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PubMed1998

Knowledge enrichment and conceptual change in folkbiology: evidence from Williams syndrome.

Ten participants with Williams syndrome (WS) (average verbal mental age of 11;5) were compared to two groups of normally developing children (average mental ages 10;11 and 6;7 years) with respect to intuitive biological knowledge about people, animals, and plants. Participants in the older control group were individually matched to the participants with WS on verbal mental age. The probes for biological understanding were drawn from the existing literature on the development of folkbiology and were divided into two batteries based on the hypothesized distinction of (1) general knowledge consistent with the conceptual repertoire of normally developing preschool children (the T1/T2-Neutral Animal Knowledge battery) and (2) folkbiological concepts normally acquired between ages 6 and 12 which require conceptual change for their construction (life, death, people-as-one-animal-among-many, species kind as determined by origin of the animal; the T2-Dependent battery). The two task batteries were equated for task demands, differing only in the content of the concepts probed. It was hypothesized that if this distinction is a false one, and the construction of folkbiology is accomplished entirely by enrichment of the preschooler's knowledge, there should never be a population with differential performance on these two batteries. People with WS were nonetheless found to be differentially impaired on the T2-Dependent battery. They performed at the level of the older control group on the T1/T2-Neutral battery, but at the level of the 6-year-olds on the T2-Dependent battery. These data support the distinction between two types of conceptual knowledge acquisition: acquisition of new knowledge formulated over an existing conceptual base (enrichment), on the one hand, and knowledge acquisition that results in genuine conceptual change, on the other. The implication of these results for a precise characterization of how concepts of people with "cocktail party syndrome" may be "superficial" is also discussed.

Adolescent↗
PubMed1993

Children's understanding of the relation between referential knowledge and referential behavior.

Young children often confuse what is said and meant in referential communication. This study determines exactly what is confused by kindergarten children, second graders, and fourth graders. In each of four experiments, a story listener's referential knowledge variously came from object details in the context and in an utterance, and children were asked independently to judge knowledge sufficiency for identifying one referent in a display, and whether the knowledge came from the utterance alone. In Experiments 1 and 2, experimenter identification of the correct referent was manipulated to determine if children confuse internal representations of information knowledge and referential behavior, or behavior and the real world referent, in determining the listerner's knowledge. In other experiments, the consistency of referential behavior with the correct referent was manipulated to determine the basis of children's knowledge assessments. Overall the results show that children's say-mean confusion varies depending on situational factors and variably reflects children's use of internal representations and external referential behavior in assessing knowledge.

Child↗
PubMed2000

A Practical Procedure to Build a Knowledge Structure.

Computerized assessment of knowledge is one of the most promising applications of knowledge space theory. The first requirement of any such assessment is to produce as accurate a picture as possible of the organization of the knowledge. So far, all procedures designed for this purpose rely exclusively on the query of an expert. Several experiments have shown the limitations of that approach in realistic conditions. One source of difficulty is the very high sensitivity of the querying algorithms to an expert's mistakes. Another source of difficulty concerns the validity of the expert: His or her knowledge structure may diverge greatly from the knowledge structure of the actual population. To solve these difficulties, the present paper proposes and simulates a two-step procedure. The first step implements a modification of an existing querying procedure. The modification implements an error-handling mechanism which lowers the incidence of an expert's careless errors. The second step consists in a refinement mechanism which relies on the knowledge assessments of many subjects to refine the very structure used by these assessments. For each step, it is shown that the underlying knowledge structure can be recovered. Copyright 2000 Academic Press.

Journal Article↗
PubMed1989

Relation of knowledge and performance in boys' tennis: age and expertise.

