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PubMedDate not supplied

[Level of knowledge about epilepsy among Polish patients with epilepsy and their families in the European study SPOKE (Sanofi-Synthelabo Programme for Outcome Knowledge of Epilepsy)].

BACKGROUND AND PURPOSE: The main aim of the European Study SPOKE (Sanofi-Synthelabo Programme for Outcome Knowledge of Epilepsy) designed by the Department of Neurosciences, Walton Hospital in Liverpool and the Centre for Health Services Research at the University of Newcastle upon Tyne, England, was to describe levels of knowledge about epilepsy among people with epilepsy and their families. It was equally important to identify gaps in understanding the most important aspects of the illness as well as to identify characteristics of people who score poorly on the Epilepsy Knowledge Questionnaire (EKQ). Another aim was to consider the implications of identified gaps in knowledge for future educational and psychosocial interventions. MATERIAL AND METHODS: The study was conducted in 10 European countries and included 6156 people with epilepsy and 6506 members of their families. Results presented here relate to data for Poland only, where the examined population consisted of 1028 patients with epilepsy. 1033 questionnaires were returned by carers. RESULTS: Over 40% of all respondents had frequent seizures, and one third were seizure free. Scores on the Epilepsy Knowledge Questionnaire were high for the majority of respondents, but generally lower than in most of the countries. With reference to some aspects of illness important gaps in knowledge have been demonstrated. For example, it was shown that a significant number of respondents provided incorrect answers to questions relating to aspects of the etiology of epilepsy and administration of antiepileptic drug medication. There were a number of significant differences between the profiles of high and low scorers on the EKQ; high scorers were likely to have spent longer on education, have lower scores on the impact of epilepsy scale and report better adjustment to their epilepsy. CONCLUSIONS: The results of the study once again underline the importance of continued information among patients with epilepsy and their families in order to achieve.

Adolescent↗
PubMed1997

Using the Basis of a Knowledge Space for Determining the Fringe of a Knowledge State

Doignon and Falmagne have developed the concept of the fringe of a knowledge state based upon the neighborhood of knowledge states. This concept is useful for probabilistic assessment of knowledge and for the suggestion of training problems in an intelligent tutoring system. In this paper, a generalized definition of the fringe of knowledge states is introduced. An efficient procedure is presented which computes the fringe of knowledge states using the basis of a knowledge space. In a simulation study, this procedure is compared with the approach described by Doignon and Falmagne. Copyright 1997 Academic Press

Journal Article↗
PubMed2006

When is a little knowledge dangerous? Circumstances of recent heroin overdose and links to knowledge of overdose risk factors.

OBJECTIVES: To describe the circumstances surrounding recent heroin overdose among a sample of heroin overdose survivors and the links to their knowledge of overdose risk. METHODS: A cross-sectional survey of 257 recent non-fatal heroin overdose survivors was undertaken to examine self-reported knowledge of overdose risk reduction strategies, behaviour in the 12 h prior to overdose and attributions of overdose causation. RESULTS: Most of the overdoses occurred in public spaces as a result of heroin use within 5 min of purchasing the drug. A substantial number of overdoses occurred with no one else present and/or involved the concomitant use of other drugs. While knowledge of at least one overdose prevention strategy was reported by 90% of the sample, less then half of the sample knew any single strategy. Furthermore knowledge of the dangers of mixing benzodiazepines and/or alcohol with heroin was associated with an increased likelihood of such mixing being reported prior to overdose. CONCLUSIONS: While heroin users can articulate knowledge of key overdose risk reduction strategies, this knowledge was not generally associated with a reduction in risk behaviours but was in some cases associated with increased reports of overdose risk behaviours. Further research is required in order to better understand this paradoxical effect, focussing on risk reduction education amenable to the social contexts in which heroin use takes place.

Adolescent↗
PubMed2001

Medical knowledge reengineering--converting major portions of the UMLS into a terminological knowledge base.

