bims-evares Biomed News
on Evaluation of research
Issue of 2019‒07‒14
fourteen papers selected by
Thomas Krichel
Open Library Society

  1. Health Lit Res Pract. 2017 Oct;1(4): e182-e191
    Massey PM, Kim MC, Dalrymple PW, Rogers ML, Hawthorne KH, Manganello JA.
      Background: With an increase in the number of disciplines contributing to health literacy scholarship, we sought to explore the nature of interdisciplinary research in the field.Objective: This study sought to describe disciplines that contribute to health literacy research and to quantify how disciplines draw from and contribute to an interdisciplinary evidence base, as measured by citation networks.
    Methods: We conducted a literature search for health literacy articles published between 1991 and 2015 in four bibliographic databases, producing 6,229 unique bibliographic records. We employed a scientometric tool (CiteSpace [Version 4.4.R1]) to quantify patterns in published health literacy research, including a visual path from cited discipline domains to citing discipline domains.
    Key Results: The number of health literacy publications increased each year between 1991 and 2015. Two spikes, in 2008 and 2013, correspond to the introduction of additional subject categories, including information science and communication. Two journals have been cited more than 2,000 times-the Journal of General Internal Medicine (n = 2,432) and Patient Education and Counseling (n = 2,252). The most recently cited journal added to the top 10 list of cited journals is the Journal of Health Communication (n = 989). Three main citation paths exist in the health literacy data set. Articles from the domain "medicine, medical, clinical" heavily cite from one domain (health, nursing, medicine), whereas articles from the domain "psychology, education, health" cite from two separate domains (health, nursing, medicine and psychology, education, social).
    Conclusions: Recent spikes in the number of published health literacy articles have been spurred by a greater diversity of disciplines contributing to the evidence base. However, despite the diversity of disciplines, citation paths indicate the presence of a few, self-contained disciplines contributing to most of the literature, suggesting a lack of interdisciplinary research. To address complex and evolving challenges in the health literacy field, interdisciplinary team science, that is, integrating science from across multiple disciplines, should continue to grow. [Health Literacy Research and Practice. 2017;1(4):e182-e191.].
    Plain Language Summary: The addition of diverse disciplines conducting health literacy scholarship has spurred recent spikes in the number of publications. However, citation paths suggest that interdisciplinary research can be strengthened. Findings directly align with the increasing emphasis on team science, and support opportunities and resources that incentivize interdisciplinary health literacy research.
  2. Clin Orthop Relat Res. 2019 Jun 17.
    Brown MA, Erdman MK, Munger AM, Miller AN.
      BACKGROUND: The most recent demographic data reveal that only 6.5% of practicing orthopaedic surgeons are women, and as far as we know, only two women have held chair positions in academic orthopaedic programs in the United States. Furthermore, orthopaedic surgery is the least gender-diverse speciality recognized by the Accreditation Council for Graduate Medical Education. The factors that contribute to the lack of gender diversity in orthopaedics remain ill-defined. A lag in publication productivity may be a barrier to career advancement for women orthopaedic surgeons, but this has not been well studied.QUESTIONS/PURPOSES: (1) What is the proportion of orthopaedic studies published in six major orthopaedic journals by women first or senior authors from 1987 to 2017? (2) Did men and women orthopaedic surgeons publish in equal proportions during the study period (measured in 5-year intervals)? (3) Are there differences in the characteristics (such as study type or subject focus) of orthopaedic publications authored by women and those authored by men? (4) Has the increased proportion of practicing women orthopaedic surgeons been matched by an equal increase in authorship by women orthopaedic surgeons during the study timeframe?
    METHODS: A cross-sectional analysis was designed to characterize trends in authorship of orthopaedic studies by women over time. All publications from the first issue of each of six major orthopaedic journals were evaluated at seven time points (1987, 1992, 1997, 2002, 2007, 2012, and 2017). Characteristics of each first and senior author (including gender, academic degree, and specialty), and study category of each publication were collected. Articles for which this information was not available were excluded (35 of 1073, or 3.3% of published studies, no difference in proportion of excluded studies between journals). The proportions of women and men authors were compared at the seven time points and for six study categories (basic science, case report/technique article, clinical medicine, economics/practice management, editorial content [including true editorials, letters to the editor, commentaries, and book reviews] and review/meta-analysis) using a Fisher's exact test or chi-squared analysis. We compared the rates of change of women authorship, practicing women orthopaedic surgeons, and women orthopaedic residents during the study period using an ANOVA and Tukey's honestly significant difference (HSD) post-hoc test with Cohen's D measure of effect size.
