martin Katherine E Martin Sarah J Martin Toni Annissa Mason Francis L Mastaglia C Scott Masters Timothy H Mathew John D Mathews Danielle Mazza Jeremy M McAnulty Morag McArthur Kristin Emma McBain-Rigg W John H McBride Bradley J McCall James S McCarthy Nicole Jean McCarthy Sally M McCarthy Brian C McCaughan Geoffrey W McCaughan Kieran A McCaul Geoffrey J McColl Joseph G McCormack Geoffrey B McCowage Robyn A McDermott Fiona J McDonald Suzanne P McEvoy Alexander C McFarlane Neil W McGill Barry P McGrath Katherine M McGrath Elizabeth C McInnes Catherine A McIntosh Peter B McIntyre Andrew J McLachlan Robert I McLachlan Rick McLean Andrew P McLean-Tooke Anthony J McMichael Gabrielle M McMullin Alan A McNab Gregor B S McNeill Bernadette M McSherry Graham N Meadows Alan C Meek Wayne D Melrose Paul Christopher Memmott Muhammed A Memon Richard M Mendelson Tracy Lee Merlin Geoffrey Metz Caroline Meyer Antonina A Mikocka-Walus Graeme C Miller Mark K Miller Carole Millichip Michael J Millward Helen Milroy Riyana (Mira) Miranti Charles A Mitchell Christopher D Mitchell Geoffrey K Mitchell Paul J Mitchell Philip B Mitchell Paula J Mohacsi Mohammed M Mohsin Lindsay C Mollison Harry G Mond Michael Montalto John F Cade Will Cairns Adrian J Cameron Ian D Cameron Peter A Cameron Terence J Campbell Ben J Canny Gideon A Caplan John B Carlin Allan Carmichael A Simon Carney Nicholas F Carr Vaughan J Carr Robin W Carrell Phillip J Carson Andrew C Carter Owen B J Carter Armand Casolin Erin Cassell David J Castle Enrico Cementon Steven J Chadban Donald R C Chalmers Alex J Chamberlain Albert K F Chan Jeremy R Chapman Kathryn E Chapman Michael G Chapman Simon Chapman Julia A Charkey-Papp Patrick G P Charles Mark D Chatfield Barry E Chatterton Celia Shin-Wen Chen Jian Sheng Charles Chen Allen C Cheng Elaine Y L Cheong Ian R Cheong N Wah Cheung Derek P B Chew Tien Chey Donald J Chisholm Christopher Y P Choong Peter F M Choong Helen Christensen MacDonald J Christie Flavia M Cicuttini Peter A Cistulli Ian D Civil Caroline F Clarke David M Clarke Stephen J Clarke Alan R Clough Harvey L C Coates Milton L Cohen Stephen Colagiuri Catherine H Cole Stephen A Cole Justin J Coleman Brian T Collopy Peter G Colman Elizabeth J Comino Christopher A Commens Jennifer J Conn Kathryn A Cook Matthew C Cook Raymond J Cook Nicholas B Cooling Alan J Cooper Caroline L Cooper Chris W Cooper Gabrielle M Cooper Michael D Coory Charles Cope Stephen J Corbett Peter Hani Tawfik Cosman Yvonne E Cossart Anthony J Costello Richard T L Couper Sophie Couzos Benjamin C Cowie Terry J Coyne Paul S Craft Patrick C Cregan Michelle A Cretikos John L Crompton David B Cross Gary J Croton Robert G Cumming Anthony L Cunningham David C Currow Hannah G Dahlen Phil Dalgarno Andrew Dalton Craig B Dalton A Rob Moodie Gavin H Mooney David J Moore Elizabeth M Moore Vera Anne Morgan Frederick M Morgan, Jr. Peter Morley Kathy Mott Robert F W Moulds David Mountain Bryan John Mowry Alison M Mudge Brian P Mulhall H Konrad Muller Raymond J Mullins Blair J Munford Craig F Munns Michael Murray Richard B Murray Arthur (Bill) W Musk Kenneth A Myers Sydney M L Nade Alison J Nankervis Geraldine A Naughton Matthew T Naughton Joel Negin Rose K Neild Mark R Nelson John C Newman Harvey H Newnham Janice G Newton Hanh T T Ngo Tuan V Nguyen Kathleen M Nicholls Suzanne Nielsen Graeme R Nimmo Gillian Nisbet Paul Nisselle Rosemary L Nixon Anita Nolan B E Christopher Nordin Richard P Norman Trevor R Norman Susan Norris Robert E Norton Caryl Nowson Jeremy J N Oats Tony J O'Connell Kerin O'Dea Christopher J O'Donnell Stephen J O'Leary Jake H Olivier Ian N Olver John H Olver Susanne P O'Malley Michael F O'Rourke Peter K O'Rourke Harry Owen Don Packham Robert T A Padbury Colin B Page Mark A Paine Jeyaraj D Pandian Francesco Paolucci Vanita R Parekh Malcolm H Parker Rhian M Parker Robert M Parker Jennifer S Parsons Mark W Parsons Julie A Pasco Dennis R Pashen Anushka A Patel Hedley G Peach Louis G Peachey Martin Pera Sumathy Perampalam Gavin F Pereira Paul L Pers Kathy Petoumenos Lynne Pezzullo Peter I Pillans S Praga Pillay Louis S Pilotto Carole B Pinnock Marie V Pirotta Leon Piterman Christopher S Pokorny Hans C Pols Rene G Pols Cynthia Porter Jennifer R Powers David A Powis Frank F S Daly Diona L Damian John Daniels Anthony M Dart Nicholas Daunt Philip K Davies Joshua S Davis Timothy M E Davis Richard O Day John F de Campo David J de Carle Caroline M de Costa Julien P de Jager Nicholas H de Klerk Gregory M de Moore Carmine G De Pasquale Christopher B Del Mar Martin B Delatycki Stephen Anthony Della-Fiorentina Charles P Denaro Justin T Denholm Graeme J Dennerstein Louise Dennis Catherine A D'Este Peter G Devitt Helen M Dewey Terrence H Diamond James A Dickinson Paul M Dietze Geoffrey J Dobb Malcolm D H Dobbin Timothy A Dobbins Annette J Dobson Jodie M Dodd Dorota A Doherty Susan M Donath Basil J Donovan Michael J Dooley Evan Doran Gregory J Dore Jo A Douglass Robert P Dowsett Francis J Dudley Johan A Duflou Trevor Duke David W Dunbabin James A Dunbar Emma L Duncan Elizabeth K Dunford David N Durrheim John M Dwyer Judith M Dwyer John R Dyer Sandra J Eades Kathy Eagar Arul Earnest Creswell J Eastman Bernadette I Eather Peter R Ebeling Phillip S Ebrall John A Eden Carl W Edmonds David Jan Edvardsson Hooi C Ee Garry J Egger John W Eikelboom Robert H Eikelboom John A Eisman Diann S Eley Jaklin A Eliott Ron Elisha Kathryn S Elkins David A Ellwood J Mark Elwood Michael W N Epstein Edzard Ernst Guy D Eslick Adrian J Esterman Julie A Evans Daniel P Ewald Paul A Fagan Paul P Fahey Christopher K Fairley Kieran E Fallon H John Fardy Elizabeth A Farmer K Chip Farmer Annabelle Farnsworth Cynthia M Farquhar A Michael Fasher Bruce J Fasher Robert G Fassett Thomas A Faunce Michael R Fearnside Claude G Preitner Brian Gregory Priestly Richard L Prince David L Prior Perry A Pugno Carolyn Quadrio Julie A Quinlivan Geetha Ranmuthugala Beverley Raphael Stephen J Read Julie Redfern Tom S Reeve C Martyn Regan Christopher M Reid Ian R Reid Joseph M Rey Alun H Richards Drew B Richardson Jeff R Richardson Malcolm D Riley Richard H Riley Thomas V Riley Helen E Ritchie Christopher Roberts Iain Kilpatrick Robertson Roy M Robins-Browne David M Roder Alan Rodger Leigh Roeger Maureen Rogers Wendy A Rogers Kathlyn J Ronaldson Jeffrey V Rosenfeld Glynis P Ross Ian James Roth Beverley J Rowbotham Tilman A Ruff Richard E Ruffin Bruce David Rumbold William B Runciman Darren B Russell Grant M Russell Lesley M Russell Christopher J Ryan Peter F J Ryan Peter Sainsbury Matthew R Sanders Kristy Sanderson W Peter Saul Carlos D Scheinkestel Patrick M Schlievert Philip J Schluter Hans-Gerhard F Schneider Deborah J Schofield Peter R Schofield Thomas R Schulz Max A Schwarz Anthony Scott Ian A Scott James Graham Scott Russ J Scott Ego Seeman Markus J Seibel Warwick S Selby Linda A Selvey Sanjaya N Senanayake Narelle E Shadbolt Shaouli Shahid Anthony Shakeshaft G Dennis Shanks Mary-Jane S Sharp David R Shaw Jonathan E Shaw Dale C Sheehan Julia M Shelley John Shine David Alan Sholl Bruce H Short Rupendra N Shrestha Stephen P Shumack David W Sibbritt William Sievert Kenneth A Sikaris Jerzy (George) M Sikorski Morry Silberstein Derrick M Silove Ian J Simpson Judy M Simpson Rodney D Sinclair Andrew Harris Singer Vitali Sintchenko Freddy Sitas Roderick J Sitlington Brooke Elizabeth Ferguson John K Ferguson Mark J Ferson David W Firman Colleen M Fisher Jane R W Fisher Malcolm McD Fisher D James Fitzgerald Gerard J FitzGerald Mark C B Fitzgerald Michael P Fitzharris Louisa Flander Karen M Flegg John I Fleming David R Fletcher Felicia R Fletcher Janice M Fletcher Simon J Fletcher Victoria Flood Eleanor M Flynn Peter A Foley Kwun M Fong Therese (Terri) M Foran Roberto Forero Brett H Forge S Lesley Forster Kevin D Forsyth Gillian K Fox Ian S Fraser Saul B Freedman Matthew Y Frei Simon D French Lin Fritschi Mark Frydenberg Victor SC Fung John S Furler Isabelle Gaboury T Eng Gan Ed John Gane Robert (Frank) A Gardiner Andrew P Garnham Coral E Gartner Kevin J Gaskin Paul A Gatenby Melina Gattellari Matt D Gaughwin Paul H Gavel Graham J Gee Paul Gerber Richard P Gerraty Mounir N Ghabriel Davina Ghersi Kay L Gibbons John Gibson Peter G Gibson Peter R Gibson Alan J Gijsbers Sabrina Gill Sanjeev Singh Gill Marisa T Gilles James Gillespie Amanda K Gilligan Conor Gilligan Jonathan Gillis Rodney C Givney Nicholas J Glasgow Katie Glass Paul P Glasziou John D Glover Michael S Gold Paul N Goldwater Phillip D Good David L Gordon Michael S Gordon Alexandra S Gorelik Des F Gorman Iain B Gosbell Geraldine A Goss Thomas Gottlieb C Roger Goucke Andis Graudins Stephen E Graves M Lindsay Grayson Peter H R Green Peter B Greenberg Kelly Jane Greenop Scott D Grosse Sonia R Grover Michele A Groves Jane M Gunn Jillian A Guthrie Paul S Haber Wendy E Hague Ian E Haines Mary M Haines George Halasz Loane L C Skene Steven J Skov Richard A Smallwood Joanne M Smart Christine H Smith David E Smith Jacky A Smith Julian A Smith Mitchell M Smith Richard S W Smith Tony Neil Smith William B Smith Richard Speare Denis W Spelman W John Spicer Allan D Spigelman Andrew Spillane Katrina Spilsbury Arn Sprogis Tim W Sprott Geoffrey K Spurling D James B St John E Greg Stafford Margaret P Staples Richard J Stark Efty P Stavrou Amanda M Stephens Jessica R Stephens Matthew Stevens Christopher E Stevenson Cameron Stewart Robert J Stillman Jim R Stockigt Nigel P Stocks Timothy R Stockwell Johannes U Stoelwinder Alina Stoita H Victor Storm Roger P Strasser Simone I Strasser Alison M Street Annette F Street Rhonda L Stuart Christina O Stubbs Stephen L Stuckey David M Studdert Joachim P Sturmberg Carolyn M Sue Rajah Supramaniam Rand S Swenson Brian Symon Peter W Tait Michael L Talbot Martin H N Tattersall Tracey M Tay Hugh R Taylor Penny S Taylor Francis C K Thien Jill E Thistlethwaite David P Thomas Merlin C Thomas Campbell H Thompson Napier M Thomson David R Thorburn Anne Marie T Thow Peter F Thursby Dominic S Thyagarajan Mark L H Tie Joseph Y S Ting Stephen H D Tisch Bernadette M Tobin Robert J Todd Ronald P Tomlins Anne L Tonkin Nicholas A Tonti-Filippini Michael J Toole Les J Toop Duncan J Topliss Adrienne J Torda Paul J Torzillo Joanne F Travaglia Stephen C Trumble A Stewart Truswell David Vaile Lisa Anne Valenti Marina Jill Vamos Anneke Van Der Walt Martin B Van Der Weyden Mieke L van Driel Samuel D Vasikaran Luis Vitetta Lesley Marian Voss Mark L Wahlqvist Robert G Hall John D Hamilton Alan W Hampson Peter J Hand David J Handelsman Elizabeth Handsley Graeme J Hankey Terry J Hannan Paul L Harper Richard W Harper Anthony Walter Forster Harris David C Harris Elizabeth Harris Mark F Harris Phillip J Harris Bernie T Harrison Simon J Harrison Rosemary Anne Harrup Roger J Hart Ken J Harvey Michael P Harvey Nicholas J Hawkins Noel E Hayman Richard B Hays Colleen P Hayward Robert N S Heard Christopher Hamilton Heath William F Heddle John C P Heggie Tim R M Henderson Melinda B Henne David A Henry Margaret J Henry Ana Herceg Wayne M Herdy David G Hewett Ian K Hewitt Kenneth M Hillman Lybus C Hillman Darryl J Hodgkinson John Hoey Christopher D Hogan Patrick G Hogan Geoffrey G Hogg Brien A Holden Stephen R Holdsworth Andrew J A Holland C D'Arcy J Holman Peter W Holmes Stephen Honeybul Sean Hood Danielle Rebekah Horyniak Kenneth F Hossack Nehmat Houssami Kirsten Howard Mark E Howard Benjamin P Howden Peter Phillip Howley Rae-Lin Huang Bernard J Hudson Clifford F Hughes James T Hughes Michael A Hull Jennifer M Hunt Leonie G Hunt Roger W Hunt Peter C Hunter Susan F Hurley Joseph E Ibrahim Francesco L Ierino Timothy J J Inglis David M Irby Donald H Irvine Timothy W Isaacs Geoffrey K Isbister James P Isbister Rowena G Ivers Assen V Jablensky Claire L Jackson Lisa R Jackson Pulver Peter A Jacoby Stacey K Jankelowitz Robert P S Jansen Edward D Janus Tania (Tatiana) Janusic Heather E Jeffery George A Jelinek V Michael Jelinek Christine R Jenkins Rebecca A Jenkinson Garry L R Jennings Richmond W Jeremy Moyez Jiwa William R Johnson Judith H Walker Kate A Walker Robert James Walker Robyn M Walker Euan M Wallace Marina Wallace John P Walsh Nick M Walsh Barry N J Walters Darren L Walters E Haydn Walters Han Wang Zhiqiang Wang Gregory John Ward Helena Mary Ward James S Ward Michael R Ward Peter D Ward Robert S Ware Lachlan J Warren Grant W Waterer John A Waterston David I Watson David O Watson David A K Watters Gerald F Watts John R Waugh Bruce P Waxman Susan M Wearne Edward W Weaver Lynn M Weekes Peter Wein John M Weiner Philip Weinstein Timothy A Welborn Beres C A Wenck Michel J P Wensing Steven L Wesselingh Johanna I Westbrook Andrew V White Benjamin P White Joshua P White Leslie White John S Whitehall Maxine Anne Whittaker Judith A Whitworth Bridget M Wilcken Kay A Wilhelm Garry John Wilkes David Wilkinson Simon M Willcock Ian R Willett Isla M Williams Trevor J Williams Anna B Williamson Donald Andrew Wilson Ian G Wilson John W Wilson Chris Winder Lindon M H Wing Adam R Winstock Gary A Wittert John H Wlodarczyk Alex D Wodak Max Wolf Fiona M Wood Richard J Woodman Michael C Woodward Ian J Woolley Paul S Worley Stephen G Worthley Elizabeth J Wylie Ian A Yang Piers J Yates Kwang C Yee Lisa N Yelland Michael J Yelland Stephen Lloyd Yelland Neville D Yeomans John Yiannikas Choong Siew Yong Danny Youlden Christine Younan Doris Y L Young Stephanie Young Dennis K-S Yue Jeffrey D Zajac Yuejen Zhao Stephen R Zubrick Tamara L Zutlevics Nicholas A Zwar Anthony B Zwi Manuscripts received 2010–2011 Manuscripts accepted/received (%) Total 584/1547 (38%) Research 97/535 (18%) Cases 33/230 (14%) Reviews 9/50 (18%) Letters 211/314 (67%) Mean days to decision To reject 37 (research articles, 37) To accept 82 (research articles, 145) Reviewers used 1657 Impact factor (2010) 2.68

