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What American surgeons read: a survey of a thousand Fellows of the American College of Surgeons.

PURPOSE: The modern American surgeon is immersed in an ever-deepening sea of printed and electronic information. Although publishers know how many books and journals they sell, and journals can quote their calculated impact factor, no information exists whatsoever about what surgeons read. Which surgical journals are "popular," and how does it compare with their impact factor (IF)? Our objective was to assess the sources of information and reading habits of American surgeons and to compare the "popularity" of journals with their IFs.A questionnaire was mailed to 1000 American surgeons, randomly selected from a list provided by the American College of Surgeons.A total of 418 surgeons responded, and 371 responses could be analyzed (37%). The leading sources of medical information were medical literature (93%), professional meetings (88%), and CME courses (69%). The average time per surgeon/month dedicated to medical literature was 14 hours (range, 1 to 120). Peer-reviewed journals were read by 95%, textbooks by 68%, and update series by 60% of the respondents. The three most popular surgical journals were Annals of Surgery (IF, 5.40), selected by 60%; Journal of the American College of Surgery (IF, 1.87), selected by 48%; and Archives of Surgery (IF, 2.53), selected by 36%. The most popular subspecialty journals were Cancer (IF, 3.66), selected by 31%; Critical Care Medicine (IF, 3.74), selected by 17%; and Gastroenterology (IF, 10.33), selected by 12%. The New England Journal of Medicine (IF, 28.66), selected by 67%, and the Journal of the American Medical Association (IF, 9.55), selected by 66%, were the most popular general medical journals, followed by Mayo Clinic Proceedings (IF, 1.98), selected by 16%. Among the "leaders" on the IF list for international, British medical and surgical journals were Lancet (IF, 11.79), selected by 5%, and British Journal of Surgery (IF, 2.38), selected by 0.5% of the respondents.Those American surgeons responding consider published literature as their chief source of information, especially peer-reviewed journals. Overall, they ignore non-United States publications and select the journals they read without considering its IF.

Journal Article↗

Importance of the lay press in the transmission of medical knowledge to the scientific community.

BACKGROUND: Efficient, undistorted communication of the results of medical research is important to physicians, the scientific community, and the public. Information that first appears in the scientific literature is frequently retransmitted in the popular press. Does popular coverage of medical research in turn amplify the effects of that research on the scientific community? METHODS: To test the hypothesis that researchers are more likely to cite papers that have been publicized in the popular press, we compared the number of references in the Science Citation Index to articles in the New England Journal of Medicine that were covered by The New York Times with the number of references to similar articles that were not covered by the Times. We also performed the comparison during a three-month period when the Times was on strike but continued to prepare an "edition of record" that was not distributed; doing so enabled us to address the possibility that coverage in the Times was simply a marker of the most important articles, which would therefore be cited more frequently, even without coverage in the popular press. RESULTS: Articles in the Journal that were covered by the Times received a disproportionate number of scientific citations in each of the 10 years after the Journal articles appeared. The effect was strongest in the first year after publication, when Journal articles publicized by the Times received 72.8 percent more scientific citations than control articles. This effect was not present for articles published during the strike; articles covered by the Times during this period were no more likely to be cited than those not covered. CONCLUSIONS: Coverage of medical research in the popular press amplifies the transmission of medical information from the scientific literature to the research community.

Bibliographies as Topic↗

Influence of alternative birth methods on traditional birth management.

