SEARCH · PubMed Health
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.
Recall of a storyboard description of an unfamiliar illness was assessed in 66 healthy children and 40 children with chronic illness (cystic fibrosis or asthma). A significant interaction between verbal intelligence quotient and illness experience (p < 0.001) suggested that more able sick children may be resistant to learning new medical information.
Progress in the past few decades in representing medical knowledge, along with the availability of low-cost, powerful workstation computers, has increased interest in encoding all medical records in electronic form. But despite the advantages of legibility, access, and automated performance reviews, computerization may also restrict what can be recorded and rigidify health care interactions with patients. Balancing the beneficial and negative effects requires an understanding of medical practice, especially the difference between human knowledge and today's computer programs. Human perceptual and conceptual capabilities bring an aspect of improvisation and reinterpretation to every human action, which in general computers today cannot replicate. Designers of medical record systems must consider the creative process by which descriptions are generated by people, as well as the collaborative process by which descriptions of past work are reinterpreted for guiding future decisions. This paper provides a framework for understanding these issues, illustrated by design opportunities.
Ginkgo biloba is reported to improve learning and memory in animals. However, many studies do not directly test the effects of Ginkgo on memory because the drug is administered during the learning phase of the experiments. In this study, we examined the effect of 10 mg/kg, 20 mg/kg, or 40 mg/kg G. biloba extract on spatial memory by administering the drug in the interval between training and testing. Rats were tested for long-term reference memory retention in the radial arm maze and in the Morris water maze during daily probe trials in which the hidden platform was removed. G. biloba had no effect on reference memory in either the water maze or radial arm maze. To test short-term working spatial memory using the radial arm maze, animals were removed after receiving the reward from 4 of the 8 arms and were returned to complete the maze 2 h later. While Ginkgo had no effect on working memory, over time animals exposed to Ginkgo learned task better than control animals. Thus, Ginkgo appears to enhance neither short-term working memory nor long-term reference memory, but it may promote learning of spatial information.
OBJECTIVE: To evaluate patient acceptance of an automated medical information system specific to headache. BACKGROUND: Studies suggest that automated tools may help health care delivery systems to be efficient and effective, but patient satisfaction remains a major concern. METHODS: We adapted our software reuse reference model and Unified Modeling Language to apply the domain model to the headache population. Patients with headache were tested both to validate the system and to evaluate patient satisfaction and headache management with an automated system. RESULTS: The mean age of all study participants was 44 years. Over 95% of the participants were satisfied or strongly satisfied with the Automated Medical Information System. CONCLUSIONS: The results strongly suggest that patients are willing and able to use nontraditional sources, such as the Automated Medical Information System, to learn about their illnesses.
Explore the source record for details and available documents.
The purpose of this study is to describe and understand the parental coping and the social support received by the parents of diabetic children. The parental coping process was followed for a 4-week period after the diagnosis of diabetes. The parents of two girls, whose diabetes was diagnosed in early childhood, served as study subjects. Data were collected by interviewing and observing the parents over four separate periods. The data were analyzed by the time series and content analysis methods. Six phases of parental coping were identified: disbelief, lack of information and guilt, learning to care, normalization, uncertainty and reorganization. In the different phases of parental coping, the parents' experience of stress, coping strategies and sense of control varied. In the phase of disbelief, the parents tried to reject the child's diabetes by questioning the diagnosis. The initial information given to the parents regarding their child's diabetes proved to be important for parental coping. In the phase of lack of information and guilt, the parents sought reasons for their child's diabetes and felt guilty about it. As coping responses, the parents sought support from each other and from people who had experienced the same. In the learning to care phase, they recognized the demands caused by diabetes and took responsibility for the child's care. The parents appreciated supervision based on their problems. In the normalization phase, the parents prepared to return home with the diabetic child. Getting back to normal life was one of the most effective parental coping responses. In the uncertainty phase, the care to be given to the diabetic child changed the daily routines of the family. In the reorganization phase, the parents adapted to the diagnosis of diabetes and to the care of their diabetic child. The parents felt that the life of the family normalized and was able to be controlled.
