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PubMed1998

Nursing practice draws upon several different ways of knowing.

This paper explores the proposition that nursing practice draws upon several different ways of knowing. It highlights difficulties often faced by practising nurses in defining what they do and hence what it is that constitutes nursing practice. Following formal definition and analysis of sources of literature regarding nursing knowledge, issues such as the origins of knowledge and the sources of nursing knowledge are addressed. The types of knowledge required to enhance nursing practice are discussed, focusing upon future opportunities and innovations in the generation of knowledge for nursing. Finally, recommendations are made regarding the way forward for nurses endeavouring to communicate the complexities of nursing practice.

Health Knowledge, Attitudes, Practice↗

PubMed2003

A dual-process model of belief and evidence interactions in causal reasoning.

In three experiments, we examined how reasoners' preexisting beliefs about causal relations constrained their evaluation of covariation-based empirical evidence. Reasoners were presented with causal candidates that were a priori rated to be either believable or unbelievable, as well as information regarding the degree to which the cause and the effect covaried. Several findings supported the conclusion that preexisting beliefs about causal relations reflect knowledge of both causal mechanisms and covariation relations, that these sources of knowledge are represented independently and contribute independently to causal judgments, and that the evaluation of new empirical evidence is influenced differently by mechanism-based and covariation-based beliefs. Finally, we observed that reasoners were relatively accurate in evaluating the degree to which their judgments were sensitive to empirical evidence but were less able to judge how much their judgments were influenced by their prior beliefs. We present a dual-process model that provides a descriptive account of the boundary conditions for belief and evidence interactions in causal reasoning.

Adolescent↗

PubMed2004

Osteoporosis among perimenopausal African-American women: the relationship between sources of information and levels of knowledge about osteoporosis.

The aim of this study is to increase awareness of the occurrence of osteoporosis in perimenopausal African-American women. This quantitative study was designed to measure African-American women's knowledge of osteoporosis and to determine on what sources of information about osteoporosis African-American women rely Aside from demographic variables, other data were collected to determine which sources of information about osteoporosis African-American women use, whether they know that osteoporosis is a preventable disease, and whether there is a relationship between sources of information and the level of knowledge about osteoporosis among these women. Participants consisted of 45 perimenopausal African-American women from 42 to 52 years of age residing in Houston, Texas Data were utilized from an ongoing research project. Analysis of the data presented suggests that there is an association between specific sources of information and the level of knowledge about osteoporosis in this age group of African-American women.

Adult↗

PubMed2003

Protégé-2000: an open-source ontology-development and knowledge-acquisition environment.

Protégé-2000 is an open-source tool that assists users in the construction of large electronic knowledge bases. It has an intuitive user interface that enables developers to create and edit domain ontologies. Numerous plugins provide alternative visualization mechanisms, enable management of multiple ontologies, allow the use of interference engines and problem solvers with Protégé ontologies, and provide other functionality. The Protégé user community has more than 7000 members.

Database Management Systems↗

PubMedDate not supplied

Parental monitoring: a reinterpretation.

Monitoring (tracking and surveillance) of children's behavior is considered an essential parenting skill. Numerous studies show that well-monitored youths are less involved in delinquency and other normbreaking behaviors, and scholars conclude that parents should track their children more carefully. This study questions that conclusion. We point out that monitoring measures typically assess parents' knowledge but not its source, and parents could get knowledge from their children's free disclosure of information as well as their own active surveillance efforts. In our study of 703 14-year-olds in central Sweden and their parents, parental knowledge came mainly from child disclosure, and child disclosure was the source of knowledge that was most closely linked to broad and narrow measures of delinquency (normbreaking and police contact). These results held for both children's and parents' reports, for both sexes, and were independent of whether the children were exhibiting problem behavior or not. We conclude that tracking and surveillance is not the best prescription for parental behavior and that a new prescription must rest on an understanding of the factors that determine child disclosure.

Adolescent↗

PubMed2001

[Candid, not monitored children run less risk of becoming delinquent].

