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Using  Web  2.0  Social  Technology  to  Build  a  Cyber-­infrastructure  for  an  Interdisciplinary  Biomedical  Research  Community  of  Practice  
                                                                                                                                                                                                                                     1                                                            1                                                      2                                                              3                                                       4
                                                                                                                                  Michelle  C.  Farabough ,  MSKM;  Frances  K.  Wen ,  PhD;  Cecelia  Brown ,  PhD,  MLIS;  Lynn  Yeager ,  MLIS;  Steven  D.  Shelton ,  MLIS  
                                                                                                              1                                                                                                                                                                                                                                      2
                                                                                                                  University  of  Oklahoma  School  of  Community  Medicine,  Department  of  Family  Medicine,  Tulsa,  OK;     University  of  Oklahoma,  School  of  Library  and  Information  Studies,  Norman,  OK;    
                                                                                                                            3                                                                                                                    4  
                                                                                                                              University  of  Oklahoma-­‐Tulsa,  Department  of  Health  Sciences  and  Information  Management,  Tulsa,  OK;     University  of  Arkansas,  Borehm  Library,  Fort  Smith,  AR  


                      Background:  Read/Write  Web  Gaining  Popularity  
                                               INTRODUCTION                                                                                                                                                                                                        Results:  Exploring  Innovation  and  Determining  a  Web  2.0  Platform                                                                                                                                    Discussion:  Pilot  Study  Usage  and  Trends  

Web  2.0  social  technologies  enable  and  facilitate  social  networking,  participation,  communication,                                                                                                                                                                                                                                                                                                                                  This  study  examined  3-­‐month  baseline  findings  of  a  longitudinal,  12-­‐month  project.  
                                                                                                                                                                                                                                                                                                                                                                                                                                                

and  knowledge  sharing.  They  aid  in  the  creation  of  an  organic  knowledge  base  for  a  Community  of                                                                                                                      SWOT  Analysis                                              Selection  Criteria  for  Web  2.0  Platform                                                                                                 Barriers  to  adoption  and  usage:  
Practice  (CoP),  built  as  a  byproduct  of  team  collaboration.                                                                                                                                                                                                                                                                                                                                                                             University  and  professional  culture  
                                                                                                                                                                                                             Helpful                                          Harmful                            Criteria                    Considerations                                   PBworks*  
    A  new  generation  of  the  Internet  advances  to  platform  Service-­‐as-­‐a-­‐Software  (SaaS)  solutions.                                                                               to  achieving  objective                            to  achieving  objective                                                                                                                                                                   Time  constraints  for  physicians  
                                                                                                                                                                                                                                                                                                 Hosting                     Internal  or  external  servers                  External    server  
                                                                                                                                                                                                                                              
                                                                                                                                                                                                                                                                                                                                                                                                                                                Various  levels  of  technical  savvy  
    Facebook  usage  increased  700%,  and  Twitter  usage  increased  3,712%  from  4/2009  to  4/2010 .                     1                                                                        S  t  r  e  n  g  t  h  s                       W  e  a  k  n  e  s  s  e  s              Pricing                     Open  source;  commercial  licensing;            Free  subscription  for  non-­‐commercial,    




                                                                                                                                                   attributes  of  the  organization  
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 
    Social  media  usage  increases  15%  among  Inc.  500  companies .                  2                                                                                                   Increase  speed  and  improve                       Digital  divide  in  terms  of                                              subscription-­‐based                             education  projects                                                                                                        
                                                                                                                                                                                             access  to  knowledge  and                          technical  savvy                                Security                    HIPAA  compliant;  mail  encryption              Not  posting  protected  health  information  
    69%  of  McKinsey  survey  respondents  report  measureable  benefits  of  Web  2.0  social                                                                                                                                                                                                                                                                                                                                                     University  IT  concern  over  safety  of  protected  health  information  (PHI)  
                                                                                                                                                                                             knowledge  experts                                  Organizational  culture,                                                                                                     (PHI);  use  university  email                                    




