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PubMed1999

The role of epidemiological knowledge and grazing management for helminth control in small ruminants.

There is no single requirement more crucial to the rational and sustainable control of helminth parasites in grazing animals than a comprehensive knowledge of the epidemiology of the parasite as it interacts with the host in a specific climatic, management and production environment. In its absence, anthelmintic treatment is either given suppressively, which provokes resistance, or therapeutically, which risks clinical disease and production losses. Sustainable parasite-control programmes require knowledge of seasonal larval availability, origin of larvae contributing to any peaks and climatic requirements for worm egg hatching, larval development and survival. Control measures based on this knowledge include strategic anthelmintic treatments and various forms of grazing management. While these measures can reduce the frequency of anthelmintic treatment required, their effect on selection for drench resistance is more problematical, unless they can be combined with other forms of control to reduce our current dependence on anthelmintics.

Animal Husbandry↗
PubMed1999

Knowledge discovery for advanced clinical data management and analysis.

Knowledge discovery is a broad research field in which methods are developed to support discovery of novel and potentially useful knowledge from clinical databases and registers in systems for patient care. However, the techniques available are not readily applicable in medical domains, due to, among other reasons, low user friendliness and lack of proper methodological background. Data mining approaches to be explored and improved are predictive modelling, segmentation, dependency modelling, summarization, and change and deviation detection/modelling (in data or knowledge). Another and original contribution of the research is to build up efficient feedback loops. Human experts and available domain expert systems could provide suggestions as how to improve all major steps in the knowledge discovery process such as evaluation of knowledge, choice of data mining methods and data input. A long tradition of collecting and maintaining clinical and administrative data could be found in fields of oncology, cardiology, coronary surgery, social and primary health care medicine. All these areas, that gather data over long periods of time, could benefit from knowledge discovery.

Artificial Intelligence↗
PubMed2002

Representing knowledge: instances of management information.

Against the backdrop of discussions about the 'Information Society', the 'Informational Economy' and the role of IT in realizing organizational change we examine how representations of 'organizational knowledge' are constructed and used in work settings. We do this through the explication of ethnographic materials that detail the realization and use of Management Information (MI) in a major UK retail bank undergoing massive organizational change. We focus in particular on explicating how existing metric information was drawn upon to construct a representation of the work of the bank for those involved in managing that work. Systems designers have been increasingly interested in offering ways of conceptualizing the problem of 'knowledge' with a view to embedding these properties in systems. In the quest to develop representations of procedural knowledge to support work we argue that it is first necessary to understand how representations are actually created and used in work to support existing work practices.

Cognition↗
PubMed2005

Differences in education, knowledge, self-management activities, and health outcomes for patients with heart failure cared for under the chronic disease model: the improving chronic illness care evaluation.

BACKGROUND: The objective of this study was to determine whether participation in a quality improvement (QI) collaborative for heart failure (HF) was associated with better interpersonal aspects of care and health outcomes. METHODS AND RESULTS: We conducted a cross-sectional telephone survey of patients in 6 organizations who participated in a QI collaborative for HF (participants, n = 387) and 6 comparable control organizations (controls, n = 414) and measured provider-patient communication, education received, knowledge of HF, self-management behaviors, satisfaction, and quality of life. The participant group patients were more likely to report their doctor and nurse discussed treatment options and reviewed self-management (P < .01 for both). A total of 88% of participants were told to weigh themselves daily and record their weight compared with 34% of controls (P < .01). Participants were more likely to know how often to check their weight (P < .01), recognize symptoms of worsening HF (P < or = .01 for all), have a scale (P = .002), and monitor their weight daily (P < .001). Participants had similar quality of life but fewer emergency department visits and hospitalizations. CONCLUSION: Participation in a QI collaborative for HF was associated with better communication, education, and knowledge, and lower health care use. Collaboratives may be a useful method for disseminating quality improvement strategies.

Adolescent↗
PubMedDate not supplied

Fair process: managing in the knowledge economy.

