How much effort is needed to keep up with the literature relevant for primary care?

OBJECTIVES: Medicine must keep current with the research literature, and keeping current requires continuously updating the clinical knowledge base (i.e., references that provide answers to clinical questions). The authors estimated the volume of medical literature potentially relevant to primary care published in a month and the time required for physicians trained in medical epidemiology to evaluate it for updating a clinical knowledge base. METHODS: We included journals listed in five primary care journal review services (ACP Journal Club, DynaMed, Evidence-Based Practice, Journal Watch, and QuickScan Reviews). Finding little overlap, we added the 2001 "Brandon/Hill Selected List of Print Books and Journals for the Small Medical Library." We counted articles (including letters, editorials, and other commentaries) published in March 2002, using bibliographic software where possible and hand counting when necessary. For journals not published in March 2002, we reviewed the nearest issue. Five primary care physicians independently evaluated fifty randomly selected articles and timed the process. RESULTS: The combined list contained 341 currently active journals with 8,265 articles. Adjusting for publication frequency, we estimate 7,287 articles are published monthly in this set of journals. Physicians trained in epidemiology would take an estimated 627.5 hours per month to evaluate these articles. CONCLUSIONS: To provide practicing clinicians with the best current evidence, more comprehensive and systematic literature surveillance efforts are needed.     

Gender differences among sagittal plane knee kinematic and ground reaction force characteristics during a rapid sprint and cut maneuver

Women are more prone to anterior cruciate ligament (ACL) injury during cutting sports than men. The purpose of this study was to examine knee kinematic and ground reaction forces (GRF) differences between genders during cutting. Male and female athletes performed cutting trials while force platform and video data were recorded (180 Hz). Differences (p < . 05) were observed between groups for knee flexion at contact and GRF at maximum knee flexion. Women averaged 5.8 degrees less flexion at contact and 1.0 N. (kg x m x s(-1))(-1) greater GRF at maximum flexion. Knee range of motion and peak GRF variables were not significantly different, but women had greater values. Women exhibited technique characteristics believed to increase ACL injury risk, but men exhibiting similar characteristics were also observed and could also be at risk.     

Optimizing segmental movement in the jumping header in soccer

This study looks at segmental movements in the jumping header from an optimization viewpoint. Investigations on the header so far have focused on head restriction in the movement but have not clarified how and to what extent body segments influence the performance of the skill. In the present study a biomechanical model was used to analyze the jumping header in simulated competition to give a clear picture of an optimized header. Skilled soccer players headed balls at speeds of 13 m x s(-1) the results indicated that the head moves as a free non-restricted segment in the jumping header and should be allowed to do so, even though much soccer literature says otherwise to prevent injuries. The arm movement showed individual characteristics and gave no general advantages in optimizing ball speed after impact in the header The movement of the legs was, on the other hand, the single most important factor in the skill. Therefore, coaches and players shouldfocus on developing muscle strength in the stomach, back and pelvis and should put no restrictions on head and arm movement to optimize the jumping header.     

The Penultimate Teaching Machine

This paper discusses the possibility of building an electronic transducer to take the place of the existing teaching machines. The tasks that can be performed by such a machine as well as the advantages and risks involved are discussed.