    RESULTS: From 1987 to 2017, only 1.7% (15 of 880) of senior authors and 4.4% (46 of 1038) of first authors of orthopaedic publications were women orthopaedic surgeons. Based on population proportions (that is, percent of practicing women orthopaedic surgeons compared with men), the proportion of women senior authors was less than would be expected at each time point after 1987 compared with men. There were no differences between the types of studies authored by women or men. Finally, during the study period, the rate of growth of women senior authorship was less than the rates of growth of both practicing women orthopaedic surgeons (d = 5.3, 95% CI, 4.8-5.6; p = 0.023) and women first authorship (d = -4.3, 95% CI -4.6 to -3.6, p = 0.030; estimated mean 3.3, p = 0.013).
    CONCLUSIONS: Women orthopaedic surgeons published a small proportion of academic orthopaedic research from 1987 to 2017, and women senior authors consistently published less than would be expected based on their population proportion compared with men orthopaedic surgeons. Furthermore, the growth of practicing women orthopaedic surgeons has not been matched by growth in senior authorship by women over the same timeframe.
    CLINICAL RELEVANCE: This discrepancy warrants further exploration because a low rate of publication may negatively impact the career advancement of women orthopaedic surgeons and contribute to the overall lack of gender diversity in orthopaedics. We suggest that journals and publishers review their editorial processes to ensure blinding of author names during peer review and editorial decision-making, and to disclose those review processes to authors. We also suggest that institutions encourage women trainees and junior faculty to participate in mentorship programs and specialty societies that promote academic productivity.
  3. J Am Coll Radiol. 2019 Jul 09. pii: S1546-1440(19)30718-5. [Epub ahead of print]
    Khoshpouri P, Khoshpouri P, Beheshtian E, Yousem DM.
      OBJECTIVE: Increasingly, medical journals are recognizing "equally credited authors" (ECA) in the primary and senior authorship of articles. The aim of this study was to assess the policies of co-first authorship, co-senior authorship, and designation of a corresponding author in the radiology literature.METHODS: We identified 29 radiology journals based on impact factor ranking. Journal offices were contacted by phone and e-mail to ascertain their practices on first and senior authorship ECA designations. We surveyed the March, June, and December 2018 issues of each journal (when available) to assess the utilization of the co-designations in articles.
    RESULTS: Twenty-five of 29 journals responded to our survey (response rate: 86.2%). Of 25 journals, 20 (80%) allowed co-first authorship. Among these, 4 of 25 journals (16%) allowed more than two co-first authors. Among the 25 responses, 14 journals (56%) allowed co-senior authorship. Among the 24 journals who responded to this specific question, 23 (96%) approved designation of a corresponding author, different from the first or senior author. The review of March, June, December 2018 editions found co-first authorship and co-senior authorship ECA rates of 8.6% (range 0.0%-22.7%) and 1.8% (range 0.0%-13.3%), respectively. A corresponding author other than first or senior author was noted in 13.3% (range 0.0%-34.7%).
    DISCUSSION: There has been widespread acceptance of the concept of ECA in the policies of the top cited imaging journals particularly for first authors (80%). However, the utilization of these designations is uncommon for first authorship (8.6%) and rare (1.8%) for senior authorship based on our 2018 sampling.
    Keywords:  Authorship; contribution; credit; journal
  4. J Med Genet. 2019 Jul 12. pii: jmedgenet-2019-106137. [Epub ahead of print]
    Dal-Ré R, Ayuso C.
      INTRODUCTION: Between 0.02% and 0.04% of articles are retracted. We aim to: (a) describe the reasons for retraction of genetics articles and the time elapsed between the publication of an article and that of the retraction notice because of research misconduct (ie, fabrication, falsification, plagiarism); and (b) compare all these variables between retracted medical genetics (MG) and non-medical genetics (NMG) articles.METHODS: All retracted genetics articles published between 1970 and 2018 were retrieved from the Retraction Watch database. The reasons for retraction were fabrication/falsification, plagiarism, duplication, unreliability, and authorship issues. Articles subject to investigation by company/institution, journal, US Office for Research Integrity or third party were also retrieved.
