Less work, less respect: authors' perceived importance of research contributions and their declared contributions to research articles.

BACKGROUND: Attitudes towards authorship are connected with authors' research experience and with knowledge of authorship criteria of International Committee of Medical Journal Editors (ICMJE). The objective of this study was to assess association between authors' perceived importance of contributions for authorship qualification and their participation in manuscripts submitted to a journal. METHODS: Authors (n = 1181) of 265 manuscripts submitted to the Croatian Medical Journal were asked to identify and rate their contribution in the preparation of the submitted manuscript (0-none to 4-full for 11 listed contributions) and the importance of these contributions as authorship qualifications (0-none to 4-full). They were randomly allocated into 3 groups: the first (n = 90 manuscripts, n = 404 authors) first received the contribution disclosure form and then contribution importance-rating questionnaire; the second (n = 88 manuscripts, n = 382 authors) first received the rating questionnaire and then the contribution disclosure form, and the third group (n = 87 manuscripts, n = 395 authors) received both questionnaires at the same time. We compared authors' perception of importance of contribution categories. RESULTS: 1014 (85.9%) authors of 235 manuscripts responded. Authors who declared contribution to a specific category rated it as more important for authorship than those authors who did not contribute to the same category (P>0.005 for all contribution categories, Mann-Withney test). Authors qualifying for ICMJE authorship rated all contribution categories higher than non-qualifying authors. For all contributions, associations between perceived importance of contribution and actual author's contribution were statistically significant. CONCLUSIONS: Authorship seems to be not a normative issue subjective to categorization into criteria, but also a very personal view of the importance and value of one's contributions.

Changing the structure of the hospitalized patients at the Psychiatric Clinic Vrapce.

INTRODUCTION: Psychiatric treatment in developed countries has significantly changed in the last few decades, with a significant shortening of the duration of hospitalization. Numerous West European countries are undertaking health system reforms to improve treatment efficiency. OBJECTIVE: The aim of the study was to present the structure of hospitalized patients according to diagnostic categories of International Classification of Diseases and Related Health Problems - 10th Revision (ICD-10), and average duration of hospitalization from 2001 till 2010. METHODS: Data was collected from hospital medical charts for the period from 2001 till 2010 on the number of hospitalized patients, diagnosis and duration of hospitalization. RESULTS: Number of hospitalized patients increased by 27% (6309 vs. 8032). Average duration of hospitalization decreased for 45.1% (72.3 vs. 39.7 days), while the number of hospitalized patients decreased from 1284 (20.4%) in 2001 to 995 (12.4%) in 2010, the number of patients hospitalized because of depressive disorder increased from 309 (4.9%) in 2001 to 994 (12.4%) in 2010. The number of patients hospitalized because of enduring personality changes increased from 104 (1.7%) in 2001 to 449 (5.6%) in 2010. CONCLUSION: In the last decade the number of hospitalized patients suffering from schizophrenia at the Psychiatric Clinic Vrapce decreased, while the number of those suffering from depression and enduring personality change increased. The number of hospitalizations in the observed period increased overall. Observed changes can be explained by new therapeutic approaches, but also by objective social and economic factors and organization of the healthcare system.

Can teaching research methodology influence students' attitude toward science? Cohort study and nonrandomized trial in a single medical school.

BACKGROUND: Medical teaching aims to develop attitudes and behaviors underlying professional competence of future physicians. We investigated whether a mandatory course on scientific methodology in the second study year could affect students' attitudes toward science in medicine. METHOD: In a longitudinal study, students (n = 241) enrolling in 2001-2002 academic year at a single medical school were followed up until graduation in 2006-2007. Each year, they filled out a Likert-type questionnaire of 18 statements evaluating attitude toward science. Direct influence of the course on students' attitudes was tested in a nonrandomized controlled trial with the 2006-2007 second year student cohort. RESULTS: Positive students' attitudes toward science increased during study years (mean [SD] score of the maximum score of 90): from 57.6 (6.0) in the first to 69.8 (10.4) in the sixth year. There was a significant trend of increase in attitudes with the years of study (cubic trend by polynomial contrasts analysis, P = 0.011). Attendance of a course on research methodology significantly increased positive attitudes (score, 67.0 [7.0] before and 70.8 [7.5] after course, P = 0.032 vs control group), regardless of grade point average. The intervention had an effect even when the influence of the initial attitude was accounted for (F1,140 = 9.25, P = 0.003; analysis of covariance). The attitude changes after the course was greatest in students with low initial attitude scores (Spearman rinitial score, score difference, -0.44). CONCLUSIONS: Medical students have positive attitudes toward science and scientific method in medicine. Attendance of a course on research methodology had positive short-term effect on students' attitudes toward science. This positive effect should be maintained by vertical integration of the course in the medical curriculum.

