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Summary of: An investigation of antibiotic prophylaxis in implant practice in the UK

Background There is increasing evidence of the inappropriate use of antimicrobials in dentistry and this may contribute to the problem of antimicrobial resistance. The research to date with regard to efficacy of antimicrobial prophylaxis in reducing failure of integration and postoperative complications when placing dental implants remains equivocal. The aim of this study was to investigate how dentists in the UK use antimicrobials prophylactically in implant practice. Method An e-mail link was provided in 2011 to an anonymous online (Smart-Survey) questionnaire using three databases of dentists who, by being on them, had registered an interest in placing dental implants. Absolute frequencies were used to describe the study sample demographics and examine the distribution of responses for all the variables investigated. Results One hundred and nine completed questionnaires were received. Seventy-two percent (n = 76) routinely prescribed prophylactic antibiotics for all procedures. There was a wide variation in the pre-operative and postoperative prescription regimens with the majority (84%) stating that it was to prevent infection at the site of surgery or to reduce a bacteraemia. Conclusions Although this was a small study with a low response rate, wide variations in antibiotic prescribing regimens with respect to drug, dose and duration were found. Further research is needed and guidelines developed to prevent antibiotic overprescribing and misuse.

AVIA: an interactive web-server for annotation, visualization and impact analysis of genomic variations

Motivation: The plethora of information that emerges from largescale genome characterization studies has triggered the development of computational frameworks and tools for efficient analysis, interpretation and visualization of genomic data. Functional annotation of genomic variations and the ability to visualize the data in the context of whole genome and/or multiple genomes has remained a challenging task. We have developed an interactive web-based tool, AVIA (Annotation, Visualization and Impact Analysis), to explore and interpret large sets of genomic variations (single nucleotide variations and insertion/deletions) and to help guide and summarize genomic experiments. The annotation, summary plots and tables are packaged and can be downloaded by the user from the email link provided. Availability and implementation: http://avia.abcc.ncifcrf.gov. Contact: vuonghm@mail.nih.gov Supplementary information: Supplementary data are available at Bioinformatics online.

Nutrition education and counselling practices in mother and child health clinics: study amongst nurses

To investigate current nutrition counselling practices, knowledge of nutrition and the need for nutrition education by nurses in mother and child health clinics. Nutrition counselling of young families offers a tangible means to implement preventive measures for lifestyle-related chronic diseases. Nurses in health clinics are at prime position to execute this preventive work, which demands knowledge of current nutrition research as well as skill in counselling. Knowledge is limited regarding the current nutrition counselling practices of nurses and their needs in improving counselling. Descriptive questionnaire survey. A questionnaire was formulated and sent to nurses in mother and child health clinics (n=650) nationwide via e-mail links using a computerised program. Non-respondents were re-contacted twice, the final response rate being 50% (n=327). Nurses considered nutrition counselling an important but challenging task in the clinics. In addition to promotion of health, they had counselled clients in the management of various disorders ranging from constipation to coeliac disease. Variability was noted in the extent to which nurses had adopted nutrition guidelines. As means to improve counselling, better collaboration with both families and healthcare professionals and an increase in resources, including time available for counselling, up-to-date educational material and clinical guidelines, as well as increased education in nutrition were suggested. The results demonstrated a need and a readiness amongst nurses to develop nutrition counselling in health clinics. Given the health benefits presumably deriving from nutrition counselling, investments in operational counselling, comprising advancement of both knowledge and skills in the health clinics, are clearly warranted. RELEVANCE TO CLINICAL PRACTICES: The findings provide important insights into the current clinical practice in health clinics and can be exploited in designing nutrition counselling and in-service training.

