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Knowledge management in pediatric pain: mapping on-line expert discussions to medical literature.

Clinical decision-making can be vastly improved with the availability of the right medical knowledge at the right time. This concept paper presents a knowledge management re-search program to (a) identify, capture and organize the tacit knowledge inherent within on-line problem-solving discussions between pediatric pain practitioners; (b) establish linkages between topic-specific pediatric pain discussions and corresponding published medical literature on children's pain available at PubMed--i.e. linking tacit expert knowledge to explicit medical literature; and (c) make these knowledge re-sources available to pediatric pain practitioners via the WWW for timely access to various modalities of clinical knowledge.

Artificial Intelligence↗

Racial differences in AIDS knowledge among adults.

Adults 18 to 65 years of age (N = 1237) were interviewed by telephone to explore differences in AIDS knowledge between black and white Americans. Adjusted odds ratios were calculated to determine the association between race and AIDS knowledge. Results show no discrepancies between black and white respondents in the level of knowledge about proved HIV transmission modes (odds ratio [OR] = 1.31, 95% confidence interval [CI] 0.90-1.90). Racial differences in the level of knowledge of preventive measures (ORadj = 1.39, 95% CI 1.00-1.94) are due primarily to differences in educational attainment and not to race. However, lack of awareness of the difference between asymptomatic individuals infected with human immunodeficiency virus (HIV) and persons with AIDS (PWAs) remained significantly higher for black than for white respondents (ORadj = 1.81, 95% CI 1.32-2.50) after adjustment for educational attainment. This lack of awarenes may facilitate exposure of a larger proportion of black respondents to HIV. Racial disparities in the level of knowledge about unproved transmission modes also remained after adjustment for educational attainment (ORadj = 1.92, 95% CI 1.37-2.70). To interpret unexplained differences in knowledge, factors related to unaccounted-for socioeconomic confounding and to the effect of several variables involved in the communication process are discussed.

Acquired Immunodeficiency Syndrome↗

The role of knowledge translation for cancer control in Canada.

The definition and scope of cancer control has been evolving since its inception. The most recent model of cancer control in Canada has acknowledged the importance of knowledge translation to ensure that research results are implemented in practice and will be used to inform policy. However, without effort, the process of translation does not happen on a consistent basis. Knowledge translation focusses on improving the adoption of an innovation, e.g., research results. A number of health organizations in Canada have identified knowledge translation as an important activity and have begun to develop departments or initiatives dedicated to its achievement. As the emphasis in cancer control is on the application of knowledge, knowledge translation has a role to play in attaining the objectives of cancer control in Canada. It is an ideal time for the Canadian Strategy for Cancer Control and other Canadian cancer control initiatives to determine where they will locate knowledge translation in relation to their objectives.

Biomedical Research↗

Multicultural education: Israeli and German adolescents' knowledge and views regarding the Holocaust.

This study probes a unique case of multicultural education of Israeli and German students regarding the Holocaust. Their knowledge level of German history leading to the rise of Hitler and the Nazi party to power, knowledge about the Holocaust, the relation between their knowledge of attitudes toward the "other" (German/Israeli) group, and their reaction to a racist-dictatorial regime are explored. The findings were that German adolescents (high school students) knowledge regarding the events leading to the rise of the Nazi party was greater than that of the Israeli adolescents. However, the knowledge of Israelis was greater regarding the Holocaust. A positive correlation was found between the knowledge levels and their attitudes toward the other groups (German/Israeli) and toward resistance to the possible rise of a dictatorial regime. The findings point to the fact that multicultural education, which combines attitudinal, cognitive, and instrumental goals, can succeed in promoting nonracist views.

Adolescent↗

[The knowledge, clinical control and attitudes of Primary Care physicians when dealing with epileptic patients. Preliminary findings].

