Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Knowledge”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 91 records · Page 5Linked to original sources
PubMed2003

Towards knowledge-based systems in clinical practice: development of an integrated clinical information and knowledge management support system.

Given that clinicians presented with identical clinical information will act in different ways, there is a need to introduce into routine clinical practice methods and tools to support the scientific homogeneity and accountability of healthcare decisions and actions. The benefits expected from such action include an overall reduction in cost, improved quality of care, patient and public opinion satisfaction. Computer-based medical data processing has yielded methods and tools for managing the task away from the hospital management level and closer to the desired disease and patient management level. To this end, advanced applications of information and disease process modelling technologies have already demonstrated an ability to significantly augment clinical decision making as a by-product. The wide-spread acceptance of evidence-based medicine as the basis of cost-conscious and concurrently quality-wise accountable clinical practice suffices as evidence supporting this claim. Electronic libraries are one-step towards an online status of this key health-care delivery quality control environment. Nonetheless, to date, the underlying information and knowledge management technologies have failed to be integrated into any form of pragmatic or marketable online and real-time clinical decision making tool. One of the main obstacles that needs to be overcome is the development of systems that treat both information and knowledge as clinical objects with same modelling requirements. This paper describes the development of such a system in the form of an intelligent clinical information management system: a system which at the most fundamental level of clinical decision support facilitates both the organised acquisition of clinical information and knowledge and provides a test-bed for the development and evaluation of knowledge-based decision support functions.

Artificial Intelligence↗
PubMed1999

Adolescents' knowledge and attitudes concerning HIV infection and HIV-infected persons: how a survey and focus group discussions are suited for researching adolescents' HIV/AIDS knowledge and attitudes.

The purpose of this article is to examine how two different corpora of material are suited for researching the sexuality of youth on the basis of material gathered via a structured questionnaire (N = 1183, response rate 87%) and via eight focus group discussions (FGDs), and to investigate the knowledge and opinions of adolescents at the age of 15 years about HIV infection and HIV-infected persons. Both boys and girls showed a good level of knowledge about HIV infection and AIDS. While their level of knowledge was good, their attitude was that the threat of an HIV infection was not a personal issue. Furthermore, negative attitudes to those having HIV/AIDS became more pronounced the more socially distant the infected person was to the respondent. The FGDs presented a more sceptical view of the attitudes of adolescents than the survey, while the knowledge about HIV infection and AIDS was the same regardless of the research method. In the FGDs, girls discussed the topics more extensively than boys, they used longer sentences, there was spontaneous discussion within the groups and the participants commented on each other's opinions. Boys were often content with short dichotomous responses and the interviewers had to qualify the responses with supplementary questions.

Adolescent↗
PubMed1998

Knowledge through documentation: from patients' data records to the basis of knowledge.

The written documentation generated in the dental practice can only be used for clinical tasks under certain conditions. The systematic use of clinical information is not possible until therapy and record data are organized as empirical bases of knowledge by electronic application. Then all documented data are available to support clinical decisions. The first task of dental treatment planning is the assessment of the individualized prognosis. Empirical bases of knowledge can process the surveyed information for this purpose and present it in a suitable manner. Moreover, an empirical basis of knowledge is suitable for an analysis of the effectiveness of dental therapy measures and for the elaboration of empirical foundations for discussion between colleagues. The most advanced form of data application is the expert system, which is able to carry out case comparisons and draw model-based conclusions on the basis of empirical knowledge.

Artificial Intelligence↗
PubMed2001

An informatics system to support knowledge management in the health sector--the South African National Health Knowledge Network.

This paper discusses the planning and development of a South African national health knowledge network. The methodology is in essence based on the principles of knowledge management and the drivers of a system of innovation. The knowledge network, SA HealthInfo, aims to provide a one-stop interactive forum/resource, for quality-controlled and evidence-based health research information, to a wide spectrum of users, at various levels of aggregation, with the necessary security arrangements and facilities for interaction among users to promote explicit (codified) and tacit knowledge flow. It will therefore stimulate the process of innovation within the South African health system.

Computer Security↗
PubMed2002

[Evidence-based guidelines as tools for medical knowledge transfer. The work mode of the Medical Knowledge Network evidence.de].

