SEARCH · PubMed Health

Results for “Knowledge Management”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 451 records · Page 25Linked to original sources

PubMed2000

Issues in the development of an industrial bioprocess advisory system.

The background and motivation for the construction of a fault detection and advisory system for an industrial fermentation process plant are described. Here, the knowledge extracted from the operators (implemented in the form of production rules) is integrated with multivariate data-based methods for fault detection. The industrial benefits arising from this integrated system include: (1) reduced variability, (2) increased mean performance levels, (3) reduced operator-training time and (4) knowledge management in the broader organization.

Algorithms↗

PubMed1982

Review of significant progress in clinical dermatology since 1977.

The disease rules all; the patient, except for HLA typing, is in eclipse. Immunology holds the key to new knowledge. Management lingers at present behind scientific advance (systemic lupus erythematosus), or is fired by a new, and possibly overenthusiastic, aggressive spirit (mycosis fungoides). Classification of clinical disease is bound to change (dermatitis herpetiformis). Our concept of Staphylococcus aureus has been widened further (toxic shock syndrome). Psoriasis, a more unpleasant disease than we have cared to admit, may be connected with a generalized enzyme defect. Psoriasis, acne, and other disorders of keratinization respond to newer oral retinoids. Some vignettes of new therapy, new toxicity, new ideas, and old ideas seen anew have been presented.

Humans↗

PubMed1997

Learning the practice of nursing: views about preceptorship.

The provision of clinically based education for nursing students is an essential part of their learning needs. In this article, the opportunity to enhance clinically based learning by means of preceptors is discussed and investigated. A case study was conducted of one college of nursing after the introduction of the Preregistration Diploma of Higher Education in Nursing (Project 2000) course. The study involved preceptors (62), nursing students (15), ward managers (4), senior nurse managers (2) and nurse teachers (8). The investigation involved quantitative and qualitative approaches, data being gathered through questionnaires and interviews. The results indicate that preceptors included functions such as being a role model and supervision of learners' skills but not assessment as part of their role. These views were supported by students, teachers and managers. Knowledge of the clinical area and experience were reported to be preceptors' greatest assets for the role but lack of time to work with students was cited as the greatest barrier. Extra resources required were reported to be protected time for the student and preceptor to work together and further in-service education. The implications of these results for clinically based learning opportunities in the future are discussed.

Adult↗

PubMed2003

Recurrent pericarditis in children and adolescents: report of 15 cases.

OBJECTIVES: The aim of this study was to analyze the clinical findings, course, and treatment of recurrent pericarditis (RP) in patients with onset in childhood and adolescence. BACKGROUND: Recurrent pericarditis is a chronic condition that has presented problems in management. Knowledge about this disease is based on observations in adults, and no series of children has previously been published. METHODS: Fifteen children (nine males, six females) in whom pericarditis had recurred at least twice were encountered in the period 1985 to 1998. Their age at onset was 6.5 to 16.8 years (mean 11.6 years), and the follow-up was 4.0 to 16.2 years (mean 8.0 years). RESULTS: Recurrent pericarditis was preceded by open-heart surgery by 1 month to 5 years earlier in 7 of 15 patients. The six children with an atrial septal defect (ASD) had an operation at an older age (mean 9.9 years) than usual (mean 4.8 years). The risk of RP in children operated on for ASD at the age of six years or later was 5%. An initial attack of pericarditis was associated with pleuritis and/or pneumonia in 10 of 15 patients and with colitis in 2 of 15 patients During follow-up, the patients had 2 to 30 recurrences (mean 9.9). Later attacks tended to be milder. At the end of follow-up, 7 patients had been without attacks for >or=4 years, whereas after 4 to 16 years, the remaining patients still had active disease. No instance of constriction was found. Altogether, 11 of 15 patients were treated with corticosteroids. However, corticosteroids, whether alone or with methotrexate (n = 5), azathioprine (n = 1), cyclosporine (n = 1), or colchicine (n = 4) did not prevent recurrences. CONCLUSIONS: The most frequent background for RP in children was the closure of ASD after the age of six years. Its course was unpredictable and often chronic, irrespective of the underlying cause or the therapy given. Colchicine did not prevent relapses.

Adolescent↗

PubMedDate not supplied

Agenda setting within a community-based food security planning process: the influence of power.

