Research on Knowledge Gap Recognition Mechanism of Virtual Industry Cluster

OpenAIRE

Lu Cheng

2013-01-01

As a new organizing form, VIC gets rid of regional limit of traditional cluster, realizing virtual space agglomeration which crossing space and time. Knowledge sharing and complementary is foundation to form VIC and be one of the main goals. As preparation of the knowledge transfer, recognizing and making up for knowledge gap did not caused most scholars' attention. This study argues that, knowledge gap recognition is the premise of knowledge transfer, combined with knowledge theories, the co...

Bridging the Gap in Knowledge Transfer between Academia and Practitioners

Science.gov (United States)

Gera, Rajat

2012-01-01

Purpose: The paper intends to identify the causes or gaps in transfer of managerial knowledge between academia and practitioners and to develop a framework that overcomes the gaps through knowledge management, information technology and human resource practices. The paper aims to suggest a strategic approach based on the knowledge transfer cycle.…

The biomedical disciplines and the structure of biomedical and clinical knowledge.

Science.gov (United States)

Nederbragt, H

2000-11-01

The relation between biomedical knowledge and clinical knowledge is discussed by comparing their respective structures. The knowledge of a disease as a biological phenomenon is constructed by the interaction of facts and theories from the main biomedical disciplines: epidemiology, diagnostics, clinical trial, therapy development and pathogenesis. Although these facts and theories are based on probabilities and extrapolations, the interaction provides a reliable and coherent structure, comparable to a Kuhnian paradigma. In the structure of clinical knowledge, i.e. knowledge of the patient with the disease, not only biomedical knowledge contributes to the structure but also economic and social relations, ethics and personal experience. However, the interaction between each of the participating "knowledges" in clinical knowledge is not based on mutual dependency and accumulation of different arguments from each, as in biomedical knowledge, but on competition and partial exclusion. Therefore, the structure of biomedical knowledge is different from that of clinical knowledge. This difference is used as the basis for a discussion in which the place of technology, evidence-based medicine and the gap between scientific and clinical knowledge are evaluated.

Understanding the Financial Knowledge Gap: A New Dimension of Inequality in Later Life.

Science.gov (United States)

Khan, Mohammad Nuruzzaman; Rothwell, David W; Cherney, Katrina; Sussman, Tamara

2017-01-01

To understand individuals' financial behaviors, it is important to understand the financial knowledge gap - the distance between one's objective and subjective financial knowledge. Overestimating one's financial knowledge can lead to risky financial behaviors. To date, limited empirical work has examined how financial knowledge gap varies across age groups. We analyze the size and nature of the financial knowledge gap and its variation across age groups. Using nationally representative data, we find robust evidence that older adults overestimate their financial knowledge. Social workers can assess the financial knowledge gap and educate their clients to protect from financial fraud, exploitation, and abuse.

Determinants of nurses' knowledge gap on pain management in Ghana.

Science.gov (United States)

Aziato, Lydia; Adejumo, Oluyinka

2014-03-01

There are concerns about adequacy of nurses' knowledge and skill in effective pain management since effective pain management promotes early recovery after surgery. This study explores factors that accounted for Ghanaian nurses' inadequate knowledge of postoperative pain management using a focused ethnographic design for data collection at a tertiary teaching hospital in Ghana. Fourteen nurses designated as key informants with different backgrounds as nurse educators and leaders were purposively sampled to participate. Data were collected through in-depth individual interviews; all interviews were conducted in English, audio-taped and transcribed verbatim. The study revealed that nurses' inadequate pain management knowledge might have resulted from curriculum gaps during training; inadequate clinical supervision, study days, and workshops for practising nurses; lack of funding for organising regular workshops; and, negative attitudes of nurses whereby new information learned at workshops was not readily applied in clinical practice. It was concluded that nursing curricula at all levels of training in Ghana should incorporate credit-bearing courses on pain management, and appropriate pain management education programmes should be instituted for practising nurses. Regular monitoring and evaluation of the impact of such education programs is required. Copyright © 2013 Elsevier Ltd. All rights reserved.

The knowledge and skills gap of medical practitioners delivering ...

African Journals Online (AJOL)

The knowledge and skills gap of medical practitioners delivering district hospital ... and quality health services, and also for guiding appropriate undergraduate, ... The uneven skill and knowledge base in aspects of HIV/AIDS management ...

Experimental Evidence of the Knowledge Gap: Message Arousal, Motivation, and Time Delay

Science.gov (United States)

Grabe, Maria Elizabeth; Yegiyan, Narine; Kamhawi, Rasha

2008-01-01

This study experimentally tested the knowledge gap from an information processing perspective. Specifically, knowledge acquisition was investigated under conditions of medium and low news message arousal, with time delay. Results show the persistence of a knowledge gap, particularly for low arousing messages. In fact, at low levels of message…

The gap in scientific knowledge and role of science communication in South Korea.

Science.gov (United States)

Chang, Jeong-Heon; Kim, Sei-Hill; Kang, Myung-Hyun; Shim, Jae Chul; Ma, Dong Hoon

2017-01-01

Using data from a national survey of South Koreans, this study explores the role of science communication in enhancing three different forms of scientific knowledge ( factual, procedural, and subjective). We first assess learning effects, looking at the extent to which citizens learn science from different channels of communication (interpersonal discussions, traditional newspapers, television, online newspapers, and social media). We then look into the knowledge gap hypothesis, investigating how different communication channels can either widen or narrow the gap in knowledge between social classes. Television was found to function as a "knowledge leveler," narrowing the gap between highly and less educated South Koreans. The role of online newspapers in science learning is pronounced in our research. Reading newspapers online indicated a positive relationship to all three measures of knowledge. Contrary to the knowledge-leveling effect of television viewing, reading online newspapers was found to increase, rather than decrease, the gap in knowledge. Implications of our findings are discussed in detail.

WhatsApp: A Real-Time Tool to Reduce the Knowledge Gap and Share the Best Clinical Practices in Psoriasis.

Science.gov (United States)

Mazzuoccolo, Luis D; Esposito, Maria Noel; Luna, Paula C; Seiref, Sharon; Dominguez, Mirtha; Echeverria, Cristina M

2018-06-20

Psoriasis is a chronic inflammatory disease that affects around 100 million people worldwide. The burden of disease is high, but more recent therapies show promising results. Clinicians need, however, more training in the use of such therapies. Project ECHO ® (Extension for Community Healthcare Outcomes) is structured around the promise of delivering medical education at a distance, empowering clinicians who operate in remote areas. The use of instant messaging services, such as WhatsApp ® Messenger, has the potential to improve on the existing framework and bridge the existing gap of knowledge. This article reports on a study concerning the implementation of a WhatsApp discussion group in Project ECHO Psoriasis in Argentina. One hundred thirty-two dermatologists in Argentina were invited to participate in the WhatsApp discussion group. After 1 year of participation, a follow-up questionnaire was used to assess the effectiveness of the project. Eighty dermatologists participated. All questions placed in the discussion were answered by a psoriasis specialist, 79% of which were answered within the first 5 min. Clinicians report significant improvement in diagnosis, comorbidities, and treatment with both conventional and biological therapies. Preliminary results are promising. This new cost-effective solution builds on the existing Project ECHO Psoriasis in Argentina and shows potential in bridging the gap of knowledge, promoting better clinical decisions through empowerment of medical doctors operating in remote locations. Further research is needed to increase generalization of the results. Moreover, it would be interesting to match the data from the discussion group with follow-up questionnaires.

Identification of knowledge gaps in neurosurgery using a validated self-assessment examination: differences between general and spinal neurosurgeons.

Science.gov (United States)

Sheehan, Jason; Starke, Robert M; Pouratian, Nader; Litvack, Zachary

2013-11-01

The practice of neurosurgery requires fundamental knowledge base. Residency training programs and continuing medical education courses are designed to teach relevant neurosurgical principles. Nevertheless, knowledge gaps exist for neurosurgeons and may be different between cohorts of neurosurgeons. The Self-Assessment in Neurological Surgery (SANS) General Examination and Spine Examination are online educational tools for lifelong learning and maintenance of certification. This study examines the gaps in knowledge of spinal neurosurgeons and general neurosurgeons taking SANS. From 2008 to 2010, a total of 165 spinal neurosurgeons completed the 243 available questions of the SANS Spine Examination. Over that same time frame, 993 general neurosurgeons completed the SANS General Spine Examination. Mean scores were calculated and assessed according to 18 major neurosurgical knowledge disciplines. Statistical analysis was carried out to evaluate for significant knowledge gaps among all users and significant differences in performance between spinal neurosurgeons and their general neurosurgeon counterparts. The mean overall examination score was 87.4% ± 7.5% for spinal neurosurgeons and 71.5% ± 8.9% for general neurosurgeons (P neurosurgeons (n = 165) answered questions incorrectly 15% or greater of the time in five of the categories. The categories of lower performance for spinal neurosurgeons were cerebrovascular, anesthesia and critical care, general clinical, tumor, and trauma. For general neurosurgeons (n = 993), the five knowledge categories with lowest performance were cerebrovascular, epilepsy, peripheral nerve, trauma, and radiosurgery. Although spinal neurosurgeons and general neurosurgeons shared some areas of decreased performance including trauma and cerebrovascular, spine neurosurgeons relatively underperformed in general clinical, anesthesia and critical care, and tumor. The SANS Spine Examination demonstrated knowledge gaps in specific categories for

The Data Gap in the EHR for Clinical Research Eligibility Screening.

Science.gov (United States)

Butler, Alex; Wei, Wei; Yuan, Chi; Kang, Tian; Si, Yuqi; Weng, Chunhua

2018-01-01

Much effort has been devoted to leverage EHR data for matching patients into clinical trials. However, EHRs may not contain all important data elements for clinical research eligibility screening. To better design research-friendly EHRs, an important step is to identify data elements frequently used for eligibility screening but not yet available in EHRs. This study fills this knowledge gap. Using the Alzheimer's disease domain as an example, we performed text mining on the eligibility criteria text in Clinicaltrials.gov to identify frequently used eligibility criteria concepts. We compared them to the EHR data elements of a cohort of Alzheimer's Disease patients to assess the data gap by usingthe OMOP Common Data Model to standardize the representations for both criteria concepts and EHR data elements. We identified the most common SNOMED CT concepts used in Alzheimer 's Disease trials, andfound 40% of common eligibility criteria concepts were not even defined in the concept space in the EHR dataset for a cohort of Alzheimer 'sDisease patients, indicating a significant data gap may impede EHR-based eligibility screening. The results of this study can be useful for designing targeted research data collection forms to help fill the data gap in the EHR.

Planetary Protection Knowledge Gaps for Human Extraterrestrial Missions: Workshop Report

Science.gov (United States)

Race, Margaret S. (Editor); Johnson, James E. (Editor); Spry, James A. (Editor); Siegel, Bette; Conley, Catharine A.

2015-01-01

This report on Planetary Protection Knowledge Gaps for Human Extraterrestrial Missions summarizes the presentations, deliberations and findings of a workshop at NASA Ames Research Center, March 24-26, 2015, which was attended by more than 100 participants representing a diverse mix of science, engineering, technology, and policy areas. The main objective of the three-day workshop was to identify specific knowledge gaps that need to be addressed to make incremental progress towards the development of NASA Procedural Requirements (NPRs) for Planetary Protection during human missions to Mars.

Bridging the gap: simulations meet knowledge bases

Science.gov (United States)

King, Gary W.; Morrison, Clayton T.; Westbrook, David L.; Cohen, Paul R.

2003-09-01

Tapir and Krill are declarative languages for specifying actions and agents, respectively, that can be executed in simulation. As such, they bridge the gap between strictly declarative knowledge bases and strictly executable code. Tapir and Krill components can be combined to produce models of activity which can answer questions about mechanisms and processes using conventional inference methods and simulation. Tapir was used in DARPA's Rapid Knowledge Formation (RKF) project to construct models of military tactics from the Army Field Manual FM3-90. These were then used to build Courses of Actions (COAs) which could be critiqued by declarative reasoning or via Monte Carlo simulation. Tapir and Krill can be read and written by non-knowledge engineers making it an excellent vehicle for Subject Matter Experts to build and critique knowledge bases.

Internet Use and the Political Knowledge Gap in Spain

Directory of Open Access Journals (Sweden)

Anduiza, Eva

2012-04-01

Full Text Available Media availability and fragmentation and the resulting possibilities of content selection have risen dramatically with the expansion of new digital media. Previous research has found that this may increase knowledge gaps among citizens with different resources and motivations. This article analyses how Internet use affects political knowledge gaps due to education and to political interest in Spain. As expected, frequent Internet users are more knowledgeable about politics than non-users. Furthermore, Internet use increases knowledge more for the highly educated than for citizens with lower levels of education. Thus, the political knowledge gap related to education seems to be growing with the introduction of new media. However, the knowledge gap between citizens with high and low levels of political interest is smaller for frequent Internet users than for non-users. These findings provide a complex picture and partially contradict the pessimistic theory about the impact of increasing media choice on political knowledge.

La disponibilidad y fragmentación de medios de comunicación y las posibilidades de elegir contenidos han aumentado en gran medida a raíz de la expansión de los medios digitales. Éstos pueden, según investigaciones anteriores, incrementar las diferencias en los niveles de conocimiento entre ciudadanos con distintas características. En este artículo se analiza cómo el uso de Internet afecta a las diferencias en el conocimiento político según el nivel educativo y el interés por la política en España. Los usuarios frecuentes de Internet saben más sobre política que los no usuarios, como era de esperar. Además, el uso de Internet incrementa el conocimiento político de manera más intensa para los usuarios con niveles educativos más elevados. Por tanto, parece que las diferencias en los niveles de conocimiento pueden estar creciendo con la expansión de los medios digitales. Sin embargo, las diferencias

Identifying Knowledge Gaps in Clinicians Who Evaluate and Treat Vocal Performing Artists in College Health Settings.

Science.gov (United States)

McKinnon-Howe, Leah; Dowdall, Jayme

2018-05-01

The goal of this study was to identify knowledge gaps in clinicians who evaluate and treat performing artists for illnesses and injuries that affect vocal function in college health settings. This pilot study utilized a web-based cross-sectional survey design incorporating common clinical scenarios to test knowledge of evaluation and management strategies in the vocal performing artist. A web-based survey was administered to a purposive sample of 28 clinicians to identify the approach utilized to evaluate and treat vocal performing artists in college health settings, and factors that might affect knowledge gaps and influence referral patterns to voice specialists. Twenty-eight clinicians were surveyed, with 36% of respondents incorrectly identifying appropriate vocal hygiene measures, 56% of respondents failing to identify symptoms of vocal fold hemorrhage, 84% failing to identify other indications for referral to a voice specialist, 96% of respondents acknowledging unfamiliarity with the Voice Handicap Index and the Singers Voice Handicap Index, and 68% acknowledging unfamiliarity with the Reflux Symptom Index. The data elucidated specific knowledge gaps in college health providers who are responsible for evaluating and treating common illnesses that affect vocal function, and triaging and referring students experiencing symptoms of potential vocal emergencies. Future work is needed to improve the standard of care for this population. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Education-based disparities in knowledge of novel health risks: The case of knowledge gaps in HIV risk perceptions.

Science.gov (United States)

Kiviniemi, Marc T; Orom, Heather; Waters, Erika A; McKillip, Megan; Hay, Jennifer L

2018-05-01

Risk perception is a key determinant of preventive health behaviour, but when asked, some individuals indicate they do not know their health risk. Low education is associated with both lack of knowledge about health risk and with the persistence and exacerbation of gaps in knowledge about health issues. This study uses the context of an emerging infectious disease threat to explore the hypothesis that the education-don't know risk relation results from differences in knowledge about the health issue of interest. Specifically, we examine whether patterns of change over time follow theoretical predictions that disparities in risk knowledge would increase over time in less educated sectors of the population (knowledge gap hypothesis). Secondary analysis of population-representative behavioural surveillance survey. We analysed data from the 1993 to 2000 Behavior Risk Factor Surveillance System surveys, which measured education and perceived HIV/AIDS risk in a population sample collected separately in each survey year; don't know responses were coded. In each year, individuals with higher education were less likely to respond don't know. The absolute prevalence of don't know responding dropped over time; nonetheless, there was an increase over time in the magnitude of the pattern of lower education being associated with greater don't know responding. We found support for the knowledge gap hypothesis. Over time, populations with greater education gained more knowledge about their HIV risk than populations with lower education. Results highlight the need to carefully consider health communication strategies to reach and address those individuals with low education and health knowledge. Statement of contribution What is already known on this subject? A meaningful potion of the population answers 'don't know' when asked to report their risk for health problems, indicating a lack of risk perception in the domain. Previous studies have shown that level of education is

Bridging Implementation, Knowledge, and Ambition Gaps to Eliminate Tuberculosis

Centers for Disease Control (CDC) Podcasts

2011-02-22

In this podcast, Dr. Kenneth Castro, director of CDC's Division of Tuberculosis Eliminatio,discusses bridging implementation, knowledge, and ambition gaps to eliminate tuberculosis.  Created: 2/22/2011 by National Center for Emerging Zoonotic and Infectious Diseases (NCEZID).   Date Released: 3/2/2011.

Closing the Knowledge Gap in Foreign Markets

DEFF Research Database (Denmark)

Lyles, Marjorie A.; Pedersen, Torben; Petersen, Bent

The study explores how firms close their knowledge gaps in relation to business environments of foreign markets. Potential determinants are derived from traditional internationalization process theory as well as more recent literature on organizational learning processes, including the concept...... of absorptive capacity. Building on these two literature streams a conceptual model is developed and tested on a set of primary data of Danish firms and their foreign market operations. The empirical study suggests that factors considered essential in traditional internationalization process theory...

Primary Health Care Providers' Knowledge Gaps on Parkinson's Disease

Science.gov (United States)

Thompson, Megan R.; Stone, Ramona F.; Ochs, V. Dan; Litvan, Irene

2013-01-01

In order to determine primary health care providers' (PCPs) knowledge gaps on Parkinson's disease, data were collected before and after a one-hour continuing medical education (CME) lecture on early Parkinson's disease recognition and treatment from a sample of 104 PCPs participating at an annual meeting. The main outcome measure was the…

Giving what one should: explanations for the knowledge-behavior gap for altruistic giving.

Science.gov (United States)

Blake, Peter R

2018-04-01

Several studies have shown that children struggle to give what they believe that they should: the so-called knowledge-behavior gap. Over a dozen recent Dictator Game studies find that, although young children believe that they should give half of a set of resources to a peer, they typically give less and often keep all of the resources for themselves. This article reviews recent evidence for five potential explanations for the gap and how children close it with age: self-regulation, social distance, theory of mind, moral knowledge and social learning. I conclude that self-regulation, social distance, and social learning show the most promising evidence for understanding the mechanisms that can close the gap. Copyright © 2017 Elsevier Ltd. All rights reserved.

Business travelers' risk perception of infectious diseases: where are the knowledge gaps, and how serious are they?

Science.gov (United States)

Wynberg, Elke; Toner, Sharyn; Wendt, Judy K; Visser, Leo G; Breederveld, Daan; Berg, Johannes

2013-01-01

Many studies have explored the risk perception of frequent business travelers (FBT) toward malaria. However, less is known about their knowledge of other infectious diseases. This study aimed to identify knowledge gaps by determining the risk perception of FBT toward 11 infectious diseases. Our retrospective web-based survey assessed the accuracy of risk perception among a defined cohort of FBT for 11 infectious diseases. We used logistic regression and the chi-square test to determine the association of risk perception with source of travel advice, demographic variables, and features of trip preparation. Surveys were returned by 63% of the 608 self-registered FBT in Rijswijk, and only the 328 completed questionnaires that adhered to our inclusion criteria were used for analysis. The majority (71%) sought pre-travel health advice and used a company health source (83%). Participants seeking company travel health advice instead of external had significantly more accurate risk knowledge (p = 0.03), but more frequently overestimated typhoid risk (odds ratio = 2.03; 95% confidence interval = 1.23-3.34). While underestimation of disease risk was on average 23% more common than overestimation, HIV risk was overestimated by 75% of FBT. More accurate knowledge among FBT seeking company health advice demonstrates that access to in-company travel clinics can improve risk perception. However, there is an obvious need for risk knowledge improvement, given the overall underestimation of risk. The substantial overestimation of HIV risk is probably due to both public and in-company awareness efforts. Conversely, typhoid risk overestimation was statistically associated with seeking company health advice, and therefore specifically reflects the high focus on typhoid fever within Shell's travel clinic. This study serves as a reminder that a knowledge gap toward infectious diseases besides malaria still exists. Our article will explore the future requirements for more

Mitigating the Mathematical Knowledge Gap between High School and First Year University Chemical Engineering Mathematics Course

Science.gov (United States)

Basitere, Moses; Ivala, Eunice

2015-01-01

This paper reports on a study carried out at a University of Technology, South Africa, aimed at identifying the existence of the mathematical knowledge gap and evaluating the intervention designed to bridge the knowledge gap amongst students studying first year mathematics at the Chemical Engineering Extended Curriculum Program (ECP). In this…

Scoping study for a one-health response to knowledge gaps in ...

International Development Research Centre (IDRC) Digital Library (Canada)

Scoping study for a one-health response to knowledge gaps in antimicrobial ... A recent World Bank report finds that drug-resistant infections have the ... Going to Scale : Sustainable Land Management in the Highlands of Eastern Africa.

Evidence-based decision-making 7: Knowledge translation.

Science.gov (United States)

Manns, Braden J

2015-01-01

There is a significant gap between what is known and what is implemented by key stakeholders in practice (the evidence to practice gap). The primary purpose of knowledge translation is to address this gap, bridging evidence to clinical practice. The knowledge to action cycle is one framework for knowledge translation that integrates policy-makers throughout the research cycle. The knowledge to action cycle begins with the identification of a problem (usually a gap in care provision). After identification of the problem, knowledge creation is undertaken, depicted at the center of the cycle as a funnel. Knowledge inquiry is at the wide end of the funnel, and moving down the funnel, the primary data is synthesized into knowledge products in the form of educational materials, guidelines, decision aids, or clinical pathways. The remaining components of the knowledge to action cycle refer to the action of applying the knowledge that has been created. This includes adapting knowledge to local context, assessing barriers to knowledge use, selecting, tailoring implementing interventions, monitoring knowledge use, evaluating outcomes, and sustaining knowledge use. Each of these steps is connected by bidirectional arrows and ideally involves healthcare decision-makers and key stakeholders at each transition.

Factors impacting on nurses' transference of theoretical knowledge of holistic care into clinical practice.

Science.gov (United States)

Henderson, Saras

2002-12-01

Since nurse education moved to universities, a reoccurring concern of health consumers, health administrators, and some practising nurses is that nurses are not able to transfer the theoretical knowledge of holistic care into practice. Much has been written about this concern usually under the heading of the theory-practice gap. A common reason that has been highlighted as the cause of this gap is that the theoretical knowledge that nurses learn in academia is predicated on concepts such as humanism and holistic caring. In contrast, the bureaucratic organisation where nurses provide care tends to be based on management concepts where cost containment and outcome measures are more acceptable. Hence nurses' learned values of holistic caring are pitted against the reality of the practice setting. So what is this practice reality? This paper attempts to provide an insider view of why the theoretical knowledge of holistic care may be difficult to enact in the clinical setting. In-depth taped interviews with nurses and participant observation were conducted in acute care hospitals in Western Australia. The interviews were transcribed verbatim and analysed using the constant comparative method. The findings indicated that utilitarian nursing and role models had impacted on the transference of theoretical knowledge of holistic care into practice. The paper outlines some measures that nurses themselves can undertake to ensure the narrowing of the theory-practice gap in this area.

Clinical outcome of increased flexion gap after total knee arthroplasty. Can controlled gap imbalance improve knee flexion?

Science.gov (United States)

Ismailidis, P; Kuster, M S; Jost, B; Giesinger, K; Behrend, H

2017-06-01

Increased range of motion (ROM) while maintaining joint stability is the goal of modern total knee arthroplasty (TKA). A biomechanical study has shown that small increases in flexion gap result in decreased tibiofemoral force beyond 90° flexion. The purpose of this paper was to investigate clinical implications of controlled increased flexion gap. Four hundred and four TKAs were allocated into one of two groups and analysed retrospectively. In the first group (n = 352), flexion gap exceeded extension gap by 2.5 mm, while in the second group (n = 52) flexion gap was equal to the extension gap. The procedures were performed from 2008 to 2012. The patients were reviewed 12 months postoperatively. Objective clinical results were assessed for ROM, mediolateral and sagittal stability. Patient-reported outcome measures were the WOMAC score and the Forgotten Joint Score (FJS-12). After categorizing postoperative flexion into three groups (poor < 90°, satisfactory 91°-119°, good ≥ 120°) significantly more patients in group 1 achieved satisfactory or good ROM (p = 0.006). Group 1 also showed a significantly higher mean FJS-12 (group 1: 73, group 2: 61, p = 0.02). The mean WOMAC score was 11 in the first and 14 in the second group (n.s.). Increase in flexion gap did not influence knee stability. The clinical relevance of this study is that a controlled flexion gap increase of 2.5 mm may have a positive effect on postoperative flexion and patient satisfaction after TKA. Neither knee stability in the coronal and sagittal planes nor complications were influenced by a controlled increase in flexion gap. III.

Analyzing the "CareGap": assessing gaps in adherence to clinical guidelines in adult soft tissue sarcoma.

Science.gov (United States)

Waks, Zeev; Goldbraich, Esther; Farkash, Ariel; Torresani, Michele; Bertulli, Rossella; Restifo, Nicola; Locatelli, Paolo; Casali, Paolo; Carmeli, Boaz

2013-01-01

Clinical decision support systems (CDSSs) are gaining popularity as tools that assist physicians in optimizing medical care. These systems typically comply with evidence-based medicine and are designed with input from domain experts. Nonetheless, deviations from CDSS recommendations are abundant across a broad spectrum of disorders, raising the question as to why this phenomenon exists. Here, we analyze this gap in adherence to a clinical guidelines-based CDSS by examining the physician treatment decisions for 1329 adult soft tissue sarcoma patients in northern Italy using patient-specific parameters. Dubbing this analysis "CareGap", we find that deviations correlate strongly with certain disease features such as local versus metastatic clinical presentation. We also notice that deviations from the guideline-based CDSS suggestions occur more frequently for patients with shorter survival time. Such observations can direct physicians' attention to distinct patient cohorts that are prone to higher deviation levels from clinical practice guidelines. This illustrates the value of CareGap analysis in assessing quality of care for subsets of patients within a larger pathology.

The 5As team intervention: bridging the knowledge gap in obesity management among primary care practitioners.

Science.gov (United States)

Ogunleye, Ayodele; Osunlana, Adedayo; Asselin, Jodie; Cave, Andrew; Sharma, Arya Mitra; Campbell-Scherer, Denise Lynn

2015-12-22

Despite opportunities for didactic education on obesity management, we still observe low rates of weight management visits in our primary care setting. This paper describes the co-creation by front-line interdisciplinary health care providers and researchers of the 5As Team intervention to improve obesity prevention and management in primary care. We describe the theoretical foundations, design, and core elements of the 5AsT intervention, and the process of eliciting practitioners' self-identified knowledge gaps to inform the curricula for the 5AsT intervention. Themes and topics were identified through facilitated group discussion and a curriculum relevant to this group of practitioners was developed and delivered in a series of 12 workshops. The research question and approach were co-created with the clinical leadership of the PCN; the PCN committed internal resources and a practice facilitator to the effort. Practice facilitation and learning collaboratives were used in the intervention For the content, front-line providers identified 43 topics, related to 13 themes around obesity assessment and management for which they felt the need for further education and training. These needs included: cultural identity and body image, emotional and mental health, motivation, setting goals, managing expectations, weight-bias, caregiver fatigue, clinic dynamics and team-based care, greater understanding of physiology and the use of a systematic framework for obesity assessment (the "4Ms" of obesity). The content of the 12 intervention sessions were designed based on these themes. There was a strong innovation values fit with the 5AsT intervention, and providers were more comfortable with obesity management following the intervention. The 5AsT intervention, including videos, resources and tools, has been compiled for use by clinical teams and is available online at http://www.obesitynetwork.ca/5As_Team . Primary care interdisciplinary practitioners perceive important

Tacit knowledge in dental clinical teaching.

Science.gov (United States)

Fugill, M

2012-02-01

The term 'tacit' is used to describe knowledge that is not necessarily understood in words. We frequently make use of such knowledge without conscious awareness that we are doing so. This article explores two different conceptions of tacit knowledge and considers their implications for the clinical teaching of dentistry. It recognises the communication barrier that clinical dependence on tacit knowledge creates between teacher and student. It identifies the ability to surface tacit clinical knowledge for the student as one of the most significant skills of the clinical teacher. Finally, the article examines the potential for conflict between the evidence-based practice paradigm, with its dependence on codified, explicit knowledge and the notion of clinical practice, which is at least partly experiential and tacit. © 2011 John Wiley & Sons A/S.

Knowledge gaps that hamper prevention and control of Mycobacterium avium subspecies paratuberculosis infection

DEFF Research Database (Denmark)

Barkema, H W; Orsel, K; Nielsen, S S

2018-01-01

In the last decades, many regional and country-wide control programmes for Johne's disease (JD) were developed due to associated economic losses, or because of a possible association with Crohn's disease. These control programmes were often not successful, partly because management protocols were...... programmes are typically evaluated in a limited number of herds and the duration of the study is less than 5 year, making it difficult to adequately assess the efficacy of control programmes. In this manuscript, we identify the most important gaps in knowledge hampering JD prevention and control programmes......, including vaccination and diagnostics. Secondly, we discuss directions that research should take to address those knowledge gaps....

Exploring Gaps in Concussion Knowledge and Knowledge Translation Among Coaches of Youth Female Hockey.

Science.gov (United States)

Guo, David; Verweel, Lee; Reed, Nick

2017-10-27

To better understand the level of concussion knowledge of youth female hockey coaches and to identify preferred methods of knowledge translation for this population. Cross-sectional survey. Participants independently completed written surveys before in-person concussion information sessions or online surveys through link provided in emails. Convenience sampling yielded 130 coaches of youth female hockey from Canada. Knowledge level on concussion, resources from which coaches obtained information on concussion, opinions on the current level of concussion knowledge, and knowledge translation. Coaches demonstrated adequate knowledge on concussion, achieving 84% correct on true-false questions and 92% correct on symptom identification accuracy. However, coaches showed limited awareness of concussion specific to mechanisms for injury (identification) and postconcussion symptoms. Internet resources were rated as the most used resources for concussion yet were not rated very helpful. Nonetheless, coaches indicated online courses and web sites as the most preferred method for concussion knowledge translation. Youth female hockey coaches have overall adequate knowledge of concussion; however, gaps in knowledge do exist. Future efforts to raise the concussion knowledge among coaches of female youth hockey should include information specific to the mechanism of injury, along with sign and symptom identification, with particular attention paid to emotional symptoms. Given the reported preferences and the widespread availability of the Internet, further exploration and research validation of online courses and web sites tailored to the youth female hockey community is encouraged.

Arizona Registered Dietitians Show Gaps in Knowledge of Bean Health Benefits

Science.gov (United States)

Thompson, Sharon V.; Dougherty, Mariah K.

2018-01-01

Registered Dietitians (RDs) promote nutrition practices and policies and can influence food consumption patterns to include nutrient dense foods such as beans. Although many evidence-based health benefits of bean consumption (e.g., cholesterol reduction, glycemic control) have been demonstrated, there is limited research on the knowledge, attitudes, and perceptions of RDs regarding the inclusion of beans in a healthy diet. To fill this existing research gap, this cross-sectional survey explored the perceptions, knowledge, and attitudes of 296 RDs in Arizona, USA, toward beans. The RDs largely held positive attitudes toward the healthfulness of beans and were aware of many health benefits. Some gaps in awareness were evident, including effect on cancer risk, intestinal health benefits, folate content, and application with celiac disease patients. RDs with greater personal bean consumption had significantly higher bean health benefit knowledge. Twenty-nine percent of the RDs did not know the meaning of ‘legume’, and over two-thirds could not define the term ‘pulse’. It is essential that RDs have up-to-date, evidence-based information regarding bean benefits to provide appropriate education to patients, clients, and the public. PMID:29316699

Arizona Registered Dietitians Show Gaps in Knowledge of Bean Health Benefits

Directory of Open Access Journals (Sweden)

Donna M. Winham

2018-01-01

Full Text Available Registered Dietitians (RDs promote nutrition practices and policies and can influence food consumption patterns to include nutrient dense foods such as beans. Although many evidence-based health benefits of bean consumption (e.g., cholesterol reduction, glycemic control have been demonstrated, there is limited research on the knowledge, attitudes, and perceptions of RDs regarding the inclusion of beans in a healthy diet. To fill this existing research gap, this cross-sectional survey explored the perceptions, knowledge, and attitudes of 296 RDs in Arizona, USA, toward beans. The RDs largely held positive attitudes toward the healthfulness of beans and were aware of many health benefits. Some gaps in awareness were evident, including effect on cancer risk, intestinal health benefits, folate content, and application with celiac disease patients. RDs with greater personal bean consumption had significantly higher bean health benefit knowledge. Twenty-nine percent of the RDs did not know the meaning of ‘legume’, and over two-thirds could not define the term ‘pulse’. It is essential that RDs have up-to-date, evidence-based information regarding bean benefits to provide appropriate education to patients, clients, and the public.

Selective media exposure and increasing knowledge gaps in Swiss referendum campaigns

NARCIS (Netherlands)

Hopmann, D.N.; Wonneberger, A.; Shehata, A.; Höijer, J.

2016-01-01

This study aims to contribute to the discussion on how the growing opportunities for media choice influence gaps in political knowledge among those motivated to consume news versus those who are not. With more television channels available, it becomes easier to choose content matching personal

Oncology knowledge gap among freshly passed interns in a Government Medical College of Eastern India.