                                                                                                                                          Internal  
                              3
    technologies  in  business .                                                                                                                                                             Real  time  documentation                           including  IT  policies                                                                                                                                                                      Benefits  to  adoption  and  usage:  
                                                                                                                                                                                                                                                                                                 Interoperability            IT  technology  and  policies                    Does  not  interface  with  MOSS  SharePoint  
    Technology  experts  responding  to  a  Pew  survey  believe  innovative  online  cooperation  could                                                                                     Accelerate  project  decisions                      Reliability  of  information                                                                                                                                                                   Increase  university  awareness  of  the  capabilities  of  Web  2.0  social  technologies  
                                                                                                                                                                                                                                                                                                 Content  Access             Access  and  authoring  granularity  for         Secure  url  with  robust,  granular  access  
                                                                                                                                                                                             and  task  time  cycles                                                                                                                                                                                                                            No  additional  cost  to  universities  
    result  in  more  efficient  for-­‐profit,  non-­‐profit,  and  government  agencies  by  2020,  but  they                                                                                                                                   Gaps  in  design  and  purpose                                              internal  and  external  users                   levels  for    users  
                                                          4                                                                                                                                  Reduce  e-­‐mail  and  costs  
                                                                                                                                                                                                                                                                                                                                                                                                                                                IT  assistance  not  required;  easily  implemented  without  programming  expertise  
    express  concern  over  resistance  to  change .                                                                                                                                                                                             Asynchronous  communication  
                                                                                                                                                                                                                                                                                                 Communication               Blogs,  wikis,  forums,  comments,               Free  subscription  includes  shared  online                      Asynchronous  communication  to  bridge  gaps  in  time  and  location  
    Email  is  recognized  as  the  number  one  social  software  application .               5                                                                                             Increase  ability  to  share  ideas                 limited  use  of  non-­‐verbal  cues    
                                                                                                                                                                                                                                                                                                 Mix                         instant  messaging;  chat;  voice                workspace  wiki  and  flat  comments                              Shared  resources  and  knowledge  
                                                                                                                                                                                             and  resources                                        
                                                                                                                                                                                                                                                                                                                             collaboration;  microblogging                                                                                      Real-­‐time  documentation  and  project  management  
                                                                                                                                                                                                 O  p  p  o  r  t  u  n  i  t  i  e  s                      T  h  r  e  a  t  s                  User  Interface             Ease  of  customization;  templates;             Easily  implemented  without  IT  expertise;                      CoP  members  perceive  wiki  is  more  efficient  than  email  for  sharing,  organizing  and    
    Although  the  importance  of  multidisciplinary  health  care  research  and  accompanying  funding  




                                                                                                                                                       attributes  of  the  organization  
                                                                                                                                                                                             Variety  and  expansion  of                         HIPAA                                                                       training  requirements;    page  and             preset  and  custom  templates;  intuitive                        finding  information  
    opportunities  continues  to  increase,  few  evidence-­‐based  results  of  Web  2.0  social  technology                                                                                                                                                                                                                                                                                                                                   The  easier  the  task,  the  more  likely  CoP  members  use  the  wiki  
                                                                                                                                                                                             Web  2.0  technology                                Continuity  of  SaaS  providers                                             folder-­‐level  robust  organization  of         user  interface;  limited  training  needed;  
    use  in  health  care  are  available.                                                                                                                                                                                                                                                                                   information                                      video  tutorials  and  help  pages  provided  
                                                                                                                                                                                             Variety  of  pricing  models                        Interoperability  




                                                                                                                                          External  
                                                                                                                                                                                             Open  source  community                                        TM
                                                                                                                                                                                                                                                 Microsoft   market  share                       Content  Creation           Document  management  and  import                Import  feature  for  documents,  spread-­‐
                                                                                                                                                                                             Cultural  change  toward                                                                                                        for  documents,  spreadsheets,  and              sheets,  and  powerpoint  presentations;  
                                                                                                                                                                                                                                                 Security  of  intellectual  
                                                                                                                                                                                                                                                                                                                             presentations;  collaborative  editing                                  -­‐                   
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Limitations  and  Future  Direction  
                   Purpose:  Web  2.0  Social  Technologies  in  Healthcare                                                                                                                  interdisciplinary  research  and                    property    
                                                                                                                                                                                             funding  for  health  care                                                                          Search  and  Tagging        Retrieval  of  folksonomy  terms                 Tagging;    intuitive  and  granular  searching  
                                                                                                                                                                                             Consumer  driven  success  of                                                                                                                                                                                                             Limitations:  A  relatively  small  number  of  committee  members  and  access  to  only  preliminary  baseline  
The  goal  of  this  study  is  to  evaluate  the  utility  of  Web  2.0  social  technology  for  health  care                                                                                                                                                                                  Linking                     Hypertext  link  to  redirect  user  from  
                                                                                                                                                                                             social  networking                                                                                                                                                                                                                        data  placed  certain  limitations  on  the  ability  to  draw  conclusions  and  make  inferences  from  results.  
research  by  investigating  the  viability,  and  then  analyzing  the  use  and  associated  opinions                                                                                                                                                                                                                      home  page  to  other  platform                  images,  documents,  spreadsheets,  pages                  