Bronwyn Gaut

Objective: To investigate how Australian print news media portray psychiatric genetics.Design and setting: Content and framing analysis of a structured sample of print news items about psychiatric genetics published in Australian newspapers between 1996 and 2009.Main outcome measures: Identify dominant discourses about aetiology of mental illness, and perceived clinical outcomes and implications of psychiatric genetics research.Results: We analysed 406 eligible items about the genetics of psychiatric disorders. News coverage of psychiatric genetics has steadily increased since 1996. Items attributing the aetiology of psychiatric disorders to gene–environment interactions (51%) outnumbered items attributing only genetic (30%) or only environmental factors (20%). Of items that referred to heritability of mental illness, frames of genetic determinism (78%) occurred more frequently than probabilistic frames (22%). Of frames related to genetic prophesy, genetic optimism frames (78%) were used more frequently than frames of genetic pessimism (22%). Psychosocial and ethical implications of psychiatric genetics received comparatively relatively little coverage (23%). The analysis identified 22 predictions about psychiatric genetic discoveries and the availability of molecular-based interventions in psychiatry, most of which (20/22, 91%) failed to manifest by the predicted year.Conclusions: Excessive optimism about the power of genetic technology in psychiatric health care, perceived clinical benefits, and largely unfulfilled predictions about availability of these benefits could encourage unrealistic expectations about future molecular-based treatment options for mental health.