Science.gov (United States)

Bandyopadhyay, Anis; Das, Anuradha; Ghosh, Ashok; Giri, Rajsekhar; Biswas, Nilay

2013-04-01

A survey was conducted among freshly passed undergraduate doctors of a medical college in Eastern India with the aim to investigate their exposure to oncology patients, their knowledge about various aspects of oncology patient management and their confidence in managing patients with cancer. One hundred and twelve newly passed interns of a Government Medical College in Kolkata were interviewed using semi-structured partly open ended and partly closed end questionnaire. The questionnaire dealt with the qualitative and quantitative aspects of knowledge and perception of the interns about the problem of cancer and its management. A total of 82 interns responded to the questionnaire, with a response rate of 73.2%. About 53% of the respondents have seen less than five patients during their undergraduate ward/clinical postings. Among the respondents, 71% felt they were confident in diagnosing cancer, and about 56% were confident in counseling of patient and their relatives about cancer. About 63% were aware about the role of surgery; however, only 32% and 37.5% were aware about the role of radiotherapy and chemotherapy, respectively. A dismal 12.5% were confident of care of terminal and late stage patients. Preparedness was correlated with exposure to patients with cancer (P = 0.03). Majority (87%) felt the need for incorporating oncology training at the undergraduate level and the most frequent method (67%) suggested for doing so was having separate posting in radiotherapy department/oncology wards. There is glaring knowledge gap among newly passed doctors and integrated oncology postings during undergraduate training and during internship may help seal this gap.

Knowledge, attitude and practice GAP in family planning usage: an analysis of selected cities of Uttar Pradesh.

Science.gov (United States)

Singh, Anjali; Singh, K K; Verma, Prashant

2016-01-01

The GAP between the knowledge of contraception and its actual practice is well recognized in the literature of family welfare studies. The present study assessed the relation between the level of knowledge and practice of contraception among the women and sought to explore the reasons behind the Knowledge, Attitude, and Practice - GAP (KAP GAP) regarding contraceptive users in six cities of Uttar Pradesh. Present analysis based on 17,643 currently married women aged 15 to 49. A Bivariate analysis ( χ 2 test) and a multivariable logistic regression were performed for the study. The highest percentages of respondents (women) were in the age group 35-49 (40-45 %) in all the districts considered. Knowledge of contraceptives was almost universal; tubal ligation and pill were the commonly known methods. Information about the contraceptive methods was mostly obtained through the husband. In the present study, there was a highly significant association ( p  GAP for all six cities. Health concern issues in all the districts were the most prominent reason for not using contraception. There differences in the socioeconomic and demographic factors exist, which lead to KAP GAP in the family planning (FP) usages. Therefore, in designing effective family planning programme, there is a need to understand the various factors which influence the practice of contraception.

MERS-CoV infection: Mind the public knowledge gap.

Science.gov (United States)

Bawazir, Amen; Al-Mazroo, Eman; Jradi, Hoda; Ahmed, Anwar; Badri, Motasim

In August 2015, the Corona outbreak caused by Middle East respiratory syndrome coronavirus (MERS-CoV) was the 9th episode since June 2012 in Saudi Arabia. Little is known about the public awareness toward the nature or prevention of the disease. The aim of this work was to assess the knowledge of the adult population in Riyadh toward the MERS-CoV. In this cross-sectional survey, a self-administrated questionnaire was distributed to randomly selected participants visiting malls in Riyadh. The questionnaire contained measurable epidemiological and clinical MERS-CoV knowledge level variables and relevant source of information. The study included 676 participants. Mean age was 32.5 (±SD 8.6) years and 353 (47.8%) were males. Almost all participants heard about the corona disease and causative agent. The study showed a fair overall knowledge (66.0%), less knowledge on epidemiological features of the disease (58.3%), and good knowledge (90.7%) on the clinical manifestation of the MERS-CoV. Internet was the major (89.0%) source of disease information, and other sources including health care providers, SMS, television, magazines and books were low rated (all knowledge. This study concludes that there was inadequate epidemiological knowledge received by the public and the reliance mostly on the clinical manifestations to recognizing the MERS-CoV disease. Comprehensive public health education programs is important to increase awareness of simple epidemiological determinants of the disease is warranted. Copyright © 2017. Published by Elsevier Ltd.

Knowledge Management Practices and Enablers in Public Universities: A Gap Analysis

Science.gov (United States)

Ramachandran, Sharimllah Devi; Chong, Siong-Choy; Wong, Kuan-Yew

2013-01-01

Purpose: The purpose of this paper is to examine the gap between knowledge management (KM) practices and key strategic enablers in public universities. For this purpose, a 57-item survey on two dimensions--"use" and "importance"--was used as the instrument for this study. Design/methodology/approach: The questionnaire was…

[Evidence and Evidence Gaps - an Introduction].

Science.gov (United States)

Dreier, G; Löhler, J

2016-04-01

Treating patients requires the inclusion of existing evidence in any health care decision, to be able to choose the best diagnosis or treatment measure or to make valid prognosis statements for a particular patient in consideration of the physician's own expertise.The basis are clinical trials, the results of which are ideally gathered in systematic reviews, rated, summarized and published. In addition to the GCP (Good Clinical Practice)-compliant planning, conducting and analysis of clinical studies it is essential, that all study results are made publicly available, in order to avoid publication bias. This includes the public registration of planned and discontinued trials. In the last 25 years, the evidence-based medicine (EbM) has increasingly found its way into clinical practice and research. Here EbM is closely associated with the names Archibald Cochrane and David Sackett. In Germany, both the German Cochrane Centre (DCZ) and the network of evidence-based medicine (DNEbM) were established approximately 15 years ago. In the international Cochrane Collaboration clinicians and other scientists like statisticians interdisciplinary work side by side to develop the methods of evidence-based medicine and to address the topics of evidence generation and processing as well as the transfer of knowledge. Challenge: Existing evidence primarily serves doctors to support their decision-making, but is also the basis for providing scientific proof for a health care intervention's benefit to patients and ultimately payers/health insurances. The closure of existing evidence gaps requires substantial human and financial resources, a complex organizational structure and can only succeed with the involvement of clinical and methodological expertise and specific knowledge in the field of clinical research. In addition, the knowledge must be transferred into practice, using journals, guidelines, conferences, databases, information portals with processed evidence and not least the

Beyond Knowledge Gaps: Examining Socioeconomic Differences in Response to Cancer News

Science.gov (United States)

Niederdeppe, Jeff

2008-01-01

This article tested a model, informed by the knowledge gap hypothesis, to predict information seeking about cancer immediately following news about the diagnosis or death from cancer of a national celebrity. I identified five celebrity news events and examined their impact using data from the 2005 Health Information National Trends Survey. News…

A New Clinical Pain Knowledge Test for Nurses: Development and Psychometric Evaluation.

Science.gov (United States)

Bernhofer, Esther I; St Marie, Barbara; Bena, James F

2017-08-01

All nurses care for patients with pain, and pain management knowledge and attitude surveys for nurses have been around since 1987. However, no validated knowledge test exists to measure postlicensure clinicians' knowledge of the core competencies of pain management in current complex patient populations. To develop and test the psychometric properties of an instrument designed to measure pain management knowledge of postlicensure nurses. Psychometric instrument validation. Four large Midwestern U.S. hospitals. Registered nurses employed full time and part time August 2015 to April 2016, aged M = 43.25 years; time as RN, M = 16.13 years. Prospective survey design using e-mail to invite nurses to take an electronic multiple choice pain knowledge test. Content validity of initial 36-item test "very good" (95.1% agreement). Completed tests that met analysis criteria, N = 747. Mean initial test score, 69.4% correct (range 27.8-97.2). After revision/removal of 13 unacceptable questions, mean test score was 50.4% correct (range 8.7-82.6). Initial test item percent difficulty range was 15.2%-98.1%; discrimination values range, 0.03-0.50; final test item percent difficulty range, 17.6%-91.1%, discrimination values range, -0.04 to 1.04. Split-half reliability final test was 0.66. A high decision consistency reliability was identified, with test cut-score of 75%. The final 23-item Clinical Pain Knowledge Test has acceptable discrimination, difficulty, decision consistency, reliability, and validity in the general clinical inpatient nurse population. This instrument will be useful in assessing pain management knowledge of clinical nurses to determine gaps in education, evaluate knowledge after pain management education, and measure research outcomes. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Cybernetics: A Possible Solution for the "Knowledge Gap" between "External" and "Internal" in Evaluation Processes

Science.gov (United States)

Levin-Rozalis, Miri

2010-01-01

This paper addresses the issue of the knowledge gap between evaluators and the entity being evaluated: the dilemma of the knowledge of professional evaluators vs. the in-depth knowledge of the evaluated subjects. In order to optimize evaluative outcomes, the author suggests an approach based on ideas borrowed from the science of cybernetics as a…

The Relationship between Immediate Relevant Basic Science Knowledge and Clinical Knowledge: Physiology Knowledge and Transthoracic Echocardiography Image Interpretation

Science.gov (United States)

Nielsen, Dorte Guldbrand; Gotzsche, Ole; Sonne, Ole; Eika, Berit

2012-01-01

Two major views on the relationship between basic science knowledge and clinical knowledge stand out; the Two-world view seeing basic science and clinical science as two separate knowledge bases and the encapsulated knowledge view stating that basic science knowledge plays an overt role being encapsulated in the clinical knowledge. However, resent…

Pre-Service Teachers' Knowledge, Misconceptions and Gaps about Autism Spectrum Disorder

Science.gov (United States)

Sanz-Cervera, Pilar; Fernández-Andrés, María-Inmaculada; Pastor-Cerezuela, Gemma; Tárraga-Mínguez, Raúl

2017-01-01

The inclusive education framework and the increase in autism diagnoses have led to an overwhelming challenge for pre-service teachers who need to be qualified to teach all children. To test the quality of their training, the main purpose of this study was to compare 866 pre-service teachers' knowledge, misconceptions, and gaps about autism in…

Major Care Gaps in Asthma, Sleep and Chronic Obstructive Pulmonary Disease: A Road Map for Knowledge Translation

Directory of Open Access Journals (Sweden)

Louis-Philippe Boulet

2013-01-01

Full Text Available Large gaps between best evidence-based care and actual clinical practice exist in respiratory medicine, and carry a significant health burden. The authors reviewed two key care gaps in each of asthma, chronic obstructive pulmonary disease and obstructive sleep apnea. Using the ‘Knowledge-to-Action Framework’, the nature of each gap, its magnitude, the barriers that cause and perpetuate it, and past and future strategies that might address the problem were considered. In asthma: disease control is ascertained inadequately, leading to a prevalence of poor asthma control of approximately 50%; and asthma action plans, a key component of asthma management, are provided by only 22% of physicians. In obstructive sleep apnea: disease is under-recognized, with sleep histories ascertained in only 10% of patients; and Canadian polysomnography wait times remain longer than recommended, leading to unnecessary morbidity and societal cost. In chronic obstructive pulmonary disease: a large proportion of patients seen in primary care remain undiagnosed, mainly due to underuse of spirometry; and <10% of patients are referred for pulmonary rehabilitation, despite strong evidence demonstrating its cost effectiveness. Given the prevalence of these chronic conditions and the size and nature of these gaps, the latter exact an important toll on patients, the health care system and society. In turn, complex barriers at the patient, provider and health care system levels contribute to each gap. There have been few previous attempts to bridge these gaps. Innovative and multifaceted implementation approaches are needed and have the potential to make a large impact on Canadian respiratory health.

An eHealth Approach to Reporting Allergic Reactions to Food and Closing the Knowledge Gap.

Science.gov (United States)

Munro, Christopher; Semic-Jusufagic, Aida; Pyrz, Katarzyna; Couch, Philip; Dunn-Galvin, Audrey; Peek, Niels; Themis, Marina; Mills, Clare; Buchan, Iain; Hourihane, Jonathan; Simpson, Angela

2015-01-01

There is an important knowledge gap in food allergy management in understanding the factors that determine allergic reactions to food, in gathering objective reports of reactions in real time, and in accessing patients' reaction-histories during consultations. We investigate how eHealth methods can close this knowledge gap. We report experiences with an online tool for reporting allergic reactions that we have developed as a web application. This application has been successfully validated by participants from Ireland and the UK, and is currently being used in a pilot where participants report allergic reactions in near-real time.

A review of higher education image and reputation literature: Knowledge gaps and a research agenda

Directory of Open Access Journals (Sweden)

Amaia Lafuente-Ruiz-de-Sabando

2018-01-01

Full Text Available Higher education institutions are investing increasing resources in order to achieve favourable perceptions among their stakeholders. However, image and reputation management is a complex issue and how stakeholders perceive universities does not always coincide with the image the latter wish to project. For this reason, in this article we address a review of the literature on higher education image and reputation to identify the main knowledge gaps and establish the research lines that merit deeper examination in the future. The gaps identified highlight the need to improve knowledge about the way perceptions (image and reputation of university institutions are shaped, pinpointing the dimensions or essential aspects that influence their formation and determining whether their degree of influence differs when considering the perspectives of different stakeholders or individuals from different geographical areas. Theoretical propositions related to the identified gaps have been set out.

Melanoma reporting to central cancer registries by US dermatologists: an analysis of the persistent knowledge and practice gap.

Science.gov (United States)

Cartee, Todd V; Kini, Seema P; Chen, Suephy C

2011-11-01

Every state requires diagnosing physicians to report new cases of melanoma to its central cancer registry. Previous regional studies and anecdotal experience suggest that few dermatologists are cognizant of this obligation. This oversight could result in a large number of unreported melanomas annually and, in turn, US melanoma statistics that markedly underestimate the true incidence of the disease. We sought to quantify the percentage of dermatologists who are unaware of melanoma reporting requirements (the knowledge gap) and who are not reporting melanoma diagnoses (the practice gap). We also sought to delineate factors predictive of reporting knowledge and behavior. A survey was administered to attendees of the Cutaneous Oncology Symposium at the 2010 American Academy of Dermatology annual meeting. In all, 104 of 419 eligible attendees completed surveys (response rate 26%). Fifty percent of respondents do not believe they are required to report melanomas and 56% do not actively report their diagnoses to a registry. Practice duration of less than 10 years was significantly associated with both a knowledge gap (P = .047) and practice gap (P = .056). Similarly, dermatologists who diagnosed fewer than 10 melanomas per year were more likely to possess a knowledge gap (P = .096) and a practice gap (P = .087) than those who diagnosed more than 10. Limitations include small sample size and low response rate. A majority of dermatologists are not reporting melanomas they diagnose to a cancer registry, and half of those surveyed were not aware that diagnosing physicians are required to report melanoma. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Excellence in clinical teaching: knowledge transformation and development required.

Science.gov (United States)

Irby, David M

2014-08-01

Clinical teachers in medicine face the daunting task of mastering the many domains of knowledge needed for practice and teaching. The breadth and complexity of this knowledge continue to increase, as does the difficulty of transforming the knowledge into concepts that are understandable to learners. Properly targeted faculty development has the potential to expedite the knowledge transformation process for clinical teachers. Based on my own research in clinical teaching and faculty development, as well as the work of others, I describe the unique forms of clinical teacher knowledge, the transformation of that knowledge for teaching purposes and implications for faculty development. The following forms of knowledge for clinical teaching in medicine need to be mastered and transformed: (i) knowledge of medicine and patients; (ii) knowledge of context; (iii) knowledge of pedagogy and learners, and (iv) knowledge integrated into teaching scripts. This knowledge is employed and conveyed through the parallel processes of clinical reasoning and clinical instructional reasoning. Faculty development can facilitate this knowledge transformation process by: (i) examining, deconstructing and practising new teaching scripts; (ii) focusing on foundational concepts; (iii) demonstrating knowledge-in-use, and (iv) creating a supportive organisational climate for clinical teaching. To become an excellent clinical teacher in medicine requires the transformation of multiple forms of knowledge for teaching purposes. These domains of knowledge allow clinical teachers to provide tailored instruction to learners at varying levels in the context of fast-paced and demanding clinical practice. Faculty development can facilitate this knowledge transformation process. © 2014 John Wiley & Sons Ltd.

From dental science to clinical practice: Knowledge translation and evidence-based dentistry principles

Directory of Open Access Journals (Sweden)

Kelvin I. Afrashtehfar

2017-07-01

Full Text Available It has been claimed that in order to decrease the gap between what we know and what we do, research findings must be translated from knowledge to action. Such practices better enable dentists to make evidence-based decisions instead of personal ideas and judgments. To this end, this literature review aims to revisit the concepts of knowledge translation and evidence-based dentistry (EBD and depict their role and influence within dental education. It addresses some possible strategies to facilitate knowledge translation (KT, encourage dental students to use EBD principles, and to encourage dental educators to create an environment in which students become self-directed learners. It concludes with a call to develop up-to-date and efficient online platforms that could grant dentists better access to EBD sources in order to more efficiently translate research evidence into the clinic.

From dental science to clinical practice: Knowledge translation and evidence-based dentistry principles.

Science.gov (United States)

Afrashtehfar, Kelvin I; Assery, Mansour K

2017-07-01

It has been claimed that in order to decrease the gap between what we know and what we do, research findings must be translated from knowledge to action. Such practices better enable dentists to make evidence-based decisions instead of personal ideas and judgments. To this end, this literature review aims to revisit the concepts of knowledge translation and evidence-based dentistry (EBD) and depict their role and influence within dental education. It addresses some possible strategies to facilitate knowledge translation (KT), encourage dental students to use EBD principles, and to encourage dental educators to create an environment in which students become self-directed learners. It concludes with a call to develop up-to-date and efficient online platforms that could grant dentists better access to EBD sources in order to more efficiently translate research evidence into the clinic.

Motivation and the Knowledge Gap: Effects of a Campaign to Reduce Diet-Related Cancer Risk.

Science.gov (United States)

Viswanath, K.; And Others

1993-01-01

Examines whether knowledge gaps decrease when motivation to acquire information is similar among more and less educated groups. Compares two groups with differing motivations to acquire cancer and diet information in a community that received a year-long health campaign. Finds evidence of education-based differences in knowledge even among members…

Mapping the global research landscape and knowledge gaps on multimorbidity: a bibliometric study.

Science.gov (United States)

Xu, Xiaolin; Mishra, Gita D; Jones, Mark

2017-06-01

To summarize global research trends and activities on multimorbidity; then to assess the knowledge gaps and to identify implications for knowledge exchange between high income countries (HICs) and low- and middle- income countries (LMICs). A comprehensive search was conducted to identify research publications on multimorbidity in the Web of Science TM , as well as diabetes, depression, hypertension, and Chronic Obstructive Pulmonary Disease (COPD). The time frame for the search was from 1900 to June, 2016. Information (such as publication date, subject category, author, country of origin, title, abstract, and keywords) were extracted and the full texts were obtained for the co-citation analysis. Data were linked with the life expectancy at birth (years) and Gross National Income (GNI). Co-citation and hierarchal clustering analysis was used to map the trends and research networks with CiteSpace II (JAVA freeware, copyright Chaomei Chen, http://cluster.cis.drexel.edu/~cchen/citespace/). We identified 2864 relevant publications as at June 2016, with the first paper on this topic indexed in 1974 from Germany, but 80% were published after 2010. Further analysis yielded two knowledge gaps: (1) compared with single conditions (diabetes, hypertension, depression, and COPD), there is a mismatch between the high prevalence of multimorbidity and its research outputs (ratio of articles on multimorbidity vs other four single conditions is 1:13-150); (2) although a total of 76 countries have contributed to this research area, only 5% of research originated from LMICs where 73% of non-communicable disease (NCD) related deaths had occurred. Additional analysis showed the median year of first publication occurred 15 years later in the LMICs compared with HICs (2010 vs 1995); and longer life expectancy was associated with exponentially higher publication outputs (Pearson correlation coefficient r  = 0.95) at the global level. The life expectancy at the median year (1994) of

The Longitudinal Study of Aging in Human Young Adults: Knowledge Gaps and Research Agenda.

Science.gov (United States)

Moffitt, Terrie E; Belsky, Daniel W; Danese, Andrea; Poulton, Richie; Caspi, Avshalom

2017-02-01

To prevent onset of age-related diseases and physical and cognitive decline, interventions to slow human aging and extend health span must eventually be applied to people while they are still young and healthy. Yet most human aging research examines older adults, many with chronic disease, and little is known about aging in healthy young humans. This article explains how this knowledge gap is a barrier to extending health span and puts forward the case that geroscience should invest in researching the pace of aging in young adults. As one illustrative example, we describe an initial effort to study the pace of aging in a young-adult birth cohort by using repeated waves of biomarkers collected across the third and fourth decades to quantify the pace of coordinated physiological deterioration across multiple organ systems (eg, pulmonary, periodontal, cardiovascular, renal, hepatic, metabolic, and immune function). Findings provided proof of principle that it is possible to quantify individual variation in the pace of aging in young adults still free of age-related diseases. This article articulates research needs to improve longitudinal measurement of the pace of aging in young people, to pinpoint factors that slow or speed the pace of aging, to compare pace of aging against genomic clocks, to explain slow-aging young adults, and to apply pace of aging in preventive clinical trials of antiaging therapies. This article puts forward a research agenda to fill the knowledge gap concerning lifelong causes of aging. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Research gaps identified during systematic reviews of clinical trials: glass-ionomer cements.

Science.gov (United States)

Mickenautsch, Steffen

2012-06-29

To report the results of an audit concerning research gaps in clinical trials that were accepted for appraisal in authored and published systematic reviews regarding the application of glass-ionomer cements (GIC) in dental practice Information concerning research gaps in trial precision was extracted, following a framework that included classification of the research gap reasons: 'imprecision of information (results)', 'biased information', 'inconsistency or unknown consistency' and 'not the right information', as well as research gap characterization using PICOS elements: population (P), intervention (I), comparison (C), outcomes (O) and setting (S). Internal trial validity assessment was based on the understanding that successful control for systematic error cannot be assured on the basis of inclusion of adequate methods alone, but also requires empirical evidence about whether such attempt was successful. A comprehensive and interconnected coverage of GIC-related clinical topics was established. The most common reasons found for gaps in trial precision were lack of sufficient trials and lack of sufficient large sample size. Only a few research gaps were ascribed to 'Lack of information' caused by focus on mainly surrogate trial outcomes. According to the chosen assessment criteria, a lack of adequate randomisation, allocation concealment and blinding/masking in trials covering all reviewed GIC topics was noted (selection- and detection/performance bias risk). Trial results appear to be less affected by loss-to-follow-up (attrition bias risk). This audit represents an adjunct of the systematic review articles it has covered. Its results do not change the systematic review's conclusions but highlight existing research gaps concerning the precision and internal validity of reviewed trials in detail. These gaps should be addressed in future GIC-related clinical research.

Cross-sectional study to examine evidence-based practice skills and behaviors of physical therapy graduates: is there a knowledge-to-practice gap?

Science.gov (United States)

Manns, Patricia J; Norton, Amy V; Darrah, Johanna

2015-04-01

Curricula changes in physical therapist education programs in Canada emphasize evidence-based practice skills, including literature retrieval and evaluation. Do graduates use these skills in practice? The aim of this study was to evaluate the use of research information in the clinical decision making of therapists with different years of experience and evidence-based practice preparation. Perceptions about evidence-based practice were explored qualitatively. A cross-sectional study with 4 graduating cohorts was conducted. Eighty physical therapists representing 4 different graduating cohorts participated in interviews focused on 2 clinical scenarios. Participants had varying years of clinical experience (range=1-15 years) and academic knowledge of evidence-based practice skills. Therapists discussed the effectiveness of interventions related to the scenarios and identified the sources of information used to reach decisions. Participants also answered general questions related to evidence-based practice knowledge. Recent graduates demonstrated better knowledge of evidence-based practice skills compared with therapists with 6 to 15 years of clinical experience. However, all groups used clinical experience most frequently as their source of information for clinical decisions. Research evidence was infrequently included in decision making. This study used a convenience sample of therapists who agreed to volunteer for the study. The results suggest a knowledge-to-practice gap; graduates are not using the new skills to inform their practice. Tailoring academic evidence-based activities more to the time constraints of clinical practice may help students to be more successful in applying evidence in practice. Academic programs need to do more to create and nurture environments in both academic and clinical settings to ensure students practice using evidence-based practice skills across settings. © 2015 American Physical Therapy Association.

Using Cyber-Insurance as a Risk Management Strategy: Knowledge Gaps and Recommendations for Further Research

OpenAIRE

Tøndel, Inger Anne; Meland, Per Håkon; Omerovic, Aida; Gjære, Erlend Andreas; Solhaug, Bjørnar

2015-01-01

- Risk transfer can be an economically favorable way of handling security and privacy issues, but choosing this option indiscriminately and without proper knowledge is a risk in itself. This report provides an overview of knowledge gaps related to cyber-insurance as a risk management strategy. These are grouped into three high-level topics; cyber-insurance products, understanding and measuring risk and estimation of consequences. The topics are further divided into 11 knowledge areas with ...

Research gaps identified during systematic reviews of clinical trials: glass-ionomer cements

Directory of Open Access Journals (Sweden)

Mickenautsch Steffen

2012-06-01

Full Text Available Abstract Background To report the results of an audit concerning research gaps in clinical trials that were accepted for appraisal in authored and published systematic reviews regarding the application of glass-ionomer cements (GIC in dental practice Methods Information concerning research gaps in trial precision was extracted, following a framework that included classification of the research gap reasons: ‘imprecision of information (results’, ‘biased information’, ‘inconsistency or unknown consistency’ and ‘not the right information’, as well as research gap characterization using PICOS elements: population (P, intervention (I, comparison (C, outcomes (O and setting (S. Internal trial validity assessment was based on the understanding that successful control for systematic error cannot be assured on the basis of inclusion of adequate methods alone, but also requires empirical evidence about whether such attempt was successful. Results A comprehensive and interconnected coverage of GIC-related clinical topics was established. The most common reasons found for gaps in trial precision were lack of sufficient trials and lack of sufficient large sample size. Only a few research gaps were ascribed to ‘Lack of information’ caused by focus on mainly surrogate trial outcomes. According to the chosen assessment criteria, a lack of adequate randomisation, allocation concealment and blinding/masking in trials covering all reviewed GIC topics was noted (selection- and detection/performance bias risk. Trial results appear to be less affected by loss-to-follow-up (attrition bias risk. Conclusion This audit represents an adjunct of the systematic review articles it has covered. Its results do not change the systematic review’s conclusions but highlight existing research gaps concerning the precision and internal validity of reviewed trials in detail. These gaps should be addressed in future GIC-related clinical research.

Crucial knowledge gaps in current understanding of climate change impacts on coral reef fishes

KAUST Repository

Wilson, S. K.; Adjeroud, M.; Bellwood, D. R.; Berumen, Michael L.; Booth, D.; Bozec, Y.-M.; Chabanet, P.; Cheal, A.; Cinner, J.; Depczynski, M.; Feary, D. A.; Gagliano, M.; Graham, N. A. J.; Halford, A. R.; Halpern, B. S.; Harborne, A. R.; Hoey, A. S.; Holbrook, S. J.; Jones, G. P.; Kulbiki, M.; Letourneur, Y.; De Loma, T. L.; McClanahan, T.; McCormick, M. I.; Meekan, M. G.; Mumby, P. J.; Munday, P. L.; Ohman, M. C.; Pratchett, M. S.; Riegl, B.; Sano, M.; Schmitt, R. J.; Syms, C.

2010-01-01

Expert opinion was canvassed to identify crucial knowledge gaps in current understanding of climate change impacts on coral reef fishes. Scientists that had published three or more papers on the effects of climate and environmental factors on reef

Results of the Lunar Exploration Analysis Group (LEAG) Gap Review: Specific Action Team (SAT), Examination of Strategic Knowledge Gaps (SKGs) for Human Exploration of the Moon

Science.gov (United States)

Shearer, C. K.; Eppler, D.; Farrell, W.; Gruener, J.; Lawrence, S.; Pellis, N.; Spudis, P. D.; Stopar, J.; Zeigler, R.; Neal, C;

Patient safety, quality of care, and knowledge translation in the intensive care unit.

Science.gov (United States)

Needham, Dale M

2010-07-01

A large gap exists between the completion of clinical research demonstrating the benefit of new treatment interventions and improved patient outcomes resulting from implementation of these interventions as part of routine clinical practice. This gap clearly affects patient safety and quality of care. Knowledge translation is important for addressing this gap, but evaluation of the most appropriate and effective knowledge translation methods is still ongoing. Through describing one model for knowledge translation and an example of its implementation, insights can be gained into systematic methods for advancing the implementation of evidence-based interventions to improve safety, quality, and patient outcomes.

RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 1: Evidence analysis and consensus process: collaborative path toward small animal CPR guidelines.

Science.gov (United States)

Boller, Manuel; Fletcher, Daniel J

2012-06-01

To describe the methodology used by the Reassessment Campaign on Veterinary Resuscitation (RECOVER) to evaluate the scientific evidence relevant to small animal CPR and to compose consensus-based clinical CPR guidelines for dogs and cats. This report is part of a series of 7 articles on the RECOVER evidence and knowledge gap analysis and consensus-based small animal CPR guidelines. It describes the organizational structure of RECOVER, the evaluation process employed, consisting of standardized literature searches, the analysis of relevant articles according to study design, species and predefined quality markers, and the drafting of clinical CPR guidelines based on these data. Therefore, this article serves as the methodology section for the subsequent 6 RECOVER articles. Academia, referral practice. RECOVER is a collaborative initiative that systematically evaluated the evidence on 74 topics relevant to small animal CPR and generated 101 clinical CPR guidelines from this analysis. All primary contributors were veterinary specialists, approximately evenly split between academic institutions and private referral practices. The evidence evaluation and guideline drafting processes were conducted according to a predefined sequence of steps designed to reduce bias and increase the repeatability of the findings, including multiple levels of review, culminating in a consensus process. Many knowledge gaps were identified that will allow prioritization of research efforts in veterinary CPR. Collaborative systematic evidence review is organizationally challenging but feasible and effective in veterinary medicine. More experience is needed to refine the process. © Veterinary Emergency and Critical Care Society 2012.

Clinical practitioners' knowledge of ionizing radiation doses in ...

African Journals Online (AJOL)

Questions on radiosensitivity of different organs, imaging modalities that use ionizing radiation and considerations for the choice of ionizing radiation (IR) based examinations were included. Participants were also asked for their preferred methods of filling any knowledge gap on IR issues. Responses were presented in ...

Knowledge Translation for Cardiovascular Disease Research and Management in Japan.

Science.gov (United States)

Shommu, Nusrat S; Turin, Tanvir C

2017-09-01

Knowledge translation is an essential and emerging arena in healthcare research. It is the process of aiding the application of research knowledge into clinical practice or policymaking. Individuals at all levels of the health care system, including patients, healthcare professionals, and policymakers, are affected by the gaps that exist between research evidence and practice; the process of knowledge translation plays a role in bridging these gaps and incorporating high-quality clinical research into decision-making. Cardiovascular disease (CVD) management is a crucial area of healthcare where information gaps are known to exist. Although Japan has one of the lowest risks and mortality rates from CVDs, an increasing trend of cardiovascular incidence and changes in the risk factor conditions have been observed in recent years. This article provides an overview of knowledge translation and its importance in the cardiovascular health of the Japanese population, and describes the key steps of a typical knowledge translation strategy.

Conceptual Model-based Systems Biology: mapping knowledge and discovering gaps in the mRNA transcription cycle.

Directory of Open Access Journals (Sweden)

Judith Somekh

2012-12-01

Full Text Available We propose a Conceptual Model-based Systems Biology framework for qualitative modeling, executing, and eliciting knowledge gaps in molecular biology systems. The framework is an adaptation of Object-Process Methodology (OPM, a graphical and textual executable modeling language. OPM enables concurrent representation of the system's structure-the objects that comprise the system, and behavior-how processes transform objects over time. Applying a top-down approach of recursively zooming into processes, we model a case in point-the mRNA transcription cycle. Starting with this high level cell function, we model increasingly detailed processes along with participating objects. Our modeling approach is capable of modeling molecular processes such as complex formation, localization and trafficking, molecular binding, enzymatic stimulation, and environmental intervention. At the lowest level, similar to the Gene Ontology, all biological processes boil down to three basic molecular functions: catalysis, binding/dissociation, and transporting. During modeling and execution of the mRNA transcription model, we discovered knowledge gaps, which we present and classify into various types. We also show how model execution enhances a coherent model construction. Identification and pinpointing knowledge gaps is an important feature of the framework, as it suggests where research should focus and whether conjectures about uncertain mechanisms fit into the already verified model.

Cognitive development, clinical knowledge, and clinical experience related to diagnostic ability.

Science.gov (United States)

Aquilino, M L

1997-01-01

To examine the relationship among cognitive development, clinical knowledge, and clinical experience in nursing students. A survey of junior and senior baccalaureate nursing students from three Midwestern colleges (N = 55). Students' diagnostic ability increased as they gained clinical experience and clinical knowledge. However, students failed to identify many nursing diagnoses and demonstrated only moderate levels of cognitive development. Nurse educators and nursing students need to change their approaches to teaching and learning to enhance students' diagnostic ability and cognitive development.

A MSFD complementary approach for the assessment of pressures, knowledge and data gaps in Southern European Seas: The PERSEUS experience

DEFF Research Database (Denmark)

Crise, A.; Kaberi, H.; Ruiz, José Luis Martinez

2015-01-01

PERSEUS project aims to identify the most relevant pressures exerted on the ecosystems of the Southern European Seas (SES), highlighting knowledge and data gaps that endanger the achievement of SES Good Environmental Status (GES) as mandated by the Marine Strategy Framework Directive (MSFD......). A complementary approach has been adopted, by a meta-analysis of existing literature on pressure/impact/knowledge gaps summarized in tables related to the MSFD descriptors, discriminating open waters from coastal areas. A comparative assessment of the Initial Assessments (IAs) for five SES countries has been also...... independently performed. The comparison between meta-analysis results and IAs shows similarities for coastal areas only. Major knowledge gaps have been detected for the biodiversity, marine food web, marine litter and underwater noise descriptors. The meta-analysis also allowed the identification of additional...

Knowledge Translation in Audiology

Science.gov (United States)

Kothari, Anita; Bagatto, Marlene P.; Seewald, Richard; Miller, Linda T.; Scollie, Susan D.