                                                                                                                                                                                                                                                                                                                             elements  or  outside  resources                 and  folders,  email  addresses,  and  urls              Future  Directions:  Analyzing  committee  email  and  wiki  usage  and  repeating  the  survey  subsequent  to  
of  research  team  members  to  ascertain  benefits  for  and  barriers  to  improved  collaboration,  
knowledge  sharing    and  communication.                                                                                                                                                                                                                                                        Notifications               RSS  feeds  and  email  subscriptions            Interval  options,  including  live  notification        wiki  implementation  after  6-­‐  and  12-­‐months  will  aid  in  evaluation.  Additional  outcome  measures  are  
                                                                                                                                                                                                                                                                                                 Extras                      Integrated  calendar;  media  and  file          Complete  audit  and  history  trail;  recent            recommended.    
                                                                                                                                         Web  analytics                                                                                                                                                                      attachments;  plug-­‐ins;  user  analytics       changes  and  visitors;    plug-­‐ins                       Authors  have  initiated  a  similar  study  for  a  Community-­‐based  Participatory  Research  (CBPR)  CoP  
                                                                                                                                          Over  50%  of  CoP  members  invited  to  access  the  wiki                                                                                            *Other  Web  2.0  platforms  considered:  MOSS  SharePoint,  Open  Atrium,  Elgg,  Google  Apps.  See  brochure.                                                                                                                                                                           
             Methods:  Exploring  Innovations  in  Peer-­to-­Peer  Collaboration                                                          were  faculty  and  resident  physicians.                                                                                                                                                                                                                                                                Further  evidence-­‐based  investigation  of  Web  2.0  social  technologies  for  peer-­‐to-­‐peer  (P2P)  
                                                                                                                                          Of  the  13  members  invited,  eight  (69%)  accessed  the  wiki.                                                                                                                                                                                                                                       collaboration  and  communication  in  health  care  research  are  necessary.  
The  study  explored  innovative  methods  to  facilitate  collaboration,  knowledge  sharing,  and                                       Of  those  that  accessed  the  wiki,  14%  created  a  page,  and  
                                                                                                                                          43%  edited,  commented,  or  uploaded  an  attachment.                                                                                                Perception  of  Wiki  Efficiency                                           Measure  of  Comfort  using  Wiki
communication  among  a  13-­‐member  multidisciplinary  biomedical  research  Community  of                                                                                                                                                                                                60                                                                    80
                                                                                                                                          36%  of  CoP  members  emailed  information  to  the  wiki    
Practice  (CoP)  comprised  of  faculty  and  resident  physicians,  staff,  and  students  from  two  major                                                                                                                                                                                                                                                      70
                                                                                                                                          administrator  instead  of  uploading  to  the  wiki.                                                                                             50
                                                                                                                                                                                                                                                                                                                                                                  60                                          Log  on                                                                                    References  
southwestern  universities  and  an  institute  of  brain  research.                                                                                                                                                                                                                        40
                                                                                                                                                                                                                                                                                                                             Store  information                   50                                          Edit  a  page
                                                                                                                                         Survey  results                                                                                                                                %   30                                                                %   40




