The fate of papers rejected by Australian Family Physician.

Background: Research papers submitted to Australian Family Physician (AFP) are accepted or rejected on the judgment of the research editor with advice from expert reviewers. Rejection can be outright (e.g.

Safety of neuraminidase inhibitors for influenza.

Neuraminidase inhibitors, oseltamivir and zanamivir, are used for the treatment of, and protection from, influenza. The safety of these compounds has been assessed in systematic reviews. However, the data presented are somewhat limited by the paucity of good quality adverse event data available.

Topical analgesia for acute otitis media.

Background: Acute otitis media (AOM) is a spontaneously remitting disease for which pain is the most distressing symptom. Antibiotics are now known to have less benefit than previously assumed.

Objectives: To assess the effectiveness of topical analgesia for AOM.

A radical new treatment for the sick health workforce.

The health workforce crisis needs radical treatment; simply educating more health workers will be insufficient, and role substitution among existing health workers is untenable. We propose a new class of health worker who would take on single disease or single procedure responsibilities, working mostly to protocols; and be embedded within current structures. We also propose modular health education which has fewer entry points into the health system, allows transfer between different disciplines, and is based on modules that can be accumulated to allow progress through the system to gain more clinical responsibility.

Celecoxib compared with sustained-release paracetamol for osteoarthritis: a series of n-of-1 trials.

Objective: To assess the use of n-of-1 trials for short-term choice of drugs for osteoarthritis, with particular reference to comparing the efficacy of sustained-release [SR] paracetamol with celecoxib in individual patients.

Methods: Evaluation of community-based patients undergoing n-of-1 trials which consisted of double-blind, crossover comparisons of celecoxib 200 or 400 mg/day with sustained-release paracetamol 1330 mg three times a day in three pairs of 2 week treatment periods per drug with random order of the drugs within pairs. Outcomes evaluated were pain and stiffness in sites nominated by the patient, functional limitation scores, preferred medication, side effects and changes in drug use after an n-of-1 trial.

An n-of-1 trial service in clinical practice: testing the effectiveness of stimulants for attention-deficit/hyperactivity disorder.

Objective: We sought to describe the clinical use of n-of-1 trials for attention-deficit/hyperactivity disorder in publicly and privately funded family and specialized pediatric practice in Australia.

Methods: We used a within-patient randomized, double-blind, crossover comparison of stimulant (dexamphetamine or methylphenidate) versus placebo or alternative stimulant using 3 pairs of treatment periods. Trials were conducted from a central location using mail and telephone communication, with local supervision by the patients' clinicians.

Improving prescribing practices in primary care. A randomised trial and economic analysis of a multicomponent intervention showed small, but important, gains.

Del Mar discusses the implications of the RaPP trial, a cluster RCT of a multi-component intervention to improve prescribing of antihypertensive and cholesterol-lowering drugs in primary care.

Research papers submitted to Australian Family Physician - types and timelines.

Background: Articles published in the research section of Australian Family Physician (AFP) are subject to an editorial process comprising several stages.

Method: Timelines tracking the movement of each research manuscript submitted to AFP from 2002-2004 through all stages of the editorial process were constructed. Of 179 papers, 130 had sufficiently progressed to be included in this study.

Colorectal cancer screening with faecal occult blood testing: community intention, knowledge, beliefs and behaviour.

The objective of this study was to examine the current community intention, knowledge, beliefs and behaviour regarding colorectal cancer (CRC) screening with faecal occult blood testing (FOBT). A cross sectional telephone survey of the general population was conducted in Queensland, Australia. A random sample of 1,136 residents aged 40-80 years were invited to participate in the survey with a response rate of 77.

Reducing occupational psychological distress: a randomized controlled trial of a mailed intervention.

There are increasing levels of psychological distress among general practitioners (GPs). The purpose of this study is to evaluate the effectiveness of a mailed intervention to reduce distress among 'at-risk' GPs. A questionnaire was sent to 1356 GPs from eight Divisions of General Practice.

Advising patients to increase fluid intake for treating acute respiratory infections.

Background: Acute respiratory infection is a common reason for people to present for medical care. Advice to increase fluid intake is a frequent treatment recommendation. Attributed benefits of fluids include replacing increased insensible fluid losses, correcting dehydration from reduced intake and reducing the viscosity of mucus.