INTRODUCTION: Epilepsy is a common disease with important social and economic repercussions. Patients with epilepsy have traditionally been discriminated by both the general population and physicians. A physician's lack of knowledge about epilepsy could be the cause of an incorrect clinical control (CC). AIMS: The purpose of this study is to examine the origins of the knowledge, the CC and the attitudes of physicians in Tenerife with respect to the treatment of patients with epilepsy. MATERIALS AND METHODS: In January 2003, all Primary Care physicians in Tenerife were given a questionnaire that asked them about their knowledge, CC and attitudes when dealing with cases of epilepsy. Of the 260 surveys initially sent out, 182 were returned. RESULTS: The questionnaire was answered by 70% of doctors, of which 34 were paediatricians and 148 were general practitioners, with no differences between sexes. Most physicians acquire their knowledge, observe and treat their first seizure in the Faculty and during their period of hospital residency. 44% of them are barely or not at all satisfied with their knowledge on the subject. The most highly valued therapists are neurologists and neuropaediatricians. The goal that is sought is to eliminate the impact of the disease on the patient's quality of life. They rarely establish or modify antiepileptic treatment and state that they have doubts about neuropsychological disorders and integrating patients with epilepsy in the workplace. CONCLUSIONS: The physicians in Tenerife define themselves as professionals with scant knowledge about epilepsy and feel they are poorly qualified to treat patients with the disease, who are usually referred to specialists in Neurology.

Adult↗

[A survey on knowledge, attitude, and practice of emergency department practitioners in musculoskeletal injuries].

OBJECTIVES: A knowledge, attitude, and practice study was conducted in relation to musculoskeletal injuries among emergency department practitioners working in the town of Afyon, Turkey. METHODS: Of 40 practitioners working at emergency health services in Afyon, 32 (80%) responded to a 20-item questionnaire that inquired about their knowledge, attitude and practice. A 100-point scoring system was used for the first half of the questionnaire including 10 questions about their knowledge, and a total score of 60 or above was regarded as successful. Inquiry was focused on frequent emergency problems that require intervention by the emergency department practitioners, such as neck examination in trauma patients, treatment of open fractures, intervention to dislocations, treatment in gunshot injuries, and transportation of traumatic amputated organs. RESULTS: The mean duration of professional practice was 7.8+/-3.9 years. The mean achievement score was 66.6+/-15.8, without any significant difference among institutions. No significant relationship existed between the duration of professional practice and knowledge scores. Despite a success rate of 81.3% in knowledge scores, the following shortcomings were notable: neglect in the neurological examination of the lower extremity during neck examination, and inappropriate definitions and interventions in open fractures, tetanus prophylaxis, and antibiotic treatment. CONCLUSION: The survey showed that the practitioners in Afyon have sufficient knowledge levels; however, it seems apparent that there are shortcomings in their practice, which require continuing education for all the staff.

Adult↗

Framework for measuring adaptive knowledge-rich systems performance.

The universe is non repeatable in nature--most of events cannot be prestated and do not repeat themselves. The only way to create systems that are truly useful is to make them adaptive (able to reason by analogy and learn) and rich in knowledge (including common sense knowledge). Adaptive and knowledge-rich health management could get us closer to errorless health care where small incremental adjustments happen all the time preventing occurrence of an error. In the era of adaptive systems we need to have a way to evaluate their performance. Are they truly adaptive? How adaptive are they? Are they accurate enough? Are they fast enough? Are they cost effective? This chapter presents general framework for measuring adaptive knowledge-rich systems' performance and includes among others definitions of adaptiveness factor, britt (a unit of brittleness) and uso-quant (unit of usefulness of a piece of knowledge). Measuring adaptive knowledge-rich systems performance is one of the most important research areas that can have a big pay-off in healthcare now and in the future.

Artificial Intelligence↗

Effectiveness of structured teaching program in improving knowledge and attitude of school going adolescents on reproductive health.