The comparison of anthropometrical parameters of the four-year-old children in the urban and rural Slavonia, Croatia, 1985 and 2005.

The aim of the study is to identify the secular trends in the anthropometrical parameters of the 4-year-old children in Slavonski Brod, Slavonia, Croatia, and the nearby rural area by comparing data of height, weight, and mid-arm circumferences from 2005 with the historical control data published in 1985. The cross-sectional study of 342 children, aged 4 years, from Slavonski Brod and the nearby villages was taken in 2005. The body height, weight, and mid-arm circumferences were measured and compared with the historical control data from the study performed in 1985 in the same area using the same methods. The data were compared according to sex and the place of residence. Results show that there were no significant differences in the body height, weight, mid-arm circumference and body mass index (BMI) between the urban and rural children in 2005. The Children in 2005 were significantly shorter (103.7 +/- 8.3 cm vs. 108.3 cm in 1985, P < 0.001, one-sample T test) and had lower weight (17.4 +/- 2.7 kg vs. 17.9 kg, P = 0.001, one-sample T test) compared with their counterparts in 1985. In 2005 there was no significant difference in the body mass index (kg/m2) between girls and boys in total (15.9 +/- 2.12, vs. 16.1 +/- 1.8, p = 0.262, Independent samples t-test). Differences between the urban and rural parameters have disappeared over the last 20 years, which could be assigned to life-style changes in the rural areas.

Quantification of authors' contributions and eligibility for authorship: randomized study in a general medical journal.

BACKGROUND: Assessment of authorship contribution is often based on unreliable questionnaires. OBJECTIVE: To assess if the use of different formats for the disclosure of authorship contributions influences authors' compliance with the criteria of the International Committee of Medical Journal Editors (ICMJE). DESIGN: Randomized study. PARTICIPANTS AND MEASUREMENTS: Eight hundred sixty-five authors of 181 manuscripts submitted to the Croatian Medical Journal from January to July 2005 were randomly allocated into 2 groups: 456 authors (94 manuscripts) received an ordinal rating form to rate their contributions to the submitted manuscript in 12 categories on a scale from 0 (none) to 4 (full), whereas 409 authors (87 manuscripts) received a binary rating form to tick the categories in which they made a contribution. RESULTS: The ordinal rating form identified twice as many authors (87.9%) as meeting the ICMJE criteria than the binary rating form (39.2%, P < .001). The group answering the ordinal rating form also had 5 times more manuscripts (71.6%) with all authors meeting the ICMJE criteria than the binary rating form group (15.5%, P < .001). The fraction of authors who reported contributions on each item on the binary rating form was similar to the fraction of authors who reported at least moderate participation to the same items on the ordinal rating form except "Final approval of the article." CONCLUSIONS: Ordinal scales for reporting authors' contributions to manuscripts were more sensitive than tick boxes for assessing the appropriateness of authorship. The exception is "Final approval of the article," which should be considered a dichotomous variable and may not be appropriate for the ICMJE definition of authorship.

Citation analysis of the Croatian Medical Journal: the first 15 years.

