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Medical Journals (medical + journal)
Kinds of Medical Journals Selected AbstractsA MASTER CLASS IN UNDERSTANDING VARIATIONS IN HEALTHCARECYTOPATHOLOGY, Issue 2006M. Mohammed That there is wide-spread variation in healthcare outcomes cannot be denied. The question is what does the variation mean and what can we do about it? Using a series of well-known case-studies, which include data from the Bristol and Shipman Inquiries, fundamental limitations of traditional methods of understanding variation will be highlighted. These methods, which include comparison with standards, league tables and statistical testing, have flaws and they offer little or no guidance on how to re-act to the variation. Fortunately, there is a theory of variation that overcomes these limitations and provides useful guidance on re-acting to variation, which was developed by Walter Shewhart in the 1920s in an industrial setting. Shewhart's theory of variation found widespread application and won him the accolade ,Father of modern quality control'. His work is central to philosophies of continual improvement. Application of Shewhart's theory of variation, also known as Statistical Process Control (SPC), to case-studies from healthcare will be demonstrated, whilst highlighting the implications and challenges for performance management/monitoring and continual improvement in the healthcare. References:, 1. M A Mohammed, KK Cheng, A Rouse, T Marshall. "Bristol, Shipman and clinical governance: Shewhart's forgotten lessons" The Lancet 2001; 357: 463,7. 2. P Adab, A Rouse, M A Mohammed, T Marshall. "Performance league tables: the NHS deserves better" British Medical Journal 2002; 324: 95,98 [source] Inconsistencies between reported test statistics and p- values in two psychiatry journalsINTERNATIONAL JOURNAL OF METHODS IN PSYCHIATRIC RESEARCH, Issue 4 2007David Berle Abstract A recent survey of the British Medical Journal (BMJ) and Nature revealed that inconsistencies in reported statistics were common. We sought to replicate that survey in the psychiatry literature. We checked the consistency of reported t -test, F -test and ,2 -test values with their corresponding p -values in the 2005 issues of the Australian and New Zealand Journal of Psychiatry (ANZJP) and compared this with the issues of the ANZJP from 2000, and with a similar journal, Acta Psychiatrica Scandinavica (APS). A reported p -value was ,inconsistent' if it differed (at its reported number of decimal places) from our calculated p -values (using three different software packages), which we based on the reported test statistic and degrees of freedom. Of the 546 results that we checked, 78 (14.3%) of the p -values were inconsistent with the corresponding degrees of freedom and test statistic. Similar rates of inconsistency were found in APS and ANZJP, and when comparing the ANZJP between 2000 and 2005. The percentages of articles with at least one inconsistency were 8.5% for ANZJP 2005, 9.9% for ANZJP 2000 and 12.1% for APS. We conclude that inconsistencies in p -values are common and may reflect errors of analysis and rounding, typographic errors or typesetting errors. Suggestions for reducing the occurrence of such inconsistencies are provided. Copyright © 2008 John Wiley & Sons, Ltd. [source] Early head injury and attention deficit hyperactivity disorder: retrospective cohort studyCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 2 2009Richard Reading Early head injury and attention deficit hyperactivity disorder: retrospective cohort study . KeenanH. T., HallG. C. & MarshallS.W. ( 2008 ) British Medical Journal , 337 , a1984 . DOI:10.1136/bmj.a1984 . Objective To explore the hypothesis that medically attended head injury in young children may be causal in the later development of attention deficit hyperactivity disorder. Design Retrospective cohort study. Setting Health improvement network database (1988,2003), a longitudinal UK general practice dataset. Participants All children registered in the database from birth until their 10th birthday. Main outcome measures Risk of a child with a head injury before age 2 developing attention deficit hyperactivity disorder before age 10 compared with children with a burn injury before age 2 and children with neither a burn nor a head injury. Results Of the 62 088 children who comprised the cohort, 2782 (4.5%) had a head injury and 1116 (1.8%) had a burn injury. The risk of diagnosis of attention deficit hyperactivity disorder before 10 years of age after adjustment for sex, prematurity, socio-economic status and practice identification number was similar in the head injury (relative risk 1.9, 95% confidence interval 1.5 to 2.5) and burn injury groups (1.7, 1.2 to 2.5) compared with all other children. Discussion Medically attended head injury before 2 years of age does not seem to