                                                                                                                                                                                                                                                                                        %




                                                                                                                                                                                                                                                                                                                                                               %
       Identified  strengths  and  weaknesses  of  Web  2.0  social  technologies  using  a  SWOT  analysis                                                                                                                                                                                                                                                                                                                                 1.                                                                                                                                -­‐100-­‐  
                                                                                                                                                                                                                                                                                            20                               Organize  information                30                                          Create  a  page
                                                                                                                                          Six  members  (46%)  completed  the  survey.                                                                                                                                                                            20
                                                                                                                                                                                                                                                                                                                                                                                                                                             social-­‐media/.  Accessed  8/4/2010  
                                                                                                                                          83%  were  50  years-­‐of-­‐age  or  older.                                                                                                       10                               Find  information                                                                Use  the  s earch  box        2.
                                                                                                                                                                                                                                                                                                                                                                  10
       Architected  a  basic  wiki  with  user-­‐friendly  interface,  and  then  invited  and  trained  users                                                                                                                                                                               0                                                                                                                                               bid/5326/Learning-­‐From-­‐Leaders-­‐The-­‐Inc-­‐500-­‐and-­‐Social-­‐Media-­‐Usage.aspx.  Accessed  8/2/2010  
                                                                                                                                          50%  were  faculty  and  resident  physicians.                                                                                                                                                                           0
                                                                                                                                                                                                                                                                                                                                                                                                                                            3.                                                                                                                                            
       Analyzed  CoP  email  and  wiki  usage                                                                                             100%  indicated  comfort  logging  on.                                                                                                                                                                                                                                                             https://www.mckinseyquarterly.com/Business_Technology/BT_Strategy/How_companies_are_benefiting_from_Web_20_  
                                                                                                                                          83%  felt  comfortable  editing  a  page.                                                                                                                                                                                                                                                         4.McKinsey_Global_Survey_Results_2432.  Accessed  8/2/2010  
       Administered  a  survey  using    Survey  Monkey  to  obtain  CoP  perceptions  
                                                                                                                                          50%  felt  comfortable  using  the  search  box.                                                                                                                                                                                                                                                  5.                                                                                                                               
       Analyzed  3-­‐month  baseline  data                                                                                                33%  felt  comfortable  creating  a  page.                                                                                                                                                                                                                                                                                                                                                                         -­‐of-­‐the-­‐internet-­‐on-­‐
                                                                                                                                                                                                                                                                                                                                                                                                                                             institutions-­‐in-­‐the-­‐future.  Accessed  8//2/2010  
                             The  University  of  Oklahoma  is  an  equal  opportunity  institution.                                                                                                                                                                                                                                                                                                                                        6.Extrapolations  and  counting  by  Radicati  Group,  May  2009  

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National Conference on Health Communication, Marketing and Media 2010

