It can be said without doubt that every scientist who has done research and tried to publish a paper in a journal has at some stage been at the receiving end of the peer-review process. There are different forms of peer review associated with pub- lishing research but the most common version is where the editor of the journal chooses reviewers (at least two) who are asked to provide a critique of a paper which has been submitted to the journal. The reviewers are asked to make a recommendation on whether or not the paper should be published. The identity of the authors is not revealed to the reviewers and usually the reviewers are not known to the authors. Reviewers are not paid for their efforts despite the process taking several hours. It is an unwritten code that be- ing asked to review a paper is pay-back for the occasions on which one’s own research is reviewed by other unknown sci- entists. This is the style of review used by the South African Journal of Sports Medicine. Not everyone supports peer review as it is currently practised. Most of the complaints concern the slow process and the fact that sometimes reviewers might reject a paper because it does not fit into their own research paradigm. Furthermore, the process often fails to detect errors in analysis, ethical problems or scientific fraud. 1,2 The system has also been accused of blocking innovation and the promotion of new ideas. 1 The chance of two reviewers of a paper giving identical reports and identifying the same problems with the paper are remote. To counter this problem several reviewers need to be used, but this imposes large time and financial hurdles which most journals find unacceptable. 1 A recent report concluded that improving peer review ‘…depends on making its human aspects more humane. Journals need to ask the right reviewers to review the right articles, help them to do it quickly and thoroughly, make them feel happy to sign their reports, thank them, tell them how they did, and encourage wide recognition of what’s too often a thankless task’. 1 High-quality journals address these points and facilitate the reviewing process by having a large database of reviewers with records of which papers they have reviewed, when they last reviewed a paper, an online tracking system, automated reminders and strict deadlines. Whilst we do not have a sophisticated online tracking system at the SAJSM we do try to enforce strict deadlines for reviewers. However, this process is undergoing change and we hope that by this time next year we will have an online submission with better tracking systems for reviewers. A problem with the smaller specialist journals such as the SAJSM is the relatively small pool of potential reviewers. We aim to increase this pool by marketing the journal beyond the confines of the members of the South African Sports Medicine Association and if there is sufficient interest we will have workshops on peer review for interested members who may lack experience in reviewing papers. However, given the acknowledged limitations of peer review it remains the only practical system of quality control presently available. Until a better system evolves or is invented we have to accept and embrace the process and make sure that all the factors which facilitate a smooth reviewing process are controlled. Mike Lambert Editor-in-Chief 1. Groves T. Quality and value: How can we get the best out of peer review? Nature 2006; 441: xi - xi. 2. Smith R. Peer review: reform or revolution? BMJ 1997; 315:759-760. Peer review – a part of the process? A topic which is receiving much publicity as I write is the banning of 5 skinny models from participating in the Madrid fashion week. Madrid’s regional govern- ment imposed the rules ‘to protect the models as well as teenagers who may develop anorexia as they try to copy underweight catwalk stars’. 1 They used a body mass index of 18 as their cut- off value. The ‘anti-thin’ move has been criticised in Paris and New York, two of the world’s leading fashion centres. However, in Italy the move was supported by the mayor who intimated that she would like to apply the same rulings when the fashion show moves to Milan. The motive for imposing the ban is noble, as the ‘skinny trend’ is not showing signs of abating. A recent report by the British Medical Association identifies a link between the images of ‘abnormally thin’ models that dominate television and magazines, and the increase in cases of anorexia nervosa and bulimia. 2 The incidence of anorexia is at an all-time high with predictions of 0 - 5% of all females having eating disorders. While eating disorders were previously usually regarded as a female syndrome, the situation is changing with a steady increase in the number of men being diagnosed with eating disorders. A recent estimate predicts that of the 60 000 people with eating disorders in the UK, 10% are male. 2 This trend can most likely be explained by the contemporary lean, hungry look of male stars. To get a snapshot view of changing body beautiful images of different eras one only has to compare the ‘hunks’ of the 1960’s movies (i.e. Sean Connery as James Bond) to modern day hunks to see how the masculine image has changed. Marilyn Monroe, with her curvy body shape in the 1950s would probably be regarded as too fat for a leading role 50 years later. While the organisers of the fashion shows should be complimented for taking a bold stand against their skinny, unhealthy-looking models, they can be criticised for the way in which they have gone about it. Using a body mass index of 18 as a cut-off value is inappropriate and may penalise some models who live normal healthy lives. Instead of this approach the organisers should establish a structure that evaluates the health status of the models including their eating, sleeping and substance abuse habits and make decisions accordingly. The information on how to do this is available; it just needs to be applied. This third issue of the journal for 2006 has 4 interesting papers. The first paper by Professor Mars and colleagues examines the cooling of skin, subcutaneous fat and muscle with an icepack, at rest and after short-duration exhaustive exercise. This study produced some interesting results with important clinical applications. The next paper by Ian Cook examines the accuracy of different types of pedometers. It is well known that people who use pedometers are encouraged to be more physically active, so therefore there is great value in making pedometers available to the general public. However, the enthusiasm to make and distribute pedometers has exceeded the concern about their accuracy. This study addresses this point with a comprehensive research design. The results make a valuable contribution to the literature. The third paper, by Dr McHardy and colleagues from Macquarie Injury Management Group, Macquarie University, Sydney, Australia, is a clinician’s perspective of the modern and classic golf swing. This paper is relevant to sports physicians, biokineticists and physiotherapists and provides a clear analysis of the different types of golf swing and their possible link to injury, particularly lower back pain. Finally the paper by Dr Draper and her colleagues describes the state of the fitness industry in South Africa. This comprehensive study gathered data from 442 facilities around the country. The data provide an important benchmark for the state of the industry and will make a significant contribution to the development of perceived weaknesses in the industry. Mike Lambert Editor-in-Chief 1. Milan fashionistas fear Spanish skinny model ban. news.yahoo.com/s/ nm/20060914/od_nm/italy_models_dc (accessed 18 September 2006) 2. The changing shape of the model. news.bbc.co.uk/1/hi/uk/769460.stm (ac- cessed 18 September 2006) Skinny fashion – a role for sports medicine? SAJSM voL 18 No. 3 2006 57 editoriAL pg57.indd 57 9/21/06 12:15:22 PM SAJSM voL 18 No. 4 2006 105 editoriAL pg105.indd 105 11/22/06 12:17:45 PM