Structure and properties of alpha-synuclein and other amyloids determined at the amino acid level.

The structure of alpha-synuclein (alpha-syn) amyloid was studied by hydrogen-deuterium exchange by using a fragment separation-MS analysis. The conditions used made it possible to distinguish the exchange of unprotected and protected amide hydrogens and to define the order/disorder boundaries at close to amino acid resolution. The soluble alpha-syn monomer exchanges its amide hydrogens with water hydrogens at random coil rates, consistent with its natively unstructured condition.

Guaiac versus immunochemical tests: faecal occult blood test screening for colorectal cancer in a rural community.

Objective: To describe patient participation and clinical performance in a colorectal cancer (CRC) screening program utilising faecal occult blood test (FOBT).

Methods: A community-based intervention was conducted in a small, rural community in north Queensland, 2000/01. One of two FOBT kits--guaiac (Hemoccult-II) or immunochemical (!nform)--was assigned by general practice and mailed to participants (3,358 patients aged 50-74 years listed with the local practices).

Early management of meningococcal disease--do attitudes of GPs influence practice?

Background: Survival from early meningococcal disease might be improved if general practitioners followed guidelines by immediately administering parenteral antibiotics (before hospital referral).

Methods: Structured telephone interviews with 20 GPs who had previously treated meningococcal cases.

Results: General practitioners knew guideline recommendations for early management of meningococcal disease: early parenteral antibiotics would be given by about half the GPs entertaining a diagnosis of meningococcal infection.

Caspases from apoptotic myocytes degrade extracellular matrix: a novel remodeling paradigm.

Induction of smooth muscle cell apoptosis is critical to the reversal of severe structural remodeling in hypertensive pulmonary arteries during disease regression. This process involves coordinated resorption of pathologically deposited extracellular matrix, including elastin, and occurs in the presence of serine elastase and matrix metalloproteinase inhibitors. Here, we show that apoptotic smooth muscle cells exhibit extensive degradation of elastin coincident with cell surface immunolocalization and release of caspases.

Psychological distress among GPs--who is at risk and how best to reach them?

Objective: To identify key characteristics of psychologically distressed general practitioners and whether these GPs volunteered for a "GP health" educational program.

Setting: Eight Australian divisions of general practice responding to an invitation to participate in the research in 1999, representing 1356 GPs.

Main Outcome Measure: The General Health Questionnaire (GHQ-12), together with demographic and practice questions.

Community perceptions of suspicious pigmented skin lesions: are they accurate when compared to general practitioners?

Community responses (n=925, response rate=71%) of a series of eight photographs of pigmented skin lesions were compared against those of general practitioners (n=114, response rate=77%), considered to be the most relevant gold standard. The eight photographs included three melanomas, two potentially malignant lesions and three benign pigmented lesions. Over the pool of lesions examined, the average probability that community members thought a lesion was likely to be skin cancer (0.

General practitioner, specialist providers case conferences in palliative care--lessons learned from 56 case conferences.

Objective: To describe the utility and acceptability to general practitioners and palliative care staff of case conferences in palliative care.

Method: Research focussed on case conferences conducted between GPs and staff of three specialist palliative care units (in an inner urban, outer metropolitan and regional setting), at the time of referral of patients to the service. Telephone interviews were conducted with all GPs who participated in a case conference, and focus groups were conducted with palliative care staff.

Psychological interventions for overweight or obesity.

Background: Overweight and obesity are global health problems which are increasing throughout the industrialised world. If left unchecked, they will continue to contribute to the ever increasing noncommunicable disease burden.

Objectives: To assess the effects of psychological interventions for overweight or obesity as a means of achieving sustained weight loss.

Using n-of-1 trials as a clinical tool to improve prescribing.

Background: N-of-1 trials are within-patient, randomised, double-blind, placebo-controlled cross-over comparisons of two drugs for chronic illnesses. We have investigated the use of these, offered to doctors as individualised medication effectiveness tests (IMETs), as a tool to improve drug prescribing.

Aim: To examine patient perspectives and experiences of n-of-1 trials.