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PubMed2002

Knowledge of object manipulation and object function: dissociations in apraxic and nonapraxic subjects.

An influential account of selective semantic deficits posits that visual features are heavily weighted in the representations of animals, whereas information about function is central in the representations of tools (e.g., Warrington & Shallice, 1984 ). An alternative account proposes that information about all types of objects-animate and inanimate alike-is represented in a distributed semantic architecture by verbal-propositional, tactile, visual, and proprioceptive-motor nodes, reflecting the degree to which these systems were activated when the knowledge was acquired (e.g., Allport, 1985 ). We studied a group of left hemisphere chronic stroke patients, some of whom were apraxic, with measures of declarative tool and animal knowledge, body part knowledge, and function and manipulation knowledge of artifacts. Apraxic (n=7) and nonapraxic (n=6) subjects demonstrated a double dissociation of performance on tests of tool and animal knowledge, suggesting that the apraxic group was not simply more severely impaired overall. Apraxics were relatively impaired in manipulation knowledge, whereas nonapraxics tended to be relatively impaired in function knowledge. Apraxics were also more impaired with body parts than nonapraxics. The association of gestural praxis, tool knowledge, body part knowledge, and manipulation knowledge suggests a coherent basis for the organization of semantic artifact knowledge in frontoparietal cortical regions specialized for sensorimotor functions, and thus provides support for the distributed architecture account of the semantic system.

Aged↗

PubMed2000

Category learning with minimal prior knowledge.

In 6 experiments, the authors examined the use of prior knowledge in category learning. Previous studies of the effects of knowledge on category learning have used categories in which knowledge was related to all of the category's features. However, people's knowledge of real-world categories often consists of many "rote" features that are not related to their prior knowledge. Five experiments found that even minimal prior knowledge (1 knowledge-relevant feature and 5 rote features per exemplar) can facilitate category learning. Posttests revealed that although the knowledge aided learning, subjects also acquired the rote features that were not related to knowledge, contradicting predictions of an attentional explanation of the knowledge effect. The results of Experiment 6 suggested that subjects attempt to link even rote features to their knowledge.

Cognition↗

PubMed1993

A Pathfinder analysis of pedagogical knowledge structures: a follow-up investigation.

This study is an extension of an earlier investigation of undergraduate students' acquisition of key pedagogical concepts in a physical education teaching methodology course. In that study, Pathfinder, a method for eliciting associative memory networks, was used to describe and compare the pedagogical knowledge structures of students to that of the course instructor. After the course, students' pedagogical knowledge structures corresponded more closely with that of the instructor, and students who corresponded the closest performed better in the course. The results raised an interesting issue regarding the acquisition of knowledge in undergraduate students. Did students acquire a generalizable body of pedagogical knowledge applicable beyond the context of the teaching methodology course or a highly contextualized reflection of their course instructor's knowledge base? In the present study the external validity of the pedagogical knowledge base was examined by using Pathfinder to compare the knowledge structures of students from the initial investigation with knowledge structures of five experienced teacher educators from five different teacher education programs. The findings indicated that students' knowledge structures became significantly more correspondent with that of the experienced teachers' structures from the beginning to the end of the course. Also, students' correspondence with teacher educators' structures following instruction was found to be significantly correlated with academic and teaching performance. The findings point to the external validity of the domain of knowledge under study and the robustness of Pathfinder for capturing pedagogical knowledge.

Adult↗

PubMed1993

Expertise in expert systems: knowledge acquisition for biological expert systems.

