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Bridging the digital divide between information and technology haves and have-nots has waned from the top of the national policy agenda in the United States during a time in which the sunken investments of the 1990s need to be leveraged. A national information network now exists yet this infrastructure--largely hardware--needs to be continually modernized and parlayed with commitments to building human capacity, developing relevant content, and scaling socially beneficial technology applications, such as telemedicine, in order to optimize these initial multi-billion-dollar outlays. This article makes the case that sidestepping public-private initiatives aimed at accelerating digital opportunity is imprudent, given the mounting empirical evidence highlighting the payoffs of information and communications technologies, when properly integrated and applied, especially in enhancing the life chances of underserved Americans. Policy next steps should advance the goals of expanding universal service initiatives, including hastening broadband deployment to homes and learning institutions, and deepening programs which leverage the utility of the existing infrastructure, such as expanding human-capital development, producing relevant content, and innovating socially beneficial technology applications.  相似文献   
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Abstract

Drug abuse by adolescents has been investigated in various surveys that reported correlations between age, gender, and activity. However, none of these studies included chemical analyses to help substantiate the statements of participants. In the present study, the urine specimens of 964 students (439 females, 525 males; mean age 22.1 years, s = 1.7), who applied to study sports sciences at university, were assessed for anabolic steroids, stimulants, and selected drugs prohibited in sports. In total, 11.2% of the urine specimens provided contained drugs covered by doping controls. The most frequently detected compound was the major metabolite of tetrahydrocannabinol (9.8%) followed by various stimulants related to amphetamine and cocaine (1.0%). Indications of anabolic steroid use were found in 0.4% of urine samples but originated from contraceptives containing norethisterone. The present study provided unambiguous data on the status quo of drug (ab)use by adolescents hoping for a career related to elite sport or sports sciences. No use of anabolic steroids was detected. However, evidence for stimulants and tetrahydrocannabinol administration was obtained, although not reported by any participant, which highlights the issue of under-reporting in surveys based solely on questionnaires.  相似文献   
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Using a complex simulation study we investigated parameter recovery, classification accuracy, and performance of two item‐fit statistics for correct and misspecified diagnostic classification models within a log‐linear modeling framework. The basic manipulated test design factors included the number of respondents (1,000 vs. 10,000), attributes (3 vs. 5), and items (25 vs. 50) as well as different attribute correlations (.50 vs. .80) and marginal attribute difficulties (equal vs. different). We investigated misspecifications of interaction effect parameters under correct Q‐matrix specification and two types of Q‐matrix misspecification. While the misspecification of interaction effects had little impact on classification accuracy, invalid Q‐matrix specifications led to notably decreased classification accuracy. Two proposed item‐fit indexes were more strongly sensitive to overspecification of Q‐matrix entries for items than to underspecification. Information‐based fit indexes AIC and BIC were sensitive to both over‐ and underspecification.  相似文献   
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Most childhood cancer survivors are insufficiently active. Researchers are focusing on strategies to increase physical activity (PA). However, a detailed understanding of participation in specific types of PA is missing, meaning current strategies may lack relevant information. Thus, our study sought to analyze participation in different types of PA commonly engaged in by children: organized sports, physical education in school (PES), therapeutic exercise, and non-organized leisure-time PA. Thirty-eight childhood cancer outpatients and 51 healthy children completed questionnaires. Compared to healthy children, childhood cancer outpatients, especially those who are shortly after cessation of inpatient treatment, participated significantly less often in organized sports and PES and significantly more often in therapeutic exercise compared to the healthy children. Considering organized sports and PES afford children unique social benefits and provide the potential to motivate lifelong activity, future efforts should be placed on ensuring children with cancer can access these types of PA. Educating parents, teachers, and coaches, exploring referral pathways to exercise professionals and providing individual support may enhance participation rates in organized PA and should be investigated.  相似文献   
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Zusammenfassung. Eine Vernetzung der Dienstleister im Gesundheitswesen wird aus Effizienzgründen immer wichtiger. Schwierigkeiten bereitet jedoch die Interoperabilität, womit die korrekte Kommunikation von beteiligten Softwaresystemen verschiedener Herkunft gemeint ist. Dieser Beitrag konzentriert sich auf die Interoperabilitätsproblematik auf der Ebene der Anwendungsarchitekturen. Mit Hilfe von Standards und Integrationstechniken bemühen sich verschiedene Lösungsansätze die Heterogenität zu überwinden, die einer umfassenden Interoperabilität im Wege steht. Die Frage, die sich uns in diesem Zusammenhang nun stellt ist, ob diverse Standards im Gesundheitswesen sinnvoll kombiniert werden können bzw. zwischen ihnen vermittelt werden kann. In diesem Artikel stellen wir die Grundzüge einer Architektur vor, die auf der Basis von Standards eine institutionsübergreifende Interoperabilität im Gesundheitswesen ermöglichen soll. Die Strukturen der relevanten Standards werden einheitlich als Instanzen des Meta-Object Facility (MOF) spezifiziert und dann geeignet zueinander in Beziehung gesetzt. Die resultierenden Modelle und Metamodelle bilden einen Leitfaden zur Strukturanalyse der Standards und helfen so beim Entwurf der Transformationen zwischen den verschiedenen Standards. Architektur und Metamodelle dienen als Grundlage für eine prototypische Implementierung am Beispiel des Epidemiologischen Krebsregisters Niedersachsen zur Evaluation des vorgestellten Konzeptes.Eingegangen am 14. März 2003, Angenommen am 9. Januar 2004, CR Subject Classification: H.2.1, H.2.5, J.3.  相似文献   
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