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PubMedDate not supplied

Original research: an investigation of life with end stage renal disease: sociocultural case studies analysis.

The goal of this research was to gain an integrated understanding of the lives of people with end stage renal disease (ESRD) requiring hemodialysis (HD)--one that included cultural, institutional and historical contexts. In this research a sociocultural analysis of four cases of everyday life with ESRD offered a situated understanding of life with this disease. This study revealed that life with ESRD is work. Moreover, while people living with ESRD do the bulk of that work, family also work to "live" with ESRD. Biomedically-based knowledge can be enriched by incorporating two relevant sources of knowledge: participants and participants' significant others. The addition of these sources of knowledge broadens health care practitioners' understanding of ESRD as it is "lived," and, so informed, practitioners can better provide the kinds of education and support that will enhance the lives of people with this illness.

Adaptation, Psychological↗

PubMed2001

[The sources of self-knowledge and the cultural view of self].

A number of 1,604 respondents, divided into six age-categories, answered a questionnaire to examine the sources of self-knowledge as defined and measured by Schoeneman's method, and the cultural view of self measured by Takata's scale. The results revealed that adolescent categories displayed the strongest self-critical and interdependent tendencies, but referred to social sources (e.g., social feedback and social comparison) for self-knowledge least. On the contrary, adult categories were the most likely to refer to social sources in spite of their independent and self-enhancement tendencies. The results suggest that, positive self-images depend strongly on reference to social sources in Japanese culture, and that the independent construal of self, which is a dominant characteristic of Japanese people, is highly active in the adolescence period.

Adolescent↗

PubMed1999

Knowledge in health visiting practice.

Health visiting is a practical discipline, hence knowledge in health visiting practice cannot be thought of as inert, that is merely as items of information merely; rather, it must be thought of in terms of a dynamic interplay among the individuality of the knower (the practitioner), the sources whereby knowledge may be acquired, and the contexts in which it must be applied. This discussion is an exploration of that interplay. Thus, in the discussion, the distinctive demands on the practitioner (and the kinds of personal qualities these entail) in acquiring and applying knowledge are highlighted, as are the sources of knowledge and the constraints of context. Three sources of knowledge are noted: authority, personal experience, and intuition. Context is conceived both in terms of the macro, sociopolitical, level and in terms of the micro level, i.e. the individual homes and interpersonal relationships in and through which health visiting is typically practised. Conclusions are drawn relating to the education of health visitors. The discussion draws on a distinction between three kinds of knowledge: factual or propositional knowledge, knowledge by acquaintance, and practical knowledge, or know-how.

Clinical Competence↗

PubMed1991

Use of prior knowledge in brain electromagnetic source analysis.

Using multichannel measurements of EEG and/or MEG, macroscopic source activities can be estimated in the human brain using brain electric source analysis (BESA, Scherg 1990). If a discrete number of brain areas is active, functional brain images which depict the locations and orientations of equivalent dipole sources as well as the dynamics of the local macroscopic currents can be obtained from such data--in principle--without external knowledge. However, given a certain number of sources or 'neural masses' (Freeman 1975) which contribute to an event related response (ERP), it can be difficult to find the correct solution due to background noise in the data and distortions from the head model. Prior knowledge based on anatomy and physiology can be useful to constrain spatial or temporal parameters of the model and to define better cost functions for fitting locations and orientations. An analysis of the auditory evoked N100 complex and of the auditory mismatch negativity (MMN) is presented which illustrates the use of spatial constraints. Also, the use of a modified cost function is demonstrated which limits source currents in certain time intervals.

Brain↗

PubMed1996

Otorhinolaryngological diseases in Byzantium (A.D. 324-1453): information from non-medical literary sources.

The knowledge of the Byzantine physicians in the field of otorhinolaryngology and especially of the eminent ones, Oribasius, Aetius of Ameda, Paul of Aegina and Alexander of Tralles is noteworthy. They knew an adequate number of diseases of the ear, nose and throat and treated them with a plethora of drugs and some of them, especially tonsillitis and tonsillar abscess, with operations. The writer, based on the texts of the Byzantine historians and chroniclers, presents information previously unknown. This includes analysis of cases of an epidemic of angina, speech defects, instances of otitis, epistaxis, ulcer of the mouth, acute laryngitis or pharyngitis and psychogenic aphonia. Most cases concern emperors and other prominent figures of the State and Church. This information complements, from the historical point of view, the scientific knowledge of the medical writers in the field of otorhinolaryngology.