be causal in the development of attention deficit hyperactivity disorder. Medically attended injury before 2 years of age may be a marker for subsequent diagnosis of attention deficit hyperactivity disorder. [source] Realist review to understand the efficacy of school feeding programmesCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 2 2008Richard Reading Realist review to understand the efficacy of school feeding programmes . GreenhalghT., KristjanssonE. & RobinsonV. ( 2007 ) British Medical Journal , 335 , 858 , 861 . DOI: 10.1136/bmj.39359.525174.AD. [source] Impact of a theoretically based sex education programme (SHARE) delivered by teachers on NHS registered conceptions and terminations: final results of cluster randomised trialCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 3 2007Richard Reading Impact of a theoretically based sex education programme (SHARE) delivered by teachers on NHS registered conceptions and terminations: final results of cluster randomised trial . Henderson, M., Wight, D., Raab, G. M., Abraham, C., Parkes, A., Scott, S. & Hart, G. ( 2007 ) British Medical Journal , 334 , 133 , 6 . DOI: 10.1136/bmj.39014.503692.55. Objective To assess the impact of a theoretically based sex education programme (SHARE) delivered by teachers compared with conventional education in terms of conceptions and terminations registered by the National Health Service. Design Follow-up of cluster randomized trial 4.5 years after intervention. Setting National Health Service records of women who had attended 25 secondary schools in east Scotland. Participants A total of 4196 women (99.5% of those eligible). Intervention SHARE programme (intervention group) vs. existing sex education (control group). Main outcome measure National Health Service recorded conceptions and terminations for the achieved sample linked at age 20 years. Results In an ,intention to treat' analysis, there were no significant differences between the groups in registered conceptions per 1000 pupils (300 SHARE vs. 274 control; difference 26, 95% CI ,33 to 86) and terminations per 1000 pupils (127 vs. 112; difference 15, ,13 to 42) between ages 16 and 20 years. Conclusions This specially designed sex education programme did not reduce conceptions or terminations by age 20 years compared with conventional provision. The lack of effect was not due to quality of delivery. Enhancing teacher-led school sex education beyond conventional provision in eastern Scotland is unlikely to reduce terminations in teenagers. [source] Physical activity to prevent obesity in young children: cluster randomised controlled trialCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 3 2007Richard Reading Physical activity to prevent obesity in young children: cluster randomised controlled trial . Reilly, J. J., Kelly, L., Montgomery, C., Williamson, A., Fisher, A., McColl, J. H., Lo Conte, R., Paton, J. Y. & Grant, S. ( 2006 ) British Medical Journal , 333 , 1041 DOI: 10.1136/bmj.38979.623773.55. Objective To assess whether a physical activity intervention reduces body mass index in young children. Design Cluster randomized controlled single blinded trial over 12 months. Setting Thirty-six nurseries in Glasgow, Scotland. Participants In total, 545 children in their pre-school year, mean age 4.2 years (SD 0.2) at baseline. Intervention Enhanced physical activity programme in nursery (three 30-minute sessions a week over 24 weeks) plus home-based health education aimed at increasing physical activity through play and reducing sedentary behaviour. Main outcome measure Body mass index, expressed as a standard deviation score relative to UK 1990 reference data. Secondary measures were objectively measured physical activity and sedentary behaviour; fundamental movement skills; and evaluation of the process. Results Group allocation had no significant effect on the primary outcome measure at 6 and 12 months or on measures of physical activity and sedentary behaviour by accelerometry. Children in the intervention group had significantly higher performance in movement skills tests than control children at 6-month follow-up (P = 0.0027; 95% CI 0.3,1.3) after adjustment for sex and baseline performance. Conclusions Physical activity can significantly improve motor skills but did not reduce body mass index in young children in this trial. [source] Supplements to Medical Journals: Adding Knowledge or Subtracting from the Public Trust?JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 1 2006Thomas T. Yoshikawa MD No abstract is available for this article. [source] Medical Advertisements in Medical Journals: the Case AgainstACADEMIC EMERGENCY MEDICINE, Issue 10 2009Carey D. Chisholm MD No abstract is available for this article. [source] The Trouble with Medical Journals (First Edition)ANZ JOURNAL OF SURGERY, Issue 5 2010Cameron Platell MBBS, FRACS No abstract