In this paper it is argued that an expert system requires more than factual knowledge before it can display expertise in a given domain. The additional knowledge consists of the heuristics or 'rules of thumb' used by an expert to manipulate and interpret the factual knowledge. The knowledge acquisition phase of an expert system project involves determining the factual knowledge (which may be obtained from published sources) and the heuristics used by an expert to manipulate that knowledge--these heuristics can only be obtained from an expert. In reviewing existing biological expert systems it is apparent that many contain only the factual knowledge relating to the domain, and lack the heuristics that enable such systems to show expertise. This paper reviews a number of knowledge acquisition techniques which could be used for acquiring heuristic knowledge and discusses when their use is appropriate. The knowledge acquisition techniques discussed are those suitable for the development of small-scale expert systems as these are most likely to be of interest to biologists. The techniques include the use of questionnaires, interview techniques and protocol analysis; particular emphasis is placed on a modification to the 'twenty questions' interview technique which was developed specifically to elicit taxonomic knowledge relating to water mite identification.

Biology↗

PubMed1997

The forms of knowledge mobilized in some machine vision systems.

This paper describes a number of computer vision systems that we have constructed, and which are firmly based on knowledge of diverse sorts. However, that knowledge is often represented in a way that is only accessible to a limited set of processes, that make limited use of it, and though the knowledge is amenable to change, in practice it can only be changed in rather simple ways. The rest of the paper addresses the questions: (i) what knowledge is mobilized in the furtherance of a perceptual task?; (ii) how is that knowledge represented?; and (iii) how is that knowledge mobilized? First we review some cases of early visual processing where the mobilization of knowledge seems to be a key contributor to success yet where the knowledge is deliberately represented in a quite inflexible way. After considering the knowledge that is involved in overcoming the projective nature of images, we move the discussion to the knowledge that was required in programs to match, register, and recognize shapes in a range of applications. Finally, we discuss the current state of process architectures for knowledge mobilization.

Humans↗

PubMed2000

Ontology acquisition from on-line knowledge sources.

Electronic knowledge representation is becoming more and more pervasive both in the form of formal ontologies and less formal reference vocabularies, such as UMLS. The developers of clinical knowledge bases need to reuse these resources. Such reuse requires a new generation of tools for ontology development and management. Medical experts with little or no computer science experience need tools that will enable them to develop knowledge bases and provide capabilities for directly importing knowledge not only from formal knowledge bases but also from reference terminologies. The portions of knowledge bases that are imported from disparate resources then need to be merged or aligned to one another in order to link corresponding terms, to remove redundancies, to resolve logical conflicts. We discuss the requirements for ontology-management tools that will enable interoperability of disparate knowledge sources. Our group is developing a suite of tools for knowledge-base management based on the Protégé-2000 environment for ontology development and knowledge acquisition. We describe one such tool in detail here: an application for incorporating information from remote knowledge sources such as UMLS into a Protégé knowledge base.

Artificial Intelligence↗

PubMed2001

The role of tacit knowledge in the work context of nursing.

AIMS OF THE STUDY: Previous research on the role of tacit knowledge is ambiguous. Some studies show the superiority of expertise, while other studies found experts would not be better than laymen. This paper aims at clarifying the contribution of tacit knowledge to expertise in the domain of nursing. BACKGROUND: Two important concepts for dealing with critical situations are outlined - tacit knowledge and experience-guided working. The framework of tacit knowledge and experience-guided working can contribute to an explanation of the ambiguous results. Tacit knowledge is acquired implicitly in the course of working and is therefore not subject to reflection. For this reason it can contain erroneous or problematic contents. METHODS: A method for the explication of tacit knowledge was developed and a laboratory study with 16 experienced nurses conducted. In the laboratory study the nurses had to deal with a critical nursing situation that was developed in co-operation with nursing experts. The explicit knowledge of the nurses was tested before the laboratory study. RESULTS: No systematic differences in explicit knowledge could be observed, i.e. differences in performance could not be attributed to this knowledge mode. Results from multidimensional scaling procedures illustrate differences in the tacit knowledge of nurses who successfully accomplished the critical situation and those who did not. CONCLUSIONS: The findings are in line with the assumption that experience-guided working is of the utmost importance for dealing with critical situations. Consequences of these results for nursing and person-related services in general are discussed and the aim of future research is outlined.

