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PubMed1992

[The evaluation of sexual behavior and knowledge of AIDS in the schools of Burkina Faso. A Knowledge, Attitude, Belief and Practice (KABP) survey in Banfora among 474 adolescents of 14-to-25-years old].

The results of a survey carried out in 1990 on the knowledge, attitudes, beliefs, and practice (KABP) concerning AIDS are presented and discussed. The population surveyed was a random sample of 474 secondary school students (SSS), aged 14-25, in Banfora (Burkina Faso). Among the SSS, a high level of general knowledge about AIDS as a sexually transmitted disease (92.2%) and about condoms (83.1%) is noted. More specific knowledges however, such as the notion of seropositivity, is less well understood (36.7%). Their sources of information are essentially the radio (57.8%) and newspapers (45.4%). The SSS are afraid of AIDS and report that they have changed their behaviour (71.7%). Sexual experiences at young age and risky sexual behaviour (no use of condoms) are however reported. The place of residence, religion, and job and income of their parents or other relatives they are living with, seem to have no effect on the age of the first sexual experience. At present, the SSS of Banfora are aware of the AIDS problem but have not changed their sexual behaviour accordingly, even if they report having done so. The SSS are a prime target population group for any AIDS prevention program.

Acquired Immunodeficiency Syndrome↗

PubMed2006

[In the consultation room, knowledge that must be looked up is more important than ready knowledge].

In the consultation room, it is better to have a doctor that looks something up than one who thinks that he has (or should have) everything at his fingertips. Doctors require ready knowledge, but the rapid changes make it impossible to keep all knowledge at the ready. Training courses must pay attention to the retrieval, assessment and maintenance of (new) professional knowledge. A positive attitude and helpful aids are essential here.

Health Knowledge, Attitudes, Practice↗

PubMed1990

Extracting knowledge from a large primary health care database using a knowledge-based statistical approach.

Clinical databases from automated medical records represent a growing resource for deriving new medical knowledge. In this study a large primary health care database was explored with respect to the association between hypertension and diabetes. Data collection was made with a query language, and data analysis performed with an interactive knowledge-based statistical tool, MAXITAB, employing a multivariate tabular analysis technique. In the study population of 6660 patients the prevalence of diabetes was almost three times higher for hypertensive patients than for those with no hypertension. Conversely, the prevalence of hypertension was 2.6 times higher for diabetic patients than for those with no diabetes. The results support the assumption of a relationship between hypertension and diabetes, although the question of causality between the two diagnoses remains unsolved. Knowledge-based statistical tools of this kind may be feasible for exploring large clinical databases and may result in new medical hypotheses, worthy of further investigation.

Aged↗

PubMed1985

QUICK (QUick Index to Caduceus Knowledge): using the INTERNIST-1/CADUCEUS knowledge base as an electronic textbook of medicine.

QUICK (QUick Index to Caduceus Knowledge), is a prototypical user-friendly access system which adapts the INTERNIST-1/CADUCEUS knowledge base for use as an electronic textbook of medicine. The QUICK program can be used both as a diagnostic aid and a teaching tool in the field of internal medicine. A preliminary evaluation of a prototypical version of QUICK was conducted in order to identify its strengths and weaknesses. QUICK was made available to the medical housestaff at three Pittsburgh area teaching hospitals for a period of 2 months. Most users felt QUICK was educational and wanted future access to the system. An examination of log files revealed the users' most frequently encountered difficulties. Using the INTERNIST-I knowledge base as an electronic textbook expands the project's intended audience by providing clinical support for a broad group of diagnostic problems.

Computer-Assisted Instruction↗

PubMedDate not supplied

From knowledge generation to knowledge archive. A general strategy using TOPS-MODE with DEREK to formulate new alerts for skin sensitization.

