E-MAIL FOR NEPHROLOGISTS

(Handout for ASN '97 Computing Course Lecture) John T. Daugirdas MD
Professor of Medicine
Univ of IL at Chicago
(October 31, 1997)

Introduction

Advantages of email
  1. Fast and cheap
  2. Ideal way to reach persons who are difficult to get on the phone (e.g. most physicians!)
  3. Because it is written, you can compose and review your message before sending
  4. Ideal for international communications (expense, problems reaching colleagues, differences in time zones)
  5. Convenient and non-intrusive: I typically review and answer emails late at night after the kids have gone to bed
  6. You can check your email from any computer in the world; e.g., while visiting, from a hotel room, in your car, etc.
  7. You can easily include all or part of previous messages, or the message you are responding to, including point by point responses to questions, etc.
  8. Ability to send same message to predefined groups of people
  9. Ability to include attached files, documents, pictures, datasets
  10. Messages easily archivable and storable in a database; search by sender, date, subject, or put into separate mailboxes
  11. Ability to paste from other applications directly into email document (e.g., a review of a paper found on a website)
Disadvantages of email
  1. You don't always know when/if your message has been read (some email programs notify sender when email has been read)
  2. Privacy issues
    • Interception: By company, hospital, university administration, or by unauthorized snoops on the Web (email can be encrypted)
    • Difficult to delete: Emails are stored in a variety of places on computer disks. Difficult to completely erase and destroy.
    • Masquerade: Someone can masquerade as you; send emails in your name. No unique signature.
    • Forwarding function: A recipient can remail a sender's message to a large number of people; e.g., you criticize the boss, and your colleague forwards your critical letter to all the employees in the company
  3. Easy to get swamped (but you can filter and sort messages)
  4. A hazard for emotionally "fiery" people; you get mad, you fire off an email, the recipient forwards it to 10 other people, including the target of your anger, and you pay the consequences for many months to come.

Email connections



Email Addresses

Structure
Most often take the form of loginID@domain-name; e.g., jjbinksr@uic.edu. No spaces, no parentheses, and no commas in the address! Some email addresses include the computer (machine) name, e.g., jjbinks@tigger.uic.edu. Others begin with INTERNET:loginID@domain-name. Compuserve users replace the comma in their numerical ID with a period. America On-Line users remove spaces from their login name and add @aol.com. When an email address is followed by < name >, the text between the lesser and greater signs is optional; e.g. jjbinks@uic.edu < Dr. John T. Daugirdas >

Email address directories
There are several directories of email addresses on the Web, but these are NOT GOOD for academic addresses. You can try www.whowere.com and www.bigfoot.com , but the best way to find an email address of a professional colleague, other than calling him/her up, is to go to the Web page of their institution. Most universities have searchable phonebooks which include email addresses. How do you find the website of a given University? One very good search site for this is www.scholarstuff.com/colleges/colleges.htm .

Email on UNIX machines: Using pine

Most people at Universities, and most people with local Internet Service Provider (ISP) accounts are given a directory on a UNIX machine. You can reach this machine using direct dial (via phone) or using telnet (from any computer connected to the web), and read your email directly. This is complicated, and is much better done by manipulating the email on your UNIX machine using a PC email program such as Eudora or Pegasus. However, you can handle many email chores directly this way from your UNIX machine. Another problem is, that each keystroke is subject to delays due to high internet traffic while you're composing email, and you may be subject to high phone charges if you're direct dialing into your account from a distance.

Pine and Elm are the two most common "front ends" available on UNIX machines for email. The Elm UNIX mail program is no longer being actively supported and its development has stagnated. I have no experience with it. Most UNIX-based ISPs offer both Pine and Elm. Mail on UNIX machines is stored in a /usr/mail directory. With Pine, emails are stored in a number of files or folders. INBOX for received email, and sent-mail for copies of sent mail. You can make additional mailboxes and can manually put messages into these using the "save" command and CTRL-T to show you the mailboxes, but to set up delivery based filtering, to route to different boxes based on message content, you need to set up separate procedure file using procmail commands (see the Pine FAQ for further information on filtering with procmail and pine. Your system administrator needs to help you with this.

TIPS on using pine: (see Pine Information Center )
You open the folder index by highlighting it. All your email will be displayed stored in one long list. You highlight a message, and then reply to, forward or delete it email using letters at the bottom of the pine screen. You compose by using the Compose option from the main menu. You can use nicknames and keep an address book.