2011-01-01

The impetus for evidence-based practice (EBP) has grown out of widespread concern with the quality, effectiveness (including cost-effectiveness), and efficiency of medical care received by the public. Although initially focused on medicine, EBP principles have been adopted by many of the health care professions and are often represented in practice through the development and use of clinical practice guidelines (CPGs). Audiology has been working on incorporating EBP principles into its mandate for professional practice since the mid-1990s. Despite widespread efforts to implement EBP and guidelines into audiology practice, gaps still exist between the best evidence based on research and what is being done in clinical practice. A collaborative dynamic and iterative integrated knowledge translation (KT) framework rather than a researcher-driven hierarchical approach to EBP and the development of CPGs has been shown to reduce the knowledge-to-clinical action gaps. This article provides a brief overview of EBP and CPGs, including a discussion of the barriers to implementing CPGs into clinical practice. It then offers a discussion of how an integrated KT process combined with a community of practice (CoP) might facilitate the development and dissemination of evidence for clinical audiology practice. Finally, a project that uses the knowledge-to-action (KTA) framework for the development of outcome measures in pediatric audiology is introduced. PMID:22194314

Theory as metaphor: clinical knowledge and its communication.

Science.gov (United States)

Colman, Warren

2009-04-01

This paper investigates the relationship between clinical knowledge and psychological theory and considers the implications for clinical writing. I argue that clinical knowledge is a way of understanding rather than a body of facts and compare clinical material to 'texts' that generate multiple and indeterminate meanings. Analytic theories, which represent the crystallization of ways of understanding clinical phenomena, have an inherently metaphorical 'as if' quality since they are derived from and adapted to the clinical process of making meaning by representing psychic states in symbolic form. Thus good clinical writing demonstrates an integration of theory and clinical material into a unified network of symbolic meanings. Redfearn's paper, 'The captive, the treasure, the hero and the "anal" stage of development' (1979), is discussed as an exemplar of such integration. It is suggested that clinical knowledge is equivalent to the skill of making effective interpretations.

Practice Patterns of School-Based Occupational Therapists Targeting Handwriting: A Knowledge-to-Practice Gap

Science.gov (United States)

Cramm, Heidi; Egan, Mary

2015-01-01

Poor handwriting is a common reason for referral to school-based occupational therapy. A survey was used to explore the extent to which current practice patterns in Ontario, Canada, align with evidence on effective intervention for handwriting. Knowledge-to-practice gaps were identified related to focus on performance components versus…

What College Students Do Not Know: Where Are the Gaps in Sexual Health Knowledge?

Science.gov (United States)

Moore, Erin W.; Smith, William E.

2012-01-01

Objective: This study aimed to understand the gaps in college students' knowledge regarding sexual health information. Participants: A sample of 242 participants enrolled in an introductory college course participated in this study in the Fall 2009 semester. Methods: Students participated in 1 of 2 brief interventions and wrote a response paper…

Mind the gap in clinical trials: A participatory action analysis with citizen collaborators.

Science.gov (United States)

Price, Amy; Liew, Su May; Kirkpatrick, Jo; Price, Jazmin; Lopreto, Taylor; Nelken, Yasmin

2017-02-01

What are the strengths, gaps, expectations, and barriers to research engagement in clinical trials as communicated through social media? Clinical trials test treatments to provide reliable information for safety and effectiveness. Trials are building blocks in which what is learned in earlier research can be used to improve treatments, compare alternatives, and improve quality of life. For 20 years, the percentages of clinical trials volunteers have decreased whereas the costs of running clinical trials have multiplied. Participants enroll in trials to access latest treatments, to help others, and to advance science, but there is growing unrest. The priorities of those running the trials differ from those of the participants, and the roles for public research involvement lack clarity. Changes to bridge these gaps in the research culture are proposed through the use of participatory action research (PAR) in which stakeholders collaborate to improve research methodology, galvanize citizen participation, multiply health knowledge, problem-solve barriers to access, and explore the value of research volunteers as collaborators. PAR enabled the inclusion of citizens as full collaborators. Social media data were gathered for 120 days until saturation was reached. De-identified data were organized into a Strengths Weaknesses, Opportunities and Threats framework and coded into themes for analysis. After the analysis, the authors prioritized potential solutions for improving research engagement. Strengths and opportunities remained constant through trial phases, disease burdens, and interventions. Threats included alienation, litigation, disparity, and shaming. Poor management and barriers to inclusion were identified as weaknesses. Opportunities included improving resource management and information quality. Barriers were minimized when relationships between staff and participants were inclusive, respectful, tolerant, and open to change. Participants' communications

Major knowledge gaps and system barriers to guideline implementation among European physicians treating patients with atrial fibrillation: a European Society of Cardiology international educational needs assessment.

Science.gov (United States)

Heidbuchel, Hein; Dagres, Nikolaos; Antz, Matthias; Kuck, Karl-Heinz; Lazure, Patrice; Murray, Suzanne; Carrera, Céline; Hindricks, Gerhard; Vahanian, Alec

2018-03-12

Guideline-adherent treatment is associated with improved prognosis in atrial fibrillation (AF) patients but is insufficiently implemented in clinical practice. The European Society of Cardiology (ESC) performed a multinational educational needs assessment study among cardiologists, general practitioners/family physicians (GPs/FPs), and neurologists in order to evaluate knowledge and skills of physicians and system factors related to AF care delivery. A total of 561 physicians (294 cardiologists, 131 neurologists, and 136 GPs/FPs) from six European countries participated. This mixed-methods study included exploratory semi-structured qualitative interviews (n = 30) and a quantitative survey that included two clinical cases (n = 531). We identified eight key knowledge gaps and system barriers across all domains of AF care. A majority across all specialties reported skills needing improvement to classify AF pathophysiologically, rather than based on duration of episodes, and reported lack of availability of long-term electrocardiogram recording. Skills interpreting the CHA2DS2-VASc and the HAS-BLED scores were reported as needing improvement by the majority of neurologists (52% and 60%, respectively) and GPs/FPs (65% and 74%). Cardiologists calculated the CHA2DS2-VASc and HAS-BLED scores in 94%/70% in a presented case patient, but only 60%/49% of neurologists and 58%/42% of GPs/FPs did. There was much uncertainty on how to deal with anticoagulant therapy in complex patients. There was also a high disparity in using rate or rhythm control strategies, and indications for ablation. Information delivery to patients and communication between different specialties was often considered suboptimal, while national regulations and restrictions often hamper international guideline implementation. We identified major gaps in physicians' knowledge and skills across all domains of AF care, as well as system factors hampering guideline-compliant care implementation and

How writing records reduces clinical knowledge

DEFF Research Database (Denmark)

Buus, Niels

2009-01-01

drew on data from an extended fieldwork on two Danish "special observation" wards. The results indicated that the nurses' recording produced "stereotyping" representations of the patients and reduced the nurses' clinical knowledge but that this particular way of recording made good sense in relation......Through the practices of recording, psychiatric nurses produce clinical knowledge about the patients in their care. The objective of this study was to examine the conventionalized practices of recording among psychiatric nurses and the typical linguistic organization of their records. The study...

Evidence and evidence gaps - an introduction.

Science.gov (United States)

Dreier, Gabriele; Löhler, Jan

2016-01-01

Background: Medical treatment requires the implementation of existing evidence in the decision making process in order to be able to find the best possible diagnostic, therapeutic or prognostic measure for the individual patient based on the physician's own expertise. Clinical trials form the evidence base and ideally, their results are assembled, analyzed, summarized, and made available in systematic review articles. Beside planning, conducting, and evaluating clinical trials in conformity with GCP (good clinical practice), it is essential that all results of conducted studies are publicly available in order to avoid publication bias. This includes also the public registration of planned and cancelled trials. History: During the last 25 years, evidence-based medicine became increasingly important in medical care and research. It is closely associated with the names of Archibald Cochrane and David Sackett. About 15 years ago, the Deutsche Cochrane Zentrum (Cochrane Germany) and the Deutsche Netzwerk Evidenzbasierte Medizin e.V. (German Network for Evidence-based Medicine, DNEbM) were founded in Germany. In the International Cochrane Collaboration, clinicians and methodologists come together on an interdisciplinary level to further develop methods of evidence-based medicine and to discuss the topics of evidence generation and processing as well as knowledge transfer. Problem: Evidence is particularly important for physicians in the process of decision making, however, at the same time it is the base of a scientific proof of benefit for the patient and finally for the payers in health care. The closure of evidence gaps requires enormously high staff and financial resources, significant organizational efforts, and it is only successful when clinical and methodical expertise as well as specific knowledge in the field of clinical research are included. On the other hand, the knowledge has to be transferred into practice. For this purpose, practice guidelines, meetings

Stakeholder Meeting: Integrated Knowledge Translation Approach to Address the Caregiver Support Gap.

Science.gov (United States)

Holroyd-Leduc, Jayna M; McMillan, Jacqueline; Jette, Nathalie; Brémault-Phillips, Suzette C; Duggleby, Wendy; Hanson, Heather M; Parmar, Jasneet

2017-03-01

Family caregivers are an integral and increasingly overburdened part of the health care system. There is a gap between what research evidence shows is beneficial to caregivers and what is actually provided. Using an integrated knowledge translation approach, a stakeholder meeting was held among researchers, family caregivers, caregiver associations, clinicians, health care administrators, and policy makers. The objectives of the meeting were to review current research evidence and conduct multi-stakeholder dialogue on the potential gaps, facilitators, and barriers to the provision of caregiver supports. A two-day meeting was attended by 123 individuals. Three target populations of family caregivers were identified for discussion: caregivers of seniors with dementia, caregivers in end-of-life care, and caregivers of frail seniors with complex health needs. The results of this meeting can and are being used to inform the development of implementation research endeavours and policies targeted at providing evidence-informed caregiver supports.

Towards a Consensus View on Understanding Nanomaterials Hazards and Managing Exposure: Knowledge Gaps and Recommendations

Science.gov (United States)

Hunt, Geoffrey; Lynch, Iseult; Cassee, Flemming; Handy, Richard D.; Fernandes, Teresa F.; Berges, Markus; Kuhlbusch, Thomas A. J.; Dusinska, Maria; Riediker, Michael

2013-01-01

The aim of this article is to present an overview of salient issues of exposure, characterisation and hazard assessment of nanomaterials as they emerged from the consensus-building of experts undertaken within the four year European Commission coordination project NanoImpactNet. The approach adopted is to consolidate and condense the findings and problem-identification in such a way as to identify knowledge-gaps and generate a set of interim recommendations of use to industry, regulators, research bodies and funders. The categories of recommendation arising from the consensual view address: significant gaps in vital factual knowledge of exposure, characterisation and hazards; the development, dissemination and standardisation of appropriate laboratory protocols; address a wide range of technical issues in establishing an adequate risk assessment platform; the more efficient and coordinated gathering of basic data; greater inter-organisational cooperation; regulatory harmonization; the wider use of the life-cycle approaches; and the wider involvement of all stakeholders in the discussion and solution-finding efforts for nanosafety. PMID:28809359

Closing the Knowledge Gap on Effective Professional Development

Science.gov (United States)

Guskey, Thomas R.

2009-01-01

Achievement gaps concern educators at all levels today. Educators recognize the threats these gaps pose to education quality and equity, and they are working hard to close them--but an equally threatening gap in education with consequences just as serious is largely ignored. It influences every educational-improvement effort and seriously…

Hazard Characterization of Modified Vaccinia Virus Ankara Vector: What Are the Knowledge Gaps?

Directory of Open Access Journals (Sweden)

Malachy I. Okeke

2017-10-01

Full Text Available Modified vaccinia virus Ankara (MVA is the vector of choice for human and veterinary applications due to its strong safety profile and immunogenicity in vivo. The use of MVA and MVA-vectored vaccines against human and animal diseases must comply with regulatory requirements as they pertain to environmental risk assessment, particularly the characterization of potential adverse effects to humans, animals and the environment. MVA and recombinant MVA are widely believed to pose low or negligible risk to ecosystem health. However, key aspects of MVA biology require further research in order to provide data needed to evaluate the potential risks that may occur due to the use of MVA and MVA-vectored vaccines. The purpose of this paper is to identify knowledge gaps in the biology of MVA and recombinant MVA that are of relevance to its hazard characterization and discuss ongoing and future experiments aimed at providing data necessary to fill in the knowledge gaps. In addition, we presented arguments for the inclusion of uncertainty analysis and experimental investigation of verifiable worst-case scenarios in the environmental risk assessment of MVA and recombinant MVA. These will contribute to improved risk assessment of MVA and recombinant MVA vaccines.

Gaps in Science Content Knowledge Encountered during Teaching Practice: A Study of Early-Career Middle-School Science Teachers

Science.gov (United States)

Kinghorn, Brian Edward

2013-01-01

Subject-specific content knowledge is crucial for effective science teaching, yet many teachers are entering the field not fully equipped with all the science content knowledge they need to effectively teach the subject. Learning from practice is one approach to bridging the gap between what practicing teachers know and what they need to know.…

Robustness of risk maps and survey networks to knowledge gaps about a new invasive pest

Science.gov (United States)

Denys Yemshanov; Frank H. Koch; Yakov Ben-Haim; William D. Smith

2010-01-01

In pest risk assessment it is frequently necessary to make management decisions regarding emerging threats under severe uncertainty. Although risk maps provide useful decision support for invasive alien species, they rarely address knowledge gaps associated with the underlying risk model or how they may change the risk estimates. Failure to recognize uncertainty leads...

Applying Advanced Analytical Approaches to Characterize the Impact of Specific Clinical Gaps and Profiles on the Management of Rheumatoid Arthritis.

Science.gov (United States)

Ruiz-Cordell, Karyn D; Joubin, Kathy; Haimowitz, Steven

2016-01-01

The goal of this study was to add a predictive modeling approach to the meta-analysis of continuing medical education curricula to determine whether this technique can be used to better understand clinical decision making. Using the education of rheumatologists on rheumatoid arthritis management as a model, this study demonstrates how the combined methodology has the ability to not only characterize learning gaps but also identify those proficiency areas that have the greatest impact on clinical behavior. The meta-analysis included seven curricula with 25 activities. Learners who identified as rheumatologists were evaluated across multiple learning domains, using a uniform methodology to characterize learning gains and gaps. A performance composite variable (called the treatment individualization and optimization score) was then established as a target upon which predictive analytics were conducted. Significant predictors of the target included items related to the knowledge of rheumatologists and confidence concerning 1) treatment guidelines and 2) tests that measure disease activity. In addition, a striking demographic predictor related to geographic practice setting was also identified. The results demonstrate the power of advanced analytics to identify key predictors that influence clinical behaviors. Furthermore, the ability to provide an expected magnitude of change if these predictors are addressed has the potential to substantially refine educational priorities to those drivers that, if targeted, will most effectively overcome clinical barriers and lead to the greatest success in achieving treatment goals.

A brief simulation intervention increasing basic science and clinical knowledge

Directory of Open Access Journals (Sweden)

Maria L. Sheakley

2016-04-01

Full Text Available Background: The United States Medical Licensing Examination (USMLE is increasing clinical content on the Step 1 exam; thus, inclusion of clinical applications within the basic science curriculum is crucial. Including simulation activities during basic science years bridges the knowledge gap between basic science content and clinical application. Purpose: To evaluate the effects of a one-off, 1-hour cardiovascular simulation intervention on a summative assessment after adjusting for relevant demographic and academic predictors. Methods: This study was a non-randomized study using historical controls to evaluate curricular change. The control group received lecture (n l=515 and the intervention group received lecture plus a simulation exercise (nl+s=1,066. Assessment included summative exam questions (n=4 that were scored as pass/fail (≥75%. USMLE-style assessment questions were identical for both cohorts. Descriptive statistics for variables are presented and odds of passage calculated using logistic regression. Results: Undergraduate grade point ratio, MCAT-BS, MCAT-PS, age, attendance at an academic review program, and gender were significant predictors of summative exam passage. Students receiving the intervention were significantly more likely to pass the summative exam than students receiving lecture only (P=0.0003. Discussion: Simulation plus lecture increases short-term understanding as tested by a written exam. A longitudinal study is needed to assess the effect of a brief simulation intervention on long-term retention of clinical concepts in a basic science curriculum.

Mind the gap! A comparison of oral health knowledge between dental, healthcare professionals and the public.

Science.gov (United States)

Richards, W; Filipponi, T; Roberts-Burt, V

2014-02-01

The importance of consistent, accurate and unambiguous messages are well documented in oral health promotion literature. Whether the reality of delivering messages in the field fulfils these principle is questionable. This paper explores the perceptions of dental professionals, healthcare professionals and lay community members with regard to key oral health messages in order to highlight any inconsistencies and knowledge gaps between and within groups for disease risk factors. A questionnaire was administered to individuals who belonged to three groups: dental professionals, healthcare professionals and lay community members. The questionnaire established knowledge regarding risk factors for caries, periodontal disease and erosion. Thirty-five (57.4%) of the dental group answered the whole questionnaire correctly, with 22 (27.8%) and 9 (5.1%) of the healthcare and lay community group answering the whole questionnaire correctly, respectively. The question of fluoride levels in children's toothpaste was the main reason for incorrect answers in the dental group. The results of this survey demonstrate a knowledge gradient from dental professionals through to healthcare professionals and then to lay members of the community. The knowledge base observed in the dental group is reflected in the other two groups as would be expected albeit with a significant gap between each group. As expected the dental professionals are generally well informed, but not as well informed as could be expected.

Knowledge and skills of cancer clinical trials nurses in Australia.

Science.gov (United States)

Scott, Kathleen; White, Kate; Johnson, Catherine; Roydhouse, Jessica K

2012-05-01

  This paper is a report of the development and testing of a questionnaire measuring knowledge and skills of cancer clinical trials nurse in Australia.   The role of cancer clinical trials nurse, widely acknowledged as an integral member of the clinical research team, has evolved in recent years. Elements of the clinical trials nurse role in cancer have previously been described. To evaluate specific cancer clinical trials nurse educational and training needs, the development of a valid and reliable tool is required.   In 2009, a study was conducted in three stages. Stage I: questionnaire development and pilot testing; stage II: focus group; stage III: national survey. Internal consistency reliability testing and multi-trait analysis of item convergent/divergent validity were employed. Regression analysis was used to identify predictors of clinical trials nurse knowledge and skills.   The national survey was a 48-item questionnaire, measuring six clinical trial knowledge and seven skills sub-scales. Of 61 respondents, 90% were women, with mean age 43 years, 19 years as a Registered Nurse and 5 years as a cancer clinical trials nurse. Self-reported knowledge and skills were satisfactory to good. Internal consistency reliability was high (Cronbach's alpha: knowledge = 0·98; skills = 0·90). Criteria for item convergent/divergent validity were met. Number of years as cancer clinical trials nurse was positively related to self-reported knowledge and skills.   Preliminary data suggest that the national survey is reliable and valid. Data have contributed to better understanding the knowledge and skills of cancer clinical trials nurse in Australia and development of a postgraduate course in clinical trials. © 2011 Blackwell Publishing Ltd.

Knowledge Gaps Impacting the Development of Bovine Viral Diarrhea Virus Control Programs in the United States

Science.gov (United States)

This paper identifies knowledge gaps that impact on the design of programs to control and or eradicate bovine viral diarrhea viruses (BVDV) in the United States. Currently there are several voluntary regional BVDV control programs in place. These control programs are aimed at the removal of animals ...

Use of e-learning in clinical clerkships: effects on acquisition of dermatological knowledge and learning processes

Science.gov (United States)

Martens, Herm; Nagtzaam, Ivo; Heeneman, Sylvia

2018-01-01

Objectives To obtain a deeper understanding of how the e-learning program, Education in Dermatology (ED), affects the acquisition of dermatological knowledge and the underlying learning processes of medical students in their clinical phase. Methods The study used a mixed method design with a convergent parallel collection of data. Medical students (n=62) from Maastricht University (The Netherlands) were randomized to either a conventional teaching group (control group n=30) or conventional teaching plus the e-learning program (application on smartphone) group (e-learning group n=32). Pre- and post-intervention knowledge test results were analysed using an independent t-test. Individual semi-structured interviews (n=9) were conducted and verbatim-transcribed recordings were analysed using King’s template analysis. Results The e-learning program positively influenced students’ level of knowledge and their process of learning. A significant difference was found in the post-test scores for the control group (M=51.4, SD=6.43) and the e-learning group (M=73.09, SD=5.12); t(60)=-14.75, pe-learning program stimulated students’ learning as the application promoted the identification and recognition of skin disorders, the use of references, creation of documents and sharing information with colleagues. Conclusions This study demonstrated that use of the e-learning program led to a significant improvement in basic dermatological knowledge. The underlying learning processes indicated that e-learning programs in dermatology filled a vital gap in the understanding of clinical reasoning in dermatology. These results might be useful when developing (clinical) teaching formats with a special focus on visual disciplines.  PMID:29352748

Use of e-learning in clinical clerkships: effects on acquisition of dermatological knowledge and learning processes.

Science.gov (United States)

Fransen, Frederike; Martens, Herm; Nagtzaam, Ivo; Heeneman, Sylvia

2018-01-17

To obtain a deeper understanding of how the e-learning program, Education in Dermatology (ED), affects the acquisition of dermatological knowledge and the underlying learning processes of medical students in their clinical phase. The study used a mixed method design with a convergent parallel collection of data. Medical students (n=62) from Maastricht University (The Netherlands) were randomized to either a conventional teaching group (control group n=30) or conventional teaching plus the e-learning program (application on smartphone) group (e-learning group n=32). Pre- and post-intervention knowledge test results were analysed using an independent t-test. Individual semi-structured interviews (n=9) were conducted and verbatim-transcribed recordings were analysed using King's template analysis. The e-learning program positively influenced students' level of knowledge and their process of learning. A significant difference was found in the post-test scores for the control group (M=51.4, SD=6.43) and the e-learning group (M=73.09, SD=5.12); t(60)=-14.75, pe-learning program stimulated students' learning as the application promoted the identification and recognition of skin disorders, the use of references, creation of documents and sharing information with colleagues. This study demonstrated that use of the e-learning program led to a significant improvement in basic dermatological knowledge. The underlying learning processes indicated that e-learning programs in dermatology filled a vital gap in the understanding of clinical reasoning in dermatology. These results might be useful when developing (clinical) teaching formats with a special focus on visual disciplines.

Assessment of hospital pharmacists' clinical knowledge and ...

African Journals Online (AJOL)

reproduction in any medium, provided the original work is properly credited. ... drug use, which improves the quality of life. ... balance of clinical knowledge, practical skills, ... Ethical approval ... plans, clinical decision making, and finding the.

WHO Mental Health Gap Action Programme (mhGAP) Intervention Guide: a systematic review of evidence from low and middle-income countries.

Science.gov (United States)

Keynejad, Roxanne C; Dua, Tarun; Barbui, Corrado; Thornicroft, Graham

2018-02-01

Despite mental, neurological and substance use (MNS) disorders being highly prevalent, there is a worldwide gap between service need and provision. WHO launched its Mental Health Gap Action Programme (mhGAP) in 2008, and the Intervention Guide (mhGAP-IG) in 2010. mhGAP-IG provides evidence-based guidance and tools for assessment and integrated management of priority MNS disorders in low and middle-income countries (LMICs), using clinical decision-making protocols. It targets a non-specialised primary healthcare audience, but has also been used by ministries, non-governmental organisations and academics, for mental health service scale-up in 90 countries. This review aimed to identify evidence to date for mhGAP-IG implementation in LMICs. We searched MEDLINE, Embase, PsycINFO, Web of Knowledge/Web of Science, Scopus, CINAHL, LILACS, SciELO/Web of Science, Cochrane, Pubmed databases and Google Scholar for studies reporting evidence, experience or evaluation of mhGAP-IG in LMICs, in any language. Data were extracted from included papers, but heterogeneity prevented meta-analysis. We conducted a systematic review of evidence to date, of mhGAP-IG implementation and evaluation in LMICs. Thirty-three included studies reported 15 training courses, 9 clinical implementations, 3 country contextualisations, 3 economic models, 2 uses as control interventions and 1 use to develop a rating scale. Our review identified the importance of detailed reports of contextual challenges in the field, alongside detailed protocols, qualitative studies and randomised controlled trials. The mhGAP-IG literature is substantial, relative to other published evaluations of clinical practice guidelines: an important contribution to a neglected field. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Bridging the Measurement Gap Between Research and Clinical Care in Schizophrenia

DEFF Research Database (Denmark)

Østergaard, Søren D; Opler, Mark G A; Correll, Christoph U

2017-01-01

studies suggest that the much briefer PANSS-6 is a psychometrically valid measure of core positive and negative symptoms of schizophrenia and that the scale is sensitive to symptom improvement following pharmacological treatment. SNAPSI is a brief interview that yields the information needed to rate PANSS......There is currently a "measurement gap" between research and clinical care in schizophrenia. The main reason behind this gap is that the most widely used rating scale in schizophrenia research, the 30-item Positive and Negative Syndrome Scale (PANSS), takes so long to administer that it is rarely......-item PANSS in clinical practice; 2) how the brief, six-item version of the Positive and Negative Syndrome Scale (PANSS-6) was derived empirically from the full 30-item PANSS and what the initial results obtained with PANSS-6 entail; and 3) how PANSS-6 ratings, guided by the newly developed, 15...

Assessing Antiretroviral Use During Gaps in HIV Primary Care Using Multisite Medicaid Claims and Clinical Data.

Science.gov (United States)

Monroe, Anne K; Fleishman, John A; Voss, Cindy C; Keruly, Jeanne C; Nijhawan, Ank E; Agwu, Allison L; Aberg, Judith A; Rutstein, Richard M; Moore, Richard D; Gebo, Kelly A

2017-09-01

Some individuals who appear poorly retained by clinic visit-based retention measures are using antiretroviral therapy (ART) and maintaining viral suppression. We examined whether individuals with a gap in HIV primary care (≥180 days between HIV outpatient clinic visits) obtained ART during that gap after 180 days. HIV Research Network data from 5 sites and Medicaid Analytic Extract eligibility and pharmacy data were combined. Factors associated with having both an HIV primary care gap and a new (ie, nonrefill) ART prescription during a gap were evaluated with multinomial logistic regression. Of 6892 HIV Research Network patients, 6196 (90%) were linked to Medicaid data, and 4275 had any Medicaid ART prescription. Over half (54%) had occasional gaps in HIV primary care. Women, older people, and those with suppressed viral load were less likely to have a gap. Among those with occasional gaps (n = 2282), 51% received a new ART prescription in a gap. Viral load suppression before gap was associated with receiving a new ART prescription in a gap (odds ratio = 1.91, 95% confidence interval: 1.57 to 2.32), as was number of days in a gap (odds ratio = 1.04, 95% confidence interval: 1.02 to 1.05), and the proportion of months in the gap enrolled in Medicaid. Medicaid-insured individuals commonly receive ART during gaps in HIV primary care, but almost half do not. Retention measures based on visit frequency data that do not incorporate receipt of ART and/or viral suppression may misclassify individuals who remain suppressed on ART as not retained.

Empirical study using network of semantically related associations in bridging the knowledge gap.

Science.gov (United States)

Abedi, Vida; Yeasin, Mohammed; Zand, Ramin

2014-11-27

The data overload has created a new set of challenges in finding meaningful and relevant information with minimal cognitive effort. However designing robust and scalable knowledge discovery systems remains a challenge. Recent innovations in the (biological) literature mining tools have opened new avenues to understand the confluence of various diseases, genes, risk factors as well as biological processes in bridging the gaps between the massive amounts of scientific data and harvesting useful knowledge. In this paper, we highlight some of the findings using a text analytics tool, called ARIANA--Adaptive Robust and Integrative Analysis for finding Novel Associations. Empirical study using ARIANA reveals knowledge discovery instances that illustrate the efficacy of such tool. For example, ARIANA can capture the connection between the drug hexamethonium and pulmonary inflammation and fibrosis that caused the tragic death of a healthy volunteer in a 2001 John Hopkins asthma study, even though the abstract of the study was not part of the semantic model. An integrated system, such as ARIANA, could assist the human expert in exploratory literature search by bringing forward hidden associations, promoting data reuse and knowledge discovery as well as stimulating interdisciplinary projects by connecting information across the disciplines.

[Research progress of larger flexion gap than extension gap in total knee arthroplasty].

Science.gov (United States)

Zhang, Weisong; Hao, Dingjun

2017-05-01

To summarize the progress of larger flexion gap than extension gap in total knee arthro-plasty (TKA). The domestic and foreign related literature about larger flexion gap than extension gap in TKA, and its impact factors, biomechanical and kinematic features, and clinical results were summarized. During TKA, to adjust the relations of flexion gap and extension gap is one of the key factors of successful operation. The biomechanical, kinematic, and clinical researches show that properly larger flexion gap than extension gap can improve both the postoperative knee range of motion and the satisfaction of patients, but does not affect the stability of the knee joint. However, there are also contrary findings. So adjustment of flexion gap and extension gap during TKA is still in dispute. Larger flexion gap than extension gap in TKA is a new joint space theory, and long-term clinical efficacy, operation skills, and related complications still need further study.

Knowledge gaps in economic analyses of advanced reactor concepts

International Nuclear Information System (INIS)

Moore, M.; Pencer, J.; Leung, L.K.H.; Sadhankar, R.

2014-01-01

The development of next generation nuclear systems is predicated on improvement in sustainability, safety, proliferation resistance and economics. The economic assessment of the reactor concept is required as early as in the concept development stage. The Generation IV International Forum (GIF) has developed a methodology for economic assessment of the Generation IV (GEN-IV) nuclear energy systems. The GIF economics methodology was used for the assessment of one of the reactor concepts for the Super-Critical Water-cooled Reactors (SCWR), namely the European pressure-vessel type concept referred to as the High Performance Light Water Reactor (HPLWR). The economic analysis involved studying the sensitivity of two main economic indicators, namely, the Levelized Unit Electricity Cost (LUEC) and the Total Capital Investment Cost (TCIC). The knowledge gaps in estimating the capital costs and fuel costs, as well as the uncertainties in other cost parameters affecting the economic assessment of the nuclear energy system in the concept development stage are presented. (author)

Locating relevant patient information in electronic health record data using representations of clinical concepts and database structures.

Science.gov (United States)

Pan, Xuequn; Cimino, James J

2014-01-01

Clinicians and clinical researchers often seek information in electronic health records (EHRs) that are relevant to some concept of interest, such as a disease or finding. The heterogeneous nature of EHRs can complicate retrieval, risking incomplete results. We frame this problem as the presence of two gaps: 1) a gap between clinical concepts and their representations in EHR data and 2) a gap between data representations and their locations within EHR data structures. We bridge these gaps with a knowledge structure that comprises relationships among clinical concepts (including concepts of interest and concepts that may be instantiated in EHR data) and relationships between clinical concepts and the database structures. We make use of available knowledge resources to develop a reproducible, scalable process for creating a knowledge base that can support automated query expansion from a clinical concept to all relevant EHR data.

Clinical Trials

Medline Plus

Full Text Available ... successfully developed and evaluated to fill an important gap in information and education for parents, clinicians, researchers, ... gathered can help others and add to scientific knowledge. People who take part in clinical trials are ...

Two approaches to bridging the knowledge-practice gap in oncology nursing.

Science.gov (United States)

Peek, Gloanna J

2015-01-01

The field of oncology nursing is continually changing. New drugs to aid in the fight against cancer are being developed, complementary therapies to ease symptoms are gaining prominence, and survivorship care is becoming a welcome yet challenging area of subspecialty. For oncology nurses to provide quality care and to develop improved care delivery systems, they must not only have access to the most current knowledge in the field, but also be equipped with the skills necessary to integrate that knowledge into practice for the benefit of patients and families (LoBiondo-Wood et al., 2014). The importance of nursing research and its relationship to the practice of oncology nursing cannot be minimized (Moore & Badger, 2014). Oncology nurse researchers advance knowledge and, consequently, improve the quality of care for patients with cancer and their families. For example, the Oncology Nursing Society (ONS) regularly surveys its membership to identify key areas of research focus that then guide the work of nurse investigators (LoBiondo-Wood et al., 2014; ONS Research Agenda Team, 2009). Unfortunately, the shortage of nurse scientists, particularly in oncology nursing, continues to increase as senior doctoral faculty reach retirement age and doctoral education program development remains stagnant (Glasgow & Dreher, 2010; LoBiondo-Wood et al., 2014). This shortage has and will continue to lead to gaps in the generation and implementation of new knowledge, negatively affecting the quality of patient care. As a result, an urgent need exists for innovative and quality doctoral educational programs to develop nurse scientists (Moore & Badger, 2014).

Bridging the Gap Between Science and Clinical Efficacy: Physiology, Imaging, and Modeling of Aerosols in the Lung.

Science.gov (United States)

Darquenne, Chantal; Fleming, John S; Katz, Ira; Martin, Andrew R; Schroeter, Jeffry; Usmani, Omar S; Venegas, Jose; Schmid, Otmar

2016-04-01

Development of a new drug for the treatment of lung disease is a complex and time consuming process involving numerous disciplines of basic and applied sciences. During the 2015 Congress of the International Society for Aerosols in Medicine, a group of experts including aerosol scientists, physiologists, modelers, imagers, and clinicians participated in a workshop aiming at bridging the gap between basic research and clinical efficacy of inhaled drugs. This publication summarizes the current consensus on the topic. It begins with a short description of basic concepts of aerosol transport and a discussion on targeting strategies of inhaled aerosols to the lungs. It is followed by a description of both computational and biological lung models, and the use of imaging techniques to determine aerosol deposition distribution (ADD) in the lung. Finally, the importance of ADD to clinical efficacy is discussed. Several gaps were identified between basic science and clinical efficacy. One gap between scientific research aimed at predicting, controlling, and measuring ADD and the clinical use of inhaled aerosols is the considerable challenge of obtaining, in a single study, accurate information describing the optimal lung regions to be targeted, the effectiveness of targeting determined from ADD, and some measure of the drug's effectiveness. Other identified gaps were the language and methodology barriers that exist among disciplines, along with the significant regulatory hurdles that need to be overcome for novel drugs and/or therapies to reach the marketplace and benefit the patient. Despite these gaps, much progress has been made in recent years to improve clinical efficacy of inhaled drugs. Also, the recent efforts by many funding agencies and industry to support multidisciplinary networks including basic science researchers, R&D scientists, and clinicians will go a long way to further reduce the gap between science and clinical efficacy.