Monitoring (tracking and surveillance) of children's behavior is considered an essential parenting skill. Numerous studies show that well monitored youths are less involved in delinquency and other norm-breaking behaviors, and scholars conclude that parents should track their children more carefully. We have questioned that conclusion. We point out that monitoring measures typically assess parents' knowledge, but not its source, and parents could derive knowledge from their children's free disclosure of information as well as their own active surveillance efforts. In our study of 14-year-olds in central Sweden and their parents, parental knowledge came mainly from child disclosure, and child disclosure was the source of knowledge that was most closely linked to broad and narrow measures of delinquency (norm-breaking and police contact). Parents' control efforts were related to good adjustment only after the child's feelings of being controlled, which were linked to poor adjustment, were partialled-out. These results held for both children's and parents' reports, for both sexes, and independent of whether the children were exhibiting problem behavior or not. We conclude that tracking and surveillance is not the best prescription for parental behavior, and a new prescription must rest on an understanding of the factors that determine child disclosure. As adolescents spend increasing amounts of time away from home, parental trust should become important, but little is known about how trust develops. We propose that parental trust is based on knowledge, primarily. We have pitted three types of knowledge about the child against each other in the prediction of parental trust--knowledge of: feelings and concerns, past delinquency, and daily activities. Results showed that knowledge of daily activities was more important than knowledge of past delinquency. In further analyses, knowledge of daily activities that came from the child's spontaneous disclosure was most closely linked to parents' trust. These findings add support to our reinterpretation of parental "monitoring" as parental knowledge that mainly comes from spontaneous child disclosure. Additionally, the role of parental trust for dysfunctional family relations was examined, and it was found that the relations between the child's delinquency and family dysfunction were mediated by parental trust. Finally, even though there was substantial agreement between parents and children about parents' trust in the child, the individual's unique perspectives were important. Family dysfunction from the child's perspective was based on whether they believed that their parents trusted them, and parents' perceptions of family dysfunction were based on their trust in the child.

Adolescent↗

PubMedDate not supplied

An optimal constrained linear inverse method for magnetic source imaging.

Magnetic source imaging is the reconstruction of the current source distribution inside an inaccessible volume from magnetic field measurements made outside the volume. It is possible in many applications to estimate, from prior physiological and anatomical knowledge, the source positions, amplitudes, and correlations, as well as the noise amplitudes and correlations. The optimal constrained linear inverse method (OCLIM) uses this prior knowledge to obtain a minimum mean-square error estimate of the current distribution. OCLIM can be efficiently computed using the Cholesky decomposition, taking about a second on a workstation-class computer for a problem with 64 sources and 144 detectors. Any source and detector configuration is allowed as long as their positions are fixed a priori. Correlations among source and noise amplitudes are permitted. OCLIM reduces to the optimally weighted pseudoinverse method of Shim and Cho if the source amplitudes are independent and identically distributed and to the minimum-norm least-squares estimate in the limit of no measurement noise or no prior knowledge of the source amplitudes. In the general case, OCLIM has better mean-square error than either previous method. OCLIM appears well suited to magnetic imaging, since it exploits prior information, provides the minimum reconstruction error, and is inexpensive to compute.

Computer Simulation↗

PubMed1995

Knowledge acquisition from the UMLS sources: application to the description of surgical procedures.

The re-usability of lexicons and knowledge in medicine is a crucial challenge. The Unified Medical Language System (UMLS) project has attempted to provide a repository of concepts, semantically categorized for biomedical domain. This paper describes some results about the relevance of UMLS structures for specific purposes. We have focused on the description of surgical procedures. Discussion concerns synonymy of terms, granularity of concepts, and ontology. A preliminary work on the exploitation of interconcept links by a computerized application reveals a heterogeneous implementation of those relationships. However, the UMLS provides a powerful knowledge base for developers.

General Surgery↗

PubMed2004

Source apportionment of sediment PAHs in Lake Calumet, Chicago: application of factor analysis with nonnegative constraints.

