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Defaults, context, and knowledge: alternatives for OWL-indexed knowledge bases.

The new Web Ontology Language (OWL) and its Description Logic compatible sublanguage (OWL-DL) explicitly exclude defaults and exceptions, as do all logic based formalisms for ontologies. However, many biomedical applications appear to require default reasoning, at least if they are to be engineered in a maintainable way. Default reasoning has always been one of the great strengths of Frame systems such as Protégé. Resolving this conflict requires analysis of the different uses for defaults and exceptions. In some cases, alternatives can be provided within the OWL framework; in others, it appears that hybrid reasoning about a knowledge base of contingent facts built around the core ontology is necessary. Trade-offs include both human factors and the scaling of computational performance. The analysis presented here is based on the OpenGALEN experience with large scale ontologies using a formalism, GRAIL, which explicitly incorporates constructs for hybrid reasoning, numerous experiments with OWL, and initial work on combining OWL and Protégé.

Abstracting and Indexing↗

Letter knowledge, phonological processing, and print knowledge: skill development in nonreading preschool children.

Development of reading skills was examined in 4-year-old children from low-income homes attending a prekindergarten program. Fall to spring gains in letter identification were examined and compared with skills in phonological processing, rhyme detection, and environmental print, and with performance on a screening tool (Get Ready to Read). It was anticipated that participants might show slow skill development. However, the identification of a large group of children (n = 30) who made little or no gains in letter identification compared to their classmates (n = 27), whose gains averaged 7 letters, was not anticipated. Fall to spring gains in letter identification correlated with phonological processing, rhyme detection, environmental print, and Get Ready to Read! scores. Age and general cognitive skills influenced performance on some tasks. More knowledge of the characteristics of children who show the most variations in skill development may lead to insights on using classroom curriculum to focus on skill development.

Awareness↗

[From blind knowledge to experiential knowledge].

A postgraduate course in psychosomatic and psychosocial medicine for general practitioners started in 1999 from Marc Archinard advice. It consists of about half the hours required for the "Attestation de formation complémentaire" granted by the Swiss Academy of psychosomatic and psychosocial medicine (AMPP). This article describes the elaboration of a questionnaire assessing the professional competences acquired by the practitioners after the course. As practitioners they valorise knowledge coming from their experiences on patient relationships and group exchanges, own maturational process, delegation process as well as expansion of therapeutic choices.

Academies and Institutes↗

[Evolution of the knowledge on the blood and its movement. Part two. The knowledge about its composition. Iatrochemistry of the blood].

To know the composition of blood and the benefits rendered by its components to life has been a question that for centuries stimulated the curiosity of researchers. Each of the human knowledge eras has provided its own explanation and gradually contributed with a series of discoveries, which by accumulating, have allowed to explain the physiological processes of this fluid, considered like vital since the most remote times. From being one more of the four humors that constitute living matter, according to ancient medicine, blood became, during seventeenth century, a mixture of fluids and diverse particles moved incessantly by the action of the heart. Once the iatromechanical aspect of blood circulation was known, the researchers approached the problem of its composition, using the new scientific tools (observation, experimentation and measurement), such as the microscope, quantification instruments, stains and chemical reagents, that appeared during the Baroque Period and later. During seventeenth century erythocytes were discovered as well as the metallic nature of blood when iron particles were detected in it. In the eighteenth century, leukocytes were discovered and, almost a century later, platelets were added. One of the great mysteries to solve, the coagulation of the blood, began to be deciphered in the seventeenth century, when fibrin was observed in the structure of the clots. Thrombin and tissue factor was discovered during nineteenth century. At the beginnings of the twentieth century, the morphology and origin of blood cells became known, as well as their variations during some diseases. The bases for the clinical laboratory, the hematology clinic and some therapeutic procedures, such as blood transfusion, developed. Separation of plasma components, cellular identification techniques, inheritance laws, and the talent to construct instruments for ever increasing precise analyses gave rise to the numerous specialties in science that has studied the blood: Hematology, Immunology, Clinical Biochemistry, Clinical Pathology, Hemostasis and Thrombosis, Transfusional Medicine, Hematogenetics, Chemotherapy and many others.

Blood Cells↗

The rationale of interorganizational linkages to connect multiple sites of expertise, knowledge production, and knowledge transfer: an example from HIV/AIDS services for the inner city.

This paper presents the rationale for a long-running project in which various community-based and tertiary-based providers are being linked to each other in order to understand, reach, and engage high-risk, hard-to-reach inner-city residents for prevention, treatment, and management of HIV/AIDS. Not simply a program to link disparate actors, the work has developed into a more fundamental approach through which to build and maintain the infrastructure required to generate and sustain knowledge development and integration within and between systems. This work is grounded in the recognition that each type of provider, as well as patients and clients themselves, has a particular type of expertise. All forms of expertise are necessary to fight HIV/ AIDS. Different forms of expertise are necessary to diagnose, treat, prevent, and cure HIV/AIDS and its sequelae. This work suggests revisions in traditional approaches to expertise and to the content and geometry of dissemination networks, and ultimately challenges the very concepts of dissemination and the lay/scientific boundary.

Acquired Immunodeficiency Syndrome↗

Development of a controlled medical terminology: knowledge acquisition and knowledge representation.

The creation of controlled medical terminologies is a central challenge in the development of electronic patient records. In the T-Helper patient-record system, designed for the care of patients with HIV disease, the IVORY module allows health-care workers to compose textual progress notes by making selections from menus generated automatically from a controlled medical terminology. Construction of this IVORY terminology required extensive design sessions with a team of computer scientists and an expert physician. Refinement of the terminology was only possible when the design team could envision how the completed T-Helper system would be used in the context of clinical practice. Development of controlled medical terminologies is a significant problem in knowledge acquisition. Techniques used to acquire and represent clinical concepts for the purpose of building decision-support systems also are appropriate for the construction of controlled terminologies such as the one in T-Helper.

Artificial Intelligence↗

Knowledge translation versus knowledge integration: a "funder's" perspective.

Each year, billions of US tax dollars are spent on basic discovery, intervention development, and efficacy research, while hundreds of billions of US tax dollars are also spent on health service delivery programs. However, little is spent on or known about how best to ensure that the lessons learned from science inform and improve the quality of health services and the availability of evidence-based approaches. To close this discovery-delivery gap, researchers and their funding agencies not only must recognize the gap between basic discovery and intervention development, addressed in part through translational research investments, but they must also work together with practitioners and their funding agencies to recognize the growing gap between innovative interventions developed through research and what is actually delivered to reduce the burden of chronic disease within the United States. From a funding-agency perspective, the complexity of the challenges of translating lessons learned from science to public health, primary care, or disease specialty service settings requires a multifaceted partnership approach to accelerate the translation of research into practice. This essay reviews the background and challenges of closing the development-to-delivery gap and some exemplar strategies that have been used by funding agencies to address these challenges to date.

Education, Continuing↗

Doctoral education in nursing for practitioner knowledge and for academic knowledge: the University of Adelaide, Australia.

Australian nursing has undergone rapid academization in the past 10 years and this radical change has tended to meld the somewhat different academic traditions of North America and Britain. The introduction of doctoral education in nursing in 1987 has led to a massive increase in scholarly activity and to the preparation of talented leaders. We concur with the view expressed by Henry (1997), "I am convinced that the problems we face in the nursing services would be much more creatively solved if the majority of our doctoral programs prepared young, energetic nurses, early in their career, for clinical practice, not for research and teaching" (p. 162).

Australia↗