SEARCH · PubMed Health

Results for “Knowledge base”

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.

At least 1,549 records · Page 86Linked to original sources

PubMedDate not supplied

The assessment of knowledge and application of proper body mechanics in the workplace.

Back pain is the most expensive industrial injury. Representatives at DeRoyal, a manufacturer of orthopaedic soft goods, believed a total back hygiene program that included aggressive training in body mechanics would reduce the cost associated with back injury. Prior to implementing a back educational program, the knowledge base of employees was assessed. A survey designed to measure knowledge and application of proper body mechanics was developed and distributed to 100 randomly selected workers. Most workers know the best way to lift. But, they had less knowledge of the best way to push. They also did not always use proper technique in lifting without twisting, planning lifts, and proper standing. A subset of workers that has previously attended back training sessions (n = 6) all gave the correct answers on 4 or the 5 survey items. Orthopaedic nurses could play a critical role in the industrial setting through assessment of body mechanic knowledge and implementation of educational programs.

Biomechanical Phenomena↗

PubMed2002

The decision making process in a district nursing assessment.

Assessment is a key element of district nursing practice and a cornerstone of community care. Yet very little research has been undertaken in this area. Given the current emphasis on evidence-based practice in health care, there is a need to ensure that district nurses, nursing students and educators can draw from an empirically derived and sound knowledge base. This article explores the relationship between knowledge and decision-making in district nursing assessment. It is based on a case study of one district nurse participant from a qualitative study of district nursing assessment. The case study material illustrates key findings from this study in order to examine the relationship between theoretical perspectives and everyday decision-making, based on the stages of decision-making identified by Carroll and Johnson (1990).

Attitude of Health Personnel↗

PubMedDate not supplied

Nurses' knowledge of heart failure education topics as reported in a small midwestern community hospital.

Recurrent heart failure (HF) is the most common cause for readmission of elderly patients with HF. Patient education is an essential component of care for these patients. Healthcare providers must have a sufficient knowledge base to facilitate this education. This study aims to describe nurses' knowledge of HF self-management education principles. Fifty-one nurses working in a small Midwestern community hospital completed a 20-item true or false written survey developed by Albert et al (Heart Lung. 2002;31:102-112) to assess their knowledge of 5 areas of HF self-management. The sample included 14 nurses working in an intensive care unit and 41 nurses working on a general medical unit, all routinely providing care to patients with HF. The mean (+/-SD) HF self-care knowledge score was 14.6 +/- 2 (range = 9-19). There was no statistical difference in mean score between intensive care unit (14.7 +/- 1.6) and floor (14.5 +/- 2.1) nurses. Correct responses to individual survey items ranged from 20% to 100%; 6 questions resulted in mean scores >90% correct, 9 questions had mean scores between 70% and 90% correct, and 5 questions had mean scores <70% correct. Most respondents (90%) answered 6 questions correctly, but on 9 questions, 70% and 90% answered correctly. On 5 questions, less than 70% answered them correctly. Two questions (need for daily weight monitoring when asymptomatic and the importance of notifying the doctor of new onset or worsening of fatigue) were answered correctly by all participants. Subject areas of frequently missed questions were the use of nonsteroidal anti-inflammatory drugs, use of potassium-based salt substitutes, assessment of weight results, and physician notification of asymptomatic low blood pressure and momentary dizziness when rising. These results suggest that nurses working in a small community hospital may not be sufficiently knowledgeable in HF management principles. Additional emphasis on HF educational principles may improve the quality of patient education. One suggested intervention is to provide ongoing education for nurses regarding HF management.

Aged↗

PubMed1995

Evaluating four diagnostic methods with acute abdominal pain cases.