    RESULTS: 1582 retracted genetics articles (MG, n=690; NMG, n=892) were identified . Research misconduct and duplication were involved in 33% and 24% of retracted papers, respectively; 37% were subject to investigation. Only 0.8% of articles involved both fabrication/falsification and plagiarism. In this century the incidence of both plagiarism and duplication increased statistically significantly in genetics retracted articles; conversely, fabrication/falsification was significantly reduced. Time to retraction due to scientific misconduct was statistically significantly shorter in the period 2006-2018 compared with 1970-2000. Fabrication/falsification was statistically significantly more common in NMG (28%) than in MG (19%) articles. MG articles were significantly more frequently investigated (45%) than NMG articles (31%). Time to retraction of articles due to fabrication/falsification was significantly shorter for MG (mean 4.7 years) than for NMG (mean 6.4 years) articles; no differences for plagiarism (mean 2.3 years) were found. The USA (mainly NMG articles) and China (mainly MG articles) accounted for the largest number of retracted articles.
    CONCLUSION: Genetics is a discipline with a high article retraction rate (estimated retraction rate 0.15%). Fabrication/falsification and plagiarism were almost mutually exclusive reasons for article retraction. Retracted MG articles were more frequently subject to investigation than NMG articles. Retracted articles due to fabrication/falsification required 2.0-2.8 times longer to retract than when plagiarism was involved.
    Keywords:  duplication; fabrication/falsification; genetics; medical genetics; non−medical genetics; plagiarism; research misconduct; retraction notices
  5. Perspect Med Educ. 2019 Jul 09.
    Waaijer CJF, Ommering BWC, van der Wurff LJ, van Leeuwen TN, Dekker FW, .
      INTRODUCTION: Engagement of clinicians in research is important for the integration of science and clinical practice. However, at this moment, there is a shortage of clinician-scientists. Success experiences can stimulate student interest in a research career. Conducting actual research leading to publication is a potential method to gain success experience. This study assessed whether publication as a medical student is associated with publication after graduation. We determined whether medical students in the Netherlands who are involved in research, as measured by publication in international journals before graduation: 1) are more likely to publish, 2) publish a greater number of papers, and 3) have higher citation impact scores after graduation.METHODS: We matched 2005-2008 MD graduates (with rare names, n = 4145 in total) from all eight Dutch university medical centres to their publications indexed in the Web of Science and published between 6 years before and 6 years after graduation. For sensitivity analysis we performed both automatic assignment on the whole group and manual assignment on a 10% random sample.
    RESULTS: Students who had published before graduation: 1) were 1.9 times as likely to publish, 2) published more papers, and 3) had a slightly higher citation impact after graduation.
    DISCUSSION: Medical students who conducted research leading to a publication before graduation were more likely to be scientifically active after graduation. While this is not a causal relationship per se, these results cautiously suggest that successful early involvement in research could influence the long-term scientific activity of clinicians.
    Keywords:  Bibliometrics; Clinician-scientists; Medical students; Research in medical education
  6. World Neurosurg. 2019 Jul 08. pii: S1878-8750(19)31888-1. [Epub ahead of print]
    Servadei F, Tropeano MP, Spaggiari R, Cannizzaro D, Al Fauzi A, Bajamal AH, Khan T, Kolias AG, Hutchinson PJ.
      OBJECT: In 2015, the Lancet Commission on Global Surgery highlighted the disparities in surgical care worldwide. The aim of this study was to investigate the research productivity of Low and Low-Middle Income countries (LMICs) in selected journals representing the worldwide neurosurgical literature and their ability to publish and communicate globally the existing differences between High Income Countries (HIC) and LMICs.METHODS: This was a retrospective bibliometric analysis using Pubmed and Scopus databases to record all publications between 2015 and 2017 by authors affiliated with neurosurgical departments in Low Income Countries (LICs) and Low-Middle Income countries (L-MICs).
