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At least 1,531 records · Page 85Linked to original sources
PubMed2006

CT perfusion source images improve identification of early ischaemic change in hyperacute stroke.

CT perfusion scanning produces dynamic contrast-enhanced brain images, but to generate and interpret the colour maps of cerebral perfusion from these source images requires specialist neuroimaging knowledge. We hypothesized that physicians without such training might still utilise the CT perfusion source images (CTPSI) to diagnose early ischaemic change. Fifteen patients had cerebral non-contrast CT (NCCT) and perfusion CT within 6 hours of hemispheric stroke onset. We tested 15 non-stroke clinicians and radiology trainees, plus three experts, in assessing the presence and extent of early ischaemic change on NCCT versus CTPSI. Day 5-7 CT or MRI was used as the gold standard. Agreement with follow-up imaging was poor for both detection, and extent of early ischaemic change on NCCT (kappa = 0.01-0.11). There was a marked improvement in agreement for both the presence and extent of early ischaemic change on CTPSI (kappa = 0.67-0.83). CTPSI were much more accurate than NCCT in identifying acute ischaemic change. 'Less expert' users accurately identified major early ischaemic change on acute CTPSI. These findings suggest that such physicians might utilise CTPSI to screen potential thrombolysis candidates.

Acute Disease↗
PubMedDate not supplied

Awareness of AIDS among school children in Haryana.

The study is aimed to assess the existing level of knowledge of school children of 9th and 10th classes about Acquired Immune Deficiency Syndrome (AIDS). Three high schools in an urban area and three in the villages of a district of North India were included in the study. A pretested closed-ended questionnaire was administered to 336 students available. Overall level of knowledge about AIDS was found to be high. However, there were significant differences in knowledge among rural-urban and male-female students. There were some misconceptions in knowledge regarding transmission, prognosis and prevention. Books and media were the most common sources of information. Most of the students wanted to learn more about AIDS. Since overall knowledge levels were high we conclude that AIDS education should concentrate on clarifying areas of misconceptions.

Acquired Immunodeficiency Syndrome↗
PubMed2002

Episodic and semantic knowledge in emotional self-report: evidence for two judgment processes.

Three studies involving 3 participant samples (Ns = 39, 55, and 53) tested the hypothesis that people retrieve episodic emotion knowledge when reporting on their emotions over short (e.g., last few hours) time frames, but that they retrieve semantic emotion knowledge when reporting on their emotions over long (e.g., last few months) time frames. Support for 2 distinct judgment strategies was based on judgment latencies (Studies 1 and 2) and priming paradigms (Studies 2 and 3). The authors suggest that self-reports of emotion over short versus long time frames assess qualitatively different sources of self-knowledge.

Adult↗
PubMed1991

The structure of expert diagnostic knowledge in occupational medicine.

Development of an artificial intelligence expert system for diagnosing occupational lung disease requires explicit specification of the structure of knowledge necessary in clinical occupational medicine independent of the process by which the knowledge is utilized. Furthermore, explicit recognition of sources of uncertainty is necessary. Seven categories of knowledge define the diagnostic knowledge base in occupational pulmonary medicine. These include four objects (jobs, industries, exposures, and diseases) and three relationships between pairs of objects. This analysis demonstrates some of the unique aspects of occupational medicine expertise.

Algorithms↗
PubMedDate not supplied

Occupational stress in a rural hospital.

A rural hospital served as the research setting for this study. Respondents completed occupational stress questionnaires which incorporated five sources of work-related stress factors. Specifically, knowledge, patient care, conflict, environmental, and managerial sources of stress were assessed. The results of an analysis of variance procedure indicated that certain forms of occupational stress were clearly more associated with certain departmental groupings within the hospital than others.

Hospital Bed Capacity, 100 to 299↗
PubMed2006

Knowledge about sepsis among training-grade doctors.