We describe a semi-automatic knowledge engineering approach for converting the human anatomy and pathology portion of the UMLS metathesaurus into a terminological knowledge base. Particular attention is paid to the proper representation of part-whole hierarchies, which complement taxonomic ones as a major hierarchy-forming principle for anatomical knowledge. Our approach consists of four steps. First, concept definitions are automatically generated from the metathesaurus, with LOOM as the target language. Second, integrity checking of the emerging taxonomic and partonomic hierarchies is automatically carried out by the terminological classifier. Third, terminological cycles and inconsistencies are manually eliminated and, in the last step, the knowledge base built this way is incrementally refined by a medical expert. Our experiments were run on a terminological knowledge base which is composed of 164,000 concepts and 76,000 relations. Empirical evidence for the lack of logical consistency, adequacy and improper granularity of the UMLS knowledge source is given, and finally, assessments of what kind of efforts are needed to render the formal target representation structures complete and empirically adequate.

Anatomy↗
PubMedDate not supplied

There is no gap 'per se' between theory and practice: Research knowledge and clinical knowledge are developed in different contexts and follow their own logic.

The aim of this article is to highlight relations between theory and practice and the genesis of professional action in clinical nursing and among researchers. With use of a sociologically based empirical approach, focus is placed on the knowledge involved in the work of researchers and practitioners in terms of the source of their knowledge. Unlike a dominant barrier paradigm, theory and practice have different logics; they are not on a continuum nor are they hierarchically ordered. They exist in their own right as theoretical knowledge and practical knowledge. In daily practice, clinical nurses are inspired and learn from the context, including each other, and they are active producers of knowledge, not simply recipients of knowledge. This study, therefore, claims that there is no research-practice gap "in itself" (per se) as argued in the "barriers paradigm."

Ethics, Clinical↗
PubMed2006

A revised sexual knowledge assessment tool for people with intellectual disabilities: is sexual knowledge related to sexual offending behaviour?

BACKGROUND: The aim of the current study was to update an existing short measure of sexual knowledge and generate some initial reliability and normative data. Comparisons of sexual knowledge across several groups were made to examine whether or not a lack of sexual knowledge is related to sexual offending. METHODS: The Bender Sexual Knowledge Questionnaire (BSKQ) was revised, and a new questionnaire, the General Sexual Knowledge Questionnaire (GSKQ), was created and administered to four groups of participants: (1) sex offenders with an intellectual disability (ID) and a history of engagement in treatment (n = 12); (2) sex offenders with an ID and no history of treatment (n = 13); (3) non-offenders with an ID (n = 28); and (4) non-offenders without an ID (n = 10). Between-group comparisons were made; internal consistency, split-half reliability and correlations were examined. RESULTS: The internal consistency and the split-half reliability of the entire questionnaire was good. Non-offenders without an ID scored significantly higher than non-offenders with an ID on all sections of the GSKQ. Sex offenders who had undergone treatment scored significantly higher than non-offenders with an ID on several sections of this questionnaire. CONCLUSIONS: The initial findings from this study suggest that the psychometric properties of the GSKQ are promising. The assumption that lower sexual knowledge may be related to the risk of committing a sexual offence by people with IDs is possibly erroneous, and further research is required to clarify this possibility.

Adult↗
PubMed2002

46,XY intersex individuals: phenotypic and etiologic classification, knowledge of condition, and satisfaction with knowledge in adulthood.

OBJECTIVES: The objective of this study was to identify and study adults who have a 46,XY karyotype and presented as infants or children with variable degrees of undermasculinization of their genitalia (female genitalia, ambiguous genitalia, or micropenis). Participants' knowledge of their condition, satisfaction with their knowledge, and desire for additional education about their intersex condition were assessed. METHODS: Participants were classified according to the cause underlying their intersex condition based on review of medical and surgical records. Knowledge of medical condition, satisfaction with that knowledge, and desire for additional education were assessed with a written questionnaire and a semistructured interview. RESULTS: Patients were ineligible for recruitment because of death (9%), because of developmental delay (12%), or because they were not located (27%). Among the 96 eligible patients, 78% participated. Approximately half of the men (53%) and women (54%) exhibited a good understanding of their history. Fewer women who have a 46,XY chromosome complement and were born with female genitalia were informed about their intersex condition (36% with complete androgen insensitivity syndrome) than were women who were born with masculinized genitalia such as micropenis (80%) or ambiguous genitalia (72%). More women (66%) than men (38%) were satisfied with their knowledge of their medical and surgical history. CONCLUSIONS: Almost half of the patients, reared male or female, were neither well informed about their medical and surgical history nor satisfied with their knowledge.

