Improving Online Access to Medical Information for Low-Income Countries

Abstract

of this crucial test in generalists' offices. Unfortunately, additional information is still needed to complement the assessment of spirometry. The article by Celli and colleagues in this issue of the Journal (pages 1005-1012) helps to address this need.These investigators developed a multistage scoring system that incorporates a spirometric measure of airflow together with an assessment of symptoms, body habitus, and exercise capacity. Variables that can be evaluated easily in any office setting were chosen intentionally, so that the index can be applied readily and simply. Having established the measures in a retrospective cohort, the investigators then prospectively validated the use of their "BODE index." (The B stands for body-mass index, O for the degree of airflow obstruction, D for dyspnea, and E for exercise capacity.) The acronym, with its obvious implications, was suggested by Gordon Snider, a physician-scientist with a career-long interest in COPD, precisely because it provides useful prognostic information. This index is desperately needed.Without doubt, the assessment of airflow is crucial in establishing the diagnosis of COPD and, in the opinion of many experts, can often help to guide therapy. The availability of other validated measures, particularly those that integrate multiple non-airflow-related variables, is also essential. Clinicians will be faced with increasing numbers of patients with COPD. Fortunately, we will also have increasingly effective forms of therapy. The successful development and use of these treatments will require careful assessment of patients. The BODE index promises to be an important tool in this regard.

Imagining the ‘open’ university: Sharing scholarship to improve research and education

“…A new study by Piwowar et al estimates that overall 82 28% of the academic literature is free to access online, and though that number is growing, it was only 45% 83 as of 2015 [36]. A study by the World Health Organization demonstrates the scope of the problem [37]: 84 " In the lowest-income countries, 56 percent of the institutions had no current subscriptions to international journals and 21 percent had an average of only two journal subscriptions. In the tier with the next-lowest incomes, 34 percent of institutions had no current subscriptions, and 34 percent had two to five journal subscriptions. "…”

Counterpoints about predatory open access and knowledge publishing in Africa

“…They believe that OA will provide equality of access to essential research information to all people irrespective of their development status, and also raise the significance of national research in the world's poorer regions. OA is expected to promote the integration of national research into the global knowledge pool, and reduce (if not obliterate) the imbalance in scientific information flow between developed and developing countries (Aronson, 2004;Kirsop and Chan, 2005;Kirsop et al, 2007). However, there are other scholars who argue that the movement will have gross negative social, economic, and other consequences for society and for science.…”

Accessing research literature: A mixed-method study of academics in Higher Education Institutions in Nepal

“…However lack of research literature tends to be a serious obstacle for health professionals and researchers in the developing world. According to a World Health Organization survey, of the 75 countries with an annual income per capita of less than US $1000, 56% of medical institutions have had no subscriptions to journals over the last five years 6 . Despite the enormous disease burden in Nepal, research is often viewed as expenditure rather than an investment.…”