Global Health Competencies for Nurses in the Americas

This article reports the findings from an online survey of nursing faculty from the United States, Canada, Latin America, and Caribbean countries to identify their perceptions about global health competencies for undergraduate nursing students. A list of global health competencies for medical students developed by the Association of Faculties of Medicine of Canada Resource Group on Global Health and the Global Health Education Consortium was adapted for nurses and translated from English to Spanish and Portuguese. The competencies were divided into six subscales, and respondents rated each competency on a 4-point Likert scale, with high scores reflecting strong agreement that the competency was essential for undergraduate nursing students. E-mail invitations and links to the online survey were distributed using a nonprobability convenience sampling strategy. This article reports findings only from the respondents to the English and Spanish surveys. The final sample included 542 responses to the English survey and 51 responses to the Spanish survey. Cronbach's alpha reliability coefficients for the subscales ranged from .78 to .96. The mean values for all 6 subscales and for each of the 30 items were greater than 3.0 for the respondents to the Spanish survey, and the mean values for 27 of the items were greater than 3.0 for the respondents to the English survey. These findings suggest that respondents perceived the competencies as essential global health competencies for undergraduate nursing students in the Americas. Narrative comments written by respondents indicate additional competencies and specific concerns about adding additional content to an already full curricula. Results of this study can be used to guide faculty deliberations about global health competencies that should be incorporated in the nursing curricula.

Teaching Competitive Racing Starts: Practices and Opinions of Professional Swim Coaches

The purpose of this study was to gain a better understanding of coaches’ perceptions regarding the most important elements of the competitive swim start and the progressions coaches use to teach the skill to novice swimmers. A survey was developed specifically for this project and administered via an email link sent to all registered USA Swimming coaches. The final survey elicited 471 responses. When coaches were asked if a progression was used when teaching starts, 4.6% reported using a written checklist, 89.8 % a mental one, and 5.5% none at all. Of those that used a progression to teach racing starts, 78.3% used a personally designed progression while the remaining 21.7% used information provided by a professional organization. The information obtained from the survey suggests that teaching the racing start is an informal process. The lack of use of an authoritative resource utilized in teaching racing starts to novice swimmers warrants further investigation with regard to the safety of this complex skill.

Do teachers believe they are competent to promote healthy ICT use among their students?

Information and communication technologies (ICT), including computers, are becoming commonplace tools for learning by school children in Australia and around the world. Teachers are responsible for integrating ICT into the school learning environment; however, they may not recognize how and when ICT use may compromise their students' physical health. Children's exposure to physical harm through the unhealthy use of ICT may have liability implications for the education sector. To determine (i) whether teachers consider it their responsibility to promote healthy ICT use among their students; (ii) teachers' self-perceived competence to do so; and (iii) what teachers perceive are the barriers and enablers to promoting healthy ICT use among their students. An online survey was developed for the study. All Catholic Education school principals in Western Australia (n=157) were sent an email link to the survey for distribution to teachers at their respective schools. Over the three week survey period, 95 teachers completed the survey. Descriptive and inferential statistics were used to analyze the data and summarize participants' responses. Fifty-five percent of teachers agreed they were concerned about their students' physical health when using ICT. Only 19% of teachers reported they frequently or always provided their students with information on how to use computers in their class in a way, so as to promote physical health. Teachers identified barriers to promoting healthy computing use among students including; insufficient time (47%), non-adjustable furniture (46%), and insufficient knowledge (41%). Male teachers reported more confidence in their ability to promote healthy ICT use among students than female teachers. Just over half of the teachers in this study were concerned for the physical health of their students when using ICT in the classroom. Respondents identified barriers that limit their ability to promote healthy practices to their students. Designing and implementing school-based computer ergonomics education programmes may assist teachers fulfil their duty of care in regard to the physical health and well-being of their students.