is available for this article. [source] Medical journals and effective dissemination of health researchHEALTH INFORMATION & LIBRARIES JOURNAL, Issue 4 2001Aravinthan Coomarasamy Clinical medical journals have not been effective in meeting the information needs of practitioners and bridging the gap between clinical research and practice. The slow adoption of results of clinical research is at least partly due to the failure of clinical journals to disseminate information in a way that would motivate practitioners to change practice. Although implementation is primarily a local process, medical journals are in a unique position to advance implementation by modifying their focus and adjusting their contents. Strategies that may be useful include publication of pre-appraised evidence summaries and ,clinical bottom-lines' and giving importance to systematic reviews and large evaluative research articles as they represent higher levels of evidence and have greater potential to change practice. Clinical journals should encourage researchers to consider how and by whom the findings will be used and provide information on implications for implementation such as possible strategies that may work, cost-effectiveness, side-effects and potential barriers to implementation. Medical journal publishers should explore ways to cooperate so that findings of landmark clinical trials could be shared thus reducing the ,scatter' of medical information. Electronic media offers numerous advantages such as quick accessibility and linking of information, and medical journals should capitalize on such innovations. There is a paradigm shift in health care practice as evidence is consciously and explicitly incorporated into individual patient care. Medical journals need to change to reflect this change in practice and provide practitioners with valid and relevant information. [source] Cosmeceuticals Containing Herbs: Fact, Fiction, and FutureDERMATOLOGIC SURGERY, Issue 2005Carl Thornfeldt MD Background. Modern medicine is rooted in ethnobotanical traditions using indigenous flora to treat symptoms of human diseases or to improve specific aspects of the body condition. Herbal medicine is now used by over half of the American population. Yet the American medical community generally lacks knowledge of the function, metabolism, interaction, adverse reactions, and preparation of herbal products. Objective. Because over 60 botanicals are marketed in cosmeceutical formulations, dermatologists need to obtain working knowledge of the major botanicals. The preparation, traditional uses, mechanisms of action, human clinical data, adverse reactions, and interactions all impact herbal efficacy and are discussed below. Method. English-language medical journal and symposium searches. Results. The most important botanicals pertaining to dermatologic uses, such as cosmeceuticals, include teas, soy, pomegranate, date, grape seed, Pycnogenol, horse chestnut, German chamomile, curcumin, comfrey, allantoin, and aloe. All are documented to treat dermatologic conditions. Only green and black tea, soy, pomegranate, and date have published clinical trials for the treatment of parameters of extrinsic aging. Conclusions. Preparation of botanical-based cosmeceuticals is complex. Very few of these products are supported by evidence-based science. CARL THORNFELDT, MD, FAAD, HAS INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [source] An appreciation of Ronnie Mac Keith (1978)DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 2 2008Martin Bax DM It is 100 years since Ronnie Mac Keith's birth and 50 years since he started the Journal Developmental Medicine & Child Neurology (DMCN; initially called The Cerebral Palsy Bulletin), the first number being a reprint of William Little's original article. Scope, then The Spastics Society, had just begun to raise significant sums of money and Ronnie persuaded them not only to put some money into medical research, which they did, funding the research laboratories at Guy's, but also, uniquely, to spend some money on educating and informing doctors. This led to financial backing, happily still continuing, to the publishers of DMCN, now the Mac Keith Press. Initially, it was published under the title Spastics International Medical Publications but this was a clumsy and difficult title because of the unfortunate use of the word 'spastics'and soon after Ronnie's death, who was then senior editor, the Mac Keith Press Board were delighted that his family agreed that the Press would be named after him. In the late 1950s and early 1960s, Ronnie was collecting a team around him to develop the Journal and the books, and contacted me because he knew I had literary interests. I didn't really want to edit a medical journal but I was interested in paediatrics so in the end I got involved! I worked very closely with Ronnie, both clinically