This research examined boys' development of knowledge structure and sport performance in tennis. To assess decision-making and performance, expert and novice tennis players (10-11 and 12-13 years old) were compared on tennis performance (control, decision, and execution), tennis knowledge, serve skill, and groundstroke skill. Experts regardless of age performed better than novices on tennis skill and knowledge; experts' decisions and actions were better during tennis game performance. Declarative knowledge was related to the development of procedural knowledge; serve and groundstroke skill were related to the motor execution components of performance. Interviews during and after game play were used to examine knowledge and decision-making. Experts, as compared to novices, focused on higher level concepts, had more connections between concepts, and had more condition and alternative action concepts that were important to the game's goal structure. Experts' greater decision-making ability during game play was related to their knowledge structure.

Age Factors↗
PubMed1992

A comparison of knowledge of medical students and practicing primary care physicians about cardiovascular risk assessment and intervention.

BACKGROUND: Heart attack and stroke are still prevalent causes of death and disability in the U.S. adult population (1, 2). Studies (3-9) have shown that modification of hypertension, smoking, and hypercholesterolemia can reduce risks for atherosclerosis and subsequent cardiovascular events. Therefore, it is important that physicians be skilled in assessing and modifying patients' overall cardiovascular risk. This study compares acquired knowledge of second-year medical students about cardiovascular risk assessment with knowledge in a selected group of practicing primary care physicians, who are members of the medical school's clinical faculty, using a new experimental testing technique called the tailored response test (TRT). METHODS: Students performed a structured cardiovascular risk intervention on a patient in primary care clinics. Their acquired knowledge was then tested using the TRT, which contained 43 discrete judgments about a clinical case. Test scores of students and faculty were compared. RESULTS: Both students and faculty demonstrated knowledge about the most important risk factors, appropriate screening tools, and interventions. However, the selected physicians did not demonstrate knowledge of certain important risk assessment and intervention recommendations, based on national standards. Only 38% of faculty and 27% of students were aware that a "fasting" serum cholesterol is not needed for screening, 30% of faculty believed that if cholesterol was over 300 they would "probably prescribe medicine" before other intervention strategies were tried, and 32% of faculty and 30% of students would order a screening chest X-ray, which is incorrect in the case history. CONCLUSIONS: The TRT, in contrast to self-report surveys, demonstrates that important cardiovascular risk assessment and intervention knowledge, with implications for cost effectiveness in health care delivery, has not penetrated to a selected group of physicians who are members of the medical school's clinical faculty and therefore serve as role models for medical students. This is disturbing, in light of current emphases on cost effectiveness in health care. Greater undergraduate curricula and CME emphasis on cardiovascular preventive practice is needed, such that almost 100% of students and faculty demonstrate knowledge, and practice, of preventive medicine according to national standards. In turn, groups developing national standards are enjoined to design and implement effective approaches for disseminating these recommendations.

Cardiovascular Diseases↗
PubMed1988

Alcohol-related knowledge, beliefs and attitudes among health and clerical personnel.

Health personnel has been thought to pay too little attention to alcohol-related problems. Knowledge, attitudes and beliefs related to alcohol were studied among 225 physicians, 296 nurses, and 279 clerical employees. Knowledge scores were constructed by giving one point for every correct answer. For knowledge on alcoholic beverages and biological facts (11 questions), the mean scores were: physicians 7.7, nurses 6.7, and clerical employees 6.5. For etiologic knowledge (12 items), the means were: physicians 8.6, nurses 6.9, and clerical employees 6.3. The respective scores for prognostic knowledge (9 items) were: physicians 6.8, nurses 6.3, clerical employees 5.5. For knowledge on prevention and treatment the mean scores were: physicians 2.7, nurses 2.2 and clerical personnel 2.3. Physicians had more permissive attitudes towards alcohol use in various social situations and were less likely to recommend compulsory treatment than nurses or clerical employees. With respect to the prevention of alcohol problems, all groups considered face-to-face health education to be the most effective approach, followed by radio and TV education, and then voluntary treatment. Beverage price increases were regarded to be the least effective approach by nurses and clerical employees, while physicians felt that the press was the least likely source of enlightenment. Knowledge was only remotely related to age, marital status and permissive attitudes. Health personnel knew more about alcohol-related problems than lay people, but there is room for further improvement.

