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Results for “Knowledge base”

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PubMed1988

Social marketing and public health intervention.

The rapid proliferation of community-based health education programs has out-paced the knowledge base of behavior change strategies that are appropriate and effective for public health interventions. However, experiences from a variety of large-scale studies suggest that principles and techniques of social marketing may help bridge this gap. This article discusses eight essential aspects of the social marketing process: the use of a consumer orientation to develop and market intervention techniques, exchange theory as a model from which to conceptualize service delivery and program participation, audience analysis and segmentation strategies, the use of formative research in program design and pretesting of intervention materials, channel analysis for devising distribution systems and promotional campaigns, employment of the "marketing mix" concept in intervention planning and implementation, development of a process tracking system, and a management process of problem analysis, planning, implementation, feedback and control functions. Attention to such variables could result in more cost-effective programs that reach larger numbers of the target audience.

Health Promotion↗

PubMed2001

The management of constipation in people with advanced cancer.

Constipation represents a significant problem for people with advanced cancer. It ranks in the top three most uncomfortable symptoms experienced, causing pain and anorexia that ultimately result in misery. The negative impact upon the quality of life of the patient and their carers is significant. The key to the provision of effective care lies in the informed application of the nursing process, underpinned by a sound knowledge base in relation to the management of constipation. Theoretical knowledge enables appropriate preventative interventions to be planned in collaboration with other members of the multidisciplinary team. When preventative measures are not applied or are unsuccessful, informed assessment and care planning enables appropriate interventions to be applied in order to resolve constipation. This article will discuss the causes and management of constipation. The discussion focuses on assessment, setting goals with the patient and their carers, planning appropriate nursing interventions to support medical interventions and evaluating clinical outcomes.

Cathartics↗

PubMed1991

Competency requirements for policy gerontologists: what are the essentials?

"Policy gerontologists" are professionals knowledgeable about both public policy and aging. Through a survey of potential employers about the education of these specialists, the authors examined what is desired in terms of knowledge base, skill proficiencies, and behavioral characteristics. Although a solid knowledge of aging policies and the policymaking process are considered essential for policy gerontologists, respondents suggested that communication and political skills as well as the ability to take initiative and to follow through were also essential.

Aged↗

PubMed2000

WebDietAID: an interactive Web-based nutritional counselor.

WebDietAID is a Web-based system aimed at assisting individuals affected by high serum cholesterol. The system tries to reproduce the types of intervention performed by a nutritional counselor. It is structured as a set of advisors, each of which handles a different side of the counseling process. The tasks of the advisors range from monitoring weight, to teaching about healthy nutrition, to assessing motivation and psychological obstacles to behavior change. WebDietAID is based on a development environment for Web-based applications that includes a dynamical Web server, a knowledge base management system, and an interface to a relational database. We describe the architecture of the system, and several of the implemented advisors. Finally, we discuss how the architecture could be generalized to other counseling domains.

Computer-Assisted Instruction↗

PubMed2001

An approach to guideline implementation with GEM.

Implementation of practice guidelines refers to the creation of strategies and systems to operationalize the knowledge and recommendations set forth by guideline developers. We describe an approach to guideline implementation that makes direct use of the guideline document as a knowledge base. The Guideline Elements Model (GEM) provides an XML-based guideline document model that facilitates implementation of guidelines. Knowledge extraction using GEM requires document markup rather than programming and can promote authenticity and consistent knowledge encoding. Knowledge customization for the local enterprise requires addition of meta-information to pertinent components of the GEM hierarchy in a design database. GEM provides an audit trail to track local adaptation. Knowledge integration with patient data can be promoted using information management services. A design goal is to devise a system that can be applied by local clinical domain experts, quality assurance experts, and information systems programmers without requiring trained informaticians and knowledge engineers to serve as intermediaries

Artificial Intelligence↗

PubMed2006

Aligning biomedical ontologies using lexical methods and the UMLS: the case of disease ontologies.

