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.     

Age-related differences in vision and proprioception in a lower limb interceptive task: the effects of skill level and practice

This study examined age-related differences in the role of visual proprioception during a lower limb interceptive action and how this varies as a function of skill and practice. In Experiment 1, skilled and less-skilled 8-, 10-, and 12-year-old boys controlled a soccer ball using their preferred foot under full vision and when sight of the effector was occluded. With the exception of the high-skilled 12-year-olds and low-skilled 8-year-olds, participants showed a decrement in peformance when denied access to visual proprioception. In Experiment 2, the effect of practicing under different informational constraints was examined for 12 year-old boys. Children performed varying amounts of practice under full vision, or in a condition where sight of the foot was occluded, before being transferred to the alternative viewing condition. Participants who practiced under occluded viewing conditions showed greater relative improvement in performance over practice and transfer sessions compared with a full vision control group. Some support is provided for the manipulation of visual informational constraints as an effective pedagogical approach to motor learning.     

A mathematical model for power output in rowing on an ergometer

A mathematical model relating power output of rower to stroke rate on an ergometer (the Concept II Indoor Rower TM, Model C) is studied. The model is used to analyse the ergometer performance of a particular rower. It is determined that he can be more efficient (i.e. decrease power output while maintaining fixed velocity) by decreasing stroke rate, but at the expense of increasing force during the drive. It is also shown that he can be more efficient by increasing the drag factor (using higher vent setting) without increasing force. Dependence of power output on rowing style (the shape of the force curve) is also examined. It is shown that variation of force during the drive has little effect on efficiency, but efficiency is reduced by asymmetry of the force curve that favours the legs.     

User satisfaction survey and usage of an electronic desktop document delivery service at an academic medical library

In June 2000, the Biomedical Library at the University of South Alabama introduced Prospero, an electronic desktop document delivery service. From June 2000 to November 2002, Prospero delivered 28% of interlibrary loan requests and 72% of document delivery requests. In November 2002, the library conducted a user satisfaction survey of the Prospero service. Forty-two surveys were used. Fifteen responses were received from affiliated faculty, staff, and students, who generally expressed satisfaction with the service. Twenty-seven responses were received from unaffiliated users, comprised of medical libraries, individual users, and businesses. Based on the survey results, the library deemed the Prospero service a success. To better support users, the library's Web page was updated to include hardware and software requirements for successful use of the Prospero service, as well as screen shots of the Prospero process.     

Index to Volume XLI

Other Index

Index to Volume XLI