Do case studies mislead about the nature of reality?
This paper attempts a partial, critical look at the construction and use of case studies in ethics education. It argues that the authors and users of case studies are often insufficiently aware of the literary nature of these artefacts: this may lead to some confusion between fiction and reality. Issues of the nature of the genre, the fictional, story-constructing aspect of case studies, the nature of authorship, and the purposes and uses of case studies as "texts" are outlined and discussed. The paper concludes with some critical questions that can be applied to the construction and use of case studies in the light of the foregoing analysis. (+info
The impact of Alcohol and Alcoholism among substance abuse journals.
This article concerns the question of journal impact factor and other bibliometric indicators made available by the Institute for Scientific Information in their Journal Citation Report for 1996. The impact factors of journals within the subject category 'substance abuse' are listed along with total citations, immediacy indices, and cited half-lives. The relationship between cited and citing journals is discussed with the main focus on the data available for Alcohol and Alcoholism. Some of the problems and limitations of bibliometric measures of productivity are dealt with, especially when these are used to evaluate the work of individual scientists. Although bibliometric measures are easy to compute, they become difficult to interpret, such as when dealing with collaborative research and the problem posed by multiple authorship. The need to adjust impact factors and citation counts for the number of co-authors in a paper becomes important when credit has to be attributed to one individual from a multi-author paper. This is often necessary in connection with grant applications and when making decisions about academic promotion and tenure. The impact factor of Alcohol and Alcoholism has increased steadily over the past 5 years, even after adjusting for the number of self-citations, which resulted in an even greater increase in impact. However, the impact factors of substance abuse journals are generally low, compared with disciplines such as immunology, genetics, and biochemistry. Some suggestions are made for increasing the impact factors of substance abuse journals if this is considered necessary. But instead of paying attention to the impact factor of a journal, scientists should give more consideration to the speed and efficiency of the editorial handling of their manuscripts and particularly to the quality and timeliness of the peer review. (+info
Lessons from a review of publications in three health promotion journals from 1989 to 1994.
A thematic analysis was undertaken of 72 editorials in three leading health promotion journals, Health Education Research: Theory & Practice, Health Education Quarterly and Health Promotion International, from 1989 to 1994. The three main themes which emerged were (1) the need to broaden health promotion interventions, (2) the need to promote rigour and professionalism in the discipline of health promotion, and (3) the need to respond to the information requirements of practitioners. Against this context, we conducted a content analysis of the journals, examining the nature of the 649 peer-reviewed publications in the same time period. Categories from the traditional bio-medical 'stages of research' models had to be adapted before full classification of articles published was feasible. The largest number of articles published could be termed descriptive research, followed by studies developing and validating health promotion measurement tools and health promotion theory. The proportion of program evaluations was small and the proportion of randomized controlled trials ('highest quality evidence' of effectiveness) decreased over time. Dissemination studies were also poorly represented in spite of this being identified in editorials as an important professional need. Ways to redress some of the imbalances observed are discussed. (+info
Gastroenterology research in the United Kingdom: funding sources and impact.
AIMS: To determine the sources of founding for UK gastroenterology research papers and the relative impact of papers funded by different groups and of unfunded ones. METHODS: UK gastroenterology papers from 1988-94 were selectively retrieved from the Science Citation Index by means of a specially constructed filter based on their title keywords and journal names. They were looked up in libraries to determine their funding sources and these, together with their numbers of authors, numbers of addresses, and research category (clinical/basic) were considered as input parameters to the research. Output parameters analysed were mean journal impact category, citation counts by papers, and the frequency of citation by a US patient. RESULTS: Gastroenterology papers comprise about 7% of all UK biomedical research and 46% of them have no acknowledged funding source. One quarter of the papers acknowledged government support, and a similar fraction a private, non-profit source; 11% were funded by the pharmaceutical industry. The papers acknowledging funding had significantly more impact than the others on all three measures. The citing patents had six times more UK inventors than the average for all US Patent and Trademark Office patents in the relevant classes and were mostly generic in application. CONCLUSION: The variation in impact of papers funded by different sources can mostly be explained by a simple model based on the input factors (numbers of funding bodies, numbers of authors, numbers of addresses, and research type). The national science base in gastroenterology is important for the underpinning of UK invented patents citing to it. (+info
Trends in antihypertensive drug advertising, 1985-1996.
BACKGROUND: Over the past decade, calcium channel blockers (CCBs) and ACE inhibitors have been used increasingly in the treatment of hypertension. In contrast, beta-blocker and diuretic use has decreased. It has been suggested that pharmaceutical marketing has influenced these prescribing patterns. No objective analysis of advertising for antihypertensive therapies exists, however. METHODS AND RESULTS: We reviewed the January, April, July, and October issues of the New England Journal of Medicine from 1985 to 1996 (210 issues). The intensity of drug promotion was measured as the proportion of advertising pages used to promote a given medication. Statistical analyses used the chi2 test for trend. Advertising for CCBs increased from 4.6% of advertising pages in 1985 to 26.9% in 1996, while advertising for beta-blockers (12.4% in 1985 to 0% in 1996) and diuretics (4.2% to 0%) decreased (all P<0.0001). A nonsignificant increase was observed in advertising for ACE inhibitors (3.5% to 4.3%, P=0.17). Although the total number of drug advertising pages per issue decreased from 60 pages in 1985 to 42 pages in 1996 (P<0.001), the number of pages devoted to calcium channel blocker advertisements nearly quadrupled. CONCLUSIONS: Increasing promotion of CCBs has mirrored trends in physician prescribing. An association between advertising and prescribing patterns could explain why CCBs have supplanted better-substantiated therapies for hypertension. (+info
Digital photography of digital imaging and communications in medicine-3 images from computers in the radiologist's office.
To fully take advantage of the widespread use of digital imaging systems and to update and eliminate redundant steps involved in medical radiographic publication, we present our experience of processing Digital Imaging and Communications in Medicine (DICOM)-3 digital images from the point of acquisition to the point of publisher-ready radiographic images without intervening hardcopies. (+info
Where do UK health services researchers publish their findings?
Health services research has emerged as the third vital requirement for understanding and improving health care, alongside basic science and clinical research. This has coincided with more stringent management of research, in particular by funding bodies. The latter are seeking to use bibliographic databases to aid the monitoring of the output of their investments. The principal source of data in the UK is the Research Outputs Database (ROD) set up by the Wellcome Trust primarily to monitor basic and clinical research. Health services researchers' output is difficult to monitor in view of the large number and wide variety of journals in which they publish. In addition, nearly half the journals (representing 35% of the articles) are not currently covered by the ROD. Funding bodies will underestimate the quantity of health services researchers' output unless they take these findings into account. (+info
The impact of functional analysis methodology on treatment choice for self-injurious and aggressive behavior.
Self-injurious behavior (SIB) and aggression have been the concern of researchers because of the serious impact these behaviors have on individuals' lives. Despite the plethora of research on the treatment of SIB and aggressive behavior, the reported findings have been inconsistent regarding the effectiveness of reinforcement-based versus punishment-based procedures. We conducted a literature review to determine whether a trend could be detected in researchers' selection of reinforcement-based procedures versus punishment-based procedures, particularly since the introduction of functional analysis to behavioral assessment. The data are consistent with predictions made in the past regarding the potential impact of functional analysis methodology. Specifically, the findings indicate that, once maintaining variables for problem behavior are identified, experimenters tend to choose reinforcement-based procedures rather than punishment-based procedures as treatment for both SIB and aggressive behavior. Results indicated an increased interest in studies on the treatment of SIB and aggressive behavior, particularly since 1988. (+info