Is family medicine meeting the HIV/AIDS challenge? A national survey of family physicians' beliefs, clinical competence, and experience regarding HIV disease

A national sample of family physicians was surveyed to (1) assess family physicians' beliefs about the human immunodeficiency virus (HIV) and individuals at risk for infection, their clinical competence regarding HIV-related issues, and their experiences with HIV disease; (2) present conclusions to the American Academy of Family Physicians (AAFP) to effect the development of an early clinical care protocol and a continuing medical education curriculum; and (3) collect base-line data for use in the evaluation of an early clinical care protocol and a continuing medical education curriculum, in the case that such programs are developed and disseminated. After considering retired or deceased respondents, of the 2,660 physicians surveyed, 1,678 (63.7%) responded. The resulting sample was representative of the active members of the AAFP. About 77% of the respondents were unable to accurately identify the universal precautions for blood and body fluids to prevent occupational transmission of HIV or hepatitis B virus (HBV). Residency trained and board certified physicians expressed fewer "external constraints," such as fear of losing patients, obviating them from providing treatment to individuals with HIV disease (p =.004 and p $<$.001, respectively). These physicians also manifested fewer "internal constraints" to the provision of HIV treatment, such as fear of becoming infected (p $<$.001 and p =.012, respectively). Residency trained physicians also expressed a greater comfort with discussing sexually-related topics with their patients than did non-residency trained physicians (p $<$.001). There were 67.1% of the physicians surveyed who reported never providing treatment to an individual with HIV disease. Residency trained and board certified physicians expressed a greater likelihood to provide treatment to HIV-infected patients (p $<$.001) than non-residency trained and non-board certified physicians.^ Among the various primary care specialties, family medicine is especially vulnerable to the current challenges of HIV/AIDS. These challenges are augmented by the epidemiologic pattern that characterizes AIDS. For the past several years, we have seen AIDS in this country assume a similar pattern to that seen in most other countries; HIV is becoming increasingly prevalent in the heterosexual population as well as in locations removed from metropolitan centers. This current phase of the epidemic generates greater pressures upon primary care physicians, particularly family physicians, to become better acquainted with the means to provide early care to HIV/AIDS patients and to prevent HIV/AIDS among their patients. Family medicine is especially appropriate for providing care to HIV patients because family medicine involves treatment to all age groups and conditions; other primary care specialties focus on limited patient populations or specific conditions. Family physicians should be armed with the expertise to confront HIV/AIDS. However, family physicians' clinical competence and experience with HIV is not known. The data collected in this survey describes their competencies, attitudes, and experiences. ^

The heart challenge: The effect of regular aerobic exercise on body fat distribution in third and fourth grade school children: A randomized clinical trial

The pattern of body fat distribution known as "centralized", and characterized by a predominance of subcutaneous fat on the trunk and a "pot belly", has been associated with an increased risk of chronic disease. These patterns of fat distribution, as well as the lifestyle habit variables associated with adult fatness and chronic morbidity clearly begin to develop during childhood, indicating the need for intervention and primary prevention of obesity, particularly the centralized form, during childhood or adolescence. The purpose of this study was to determine whether regular aerobic exercise could beneficially alter the distribution of body fat in 8 and 9 year old children. One hundred and eighty-eight participants were randomized into either a regular aerobic exercise treatment group or a standard physical education program control group. A variety of aerobic activities was used for intervention 5 days per week during physical education class for a period of 12 weeks. Fat distribution was measured by a number of the most commonly used indices, including ratios of body circumferences and skinfolds and indices derived from a principal components analysis. Change over time in average pulse rate was used to determine if intervention actually occurred. Approximately 10% of the students were remeasured, allowing the calculation of intra- and interexaminer measurement reliability estimates for all indices.^ This study group was comparable to the U.S. population, though the study children were slightly larger for certain measures. No effect of the exercise intervention was found. The most likely explanation for this was inadequacy of the intervention, as indicated by the lack of any change in average pulse rate with treatment. The results of the measurement reliability analysis are reported and indicate that body circumference ratios are more precise than skinfold ratios, particularly when multiple observers are used. Reliability estimates for the principal component indices were also high.^ It remains unclear whether the distribution of body fat can be altered with exercise. It is likely that this issue will remain undecided until one highly reliable, valid, and sensitive measure of fat distribution can be found. ^