Alex Wilde BSc(Hons),PhD · Catriona Bonfiglioli BA(Hons), PhD · Bettina Meiser PhD · Philip B Mitchell AM, MD · Peter R Schofield PhD, DSc

Doctors are accustomed to taking on clinically related tasks — including management, organisational redesign, quality improvement and teaching — despite a lack of formal training, funding or protected time. There is a great tradition in medicine of clinical teaching while providing patient care. Although doctors are encouraged to base practice on evidence, their teaching methods are often simply based on the methods by which they themselves were taught. There is considerable pressure on general practitioners to provide more medical student education (MJA 2007; 187: 124-128) and to take on more general practice trainees (MJA 2009; 191: 102-104). Renewed pressure to place interns and postgraduate year (PGY) 1 and 2 trainees in general practices adds to this load. Currently, academic departments of general practice are small and under-equipped to build teaching capacity in general practice. The high workload of general practice makes it hard to “squeeze teaching in”. The GP, who often works alone, lacks the advantage of the hierarchical structure of the teaching hospital, where medical students, interns, PGY1 and 2 trainees, junior and senior registrars and consultants are all available, and appropriately delegated teaching and supervision generally occur. GP supervisors also lack the ability to assess trainees’ progress in the graded manner that is possible in some other specialties. In procedural specialties, trainees’ progress toward independent practice is partly assessed by their performance of a specified number of procedures. In contrast, GPs deal with a seemingly infinite variety of patient presentations and, without direct supervision, it is very hard for GP supervisors to be sure that trainees will be able to cope on their own with the next patient who comes through the door. The Journal recently published on future GP-training models, including the proposal to vertically integrate vocational training with undergraduate education (MJA 2011; 194: S97-S100). In this issue, some fundamental concerns are raised. Sturman discusses the tension GPs feel about allowing medical students to play major roles in the care of patients whom the GPs will bill (page 231). There is a broader ethical issue too — the possibility that the patient’s needs may be marginalised in the teaching context. Wearne lists some problems with the current model of GP training (page 224). Of special note is the risk to patient safety when GP supervisors are interrupted in their own work with patients. Interruptions disrupt cognition (memory of the primary task begins to decay when a new task is taken on) and thus may contribute to medical errors (Qual Saf Health Care 2010; 19: 304-312). Our present system is unable to cope with the rapid increase in demand for practice-based medical education. Wearne suggests a new and expensive supervisory model for general practice training but, as she observes, this cost merely “reflects ... the true cost of quality supervision in general practice”. Both training and time are needed and will require funding. Creative approaches to solving this problem are clearly called for. Ultimately, it is most important that the placement experience is a positive one for patients, GPs and students. For students, it may otherwise mean they will not choose a career in general practice.

Annette Katelaris · Christine Jorm

For all of us who have tried and failed to help obese patients lose weight, the viewpoint by Proietto in this issue of the Journal offers some explanation for our defeat. Overeating and low activity levels cause everyone to gain weight. However, the propensity to become obese is genetically predisposed, and expression of the genes involved may well be permanently up-regulated by early experience of overeating. When weight is lost, there are hormonal changes that favour weight regain. These factors make it very difficult for obese people to achieve significant and sustained weight loss with diet, exercise, medication or food replacement programs. For this reason (and because studies of bariatric surgery have repeatedly shown significant long-term weight loss), Proietto calls for bariatric surgery to be made more widely available in public hospitals. This view has widespread support from many sectors of the medical profession. Bariatric surgery has generally only been available at high financial cost to patients, and, indeed, a lucrative private bariatric surgery industry exists. However, in Australia, as in other developed countries, highly processed food with low nutritional value and high caloric density is often cheaper and easier to prepare than more nutritious food, so obesity is more commonly a disease of the poor, who would need public funding to make bariatric surgery accessible. Greater availability of gastric banding may well have some impact on the burden of chronic disease in our society. Proietto reminds us that significant weight loss is accompanied by a degree of reversibility of conditions that are common in obese people, such as diabetes, metabolic syndrome, obstructive sleep apnoea and infertility. Nonetheless, as a public health measure and in the long term, bariatric surgery is unlikely to be our most effective approach to the obesity epidemic. It is time to look seriously at primary prevention, and Proietto’s discussion of epigenetics explains why this must start with maternal diet in pregnancy and infant feeding. We have waited far too long for legislated public health measures that will improve the food intake of Australians. Clinical medicine doesn’t happen in a vacuum. Various legislative measures support the medical message to stop smoking and moderate alcohol intake. We need to be equally aggressive towards the obesity epidemic. This, of course, includes strategies to encourage regular daily exercise. There is good evidence that self-regulation by the food industry has been ineffective. In a previous issue of the Journal, Hebden et al (Med J Aust 2011;195: 20-24) reported that junk food advertising during children’s peak hours of television viewing actually increased after self-regulation was introduced. We have previously debated the problems inherent in the National Heart Foundation Tick program (Stanton, Med J Aust 2011; 194: 284-285). It is important for food labelling programs to be transparent and universal. Many experts argue that sugar and fats are far too cheap, and should be taxed. The government is already fighting the alcohol and tobacco industries. It is time to take on the processed food lobby as well.

Annette G Katelaris

How to ensure a better match between grant applicant and reviewer expertise All researchers have experienced dismay at the failings of peer review.1,2 These include cursory or ill informed reviews from those apparently unschooled in applicants’ disciplines and with superficial understanding of the quality and significance of proposals, publications and achievements being described by aspiring applicants. Only the greenest researchers assume that those who assign papers or grants to reviewers possess Solomonic wisdom in matching the expertise of researchers and reviewers. The reality is very different. Reviewer assigners rely on reviewer databases, particularly for areas beyond their specific expertise. It is here that many problems start. Some names are in these databases by virtue of having previously submitted a grant or paper, regardless of quality or success. Self-chosen research keywords may bear little correspondence to actual expertise. Many relatively inexperienced names appear and searches suggest many who have published little. Grant review panels seek reputable reviewers but reviewer refusal means suboptimal reviewers are often used. No published information is available on grant review refusal rates, but data obtained from the BMJ Publishing Group for 300 866 review requests sent out by 20 journals between 2002 and 2009 show that 32.4% of those asked declined to review.3 Reviewer assigners can then resort to selecting names on the basis of reviewer supplied keywords, without detailed knowledge of the reviewer. Although this can sometimes produce superb reviews, it can also produce those that are confidently written but ill informed. The core problem with current approaches to reviewer selection is that a small number of assessors are involved, typically two or three. Although it would be impractical to involve more people in grant assessments, the rating of track record — typically attracting at least 25% of overall score — could easily break free from the reputational lottery affected by the opinions of a few, sometimes ill informed, people that may affect the fate of a grant application. There is an easily managed, low-cost way of democratising the rating of researcher track record that would end the practice of relying on a small number of sometimes inexpert peers rating applicants’ track records. As part of a project examining the nature of researcher influence, we invited all Australia-based researchers in six research public health fields who had published 10 or more Institute for Scientific Information-indexed publications in the past 10 years to nominate up to five Australian researchers in their respective fields whom they considered to be the most “influential” researchers. Full descriptions of the selection of participants are provided elsewhere.4,5 Participation was high: 83% of invited eligible Australia-based researchers (175/211) completed the rating task, which took about 10 minutes. One hundred and eighty-two individuals across these fields received at least one nomination, producing a distribution of “votes” on researcher influence across these researchers. In five of the six fields, there was impressive consensus on which researchers were most influential, with a long tail of researchers receiving a smaller number of votes, and many none. In all six fields, a large number of researchers (108/182; 59%) received only one vote from all those voting. Of these, 48 (26% of all nominations) were self-nominations. Peer-influence rating generally correlated strongly with four commonly used bibliometric indices of research impact6 (the h, m and q2-indices and the m-quotient).7-10 The traditional approach to track-record ranking involves a small number of researchers being selected as reviewers by an often idiosyncratic process that reflects selector knowledge and preferences and reviewer self-nomination and availability. The existing process lacks transparency and probably provides biased results from an unrepresentative sample of reviewers. Our study demonstrated that the process can be opened up by seeking votes from all research-active peers in each relevant field. Most researchers agreed to participate and found the task unproblematic. We received no critical feedback from those involved. We asked participants to select five researchers they considered to be “most influential” in their fields. The concept of “researcher influence” is arguably wider than that of research track record, but we could have just as easily asked participants to rate the narrower concept of “research track record”. Equally, we could have asked participants to nominate and rank a larger, but non-onerous, number of influential researchers (say, 20), which would have produced a more finely grained distribution of voting, facilitating the overall ranking into quartiles or quintiles that ranged from those considered by many to be influential through to those considered influential by none of their peers. Our proposalIt could be made mandatory for all researchers submitting grant applications to rank the track records of a reasonable number of their peers. Each applicant could be sent a random, computer-generated list of research peers (say, 10) from their respective research fields who where also seeking funding and to rank them as a condition of grant application submission. The generation of these lists could be stratified to ensure that all researchers, regardless of experience, were guaranteed to be ranked by 10 randomly selected peers. Every applicant would thus receive a score of between 100 (if all 10 peers ranked them first) and 10 (if all ranked them 10th). Track record could then be taken as this aggregated raw score. To assist ranking, links could be provided to publications, citations and grant successes. In Australia, the National Health and Medical Research Council now requires all applicants to complete an online track record where all publications and competitive grants are entered into a database which could be linked for this purpose. There are potential weaknesses in this process, although none that are weaker than the approach now operating. Early career researchers would be disadvantaged as they would be unlikely to be competitive with more experienced researchers and would receive lower rankings. This could be addressed by finally dividing all researchers into either “open” or “early career” divisions. Some researchers who challenge research orthodoxies may have the importance of their work discounted by those inhabiting those orthodoxies, and receive fewer votes than their contributions might deserve, but this is already possible under the present system.

