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PubMed2002

The performance of matched-field track-before-detect methods using shallow-water Pacific data.

Matched-field track-before-detect processing, which extends the concept of matched-field processing to include modeling of the source dynamics, has recently emerged as a promising approach for maintaining the track of a moving source. In this paper, optimal Bayesian and minimum variance beamforming track-before-detect algorithms which incorporate a priori knowledge of the source dynamics in addition to the underlying uncertainties in the ocean environment are presented. A Markov model is utilized for the source motion as a means of capturing the stochastic nature of the source dynamics without assuming uniform motion. In addition, the relationship between optimal Bayesian track-before-detect processing and minimum variance track-before-detect beamforming is examined, revealing how an optimal tracking philosophy may be used to guide the modification of existing beamforming techniques to incorporate track-before-detect capabilities. Further, the benefits of implementing an optimal approach over conventional methods are illustrated through application of these methods to shallow-water Pacific data collected as part of the SWellEX-1 experiment. The results show that incorporating Markovian dynamics for the source motion provides marked improvement in the ability to maintain target track without the use of a uniform velocity hypothesis.

Acoustics↗

PubMed1990

[Families with hereditary cancer--a target group for prevention].

Although a large proportion of the population contract cancer, the risk is not uniform. In a small group (an estimated five per cent) with hereditary predisposition, the risk of cancer is high (often as high as 50 per cent) in every child of an affected parent. Another, considerably larger group consists of individuals at high risk (though how high is unknown), where a combination of hereditary and environmental factors is probably involved. In all likelihood, it is this group which would benefit most from general recommendations as to preventive measures. The study of such individuals will enhance our knowledge of the source of their vulnerability, thus facilitating the understanding of tumorigenic mechanisms in general, and on the basis of such knowledge improve the prospect of general and specific screening programmes, prevention and treatment.

Adolescent↗

PubMed2004

A novel method for visualizing nuclear hormone receptor networks relevant to drug metabolism.

The increasing generation of biological data represents a challenge to understanding the complexity of systems, resulting in scientists increasingly focused on a relatively narrow area of study, thereby limiting insight that can be gained from a broader perspective. In the field of drug metabolism and toxicology we are witnessing the characterization of many proteins. Most of the key enzymes and transporters are recognized as transcriptionally regulated by the nuclear hormone receptors such as pregnane X receptor, constitutive androstane receptor, vitamin D receptor, glucocorticoid receptor, and others. There is apparent cross talk in regulation, since multiple receptors may modulate expression of a single enzyme or transporter, representing one of many areas of active research interest. We have used published data on nuclear hormone receptors, enzymes, ligands, and other biological information to manually annotate an Oracle database, forming the basis of a platform for querying (MetaDrug). Using algorithms, we have demonstrated how nuclear hormone receptors alone can form a network of direct interactions, and when expanded, this network increases in complexity to describe the interactions with target genes as well as small molecules known to bind a receptor, enzyme, or transporter. We have also described how the database can be used for visualizing high-throughput microarray data derived from a published study of MCF-7 cells treated with 4-hydroxytamoxifen, to highlight potential downstream effects of molecule treatment. The database represents a novel knowledge mining and analytical tool that, to be relevant, requires continual updating to evolve alongside other key storage systems and sources of biological knowledge.

Databases, Factual↗

PubMed1989

[Knowledge of sexually transmitted diseases and attitudes towards them in populations at risk in Djibouti].

Sexually transmitted diseases (STDs) are an increasing public health problem in Djibouti. The authors have attempted to obtain basic information on the level of knowledge concerning STDs and on the sexual behaviour of highly sexually promiscuous individuals for use in the organization of future STD control programmes; the information was obtained from a population of 213 bar hostesses, 66 unlicensed prostitutes, and 115 male sufferers from STDs. The level of knowledge of these diseases was very high among the prostitutes and the bar hostesses, except that little was known about syphilis by the bar hostesses; the male sufferers were relatively ignorant concerning both syphilis and AIDS. Medical and paramedical personnel do not figure among the sources given for knowledge of STDs. On the other hand, friends play an important role in this knowledge, especially among unlicensed prostitutes. The second most frequently instanced source was radio and TV. The bar hostesses and the unlicensed prostitutes often exhibited distinct social characteristics. Neither education nor marriage appeared to prevent men from contracting STDs. The use of condoms is extremely rare among STD patients and not very common among unlicensed prostitutes. Half the bar hostesses report their frequent use.