    RESULTS: A total of 8459 articles by authors self-identified as members of neurosurgery departments from all over the world were identified. 6708 articles were included according to our methodology in the final analysis. The systematic search resulted in 459 articles published by LICs and L-MICs. Three hundred and thirty-four articles for full text evaluation were included. Three hundred and three (4.52%) articles were published with L-MIC affiliation and only 31 (0.46%) were affiliated to a LIC. Leading countries, were India with 182 (54.5% among L-MIC and LIC, 2.71% overall), followed by Egypt at 66 (19.76% among L-MIC and LIC, 0.98% overall), with a large difference as compared to the other countries like Uganda at 9 (2.69% among L-MIC and LIC) and Tunisia and Pakistan at 8 (2.4% each among L-MIC and LIC). A few published papers were generated by a collaboration with HIC neurosurgeons.
    CONCLUSIONS: Research studies from LMICs are under-represented. Understanding and discussing the reasons for this underrepresentation is necessary in order to start addressing the disparities in neurosurgical research and care capacity. Future engagement from international journals, more partnership collaboration from HIC and tailored funding to support researchers, collaborations, and networks could be of help .
    Keywords:  developing countries; education; global neurosurgery; literature; world health
  7. J Ayurveda Integr Med. 2019 Jul 06. pii: S0975-9476(18)30349-8. [Epub ahead of print]
    Şenel E, Taylan Özkan A, Mumcuoglu KY.
      BACKGROUND: Hirudotherapy, also known as medicinal leech therapy, has been used to treat a wide range of disorders for thousands of years since Ancient Egypt. Leech therapy is also mentioned as a minimal invasive technique called Jalaukavacharana in the Sushruta Samhita, an ancient Sanskrit text of Ayurvedic medicine. Although hirudotherapy has become a popular component of complementary medicine in the last decade, scientometric studies investigating the articles published in this field, do not exist.OBJECTIVE: In this study, we aimed to perform a detailed scientometric analysis of hirudotherapy literature.
    MATERIALS AND METHODS: We collected data by using four databases provided by Web of Science using the keywords "hirudotherapy", "leech therapy", "medicinal leech" and "medicinal leech therapy".
    RESULTS: A total of 834 articles were found of which 89.8% were original articles. USA was the leading country with 280 publications, followed by UK, Germany and France (128, 101 and 41 items, respectively). The most productive countries regarding hirudotherapy were the UK (1.93), Slovenia (1.44), and Israel (1.32). The peak publication year for hirudotherapy literature was 2011 with 41 papers.
    CONCLUSION: To the best of our knowledge, our study was the first bibliometric and scientometric analysis in this field and we believe that multicenter studies and further searches from developing and least-developed countries are needed in hirudotherapy literature.
    Keywords:  Bibliometrics; Hirudotherapy; Leech therapy; Medicinal leech therapy; Publication trend analysis; Scientometrics
  8. J Can Assoc Gastroenterol. 2019 Feb;2(Suppl 1): S81-S91
    Rose KL, Sherman PM, Cooke-Lauder J, Mawani M, Benchimol EI, Kaplan GG, Bernstein CN, Bitton A, Murthy SK, Nguyen GC, Lee K.
      Background: Health research in Canada is funded by government, health charities, foundations and industry. We investigated levels of IBD research funding and the scientific impact of this research in Canada between 2013 and 2017.Methods: An analysis of global and Canadian funding in IBD research was conducted using the Canadian Institutes of Health Research (CIHR) Funded Research Database and UberResearch's Dimensions platform. Examples of priority-driven and investigator-initiated IBD research in Canada are provided. Bibliometric analysis was used to assess the quality of IBD research output in Canada.
    Results: Total funding for IBD research Canada between 2013 and 2017 was over $119 million Canadian dollars (CAD), with CIHR, the largest funder, contributing almost $66 million CAD, and Crohn's and Colitis Canada, investing more than $32 million CAD. This ranks Canada fourth internationally. A comparative analysis indicates that publications by Canadian IBD researchers have a greater impact than other Canadian and international comparators. When productivity and impact in IBD research are combined, Canada is among the top three in the world.
    Conclusions: Investment in IBD research in Canada has resulted in the development of a strong collaborative group of researchers producing impactful, world-class research. On all measures of academic productivity and influence, Canada ranks in the top two or three internationally. The challenges ahead are to continue to fund innovative IBD research and grow the next generation of IBD researchers while moving research findings into changes in health policy and practice in order to benefit affected patients and their families-and ultimately, to find the cause(s) and identify the cure(s).
    Keywords:  CIHR; Crohn’s and Colitis Canada; Gastroenterology; Inflammatory bowel disease; Research capacity
  9. Int J Health Plann Manage. 2019 Jul 11.
    Ye L, Zhang X.