American Physical Therapy Association-Credentialed Clinical Instructors: A Survey Regarding Source of Motivation for Pursuing Credentialing

Background and Purpose. The American Physical Therapy Association (APTA) promotes clinical education credentialing for clinical instructors (CIs) through the Clinical Instructor Education and Credentialing Program (CIECP). APTA reports that since the program's inception, 34,657 CIs have received Basic CIECP credentialing status, which represents less than half of APTA's membership, and an unknown percentage of non-APTA members. To date, it is not known what motivates CIs to pursue credentialing, or if the motivation is more intrinsically or extrinsically driven. The purpose of this study was to determine the source of the motivational factors for physical therapist CIs who have pursued credentialing by APTA. Subjects. The subjects included 2,209 APTA-credentialed physical therapist CIs distributed throughout the United States. Methods. A pilot form of the survey was used to gain feedback from local credentialed CIs to establish face and content validity. Credentialed CIs were sent an email link to a 3-section survey. The first section consisted of demographic questions, while the second section consisted of 7-point Likert scale questions pertaining to intrinsic versus extrinsic motivation for becoming credentialed. Finally, the last section was forced choice questions also pertaining to motivational factors. Repeated measures ANOVAs were used to compare all responses in section 2 between the intrinsic and extrinsic oriented questions, with paired t tests to determine specific question response differences. Results. Analysis revealed significant differences favoring intrinsic motivation. The 2 most significant intrinsic factors included contribution to the education of student physical therapists (SPTs) and professional development. Within the open-ended section of the survey more than 50% of the respondents reported intrinsic motivational reasons for becoming APTA Basic CIECP CIs. Discussion and Conclusion. Results from both the close-ended and forcedchoice questions demonstrate that the driving forces behind a CI obtaining APTA credentialing are intrinsic. The primary intrinsic motivators were professional development and personal satisfaction of helping educate students.

Current joint therapy usage in equine practice: A survey of veterinarians 2009

Medications are frequently employed to treat intra-articular (IA) problems in the performance horse. Actual usage of the different IA medications in horses is not available. To determine the most common usage of these medications, members of the American Association of Equine Practitioners (AAEP) were surveyed. An email link to an online survey was electronically sent to 6305 AAEP members and the responses tabulated and analysed with a logistic regression model. A total of 831 survey responses were submitted and tabulated. Eighty per cent of the respondents indicated that they see 100% equine cases in their practice. The majority of respondents (77%) use triamcinolone acetonide (TA) to treat high motion joints and 73% use methylprednisolone acetate (MPA) to treat low motion joints. Veterinarians treating the Western performance and Sport horse were significantly more likely to use TA in high motion joints compared to MPA (P = 0.0201 and P<0.0001, respectively). Triamcinolone acetonide use compared to MPA in high motion joints by racehorse veterinarians was significantly lower compared to other veterinarians (P<0.0001). Polysulphated glycosaminoglycan (Adequan) and hyaluronate sodium (Legend) were the most commonly used disease modifying products (63 and 57% of respondents, respectively). Sport horse practitioners were significantly more likely than race or show horse veterinarians to utilise IRAP products (P = 0.0035 and P = 0.04, respectively). Respondents who had been in practice for more than 10 years were significantly less likely to use antimicrobials in their joint injections compared to those in practice for less than 10 years (P<0.0001). Significant differences existed in usage of medications related to primary discipline treated and years practicing. The results of this study aid in defining the current usage of different joint therapy medications within equine practice. This knowledge can guide further research as well as education.

Staying Up to Date

You have accessThe ASHA LeaderInbox1 Jun 2011Staying Up to Date Valerie Inwald Valerie Inwald Google Scholar More articles by this author https://doi.org/10.1044/leader.IN1.16062011.2 SectionsAbout ToolsAdd to favorites ShareFacebookTwitterLinked In http://www.asha.org/Publications/leader/2011/110517/Readers-Respond--May-17,-2011.htm In the April 5 issue, one reader expressed concern over whether or not the field’s scholarly journals are offered in print, stating, “I no longer read the journals because I feel that I need to have several hours to look up the information, find it, and then print it.” The editor clarified that these journals are offered in print; however, I found a deeper issue with the submitter’s statement. I encourage SLPs to provide ASHA with an updated e-mail address and check their accounts regularly, as ASHA sends e-mail links to newly published articles monthly. Part of staying up to date in our practice (and thus providing the most competent services possible) necessarily involves proficient use of the basic technology supporting our field. Public schools and hospitals alike are pushing toward paperless documentation because it increases productivity and supports the environment. Although I do not refute one’s choice of journal format, I do not believe that staying informed on the research in our field is a choice. It is within our Code of Ethics that we utilize every resource possible to ensure we are providing high-quality services. SLPs have a responsibility toward the field and the individuals we serve to provide evidence-based care, and that evidence is constantly evolving. If an ASHA member has access to a computer, s/he has access to journals, and is accountable for staying informed. We must remember that these journals are more than just pleasure reading for our “spare time.” These journals are the foundation for the skilled services we are able to provide. Valerie InwaldChicago, Illinois Advertising Disclaimer | Advertise With Us Advertising Disclaimer | Advertise With Us Additional Resources FiguresSourcesRelatedDetails Volume 16Issue 6June 2011 Get Permissions Add to your Mendeley library History Published in print: Jun 1, 2011 Metrics Downloaded 86 times Topicsasha-topicsleader_do_tagleader-topicsasha-article-typesCopyright & Permissions© 2011 American Speech-Language-Hearing AssociationLoading ...

