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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↗

PubMed2004

Information sources and level of knowledge of contraception issues among Greek women and men in the reproductive age: a country-wide survey.

OBJECTIVE: Good reproductive health depends to a great extent on how well informed people are on contraception issues. Contrary to the situation existing in many European countries, in Greece there has been a lack of studies investigating how well informed Greek women and men are. Also, the sources on which they draw are equally important. The aim of this study was to examine the knowledge of Greek women and men on issues of contraception, with the ultimate goal of identifying which groups should be the focus of prevention planning programs. METHOD: A country-wide survey was conducted through a self-administered questionnaire. The sample, numbering 1500 people, was representative of the Greek population aged 16-45 years. RESULTS: A key finding was that only a small percentage of the respondents were able to answer correctly 50% or more of the questions on knowledge of basic contraceptive issues (30.6% of women and 14.7% of men). Regarding sources of information, media and friends were reported as the primary sources of information for men of all ages and young women. The gynecologist becomes a significant source of consultation for women only after the age of 25 years. Even then, only 4% of women visiting a gynecologist do so to obtain information on prevention of pregnancy. The majority of women asking professional advice have already experienced an unwanted pregnancy. CONCLUSION: The need for health education is apparent, especially for young people.

Adolescent↗

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↗

PubMedDate not supplied

HIV/AIDS knowledge and attitudes amongst pharmacists in Zimbabwe.

OBJECTIVE: To examine the knowledge of HIV/AIDS amongst pharmacists in Zimbabwe. DESIGN: Cross sectional survey. SETTING: National survey of pharmacists in major urban areas and final year pharmacy students at the University of Zimbabwe. SUBJECTS: 250 pharmacists and 47 pharmacy students with 126 completed questionnaires returned (42.4%). INTERVENTIONS: The questionnaire asked for demographic details of the respondent, sources of knowledge about HIV/AIDS and measured knowledge (KW), fear of contagion (FC), negative emotions (NE) and professional resistance (PR) using a Likert scale of 1 to 5. MAIN OUTCOME MEASURES: Computed scores of KW, FC, NE and PR and reported sources of knowledge on HIV/AIDS. RESULTS: All pharmacists scored highly on KW (mean [SEM] = 4.0 [0.0] with academics scoring the highest (4.2 [0.5]; n = 7) and private hospital pharmacists the lowest (3.7 [0.2]; n = 5). Medical books/journals and professional colleagues were the most important sources of information. Scores for FC (2.7 [0.1]), PR (2.4 [0.1]) and NE (2.1 [0.1]) were low. Government hospital pharmacists tended to have a higher KW score than those in private hospitals (4.1 [0.3] vs 3.7 [0.2] respectively). Most of the respondents believed that HIV/AIDS had increased their workload. However, they saw a role for pharmacists in the prevention and management of HIV/AIDS but felt there were important time constraints. CONCLUSION: Pharmacists can play an important part in the strategy to manage the national HIV/AIDS epidemic, but negative attitudes towards HIV/AIDS sufferers may adversely affect their efficiency.

Adult↗

PubMed1987

Philosophic analysis of a theory of clinical nursing.

Knowledge in nursing requires development of theories that address both the science and art of the professional practice discipline. "A Theory of Clinical Nursing" was analyzed to explicate the epistemologic dimensions within an historic perspective. Epistemologic dimensions defined by the philosophy of science--approaches to theory development, sources of knowledge, and methodology--were characterized from two perspectives, scientific inquiry and historicism. The major perspectives in the scientific mode, namely, mechanism, empiricism, logical positivism, and logical empiricism, were analyzed along the three dimensions of theory development, sources of knowledge, and methodology. Trends in theoretical developments in nursing were related to the scientific and historic perspectives and to the epistemologic dimensions. Juxtaposing the diversity of knowledge required for nursing science and practice, and the values systems of the practitioners, revealed the inadequacy of the scientific model. Nursing knowledge explication required several modes of inquiry to articulate the scientific basis of the discipline and the art of delivery of the practice. The historicist approach framed scientific work with the prevailing World View. The Rubin theory was located within the matrix of approaches to inquiry and perspectives in nursing science. Labeled by the theorist as both a nursing research and a nursing care model, "A Theory of Clinical Nursing" represented a transition model of nursing, undergirded by the major conceptualizations and methodologies of field, psychoanalytic, and social behaviorist traditions, but implicitly coalescing the art with the science of nursing. The theory addressed core concepts of person, situation, and nursing care, as well as major process themes of change and interaction. Nursing theories of a more narrow range, such as maternal role attainment and maternal identity, nested within the theory, while subsequent theoretical clarifications and expansions have been constructed by students of the theorist. In the hierarchy of knowledge conceptualizations, Rubin's theory represents a disciplinary matrix: ordering theories, methods, and exemplars; giving direction to the development of theories of nursing that address empirical problems of the discipline; and cohering to the metaparadigm of nursing. Philosophic analysis of theories of nursing can yield an articulated, clearly depicted framework of concepts and their relationships from which new understandings may emerge.

Cognition↗

PubMedDate not supplied

Comparing evidence-based practice of nurses and physiotherapists.

Evidence-based practice has become an ubiquitous concept within nursing. However, there is little comparative data of nursing with other professions on attitudes to evidence-based practice. This article reports on a survey of nurses' and physiotherapists' sources of knowledge and perceived barriers to evidence-based practice within a large teaching hospital. A total of 324 questionnaires were sent to nurses and physiotherapists. The results showed that both physiotherapists and nurses accessed a wide variety of sources of knowledge. However, nurses were more likely than physiotherapists to use policy and procedure manuals and discussions with medical staff. Both professions have problems with overcoming the barrier of time. Nurses were more likely than physiotherapists to rate themselves as having poor evidence-based practice skills.

Attitude of Health Personnel↗

PubMed1994

Coming to terms with advanced breast cancer: black women's narratives from eastern North Carolina.

This paper analyzes in-depth interviews with 26 black women who entered the medical system in rural North Carolina with advanced breast disease. In these narratives, women draw on multiple sources of knowledge in order to come to terms with the diagnosis of breast cancer--a biomedically-defined disease that they often refuse to acknowledge or accept. The analysis demonstrates how women relate the meaning of their individual episodes of illness to one or more of the following sources of knowledge: an indigenous model of health emphasizing balance in the blood, popular American notions about cancer, and particular biomedical conceptions about breast disease and its treatment. These narratives provide an important window into the processes involved when individuals attempt to adapt personal experience to pre-existing cultural models, modify such models in the light of new information, and confront conflicts in their own interpretations of the meaning of a single episode of illness.

Adult↗

PubMed2003

Implementing evidence-based nursing practice: a tale of two intrapartum nursing units.

Despite concerns that the rise of evidence-based practice threatens to transform nursing practice into a performative exercise disciplined by scientific knowledge, others have found that scientific knowledge is by no means the preeminent source of knowledge within the dynamic settings of health-care. We argue that the contexts within which evidence-based innovations are implemented are as influential in the outcomes as the individual practitioners who attempt these changes. A focused ethnography was done in follow-up to an earlier trial that evaluated the effectiveness of a marketing strategy to encourage the adoption of evidence-based intrapartum nursing practice. Bourdieu's (1990, 1991) concepts of habitus, capital and social field were used in our refinement of the analysis of the ethnographic findings. Nursing leadership, interprofessional struggle with physicians, the characteristics of the community and the physical environment were prominent issues at all of the sites. Detailed descriptions of the sociohistorical context and of the experiences at two sites are presented to illustrate the complexities encountered when implementing innovations.

Adaptation, Psychological↗