BACKGROUND: Prescribing of antibiotics, often in the empirical setting, frequently falls on training-grade or junior doctors, who are often the least experienced in this. Indeed, improving the knowledge base of training-grade doctors or senior medical students through education has been identified as one of the key measures to improve antibiotic prescribing behaviour. METHODOLOGY: We undertook two descriptive questionnaire- and interview-based surveys (1999 and 2003) of prescribing training-grade doctors in a teaching hospital in north-east Scotland to determine their knowledge level regarding various sepsis definitions, sources of local information used when prescribing an antimicrobial, and awareness of the cost difference between intravenous and oral antibiotics. A total of 55 junior doctors in a large teaching hospital participated in the survey in 1999 and 78 participated in 2003. INTERVENTIONS: Between the two audits, which were conducted 4 years apart, several initiatives were introduced to improve the education and support related to antibiotic prescription. RESULTS: There has been a significant improvement in doctors' knowledge regarding various sepsis definitions, whether the infection was hospital or community acquired, empirical choice, dose, route of administration and monitoring of the antibiotic, and options for drug hypersensitivity. More training-grade doctors (approximately 29%) used the desired locally derived sepsis protocol, which guides the prescriber through sepsis recognition. There was no significant improvement in the percentage of doctors who recognized that parenteral antimicrobials were more expensive (approximately 10-fold) than oral antimicrobials (63.7% in 1999, 64.2% in 2003). CONCLUSIONS: Overall, there was a significant improvement in doctors' understanding of sepsis and knowledge of the source of information that they utilized to select the antibiotic of choice, although the majority did not acknowledge the price difference between intravenous and oral forms of antibiotics.

Anti-Bacterial Agents↗
PubMed2005

Peopling of the Azores Islands (Portugal): data from the Y chromosome.

Nine Atlantic islands with approximately five and a half centuries of demographic history constitute the Portuguese archipelago of the Azores. Despite the recent peopling history of these islands, written records regarding the specific origin and relative proportions of the first settlers are scarce and incomplete. To gain insights into the history of the peopling of the Azores and to evaluate to what extent population imports described in historical sources left their marks on the genetic constitution of the present-day populations, we analyzed 11 Y-chromosome biallelic markers in a sample of 145 unrelated individuals of Azorean ancestry. The main results of this study indicate that the genetic profile of the Azorean male population shows high affinities with that of mainland Portugal, in accordance with the general knowledge, derived from historical sources, that the Portuguese were the major contributors to the Azorean founding population. Nevertheless, genetic traces of settlers from other origins also mentioned in historical records can still be found in the present-day population. Thus typically sub-Saharan male lineages were detected in the archipelago, in contrast to what has been described for mainland Portugal. Furthermore, compared to what has been described for the mainland Portugal population, our data support a stronger influence of people of Jewish origin, as detected by an increased frequency of lineages belonging to haplogroup J.

Azores↗
PubMed2006

Factors influencing consumer dietary health preventative behaviours.

BACKGROUND: The deterioration of the health status of the Romanian population during the economic transition from a centrally planned to a free market economy has been linked to lifestyles factors (e.g. diet) regarded as a main determinants of the disparity in life expectancy between Eastern and Western Europe. Reforms in the health care system in this transition economy aim to focus on preventive action. The purpose of this study was to identify the factors that impact on the individual decision to engage in Dietary Health Preventive Behaviour (DHPB) and investigate their influence in the context of an adapted health cognition model. METHODS: A population-based study recruited 485 adult respondents using random route sampling and face-to-face administered questionnaires. RESULTS AND DISCUSSION: Respondents' health motivation, beliefs that diet can prevent disease, knowledge about nutrition, level of education attainment and age have a positive influence on DHPB. Perceived barriers to healthy eating have a negative impact on alcohol moderation. The information acquisition behaviour (frequency of reading food labels) is negatively predicted by age and positively predicted by health motivation, education, self-reported knowledge about nutrition and household financial status. A significant segment of respondents believe they are not susceptible to the elicited diseases. Health promotion strategies should aim to change the judgments of health risk. CONCLUSION: The adaptation of the Health Belief Model and the Theory of Health Preventive Behaviour represents a valid framework of predicting DHPB. The negative sign of perceived threat of disease on DHPB may suggest that, under an income constraint, consumers tend to trade off long-term health benefits for short-term benefits. This cautions against the use of negative messages in public health campaigns. Raising the awareness of diet-disease relationships, knowledge about nutrition (particularly sources and risks associated with dietary fat and cholesterol) may induce people to adopt preventive dietary habits.