The amount of medical knowledge is growing with increasing speed. Physicians are confronted with more and more--and often useless--information. However, the time lag between the creation of new knowledge and its implementation into daily medical practice is often exceeding a decade. In view of these challenges the knowledge network of the medical faculty of the University Witten/Herdecke is focusing on two different tasks: It provides evidence based medical guidelines in a format that is meant for easy access and use in daily practice. It scientifically explores different ways of presenting and transferring evidence based guidelines in order to develop better and easier ways of implementation. National and international guidelines and studies are screened, evaluated, updated and adapted for its use in the academic network by a team of five university based physicians. In addition, clinical specialists as well as primary care physicians provide expertise for detailed scientific adaptations and for adequate implementation strategies. The implementation process of the guidelines among the faculty based primary care physicians is continuously monitored and evaluated. The main goal of this concept is to create a learning environment for the complex process of medical knowledge transfer.

Decision Making↗
PubMed1996

Database and knowledge base integration--a data mapping method for Arden Syntax knowledge modules.

One of the most important categories of decision-support systems in medicine are data driven systems where the inference engine is linked to a database. It is, therefore, important to find methods that facilitate the implementation of database queries referred to in the knowledge modules. A method is described for linking clinical databases to a knowledge base with Arden Syntax modules. The method is based on a query meta-database including templates for SQL queries which is maintained by a database administrator. During knowledge module authoring the medical expert refers only to a code in the query meta-database; no knowledge is needed about the database model or the naming of attributes and relations. The method uses standard tools, such as C+2 and ODBC, which makes it possible to implement the method at many platforms and to link to different clinical databases in a standardized way.

Databases, Factual↗
PubMed1995

The separation of reviewing knowledge from medical knowledge.

The developers of reviewing systems that rely on computer-based patient-record systems as a source of data need to model reviewing knowledge and medical knowledge. We simulate how the same medical knowledge could be entered in four different systems: CARE, the Arden syntax, Essential-attending and HyperCritic. We subsequently analyze how the original knowledge is represented in the symbols or syntax used by these systems. We conclude that these systems provide different alternatives in dealing with the vocabulary provided by the computer-based patient records. In addition, the use of computer-based patient records for review poses new challenges for the content of that record: to facilitate review, the reasoning of the physician needs to be captured in addition to the actions of the physician.

Artificial Intelligence↗
PubMedDate not supplied

The Spoken Knowledge in Low Literacy in Diabetes scale: a diabetes knowledge scale for vulnerable patients.

PURPOSE: The purpose of this study was to develop and validate a new knowledge scale for patients with type 2 diabetes and poor literacy: the Spoken Knowledge in Low Literacy patients with Diabetes (SKILLD). METHODS: The authors evaluated the 10-item SKILLD among 217 patients with type 2 diabetes and poor glycemic control at an academic general medicine clinic. Internal reliability was measured using the Kuder-Richardson coefficient. Performance on the SKILLD was compared to patient socioeconomic status, literacy level, duration of diabetes, and glycated hemoglobin (A1C). RESULTS: Respondents' mean age was 55 years, and they had diabetes for an average of 8.4 years; 38% had less than a sixth-grade literacy level. The average score on the SKILLD was 49%. Less than one third of patients knew the signs of hypoglycemia or the normal fasting blood glucose range. The internal reliability of the SKILLD was good (0.72). Higher performance on the SKILLD was significantly correlated with higher income (r = 0.22), education level (r = 0.36), literacy status (r = 0.33), duration of diabetes (r = 0.30), and lower A1C (r = -0.16). When dichotomized, patients with low SKILLD scores (< or = 50%) had significantly higher A1C (11.2% vs 10.3%, P < .01). This difference remained significant when adjusted for covariates. CONCLUSION: The SKILLD demonstrated good internal consistency and validity. It revealed significant knowledge deficits and was associated with glycemic control. The SKILLD represents a practical scale for patients with diabetes and low literacy.

Adult↗
PubMed1993

The development of a questionnaire to assess knowledge of epilepsy: 2--Knowledge of own condition.

In a previous paper, a questionnaire to assess general knowledge of epilepsy (E.K.P.--G) was described (same authors). In the present paper, the development of a complementary questionnaire providing a profile of the individual's knowledge of his or her own condition is described. Results from external validation, item refinement and a clinical trial suggest this measure (the Epilepsy Knowledge Profile--Personal) provides a valid and comprehensive assessment profile which has considerable practical applications.