BACKGROUND: Because of popular demand for more natural childbirth, a new concept was introduced in 1991 in our clinic. It consisted of careful monitoring and birth management, restrictive use of invasive methods, and free choice of different birth methods including waterbirths and other alternative birth methods. Our aim was to determine the influence of our new birth concept on the way women give birth and on the birth management in our clinic. METHODS: In a total of 9,418 births between 1991 and 1997 [new birth concept KSF (KSF = Kantonsspital Frauenfeld)], the changing pattern of birth methods and birth management in our clinic under the influence of the new birth concept were analysed. The results were compared to a historical group in our clinic, a total of 5,602 births from 1986 to 1990, and to data from a contemporary group from Swiss clinics, a total of 344,328 births from 1986 to 1997. FINDINGS: Our study shows that alternative birth methods are very popular. The waterbirth rates have risen steadily and stabilized at around 40-50% of the spontaneous births. The Maia-birthing stool births rates reached a peak of popularity in 1993 (23%) 5 years after their introduction, dropping again to 10% of the spontaneous births. The bedbirth rates have stabilized at around 40% of the spontaneous births. Other birth methods such as standing, supported by a rope, on the mat or on all fours are much less popular. The impact of our new birth concept on different aspects of birth management differs greatly from one to another. The episiotomy rate has dropped from a previous rate higher than 80% to a rate lower than 15%. The caesarean section rate in our clinic (around 10%) has remained substantially below the Swiss average (around 15%). The rate of the spinal and epidural analgesia was maintained at a constant level, around 13%, while the Swiss average rates doubled and reached 23% in 1997. The induction and amniotomy rates as well as the use of oxytocin were not influenced by the new birth concept and are comparable to the Swiss average. CONCLUSION: Alternative birth methods and in particular waterbirths are very sought after. This popular pressure insisting upon less invasive, more natural birth management can be well integrated into the security-oriented way of thinking of classical medicine. In our clinic the general trend towards more invasive measures in birth management could be countered by the introduction of a new birth concept with alternative birth methods.

Analgesia, Epidural↗

Medical history for the masses: how American comic books celebrated heroes of medicine in the 1940s.

When comic books rose to mass popularity in the early 1940s, one segment of the industry specialized in "true adventures," with stories about real people from the past and the present--in contrast to competing books that offered fantasy, science fiction, superheroes, detectives and crime, funny people, or funny animals. This study examines the figures from both medical history and twentieth-century medicine who were portrayed as heroes and role models in these comic books: first, to call attention to this very popular, if unknown, genre of medical history, and second, to illustrate how medical history was used at that time to popularize scientific and medical ideas, to celebrate the achievements of medical research, to encourage medical science as a career choice, and to show medicine as a humane and noble enterprise. The study explains how these medical history stories were situated in American popular culture more generally, and how the graphic power of comic books successfully conveyed both values and information while also telling a good story. Attention to this colorful genre of popular medical history enriches our picture of the mid-twentieth-century public's enthusiasm for medical progress.

History, 20th Century↗

[A nationwide survey on the use of organic solvents in Japan].

A total of 1,179 organic solvent products used as thinners, paint, degreasers, inks, adhesive and others, were collected nationwide from factories of various sizes and kinds in Japan, and analyzed by gas chromatography. Solvent components per sample, frequency of each solvent component, and contents of each component were analyzed and classified by use. Paints, inks, and adhesives which contained nonvolatile substances were analyzed by head space techniques. Seventy-seven percent of all samples, 93% of paints, 85% of thinners, 73% of adhesives, and 52% of degreasers contained mixed organic solvents. The average numbers of solvent components per sample were 4.14 (max. 13) in thinner, 3.29 (max. 7) in paint, 2.23 (max. 5) ink, 2.19 (max. 6) in adhesive, 1.71 (max. 6) in degreaser, when gasoline was excluded. Toluene, xylene, methylalcohol, isopropylalcohol, ethylacetate, methylethylketone, industrial gasoline were widely used in the above-mentioned products. Toluene was the most popular component in the solvent products, excluding degreasers. Many kinds of solvent components were used in thinner and paint. However, toluene, xylene and industrial gasoline were their main components and contents per sample were very high. Acetates, alcohols, ketones and glycols were frequently detected in solvent products, but their contents per sample were relatively low, because these solvent components were usually used as subordinate solvents. The chlorinated hydrocarbons such as trichloroethylene, tetrachloroethylene and 1,1,1-trichloroethane, and industrial gasoline were the most popular components in degreasers. 1,4-dioxane was detected in a relatively large number of the samples, but its content per sample was very low, because it is usually used as an additive to 1,1,1-trichloroethane. Toluene was the most popular component in ink solvents, too. In addition, isopropylacohol, methylalcohol, methylethylketone were frequently detected in inks. Toluene was also the most popular component in adhesives, and n-hexane was also frequently detected in them. In order to prevent poisoning by industrial solvents, special attention should be paid to toluene and xylene, which are frequently and largely used for wide purposes, trichloroethylene which is largely used as a degreaser and has a severe toxicity, n-hexane which is frequently used in adhesives and has a high volatility and severe neurotoxicity, and other popular and toxic solvents. The severely toxic solvents such as benzene, chloroform, carbon tetrachloride, 1,2-dichloroethane, 1,1,2,2-tetrachloroethane and carbon disulfide were detected in few samples.(ABSTRACT TRUNCATED AT 250 WORDS)

