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The Vibrant Soundbridge middle ear implant and the Bonebridge bone conducting hearing device are hearing implants that use radio frequency transmission to send information from the sound processor to the internal transducer. This reduces the risk of skin problems and infection but requires a more involved surgical procedure than competitor skin penetrating devices. It is not known whether more complex surgery will lead to additional complications. There is little information available on the reliability of these systems and adverse medical or surgical events. The primary research question is to determine the reliability and complication rate for the Vibrant Soundbridge and Bonebridge. The secondary research question explores changes in quality of life following implantation of the devices. The tertiary research question looks at effectiveness via changes in auditory performance.

To evaluate the impact of increasing the minimum re‐supply period for prescriptions on the Pharmaceutical Benefits Scheme (PBS) in November 1994. The intervention was designed to reduce the stockpiling of medicines used for chronic medical conditions under the PBS safety net.

This study aimed to examine whether knowledge, attitudes and concerns predicted attendance at the mobile Breast X‐Ray Programme in Sydney. A cohort study design was used, whereby women were surveyed prior to the implementation of the program, and two years later records were checked to determine whether they had attended for screening. Telephone interviews were sought with randomly selected women aged 45 to 70 years living in the central Sydney area (the screening van's catchment area). A total of 285 women was surveyed (response rate: 50 per cent). Of these, 86 (30 per cent) subsequently attended at the mobile van and 199 did not. Attendance did not appear to be related to any of the following factors: knowledge; attitudes; prior experience; perceived susceptibility and morbid concern in relation to breast cancer; the amount of information about screening mammography to which a woman had been exposed. The results are interpreted in light of methodological considerations plus findings from our other research.

A randomised controlled trial studied the effect of an educational visit on benzodiazepine prescribing. An approximately representative sample of 286 general practitioners was allocated to an intervention or a control group. Rates of benzodiazepine prescriptions were derived from two comprehensive self‐report surveys seven months apart. Two months after the first survey the intervention group received an educational visit and supporting material from a doctor or pharmacist, ostensibly unconnected with the surveys. The overall benzodiazepine prescribing rate fell by 23.7 per cent from the first to the second surveys, from 4.93 to 3.76 prescriptions per 100 encounters (P< 0.001). Anxiety and insomnia diagnosis rates also declined from 4.68 to 3.76 per 100 encounters (19.7 per cent). After adjusting for confounders, there was a differential downward trend in prescriptions per diagnosis of insomnia but not to a statistical level. The same was true of initial prescriptions per insomnia diagnosis. In a subsidiary analysis selecting only new insomnia diagnoses, the intervention had a strong effect in reducing initial prescriptions (odds ratio 0.18, 95 per cent confidence interval 0.04 to 0.73). No effect was seen on prescribing for anxiety diagnoses. Educational practice visiting for benzodiazepine prescribing in anxiety, as we conducted it, is not justified in an unselected population of general practitioners. Specific education on prescribing for insomnia is probably useful. Our interpretation of the reduction in benzodiazepine prescribing is that probably there was an effect from self‐monitoring alone which overwhelmed a main‐analysis intervention effect. Retrospective diagnosis may also have obscured a real intervention effect.

In 1987 the Cannabis Expiation Notice scheme decreased penalties for the personal use of cannabis in South Australia. Data from four National Campaign Against Drug Abuse (NCADA) household drug‐use surveys covering the period 1985 to 1993 were analysed to measure the effect of the decriminalisation on cannabis use. The main outcomes used were the self‐reported prevalence rates of having ever used cannabis and current weekly use. Logistic regression was used to control for the potentially confounding effects of age and sex. Other outcomes were rates of having ever been offered cannabis and willingness to use cannabis if offered it. Between 1985 and 1993 the adjusted prevalence rate of ever having used cannabis increased in South Australia from 26 per cent to 38 per cent There were also significant increases in Victoria and Tasmania, and to a lesser extent in New South Wales. The increase in South Australia was not significantly greater than the average increase (P= 0.1). Adjusted rates of weekly use increased between 1988 and 1991 in South Australia, but did not change through 1993. Although the effect was in the direction of a greater increase in Soudi Australia, this was not statistically significant when compared to increases in the rest of Australia (P= 0.07). The greatest increase in adjusted weekly use occurred in Tasmania between 1991 and 1993, from 2 per cent to 7 per cent. Although the NCADA survey data indicate that there were increases in cannabis use in South Australia in 1985–1993, they cannot be attributed to the effects of partial decriminalisation, because similar increases occurred in other states.