Human strongyloidiasis: identifying knowledge gaps, with emphasis on environmental control

Directory of Open Access Journals (Sweden)

Taylor MJ

2014-08-01

Full Text Available Michael J Taylor, Tara A Garrard, Francis J O'Donahoo, Kirstin E Ross Health and Environment, School of the Environment, Flinders University, Adelaide, SA, Australia Abstract: Strongyloides is a human parasitic nematode that is poorly understood outside a clinical context. This article identifies gaps within the literature, with particular emphasis on gaps that are hindering environmental control of Strongyloides. The prevalence and distribution of Strongyloides is unclear. An estimate of 100–370 million people infected worldwide has been proposed; however, inaccuracy of diagnosis, unreliability of prevalence mapping, and the fact that strongyloidiasis remains a neglected disease suggest that the higher figure of more than 300 million cases is likely to be a more accurate estimate. The complexity of Strongyloides life cycle means that laboratory cultures cannot be maintained outside of a host. This currently limits the range of laboratory-based research, which is vital to controlling Strongyloides through environmental alteration or treatment. Successful clinical treatment with antihelminthic drugs has meant that controlling Strongyloides through environmental control, rather than clinical intervention, has been largely overlooked. These control measures may encompass alteration of the soil environment through physical means, such as desiccation or removal of nutrients, or through chemical or biological agents. Repeated antihelminthic treatment of individuals with recurrent strongyloidiasis has not been observed to result in the selection of resistant strains; however, this has not been explicitly demonstrated, and relying on such assumptions in the long-term may prove to be shortsighted. It is ultimately naive to assume that continued administration of antihelminthics will be without any negative long-term effects. In Australia, strongyloidiasis primarily affects Indigenous communities, including communities from arid central Australia. This

Beyond bridging the know-do gap: a qualitative study of systemic interaction to foster knowledge exchange in the public health sector in The Netherlands.

Science.gov (United States)

van den Driessen Mareeuw, Francine; Vaandrager, Lenneke; Klerkx, Laurens; Naaldenberg, Jenneken; Koelen, Maria

2015-09-19

Despite considerable attention currently being given to facilitating the use of research results in public health practice, several concerns remain, resulting in the so-called know-do gap. This article aims to identify the key tensions causing the know-do gap from a broad perspective by using a systemic approach and considering the public health sector as an innovation system. An exploratory qualitative design including in-depth semi-structured interviews was used, with 33 interviewees from different actor categories in the Dutch public health innovation system. The analyses employed an innovation system matrix to highlight the principal tensions causing the know-do gap. Seven key tensions were identified, including: research priorities determined by powerful players; no consensus about criteria for knowledge quality; different perceptions about the knowledge broker role; competition engendering fragmentation; thematic funding engendering fragmentation; predominance of passive knowledge sharing; and lack of capacity among users to use and influence research. The identified tensions indicate that bridging the know-do gap requires much more than linking research to practice or translating knowledge. An innovation system perspective is crucial in providing information on the total picture of knowledge exchange within the Dutch public health sector. Such a system includes broader stakeholder involvement as well as the creation of social, economic, and contextual conditions (achieving shared visions, building networks, institutional change, removing financial and infrastructural barriers), as these create conducive factors at several system levels and induce knowledge co-creation and innovation.

Clinical staff nurse leadership: Identifying gaps in competency development.

Science.gov (United States)

Franks-Meeks, Sherron

2018-01-01

To date, there has been no development of a complete, applicable inventory of clinical staff nurse (CSN) leadership role competencies through a valid and reliable methodology. Further, the CSN has not been invited to engage in the identification, definition, or development of their own leadership competencies. Compare existing leadership competencies to identify and highlight gaps in clinical staff nurse leadership role competency development and validation. Literature review. The CSN has not participated in the development of CSN leadership role competencies, nor have the currently identified CSN leadership role competencies been scientifically validated through research. Finally, CSN leadership role competencies are incomplete and do not reflect the CSN perspective. © 2017 Wiley Periodicals, Inc.

WILDLIFE HEALTH 2.0: BRIDGING THE KNOWLEDGE-TO-ACTION GAP.

Science.gov (United States)

Stephen, Craig

2017-01-01

The unprecedented threats to the health and sustainability of wildlife populations are inspiring conversations on the need to change the way knowledge is generated, valued, and used to promote action to protect wildlife health. Wildlife Health 2.0 symbolizes the need to investigate how to improve connections between research expertise and policy or practices to protect wildlife health. Two imperatives drive this evolution: 1) growing frustrations that research is inadequately being used to inform management decisions and 2) the realization that scientific certainty is context specific for complex socioecologic issues, such as wildlife health. Failure to appreciate the unpredictability of complex systems or to incorporate ethical and cultural dimensions of decisions has limited the contribution of research to decision making. Wildlife health can draw from scholarship in other fields, such as public health and conservation, to bridge the knowledge-to-action gap. Efforts to integrate science into decisions are more likely to be effective when they enhance relevance, credibility, and legitimacy of information for people who will make or be affected by management decisions. A Wildlife Health 2.0 agenda is not a rejection of the current research paradigm but rather a call to expand our areas of inquiry to ensure that the additional contextual understanding is generated to help decision makers make good choices.

Knowledge diffusion in social work: a new approach to bridging the gap.

Science.gov (United States)

Herie, Marilyn; Martin, Garth W

2002-01-01

The continuing gap between research and practice has long been a problem in social work. A great deal of the empirical practice literature has emphasized practice evaluation (usually in the form of single-case methodologies) at the expense of research dissemination and utilization. An alternative focus for social work researchers can be found in the extensive theoretical and research literature on knowledge diffusion, technology transfer, and social marketing. Knowledge diffusion and social marketing theory is explored in terms of its relevance to social work education and practice, including a consideration of issues of culture and power. The authors present an integrated dissemination model for social work and use a case example to illustrate the practical application of the model. The OPTIONS (OutPatient Treatment In ONtario Services) project is an example of the effective dissemination of two research-based addiction treatment modalities to nearly 1,000 direct practice clinicians in Ontario, Canada.

Assessment of hospital pharmacists' clinical knowledge and ...

African Journals Online (AJOL)

Purpose: To evaluate hospital pharmacists' clinical knowledge and practical skill levels for pharmaceutical care. Methods: A quasi-experimental prospective longitudinal study design was used to evaluate the level of clinical skills with problem-based learning (PBL) sessions. Pharmacists' in three different government ...

Maximizing scientific knowledge from randomized clinical trials

DEFF Research Database (Denmark)

Gustafsson, Finn; Atar, Dan; Pitt, Bertram

2010-01-01

Trialists have an ethical and financial responsibility to plan and conduct clinical trials in a manner that will maximize the scientific knowledge gained from the trial. However, the amount of scientific information generated by randomized clinical trials in cardiovascular medicine is highly vari...

Caste- and ethnicity-based inequalities in HIV/AIDS-related knowledge gap: a case of Nepal.

Science.gov (United States)

Atteraya, Madhu; Kimm, HeeJin; Song, In Han

2015-05-01

Caste- and ethnicity-based inequalities are major obstacles to achieving health equity. The authors investigated whether there is any association between caste- and ethnicity-based inequalities and HIV-related knowledge within caste and ethnic populations. They used the 2011 Nepal Demographic and Health Survey, a nationally represented cross-sectional study data set. The study sample consisted of 11,273 women between 15 and 49 years of age. Univariate and logistic regression models were used to examine the relationship between caste- and ethnicity-based inequalities and HIV-related knowledge. The study sample was divided into high Hindu caste (47.9 percent), "untouchable" caste (18.4 percent), and indigenous populations (33.7 percent). Within the study sample, the high-caste population was found to have the greatest knowledge of the means by which HIV is prevented and transmitted. After controlling for socioeconomic and demographic characteristics, untouchables were the least knowledgeable. The odds ratio for incomplete knowledge about transmission among indigenous populations was 1.27 times higher than that for high Hindu castes, but there was no significant difference in knowledge of preventive measures. The findings suggest the existence of a prevailing HIV knowledge gap. This in turn suggests that appropriate steps need to be implemented to convey complete knowledge to underprivileged populations.

A knowledge transfer scheme to bridge the gap between science and practice: an integration of existing research frameworks into a tool for practice.

Science.gov (United States)

Verhagen, Evert; Voogt, Nelly; Bruinsma, Anja; Finch, Caroline F

2014-04-01

Evidence of effectiveness does not equal successful implementation. To progress the field, practical tools are needed to bridge the gap between research and practice and to truly unite effectiveness and implementation evidence. This paper describes the Knowledge Transfer Scheme integrating existing implementation research frameworks into a tool which has been developed specifically to bridge the gap between knowledge derived from research on the one side and evidence-based usable information and tools for practice on the other.

Identifying knowledge gaps for gene drive research to control invasive animal species: The next CRISPR step

Directory of Open Access Journals (Sweden)

Dorian Moro

2018-01-01

Full Text Available Invasive animals have been linked to the extinctions of native wildlife, and to significant agricultural financial losses or impacts. Current approaches to control invasive species require ongoing resources and management over large geographic scales, and often result in the short-term suppression of populations. New and innovative approaches are warranted. Recently, the RNA guided gene drive system based on CRISPR/Cas9 is being proposed as a potential gene editing tool that could be used by wildlife managers as a non-lethal addition or alternative to help reduce pest animal populations. While regulatory control and social acceptance are crucial issues that must be addressed, there is an opportunity now to identify the knowledge and research gaps that exist for some important invasive species. Here we systematically determine the knowledge gaps for pest species for which gene drives could potentially be applied. We apply a conceptual ecological risk framework within the gene drive context within an Australian environment to identify key requirements for undertaking work on seven exemplar invasive species in Australia. This framework allows an evaluation of the potential research on an invasive species of interest and within a gene drive and risk context. We consider the currently available biological, genetic and ecological information for the house mouse, European red fox, feral cat, European rabbit, cane toad, black rat and European starling to evaluate knowledge gaps and identify candidate species for future research. We discuss these findings in the context of future thematic areas of research worth pursuing in preparation for a more formal assessment of the use of gene drives as a novel strategy for the control of these and other invasive species. Keywords: Invasive species, Gene drive, CRISPR, Pest management, Islands

Cross-cultural differences in levels of knowledge about epilepsy.

Science.gov (United States)

Doughty, Julie; Baker, Gus A; Jacoby, Ann; Lavaud, Virginie

2003-01-01

To study how much people with epilepsy in Europe know and understand about their condition and how this might affect their lives. Clinical, demographic, psychosocial details and information assessing knowledge were collected by using self-completion questionnaires mailed to members of epilepsy support groups. Data were collected from 6,156 people with epilepsy from ten European countries. There were significant between-country differences in all variables considered. Overall levels of knowledge were acceptable when measured by the epilepsy knowledge questionnaire (EKQ, medical items). However, there were some gaps in knowledge, particularly in issues relating to medication and cause of epilepsy. This is the largest study of its kind to date. Results clearly highlighted that levels of knowledge differed significantly between countries. Overall, people with epilepsy are reasonably well informed about epilepsy, although some gaps in knowledge were evident.

Knowledge translation of the HELPinKIDS clinical practice guideline for managing childhood vaccination pain: usability and knowledge uptake of educational materials directed to new parents.

Science.gov (United States)

Taddio, Anna; Shah, Vibhuti; Leung, Eman; Wang, Jane; Parikh, Chaitya; Smart, Sarah; Hetherington, Ross; Ipp, Moshe; Riddell, Rebecca Pillai; Sgro, Michael; Jovicic, Aleksandra; Franck, Linda

2013-02-08

Although numerous evidence-based and feasible interventions are available to treat pain from childhood vaccine injections, evidence indicates that children are not benefitting from this knowledge. Unrelieved vaccination pain puts children at risk for significant long-term harms including the development of needle fears and subsequent health care avoidance behaviours. Parents report that while they want to mitigate vaccination pain in their children, they lack knowledge about how to do so. An evidence-based clinical practice guideline for managing vaccination pain was recently developed in order to address this knowledge-to-care gap. Educational tools (pamphlet and video) for parents were included to facilitate knowledge transfer at the point of care. The objectives of this study were to evaluate usability and effectiveness in terms of knowledge acquisition from the pamphlet and video in parents of newly born infants. Mixed methods design. Following heuristic usability evaluation of the pamphlet and video, parents of newborn infants reviewed revised versions of both tools and participated in individual and group interviews and individual knowledge testing. The knowledge test comprised of 10 true/false questions about the effectiveness of various pain management interventions, and was administered at three time points: at baseline, after review of the pamphlet, and after review of the video. Three overarching themes were identified from the interviews regarding usability of these educational tools: receptivity to learning, accessibility to information, and validity of information. Parents' performance on the knowledge test improved (p≤0.001) from the baseline phase to after review of the pamphlet, and again from the pamphlet review phase to after review of the video. Using a robust testing process, we demonstrated usability and conceptual knowledge acquisition from a parent-directed educational pamphlet and video about management of vaccination pain. Future studies

Knowledge translation of the HELPinKIDS clinical practice guideline for managing childhood vaccination pain: usability and knowledge uptake of educational materials directed to new parents

Directory of Open Access Journals (Sweden)

Taddio Anna

2013-02-01

Full Text Available Abstract Background Although numerous evidence-based and feasible interventions are available to treat pain from childhood vaccine injections, evidence indicates that children are not benefitting from this knowledge. Unrelieved vaccination pain puts children at risk for significant long-term harms including the development of needle fears and subsequent health care avoidance behaviours. Parents report that while they want to mitigate vaccination pain in their children, they lack knowledge about how to do so. An evidence-based clinical practice guideline for managing vaccination pain was recently developed in order to address this knowledge-to-care gap. Educational tools (pamphlet and video for parents were included to facilitate knowledge transfer at the point of care. The objectives of this study were to evaluate usability and effectiveness in terms of knowledge acquisition from the pamphlet and video in parents of newly born infants. Methods Mixed methods design. Following heuristic usability evaluation of the pamphlet and video, parents of newborn infants reviewed revised versions of both tools and participated in individual and group interviews and individual knowledge testing. The knowledge test comprised of 10 true/false questions about the effectiveness of various pain management interventions, and was administered at three time points: at baseline, after review of the pamphlet, and after review of the video. Results Three overarching themes were identified from the interviews regarding usability of these educational tools: receptivity to learning, accessibility to information, and validity of information. Parents’ performance on the knowledge test improved (p≤0.001 from the baseline phase to after review of the pamphlet, and again from the pamphlet review phase to after review of the video. Conclusions Using a robust testing process, we demonstrated usability and conceptual knowledge acquisition from a parent-directed educational

Clinical teachers' tacit knowledge of basic pedagogic principles.

Science.gov (United States)

McLeod, P J; Meagher, T; Steinert, Y; Schuwirth, L; McLeod, A H

2004-02-01

Academic faculty members in medical schools rarely receive formal instruction in basic pedagogic principles; nevertheless many develop into competent teachers. Perhaps they acquire tacit knowledge of these principles with teaching experience. This study was designed to assess clinical teachers' tacit knowledge of basic pedagogic principles and concepts. The authors developed a multiple-choice question (MCQ) exam based on 20 pedagogic principles judged by a panel of education experts to be important for clinical teaching. Three groups of clinician-educators sat the test: (1) clinicians with advanced education training and experience; (2) internal medicine specialists; (3) surgical specialists. All four groups of clinicians-educators passed the test, indicating that they possess a reasonable tacit knowledge of basic pedagogic principles. Those with advanced education training performed much better than members of the other two groups while specialists and residents working in teaching hospitals outperformed specialists from non-teaching hospitals. It is possible that converting this tacit knowledge to explicit knowledge may improve individual teaching effectiveness.

Increasing gap junctional coupling: a tool for dissecting the role of gap junctions

DEFF Research Database (Denmark)

Axelsen, Lene Nygaard; Haugan, Ketil; Stahlhut, Martin

2007-01-01

Much of our current knowledge about the physiological and pathophysiological role of gap junctions is based on experiments where coupling has been reduced by either chemical agents or genetic modification. This has brought evidence that gap junctions are important in many physiological processes....... In a number of cases, gap junctions have been implicated in the initiation and progress of disease, and experimental uncoupling has been used to investigate the exact role of coupling. The inverse approach, i.e., to increase coupling, has become possible in recent years and represents a new way of testing...... the role of gap junctions. The aim of this review is to summarize the current knowledge obtained with agents that selectively increase gap junctional intercellular coupling. Two approaches will be reviewed: increasing coupling by the use of antiarrhythmic peptide and its synthetic analogs...

There is no gap 'per se' between theory and practice

DEFF Research Database (Denmark)

Larsen, Kristian; Adamsen, Lis; Bjerregaard, Lene Berit Skov

2003-01-01

The aim of this article is to highlight relations between theory and practice and the genesis of professional action in clinical nursing and among researchers. With use of a sociologically based empirical approach, focus is placed on the knowledge involved in the work of researchers and practitio...... nurses are inspired and learn from the context, including each other, and they are active producers of knowledge, not simply recipients of knowledge. This study, therefore, claims that there is no research-practice gap “in itself” (per se) as argued in the “barriers paradigm.”......The aim of this article is to highlight relations between theory and practice and the genesis of professional action in clinical nursing and among researchers. With use of a sociologically based empirical approach, focus is placed on the knowledge involved in the work of researchers...

HRS/NSA 2014 Survey of Atrial Fibrillation and Stroke: Gaps in Knowledge and Perspective, Opportunities for Improvement.

Science.gov (United States)

Frankel, David S; Parker, Sarah E; Rosenfeld, Lynda E; Gorelick, Philip B

2015-08-01

The prevalence of atrial fibrillation (AF) is substantial and increasing. Stroke is common in AF and can have devastating consequences. Oral anticoagulants are effective in reducing stroke risk, but are underutilized. We sought to characterize the impact of stroke on AF patients and their caregivers, gaps in knowledge and perspective between physicians and patients, and barriers to effective communication and optimal anticoagulation use. A survey was administered to AF patients with and without history of stroke, caregivers of stroke survivors, and physicians across the range of specialties caring for AF and stroke patients. While AF patients (n = 499) had limited knowledge about stroke, they expressed great desire to learn more and take action to reduce their risk. They were often dissatisfied with the education they had received and desired high-quality written materials. Stroke survivors (n = 251) had poor functional outcomes and often underestimated the burden of caring for them. Caregivers (n = 203) also wished they had received more information about reducing stroke risk before their survivor's event. They commonly felt overwhelmed and socially isolated. Physicians (n = 504) did not prescribe anticoagulants as frequently as recommended by guidelines. Concerns about monitoring anticoagulation and patient compliance were commonly reported barriers. Physicians may underestimate patient willingness to take anticoagulants. We identified significant knowledge gaps among patients, caregivers, and physicians in relation to AF and stroke. Furthermore, gaps in perspective often lead to suboptimal communication and decision making. Increased education and better communication between all stakeholders are needed to reduce the impact of stroke in AF. Copyright © 2015 Heart Rhythm Society and National Stroke Association. Published by Elsevier Inc. All rights reserved.

Crucial knowledge gaps in current understanding of climate change impacts on coral reef fishes

KAUST Repository

Wilson, S. K.

2010-02-26

Expert opinion was canvassed to identify crucial knowledge gaps in current understanding of climate change impacts on coral reef fishes. Scientists that had published three or more papers on the effects of climate and environmental factors on reef fishes were invited to submit five questions that, if addressed, would improve our understanding of climate change effects on coral reef fishes. Thirty-three scientists provided 155 questions, and 32 scientists scored these questions in terms of: (i) identifying a knowledge gap, (ii) achievability, (iii) applicability to a broad spectrum of species and reef habitats, and (iv) priority. Forty-two per cent of the questions related to habitat associations and community dynamics of fish, reflecting the established effects and immediate concern relating to climate-induced coral loss and habitat degradation. However, there were also questions on fish demographics, physiology, behaviour and management, all of which could be potentially affected by climate change. Irrespective of their individual expertise and background, scientists scored questions from different topics similarly, suggesting limited bias and recognition of a need for greater interdisciplinary and collaborative research. Presented here are the 53 highest-scoring unique questions. These questions should act as a guide for future research, providing a basis for better assessment and management of climate change impacts on coral reefs and associated fish communities.

Knowledge is not enough to solve the problems – The role of diagnostic knowledge in clinical reasoning activities

Directory of Open Access Journals (Sweden)

Jan Kiesewetter

2016-11-01

Full Text Available Abstract Background Clinical reasoning is a key competence in medicine. There is a lack of knowledge, how non-experts like medical students solve clinical problems. It is known that they have difficulties applying conceptual knowledge to clinical cases, that they lack metacognitive awareness and that higher level cognitive actions correlate with diagnostic accuracy. However, the role of conceptual, strategic, conditional, and metacognitive knowledge for clinical reasoning is unknown. Methods Medical students (n = 21 were exposed to three different clinical cases and instructed to use the think-aloud method. The recorded sessions were transcribed and coded with regards to the four different categories of diagnostic knowledge (see above. The transcripts were coded using the frequencies and time-coding of the categories of knowledge. The relationship between the coded data and accuracy of diagnosis was investigated with inferential statistical methods. Results The use of metacognitive knowledge is correlated with application of conceptual, but not with conditional and strategic knowledge. Furthermore, conceptual and strategic knowledge application is associated with longer time on task. However, in contrast to cognitive action levels the use of different categories of diagnostic knowledge was not associated with better diagnostic accuracy. Conclusions The longer case work and the more intense application of conceptual knowledge in individuals with high metacognitive activity may hint towards reduced premature closure as one of the major cognitive causes of errors in medicine. Additionally, for correct case solution the cognitive actions seem to be more important than the diagnostic knowledge categories.

Medical teachers conceptualize a distinctive form of clinical knowledge.

Science.gov (United States)

Barrett, J; Yates, L; McColl, G

2015-05-01

For over four decades, there have been efforts to specify the types of knowledge that medical students need, how that knowledge is acquired and how its constituent parts are related. It is one of the areas of continuing concern underlying medical education reform. Despite their importance to medical students' learning and development, the perspectives of medical teachers in hospitals are not always considered in such discourse. This study sought to generate an understanding of these teachers' values, perspectives and approaches by listening to them and seeing them in their everyday teaching work, finding and understanding the meanings they bring to the work of medical teaching in hospitals. In interviews, all of the teachers talked more about the optimal forms of knowledge that are important for students than they talked about the form of the teaching itself. Many revealed to students what knowledge they do and do not value. They had a particular way of thinking about clinical knowledge as existing in the people and the places in which the teaching and the clinical practice happen, and represented this as 'real' knowledge. By implication, there is other knowledge in medical education or in students' heads that is not real and needs to be transformed. Their values, practices and passions add texture and vitality to existing ways of thinking about the characteristics of clinical knowledge, how it is depicted in the discourse and the curriculum and how it is more dynamically related to other knowledge than is suggested in traditional conceptualizations of knowledge relationships.

Designing a clinical dashboard to fill information gaps in the emergency department.

Science.gov (United States)

Swartz, Jordan L; Cimino, James J; Fred, Matthew R; Green, Robert A; Vawdrey, David K

2014-01-01

Data fragmentation within electronic health records causes gaps in the information readily available to clinicians. We investigated the information needs of emergency medicine clinicians in order to design an electronic dashboard to fill information gaps in the emergency department. An online survey was distributed to all emergency medicine physicians at a large, urban academic medical center. The survey response rate was 48% (52/109). The clinical information items reported to be most helpful while caring for patients in the emergency department were vital signs, electrocardiogram (ECG) reports, previous discharge summaries, and previous lab results. Brief structured interviews were also conducted with 18 clinicians during their shifts in the emergency department. From the interviews, three themes emerged: 1) difficulty accessing vital signs, 2) difficulty accessing point-of-care tests, and 3) difficulty comparing the current ECG with the previous ECG. An emergency medicine clinical dashboard was developed to address these difficulties.

The Adaptation Finance Gap Report

DEFF Research Database (Denmark)

UNEP’s Adaptation Gap Report series focuses on Finance, Technology and Knowledge gaps in climate change adaptation. It compliments the Emissions Gap Report series, and explores the implications of failing to close the emissions gap. The report builds on a 2014 assessment by the United Nations...... Environment Programme (UNEP), which laid out the concept of ‘adaptation gaps’ and outlined three such gaps: technology, finance and knowledge. The 2016 Adaptation Gap Report assesses the difference between the financial costs of adapting to climate change in developing countries and the amount of money...... actually available to meet these costs – a difference known as the “adaptation finance gap”. Like the 2014 report, the 2016 report focuses on developing countries, where adaptation capacity is often the lowest and needs the highest, and concentrates on the period up to 2050. The report identifies trends...

Negotiating clinical knowledge:a field study of psychiatric nurses' everyday communication

DEFF Research Database (Denmark)

Buus, Niels

2008-01-01

Nursing practices at psychiatric hospitals have changed significantly over the last decades. In this paper, everyday nursing practices were interpreted in light of these institutional changes. The objective was to examine how mental health nurses' production of clinical knowledge was influenced b...... knowledge influenced processes of clinical decision-making among the nurses as the game added to a distorted widening of a 'fictional distance' between patients and the representations produced by the nurses.......Nursing practices at psychiatric hospitals have changed significantly over the last decades. In this paper, everyday nursing practices were interpreted in light of these institutional changes. The objective was to examine how mental health nurses' production of clinical knowledge was influenced...... by the particular social relations on hospital wards. Empirical data stemming from an extended fieldwork at two Danish psychiatric hospital wards were interpreted using interactionistic theory and the metaphor: 'the game of clinical knowledge'. The results indicated that the nurses' production of clinical knowledge...

Mammalian Metabolism of β-Carotene: Gaps in Knowledge

Directory of Open Access Journals (Sweden)

Varsha Shete

2013-11-01

Full Text Available β-carotene is the most abundant provitamin A carotenoid in human diet and tissues. It exerts a number of beneficial functions in mammals, including humans, owing to its ability to generate vitamin A as well as to emerging crucial signaling functions of its metabolites. Even though β-carotene is generally considered a safer form of vitamin A due to its highly regulated intestinal absorption, detrimental effects have also been ascribed to its intake, at least under specific circumstances. A better understanding of the metabolism of β-carotene is still needed to unequivocally discriminate the conditions under which it may exert beneficial or detrimental effects on human health and thus to enable the formulation of dietary recommendations adequate for different groups of individuals and populations worldwide. Here we provide a general overview of the metabolism of this vitamin A precursor in mammals with the aim of identifying the gaps in knowledge that call for immediate attention. We highlight the main questions that remain to be answered in regards to the cleavage, uptake, extracellular and intracellular transport of β-carotene as well as the interactions between the metabolism of β-carotene and that of other macronutrients such as lipids.

76 FR 72957 - 4th Annual Trauma Spectrum Conference: Bridging the Gap Between Research and Clinical Practice of...

Science.gov (United States)

2011-11-28

... Conference: Bridging the Gap Between Research and Clinical Practice of Psychological Health and Traumatic... is hereby given of the ``4th Annual Trauma Spectrum Conference: Bridging the Gap Between Research and... Health (NIH), Bethesda, Maryland. This year's event focuses on bridging the gap between research and...

Summary of: Mind the gap! A comparison of oral health knowledge between dental, healthcare professionals and the public.

Science.gov (United States)

Levine, R S

2014-02-01

The importance of consistent, accurate and unambiguous messages are well documented in oral health promotion literature. Whether the reality of delivering messages in the field fulfils these principle is questionable. This paper explores the perceptions of dental professionals, healthcare professionals and lay community members with regard to key oral health messages in order to highlight any inconsistencies and knowledge gaps between and within groups for disease risk factors. A questionnaire was administered to individuals who belonged to three groups: dental professionals, healthcare professionals and lay community members. The questionnaire established knowledge regarding risk factors for caries, periodontal disease and erosion. Thirty-five (57.4%) of the dental group answered the whole questionnaire correctly, with 22 (27.8%) and 9 (5.1%) of the healthcare and lay community group answering the whole questionnaire correctly, respectively. The question of fluoride levels in children's toothpaste was the main reason for incorrect answers in the dental group. The results of this survey demonstrate a knowledge gradient from dental professionals through to healthcare professionals and then to lay members of the community. The knowledge base observed in the dental group is reflected in the other two groups as would be expected albeit with a significant gap between each group. As expected the dental professionals are generally well informed, but not as well informed as could be expected.

Knowledge translation in Africa for 21st century integrative biology: the "know-do gap" in family planning with contraceptive use among Somali women.

Science.gov (United States)

Ahmed, Ahmed A; Mohamed, Abdullahi A; Guled, Ibrahim A; Elamin, Hayfa M; Abou-Zeid, Alaa H

2014-11-01

An emerging dimension of 21(st) century integrative biology is knowledge translation in global health. The maternal mortality rate in Somalia is amongst the highest in the world. We set out to study the "know-do" gap in family planning measures in Somalia, with a view to inform future interventions for knowledge integration between theory and practice. We interviewed 360 Somali females of reproductive age and compared university-educated females to women with less or no education, using structured interviews, with a validated questionnaire. The mean age of marriage was 18 years, with 4.5 pregnancies per marriage. The mean for the desired family size was 9.3 and 10.5 children for the university-educated group and the less-educated group, respectively. Importantly, nearly 90% of the university-educated group knew about family planning, compared to 45.6% of the less-educated group. All of the less-educated group indicated that they would never use contraceptives, as compared to 43.5% of the university-educated group. Prevalence of contraceptive use among ever-married women was 4.3%. In the less-educated group, 80.6% indicated that they would not recommend contraceptives to other women as compared to 66.0% of the university-educated group. There is a huge gap between knowledge and practice regarding family planning in Somalia. The attendant reasons for this gap, such as level of education, expressed personal religious beliefs and others, are examined here. For primary health care to gain traction in Africa, we need to address the existing "know-do" gaps that are endemic and adversely impacting on global health. This is the first independent research study examining the knowledge gaps for family planning in Somalia in the last 20 years, with a view to understanding knowledge integration in a global world. The results shall guide policy makers, donors, and implementers to develop a sound family planning policy and program to improve maternal and child health in 21(st

Polyfluorinated alkyl phosphate ester surfactants - current knowledge and knowledge gaps

DEFF Research Database (Denmark)

Taxvig, Camilla; Rosenmai, Anna Kjerstine; Vinggaard, Anne Marie

2014-01-01

as in human blood, urine and milk. Due to their long half-life in human beings, there is an increased risk that exposure to these compounds can cause adverse effects. However, except for perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS), there is a large data gap regarding toxicological...

Detailed clinical models: representing knowledge, data and semantics in healthcare information technology.

Science.gov (United States)

Goossen, William T F

2014-07-01

This paper will present an overview of the developmental effort in harmonizing clinical knowledge modeling using the Detailed Clinical Models (DCMs), and will explain how it can contribute to the preservation of Electronic Health Records (EHR) data. Clinical knowledge modeling is vital for the management and preservation of EHR and data. Such modeling provides common data elements and terminology binding with the intention of capturing and managing clinical information over time and location independent from technology. Any EHR data exchange without an agreed clinical knowledge modeling will potentially result in loss of information. Many attempts exist from the past to model clinical knowledge for the benefits of semantic interoperability using standardized data representation and common terminologies. The objective of each project is similar with respect to consistent representation of clinical data, using standardized terminologies, and an overall logical approach. However, the conceptual, logical, and the technical expressions are quite different in one clinical knowledge modeling approach versus another. There currently are synergies under the Clinical Information Modeling Initiative (CIMI) in order to create a harmonized reference model for clinical knowledge models. The goal for the CIMI is to create a reference model and formalisms based on for instance the DCM (ISO/TS 13972), among other work. A global repository of DCMs may potentially be established in the future.

Gaps in college biology students' understanding of photosynthesis: Implications for human constructivist learning theory and college classroom practice

Science.gov (United States)

Griffard, Phyllis Baudoin

1999-11-01

The main research question of this study was: What gaps in biochemical understanding are revealed by a range of university introductory biology students as they work through a critically acclaimed multimedia program on photosynthesis, and what are the corresponding implications for elaboration of the Ausubel-Novak-Gowin Learning Theory (ANG, now Human Constructivism)? Twelve students, mixed for ability, gender and ethnicity, were recruited from two sections of "Bio 101." Before and after instruction in photosynthesis, in-depth clinical interviews were conducted during which participants completed a range of cognitive tasks such as sorting, concept mapping, explaining and predicting. Some tasks involved interacting with a computer simulation of photosynthesis. This study primarily employed qualitative case study and verbal analysis methods. Verbal analysis of the clinical interviews revealed numerous gaps that were categorized into typologies. The two major categories were propositional gaps and processing gaps. Propositional gaps were evident in development of participants' concepts, links and constructs. Significant among these were conceptual distance gaps and continuity of matter gaps. Gaps such as convention gaps and relative significance gaps seem to be due to naivete in the discipline. Processing gaps included gaps in graphic decoding skills and relevant cognitive habits such as self-monitoring and consulting prior knowledge. Although the gaps were easier to detect and isolate with the above-average participants, all participants showed evidence of at least some of these gaps. Since some gaps are not unexpected at all but the highest literacy levels, not all the gaps identified are to be considered deficiencies. The gaps identified support the attention given by ANG theorists to the role of prior knowledge and metacognition as well as the value of graphic organizers in knowledge construction. In addition, this study revealed numerous gaps in graphic decoding

Determining the ’Gap’

Science.gov (United States)

2009-05-01

Army training doctrine, and by adjusting the curriculum of the officer core in order to close the knowledge gap . The author closes by concluding...fight. The research to find these gaps begins with a process trace of doctrine from 1976 to the present, starting with the advent of Active Defense...discovering the one gap , three were found. Upon further examination below, even these initially perceived gaps dissipate under close scrutiny. Gap

The cognitive organization of music knowledge: a clinical analysis.

