Expanding rural primary care training by employing information technologies: the need for participation by medical reference librarians     

Coggan JM  Crandall LA 《Medical reference services quarterly》1995,14(1):9-16

The use of rural sites to train badly needed primary care providers requires access to sophisticated medical information not traditionally available outside of academic health centers. Medical reference librarians can play a key role in the development of primary care training sites in rural settings. Electronic information technologies, with proactive support from medical reference librarians, can provide current and detailed information without concern for distance from the health science center library. This paper discusses recent developments in technology, describes current challenges to the application of this technology in rural settings, and provides policy recommendations for medical reference librarians to enhance rural primary care training.  相似文献   

Evidence-Based Practice for Information Professionals: A Handbook     

Janet M. Coggan 《Journal of the Medical Library Association》2004,92(4):503-504

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Sweat lactate response during cycling at 30°C and 18°C WBGT     

JM Green  RC Pritchett  DC Tucker  TR Crews  JR McLester 《Journal of sports sciences》2013,31(4):321-327

Sweat lactate reflects eccrine gland metabolism. However, the metabolic tendencies of eccrine glands in a hot versus thermoneutral environment are not well understood. Sixteen male volunteers completed a maximal cycling trial and two 60-min cycling trials [30°C?=?30±1°C and 18°C?=?18±1°C wet bulb globe temperature (WBGT)]. The participants were requested to maintain a cadence of 60 rev?·?min^?1 with the intensity individualized at ～ 90% of the ventilatory threshold. Sweat samples at 10, 20, 30, 40, 50 and 60?min were analysed for lactate concentration. Sweat rate at 30°C (1380±325?ml?·?h^?1) was significantly greater (P<0.05) than at 18°C (632±311?ml?·?h^?1). Sweat lactate concentration was significantly greater (P<0.05) at each time point during the 18°C trial, with values between trials tending to converge across time. During the 30°C trial, both heart rate (20, 30, 40, 50 and 60?min) and rectal temperature (30, 40, 50 and 60?min) were significantly higher than in the 18°C trial. Higher sweat lactate concentrations coupled with lower sweat rates may indicate a greater relative contribution of oxygen-independent metabolism within eccrine glands during exercise at 18°C. Decreases in sweat lactate concentration across time suggest either greater dilution due to greater sweat volume or increased reliance on aerobic metabolism within eccrine glands. The convergence of lactate concentrations between trials may indicate that time-dependent modifications in sweat gland metabolism occur at different rates contingent partially on environmental conditions.  相似文献