Simon Chapman PhD, FASSA · Gemma E Derrick PhD · Abby S Haynes MA · Wayne D Hall PhD, FASSA

Deaths in custody rightly receive significant attention in the media, but the far higher rate of deaths among ex-prisoners during their first year after release from prison is not widely reported. A high risk of death after release from custody seems counterintuitive, but the phenomenon has been reported in overseas literature. In this issue of the Journal (Kinner), we present the first Australian evidence. Kinner and colleagues found that, in 2007–08, more than 400 ex-prisoners died in their first year after release — up to 30% of these in the first month. While their analysis had methodological limitations, it is likely that their estimates understate the mortality rate. The Australian prison population is about 30 000, a figure that had increased by 39% over the decade to 2009. Approximately 50 000 prisoners are released each year, and there are about 385 000 ex-prisoners living in the community (http://www.aihw.gov.au/publication-detail/?id=6442468371). This represents 1.8% of the Australian population, so ex-prisoner health has significant repercussions, and the load on our health services is likely to increase. It is now clear that this population is extremely vulnerable. Almost half of all deaths were drug-related, involving mostly non-Indigenous ex-prisoners. While Indigenous Australians comprise more than a quarter of the total prisoner population, they are less likely to be injecting drug users. As Kinner et al discuss, there are evidence-based programs available that may reduce drug-related deaths, yet they are not being widely implemented. Reducing deaths from non-drug-related causes is more complex. Interventions that target mental illness, chronic disease and injury prevention will be required as part of the solution. Sadly, a United States man with chronic health problems recently resorted to stealing $1 from his bank with the aim of being arrested to gain access to prison health services. If we are to look for answers overseas, there is probably more to be learnt from the German penal system, which aims to resocialise and rehabilitate prisoners. It endeavours to “normalise” living conditions so that they resemble life in the community (http://www.publications.parliament.uk/pa/cm200405/cmselect/cmhaff/193/19304.htm). Presumably, this makes the transition to freedom less stressful. The Australian penal system, with a 2-year recidivism rate of about 40%, and about half of prisoners having been previously imprisoned, is failing. Prisoner health must be seen to encompass both inmates and those recently released. It should be seen to include justice issues that influence health: is the quantum of punishment appropriate; are there alternatives to incarceration; are rehabilitation and education programs available? Programs that smooth the reintegration of prisoners into society are urgently required. Better data are needed to understand what is happening to prisoners after release, but the results of the study by Kinner et al leave no doubt that the health care system must flag ex-prisoners as a high-risk group, and move to meet its needs.

Amanda Leach (centre), coauthor of the winning article and recipient of the 2010 MJA/Pfizer Research Award, with Bill Ketelby, Country Medical Director of Pfizer (left), and Annette Katelaris, Editor of the MJA (right). I am pleased to announce the winner of the Medical Journal of Australia/Pfizer Australia Research Award for 2010. This $10 000 award recognises and rewards the best original research published each year in the Journal, and was presented at the annual Australian Medical Association National Conference in May this year. This year, the Journal’s Content Review Committee awarded the 2010 prize to Peter Morris and his colleagues from the Menzies School of Health Research, Charles Darwin University and the Northern Territory Clinical School of Flinders University in Darwin and Royal Prince Alfred Hospital in Sydney for their article, “Single-dose azithromycin versus seven days of amoxycillin in the treatment of acute otitis media in Aboriginal children (AATAAC): a double blind, randomised controlled trial”. This trial was funded by the National Health and Medical Research Council and the report was published in the Medical Journal of Australia on 4 January 2010. Acute otitis media, particularly perforation of the tympanic membrane, is a major public health problem among Aboriginal children. Only one in 10 children has bilaterally normal ears and hearing. This research group has previously found that long-term antibiotic treatment resolves middle ear effusion and prevents perforation. Because of often poor compliance with treatment regimens over several days, this trial compared a one-off intervention with a standard 7-day regimen. They found that single-dose azithromycin was more effective than a 7-day course of amoxycillin at eliminating the bacterial pathogens, but it was not more effective at curing acute otitis media in this population. Disturbingly, both treatments failed in half the cases treated. The group is now evaluating a double-dose regimen of azithromycin. This was the first randomised controlled trial of antibiotic treatment of acute otitis media in a population with high rates of acute and chronic tympanic membrane perforation. Because single-dose therapy virtually ensures treatment compliance, the findings of this study are potentially practice changing. This award has been sponsored by Wyeth Australia since 1995. We are grateful for their support over the years, and now welcome Pfizer, who acquired Wyeth in 2009, as our cosponsor. The award was presented by Dr Bill Ketelby, Country Medical Director of Pfizer. Pfizer had no role in the study or in the choice of a winner, and it was purely coincidental that a drug that is manufactured by the company was used in the study.

Annette Katelaris MB BS, MPH, FRACGP

The life and work of Dr Ross Ingram (1967–2003) have inspired many Aboriginal and Torres Strait Islander people to send their stories and ideas to the Medical Journal of Australia. It was with much pleasure, therefore, that we welcomed three members of Ross’s family to the presentation of the Dr Ross Ingram Memorial Prizes, at the National Conference of the Australian Medical Association, in Brisbane on 27 May 2011. Ross’s partner, Julie Neville, presented the prizes on behalf of the Australasian Medical Publishing Company. The Competition now has two categories: best essay, and best original artwork. It took us a few years, but the MJA editors finally realised that words are not everything — images can tell powerful stories too! Lindy Moffatt, a Wakka-Wakka, Dunghutti and Gumbaynggirr woman with family ties to both Cherbourg, Queensland, and Grafton on the North Coast of New South Wales, won the essay category, for her story, “Mental illness or spiritual illness: what should we call it?”. Lindy has worked extensively in community work and counseling, and is now an Indigenous Visiting Research Fellow at the Australian Institute of Aboriginal and Torres Strait Islander Studies in Canberra. Her essay vividly describes her son’s journey with mental illness, and explores the effects of transgenerational trauma on Aboriginal and Torres Strait Islander people. It was published in the 16 May 2011 issue of the Journal. Also published in the 16 May 2011 issue, were an excerpt from, and a link to, the winning artwork: an animation called “Alfie the tooth fairy”. Accepting the prize in this category was Alison Dimer, a senior woman of the Madawonga-Galagoo people, the Fire People of the Eastern Goldfields, Western Australia. In her role as an Aboriginal Health Worker, Alison produced the animation for the Western Desert Kidney Health Project of the Rural Clinical School of Western Australia. She worked with animation artist Steven Aiton, local artist Catherine Howard and the children at three local schools to produce the piece, which uses an engaging story to promote the benefits of a healthy lifestyle. Entries for next year’s Dr Ross Ingram Memorial Competition are currently open. For full details see http://www.mja.com.au/public/information/RossIngramCompetition.html. Left to right: Douglas Johnson, Karen Johnson and Julie Neville (members of Dr Ross Ingram’s family), Alison Dimer (producer, best artwork), Lindy Moffatt (winner, best essay), Annette Katelaris (Editor, MJA), Catherine Howard (artist and narrator, best artwork), Ruth Armstrong (Deputy Medical Editor, MJA).

Ruth Armstrong BMed

It has long been known that poverty has a negative impact on health. In this issue of the Journal, Heeley and colleagues show that people living in socioeconomically deprived areas in Australia and New Zealand experience higher rates of stroke. They tend to be younger, more likely to have hypertension and diabetes and, not surprisingly, are more likely to smoke. The magnitude of the difference was startling. When comparing the most deprived with the least deprived groups, the age standardised incidence rate for stroke per 100 000 person years was 70% higher. After adjusting for age, they found that almost one in five strokes could be attributed to living in the most socioeconomically deprived areas compared with the least deprived areas. In developed countries, stroke is the second most common cause of death after heart disease, and it is predicted that by 2020 this will be the case worldwide. Stroke is a leading cause of disability and results in the loss of at least 49 million disability-adjusted life-years annually throughout the world. Stroke in later life has been linked to socioeconomic deprivation in early life, and even to prenatal factors that have socioeconomic determinants, such as low birthweight and short birth length (Lancet Neurol 2006; 5: 181-188). The effect of socioeconomic status on health is multifactorial. Income, environment, education level and social support are important, as are lifestyle factors such as diet, exercise and smoking. Service provision and access also matter. The Marmot Review (http://www.marmotreview.org/reviews/english-review-of-hi) was undertaken to put forward evidence-based strategies for reducing health inequalities in England from 2010. Its key message was that health inequalities result from social inequalities and that the reduction of inequality is a matter of fairness and social justice. The Review also identified a “social gradient” for health in England: people living in the poorest neighbourhoods have a life expectancy that is 7 years less than those living in the richest neighbourhoods. In addition to the health benefits for an individual, the Marmot Review also points out the economic benefits of alleviating health inequalities. These include reduced productivity losses and forgone tax revenue, and reduced treatment costs and welfare payments — all especially relevant to stroke. In Australia, belatedly, we are aware of the survival difference between Indigenous and non-Indigenous people and there are now calls to “close the gap”. There is less awareness of the difference in survival rates across socioeconomic groups. As a profession, we have a responsibility to the community as well as our individual patients to ensure that the treatments we employ are cost-effective. By extrapolating the message of Heeley et al and Marmot, it’s also part of our role to promote health by advocating for policy that diminishes socioeconomic inequality. The “debate” of the moment is about plain packaging of cigarettes. Smoking has a strong inverse relationship with socioeconomic status and is a major risk factor for stroke. We should continue to advocate for any measure that will reduce it — not nanny state, but Nanny knows best.