Prophylactic antibiotic trends in transsphenoidal surgery for pituitary lesions

Pituitary surgery involves operating in the nasal cavity, which is considered a clean-contaminated wound. In the absence of evidence-based guidelines for preventing surgical site infections in trans-sphenoidal surgery, a survey of current opinion on prophylactic antibiotics might help elucidate the current acceptable practices and identify opportunities for prospective clinical trials that could lead to the development of practice guidelines. An on-line, 10-question, multiple-choice survey was distributed by e-mail link to the membership of the International Society of Pituitary Surgeons. Sixty-nine members responded to the survey. Ninety-one percent indicated that there was no strong evidence supporting antibiotic use, but 81% used them to be safe. Ninety percent of respondents used intravenous prophylactic antibiotics, while only 16% used intranasal antibiotics. The most commonly used antibiotics were cephalosporins (72%) and penicillins (21%). Seventy-six percent used antibiotics for 24 h or less after surgery. The most commonly reported indications for prophylactic antibiotics were prevention of meningitis and sinusitis. The results of the survey describe current acceptable practices for chemoprophylaxis in patients undergoing transsphenoidal pituitary surgery.

Feasibility of Internet-Based Health-Related Quality of Life Data Collection in a Large Patient Cohort

BackgroundPatient registries are commonly used to track survival and medical outcomes in large cohorts. However, large-scale collection of health-related quality of life (HRQOL) data is more challenging because such data must be collected directly from patients. Internet-based HRQOL questionnaires are a potential solution, allowing home data collection with immediate storage in a central database.ObjectivesOur objectives were to investigate the sociodemographic predictors of Internet use and willingness to convey HRQOL information over the Internet in a Canadian tertiary care patient population and to determine whether Internet use patterns of tertiary care patients differ from those of the general Canadian population. Additionally, we sought to identify the success of home completion of Internet-based HRQOL questionnaires, as well as factors hindering home completion.MethodsWe surveyed 644 patients at the Toronto General and St. Michael’s Hospitals from November 2003 through July 2006 within a prospective, longitudinal cohort study of HRQOL in patients with lung disease or lung transplants. Using multiple logistic regression, we assessed patient age, gender, rurality, marital status, and employment or education status as potential sociodemographic predictors of having an Internet-accessible home computer, using email at least weekly, and willingness to complete a quality of life questionnaire over the Internet. Patients electing to complete questionnaires over the Internet were followed from September 2005 through March 2008 to assess completion of HRQOL questionnaires from home, identify barriers for noncompletion, and determine sociodemographic predictors for home completion.ResultsOf the 644 patients, the median age was 51 years, with a similar number of males and females. Most were urban Ontario residents, were unemployed, and were married or in a common-law relationship. Having an Internet-accessible home computer was reported by 79.7% (513/644) of patients and use of email at least weekly by 66.5% (414/623) of patients. A majority of patients (57.1% 368/644) were willing to complete HRQOL questionnaires over the Internet via an emailed link. Of the participating 644 patients, 368 elected to complete future questionnaires from home and, as part of a gradual roll-out of the home HRQOL questionnaire, 211 were sent emails inviting them to do so. Of the invited patients, 78% (165/211) completed at least one questionnaire from home. The most common reason for noncompletion was a lack of or an inability to find time to complete the questionnaire. No statistically significant sociodemographic predictors of Internet use were associated with completion or noncompletion of questionnaires from home.ConclusionsHome, Internet-based HRQOL assessment is feasible in tertiary care patient populations with a high predicted rate of Internet usage based on sociodemographic parameters. A large minority of patients were unwilling or unable to take part in home HRQOL assessments indicating that alternative methods of data collection are still required. However, the majority of patients electing to complete home HRQOL assessments went on to do so over the Internet.

