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In 2001, the Regenstrief Institute for Health Care and the Indiana University School of Medicine (IUSM) began an IAIMS planning effort to create a vision and a tactical plan for the first Integrated Advanced Information Management Systems (IAIMS) implementation to cross a large area and include unaffiliated institutions. A number of elements made this planning effort unique. Among these elements were the existence of a network infrastructure that supported the Indianapolis Network for Patient Care, the existence of a mature medical informatics program at the Regenstrief Institute, and the existence of a wide-area knowledge network fostered by the IUSM libraries. However, the leadership for a strong information technology role in the IUSM that could promote collaboration in support of education and research across the diverse Indianapolis hospital systems had been lacking. By bringing together various groups, each with a commitment to improve health care quality and public health across the Indianapolis metropolitan area, regardless of individual institutional affiliation, the strategic directions for I3-Indianapolis IAIMS Initiative have been defined and the foundations for a third generation IAIMS construct have been laid in Indianapolis, Indiana.  相似文献   
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ABSTRACT

Introduction: Low energy availability (LEA) results in physiological adaptations, which can contribute to unfavourable health outcomes. Little information exists on risk of LEA in active individuals competing in different sports or levels of competition. The aims of this study were to (1) identify risk of LEA in females competing at different levels of competition and (2) investigate associations between risk of LEA, illness and dietary habits. Methods: The validated questionnaire, ‘Low Energy Availability in Females Questionnaire’ was distributed online (November 2016–February 2017) to assess risk of LEA. Twenty-nine additional questions collected information on demographics, illness history and dietary habits. Participants were considered at risk of LEA if they attained a score of?≥?8 and were grouped into: (i) international; (ii) provincial/inter-county; (iii) competitive; and (iv) recreationally active. Chi-square and logistic regression analyses were used to explore differences between those at risk or not at risk of LEA. Results: Risk of LEA was identified in 40% (n?=?331) of 833 participants and was 1.7 and 1.8 times more likely in international and provincial/inter-county athletes compared to those who were recreationally active (International: odds ratios (OR) 1.68, 95% confidence intervals (95%CI) 1.12–2.54; Provincial/inter-county: OR 1.83, 95%CI 1.20–2.77). In participants at risk of LEA, missing >22 days of training during the previous year due to illness occurred 3 times more frequently (OR 3.01, 95%CI 1.81–5.02). Conclusion: Risk of LEA was widespread in this heterogeneous sample. Awareness of LEA and the development of appropriate energy management strategies to ensure athlete health across levels of competition are required.  相似文献   
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As counselor preparation programs are compelled to demonstrate student social and cultural competence, valid inventories are needed to measure development consistent with contemporary standards. The Intersectional Privilege Screening Inventory was created for this purpose, was assessed using 4 types of validity evidence, and has results supporting its use in student development.  相似文献   
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As a participating student in the Border Studies Program in the fall semester of 2000, the author did a field study working as a volunteer at El Centro de los Trabajadores Agrvcolas Fronterizos (The Border Agricultural Workers' Center, or CTAF). In this ethnography, he intertwines the exploration of several different relationships. He examines the relationship between the current struggles of farm workers in the U.S. and the movement led by Cesar Chavez in the 1970s; and the relationship between the ''periphery'' and the ''center.'' He also reflects upon his own position within the progressive movement, given the social privilege that adheres to him by virtue of race, class, and sex.  相似文献   
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HIV remains a significant health concern entering the fourth decade of the epidemic [Centers for Disease Control and Prevention. 2014. HIV basics. Retrieved from http://www.cdc.gov/hiv/basics/index.html], and people living with HIV continue to grapple with stigma. This study uses Leary and Schreindorfer's [1998 Leary, M. R., &; Schreindorfer, L. S. (1998). The stigmatization of HIV and AIDS: Rubbing salt in the wound. In V. J. Derlega &; A. P. Barbee (Eds.), HIV and social interaction (pp. 1229). Thousand Oaks, CA: Sage. [Google Scholar]. The stigmatization of HIV and AIDS: Rubbing salt in the wound. In V. J. Derlega &; A. P. Barbee (Eds.), HIV and social interaction (pp. 12 Lekas, H. M., Siegel, K., &; Schrimshaw, E. W. (2006). Continuities and discontinuities in the experiences of felt and enacted stigma among women with HIV/AIDS. Qualitative Health Research, 16, 11651190. doi:10.1177/1049732306292284[Crossref], [PubMed], [Web of Science ®] [Google Scholar]29 Lekas, H. M., Siegel, K., &; Schrimshaw, E. W. (2006). Continuities and discontinuities in the experiences of felt and enacted stigma among women with HIV/AIDS. Qualitative Health Research, 16, 11651190. doi:10.1177/1049732306292284[Crossref], [PubMed], [Web of Science ®] [Google Scholar]). Thousand Oaks, CA: Sage] conceptualization of stigma to explore prior stigmatization on reasons for and against future disclosures. We interviewed HIV+ individuals (N?=?59) and used a combination of deductive and inductive coding to analyze participants’ responses. Deductive codes consisted of four stigma characteristics (pose a threat to others’ health and safety, deviate from group standards, create negative emotional reactions in others, and failure to contribute), experiences of feeling stigmatized due to HIV status (yes or no), and the degree to which HIV stigma was a concern (major, minor, or no concern). Inductive coding identified examples of perceived and experienced stigma and stigma concerns on future disclosure decision-making. Practical implications discuss individual, institutional, and societal stigma-reduction interventions and programs.  相似文献   