and at the Mac Keith Press, and also with the Medical Education Information Unit of the Spastics Society on the meetings he ran. When he died, I tried to pull together something of Ronnie's nature in this personal memoir below, which supplemented the more formal statements about his life and career which can be found in the relevant number of the Journal.1 One hopes that Ronnie would be pleased with what we have done and I know that he would be hoping that we would continue for another 50 years developing ideas and approaches which were essentially developed by Ronnie Mac Keith. [source] Why buy a medical journal?EMERGENCY MEDICINE AUSTRALASIA, Issue 1 2004Anthony FT Brown No abstract is available for this article. [source] An overview of 45 published database resources for complementary and alternative medicineHEALTH INFORMATION & LIBRARIES JOURNAL, Issue 2 2010Katja Boehm Background:, Complementary and alternative medicine (CAM) has succeeded to implement itself in the academic context of universities. In order to get information on CAM, clinicians, researchers and healthcare professionals as well as the lay public are increasingly turning to online portals and databases, which disseminate relevant resources. One specific type of online information retrieval systems, namely the database, is being reviewed in this article. Question:, This overview aims at systematically retrieving and describing all databases covering the field of CAM. One of the requirements for inclusion was that the database would also have to be published in a medical journal. Data sources:, The databases amed, CAMbase, embase, and medline/PubMed were searched between December 2008 and December 2009 for publications relevant to CAM databases. The authors' specialist library was also searched for grey literature to be included. Study selection:, All included databases were then visited online and information on the context, structure and volume of the database was extracted. Main results:, Forty-five databases were included in this overview. Databases covered herbal therapies (n = 11), traditional Chinese medicine (n = 9) and some dealt with a vast number of CAM modalities (n = 9), amongst others. The amount of time the databases had been in existence ranged from 4 to 53 years. Countries of origin included the USA (n = 14), UK (n = 7) and Germany (n = 6), amongst others. The main language in 42 of 45 databases was English. Conclusions:, Although this overview is quite comprehensive with respect to the field of CAM, certain CAM practices such as chiropractic, massage, reflexology, meditation or yoga may not have been covered adequately. A more detailed assessment of the quality of the included databases might give additional insights into the listed resources. The creation of a personalised meta-search engine is suggested, towards which this overview could be seen as a first step. [source] Changes in the impact factor of anesthesia/critical care journals within the past 10 yearsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2000J. Boldt Background: The impact factor (IF) is published by the Institute for Scientific Information (ISI). There is a tendency to assess quality of scientific journals with the help of the IF. An analysis of the changes in the IF over time in the different specialities may help to further enlighten the worth and problems of the IF. Methods: The IFs listed under the subheadings Anesthesiology and Emergency Medicine & Critical Care in the Science Citation Index , Journal Citation Report were descriptively analysed over the past 10 years. Additionally, IFs of some other important journals (subheadings Surgery, Cardiovascular, General Medicine) were analysed. Results: The IF of most of the journals showed a constant increase over the years (average in Anesthesiology: +65%; average in Emergency Medicine & Critical Care: +145%). IFs of the highest ranked journals of other specialities showed a similar increase over the years (average in surgical journals: +56%; average in cardiac journals: +59%; average in general journals: +40%). More Anesthesiology and Emergency Medicine & Critical Care journals originated from the USA show an IF >2.0 over the past 10 years than do European journals. Conclusion: Although the value of the IF is highly controversial, it is a frequently used tool to assess rating of a medical journal. Anesthesiology and Emergency Medicine & Critical Care journals showed a continuous increase in the IF over the past 10 years. [source] Saka, an ancestral possession: MalaysiaASIA-PACIFIC PSYCHIATRY, Issue 3 2010Hasanah Che Ismail MBBS MPM Abstract This report illustrates a culture-bound disorder known as "saka" in the local population of Kelantan, as well as other states in Malaysia. It is a form of possession by the spirit of a deceased ancestor who was once a traditional healer or shaman. While