Adhesives↗

The symbol of modern medicine: why one snake is more than two.

Today, two serpent motifs are commonly used to symbolize the practice and profession of medicine. Internationally, the most popular symbol of medicine is the single serpent-entwined staff of Asklepios (Latin, Aesculapius), the ancient Greco-Roman god of medicine. However, in the United States, the staff of Asklepios (the Asklepian) and a double serpent-entwined staff with surmounting wings (the caduceus) are both popular medical symbols. The latter symbol is often designated as the "medical caduceus" and is equated with the ancient caduceus, the double serpent-entwined staff of the Greco-Roman god Hermes (Latin, Mercury). Many physicians would be surprised to learn that the medical caduceus has a quite modern origin: Its design is derived not from the ancient caduceus of Hermes but from the printer's mark of a popular 19th-century medical publisher. Furthermore, this modern caduceus became a popular medical symbol only after its adoption by the U.S. Army Medical Corps at the beginning of the 20th century. This paper describes the ancient origin of the Asklepian and how a misunderstanding of ancient mythology and iconography seems to have led to the inappropriate popularization of the modern caduceus as a medical symbol.

Animals↗

Characteristics attributed to individuals on the basis of their first names.

Characteristics connoted by first names were explored in 7 studies. Four factors were identified: Ethical Caring, Popular Fun, Successful, and Masculine-Feminine (Study 1, N = 165). Men's names connoted more masculine characteristics, less ethical caring, and more successful characteristics than did women's names (Study 2, N = 274). Nicknames connoted less successful characteristics, more popular fun, and less ethical caring characteristics than did given names (Study 3, N = 289). Androgynous names connoted more popular fun and less masculine characteristics for men and more popular fun, less ethical caring, and more masculine characteristics for women than did gender-specific names (Study 4, N = 378). Less conventionally spelled names connoted uniformly less attractive characteristics (Study 5, N = 145). For men only, longer names connoted more ethical caring, less popular fun, more successful, and less masculine characteristics (Study 6, N = 620). More anxiety and neuroticism were attributed to those with less common names and more exuberance was attributed to those with more attractive names (Study 7, N = 137).

Adult↗

Preschool peer perceptions of the behavior of hyperactive and aggressive children.

To assess if preschool children can successfully identify externalizing symptomatic behaviors in their male classmates, and if these perceptions are associated with peer-rated popularity and rejection, 154 preschool boys and girls were interviewed using a peer nomination procedure. Behavioral data on the same preschool boys (N = 86) were also provided by their respective teachers. Preschool children were capable of providing stable nominations of popularity, rejection, and aggression, boys and girls significantly agreed in their nominations, and these nominations were not a function of the age of the rated child, although they differed somewhat as a function of the age of the rater. Teachers and peers reflected significant convergence in ratings of hyperactivity and aggression and teacher ratings of peer problems significantly agreed with actual peer nominations of popularity and rejection. Boys nominated as aggressive were more rejected by their classmates, whereas boys nominated as hyperactive were either more popular and/or more rejected. Limited evidence for differential patterns of relationships among hyperactivity, aggression, and peer status was obtained for both the peer and teacher data.

Aggression↗

The bioethics tabloids: how professional ethicists have fallen for the myth of tertiary transmitted heterosexual AIDS.