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This study investigated the acute endocrine responses to a 164-km road cycling event in a hot environment. Thirty-four male experienced cyclists (49.1 ± 8.3 years, 86.8 ± 12.5 kg, 178.1 ± 5.1 cm) participating in a 164-km road cycling event were recruited. Blood samples were collected within 0.3–2.0 h before the start (PRE: ~0500–0700 h) and immediately following the ride (POST). Samples were analysed for testosterone, growth hormone (GH), cortisol and interleukin-6 (IL-6). The temperature and humidity during the event were 35.3 ± 4.9°C and 47.2 ± 14.0%, respectively. Based on the finishing time, results for the fastest (FAST, 305 ± 10 min) and the slowest (SLOW, 467 ± 31 min) quartiles were compared. At POST, testosterone concentration was significantly (P < 0.05) lower (PRE, 20.8 ± 8.6; POST, 18.2 ± 6.7 nmol · L?1), while GH (PRE, 0.3 ± 0.1; POST, 2.3 ± 0.3 µg · L?1), cortisol (PRE, 661 ± 165; POST, 1073 ± 260 nmol · L?1) and IL-6 (PRE, 4.0 ± 3.4; POST, 22.4 ± 15.2 pg · mL?1) concentrations were significantly higher than those at PRE. At POST, GH and cortisol were significantly higher for the FAST group than for the SLOW group (GH, 3.6 ± 2.0 and 1.0 ± 0.8 µg · L?1; cortisol, 1187 ± 209 and 867 ± 215 nmol · L?1). Participation in an ultra-endurance road cycling event in a hot environment induced significant acute changes in concentrations of circulating hormones, with a greater augmentation of GH and cortisol in those completing the ride fastest.  相似文献   
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Distance education planners face two basic, yet difficult decisions: which students should be targeted and which programs should be offered? This paper reports the process and results of the planning committee of a consortium of engineering schools in the United States that was tasked with these very decisions. A market research study measured the program preferences of potential students. Three program characteristics (course type, delivery method, and time availability) were examined. The results show there is no ‘average’ student and no single program will satisfy all the needs of the student population. Rather, the committee must choose one or more segments based on the program preferences of the students and the resources required to provide the programs.  相似文献   
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Résumé Le nouvel équilibre économique et social en Europe qui se met en place progressivement a d'importantes conséquences en termes de mobilité, de gestion des qualifications et des diplômes. Dans le domaine spécifiquement éducatif, la question de la valeur sociale et professionnelle des diplômes et des reconnaissances des com-pétences professionnelles se pose. Ces compétences constituent une des richesses particulières dont disposent les pays des Communautés ainsi que chacun des individus confrontés à l'espace économique et social, élargi et multiforme.Dans ce contexte européen, on examine ici plus particulièrement la situation française sous l'angle des évolutions de la notion de diplôme et de reconnaissances des compétences, et les politiques de qualification, de formation initiale et de formation continue de la main-d'oeuvre.
The new economic and social equilibrium which is gradually coming about in Europe has significant consequences in terms of mobility, recognition of qualifications and certification. Specifically in the educational arena, questions are raised as to the social and vocational value of certificates, and the recognition of vocational skills. These skills are part of the wealth of the particular countries in the Community, and of each of the individuals who are now confronted by the enlarged economic and social space, in its varying forms. In this European context, what is examined here is more particularly the French situation, from the point of view of the evolution of the notion of certification and recognition of skills, and of policies both of qualification, and of initial and continuing training of the work force.

Zusammenfassung Das sich allmählich in Europa abzeichnende wirtschaftliche und soziale Gleichgewicht wirkt sich entscheidend auf die Mobilität der Arbeitskräfte und die Anerkennung von Qualifikationen, Zeugnissen und Diplomen aus. Besonders auf dem Bildungssektor stellt sich die Frage nach dem sozialen und beruflichen Wert von Zeugnissen und der Anerkennung beruflicher Fähigkeiten. Diese Fähigkeiten sind Teil der Grundeigenschaften bestimmter Länder der Gemeinschaft und jedes Einzelnen, der nunmehr mit der Erweiterung wirtschaftlichen und sozialen Raumes in unterschiedlichster Form konfrontiert wird. In diesem europäischen Kontext wird hier im besonderen die Situation Frankreichs beschrieben unter dem Aspekt einer Evolution des Begriffs Zeugnis und der Anerkennung beruflicher Fähigkeiten, sowie einer Qualifikations- und Ausbildungspolitik für die Arbeitskräfte.
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