INTRODUCTION: Development of knowledge and attitude takes place during the adolescent period, which can have lifelong effects on the individual, family and society. Proper education in this age group is important for prevention of untoward social and health related problems. OBJECTIVE: To find out the effectiveness of structured teaching program in improving knowledge and attitude of school going adolescents on reproductive health. MATERIALS AND METHODS: An experimental study with pretest - posttest control group design was carried out in four selected schools with similar settings in Dharan town of Nepal. All the subjects were divided into two groups: experimental and control, each comprising of two subgroups of 50 boys and 50 girls. Structured teaching program consisting of information on human reproductive system was used as a tool of investigation for the experimental group, whereas conventional teaching method was used for the control group. RESULTS: A total of 200 Adolescent school students were included in this study. The mean (+/-SD) pretest score of the experimental group on knowledge of reproductive health was 39.83 (+/- 16.89) and of the control group was 39.47(+/- 0.08). The same of experimental group after administration of the structured teaching program (84.60+/-10.60) and of the control group with conventional teaching method (43.93+/-10.08) was statistically significant (p<0.001). Similarly, the post-test scores of knowledge of the groups on responsible sexual behaviour and their attitude towards reproductive health were better in the experimental group than in the control group (p<0.001). CONCLUSION: The knowledge of adolescent school students on reproductive health is inadequate. The use of structured teaching program is effective in improving knowledge and attitude of the adolescents on reproductive health.

Adolescent↗

Knowledge and Attitudes of Certified Athletic Trainers in Pennsylvania Toward HIV/AIDS and Treating HIV-Positive Athletes.

OBJECTIVE: As the number of people infected with the Human Immunodeficiency Virus (HIV) continues to increase so does the likelihood that athletic trainers will treat HIV-positive athletes. The purposes of this study were to determine how knowledgeable certified athletic trainers in Pennsylvania are about HIV/ AIDS and their attitudes toward treating the injuries of HIV- positive/AIDS athletes. Another purpose of this study was to determine what effect the athletic trainers' HIV/AIDS attitudes had on their HIV/AIDS knowledge level. DESIGN AND SETTING: A questionnaire was mailed to 807 NATA-certified athletic trainers who resided in the state of Pennsylvania. A total of 410 (50.8%) athletic trainers participated in the study: 241 (58.8%) males and 169 (41.2%) females. SUBJECTS: NATA-certified athletic trainers who resided in the state of Pennsylvania as of March 19, 1994. MEASUREMENTS: A questionnaire was developed by the investigators after reviewing the appropriate literature and in consultation with a panel of experts that consisted of athletic trainers, physicians, and a health educator who specialized in HIV/AIDS education. The questionnaire consisted of three sections: demographic information, HIV/AIDS knowledge, and HIV/AIDS attitude. Returned questionnaires were analyzed via descriptive (frequencies, percentages, and means) and inferential statistics. Univariate analysis consisted of independent t tests to determine what effect the athletic trainers' HIV/AIDS attitudes had on their HIV/AIDS knowledge level. RESULTS: NATA-certified athletic trainers in Pennsylvania are moderately knowledgeable about HIV/AIDS and have constructive attitudes in treating the athletic injuries of HIV-positive/ AIDS athletes. Their major concern, however, is fear of HIV transmission. It was further determined that differences in HIV/AIDS attitudes had no effect on HIV/ AIDS knowledge level. CONCLUSIONS: The likelihood that athletic trainers will treat HIV-positive athletes is ever increasing. HIV/AIDS education and appropriate clinical precautions are paramount in protecting the clinician and athlete alike.

Journal Article↗

Knowledge of stroke among stroke patients and their relatives in Northwest India.

BACKGROUND: The knowledge of warning symptoms and risk factors for stroke has not been studied among patients with stroke in developing countries. AIMS: We aimed to assess the knowledge of stroke among patients with stroke and their relatives. SETTINGS AND DESIGN: Prospective tertiary referral hospital-based study in Northwest India. MATERIALS AND METHODS: Trained nurses and medical interns interviewed patients with stroke and transient ischemic attack and their relatives about their knowledge of stroke symptoms and risk factors. STATISTICAL ANALYSIS: Univariable and multivariable logistic regression were used. RESULTS: Of the 147 subjects interviewed, 102 (69%) were patients and 45 (31%) were relatives. There were 99 (67%) men and 48 (33%) women and the mean age was 59.7+/-14.1 years. Sixty-two percent of respondents recognized paralysis of one side as a warning symptom and 54% recognized hypertension as a risk factor for stroke. In the multivariable logistic regression analysis, higher education was associated with the knowledge of correct organ involvement in stroke (OR 2.6, CI 1.1- 6.1, P =0.02), whereas younger age (OR 2.7, CI 1.1-7.0, P =0.04) and higher education (OR 4.1, CI 1.5-10.9, P =0.005) correlated with a better knowledge regarding warning symptoms of stroke. CONCLUSIONS: In this study cohort, in general, there is lack of awareness of major warning symptoms, risk factors, organ involvement and self-recognition of stroke. However younger age and education status were associated with better knowledge. There is an urgent need for awareness programs about stroke in this study cohort.