Science.gov (United States)

Omar, Rohani; Hailstone, Julia C; Warren, Jane E; Crutch, Sebastian J; Warren, Jason D

2010-04-01

Despite much recent interest in the clinical neuroscience of music processing, the cognitive organization of music as a domain of non-verbal knowledge has been little studied. Here we addressed this issue systematically in two expert musicians with clinical diagnoses of semantic dementia and Alzheimer's disease, in comparison with a control group of healthy expert musicians. In a series of neuropsychological experiments, we investigated associative knowledge of musical compositions (musical objects), musical emotions, musical instruments (musical sources) and music notation (musical symbols). These aspects of music knowledge were assessed in relation to musical perceptual abilities and extra-musical neuropsychological functions. The patient with semantic dementia showed relatively preserved recognition of musical compositions and musical symbols despite severely impaired recognition of musical emotions and musical instruments from sound. In contrast, the patient with Alzheimer's disease showed impaired recognition of compositions, with somewhat better recognition of composer and musical era, and impaired comprehension of musical symbols, but normal recognition of musical emotions and musical instruments from sound. The findings suggest that music knowledge is fractionated, and superordinate musical knowledge is relatively more robust than knowledge of particular music. We propose that music constitutes a distinct domain of non-verbal knowledge but shares certain cognitive organizational features with other brain knowledge systems. Within the domain of music knowledge, dissociable cognitive mechanisms process knowledge derived from physical sources and the knowledge of abstract musical entities.

Knowledge Translation in Rehabilitation: A Shared Vision.

Science.gov (United States)

Moore, Jennifer L; Shikako-Thomas, Keiko; Backus, Deborah

2017-07-01

Advances in rehabilitation provide the infrastructure for research and clinical data to improve care and patient outcomes. However, gaps between research and practice are prevalent. Knowledge translation (KT) aims to decrease the gap between research and its clinical use. This special communication summarizes KT-related proceedings from the 2016 IV STEP conference, describes current KT in rehabilitation science, and provides suggestions for its application in clinical care. We propose a vision for rehabilitation clinical practice and research that includes the development, adaptation, and implementation of evidence-based practice recommendations, which will contribute to a learning health care system. A clinical research culture that supports this vision and methods to engage key stakeholders to innovate rehabilitation science and practice are described. Through implementation of this vision, we can lead an evolution in rehabilitation practice to ultimately prevent disabilities, predict better outcomes, exploit plasticity, and promote participation.

Toxoplasmosis - Awareness and knowledge among medical doctors in Nigeria.

Science.gov (United States)

Efunshile, Akinwale Michael; Elikwu, Charles John; Jokelainen, Pikka

2017-01-01

Toxoplasma gondii is a zoonotic parasite causing high disease burden worldwide. A One Health approach is needed to understand, prevent, and control toxoplasmosis, while knowledge gaps in the One Health aspects have been identified among medical professionals in earlier studies. As a One Health collaboration between veterinary and medical fields, we surveyed the knowledge on toxoplasmosis among medical doctors in Nigeria. The knowledge questions, which the participants answered without consulting literature and colleagues, covered epidemiological One Health aspects as well as clinical interspecialty aspects of T. gondii infections. Altogether 522 medical doctors from four tertiary hospitals completed the questionnaire. The mean number of correct answers in the knowledge questions was 7.5, and 8.4% of the participants selected at least 12 of the 17 correct answers. The proportion of medical doctors scoring such a high score was significantly higher among those who reported having seen a case of clinical toxoplasmosis than in those who did not. While 62% of the medical doctors participating in our study knew that cats can shed T. gondii in their feces, 36% incorrectly suggested that humans could do that too. That T. gondii infection can be meatborne was known by 69%, but that it can be also waterborne only by 28% of the medical doctors participating in our study. Most of the medical doctors, 78%, knew that clinical toxoplasmosis may involve the central nervous system, while only 37% answered that it can involve the eyes. Our results suggested knowledge gaps, which need to be addressed in Continuous Medical Education. The identified gaps included both intersectoral One Health aspects and interspecialty aspects: For prevention and management of toxoplasmosis, knowing the main transmission routes and that the parasite can affect several organs is relevant.

Exploring the gap between hand washing knowledge and practices in Bangladesh: a cross-sectional comparative study.

Science.gov (United States)

Rabbi, Sifat E; Dey, Nepal C

2013-01-30

Hand washing is considered as one of the most effective hygiene promotion activities for public health in developing countries. This study compared hand washing knowledge and practices in BRAC's water; sanitation and hygiene (WASH) programme areas over time. This study is a cross-sectional comparative study between baseline (2006), midline (2009) and end-line (2011) surveys in 50 sub-districts from the first phase of the programme. Thirty thousand households from 50 sub-districts were selected in two steps: i) 30 villages were selected from each sub-district by cluster sampling, and ii) 20 households were chosen systematically from each village. The matched households were considered (26,404 in each survey) for analysis. Data were collected from households through face-to-face interview using a pre-tested questionnaire. Respondents were the adult female members of the same households, who had knowledge of day-to-day household activities related to water, sanitation and hygiene. A gap between perception and practice of proper hand washing practices with soap was identified in the study areas. Hand washing practice with soap before eating was much lower than after defecation. In baseline data, 8% reported to wash their hands with soap which significantly increased to 22% in end line. Hand washing knowledge and practices before cooking food, before serving food and while handling babies is considerably limited than other critical times. A multivariate analysis shows that socio-economic factors including education of household head and respondent, water availability and access to media have strong positive association with hand washing with soap. Gap between knowledge and practice still persists in hand washing practices. Long term and extensive initiatives can aware people about the effectiveness of hand washing.

Exploring the gap between hand washing knowledge and practices in Bangladesh: a cross-sectional comparative study

Directory of Open Access Journals (Sweden)

Rabbi Sifat E

2013-01-01

Full Text Available Abstract Background Hand washing is considered as one of the most effective hygiene promotion activities for public health in developing countries. This study compared hand washing knowledge and practices in BRAC’s water; sanitation and hygiene (WASH programme areas over time. Methods This study is a cross-sectional comparative study between baseline (2006, midline (2009 and end-line (2011 surveys in 50 sub-districts from the first phase of the programme. Thirty thousand households from 50 sub-districts were selected in two steps: i 30 villages were selected from each sub-district by cluster sampling, and ii 20 households were chosen systematically from each village. The matched households were considered (26,404 in each survey for analysis. Data were collected from households through face-to-face interview using a pre-tested questionnaire. Respondents were the adult female members of the same households, who had knowledge of day-to-day household activities related to water, sanitation and hygiene. Results A gap between perception and practice of proper hand washing practices with soap was identified in the study areas. Hand washing practice with soap before eating was much lower than after defecation. In baseline data, 8% reported to wash their hands with soap which significantly increased to 22% in end line. Hand washing knowledge and practices before cooking food, before serving food and while handling babies is considerably limited than other critical times. A multivariate analysis shows that socio-economic factors including education of household head and respondent, water availability and access to media have strong positive association with hand washing with soap. Conclusion Gap between knowledge and practice still persists in hand washing practices. Long term and extensive initiatives can aware people about the effectiveness of hand washing.

[Knowledge management system for laboratory work and clinical decision support].

Science.gov (United States)

Inada, Masanori; Sato, Mayumi; Yoneyama, Akiko

2011-05-01

This paper discusses a knowledge management system for clinical laboratories. In the clinical laboratory of Toranomon Hospital, we receive about 20 questions relevant to laboratory tests per day from medical doctors or co-medical staff. These questions mostly involve the essence to appropriately accomplish laboratory tests. We have to answer them carefully and suitably because an incorrect answer may cause a medical accident. Up to now, no method has been in place to achieve a rapid response and standardized answers. For this reason, the laboratory staff have responded to various questions based on their individual knowledge. We began to develop a knowledge management system to promote the knowledge of staff working for the laboratory. This system is a type of knowledge base for assisting the work, such as inquiry management, laboratory consultation, process management, and clinical support. It consists of several functions: guiding laboratory test information, managing inquiries from medical staff, reporting results of patient consultation, distributing laboratory staffs notes, and recording guidelines for laboratory medicine. The laboratory test information guide has 2,000 records of medical test information registered in the database with flexible retrieval. The inquiry management tool provides a methos to record all questions, answer easily, and retrieve cases. It helps staff to respond appropriately in a short period of time. The consulting report system treats patients' claims regarding medical tests. The laboratory staffs notes enter a file management system so they can be accessed to aid in clinical support. Knowledge sharing using this function can achieve the transition from individual to organizational learning. Storing guidelines for laboratory medicine will support EBM. Finally, it is expected that this system will support intellectual activity concerning laboratory work and contribute to the practice of knowledge management for clinical work support.

A Framework for a Clinical Reasoning Knowledge Warehouse

DEFF Research Database (Denmark)

Vilstrup Pedersen, Klaus; Boye, Niels

2004-01-01

is stored and made accessible when relevant to the reasoning context and the specific patient case. Furthermore, the information structure supports the creation of new generalized knowledge using data mining tools. The patient case is divided into an observation level and an opinion level. At the opinion......, Knowledge Management Systems and Business Intelligence to make context based, patient case specific analysis and knowledge management. The knowledge base integrates three sources of information that supports clinical reasoning: general information, guidelines and health records. New generalized knowledge...... level, reasoning participants can express their argument based opinions about a patient case, thereby enhancing the knowledge about the state of and plans for the patient. An opinion language that supports expressing a possible imprecise/uncertain opinion based on imprecise...

Teachers' instructional goals for science practice: Identifying knowledge gaps using cultural-historical activity theory (CHAT)

Science.gov (United States)

Farrar, Cynthia Hamen

In AP Biology, the course goal, with respect to scientific acts and reasoning, has recently shifted toward a reform goal of science practice, where the goal is for students to have a scientific perspective that views science as a practice of a community rather than a body of knowledge. Given this recent shift, this study is interested in the gaps that may exist between an individual teacher's instructional goal and the goals of the AP Biology course. A Cultural-Historical Activity Theory (CHAT) methodology and perspective is used to analyze four teachers' knowledge, practice, and learning. Teachers have content knowledge for teaching, a form of knowledge that is unique for teaching called specialized content knowledge. This specialized content knowledge (SCK) defines their instructional goals, the student outcomes they ultimately aim to achieve with their students. The study employs a cultural-historical continuum of scientific acts and reasoning, which represents the development of the AP Biology goal over time, to study gaps in their instructional goal. The study also analyzes the contradictions within their teaching practice and how teachers address those contradictions to shift their instructional practice and learn. The findings suggest that teachers have different interpretations of the AP Biology goals of science practice, placing their instructional goal at different points along the continuum. Based on the location of their instructional goal, different micro-communities of teachers exist along the continuum, comprised of teachers with a shared goal, language, and culture of their AP Biology teaching. The in-depth study of one teacher's AP Biology teaching, using a CHAT perspective, provides a means for studying the mechanisms that connect SCK to classroom actions and ultimately to instructional practice. CHAT also reveals the nature and importance of contradictions or cognitive dissonance in teacher learning and the types of support teachers need to

Expanding Knowledge Gaps: The Function of Fictions in Teaching Materials after the 2011 Swedish High School Reform

Science.gov (United States)

Graeske, Caroline

2016-01-01

The aim in the study is to analyze how work with fiction is organized in six textbooks for senior high school in Sweden after the school reform 2011. Research into Swedish teaching materials has been neglected in recent years and there is a knowledge gap about how the work with fictions is affected by the reform in 2011. In the study quantitative…

Detection of muscle gap by L-BIA in muscle injuries: clinical prognosis.

Science.gov (United States)

Nescolarde, L; Yanguas, J; Terricabras, J; Lukaski, H; Alomar, X; Rosell-Ferrer, J; Rodas, G

2017-06-21

Sport-related muscle injury classifications are based basically on imaging criteria such as ultrasound (US) and magnetic resonance imaging (MRI) without consensus because of a lack of clinical prognostics for return-to-play (RTP), which is conditioned upon the severity of the injury, and this in turn with the muscle gap (muscular fibers retraction). Recently, Futbol Club Barcelona's medical department proposed a new muscle injury classification in which muscle gap plays an important role, with the drawback that it is not always possible to identify by MRI. Localized bioimpedance measurement (L-BIA) has emerged as a non-invasive technique for supporting US and MRI to quantify the disrupted soft tissue structure in injured muscles. To correlate the severity of the injury according to the gap with the RTP, through the percent of change in resistance (R), reactance (Xc) and phase-angle (PA) by L-BIA measurements in 22 muscle injuries. After grouping the data according to the muscle gap (by MRI exam), there were significant differences in R between grade 1 and grade 2f (myotendinous or myofascial muscle injury with feather-like appearance), as well as between grade 2f and grade 2g (myotendinous or myofascial muscle injury with feather and gap). The Xc and PA values decrease significantly between each grade (i.e. 1 versus 2f, 1 versus 2g and 2f versus 2g). In addition, the severity of the muscle gap adversely affected the RTP with significant differences observed between 1 and 2g as well as between 2f and 2g. These results show that L-BIA could aid MRI and US in identifying the severity of an injured muscle according to muscle gap and therefore to accurately predict the RTP.

Closing the antidepressant efficacy gap between clinical trials and real patient populations.

Science.gov (United States)

Wade, Alan G

2006-01-01

Overall, patient outcomes in the primary care of depression are seldom as good as those achieved in clinical trials - the "efficacy gap". Many factors contribute to this, including poor patient compliance, poor family and social support and negative media reporting of antidepressants. Indeed, negative media reporting has had far more impact on physicians' prescribing of antidepressants than have regulatory agencies, partly as a result of changing public attitudes. Negative media reports linking SSRIs to increased child suicide rates have also resulted in a decline in the prescribing of SSRIs to this age group, but with no concomitant increase in the prescribing of fluoxetine, the only antidepressant recommended for the treatment of children. There are also inadequacies in the guidelines available to primary care givers that might contribute to the efficacy gap. Guidelines can be too specific for clinical practice - especially where depression coexists with anxiety disorders - and too passive, resulting in delayed or inadequate intervention. Evidence suggests that many physicians prefer to be more proactive. In the recent AHEAD survey, physicians identified faster resolution of symptoms as the property most desirable for improving antidepressant therapy. There is recent evidence that structured long-term therapy and easily-implemented measurement-based care procedures can improve remission rates and help bridge the efficacy gap. If these can be allied with greater public/media understanding of depression and its treatment, along with improved guidelines, then significant progress can be anticipated in the management of mood disorders.

Update on Mycoplasma hyopneumoniae infections in pigs: Knowledge gaps for improved disease control.

Science.gov (United States)

Maes, D; Sibila, M; Kuhnert, P; Segalés, J; Haesebrouck, F; Pieters, M

2017-08-23

Mycoplasma hyopneumoniae (M. hyopneumoniae) is the primary pathogen of enzootic pneumonia, a chronic respiratory disease in pigs. Infections occur worldwide and cause major economic losses to the pig industry. The present paper reviews the current knowledge on M. hyopneumoniae infections, with emphasis on identification and analysis of knowledge gaps for optimizing control of the disease. Close contact between infected and susceptible pigs is the main route of M. hyopneumoniae transmission. Management and housing conditions predisposing for infection or disease are known, but further research is needed to better understand M. hyopneumoniae transmission patterns in modern pig production systems, and to assess the importance of the breeding population for downstream disease control. The organism is primarily found on the mucosal surface of the trachea, bronchi and bronchioles. Different adhesins and lipoproteins are involved in the adherence process. However, a clear picture of the virulence and pathogenicity of M. hyopneumoniae is still missing. The role of glycerol metabolism, myoinositol metabolism and the Mycoplasma Ig binding protein-Mycoplasma Ig protease system should be further investigated for their contribution to virulence. The destruction of the mucociliary apparatus, together with modulating the immune response, enhances the susceptibility of infected pigs to secondary pathogens. Clinical signs and severity of lesions depend on different factors, such as management, environmental conditions and likely also M. hyopneumoniae strain. The potential impact of strain variability on disease severity is not well defined. Diagnostics could be improved by developing tests that may detect virulent strains, by improving sampling in live animals and by designing ELISAs allowing discrimination between infected and vaccinated pigs. The currently available vaccines are often cost-efficient, but the ongoing research on developing new vaccines that confer protective

Crowdsourcing awareness: exploration of the ovarian cancer knowledge gap through Amazon Mechanical Turk.

Science.gov (United States)

Carter, Rebecca R; DiFeo, Analisa; Bogie, Kath; Zhang, Guo-Qiang; Sun, Jiayang

2014-01-01

Ovarian cancer is the most lethal gynecologic disease in the United States, with more women dying from this cancer than all gynecological cancers combined. Ovarian cancer has been termed the "silent killer" because some patients do not show clear symptoms at an early stage. Currently, there is a lack of approved and effective early diagnostic tools for ovarian cancer. There is also an apparent severe knowledge gap of ovarian cancer in general and of its indicative symptoms among both public and many health professionals. These factors have significantly contributed to the late stage diagnosis of most ovarian cancer patients (63% are diagnosed at Stage III or above), where the 5-year survival rate is less than 30%. The paucity of knowledge concerning ovarian cancer in the United States is unknown. The present investigation examined current public awareness and knowledge about ovarian cancer. The study implemented design strategies to develop an unbiased survey with quality control measures, including the modern application of multiple statistical analyses. The survey assessed a reasonable proxy of the US population by crowdsourcing participants through the online task marketplace Amazon Mechanical Turk, at a highly condensed rate of cost and time compared to traditional recruitment methods. Knowledge of ovarian cancer was compared to that of breast cancer using repeated measures, bias control and other quality control measures in the survey design. Analyses included multinomial logistic regression and categorical data analysis procedures such as correspondence analysis, among other statistics. We confirmed the relatively poor public knowledge of ovarian cancer among the US population. The simple, yet novel design should set an example for designing surveys to obtain quality data via Amazon Mechanical Turk with the associated analyses.

Clinical Decision Support Knowledge Management: Strategies for Success.

Science.gov (United States)

Khalifa, Mohamed; Alswailem, Osama

2015-01-01

Clinical Decision Support Systems have been shown to increase quality of care, patient safety, improve adherence to guidelines for prevention and treatment, and avoid medication errors. Such systems depend mainly on two types of content; the clinical information related to patients and the medical knowledge related to the specialty that informs the system rules and alerts. At King Faisal Specialist Hospital and Research Center, Saudi Arabia, the Health Information Technology Affairs worked on identifying best strategies and recommendations for successful CDSS knowledge management. A review of literature was conducted to identify main areas of challenges and factors of success. A qualitative survey was used over six months' duration to collect opinions, experiences and suggestions from both IT and healthcare professionals. Recommendations were categorized into ten main topics that should be addressed during the development and implementation of CDSS knowledge management tools in the hospital.

Essential nurse practitioner business knowledge: An interprofessional perspective.

Science.gov (United States)

LaFevers, David; Ward-Smith, Peggy; Wright, Wendy

2015-04-01

To describe business practice knowledge from the perspectives of nurse practitioners (NPs) who are practicing clinicians, academic instructors, and clinic managers. Using the eight domains of business practice attitudes identified by the Medical Group Management Associations Body of Knowledge (MGMA), which are supported by the American Association of Colleges of Nursing (AACN), a study-specific survey was developed. Data, which describe the knowledge and attitudes with respect to business practices, were obtained from 370 participants. Regardless of their job classification, these participants described (1) quality management, (2) risk management, and (3) patient care systems as critical business practice knowledge. Consensus was also achieved when ranking the content for business practice knowledge: (1) patient care systems, (2) business operation, and (3) financial management. These data identify gaps in business practice knowledge and content that should be included in educational programs. Business practice knowledge is essential for a successful clinical practice and should be a professional practice skill for the NP. ©2015 American Association of Nurse Practitioners.

Gap analysis between provisional diagnosis and final diagnosis in government and private teaching hospitals: A record-linked comparative study.

Science.gov (United States)

Chatterjee, Sudeshna; Ray, Krishnangshu; Das, Anup Kumar

2016-01-01

1. To identify the extent of clinical gaps at the context of knowledge, practice and systems. 2. To formulate necessary intervention measures towards bridging the gaps. Comparative, cross-sectional and non-interventional study. It is retrospective, record-based study conducted upon inpatients ( n = 200) of major disciplines of two teaching hospitals. Major outcome variables were to observe the matching and un-matching of final and provisional diagnosis by using ICD-10 criteria. Comparative analysis of specific and selective gaps were estimated in terms of percentage (%). Pilot observation showed the existence of gaps between provisional and final diagnosis in both private and government institution. Both knowledge and skill gaps were evident in caregivers and gap in documentation was existent in medical records. The pilot data is may be an eye-opener to public and private governance systems for understanding and revising the process service planning and service delivery. Necessary intervention measures may be contemplated towards enhancing diagnostic skill of doctors for quality hospital care.

PhoneGap for enterprise

CERN Document Server

Shotts, Kerri

2014-01-01

This book is intended for developers who wish to use PhoneGap to develop useful, rich, secure mobile applications for their enterprise environment. The book assumes you have working knowledge of PhoneGap, HTML5, CSS3, and JavaScript, and a reasonable understanding of networking and n-tier architectures.

Phenomena identification ranking table and knowledge base gaps and needs for the modular high-temperature gas-cooled reactor

International Nuclear Information System (INIS)

Tokuhiro, Akira; Potirniche, Gabriel; Rink, Karl

2009-01-01

The U.S. is developing a modular high-temperature gas-cooled reactor (MHTGR) under the Next Generation Nuclear Plant (NGNP); also known as the Very High Temperature Reactor (VHTR). The generic MHTGR is a graphite-moderated, gas-cooled reactor (GCR) of either a prismatic modular (block-type, PMR) or pebble-bed (PBR) core configuration. The pebble-bed design requires new attention with respect to neutronics, materials, thermal hydraulic, safety and licensing relative to the set of phenomena and engineering analyses associated with the current fleet of legacy LWRs. In fact, the relative knowledge and experiential base on gas reactors is small in comparison to the LWR. There is a dated body of knowledge from some 25+ years ago on GCRs; recently there is a renewed interest. Thus in the present design and development phase of the NGNP/VHTR, there are relevant thermohydraulic safety issues surrounding the MHTGR with issues impacting foremost the design review process. A common phenomena with respect to PMR and PBR core design, is that concerning 'graphite dust' and its interaction and transport with potential fission products (FP) that may be present within the graphite and subsequently in the primary system. The nature of the graphite and FPs, when circulated or transported in the primary, and possibly beyond, is of concern as potentially an relevant 'source term' (radionuclide inventory) of the MHTGR. Based on NUREG/CR-6944, Volumes 1-5, the author briefly describes the state-of-the art knowledge base on graphite dust and FP transport with respect to the anticipated design of the MHTGR. In addition, from the Phenomena Identification and Ranking Tables (PIRTs) developed in these reports we concurrently identify and describe 'gaps and needs' of the knowledge base. That is, we also present the knowledge base gaps and needs with respect to the following: 1) R and D needs relative to PIRTs, 2) (experimental) database needs relative to PIRTs, and 3) simulation and modeling

ROSS Skills, Knowledge, and Abilities Training Evaluation. Gaps and Recommendations

Energy Technology Data Exchange (ETDEWEB)

Ala, Maureen [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Gruidl, Jeremiah [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Buddemeier, Brooke [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

2015-09-30

This document describes the development of the ROSS SKAs, the cross-mapping of the SKAs to the available training, identifies gaps in the SKA and training, and provides recommendations to address those gaps.

Crowdsourcing awareness: exploration of the ovarian cancer knowledge gap through Amazon Mechanical Turk.

Directory of Open Access Journals (Sweden)

Rebecca R Carter

Full Text Available BACKGROUND: Ovarian cancer is the most lethal gynecologic disease in the United States, with more women dying from this cancer than all gynecological cancers combined. Ovarian cancer has been termed the "silent killer" because some patients do not show clear symptoms at an early stage. Currently, there is a lack of approved and effective early diagnostic tools for ovarian cancer. There is also an apparent severe knowledge gap of ovarian cancer in general and of its indicative symptoms among both public and many health professionals. These factors have significantly contributed to the late stage diagnosis of most ovarian cancer patients (63% are diagnosed at Stage III or above, where the 5-year survival rate is less than 30%. The paucity of knowledge concerning ovarian cancer in the United States is unknown. METHODS: The present investigation examined current public awareness and knowledge about ovarian cancer. The study implemented design strategies to develop an unbiased survey with quality control measures, including the modern application of multiple statistical analyses. The survey assessed a reasonable proxy of the US population by crowdsourcing participants through the online task marketplace Amazon Mechanical Turk, at a highly condensed rate of cost and time compared to traditional recruitment methods. CONCLUSION: Knowledge of ovarian cancer was compared to that of breast cancer using repeated measures, bias control and other quality control measures in the survey design. Analyses included multinomial logistic regression and categorical data analysis procedures such as correspondence analysis, among other statistics. We confirmed the relatively poor public knowledge of ovarian cancer among the US population. The simple, yet novel design should set an example for designing surveys to obtain quality data via Amazon Mechanical Turk with the associated analyses.

Bridging the Nagoya Compliance Gap: The Fundamental Role of Customary Law in Protection of Indigenous Peoples’ Resource and Knowledge Rights

Directory of Open Access Journals (Sweden)

Brendan M. Tobin

2013-09-01

Full Text Available The Nagoya Protocol requires states to ensure that access to and use of genetic resources and traditional knowledge of Indigenous peoples and local communities is subject to their prior informed consent (PIC. It also requires states to take into consideration their customary laws. However, it lacks effective compliance mechanisms, a gap exposed in draft European legislation that sidesteps the Nagoya Protocol’s obligations regarding PIC and customary law, leaving traditional knowledge largely unprotected. This article examines the status of customary law under international, regional and national law, and the challenges and opportunities for securing recognition of its role in the protection of traditional knowledge. The article contends that all commercial and development activities with the potential to impact on Nagoya Protocol rights will in the future need to ensure compliance with relevant customary law. It finds state reluctance to adopt measures to ensure consideration of customary law shortsighted and likely to lead to increased litigation. It concludes that customary law has a key role to play in closing the Nagoya compliance gap but to do so it will need to be supported by enforcement mechanisms such as disclosure of origin regimes in intellectual property law.

Setting Priorities for Diabetic Retinopathy Clinical Research and Identifying Evidence Gaps.

Science.gov (United States)

Le, Jimmy T; Hutfless, Susan; Li, Tianjing; Bressler, Neil M; Heyward, James; Bittner, Ava K; Glassman, Adam; Dickersin, Kay

2017-01-01

Prioritizing comparative effectiveness research may contribute to obtaining answers that clinicians perceive they need and may minimize research that could be considered wasteful. Our objective was to identify evidence gaps and set priorities for new systematic reviews and randomized controlled trials for managing diabetic retinopathy (DR), including diabetic macular edema (DME). Cross-sectional study. Diabetic Retinopathy Clinical Research Network (DRCR.net) investigators. We provided recommendations from the American Academy of Ophthalmology's 2012 Preferred Practice Patterns for Diabetic Retinopathy as 91 answerable clinical research questions about intervention effectiveness to 410 DRCR.net investigators to rate each question's importance from 0 (not important) to 10 (very important) using a 2-round Delphi survey and to suggest additional questions. We considered questions as high priority if at least 75% of respondents to both rounds assigned an importance rating of 5 or more in round 2. We also extracted outcome measures relevant to DR and asked respondents to identify those that must be measured in all studies. We mapped Cochrane reviews published up to March 2016 to high-priority clinical research questions. Ranking of importance of each clinical question. Thirty-two individuals completed rounds 1 and 2 and suggested 15 questions. Among the final list of 106 clinical research questions, 22 questions met our definition of high priority: 9 of 22 concerned the effectiveness of anti-VEGF therapy, and 13 of 22 focused on how often patients should be followed up (re-examination) and treatment effectiveness in patients with specific characteristics (e.g., DME). Outcomes that 75% or more of respondents marked as "must be measured in all studies" included visual acuity and visual loss, death of participants, and intraocular pressure. Only 1 prioritized question was associated with conclusive evidence from a Cochrane systematic review. A limited response rate among

Representation and integration of sociological knowledge using knowledge graphs

NARCIS (Netherlands)

Popping, R; Strijker, [No Value

1997-01-01

The representation and integration of sociological knowledge using knowledge graphs, a specific kind of semantic network, is discussed. Knowledge it systematically searched this reveals. inconsistencies, reducing superfluous research and knowledge, and showing gaps in a theory. This representation

Knowledge and Attitude of clinical level dental students concerning ...

African Journals Online (AJOL)

Objective: To determine the knowledge and attitude of clinical level dental students concerning Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS). Methods: Two hundred and fifteen clinical level dental students from three Nigerian universities were requested to complete a self- ...

Zika virus infection, transmission, associated neurological disorders and birth abnormalities: A review of progress in research, priorities and knowledge gaps

Institute of Scientific and Technical Information of China (English)

Yitades Gebre; Nikkiah Forbes; Teshome Gebre

2016-01-01

On February 1, 2016, the World Health Organization declared that the cluster of microcephaly cases and other neurological disorders constitute public health emergency of international concern. Furthermore, few studies demonstrated that there was an increased evidence of causal relationship of Zika virus(ZIKAV) infection and microcephaly, birth abnormalities and neurological disorders such as Guillain–Barre′ syndrome.ZIKAV transmission occurs mainly by the bite of infected mosquitos(Aedes species), but there are also reports that infections could occur via the placenta, breast milk, saliva,blood transfusion and sex. This article reviews the global efforts, progress in scientific research to understand the pathogenesis of ZIKAV infection & disease, clinical presentations, congenital transmission and autoimmune neurological disorders. The paper further explores the knowledge gaps, future priority research agenda for strategic response including vector control and prevention. We conducted a systematic literature review to synthesise available evidence on ZIKAV infection and its vector and host interaction from electronic databases.

Zika virus infection, transmission, associated neurological disorders and birth abnormalities:A review of progress in research, priorities and knowledge gaps

Institute of Scientific and Technical Information of China (English)

Yitades Gebre; Nikkiah Forbes; Teshome Gebre

2016-01-01

On February 1, 2016, the World Health Organization declared that the cluster of microcephaly cases and other neurological disorders constitute public health emergency of international concern. Furthermore, few studies demonstrated that there was an increased evidence of causal relationship of Zika virus (ZIKAV) infection and micro-cephaly, birth abnormalities and neurological disorders such as Guillain–Barr ´e syndrome. ZIKAV transmission occurs mainly by the bite of infected mosquitos (Aedes species), but there are also reports that infections could occur via the placenta, breast milk, saliva, blood transfusion and sex. This article reviews the global efforts, progress in scientific research to understand the pathogenesis of ZIKAV infection & disease, clinical pre-sentations, congenital transmission and autoimmune neurological disorders. The paper further explores the knowledge gaps, future priority research agenda for strategic response including vector control and prevention. We conducted a systematic literature review to synthesise available evidence on ZIKAV infection and its vector and host interaction from electronic databases.

Zika virus infection, transmission, associated neurological disorders and birth abnormalities: A review of progress in research, priorities and knowledge gaps

Directory of Open Access Journals (Sweden)

Yitades Gebre

2016-10-01

Full Text Available On February 1, 2016, the World Health Organization declared that the cluster of microcephaly cases and other neurological disorders constitute public health emergency of international concern. Furthermore, few studies demonstrated that there was an increased evidence of causal relationship of Zika virus (ZIKAV infection and microcephaly, birth abnormalities and neurological disorders such as Guillain–Barré syndrome. ZIKAV transmission occurs mainly by the bite of infected mosquitos (Aedes species, but there are also reports that infections could occur via the placenta, breast milk, saliva, blood transfusion and sex. This article reviews the global efforts, progress in scientific research to understand the pathogenesis of ZIKAV infection & disease, clinical presentations, congenital transmission and autoimmune neurological disorders. The paper further explores the knowledge gaps, future priority research agenda for strategic response including vector control and prevention. We conducted a systematic literature review to synthesise available evidence on ZIKAV infection and its vector and host interaction from electronic databases.

An analysis of clinical transition stresses experienced by dental students: A qualitative methods approach.

Science.gov (United States)

Botelho, M; Gao, X; Bhuyan, S Y

2018-04-17

Stress in dental students is well established with potential psychological distress, emotional exhaustion and burnout-related symptoms. Little attention has been given to the problems encountered by dental students during the transition from theoretical or paraclinical training to the clinical environment. The aim of this study was to adopt a qualitative research methods approach to understand the perceived stressors during students' clinical transition and provide insights for curriculum planners to enhance learning. This study analysed four groups of 2nd- and 3rd-year BDS students' experiences in focus group interviews relating to their pre-clinical and clinical transitions. The interviews were recorded and transcribed verbatim, and a thematic analysis was performed using an inductive qualitative approach. Key overlapping domains identified were the transition gap and stresses. The transition gap was subclassified into knowledge and skill (hard and soft), and stresses was subcategorised into internal and external stresses. On first coming to clinics, students experienced knowledge gaps of unfamiliar clinical treatments with mismatches between knowledge acquisition and clinical exposure. Students felt incompetent owing to the stresses attributable to curriculum design, staff and the patient. This negatively affected their confidence and clinical performance. A range of challenges have been identified that will allow curriculum designer's to plan a more supportive learning experience to help students during their transition to clinical practice giving them timely knowledge, confidence and clinical performance to better prepare them for entering clinics. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Addressing social barriers and closing the gender knowledge gap: exposure to road shows is associated with more knowledge and more positive beliefs, attitudes and social norms regarding exclusive breastfeeding in rural Zimbabwe.