A general strategy for knowledge flow concerning skin sensitization based on the combined use of TOPS-MODE and DEREK expert system is proposed. TOPS-MODE is used as a knowledge generator, while DEREK represents the knowledge archive. A TOPS-MODE classification model allows the identification of structural fragments and groups responsible for strong/moderate skin sensitization. These structural contributions are sorted, analyzed, and graphically displayed in an appropriate way allowing the identification of several structural alerts for skin sensitization. Nine structural alerts already implemented in DEREK are identified using this strategy. They comprise, among others, alkyl halides, aldehydes, alpha,beta-unsaturated compounds, aromatic amines, phenols, hydroquinone, isothiazolinone, and alkyl sulfonates. Four new hypotheses are generated using TOPS-MODE structural contributions to skin sensitization, which are not recognized as structural alerts by DEREK. They include the reduction of aromatic nitro groups and epoxidation reaction of double bonds as metabolic activation steps that can lead to reactive haptens which can trigger the skin sensitization mechanism. Another new alert is based on 1,2,5-thiadiazole-1,1-dioxide for which we have identified a possible mechanism explaining its strong skin sensitization profile. It is based on the existence of a tautomeric equilibrium and further reaction with nucleophiles, which are both supported by experimental evidence. Finally, we have identified a possible new mechanism for the skin sensitization of nonreactive compounds, which involves the formation of noncovalent complexes with proteins in a processing- and metabolism-independent way.

Journal Article↗

PubMed1989

Nursing knowledge: women's knowledge. A sociological perspective.

As nurses approach the 21st century questions are being raised regarding the direction in which the profession is moving. The majority of leaders and educators in the field of nursing have, to this point, stressed the importance of defining nursing as a science and of developing a scientific knowledge base. Recently, however, there has been a move among some researchers and theorists in the field of nursing to question the ability of science and the scientific method to deal with nursing concerns. Using a variety of perspectives, including feminist theory, they are critiquing many of the basic assumptions about science, scientific method and scientific knowledge. This paper uses sociological and feminist theory to support the idea that nursing, as a discipline, has a distinct knowledge base which is not grounded in empirico-analytic science and its methodology but which stems from the lived experiences of nurses as women and as nurses involved in caring relationships with their clients.

Education, Nursing↗

PubMed1996

Transforming practice knowledge into nursing knowledge--a revisionist analysis of Peplau.

Nursing practice typically has been viewed as applying knowledge. However, currently, there is increasing awareness that nursing practice is also a process of knowledge development. Still, research and practice are not always connected. Analysis of Peplau's works illuminates a scholarship of nursing practice that is relevant today. This paper focuses on a specific strategy and philosophic perspective, as derived from Peplau, for integrating nursing practice more fully into today's knowledge development. Emphasis is on the need for nursing practice-based theory, as well as nursing theory-based practice.

History, 20th Century↗

PubMed2006

Defining the effect and mediators of two knowledge translation strategies designed to alter knowledge, intent and clinical utilization of rehabilitation outcome measures: a study protocol [NCT00298727].

BACKGROUND: A substantial number of valid outcome measures have been developed to measure health in adult musculoskeletal and childhood disability. Regrettably, national initiatives have merely resulted in changes in attitude, while utilization remains unacceptably low. This study will compare the effectiveness and mediators of two different knowledge transfer (KT) interventions in terms of their impact on changing knowledge and behavior (utilization and clinical reasoning) related to health outcome measures. METHOD/DESIGN: Physical and occupational therapists (n = 144) will be recruited in partnership with the national professional associations to evaluate two different KT interventions with the same curriculum: 1) Stakeholder-Hosted Interactive Problem-Based Seminar (SHIPS), and 2) Online Problem-Based course (e-PBL). SHIPS will consist of face-to-face problem-based learning (PBL) for 2 1/2 days with outcome measure developers as facilitators, using six problems generated in consultation with participants. The e-PBL will consist of a 6-week web-based course with six generic problems developed by content experts. SHIPS will be conducted in three urban centers in Canada. Participants will be block-allocated by a minimization procedure to either of the two interventions to minimize any prognostic differences. Trained evaluators at each site will conduct chart audits and chart-stimulated recall. Trained interviewers will conduct semi-structured interviews focused on identifying critical elements in KT and implementing practice changes. Interviews will be transcribed verbatim. Baseline predictors including demographics, knowledge, attitudes/barriers regarding outcome measures, and Readiness to Change will be assessed by self-report. Immediately post-intervention and 6 months later, these will be re-administered. Primary qualitative and quantitative evaluations will be conducted 6-months post-intervention to assess the relative effectiveness of KT interventions and to identify elements that contribute to changing clinical behavior. Chart audits will determine the utilization of outcome measures (counts). Incorporation of outcome measures into clinical reasoning will be assessed using an innovative technique: chart-stimulated recall. DISCUSSION: A strategy for optimal transfer of health outcome measures into practice will be developed and shared with multiple disciplines involved in primary and specialty management of musculoskeletal and childhood disability.