Adaptation, Psychological↗
PubMedDate not supplied

Reliability and validity of nutrition knowledge, social-psychological factors, and food label use scales from the 1995 Diet and Health Knowledge Survey.

OBJECTIVE: To test the reliability and validity of scales on nutrition knowledge, social-psychological factors, and use of food labels developed from the 1995 Diet and Health Knowledge Survey (DHKS) questions. DESIGN: The 1995 DHKS questions within a section were pooled together as a scale and their reliability and validity were examined. PARTICIPANTS: US adults (> or =20 years) in the 1995 DHKS who responded to questions selected for this study (n = 1196). VARIABLES: Nutrition knowledge about the diet-disease relationship and nutrient content of products, perceived barriers and benefits of food labels, perceived ease of understanding food labels, food label use, and importance of healthful eating. ANALYSIS: Scales validity, Cronbach alpha, item total correlation, alpha if the item was deleted, and discriminant, convergence, and correspondence validity. RESULTS: Scales on perceived ease of understanding the food label, benefits of using food labels, food label use, and importance of healthful eating were reliable (Cronbach alpha =.78,.82,.91, and.82, respectively) and valid. CONCLUSION AND IMPLICATIONS: Accurate findings and interpretation of survey data depend on the use of reliable and valid instruments. This study identified the scales in the DHKS that can substantiate the conclusion on which effective nutrition education strategies should be established.

Adult↗
PubMed2005

Age, ability, and the role of prior knowledge on the acquisition of new domain knowledge: promising results in a real-world learning environment.

Prior knowledge, fluid intelligence (Gf), and crystallized intelligence (Gc) were investigated as predictors of learning new information about cardiovascular disease and xerography with a sample of 199 adults (19 to 68 years). The learning environment included a laboratory multimedia presentation (high-constraint-maximal effort), and a self-directed at-home study component (low-constraint-typical performance). Results indicated that prior knowledge and ability were important predictors of knowledge acquisition for learning. Gc was directly related to learning from the video for both domains. Because the trajectory of Gc stays relatively stable throughout the life span, these findings provide a more optimistic perspective on the relationship between aging and learning than that offered by theories that focus on the role of fluid abilities in learning.

Adult↗
PubMed2006

Conventionalized knowledge: mental health nurses producing clinical knowledge at intershift handovers.

Mental health nurses routinely hand over clinical knowledge at intershift reports. In the present study, field descriptions from prolonged fieldwork and transcripts of audio recordings of handovers were analysed discursively drawing on ethnomethodology and conversation analysis. The analysis identified linguistic and social conventions for handing over clinical knowledge; in particular, differences were identified between non-interactional and interactional handovers. The interactional handovers were relatively more substantial but did also bring forth obvious signs of uncertainty regarding exact clinical situations. Handing over caused a silencing of the least powerful nurses' voices, generated uncertainty, and promoted knowledge about the patients' clinical situation that was not necessarily precise or up-to-date.

Anthropology, Cultural↗
PubMedDate not supplied

Knowledge workers and knowledge-intense organizations, Part 1: A promising framework for nursing and healthcare.

Although some of the models and practices imported from business and industry have dubious or uncomfortable application to healthcare, one of the rapidly emerging paradigms appears to fit nursing and healthcare well. The concept of the knowledge-intense or knowledge work company or firm, staffed primarily by a workforce of knowledge workers, appears to describe the healthcare organization more accurately than the traditional industrial organization model drawn from the production floor or the sales organization.

Humans↗
PubMed2004

'Core knowledges': a dissociation between spatiotemporal knowledge and contact-mechanics in a non-human primate?

Human toddlers demonstrate striking failures when searching for hidden objects that interact with other objects, yet successfully locate hidden objects that do not undergo mechanical interactions. This pattern hints at a developmental dissociation between contact-mechanical and spatiotemporal knowledge. Recent studies suggest that adult non-human primates may exhibit a similar dissociation. Here, I provide the first direct test of this dissociation using a search paradigm with adult rhesus monkeys. Subjects watched as a plum rolled behind one of two opaque barriers. In Experiment 1, subjects had to locate the plum based on the position of a wall that blocked the plum's trajectory. Subjects searched incorrectly, apparently neglecting information about the location of the wall. However, subjects searched correctly in Experiments 2-4 when they were given spatiotemporal information about the plum's movement. Results indicate that adult monkeys use spatiotemporal information, but not contact-mechanical information, to locate hidden objects. This dissociation between contact-mechanical and spatiotemporal knowledge is discussed in light of developmental theories of core knowledge and the literature on object-based attention in human adults.