Djibouti↗

PubMed1995

AIDS related information, attitudes and behaviours among Italian male young people.

In order to evaluate the AIDS related sources of information, knowledge, attitudes and behaviours among male young people it was filled in a multi-choice anonymous questionnaire by 2018 subjects, called for the first medical examination to Italian Navy and by 1348 recruits. The data from the latter group were used to make comparisons with our previous survey carried out in 1988. The most important sources of information on AIDS were mass media and school, on sexuality friends and family. AIDS awareness was greater among the high educated subjects and positively influenced by mass media and school as sources of information. In agreement with these data, knowledge was better about AIDS than about sexuality. Risk perception was positively influenced by the AIDS-related knowledge for called youth and a greater intolerance towards infected people was observed among the less educated and the less AIDS-aware subjects. On average 46% of the called up young men and 74% of recruits declared to be sexually active: among these, the mean age at the first sexual intercourse was 16, over 60% declared to have had multiple partners, over 30% unknown partners and over 30% didn't use condoms; 20% of called up and 38% of recruits indicated 2 or 3 risk behaviours. Factors determining sex-related risks were different according to the behaviour and the considered group. These results suggest that it is important for young people to be well informed about sex and AIDS before the beginning of sexual activity, if possible during compulsory school.

Acquired Immunodeficiency Syndrome↗

PubMed1996

Demographic and epidemiologic features of female adolescents in Turkey.

OBJECTIVES: To determine the average menarcheal age and menstrual cycle pattern, prevalence of dysmenorrhea, frequency of smoking, alcohol and drug use, sexual education level, and the gynecologic problems in female adolescents in Turkey. METHODS: A questionnaire consisting of 43 questions were given to 13,665 high school girls between the ages 13-18 years. RESULTS: The results showed that average menarcheal age was 13.28 +/- 1.09 years and 77.8% of the girls had menstrual cycles between 20-35 days; 10,688 (78.1%) of the girls complained about pain during their menstruation and 25.6% frequently missed school for this reason. That notwithstanding, only 0.4% of the adolescents with dysmenorrhea had sought medical consultation. Out of 13,665 girls, 19.7% smoked cigarettes, 14.9% used alcohol, and 0.63% used other drugs. Although 50.8% of the students believed that their knowledge about sexuality was adequate, on evaluating the results, this was not confirmed. Girlfriends were found to be the most important source of sexual knowledge. The study indicated that 88.8% of the girls wanted to have sexual education at schools and 60.5% of those preferred to take such a lecture together with boys. The study also revealed that 10.5% of the girls previously consulted a gynecologist and menstrual disorders (26.1%) and dysmenorrhea (23.4%) were the most common complaints. The results showed that 68.7% of the girls preferred a woman gynecologist and 66.3% wanted to be alone with the doctor during examination. CONCLUSION: We provided data about demographic and epidemiologic features of Turkish female adolescents.

Adolescent↗

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↗

PubMed2003

Beam intensity striations and applications.

The single-element spectrogram for a continuous broadband signal, plotted as a function of range, has been shown to exhibit striated bands of intensity maxima and minima. The slope of the striations is an invariant of the modal interference and is described by a waveguide invariant parameter "beta." The striation pattern is analyzed and modeled in this paper for the beam outputs of a horizontal line array obtained by conventional beamforming. Array beamforming makes it possible to measure the waveguide invariant parameter for weak signals due to the enhancement of signal levels by the array gain over that of a single element. It is shown that the signal beam spectrogram as a function of range exhibits the same striation pattern as that (predicted) for a single element. Specifically, for a broadside signal, the beam striation is identical to that of a single-element plus a constant signal gain. For a nonbroadside target, the signal beam intensity will be modified by a frequency-bearing dependent signal gain due to the signal spread over multiple beams, nevertheless the beam spectrogram retains the same striation pattern (slope) as for a single element. The sidelobe beams (outside the canonical cones containing the signal arrivals) exhibit an entirely different striation pattern as a function of frequency and range. For array processing, it is shown that a fast range-rate, close range target and a distant, slow range-rate interference source will have a different striation pattern (slope) in the corresponding beam spectrograms as a function of time, assuming no prior knowledge of the source ranges. The difference in the striations between the beam spectrograms can be used in array processing to suppress the interference contribution. A 5-7 dB interference suppression is demonstrated using simulated data.