Journal Article↗

PubMed2002

Knowledge Impact Conference 2001: action plans linking nursing knowledge to practice outcomes.

The work of the Knowledge Conferences in Northeastern USA over 2 decades has been significant. A major contribution is a Consensus Statement that provides the basis for dialogue about nursing knowledge worldwide. In addition to proceedings that have been circulated, the best of the most recent series of conferences-from 1996 through the recent conference in October 2001-will be included in the forthcoming book on knowledge and practice.

Clinical Competence↗

PubMed2006

Knowledge-based control and case-based diagnosis based upon empirical knowledge and fuzzy logic for the SBR plant.

Because biological wastewater treatment plants (WWTPs) involve a long time-delay and various disturbances, in general, skilled operators manually control the plant based on empirical knowledge. And operators usually diagnose the plant using similar cases experienced in the past. For the effective management of the plant, system automation has to be accomplished based upon operating recipes. This paper introduces automatic control and diagnosis based upon the operator's knowledge. Fuzzy logic was employed to design this knowledge-based controller because fuzzy logic can convert the linguistic information to rules. The controller can manage the influent and external carbon in considering the loading rate. The input of the controller is not the loading rate but the dissolved oxygen (DO) lag-time, which has a strong relation to the loading rate. This approach can replace an expensive sensor, which measures the loading rate and ammonia concentration in the reactor, with a cheaper DO sensor. The proposed controller can assure optimal operation and prevent the over-feeding problem. Case-based diagnosis was achieved by the analysis of profile patterns collected from the past. A new test profile was diagnosed by comparing it with template patterns containing normal and abnormal cases. The proposed control and diagnostic system will guarantee the effective and stable operation of WWTPs.

Ammonia↗

PubMed2002

Automatic generation of a metamodel from an existing knowledge base to assist the development of a new analogous knowledge base.

Knowledge acquisition is a key step in the development of knowledge-based systems and methods have been proposed to help elicitating a domain-specific task model from a generic task model. We explored how an existing validated knowledge base (KB) represented by a decision tree could be automatically processed to infer a higher level domain-specific task model. On-codoc is a guideline-based decision support system applied to breast cancer therapy. Assuming task identity and ontological proximity between breast and lung cancer domains, the generalization of the breast can-cer KB should allow to build a metamodel to serve as a guide for the elaboration of a new specific KB on lung cancer. Two types of parametrized generalization methods based on tree structure simplification and ontological abstraction were used. We defined a similarity distance and a generalization coefficient to select the best metamodel identified as the closest to the original decision tree of the most generalized metamodels.

Artificial Intelligence↗

PubMed1992

[Self-instruction expert systems in medicine. Presentation of knowledge, acquisition of knowledge, prediction of suicide as an example].

AIMS: 1. Description of how self-learning expert systems work, and 2. comparison of various algorithms for the establishment of a data base for suicide prediction. POINTS DISCUSSED: from exemplary patient data, self-learning expert systems obtain their expert knowledge which they subsequently employ to establish the diagnosis in new patients. Various possibilities of storing knowledge may be employed, for example the decision tree, classes of rules or neuronal networks. The various forms of representing knowledge are also presented. Taking the prediction of suicidal risk as an example, the effectiveness of the algorithm is tested with the aid of a patient questionnaire. CONCLUSIONS: Different fields of application require different systems. The diagnosis of such expert systems can at least prompt the care-providing physician to reconsider his own diagnosis.

Artificial Intelligence↗

PubMed2006

Decision support, knowledge representation and management: A broad methodological spectrum. Findings from the Decision Support, Knowledge Representation and Management.