Contemporary work in medical decision support is characterized by a multitude of methods. To investigate their relative strengths and weaknesses, we built four diagnostic expert systems based on different methods (Bayes, case-based classification, heuristic classification) for analysis of the same set of 1254 cases of acute abdominal pain previously documented in a prospective multicenter study. The results of the comparative evaluation indicate that differences in overall performance are relatively small (statistically not significant). The performance depends more on the quality of the knowledge base and the case data than on the inference methods of the expert systems. Methods relying exclusively on empirical knowledge (Bayes, case-based classification) tend to have slightly higher overall performance scores due to a diagnostic bias toward ordinary and common diseases. By contrast, methods operating with expert knowledge (e.g., heuristic classification) perform slightly worse overall, but are more sensitive toward uncommon (serious) diseases.

Abdominal Pain↗

PubMedDate not supplied

Data, knowledge and method bases in chemical sciences. Part IV. Current status in databases.

Computer readable databases have become an integral part of chemical research right from planning data acquisition to interpretation of the information generated. The databases available today are numerical, spectral and bibliographic. Data representation by different schemes--relational, hierarchical and objects--is demonstrated. Quality index (QI) throws light on the quality of data. The objective, prospects and impact of database activity on expert systems are discussed. The number and size of corporate databases available on international networks crossed manageable number leading to databases about their contents. Subsets of corporate or small databases have been developed by groups of chemists. The features and role of knowledge-based or intelligent databases are described.

Artificial Intelligence↗

PubMed2000

Reflections on empowerment-based practice.

Social work education presents students with theories for understanding human beings and the social-historical contexts they share. These assumptions are supposed to make social workers' roles, practices, and agencies make sense. But where do they come from? How are the theories selected--and from among what alternatives? The people or licensing bodies choosing or approving these options control knowledge and inhibit knowing beyond the parameters of what they have designated for social work's knowledge base. What were the knowledge requirements or factors used to select prevailing theories about human behavior and the social environment or about social work practice? What happens to practitioners when feelings about their work contradicts what they were taught they should be thinking? This article is a reflection of formal social work learning interacting with the author's own social work experience. The article discusses what receiving knowledge (as opposed to sharing in producing or generating it) means for a practice supposedly committed to the social work values of human dignity and social justice. The experiences that led to the author's work on empowerment-based practice are presented and discussed. These experiences precipitated critical questioning that continues today.

Cultural Diversity↗

PubMedDate not supplied

HYDRA: a knowledge acquisition tool for expert systems that critique medical workup.

HYDRA is a computer-based knowledge acquisition tool under development to assist in the creation of expert systems which critique medical workup. To use HYDRA, a domain expert first outlines the recommended approaches to the workup of a chosen medical problem, using the Augmented Transition Network formalism. From this model, HYDRA produces a list of the various conditions for which critiquing comments may be required to react to all possible approaches that might be proposed by the user of the critiquing system. Domain-specific constraints can be used to restrict the number of conditions suggested. In this way, HYDRA assists the domain expert by providing a model for structuring the problem, and by breaking down the domain expert's work into a set of small, easily understood tasks.

Algorithms↗

PubMed2005

Learning motor sequences with and without knowledge of governing rules.

OBJECTIVE: To investigate the behavioral and neural effects of rule-based knowledge on motor sequence learning. METHODS: The authors developed a novel 2-dimensional variant of the serial reaction time (SRT) task to test the effect of prior, verbalizable rule knowledge on motor learning behavior. To examine neurophysiological effects, they also performed functional magnetic resonance imaging on a small cohort of subjects while performing the same task. RESULTS: Behavioral data demonstrated that instruction on sequence-governing rules enhanced behavioral performance in both learning magnitudes and rates. The neuroimaging data revealed substantially different, but partially overlapping, learning-related activation patterns with and without prior rule instruction. Direct comparison of these 2 conditions revealed significantly different involvement of bilateral superior and anterior prefrontal cortex (Brodmann areas 8 and 10, respectively), right superior temporal cortex (BA 38/21), and left cerebellum. CONCLUSIONS: These behavioral findings demonstrate an advantage of teaching governing rules prior to 2D-SRT task performance. While these neuroimaging findings remain to be replicated in a larger cohort of subjects, results suggest that substantially different-though partially overlapping-brain regions subserve learning in these 2 rehabilitation-relevant conditions. Thus, appropriate choice of pretraining may benefit, for example, rehabilitation populations, at least in motor skill acquisition that requires sequencing.