Engaging stakeholders in community-level obesity prevention programming: Evaluation of the Fit Family Challenge

Introduction: Both a systems approach to change and a focus on multi-sector interventions ensures obesity prevention programming within the community is equitable, sustainable, and cost-effective. An authentic community engagement approach is required to implement interventions guided by best-evidence research and practice. Although there are examples illustrating the benefits of community engagement, there is no standardized method to implement it. The San Antonio Sports Foundation (SA Sports), a non-profit community-based organization, implements a variety of free events and programs promoting active life styles. One such program is the Fit Family Challenge which is a summer-long program implemented at the school level targeted at families. ^ Aims: This thesis was a culmination of the experience from the student collaborating with SA Sports as part of a practicum opportunity. Using secondary data collected by the Fit Family Challenge during the 2011 year, the goals of this thesis were: to assess individual changes; evaluate short-term impact; and describe the community engagement process. ^ Methods: SA Sports collected quantitative and qualitative data during the implementation and evaluation of the FFC program. SA Sports allowed the used of de-identified data to be analyzed to study the aims of this thesis. ^ Results: The program was able to provide families with the knowledge, information, and opportunity to exercise as a family and cook healthier meals. School district coordinators were generally satisfied and illustrated the benefits of a community partnership. An authentic community engagement was present highlighting the importance of communication, collaboration and the sustainability of such partnerships in the community. ^ Conclusion: The success of an obesity program should focus on triggers that initiate behavioral change rather than physiological changes. The evaluation was guided by a community engagement approach, which illustrated the development of new partnerships and the strengthening of other collaborations. Ultimately, the engagement approach empowered the community to identify their own problems and build collaboration, rather than tackling obesity prevention alone. ^

Territorial Intelligence of Vulnerability Systems 2- Sustainable Modelling of Globalization Challenge

Globalization as progress of economic development has increased population socioeconomical vulnerability when unequal wealth distribution within economic development process constitutes the main rule, with widening the gap between rich and poors by environmental pricing. Econological vulnerability is therefore increasing too, as dangerous substance and techniques should produce polluted effluents and industrial or climatic risk increasing (Woloszyn, Quenault, Faburel, 2012). To illustrate and model this process, we propose to introduce an analogical induction-model to describe both vulnerability situations and associated resilience procedures. At this aim, we first develop a well-known late 80?s model of socio-economic crack-up, known as 'Silent Weapons for Quiet Wars', which presents economics as a social extension of natural energy systems. This last, also named 'E-model', is constituted by three passive components, potential energy, kinetic energy, and energy dissipation, thus allowing economical data to be treated as a thermodynamical system. To extend this model to social and ecological sustainability pillars, we propose to built an extended E(Economic)-S(Social)-O(Organic) model, based on the three previous components, as an open model considering feedbacks as evolution sources. An applicative illustration of this model will then be described, through this summer's american severe drought event analysis

Equity and guidance : The challenge of a proposal

La presente propuesta corresponde a un proyecto de extensión universitaria, acreditado y subsidiado por la Secretaría de Extensión Universitaria de la Universidad Nacional de La Plata. Este plan de trabajo interinstitucional e interdisciplinario formó parte de una de las acciones de transferencia de nuestro último proyecto de investigación denominado La Orientación Vocacional Ocupacional en escuelas denominadas de alta vulnerabilidad psicosocial.