Adaptation, Psychological↗

PubMed1993

Knowledge and practices of pregnant women in relation to the intake of drugs during pregnancy.

The present study was done to assess Knowledge and practices of expectant women regarding drug intake during pregnancy. To achieve this aim, a simple random sample of 400 pregnant women during their last trimester of pregnancy were selected. A specially designed interview schedule was developed and used to collect the necessary data about the study subjects. The interview schedule consisted of four main parts to cover the following: 1. General characteristics of the sample. 2. Obstetrical characteristics of the sample 3. Knowledge about drug intake during pregnancy. 4. Practices of the study subjects in relation to drug intake during pregnancy. 5. Factors affecting their knowledge regarding drug intake during pregnancy. The main findings of the study were: 1. In general, the study sample lacked the essential knowledge regarding drug intake during pregnancy especially in relation to the risk time for taking drugs in which nearly one-fifth of the sample (19.5%) did not know that it is risky to take drugs during pregnancy without doctor's order. 2. Regarding the practices of the study subjects in relation to drug intake during pregnancy, it was observed that the majority of the sample (86%) took drugs without prescription such as vitamins and general tonics, antacids, analgesics, anti-emetics, sedatives and antibiotics to treat their minor or major complaints during pregnancy. 3. In this study, it was also found that certain factors seemed to affect women's knowledge regarding drug intake during pregnancy. It was more obvious to observe that nearly two-thirds (60.8%) of women whose age was less than 30 years were more likely to have inadequate and poor knowledge in this respect. It was observed that the majority (81.9%) of illiterate women were more likely to have inadequate and poor knowledge about drug intake during pregnancy. It was also found that nearly three-quarters (72.3%) of housewives were more likely to have poor and inadequate knowledge. It was also noticed that the majority (81.5%) of the primigravidae women were more likely to have poor and inadequate knowledge. It was also noted that the majority of women (87.1%) who had previous abortions were more likely to have poor and inadequate knowledge.

Abnormalities, Drug-Induced↗

PubMed1990

Effects of an AIDS education program on the knowledge, attitudes and practices of low income black and Latina women.

The purpose of this study was to test the effects of an AIDS education program on the knowledge, attitudes and practices of low income black and Latina women. A pretest-posttest nonequivalent control group design was used with a 2-3 month retest of the experimental group. The sample consisted of 506 experimental and 206 control group women who were clients of the Public Health Foundation's Nutrition Program for Women, Infants and Children in Los Angeles County. The program included a slide-tape presentation, and educational and resource brochures in English and Spanish. Knowledge, attitudes, and sexual and drug use practices were measured using a structured questionnaire that was developed in English and Spanish. Content validity and reliability of the questionnaire were established. A 2-way repeated measures ANOVA examined differences in pretest-posttest knowledge, attitudes, and practices for experimental and control groups and for both racial/ethnic groups. The experimental group made significant gains over the control group on pretest-posttest measures of knowledge and attitudes. Both experimental and control groups made significant changes in practice. Changes in knowledge were retained on retest; changes in practices came close to significance on retest. Blacks and Latinas differed on pretest knowledge and attitudes but not practices. Blacks had more knowledge and positive attitudes on pretest. However, posttest improvements for both knowledge and attitudes were greater in Latinas than in blacks. A multiple regression analysis revealed that the best predictors of knowledge, attitudes and practices were racial/ethnic group, education, and religion. It is concluded that a didactic audio visual program can positively affect the knowledge and possibly the practices of participants and that these are retained over time but that changes in attitudes will take further efforts.

Acquired Immunodeficiency Syndrome↗

PubMed2002

Swiss nurses' knowledge related to health care reforms: an exploratory study.

