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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↗

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↗

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↗

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↗

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↗

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↗

The incidental orgasm: the presence of clitoral knowledge and the absence of orgasm for women.

Women report anorgasmia and other difficulties achieving orgasm. One approach to alleviating this problem is to teach women about the clitoris. This assumes that women lack information about the clitoris and that knowledge about the clitoris is correlated with orgasm. Using a non-random sample of 833 undergraduate students, our study investigates both assumptions. First, we test the amount of knowledge about the clitoris, the reported sources of this knowledge, and the correlation between citing a source and actual knowledge. Second, we measure the correlation between clitoral knowledge and orgasm in both masturbation and partnered sex. Among a sample of undergraduate students, the most frequently cited sources of clitoral knowledge (school and friends) were associated with the least amount of tested knowledge. The source most likely to correlate with clitoral knowledge (self-exploration) was among the most rarely cited. Despite this, respondents correctly answered, on average, three of the five clitoral knowledge measures. Knowledge correlated significantly with the frequency of women's orgasm in masturbation but not partnered sex. Our results are discussed in light of gender inequality and a social construction of sexuality, endorsed by both men and women, that privileges men's sexual pleasure over women's, such that orgasm for women is pleasing, but ultimately incidental.

Clitoris↗

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↗

Intentional sun exposure in infancy in Sakarya, Turkey.

OBJECTIVE: To determine the extent of intentional sun exposure in infancy, and the prevalence of maternal belief that potentially increases the children's harm risk from ultraviolet radiation. The major determinants of mothers' beliefs and behaviors regarding sunning were also assessed. METHODS: Three hundred and ninety six Caucasian women mothering 0-12 month old infants, attending to Sakarya State Hospital Healthy Infant outpatient clinic in November 2003, filled in the questionnaire after giving their informed consent. Each mother was asked 11 structured questions regarding maternal education, beliefs regarding benefits or harms of sun exposure, use of sunlight for therapeutic purposes, use of sun protection, and source of knowledge. RESULTS: The mean age of the mothers was 27.37 +/- 5.36 years and the children was 5.71 +/- 3.53 months. Two hundred and thirty-five mothers (64.1%) believed that sunlight is harmful, but 296 (79.7%) named one benefit of intentional baby sunning. Sun causes cutaneous diseases was the most frequently (n=83/126) mentioned harm and sun strengthens bones and teeth was the number one (n=250/296) benefit according to the mothers. The leading source of knowledge for the beneficial effects of the sun was health care professionals (physician, midwife, nurse) 45.7% (130/284). There was no significant correlation between mothers' sunning behavior and age, education level, being advised so by a health care professional or believing that the sun was harmful. CONCLUSION: As these results display being the leading source of knowledge and initiative of healthy/risky behaviors, primary health care physicians/workers have to be informed regarding the vitamin D supplementation and risks of sun exposure.

Adult↗

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↗

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↗

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↗

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↗

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↗

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↗

Critical care outreach 2: uncovering the underpinning philosophy and knowledge through collaborative reflection.

Critical care outreach (Outreach) was introduced as part of a government strategy to address increasing demands on limited intensive care (level 3) and high-dependency (level 2) resources. The discipline of Outreach developed rapidly and, as a result, the fundamental philosophical theories and sources of knowledge that underpin its practice remain, at least to some extent, unexplored, and their contribution to practice overlooked. It is important that we understand these philosophical theories and sources of knowledge so that we are able to provide sound rationale and guidance for practice and address the increasing pressure to demonstrate effectiveness. The authors argue that the complex situations encountered and managed by Outreach are not entirely amenable to traditional forms of measurement, and that its impact on patient care is, therefore, not readily acknowledged. In applying a model of collaborative reflection, this study analyses the management of a clinical case by a nurse consultant in Outreach. In doing so, it explores the realities of practice by deconstructing the complexity of a particular situation and highlights the variety of knowledge that contributes to effective Outreach practice.

Attitude of Health Personnel↗

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↗

[Between collegial conversation and controlled trials: hospital-based neurologists' sources of information and their practical knowledge in the treatment of stroke patients].

The application of evidence-based and standardized knowledge is an important basis for coordinated and effective clinical work. A multicenter study, which was conducted in 30 clinical neurology departments and included 99 junior and senior registrars, addressed aspects of practical knowledge of stroke treatment by open structured oral interviews which were analyzed with respect to interphysician and guideline conformity. In addition, the participants were asked to rate the usefulness of various informational sources and describe their informational sources used according to the aspects of practical knowledge addressed. The respective departmental directors were questioned about the sources of medical knowledge accessible in their clinic. In almost all hospitals, physicians had access to a library and the Internet. However, departments differed with respect to their information management (frequency and type of medical education, quality management, participation in research activities). In accordance with other studies, the knowledge sources reported most often were textbooks, journals and clinical studies. For most sources, the usefulness rankings largely corresponded to the rankings of user behavior. Both were only weak predictors for interphysician and guideline conformity. They are more closely related to the within-department homogeneity of practical knowledge than to interdepartmental and guideline conformity. Within-department homogeneity is enhanced by the use of recent, published and evidence-based sources and topical interaction with clinical colleagues. Guideline conformity was related to the use of databases and professional journals. A preference for colleagues from out-patient practices diminished both interphysician and guideline conformity. It seems there is still untapped potential for within-department knowledge management, such as medical education, implementation and use of guidelines and topical discussions, which may enhance the homogeneity and guideline conformity of the practical knowledge that clinicians apply.

Communication↗