Adult↗
PubMed1989

The Finnish family competence study: characteristics of pregnant women with low childbirth knowledge.

The present paper characterizes the socio-demographic background, health behaviour and attitudes of 1443 nulliparous women in relation to their level of childbirth knowledge. The response rate was 92%. Those women who refused to participate were not significantly occupationally different from the study subjects. Practically all pregnant women in Finland use maternity health care services. However, those with a low childbirth knowledge needed more health counselling and were largely characterized by the same factors that identify mothers in other countries who do not use such services. This finding emphasizes the importance of a wide coverage of antenatal care. Mothers with low childbirth knowledge were more often than those with high knowledge, unemployed, somewhat younger, living near or with their parents, and less well educated. They felt that they had had no education in child rearing, but they also felt no need for such guidance. They smoked more than mothers with high knowledge both before and during pregnancy. They had less physical exercise, ate more fatty foods and less vegetables. They also used more drugs during the first trimester of pregnancy and had fewer leisure time activities, read fewer books and used fewer cultural services. They assessed themselves as emotionally closer to their own mothers than did those with high childbirth knowledge. A low level of childbirth knowledge seems to be associated with risks in health-connected behaviour, which has important implications for prenatal health education.

Adult↗
PubMed2007

Effect of an evidence-based paediatric fever education program on emergency nurses' knowledge.

INTRODUCTION: This study examined the effect of an educational intervention of factual knowledge on emergency nurses' knowledge and clinical decisions related to paediatric fever. METHOD: A prospective pre-test/post-test design was used. Emergency nurses' factual knowledge was measured by parallel multiple choice questions and the intervention for the study was an educational intervention consisting of two tutorials. Pre-test data were collected in early June 2005 and post-test data were collected during August 2005. RESULTS: Thirty-one emergency nurses completed the pre and post-test multiple choice questions. Emergency nurses' knowledge increased following the tutorials. Pre-test score was positively correlated with knowledge acquisition. Self-reports of independent decisions related to fever management were influenced by experience, hours of employment, level of appointment, postgraduate qualifications and pre-test score. DISCUSSION: High levels of variability in knowledge and knowledge acquisition suggest a review of undergraduate and postgraduate curricula is warranted. Although this study identified associations between independent fever management decisions and participant characteristics, further research is pivotal to better understanding these relationships.

Adult↗
PubMed2006

Dynamic knowledge validation and verification for CBR teledermatology system.

OBJECTIVE: Case-based reasoning has been of great importance in the development of many decision support applications. However, relatively little effort has gone into investigating how new knowledge can be validated. Knowledge validation is important in dealing with imperfect data collected over time, because inconsistencies in data do occur and adversely affect the performance of a diagnostic system. METHODS: This paper consists of two parts. First, it describes methods that enable the domain expert, who may not be familiar with machine learning, to interactively validate knowledge base of a Web-based teledermatology system. The validation techniques involve decision tree classification and formal concept analysis. Second, it describes techniques to discover unusual relationships hidden in the dataset for building and updating a comprehensive knowledge base, because the diagnostic performance of the system is highly dependent on the content thereof. Therefore, in order to classify different kinds of diseases, it is desirable to have a knowledge base that covers common as well as uncommon diagnoses. RESULTS AND CONCLUSION: Evaluation results show that the knowledge validation techniques are effective in keeping the knowledge base consistent, and that the query refinement techniques are useful in improving the comprehensiveness of the case base.

Dermatology↗
PubMed2005

Validation of self assessment patient knowledge questionnaire for heart failure patients.