BACKGROUND: This study examines health care reforms' implementation processes from the perspective of nurses' knowledge regarding the reforms. The research has been carried out in the Swiss (Canton Vaud) context, where health care reforms have been initiated, on the National (Federal) level, in 1996. OBJECTIVES: Three research questions were formulated: (a) What is the level of nurses' knowledge regarding the basic principles of LAMal (Loi fédérale sur l'assurance maladie, Federal Health Insurance Law)? (b) What is the level of nurses' knowledge concerning the principles of health care reforms in Canton Vaud (NOPS, Nouvelles Orientations de la Politique Sanitaire)? and (c) Are there knowledge differences relating to employment setting (hospital, community, and education), nurses' roles (managerial vs. staff nurses) and level of education? METHODS: The sample consisted of a total of 74 nurses. Of these, 20 were employed in the community, 30 in hospital settings and 24 worked in schools of nursing. The research tool utilized was 40-items nurses' knowledge questionnaire developed for the purpose of this study. Three knowledge subscales and a subscale of certainty were constructed. RESULTS: Overall, data showed a moderate to high mean level of knowledge (around 70% correct responses) on all knowledge scales considered. Community setting, managerial position, and a nonacademic nursing degree were all positively related to higher levels of reforms' knowledge. On the contrary, employment in a hospital setting and having a university degree had both negative impacts on achieving a high score of knowledge. Levels of certainty were significantly higher for LAMal than NOPS and for correct rather than for wrong responses.

Adult↗

PubMed1993

HIV infection and Norwegian general practitioners: does fear affect knowledge?

The objective was to study the dimensionality of knowledge among general practitioners in Norway about transmission of HIV and what factors influence the degree of knowledge. Data were collected by a mailed questionnaire. Independent variables were experience of HIV, acquisition of knowledge and confidence in information on HIV from the central authorities and perception of own knowledge, skills of practice and fear of oneself or one's family contracting the HIV infection. Analysis of variance and multiple classification analysis were applied to measure the effect of independent variables on knowledge about transmission of HIV. The general practitioners in three counties (Oslo, Møre og Romsdal and Troms), constituting one-quarter of the Norwegian general practitioner population were selected (n = 578). The response rate was 65%, and the results are assumed to be representative of Norwegian general practitioners. Four dimensions of knowledge about transmission of HIV were identified by factor analysis. The two most important, transmission through 'body fluids' and transmission by 'needle sticks', were subsequently converted into sum scores and used as dependent variables. Forty-five per cent of the respondents were uncertain about ways in which HIV is not transmitted through 'body fluids'. There was an association between knowledge about transmission through 'body fluids' and the variables county background, confidence in the information about HIV and fear of contracting HIV. In the multiple classification analysis these three variables explained 11% of the variation in knowledge about transmission through 'body fluids'. Only confidence and fear significantly predicted the degree of knowledge, and among the 11% who had no confidence in the information received the effect of fear on knowledge increased significantly.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗

PubMedDate not supplied

Knowledge utilization among experienced staff nurses.

The purpose of this descriptive exploratory study was to describe the processes staff nurses use to select and transfer new knowledge to practice. Eleven experienced staff nurses shared 29 examples in which gaining new knowledge resulted in changes in thinking or acting in a clinical situation. Findings indicated that knowledge utilization originated with the nurse who was active in selecting and using new knowledge. Nurses used multiple knowledge utilization processes primarily involving factual knowledge and instrumental utilization. Often, the decision to move knowledge to practice was based on comparison by similarity. There were no variations in utilization processes as nurses floated across units. Sources of new knowledge were primarily informal and unit based. Implications for staff development focus on developing unit-based resources and resource personnel, using innovative ways to introduce new knowledge on the unit, and providing time in formal classes for exchange of ideas on using new knowledge in practice.

Clinical Competence↗

PubMed1994

Dental health knowledge and attitudes among the middle-aged and the elderly in Hong Kong.