Equity and Guidance : The challenge of following up young graduates

In this paper we present a support strategy of guidance for the young people from vulnerable population, both urban and rural, who have completed high school and are involved in an extension program so called Equity and guidance: the challenge of a proposal in state educational institutions from the La Plata, Berisso and Ensenada districts. This program gives them a reflection space to analyze their personal, social and community situation as a self-managed process towards a project of life. For some time we have supported young people with the purpose of helping them to make a life project. When doing so, we've always noticed the need of finding strategies to provide reasons to carry on the project of completing high school, to search new knowledge, request scholarships, to think of alternatives according to their circumstances, etc. In this sense, the Project: ?Equity and Guidance: the challenge of following up young graduates? is a revealing experience since it shows the urgent need to provide real means to enable communities we work with to make the most of opportunities. For the young people who belong to a vulnerable community, a project of life doesn't mean just thinking of the choice of careers, trainings or jobs. It also means to find how to make it possible in their daily life. Everything we make, think and manage in this project has the same purpose: help them so they can make a life project according to their subjectivity

Equity and guidance : The challenge of a proposal

La presente propuesta corresponde a un proyecto de extensión universitaria, acreditado y subsidiado por la Secretaría de Extensión Universitaria de la Universidad Nacional de La Plata. Este plan de trabajo interinstitucional e interdisciplinario formó parte de una de las acciones de transferencia de nuestro último proyecto de investigación denominado La Orientación Vocacional Ocupacional en escuelas denominadas de alta vulnerabilidad psicosocial.

Equity and Guidance : The challenge of following up young graduates

In this paper we present a support strategy of guidance for the young people from vulnerable population, both urban and rural, who have completed high school and are involved in an extension program so called Equity and guidance: the challenge of a proposal in state educational institutions from the La Plata, Berisso and Ensenada districts. This program gives them a reflection space to analyze their personal, social and community situation as a self-managed process towards a project of life. For some time we have supported young people with the purpose of helping them to make a life project. When doing so, we've always noticed the need of finding strategies to provide reasons to carry on the project of completing high school, to search new knowledge, request scholarships, to think of alternatives according to their circumstances, etc. In this sense, the Project: ?Equity and Guidance: the challenge of following up young graduates? is a revealing experience since it shows the urgent need to provide real means to enable communities we work with to make the most of opportunities. For the young people who belong to a vulnerable community, a project of life doesn't mean just thinking of the choice of careers, trainings or jobs. It also means to find how to make it possible in their daily life. Everything we make, think and manage in this project has the same purpose: help them so they can make a life project according to their subjectivity

Territorial Intelligence of Vulnerability Systems 2- Sustainable Modelling of Globalization Challenge

Globalization as progress of economic development has increased population socioeconomical vulnerability when unequal wealth distribution within economic development process constitutes the main rule, with widening the gap between rich and poors by environmental pricing. Econological vulnerability is therefore increasing too, as dangerous substance and techniques should produce polluted effluents and industrial or climatic risk increasing (Woloszyn, Quenault, Faburel, 2012). To illustrate and model this process, we propose to introduce an analogical induction-model to describe both vulnerability situations and associated resilience procedures. At this aim, we first develop a well-known late 80?s model of socio-economic crack-up, known as 'Silent Weapons for Quiet Wars', which presents economics as a social extension of natural energy systems. This last, also named 'E-model', is constituted by three passive components, potential energy, kinetic energy, and energy dissipation, thus allowing economical data to be treated as a thermodynamical system. To extend this model to social and ecological sustainability pillars, we propose to built an extended E(Economic)-S(Social)-O(Organic) model, based on the three previous components, as an open model considering feedbacks as evolution sources. An applicative illustration of this model will then be described, through this summer's american severe drought event analysis

Equity and Guidance : The challenge of following up young graduates

In this paper we present a support strategy of guidance for the young people from vulnerable population, both urban and rural, who have completed high school and are involved in an extension program so called Equity and guidance: the challenge of a proposal in state educational institutions from the La Plata, Berisso and Ensenada districts. This program gives them a reflection space to analyze their personal, social and community situation as a self-managed process towards a project of life. For some time we have supported young people with the purpose of helping them to make a life project. When doing so, we've always noticed the need of finding strategies to provide reasons to carry on the project of completing high school, to search new knowledge, request scholarships, to think of alternatives according to their circumstances, etc. In this sense, the Project: ?Equity and Guidance: the challenge of following up young graduates? is a revealing experience since it shows the urgent need to provide real means to enable communities we work with to make the most of opportunities. For the young people who belong to a vulnerable community, a project of life doesn't mean just thinking of the choice of careers, trainings or jobs. It also means to find how to make it possible in their daily life. Everything we make, think and manage in this project has the same purpose: help them so they can make a life project according to their subjectivity