BACKGROUND: Several studies showed insufficient knowledge and poor compliance to non-pharmacological management in heart failure patients. Only a limited number of validated tools are available to assess their knowledge. The aim of the study was to test our 10-item Patient knowledge questionnaire. METHODS: The Patient knowledge questionnaire was administered to 42 heart failure patients from Heart failure clinic and to 40 heart failure patients receiving usual care. Construct validity (Pearson correlation coefficient), internal consistency (Cronbach alpha), reproducibility (Wilcoxon signed rank test), and reliability (chi-square test and Student's t-test for independent samples) were assessed. RESULTS: Overall score of the Patient knowledge questionnaire had the strongest correlation to the question about regular weighing (r=0.69) and the weakest to the question about presence of heart disease (r=0.33). There was a strong correlation between question about fluid retention and questions assessing regular weighing, (r=0.86), weight of one litre of water (r=0.86), and salt restriction (r=0.57). The Cronbach alpha was 0.74 and could be improved by exclusion of questions about clear explanation (Chronbach alpha 0.75), importance of fruit, soup, and vegetables (Chronbach alpha 0.75), and self adjustment of diuretic (Chronbach alpha 0.81). During reproducibility testing 91% to 98% of questions were answered equally. Patients from Heart failure clinic scored significantly better than patients receiving usual care (7.9 (1.3) vs. 5.7 (2.2), p<0.001). CONCLUSIONS: Patient knowledge questionnaire is a valid and reliable tool to measure knowledge of heart failure patients.

Ambulatory Care Facilities↗
PubMed2006

In pursuit of knowledge.

This article is based on the proposition that to understand the nature of knowledge, and how best to acquire it, one must look first at how the brain abstracts knowledge from the information provided by sensory receptors. The nature of this biological process of knowledge acquisition is suggested by the necessary conditions for the occurrence of learning, and from consideration of these necessary conditions in terms of what is currently known about the properties and limitations of neural systems. This entails discussion of an important distinction that must be made between "perceptual" and "associative" learning and between the neural systems required to mediate these two kinds of learning. There is also discussion of the manner in which language can overcome the limitations of neurological systems to greatly extend the scope of associative learning. This leads on to discussion of the role of active efferent language systems and temporary memory in the mediation of thinking. Consideration of the main features of the biological process of knowledge acquisition confirms, and extends to perception, Hume's famous conclusion that knowledge derives from the similarity or temporal contiguity of recurring events. New insights are also obtained concerning the biological causes of bias in the knowledge acquisition process, concerning the intellectual process of theory generation, and concerning the role of theory in the conduct of empirical research. Finally, and most importantly, it can be concluded that all knowledge is theory and hence that the ultimate goal of science is the development of better theories.

History, 20th Century↗
PubMed2004

Patient knowledge of their disease: a French multicenter study in ankylosing spondylitis.

OBJECTIVES: To assess knowledge of ankylosing spondylitis (AS) by patients and to identify factors associated with knowledge. METHODS: Ninety patients receiving follow-up in France for AS completed a disease knowledge auto-questionnaire yielding a correct answer score [CAS] and a correct item score [CIS]. Correlations between these scores and other factors were examined. RESULTS: Mean CAS was 16.4/25 (SD = 4.8) and mean CIS 7.3 +/- 3.1/14. Female gender, higher educational level, having read about AS, being aware of AS support groups, and having received longer tertiary-care hospital management were associated with better knowledge. In the multivariate analysis, only three factors were independently associated with the level of knowledge in this population: "reading about AS", "level of general education", and "awareness of an AS support group". CONCLUSION: Knowledge of AS by French patients was lower than previously reported in a British population. Although education should be offered to all AS patients, the need may be greater in those with limited formal schooling. Booklets on the disease and contact with patient groups seem to be useful tools for improving knowledge of the disease.

Adult↗
PubMed2004

Knowledge of indications for EUS among gastroenterologists and non-gastroenterologists.