      This study involves a bibliometric analysis of the medication-adherence research and covers publications from 1997 to 2016. A database of 19 621 publications and 335 208 references from the Web of Science was investigated using the CiteSpace software. Some interesting findings were obtained. First, the most significant developments and progress in the medication-adherence research have occurred in North America and Europe. Second, Osterberg L. and the Journal of the American Medical Association (JAMA) are the most cited author and journal, respectively, with the strongest academic influence. Third, the existing studies on medication adherence primarily focus on pharmacology/pharmacy, psychiatry, public environmental occupational health, and general internal medicine. Fourth, research hotspots showed a diversifying trend and increasingly covered chronic diseases. Moreover, the topic of integrating formal outcome evaluations into adherence interventions is one long-term research hotspot. In addition, the research frontiers mainly focus on medication adherence for HIV/AIDS patients, especially active antiretroviral therapy. Finally, the evolution of the medication-adherence research has occurred in approximately three stages: The first stage involved the introduction of the term "compliance" into medicine, then the primary focus shifted to patient adherence to HIV/AIDS medication, and the final stage has involved a diversifying trend with more diseases and methods for measuring adherence being researched in the current stage. Furthermore, because of an aging population and a disease spectrum change in the current phase, the focus of medication-adherence research has gradually shifted from infectious diseases to chronic diseases.
    Keywords:  CiteSpace; bibliometric analysis; medication adherence; visualization research
  10. Eklem Hastalik Cerrahisi. 2019 Aug;pii: ehc.2019.64729. [Epub ahead of print]30(2): 163-7
    Polat B, Özmanevra R, Özmanevra PT, Kazıkdaş KÇ.
      OBJECTIVES: This study aims to compare the annual impact factors (IFs) for the period 1999-2017 and the tri-annual IFs in 2011, 2014 and 2017 of the subscription access (SA) and open access (OA) journals published in the field of orthopedics, traumatology and sports medicine according to the SCImago Journal Rank (SJR).MATERIAL AND METHODS: All data for this study were obtained from the SCImago Journal & Country Rank database. We compared the change in the mean annual IFs of 197 SA journals with 52 OA journals in the field of orthopedics and sports medicine for the period between 1999 and 2017. In addition, we determined and compared the changes in the mean tri-annual IFs of these journals in 2011, 2014 and 2017. The mean publication fee values of the OA journals as well as the correlation between the three-year IFs of the year 2017 and the publication fee values were evaluated.
    RESULTS: From 1999 to 2017, the mean IF of SA journals increased 0.47-fold to 0.69, while the mean IF of the OA journals increased 0.85-fold to 0.63. Significant positive correlation was observed between the tri-annual IF and publication fee of OA journals in 2017 (r=0.458, p=0.001).
    CONCLUSION: We can predict that the mean IFs of OA journals in the field of orthopedics and sports medicine will reach the mean IFs of SA journals after several years. Choosing OA journals becomes advantageous when the desire for a higher number of citations is the most important factor.
  11. PLoS One. 2019 ;14(7): e0219458
    van Heteren JAA, van Beurden I, Peters JPM, Smit AL, Stegeman I.
      OBJECTIVES: To examine 1) the publication rate of registered otology trials in, 2) the public availability of the results, 3) the study characteristics associated with publication, and 4) the time to publication after trial completion.BACKGROUND: Publication bias, the publication or non-publication of research findings, depending on the nature and direction of results, is accountable for wrong treatment decisions. The extent of publication bias in otology trials has not been evaluated.
    METHODS: All registered otology trials were extracted from with completion date up to December 2015. A search strategy was used to identify corresponding publications up to June 2017, providing at least 18 months to publish the results after trial completion. Characteristics were obtained from and corresponding publications. Regression models were used to examine study characteristics associated with publication or non-publication.
    RESULTS: From the 419 trials identified on, 225 (53.7%) corresponding publications were found in PubMed. Among these, 109 (48.4%) publications were cited on and 124 (55.1%) articles reported the National Clinical Trial registry number. For 36 (8.6%) trials, results were only reported in Trials with a biological intervention were more likely to be published than studies involving drugs (odds ratio (OR) 10.41, 95% confidence interval (CI) 1.26-86.22, P = 0.030). Trials funded by industry were less likely to be published (OR 0.46, CI 0.25-0.84, P = 0.011). The median trial duration was 20 months (interquartile range (IQR) 26 months), and median time from trial completion to publication was 24 months (IQR 22 months).