Martin Van Der Weyden

Given the nexus between published research, medical practice and public health policy, the veracity of published medical research is vital. Melbourne newspaper The Age recently reported on an “explosion of medical research fraud” (12 May 2011), and Myburgh’s editorial in this issue of the Journal (→ Fraud in fluid resuscitation research) examines a specific incident of fraud. Trust in the ethical behaviour of researchers is the cornerstone of medical science and publication. The Guideline for Good Clinical Practice, to which Australia adheres, provides some regulation but not enough to protect against fraud. It is up to medical journals to take a primary role in the prevention of research fraud, and many already have policies in place. These include requirements for ethics approval and registration of all trials before publication will even be considered. Authors should state their contribution to the study and manuscript and must declare all financial conflicts of interest. Finally, articles must be skilfully peer reviewed before publication. Despite all this, as described in Myburgh’s editorial, it is clear that current policies are inadequate and we must ask — what else can be done? The role of thorough audits is well established to improve regulation by funding bodies and ethics committees. There is a push to make raw trial data available to reviewers and readers. Already, some agencies such as the United States Food and Drug Administration mandate that raw data be made available to them for their own independent analysis. In principle, making raw datasets available at or before the time of publication has many potential advantages, with deterrence of fraud being only one important benefit. Facilitating data sharing among researchers, allowing other researchers and peer reviewers to test published conclusions, testing of secondary hypotheses, simplifying data acquisition for meta-analyses, and preventing selective reporting are all important advantages. It may even reduce unnecessary research duplication and facilitate research progress. In comparison, the case against the publication of raw datasets seems flimsy. Issues of confidentiality are easily overcome, and issues of data dredging and invalid analyses are no different to those already confronted by ethics committees and the peer-review process. However, the practical difficulties of data sharing cannot be understated. The vast quantity of data collected in large clinical trials would require the provision of the data dictionary and statistical code to make the data intelligible. Further, it is unlikely that peer reviewers would be able to make sense of the data in a timely way. But practical issues are not the only obstacle. Clearly, there is resistance to the publication of raw data; researchers have a natural tendency to view the collected data as their own. However, there is a compelling argument to maximise the utility of data collected when research has been funded by the public purse. The Wellcome Trust has already stated its aspiration to share data (BMJ 2011; 342: d2323). For now, however, to prevent research fraud, we need to ensure that we seek out smart, proactive peer reviewers, and the research community needs to ensure that audits are carried out so that history does not repeat itself and researchers are called to account early in their careers. Change is inevitable, but what shape it takes is yet to be defined.

Annette Katelaris MB BS, MPH, FRACGP

Research into the health of Aboriginal and Torres Strait Islander people has often been accused of being too observational and deficit-focused, with a dearth of interventional studies. Ten years ago, when the MJA editors were reviewing the Journal’s coverage of the topic, we even considered putting a moratorium on publishing the many observational studies that were crossing our desks. In the past few years, the concept of closing the gap in life expectancy between Indigenous and non-Indigenous Australians has galvanised thinking in the area. Coming as it did from Indigenous leaders, and rapidly gaining widespread support, this movement has provided a much needed focus for all Australians. But as time has moved on, it has become increasingly obvious that we need to better understand the contributors to the gap in order to close it. In this issue, for instance, McDermott and colleagues are able to show, after following a cohort of Aboriginal and Torres Strait Islander adults for over 7 years, that the non-traditional risk factors of glycaemia and proteinuria make a significant contribution to the excess cardiovascular risk seen in Indigenous Australians (→ Glycaemia and albuminuria as predictors of coronary heart disease in Aboriginal and Torres Strait Islander adults: a north Queensland cohort). This has important implications for screening and treatment. Looking beyond conventional causes of morbidity, Priest and colleagues quantify the devastating effect of racism on the social and emotional wellbeing of Aboriginal adolescents (→ Racism as a determinant of social and emotional wellbeing for Aboriginal Australian youth). Larkins and colleagues use mixed methods to tease out some of the issues for disadvantaged young Indigenous people with high rates of teen pregnancy (→ The transformative potential of young motherhood for disadvantaged Aboriginal and Torres Strait Islander women in Townsville, Australia). Neither of the latter two studies suggests any simple avenue for medical intervention, but the findings should strengthen our resolve, as a nation, to identify and overcome the root causes of the health gap. We asked Professor Sir Michael Marmot, who chaired the World Health Organization’s Commission on Social Determinants of Health, to comment on how the Commission’s findings might be applied to the health of Australia’s first peoples (→ Social determinants and the health of Indigenous Australians). He identified two classes of influence that help explain the poor health of Indigenous Australians: social disadvantage, and marginalisation within Australian society. Both the need to understand the contributors to the health gap and Marmot’s observation that people who are marginalised and disempowered cannot enjoy good health underscore an important principle: Indigenous Australians should have the opportunity to lead and guide research into their own health and any proposed interventions. The ongoing work of the newly formed Lowitja Institute (previously the Cooperative Research Centre for Aboriginal Health), described by Arabena and Moodie (→ The Lowitja Institute: building a national strategic research agenda to improve the health of Aboriginal and Torres Strait Islander peoples), is vital in this respect. The Institute’s Indigenous leadership, and its charter to ensure that Aboriginal and Torres Strait Islander voices have strong input at each step of the research process, will give the best chance of asking the right questions and getting the right answers. We do need more high-quality interventional research in Indigenous health but, with many of the answers already obtained from research into other populations, we know that without addressing disadvantage and marginalisation, we will at best be tinkering around the edges. There is now a need to explore the best ways of applying what we know to the many and varied circumstances of Aboriginal and Torres Strait Islander people; and for this, we need Indigenous Australians firmly in the driving seat.

Ruth M Armstrong

The Journal has a new Editor and big plans for the future With this issue, Dr Martin Van Der Weyden retires after 16 years as Editor of the Journal. A tribute to Martin and his many achievements will appear in the next issue. Martin has been a generous and wise teacher, and his columns have set the benchmark in editorial writing. Under his guidance, the Medical Journal of Australia has become the leading publisher of general medical research in Australia. It makes a vital contribution to the debate on local and global medical issues including Indigenous health, patient safety, the honesty and integrity of scientific publishing and peer review, and Australian health policy. The Journal he bequeaths is robust and central to medical communication in this country. As the Journal of the Australian Medical Association, the MJA has a freedom that is unavailable to most other general medical publications in the country: to publish and report free of commercial interests. You can be confident that studies published in the MJA are subject to strict rules requiring disclosure of conflicts of interest, and that they have been expertly peer reviewed. The MJA is uniquely placed to inform and facilitate discussion and education across our profession, and to anchor it within the context of the broader Australian health system. To keep abreast of changes in clinical medicine and professional issues, and to meet the challenge of maintaining the Journal’s relevance for all doctors in the face of these changes, there are plans for the continued evolution of our print publication and an enhanced presence on the web. The MJA will continue to publish major Australian research studies and remain the natural place for publication of data that are important to all Australian clinicians. I want to foster this role for the Journal. My dilemma, however, is that of the editor of any general medical journal: it is difficult to produce an article that meets the needs of both researchers who are interested in the minutiae of their topic and readers who may prefer a brief overview.1 While many Australian studies are appropriately published in specialty and international journals, general medical journals such as the MJA have a crucial role in building and disseminating a strong, usable base of medical knowledge. All doctors have specialised educational requirements and have to be selective in their reading — 75 trials and 11 systematic reviews are published daily2 — thus there is a greater need than ever for relevant interpretation and commentary. I will be inviting the authors of these “specialty” or “international” papers to write editorials for the MJA, which interpret their data. This will feed into an increased emphasis on articles, written by leaders in their field, that synthesise new information for our readership. I want to develop the MJA ’ s natural role as a forum for the presentation of news relevant to doctors and for debate that develops around these issues. Currently, too many medical issues play out in the public media before the profession has a chance to consider or respond. A prime example has been the coverage of prescribing rights for non-doctors.3 Other important issues include the delivery of effective and efficient health care, the planning for, and training of, our medical workforce, and the improvement of Indigenous health outcomes. Our engagement in this process will determine the degree to which we remain an independent and vital profession and will also help to improve health outcomes for the community. One crucial issue is health funding. Currently, Australia spends over 9% of its gross domestic product on health,4 increasing at up to 0.5% per annum.5 The population is ageing and demands on the health system are increasing, necessitating hard choices with respect to the way a limited health budget is spent. As doctors, we need to understand the opportunity costs of ordering a test or admitting an elderly patient to intensive care. In this way, we can participate in decisions involving the allocation of funds within the health budget. The MJA is the appropriate forum for this informed conversation. Discussion about the practice of medicine needs to continue. Good medical practice: a code of conduct for doctors in Australia, adopted by the new Medical Board of Australia, was developed with little discussion within the profession.6 How this code is implemented is yet to be defined, and we should take this opportunity to explore and, perhaps, refine the way we practise. This debate should include doctors’ contributions to the public health care system, the organisation of medical practices, billing practices and time spent with patients, and the complexities of patient education and obtaining informed consent. Our future doctors also need to be included. I plan to engage more with our readers via electronic media. Inevitably our website, planned to be relaunched, will become increasingly important in the life of the Journal. It will embrace new technologies and media, allow for the publication of more research and medical content and facilitate timely discussion around issues. Soon, I hope you will enjoy easy access to the Journal from mobile electronic devices and that you will use this resource to have your say in these conversations. The MJA is your forum. Already, our recently launched email newsletter, MJA InSight, boasts the highest audited email circulation of any medical newsletter in the country.7 My background is as a general practitioner and medical editor, and I will be seeking to both broaden and strengthen the MJA community so that many voices (not just the loudest or best-positioned) are heard. I will be expanding our base of peer reviewers and plan to introduce a rotating position of “Guest Medical Editor”. This person will commission work in his or her field of expertise and refresh and inform our editorial team about advances in his or her area of interest. Already, I have been overwhelmed by the passion and generosity of the MJA community, who, without favour, payment or (much) recognition, contribute to this publication. Peer reviewers are indeed our “unsung heroes”.1 Thank you to all who already contribute to the MJA and to those who will help in the future. I envisage that an enhanced MJA will play an even more important role in the discussion of issues that affect medicine in Australia. With an expanded range of content and new technologies, we have the potential to engage the entire profession. As the new Editor of the MJA, I look forward to guiding its evolution and to working with you.