1) Difference between Cc: and Bcc: Cc: stands for "carbon copy", and is to send copies to other people: the recipient will know to whom copies have been sent. Bcc: stands for blind carbon copy: The recipient will NOT know that a blind carbon copy was sent.

2) Difference between From: and Reply to: Typically in mailing lists such as NEPHROL, Reply to: is to everyone on the list, and From will go just to the person who sent the message to the list. Be careful not to mix these up! 3) CTRL-G will give you HELP: When replying to a message there are a host of useful keyboard strokes for editing: CTRL-Y scrolls up, CTRL-V (or spacebar) scrolls down, CTRL-K deletes the current line. CTRL-E goes to end of line, etc.

4) Address book with nicknames: It's a pain to fill out, but very useful. When composing a message, if you forgot the nickname, use CTRL-T in any one of the header fields to take you right to the addressbook.

4)Uploading/sending outside files with your email:
a) Method 1: (Text files only)
Save your document as an MS-DOS text file on your PC (or Mac) using your File Save As command. Then FTP the file to your UNIX machine in your home directory. Open pine. Use COMPOSE to start a message. Then use CTRL-R to input the text file into the body of your document. If you can't remember the filename you can use CTRL-R and CTRL-T to scroll through the files on your UNIX home directory. In this method your file will be INSIDE your email and will not really be attached.

b)Method 2: (Text files only)
If your telnet program supports the Edit toolbar, first copy the text from your PC application by highlighting it and saving it to the Windows notepad using Edit Copy. Once in telnet, after you've opened pine and your message, at your cursor, use Edit Paste to paste in the text. This is also useful for taking things off the Web and putting them into email.

b)Method 3: (Any file)
Upload your file from PC to UNIX machine using FTP. Type in the filename in the attached field of the header, or else use CTRL-J.

5) Reading/downloading attached files:
If you want to save the text of your message, press E for export and give a filename. Then use FTP go transport it back to your PC. For short text, if your telnet program supports cut and paste, you can just highlight the text and save it to the Windows notepad with Edit Copy. Then Edit Paste to a document on your PC or Mac. If you get a message with an attached file, if it is encoded using BinHex or UUENCODE, this is too bad! Get help to unencode it. It should be encoded using MIME. Then just press V to save it to a textfile on your UNIX machine, and FTP it down to your PC.

6) .signature file and .vacation.msg file
You can create these in your home directory using the UNIX text editor pico. The .signature file will be added to all of your outgoing emails (but not forwarded messages). The vacation message can be activated by typing in a UNIX command: vacation -i, and an appropriate .forward file. Ask your system administrator for help.

Email on UNIX machines: Using Eudora or Pegasus

You download this software from the above websites and install it on your computer. These programs invoke your modem, connect to the computer where your email is stored, and pull off the unread messages, downloading them to your computer. You then read your messages, distribute them to mailboxes (or have this done automatically using a filtering option), and compose replies. Most of the work is done off-line. The big advantage is, that you can work on your mail locally, whereas when you connect using telnet and pine, your work is often hampered by a slow connection. This software requires a Post-Office-Protocol (POP3) connection to your email site. Normally, your site will use an SMTP protocol to talk to other internet computers. You need to know the addresses for the POP3 and SMTP protocols to put these into your configuration file when you are setting up Eudora and Pegasus. Eudora and Pegasus Mail have made PINE and Elm obsolete.

Working with Eudora and Pegasus Mail Eudora Light is free. Eudora Pro costs money. Eudora Light will not handle UUENCODE attached files. Use of the program is straightforward and well documented. For many valuable tips, see Pete Beim's Unofficial Eudora FAQs and Links. In particular, there are useful tips here on setting up filters, multiple accounts, etc. Pegasus Mail is also an excellent program, and is completely free.

Other options for pulling E-Mail off University of ISP accounts

For Macintosh Users, one can use QuickMail Pro 1.1 or Claris Emailer 2.0. Both Mac and PC users can use the mail programs built into Netscape Navigator and Internet Explorer (Mail and Exchange). The general consensus is, that the Netscape and Internet Explorer mail programs are not as good as Eudora. Outlook 97 is Microsoft's new email program. It uses Microsoft Word as an editor. Caution!: Both these programs can send email complete with HTML characters for formatting. Unless the user is using a compatible email program, all of these characters appear in the message, making it hard to read!

America On-Line and CompuServe Email Programs

These have their built in email programs. Discussion of these is beyond the scope of this presentation.