in a dissociative state, the patient introduced a 7 × 3,4 cm wooden stick precisely into his inferior rectus muscle, in an attempt to identify with a blind ancestor who showed his presence momentarily and specifically to the patient. The stick remained hidden to ophthalmologists for 17 days and during this period the patient developed right orbital cellulitis, bilateral cavernous sinus thrombosis and sepsis. The stick was identified after the family took the patient home for cultural healing rites to be performed. The patient's altered behavior resolved with the removal of the stick and he returned to his premorbid personality and functioning without psychotropic medication. To date, saka has not been reported in any peer-reviewed medical journal. [source] How honest can a medical journal be?AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2006Trish GROVES No abstract is available for this article. [source] Cost-effectiveness acceptability curves , facts, fallacies and frequently asked questionsHEALTH ECONOMICS, Issue 5 2004Elisabeth Fenwick Abstract Cost-effectiveness acceptability curves (CEACs) have been widely adopted as a method to quantify and graphically represent uncertainty in economic evaluation studies of health-care technologies. However, there remain some common fallacies regarding the nature and shape of CEACs that largely result from the ,textbook' illustration of the CEAC. This ,textbook' CEAC shows a smooth curve starting at probability 0, with an asymptote to 1 for higher money values of the health outcome (,). But this familiar ,ogive' shape which makes the ,textbook' CEAC look like a cumulative distribution function is just one special case of the CEAC. The reality is that the CEAC can take many shapes and turns because it is a graphic transformation from the cost-effectiveness plane, where the joint density of incremental costs and effects may ,straddle' quadrants with attendant discontinuities and asymptotes. In fact CEACs: (i) do not have to cut the y -axis at 0; (ii) do not have to asymptote to 1; (iii) are not always monotonically increasing in ,; and (iv) do not represent cumulative distribution functions (cdfs). Within this paper we present a ,gallery' of CEACs in order to identify the fallacies and illustrate the facts surrounding the CEAC. The aim of the paper is to serve as a reference tool to accompany the increased use of CEACs within major medical journals. Copyright © 2004 John Wiley & Sons, Ltd. [source] Medical journals and effective dissemination of health researchHEALTH INFORMATION & LIBRARIES JOURNAL, Issue 4 2001Aravinthan Coomarasamy Clinical medical journals have not been effective in meeting the information needs of practitioners and bridging the gap between clinical research and practice. The slow adoption of results of clinical research is at least partly due to the failure of clinical journals to disseminate information in a way that would motivate practitioners to change practice. Although implementation is primarily a local process, medical journals are in a unique position to advance implementation by modifying their focus and adjusting their contents. Strategies that may be useful include publication of pre-appraised evidence summaries and ,clinical bottom-lines' and giving importance to systematic reviews and large evaluative research articles as they represent higher levels of evidence and have greater potential to change practice. Clinical journals should encourage researchers to consider how and by whom the findings will be used and provide information on implications for implementation such as possible strategies that may work, cost-effectiveness, side-effects and potential barriers to implementation. Medical journal publishers should explore ways to cooperate so that findings of landmark clinical trials could be shared thus reducing the ,scatter' of medical information. Electronic media offers numerous advantages such as quick accessibility and linking of information, and medical journals should capitalize on such innovations. There is a paradigm shift in health care practice as evidence is consciously and explicitly incorporated into individual patient care. Medical journals need to change to reflect this change in practice and provide practitioners with valid and relevant information. [source] Examination of the analytic quality of behavioral health randomized clinical trialsJOURNAL OF CLINICAL PSYCHOLOGY, Issue 1 2007Bonnie Spring Adoption of evidence-based practice (EBP) policy has implications for clinicians and researchers alike. In fields that have already adopted EBP, evidence-based practice guidelines derive from systematic reviews of research evidence. Ultimately, such guidelines serve as tools used by practitioners. Systematic reviews of treatment efficacy and effectiveness reserve their strongest endorsements for treatments that are