OBJECTIVE: To determine the effectiveness of using citizen politics as a framework for empowering citizens to build a community food security agenda. DESIGN: A critical perspective, case study design, and multiple qualitative methods were used. PARTICIPANTS/SETTING: Forty-four participants were purposefully recruited to participate in a community-based planning process called a search conference (SC). Seven additional disenfranchised stakeholders who did not attend the SC were also recruited to participate. PHENOMENON OF INTEREST: To assess how power influenced agenda setting and to determine the extent to which disenfranchised stakeholders' most salient interests were incorporated into the final SC action agendas. ANALYSIS: The constant comparison method, content analysis, and consensus were used to produce the final analysis. RESULTS: Power influenced agenda setting by managing knowledge, problem framing, trust, and consent. Two of seven of disenfranchised stakeholders' most salient interests, including need for adequate food preparation skills and increased availability of locally produced foods, were incorporated into the final SC action agendas. CONCLUSIONS AND IMPLICATIONS: Citizen politics can be used to build a community food security agenda on issues that are not at odds with stakeholders in positions of power. To bring about change on issues in which power differences between groups are substantial, additional theoretical frameworks and public policy-making models are needed.

Adult↗

PubMed2005

Using a framework for spread: The case of patient access in the Veterans Health Administration.

BACKGROUND: Experience indicates that an effective operational system will spread much more slowly than, for example, a new antinausea drug. The Veterans Health Administration (VHA) used a Framework for Spread to spread improvements in access to more than 1800 outpatient clinics between April 2001 and December 2003. The framework identifies strategies and methods for planning and guiding the spread of new ideas or new operational systems, including the responsibilities of leadership, packaging the new ideas, communication, strengthening the social system, measurement and feedback, and knowledge management. APPLYING THE FRAMEWORK FOR SPREAD: Following a collaborative for reducing waiting times for patients without the large-scale addition of resources, each of the participating 22 Veterans Integrated Service Networks (VISNs) used the framework to expand improvements in access to care to six additional targeted clinics (for example, primary care, eye care, cardiology). RESULTS: During the VHAs spread initiative, waiting time for a primary care appointment decreased from 60.4 days at the end of fiscal year (FY) 2000 to 28.4 at the end of FY 2002. Results were sustained. Waiting time was <25 days at the end of FY 2004. DISCUSSION: The Framework for Spread suggests areas that organizations should consider when developing and executing a strategy for a spread initiative. Further study is needed to determine the specific activities that should be emphasized to accelerate spread.

Appointments and Schedules↗

PubMed2003

[Knowledge of breastfeeding management among residents in pediatrics].

The staff of maternity wards and clinics for maternal and child health should receive appropriate basic and in-service training on the health benefits of breastfeeding and on lactation management. Pediatricians should not only be knowledgeable about the health, nutritional and physiological aspects of appropriate feeding, they should also be familiar with the mechanics of breastfeeding, its various psychosocial influences, possible difficulties and how to overcome them. To evaluate knowledge of breastfeeding among pediatrics residents throughout Spain, a survey was conducted. A total of 250 questionnaires were collected. Significant differences were observed among provinces. In most areas, residents' training was insufficient. To achieve an appropriate level of knowledge among pediatrics residents in a subject as important to mother and child health as breastfeeding, courses should be given and repeated at regular intervals. Professional associations should be actively involved in promoting appropriate training for health professionals.

Adult↗

PubMed2003

The power of collaboration: using internet-based tools to facilitate networking and benchmarking within a consortium of academic health centers.

The University HealthSystem Consortium (UHC) represents a strategic alliance of 169 academic health centers and associated institutions engaged in knowledge sharing and idea-generation. The use of the Internet as a tool in the delivery of UHC's products and services has increased dramatically over the past year and will continue to increase during the foreseeable future. This paper examines the current state of UHC-member institution driven tools and services that utilize the Web as a fundamental component in their delivery. The evolution of knowledge management at UHC, its management information and reporting tools, and expansion of e-commerce provide real world examples of Internet use in health care delivery and management. Health care workers are using these Web-based tools to help manage rising costs and optimize patient outcomes. Policy, technical, and organizational issues must be resolved to facilitate rapid adoption of Internet applications.