Adult↗
PubMed2004

Sensors network diagnosis in anaerobic digestion processes using evidence theory.

Instrumentation defines a sensors network on a process. Hardware sensors indeed allow one to get different information sources that can be often cross-checked to provide reliable data. However, each of these sources of information contains some uncertainties, either due to the hardware sensors' measurement principles, to their possible fouling, to the estimated parameters of the models used in software sensors and/or to the specific structures of the software sensors. This paper demonstrates that, in this context, the evidence theory is a very well suited formalism for fault detection and diagnosis. This theory indeed allows one to take into account the exact knowledge supported by each source of information and to combine them in order to detect the occurring faults. Moreover, this combination guarantees the best fault isolability from a practical point of view and is suitable for multiple faults occurring at the same time. Finally, the evidence theory is a highly modular formalism since new information sources can be very easily added and old ones can be removed. Validation is performed using real-life experiments from a 1 m3 anaerobic digestion fixed bed process used applied to the treatment of winery wastewaters.

Bacteria, Anaerobic↗
PubMed1994

Anxiety and perception of risk of HIV and hepatitis B infection among health-care workers reporting accidental exposures to blood and other body fluids.

We noticed considerable variation in anxiety among staff reporting blood exposure incidents and therefore undertook a study to investigate this. We studied 100 consecutive staff reporting blood or other body fluid exposures to the Occupational Health Unit. The nurse seeing the staff member administered a questionnaire about worries related to the incident, knowledge of HIV and hepatitis B transmission risks, perception of risk from the particular incident and predicted reaction of others that would be told. Level of anxiety was recorded on a visual analogue scale. Staff were then given information and counselling as usual, and asked to re-attend after a week, when the questionnaire was repeated. We found that the initial level of anxiety was not related to knowledge of HIV or hepatitis B transmission risks, but was related to perception of risk from the incident and to predicted reaction of others that would be told. The eight staff involved in exposures to known HIV-infected blood were not more anxious than the remainder. There was a reduction in anxiety between visits, which was significantly greater in women, in those who had a non-parental exposure and in those where the source patient was known. Knowledge of transmission risks also improved significantly between visits. This study underlines the importance of adequate counselling of staff who have suffered blood exposures.

Adult↗
PubMed1996

Acceptability of epidural analgesia for pain relief during labour among Kelantanese women.

Three hundred and five primigravid women were interviewed at term to assess the acceptability of epidural during labour, and reasons for the decisions. Data was collected on a prestructured proforma which consisted of background information, socio-economic status, knowledge about epidural analgesia, source of information and reasons for choice. Of the 305 patients only 17.3% were willing to receive epidural analgesia. This group consisted of 56.6% non-Malay women. Those employed in professional or skilled jobs (56.6%) also readily consented for epidural. Nearly half the women willing for epidural had received college (tertiary) education (43.3%) and more than a quarter (26.4%) were over 30 years of age. The majority of those who were unwilling had no prior knowledge about the procedure, and refused either out of fear, ignorance, resistance from husbands, on religious grounds or following poor feedback from friends. In order to advocate epidural analgesia, knowledge has to be targeted to the relatively less educated, unemployed women, mainly through the media or personally in the antenatal clinic by doctors and nurses. Services have to be improved as substandard analgesia may send out wrong messages and actually do more harm than good.

Adult↗
PubMed2004

Evidence based guidelines or collectively constructed "mindlines?" Ethnographic study of knowledge management in primary care.

