Letters from 'Karen Crawford' V1.0, 25 Jan 2001++

I have been on the net since long before it was the web. I started in December of 1983, and except for a two year hiatus when Syracuse took relay down, have been on it throughout my adult life. A great deal of my social life and friendships take place over the net, and most of the time I don’t really need the face to face contact. Yes, the net is for me a pretty good replacement for face to face social interaction. I have been on many groups; I was on ND to discuss net life when I first joined Cybermind. Cybermind sometimes discussed net life as well. Sometimes it was frivolous but it felt open, flexible, and lively. ND, at that time felt neither important nor lively to me. If you talk of life out there on ND, you get ignored or told to play in the traffic. It got so bad I finally walked, but came back later

Family food environment and dietary behaviors likely to promote fatness in 5-6 year-old children

Background: The family food environment (FFE) is likely to exert important influences on young children\u27s eating. Examination of multiple aspects of the FFE may provide useful insights regarding which of these might most effectively be targeted to prevent childhood obesity. Objective: To assess the associations between the FFE and a range of obesity-promoting dietary behaviors in 5&ndash;6-year-old children. Design: Cross-sectional study. Subjects: Five hundred and sixty families sampled from three socio-economically distinct areas. Measurements: Predictors included parental perceptions of their child\u27s diet, food availability, child feeding practices, parental modeling of eating and food preparation and television (TV) exposure. Dietary outcomes included energy intake, vegetable, sweet snack, savory snack and high-energy (non-dairy) fluid consumption. Results: Multiple linear regression analyses, adjusted for all other predictor variables and maternal education, showed that several aspects of the FFE were associated with dietary outcomes likely to promote fatness in 5&ndash;6-year-old children. For example, increased TV viewing time was associated with increased index of energy intake, increased sweet snack and high-energy drink consumption, and deceased vegetable intake. In addition, parent\u27s increased confidence in the adequacy of their child\u27s diet was associated with increased consumption of sweet and savory snacks and decreased vegetable consumption.&nbsp; Conclusion:&nbsp; This study substantially extends previous research in the area, providing important insights with which to guide family-based obesity prevention strategies.<br /

Multiplying by Division: Mapping the Collection at University of North Texas Libraries

The University of North Texas (UNT) Libraries has developed a unique collection assessment tool, the Collection Map, to provide support for a new access‐based collection development philosophy. UNT Librarians realized the limitations of traditional assessment methods to gauge the impact of emerging acquisitions models such as demand‐driven acquisitions (DDA) and large interdisciplinary e‐book collections. What was needed was a flexible, nimble assessment system to track access, holdings, and interlibrary loan (ILL) activity for each academic discipline. The Collection Map is a database that links items, and their associated data, to any one of several dozen overlapping subcollections via Library of Congress call numbers (LCCNs). The Collection Map’s unique many‐to‐many relationship of subcollections to items and data enables librarians to demonstrate support for subject areas and to make more informed collecting decisions. This article describes the components and creation of the Collection Map, including manipulation of existing systems to extract data

Working with Natural Helpers: a Handbook for Social Workers

The practicum consists of a study of methods of identifying and working with natural caregivers, based on previous descriptions in the literature of natural caregivers and their networks, presented in handbook format, and addressed to social service delivery people. Most of the natural helping literature describes natural helpers and natural helping networks, Little is available about the worker - helper relationship itself, about how to find natural helpers, and about how to develop and maintain relationships with them. It is this relationship between the worker and the natural helper that we studied and about which we have written

Keeping it Real: A Comprehensive and Transparent Evaluation of Electronic Resources

There will be a time when your library will need to evaluate all of your electronic resources. How would you do it? In response to a cut to our materials budget, we have developed a method that condenses a large amount of information into a few select criteria. In this day‐long workshop, we walked through the process using the Decision Grid process developed at the University of Maryland at College Park (Foudy and McManus, p. 533‐538) as a starting point. The workshop leaders first demonstrated each step of our process, and then the participants worked in small groups (5‐7) using their own experiences and a sample data set of their own. The steps covered included selecting and defining the criteria, gathering and analyzing the data, and determining how to make final decisions. We covered some technical aspects of gathering and analyzing data, including using Excel functions. We also included discussions about the criteria and ways of eliciting honest and useful feedback from librarians and patrons. The participants received a flash drive with Excel templates that included formulas, as well as completed sheets with sample data, and the presentation files