Academic Medical Centers↗

PubMedDate not supplied

Sharing the geo-referenced results of climate change impact research.

The Prairie Adaptation Research Collaborative (PARC) has implemented an Internet Map Server (IMS) at the PARC web site (www.parc.ca) to 1) disseminate the geo-referenced results of PARC sponsored research on climate change impacts and adaptation, and 2) address data, information and knowledge management within the PARC network of researchers and partners. PARC facilitates interdisciplinary research on adaptation to the impacts of climate change in the Canadian Prairie Provinces. The web site is intended as a platform for sharing information and encouraging discussion of climate change impacts and adaptation. The IMS enables scientists and stakeholders to apply simple climate change scenarios to geo-referenced biophysical and social data, and dynamically create maps that display the geographic distribution of potential impacts of climate change. With a limited capacity for spatial analysis, most geo-processing and the climate impact modeling is done offline within a GIS environment. The IMS will serve the output from climate impact models, such that the model results can be customized by the web site user and be most readily applied to the planning and analysis of adaptation strategies.

Climate↗

PubMedDate not supplied

An information system for community nursing.

In this article, an information system for community nursing is presented. It is critically evaluated on the basis of practical experiences. Its goal is not only to reduce the workload with modern information and communication technology but also to improve the quality of nurses' work. The quality improved because of the process method of work, which led toward a better client/patient orientation and more creative and research-oriented nurses' work based on nursing knowledge management support. It relies on an integrated and structured information picture, with special emphasis on transparency and interpretability.

Activities of Daily Living↗

PubMed2003

Biodiversity as spatial insurance in heterogeneous landscapes.

The potential consequences of biodiversity loss for ecosystem functioning and services at local scales have received considerable attention during the last decade, but little is known about how biodiversity affects ecosystem processes and stability at larger spatial scales. We propose that biodiversity provides spatial insurance for ecosystem functioning by virtue of spatial exchanges among local systems in heterogeneous landscapes. We explore this hypothesis by using a simple theoretical metacommunity model with explicit local consumer-resource dynamics and dispersal among systems. Our model shows that variation in dispersal rate affects the temporal mean and variability of ecosystem productivity strongly and nonmonotonically through two mechanisms: spatial averaging by the intermediate-type species that tends to dominate the landscape at high dispersal rates, and functional compensations between species that are made possible by the maintenance of species diversity. The spatial insurance effects of species diversity are highest at the intermediate dispersal rates that maximize local diversity. These results have profound implications for conservation and management. Knowledge of spatial processes across ecosystems is critical to predict the effects of landscape changes on both biodiversity and ecosystem functioning and services.

Biodiversity↗

PubMed1988

The rise and decline of the American asylum movement in the 19th century.

This paper traces the history of the American public asylum from the 1840s through the late 19th century. The focus is on social factors that contributed to the establishment of public institutions at the urging of reformers, the attempts to model them on the architecture and "moral treatment" offered by the best private institutions, the crowding of the asylums, the growing criticism aimed at the asylums and their superintendents, and the effects of calls for other approaches and for scientific management. Knowledge of the asylum's history may be useful today, as we stand at the crossroads in the treatment of the mentally ill.

History, 19th Century↗

PubMed1986

A prototype microcomputer-based decision support system for industrial hygienists.

A prototype Industrial Hygiene Decision Support System (IH-DSS) was designed and implemented in a microcomputer environment using an integrated knowledge management system as the implementation vehicle. The heart of the system is a relational data base designed to minimize redundant data entry and to support flexible retrieval. An industrial hygienist's routine and ad hoc requirements for information retrieval and analysis support are met by screen displays, printed reports, and graphical summaries which may be presented on the screen, in a printed form, or as multicolored plots. A petroleum refinery was selected as the application environment for the prototype system because of the variety of processes, agents, and sampling methodologies involved in industrial hygiene support in that environment.

Computers↗

PubMed2002

Toward an understanding of diagnostic teleconsultations and their impact on diagnostic confidence.

