. She can be reached by email at dneal2uwo.ca H ow do we know when to trust online health information? Recently, a gynecologist's newspaper column asserted that endometriosis, a disease that primarily affects women, could be diagnosed by an inoffice exam and that ovarian cysts could be diagnosed by an ultrasound. These claims are not true; these conditions can only be diagnosed through a surgical procedure. After being informed about the article through social networking outlets, many outraged endometriosis patients -including meposted comments online in reply to the doctor's article (until the newspaper swiftly closed the comments) and wrote letters to the editor. They published one letter to the editor: mine. Lay endometriosis bloggers announced my letter's publication on their blogs, declaring a small but significant victory in the battle against endometriosis information, and other patients also reveled in the celebration by commenting on the blog posts. Inexperienced in this form of activism, I asked a blogger why she thought my letter was published, but not anybody else's. I thought perhaps they chose it because the column was published in a Canadian newspaper, and I live in Canada. She said she thought it was because I had a PhD, which added authority to my correction. We will never know for sure why the editors chose my letter, but something about it must have captured their attention.In my role as a library and information science professor, I am currently involved in research related to issues surrounding authority and consumer health information, but this personal experience brought the issue to life for me. We can find various interplays of authority in the example. First, the gynecologist (a presumed expert in female diseases) provided incorrect information. Thanks to social networking's ability to link people who suffer from the same health conditions, patients collectively corrected him. Clearly, the traditional model of the patient relying on the expert is not in effect here; instead, the educated patient is correcting the expert. As informed patients, we worried that the doctor's misinformation could further delay undiagnosed endometriosis patients receiving diagnosis and subsequent treatment, especially since the average time from presentation of symptoms to diagnosis is approximately 10 years. From a formal education standpoint, my information science doctorate should be somewhat meaningless for inferring my authority to determine whether the gynecologist was inaccurate, but it might have played a role in publishing my letter.This experience exemplifies how the traditional lines of authority are blurring and possibly occasionally reversing in the domain of online consumer health information. More examples are created every day as people go online to research medical conditions affecting themselves and their loved ones, compare experiences with fellow patients and caregivers and share their stories. On the other hand, reputable medical professionals have told me that they are frustrated wit...

BACKGROUND: Although the increase in treatment of children and adolescents with antipsychotic medications has been well documented, much less is known about the factors related to the use of these agents and how closely the treatment follows best practice recommendations.METHODS: Prescribers of each antipsychotic medication prescription issued for a Medicaidinsured child in Vermont aged ,18 years were sent a prior authorization survey that assessed several domains including the clinical indication, other treatments, metabolic monitoring, prescriber specialty, and prescription origin. These variables were combined to categorize prescriptions as following indications approved by the US Food and Drug Administration (FDA) and best practice guidelines. RESULTS:The response rate of the survey was 80%, with 677 surveys from 147 prescribers available for analysis; more than one-half of the respondents were primary care clinicians. Overall, the clinical indication for an antipsychotic prescription followed best practice guidelines 91.7% of the time, with overall best practice guidelines followed at a rate of 50.1%. An FDA indication was followed in 27.2% of cases. Psychiatrists were significantly more likely to follow best practice guidelines than nonpsychiatrists. Antipsychotic medications were typically used only after other pharmacologic and nonpharmacologic treatments were ineffective, although previous treatment with cognitive-behavioral therapy was uncommon (15.5%). Metabolic monitoring that included serial laboratory tests was reported in 57.2% of cases.CONCLUSIONS: Current prescribing patterns of antipsychotic medications for children and adolescents follow best practice guidelines approximately one-half of the time, with nonadherence often related to lack of metabolic monitoring. WHAT'S KNOWN ON THIS SUBJECT:Although the rates of antipsychotic medication treatment are rising for children and adolescents, little is known about the factors associated with this practice. WHAT THIS STUDY ADDS:This study provides some of the first data regarding when and why clinicians decide to use antipsychotic medications. It reveals clues as to how prescribing might better follow best practice guidelines.

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This article describes the participatory research process, results, action plan, and implications of the community health information needs assessment conducted within the African American community in two South Carolina counties. The REACH 2010: Charleston and Georgetown Diabetes Coalition library program is a partnership among community organizations, public and health sciences libraries, and lay community health advisors. A planning committee studied digital divide issues related to health information, designed and implemented a survey, held focus groups, analyzed data, identified needs and assets, and formulated an action plan to increase the dissemination of diabetes information. Key survey findings show that older (older than 60) and less educated (fewer than 12 years of education) African Americans in Charleston and Georgetown counties lack skills to access Internet and library services and suffer disparities in health information. Based on assessment evidence, the community plans to increase Internet access points and provide a train-the-trainer program to teach people skills for using Internet and library resources to get high-quality information about diabetes and its complications. This process taps community resources, builds local capacities and technical skills, educates about health, and empowers participants as active partners in their own health and their community's health.

This exploratory, preliminary study seeks to determine whether the use of emotion-based, user-assigned descriptors elicited from music information retrieval (MIR) system users could improve access and retrieval for a browsing-based MIR system within the Web 2.0 environment. We used the Glass Engine, a Web-based tool designed for exploring Philip Glass' music, as the basis for conceptualizing this study. The Glass Engine allows users to browse several