Animals↗
PubMed2002

Child care program directors' level of knowledge about asthma and factors associated with knowledge.

Although asthmatic children spend a significant amount of time in child care programs, little is known about child care program directors' knowledge about asthma and what factors influence directors' level of knowledge about asthma. A telephone interview was conducted with directors of a randomly selected sample of all licensed child care centers and group day care homes in Connecticut. Directors of most child care programs were willing to admit asthmatic children to their programs, but their knowledge about asthma needs to be improved. Directors who have served for long periods of time may be a target group for additional education about asthma.

Adult↗
PubMedDate not supplied

Knowledge base and preferred methods of obtaining knowledge of glaucoma patients.

PURPOSE: To gather information regarding patient's understanding of glaucoma and the manner in which patients wish to learn about the disease with the intent of improving patient education. METHODS: Forty-four of sixty randomly selected ophthalmologists (73%) asked four of their patients consecutively to complete a questionnaire about glaucoma. The selection of questions was based on focus group interviews and suggestions from several experts. Topics included knowledge about glaucoma and its treatment, the need for information, and preferred providers and methods of patient education. RESULTS: Fifty percent of the patients had 49% or less correct answers to questions about glaucoma or its treatment. Per item the correct answers ranged from 5% to 90%. Lack of knowledge was associated with low level of education, short duration of glaucoma, high age, and no preference for the Internet as method of supplying information. These variables, however, did not identify groups with a considerable lack of knowledge sufficiently accurately to target patient education. A high need for information was observed and included information about the patient's own glaucoma. Almost all patients preferred the ophthalmologist and many also a nurse or a representative of the Glaucoma Patient Society as providers of information. Written material was the preferred method. CONCLUSIONS: Patient education should address all patients. A patient education program should cover a wide range of topics with a focus on general information through written material and information tailored to the individual glaucoma patient's needs. The ophthalmologist is a key- person, but others could play an important role in patient education.

Adult↗
PubMed1999

[Knowledge about Helicobacter pylori and antibiotic treatment of peptic ulcer. A model study of information dissemination and implementation of the new knowledge in clinical practice].

Dissemination of information concerning new knowledge on peptic ulcer disease caused by Helicobacter pylori and treatment with antibiotics was surveyed. In 1996 a questionnaire was mailed to 200 gastroenterologists and 200 general practitioners. Physicians enumerate national medical journals as the most frequent source of information about the relationship between Helicobacter pylori and gastrointestinal ulcer. Six years after the first publication in international journals, 44% of the doctors had noticed this relation. Nearly all physicians had introduced antibiotics in treatment af peptic ulcer disease ten to twelve years after first announcement. The gastroenterologists preferred international medical journals whereas general practitioners stated national medical journals were the most important sources of new knowledge. General practitioners lacked knowledge of published guidelines for treatment of peptic ulcer disease.

Clinical Competence↗
PubMed2003

[Investigation on nurses' knowledge of and experience in cardiopulmonary resuscitation and on nurses' knowledge of the guidelines for cardiopulmonary resuscitation and emergency cardiovascular care established in 2000--results of a survey at Asahikawa Medical College Hospital (second report)].

BACKGROUND: We reported that the practical knowledge and skill on basic life support were not enough among nursing staffs. Therefore, to clarify the existing conditions and issues in CPR education we carried out a survey on knowledge of and experience in cardiopulmonary resuscitation (CPR) and on knowledge of the Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care (ECC) established in 2000. METHODS: Three hundred and four nurses at Asahikawa Medical College Hospital were asked to fill in questionnaires. RESULTS: The results show that more than 80% of the nurses are much interested in CPR. Most of the nurses had received education and training in CPR as students or after graduation. However, cases of cardiopulmonary arrest and CPR were experienced by only about 40% of the nurses. Most of the nurses had never heard of the Guidelines for CPR and ECC in 2000. CONCLUSION: The results of this survey demonstrate the need to provide more education (on CPR) to nursing staff.

Cardiopulmonary Resuscitation↗