Looking back, looking forward.

As well as containing an excellent bunch of research papers, this month's BJGP celebrates two important milestones in its history — the 50th anniversary of the first publication of the Journal of the College of General Practitioners, without the appended College Research Newsletter, in 1960 and the establishment of the Journal's International Advisory Board during 2010. But first the papers. The overall theme is therapeutic interventions. Stanton and colleagues provide a valuable overview of the evidence guiding clinical decision making in patients with respiratory tract symptoms and infections, and offer a series of practical suggestions aimed at improving their management. These include the use of structured scoring systems to rule in or out bacterial infections, shared decision making, the provision of patient information, and the use of deferred prescribing in certain defined circumstances (page 916). In their study from Oslo, Hoye and co-workers discovered that deferred prescribing was not always endorsed by GPs, and emphasise the need for careful negotiation and the provision of information to patients when issuing wait-and-see prescriptions (page 907). Non-drug approaches to the management of hypertension and gastro-oesophageal reflux disease are explored in a systematic review from Ireland (page 924) and an evaluation of a group intervention from London (page 891), both suggesting that patients have an important role to play in the effective management of both conditions. Inappropriate use of antibiotics is likely to have contributed to the high rate of nasal carriage of resistant strains of Staphylococcus aureus by GPs in the Netherlands (page 902), while the telling case history by Bolton et al illustrates the need to look beyond the acute treatment of gout in younger patients, and to consider the likelihood of increased cardiovascular risk lying behind the inflamed joint (page 913). The Journal's golden anniversary is marked in the Back Pages by a series of short pieces by all but one of its editors, tracing the development of one of the world's oldest and most influential primary care publications, growing out of a cottage industry fuelled by goodwill and commitment to the highly professional publishing operation that now runs in the College's Journal office. Despite that, however, the problems facing successive editors had much in common, such as the balance between research and non-research content, the Journal's responsibility to the academic publishing community versus its relevance to the wider RCGP membership, the need to protect editorial independence, and the importance of …