Other FREE Email Options: Physicians' On-line, Juno, and HotMail

Physicians' On-Line
This program requires a separate software installation on your computer. After installation, one can connect either by direct dial-up or via the Web. You need to give them both your social security and DEA number to register! I am not familiar with the POL email program. One disadvantage is, that you can only connect to POL from a computer that has POL installed on it.

Juno
This program is a Physicians' On-Line for the masses: It is supported by advertising, and requires that you install specific software on your computer. Access is ONLY by direct dial. There is no Web access. Again, one major disadvantage is lack of portability; e.g., lack of ability to access you email account from a computer other than one in which you installed the program.

Hotmail
This is another advertising-supported site. The difference is, that it is accessible via the World Wide Web. So you do need access via the Web. One of the best uses is to provide individual email boxes for other family members when there already is one ISP- email account. Also, as the University or company email account may not be very private, having a separate hotmail email account (the choice of name for the service may be a bit inappropriate!) may be attractive to some people.

Reviews of Juno, Hotmail, and other free Email services can be found in the references. .

Junk Email

To limit the amount of junk email you get, be very careful to whom you give your email address. One sure way to get spammed is to write to USENET mailgroups or to post your email address on any public website! Your email address will be taken off by robots and given to the email spammers. Links for toolkits to fight spam e-mail are listed in the references.

Encryption of Email

All of your email will be stored on backup tapes at your ISP provider/University, and at the site of your recipient. So the public nature of email cannot be overemphasized. It is almost impossible to destroy all evidence of an email after it has been sent; not so with a letter. Encryption of email is possible, and may be an issue with regard to patient privacy; e.g., when using email for consults, etc. Encryption, especially outside of the United States, has become a political issue because of national security concerns. A good discussion of this is found in the book by Levine et al listed in the references. Also, hyperlinks to the Pretty Good Privacy - PGP program are given in the references.

E-mail discussion groups

These generally use one of 3 types of software to run them: LISTSERV, MAJORDOMO, or LISTPROC. For practical purposes they are nearly identical. NEPHROL is run by Dr. Kim Solez at the University of Alberta. HYPERTEL is run by me from the University of Illinois (currently not very active), PDIAL-L is run by Dr. Christian Verger in France, and PEDNEPHROL is run out of Chicago by Dr. Andrew Aronson. It is very useful to have filtering software set up (see above comments for Eudora and Pine) to distribute these email messages into appropriate folders, as the total number of messages per day can be substantial (usually no more than 5-10/day with NEPHROL). Selected threads from PDIAL-L and NEPHROL are posted on HDCN, and instructions on subscribing are also posted there. You will need to register on HDCN (free) to get a password to read the threads.

References:

Levine JR, Baroudi C, Young ML, Reinhold A. E-Mail for Dummies: 2nd edition. IDG Books, Chicago, IL. 1997.

Email address directories
www.whowere.com
www.bigfoot.com
www.switchboard.com (better for regular addresses and telephone numbers than for email addresses)
www.iaf.net -- another address directory (fairly spotty)
www.scholarstuff.com/colleges/colleges.htm -- List of University web addresses; includes all continents!

Local ISP providers
http://thelist.internet.com -- Definitive ISP buyer's guide. Listings by state, area code; includes USA and Canada.

Email software that works with University or ISP account
http://www.washington.edu/pine/ -- Pine Information Center
http://www.myxa.com/elm.html - Elm Links
http://www.eudora.com/ -- Eudora Home Page
http://www.pegasus.usa.com/ -- Pegasus Home Page
http://129.105.99.240/~beim/eudora/index.html -- Pete Beim's Unofficial Eudora FAQs and Links
http://www.zdnet.com/macuser/mu_0897/reviews/email.html -- MacUser magazine's review of QuickMail Pro 1.1 and Claris Emailer 2.0.
http://www.zdnet.com/cshopper/content/9709/cshp0187.html -- Computer Shopper review of Pegasus Mail.

Free Email Service Providers
http://www.zdnet.com/pcmag/iu/commun/mailserv/_mailserv.htm -- PC Magazine Site review of Juno, Hotmail, and others.
Physicians' On-line

Anti-Spam toolkits
http://www.zdnet.com/pcmag/iu/toolkit/nospam.htm -- PC Magazine's Internet Toolkit to fight junk e-mail
http://www.zdnet.com/pcmag/iu/commun/mailutil/spamhater204.htm -- Spam Hater, Version 2.04, reviewed by PC Magazine.

Pretty Good Privacy Links http://web.mit.edu/network/pgp.html -- North American distribution site for PGP.
http://world.std.com/~franl/crypto.html -- Francis Litterio's Cryptography Page