Journal Article↗

PubMed2002

Lead sources, behaviors, and socioeconomic factors in relation to blood lead of native american and white children: a community-based assessment of a former mining area.

Lead poisoning prevention requires knowledge of lead sources and of appropriate residential lead standards. Data are severely lacking on lead sources for Native American children, many of whom live in rural areas. Further, the relation of mining waste to blood lead concentrations (BPbs) of rural children is controversial. In collaboration with the eight tribes of northeastern Oklahoma, we assessed lead sources and their effects on BPbs for rural Native American and White children living in a former mining region. Venous blood lead, residential environmental (soil, dust, paint, water), and caregiver interview (e.g., hand-to-mouth behaviors, socioeconomic conditions) data were obtained from a representative sample of 245 children 1-6 years of age. BPbs ranged from 1 to 24 microg/dL. There were no ethnic differences in BPbs (p= 0.48) nor any patterns of excess lead sources for Native American or White children. Multiple linear regression analyses indicated that mean soil lead, mean floor lead loading, mouthing behaviors, caregivers' education, and residence in former mining towns were all strongly associated with BPbs. Logistic regression results showed mean floor dust lead loading greater than or equal to 10.1 microg/ft(2) (odds ratio [OR], 11.4; 95% confidence interval [CI], 3.5-37.3), and yard soil lead >165.3 mg/kg (OR, 4.1; CI, 1.3-12.4) were independently associated with BPbs greater than or equal to 10 microg/dL. We also found strong interactions between soil lead and poverty (p= 0.005), and dust and soil sources (p= 0.02). Our findings indicate that soil and dust lead derived largely from mining waste pose a health hazard to Native American and White children, and that current residential dust lead standards are insufficient to adequately protect children. Moreover, our finding that poor children are especially vulnerable to lead exposures suggests that residential standards should consider interactions among socioeconomic conditions and lead sources if environmental justice is to be achieved.

Child↗

PubMed2006

Knowledge and use of the internet as a source of controlled substances.

Despite growing evidence that the internet is a source of controlled substances for nonmedical use, there is a lack of information about who is using it to obtain these drugs. One hundred adult drug-dependent inpatients in a private residential treatment program participated in a semistructured interview regarding how they obtained their drugs. Twenty-nine percent reported knowledge of the internet as a source of drugs, and 11% reported that they had used the internet to either buy drugs or locate a drug dealer. The results of this preliminary study suggest that the internet has become a source of controlled substances for some addicted individuals. Considerations for future research and clinical practice are described.

Adult↗

PubMedDate not supplied

The discipline of innovation.

Some innovations spring from a flash of genius. But as Peter Drucker points out in this HBR Classic, most result from a conscious, purposeful search for opportunities. For managers seeking innovation, engaging in disciplined work is more important than having an entrepreneurial personality. Writing originally in the May-June 1985 issue, Drucker describes the major sources of opportunities for innovation. Within a company or industry, opportunities can be found in unexpected occurrences, incongruities of various kinds, process needs, or changes in an industry or market. Outside a company, opportunities arise from demographic changes, changes in perception, or new knowledge. These seven sources overlap, and the potential for innovation may well lie in more than one area at a time. Innovations based on new knowledge, of course, tend to have the greatest effect on the marketplace. But it often takes decades before the ideas are translated into actual products, processes, or services. The other sources of innovation are easier and simpler to handle, yet they still require managers to look beyond established practices. Drucker emphasizes that in seeking opportunities, innovators need to look for simple, focused solutions to real problems. The greatest praise an innovation can receive is for people to say, "This is obvious!" Grandiose ideas designed to revolutionize an industry rarely work. Innovation, like any other endeavor, takes talent, ingenuity, and knowledge. But Drucker cautions that if diligence, persistence, and commitment are lacking, companies are unlikely to succeed at the business of innovation.

Administrative Personnel↗

PubMed2006

Assessment of needs of men for decision support on male sterilization.