Science.gov (United States)

Jenkins, Alison L; Tavengwa, Naume V; Chasekwa, Bernard; Chatora, Kumbirai; Taruberekera, Noah; Mushayi, Wellington; Madzima, Rufaro C; Mbuya, Mduduzi N N

2012-10-01

Exclusive breastfeeding (EBF) is rarely practiced despite its significant child survival benefits. A key constraint to increasing EBF rates in Zimbabwe and most of the developing world is that key decision makers (fathers/partners and other family members) are often poorly informed about EBF and do not attend antenatal clinics where health information is routinely provided. Informed by formative research, a district-wide campaign was conducted in rural Zimbabwe to encourage EBF and expressing and heat treating (EHT) breast milk as a means to maintain EBF. The campaign combined traditional strategies of education, counselling and outreach through health service delivery with a novel road show 'edutainment' intervention to reach men and other community members. A post campaign evaluation measured the association of road show exposure with 20 knowledge items and summative scores of social norms, beliefs and attitudes obtained through exploratory factor analysis. In adjusted models, road show exposure was associated with correct EBF knowledge (β=1.0, 0.001), EHT knowledge (β=1.3, Pbenefits of condom use during pregnancy and breastfeeding (β=0.5, P<0.001), and more positive EBF social norms (β=0.6, P<0.001), EBF beliefs and attitudes (β=1.0, P<0.001) and attitudes towards condom use during breastfeeding (β=0.6, P<0.001). Road show exposure was more strongly associated with EBF knowledge among men (P-value for gender×exposure group interaction=0.03), suggesting that it also closed the knowledge gap between men and women. Longitudinal studies will determine whether road shows were associated with changes in EBF practices. © 2011 Blackwell Publishing Ltd.

Knowledge translation of research findings

Directory of Open Access Journals (Sweden)

Grimshaw Jeremy M

2012-05-01

Full Text Available Abstract Background One of the most consistent findings from clinical and health services research is the failure to translate research into practice and policy. As a result of these evidence-practice and policy gaps, patients fail to benefit optimally from advances in healthcare and are exposed to unnecessary risks of iatrogenic harms, and healthcare systems are exposed to unnecessary expenditure resulting in significant opportunity costs. Over the last decade, there has been increasing international policy and research attention on how to reduce the evidence-practice and policy gap. In this paper, we summarise the current concepts and evidence to guide knowledge translation activities, defined as T2 research (the translation of new clinical knowledge into improved health. We structure the article around five key questions: what should be transferred; to whom should research knowledge be transferred; by whom should research knowledge be transferred; how should research knowledge be transferred; and, with what effect should research knowledge be transferred? Discussion We suggest that the basic unit of knowledge translation should usually be up-to-date systematic reviews or other syntheses of research findings. Knowledge translators need to identify the key messages for different target audiences and to fashion these in language and knowledge translation products that are easily assimilated by different audiences. The relative importance of knowledge translation to different target audiences will vary by the type of research and appropriate endpoints of knowledge translation may vary across different stakeholder groups. There are a large number of planned knowledge translation models, derived from different disciplinary, contextual (i.e., setting, and target audience viewpoints. Most of these suggest that planned knowledge translation for healthcare professionals and consumers is more likely to be successful if the choice of knowledge

Knowledge translation of research findings.

Science.gov (United States)

Grimshaw, Jeremy M; Eccles, Martin P; Lavis, John N; Hill, Sophie J; Squires, Janet E

2012-05-31

One of the most consistent findings from clinical and health services research is the failure to translate research into practice and policy. As a result of these evidence-practice and policy gaps, patients fail to benefit optimally from advances in healthcare and are exposed to unnecessary risks of iatrogenic harms, and healthcare systems are exposed to unnecessary expenditure resulting in significant opportunity costs. Over the last decade, there has been increasing international policy and research attention on how to reduce the evidence-practice and policy gap. In this paper, we summarise the current concepts and evidence to guide knowledge translation activities, defined as T2 research (the translation of new clinical knowledge into improved health). We structure the article around five key questions: what should be transferred; to whom should research knowledge be transferred; by whom should research knowledge be transferred; how should research knowledge be transferred; and, with what effect should research knowledge be transferred? We suggest that the basic unit of knowledge translation should usually be up-to-date systematic reviews or other syntheses of research findings. Knowledge translators need to identify the key messages for different target audiences and to fashion these in language and knowledge translation products that are easily assimilated by different audiences. The relative importance of knowledge translation to different target audiences will vary by the type of research and appropriate endpoints of knowledge translation may vary across different stakeholder groups. There are a large number of planned knowledge translation models, derived from different disciplinary, contextual (i.e., setting), and target audience viewpoints. Most of these suggest that planned knowledge translation for healthcare professionals and consumers is more likely to be successful if the choice of knowledge translation strategy is informed by an assessment of the

Knowledge gaps and misconceptions about coronary heart disease among U.S. South Asians.

Science.gov (United States)

Kandula, Namratha R; Tirodkar, Manasi A; Lauderdale, Diane S; Khurana, Neerja R; Makoul, Gregory; Baker, David W

2010-04-01

Although South Asians are at higher risk for coronary heart disease (CHD) than most other U.S. racial/ethnic groups, very little research has addressed this disparity. As a first step in developing culturally targeted CHD prevention messages for this rapidly growing community, this study examined South Asians' knowledge and beliefs about CHD. Analyses, conducted in 2009, were based on data collected from January to July 2008 in a cross-sectional study population of 270 South Asian adults in Illinois. Interviews were conducted in English, Hindi, or Urdu using a standardized questionnaire. Multivariate regression models were used to examine the associations between sociodemographics and CHD knowledge and attitudes about preventability. Eighty-one percent of respondents had one or more CHD risk factors. Most participants (89%) said they knew little or nothing about CHD. Stress was the most frequently mentioned risk factor (44%). Few mentioned controlling blood pressure (11%); cholesterol (10%); and diabetes (5%) for prevention. Fifty-three percent said that heart attacks are not preventable. Low education level, being interviewed in Urdu or Hindi, and low level of acculturation were associated with less knowledge and believing that CHD is not preventable. A majority of South Asians in this study believed that CHD is not preventable and had low awareness of modifiable risk factors. As a first step, CHD education should target the knowledge gaps that may affect risk factor control and behavior change. Educational messages may need to be somewhat different for subgroups (e.g., by education and language) to be maximally effective. 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

knowledge and adherence to clinical practice guidelines amongst ...

African Journals Online (AJOL)

ABEOLUGBENGAS

Objective: The therapeutic management of patients with Low Back Pain (LBP) has long been characterized ... Keywords: Low back pain, Clinical practice Guidelines, Knowledge, Adherence ..... discourage the use of modalities such as TENS,.

Developing genomic knowledge bases and databases to support clinical management: current perspectives.

Science.gov (United States)

Huser, Vojtech; Sincan, Murat; Cimino, James J

2014-01-01

Personalized medicine, the ability to tailor diagnostic and treatment decisions for individual patients, is seen as the evolution of modern medicine. We characterize here the informatics resources available today or envisioned in the near future that can support clinical interpretation of genomic test results. We assume a clinical sequencing scenario (germline whole-exome sequencing) in which a clinical specialist, such as an endocrinologist, needs to tailor patient management decisions within his or her specialty (targeted findings) but relies on a genetic counselor to interpret off-target incidental findings. We characterize the genomic input data and list various types of knowledge bases that provide genomic knowledge for generating clinical decision support. We highlight the need for patient-level databases with detailed lifelong phenotype content in addition to genotype data and provide a list of recommendations for personalized medicine knowledge bases and databases. We conclude that no single knowledge base can currently support all aspects of personalized recommendations and that consolidation of several current resources into larger, more dynamic and collaborative knowledge bases may offer a future path forward.

Understanding indigenous knowledge: Bridging the knowledge gap through a knowledge creation model for agricultural development

Directory of Open Access Journals (Sweden)

Edda T. Lwoga

2010-12-01

Full Text Available This article addresses the management of agricultural indigenous knowledge (IK in developing countries, with a specific focus on Tanzania. It provides background details on IK and its importance for agricultural development. It introduces various knowledge management (KM concepts and discusses their application in managing IK in the developing world by placing Nonaka’s knowledge creation theory (Nonaka 1991; Nonaka & Takeuchi 1995; Nonaka, Toyama & Konno 2000 in the context of the local communities. Data from focus groups were used to triangulate with data from interviews in order to validate, confirm and corroborate quantitative results with qualitative findings. The study findings showed that knowledge creation theory can be used to manage IK in the local communities, however, adequate and appropriate resources need to be allocated for capturing and preserving IK before it disappears altogether. For sustainable agricultural development, the communities have to be placed within a knowledge-creating setting that continuously creates, distributes and shares knowledge within and beyond the communities’ boundaries and integrates it with new agricultural technologies, innovations and knowledge.

The Adaptation Gap Report - a Preliminary Assessment

DEFF Research Database (Denmark)

Alverson, Keith; Olhoff, Anne; Noble, Ian

This first Adaptation Gap report provides an equally sobering assessment of the gap between adaptation needs and reality, based on preliminary thinking on how baselines, future goals or targets, and gaps between them might be defined for climate change adaptation. The report focuses on gaps...... in developing countries in three important areas: finance, technology and knowledge....

Bridging the PSI Knowledge Gap: A Multi-Scale Approach

Energy Technology Data Exchange (ETDEWEB)

Wirth, Brian D. [Univ. of Tennessee, Knoxville, TN (United States)

2015-01-08

Plasma-surface interactions (PSI) pose an immense scientific hurdle in magnetic confinement fusion and our present understanding of PSI in confinement environments is highly inadequate; indeed, a recent Fusion Energy Sciences Advisory Committee report found that 4 out of the 5 top five fusion knowledge gaps were related to PSI. The time is appropriate to develop a concentrated and synergistic science effort that would expand, exploit and integrate the wealth of laboratory ion-beam and plasma research, as well as exciting new computational tools, towards the goal of bridging the PSI knowledge gap. This effort would broadly advance plasma and material sciences, while providing critical knowledge towards progress in fusion PSI. This project involves the development of a Science Center focused on a new approach to PSI science; an approach that both exploits access to state-of-the-art PSI experiments and modeling, as well as confinement devices. The organizing principle is to develop synergistic experimental and modeling tools that treat the truly coupled multi-scale aspect of the PSI issues in confinement devices. This is motivated by the simple observation that while typical lab experiments and models allow independent manipulation of controlling variables, the confinement PSI environment is essentially self-determined with few outside controls. This means that processes that may be treated independently in laboratory experiments, because they involve vastly different physical and time scales, will now affect one another in the confinement environment. Also, lab experiments cannot simultaneously match all exposure conditions found in confinement devices typically forcing a linear extrapolation of lab results. At the same time programmatic limitations prevent confinement experiments alone from answering many key PSI questions. The resolution to this problem is to usefully exploit access to PSI science in lab devices, while retooling our thinking from a linear and de

Computer knowledge amongst clinical year medical students in a ...

African Journals Online (AJOL)

Objective: To study the computer knowledge and desires of clinical year medical students at one of the oldest and largest medical schools in Nigeria. Design: A survey using validated structured questionnaires. Setting: Medical school of Ahmadu Bello University, Zaria, Nigeria. Subjects: Two hundred and thirty seven clinical ...

Bioinvasion in a Brazilian bay: filling gaps in the knowledge of southwestern Atlantic biota.

Directory of Open Access Journals (Sweden)

Barbara L Ignacio

2010-09-01

Full Text Available Biological invasions are a major cause of global species change. Nevertheless, knowledge about the distribution and ecology of introduced species is regionally biased, and many gaps in knowledge exist for most developing countries.To study the zoobenthos on the hard substratum of the Ilha Grande Bay, a survey was conducted on both natural and artificial substrata at three depths and seven sites. The species recorded were classified as native, cryptogenic or introduced. Multivariate analyses were conducted to assess the prevalence of introduced species in these communities and to compare the distribution of species on natural and artificial substrata of this bay to identify possible discrepancies in habitat use. Of the 61 species, 25 were cryptogenic, 10 were introduced and 26 were native. Similar numbers of introduced species were found on both natural and artificial substrata, though the community composition was significantly different between them. We also compared the species composition of the Ilha Grande Bay survey to other inventories taken around the world. The highest similarities were found between the Ilha Grande Bay inventory and the Atlantic coastal region (Tampa Bay, USA and the Gulf of Mexico, American Samoa and Pearl Harbor (USA inventories.This study presents the first published comprehensive list of hard substratum sessile marine invertebrate species in a Brazilian bay. The high percentage of cryptogenic species reveals gaps in both zoological records and information on introduced species for the Brazilian coast. The introduced species successfully colonized different sites in the Ilha Grande Bay, including both natural and artificial substrata. In addition, we find that artificial structures may not be good surrogates for natural rocky shores and may represent an ecological threat. Comparisons with other inventories suggest a history of broad-scale invasion, though more evidence is needed to support this conclusion.

Gap analysis between provisional diagnosis and final diagnosis in government and private teaching hospitals: A record-linked comparative study

Directory of Open Access Journals (Sweden)

Sudeshna Chatterjee

2016-01-01

Full Text Available Aims: 1. To identify the extent of clinical gaps at the context of knowledge, practice and systems. 2. To formulate necessary intervention measures towards bridging the gaps. Settings and Design: Comparative, cross-sectional and non-interventional study. Methods and Material: It is retrospective, record-based study conducted upon inpatients (n = 200 of major disciplines of two teaching hospitals. Major outcome variables were to observe the matching and un-matching of final and provisional diagnosis by using ICD-10 criteria. Statistical Analysis Used: Comparative analysis of specific and selective gaps were estimated in terms of percentage (%. Results: Pilot observation showed the existence of gaps between provisional and final diagnosis in both private and government institution. Both knowledge and skill gaps were evident in caregivers and gap in documentation was existent in medical records. Conclusions: The pilot data is may be an eye-opener to public and private governance systems for understanding and revising the process service planning and service delivery. Necessary intervention measures may be contemplated towards enhancing diagnostic skill of doctors for quality hospital care.

The disengagement of visual attention in the gap paradigm across adolescence.

Science.gov (United States)

Van der Stigchel, S; Hessels, R S; van Elst, J C; Kemner, C

2017-12-01

Attentional disengagement is important for successful interaction with our environment. The efficiency of attentional disengagement is commonly assessed using the gap paradigm. There is, however, a sharp contrast between the number of studies applying the gap paradigm to clinical populations and the knowledge about the underlying developmental trajectory of the gap effect. The aim of the present study was, therefore, to investigate attentional disengagement in a group of children aged 9-15. Besides the typically deployed gap and the overlap conditions, we also added a baseline condition in which the fixation point was removed at the moment that the target appeared. This allowed us to reveal the appropriate experimental conditions to unravel possible developmental differences. Correlational analyses showed that the size of the gap effect became smaller with increasing age, but only for the difference between the gap and the overlap conditions. This shows that there is a gradual increase in the capacity to disengage visual attention with increasing age, but that this effect only becomes apparent when the gap and the overlap conditions are compared. The gradual decrease of the gap effect with increasing age provides additional evidence that the attentional system becomes more efficient with increasing age and that this is a gradual process.

The Importance of Medicinal Chemistry Knowledge in the Clinical Pharmacist's Education.

Science.gov (United States)

Fernandes, João Paulo S

2018-03-01

Objective. To show why medicinal chemistry must be a key component of the education of pharmacy students, as well as in the pharmacist's practice. Findings. Five case reports were selected by their clinically relevant elements of medicinal chemistry and were explained using structure-activity relationship data of the drugs involved in the case easily obtained from primary literature and in medicinal chemistry textbooks. Summary. This paper demonstrates how critical clinical decisions can be addressed using medicinal chemistry knowledge. While such knowledge may not explain all clinical decisions, medicinal chemistry concepts are essential for the education of pharmacy students to explain drug action in general and clinical decisions.

Addressing the knowledge gap: sexual violence and harassment in the UK Armed Forces.

Science.gov (United States)

Godier, Lauren R; Fossey, M

2017-09-06

Despite media interest in alleged sexual violence and harassment in the UK military, there remains a paucity of UK-based peer-reviewed research in this area. Ministry of Defence and service-specific reports support the suggestion that UK service personnel may be at risk of experiencing sexual harassment. These reports however highlight a reluctance by service personnel to report sexual harassment through official channels. In this article, we discuss the paucity of UK-based research pertaining to the prevalence and impact of sexual harassment in the military, explore potential reasons for this gap in knowledge and outline future directions and priorities for academic research. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Factors shaping how clinical educators use their educational knowledge and skills in the clinical workplace: a qualitative study.

Science.gov (United States)

Kumar, Koshila; Greenhill, Jennene

2016-02-18

In order to consolidate their educational knowledge and skills and develop their educational role, many clinicians undertake professional development in clinical education and supervision. It is well established that these educationally-focussed professional development activities have a positive impact. However, it is less clear what factors within the clinical workplace can shape how health professionals may use and apply their educational knowledge and skills and undertake their educational role. Looking through the lens of workplace affordances, this paper draws attention to the contextual, personal and interactional factors that impact on how clinical educators integrate their educational knowledge and skills into the practice setting, and undertake their educational role. Data were gathered via a survey of 387 clinical educators and semi-structured interviews with 12 clinical educators and 6 workplace managers. In this paper, we focus on analysing and reporting the qualitative data gathered in this study. This qualitative data were subject to a thematic analysis and guided by theoretical constructs related to workplace affordances. Three key themes were identified including contextual, personal and interactional factors. Contextual elements referred to organisational structures and systems that impact on participants' educational role, how participants' clinical education role was articulated and configured within the organisation, and how the organisation shaped the educational opportunities available to clinicians. Personal factors encompassed clinicians' personal motivations and goals to teach and be involved in education, develop their own educational skills and function as a role model for students. Interactional factors referred to the professional interactions and networks through which clinicians shared their educational knowledge and skills and further consolidated their profile as educational advocates in their workplace. There are a number of

Gaps in nutritional research among older adults with cancer

Science.gov (United States)

Presley, Carolyn J.; Dotan, Efrat; Soto-Perez-de-Celis, Enrique; Jatoi, Aminah; Mohile, Supriya G.; Won, Elizabeth; Alibhai, Shabbir; Kilari, Deepak; Harrison, Robert; Klepin, Heidi D.; Wildes, Tanya M.; Mustian, Karen; Demark-Wahnefried, Wendy

2016-01-01

Nutritional issues among older adults with cancer are an understudied area of research despite significant prognostic implications for treatment side effects, cancer-specific mortality, and overall survival. In May of 2015, the National Cancer Institute and the National Institute on Aging co-sponsored a conference focused on future directions in geriatric oncology research. Nutritional research among older adults with cancer was highlighted as a major area of concern as most nutritional cancer research has been conducted among younger adults, with limited evidence to guide the care of nutritional issues among older adults with cancer. Cancer diagnoses among older adults are increasing, and the care of the older adult with cancer is complicated due to multimorbidity, heterogeneous functional status, polypharmacy, deficits in cognitive and mental health, and several other non-cancer factors. Due to this complexity, nutritional needs are dynamic, multifaceted, and dependent on the clinical scenario. This manuscript outlines the proceedings of this conference including knowledge gaps and recommendations for future nutritional research among older adults with cancer. Three common clinical scenarios encountered by oncologists include (1) weight loss during anti-cancer therapy, (2) malnutrition during advanced disease, and (3) obesity during survivorship. In this manuscript, we provide a brief overview of relevant cancer literature within these three areas, knowledge gaps that exist, and recommendations for future research. PMID:27197919

Gaps in Current Knowledge and Priorities for Future Research in Dry Eye.

Science.gov (United States)

Saldanha, Ian J; Dickersin, Kay; Hutfless, Susan T; Akpek, Esen K

2017-12-01

Dry eye, a common yet underrecognized and evolving field, has few recommended treatment algorithms, mostly based on expert consensus rather than robust research evidence. There are high costs associated with managing dry eye and conducting research to identify effective and safe long-term treatments. To support evidence-based management of dry eye, our purpose was to identify and prioritize important clinical research questions for future clinical research. We translated recommendations from the American Academy of Ophthalmology's 2013 Preferred Practice Patterns for dry eye into answerable clinical research questions about treatment effectiveness. Clinicians around the world who manage patients with dry eye rated each question's importance from 0 (not important) to 10 (very important) using a 2-round online Delphi survey. We considered questions as "important" if ≥75% of respondents assigned a rating of 6 or more in round 2. We mapped the identified important clinical research questions to reliable systematic reviews published up to March 2016. Seventy-five clinicians from at least 21 countries completed both Delphi rounds. Among the 58 questions, 24 met our definition of "important": 9/24 and 7/24 addressed topical and systemic treatments, respectively. All 4 questions with the highest 25th percentiles addressed topical treatments. Although 6/24 "important" questions were associated with 4 existing reliable systematic reviews, none of these reviews came to a definitive conclusion about treatment effectiveness. We identified gaps pertaining to treatment options for dry eye. Future clinical research on the management of dry eye should strongly consider these prioritized questions.

A Profile of Clinical Nutrition Knowledge Among Physicians and Medical Students

Science.gov (United States)

Podell, Richard N.; And Others

1975-01-01

An assessment of the clinical nutritional knowledge of third- and fourth-year medical students and practicing physicians revealed that overall nutritional knowledge is modest and that knowledge is highest among topics which have received the most publicity in the popular press. Methodology and specific findings are included. (JT)

Knowledge and attitude of Indian clinical dental students towards the dental treatment of patients with human immunodeficiency virus (HIV)/acquired immune-deficiency syndrome (AIDS).

Science.gov (United States)

Oberoi, Sukhvinder Singh; Marya, Charu Mohan; Sharma, Nilima; Mohanty, Vikrant; Marwah, Mohita; Oberoi, Avneet

2014-12-01

Oral health care of patients with human immunodeficiency virus (HIV)/acquired immune-deficiency syndrome (AIDS) is a growing area of concern. Information on HIV- and AIDS-related knowledge among dental students provides a crucial foundation for efforts aimed at developing an appropriate dental curriculum on HIV and AIDS. The purpose of this study was to assess the knowledge and attitude of Indian clinical dental students towards the treatment of patients with HIV/AIDS and perceived sources of information regarding HIV-related issues. Data were collected from clinical dental students (third year, fourth year and internship) from three dental institutions in Delhi National Capital Region (NCR). The questions assessed the knowledge and attitude towards treatment of patients with HIV and the perceived source of information related to HIV. The willingness to treat HIV-positive patients among dental students was 67.0%, and 74.20% were confident of treating a patient with HIV/AIDS. The potential problems in rendering treatment to these patients were effect on the attitude of other patients (49.90%) and staff fears (52.50%). The correct knowledge regarding the infection-control practice (barrier technique) was found among only 15.50% of respondents. The respondents had sufficient knowledge regarding the oral manifestations of HIV/AIDS. There was no correlation between the knowledge and attitude score, demonstrating a gap between knowledge and attitude among dental students regarding treatment of HIV-infected patients. Appropriate knowledge has to be delivered through the dental education curriculum, which can instil confidence in students about their ability to manage HIV-positive patients. © 2014 FDI World Dental Federation.

Evolution in Clinical Knowledge Management Strategy at Intermountain Healthcare

Science.gov (United States)

Hulse, Nathan C.; Galland, Joel; Borsato, Emerson P.

2012-01-01

In this manuscript, we present an overview of the clinical knowledge management strategy at Intermountain Healthcare in support of our electronic medical record systems. Intermountain first initiated efforts in developing a centralized enterprise knowledge repository in 2001. Applications developed, areas of emphasis served, and key areas of focus are presented. We also detail historical and current areas of emphasis, in response to business needs. PMID:23304309

From Idea to Product--Translating Knowledge between the Lab and the Clinic

Science.gov (United States)

Ali, Ayfer Habib

2012-01-01

This dissertation is composed of three essays looking at innovation at Academic Medical Centers. It tries to empirically explore the problem of translating knowledge from the laboratory bench to the clinic and from the clinic to the bench. Chapter 1, co-authored with Iain Cockburn, establishes the importance of in-house complementary knowledge in…

Using a research framework to identify knowledge gaps in research on food marketing to children in Australia.

Science.gov (United States)

Chapman, Kathy; Kelly, Bridget; King, Lesley

2009-06-01

Research in the field of food marketing to children requires a better understanding of the research gaps in order to inform policy development. The purpose of this paper was to propose a framework for classifying food marketing research, using Australian research on food marketing to children to demonstrate how this framework can be used to determine knowledge gaps. A literature review of research databases and 'grey' material was conducted to identify research from the previous 10 years. Studies were classified according to their research focus, and media type, as either: exposure, including content analyses; effects of exposure, including opinions, attitudes and actions resulting from food marketing exposure; regulations, including the type and level of regulation that applies to food marketing; or breaches of regulations, including instances where marketing regulations have been violated. The majority of Australian research on food marketing to children has focused on television advertising and exposure research. Research has consistently shown that the content of food marketing directed at children is predominately for unhealthy foods. There is a lack of research on the effects of food marketing, which would be valuable to inform policy. The development of a logical framework for food marketing research allows for the identification of research gaps and enables research priorities to be identified.

Assessing the Knowledge and Attitudes of Medical Students and Graduates about Clinical Governance

Directory of Open Access Journals (Sweden)

Rana Gholamzadeh nikjoo

2015-08-01

Full Text Available Background and Objectives : In order to implement clinical governance successfully, it should be perceived positively and there must be a positive attitude towards it. The current policy of the Ministry of Health and Medical Education about clinical governance requires assessing the knowledge and attitudes of medical students to identify their educational needs and the necessary steps needed to be taken in educational planning, designing and modification of the courses. This study aimed to evaluate the knowledge and attitudes of medical students and graduates about clinical governance in 1391. Materials and Methods : This is a descriptive–analytic study. This research was conducted on 159 students from different medical fields simple random sampling method. For data collecting, a researcher-made questionnaire was used which its validity was confirmed by using content validity and construct validity. To determine the reliability of the questionnaire, internal consistency and Cronbach's Alpha were used for field of knowledge (0.78 and attitude (0.68. For data analysis, SPSS version 11.5 software was applied using exploratory factor analysis method. Results : 64% of the participants were female and 36% were male. 71% of the participants were in the health care management field and 29% from other medical fields. Mean and standard deviation of knowledge and attitude scores were 64.2 ± 5.8 and 13.06 ± 3.02 respectively. Comparing the students' and graduates’ knowledge and attitudes with their educational level showed no significant correlation. (P> 0.05 Although, there was a significant correlation between educational level and attitude (P = 0.001. In higher levels of education, students' attitude towards clinical governance reduced. Conclusion : The knowledge of medical students and graduates was estimated average to high about clinical governance but their attitude was very poor. This reflects negative views of medical students despite the

First-Time Knowledge Brokers in Health Care: The Experiences of Nurses and Allied Health Professionals of Bridging the Research-Practice Gap

Science.gov (United States)

Wright, Nicola

2013-01-01

This study describes the experiences of nurses and allied health professionals as first-time knowledge brokers, attempting to bridge the research-practice gap within health care. A qualitative study using in-depth interviews and documentary analysis was conducted. The data was analysed using a thematic analysis strategy. Participants were 17…

Financial Knowledge and the Gender Gap

Directory of Open Access Journals (Sweden)

Ann Woodyard

2012-06-01

Full Text Available Financial knowledge has been identified as an issue of importance to individual financial wellness. The FINRA Financial Capability Study provides data that make it possible to assess financial knowledge, and to analyze it in the context of financial satisfaction and participation in financial behaviors that are generally considered positive. This paper looks at these relationships by gender and by age group, identifying key differences in outcomes and behaviors. The aim of this study was to identify areas and issues where policy makers can focus efforts, and where practitioners can develop education and therapy protocols to assist clients in financial development and restoration.

Addressing the common pathway underlying hypertension and diabetes in people who are obese by maximizing health: the ultimate knowledge translation gap.

Science.gov (United States)

Dean, Elizabeth; Lomi, Constantina; Bruno, Selma; Awad, Hamzeh; O'Donoghue, Grainne

2011-03-06

In accordance with the WHO definition of health, this article examines the alarming discord between the epidemiology of hypertension, type 2 diabetes mellitus (T2DM), and obesity and the low profile of noninvasive (nondrug) compared with invasive (drug) interventions with respect to their prevention, reversal and management. Herein lies the ultimate knowledge translation gap and challenge in 21st century health care. Although lifestyle modification has long appeared in guidelines for medically managing these conditions, this evidence-based strategy is seldom implemented as rigorously as drug prescription. Biomedicine focuses largely on reducing signs and symptoms; the effects of the problem rather than the problem. This article highlights the evidence-based rationale supporting prioritizing the underlying causes and contributing factors for hypertension and T2DM, and, in turn, obesity. We argue that a primary focus on maximizing health could eliminate all three conditions, at best, or, at worst, minimize their severity, complications, and medication needs. To enable such knowledge translation and maximizing health outcome, the health care community needs to practice as an integrated team, and address barriers to effecting maximal health in all patients. Addressing the ultimate knowledge translation gap, by aligning the health care paradigm to 21st century needs, would constitute a major advance.

Addressing the Common Pathway Underlying Hypertension and Diabetes in People Who Are Obese by Maximizing Health: The Ultimate Knowledge Translation Gap

Directory of Open Access Journals (Sweden)

Elizabeth Dean

2011-01-01

Full Text Available In accordance with the WHO definition of health, this article examines the alarming discord between the epidemiology of hypertension, type 2 diabetes mellitus (T2DM, and obesity and the low profile of noninvasive (nondrug compared with invasive (drug interventions with respect to their prevention, reversal and management. Herein lies the ultimate knowledge translation gap and challenge in 21st century health care. Although lifestyle modification has long appeared in guidelines for medically managing these conditions, this evidence-based strategy is seldom implemented as rigorously as drug prescription. Biomedicine focuses largely on reducing signs and symptoms; the effects of the problem rather than the problem. This article highlights the evidence-based rationale supporting prioritizing the underlying causes and contributing factors for hypertension and T2DM, and, in turn, obesity. We argue that a primary focus on maximizing health could eliminate all three conditions, at best, or, at worst, minimize their severity, complications, and medication needs. To enable such knowledge translation and maximizing health outcome, the health care community needs to practice as an integrated team, and address barriers to effecting maximal health in all patients. Addressing the ultimate knowledge translation gap, by aligning the health care paradigm to 21st century needs, would constitute a major advance.

A Framework for a Clinical Reasoning Knowledge Warehouse

DEFF Research Database (Denmark)

Vilstrup Pedersen, Klaus; Boye, Niels

2004-01-01

In many areas of the medical domain, the decision process i.e. reasoning, involving health care professionals is distributed, cooperative and complex. This paper presents a framework for a Clinical Reasoning Knowledge Warehouse that combines theories and models from Artificial Intelligence...... is stored and made accessible when relevant to the reasoning context and the specific patient case. Furthermore, the information structure supports the creation of new generalized knowledge using data mining tools. The patient case is divided into an observation level and an opinion level. At the opinion...

Closing the gap between research and management

Science.gov (United States)

Deborah M. Finch; Marcia Patton-Mallory

1993-01-01

In this paper, we evaluate the reasons for gaps in communication between researchers and natural resource managers and identify methods to close these gaps. Gaps originate from differing patterns of language use, disparities in organizational culture and values, generation of knowledge that is too narrowly-focused to solve complex problems, failure by managers to relay...

Gap Junctions

Science.gov (United States)

Nielsen, Morten Schak; Axelsen, Lene Nygaard; Sorgen, Paul L.; Verma, Vandana; Delmar, Mario; Holstein-Rathlou, Niels-Henrik

2013-01-01

Gap junctions are essential to the function of multicellular animals, which require a high degree of coordination between cells. In vertebrates, gap junctions comprise connexins and currently 21 connexins are known in humans. The functions of gap junctions are highly diverse and include exchange of metabolites and electrical signals between cells, as well as functions, which are apparently unrelated to intercellular communication. Given the diversity of gap junction physiology, regulation of gap junction activity is complex. The structure of the various connexins is known to some extent; and structural rearrangements and intramolecular interactions are important for regulation of channel function. Intercellular coupling is further regulated by the number and activity of channels present in gap junctional plaques. The number of connexins in cell-cell channels is regulated by controlling transcription, translation, trafficking, and degradation; and all of these processes are under strict control. Once in the membrane, channel activity is determined by the conductive properties of the connexin involved, which can be regulated by voltage and chemical gating, as well as a large number of posttranslational modifications. The aim of the present article is to review our current knowledge on the structure, regulation, function, and pharmacology of gap junctions. This will be supported by examples of how different connexins and their regulation act in concert to achieve appropriate physiological control, and how disturbances of connexin function can lead to disease. © 2012 American Physiological Society. Compr Physiol 2:1981-2035, 2012. PMID:23723031

The Impact of Electronic Knowledge-Based Nursing Content and Decision-Support on Nursing-Sensitive Patient Outcomes

Science.gov (United States)

2017-01-01

Behavior Observation Techniques • Clinical Nursing Research • Decision Support Systems, Clinical • Dissemination, Information • Evidence-Based...gap and getting nurses in clinical settings to use evidence to support clinical decision -making (Duffy et al. 2015; Melynk, Fineout-Overholt...patient outcomes. However, it has been shown that nurses ’ knowledge and use of best evidence for clinical decision - making is often hindered by many

Ambulatory and home blood pressure monitoring: gaps between clinical guidelines and clinical practice in Singapore.

Science.gov (United States)

Setia, Sajita; Subramaniam, Kannan; Teo, Boon Wee; Tay, Jam Chin

2017-01-01

Out-of-office blood pressure (BP) measurements (home blood pressure monitoring [HBPM] and ambulatory blood pressure monitoring [ABPM]) provide important additional information for effective hypertension detection and management decisions. Therefore, out-of-office BP measurement is now recommended by several international guidelines. This study evaluated the practice and uptake of HBPM and ABPM among physicians from Singapore. A sample of physicians from Singapore was surveyed between 8 September and 5 October 2016. Those included were in public or private practice had been practicing for ≥3 years, directly cared for patients ≥70% of the time, and treated ≥30 patients for hypertension per month. The questionnaire covered six main categories: general BP management, BP variability (BPV) awareness/diagnosis, HBPM, ABPM, BPV management, and associated training needs. Sixty physicians (30 general practitioners, 20 cardiologists, and 10 nephrologists) were included (77% male, 85% aged 31-60 years, and mean 22-year practice). Physicians recommended HBPM and ABPM to 81% and 27% of hypertensive patients, respectively. HBPM was most often used to monitor antihypertensive therapy (88% of physicians) and 97% thought that ABPM was useful for providing information on BPV. HBPM instructions often differed from current guideline recommendations in terms of frequency, number of measurements, and timing. The proportion of consultation time devoted to discussing HBPM and BPV was one-quarter or less for 73% of physicians, and only 55% said that they had the ability to provide education on HBPM and BPV. Patient inertia, poor patient compliance, lack of medical consultation time, and poor patient access to a BP machine were the most common challenges for implementing out-of-office BP monitoring. Although physicians from Singapore do recommend out-of-office BP measurement to patients with hypertension, this survey identified several important gaps in knowledge and clinical practice.