supported by high-quality randomized clinical trials (RCTs). It is unknown how well RCTs reported in behavioral science journals fare compared to quality standards set forth in fields that pioneered the evidence-based movement. We compared analytic quality features of all behavioral health RCTs (n = 73) published in three leading behavioral journals and two leading medical journals between January 2000 and July 2003. A behavioral health trial was operationalized as one employing a behavioral treatment modality to prevent or treat an acute or chronic physical disease or condition. Findings revealed areas of weakness in analytic aspects of the behavioral health RCTs reported in both sets of journals. Weaknesses were more pronounced in behavioral journals. The authors offer recommendations for improving the analytic quality of behavioral health RCTs to ensure that evidence about behavioral treatments is highly weighted in systematic reviews. © 2006 Wiley Periodicals, Inc. J Clin Psychol 63: 53,71, 2007. [source] Author-choice open-access publishing in the biological and medical literature: A citation analysisJOURNAL OF THE AMERICAN SOCIETY FOR INFORMATION SCIENCE AND TECHNOLOGY, Issue 1 2009Philip M. Davis In this article, we analyze the citations to articles published in 11 biological and medical journals from 2003 to 2007 that employ author-choice open-access models. Controlling for known explanatory predictors of citations, only 2 of the 11 journals show positive and significant open-access effects. Analyzing all journals together, we report a small but significant increase in article citations of 17%. In addition, there is strong evidence to suggest that the open-access advantage is declining by about 7% per year, from 32% in 2004 to 11% in 2007. [source] Quality of Reporting of Clinical Trials of Dogs and Cats and Associations with Treatment EffectsJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 1 2010J.M. Sargeant Background: To address concerns about the quality of reporting of randomized controlled trials, and the potential for biased treatment effects in poorly reported trials, medical journals have adopted a common set of reporting guidelines, the Consolidated Standards of Reporting Trials (CONSORT) statement, to improve the reporting of randomized controlled trials. Hypothesis: The reporting of clinical trials involving dogs and cats might not be ideal, and this might be associated with biased treatment effects. Animals: Dogs and cats used in 100 randomly selected reports of clinical trials. Methods: Data related to methodological quality and completeness of reporting were extracted from each trial. Associations between reporting of trial features and the proportion of positive treatment effects within trials were evaluated by generalized linear models. Results: There were substantive deficiencies in reporting of key trial features. An increased proportion of positive treatment effects within a trial was associated with not reporting: the method used to generate the random allocation sequence (P < .001), the use of double blinding (P < .001), the inclusion criteria for study subjects (P= .003), baseline differences between treatment groups (P= .006), the measurement used for all outcomes (P= .002), and possible study limitations (P= .03). Conclusions and Clinical Importance: Many clinical trials involving dogs and cats in the literature do not report details related to methodological quality and aspects necessary to evaluate external validity. There is some evidence that these deficiencies are associated with treatment effects. There is a need to improve reporting of clinical trials, and guidelines, such as the CONSORT statement, can provide a valuable tool for meeting this need. [source] Helicobacter pylori and dyspepsia: physicians' attitudes, clinical practice, and prescribing habitsALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 3 2002H. J. O'Connor Background: Consensus guidelines have been published on the management of Helicobacter pylori infection and it is assumed that these guidelines are adhered to in clinical practice. Aim: To assess the changing attitudes of medical practitioners to H. pylori, and the impact of H. pylori infection on everyday clinical practice and prescribing patterns. Methods: Data for this review were gathered up to December 2000 from detailed review of medical journals, the biomedical database MEDLINE, and relevant abstracts. Results: Physician surveys show widespread acceptance of H. pylori as a causal agent in peptic ulcer disease. Gastroenterologists adopted H. pylori therapy for peptic ulcer earlier and more comprehensively than primary care physicians. Despite a low level of belief in H. pylori as a causal agent in nonulcer dyspepsia and gastro-oesophageal reflux disease (GERD), H. pylori therapy is widely prescribed for these conditions. Proton pump