OBJECTIVE: To assess the needs of men for decision support on male sterilization. METHODS: Forty-two men facing a decision about undergoing a vasectomy or not and 11 physicians who perform vasectomy were interviewed to assess the sources of difficulty in this decision-making process. On the day of their vasectomy, 209 men completed the decisional conflict scale (DCS) and a knowledge test. RESULTS: Sources of difficulty about the decision to have a vasectomy or not included: lack of information about risks and benefits, clarification of personal values concerning parenthood after the vasectomy, and undue pressure from partner. On the day of their vasectomy, only 1.9% (95% confidence interval 0.5-4.8%) of men had unresolved decisional conflict. However, most men scored poorly on their knowledge test mean score (58.2+/-13.5%). CONCLUSION: Men facing the decision about having a vasectomy or not would benefit from a decision support intervention that would address conflicting information and clarification of values. PRACTICE IMPLICATIONS: Health professionals should provide decision support to men facing the decision about having a vasectomy or not. A decision aid on male sterilization would be useful in this respect.

Conflict, Psychological↗

PubMed1999

'It's the best of two evils': a study of patients' perceived information needs about oral steroids for asthma.

OBJECTIVES: To explore the sources of patients' knowledge about the potential side-effects of oral steroids prescribed to treat asthma. METHODS: Seventeen in-depth interviews were conducted with patients taking prescribed oral steroid medication (prednisolone) for asthma. The interviews were transcribed verbatim and the data organized according to common themes. RESULTS: All the respondents acknowledged they had no choice but to take oral steroids but they wanted to be informed about the potential side-effects. Respondents reported that they had not received sufficient information about side-effects from their general practitioner (GP). Information was sought from both medical sources (pharmacists and asthma nurses) and non-medical sources (friends and family, self-help groups and the media) to supplement their knowledge. The conclusions drawn about the risks of taking oral steroids were also influenced by respondents' existing beliefs. CONCLUSIONS: Respondents drew upon information about oral steroids from a variety of professional and lay sources. The findings add weight to calls for doctors and patients to share their respective knowledge in consultations. Developing an understanding of the views of GPs about the provision of information about side-effects would help to identify any perceived barriers to a more open exchange of information in the consultation.

Journal Article↗

PubMed1993

[The education of neurologists for the XXI century].

The training of neurologists for the practice in the coming years requires deep changes in the system of medical education. It is critical for the medical student and the resident the acquisition of a broad knowledge of scientific information. But physicians must also know how to use knowledge they have accumulated from a variety of sources. They express their knowledge through abilities in the wards or in ambulatory settings in order to get an accurate diagnosis and the proper management of a particular condition. In addition to that they are expected to develop ethical attitudes toward their patients, peers and the greater society. They must be committed to work, to independent learning and to rationality. To accomplish its scholarly goals medical education has to emphasize the development of adequate personal attributes, skills and habits of mind rather than the transmission of factual information. With today's technology all the scientific information necessary for the practice of medicine is at the fingertips through computers. Memorization is therefore an absolute nonsense in teaching. A better education involves reducing the working load and the number of lecture hours providing students and residents with sufficient unscheduled time to seek out information independently and to assess their own learning. Problem-solving methods of teaching providing the formulation of multiple concurrent hypotheses, the critical analysis and evaluation of data and the application of new acquired knowledge as well as previously learned concepts to the solution of problems should be widely employed. Faculty members are guides who assist students and residents to develop analytical and critical skills.(ABSTRACT TRUNCATED AT 250 WORDS)

Education, Medical↗

PubMed1980

How internists learned about cimetidine.

We surveyed 449 general internists to determine how they first heard about, learned the clinical principles of usage of, and gained update information on cimetidine. Fifty-six percent of those responding named two or more sources for learning how to use cimetidine, and 59% named two or more sources for updating their knowledge. Medical journals were the single most popular source of information in all stages of learning; the next commonest sources were continuing medical education programs and discussion with colleagues, followed by Medical Letter, pharmaceutical company representatives, and hospital rounds. The importance of individual learning should not be overlooked by medical educators in attempts to improve continuing medical education.

Cimetidine↗

PubMed2005

Knowledge logistics as an intelligent service for healthcare.

