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.     

Kinematics of cycling in relation to anterior knee pain and patellar tendinitis

The coronal and sagittal plane leg movements of 24 experienced male cyclists were assessed using video analysis while cycling on a Kingcycle windload simulator. The cyclists were grouped into those with a history of injury and an asymptomatic group on the basis of self-reported injury status. The ages, cycling experience, competition distances and competition speeds of the two groups were compared using Student's t-test. No significant differences (P < 0.05) were found for any of these variables. The maximum and minimum shank adduction, shank adduction velocities, knee flexion and ankle dorsiflexion values were also compared using Student's t-test. Significant differences were found at the point of maximum adduction (1.9 degrees; P = 0.019) and minimum dorsiflexion (4.9 degrees; P = 0.014). These differences indicated more dorsiflexion and greater abduction on the part of the symptomatic cyclists, supporting previous research that found that cyclists with a history of injury differ from those without a history of injury in the coronal plane leg movement patterns they adopt. Also, the most extreme medial position of the knee relative to the ankle occurred during knee extension. This supports the potential injury mechanism proposed by Francis (1986), which had previously only been examined using coronal plane kinematics.     

The risks of ‘university speak’: relationship management and identity negotiation by mature students off campus

Research finds that participation in higher education is generally empowering for mature students but that it can also create tensions in their off-campus relationships. This article reports on findings from an ongoing study of the experiences of mature students at university in Ireland and draws from interviews with 15 such students in the final year of their studies. Following similar research by Baxter and Britton in the UK, the article considers how mature students experience and represent changes in identities and social relationships brought about by entry to higher education. Specifically, the article focuses on the risks associated with using newly acquired academic language (or ‘university speak’) off campus. The findings reported here complement existing research and offer support for Baxter and Britton’s suggestion that mature students often experience compartmentalisation and fragmentation in their self-identities.     

Decolonising curriculum practice: developing the indigenous cultural capability of university graduates

Higher Education - The pedagogical urge to decolonise student thinking has been at the heart of the drive to embed Indigenous knowledge in universities throughout the western world. Despite ongoing...     

Employment and further study outcomes for care-experienced graduates in the UK

Higher Education - Life outcomes for people who spent time in the care of the state as children (‘care-experienced’) are known to be significantly lower, on average, than for the...