OBJECTIVE: To explore in depth how primary care clinicians (general practitioners and practice nurses) derive their individual and collective healthcare decisions. DESIGN: Ethnographic study using standard methods (non-participant observation, semistructured interviews, and documentary review) over two years to collect data, which were analysed thematically. SETTING: Two general practices, one in the south of England and the other in the north of England. PARTICIPANTS: Nine doctors, three nurses, one phlebotomist, and associated medical staff in one practice provided the initial data; the emerging model was checked for transferability with general practitioners in the second practice. RESULTS: Clinicians rarely accessed and used explicit evidence from research or other sources directly, but relied on "mindlines"--collectively reinforced, internalised, tacit guidelines. These were informed by brief reading but mainly by their own and their colleagues' experience, their interactions with each other and with opinion leaders, patients, and pharmaceutical representatives, and other sources of largely tacit knowledge. Mediated by organisational demands and constraints, mindlines were iteratively negotiated with a variety of key actors, often through a range of informal interactions in fluid "communities of practice," resulting in socially constructed "knowledge in practice." CONCLUSIONS: These findings highlight the potential advantage of exploiting existing formal and informal networking as a key to conveying evidence to clinicians.

England↗
PubMed1996

Endoscopy of the normal stomach.

Diagnostic upper endoscopy is the best tool to obtain the most information regarding potential gastric abnormalities that may lead to clinical symptoms. Its usefulness is related to its application for appropriate indications by an experienced endoscopist. The endoscopist should not only be familiar with the appropriate techniques to allow for complete visualization of the stomach, but with the normal appearance of the different regions of the stomach. In addition, optimal performance of upper endoscopy requires a knowledge of the subtle variations from normal that do not require further investigation as a potential source of clinical symptoms. This knowledge is often as important to the patient as the ability to recognize obvious abnormalities.

Gastroscopy↗
PubMed2005

Phloem-localized, proton-coupled sucrose carrier ZmSUT1 mediates sucrose efflux under the control of the sucrose gradient and the proton motive force.

The phloem network is as essential for plants as the vascular system is for humans. This network, assembled by nucleus- and vacuole-free interconnected living cells, represents a long distance transport pathway for nutrients and information. According to the Münch hypothesis, osmolytes such as sucrose generate the hydrostatic pressure that drives nutrient and water flow between the source and the sink phloem (Münch, E. (1930) Die Stoffbewegungen in der Pflanze, Gustav Fischer, Jena, Germany). Although proton-coupled sucrose carriers have been localized to the sieve tube and the companion cell plasma membrane of both source and sink tissues, knowledge of the molecular representatives and the mechanism of the sucrose phloem efflux is still scant. We expressed ZmSUT1, a maize sucrose/proton symporter, in Xenopus oocytes and studied the transport characteristics of the carrier by electrophysiological methods. Using the patch clamp techniques in the giant inside-out patch mode, we altered the chemical and electrochemical gradient across the sucrose carrier and analyzed the currents generated by the proton flux. Thereby we could show that ZmSUT1 is capable of mediating both the sucrose uptake into the phloem in mature leaves (source) as well as the desorption of sugar from the phloem vessels into heterotrophic tissues (sink). As predicted from a perfect molecular machine, the ZmSUT1-mediated sucrose-coupled proton current was reversible and depended on the direction of the sucrose and pH gradient as well as the membrane potential across the transporter.

Animals↗
PubMed2002

Socio-economic determinants of knowledge and attitudes about tuberculosis among the general population of Metro Manila, Philippines.