D-dimer test for excluding the diagnosis of pulmonary embolism

Background Pulmonary embolism (PE) can occur when a thrombus (blood clot) travels through the veins and lodges in the arteries of the lungs, producing an obstruction. People who are thought to be at risk include those with cancer, people who have had a recent surgical procedure or have experienced long periods of immobilisation and women who are pregnant. The clinical presentation can vary, but unexplained respiratory symptoms such as difficulty breathing, chest pain and an increased respiratory rate are common. D‐dimers are fragments of protein released into the circulation when a blood clot breaks down as a result of normal body processes or with use of prescribed fibrinolytic medication. The D‐dimer test is a laboratory assay currently used to rule out the presence of high D‐dimer plasma levels and, by association, venous thromboembolism (VTE). D‐dimer tests are rapid, simple and inexpensive and can prevent the high costs associated with expensive diagnostic tests. Objectives To investigate the ability of the D‐dimer test to rule out a diagnosis of acute PE in patients treated in hospital outpatient and accident and emergency (A&E) settings who have had a pre‐test probability (PTP) of PE determined according to a clinical prediction rule (CPR), by estimating the accuracy of the test according to estimates of sensitivity and specificity. The review focuses on those patients who are not already established on anticoagulation at the time of study recruitment. Search methods We searched 13 databases from conception until December 2013. We cross‐checked the reference lists of relevant studies. Selection criteria Two review authors independently applied exclusion criteria to full papers and resolved disagreements by discussion. We included cross‐sectional studies of D‐dimer in which ventilation/perfusion (V/Q) scintigraphy, computerised tomography pulmonary angiography (CTPA), selective pulmonary angiography and magnetic resonance pulmonary angiography (MRPA) were used as the reference standard. • Participants: Adults who were managed in hospital outpatient and A&E settings and were suspected of acute PE were eligible for inclusion in the review if they had received a pre‐test probability score based on a CPR. • Index tests: quantitative, semi quantitative and qualitative D‐dimer tests. • Target condition: acute symptomatic PE. • Reference standards: We included studies that used pulmonary angiography, V/Q scintigraphy, CTPA and MRPA as reference standard tests. Data collection and analysis Two review authors independently extracted data and assessed quality using Quality Assessment of Diagnostic Accuracy Studies‐2 (QUADAS‐2). We resolved disagreements by discussion. Review authors extracted patient‐level data when available to populate 2 × 2 contingency tables (true‐positives (TPs), true‐negatives (TNs), false‐positives (FPs) and false‐negatives (FNs)). Main results We included four studies in the review (n = 1585 patients). None of the studies were at high risk of bias in any of the QUADAS‐2 domains, but some uncertainty surrounded the validity of studies in some domains for which the risk of bias was uncertain. D‐dimer assays demonstrated high sensitivity in all four studies, but with high levels of false‐positive results, especially among those over the age of 65 years. Estimates of sensitivity ranged from 80% to 100%, and estimates of specificity from 23% to 63%. Authors' conclusions A negative D‐dimer test is valuable in ruling out PE in patients who present to the A&E setting with a low PTP. Evidence from one study suggests that this test may have less utility in older populations, but no empirical evidence was available to support an increase in the diagnostic threshold of interpretation of D‐dimer results for those over the age of 65 years.Publisher PDFPeer reviewe

Ankle brachial index for the diagnosis of lower limb peripheral arterial disease

Background Peripheral arterial disease (PAD) of the lower limb is common, with prevalence of both symptomatic and asymptomatic disease estimated at 13% in the over 50 age group. Symptomatic PAD affects about 5% of individuals in Western populations between the ages of 55 and 74 years. The most common initial symptom of PAD is muscle pain on exercise that is relieved by rest and is attributed to reduced lower limb blood flow due to atherosclerotic disease (intermittent claudication). The ankle brachial index (ABI) is widely used by a variety of healthcare professionals, including specialist nurses, physicians, surgeons and podiatrists working in primary and secondary care settings, to assess signs and symptoms of PAD. As the ABI test is non‐invasive and inexpensive and is in widespread clinical use, a systematic review of its diagnostic accuracy in people presenting with leg pain suggestive of PAD is highly relevant to routine clinical practice. Objectives To estimate the diagnostic accuracy of the ankle brachial index (ABI) ‐ also known as the ankle brachial pressure index (ABPI) ‐ for the diagnosis of peripheral arterial disease in people who experience leg pain on walking that is alleviated by rest. Search methods We carried out searches of the following databases in August 2013: MEDLINE (Ovid SP),Embase (Ovid SP), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCO), Latin American and Caribbean Health Sciences (LILACS) (Bireme), Database of Abstracts of Reviews of Effects and the Health Technology Assessment Database in The Cochrane Library, the Institute for Scientific Information (ISI) Conference Proceedings Citation Index ‐ Science, the British Library Zetoc Conference search and Medion. Selection criteria We included cross‐sectional studies of ABI in which duplex ultrasonography or angiography was used as the reference standard. We also included cross‐sectional or diagnostic test accuracy (DTA) cohort studies consisting of both prospective and retrospective studies.Participants were adults presenting with leg pain on walking that was relieved by rest, who were tested in primary care settings or secondary care settings (hospital outpatients only) and who did not have signs or symptoms of critical limb ischaemia (rest pain, ischaemic ulcers or gangrene).The index test was ABI, also called the ankle brachial pressure index (ABPI) or the Ankle Arm Index (AAI), which was performed with a hand‐held doppler or oscillometry device to detect ankle vessels. We included data collected via sphygmomanometers (both manual and aneroid) and digital equipment. Data collection and analysis Two review authors independently replicated data extraction by using a standard form, which included an assessment of study quality, and resolved disagreements by discussion. Two review authors extracted participant‐level data when available to populate 2×2 contingency tables (true positives, true negatives, false positives and false negatives).After a pilot phase involving two review authors working independently, we used the methodological quality assessment tool the Quality Assessment of Diagnostic Accuracy Studies‐2 (QUADAS‐2), which incorporated our review question ‐ along with a flow diagram to aid reviewers' understanding of the conduct of the study when necessary and an assessment of risk of bias and applicability judgements. Main results We screened 17,055 records identified through searches of databases. We obtained 746 full‐text articles and assessed them for relevance. We scrutinised 49 studies to establish their eligibility for inclusion in the review and excluded 48, primarily because participants were not patients presenting solely with exertional leg pain, investigators used no reference standard or investigators used neither angiography nor duplex ultrasonography as the reference standard. We excluded most studies for more than one reason.Only one study met the eligibility criteria and provided limb‐level accuracy data from just 85 participants (158 legs). This prospective study compared the manual doppler method of obtaining an ABI (performed by untrained personnel) with the automated oscillometric method. Limb‐level data, as reported by the study, indicated that the accuracy of the ABI in detecting significant arterial disease on angiography is superior when stenosis is present in the femoropopliteal vessels, with sensitivity of 97% (95% confidence interval (CI) 93% to 99%) and specificity of 89% (95% CI 67% to 95%) for oscillometric ABI, and sensitivity of 95% (95% CI 89% to 97%) and specificity of 56% (95% CI 33% to 70%) for doppler ABI. The ABI threshold was not reported. Investigators attributed the lower specificity for doppler to the fact that a tibial or dorsalis pedis pulse could not be detected by doppler in 12 of 27 legs with normal vessels or non‐significant lesions. The superiority of the oscillometric (automated) method for obtaining an ABI reading over the manual method with a doppler probe used by inexperienced operators may be a clinically important finding. Authors' conclusions Evidence about the accuracy of the ankle brachial index for the diagnosis of PAD in people with leg pain on exercise that is alleviated by rest is sparse. The single study included in our review provided only limb‐level data from a few participants. Well‐designed cross‐sectional studies are required to evaluate the accuracy of ABI in patients presenting with early symptoms of peripheral arterial disease in all healthcare settings. Another systematic review of existing studies assessing the use of ABI in alternative patient groups, including asymptomatic, high‐risk patients, is required.Publisher PDFPeer reviewe