Adult↗

Trends in public knowledge and attitudes about AIDS, South Carolina, 1987-1988.

The South Carolina Department of Health and Environmental Control AIDS Program assessed the state population's knowledge and attitudes about AIDS and HIV transmission in 1987 and 1988. Each year approximately 1,800 adults were selected by a random 3-stage cluster design and asked seventeen questions by telephone about AIDS and HIV. Questions addressed attitudes, general knowledge, HIV transmission by casual contact, HIV transmission by sex and IV drug contact, and HIV transmission by blood donation and transfusion. Over 90 percent of respondents were knowledgeable about HIV transmission by high risk behaviors addressed in the questionnaire. Respondents were less knowledgeable about HIV transmission by casual contact (12 to 41 percent gave incorrect answers), HIV testing (45 to 48 percent gave incorrect answers), and transmission by blood donation (43 to 52 percent gave incorrect answers). In general, a higher percentage of correct responses were given in 1988 than in 1987. In regard to responses measured by this survey, we conclude that: (1) there is a high level of knowledge in the state about transmission by high risk behaviors, (2) there are still many misconceptions about casual transmission, HIV testing, and blood donation, and (3) there was improvement in knowledge about AIDS and HIV from 1987 to 1988.

Acquired Immunodeficiency Syndrome↗

[Knowledge of dental treatment in the Dutch population].

A survey in an at random sample of 18-66 years old persons was conducted in the Netherlands to assess knowledge of dental treatment possibilities. The results show that 29% has an inadequate level of knowledge, 54% a moderate level and 17% a good level. With regard to the dental subjects, it turns out that knowledge was good on preventive items while a poor knowledge score was found on items of oral surgery and aesthetic dentistry. People without a dentist, with lower income and occupation have less knowledge than people that report having a dentist, a higher income and a higher occupation. The occupation has the largest effect on the knowledge score.

Attitude to Health↗

Medical students' knowledge, attitudes, and behavior concerning diet and heart disease.

Demand for physician-based dietary treatment of hypercholesterolemia is increasing, but medical care providers feel that they lack the skills and confidence necessary to provide these services. Using a self-administered questionnaire, we studied the relationships among dietary knowledge, attitudes, and behaviors to identify the educational needs of entering medical students. On average, dietary behavior and background knowledge of the diet-coronary heart disease association compared favorably to national dietary recommendations and knowledge of the U.S. public. However, practical knowledge necessary for diet counseling was weak, and attitudes about the "prudent" diet were poor. More favorable attitude scores were associated with healthier eating habits, while greater knowledge was not. Our results suggest that entering medical students already have a basic understanding of the diet-heart disease link, which is covered in the curricula of most medical schools. Medical education should include more emphasis on practical dietary knowledge and improving attitudes about the prudent diet.

Adult↗

Knowledge and attitudes of AIDS health care providers before and after education programs.

Analysis of the responses of 1,247 health care providers to questionnaires immediately before and after educational programs on acquired immunodeficiency syndrome (AIDS) revealed significant (P less than .05) improvements in accuracy of knowledge about 7 of 15 modes of transmission and 7 of 11 means of infection control. Sizeable percentages, however, continued to believe after the programs that AIDS could be transmitted by casual contact, such as sharing coffee cups. Provider attitudes about caring for persons with AIDS shifted in the direction desired (P less than .001) on six of nine questions. After programs, 92 percent believed that they had sufficient knowledge to protect themselves from getting AIDS, and 79 percent felt professionally competent to care for a person with AIDS. Both before and after programs, providers who established regulations for the care of persons with AIDS and outpatient care providers had the most accurate knowledge and felt most comfortable with persons with AIDS, while inpatient care providers had the least accurate knowledge and felt least comfortable. A 1-month followup of 159 providers revealed that postprogram changes in knowledge and attitudes were largely retained. Results point to the need for education at all levels of the health care system, to a persistent gap in knowledge and attitudes between those persons who establish regulations and those who carry them out, and to the possibility of creating significant changes through education.

