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.     

Evidence-based practice: extending the search to find material for the systematic review

BACKGROUND: Cochrane-style systematic reviews increasingly require the participation of librarians. Guidelines on the appropriate search strategy to use for systematic reviews have been proposed. However, research evidence supporting these recommendations is limited. OBJECTIVE: This study investigates the effectiveness of various systematic search methods used to uncover randomized controlled trials (RCTs) for systematic reviews. Effectiveness is defined as the proportion of relevant material uncovered for the systematic review using extended systematic review search methods. The following extended systematic search methods are evaluated: searching subject-specific or specialized databases (including trial registries), hand searching, scanning reference lists, and communicating personally. METHODS: Two systematic review projects were prospectively monitored regarding the method used to identify items as well as the type of items retrieved. The proportion of RCTs identified by each systematic search method was calculated. RESULTS: The extended systematic search methods uncovered 29.2% of all items retrieved for the systematic reviews. The search of specialized databases was the most effective method, followed by scanning of reference lists, communicating personally, and hand searching. Although the number of items identified through hand searching was small, these unique items would otherwise have been missed. CONCLUSIONS: Extended systematic search methods are effective tools for uncovering material for the systematic review. The quality of the items uncovered has yet to be assessed and will be key in evaluating the value of the systematic search methods.     

Interaction of wrestling shoe and competition surface: effects on coefficient of friction with implications for injury

The purpose of this study was to determine whether there is a significant difference in the co-efficient of friction (Fc) between old versus new wrestling shoes and mats and to investigate the effect of perspiration. Fc was measured by dragging a weighted shoe over a wrestling mat surface and measuring the vertical and horizontal forces produced. Three different shoe conditions were assessed over two mat types for both wet and dry conditions for a total of 12 conditions. To simulate the wet condition, saline solution was smeared over the surface of the mat. There was a significant effect of shoe, mat, and wet/dry conditions. In addition, significant interactions of shoe by mat, shoe by dry/wet, and mat by dry/wet were observed. Overall, Fc was 36% higher for the new wrestling mat compared to the old wrestling mat. Application of the saline solution reduced Fc by 14% compared to the dry condition. Comparison of the mean Fc for all three shoe types revealed the Fc for the older design shoe was 23% to 28% lower than the brand new shoe and the worn newer design, respectively. A high Fc, such as in the new mat/new shoe combination, has the potential to increase the risk of knee and ankle injuries by fixing the foot more securely to the ground.     

Perceptual judgments for stair climbing as a function of pitch angle

Two experiments explored perception and action for stair climbing, with manipulations to the stair dimensions. In Experiment 1, a custom-built apparatus manipulated the stair dimensions, while three groups of participants made perceptual judgments of climbability. The groups differed significantly for absolute leg length (p < .0001), but there was no significant difference between the groups when stair dimensions were calculated relative to leg length. The selected tread depths and riser heights reflected constant proportions of participants' leg length. Using the pitch angles formed as a composite metric, the results revealed that all groups selected 60 degrees as the limit for climbability. Experiment 2 scaled pitch angle systematically from 20 degrees to 80 degrees, and participants judged 65 degrees and beyond to be unclimbable. These results provided evidence that pitch angle might be used in perceptual judgments for stair climbability.     

Legal and Psychometric Criteria for Evaluating Teacher Certification Tests

Will our teacher certification testing program stand up to a court challenge? What are the critical issues the courts consider in examining teacher certification testing? What do we need to do to strengthen our program legally and psychometrically?     

Title IX and Retaliation: The Impact of Jackson v. Birmingham Board of Education on Higher Education

In 2005, the United States Supreme Court rendered a closely divided opinion that extends the protections against discrimination provided by Title IX of the Education Amendments of 1972 to include a private cause of action for retaliation in Jackson v. Birmingham Board of Education. Therefore, “whistleblowers,” or employees who report allegedly discriminatory practices, can file suit against employers who retaliate against them on the basis of their complaints under the auspices of Title IX, which prohibits discrimination “on the basis of sex” by recipients of federal education funds. Unlike other federal anti-discrimination laws such as Title VII of the Civil Rights Act of 1964, retaliation is not expressly mentioned within the text of Title IX, and the Supreme Court reasoned that the broad language of the statute encompasses implied protections against retaliation, regardless of the gender of the employee who alleges retaliatory action. As a result of Jackson, the first generation of litigation against colleges and universities under this expanded standard has begun to navigate the federal courts. This article analyzes the Supreme Court’s opinion in Jackson and the related cases representing the first application of the retaliation standard articulated therein to colleges and universities. The article concludes with suggestions for insulation from liability associated with alleged retaliation claims against administrators and educational institutions.