The process of aligning ontologies comprises two major steps: i) mapping concepts and ii) characterizing the relations between the concepts. In this paper, we present an alignment method based on a hybrid approach that reuses the UMLS knowledge base and aims at identifying patterns to characterize the relations. The proposed method consist in four steps: 1) exact matching, 2) searching for terms from one ontology that are included in terms from the other ontology, 3) identifying direct relations through the UMLS and 4) extracting syntactico-semantic patterns to infer novel alignments. This method has been applied to aligning the Human Disease ontology and the Mouse Pathology ontology resulting in 48 exact matches and 3,697 pairs of concepts for which one term is included in a term from the other ontology. 1,270 alignments are present in the UMLS. Among these, 903 are characterized by a semantic attribute. Based on these alignments, a study of the syntactic patterns has been done. Not surprisingly, the distribution of the different syntactic patterns is not sufficient to discriminate the different types of relationships found in the UMLS alignments. We have used the semantic categorization of the concepts provided by the UMLS to extract syntactico-semantic patterns. 87 novel alignments based on 6 syntactico-semantic patterns associated with isa and has associated morphology have been inferred.

Animals↗

PubMed1993

Recognizing new medical knowledge computationally.

Can new medical knowledge be recognized computationally? We know knowledge is changing, and our knowledge-based systems will need to accommodate that change in knowledge on a regular basis if they are to stay successful. Computational recognition of these changes seems desirable. It is unlikely that low level objects in the computational universe, bits and characters, will change much over time, higher level objects of language, where meaning begins to emerge, may show change. An analysis of ten arbitrarily selected paragraphs from the Medical Knowledge Self-Assessment Program of the American College of Physicians was used as a test bed for nominal phrase recognition. While there were words not known to Meta-1.2, only 8 of the 32 concepts new to the primary author were pointed to by new words. Use of a barrier word method was successful in identifying 23 of the 32 new concepts. Use of co-occurrence (in sentences) of putative nominal phrases may reduce the amount of human effort involved in recognizing the emergence of new relationships.

Artificial Intelligence↗

PubMed1998

Recognition of native structure from complete enumeration of low-resolution models with constraints.

Complete sets of low-resolution conformations are generated for eight small proteins by rotating the Calpha-Calpha virtual bonds at selected flexible regions, while the remaining structural elements are assumed to move in rigid blocks. Several filtering criteria are used to reduce the ensemble size and to ensure the sampling of well-constructed conformations. These filters, based on structure and energy constraints deduced from knowledge-based studies, include the excluded volume requirement, the radius of gyration constraint, and the occurrence of sufficiently strong attractive inter-residue potentials to stabilize compact forms. About 8,000 well-constructed decoys or "probable folds" (PFs) are constructed for each protein. A correlation between root-mean-square (rms) deviations from X-ray structure and total energies is observed, revealing a decrease in energy as the rms deviation decreases. The conformation with the lowest energy exhibits an rms deviation smaller than 3.0 A, in most of the proteins considered. The results are highly sensitive to the choice of flexible regions. A strong tendency to assume native state rotational angles is revealed for some flexible bonds from the analysis of the distributions of dihedral angles in the PFs, suggesting the formation of foldons near these locally stable regions at early folding pathway.

Computer Simulation↗

PubMed1990

Social behavior and knowledge of social "scripts" among mentally retarded adults.

Mentally retarded individuals' script-based knowledge and performance of routine events was explored. Twenty mentally retarded adults and 20 nonretarded preschoolers were asked to sequence photographs of events depicted in familiar and novel contexts. Retarded individuals were better able to sequence events depicted in familiar contexts than in novel contexts, suggesting deficits in generalizing social knowledge. Preschoolers performed above chance levels in the familiar context only. Observations of retarded individuals during naturally occurring events indicated that actual social behavior was unrelated to event knowledge.

Activities of Daily Living↗

PubMed2000

MedSynDiKATe--design considerations for an ontology-based medical text understanding system.