Canine vector-borne diseases in India: a review of the literature and identification of existing knowledge gaps

Directory of Open Access Journals (Sweden)

Coleman Glen T

2010-04-01

Full Text Available Abstract Despite the combination of favourable climate for parasites and vectors, and large populations of stray dogs, information concerning the epidemiology, diagnosis and management of canine vector-borne diseases in India is limited. However, with the country's expanding economy and adaptation to western culture, higher expectations and demands are being placed on veterinary surgeons for improved knowledge of diseases and control. This review aims to provide an overview of the current state of knowledge of these diseases in India and identify existing knowledge gaps in the literature which need to be addressed. The available literature on this subject, although limited, suggests that a number of canine vector-borne diseases such as filariasis, babesiosis and ehrlichiosis are endemic throughout India, as diagnosed mostly by morphological methods. Detailed investigations of the epidemiology and zoonotic potential of these pathogens has been neglected. Further study is essential to develop a better understanding of the diversity of canine vector-borne diseases in India, and their significance for veterinary and public health.

The Gap in Knowledge of Clinical Practice Guidelines by Mental Health Residents in Buenos Aires (Argentina

Directory of Open Access Journals (Sweden)

Javier Fabrissin

2014-05-01

Full Text Available The aim of this pilot study was to evaluate if the residents of psychiatry and clinical psychology from the city of Buenos Aires knew any of the existing mental health Clinical Practice and Treatment Guidelines (CPTGs. We asked residents their opinion about CPTGs and, also, if they followed their recommendations in clinical practice. We asked 59 mental health residents (28 physicians and 29 psychologists with different years of clinical training to fill a questionnaire to know their opinion about CPTGs and also if they follow the CPTG recommendations in their clinical practice. We found that 79.31% of residents did not know any CPTG. Eighty percent of the residents who did know any CPTG have a positive opinion about CPTGs. Finally, the American Psychiatric Association Guidelines were the most known CPTGs. The authors emphasize the need for a clinical guidelines diffusion policy in Buenos Aires city and particularly as a clinical and training resource for mental health residents.

Biochar effects on soils: overview and knowledge gaps

Science.gov (United States)

Verheijen, F. G. A.; Jeffery, S.; Bastos, A. C.; van der Velde, M.

2012-04-01

One of the cornerstones of the sustainable biochar concept is to improve, or at least to not deteriorate, soil quality and functioning. The idea of global sustainable biochar systems, with biochar applied to global cropland and grassland soils, has highlighted limitations in: i) current scientific understanding of biochar interactions with soil components, ii) the capacity to assess ecosystem services provided by soils, and iii) the uncertainty in spatio-temporal representation of both (i) and (ii). Pyrolysis conditions and feedstock characteristics largely control the physico-chemical properties of the resulting biochar, which in turn determine the suitability for a given application. Soils are highly heterogeneous systems at a range of scales. Combinations of land use, soil management and changing climatic conditions further enhance this heterogeneity. While this leads to difficulties in identifying the underlying mechanisms behind reported effects in the scientific literature, it also provides an opportunity for 'critical matching' of biochar properties that are best suited to a particular site (depending on soil type, hydrology, climate, land use, soil contaminants, etc.). Biochar's relatively long mean residence times in soils (100s of years) make it a potential instrument for sequestering carbon (if done sustainably). However, that same long mean residence time sets biochar apart from conventional soil amendments (such as manures and other organic fertilizers) that are considered as transient in the soil (1-10s of years). The functional life time of biochar in soils essentially moves biochar from a soil management tool to a geo-engineering technique. One of the consequences is that desired ecosystem services that are provided by soils, have to be projected for the same time period. This presentation aims to discuss critical knowledge gaps in biochar-soil-ecosystem interactions against a background of ecosystem services.

A Review of Current Research and Knowledge Gaps in the Epidemiology of Shiga Toxin-Producing Escherichia coli and Salmonella spp. in Trinidad and Tobago.

Science.gov (United States)

Persad, Anil K; LeJeune, Jeffrey

2018-04-17

Salmonella and Shiga toxin-producing Escherichia coli are two of the main causes of foodborne disease globally, and while they have been implicated as possible causes of foodborne disease within the Caribbean region, the actual incidence is unknown. Trinidad and Tobago, one of the larger countries in the Caribbean, has an estimated annual foodborne disease burden of over 100,000 cases and, similar to other countries, the etiology of most of these cases is unknown. Both pathogens can reside as part of the normal gastrointestinal microflora of many wild and domestic animals, with animals acting as reservoirs, spillover hosts, or dead-end hosts. Carriage in animal species can be asymptomatic or, in the case of Salmonella in particular, there may be clinical manifestation in animals, which resemble the disease seen in humans. In this review, we will focus on the epidemiology of these two foodborne pathogens in Trinidad and Tobago and identify any knowledge gaps in the published literature. The filling of this critical knowledge void is essential for the development and implementation of appropriate mechanisms to reduce the dissemination and transmission of these pathogens, not only in Trinidad and Tobago, but also in the wider Caribbean.

Cervical and Breast Cancer-Screening Knowledge of Women with Developmental Disabilities

Science.gov (United States)

Parish, Susan L.; Swaine, Jamie G.; Luken, Karen; Rose, Roderick A.; Dababnah, Sarah

2012-01-01

Women with developmental disabilities are significantly less likely than women without disabilities to receive cervical and breast cancer screening according to clinical guidelines. The reasons for this gap are not understood. The present study examined the extent of women's knowledge about cervical and breast cancer screening, with the intention…

Knowledge gap regarding dementia care among nurses in Taiwanese acute care hospitals: A cross-sectional study.

Science.gov (United States)

Lin, Pei-Chao; Hsieh, Mei-Hui; Chen, Meng-Chin; Yang, Yung-Mei; Lin, Li-Chan

2018-02-01

The quality of dementia care in hospitals is typically substandard. Staff members are underprepared for providing care to older people with dementia. The objective of the present study was to examine dementia care knowledge, attitude and behavior regarding self-education about dementia care among nurses working in different wards. This was a descriptive cross-sectional study. The present study was carried out from July 2013 to December 2013. In total, 387 nurses working in different wards were recruited from two hospitals in Taiwan by using convenience sampling. The nurses completed a self-report questionnaire on demographic data, experience and learning behavior, and attitude towards dementia care, and a 16-item questionnaire on dementia care knowledge. Descriptive and inferential statistics were used to analyze the status and differences in dementia care knowledge among nurse in different wards. The average dementia care knowledge score was 10.46 (SD 2.13), with a 66.5% mean accuracy among all nurses. Dementia care knowledge was significantly associated with age, nursing experience, possession of a registered nurse license, holding a bachelor's degree, work unit, training courses and learning behavior towards dementia care. The dementia care knowledge of the emergency room nurses was significantly lower than that of the psychiatric and neurology ward nurses. A significantly lower percentage of emergency room nurses underwent dementia care training and actively searched for information on dementia care, compared with the psychiatric and neurology ward nurses. Hospital nurses show a knowledge gap regarding dementia care, especially emergency room nurses. Providing dementia care training to hospital nurses, particularly emergency room nurses, is crucial for improving the quality of care for patients with dementia. Geriatr Gerontol Int 2018; 18: 276-285. © 2017 Japan Geriatrics Society.

Transforming practice into clinical scholarship.

Science.gov (United States)

Limoges, Jacqueline; Acorn, Sonia

2016-04-01

The aims of this paper were to explicate clinical scholarship as synonymous with the scholarship of application and to explore the evolution of scholarly practice to clinical scholarship. Boyer contributed an expanded view of scholarship that recognized various approaches to knowledge production beyond pure research (discovery) to include the scholarship of integration, application and teaching. There is growing interest in using Boyer's framework to advance knowledge production in nursing but the discussion of clinical scholarship in relation to Boyer's framework is sparse. Discussion paper. Literature from 1983-2015 and Boyer's framework. When clinical scholarship is viewed as a synonym for Boyer's scholarship of application, it can be aligned to this well established framework to support knowledge generated in clinical practice. For instance, applying the three criteria for scholarship (documentation, peer review and dissemination) can ensure that the knowledge produced is rigorous, available for critique and used by others to advance nursing practice and patient care. Understanding the differences between scholarly practice and clinical scholarship can promote the development of clinical scholarship. Supporting clinical leaders to identify issues confronting nursing practice can enable scholarly practice to be transformed into clinical scholarship. Expanding the understanding of clinical scholarship and linking it to Boyer's scholarship of application can assist nurses to generate knowledge that addresses clinical concerns. Further dialogue about how clinical scholarship can address the theory-practice gap and how publication of clinical scholarship could be expanded given the goals of clinical scholarship is warranted. © 2016 John Wiley & Sons Ltd.

Evaluating Clinical Knowledge across Years of Medical Training.

Science.gov (United States)

And Others; Mazzuca, Steven A

1981-01-01

The evolution of clinical knowledge about the management of a common chronic disease was determined by applying analysis of variance and multiple discriminant analysis to responses on two patient management problems by groups of junior medical students and internal medicine residents. The applying analysis of variance and multiple discriminant…

Critical Knowledge Gaps in Our Understanding of Environmental Cycling and Transmission of Leptospira spp.

Science.gov (United States)

Barragan, Veronica; Olivas, Sonora; Keim, Paul; Pearson, Talima

2017-10-01

Exposure to soil or water contaminated with the urine of Leptospira -infected animals is the most common way in which humans contract leptospirosis. Entire populations can be at high risk of leptospirosis while working in inundated fields, when engaging in aquatic sports, or after periods of heavy rainfall. The risk of infection after contact with these environmental sources depends on the ability of Leptospira bacteria to survive, persist, and infect new hosts. Multiple variables such as soil and water pH, temperature, and even environmental microbial communities are likely to shape the environmental conditions needed by the pathogen to persist. Here we review what is known about the environmental phase of the infectious Leptospira transmission cycle and identify knowledge gaps that will serve as a guide for future research. Copyright © 2017 Barragan et al.

Mainstreaming conservation agriculture in Malawi: Knowledge gaps and institutional barriers.

Science.gov (United States)

Dougill, Andrew J; Whitfield, Stephen; Stringer, Lindsay C; Vincent, Katharine; Wood, Benjamin T; Chinseu, Edna L; Steward, Peter; Mkwambisi, David D

2017-06-15

Conservation agriculture (CA) practices of reduced soil tillage, permanent organic soil coverage and intercropping/crop rotation, are being advocated globally, based on perceived benefits for crop yields, soil carbon storage, weed suppression, reduced soil erosion and improved soil water retention. However, some have questioned their efficacy due to uncertainty around the performance and trade-offs associated with CA practices, and their compatibility with the diverse livelihood strategies and varied agro-ecological conditions across African smallholder systems. This paper assesses the role of key institutions in Malawi in shaping pathways towards more sustainable land management based on CA by outlining their impact on national policy-making and the design and implementation of agricultural development projects. It draws on interviews at national, district and project levels and a multi-stakeholder workshop that mapped the institutional landscape of decision-making for agricultural land management practices. Findings identify knowledge gaps and institutional barriers that influence land management decision-making and constrain CA uptake. We use our findings to set out an integrated roadmap of research needs and policy options aimed at supporting CA as a route to enhanced sustainable land management in Malawi. Findings offer lessons that can inform design, planning and implementation of CA projects, and identify the multi-level institutional support structures required for mainstreaming sustainable land management in sub-Saharan Africa. Copyright © 2016 Elsevier Ltd. All rights reserved.

Knowledge bases, clinical decision support systems, and rapid learning in oncology.

Science.gov (United States)

Yu, Peter Paul

2015-03-01

One of the most important benefits of health information technology is to assist the cognitive process of the human mind in the face of vast amounts of health data, limited time for decision making, and the complexity of the patient with cancer. Clinical decision support tools are frequently cited as a technologic solution to this problem, but to date useful clinical decision support systems (CDSS) have been limited in utility and implementation. This article describes three unique sources of health data that underlie fundamentally different types of knowledge bases which feed into CDSS. CDSS themselves comprise a variety of models which are discussed. The relationship of knowledge bases and CDSS to rapid learning health systems design is critical as CDSS are essential drivers of rapid learning in clinical care. Copyright © 2015 by American Society of Clinical Oncology.

Development of traditional Chinese medicine clinical data warehouse for medical knowledge discovery and decision support.

Science.gov (United States)

Zhou, Xuezhong; Chen, Shibo; Liu, Baoyan; Zhang, Runsun; Wang, Yinghui; Li, Ping; Guo, Yufeng; Zhang, Hua; Gao, Zhuye; Yan, Xiufeng

2010-01-01

Traditional Chinese medicine (TCM) is a scientific discipline, which develops the related theories from the long-term clinical practices. The large-scale clinical data are the core empirical knowledge source for TCM research. This paper introduces a clinical data warehouse (CDW) system, which incorporates the structured electronic medical record (SEMR) data for medical knowledge discovery and TCM clinical decision support (CDS). We have developed the clinical reference information model (RIM) and physical data model to manage the various information entities and their relationships in TCM clinical data. An extraction-transformation-loading (ETL) tool is implemented to integrate and normalize the clinical data from different operational data sources. The CDW includes online analytical processing (OLAP) and complex network analysis (CNA) components to explore the various clinical relationships. Furthermore, the data mining and CNA methods are used to discover the valuable clinical knowledge from the data. The CDW has integrated 20,000 TCM inpatient data and 20,000 outpatient data, which contains manifestations (e.g. symptoms, physical examinations and laboratory test results), diagnoses and prescriptions as the main information components. We propose a practical solution to accomplish the large-scale clinical data integration and preprocessing tasks. Meanwhile, we have developed over 400 OLAP reports to enable the multidimensional analysis of clinical data and the case-based CDS. We have successfully conducted several interesting data mining applications. Particularly, we use various classification methods, namely support vector machine, decision tree and Bayesian network, to discover the knowledge of syndrome differentiation. Furthermore, we have applied association rule and CNA to extract the useful acupuncture point and herb combination patterns from the clinical prescriptions. A CDW system consisting of TCM clinical RIM, ETL, OLAP and data mining as the core

A scalable architecture for incremental specification and maintenance of procedural and declarative clinical decision-support knowledge.

Science.gov (United States)

Hatsek, Avner; Shahar, Yuval; Taieb-Maimon, Meirav; Shalom, Erez; Klimov, Denis; Lunenfeld, Eitan

2010-01-01

Clinical guidelines have been shown to improve the quality of medical care and to reduce its costs. However, most guidelines exist in a free-text representation and, without automation, are not sufficiently accessible to clinicians at the point of care. A prerequisite for automated guideline application is a machine-comprehensible representation of the guidelines. In this study, we designed and implemented a scalable architecture to support medical experts and knowledge engineers in specifying and maintaining the procedural and declarative aspects of clinical guideline knowledge, resulting in a machine comprehensible representation. The new framework significantly extends our previous work on the Digital electronic Guidelines Library (DeGeL) The current study designed and implemented a graphical framework for specification of declarative and procedural clinical knowledge, Gesher. We performed three different experiments to evaluate the functionality and usability of the major aspects of the new framework: Specification of procedural clinical knowledge, specification of declarative clinical knowledge, and exploration of a given clinical guideline. The subjects included clinicians and knowledge engineers (overall, 27 participants). The evaluations indicated high levels of completeness and correctness of the guideline specification process by both the clinicians and the knowledge engineers, although the best results, in the case of declarative-knowledge specification, were achieved by teams including a clinician and a knowledge engineer. The usability scores were high as well, although the clinicians' assessment was significantly lower than the assessment of the knowledge engineers.

Semantics-based plausible reasoning to extend the knowledge coverage of medical knowledge bases for improved clinical decision support.

Science.gov (United States)

Mohammadhassanzadeh, Hossein; Van Woensel, William; Abidi, Samina Raza; Abidi, Syed Sibte Raza

2017-01-01

Capturing complete medical knowledge is challenging-often due to incomplete patient Electronic Health Records (EHR), but also because of valuable, tacit medical knowledge hidden away in physicians' experiences. To extend the coverage of incomplete medical knowledge-based systems beyond their deductive closure, and thus enhance their decision-support capabilities, we argue that innovative, multi-strategy reasoning approaches should be applied. In particular, plausible reasoning mechanisms apply patterns from human thought processes, such as generalization, similarity and interpolation, based on attributional, hierarchical, and relational knowledge. Plausible reasoning mechanisms include inductive reasoning , which generalizes the commonalities among the data to induce new rules, and analogical reasoning , which is guided by data similarities to infer new facts. By further leveraging rich, biomedical Semantic Web ontologies to represent medical knowledge, both known and tentative, we increase the accuracy and expressivity of plausible reasoning, and cope with issues such as data heterogeneity, inconsistency and interoperability. In this paper, we present a Semantic Web-based, multi-strategy reasoning approach, which integrates deductive and plausible reasoning and exploits Semantic Web technology to solve complex clinical decision support queries. We evaluated our system using a real-world medical dataset of patients with hepatitis, from which we randomly removed different percentages of data (5%, 10%, 15%, and 20%) to reflect scenarios with increasing amounts of incomplete medical knowledge. To increase the reliability of the results, we generated 5 independent datasets for each percentage of missing values, which resulted in 20 experimental datasets (in addition to the original dataset). The results show that plausibly inferred knowledge extends the coverage of the knowledge base by, on average, 2%, 7%, 12%, and 16% for datasets with, respectively, 5%, 10%, 15

Clinical knowledge management: an overview of current understanding.

Science.gov (United States)

Bali, Rajeev K; Dwivedi, Ashish

2005-01-01

This chapter outlines contributions to a workshop for ICMCC 2005. We details some of the central issues surrounding the incorporation of the Knowledge Management (KM) paradigm for the healthcare and clinical sectors. The complex nature of KM is discussed, together with some essential theories and some contemporary applications of the tools and techniques are presented.

Gap analysis: a method to assess core competency development in the curriculum.

Science.gov (United States)

Fater, Kerry H

2013-01-01

To determine the extent to which safety and quality improvement core competency development occurs in an undergraduate nursing program. Rapid change and increased complexity of health care environments demands that health care professionals are adequately prepared to provide high quality, safe care. A gap analysis compared the present state of competency development to a desirable (ideal) state. The core competencies, Nurse of the Future Nursing Core Competencies, reflect the ideal state and represent minimal expectations for entry into practice from pre-licensure programs. Findings from the gap analysis suggest significant strengths in numerous competency domains, deficiencies in two competency domains, and areas of redundancy in the curriculum. Gap analysis provides valuable data to direct curriculum revision. Opportunities for competency development were identified, and strategies were created jointly with the practice partner, thereby enhancing relevant knowledge, attitudes, and skills nurses need for clinical practice currently and in the future.

Knowledge, skills and attitudes of hospital pharmacists in the use of information technology and electronic tools to support clinical practice: A Brazilian survey.

Science.gov (United States)

Néri, Eugenie Desirèe Rabelo; Meira, Assuero Silva; Vasconcelos, Hemerson Bruno da Silva; Woods, David John; Fonteles, Marta Maria de França

2017-01-01

pharmacists in the field of information technology to support clinical practice. Knowledge and skill gaps are evident in the use of bibliographic databases, spreadsheets and statistical tools.

Methods to Succeed in Effective Knowledge Translation in Clinical Practice.

Science.gov (United States)

Kitson, Alison L; Harvey, Gillian

2016-05-01

To explore the evidence around facilitation as an intervention for the successful implementation of new knowledge into clinical practice. The revised version of the Promoting Action on Research Implementation in Health Services (PARIHS) framework, called the integrated or i-PARIHS framework, is used as the explanatory framework. This framework posits that evidence is a multidimensional construct embedded within innovation and operationalized by clinicians (individuals and within teams), working across multiple layers of context. Facilitation is the active ingredient that promotes successful implementation. An emerging body of evidence supports facilitation as a mechanism to getting new knowledge into clinical practice. Facilitation roles are divided into beginner, experienced, and expert facilitators. Facilitators can be internal or external to the organization they work in, and their skills and attributes complement other knowledge translation (KT) roles. Complex KT projects require facilitators who are experienced in implementation methods. Facilitation is positioned as the active ingredient to effectively introduce new knowledge into a clinical setting. Levels of facilitation experience are assessed in relation to the complexity of the KT task. Three core facilitation roles are identified, and structured interventions are established taking into account the nature and novelty of the evidence, the receptiveness of the clinicians, and the context or setting where the new evidence is to be introduced. Roles such as novice, experienced, and expert facilitators have important and complementary parts to play in enabling the successful translation of evidence into everyday practice in order to provide effective care for patients. © 2016 Sigma Theta Tau International.

Overcoming Knowledge Gaps in Postmerger Integration

DEFF Research Database (Denmark)

Alaranta, Maria Eliisa; Martela, Eero

2012-01-01

Over 50% of mergers and acquisitions (M&As) fail, mainly because of integration problems. In such integrations, much of the experiential (learning-by-doing) knowledge critical for running the business becomes redundant or is lost. However, we know virtually nothing about what type of mechanisms...

The Northern Climate Exchange Gap Analysis Project : an assessment of the current state of knowledge about the impacts of climate change in northern Canada

International Nuclear Information System (INIS)

2002-01-01

The Northern Climate ExChange (NCE) Gap Analysis Project was launched in 1999 with an objective to assess the state of knowledge on climate change in northern Canada. Resulting products of the project have included the Infosource Database, an on-line database of published climate change research related to the Canadian North, the Directory of Contacts, another on-line database of interested parties to climate change issues, and a set of tables that rate the level of available information on climate change as it relates to natural, economic and community systems. Other products include a report of a workshop on climate change research, 2 reports assessing the level of traditional northern knowledge about climate change, 2 reports assessing the completeness and value of the Infosource Database, a web site for NCE, and this report. All products are available to the public on the Internet or on a CD-ROM. The NCE Gap Analysis Project has shown there are inequalities in the amount of information across different systems, and that there is more knowledge on predicted temperature changes than for other climate components. The study notes that there are strong regional trends for compiled knowledge, with some regions having been better studied than others. The project revealed that traditional knowledge of climate change has not been well documented, and that more information exists about climate change impacts on biological systems with an economic component than those without economic significance. refs., tabs., figs

The ecotoxicity of graphene family materials: current status, knowledge gaps and future needs

International Nuclear Information System (INIS)

Jastrzębska, Agnieszka Maria; Olszyna, Andrzej Roman

2015-01-01

Recently, graphene family materials (GFMs) have been introduced among all fields of science and still get numerous attention. Also, the applicability of these materials in many areas makes them very attractive. GFMs have attracted both academic and industrial interest as they can produce a dramatic improvement in materials properties at very low filler content. The aim of this review is to identify, summarize, and present the first available information on the influence of GFMs on soil and water environment as well as identify the knowledge gaps and indicate the directions for the next generation of the original scientific investigations. The paper also presents our first preliminary impact assessment and potential pathways of GFMs distribution in the environment. We used as an example the reduced graphene oxide/Al 2 O 3 nanocomposite (RGO/Al 2 O 3 ) that has been previously designed and synthesized by us. Authors believe that further work should focus on improvement of characterization methodology applicable for ecotoxicity analyses and possible interactions between GFMs and different living ecosystems. Consequently, the potential impact of graphene and its derivatives on environmental health is a matter of academic interest. However, potential hazards sufficient for risk assessment and concerned with GFMs usage in consumer products first need to be investigated and identified. Further research should focus on gathering knowledge on GFMs properties for life cycle analyses, which still poses a great challenge for scientists

The ecotoxicity of graphene family materials: current status, knowledge gaps and future needs

Energy Technology Data Exchange (ETDEWEB)

Jastrzębska, Agnieszka Maria, E-mail: agsolgala@gmail.com; Olszyna, Andrzej Roman, E-mail: aolszyna@meil.pw.edu.pl [Warsaw University of Technology, Faculty of Materials Science and Engineering (Poland)

2015-01-15

Recently, graphene family materials (GFMs) have been introduced among all fields of science and still get numerous attention. Also, the applicability of these materials in many areas makes them very attractive. GFMs have attracted both academic and industrial interest as they can produce a dramatic improvement in materials properties at very low filler content. The aim of this review is to identify, summarize, and present the first available information on the influence of GFMs on soil and water environment as well as identify the knowledge gaps and indicate the directions for the next generation of the original scientific investigations. The paper also presents our first preliminary impact assessment and potential pathways of GFMs distribution in the environment. We used as an example the reduced graphene oxide/Al{sub 2}O{sub 3} nanocomposite (RGO/Al{sub 2}O{sub 3}) that has been previously designed and synthesized by us. Authors believe that further work should focus on improvement of characterization methodology applicable for ecotoxicity analyses and possible interactions between GFMs and different living ecosystems. Consequently, the potential impact of graphene and its derivatives on environmental health is a matter of academic interest. However, potential hazards sufficient for risk assessment and concerned with GFMs usage in consumer products first need to be investigated and identified. Further research should focus on gathering knowledge on GFMs properties for life cycle analyses, which still poses a great challenge for scientists.

Assessment of the knowledge and attitudes regarding HIV/AIDS among pre-clinical medical students in Israel

Science.gov (United States)

2014-01-01

Background Today’s medical students are the future physicians of people living with HIV/AIDS (PLWHA). It is therefore essential that medical students possess the appropriate knowledge and attitudes regarding PLWHA. This study aims to evaluate knowledge and attitudes of pre-clinical Israeli medical students and to assess whether their knowledge and attitudes change throughout their pre-clinical studies. Methods A cross-sectional study was conducted among all pre-clinical medical students from the four medical schools in Israel during the academic year of 2010/2011 (a total of 1,470 students). A self-administered questionnaire was distributed. The questionnaire sought student responses pertaining to knowledge of HIV transmission and non-transmission routes, basic knowledge of HIV/AIDS treatment and attitudes towards HIV/AIDS. Results The study’s response rate was 62.24 percent. Knowledge among pre-clinical medical students was generally high and showed a statistically significant improvement as students progressed through their pre-clinical studies. However, there were some misconceptions, mostly regarding HIV transmission via breastfeeding and knowledge of HIV prevention after exposure to the virus. Students’ attitudes were found to include stigmatizing notions. Furthermore, the majority of medical students correlated HIV with shame and fear. In addition, students’ attitudes toward HIV testing and providing confidential medical information were contradictory to health laws, protocols and guidelines. Overall, no positive changes in students’ attitudes were observed during the pre-clinical years of medical school. Conclusion The knowledge of pre-clinical medical students in Israel is generally high, although there are some knowledge inadequacies that require more emphasis in the curricula of the medical schools. Contrary to HIV-related knowledge, medical students’ attitudes are unaffected by their progression through medical school. Therefore, medical

Translation of New Molecular Imaging Approaches to the Clinical Setting: Bridging the Gap to Implementation.

Science.gov (United States)

van Es, Suzanne C; Venema, Clasina M; Glaudemans, Andor W J M; Lub-de Hooge, Marjolijn N; Elias, Sjoerd G; Boellaard, Ronald; Hospers, Geke A P; Schröder, Carolina P; de Vries, Elisabeth G E

2016-02-01

Molecular imaging with PET is a rapidly emerging technique. In breast cancer patients, more than 45 different PET tracers have been or are presently being tested. With a good rationale, after development of the tracer and proven feasibility, it is of interest to evaluate whether there is a potential meaningful role for the tracer in the clinical setting-such as in staging, in the (early) prediction of a treatment response, or in supporting drug choices. So far, only (18)F-FDG PET has been incorporated into breast cancer guidelines. For proof of the clinical relevance of tracers, especially for analysis in a multicenter setting, standardization of the technology and access to the novel PET tracer are required. However, resources for PET implementation research are limited. Therefore, next to randomized studies, novel approaches are required for proving the clinical value of PET tracers with the smallest possible number of patients. The aim of this review is to describe the process of the development of PET tracers and the level of evidence needed for the use of these tracers in breast cancer. Several breast cancer trials have been performed with the PET tracers (18)F-FDG, 3'-deoxy-3'-(18)F-fluorothymidine ((18)F-FLT), and (18)F-fluoroestradiol ((18)F-FES). We studied them to learn lessons for the implementation of novel tracers. After defining the gap between a good rationale for a tracer and implementation in the clinical setting, we propose solutions to fill the gap to try to bring more PET tracers to daily clinical practice. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Clinical cultural competency and knowledge of health disparities among pharmacy students.

Science.gov (United States)

Okoro, Olihe N; Odedina, Folakemi T; Reams, Romonia R; Smith, W Thomas

2012-04-10

To evaluate the level of competency and knowledge about health disparities among third-year doctor of pharmacy (PharmD) students at 2 Florida public colleges of pharmacy and to explore the demographic correlates of these variables. A cross-sectional survey study design was used to collect data from participants. The students had low health-disparities knowledge and moderate skills in dealing with sociocultural issues and cross-cultural encounters. Speaking a language(s) other than English and having exposure to cultural-competency instruction were the demographic variables found to be most significantly associated with clinical cultural competency and/or knowledge of health disparities. Clinical cultural competency and health-disparities instruction may not be adequately incorporated into the pharmacy school curricula in the institutions studied. Relevant education and training are necessary to enhance cultural competency among pharmacy students.

Towards prevention of vitamin D deficiency and beyond: knowledge gaps and research needs in vitamin D nutrition and public health.

Science.gov (United States)

Cashman, Kevin D; Kiely, Mairead

2011-12-01

The North American Institute of Medicine (IOM) recently published their report on dietary reference intakes (DRI) for Ca and vitamin D. The DRI committee's deliberations underpinning this most comprehensive report on vitamin D nutrition to date benefited hugely from a much expanded knowledge base in vitamin D over the last decade or more. However, since their release, the vitamin D DRI have been the subject of intense controversy, which is largely due to the persistence of fundamental knowledge gaps in vitamin D. These can be identified at the levels of exposure, metabolism, storage, status, dose-response, function and beneficial or adverse health effects, as well as safe and effective application of intake recommendations at the population level through sustainable food-based approaches. The present review provides a brief overview of the approach used by the IOM committee to revise the DRI for vitamin D and to collate from a number of authoritative sources key knowledge gaps in vitamin D nutrition from the public health perspective. A number of research topics are outlined and data requirements within these are identified and mapped to the risk assessment framework used by the DRI committee. While not intended as an exhaustive list, it provides a basis for organising and prioritising research efforts in the area of vitamin D, which may offer a perspective on the major areas in need of attention. It is intended to be of use to researchers, national policy makers, the public health community, industry groups and other relevant stakeholders including funding institutions.

Newly graduated nurses' use of knowledge sources in clinical decision-making

DEFF Research Database (Denmark)

Voldbjerg, Siri Lygum; Grønkjaer, Mette; Wiechula, Rick

2017-01-01

AIMS AND OBJECTIVES: To explore which knowledge sources newly graduated nurses' use in clinical decision-making and why and how they are used. BACKGROUND: In spite of an increased educational focus on skills and competencies within evidence based practice newly graduated nurses' ability to use...... approaches to strengthen the knowledgebase used in clinical decision-making. DESIGN AND METHODS: Ethnographic study using participant-observation and individual semi-structured interviews of nine Danish newly graduated nurses in medical and surgical hospital settings. RESULTS: Newly graduates use...... in clinical decision-making. If newly graduates are to be supported in an articulate and reflective use of a variety of sources, they have to be allocated to experienced nurses who model a reflective, articulate and balanced use of knowledge sources. This article is protected by copyright. All rights reserved....

A Review of Current Research and Knowledge Gaps in the Epidemiology of Shiga Toxin-Producing Escherichia coli and Salmonella spp. in Trinidad and Tobago

Directory of Open Access Journals (Sweden)

Anil K. Persad

2018-04-01

Full Text Available Salmonella and Shiga toxin-producing Escherichia coli are two of the main causes of foodborne disease globally, and while they have been implicated as possible causes of foodborne disease within the Caribbean region, the actual incidence is unknown. Trinidad and Tobago, one of the larger countries in the Caribbean, has an estimated annual foodborne disease burden of over 100,000 cases and, similar to other countries, the etiology of most of these cases is unknown. Both pathogens can reside as part of the normal gastrointestinal microflora of many wild and domestic animals, with animals acting as reservoirs, spillover hosts, or dead-end hosts. Carriage in animal species can be asymptomatic or, in the case of Salmonella in particular, there may be clinical manifestation in animals, which resemble the disease seen in humans. In this review, we will focus on the epidemiology of these two foodborne pathogens in Trinidad and Tobago and identify any knowledge gaps in the published literature. The filling of this critical knowledge void is essential for the development and implementation of appropriate mechanisms to reduce the dissemination and transmission of these pathogens, not only in Trinidad and Tobago, but also in the wider Caribbean.

On the road to eliminate malaria in Sri Lanka: lessons from history, challenges, gaps in knowledge and research needs.

Science.gov (United States)

Karunaweera, Nadira D; Galappaththy, Gawrie Nl; Wirth, Dyann F

2014-02-18

Malaria is one of the most important tropical diseases that has caused devastation throughout the history of mankind. Malaria eradication programmes in the past have had many positive effects but failed to wipe out malaria from most tropical countries, including Sri Lanka. Encouraged by the impressive levels of reduction in malaria case numbers during the past decade, Sri Lanka has launched a programme to eliminate malaria by year 2014. This article reviews the historical milestones associated with the malaria eradication programme that failed subsequently and the events that led to the launch of the ongoing malaria elimination plans at national-level and its strategies that are operational across the entire country. The existing gaps in knowledge are also discussed together with the priority areas for research to fill in these gaps that are posing as challenges to the envisaged goal of wiping out malaria from this island nation.

Parent knowledge of disease management in cystic fibrosis: Assessing behavioral treatment management.