Evidence that protein synthesis inhibitors induce amnesia in a variety of species and learning paradigms indicates that the consolidation of newly acquired information into stable memories requires the synthesis of new proteins. Because extinction of a response also requires acquisition of new information, extinction, like original learning, would be expected to require protein synthesis. The present experiments examined the involvement of protein synthesis in the hippocampus in the extinction of a learned fear-based response known to involve the hippocampus. Rats were trained in a one-trial inhibitory avoidance task in which they received footshock after stepping from a small platform to a grid floor. They were then given daily retention tests without footshock. The inhibitory response (e.g., remaining on the platform) gradually extinguished with repeated testing over several days. Footshock administered in a different context, instead of a retention test, prevented the extinction. Infusions of the protein synthesis inhibitor anisomycin (80 microg) into the CA1 region of the hippocampus (bilaterally) 10 min before inhibitory avoidance training impaired retention on all subsequent tests. Anisomycin infused into the hippocampus immediately after the 1st retention test blocked extinction of the response. Infusions administered before the 1st retention test induced a temporary (i.e., 1 day) reduction in retention performance and blocked subsequent extinction. These findings are consistent with other evidence that anisomycin blocks both the consolidation of original learning and extinction.
The search for factors which influence seriously ill people's quality of life continues to generate both interest and research. A retrospective cross-sectional study was conducted among 87 patients with lung cancer who ranged between the ages of 38 and 82 years. The purposes of this investigation were to determine whether relationships existed between patients' preferences for illness-related information, their satisfaction with family functioning, their level of learned resourcefulness and their reported quality of life. This paper focuses on the results of a stepwise multiple regression analysis which identified seven factors, namely, prognosis, surgery, current radiotherapy, performance status, self-control skills (learned resourcefulness), preference for information and age-group, which accounted for 30% of explained variance in patients' reported quality of life. No single factor contributed a substantial amount of the variance in this sample's reported quality of life. This observation suggests differences in people's perceptions of these factors and their importance to them. These results support a conclusion that people's evaluation of their quality of life is subjective, changeable and depends on the circumstances they face. Congruence between the assumptions underlying Neuman's health care system model, and the personal and contextual nature of these seven factors in patients' quality of life are explored. These findings are relevant for practice.
Conventional neural networks utilize all the dimensions of the original input patterns for training and classification. However, a particular attribute of the input patterns does not necessarily contribute to classification and may even cause misclassification in certain cases. A new ensemble competitive learning method using the reduced input dimension is proposed. In contrast to the previous ensemble neural networks which adjust learning parameters, the proposed method takes advantage of the information in each dimension of the input patterns. Since the degree of contribution of each attribute to classification is not known beforehand, the different input data sets with one dimension reduced are presented to multiple neural networks. The classification information from each competitive learning neural network is then combined to make a final decision for classification. In order to improve classification accuracy, the ambiguous output neurons are eliminated which cannot be assigned to any class after training. We use three consensus schemes to judge the classification using ensemble neural networks. The experimental results with remote sensing and speech data indicate the improved performance of the proposed method.
Undergraduate occupational therapy students were given the Rezler-French Learning Preference and the Kolb Learning Style Inventories at the introduction of professional course work (pretest) and upon completion of junior year course work and Level 1 fieldwork (posttest) 1 year later. The students' course work was a guided-study, modified competency-based program that included guided independent study, laboratory work, small group study, and one-to-one tutorials in preference to, but not excluding, the more traditional lecture method. After experiencing different modes of instruction, the students indicated no significant difference in their preferences for ways of learning or in processing information. Implications of these findings for the teaching-learning process are discussed.
A clinical skills laboratory or center is a facility in which students, physicians, nurses and other health care professionals learn clinical, communication and information technology skills to a specified level of competence prior to or coordinated with direct patient contact. The purpose of the clinical skill laboratory is to support the acquisition, maintenance and enhancement of the clinical skills of students in health care professions. Within this non-threatening environment, patient volunteers, simulated patients, mannequins and information technology are employed to provide hands-on learning experiences for the practice of the essential clinical skills. The skills laboratory helps to ensure that all students have necessary learning opportunities and appropriate assessment and feedback before approaching real patients. As more and more schools integrate skills laboratories into their curricula, it is important to review this new trend, to introduce the reader to its nature, factors that led to its development, advantages and problems related to its implementation. This review will also suggest some guidelines that may help in overcoming the implementation problems.
The use of computers in the educational process is rapidly changing with emphasis now being given on the use of computers in improving the education process, primarily through computer aided instruction (CAI). A number of optometric faculty have developed CAI packages both for class and lab instruction and for simulation of clinical care. These activities are only a small part of what computers can do to enhance the educational process as the faculties and colleges need to emphasize the use of computing for both educational and information uses. The potential of improving the way students learn and deal with information is there, but the extent of the impact may not be apparent for a number of years.