Adolescent↗

PubMed2000

Derivation of protein-specific pair potentials based on weak sequence fragment similarity.

A method is presented for the derivation of knowledge-based pair potentials that corrects for the various compositions of different proteins. The resulting statistical pair potential is more specific than that derived from previous approaches as assessed by gapless threading results. Additionally, a methodology is presented that interpolates between statistical potentials when no homologous examples to the protein of interest are in the structural database used to derive the potential, to a Go-like potential (in which native interactions are favorable and all nonnative interactions are not) when homologous proteins are present. For cases in which no protein exceeds 30% sequence identity, pairs of weakly homologous interacting fragments are employed to enhance the specificity of the potential. In gapless threading, the mean z score increases from -10.4 for the best statistical pair potential to -12.8 when the local sequence similarity, fragment-based pair potentials are used. Examination of the ab initio structure prediction of four representative globular proteins consistently reveals a qualitative improvement in the yield of structures in the 4 to 6 A rmsd from native range when the fragment-based pair potential is used relative to that when the quasichemical pair potential is employed. This suggests that such protein-specific potentials provide a significant advantage relative to generic quasichemical potentials.

Amino Acids↗

PubMed1995

A case-based emergency medicine curriculum for senior medical students.

OBJECTIVE: To determine the effects of a case-based, core content-oriented emergency medicine (EM) curriculum on the basic EM knowledge of senior medical students. METHODS: All senior medical students rotating through the Milwaukee County EM elective during the 1992-1993 academic year were assigned specific chapter readings from a case-oriented EM textbook. A course curriculum consisting of goals and objectives for each chapter and two to three representative cases for the discussion topic also was distributed to each student. Interspersed with the cases was a series of questions directed at pathophysiology, diagnosis, management, and disposition. The EM faculty and residents conducted case discussions three times per week. All students completing the rotation were given a pretest at the beginning and a final examination at the end of the rotation. In addition, the students rated the textbook, coursebook, and lecture series at the end of the rotation using a five-point Likert scale. RESULTS: Seventy-five students rotated through the elective. The students showed a significant improvement in their EM knowledge base as judged by improvement in final examination scores compared with pretest scores (pretest score 62.2 +/- 7.1%; final examination score 76.2 +/- 6.3%; p < 0.0001). The mean change in scores was 14.8%, with a range of -1.6% to 34%. The students also rated the textbook, coursebook, and lecture series as effective, as shown by high median scores on a Likert scale. CONCLUSIONS: A case-based EM curriculum coupled with ED clinical experience improves basic EM diagnostic and management knowledge of senior medical students.

Analysis of Variance↗

PubMed2004

Using prior knowledge in SVD-based parameter estimation for magnetic resonance spectroscopy--the ATP example.

We introduce the knowledge-based singular value decomposition (KNOB-SVD) method for exploiting prior knowledge in magnetic resonance (MR) spectroscopy based on the SVD of the data matrix. More specifically, we assume that the MR data are well modeled by the superposition of a given number of exponentially damped sinusoidal components and that the dampings alphakappa, frequencies omegakappa, and complex amplitudes rhokappa of some components satisfy the following relations: alphakappa = alpha (alpha = unknown), omegakappa = omega + (kappa- 1)delta (omega = unknown, delta = known), and rhokappa = Ckapparho (rho = unknown, ckappa = known real constants). The adenosine triphosphate (ATP) complex, which has one triple peak and two double peaks whose dampings, frequencies, and amplitudes may in some cases be known to satisfy the above type of relations, is used as a vehicle for describing our SVD-based method throughout the paper. By means of numerical examples, we show that our method provides more accurate parameter estimates than a commonly used general-purpose SVD-based method and a previously suggested prior knowledge-based SVD method.

