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How much money do journal publishers make A lot

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Many, including me, have written about who is making money in healthcare. Sure doctors do very well, but not as well as hospitals, hospital administrators, insurance companies and their corporate officers, drug companies, device manufacturers, and others.

Another lucrative area is medical journal publication, especially if you are the publisher. A researcher gets an idea, plans and carries out a study, writes a manuscript, and submits it to a journal. The research may have been funded by the government, i.e., you and me.

An associate editor or a member of the journals editorial board looks at the manuscript, and if it is deemed worthy, it is sent out to two or more people in the same field for peer review. This process may be repeated for papers that require revision.

All of the players in the above scenario—the researchers, most of the editorial board members except maybe the editor, and the peer reviewers—are paid nothing for their work. Factor in that the cost of producing a journal has plummeted in the computer era.

How much money do journal publishers make? Here are some impressive numbers from an article that appeared on a French website called "Rue89." The figures are for the year 2011 and are in euros. They include revenue from all science publishing, not just medicine.



As you can see profit margins range from 32% to nearly 42%. Elseviers profit of over €878 million converts to just over $1 billion.

To put that into perspective, the most recent figures for Apple Inc., arguably the most successful company in the world currently, show a profit margin of 20%.

The Rue89 piece was written as an exposé about the French governments having to pay Elsevier $172 million in subscription fees to access information generated by scientists who were funded by that same government.

But the French have nothing on us.

In his presidential address to the American Surgical Association, Dr. Layton F. Rikkers, editor emeritus of the Annals of Surgery said:

Nearly $10 billion is spent annually by [US] universities and governmental agencies for access to research findings that their scientists and clinicians give to publishers for free, that their faculty peer review for the alleged honor of doing so, and that are funded by taxpayer dollars and charitable trusts. It is unclear why library budgets continue to increase above the rate of inflation when nearly all the journals they now receive are delivered electronically in large packages from the few remaining consolidated publishing houses. Examples are Wolters Kluwers Ovid and Elsevier’s Science Direct each of which contain hundreds of journal titles. Some individual journals not available within these large collections, such as Brain Research, can cost libraries more than $20,000 annually.

There are more than 9000 open access journals, and 3.5 new ones per day are setting up shop. Instead of charging for subscriptions, open access journals are free to the reader, but the authors must pay "processing costs." Many of these publications have exorbitant fees with little or no true peer review.

Before submitting any paper to an open access journal, authors should be sure they understand the fee structure and check Bealls list of predatory publishers, which has recently been updated and expanded.

Dr. Rikkers feels as I do that print journals will gradually disappear. Post-publication peer review is already gaining momentum through blogs and sites such as PubMed Commons and PubPeer. Even major journals like the BMJ have established rapid response systems for immediate feedback to authors.

The heady days of 40% profit margins may soon be over, but for now big bucks are being made.

More about journals:

How are journal articles peer-reviewed?
How journal articles are peer-reviewed: Part 2
Journals, Open Access Journals and More Journals
What you need to know about some open access journals




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That electric hand dryer study was bogus Heres why

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Just about everyone I follow on Twitter commented and/or linked to an article about a study claiming that electric hand dryers spew bacteria all over people using restrooms.

The paper, which appeared online in The Journal of Hospital Infection, said that airborne germ counts near jet air dryers were 27 times higher than counts near paper towel dispensers, and counts near warm air dryers were 4.5 times higher. The authors also coated subjects hands with black paint and measured spatter patterns on surrounding walls and persons dressed in disposable coveralls. And a photo from the study shows the dispersal pattern from a warm air dryer.

So case closed—paper towels are better, right?

Im not so sure. Instead of reading an article about the paper or just the abstract, I obtained a copy of the whole paper. I also found some comments about it from a spokesperson for a hand dryer manufacturer.

What are the flaws in the study?


From the papers Methods section: "For each test, gloved hands [not bare hands] were first coated by immersion in a suspension of lactobacilli (107 cfu/mL) that were cultured from a proprietary yoghurt." FYI, 107 cfu/mL is a lot of bacteria—certainly more than most of us would get on our hands during an average trip to the restroom. Its the equivalent of putting your hands in liquid feces, except that lactobacilli are benign bugs.

After dipping the gloved hands in bacteria, they werent washed. Stick gloved hands in bacteria, dont wash them, and then stick them in an electric dryer. No doubt there will be dispersal of bacteria around the room.

Also from the Methods section: "For [another] test, gloved hands were coated in a solution of black water-based paint." Water-based paint on gloves is not the same as water on bare hands. Have you ever seen water all over the walls next to a warm air dryer? I havent.

The study was funded by the European Tissue Symposium (ETS). Although this sounds like some kind of scientific conference, it is actually a trade organization of companies that make paper towels. The senior author of the study, Dr. M.H. Wilcox, "has received honoraria from ETS for microbiological advice and travel expenses to attend an ETS meeting." He also co-authored a consensus statement sponsored by the ETS which happened to find that paper towels are the most hygienic way to try hands.

I have always preferred paper towels. I feel that my hands can be completely dried in far less time than when I use the electric dryers. The drying process helps to reduce bacterial counts on the hands. Some studies have shown that when using electric dryers, many people do not completely dry their hands because it takes too long. See the table below.


A 2012 review of hand drying methods from the Mayo Clinic Proceedings concluded that paper towels were better than electric dryers from a hygiene standpoint, and that paper towels should be used in hospitals. [Note: One of the authors of that study had been a consultant to a paper towel manufacturer.] Thats why you dont see electric hand dryers in patient care areas of hospitals.

I also hate the noise generated by electric dryers and the faster they are, the noisier they are. You can see the decibel levels of several devices in the table above.

The paper towels vs. electric hand dryers debate has been going on for years not only about hygiene, but also about which method is better ecologically.

Although I dont believe a word of the much-tweeted European Tissue Symposium study, I still prefer paper towels.




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