inhibitor-based triple therapy is the eradication regimen of choice by all physician groups. In routine clinical practice, there appears to be significant under-treatment of peptic ulcer disease with H. pylori therapy, but extensive use for nonulcer indications. Prescription of H. pylori treatment regimens of doubtful efficacy appears commonplace, and are more likely in primary care. Despite the advent of H. pylori therapy, the prescription of antisecretory therapy, particularly of proton pump inhibitors, continues to rise. Conclusions: Publication of consensus guidelines per se is not enough to ensure optimal management of H. pylori infection. Innovative and ongoing educational measures are needed to encourage best practice in relation to H. pylori infection. These measures might be best directed at primary care, where the majority of dyspepsia is managed. [source] Secular trend in medical education regarding infectious diseaseMEDICAL EDUCATION, Issue 10 2003Kai Ming Chow Objective ,The paradigm of global medical health has been re-characterised by a shift in its major focus from infectious disease to chronic illness. Opinions vary as to the declining emphasis on infectious disease. This paper provides clinicians with an understanding of a secular trend in medical education regarding the topic of infectious diseases over a period of 26 years. Methods ,A survey was carried out to evaluate coverage of infectious disease topics within recent general medicine textbooks and journals. Results ,The percentage of content dedicated to infectious disease has remained static in 2 major medical textbooks, whereas a trend towards decreasing coverage was shown in 4 major medical journals. Of 901 original articles published in 2000, 16·4% covered certain aspects of infectious disease, as compared with 20·9% of 790 articles published in 1985. Increasing rates of infectious disease mortality in developing countries were not consistently matched with the trend in coverage of infectious disease topics in either medical textbooks or journals. Conclusions ,Our data demonstrate that coverage of infectious disease topics in publications issued in developed countries was more indicative of global trends in disease mortality rather than those of developing countries. Medical education and knowledge, which are usually delivered by the rich nations where influential medical textbooks and journals are published, place less emphasis on infectious disease relative to the burden infectious disease places on the developing world. [source] The AJT Report: News and issues that affect organ and tissue transplantationAMERICAN JOURNAL OF TRANSPLANTATION, Issue 5 2010SUE PONDROM This month, "The AJT Report" takes a look at the history of the American Journal of Transplantation,what has made it work, and what's in store for its future? Also, we explore upcoming challenges medical journals may face. [source] International Survey of Emergency Physicians' Awareness and Use of the Canadian Cervical-Spine Rule and the Canadian Computed Tomography Head RuleACADEMIC EMERGENCY MEDICINE, Issue 12 2008Debra Eagles MD Abstract Objectives:, The derivation and validation studies for the Canadian Cervical-Spine (C-Spine) Rule (CCR) and the Canadian Computed Tomography (CT) Head Rule (CCHR) have been published in major medical journals. The objectives were to determine: 1) physician awareness and use of these rules in Australasia, Canada, the United Kingdom, and the United States and 2) physician characteristics associated with awareness and use. Methods:, A self-administered e-mail and postal survey was sent to members of four national emergency physician (EP) associations using a modified Dillman technique. Results were analyzed using repeated-measures logistic regression models. Results:, The response rate was 54.8% (1,150/2,100). Reported awareness of the CCR ranged from 97% (Canada) to 65% (United States); for the CCHR it ranged from 86% (Canada) to 31% (United States). Reported use of the CCR ranged from 73% (Canada) to 30% (United States); for the CCHR, it was 57% (Canada) to 12% (United States). Predictors of awareness were country, type of rule, full-time employment, younger age, and teaching hospital (p < 0.05). Significant differences in use of the CCR by country were observed, but not for the CCHR. Teaching hospitals were more likely to use the CCR than nonteaching hospitals, but less likely to use the CCHR. Conclusions:, This large international study found notable differences among countries with regard to knowledge and use of the CCR and CCHR. Awareness and use of both rules were highest in Canada and lowest in the United States. While younger physicians, those employed full-time, and those working in teaching hospitals were more likely to be aware of a decision rule, age and employment status were not significant predictors of use. A better