Previous studies on adult Hong Kong Chinese have indicated that their level of knowledge of and attitudes toward dental health might be a potential barrier to effective oral preventive efforts. The knowledge and attitudes of elderly Chinese have not previously been studied. The objectives of this study were to describe Hong Kong adults' knowledge of the causes of the two main oral diseases, caries and periodontal disease, and possible preventive measures, and to analyse possible relationships between knowledge and attitudes and selected sociodemographic and utilization variables. Two populations aged 35-44 yr (n = 398) and 65-74 yr (n = 559) were selected for the study, which was conducted as structured interviews. A knowledge score was constructed from questions on caries and periodontal disease development and prevention. Attitudes were measured in the younger group by beliefs and evaluations of those beliefs according to the theory of reasoned action (the higher the score, the more positive the attitude). Knowledge scores were almost normally distributed in the younger respondents, but were heavily skewed toward 0 in the older group. In both age groups, increased level of education and regularity or recency of dental visits were strongly associated with dental knowledge. Women, regular dental care users, and prevention-oriented respondents had higher attitude scores. There was no correlation between knowledge and attitudes. Some improvement in knowledge seems to have taken place, especially on the cause of caries, with fewer 35-44-yr-old respondents claiming lack of knowledge of the causes of caries and gum disease than in a previous study.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1986

The role of health belief attitudes, sex education, and demographics in predicting adolescents' sexuality knowledge.

As part of a pretest-posttest design to evaluate a 15-hour Health Belief Model (HBM)-based sex education program, we interviewed 203 teenagers (aged 13-17) of both genders regarding their preintervention sexual and contraceptive knowledge, attitudes toward pregnancy and contraception, and prior sex education and sexual activity experiences. A multiitem sexual and contraceptive knowledge measure yielded several specific topic area scales and a total knowledge score, and a multiitem attitudes measure also yielded five reliable HBM-based scales. A series of regression analyses that used teenagers' previous sexuality-related experiences, demographic information, and attitudes predicted knowledge scores well (R2 = 0.22-0.54). Across specific knowledge areas, HBM-based attitudes (e.g., perceived serious consequences of teen pregnancy) were consistently significant predictors. Interestingly, neither previous sex education nor personal sexual experiences were significantly associated with specific knowledge areas (e.g., venereal disease), although they were related to total knowledge scores. Similarly, age and gender were poor predictors of specific areas of knowledge, but minority ethnic status was consistently associated with less sexual and contraceptive knowledge. Our model was highly successful in accounting for a substantial portion of the variance in total knowledge scores (R2 = 0.54). Results are discussed in terms of their implications for designing sex education programs that focus on motivation for pregnancy avoidance and contraception as well as factual information for teenagers.

Adolescent↗

PubMed1999

Knowledge of fetal alcohol syndrome (FAS) among natives in Northern Manitoba.

OBJECTIVE: To investigate knowledge about fetal alcohol syndrome (FAS) among Natives in northern Manitoba. A second objective was to determine if there are age or gender differences in level of knowledge. A third objective was to examine the relationship between knowledge about FAS and reported frequency of drug and alcohol use during pregnancy. METHOD: A nonrandom sample of 466 Natives from northern Manitoba was interviewed about drug and alcohol use during pregnancy and knowledge of FAS. The sample was proportionately representative of the 26 northern reserves, with an approximately equal number of male and female subjects ranging in age from 13 to 71 years. RESULTS: Northern Manitoban Natives have lower levels of FAS knowledge than the general public. Of this sample, 80% believed drinking alcohol could adversely affect the unborn baby and 36% had heard of FAS, compared to 90% and 64%, respectively, in the general U.S. population. Natives in their 20s and 30s were more knowledgeable than Natives in their 50s and 60s. Females tended to be more knowledgeable than males. Drug and alcohol use during pregnancy is high (51% of women report drinking during one or more pregnancies) and the relationship between FAS knowledge and drug use during pregnancy appears weak. Young people were the most knowledgeable about FAS but also the most likely to report having used drugs or alcohol during pregnancy. CONCLUSIONS: The low levels of knowledge about FAS among the Native population supports the need for continued education. However, the results also suggest that education by itself may be insufficient to make dramatic changes in behavior.