Acquired Immunodeficiency Syndrome↗

AIDS--public knowledge in Norway 1986.

This paper studied different kinds of knowledge related to HIV/AIDS in the adult Norwegian population. The empirical basis stems from two national interview surveys conducted in 1986. Data were analysed using contingency table analysis and multiple classification analysis (MCA). Totally, 64% knew that HIV/AIDS is caused by a virus. Homosexuals, drug-users, prostitutes and bisexuals were mentioned most often as groups at high risk of becoming infected. As to knowledge about the transmission of the infection, 95% were aware that sex between men and blood transfusion may be channels of infection, 93% recognized contaminated needles, and 85% sexual contact with a person of the opposite sex as possible routes of transmission. A substantial number of respondents were uncertain whether the infection can be transmitted through social contact. Knowledge about HIV/AIDS increased with diminishing age and with increased level of income and education. The direct effect of age upon knowledge may be explained by the theory of selective exposure, which predicts that the seeking of information is influenced by personal needs and interests. The social gradient of knowledge about HIV/AIDS reflects the general flow of information in a social system, and differences in the use of the media by the different social subgroups. Finally, the paper underlines the importance of filling the gaps in the public knowledge about how HIV/AIDS is not transmitted, in order to prevent unfounded fear, stigmatisation and discrimination.

Acquired Immunodeficiency Syndrome↗

Consumer knowledge of Medicare and supplemental health insurance benefits.

In this article, data from a recent study funded by the Health Care Financing Administration are used to examine the level of knowledge about health care insurance coverage among Medicare beneficiaries. Two related categories of this knowledge are analyzed: knowledge of the Medicare program itself and knowledge of supplemental health insurance policies owned by program beneficiaries. The results indicate that Medicare beneficiaries typically do not have high levels of knowledge either about Medicare or about their supplemental health insurance. Also analyzed are the factors that affect knowledge levels.

Age Factors↗

[Utilization dimensions of gerontologic knowledge in the practice of community social politics].

Although disenchantment between "science" and "practice" and complaints about the inadequate utilization of gerontological knowledge are often articulated, the problem of utilization of this knowledge in fields of practice has rarely been the topic of empirical research. By referring to the actual sociological debate about "utilization" the contribution tries to shed light on the complexity of the problem. It is important to realize that for too long utilization of knowledge, quite naively, has been looked at as a process of merely transferring true results in a "right" way. Instead, from a sociological point of view, one has to learn that the most decisive filter in selecting knowledge is represented by the context of utilization and that such contexts display their own specific logic or rationality in processing knowledge. Based on interviews in three German municipalities with employees of department of social planning, state ministries of social affairs, welfare associations and local projects on counselling about old age problems, this thesis is examined in the case of gerontological knowledge. A first partial evaluation of the material from this on-going research project confirms the relevance of this assumption.

Aged↗

Nutrition knowledge and food practices of high school athletes.

The purpose of this study was to analyze the food practices and nutrition knowledge of high school athletes currently participating in interscholastic sports and to evaluate differences in terms of selected sports variables. The data for the study were obtained by a questionnaire administered to a sample of 943 athletes from randomly selected high schools in Connecticut. The stated hypotheses were tested statistically using analysis of variance, t-tests, and Pearson correlation coefficients where appropriate. The results of the study indicated that the female athletes had better knowledge of nutrition but poorer food practices than the male athletes. There were also significant relationships between sport forms, seasons, and nutrition knowledge and food practices. High school athletes perceived their best source of nutrition knowledge to be their parents. Results on the nutrition knowledge component of the instrument showed that out of 48 possible answers, the mean correct was 26.4, while out of a possible score of 5, the mean score for food practices was 2.2. Because a positive relationship existed between the number of sport seasons and nutrition knowledge and food practice scores, sport participation may be a catalyst for learning about nutrition.

Adolescent↗