Byzantium↗

PubMed1979

Training in developmental pediatrics. How practitioners perceive the gap.

Ninety-seven randomly selected, board-certified pediatricians in five New England states were interviewed by two physicians to explore attitudes toward previous training and current sources of knowledge in developmental pediatrics. Formal training in development was rated as inadequate by 79%, of residency experience was viewed as highly valuable by only 30%, and 47% rated medical school as having no value. Although clinical experience was reported as a valuable source of knowledge by 99% of the sample, almost two thirds did not regard it as an adequate substitute for formal training. Frequent interdisciplinary communication was reported, and professional contacts were described as a highly valuable ongoing source of knowledge. Social class and size of practice did not correlate with differences in consultation patterns. A part-time longitudinal clinical experience for further education was preferred by 97%. Improved training with greater interdisciplinary content is needed.

Child↗

PubMed2002

Effects of incoherent and coherent source spectral information in geoacoustic inversion.

This paper examines the effect on matched-field geoacoustic inversion of including source spectral information, as can be available in controlled-source acoustic surveys. Source information can consist of relative or absolute knowledge of the source amplitude and/or phase spectra, and can allow frequency-coherent processing of spatial acoustic-field data. A number of multi-frequency acoustic processors, appropriate for specific types of source information, are defined based on the likelihood function for complex acoustic-field data with Gaussian noise. The information content of the various processors is quantified in terms of marginal probability distributions and highest-probability density intervals for the unknown geoacoustic and geometric parameters, which define the accuracy expected in inversion. Marginal distributions are estimated using a fast Gibbs sampler approach to Bayesian inversion, which provides an efficient, unbiased sampling of the multi-dimensional posterior probability density. The analysis is illustrated for incoherent and coherent processors corresponding to several types of source knowledge ranging from complete information to no information, and the results are considered as a function of the spatial and frequency sampling of the acoustic fields.

Acoustics↗

PubMed2004

Efficacy of an educational Web site for educating physicians about bioterrorism.

OBJECTIVES: To determine whether a Web-based educational intervention improves emergency physicians' knowledge about bioterrorism and to survey physicians' knowledge and sources of information on bioterrorism. METHODS: Prospective randomized controlled trial using pre- and postintervention testing in hospitals. Participants were general and pediatric emergency medicine attending physicians, fellows, and fourth-year emergency medicine residents. All participants completed a pretest and attended a lecture on bioterrorism. Participants were then randomized to the Web intervention group that received continuous access to a bioterrorism educational Web site with weekly exposure to case scenarios of diseases due to biological agents, or the control group. Participants were retested after one and six months and surveyed to identify their sources of information and assess their knowledge. RESULTS: Sixty-three physicians completed the pretest. There was no difference in mean +/- standard deviation (SD) pretest scores between Web intervention (45% +/- 10%) and control (44% +/- 10%) groups (mean difference: 1.9%; 95% confidence interval [CI] = -6.7% to 2.9%). There was no significant difference between pre- and posttest scores among groups at one month (Web intervention 48% +/- 10% vs. control 45% +/- 10%; mean difference: 3.3%; 95% CI = -8.5% to 2.0%) and six months (Web intervention 51% +/- 8% vs. control 47% +/- 9%; mean difference: 3.8%; 95% CI = -8.8% to 1.2%). More than 60% of physicians cited media reports as their primary source of information on bioterrorism and believed that their knowledge of bioterrorism was limited after one month. CONCLUSIONS: Providing physicians information on bioterrorism through simulated cases and continuous access to an educational Web site does not increase knowledge of bioterrorism. Physicians are more likely to use media reports for their primary source of information.

Attitude of Health Personnel↗

PubMed1999

Children's understanding of inferential knowledge.

The understanding of inference as a source of knowledge for 4- and 6-year-old children was investigated. Children and a puppet were shown 2 toys of different colors. The toys were hidden in separate plastic cans. After the puppet looked into 1 of the cans, 6-year-olds, but not 4-year-olds, usually judged that the puppet knew the color of the toy in the other can as well. The finding that 6-year-olds attributed inferential knowledge to another observer is interpreted as evidence that children begin to understand the role of cognitive processes in knowledge acquisition around the age of 6 years.

Child↗

PubMed1999

Knowledge and attitude of medical students in Delhi on postmortem examination.