Adaptation, Psychological↗
PubMed1999

Distributing knowledge maintenance for clinical decision-support systems: the "knowledge library" model.

The maintenance of knowledge-rich clinical decision-support systems is challenging, in particular in the complex setting of a large academic medical center. Distributing the maintenance tasks to the source of expertise can address scalability, accuracy and currency issues. It also helps to foster a more global sense of ownership among the system users. The knowledge maintenance model must provide processes and tools to deal with a wide range of stakeholders (resident and attending physicians, consulting specialists, other care providers, case managers, ancillary departments), with knowledge embedded in legacy departmental systems, and with the continuous evolution of the content and form of the knowledge base. We describe and illustrate the "knowledge library" model in use at Vanderbilt University Medical Center for the distributed maintenance of the integrated knowledge base that drives the WizOrder clinical decision-support, physician order entry, and notes capture system.

Artificial Intelligence↗
PubMed2002

Challenges in implementing a knowledge editor for the Arden Syntax: knowledge base maintenance and standardization of database linkages.

CONTEXT: Incorporation of research findings into clinical practice lags behind their dissemination in the medical literature. Arden Syntax is a standard that could be used to encode evidence in a clinical decision support system (CDSS). However, dissemination of knowledge is hampered by lack of standard linkages to clinical databases. OBJECTIVE: To create a knowledge editor that facilitates transfer of knowledge from the medical literature to clinical practice via a CDSS. METHODS: Using a Web browser-based application, we implemented linkages to MEDLINE to permit queries on demand and registration of queries to be executed periodically, with results copied into Arden Medical Logic Modules (MLMs). To facilitate standardization of MLMs, database linkages are encoded using emerging HL7 standards such as a data model (virtual medical record). CONCLUSIONS: A Web-based application can facilitate transfer of knowledge into clinical practice and knowledge base maintenance through periodic queries and deployment of standards for knowledge representation.

Artificial Intelligence↗
PubMed2000

Knowledge management in the NHS: positioning the healthcare librarian at the knowledge intersection.

This paper defines what is meant by Knowledge Management, investigates how it interlinks with new ways of delivering health care and gives a synopsis of a study that investigated issues around implementation of Knowledge Management across a sample of healthcare librarians. Areas of investigation that are related to Knowledge Management include: HSG(97)47, evidence-based medicine, clinical governance, information and communication technologies, and the changing role of the healthcare librarian. A diagram is included in this paper which illustrates how the healthcare librarian interacts with resources, staff and practices, so contributing to the knowledge base of health care. The paper concludes that Government policy, new technologies and the push towards the practice of information age medicine are forcing changes throughout the NHS. Recognition of Knowledge Management is still in its infancy in the NHS--it calls for major change in organizational thinking and acceptance by the librarian that their service must also be subject to continuous improvement.

Humans↗
PubMed1999

Knowledge workers and knowledge-intense organizations, Part 2: Designing and managing for productivity.

Our economy is shifting from a hard goods and material products base to one in which knowledge is the primary mode of production. Organizations are experimenting with designs that support knowledge work by clustering individuals with different but complementary skills in focused teams. The goal is to increase applied knowledge that furthers the organization's strategic intent. The team-based knowledge work model holds promise for healthcare organizations that are under pressure to use knowledge to improve clinical care, integrate care across disciplines and settings, and accept accountability for costs. However, the shift from the traditional bureaucratic model to the flexible team-based design mandates changes in the design of the organization, the role of leadership, and the attributes of the teams and team members. In Part 2 of this three-part series, the authors explore the necessary design changes and the new roles for leadership, teams, and their members. Additionally, implications for healthcare clinicians, particularly nurses, are discussed.