A factor analysis model with nonnegative constraints (FA) was used to apportion the sources of PAHs found in sediments of Lake Calumet and surrounding wetlands in southeast Chicago. Source profiles and contributions, with uncertainties, are determined with no prior knowledge of sources. The model includes scaling and backscaling of data with average PAH concentrations without sample normalization. This work is a follow-up to a study that used a chemical mass balance (CMB8.2) model to apportion sources to the same data set. Literature source profiles, modified based on gas/particle partitioning of individual PAHs, from eight PAH sources were considered for comparison. FA results for a two-source solution indicate coke oven (45%) and traffic (55%) are the primary PAH sources to Lake Calumet sediments. A six-source FA solution indicates that coke oven (47%) and traffic (45%) related sources are major PAH sources and wood burning-coal residential (2.3%) is a minor PAH source. From the six-source solution, two coke oven profiles are observed, a standard coke oven profile (33%), and a degraded or second coke oven profile (14%) low in phenanthrene and pyrene. Observed traffic related sources include gasoline engine (36%) exhaust and traffic tunnel air (9.3%). This work supports the previous study of Lake Calumet PAHs by CMB model. In addition, FA provides new insights since wood burning and secondary coke oven profiles were not recognized in the CMB model.

Coke↗

PubMed2004

Awareness and practices of contraception among Pakistani women attending a tertiary care hospital.

Pakistan is one of the most populous nations in the world, with an annual growth rate of 2.8 and high total fertility rate, even among developing nations. The Pakistan Reproductive Health and Family Planning Survey highlighted the wide gap between knowledge (97%) and use of contraceptives (28%) among currently married women. Our actual need is to enhance contraceptive practice in our country. This study was designed to investigate contraceptive knowledge and practice in Pakistani women attending a tertiary care hospital. This questionnaire-based study was conducted at the Gynaecology Unit II of Sir Ganga Ram Hospital, Fatima Jinnah Medical College, Lahore, Pakistan. A total of 204 married women of reproductive age were interviewed by a registrar to record their age, occupation, educational status, number of children, knowledge about contraceptive methods, source of the knowledge, attitudes and practices of contraception. About 57% of women were between 26 and 35 years of age, while 52% of men were between 31 and 40 years. Educational status of the majority of females was below matriculation (33%), while 34% males were above matriculation; 88% of females were housewives and less than 1% of men were out of work. Regarding the social status of couples, 64% were living on income less than 5000 rupees /month (about 60 pound sterling). Of the women, 67% were para 2-5; 68% had some sort of awareness regarding contraception. The main source of information was television (26%) and relatives (24%). The majority knew about the pill (68%) and IUCD (55%). Only 47% were using some sort of contraception. The most common method chosen was the barrier method (15%), followed by IUCD (10%) and the pill (10%). The least common methods were sterilisation (2%) and the rhythm method (2%); 85% of the women and 74% of the men in the study group had a positive attitude toward contraception. In order to improve contraceptive use in Pakistan we need to use multiple media sources to educate couples and their parents regarding contraceptive services, strengthen the perceptions that religion not only allows but also recommends family planning and to create awareness among women to have their rights and opinions about the size of family. The concept of differentiation between sons and daughters should be discouraged. In addition government and non-governmental organisations (NGOs) should organise groups to provide counselling and promotion of contraceptive services at the doorstep. We must act as a team to control our growth rate for economic stabilisation of the country and to raise the living standards of our people.

Adult↗

PubMed2001

How do patients choose private in vitro fertilization treatment? A customer survey in a tertiary fertility center in the United Kingdom.