Annette G Katelaris MB BS, MPH, FRACGP

Publications written by doctors about subjects outside their professional activities are often widely read and may be more enduring than their technical publications. Dr Graeme Robertson, Sir Clive Fitts and Professor Richard Lovell were three doctors from Victoria who wrote with skill and artistry about subjects outside their professional work. Here I discuss these publications and the reasons these doctors came to write them, and offer some reasons for the enduring interest of these publications.

Thomas H Hurley MD, MB BS, FRACP

It’s been an exhausting but productive year here at the MJA. MJA InSight (http://www.mjainsight.com.au), our weekly online newsletter, was launched in July. It has given us the opportunity to spread our wings beyond the confines of the print version of the MJA (and the limitations of the current MJA website) to cover recent medical news and to communicate more directly with our readers. MJA InSight is free for all doctors, medical students and other health practitioners and features news highlights, discussions of the latest research from the MJA and other medical international journals, and invited commentaries on controversial topics. Every second issue of MJA InSight also contains “From the Editor’s desk”, Dr Martin Van Der Weyden’s very popular column from the MJA. The responses to our invitation to “have your say” online demonstrate that we are attracting a diverse and thoughtful readership who are willing to provide their own insights into the discussion topics. Also in July, we launched MJA Careers — in the centre of the paper journal and available online as an e-mag via the MJA or MJA InSight websites (http://www.mja.com.au/careers). MJA Careers contains Jobsearch (medical job advertisements) and Marketplace (practices for sale, real estate, medical equipment, etc), with feature articles about different specialties, training or practice management. The “Q & A” and “One Day [in the life of . . .]” articles have let us briefly into the lives of some inspiring doctors who do something a little out of the ordinary. Conflict of interest (actual or potential) is an increasingly common consideration in scholarly publication. It was the main topic of discussion at the International Committee of Medical Journal Editors (ICMJE) in April in New Zealand — only the second time this august group, of which the MJA is a member, has convened in the southern hemisphere (the first was hosted by the MJA in Sydney in 2007). The ICMJE now has a long and detailed declaration form (available on our website via our “Advice to authors” page) that must accompany all articles submitted to participating journals. Conflicts of interest are ubiquitous, and not just financial — full disclosure and transparency are essential. When considering what constitutes a conflict of interest, we ask authors and reviewers to consider this quote from the World Association of Medical Editors guidelines: “if my competing interest becomes known to others later, would I feel defensive or would others in the publication process, readers or the public think I was hiding my other interests or could they feel I misled or deceived them?” This year’s MJA/Wyeth Award of $10 000 for the best published clinical research went to Tanya Bubner and her colleagues from Adelaide for their research about point-of-care testing in general practice (http://www.mja.com.au/public/issues/193_05_060910/awards_mja_fm.html). The Ross Ingram Memorial Essay Competition prize of $5000 for an essay by an Indigenous author that promotes health gains and health equity for Australia’s Indigenous peoples went to Jane Harrison, a Melbourne Aboriginal Research Officer, for “Healing our communities, healing ourselves” (http://www.mja.com.au/public/issues/193_05_060910/awards_rossingram_fm.html). These prizes are awarded in May each year so potential entrants should be making submission an urgent priority. Unfortunately, each year some of our highly valued staff move on. This year, we have “lost” Dr Kerrie Lawson, Senior Assistant Editor, to freelance work and a more balanced lifestyle, and Dr Alison Williams, Deputy Editor (and previously a Kincaid-Smith Editorial Fellow), who is relocating interstate. At the end of this year, we will also farewell Dr Ann Gregory, Deputy Editor and MJA veteran of 12 years, to family commitments and the world of art. Ann brought to her work at the Journal a wealth of experience in medical publishing, a powerhouse of ideas, a fierce and free-ranging intellect, and an uncanny ability to pull rabbits out of hats! And, at the end of January next year, our Editor of 15 years, Martin Van Der Weyden, will be retiring, although he will continue his association with the MJA as Editor Emeritus. Martin has been many things to the MJA: in his own words, he has “ensured the Journal has evolved to become more relevant to the readership and to health reform”; in our words and those of many of you who know him well, he is provocative, quirky, blunt, challenging, entertaining, but always an extremely astute judge of character and quality. Dr Annette Katelaris, a Sydney general practitioner and previous Medical Editor of magazine, has been appointed to succeed Martin. Fortunately, our dedicated band of reviewers (listed on the following pages) are always there for us, or ready to recommend an experienced colleague. The traditional peer review process is under much scrutiny these days, particularly with the ease and rapidity of comment and discussion that online publication brings, but there is no doubt in our minds that our peer reviewers add enormous value to the manuscripts we publish (and also to those we don’t publish that find other homes). We thank you all very, very much. We wish you all the best for the festive season. Manuscripts received 2009–2010 Manuscripts accepted/received (%) Total 615/1491 (41%) Research articles 125/532 (23%) Cases 29/174 (17%) Reviews 7/37 (19%) Letters 213/318 (67%) Mean days to decision To reject 36 (research articles, 38) To accept 84 (research articles, 142) Reviewers used (invited) 1740 (3134) Impact factor (2009) 2.89 Reviewers Content Review Committee Craig S Anderson Bruce P Armstrong Leon Bach Flavia Cicuttini Jennifer J Conn Marie-Louise B Dick Mark F Harris A Thomas C Kotsimbos Campbell H Thompson Timothy P Usherwood Elmer V S Villanueva E Haydn Walters Owen D Williamson Jane M Young Jeffrey D Zajac Reviewers (reviews submitted 01/11/2009–31/10/2010) Penelope A Abbott Ehtesham A Abdi Michael J Abramson Stephen P Ackland Jason P Acworth Karen Adams Robert J Adams Stephen Adelstein Michael A Adena Meera R Agar Janine J Alan (nee Calver) Rebecca M Albury Charles Algert Robert L Ali Carolyn A Allan Margaret N Allars Craig S Anderson Gerhard S Andersson D Barry Appleton Padmasiri E Aratchige Bruce K Armstrong Ruth M Armstrong Peter C Arnold Constantine N Aroney Michael A Ashby Deborah A Askew David N Atkinson Ajit Auluck Peter D Baade Wendy J Babidge Peter Bacchetti Christopher J Baggoley Peter A Baghurst Ian J Baguley Michael J Bailey Paul M Bailey Ross S Bailie Christopher A Bain Philip R Baker John I Balla Lilon G Bandler Paul R Barach Maria E Barbi Ruth A Barker Adrian G Barnett Ian G Barr Bruce H Barraclough Darryl L Bassett Ivan B Bastian Diana Battistutta Paul A Bauert Peter E Baume Spencer W Beasley Stephen J Begg John P Beilby Justin J Beilby Mary K Belfrage Derek N Bell Derrick A Bennett Michael J Bennett David I Ben-Tovim Michael Berk Andrew Berry Taryn Bessen James A Best James Donovan Best John P Best J H Nicholas Bett Beverley-Ann Biggs Colin W Binns Frances A Birrell Robert Birrell Deborah A Black Peter A Blombery Terry D Bolin Michael D Bollen Stephen N C Bolsin Patrick G M Bolton Miles R Bore Barry Borman Ron A Bouchard Christopher P Bourne Francis J Bowden Simon D Bowler Phillip M Boyce Ian W Boyd Frances M Boyle Nicholas P Boyne David L Bradford Clare E Bradley Pamela J Bradshaw George Braitberg Lesley A Braun Annette J Braunack-Mayer Graeme A Brazenor Victoria A Brazil Kerry J Breen Jo-anne E Brien Esther M Briganti Timothy A Brighton Helena C Britt Kaye E Brock Henry Brodaty Peter M Brooks Julia M L Brotherton Lois H Browne Joseph A Bucci Heather A Buchan Nicholas A Buckley Anne E Buist Jonathan G W Burdon Henry G Burger John R Burgess David Burgner John R Burnett Sarah J I Burns Colin D Butler Linda Butler Tony G Butler Phyllis N Butow John F Cade Peter I Cairney Ian D Cameron Peter A Cameron W Ian Cameron Terence J Campbell Jonathan R Carapetis Susan M Carden Magnolia Cardona John B Carlin Nicholas F Carr Phillip J Carson Andrew C Carter John N Carter Jonathan R Carter Owen B J Carter Alan Cass David J Castle Bruno A Cayoun Albert K F Chan Anne B Chang Jeremy R Chapman Kathryn E Chapman Michael G Chapman Simon Chapman Duncan Chappell Barry E Chatterton Jack Chen Allen C Cheng Ian R Cheong Derek P B Chew Tien Chey Tanya N Chikritzhs Jacqueline H Chirgwin Donald J Chisholm Christopher Y P Choong Katherine C Chretien Helen Christensen MacDonald J Christie Stephen T D Christley Kathleen F Clapham Robyn A Clark Stephen L Clark Caroline F Clarke Stephen J Clarke Mark Clements Alan R Clough Marc M Cohen Enrico W Coiera Peter J Collignon John P Collins Brian T Collopy Peter G Colman John R Condon Katherine M Conigrave Julie Considine Angus Cook Matthew C Cook Alan J Cooper Celia M Cooper Gabrielle M Cooper Michael D Coory William Coote David L Copolov Yvonne E Cossart Anthony J Costello Michael B Coulthart Richard T L Couper Sophie Couzos Benjamin C Cowie Brian Cox Maria E Craig Peter R Crampton Helen M Creasey Mick B Creati John L Crompton David B Cross Brendan J Crotty Katherine B Cullerton Robert G Cumming Margaret C Cummings Adrian G Cummins Frances C Cunningham Joan Cunningham David C Currow Henry G Cutler Olav O Dalgard Andrew Dalton Diona L Damian Scott K D'Amours Mark Daniell John Daniels Jonathan D Darby Andrew J Dare Anthony M Dart Mike M Daube Andrew R Davies Philip K Davies Andrew M Davis Stephen M Davis Timothy M E Davis Wendy A Davis Margaret L J Davy Richard O Day John F de Campo Caroline M de Costa Lachlan J de Crespigny Julien P de Jager Nicholas H de Klerk Gregory M de Moore Stephen A Deane Keith B G Dear John S Deeble Christopher B Del Mar Michael C d'Emden Charles P Denaro Justin T Denholm Helen M Dewey Terrence H Diamond James A Dickinson Andrew J Dixon Timothy A Dobbins Annette J Dobson Anthony J Dodds Dorota A Doherty Ralph L Doherty Xenia Dolja-Gore Basil J Donovan Claire Donovan Michael J Dooley Charles D Douglas Jennifer R Dowd John S Dowden S Bruce Dowton Brian M Draper Tim R Driscoll Patricia Dudgeon Francis J Dudley Michael J Dudley Johan A Duflou Graeme J Duke James A Dunbar David N Durrheim Dominic E Dwyer John M Dwyer John R Dyer Sandra J Eades Arul Earnest Creswell J Eastman Peter R Ebeling Hooi C Ee Paul V Effler Garry J Egger John W Eikelboom Lloyd J Einsiedel John A Eisman Diann S Eley Jaklin A Eliott Elizabeth J Elliott Niki Ellis Pete M Ellis Vincent C Emery Michael W N Epstein Douglas M Ezzy Paul P Fahey Elizabeth A Farmer Annabelle Farnsworth Robert G Fassett Daniel M Fatovich Michael R Fearnside Peter J Fenner Paul A Fennessy Mark J Ferson James E Fielding David W Firman Marty J Firth John W Fisher Peter Fisher Kenneth D Fitch Robert A Fitridge D James Fitzgerald Dominic A Fitzgerald Gerard J FitzGerald Michael P Fitzharris David R Fletcher Felicia R Fletcher Simon J Fletcher Leon A Flicker Joanna M Flynn Andrea S Fogarty Romano A Fois Peter A Foley Kwun M Fong Robert K Foreman Brett H Forge Kevin D Forsyth Richard M Fox Samantha F