MedSynDiKATe is a natural language processor for automatically acquiring knowledge from medical finding reports. The content of these documents is transferred to formal representation structures which constitute a corresponding text knowledge base. The general system architecture we present integrates requirements from the analysis of single sentences, as well as those of referentially linked sentences forming cohesive texts. The strong demands MedSynDiKATe poses to the availability of expressive knowledge sources are accounted for by two alternative approaches to (semi)automatic ontology engineering.

Evaluation Studies as Topic↗

PubMed2000

Expediting the transfer of evidence into practice: building clinical partnerships.

A librarian/clinician partnership was fostered in one hospital through the formation of the Evidence-based Practice Committee, with an ulterior goal of facilitating the transfer of evidence into practice. The paper will describe barriers to evidence-based practice and outline the committee's strategies for overcoming these barriers, including the development and promotion of a Web-based guide to evidence-based practice specifically designed for clinicians (health professionals). Educational strategies for use of the Web-based guide will also be addressed. Advantages of this partnership are that the skills of librarians in meeting the needs of clinicians are maximized. The evidence-based practice skills of clinicians are honed and librarians make a valuable contribution to the knowledge-base of the clinical staff. The knowledge acquired through the partnership by both clinicians and librarians will increase the sophistication of the dialogue between the two groups and in turn will expedite the transfer of evidence into practice.

Evidence-Based Medicine↗

PubMed1998

Computers in medical education 1: evaluation of a problem-orientated learning package.

BACKGROUND: A computer-based learning package has been developed, aimed at expanding students' knowledge base, as well as improving data-handling abilities and clinical problem-solving skills. The program was evaluated by monitoring its use by students, canvassing users' opinions and measuring its effectiveness as a learning tool compared to tutorials on the same material. METHODS: Evaluation was undertaken using three methods: initially, by a questionnaire on computers as a learning tool and the applicability of the content: second, through monitoring by the computer of student use, decisions and performance; finally, through pre- and post-test assessment of fifth-year students who either used a computer package or attended a tutorial on equivalent material. RESULTS: Most students provided positive comments on the learning material and expressed a willingness to see computer-aided learning (CAL) introduced into the curriculum. Over a 3-month period, 26 modules in the program were used on 1246 occasions. Objective measurement showed a significant gain in knowledge, data handling and problem-solving skills. CONCLUSIONS: Computer-aided learning is a valuable learning resource that deserves better attention in medical education. When used appropriately, the computer can be an effective learning resource, not only for the delivery of knowledge. but also to help students develop their problem-solving skills.

Clinical Competence↗

PubMed2002

Improving the management of breathlessness using a clinical effectiveness programme.

Breathlessness represents a significant problem for the person with advanced cancer. Uncontrolled breathlessness ranks highly in terms of uncomfortable symptoms experience, causing pain and distress to the patient and resulting in significant anxiety to their carers. The key to the provision of effective care lies in the informed application of the nursing process, underpinned by a sound knowledge base in relation to the nursing management of breathlessness. Theoretical knowledge enables nursing staff to offer appropriate interventions for the management of breathlessness in collaboration with other members of the multidisciplinary team. This article will discuss the cause and management of breathlessness in the person with advanced cancer; the discussion focuses on the application of research-based interventions and the evaluation of clinical outcomes in a UK clinical governance context.

Dyspnea↗

PubMed1990

Sex knowledge, attitudes, and experience of Chinese medical students in Hong Kong.

Sex knowledge, attitudes, and experience of 83 Chinese undergraduate medical students were assessed in their responses to the Sex Knowledge and Attitude Test. They were found to be relatively less knowledgeable especially in areas of social and cultural data-based knowledge and were less liberal especially in attitudes toward heterosexual relations and abortion. While increased knowledge tended to be associated with the repudiation of sexual myths, a general conservative outlook as assessed by the Wilson-Patterson Conservatism Scale was found to have the greatest influence on attitudes toward heterosexual relations, autoeroticism, and abortion. In contrast to the sexual practice of young Chinese of similar age based on another survey, the present sample of medical students was relatively heterosexually inexperienced. Implications for medical education with value reorientation are discussed.