Unlike the traditional factors of production--land, labor, and capital--knowledge is a resource that can't be forced out of people. But creating and sharing knowledge is essential to fostering innovation, the key challenge of the knowledge-based economy. To create a climate in which employees volunteer their creativity and expertise, managers need to look beyond the traditional tools at their disposal. They need to build trust. The authors have studied the links between trust, idea sharing, and corporate performance for more than a decade. They have explored the question of why managers of local subsidiaries so often fail to share information with executives at headquarters. They have studied the dynamics of idea sharing in product development teams, joint ventures, supplier partnerships, and corporate transformations. They offer an explanation for why people resist change even when it would benefit them directly. In every case, the decisive factor was what the authors call fair process--fairness in the way a company makes and executes decisions. The elements of fair process are simple: Engage people's input in decisions that directly affect them. Explain why decisions are made the way they are. Make clear what will be expected of employees after the changes are made. Fair process may sound like a soft issue, but it is crucial to building trust and unlocking ideas. Without it, people are apt to withhold their full cooperation and their creativity. The results are costly: ideas that never see daylight and initiatives that are never seized.

Creativity↗
PubMed2001

Controlled substances and pain management: changes in knowledge and attitudes of state medical regulators.

Physicians report that concern about regulatory investigation negatively influences their prescribing of opioid analgesics. The views of medical regulators about the legality of prescribing controlled substances for pain management were studied in 1991. However, little is known about whether these views have changed in light of increased emphasis on pain management and educational programs for state medical boards. Two studies that examined this issue are described. In Study 1, a 1997 survey of state medical board members was compared to results obtained in 1991 to evaluate differences in knowledge and perceptions about opioid analgesics. Important changes were observed over time, particularly regarding characteristics of "addiction" and the legality of prolonged prescribing of opioids. For Study 2, a longitudinal survey was conducted of medical board members who participated in five workshops about pain management and regulatory policy. Results revealed significant and sustained changes in attitudes about the incidence of iatrogenic addiction when using opioids to treat pain, the analgesic and side-effect properties of opioids, and the perceived legality of prescribing opioids. Recommendations for reducing concerns about regulatory scrutiny are presented, including the need for a more intensive education program, increasing the rate of adoption of new state medical board policies, and improving communication between regulators and clinicians.

Aged↗
PubMed2004

Knowledge and attitudes in pain management: Hong Kong nurses' perspective.

Effective pain management requires accurate knowledge, attitudes and assessment skills. To determine the current knowledge level and attitudes of nurses in pain management, 1,604 registered nurses working in three different hospitals in Hong Kong were invited to participate in this study. The sample consisted of 601 registered nurses, 63 nursing officers, and 14 nursing specialists (N = 678). The response rate was 43%. The Nurses' Knowledge and Attitudes Survey Instrument questionnaire developed by McCaffery and Ferrell was translated into Chinese and used with permission. To ensure the contextual relevancy and consistency of the questionnaire, content validity and test-retest reliability tests were performed. The content validity index was 0.87 and the test-retest reliability (Spearman's p coefficient) was 0.812. The percentage of correctly answered questions was 44%. There was statistical significant in educational preparation and clinical experiences with correct scores. The findings of our study support the concern of inadequate knowledge and attitudes in relation to pain management. Further intensive continuing education and staff development is highly indicated for nurses in Hong Kong.

Adult↗
PubMedDate not supplied

The use of aesthetic knowledge in the management of brain injury patients.

A patient's recovery from a brain injury (BI) is unpredictable and requires flexible nursing strategies for each stage of recovery. Empirical knowledge provides a framework for delivering nursing care based on scientific principles. Aesthetic knowledge, including intuition, provides a further opportunity to know and understand BI patients and their responses as they progress along the trajectory of recovery. Incorporating both empirical and aesthetic knowledge into the nursing plan of care for this population affords on opportunity for nurses to help patients and their families negotiate the course of recovery with greater success.

Art↗
PubMed2006

Knowledge and attitudes about cancer pain management: a national survey of Italian oncology nurses.