Fraser-Bell Saul B Freedman Becky Freeman Mark Frydenberg Gary M Frydman Gordian W O Fulde John S Furler John Galati Martin Gallagher Danielle L Gallegos Alexander S Gallus Robert (aka Frank) A Gardiner Roger J Garsia Laurie B Geffen Paul Gerber Richard P Gerraty Mounir N Ghabriel Peter R Gibson Sandra M Gifford Alan J Gijsbers Andrew L Gilbert Gwendolyn L Gilbert Glenn D Giles Timothy P Gill Amanda K Gilligan Conor Gilligan Katie Glass Paul P Glasziou Nicholas S Glozier Glenda Gobe Dianne P Goeman Stacy K Goergen Michael S Gold Robert D Goldney David Goldstein Paul N Goldwater Clayton L Golledge Jonathan Golledge Gregory J R Goodman Iain B Gosbell Kerry J Goulston John R Graham Natalie J Gray Nicholas A Gray M Lindsay Grayson Peter B Greenberg Trisha Greenhalgh Ann T Gregory Michael C Grimm Paul F Gross Luke E Grzeskowiak Murali V Guduguntla Hasantha Gunasekera Girish G Gupta Lyle C Gurrin Steven J Haas Paul S Haber Ruth M Hadfield Mukesh C Haikerwal Ian E Haines Robert G Hall Wayne D Hall G Michael Halmagyi Daniel T Halperin Ian R Hamilton-Craig Alan W Hampson Peter J Hand David J Handelsman Graeme J Hankey Jeffrey N Hanna Terry J Hannan David P Hansen Richard W Harper Anna Harris Ian A Harris Margaret-Anne Harris Mark F Harris Phillip J Harris Bernie T Harrison James E Harrison Roger J Hart Thomas F Hartley Ken J Harvey Narelle L Haworth Richard B Hays Kali W Hayward Philip L Hazell David L Healy Geoffrey S Hebbard Robert J Heddle William F Heddle Kelsey L Hegarty Hugh C Heggie Robert D Helme A Scott Henderson Robert Henning David A Henry Margaret J Henry Ana Herceg Leon G Heron Richard P Herrmann Peter Hersey Andrew Herxheimer Keith D Hill Janet E Hiller David R Hillman C Barry Hoffmaster Christopher D Hogan Russell J Hogg Stephen R Holdsworth Juliette Holland Kate E Holland C D'Arcy J Holman Roderick S Hooker Malcolm J Hopwood Janet Hornbuckle Kenneth F Hossack Anthony K House Nehmat Houssami Laurie G Howes Wendy E Hoy Lin-Min Huang Clare Hughes Clifford F Hughes Leonie G Hunt Peter C Hunter Alexander P Hunyor Rick A M Iedema Francesco L Ierino Michelle E Imison Charles A Inderjeeth David Isaacs Timothy W Isaacs Geoffrey K Isbister James P Isbister Godfrey Isouard Claire L Jackson Terri J Jackson Lisa R Jackson Pulver Ian Jacobs Peter A Jacoby Bin B Jalaludin Tania (Tatiana) Janusic George A Jelinek V Michael Jelinek Rebecca A Jenkinson Moyez Jiwa Murray W Johns William R Johnson Ian R Johnston Trisha C Johnston Vanessa Johnston Damien Jolley Dorothy A Jones Graeme Jones Graham R D Jones Ian S C Jones Mark A Jones Peter G Jones Rodney P Jones Sandra C Jones Christine M Jorm Matthew D Jose Anthony P Joseph David J L Joske Stephen M Jurd Jon N Jureidini Craig A Juresevic John M Kaldor Lisa M Kalisch Max Kamien Leonie V Katekar Frances J Kay-Lambkin Megan A Keaney Karuna Keat Marc J N C Keirse Nicholas A Keks Anne-Maree Kelly Brian J Kelly Heath A Kelly John W Kelly Patrick J Kelly Paul M Kelly Anna R Kemp Debra S Kennedy Michael C Kennedy Stephen J Kent Ross K Kerridge Alison M Kesson Michael R Kidd Merel L Kimman E Dell Kingsford Smith Scott Kinlay David W Kissane Britt Klein Marjan Kljakovic Vikki E Knott Ann P Koehler Paul A Komesaroff Cheryl A Koopman Melvyn G Korman Mark A Kotowicz Vicki Kotsirilos Gabor T Kovacs Emma E Kowal Vicki L Krause Henry Krum Petra H Lahmann Fiona R Lake Mayur K Lakhani Stephen B Lambert Phillipa J Lamont Iain A Lang Helen M Lapsley Sarah L Larkins Ann Larson M Roger Laurent Gillian A Laven John A Lawson Peter N Le Souef Amanda J Leach Julie Leask Karin S Leder Amanda J Lee Katherine Lee Y C Gary Lee Stephen R Leeder Bruce A Leff Katherine M Lepani Christopher R Levi Florence Levy Lucy N Lewis George T Lewith Joel Lexchin Mu Li Shu Qin Li Siaw-Teng Liaw J Norelle Lickiss Lynette L-Y Lim Andrew F Little J Miles Little Mark Little Peter Y Liu Serigne N Lo Bebe Loff Dina C LoGiudice David F M Looke Ruth Lopert Julie A V Lord Douglas W Lording Margaret E Loughnan William J Louis Julia M Lowe Michael P Lowy Tim R Lucket Sanja Lujic M Victoria (Vicki) Luker Harold Luntz David M Lyle Zaza Lyons Kristine K Macartney Dorothy E M Mackerras Finlay A Macrae Richard Madden Guy J Maddern Pedro V S Magalhaes Parker J Magin Roger S Magnusson Donna B Mak Laurence A Malcolm Gin S Malhi Linda Mann Louise J Maple-Brown Peter G Markey John E Marley Ian C Marschner Helen S Marshall Martin N Marshall Roderick I Marshall Roger J Marshall Andrew J Martin Frank Martin Isobel R Martin Jenepher A Martin Jennifer H Martin T John (Jack) Martin Ana Marusic Francis L Mastaglia Colin L Masters Colin D Mathers Timothy H Mathew John D Mathews Brian R McAvoy W John H McBride James S McCarthy Sally M McCarthy Brian C McCaughan Geoffrey W McCaughan Kieran A McCaul Philip I McCloud Pamela A McCombe Peter F McCombe Robyn A McDermott Christine F McDonald Elizabeth L McDonald Joseph McDonnell Michael J McDowell Aidan McElduff Suzanne P McEvoy Patrick D McGorry Barry P McGrath Fran McInerney Elizabeth C McInnes Ellen McIntyre H David McIntyre Peter B McIntyre Paul R McKenzie Andrew J McLachlan Rick McLean I Chris McManus I Caroline McMillen John J McNeil Ian B McPhee Graham N Meadows Alan P Meagher Wayne D Melrose Muhammed A Memon Richard M Mendelson Robert I Menzies Alan F Merry Geoffrey Metz Anne M Mijch J Alasdair Millar Eleanor Milligan Gary Misan Christopher D Mitchell David H Mitchell Geoffrey K Mitchell Philip B Mitchell Mohammed A Mohammed David Molloy Harry G Mond Deborah J Monk Kaveh Monshat Scott C Montgomery Gavin H Mooney Elizabeth M Moore Kevin Moran Kim L Moretti Helen J Moriarty Belinda Morley David L Morris Howard A Morris Philip L P Morris Robin H Mortimer Robert G Moses Kathy Mott Robert F W Moulds David Mountain H Konrad Muller Bridin P Murnion Richard B Murray Arthur (Bill) W Musk Paul S Myles Sydney M L Nade Christina M Nagle Balakrishnan (Kichu) R Nair Louise M Nash Matthew T Naughton Rachel E Neale Mark R Nelson Harvey H Newnham Hanh T T Ngo Tuan V Nguyen Kathleen M Nicholls Christopher P Nickson Paul Nisselle Antony Nocera B E Christopher Nordin Richard P Norman Caryl Nowson Don Nutbeam Barry W Oakes R Kim Oates Jeremy J N Oats Richard C O'Brien Dianne L O'Connell Tony J O'Connell Liam F O'Connor Justin O'Day Jake H Olivier Ian N Olver John K Olynyk Susanne P O'Malley Susan M O'Meara John W Orchard Peter K O'Rourke Robert T A Padbury Ying Pan Kathryn S Panaretto Jeyaraj D Pandian Gordon B Parker Malcolm H Parker Susan Parry Megan E Passey Anushka A Patel Mahomed S Patel George C Patton Craig B Payne Hedley G Peach Louis G Peachey Michael J Peake Brita A Pekarsky Stella Pendle David G Penington Roy H Perlis Peter D Phelan Christine B Phillips Martin J Phillips Paddy A Phillips Philayrath P Phongsavan Richard K S Phoon Avinesh Pillai Peter I Pillans Jane E Pirkis Marie V Pirotta Leon Piterman Adrian L Polglase Kevan R Polkinghorne Solomon Posen Jennifer R Powers Claude G Preitner Garrett P Prestage Naomi C Priest Susan R Priest Richard L Prince Johannes B Prins David L Prior Paul Prociv Anthony M Proietto Perry A Pugno David J Pugsley Priscilla M Pyett Helen E Quinn Michael A Quinn Eva Raik Gunesh P Rajan Duncan W Ramsay Geetha Ranmuthugala Simon Raymond Christine M Read Jennifer S Reath T John Redhead Richard L Reed Christopher M Reid Joseph M Rey Alun H Richards Drew B Richardson Rebecca A Richardson Debra J Rickwood Geoffrey J Riley Malcolm D Riley Ian T Ring Maria M Riper Christopher Roberts Jane Robertson Kaye Roberts-Thomson Ross L Roberts-Thomson Bruce W S Robinson Peter C Robinson Stephen J Robson David M Roder Alan Rodger Stephen J Rodrigues Leigh Roeger Maureen Rogers Sebastian Rosenberg Stephen J Rosenman William Rosner Stuart Ross Beverley J Rowbotham George L Rubin Tilman A Ruff William B Runciman Julie E Rust Michael D Ryan Glenn P Salkeld Philip N Sambrook Prashanthan Sanders Sally J Sandover (nee Reagan) Rob W Sanson-Fisher W Peter Saul Margo H Saunders Julian Savulescu Michael G Sawyer Susan M Sawyer Ayal Schaffer Philip J Schluter Hans-Gerhard F Schneider Peter R Schofield Udo Schuklenk Stefan Schutt Anthony Scott Ian A Scott Russ J Scott David J Scrimgeour Leonie Segal Eva Segelov Markus J Seibel Mark Selikowitz Linda A Selvey Sanjaya N Senanayake Tara Seshadri Jillian R Sewell Narelle E Shadbolt Anthony Shakeshaft Gilbert C Shardey Jonathan E Shaw Dale C Sheehan Julia M Shelley Eugene Sherry Gary F Sholler Alison E Short Bruce H Short Roger Short Rupendra N Shrestha Stephen P Shumack Damin Si Beverly M Sibthorpe William Sievert Kenneth A Sikaris Jerzy (George) M Sikorski Derrick M Silove Rebecca K Simmons Leon A Simons Bruce S Singh Vitali Sintchenko Loane L C Skene Clare A Skinner Jonathan R Skinner Steven J Skov Richard A Smallwood Christine H Smith David E Smith David W Smith James A Smith Julian A Smith Malcolm D Smith Peter J Smith Gregory I Snell Annie C Solterbeck Helen Somerville Denis W Spelman Allan D Spigelman John B Spillane Peter C Sprivulis Tim W Sprott Geoffrey K Spurling Nicola J Spurrier Ian P St James-Roberts Margaret P Staples Richard J Stark Efty P Stavrou David G Steel Matthew Stevens Christopher E Stevenson Mason R Stevenson Bernard W Stewart Graeme J Stewart Jessica M Stewart Jim R Stockigt Martin R Stockler Timothy R Stockwell Elsdon Storey Roger P Strasser Simone I Strasser Alison M Street Russell W Strong Gordon Stuart Rhonda L Stuart Bronwyn G A Stuckey Stephen L Stuckey David M Studdert Nathan W Stupiansky Allan D Sturgess Vijaya Sundararajan Rajah Supramaniam Ashwin Swaminathan Melissa A Sweet Hal Swerissen Jeffrey Szer Turgut Tatlisumak David McD Taylor Hugh R Taylor Maree R Teesson Charles Teo Francis C K Thien Jill E Thistlethwaite David P Thomas Mark A B Thomas Shane A Thomas Campbell H Thompson Peter L Thompson Sandra C Thompson Colin J H Thomson Neil J Thomson W Murray Thomson Anne Marie T Thow Peter F Thursby James Tibballs David J Tiller Joseph Y S Ting Katie K Tinning John M Togno Shilu Tong Steven Y C Tong Andrew M Tonkin John P Tonkin Nicholas A Tonti-Filippini Michael J Toole Les J Toop Stephen Toovey Duncan J Topliss Paul J Torzillo Huy A Tran Joanne F Travaglia Ronald J A Trent Julian N Trollor David R Turner Jane Turner John D Turnidge Stephen M Twigg Kavita Varshney Phillip C Vecchio Martin J Veysey Elmer V S Villanueva Graham V Vimpani John D Vinen Rosalie C Viney E Theo Vos Russell G Waddell John Wakerman Euan M Wallace Mark J Walland Ronald S Walls Alissa J Walsh James K Walsh Warren F Walsh Garry J Walter Barry N J Walters Darren L Walters E Haydn Walters Merrilyn Walton Han Wang Yueping (Alex) Wang Jeanette E Ward Michael Ward Michael R Ward Robert S Ware Kevin J Warr Keith D Waters John D G Watson John R Waugh Bruce P Waxman Karen L Webb Ian W Webster Lynn M Weekes Peter Wein Philip Weinstein Edith Weisberg Barbara Westwood Cynthia B Whitchurch Andrew V White Benjamin P White Julian White Sean L White Harvey A Whiteford John S Whitehall Judith A Whitworth Bridget Wilcken James S Wiley Kay A Wilhelm Garry J Wilkes David Wilkinson James L Wilkinson Timothy J Wilkinson Robert G Will Simon M Willcock Ian R Willett Scott G Williams Trevor J Williams Owen D Williamson David P Wilson Tania M Winzenberg Frances M Wise Alex D Wodak K Y Mark Wong Steven H Wong Nicholas J Wood Richard J Woodman Alistair J Woodward Michael C Woodward Keith V Woollard Paul S Worley Lisa N Wundersitz Anne F Wyatt Patsy M Yates Kwang C Yee Lesley A Yee Danny Youlden Christine Younan Doris Y L Young Jane M Young Stephanie Young Stuart J Youngner Dennis K-S Yue Margaret R Zacharin Jeffrey D Zajac Nikolajs Zeps John B Ziegler Anna M Ziersch Paul Z Zimmet Stephen R Zubrick Nicholas A Zwar