    CONCLUSION: In 37.7% of the registered otology trials the results remained unpublished, even several years after trial completion. With little citations on and low reporting of the Clinical Trial registry number, the accessibility is limited. Our findings show that there is room for improvement in accuracy of trial registration and publication of results, in order to diminish publication bias in otology studies.
  12. Acta Orthop Traumatol Turc. 2019 Jul 09. pii: S1017-995X(18)30148-2. [Epub ahead of print]
    Bagatur E, Yalçınkaya M.
      OBJECTIVES: The aim of this study was to determine 1) the publication rates of podium and poster presentations from the 23rd (2013) and the 24th (2014) National Turkish Orthopedics and Traumatology Congresses in peer-reviewed journals and (2) compare these rates with publication rates from the 20th congress (2007) published previously. The secondary objective was to determine the time lag to publication and compare this data with the data from the 20th congress.METHODS: All abstracts from the scientific programs of the 23rd (2013) and the 24th (2014) National Turkish Orthopedics and Traumatology Congresses were identified and computerized PubMed searches were conducted to determine whether an abstract had been followed by publication of a full-text article in peer-reviewed journals. The time lag to publication was also noted.
    RESULTS: Of the 993 presentation abstracts (302 podium and 691 poster presentations) from the 23rd congress and of the 940 presentation abstracts (310 podium and 630 poster presentations) from the 24th congress, 278 (28%) and 234 (24.9%) were followed by a full-text article in peer-reviewed journals indexed by PubMed, respectively. The rates of publication of the podium and poster presentations were 39.4% (119/302) and 23% (159/691), respectively from the 23rd and 37.7% (117/310) and 18.6% (117/630), respectively from the 24th congresses. The mean time to publication of the abstracts from the 23rd congress was 12.8 ± 18.8 (median: 13, range: -140 to 47) months and the mean time to publication of the abstracts from the 24th congress was 11.1 ± 14.42 (median: 11, range: -73 to 39) months. Fifty (50/278, 18%) abstracts from the 23rd congress (mean -11, range: [-32]-[-1], median -5 months) and 37 (37/234, 15.8%) abstracts from the 24th congress (mean -10.4, range: [-73]-[-1], median -4 months) were published as full-text articles prior to the presentation at the congress.
    CONCLUSION: The vast majority of abstracts presented at 23rd (2013) and the 24th (2014) National Turkish Orthopedics and Traumatology Congresses were not followed by publication of a full-text article in peer-reviewed journals. The publication rates of the abstracts presented at these congresses did not improve when compared with the 20th (2007) congress.
    Keywords:  Abstract; Congress; Indexed journal; Orthopedics; Presentation; Publication
  13. BMC Med Educ. 2019 Jul 09. 19(1): 255
    Luna Puerta L, Apfelbacher C, Smith H.
      BACKGROUND: In 1997 the "Wessex Research Network (WReN) Spider" was developed and validated to assess the research experience of general practice based researchers. This bibliometric study traces the use and development of this instrument over 15 years.METHODS: We performed a bibliographic search to identify all the citations of the original article since 2002.
    RESULTS: Thirty one relevant papers were found. Publications were classified according to whether they used (N = 18) or cited (N = 13) the WReN Spider. The majority of these papers came from Australia (N = 18) and 10 papers focussed on the research training of Allied Health Professionals. The WReN Spider was used in 12 studies to assess baseline experience before a training intervention or to compare before and after training scores. The WReN Spider was often (N = 9) modified to additionally assess interest, confidence or interest in up-skilling in each of its 10 limbs. It was also often (N = 14) used in tandem with open ended questions to gain a more detailed understanding of people's research skills, or with additional questions focussing on the research context, culture and team. None of the papers confirmed the validation of the WReN Spider, although it was applied in contexts that differed from the one in which it was developed.
    CONCLUSIONS: The WReN Spider continues to be used to measure the research experience of health care practitioners, but it is frequently enhanced with other questions to look at the wider issues of research success, including collaborators, resource and environment.
    Keywords:  Bibliometrics; Health care professionals; Research culture; Research experience; Research skills