Adolescent↗

PubMed1992

The influence of general practitioners' knowledge about their patients on the clinical decision-making process.

Continuity of care is claimed to be an important and integral part of general practice. A main result of continuity is the doctor's accumulated knowledge about his or her patients. The objective of the present study was to evaluate the modifying effects of this knowledge on the decision-making process that takes place in consultations, as experienced by practitioners. A representative sample of 133 Norwegian general practitioners evaluated a total of 3,918 of their own consultations. The main independent variable was the doctor's own subjectively evaluated knowledge about the patient's medical history, while the major outcome measures included the perceived influence of accumulated knowledge on the consultation process in general, and on the diagnostic and management decisions in particular. In two-thirds of all consultations, or in three out of four in which the doctor had previous knowledge about the patient, this knowledge was considered to be clinically useful. In more than one-third of all consultations with previously unknown patients, this lack of information was felt to be a hindrance. Among patients with new medical problems and when the doctor had prior knowledge about the patient, this knowledge was felt to have significantly more therapeutic than diagnostic impact. Accumulated knowledge was generally felt to be of most help in consultations due to psycho-social problems, and was of special diagnostic value in patients presenting new, unspecific problems such as fatigue, fever, and generalized pain. This study indicates that accumulated knowledge about the patient is felt by the general practitioners to play an important and integral part in their clinical decision-making process.

Continuity of Patient Care↗

PubMed2002

Just-in-time delivery comes to knowledge management.

Like all primary care physicians, Dr. Bob Goldszer must stay on top of approximately 10,000 different diseases and syndromes, 3,000 medications, 1,100 laboratory tests, and many of the 400,000 articles added each year to the biomedical literature. That's no easy task. And it is, quite literally, a matter of life and death. The Institute of Medicine's 1999 report, To Err Is Human, suggests that more than a million injuries, and 90,000 deaths are attributable to medical errors annually. Something like 5% of hospital patients have adverse reactions to drugs, another study reports, and of those, 43% are serious, life threatening, or fatal. Many knowledge workers have problems similar to Dr. Goldszer's (though they're usually less life threatening). No matter what the field, many people simply can't keep up with all they need to know. In the early years of knowledge management, companies established knowledge networks and communities of practice, built knowledge repositories, and attempted to motivate people to share knowledge. But each of these activities involved a great deal of additional labor for knowledge workers. A better approach, say the authors, is to bake specialized knowledge into the jobs of highly skilled workers. Partners HealthCare has started to embed knowledge into the technology that doctors use in their jobs so that consulting it is no longer a separate activity. Now when Dr. Goldszer orders medicine or a lab test, the order-entry system automatically checks his decision against a massive clinical database as well as the patient's own medical record. Knowledge workers in other fields could likewise benefit from a just-in-time knowledge-management system tailored to deliver the right supporting information for the job at hand.

Benchmarking↗

PubMed1991

Gender differences in adults' knowledge about fat and cholesterol.

Cognitive learning theories suggest that an individual's prior knowledge is a major factor for determining what can be learned. The objectives of this study were to compare the organization of knowledge about fat and cholesterol in adult, middle-class men and women and changes in that knowledge after reading an educational bulletin. Forty men and 48 women participated in two semistructured interviews to assess their knowledge; half received a US Department of Agriculture bulletin on fat and cholesterol at the end of the first interview. Concept maps (two-dimensional representations of an individual's cognitive knowledge structure) were made from the interview transcripts to assess knowledge organization. Both genders had limited knowledge, scoring less than 25% of the maximum possible score at interview 1. Overall, known and not known concepts were similar in men and women; however, women had slightly more integrated knowledge and more misconceptions than men. Both groups receiving the bulletin made significant gains in knowledge at interview 2, but knowledge gains were twice as great in men as in women. Our findings indicate that practitioners need not create separate materials about fat and cholesterol for middle-class men and women.

Adult↗