Breastfeeding Women’s Experience of Expressing: A Descriptive Study

There is an increasing trend in Australia and elsewhere for mothers to express breast milk. The purpose of this study was to explore breastfeeding women's experiences of expressing breast milk. An anonymous online questionnaire was sent to Victorian members of the Australian Breastfeeding Association via an e-mail link. Response fraction was 903 of 3024 (29.9%). The most common reason for expressing milk was to "store extra breast milk" (57%, 479/836). The most important reason was "not enough milk"/"to make more milk" (15%, 118/771). The majority of women (65%, 666/843) used an electric breast pump, and this method of expressing was preferred by 59% (454/769) of women. Adverse effects of pumps were pain (17%, 126/737) and damage to nipples (11%, 86/737). Breast pumps may have a role in enabling women to extend the duration of breast milk feeding, but further research is needed.

Barriers to Adoption of Evidence-Based Prehospital Airway Management Practices in California

Objective. To describe current prehospital airway management practices for adults and children and barriers to adoption of evidence-based airway management practices in California. Methods. We surveyed local medical directors of California's 31 emergency medical services (EMS) agencies regarding prehospital airway management, including provider scope of practice, continuous quality improvement practices, and perceptions regarding barriers to the implementation of evidence-based airway management practices. The survey instrument was a Web-based, closed-response form (www.surveymonkey.com) that medical directors could access by an e-mailed link provided by investigators. Medical directors were contacted by phone, mail, and e-mail to request their participation in the Web-based survey. Results. Twenty-five of 31 (81%) EMS medical directors completed the survey. Five medical directors completed surveys for two agencies over which they had responsibility. All responding medical directors employ bag–mask ventilation (BMV), airway adjuncts, and adult endotracheal intubation (ETI), which are procedures widely accepted in EMS practice. Rapid-sequence intubation (RSI), which has been shown to cause harm in certain patient subgroups, was not employed by any of the respondents. Prehospital pediatric ETI, which has been shown not to provide any benefit over BMV, was employed by 22 of 25 (88%) medical directors. Thirteen of 23 (57%) respondents identified “more evidence is needed” or “these results do not apply to my EMS system” as the top reasons to continue the practice of prehospital pediatric ETI. Conclusions. The results of our study suggest that in areas of EMS where robust evidence exists, medical directors (100%) will discontinue or not adopt skills that potentially harm patients, such as RSI, but are unlikely (12%) to discontinue procedures that show no benefit to patients (such as pediatric ETI). Barriers to adoption of evidence-based practice include difficulty in generalizing results of studies across diverse EMS systems and perceived lack of evidence that the procedure should be abandoned.

Measuring the Effectiveness of E-mail Direct Marketing in Building Customer Relationship