BACKGROUND: The level of awareness among non-gastroenterologists of the indications for EUS is unknown. This study assessed knowledge of the indications and the utility of EUS among gastroenterologists and non-gastroenterologists in a large multispecialty academic practice. METHODS: A questionnaire was designed that tested knowledge of the indications for EUS with respect to 4 organ systems: esophagus, gastroduodenum, hepatopancreatobiliary system and colorectum. The questionnaire was distributed by electronic mail to gastroenterologists, general internists, non-gastroenterologist subspecialists, and surgeons in a large multispecialty practice. RESULTS: The survey was distributed to 659 attending physicians of whom 227 (34%) replied: gastroenterologists (53%), internists (30%), non-gastroenterologist specialists (33%), and surgeons (28%). Knowledge of appropriate indications was highest among gastroenterologists (84.3%) compared with internists (68.9%), non-gastroenterologist specialists (65.4%), and surgeons (65.3%) (p < 0.0001). Among all non-gastroenterologists, knowledge of indications for hepatopancreatobiliary (mean 66.3% correct responses) and colorectal applications (64.0%) was inferior to knowledge of esophageal (71.5%) and gastroduodenal (83.5%) applications. CONCLUSIONS: Internists, non-gastroenterologist specialists, and surgeons in a large multispeciality practice have moderate knowledge of the indications and the utility of EUS. Knowledge was at the lowest level for hepatopancreatobiliary and colorectal applications of EUS for all 3 groups of non-gastroenterologists. Future studies should focus on the education of non-gastroenterologists regarding the role of EUS and assess the impact of such education on the appropriateness of EUS referral patterns.

Bile Ducts↗
PubMed2001

Tasmanian nurses' knowledge of pain management.

The aim of this research was to obtain information concerning knowledge of the pain management practices of Tasmanian nurses. We examined the knowledge of Tasmanian Registered Nurses in relation to pain management issues such as addiction, use of analgesics and the assessment of pain. In addition, we queried them about their satisfaction with information they had received about how to manage pain in both workplace programs and in their initial education. A total of 2768 registered nurses were mailed a 29-item survey examining knowledge of pain management practices. One thousand and fifteen valid surveys were returned. Mean scores on the knowledge questions (72% correct) of the survey revealed deficits in knowledge. Nurses specifically lacked up-to-date knowledge concerning the pharmacological management of pain, but displayed a more up-to-date knowledge concerning the effect of patient variables on pain perception. Nurses also rated the information they received about pain management during workplace programs as poor, feeling that they acquired significantly more in-depth information during their initial education. The results of this study have implications for institutions involved in both patient pain management and pain management education.

Adult↗
PubMedDate not supplied

Older people's knowledge and practice about lifestyle behaviors that may prevent vascular dementia.

This study examined the relationship between knowledge and practice of healthy lifestyle behaviors in the prevention of vascular dementia. Data presented here are derived from a convenience sample of 296 participants recruited through senior citizen agencies in Australia. Lifestyle was measured using the Health-promoting Lifestyle Profile (HPLP). Seven knowledge subscales were developed, consistent with the HPLP. Data were analyzed using multiple regression analysis. Correlations among the lifestyle and knowledge indicated statistically significant results. However, the strength of these associations was generally weak. Multivariate analysis found that six variables explained 20% of the variance in the lifestyle score. These included: knowledge of interpersonal relations, knowledge of physical activity, medical knowledge, medical history, self-assessment of general health, and use of alcohol. The results indicate that knowledge, by itself, does not necessarily ensure that people engage in self-practising healthy lifestyle behaviors, and those who experience illness and, perhaps exposure to risk factors, had higher HPLP scores. Recommendations for how older people can be supported to reduce some of the attitudinal barriers that reduce healthy lifestyle behaviors are discussed.

Journal Article↗
PubMed2004

The internet-based knowledge acquisition and management method to construct large-scale distributed medical expert systems.