  • 1. Using  Web  2.0  Social  Technology  to  Build  a  Cyber-­infrastructure  for  an  Interdisciplinary  Biomedical  Research  Community  of  Practice   1 1 2 3 4 Michelle  C.  Farabough ,  MSKM;  Frances  K.  Wen ,  PhD;  Cecelia  Brown ,  PhD,  MLIS;  Lynn  Yeager ,  MLIS;  Steven  D.  Shelton ,  MLIS   1 2  University  of  Oklahoma  School  of  Community  Medicine,  Department  of  Family  Medicine,  Tulsa,  OK;    University  of  Oklahoma,  School  of  Library  and  Information  Studies,  Norman,  OK;     3 4   University  of  Oklahoma-­‐Tulsa,  Department  of  Health  Sciences  and  Information  Management,  Tulsa,  OK;    University  of  Arkansas,  Borehm  Library,  Fort  Smith,  AR   Background:  Read/Write  Web  Gaining  Popularity   INTRODUCTION   Results:  Exploring  Innovation  and  Determining  a  Web  2.0  Platform   Discussion:  Pilot  Study  Usage  and  Trends   Web  2.0  social  technologies  enable  and  facilitate  social  networking,  participation,  communication,     This  study  examined  3-­‐month  baseline  findings  of  a  longitudinal,  12-­‐month  project.     and  knowledge  sharing.  They  aid  in  the  creation  of  an  organic  knowledge  base  for  a  Community  of   SWOT  Analysis   Selection  Criteria  for  Web  2.0  Platform     Barriers  to  adoption  and  usage:   Practice  (CoP),  built  as  a  byproduct  of  team  collaboration.   University  and  professional  culture   Helpful   Harmful   Criteria   Considerations   PBworks*   A  new  generation  of  the  Internet  advances  to  platform  Service-­‐as-­‐a-­‐Software  (SaaS)  solutions.   to  achieving  objective   to  achieving  objective   Time  constraints  for  physicians   Hosting   Internal  or  external  servers   External    server     Various  levels  of  technical  savvy   Facebook  usage  increased  700%,  and  Twitter  usage  increased  3,712%  from  4/2009  to  4/2010 .   1 S  t  r  e  n  g  t  h  s   W  e  a  k  n  e  s  s  e  s   Pricing   Open  source;  commercial  licensing;   Free  subscription  for  non-­‐commercial,     attributes  of  the  organization     Social  media  usage  increases  15%  among  Inc.  500  companies .   2 Increase  speed  and  improve   Digital  divide  in  terms  of   subscription-­‐based   education  projects     access  to  knowledge  and   technical  savvy   Security   HIPAA  compliant;  mail  encryption   Not  posting  protected  health  information   69%  of  McKinsey  survey  respondents  report  measureable  benefits  of  Web  2.0  social   University  IT  concern  over  safety  of  protected  health  information  (PHI)   knowledge  experts   Organizational  culture,   (PHI);  use  university  email     Internal   3 technologies  in  business .   Real  time  documentation   including  IT  policies   Benefits  to  adoption  and  usage:   Interoperability   IT  technology  and  policies   Does  not  interface  with  MOSS  SharePoint   Technology  experts  responding  to  a  Pew  survey  believe  innovative  online  cooperation  could   Accelerate  project  decisions   Reliability  of  information   Increase  university  awareness  of  the  capabilities  of  Web  2.0  social  technologies   Content  Access   Access  and  authoring  granularity  for   Secure  url  with  robust,  granular  access   and  task  time  cycles   No  additional  cost  to  universities   result  in  more  efficient  for-­‐profit,  non-­‐profit,  and  government  agencies  by  2020,  but  they   Gaps  in  design  and  purpose   internal  and  external  users   levels  for    users   4 Reduce  e-­‐mail  and  costs   IT  assistance  not  required;  easily  implemented  without  programming  expertise   express  concern  over  resistance  to  change .   Asynchronous  communication   Communication     Blogs,  wikis,  forums,  comments,   Free  subscription  includes  shared  online   Asynchronous  communication  to  bridge  gaps  in  time  and  location   Email  is  recognized  as  the  number  one  social  software  application .   5 Increase  ability  to  share  ideas   limited  use  of  non-­‐verbal  cues     Mix   instant  messaging;  chat;  voice   workspace  wiki  and  flat  comments     Shared  resources  and  knowledge   and  resources       collaboration;  microblogging   Real-­‐time  documentation  and  project  management   O  p  p  o  r  t  u  n  i  t  i  e  s   T  h  r  e  a  t  s   User  Interface   Ease  of  customization;  templates;   Easily  implemented  without  IT  expertise;   CoP  members  perceive  wiki  is  more  efficient  than  email  for  sharing,  organizing  and     Although  the  importance  of  multidisciplinary  health  care  research  and  accompanying  funding   attributes  of  the  organization   Variety  and  expansion  of     HIPAA   training  requirements;    page  and   preset  and  custom  templates;  intuitive   finding  information   opportunities  continues  to  increase,  few  evidence-­‐based  results  of  Web  2.0  social  technology   The  easier  the  task,  the  more  likely  CoP  members  use  the  wiki   Web  2.0  technology   Continuity  of  SaaS  providers   folder-­‐level  robust  organization  of   user  interface;  limited  training  needed;   use  in  health  care  are  available.   