Three drug use surveys employing a standardised questionnaire format and sampling procedure were conducted on samples of New South Wales school students in 1983, 1986 and 1989. Alcohol and tobacco were the most frequently used substances across the surveys, with rates of use of illicit substances being considerably lower. Declines in the prevalence of alcohol, tobacco and stimulant use were found between 1983 and 1986 and between 1986 and 1989 for both males and females. Rates of use of inhalants, sedatives, hallucinogens and narcotics declined between 1983 and 1986, but remained unchanged between the 1986 and 1989 samples. Cannabis use declined significantly among females between 1983 and 1989, but not among males. Possible reasons for the general decline in drug use over the six‐year period are discussed.

This paper presents findings on drug prevalences for licit and illicit drugs among New South Wales secondary school students (n= 3753) in late 1989. It also considers the accuracy of students' perceptions of the drug causing the most and fewest drug‐related deaths. Data were analysed by age and gender, using logistic regression for the prevalence data. Findings indicate that licit drugs (tobacco, alcohol and analgesics) were the most frequently and widely used. Rates for illicit drugs were low, although there was some degree of experimental use of cannabis which increased amongst older males. Perceptions were found to be inaccurate in emphasising the dangers of the illicit drug heroin over those of the licit drugs tobacco and alcohol. Reasons for these findings are discussed, and more in‐depth research recommended into the relationship between drug prevalences and perceptions for different age groups, and its relevance for planning drug prevention initiatives.

This cross-sectional survey of cancer screening in May 1996 used a national random sample of a specified group of general practitioners (GPs).The survey included items to assess the impact of the Organised Approach to the Prevention of Cervical Cancer (OAPCC). Of the 1,271 GPs who satisfied the eligibility criteria, 855 (67%) returned a completed questionnaire. Fifty-two per cent indicated they would be ‘highly’ likely to introduce a discussion about cervical smears to a 58-year-old woman who was in good health and had come for a non-gynaecological consultation. Female sex, RACGP affiliation, practising in a metropolitan area and awareness of the OAPCC booklet were independent predictors of an opportunistic orientation. By contrast, 91 % indicated that they would be ‘highly’ likely to include a Pap smear in a general health checkup. Thirty-eight per cent reported that they had found the booklet about the 1991 screening policy ‘very’ useful, while 38% found the NHMRC guidelines for the management of women with screen detected abnormalities ‘very’ useful. Around one-fifth of the GPs were not aware of these documents. Overall, 19% still recommended annual or more frequent screening. GPs from NSW and Queensland were less likely to support biennial screening than GPs from other states. Overall, 26% of GPs did not indicate that they would refer a woman who had tested positive for any grade of CIN for colposcopic assessment. Female GPs were more likely to refer women with CIN for colposcopic assessment while older doctors were less likely to do so.

Background. Very little effort has been directed to enable GPs to better informed decisions about PSA screening among their male patients. Objectives. To evaluate an innovative programme designed to enhance GPs capacity to promote informed decision making by male patients about PSA screening. Methods. The study design was a cluster randomised controlled trial set in New South Wales, Australias most populous state. 277 GPs were recruited through a major pathology laboratory. The interventions were three telephone-administered peer coaching sessions integrated with educational resources for GPs and patients and the main outcome measures were: GP knowledge; perceptions of patient involvement in informed decision making; GPs own decisional conflict; and perceptions of medicolegal risk. Results. Compared with GPs allocated to the control group, GPs allocated to our intervention gained significantly greater knowledge about PSA screening and related information [Mean 6.1 out of 7; 95% confidence interval (CI) = 5.9–6.3 versus 4.8; 95% CI = 4.6–5.0; P < 0.001]. They were less likely to agree that patients should remain passive when making decisions about PSA screening [Odds ratio (OR) = 0.11; 95% CI = 0.04–0.31; P < 0.001]. They perceived less medicolegal risk when not acceding to an ‘uninformed’ patient request for a PSA test (OR = 0.31; 95% CI 0.19–0.51). They also demonstrated lower levels of personal decisional conflict about the PSA screening (Mean 25.4; 95% CI 24.5–26.3 versus 27.8; 95% CI 26.6–29.0; P = 0.0002). Conclusion. A ‘peer coaching’ programme, supplemented by education materials, holds promise as a strategy to equip GPs to facilitate informed decision making amongst their patients.