The Internet offers an unprecedented opportunity to construct powerful large-scale medical expert systems (MES). In these systems, a cost-effective medical knowledge acquisition (KA) and management scheme is highly desirable to handle the large quantities of, often conflicting, medical information collected from medical experts in different medical fields and from different geographical regions. In this paper, we demonstrate that a medical KA/management system can be built upon a three-tier distributed client/server architecture. The knowledge in the system is stored/managed in three knowledge bases. The maturity of the medical know-how controls the knowledge flow through these knowledge bases. In addition, to facilitate the knowledge representation and application in these knowledge bases as well as information retrieval across the Internet, an 8-digit numeric coding scheme with a weight value system is proposed. At present, a medical KA and management system based on the proposed method is being tested in clinics. Current results have showed that the method is a viable solution to construct, modify, and expand a distributed MES through the Internet.

Computer Systems↗
PubMed2003

Genetic knowledge and counselling skills of Dutch cardiologists: sufficient for the genomics era?

AIMS: Genetic scientific knowledge is growing rapidly but how this affects clinical practice is unclear. We investigated the levels of knowledge, practical skills and clinical genetic practices of Dutch cardiologists. METHODS AND RESULTS: A survey was designed to assess cardiologists' experience with genetic aspects of hypertrophic cardiomyopathy, self-reported genetic knowledge, and genetic skills in general and aimed at this disease. In addition, cardiologists' opinions on five possible measures for improvement were obtained. STUDY POPULATION: all Dutch cardiologists (n=643). Median number of patients suffering from hypertrophic cardiomyopathy per cardiologist is five. Forty-one percent of respondents do not give information about genetics to all their patients. Cardiologists rarely initiate DNA tests for hypertrophic cardiomyopathy. Only 38% refer patients to clinical geneticists. Self-reported knowledge levels are low (average score 3.3-5.1, 0-10 scale). Cardiologists with an established working relationship with a clinical geneticist report significantly higher levels of knowledge. Clinical guidelines, education and improved collaboration with clinical geneticists are preferred. CONCLUSION: Dutch cardiologists' genetic knowledge and clinical genetic practice levels are insufficient. As a result, clinical genetic care for patients with hypertrophic cardiomyopathy is poor. Improvements proposed include advancement of knowledge (education, professional guidelines) and structural measures (working relationships, multidisciplinary outpatient clinics). Collaboration of cardiologists and clinical geneticists is urgently needed to optimise cardiogenetic patient care.

Adult↗
PubMed2000

[Evaluation of knowledge about climacteric in Andalusian women].

OBJECTIVES: To evaluate the level of knowledge about the menopause of Andalusian women between 30 and 60 years old; and to determine their knowledge's relationship with social and demographic variables, health service use and their position as regards the climacteric. DESIGN: Cross-sectional study. PARTICIPANTS: A sample of 770 Andalusian women between 30 and 60 was chosen, for a sample error of +/- 5% and 95% confidence interval, chosen through multi-stage sampling: at random with proportionality for province and size of habitat, and sampling by age quotas and educational background. MEASUREMENTS: The principal study variable was women's level of knowledge about the menopause, evaluated through a validated test of 56 dichotomous questions. In the descriptive analysis, the mean, standard deviation and 95% CIs were obtained; in the analysis of relationships, the test of homogeneity of means, and variance and regression analysis were used. RESULTS: On a scale of 0-56, the mean on the sample was 18.17 with a standard deviation of 14.37 (95% CI: 17.15-19.17). 57.9% of the sample polled had values of low or very low level of knowledge. In the analysis of relationships, and according to the variance analysis data, we found that the level of understanding is related (p < 0.001) to age (F = 64.21), educational background (F = 131.19), type of menopause (F = 8.94), and having received information on the menopause (F = 7.57). Of these four variables it is educational background which most explains the variability in knowledge (r = 0.52, p < 0.001). However, experience of the menopause or use of the health services for the menopause do not seem to affect knowledge about the climacteric period and its treatment. CONCLUSIONS: The lack of knowledge of the menopause shown by the population studied demonstrates the need for Health Education on this stage of life. The relationships analysis leads us to conclude that the profile of women studied who knew most was someone with middle/high educational background, aged 30-40, who had had a surgical menopause, and had received information about the menopause.

Adult↗