Adenosine Triphosphate↗

PubMed1991

Obsessive-compulsive disorder. The effect of research on nursing care.

The purpose of research is the expansion of knowledge. Research with greatest impact on the discipline is that which expands knowledge to enable the provision of effective care. Nursing, as an applied science, responds to changes in the knowledge base with concomitant changes in the application of the nursing process. OCD is an example of an expansion in knowledge after a history of care based on a limited understanding of the etiology of the disorder. The impact on the nursing care of the client with OCD includes the importance of careful assessment with attention to behaviors, feelings, and cognitions. The implementation of nursing actions is guided by a focus on the present and includes physical and emotional support provided for needs created by both the symptoms of OCD and the accompanying symptoms of anxiety and depression, as well as client education regarding OCD and the safe use of clomipramine when it is prescribed.

Adult↗

PubMed2005

Domain-based homology modeling and mapping of the conformational epitopes of envelope glycoprotein of west nile virus.

Knowledge-based modeling has proved significantly accurate for generating the quality models for proteins whose sequence identity with the structurally known targets is greater than or equal to 40%. On the other hand, models obtained for low sequence identities are not reliable. Hence, a reliable and alternative strategy that uses knowledge of domains in the protein can be used to improve the quality of the model generated by the homology method. Here, we report a method for developing a 3D-model for the envelope glycoprotein (Egp) of west nile virus (WNV), using knowledge of structurally conserved functional domains amongst the target sequence (Egp of WNV) and its homologous templates belonging to the same protein family, flaviviridae. This strategy is found to be highly effective in reducing the root mean square deviation (RMSD) value at the Calpha positions of the target and its experimental homologues. The 3D structure of a protein is a prerequisite for structure-based drug design as well as for identifying the conformational epitopes that are essential for the designing vaccines. The conformational epitopes are mapped from the 3D structure of Egp of WNV modeled using the concept of an antigenic domain. A total of five such epitope regions/sites have been identified. They have been found distributed in the loop regions (surface) of the whole protein model composed of dimerization, central and immunological domains. These sites are proposed as the binding sites for HLA proteins/B-cell receptors. Binding is required to activate the immune response against WNV.

Amino Acid Sequence↗

PubMed2000

Medical students' errors in pharmacotherapeutics.

OBJECTIVES: This study analysed the errors made by 16 final-year medical students in a classroom prescribing exercise. The aim was to gain greater understanding of the reasons for non-optimal prescribing and of how to improve basic training in pharmacotherapeutics. METHODS: The task was to adjust a patient's phenytoin sodium dosage to achieve better control of seizures. It was based on a real-life case, and was presented as a written exercise. Process-tracing and think-aloud techniques were used to study the students' performance. RESULTS: The results suggest that the root cause of the errors was lack of a knowledge base which integrated scientific knowledge with clinical know-how. Three different clinical reasoning strategies were observed. Students who followed an incremental strategy demonstrated superior scientific knowledge and this resulted in less hazardous errors. Those who followed gambling or backward-reasoning strategies appeared to possess inferior scientific knowledge and this resulted in more hazardous errors. CONCLUSIONS: The results support current trends towards integrating basic medical science into a foundation of clinical know-how, as in the problem-based curriculum. They also emphasize the importance of a thorough grounding in medical science as a means of minimizing error.

Clinical Competence↗

PubMed2006

MACSIMS: multiple alignment of complete sequences information management system.