OBJECTIVE: To assess the relevant factors affecting patients' decision when choosing a clinic for private, self-funded IVF treatment. DESIGN: Prospective anonymous closed questionnaires. SETTING: Single tertiary-care private IVF center. PATIENT(S): New patients attending primary consultation in a period of 7 months from September 1999 to March 2000. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Primary knowledge about the clinic, source of referral, knowledge of, availability of information pack, and familiarity with the clinic's success rates and treatment's price. The last question assessed the relative importance of each factor in the decision-making process according to the SERVQUAL model, modified version. All items were measured as perceptions on a 5-point Likert scale. 1 = not important, 3 = neutral, and 5 = very important. RESULTS(S): One hundred seventy-five patients completed the questionnaire. They were well informed and investigated the market before making their final choice. Patients collect information from many sources, including new channels such as the Internet. Up to one third of patients do not consult their doctor before treatment. By far the most relevant factor in decision making is the success rate (i.e., delivery rates) of the clinic, followed by recommendation by general practitioner (GP) or consultant (respectively, Likert scale score, 4.6; 95% confidence interval [CI], 4.5-4.7; and Likert scale score, 4.0; 95% CI, 3.9-4.2; P<.01). Other factors, such as cost of the treatment, friends and relatives' opinions, and distance from home were not relevant. CONCLUSION(S): Units that wish to thrive and increase their market share should deliver high-quality service and concentrate their efforts on excelling in performance.

Ambulatory Care Facilities↗

PubMed2006

Gene and protein nomenclature in public databases.

BACKGROUND: Frequently, several alternative names are in use for biological objects such as genes and proteins. Applications like manual literature search, automated text-mining, named entity identification, gene/protein annotation, and linking of knowledge from different information sources require the knowledge of all used names referring to a given gene or protein. Various organism-specific or general public databases aim at organizing knowledge about genes and proteins. These databases can be used for deriving gene and protein name dictionaries. So far, little is known about the differences between databases in terms of size, ambiguities and overlap. RESULTS: We compiled five gene and protein name dictionaries for each of the five model organisms (yeast, fly, mouse, rat, and human) from different organism-specific and general public databases. We analyzed the degree of ambiguity of gene and protein names within and between dictionaries, to a lexicon of common English words and domain-related non-gene terms, and we compared different data sources in terms of size of extracted dictionaries and overlap of synonyms between those. The study shows that the number of genes/proteins and synonyms covered in individual databases varies significantly for a given organism, and that the degree of ambiguity of synonyms varies significantly between different organisms. Furthermore, it shows that, despite considerable efforts of co-curation, the overlap of synonyms in different data sources is rather moderate and that the degree of ambiguity of gene names with common English words and domain-related non-gene terms varies depending on the considered organism. CONCLUSION: In conclusion, these results indicate that the combination of data contained in different databases allows the generation of gene and protein name dictionaries that contain significantly more used names than dictionaries obtained from individual data sources. Furthermore, curation of combined dictionaries considerably increases size and decreases ambiguity. The entries of the curated synonym dictionary are available for manual querying, editing, and PubMed- or Google-search via the ProThesaurus-wiki. For automated querying via custom software, we offer a web service and an exemplary client application.

Abstracting and Indexing↗

PubMed2005

PAHs in sediments of the Black River and the Ashtabula River, Ohio: source apportionment by factor analysis.

Sources of polycyclic aromatic hydrocarbons (PAHs) in the Black River and Ashtabula River sediments were apportioned using a factor analysis (FA) model with nonnegative constraints. Source profiles, contributions (microg/g) and percent contributions are determined with no prior knowledge of sources. The FA model includes scaling and backscaling of data with average PAH concentrations, without sample normalization. The present work is a follow-up to studies that used a chemical mass balance model to apportion sources to the same data sets. Literature source profiles, modified based on gas/particle partitioning of individual PAHs, from nine PAH sources were considered for comparison. FA results for a three-source solution indicate traffic (58%), coke oven (26%), and wood burning/coal tar (16%) are the primary PAH sources to Black River sediments. The primary PAH sources to the Ashtabula River sediments are traffic (51%), coke oven (44%), and wood burning (5%). This work supports the previous studies of Black River and Ashtabula River PAHs by CMB model. In addition, FA provides a more realistic fit to Ashtabula River model data by eliminating 100% contributions from one source.

Coke↗

PubMed1997

Sources of data for pharmacoepidemiological studies of child and adolescent psychiatric disorders.