OBJECTIVES: The technology of grid services is developing fast. This paper presents an approach to the implementation of an intelligent grid service that configures a hospital taking advantage of the knowledge logistics idea. METHODS: The presented approach is based on synergistic integration of knowledge acquired from distributed sources in order to obtain new or complement insufficient knowledge. Presented approach uses ontologies and the formalism of object-oriented constraint networks for knowledge representation and applies ILOG to constraint-based problem solving. RESULTS: The application of the approach is illustrated via a decision support system for a fictitious case study of a hospital configuration in the Binni region. The system showed the ability to produce interrelated solutions for subtasks of the hospital configuration task based on the built ontology and input parameters. Besides, such preferences as cost or time minimization are also considered by the implemented fuzzy logic module that finds a feasible solution. CONCLUSIONS: KL would benefit from the grid, and particularly from the concept of a semantic grid. The scalable architecture of the approach enables its extension with regard to knowledge/information sources number and, thereby, with regard to factors taken into account during complex problem solving. Utilizing ontologies allows integration of the approach into existing processes and facilitates knowledge sharing with similar systems. Application of constraint networks allows rapid problem manipulation and usage of such existing efficient technologies as ILOG.

Artificial Intelligence↗

PubMed2002

Distributed structure-searchable toxicity (DSSTox) public database network: a proposal.

The ability to assess the potential genotoxicity, carcinogenicity, or other toxicity of pharmaceutical or industrial chemicals based on chemical structure information is a highly coveted and shared goal of varied academic, commercial, and government regulatory groups. These diverse interests often employ different approaches and have different criteria and use for toxicity assessments, but they share a need for unrestricted access to existing public toxicity data linked with chemical structure information. Currently, there exists no central repository of toxicity information, commercial or public, that adequately meets the data requirements for flexible analogue searching, Structure-Activity Relationship (SAR) model development, or building of chemical relational databases (CRD). The distributed structure-searchable toxicity (DSSTox) public database network is being proposed as a community-supported, web-based effort to address these shared needs of the SAR and toxicology communities. The DSSTox project has the following major elements: (1) to adopt and encourage the use of a common standard file format (structure data file (SDF)) for public toxicity databases that includes chemical structure, text and property information, and that can easily be imported into available CRD applications; (2) to implement a distributed source approach, managed by a DSSTox Central Website, that will enable decentralized, free public access to structure-toxicity data files, and that will effectively link knowledgeable toxicity data sources with potential users of these data from other disciplines (such as chemistry, modeling, and computer science); and (3) to engage public/commercial/academic/industry groups in contributing to and expanding this community-wide, public data sharing and distribution effort. The DSSTox project's overall aims are to effect the closer association of chemical structure information with existing toxicity data, and to promote and facilitate structure-based exploration of these data within a common chemistry-based framework that spans toxicological disciplines.

Carcinogens↗

PubMed2006

Knowledge, attitudes and practice of medical students at the Cave Hill Campus in relation to ethics and law in healthcare.

OBJECTIVES: The purpose of this study is to assess the knowledge, attitudes and practices among medical students in relation to medical ethics and law. The results of the study will be a useful guide to tutors of medical students and curricula designers. METHODS: A thirty-item self-administered questionnaire about knowledge of law and ethics, and the role of an ethics committee in the healthcare system was devised, tested and distributed to all levels of students and staff at the Queen Elizabeth Hospital in Barbados (a tertiary care teaching hospital) in 2003. The data from the completed questionnaires were entered into an SPSS database and analyzed using frequency and multiple cross-tabulation tables. RESULTS: Completed responses were obtained from 55 (96%) of the medical students. Medical students generally attested to the importance of ethical knowledge but felt that they knew little of the law. Students varied widely as regards the frequency with which they saw ethical or legal problems, with a quarter seeing them infrequently, but another quarter seeing them every day. They received their knowledge from multiple sources and particularly from lectures/seminars, and found case conferences the most helpful. Only a few students felt that text books had been helpful. Students were generally knowledgeable about most ethical issues, but many had uncertainties on how to deal with religious differences in treating patients, on the information to be given to relatives, and how violent patients should be treated. CONCLUSIONS: The results of the study highlight that medical students felt an inadequacy of knowledge of law as it pertains to their chosen career Since most of their knowledge of law was obtained from lectures, these should be reviewed and other avenues of tuition explored. The study also highlights the need to identify the minority of students who have problems with their ethical knowledge and to devise means whereby any deficiencies can be discussed and modified.

Adult↗