Practical management of heterogeneous neuroimaging metadata by global neuroimaging data repositories

Rapidly evolving neuroimaging techniques are producing unprecedented quantities of digital data at the same time that many research studies are evolving into global, multi-disciplinary collaborations between geographically distributed scientists. While networked computers have made it almost trivial to transmit data across long distances, collecting and analyzing this data requires extensive metadata if the data is to be maximally shared. Though it is typically straightforward to encode text and numerical values into files and send content between different locations, it is often difficult to attach context and implicit assumptions to the content. As the number of and geographic separation between data contributors grows to national and global scales, the heterogeneity of the collected metadata increases and conformance to a single standardization becomes implausible. Neuroimaging data repositories must then not only accumulate data but must also consolidate disparate metadata into an integrated view. In this article, using specific examples from our experiences, we demonstrate how standardization alone cannot achieve full integration of neuroimaging data from multiple heterogeneous sources and why a fundamental change in the architecture of neuroimaging data repositories is needed instead

Are parental concerns for child TV viewing associated with child TV viewing and the home sedentary environment?

BackgroundTime spent watching television affects multiple aspects of child and adolescent health. Although a diverse range of factors have been found to be associated with young people\u27s television viewing, parents and the home environment are particularly influential. However, little is known about whether parents, particularly those who are concerned about their child\u27s television viewing habits, translate their concern into action by providing supportive home environments (e.g. rules restricting screen-time behaviours, limited access to screen-based media). The aim of this study was to examine associations between parental concerns for child television viewing and child television viewing and the home sedentary environment.MethodsParents of children aged 5-6 years (\u27younger\u27 children, n = 430) and 10-12 years (\u27older children\u27, n = 640) reported usual duration of their child\u27s television (TV) viewing, their concerns regarding the amount of time their child spends watching TV, and on aspects of the home environment. Regression analyses examined associations between parental concern and child TV viewing, and between parental concern and aspects of the home environment. Analyses were stratified by age group.ResultsChildren of concerned parents watched more TV than those whose parents were not concerned (B = 9.63, 95% CI = 1.58-17.68, p = 0.02 and B = 15.82, 95% CI = 8.85-22.80, p &lt; 0.01, for younger and older children respectively). Parental concern was positively associated with younger children eating dinner in front of the television, and with parental restriction of sedentary behaviours and offering sedentary activities (i.e. TV viewing or computer use) as a reward for good behaviour among older and young children. Furthermore, parents of older children who were concerned had fewer televisions in the home and a lower count of sedentary equipment in the home.ConclusionsChildren of concerned parents watched more TV than those whose parents who were not concerned. Parents appear to recognise excessive television viewing in their children and these parents appear to engage in conflicting parental approaches despite these concerns. Interventions targeting concerned parents may be an innovative way of reaching children most in need of strategies to reduce their television viewing and harnessing this parental concern may offer considerable opportunity to change the family and home environment.<br /