understanding of factors related to awareness and use of emergency medicine (EM) decision rules will enhance our understanding of knowledge translation and facilitate strategies to enhance dissemination and implementation of future rules. [source] PUBLICATION ETHICS AND THE GHOST MANAGEMENT OF MEDICAL PUBLICATIONBIOETHICS, Issue 6 2010SERGIO SISMONDO ABSTRACT It is by now no secret that some scientific articles are ghost authored , that is, written by someone other than the person whose name appears at the top of the article. Ghost authorship, however, is only one sort of ghosting. In this article, we present evidence that pharmaceutical companies engage in the ghost management of the scientific literature, by controlling or shaping several crucial steps in the research, writing, and publication of scientific articles. Ghost management allows the pharmaceutical industry to shape the literature in ways that serve its interests. This article aims to reinforce and expand publication ethics as an important area of concern for bioethics. Since ghost-managed research is primarily undertaken in the interests of marketing, large quantities of medical research violate not just publication norms but also research ethics. Much of this research involves human subjects, and yet is performed not primarily to increase knowledge for broad human benefit, but to disseminate results in the service of profits. Those who sponsor, manage, conduct, and publish such research therefore behave unethically, since they put patients at risk without justification. This leads us to a strong conclusion: if medical journals want to ensure that the research they publish is ethically sound, they should not publish articles that are commercially sponsored. [source] International Emergency Medicine and the Role for Academic Emergency MedicineACADEMIC EMERGENCY MEDICINE, Issue 5 2007Kumar Alagappan MD International emergency medicine continues to grow and expand. There are now more than 30 countries that recognize emergency medicine as a specialty. As the field continues to develop, many physicians are reaching across borders and working with their colleagues to improve patient care, education, and research. The future growth and success of the specialty are based on several key components. These include faculty development (because this is the key driver of education), research, and curriculum development. Each country knows what resources it has and how best to utilize them. Countries that are developing the specialty can seek consultation from successful countries and develop their academic and community practice of emergency medicine. There are many resources available to these countries, including distance learning and access to medical journals via the Internet; international exchanges by faculty, residents, and medical students; and physicians who are in fellowship training programs. International research efforts require more support and effort to be successful. This report discusses some of the advantages and hurdles to such research efforts. Physicians have a responsibility to help one another succeed. It is the hope of the authors that many more emergency physicians will lend their skills to further global development of the specialty. [source] Community-acquired pneumonia (CAP) in children in Oslo, NorwayACTA PAEDIATRICA, Issue 2 2009Anita C Senstad Abstract Aim: To investigate the epidemiology and clinical characteristics of community acquired pneumonia (CAP) in children before the introduction of the 7-valent pneumococcal vaccine in the national vaccination programme. Methods: For the period 21 May 2003 to 20 May 2005 hospitalization rates for pneumonia in children were obtained from retrospective studies of medical journals. Pneumonia was also studied prospectively in children less than sixteen years old referred to Ullevål University Hospital (Oslo) in the same time period. Results: The overall observed hospitalization rate of pneumonia was 14.7/10 000 (95% CI: 12.2,17.1), for children under five it was 32.8/10 000 (95% CI: 26.8,38.8), and for children under two 42.1/10 000 (95% CI: 32.0,52.3). In the clinical study 123 children, of whom 59% (73) were boys, met the inclusion criteria and were enrolled. Only 2.4% (3) had pneumonia complicated with pleural effusion and in general few complications were observed. No patients required assisted ventilation, and none were transferred to the intensive care unit. Penicillin was effective as treatment for pneumonia. Conclusion: Pneumonia, seen in a paediatric department in Oslo, is a common but benign disease. Penicillin is effective as treatment for pneumonia in Norwegian children. [source] Editorials on original contributions to medical journalsCLINICAL CARDIOLOGY, Issue 6 2006C. Richard Conti M.D., M.A.C.C. Editor-in-Chief No abstract is available for this article. [source] | ||||||||||||||||