The purpose of this study was to obtain information about the knowledge and attitudes of Italian oncology nurses concerning cancer pain management and to determine the predictors of nurses' pain management knowledge. The study was a nationwide descriptive survey and included 287 nurses in Italy from 21 oncology wards in the north, center and south of Italy. The Nurses' Knowledge and Attitudes Survey (Italian version) and a background information form were used to collect the data. Knowledge and attitudes regarding cancer pain were the main research variables. Among the 39 pain knowledge questions assessed, the mean number of correctly answered question was 21.4 (SD=5.5), with a range of 6-35. The correct answer rate for the entire scale, on average, was 55% (SD=25.9). Further analysis of items showed that more than 50% of oncology nurses underestimated the patients' pain and they did not treat it in the correct way; they also had an incorrect self-evaluation about their pain management knowledge. Results from stepwise regression showed that nurses with higher mean correct answer scores had attended more courses about pain education. There are still significant knowledge deficits and erroneous beliefs that may hamper treatment of oncology patients in pain. The results of this study could be useful to institutions involved in patient care and teaching of pain management.

Adult↗
PubMedDate not supplied

Nurses' knowledge of pain management: implications for staff education.

Among the 217 nurses responding (one third of those queried), average scores on the NKAS were slightly higher (68%) than that reported in the literature but still inadequate. Nurses' greatest knowledge deficits were related to pharmacotherapeutics. Knowledge scores were uncorrelated with self-assessed level of knowledge about pain. Strategies for re-dressing these nurses' knowledge through Department of Nursing Education interventions are explored.

Adult↗
PubMedDate not supplied

A cluster analysis to investigating nurses' knowledge, attitudes, and skills regarding the clinical management system.

Nurses' knowledge, attitudes, and skills regarding the Clinical Management System are explored by identifying profiles of nurses working in Hong Kong. A total of 282 nurses from four hospitals completed a self-reported questionnaire during the period from December 2004 to May 2005. Two-step cluster analysis yielded two clusters. The first cluster (n = 159, 56.4%) was labeled "negative attitudes, less skillful, and average knowledge" group. The second cluster (n = 123, 43.6%) was labeled "positive attitudes, good knowledge, but less skillful." There was a positive correlation in cluster 1 for nurses' knowledge and attitudes (rs = 0.28) and in cluster 2 for nurses' skills and attitudes (rs = 0.25) toward computerization. The study showed that senior and more highly educated nurses generally held more positive attitudes to computerization, whereas the attitudes among younger and less well educated nurses generally were more negative. Such findings should be used to formulate strategies to encourage nurses to resolve actual problems following computer training and to increase the depth and breadth of nurses' computer knowledge and skills and improve their attitudes toward computerization.

Cluster Analysis↗
PubMed1992

A comparative study of intensive therapy unit and hospice nurses' knowledge on pain management.

Caring for patients in pain is a pivotal function of nursing practice. In particular, pain control is a primary concern of hospice nurses in order to ensure comfort in the terminal phase of the person's life, and also for nurses in intensive therapy units caring for patients who may have substantial pain related either to pathologic conditions or treatment interventions and who have difficulty communicating their pain. This paper reports on a study which aimed to identify and compare the knowledge and the perceived adequacy and acquisition of knowledge of intensive therapy and hospice nurses pertaining to the theoretical, pharmacological and non-pharmacological aspects of pain and its management using multiple-choice, short-answer and open-ended questions. The sample consisted of 52 intensive therapy and 48 hospice nurses who were further divided into beginners and experts. The findings indicated that although the hospice nurses received higher knowledge scores than the intensive therapy nurses, both groups demonstrated lack of knowledge in specific content areas. In addition, the findings demonstrated few differences between the beginners and experts. The subjects, in general, were not confident about their knowledge of analgesics, nor did they believe that their basic nursing education had prepared them adequately to care for patients in pain. The working environment and clinical work in hospital since qualification were perceived by the subjects to be the most influential experiences in learning about pain and its management.

Adult↗
PubMed1999

Sociodemographic determinants of management behaviour of diabetic patients. Part II. Diabetics' knowledge of the disease and their management behaviour.

We aimed to: describe the level of knowledge of diabetic patients about the disease, show the relationship between demographic variables (age, sex and education) and level of knowledge and reveal the relationship between knowledge and management-related behaviour of diabetics. We found that a majority of diabetic patients (90.0%) had poor knowledge about the disease, 83.7% had poor knowledge about the complications associated with diabetes and 96.3% had poor awareness of how to control the disease. The poor level of knowledge that diabetics have about their disease suggests that health care providers need to be trained in the areas of information, education and communication.

Age Factors↗