BACKGROUND: In the post-genomic era, systems-level studies are being performed that seek to explain complex biological systems by integrating diverse resources from fields such as genomics, proteomics or transcriptomics. New information management systems are now needed for the collection, validation and analysis of the vast amount of heterogeneous data available. Multiple alignments of complete sequences provide an ideal environment for the integration of this information in the context of the protein family. RESULTS: MACSIMS is a multiple alignment-based information management program that combines the advantages of both knowledge-based and ab initio sequence analysis methods. Structural and functional information is retrieved automatically from the public databases. In the multiple alignment, homologous regions are identified and the retrieved data is evaluated and propagated from known to unknown sequences with these reliable regions. In a large-scale evaluation, the specificity of the propagated sequence features is estimated to be >99%, i.e. very few false positive predictions are made. MACSIMS is then used to characterise mutations in a test set of 100 proteins that are known to be involved in human genetic diseases. The number of sequence features associated with these proteins was increased by 60%, compared to the features available in the public databases. An XML format output file allows automatic parsing of the MACSIM results, while a graphical display using the JalView program allows manual analysis. CONCLUSION: MACSIMS is a new information management system that incorporates detailed analyses of protein families at the structural, functional and evolutionary levels. MACSIMS thus provides a unique environment that facilitates knowledge extraction and the presentation of the most pertinent information to the biologist. A web server and the source code are available at http://bips.u-strasbg.fr/MACSIMS/.

Algorithms↗

PubMed2004

How to train residents to identify and treat dual diagnosis patients.

Medical training has failed to address the needs of patients with comorbid substance use and psychiatric disorders. Addiction teaching is limited and often fails to change the negative attitudes of many physicians. In many psychiatry residencies, addiction training occurs on inpatient or detoxification units and the focus is on screening, detoxification, and referral. Most residents do not gain adequate experience in the long-term management of dual-diagnosis patients. Successful clinical care is based on three critical elements (the "clinician's triad"): an adequate knowledge base, a positive attitude toward the patient and the benefits of treatment, and a sense of responsibility for the clinical problem. The Boston University Psychiatry Residency has designed an addiction training program to address these three issues. In addition to a comprehensive addiction seminar series, there are several unique features. The required clinical rotation occurs in an outpatient dual-diagnosis clinic and permits residents to follow a caseload of patients for 12 months. Extensive experience is gained in motivational interviewing, cognitive behavioral therapy, and pharmacotherapy. Self-directed learning approaches are used to maximize the educational experience on services that lack addiction faculty. Guidelines are provided for establishing a similar program and for more effective approaches to resident teaching.

Curriculum↗

PubMed1992

Inductive learning of thyroid functional states using the ID3 algorithm. The effect of poor examples on the learning result.

The ID3 algorithm for inductive learning was tested using preclassified material for patients suspected to have a thyroid illness. Classification followed a rule-based expert system for the diagnosis of thyroid function. Thus, the knowledge to be learned was limited to the rules existing in the knowledge base of that expert system. The learning capability of the ID3 algorithm was tested with an unselected learning material (with some inherent missing data) and with a selected learning material (no missing data). The selected learning material was a subgroup which formed a part of the unselected learning material. When the number of learning cases was increased, the accuracy of the program improved. When the learning material was large enough, an increase in the learning material did not improve the results further. A better learning result was achieved with the selected learning material not including missing data as compared to unselected learning material. With this material we demonstrate a weakness in the ID3 algorithm: it can not find available information from good example cases if we add poor examples to the data.

Algorithms↗

PubMed1992

Insulin dosage adjustment in diabetes.

A prototype computer system has been developed to provide advice on the day-to-day adjustment of carbohydrate intake and insulin regimen in the insulin-treated diabetic patient. The system also produces a 24-hour simulation of the patient's blood glucose profile based on these adjustments. Advice is generated by a qualitative knowledge-based system which suggests what the next step in improving glycaemic control might be for a given patient, e.g. 'decrease evening medium-acting insulin by two units'. Simulations are provided by a non-linear model which consists of a one-compartment glucose model linked to a model with plasma and 'active' insulin compartments. A description of the integrated system is provided and its operation illustrated by clinical case studies from insulin-treated diabetic patients.

Blood Glucose↗