The Croatian Medical Journal (CMJ) is a bimonthly scientific journal, that publishes mostly original articles. It is indexed in the Index Medicus/MEDLINE, Current Contents/Clinical Medicine, and the Science Citation Index Expanded. Since the CMJ's 15th anniversary in 2007, our aim has been to assess the importance of the Journal through its impact factor (IF) and immediacy index, with a particular focus placed on the proportion of self-citations. According the Web of Knowledge database, the current official IF for the CMJ is 0.825, ranking it 62nd out of 103 journals within the Thomson Scientific category "Medicine - General and Internal." The exclusion of self-citations resulted in a small decrease in the journal's rank - to 66th place. According to the Web of Science database, the predicted CMJ IF in 2007 is between 1.024 and 1.125, showing a clear increase. The immediacy index of the CMJ is continuously low, with a high contribution of self-citations, implying that articles published in the CMJ require more time to be cited, and that their topics are of particular interest to the journal's readers and contributors. Self-citations contributed significantly to the IF in the first few years after the journal was established. The proportion of independent citations progressively increased, and of all the citations included in the IF in 2007, almost 70% were fully independent. Some of these citations were from articles published in journals with IF higher than 5. Taken together, our data suggest that the CMJ has significantly improved its citation ratings during the last 15 years, confirming that a quality-oriented editorial policy in a small peripheral journal may result in a truly increased international visibility.

Perceptions of authorship criteria: effects of student instruction and scientific experience.

OBJECTIVE: To analyse medical students', graduate students' and doctors' and medical teachers' perceptions of research contributions as criteria for authorship in relation to the authorship criteria defined by the International Committee of Medical Journal Editors (ICMJE). DESIGN: Medical students with (n = 152) or without (n = 85) prior instruction on ICMJE criteria, graduate students/doctors (n = 125) and medical teachers (n = 112) rated the importance of 11 contributions as authorship qualifications. They also reported single contributions eligible for authorship, as well as acceptable combinations of two or three qualifying contributions. RESULTS: Conception and design, Analysis and interpretation and Drafting of article formed the most important cluster in all four groups. Students without prior instruction rated Critical revision and Final approval lower than the other three groups. "Final approval" was a part of the least important cluster in all groups except among students with instruction. CONCLUSIONS: Conception and design, Analysis and interpretation and Drafting of article were recognised as the most important of the ICMJE criteria by all participants. They can be considered independent of previous instruction or experience. Final approval and Critical revision should be actively taught as important authorship criteria to future scientists.

Survey of attitudes towards curriculum reforms among medical teachers in different socio-economic and cultural environments.

BACKGROUND: Curriculum reforms in medical schools require cultural and conceptual changes from the faculty. AIMS AND METHODS: We assessed attitudes towards curriculum reforms in different academic, economic, and social environments among 776 teachers from 2 Western European medical schools (Belgium and Denmark) and 7 medical schools in 3 countries in post-communist transition (Croatia, Slovenia, Bosnia and Herzegovina). The survey included a 5-point Likert-type scale on attitudes towards reforms in general and towards reforms of medical curriculum (10 items each). RESULTS: Teaching staff from medical schools in Bosnia and Herzegovina had a more positive attitude towards reforms of medical curriculum (mean score 36.8 out of maximum 50 [95% CI 36.1 to 37.3]) than those from medical schools in Croatia or Slovenia (30.7 [29.8 to 31.6]) or Western Europe (27.7 [27.1 to 28.3]) (P < 0.001, ANOVA). Significant predictors of positive attitudes towards medical curriculum reform in post-communist transition countries, but not in Western European schools, was younger age, as well as female gender in Bosnia and Herzegovina. CONCLUSIONS: Factors influencing faculty attitudes may not be easy to identify and may be specific for different settings. Their identification and management is necessary for producing sustainable curriculum reform.

Survive, help, learn: experience of a medical journal in war and post-war times.

Medical journals and their editors have a unique responsibility in armed conflicts. The experience of the Croatian Medical Journal during and after the 1991-1995 war in Croatia shows how a medical journal can survive, help others and learn in times of war. The first duty of a medical journal in such circumstances is to publish scientific articles on various aspects of war medicine, and to document cases of human rights abuses. In small scientific communities, editors can offer their expertise and assist authors in writing and publishing war-related research and reports. In post-conflict period, medical journals have a responsibility to participate in peace-building and reconciliation efforts. They can do so by publishing good scientific articles regardless of their place or country of origin, re-establishing contacts with colleagues from the opposing sides, striving for the multiethnic or multinational Editorial and Advisory Boards, and engaging in collaborative research and regional initiatives.