Conversion of free-text strings in a natural language to a standard representation (codes) is an important reoccurring problem in biomedical informatics. Determining the content of a string involves identifying its meaningful constituents (morphemes). One current method of identifying these constituents is to look them up in a preexisting table (lexicon). Manual construction of lexicons and grammars in complex domains such as biomedicine is extremely laborious. As an alternative to the lexico-grammatical approach, we introduce a segmentation algorithm that automatically learns lexical and structural preferences from corpora via information compression. The method is based on the Minimum Description Length (MDL) principle from classic information theory.
Rapid advances in Information Technology in recent years have provided powerful computers and software that can be innovatively applied to create powerful pedagogical courseware that go beyond what precursors like the PLATO project could do on the mainframes of yesteryear. This article focusses on the research and development that we have carried out which is applicable to the whole area of education (including medical education). It introduces the elements of hypertext, hypermedia and the pedagogical user interface. It illustrates the principles necessary for the communication of conceptual, functional and structural knowledge. It emphasises the key aspect of mastery of Information Technology necessary for a new dimension in Computer-Enhanced Learning that will be of relevance to the Information Society of the 21st century.
To encourage high-quality patient care guided by the best evidence, many medical schools and residencies are teaching techniques for critically evaluating the medical literature. While a large step forward, these skills of evidence-based medicine are necessary but not sufficient for the practice of contemporary medicine. Incorporating the best evidence into the real world of busy clinical practice requires the applied science of information management. Clinicians must learn the techniques and skills to focus on finding, evaluating, and using information at the point of care. This information must be both relevant to themselves and their patients as well as being valid. The authors discuss the need to teach the applied science of information management along with, or perhaps even instead of, teaching the basic science of evidence-based medicine. All students, residents, and practicing physicians need three skills to practice the best medicine: the ability to select foraging--"keeping up"--tools that filter information for relevance and validity, the skill to select and use a hunting--"just in time"--information tool that presents prefiltered information easily and in a quickly accessible form at the point of care, and the ability to make decisions by combining the best patient-oriented evidence with patient-centered care, placing the evidence in perspective with the needs and desires of the patient. This teaching of information management skills will prepare students and residents for a practice of medicine that requires lifelong learning.
An understanding of how students approach their learning has important implications for medical education. Of particular interest is the fact that the approach students use in their study has a significant impact on both the quality of the learning and their academic success. It would clearly be of value to identify students whose approach to learning was predictive of unsatisfactory performance. This paper describes the initial development of two versions of an inventory (questionnaire) which was designed to aid in the diagnosis of student learning problems. Preliminary information is given on the reliability and validity of these instruments. Factor analyses support the underlying design. Correlation of subscales with academic performance has provided encouraging evidence of the potential of these inventories in identifying students with specific learning or study problems.
OBJECTIVE: To examine the stability of cognitive function in patients with asymptomatic HIV infection. DESIGN: Previous longitudinal studies of cognitive function have focused on patients who progress in terms of disease stage. The present study avoided this potential confounding factor by including only subjects who remained in the asymptomatic stage of infection over the follow-up period. METHOD: Subjects were administered an extensive neuropsychological test battery at baseline and 1 year follow-up. Overall performance was characterized as normal or abnormal based on the performance of a well-matched HIV-negative control group. RESULTS: A significantly higher proportion of HIV-positive subjects became abnormal at the follow-up examination. Comparison of the seropositive subjects who remained normal with those who became abnormal revealed no differences at baseline on age, education, depression or CD4 levels. Subjects who became abnormal had worse performance at baseline on measures of information processing, verbal learning and memory, and reaction time. CONCLUSIONS: These data indicate that cognitive function may decline in some patients who continue to be in the asymptomatic stage of infection. Patients with a pattern of cognitive abnormalities at baseline, which includes information processing and reaction time deficits, may be at increased risk for declines in function during early stages of infection.
BACKGROUND: Health care is being changed dramatically by the marriage of computers and telecommunications. Implications for hospitals and physicians already have received extensive media attention, but comparatively little has been said about the impact of information technology on dentistry. This article illustrates how the digital transformation will likely affect dentists and their patients. CONCLUSIONS: Based on recent experiences of hospitals and medical practices, dentists can expect to encounter revolutionary changes as a result of the digital transformation. The Internet, the World Wide Web and other developments of the information revolution will redefine patient care, referral relationships, practice management, quality, professional organizations and competition. PRACTICE IMPLICATIONS: To respond proactively to the digital transformation of oral health care, dentists must become familiar with its technologies and concepts. They must learn what new information technology can do for them and their patients and then develop creative applications that promote the profession and their approaches to care.