The hysteria and misconceptions about AIDS which are fostered and held by the popular press have been accepted uncritically by many bioethicists, who have not bothered to explore popular empirical claims in sufficient depth. As a result, and because ethicists attempt to sell moral problems in a manner not much different from the way the popular press attempt to sell newspapers, artificial dilemmas have been produced in professional journals. We concentrate on just one popular misconception about AIDS--that the heterosexual incidence of the syndrome is widespread--and show how bioethicists' unreflective acceptance of this myth has led them to make conceptual and practical errors.

Acquired Immunodeficiency Syndrome↗

Use of solvents in industries in Korea: experience in Sinpyeong-Jangrim industrial complex.

OBJECTIVES: To identify the most popular solvent and typical type of solvent work among solvent-using workplaces in Korea. METHODS: In practice, 862 solvent-using workshops in Sinpyeong-Jangrim industrial complex in Pusan were investigated in a 2-year period from March 1995 to February 1997. Solvent vapors in the breathing zone of workers were collected by personal sampling with charcoal tubes. The exposed charcoal was extracted with carbon disulfide, and the solvents in the extract were analyzed by flame ionization detector-equipped gas chromatography (FID-GC). RESULTS: Solvents were used in painting, glue application, cleaning, printing and solvent-mixing workshops in decreasing order of popularity. Toluene was the most frequently measured solvent. In the five types of solvent work, acetone, hexane, methyl ethyl ketone, methyl isobutyl ketone, tetrachloroethylene, trichloroethylene and xylenes were also used frequently. CONCLUSIONS: Toluene was identified as the most frequently used solvent in solvent works in Korean manufacture industries in the late 1990s. Eight types of solvent were popularly used in five popular types of solvent work. These trends are very similar to the cases reported for industries in Japan.

Adhesives↗

Home remedies and doctors' remedies in Feira (Brazil).

The analysis of popular notions and practices concerning home remedies and pharmaceutical drugs in Feira (Brazil) provides an opportunity to examine the interface, both complementary and conflictual, of different medical traditions. The popular use of drugs is in part modelled after the popular use of traditional remedies and both uses are largely influenced by the epidemiological profile of the community, by local notions of illness and therapeutic efficacy, financial constraints and medicalization processes. The usage of these remedies is also analyzed as a practical logic of popular culture.

Attitude to Health↗

Survey of sterile technique used by dermatologic surgeons.

A survey was made of the sterile technique practices of dermatologists interested in dermatologic surgery. The steam autoclave is the most popular method for sterilizing surgical instruments. Dry heat sterilization is often used, as is cold, chemical sterilization. The most popular agent for chemical sterilization continues to be quaternary ammonium compounds despite warnings to the contrary. Gas sterilization is rarely used. Alcohol is the most popular agent for prepping the skin and iodophors are also quite popular. Dermatologists are now wearing gloves for most procedures. Prophylactic antibiotics are used minimally in surgical cases, as is recommended by established standards.

Dermatology↗

The social construction of the breast cancer epidemic.

The age-adjusted incidence of breast cancer among U.S. women rose by over 30% during the 1980s. Several population-based studies have concluded that most or all of this observed increase is an artifact of the lead time afforded by mammography screening rather than an indication of a true increase in the rate at which women develop the disease. We conducted a study of the social construction of breast cancer trends as a public health problem in popular U.S. magazines. We documented trends in popular magazine article coverage of breast cancer between 1980 and 1995. In addition, we analyzed the content of a convenience sample of 228 popular magazine articles published between 1987 and 1995, focusing on a subsample of articles (n = 91) that mention the increase in breast cancer incidence. Our results show that the increase in incidence is commonly portrayed as a mysterious, unexplained epidemic occurring primarily among young, professional women in their prime years. Many articles suggest that recent changes in women's behavior such as increases in delayed childbearing, nulliparity, the use of oral contraceptives, induced abortion, and the use of tobacco and alcohol are related to the recent upsurge in the disease. The portrayal of the breast cancer epidemic in the U.S. popular press reflects a strong social desire to create order and control over a frightening disease. In the process, a common message is that the behaviors and choices of young, nontraditional women especially those related to fertility control-have led to pathological repercussions within their bodies, which in turn may be responsible for great disorder and pathology at the societal level in the epidemic of breast cancer.