In view of the dramatic shift to managed care models for United States health care delivery, reliable information on the prevalence and variations in psychopharmacological drug therapies for youth in community practice settings is essential. Pharmacoepidemiology, the study of medication use in large populations, aims to accomplish that challenging task. This article offers child psychopharmacologists a brief introduction to data sources for pharmacoepidemiology. Knowledge of these data sources combined with epidemiological methods for data analysis is a beginning step to assess the psychotropic medication prescribing patterns of community physicians. This review is organized in the following sequence: (1) characteristics of the "usual practice environment" according to setting, patient population, and physician characteristics; (2) validity issues related to data sources and their potential for outcomes research; (3) data sources divided into primary and secondary types that are described in terms of their features, advantages, and limitations, followed by examples of selected applied studies using such information; (4) procedures for analyzing secondary data; (5) data analytic and longitudinal approaches; and (6) access, confidentiality, and funding. A goal for future investigators in this emerging field is to develop applied research that is clinically sophisticated, methodologically sound, and public health-minded.

Adolescent↗

PubMed1985

Information needs in office practice: are they being met?

We studied the self-reported information needs of 47 physicians during a half day of typical office practice. The physicians raised 269 questions about patient management. Questions related to all medical specialties and were highly specific to the individual patient's problem. Subspecialists most frequently asked questions related to other subspecialties. Only 30% of physicians' information needs were met during the patient visit, usually by another physician or other health professional. Reasons print sources were not used included the age of textbooks in the office, poor organization of journal articles, inadequate indexing of books and drug information sources, lack of knowledge of an appropriate source, and the time required to find the desired information. Better methods are needed to provide answers to questions that arise in office practice.

Adult↗

PubMed1999

Workflow analysis and evidence-based medicine: towards integration of knowledge-based functions in hospital information systems.

The large extent and complexity of scientific evidence described in the concept of evidence-based medicine often overwhelms clinicians who want to apply best external evidence. Hospital Information Systems usually do not provide knowledge-based functions to support context-sensitive linking to external information sources. Knowledge-based components need specific data, which must be entered manually and should be well adapted to clinical environment to be accepted by clinicians. This paper describes a workflow-based approach to understand and visualize clinical reality as a preliminary to designing software applications, and possible starting points for further software development.

Artificial Intelligence↗

PubMed2000

Basics of evidence-based practice. Part 1: The nature of the evidence.

Basics of evidence-based practice are presented in 2 parts. Part 1 explores the characteristics of evidence used in evidence-based practice. Part 2 presents basic terms and processes of EBP. The nature of the evidence as the basis for clinical decisions is a major distinction between the new paradigm of evidence-based practice and yesterday's approaches to research utilization. This article discusses why research evidence is the best source of clinical knowledge, and why systematic reviews, in particular, provide the most stable knowledge for clinical practice. Sources of evidence summaries, such as Agency for Healthcare Research and Quality, are also discussed.

Databases, Factual↗

PubMed2001

A call for respect and equality for indigenous scholarship in Hawaiian health.

In the State of Hawai'i, there has been steady interest on the part of Western scholarly communities in studies of indigenous Hawaiian intellectual properties. There exists an academic desire to appropriate new fields of knowledge from Hawaiian sources. This pursuit of knowledge runs the risk of increasing the sense of cultural violation already felt by many indigenous populations. If conducted using the means of colonialist intellectualism common to the academy of the dominant culture, this quest for new information will likely contribute to a legacy of spiritual and cultural violation felt by the Hawaiian people. This effort will then likely lead to a further decline in feelings of cultural integrity on the part of native populations. This endeavor will then increase the basis for the psycho-spiritual malaise that underpins the negative health statistics evidenced in Native Hawaiian populations. If present day researchers are to gain greater insight into the lexicon of knowledge available from Native Hawaiians, they will have to employ methods that provide for indigenous scholars to serve as co-researchers in this quest. If Western scholars are to gain access to Native Hawaiian knowledge, such information will more likely come as a result of healing this social wound by developing a new relationship of respect for Native Hawaiian cosmology, epistemology, and pedagogy--one wherein all parties are accepted as co-equals in the scholarly process.

Attitude of Health Personnel↗