information     video  tutorials  and  help  pages  provided   Variety  of  pricing  models     Interoperability   External   Open  source  community   TM Microsoft  market  share   Content  Creation   Document  management  and  import   Import  feature  for  documents,  spread-­‐ Cultural  change  toward   for  documents,  spreadsheets,  and   sheets,  and  powerpoint  presentations;   Security  of  intellectual   presentations;  collaborative  editing   -­‐   Limitations  and  Future  Direction   Purpose:  Web  2.0  Social  Technologies  in  Healthcare   interdisciplinary  research  and   property     funding  for  health  care   Search  and  Tagging   Retrieval  of  folksonomy  terms   Tagging;    intuitive  and  granular  searching   Consumer  driven  success  of   Limitations:  A  relatively  small  number  of  committee  members  and  access  to  only  preliminary  baseline   The  goal  of  this  study  is  to  evaluate  the  utility  of  Web  2.0  social  technology  for  health  care   Linking   Hypertext  link  to  redirect  user  from   social  networking   data  placed  certain  limitations  on  the  ability  to  draw  conclusions  and  make  inferences  from  results.   research  by  investigating  the  viability,  and  then  analyzing  the  use  and  associated  opinions     home  page  to  other  platform   images,  documents,  spreadsheets,  pages     elements  or  outside  resources   and  folders,  email  addresses,  and  urls   Future  Directions:  Analyzing  committee  email  and  wiki  usage  and  repeating  the  survey  subsequent  to   of  research  team  members  to  ascertain  benefits  for  and  barriers  to  improved  collaboration,   knowledge  sharing    and  communication.   Notifications   RSS  feeds  and  email  subscriptions   Interval  options,  including  live  notification   wiki  implementation  after  6-­‐  and  12-­‐months  will  aid  in  evaluation.  Additional  outcome  measures  are   Extras   Integrated  calendar;  media  and  file   Complete  audit  and  history  trail;  recent   recommended.     Web  analytics   attachments;  plug-­‐ins;  user  analytics   changes  and  visitors;    plug-­‐ins   Authors  have  initiated  a  similar  study  for  a  Community-­‐based  Participatory  Research  (CBPR)  CoP   Over  50%  of  CoP  members  invited  to  access  the  wiki     *Other  Web  2.0  platforms  considered:  MOSS  SharePoint,  Open  Atrium,  Elgg,  Google  Apps.  See  brochure.     Methods:  Exploring  Innovations  in  Peer-­to-­Peer  Collaboration   were  faculty  and  resident  physicians.   Further  evidence-­‐based  investigation  of  Web  2.0  social  technologies  for  peer-­‐to-­‐peer  (P2P)   Of  the  13  members  invited,  eight  (69%)  accessed  the  wiki.   collaboration  and  communication  in  health  care  research  are  necessary.   The  study  explored  innovative  methods  to  facilitate  collaboration,  knowledge  sharing,  and   Of  those  that  accessed  the  wiki,  14%  created  a  page,  and   43%  edited,  commented,  or  uploaded  an  attachment.   Perception  of  Wiki  Efficiency Measure  of  Comfort  using  Wiki communication  among  a  13-­‐member  multidisciplinary  biomedical  research  Community  of   60 80 36%  of  CoP  members  emailed  information  to  the  wiki     Practice  (CoP)  comprised  of  faculty  and  resident  physicians,  staff,  and  students  from  two  major   70 administrator  instead  of  uploading  to  the  wiki.     50 60 Log  on References   southwestern  universities  and  an  institute  of  brain  research.     40 Store  information 50 Edit  a  page Survey  results   %   30 %   40 % % Identified  strengths  and  weaknesses  of  Web  2.0  social  technologies  using  a  SWOT  analysis   1. -­‐100-­‐   20 Organize  information 30 Create  a  page Six  members  (46%)  completed  the  survey.   20 social-­‐media/.  Accessed  8/4/2010     83%  were  50  years-­‐of-­‐age  or  older.   10 Find  information Use  the  s earch  box 2. 10 Architected  a  basic  wiki  with  user-­‐friendly  interface,  and  then  invited  and  trained  users   0 bid/5326/Learning-­‐From-­‐Leaders-­‐The-­‐Inc-­‐500-­‐and-­‐Social-­‐Media-­‐Usage.aspx.  Accessed  8/2/2010   50%  were  faculty  and  resident  physicians.   0 3.   Analyzed  CoP  email  and  wiki  usage   100%  indicated  comfort  logging  on.   https://www.mckinseyquarterly.com/Business_Technology/BT_Strategy/How_companies_are_benefiting_from_Web_20_   83%  felt  comfortable  editing  a  page.   4.McKinsey_Global_Survey_Results_2432.  Accessed  8/2/2010   Administered  a  survey  using    Survey  Monkey  to  obtain  CoP  perceptions   50%  felt  comfortable  using  the  search  box.   5.   Analyzed  3-­‐month  baseline  data     33%  felt  comfortable  creating  a  page.   -­‐of-­‐the-­‐internet-­‐on-­‐ institutions-­‐in-­‐the-­‐future.  Accessed  8//2/2010   The  University  of  Oklahoma  is  an  equal  opportunity  institution.   6.Extrapolations  and  counting  by  Radicati  Group,  May  2009