A survey proforma with multiple choice questionnaire was designed and asked to be filled in by two hundred medical students belonging to 3rd and 4th year of MBBS curriculum of a University medical college in Delhi. One hundred thirty-three (66.5) students responded. A large majority of 129 (96.9%) students were aware of the major use of the postmortem examination/autopsy. All students have the knowledge that postmortem involves examination of a body in detail both externally and internally. Sixty-four (48.1%) feel that it does not cause disfigurement of the body. One hundred fifteen (86.4%) students were the view that they possess satisfactory level of knowledge on postmortems. The main source of knowledge and information on the subject is teaching during medical curriculum as informed by 76 (57.1%) students. More than 50% were willing ti permit autopsy on the self/relative. While, only 7 (5.3% students showed reluctance to watch autopsy.

Adolescent↗

PubMed1990

West Texas teenagers and AIDS: a survey of their knowledge, attitudes, behavioral changes, and information sources.

We conducted this study to determine the knowledge, attitudes, behaviors, and sources of AIDS information among teenagers in West Texas. We also examined differences by gender, ethnicity, and rural/urban status. Results were divided into the following categories: general knowledge of AIDS, AIDS-related attitudes, behavior changes caused by AIDS, and AIDS information sources. The 289 ninth-grade students revealed a greater knowledge of AIDS than had been shown in studies in other states. However, there were group differences with Anglo students exhibiting greater knowledge of AIDS. There were also some differences between rural and urban students, with urban students scoring higher on knowledge. Finally, doctors were regarded as the most reliable source of AIDS information. There were many implications related to AIDS education from these results and from the other findings in this study.

Acquired Immunodeficiency Syndrome↗

PubMed1998

Knowledge and information about ADHD: evidence of cultural differences among African-American and white parents.

Attention deficit hyperactivity disorder (ADHD) is considered the most common child psychiatric disorder in the United States of America. Despite the high prevalence (estimated at 3-5%), little is known about the level and source of knowledge about ADHD among those affected by the disease, and about cultural and ethnic variations in knowledge levels and information sources. This represents a serious deficit, because health behavior, including demand for health services, is thought to be strongly influenced by knowledge or beliefs held by individuals and their networks. Furthermore, recent research suggested minority children may be less likely to receive services for ADHD. To examine possible differences in ADHD knowledge and information source, a sample of 486 African-American and white parents of children at high risk for ADHD were surveyed by telephone and subsequently participated in face-to-face interviews addressing their explanatory models of ADHD. Results revealed significant ethnic differences in knowledge and sources of information about ADHD. Fewer African-American parents than white parents indicated that they had ever heard of ADHD (69% compared to 95%, P < 0.001), or that they knew some or a lot about it (36% compared to 70%, P < 0.001) African-American parents were more likely to attribute ADHD to excessive sugar in the diet than whites (59% compared to 30.0%, P < 0.001). Finally, even though the physician was listed as the most preferred information source for both groups, only 17.5% of African-American parents reported they had received information about ADHD from the physician compared to 29% of whites (P < 0.01). African American parents reported less use of and less preference for written informational materials (newspapers, journals, library) than white parents. We conclude that substantially more research should be undertaken to examine the relationship between ethnicity and ADHD knowledge, to inform culturally appropriate education campaigns and to improve access to services for this important treatable child mental health condition.

Adult↗

PubMed2003

Impact of a course on human sexuality and adolescence.

OBJECTIVE: This study was conducted as part of a course on Human Sexuality and Adolescence for school children to ascertain the prior knowledge of children, source of their knowledge and whether the course was a felt need of the children. METHOD: Students were given a questionnaire before the course. Few selected questions were asked again after the last session. The course was conducted in a private co-educational English medium school in urban Bangalore involving 392 students 13-15 years of age. The course was designed by the authors and dealt with anatomy, physiology, social and psychological aspects of growing up, HIV and contraception. RESULTS: 55-70% of class VIII, IX and X students had learnt about sex from friends, 30% from movies, 15% from text books and only 10% from parents. Misconceptions about anatomy, childbirth, HIV were common. 90% of tenth class students felt that education in human sexuality was necessary. CONCLUSION: In spite of chapters on reproduction in textbooks, children turn to peers or media to gather information on sexuality. Education in human sexuality is required in our schools, as this need is currently not being addressed adequately in our society.

Female↗

PubMed2004

Knowledge of dietary supplement label information among female supplement users.