Body Image↗

Informing, advising, or persuading? An assessment of bone mineral density testing information from consumer health websites.

UNLABELLED: Greater access to web-based information on health-care interventions might result in greater participation by patients in care and self-care decisions, but only improve health outcomes if the indicated actions produce the intended benefits. Unbiased research on benefits and harms of health information can provide a basis for evidence-based patient information systems. OBJECTIVES: To evaluate the quality of the information content on bone-mineral density (BMD) testing posted on consumer health websites (CHWS). METHODS: Five popular engines (Yahoo, MSN, AOL, Lycos, and Go.com) were used to search for patient information on bone densitometry. The fifteen websites that supplied relevant content and were identified by three of the five search engines were selected in order of popularity of the search engine and primacy of placement. Six BMD reports from health technology assessment (HTA) organizations were used as a standard of scientific quality. These were identified from the HTA Database at York University United Kingdom and published between 1996 and 2001. Content was extracted from both document types, and these sets were compared independently by two reviewers. RESULTS: The majority of CHWS identified by popular search engines do not disclose the limited capacity of BMD to discriminate between low-risk individuals and those who will suffer future fractures. CHWS generally present BMD testing as quick, painless, noninvasive, and as being recommended, based on risk factors that are widespread among the general public. BMD testing information is prominently paired on CHWS sites with information on osteoporosis, with an emphasis on "silent disease" and the devastating consequences of advanced disease. Sponsors of CHWS sites are frequently either providers of BMD testing or companion drugs, and consequently in a position of conflict of interest with regard to decisions to undergo BMD testing. HTA organizations have no documented conflict of interest, nor do they invoke emotional arguments. Their approach is to emphasize the effects of testing on populations, on the basis of referenced research findings. CONCLUSIONS: Content analysis demonstrates the omissions and divergence of information on BMD testing available to consumers on the Internet, as compared with HTA reports. The content of HTA reports has undergone rigorous systematic and peer review; therefore, their findings may be useful to consumers. This information is not generally accessible to patients using the most popular Internet search engines. Inaccurate and incomplete information may cause harm by deflecting patients from optimal decisions.

Absorptiometry, Photon↗

Literacy as a leisure activity: free-time preferences of older children and young adolescents.

PURPOSE: Literacy plays an important role in the development of language in school-age children and adolescents. For example, by reading a variety of books, magazines, and newspapers, students gain exposure to complex vocabulary, and reading becomes a prime opportunity for learning new words. Despite the importance of reading for lexical development, little is known about the pleasure reading habits of today's youth. The first goal of this investigation was to examine the preferences of older children and young adolescents with respect to reading as a leisure-time activity and its relationship to other free-time options that are likely to compete for their attention. The second goal was to examine the amount of time that young people spend reading for pleasure each day and the types of materials they most enjoy reading. The third goal was to determine if preferences for free-time activities and reading materials would evince age- and gender-related differences during the period of development from late childhood through early adolescence (ages 11-15 years). The findings could serve as a reference point for understanding what is reasonable to expect of students during this age range. METHOD: The participants were 100 sixth graders (mean age = 11;7 [years; months]) and 100 ninth graders (mean age = 14;8) attending public schools in western Oregon. Each group contained an equal number of boys and girls, all of whom spoke English as their primary language and were considered to be typical achievers. All participants completed a survey concerning their preferred free-time activities and reading materials. They also reported the average amount of time they spent reading for pleasure each day. RESULTS: The most popular free-time activities were listening to music/going to concerts, watching television or videos, playing sports, and playing computer or video games. Least preferred activities were cooking, running or walking, writing, and arts and crafts. Reading was moderately popular. The most popular reading materials were magazines, novels, and comics; least popular were plays, technical books, and newspapers. Interest in pleasure reading declined during this age range (11-15 years), and boys were more likely than girls to report that they spent no time reading for pleasure. CLINICAL IMPLICATIONS: Given the importance of reading to lexical development in school-age children and adolescents, reading should be promoted as a leisure activity during these years. School-based speech-language pathologists (SLPs), in their role as language consultants, can benefit from understanding the pleasure-reading patterns of today's youth. It is especially important for SLPs to monitor these patterns in students who have language disorders, as it is common for these young people to experience deficits in reading and in lexical development. Fortunately, much can be done in school settings to encourage strong literacy habits in all students if SLPs work collaboratively with teachers, principals, psychologists, librarians, parents, and students. Suggestions are offered for ways to encourage young people to spend more time reading for pleasure.