The objective of the study is to examine how response data from direct marketing email campaigns could beutilized in measuring the development of a customer relationship in the context of an end-user loyalty program.The case analysed in the study is Club Sony Ericsson e-mail campaigns targeted at its registered members. Theprimary research problem covered in the study is “how can e-mail direct marketing results be measured by usingClub Sony Ericsson existing campaign response and customer data?” In order to gain understanding of the roleof e-mail direct marketing campaigns in a loyalty program, a framework is created around the concept ofcustomer relationship. As a form of interactive marketing, e-mail direct marketing contributes to relationshipdevelopment by providing a channel for dialogue that consists of both communication as well as interaction.The empirical study is conducted by using a quantitative research method. Data analysis is performed in waysthat could also be applied in ongoing monitoring of relationship development within the case company. Thestudy focus is on the information that click-through data can provide when combined with variables found fromthe customer database. The study is conducted based on individual level secondary data available on recent ClubSony Ericsson e-mail campaigns, collected from campaign report files and Club Sony Ericsson member database.Click-through activity was found to have positive correlation with all the other behavioral variables available onthe customer relationship. The youngest age group is found to have the lowest response rates. Repeat responsesare rare within the studied time period. E-mail address invalidity is found to have significant effect on dialoguetermination.Analysing interaction data from e-mail direct marketing campaigns clearly provides new insight into thedevelopment of a customer relationship. Due to the relatively high frequency, tracking click-through activitiesenables monitoring relationship development in between monetary transactions and reflects the level of interesttowards the loyalty program in particular. However, clicks on links in direct marketing e-mails should be mainlyconsidered as a confirmation of interest rather than a requirement.

An Examination of Current Hospitality and Tourism Teaching Methods

The authors examined teaching methods and materials used in hospitality and tourism classrooms. International Council on Hotel, Restaurant, and Institutional Education members were sampled using an electronic survey accessed through an email link. The researchers inventoried techniques, support media, types of activities used in teaching and evaluation, and investigated relationships between these variables. Similarities and differences between public and private schools, two-year and four-year schools, subject matter taught, the type of teaching position held by the educator, and gender differences were also explored. Suggestions are presented for the future of teaching and learning in hospitality.

A Definition, Description, and Framework For Advanced Practice in Dietetics

We explored advanced practice (AP) across the diversity of dietetics to develop a definition, description, and framework for guiding future education, research agendas, and policy development. The process began with a literature review and discussion with dietitians exploring AP in other countries. Various concepts were identified, and these informed the phase 1 survey questions. Phase 1 was a 36-item survey created in SurveyMonkey, engaging a purposeful sample of key stakeholders (n=136). A modified Delphi approach, involving seven dietitians from different geographical locations and practice areas, finalized the phase 2 survey. An e-mail link to this 50-item survey was sent to a random sample of dietitians (n=885). The proposed AP framework entailed an iterative approach, integrating survey results with AP literature. Response rates were 40% for phase 1 and 35% for phase 2. In phase 1, 83% of respondents agreed that a depth and breadth definition captured all dietetic job roles, and 95% agreed that it differentiated AP from entry-level practice. Descriptive statistics are presented to provide demographic information and level of agreement with themes relevant to AP. A framework is presented, and discrepancies with phase 2 results indicate areas for professional development, such as leadership, mentorship, and outcome measurement.

Nonsteroidal Anti-Inflammatory Drugs: A survey of practices and concerns of pediatric medical and surgical specialists and a summary of available safety data

ObjectivesTo examine the prescribing habits of NSAIDs among pediatric medical and surgical practitioners, and to examine concerns and barriers to their use.MethodsA sample of 1289 pediatricians, pediatric rheumatologists, sports medicine physicians, pediatric surgeons and pediatric orthopedic surgeons in the United States and Canada were sent an email link to a 22-question web-based survey.Results338 surveys (28%) were completed, 84 were undeliverable. Of all respondents, 164 (50%) had never prescribed a selective cyclooxygenase-2 (COX-2) NSAID. The most common reasons for ever prescribing an NSAID were musculoskeletal pain, soft-tissue injury, fever, arthritis, fracture, and headache. Compared to traditional NSAIDs, selective COX-2 NSAIDs were believed to be as safe (42%) or safer (24%); have equal (52%) to greater efficacy (20%) for pain; have equal (59%) to greater efficacy (15%) for inflammation; and have equal (39%) to improved (44%) tolerability. Pediatric rheumatologists reported significantly more frequent abdominal pain (81% vs. 23%), epistaxis (13% vs. 2%), easy bruising (64% vs. 8%), headaches (21% vs. 1%) and fatigue (12% vs. 1%) for traditional NSAIDs than for selective COX-2 NSAIDs. Prescribing habits of NSAIDs have changed since the voluntary withdrawal of rofecoxib and valdecoxib; 3% of pediatric rheumatologists reported giving fewer traditional NSAID prescriptions, and while 57% reported giving fewer selective COX-2 NSAIDs, 26% reported that they no longer prescribed these medications.ConclusionsTraditional and selective COX-2 NSAIDs were perceived as safe by pediatric specialists. The data were compared to the published pediatric safety literature.