Equity and guidance : The challenge of a proposal

La presente propuesta corresponde a un proyecto de extensión universitaria, acreditado y subsidiado por la Secretaría de Extensión Universitaria de la Universidad Nacional de La Plata. Este plan de trabajo interinstitucional e interdisciplinario formó parte de una de las acciones de transferencia de nuestro último proyecto de investigación denominado La Orientación Vocacional Ocupacional en escuelas denominadas de alta vulnerabilidad psicosocial.

Territorial Intelligence of Vulnerability Systems 2- Sustainable Modelling of Globalization Challenge

Globalization as progress of economic development has increased population socioeconomical vulnerability when unequal wealth distribution within economic development process constitutes the main rule, with widening the gap between rich and poors by environmental pricing. Econological vulnerability is therefore increasing too, as dangerous substance and techniques should produce polluted effluents and industrial or climatic risk increasing (Woloszyn, Quenault, Faburel, 2012). To illustrate and model this process, we propose to introduce an analogical induction-model to describe both vulnerability situations and associated resilience procedures. At this aim, we first develop a well-known late 80?s model of socio-economic crack-up, known as 'Silent Weapons for Quiet Wars', which presents economics as a social extension of natural energy systems. This last, also named 'E-model', is constituted by three passive components, potential energy, kinetic energy, and energy dissipation, thus allowing economical data to be treated as a thermodynamical system. To extend this model to social and ecological sustainability pillars, we propose to built an extended E(Economic)-S(Social)-O(Organic) model, based on the three previous components, as an open model considering feedbacks as evolution sources. An applicative illustration of this model will then be described, through this summer's american severe drought event analysis

Compilation, application and challenge of IDE-JETRO's International Input-Output tables

International input-output tables are among the most useful tools for economic analysis. Since these tables provide detailed information about international production networks, they have recently attracted considerable attention in research on spatial economics, global value chains, and issues relating to trade in value-added. The Institute of Developing Economies at the Japan External Trade Organization (IDE-JETRO) has more than 40 years of experience in the construction and analysis of international input-output tables. This paper explains the development of IDE-JETRO’s multi-regional input-output projects including the construction of the Asian International Input-Output table and the Transnational Interregional Input-Output table between China and Japan. To help users understand the features of the tables, this paper also gives examples of their application.

Exploring the sources of China's challenge to Japan : models of industrial organisation in the motorcycle industry

In view of the recent rise of China, this paper looks into one of the most important yet relatively overlooked ingredients of the Chinese success: industrial organisation. It will examine the case of the motorcycle industry, in which the rise of Chinese manufacturers even disrupted the established dominance of Japanese industry leaders. Adopting the modified version of the global value chain governance framework, this paper shows that the rise of China has been driven by a distinctive arm’s-length model of industrial organisation, which is in sharp contrast to the conventional captive model that has sustained the Japanese leadership.

Cross-lingual ontology matching as a challenge for the Multilingual Semantic Web

Recently, the Semantic Web has experienced significant advancements in standards and techniques, as well as in the amount of semantic information available online. Nevertheless, mechanisms are still needed to automatically reconcile information when it is expressed in different natural languages on the Web of Data, in order to improve the access to semantic information across language barriers. In this context several challenges arise [1], such as: (i) ontology translation/localization, (ii) cross-lingual ontology mappings, (iii) representation of multilingual lexical information, and (iv) cross-lingual access and querying of linked data. In the following we will focus on the second challenge, which is the necessity of establishing, representing and storing cross-lingual links among semantic information on the Web. In fact, in a “truly” multilingual Semantic Web, semantic data with lexical representations in one natural language would be mapped to equivalent or related information in other languages, thus making navigation across multilingual information possible for software agents.