Bronwyn Gaut

Objective: To describe an in-depth analysis of the content and quality of stories about new cancer interventions in Australian media.Design and setting: Search of the Media Doctor Australia media-monitoring website for stories about newly reported cancer interventions, including drugs, diagnostic tests, surgery and complementary therapies, that had been collected from June 2004 to June 2009 and rated for quality using a validated rating instrument. A mixed-methods approach was used to analyse data and story content. Data from the website on stories about other new health interventions and procedures were compared.Main outcome measures: Differences in quality scores between cancer-related news stories (“cancer stories”) and other stories, and between types of media outlet; differences in how cancer was reported in terms of cancer type, morbidity, mortality, and in the use of hyperbole and emotive language.Results: 272 unique cancer stories were critically reviewed by Media Doctor Australia. Cancer stories had significantly higher scores for quality than other stories (F = 7.1; df = 1; P = 0.008). Most cancer stories concerned disease affecting the breast or prostate gland, with breast cancer appearing to be over-represented as a topic relative to its incidence. Pairwise comparisons showed statistically significant superiority for broadsheet newspaper stories over online stories (F = 12.7; df = 1; P < 0.001) and television stories (F = 10.7; df = 1; P = 0.001). Descriptions of morbidity and mortality were variable and often confusing in terms of numbers, time periods and locations. Literary devices including hyperbole and emotive language were used extensively, mostly by the researchers.Conclusions: While reporting of cancer in the general media is of low quality, many of the poorer aspects of content are directly attributable to the researchers. Researchers and journals need to do more to ensure that a higher standard of information about cancer is presented to the media.

Amanda J Wilson PhD · Billie Bonevski PhD · Alison L Jones FRCP · David A Henry FRCPE