Audit of a sexual health website email link for general practitioners

The aim of this review was to evaluate an 'Email a Clinician' link on a medically reviewed sexual health website, which was established to allow general practitioners (GPs) to communicate remotely with sexual health clinic specialists. The website was developed in consultation with GPs and extensively promoted throughout the relevant professional primary health-care networks. Despite this, the email link appeared to fail in its objective of facilitating GP access to specialist sexual health physician opinion within five working days. An audit examining use of the email link was conducted for a one-year period, during which time 324 emails were received. Results showed that the bulk of the emails (93.2%) were spam, and only 6.8% were genuine enquiries. Of the 22 genuine emails, 21 (95%) originated from the general public and there were no enquiries from the GPs, who were the target audience of the website, resulting in removal of the email link from the site. Direct survey of local GPs to evaluate reasons for non-utilization of the link was not possible. However, discomfort with the technology, time added to existing workload, lack of direct perceived benefit and lack of immediate response have been cited as contributing factors that may limit widespread adoption of other telemedicine services. As a new generation of recently graduated GPs enters the Australian workforce, who might be expected to be skilled and comfortable with electronic medical communication, the option of a direct email link to a sexual health clinic, with a faster turnaround time, may be worth re-visiting in the future.

Effect of Contact Information on the Credibility of Online Health Information

This study analyzed the effects of publisher contact information on the credibility of online health information. Participants (n = 144) rated the credibility of Web pages with a ldquoContact Usrdquo link more highly than pages that had no contact information. Other types of contact information (street addresses and email links) did not significantly affect the credibility ratings. Qualitative results indicate that the ldquoContact Usrdquo link served as a peripheral cue to credibility, rather than triggering conscious analysis. This paper also discusses how the effectiveness of credibility cues can vary according to reader characteristics.

Are C1–2 Punctures for Routine Cervical Myelography below the Standard of Care?

Recently, the performance of C1-2 punctures for cervical myelography was challenged in a medicolegal proceeding as being below the standard of care. We sought to examine current neuroradiologic practices and opinions on the technique. An 11-question survey was sent to 120 program directors of neuroradiology via e-mail links regarding cervical myelography using a C1-2 puncture. Reminders were sent during a 2-month period before data were finalized. Eighty-five of 120 (71%) surveys were returned. In the previous year, 14.3% (12/85) of institutions had not performed a C1-2 puncture. Thirty-eight percent (32/85) had performed >or=6 in the same period. Seventy-nine percent (54/68 responding) favored a lumbar approach to cervical myelography, with 6% (4/68) having a predilection for a C1-2 puncture. Ninety-five percent (76/80 responding) thought that performing a C1-2 puncture for cervical myelography reflected the standard of care. Every institution except 1 had staff with expertise to perform C1-2 punctures, and 73% of the institutions teach their fellows the procedure. Ninety-three percent (78/84) of programs would perform a C1-2 puncture for thoracolumbar pathology if MR imaging was contraindicated and there was a contraindication such as a local wound infection precluding a lumbar puncture. Indications for a C1-2 approach included severe lumbar spinal stenosis, infection in the lumbar region, upper limit of the block to be delineated, technical issues preventing lumbar puncture, and the best assessment of the cervical region for myelographic films. C1-2 puncture for cervical myelography, though currently not the most frequently performed method at most institutions, continues to be practiced and is considered within the standard of care by most neuroradiology programs across the country.