Efficiency, Organizational↗
PubMed1999

Knowledge workers and knowledge-intense organizations, Part 3. Implications for preparing healthcare professionals.

We have outlined a framework for understanding knowledge workers, knowledge-intense organizations, and the promise of sophisticated, interdisciplinary knowledge work teams because we believe that healthcare is the quintessential knowledge-based service industry. These changes will revolutionize healthcare. We have choices to make, as individuals, and as leaders of the nursing profession. We can choose to help drive and shape the changes needed to realize the potential of this framework, or we can decide to wait and see what happens. We must find the courage and the vision to move nursing and healthcare into this knowledge-intense, interdisciplinary future. We end this series as we started it, with a quote from Peter Drucker, who said: "The best way to cope with the radically changing future is to help shape it."

Allied Health Personnel↗
PubMed2005

The Medawar Lecture 2001 knowledge for vision: vision for knowledge.

An evolutionary development of perception is suggested-from passive reception to active perception to explicit conception-earlier stages being largely retained and incorporated in later species. A key is innate and then individually learned knowledge, giving meaning to sensory signals. Inappropriate or misapplied knowledge produces rich cognitive phenomena of illusions, revealing normally hidden processes of vision, tentatively classified here in a 'periodic table'. Phenomena of physiology are distinguished from phenomena of general rules and specific object knowledge. It is concluded that vision uses implicit knowledge, and provides knowledge for intelligent behaviour and for explicit conceptual understanding including science.

Biological Evolution↗
PubMed2006

Public knowledge, public trust: understanding the 'knowledge deficit'.

This article examines the 'knowledge deficit' model, which still persists in liberal, technological societies. It is based upon the assumption that expert forms of knowledge, both in the sciences and the humanities, provide a sufficient basis for deciding the most important public policy questions. In this view, public perceptions and beliefs that run counter to this expert knowledge provide unacceptable justifications for public policies. Instead, support of expert knowledge needs to be 'built' through education and public relations strategies. This view is challenged on the basis of basic democratic theory, using the debate about genetically modified maize in Mexico as an example. 'Knowledge deficits' also exist on the side of experts.

Biotechnology↗
PubMed2006

Development and validation of an instrument to determine patient knowledge: the oral anticoagulation knowledge test.

BACKGROUND: Studies examining the relationship between patient knowledge regarding warfarin therapy and its safe and effective use are limited by the lack of validated knowledge assessment tools. OBJECTIVE: To develop and validate an instrument to assess patient knowledge regarding oral anticoagulation therapy. METHODS: Four nationally recognized anticoagulation experts participated in the instrument development process to ensure content validity. The Oral Anticoagulation Knowledge (OAK) test was administered to subjects on warfarin and a group of age-matched subjects not on warfarin to assess construct validity. A subgroup of warfarin subjects were retested approximately 2-3 months after initial testing to assess test-retest reliability. Internal consistency reliability was assessed by calculating a Kuder-Richardson 20 value. Item analysis was used to assess performance of individual questions. RESULTS: An initial 23 item instrument was pilot tested for readability and comprehension. The OAK test was administered to 74 subjects taking warfarin and 27 age-matched subjects not on warfarin. Thirty-two subjects on warfarin repeated the OAK test an average of 75 days following initial administration. Subjects taking warfarin scored significantly higher than those not on warfarin (72% vs 52%, respectively; p < 0.001), supporting the construct validity of the instrument. Test-retest reliability was acceptable, with a Pearson's correlation coefficient of 0.81. Internal consistency reliability was confirmed by a calculated Kuder-Richardson 20 value of 0.76. CONCLUSIONS: The OAK test is a brief, valid, and reliable knowledge assessment instrument that may be a useful tool for research and clinical practice to augment patient education programs.

Adult↗