The use of dietary supplements is a popular form of health behavior, especially among women. Little research has been conducted to determine consumers' comprehension of supplement label information. Therefore, this research evaluated comprehension of supplement label information among women 25-45 years of age who consumed a dietary supplement > or =4 times per week. Participants (n=51) completed a written questionnaire about supplement practices, a 10-item knowledge test, and an individual interview about terms used on supplement labels. Participants answered 70% of the questions correctly on the knowledge test indicating adequate knowledge of dietary sources of nutrients. Knowledge of recommended dosages, dosing instructions, and instructions about inappropriate use of supplements for certain people also was adequate. However, misconceptions regarding the term "natural" on supplement labels, product claims, and testing for product safety existed among participants. Supplement users need additional education about supplement claims and testing for product safety and efficacy to make informed health care choices.

Adult↗

PubMed2001

Tanzanian midwives' views on becoming a good resource and support person for postpartum women.

OBJECTIVES: to explore midwives' views in relation to the provision of systematic postpartum care. DESIGN: qualitative focus group study using grounded theory approach. SETTING: Dar es Salaam, Tanzania. PARTICIPANTS: 49 nurse/midwives in five focus group discussions, each having 9-11 participants. FINDINGS: eight categories were identified: 'reflecting', 'getting ready', 'defining abilities', 'networking', 'integrating', 'balancing', 'dealing with reality', and 'caring'. The identified core category that integrated and encapsulated all other categories was 'becoming a good resource and support person for postpartum woman'. The mediating factors found to have potential for influencing how a midwife can function in order to become a good resource and support person were: a) the structure and approach in maternal and child health services, b) midwives' knowledge, attitude and skills, c) informal sources of knowledge to parents, and d) cultural beliefs and practices. CONCLUSION: the findings of this study provide an understanding of the way midwives feel and think about the provision of postpartum care. The findings demonstrate that midwives need support in their efforts to achieve what they consider necessary for postpartum care. Interventions for educating and supporting midwives should be targeted at enabling them to deal with all the factors that influence their role and help them to identify and use better strategies to provide quality care.

Anecdotes as Topic↗

PubMedDate not supplied

Loading a nursing expert system from text: a case study.

A major bottleneck in the construction of expert systems has traditionally been the solicitation and formalization of expertise from the "human expert." As a means of reducing this bottleneck, the authors propose the use of "text" as a source of knowledge. Acquisition of knowledge from text has not been successful thus far, primarily because most text is not presented in a format (rules, frames, or logic) that can be directly used to load a knowledge base. The authors propose techniques to overcome these inherent problems. This article introduces a model for building an expert system that relies on "text" as the source of knowledge. The model is introduced via a case study involving the building of a nurse expert system designed to replicate the medical diagnostic activities of professional nurses.

Artificial Intelligence↗

PubMed2003

Making monitoring 'work': human-machine interaction and patient safety in anaesthesia.

This study aimed to explore the use of electronic monitoring within the context of anaesthetic practice. We conducted workplace observation of, and interviews with, anaesthetists and other anaesthetic staff in two UK hospitals. Transcripts were analysed inductively for recurrent themes. Whilst formal sources of knowledge in anaesthesia deal with the issue of monitoring in terms of theoretical principles and performance specifications of devices, anaesthetists in practice often 'disbelieve' monitoring information. They call on and integrate other sources of knowledge about the patient, especially from their clinical assessment. The ability to distinguish 'normal' and 'abnormal' findings is vital. Confidence in electronic information varies with experience, as does the degree to which electronic information may be considered 'redundant'. We conclude that electronic monitoring brings new dimensions of understanding but also the potential for new ways of misunderstanding. The tacit knowledge underlying the safe use of monitoring deserves greater acknowledgement in training and practice.

Anesthesia, General↗

PubMed2002

Evidence-based practice: implications for the practising oncology nurse.

While the premises of EBP seem highly appropriate on the surface, disquieting questions are raised when one examines the implications for the practising oncology nurse of attempting to implement EBP. There are clinical situations for which no empirical evidence exists on which to base nursing decisions. In some cases, empirical evidence is sparse and based on a mix of small, descriptive studies. Although guidelines exist for examining purely quantitative literature and are being developed for examining purely qualitative literature, no guidelines exist for evaluating a mixture. The process of operationalizing EBP is time-consuming and requires expertise which many oncology nurses lack. Does this mean that EBP is a laudable but impossible enterprise? I don't think so. Nurses will need to incorporate the empirical literature as well as other sources of knowledge to inform their clinical decision-making. In addition, oncology nurses need to apply and adapt models, such as Howell and Pelton's (2001), to make the best use of all sources of knowledge to facilitate excellent patient care.

Canada↗