Adaptation, Psychological↗

PubMed1997

Psychological aspects of organ donation: a critical review and synthesis of individual and next-of-kin donation decisions.

This article presents a critical review of psychological perspectives on organ donation. The review considers individual decisions to donate organs posthumously and next-of-kin consent decisions. A theoretical analysis of intention to donate is presented for both types of donation decisions, and the literature is reviewed within the context of the proposed framework. Donation decisions are examined as a function of attitude toward donation and the religious, cultural, altruistic, normative, and knowledge-based beliefs that comprise the attitude. Consent decisions are primarily influenced by prior knowledge of the deceased individual's wishes. An alternative conceptual model is offered to explain the basis of consent decisions in the absence of this knowledge. Suggestions are offered to improve measurement strategy and to guide theoretically based organ donation research within selected disciplines of psychology.

Attitude to Death↗

PubMed2004

Modeling guidelines for integration into clinical workflow.

The success of clinical decision-support systems requires that they are seamlessly integrated into clinical workflow. In the SAGE project, which aims to create the technological infra-structure for implementing computable clinical practice guide-lines in enterprise settings, we created a deployment-driven methodology for developing guideline knowledge bases. It involves (1) identification of usage scenarios of guideline-based care in clinical workflow, (2) distillation and disambiguation of guideline knowledge relevant to these usage scenarios, (3) formalization of data elements and vocabulary used in the guideline, and (4) encoding of usage scenarios and guideline knowledge using an executable guideline model. This methodology makes explicit the points in the care process where guideline-based decision aids are appropriate and the roles of clinicians for whom the guideline-based assistance is intended. We have evaluated the methodology by simulating the deployment of an immunization guideline in a real clinical information system and by reconstructing the workflow context of a deployed decision-support system for guideline-based care. We discuss the implication of deployment-driven guideline encoding for sharability of executable guidelines.

Decision Making, Computer-Assisted↗

PubMed2003

Use of latent semantic analysis for predicting psychological phenomena: two issues and proposed solutions.

Latent semantic analysis (LSA) is a computational model of human knowledge representation that approximates semantic relatedness judgments. Two issues are discussed that researchers must attend to when evaluating the utility of LSA for predicting psychological phenomena. First, the role of semantic relatedness in the psychological process of interest must be understood. LSA indices of similarity should then be derived from this theoretical understanding. Second, the knowledge base (semantic space) from which similarity indices are generated must contain 'knowledge' that is appropriate to the task at hand. Proposed solutions are illustrated with data from an experiment in which LSA-based indices were generated from theoretical analysis of the processes involved in understanding two conflicting accounts of a historical event. These indices predict the complexity of subsequent student reasoning about the event, as well as hand-coded predictions generated from think-aloud protocols collected when students were reading the accounts of the event.

Adolescent↗

PubMed1999

[The understanding of health, illness and care by Turkish immigrant women. An empirical study].

The opportunities for and parameters of individual care are determined by an understanding of the patient's sociocultural and biographical context. As a presupposition for patient-centred nursing care nurses, therefore, need a soundly based knowledge of the manifold cultural ways of coping with everyday demands, especially in crises as brought on by illness. In a qualitative study on the understanding of illness, health and care 10 Turkish women, all of whom are experienced in lay care within their own families, were interviewed. The interviews were analysed with reference to the "Development Research Sequence" of James Spradley. This method filters out cultural themes from the subjective views of the informants that centre round the topics of health, illness and care within the family, views that determine both the everyday knowledge and the activities of the women. The study is based on the two assumptions that firstly patient-specific variables, sociocultural factors, the family and the social network have to be taken into consideration if professional nursing care is to succeed and secondly that the process of immigration has effects on the understanding of illness, health and care as well as on the lay care practices which are specific to each generation and become significant for the care of family members in immigrant families. Examples will be used in writing up the results of the enquiry.

Adaptation, Psychological↗