SETTING: Five urban communities in Metro Manila with different socio-economic status. OBJECTIVE: To investigate general knowledge about tuberculosis (TB) and intended health-seeking behaviour for TB symptoms among the general population of Metro Manila, and how they are determined by socioeconomic factors. DESIGN AND METHOD: Subjects aged 18 years and over were interviewed in a cross-sectional survey. Data on TB knowledge and intended health-seeking behaviour were stratified by sex, age, educational background, occupation, average family income and place of residence. A TB knowledge score was constructed based on 10 selected questions. Multivariate analysis with standard logistic regression showed those factors that were independently correlated to understanding of the disease, and to attitudes in case of TB symptoms. The TB knowledge score was also analysed by TB information source. RESULTS: Completed surveys were obtained from 3970 subjects. They scored low in general knowledge about TB (3.64 +/- 1.67, range 0-10). A higher score was independently associated with college education (OR = 4.35, 95%CI 6.60-2.87, P < 0.0001). There was no significant difference in TB knowledge acquired through several sources. No intention of seeking health care and intention to self-treat in case of TB disease were significantly correlated to low family monthly income (OR = 7.10, 95%CI 8.25-6.11, P < 0.0001 and OR = 1.74, 95%CI 2.06-1.46, P < 0.0001, respectively). CONCLUSION: Socio-economic factors should be taken into account in the design of TB information campaigns and in prioritising public health interventions about TB.

Adolescent↗
PubMed2005

Nutritional supplement practices in UK junior national track and field athletes.

METHODS: The nutritional supplementation practices of 32 national track and field athletes competing at the 2004 World Junior Championships were studied using an anonymous questionnaire. Information was sought on the prevalence and type of supplement used, the reasons for use, knowledge of supplements, and sources of information. RESULTS: Use of supplements was widespread with 62% of respondents declaring supplement use. Prevalence in female athletes (75%) was higher than in males (55%) but was not statistically significant. No differences were found for age, training volume, or type of event. Seventeen different supplements were taken, with each athlete using an average of 2.4 products, multivitamins and minerals being the most popular. Reasons for using supplements were for health (45%), to enhance the immune system (40%), and to improve performance (25%). Of all respondents 48% believed they had an average knowledge of supplements, but three quarters felt that they required further information. Those not using supplements were more likely to think supplements were associated with health risks than those taking them (p = 0.03). Most athletes (72%) have access to a sports dietician but underutilise this resource. Coaches (65%) had the greatest influence on supplementation practices, with doctors (25%) and sports dieticians (30%) being less important. CONCLUSIONS: Supplementation practices were widespread among the population studied. The findings of this investigation could be used to enable the sports dietician and physician to identify common misconceptions held by adolescent athletes regarding nutritional supplements and to implement educational programs, which should include members of the non-medical support team.

Adolescent↗
PubMed2002

Teaching ethics to trainees.

Medical events contain many sources of uncertainty. Instruction in medical ethics gives trainees vital knowledge that assists them with some of the sources of uncertainty. Instruction to provide this knowledge is not available from the usual science curriculum. From an understanding of the principles of ethics flows an application of those principles to timely ethical issues. Ethics education has become a mandated feature in accredited residency training programs. A flexible curriculum in ethics can be developed for trainees in child neurology. The education program encourages thoughtful caregivers and teaches the methods for resolution of ethical issues and conflicts. Selection of topics is based on faculty and trainee interest and on situations of current relevance in the training program. Ethics education results in trainees who become capable of ethical reasoning and capable of resolving many of the clinical situations where issues arise that require decisions based on ethical principles.

Curriculum↗
PubMedDate not supplied

Asthma knowledge among adult asthmatic outpatients in a tertiary care hospital.

We conducted a prospective, cross sectional survey on 94 asthmatic subjects using an interviewer-administered questionnaire to audit the level of knowledge of adult asthmatic outpatients at a tertiary care hospital, in order to determine the sources of asthma information and variables associated with poor asthma knowledge. Of the 94 subjects, 39.4% were ignorant of the inflammatory nature of asthma while 56.4% did not understand the role of prednisolone in acute exacerbation of asthma. Only 17.0% reported having a written action plan. Lower educational level and older age were significantly associated with lower asthma knowledge scores. The doctor was the main source of asthma information. Asthma knowledge scores were significantly higher among those who named the doctor, pamphlets, newspapers, internet and books as a source of asthma information. Our study demonstrates that many asthmatics have poor understanding of some aspects of their disease and have no written asthma action plan.

Adolescent↗