Adolescent↗

The incidence of dieting amongst adolescent girls: a question of interpretation?

AIM: It is the intention of this study establish the extent of dieting practices amongst adolescent girls and identify their perceptions with regard to 'dieting' and 'healthy eating'. METHODS: A total of 140 girls, aged 12-13 years, were recruited from two schools. A self-reported questionnaire, which determined the incidence of dieting and sought to identify the girls' perceptions of 'dieting' and 'healthy eating', was used to collect data. RESULTS: Out of the total group, 33.6% reported that they had dieted at some time and 15.8% were presently dieting. The most popular definition of dieting amongst the dieters was 'eating less/cutting down'; however, the second most popular answer was 'eating healthy food' which was the most popular answer amongst the non-dieters. The most popular definition of healthy eating was 'increasing fruit/ veg/salads', which is similar to how many girls perceived dieting, i.e. eating healthy food (fruit/veg/salads). CONCLUSION: Establishing the actual incidence of dieting amongst adolescent girls is not a clear-cut issue as it can be interpreted in many different ways, depending on the perceptions of the individual. The results of this study showed that in many cases 'dieting' and 'healthy eating' were perceived in a similar light, concluding that the dietary intake of dieters may be similar to that of non-dieters with both groups being at risk from any related health problems.

Adolescent↗

A decade of research on health content in the media: the focus on health challenges and sociocultural context and attendant informational and ideological problems.

There is a burgeoning interest in the health and illness content of popular media in the domains of advertising, journalism, and entertainment. This article reviews the past 10 years of this research, describing the relationship between the health topics addressed in the research, the shifting focus of concerns about the media, and, ultimately, the variation in problems for health promotion. I suggest that research attending to topics related to bodily health challenges focused on whether popular media accurately or appropriately represented health challenges. The implication was that there is some consensus about more right or wrong, complete or incomplete ways of representing an issue; the problem was that the media are generally wrong. Alternatively, research addressing topics related to sociocultural context issues focused on how certain interests are privileged in the media. The implication was that competing groups are making claims on the system, but the problem was that popular media marginalizes certain interests. In short, popular media is not likely to facilitate understandings helpful to individuals coping with health challenges and is likely to perpetuate social and political power differentials with regard to health-related issues. I conclude by offering some possibilities for future health media content research.

Communication↗

Tobacco-specific nitrosamines in tobacco from U.S. brand and non-U.S. brand cigarettes.

Tobacco-specific nitrosamines (TSNAs) are one of the major classes of carcinogens found in tobacco products. As part of collaborative efforts to reduce tobacco use and resulting disease, the U.S. Centers for Disease Control and Prevention (CDC) carried out a two-phase investigation into the worldwide variation of the levels of TSNAs in cigarette tobacco. In the first phase, representatives of the World Health Organization (WHO) purchased cigarettes; scientists from the CDC subsequently measured the levels of TSNAs in tobacco from 21 different countries. Although the data collected from this initial survey suggested that globally marketed U.S.-brand cigarettes typically had higher TSNA levels than locally popular non-U.S. cigarettes in many countries, the number of samples limited the statistical power of the study. To improve statistical power and to ensure adequate sampling, the CDC conducted a second survey of 14 countries. In addition to the United States, the CDC selected the world's 10 most populous countries and three additional countries, so that at least two countries from each of the six WHO regions were represented. For each country, the CDC compared 15 packs of Marlboro cigarettes, which is the world's most popular brand of cigarettes, with 15 packs of a locally popular non-U.S. brand in the study country. Marlboro cigarettes purchased in 11/13 foreign countries had significantly higher tobacco TSNA levels than the locally popular non-U.S. brands purchased in the same country. The findings suggest that TSNA levels in tobacco can be substantially reduced in some cigarettes.

Carcinogens↗