Background: It has been well established that research is not addressing health needs in a balanced waymuch more research is conducted on diseases with more burden in high-income countries than on those with more burden in lower-income countries. In this study, we explore whether these imbalances persist and inquire about the possible influence of three factors, namely geography, industry and publication incentives. Methods: We use WHO data on the Global Burden of Disease as a proxy measure of health needs and bibliometric information as a proxy for research efforts. Scientific publications on diseases were collected from MEDLINE using MeSH terms to identify relevant publications. We used Web of Science to collect author affiliations and citation data. We developed a correspondence table between WHO ICD-10 and MeSH descriptors to compare global health needs and research efforts. This correspondence table is available as supplementary material. Results: Research output is heavily concentrated in high-income countries and is mainly focused on their health needs, resulting in a relative lack of attention to diseases in lower income countries. A new finding is that diseases with a similar burden in high-and middle-income countries are also under-researched, both globally and in relation to disease burden in high-and middle-income countries. Global industrial R&D is found to be very similar to the focus of public research. Diseases more prevalent in high-income countries generate tenfold more research attention than those in low-income countries. We find no discernible preference towards diseases of high-income countries versus those of low-income countries in the top 25% most prestigious journals. However, in middle-income countries, citation rates are substantially lower for diseases most prevalent in low-and middle-income countries. Conclusions: From a global perspective, the imbalance between research needs and research efforts persists as most of the research effort concentrates on diseases affecting high-income countries. Both pharmaceutical companies and the public sector also tend to focus on diseases with more burden in high-income countries. Our findings indicate that researchers in middle-income countries receive more citations when researching diseases more prevalent in high-income countries, and this may divert the attention of researchers in these countries from diseases more prevalent in their contexts.

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The range of theoretical frameworks currently being used by researchers into information behaviour is abundant and diverse. We need to examine thoroughly the contribution of theories and models to further research, as this would help to improve future investigations in the field. This paper adopts this approach, by thoroughly examining the influence that Elfreda Chatman's three middle-range theories have had on subsequent research. A citation context analysis was carried out on the basis of those received by Information poverty theory, Life in the round theory and Normative behaviour theory. Analysis covered the year of publication, the type of work and the subject-matter of the citing documents. The cites in context or theoretical incidents were analysed for frequency of citation in citing documents, the content of Chatman's work being cited, the context co-citation analysis, the citation style and the citation location. The analysis of citation in context has allowed us to draw a distinction between the author and her work, while verifying that not all cites are the same. These differences reflect the unequal relevance of these theories to subsequent research.

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ABSTRACT. Open access (OA)