OBJECTIVES: To summarize current excellent research in the field of decision support, knowledge management and representation. METHODS: Synopsis of the articles selected for the IMIA Yearbook 2006. RESULTS: Decision Support, Knowledge Representation and Management covers a broad spectrum of methods applied to a variety of medical problems and domains. Some particularly interesting and current topics were picked for the IMIA Yearbook 2006: the importance of ontologies for systematic system engineering of decision support systems, syndromic surveillance based on natural language processing, the evaluation of large semantic networks, and a comprehensive ontology for a randomised controlled trial database to support evidence-based practise. CONCLUSIONS: The best paper selection shows that methods for decision support, knowledge representation and management can decisively contribute to the solution of many different medical problems, but also that there is still a lot of exiting research to be done.

Awards and Prizes↗

PubMedDate not supplied

Knowledge acquisition and knowledge representation in a rule-based expert system.

It is important to understand and describe how nurses make diagnostic decisions. This article describes the process by which knowledge is acquired and represented in a rule-based expert system for nursing diagnosis. Knowledge acquisition was obtained by tapping the expertise of clinical nurse specialists who were able to articulate the elements present in their diagnostic decisions. Knowledge representation was achieved using a commercially-available software package. VP Expert (Berkeley, CA). The clinical nurse specialists contributed many of the heuristics in the determination of self-care deficit as a nursing diagnosis. Three models of rules for the determination of self-care deficit, bathing are provided. These models represent a method for discriminating between levels of patient dependence. A description of rules that define specific causes, such as immobility are also included. They will be tested in the clinical setting.

Artificial Intelligence↗

PubMed2005

Beyond knowledge transfer: a model of knowledge integration in a clinical setting.

Current conceptualizations of knowledge transfer reinforce the notion of a linear process between researchers and clinicians, who are seen as operating separately with different agenda. This paper uses a case study to illustrate a dynamic model of knowledge integration involving integrated and interdependent relationships among researchers, clinicians, and decision-makers. We believe the principles of this model are more likely to lead to effective use of research evidence in clinical practice.

Aged↗

PubMed1999

Uncertain knowledge: a national survey of high school students' knowledge and beliefs about hepatitis C.

OBJECTIVE: Hepatitis C (HCV) has recently emerged as an important public health issue. This study documents young people's hepatitis C (HCV) knowledge, risk perceptions and sources of information. METHOD: Australia, 1997; nationally representative survey; sample of students in Years 10 and 12 in government secondary schools (n = 3,550). RESULTS: Students' knowledge about HCV was found to be extremely poor. Of the seven questions on hepatitis, only one was answered correctly by more than half the students. Few could differentiate between hepatitis A, hepatitis B and hepatitis C. Only a small number (12%) perceived themselves to be at risk of hepatitis and fewer than half (41%) had sought advice about hepatitis. CONCLUSION: There is a need for more HCV education and health promotion for secondary school students. IMPLICATIONS: Some lessons from HIV education can be readily transferred to this new epidemic but others cannot. There is a danger that HIV and HCV will be conflated in education programs.

Adolescent↗

PubMed1991

The Health Knowledge Inventory-Alpha: a personal health knowledge test for high school seniors.

This study assessed validity and reliability of the Health Knowledge Inventory-Alpha (HKI-Alpha) in a sample of high school seniors. The HKI-Alpha, a general health knowledge test, consists of 110 multiple choice items covering 11 health content areas. All seniors attending one of four high schools completed HKI-Alpha twice, one week apart. A secondary sample of college students also was tested. Descriptive analysis revealed the test discriminated among examinees and avoided ceiling and floor effects. Test-retest reliability was .81 (n = 355). Internal consistency reliability (KR20) was .85 (n = 418). A sample of college students scored significantly higher than the high school students, demonstrating construct validity. Other estimates of content validity, criterion-related validity, and construct validity were high.

Adolescent↗

PubMedDate not supplied

Evaluation of a numeracy intervention program focusing on basic numerical knowledge and conceptual knowledge: a pilot study.

The preliminary results of this study suggested that children with developmental dyscalculia benefit from a numeracy intervention program that focuses on basic numerical knowledge and conceptual knowledge. All children in the experimental group showed considerable and partly significant performance increases on all calculation components. Six children with developmental dyscalculia were trained individually and in small-group settings for a relatively short duration (one school semester). We argue that the positive intervention effects to a large extent are attributable to the explicit teaching of numerical domains that often have been found to be neglected in school mathematics.

Child↗