This paper describes a four-stage model of the medical diagnostic process, and provides the results of an initial test of this emerging knowledge management theory. A study of the diagnostic teleconsultations between primary care physicians located in remote communities and specialists at the Medical College of Georgia was conducted. The study involved an analysis of the video recordings of teleconsultations and postteleconsultation telephone interviews with the specialists and physicians conducting diagnostic teleconsultations. The study revealed that the number of hypotheses generated by specialists, the overall duration of teleconsultations, and physicians' change in diagnostic confidence depended on the diagnostic stage of the specialty teleconsultation. This study demonstrated that the diagnostic stages have different behavioral and cognitive characteristics. Designers of telemedicine programs can complement these characteristics to increase the productivity of health care providers.

Clinical Competence↗

PubMed2002

Whole-system evaluation research of a scheme to support inner city recruitment and retention of GPs.

BACKGROUND: The GP Assistant/Research Associate scheme developed in the Guy's, King's and St Thomas' School of Medicine, London, aims to attract and recruit young GPs (GP Assistants) and develop their commitment to work in local inner city practices. Continuing professional development for both young and established GPs is a key feature of the scheme. OBJECTIVES: The objectives of the whole-system evaluation research were to explore the perspectives of 34 stakeholders in the academic department, the practices and the PCGs, and to investigate the experiences of 19 GP Assistants who have participated in the scheme. METHODS: Qualitative methods included semi-structured interviews, non-participant observations in the practices, audio-taped meetings and personal journals. Data collection also included reviewing documentation of the scheme, i.e. the previous quantitative evaluation report, publications and e-mails. The multi-method approach enabled individual, group and team perspectives of the scheme and triangulation of the data through comparing dialogue with observations and documentary evidence. Thematic analysis was undertaken to elicit the complex experiences of the GP Assistants. RESULTS: Wide-ranging findings included enthusiastic support for the continuation of the scheme. The GP Assistants' personal and professional development was clearly evident from the themes 'eye opener', new knowledge, managing multiple roles, feeling vulnerable, time constraints and empowering processes. Seven of the GP Assistants have become partners and ten chose to remain working in local practices. Significant challenges for managing and leading the scheme were apparent. Greater co-operation and collaborative working between the academic department and the practices is required. CONCLUSION: The scheme provides a highly valued visible means of support for GPs and could act as a model for a career pathway aimed at enhancing recruitment and retention of GPs. The scheme is also at the forefront of national initiatives aimed at supporting single-handed practices and helping GPs with their continuing professional development. An integrated approach to change, education, research and development is advocated to enable recruitment and retention of GPs, their academic development, and to underpin the evolution of PCTs as learning organizations.

Adult↗

PubMed1995

Informatics and medical libraries: changing needs and changing roles.

Medical librarians play a crucial role in the evolution of institutional information policy. As information professionals, they share many similarities with their medical informatics counterparts. Both groups emphasize information delivery to the point of decision making; both groups serve as curators of institutional knowledge bases. If the term "publication" encompasses the delivery of clinical information relevant to individuals or populations, both librarians and medical informaticians have an immediate interest in the nature of biomedical publishing, particularly in areas of intellectual ownership, confidentiality, distribution, and access. Both groups also have been early leaders in applying information technology to solve pressing knowledge-management problems, and both groups have a strong commitment to educating colleagues in the effective use of information. Although the challenges faced by librarians and medical informaticians are sometimes different, the evolution of information technology and new forms of biomedical communication suggest that there is now a greater convergence between the two disciplines.

Artificial Intelligence↗

PubMed2000

Medical complications of diabetes mellitus in pregnancy.

Many women with diabetes develop complications of their chronic disease that may have a tremendous impact on their quality of life and their ultimate prognosis. Because Type 1 diabetes often begins at a very early age, it is quite common for women in their child-bearing years to be affected by these complications. As described in this article, diabetic complications and pregnancy may significantly affect each other, but it is not always easy to predict the course of either and to counsel these patients accordingly. Nevertheless, it appears that only in rare occasions should women with diabetes be advised against pregnancy, and that in most situations, with careful and knowledgeable management, a favorable outcome of pregnancy can be expected both for the mother and her infant.

Coronary Disease↗

PubMedDate not supplied

The Emory experience.

The administrative nursing staff was asked to identify innovative technology that supported the mission and philosophy of the Emory Health Care System. The Directors of Nursing identified multiple high technology systems that enhance financial strength, innovation, leadership, people and workplace, and knowledge management. These systems are presented in this article.

Bed Occupancy↗