Science.gov (United States)

Nicolais, Christina J; Bernstein, Ruth; Riekert, Kristin A; Quittner, Alexandra L

2018-02-01

Cystic fibrosis (CF) is a life-shortening, burdensome disease requiring complex knowledge to manage the disease. Significant gaps in knowledge have been documented for parents, which may lead to unintentionally poor adherence and insufficient transfer of treatment responsibility from parents to adolescents. There are no current, validated measures of parent knowledge for this population and there are no measures that assess the knowledge required for day-to-day behavioral management of CF. We assessed the psychometric properties of the parent version of the Knowledge of Disease Management-Cystic Fibrosis measure (KDM-CF-P) using data from iCARE (I Change Adherence and Raise Expectations), a randomized control adherence intervention trial. A total of 196 parents in the iCARE standard care/control arm completed 35 items assessing their knowledge of disease management at their 12-month study visit, prior to beginning the intervention. Items were eliminated from the measure if they met the threshold for ceiling effects, were deemed clinically irrelevant, or did not correlate well with their intended scale. Item-to-total correlations, confirmatory factor analysis, discriminant function, reliability, and convergent validity were calculated. The KDM-CF-P (19 items) demonstrated internal consistency of KR20 = 0.60 on each scale and a two-scale structure. Convergent validity for knowledge scores was found with maternal education, family income, and type of medical insurance. Parents correctly answered approximately 85% of items on the KDM-CF-P. The KDM-CF-P psychometrics support a two-scale measure with clinical utility. It is useful for assessing gaps in knowledge that can be remediated through individualized, tailored interventions. © 2017 Wiley Periodicals, Inc.

Does clinical experience affect knowledge regarding hepatitis-B among male medical students at a private university

International Nuclear Information System (INIS)

Nisar, N.

2009-01-01

To assess the knowledge of male medical students about Hepatitis-B in their preclinical and clinical years and to investigate the self reported vaccination status of these students. In the year of 2007, 187 male students of Isra University Hyderabad Sindh Pakistan were selected by convenient sampling and surveyed with a self reported questionnaire comprising of questions regarding knowledge about hepatitis B. Data gathered was analyzed by SPSS V. 16. Knowledge between preclinical and clinical students were compared by Pearson's coefficient chi square test, p value < 0.005 was considered significant. Out of 187 students interviewed, 73 (39%) and 114 (61%) were from preclinical and clinical years respectively. Significant difference was found in clinical and preclinical students regarding basic knowledge about hepatitis B. and mode of transmission of disease (P= 0.004) and (P=< 0.001) respectively. Significant difference was found in the knowledge of both preclinical and clinical male medical students. (JPMA 59:808; 2009). (author)

Knowledge in schizophrenia: The Portuguese version of KAST (Knowledge About Schizophrenia Test) and analysis of social-demographic and clinical factors' influence.

Science.gov (United States)

Daltio, C S; Attux, C; Ferraz, M B

2015-10-01

Schizophrenia is a complex disorder, and the knowledge about it can have a positive impact. The purpose of this study was to make the translation and cultural adaptation of the Knowledge About Schizophrenia Test (KAST) into Portuguese and determine the influence of clinical and socio-demographic factors on knowledge. The test was applied to 189 caregivers of patients enrolled in Schizophrenia Program of the Federal University of São Paulo, 30 caregivers of clinical patients of the General Outpatient Clinic of the same University, and 30 health professionals. The face and content validity of the test was established. The mean value (SD) obtained with the application of the final version to caregivers of schizophrenic patients was 12.96 (2.45) - maximum 17. Level of knowledge increased considering the following order: caregivers of clinical patients, caregivers of patients with schizophrenia and mental health professionals. The intraclass correlation coefficient (0.592) obtained in the test-retest was statistically significant. An influence of social class, race, gender and education of the caregiver on the test was observed, and the last two factors were more relevant. The KAST translated and adapted into Portuguese is a valid instrument and can be used as an evaluation tool on psychoeducational interventions. Copyright © 2015 Elsevier B.V. All rights reserved.

The Trilogy of Science: Filling the Knowledge Management Gap with Knowledge Science and Theory

Science.gov (United States)

Bates, Anthony Shawn

2017-01-01

The international knowledge management field has different ways of investigating, developing, believing, and studying knowledge management. Knowledge management (KM) is distinguished deductively by know-how, and its intangible nature establishes different approaches to KM concepts, practices, and developments. Exploratory research and theoretical…

Integrating research into clinical internship training bridging the science/practice gap in pediatric psychology.

Science.gov (United States)

McQuaid, Elizabeth L; Spirito, Anthony

2012-03-01

Existing literature highlights a critical gap between science and practice in clinical psychology. The internship year is a "capstone experience"; training in methods of scientific evaluation should be integrated with the development of advanced clinical competencies. We provide a rationale for continued exposure to research during the clinical internship year, including, (a) critical examination and integration of the literature regarding evidence-based treatment and assessment, (b) participation in faculty-based and independent research, and (c) orientation to the science and strategy of grantsmanship. Participation in research provides exposure to new empirical models and can foster the development of applied research questions. Orientation to grantsmanship can yield an initial sense of the "business of science." Internship provides an important opportunity to examine the challenges to integrating the clinical evidence base into professional practice; for that reason, providing research exposure on internship is an important strategy in training the next generation of pediatric psychologists.

Integrating Research Into Clinical Internship Training Bridging the Science/Practice Gap in Pediatric Psychology

Science.gov (United States)

Spirito, Anthony

2012-01-01

Existing literature highlights a critical gap between science and practice in clinical psychology. The internship year is a “capstone experience”; training in methods of scientific evaluation should be integrated with the development of advanced clinical competencies. We provide a rationale for continued exposure to research during the clinical internship year, including, (a) critical examination and integration of the literature regarding evidence-based treatment and assessment, (b) participation in faculty-based and independent research, and (c) orientation to the science and strategy of grantsmanship. Participation in research provides exposure to new empirical models and can foster the development of applied research questions. Orientation to grantsmanship can yield an initial sense of the “business of science.” Internship provides an important opportunity to examine the challenges to integrating the clinical evidence base into professional practice; for that reason, providing research exposure on internship is an important strategy in training the next generation of pediatric psychologists. PMID:22286345

Acquiring, encoding, and re-using clinical knowledge in PRODIGY

Directory of Open Access Journals (Sweden)

Richard Hall

2002-11-01

Full Text Available The development, implementation and maintenance of computer-executable clinical guidelines encompass a series of complex processes. As they are often performed by more than one organisation, this introduces further complexity. Within the PRODIGY project we attempt to control as many aspects of the process as possible, in order to increase the likelihood of achieving success. To illustrate the complexity of the process and many of the inherent problems and solutions, this paper describes the evolution of the PRODIGY knowledge base, describing the steps from acquiring knowledge, through encoding, to the execution of guidelines, and 'closing the loop' by discussing an approach to knowledge re-use. We will also consider some of the wider implications of our work and propose directions for future research and development activities.

ParticipACTION: Awareness of the participACTION campaign among Canadian adults - Examining the knowledge gap hypothesis and a hierarchy-of-effects model

Directory of Open Access Journals (Sweden)

Faulkner Guy EJ

2009-12-01

Full Text Available Abstract Background ParticipACTION was a pervasive communication campaign that promoted physical activity in the Canadian population for three decades. According to McGuire's hierarchy-of-effects model (HOEM, this campaign should influence physical activity through intermediate mediators such as beliefs and intention. Also, when such media campaigns occur, knowledge gaps often develop within the population about the messages being conveyed. The purposes of this study were to (a determine the current awareness of ParticipACTION campaigns among Canadians; (b confirm if awareness of the ParticipACTION initiative varied as a function of levels of education and household income; and, (c to examine whether awareness of ParticipACTION was associated with physical activity related beliefs, intentions, and leisure-time physical activity (LTPA as suggested by the HOEM. Specifically, we tested a model including awareness of ParticipACTION (unprompted, prompted, outcome expectations, self-efficacy, intention, and physical activity status. Methods A population-based survey was conducted on 4,650 Canadians over a period of 6 months from August, 2007 to February, 2008 (response rate = 49%. The survey consisted of a set of additional questions on the 2007 Physical Activity Monitor (PAM. Our module on the PAM included questions related to awareness and knowledge of ParticipACTION. Weighted logistic models were constructed to test the knowledge gap hypotheses and to examine whether awareness was associated with physical activity related beliefs (i.e., outcome expectations, self-efficacy, intention, and LTPA. All analyses included those respondents who were 20 years of age and older in 2007/2008 (N = 4424. Results Approximately 8% of Canadians were still aware of ParticipACTION unprompted and 82% were aware when prompted. Both education and income were significant correlates of awareness among Canadians. The odds of people being aware of ParticipACTION were

ParticipACTION: awareness of the participACTION campaign among Canadian adults--examining the knowledge gap hypothesis and a hierarchy-of-effects model.

Science.gov (United States)

Spence, John C; Brawley, Lawrence R; Craig, Cora Lynn; Plotnikoff, Ronald C; Tremblay, Mark S; Bauman, Adrian; Faulkner, Guy Ej; Chad, Karen; Clark, Marianne I

2009-12-09

ParticipACTION was a pervasive communication campaign that promoted physical activity in the Canadian population for three decades. According to McGuire's hierarchy-of-effects model (HOEM), this campaign should influence physical activity through intermediate mediators such as beliefs and intention. Also, when such media campaigns occur, knowledge gaps often develop within the population about the messages being conveyed. The purposes of this study were to (a) determine the current awareness of ParticipACTION campaigns among Canadians; (b) confirm if awareness of the ParticipACTION initiative varied as a function of levels of education and household income; and, (c) to examine whether awareness of ParticipACTION was associated with physical activity related beliefs, intentions, and leisure-time physical activity (LTPA) as suggested by the HOEM. Specifically, we tested a model including awareness of ParticipACTION (unprompted, prompted), outcome expectations, self-efficacy, intention, and physical activity status. A population-based survey was conducted on 4,650 Canadians over a period of 6 months from August, 2007 to February, 2008 (response rate = 49%). The survey consisted of a set of additional questions on the 2007 Physical Activity Monitor (PAM). Our module on the PAM included questions related to awareness and knowledge of ParticipACTION. Weighted logistic models were constructed to test the knowledge gap hypotheses and to examine whether awareness was associated with physical activity related beliefs (i.e., outcome expectations, self-efficacy), intention, and LTPA. All analyses included those respondents who were 20 years of age and older in 2007/2008 (N = 4424). Approximately 8% of Canadians were still aware of ParticipACTION unprompted and 82% were aware when prompted. Both education and income were significant correlates of awareness among Canadians. The odds of people being aware of ParticipACTION were greater if they were more educated and reported

Using Best Practices to Extract, Organize, and Reuse Embedded Decision Support Content Knowledge Rules from Mature Clinical Systems.

Science.gov (United States)

DesAutels, Spencer J; Fox, Zachary E; Giuse, Dario A; Williams, Annette M; Kou, Qing-Hua; Weitkamp, Asli; Neal R, Patel; Bettinsoli Giuse, Nunzia

2016-01-01

Clinical decision support (CDS) knowledge, embedded over time in mature medical systems, presents an interesting and complex opportunity for information organization, maintenance, and reuse. To have a holistic view of all decision support requires an in-depth understanding of each clinical system as well as expert knowledge of the latest evidence. This approach to clinical decision support presents an opportunity to unify and externalize the knowledge within rules-based decision support. Driven by an institutional need to prioritize decision support content for migration to new clinical systems, the Center for Knowledge Management and Health Information Technology teams applied their unique expertise to extract content from individual systems, organize it through a single extensible schema, and present it for discovery and reuse through a newly created Clinical Support Knowledge Acquisition and Archival Tool (CS-KAAT). CS-KAAT can build and maintain the underlying knowledge infrastructure needed by clinical systems.

Using Best Practices to Extract, Organize, and Reuse Embedded Decision Support Content Knowledge Rules from Mature Clinical Systems

Science.gov (United States)

DesAutels, Spencer J.; Fox, Zachary E.; Giuse, Dario A.; Williams, Annette M.; Kou, Qing-hua; Weitkamp, Asli; Neal R, Patel; Bettinsoli Giuse, Nunzia

2016-01-01

Clinical decision support (CDS) knowledge, embedded over time in mature medical systems, presents an interesting and complex opportunity for information organization, maintenance, and reuse. To have a holistic view of all decision support requires an in-depth understanding of each clinical system as well as expert knowledge of the latest evidence. This approach to clinical decision support presents an opportunity to unify and externalize the knowledge within rules-based decision support. Driven by an institutional need to prioritize decision support content for migration to new clinical systems, the Center for Knowledge Management and Health Information Technology teams applied their unique expertise to extract content from individual systems, organize it through a single extensible schema, and present it for discovery and reuse through a newly created Clinical Support Knowledge Acquisition and Archival Tool (CS-KAAT). CS-KAAT can build and maintain the underlying knowledge infrastructure needed by clinical systems. PMID:28269846

[Clinical practice guidelines and knowledge management in healthcare].

Science.gov (United States)

Ollenschläger, Günter

2013-10-01

Clinical practice guidelines are key tools for the translation of scientific evidence into everyday patient care. Therefore guidelines can act as cornerstones of evidence based knowledge management in healthcare, if they are trustworthy, and its recommendations are not biased by authors' conflict of interests. Good medical guidelines should be disseminated by means of virtual (digital/electronic) health libraries - together with implementation tools in context, such as guideline based algorithms, check lists, patient information, a.s.f. The article presents evidence based medical knowledge management using the German experiences as an example. It discusses future steps establishing evidence based health care by means of combining patient data, evidence from medical science and patient care routine, together with feedback systems for healthcare providers.

Guideline Formalization and Knowledge Representation for Clinical Decision Support

Directory of Open Access Journals (Sweden)

Tiago OLIVEIRA

2012-09-01

Full Text Available Normal 0 21 false false false EN-US JA X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:Cambria; mso-ascii-font-family:Cambria; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Cambria; mso-hansi-theme-font:minor-latin; mso-ansi-language:EN-US;} The prevalence of situations of medical error and defensive medicine in healthcare institutions is a great concern of the medical community. Clinical Practice Guidelines are regarded by most researchers as a way to mitigate theseoccurrences; however, there is a need to make them interactive, easier to update and to deploy. This paper provides a model for Computer-Interpretable Guidelines based on the generic tasks of the clinical process, devised to be included in the framework of a Clinical Decision Support System. Aiming to represent medical recommendations in a simple and intuitive way. Hence, this work proposes a knowledge representation formalism that uses an Extension to Logic Programming to handle incomplete information. This model is used to represent different cases of missing, conflicting and inexact information with the aid of a method to quantify its quality. The integration of the guideline model with the knowledge representation formalism yields a clinical decision model that relies on the development of multiple information scenarios and the exploration of different clinical hypotheses.

Guideline Formalization and Knowledge Representation for Clinical Decision Support

Directory of Open Access Journals (Sweden)

Paulo NOVAIS

2013-07-01

Full Text Available Normal 0 21 false false false EN-US JA X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:Cambria; mso-ascii-font-family:Cambria; mso-ascii-theme-font:minor-latin; mso-hansi-font-family:Cambria; mso-hansi-theme-font:minor-latin; mso-ansi-language:EN-US;} The prevalence of situations of medical error and defensive medicine in healthcare institutions is a great concern of the medical community. Clinical Practice Guidelines are regarded by most researchers as a way to mitigate these occurrences; however, there is a need to make them interactive, easier to update and to deploy. This paper provides a model for Computer-Interpretable Guidelines based on the generic tasks of the clinical process, devised to be included in the framework of a Clinical Decision Support System. Aiming to represent medical recommendations in a simple and intuitive way. Hence, this work proposes a knowledge representation formalism that uses an Extension to Logic Programming to handle incomplete information. This model is used to represent different cases of missing, conflicting and inexact information with the aid of a method to quantify its quality. The integration of the guideline model with the knowledge representation formalism yields a clinical decision model that relies on the development of multiple information scenarios and the exploration of different clinical hypotheses.

Social Networks and Health Knowledge in India

DEFF Research Database (Denmark)

Blunch, Niels-Hugo; Datta Gupta, Nabanita

such as education and access to social networks explain part of the gap, a substantial part of the health knowledge gap is left unexplained. All groups have greater health knowledge in urban than in rural areas, but the gap is even wider in urban than in rural areas. Additionally, high caste women benefit more...... in terms of health knowledge from having health networks than women from other groups; except if the health person is of the same caste/religion, in which case low caste and Muslim women sometimes benefit by as much as double that of high caste women, or even more. It may therefore not be enough to give...... individuals access to high quality networks if caste and religion-related gaps in health knowledge are to be reduced; such networks also have to be homophilous, to have the maximum effect. Improved treatment from and confidence in the medical profession is found to be part of the mechanism linking health...

Clinical Acceptability of the Internal Gap of CAD/CAM PD-AG Crowns Using Intraoral Digital Impressions

Science.gov (United States)

Kim, Tae-Gyung; Kim, Sungtae; Lee, Jae-Hoon

2016-01-01

The purpose of this study was to compare the internal gap between CAD/CAM palladium-silver crowns and cast gold crowns generated from intraoral digital versus conventional impressions and to determine the clinical acceptability. Nickel-chrome master dies were made from the prepared resin tooth with the conventional impression method (n = 40). For ICC (Intraoral, CAD/CAM) group, 10 intraoral digital impressions were made, and 10 CAD/CAM crowns of a PD-AG (palladium-silver) machinable alloy were generated. For IC (Intraoral, Cast) group, 10 gold crowns were cast from ten intraoral digital impressions. For CCC (Conventional, CAD/CAM) group, 10 CAD/CAM PD-AG crowns were made using the conventional impression method. For CC (Conventional, Cast) group, 10 gold crowns were fabricated from 10 conventional impressions. One hundred magnifications of the internal gaps of each crown were measured at 50 points with an optical microscope and these values were statistically analyzed using a two-way analysis of variance (α = 0.05). The internal gap of the intraoral digital impression group was significantly larger than in the conventional impression group (P 0.05). Within the limitations of this in vitro study, crowns from intraoral digital impressions showed larger internal gap values than crowns from conventional impressions. PMID:28018914

Clinical Acceptability of the Internal Gap of CAD/CAM PD-AG Crowns Using Intraoral Digital Impressions

Directory of Open Access Journals (Sweden)

Tae-Gyung Kim

2016-01-01

Full Text Available The purpose of this study was to compare the internal gap between CAD/CAM palladium-silver crowns and cast gold crowns generated from intraoral digital versus conventional impressions and to determine the clinical acceptability. Nickel-chrome master dies were made from the prepared resin tooth with the conventional impression method (n=40. For ICC (Intraoral, CAD/CAM group, 10 intraoral digital impressions were made, and 10 CAD/CAM crowns of a PD-AG (palladium-silver machinable alloy were generated. For IC (Intraoral, Cast group, 10 gold crowns were cast from ten intraoral digital impressions. For CCC (Conventional, CAD/CAM group, 10 CAD/CAM PD-AG crowns were made using the conventional impression method. For CC (Conventional, Cast group, 10 gold crowns were fabricated from 10 conventional impressions. One hundred magnifications of the internal gaps of each crown were measured at 50 points with an optical microscope and these values were statistically analyzed using a two-way analysis of variance (α=0.05. The internal gap of the intraoral digital impression group was significantly larger than in the conventional impression group (P0.05. Within the limitations of this in vitro study, crowns from intraoral digital impressions showed larger internal gap values than crowns from conventional impressions.

Bridging the Otolaryngology Peer Review Knowledge Gap: A Call for a Residency Development Program.

Science.gov (United States)

Schmalbach, Cecelia E

2016-07-01

Current otolaryngology literature and future scientific direction rely heavily on a rigorous peer review process. Just as manuscripts warrant thoughtful review with constructive feedback to the authors, the same can be said for critiques written by novice peer reviewers. Formal scientific peer review training programs are lacking. Recognizing this knowledge gap, Otolaryngology-Head and Neck Surgery is excited to offer its new Resident Reviewer Development Program. All otolaryngology residents who are postgraduate year 2 and above and in excellent academic standing are eligible to participate in this mentored program, during which they will conduct 6 manuscript reviews under the direction of a seasoned reviewer in his or her subspecialty area of interest. By completing reviews alongside a mentor, participants gain the required skills to master the peer review process-a first step that often leads to journal editorial board and associate editor invitations. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Clinical utility of EEG in diagnosing and monitoring epilepsy in adults.

Science.gov (United States)

Tatum, W O; Rubboli, G; Kaplan, P W; Mirsatari, S M; Radhakrishnan, K; Gloss, D; Caboclo, L O; Drislane, F W; Koutroumanidis, M; Schomer, D L; Kasteleijn-Nolst Trenite, D; Cook, Mark; Beniczky, S

2018-05-01

Electroencephalography (EEG) remains an essential diagnostic tool for people with epilepsy (PWE). The International Federation of Clinical Neurophysiology produces new guidelines as an educational service for clinicians to address gaps in knowledge in clinical neurophysiology. The current guideline was prepared in response to gaps present in epilepsy-related neurophysiological assessment and is not intended to replace sound clinical judgement in the care of PWE. Furthermore, addressing specific pathophysiological conditions of the brain that produce epilepsy is of primary importance though is beyond the scope of this guideline. Instead, our goal is to summarize the scientific evidence for the utility of EEG when diagnosing and monitoring PWE. Copyright © 2018 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

EcAMSat and BioSentinel: Autonomous Bio Nanosatellites Addressing Strategic Knowledge Gaps for Manned Spaceflight Beyond LEO

Science.gov (United States)

Padgen, Mike

2017-01-01

Manned missions beyond low Earth orbit (LEO) require that several strategic knowledge gaps about the effects of space travel on the human body be addressed. NASA Ames Research Center has been the leader in developing autonomous bio nanosatellites, including past successful missions for GeneSat, PharmaSat, and OOREOS, that tackled some of these issues. These nanosatellites provide in situ measurements, which deliver insight into the dynamic changes in cell behavior in microgravity. In this talk, two upcoming bio nanosatellites developed at Ames, the E. coli Antimicrobial Satellite (EcAMSat) and BioSentinel, will be discussed. Both satellites contain microfluidic systems that precisely deliver nutrients to the microorganisms stored within wells of fluidic cards. Each well, in turn, has its own 3-color LED and detector system which is used to monitor changes in metabolic activity with alamarBlue, a redox indicator, and the optical density of the cells. EcAMSat investigates the effects of microgravity on bacterial resistance to antimicrobial drugs, vital knowledge for understanding how to maintain the health of astronauts in long-term and beyond LEO spaceflight. The behavior of wild type and mutant uropathic E. coli will be compared in microgravity and with ground data to help understand the molecular mechanisms behind antibiotic resistance and how these phenotypes might change in space. BioSentinel seeks to directly measure the effects of space radiation on budding yeast S. cerevisiae, particularly double strand breaks (DSB). While hitching a ride on the SLS EM-1 mission (Orions first unmanned mission to the moon) in 2018, BioSentinel will be kicked off and enter into a heliocentric orbit, becoming the first study of the effects of radiation on living organisms outside LEO since the Apollo program. The yeast are stored in eighteen independent 16-well microfluidic cards, which will be individually activated over the 12 month mission duration. In addition to the wild

On the constraints of encapsulated knowledge : Clinical case representations by medical experts and subexperts

NARCIS (Netherlands)

Rikers, Remy MJP; Schmidt, Henk G; Boshuizen, Henny PA

2002-01-01

This article is concerned with the role of so-called encapsulated knowledge and biomedical knowledge in the process of diagnosing clinical cases within and outside the medical specialist's domain of expertise. Based on the theory of knowledge encapsulation, we predicted that subexperts (i.e.,

Knowledge, skills and attitudes of hospital pharmacists in the use of information technology and electronic tools to support clinical practice: A Brazilian survey.

Directory of Open Access Journals (Sweden)

Eugenie Desirèe Rabelo Néri

pharmacists in the field of information technology to support clinical practice. Knowledge and skill gaps are evident in the use of bibliographic databases, spreadsheets and statistical tools.

Knowledge-Base Semantic Gap Analysis for the Vulnerability Detection

Science.gov (United States)

Wu, Raymond; Seki, Keisuke; Sakamoto, Ryusuke; Hisada, Masayuki

Web security became an alert in internet computing. To cope with ever-rising security complexity, semantic analysis is proposed to fill-in the gap that the current approaches fail to commit. Conventional methods limit their focus to the physical source codes instead of the abstraction of semantics. It bypasses new types of vulnerability and causes tremendous business loss.

The Knowledge Translation Toolkit: Bridging the Know–Do Gap: A ...

International Development Research Centre (IDRC) Digital Library (Canada)

2011-06-06

Jun 6, 2011 ... It presents the theories, tools, and strategies required to encourage and enable ... Toolkit: Bridging the Know–Do Gap: A Resource for Researchers ... violence, and make digital platforms work for inclusive development.

Bridging the gap with flipped classroom

DEFF Research Database (Denmark)

Selberg, Hanne; Topperzer, Martha

the theoretical knowledge acquired during the course to their participation in the simulations. It is of pivotal importance that all students obtain hands-on experience during the sessions to reduce the theory-practice gap. The ongoing study has been pilot tested during three courses with participation of 90......Bridging the gap with flipped classroom Hanne Selberg, Metropolitan University College, Copenhagen, Martha Topperzer, University Hospital Rigshospitalet, Copenhagen, Denmark Background and aims Consistent with the strategy of increasing digitization and learner-centred teaching models....... The debriefing allows for students to reflect on how they applied their knowledge in the concrete patient situation which in turn promotes a positive learning experience. The learning objectives encompass both hands-on technical skills and non-technical communication skills enabling students to apply...

Bridging the gap to evidence-based eye care

Directory of Open Access Journals (Sweden)

Richard Wormald

2004-10-01

Full Text Available In the first article in this series, I touched on the enormous challenge to make access to information equal for those who need it at the time and place when they need it. Only if this is achieved can we successfully promote an evidence-based approach to health care. The move towards open access publishing is taking us some way to achieving this. However, there are further gaps to be bridged if we are to turn eye care workers into evidence-based practitioners. We can define an evidence-based practitioner as one who combines their individual knowledge and expertise with the best available external clinical evidence from systematic research.

"Prince Charming Syndrome?" Gender gap in preferences for defined contribution pensions in Japan.

Science.gov (United States)

Watanabe, Satoshi P

2017-01-01

Using survey data collected by the Japan Institute of Life Insurance in 2002, this study finds that a significant gender gap existed in defined contribution (DC) pension knowledge among workers employed at small- to medium-sized private firms in Japan. Even with similar DC knowledge, however, men and women reveal different preferences for DC pensions, indicating that their perceptional responses may widely differ from actual behaviors. Apart from the knowledge gap, the result shows evidence of the Prince Charming Syndrome among female employees as a significant source of the gender gap in DC participation rates. Among corporate pension-covered employees, the gender difference in the efficacy of DC portability is a more significant gap-generating factor. DC tax advantage is particularly favored by pension-covered female employees over male counterparts, reducing the DC preference gap. No similar evidence is found for employees with no corporate pension coverage.

Strengths, weaknesses and future challenges of biosimilars' development. An opinion on how to improve the knowledge and use of biosimilars in clinical practice.

Science.gov (United States)

Scavone, Cristina; Rafaniello, Concetta; Berrino, Liberato; Rossi, Francesco; Capuano, Annalisa

2017-12-01

Biosimilars started receiving the marketing authorization by European Medicine Agency since 2006. The development of biosimilars follows a well-defined step-wise approach, the so-called comparability exercise, which aims to compare non-clinical (mainly quality features and biological activity) and clinical (efficacy and safety profiles) features of new biosimilars with their respective reference products. Despite the undeniable advantages of such procedure, some concerns (such as the absence of switching studies or the evaluation of efficacy and safety in all therapeutic indications) still exist about its. In particular, the European regulatory framework on biosimilars approval does not include the conduction of switching studies demonstrating the interchangeability to be carried out before marketing authorization. This is one of the main aspects that negatively affects healthcare professionals' clinical decisions on switch. In order to achieve a better knowledge on safety and efficacy of biosimilar drugs, real world data should be collected and post-marketing efficacy and safety clinical studies (including those evaluating specific endpoints, therapeutic regimens and patients population), should be planned. also the conduction of well-designed switching studies is highly advisable, especially in the case of biosimilar drugs used in oncology settings. Lastly, considering the critical role of antidrug antibodies on efficacy/safety profile of biologic drugs, studies based on therapeutic drug monitoring would be useful in order to achieve treatment optimization. Implementing the above strategies could be helpful to fill the gap in knowledge observed in the present European biosimilar regulatory framework. Copyright © 2017 Elsevier Ltd. All rights reserved.

WE-F-BRB-01: The Power of Ontologies and Standardized Terminologies for Capturing Clinical Knowledge

Energy Technology Data Exchange (ETDEWEB)

Gabriel, P. [University of Pennsylvania (United States)

2015-06-15

Advancements in informatics in radiotherapy are opening up opportunities to improve our ability to assess treatment plans. Models on individualizing patient dose constraints from prior patient data and shape relationships have been extensively researched and are now making their way into commercial products. New developments in knowledge based treatment planning involve understanding the impact of the radiation dosimetry on the patient. Akin to radiobiology models that have driven intensity modulated radiotherapy optimization, toxicity and outcome predictions based on treatment plans and prior patient experiences may be the next step in knowledge based planning. In order to realize these predictions, it is necessary to understand how the clinical information can be captured, structured and organized with ontologies and databases designed for recall. Large databases containing radiation dosimetry and outcomes present the opportunity to evaluate treatment plans against predictions of toxicity and disease response. Such evaluations can be based on dose volume histogram or even the full 3-dimensional dose distribution and its relation to the critical anatomy. This session will provide an understanding of ontologies and standard terminologies used to capture clinical knowledge into structured databases; How data can be organized and accessed to utilize the knowledge in planning; and examples of research and clinical efforts to incorporate that clinical knowledge into planning for improved care for our patients. Learning Objectives: Understand the role of standard terminologies, ontologies and data organization in oncology Understand methods to capture clinical toxicity and outcomes in a clinical setting Understand opportunities to learn from clinical data and its application to treatment planning Todd McNutt receives funding from Philips, Elekta and Toshiba for some of the work presented.

WE-F-BRB-01: The Power of Ontologies and Standardized Terminologies for Capturing Clinical Knowledge

International Nuclear Information System (INIS)

Gabriel, P.

2015-01-01

Advancements in informatics in radiotherapy are opening up opportunities to improve our ability to assess treatment plans. Models on individualizing patient dose constraints from prior patient data and shape relationships have been extensively researched and are now making their way into commercial products. New developments in knowledge based treatment planning involve understanding the impact of the radiation dosimetry on the patient. Akin to radiobiology models that have driven intensity modulated radiotherapy optimization, toxicity and outcome predictions based on treatment plans and prior patient experiences may be the next step in knowledge based planning. In order to realize these predictions, it is necessary to understand how the clinical information can be captured, structured and organized with ontologies and databases designed for recall. Large databases containing radiation dosimetry and outcomes present the opportunity to evaluate treatment plans against predictions of toxicity and disease response. Such evaluations can be based on dose volume histogram or even the full 3-dimensional dose distribution and its relation to the critical anatomy. This session will provide an understanding of ontologies and standard terminologies used to capture clinical knowledge into structured databases; How data can be organized and accessed to utilize the knowledge in planning; and examples of research and clinical efforts to incorporate that clinical knowledge into planning for improved care for our patients. Learning Objectives: Understand the role of standard terminologies, ontologies and data organization in oncology Understand methods to capture clinical toxicity and outcomes in a clinical setting Understand opportunities to learn from clinical data and its application to treatment planning Todd McNutt receives funding from Philips, Elekta and Toshiba for some of the work presented

Critical research gaps and translational priorities for the successful prevention and treatment of breast cancer

Science.gov (United States)

2013-01-01

Introduction Breast cancer remains a significant scientific, clinical and societal challenge. This gap analysis has reviewed and critically assessed enduring issues and new challenges emerging from recent research, and proposes strategies for translating solutions into practice. Methods More than 100 internationally recognised specialist breast cancer scientists, clinicians and healthcare professionals collaborated to address nine thematic areas: genetics, epigenetics and epidemiology; molecular pathology and cell biology; hormonal influences and endocrine therapy; imaging, detection and screening; current/novel therapies and biomarkers; drug resistance; metastasis, angiogenesis, circulating tumour cells, cancer ‘stem’ cells; risk and prevention; living with and managing breast cancer and its treatment. The groups developed summary papers through an iterative process which, following further appraisal from experts and patients, were melded into this summary account. Results The 10 major gaps identified were: (1) understanding the functions and contextual interactions of genetic and epigenetic changes in normal breast development and during malignant transformation; (2) how to implement sustainable lifestyle changes (diet, exercise and weight) and chemopreventive strategies; (3) the need for tailored screening approaches including clinically actionable tests; (4) enhancing knowledge of molecular drivers behind breast cancer subtypes, progression and metastasis; (5) understanding the molecular mechanisms of tumour heterogeneity, dormancy, de novo or acquired resistance and how to target key nodes in these dynamic processes; (6) developing validated markers for chemosensitivity and radiosensitivity; (7) understanding the optimal duration, sequencing and rational combinations of treatment for improved personalised therapy; (8) validating multimodality imaging biomarkers for minimally invasive diagnosis and monitoring of responses in primary and metastatic disease

Familiarity knowledge in student nurses' clinical studies: exemplified by student nurses in palliative care.

Science.gov (United States)

Haugan, Grethe; Hanssen, Ingrid

2012-01-01

In this article based on a literary study, the form of knowledge named familiarity knowledge is examined. Although rooted in the philosophical tradition of Wittgenstein and Polanyi, the development of familiarity knowledge is tied in with clinical practice and particular patients and contexts while paying attention to the framework factors influencing the setting as a whole as well as with theoretical knowledge relevant to the situation at hand. Palliative care makes a backdrop for some of the discussion. Familiarity knowledge can never be context free and attends to that which is unique in every nurse-patient relationship. Both assertive and familiarity knowledge are needed to care for dying patients in a competent, sensitive, and truly caring manner. Mentors need to help students synthesize assertive knowledge and familiarity knowledge during their clinical studies to enrich both kinds of knowledge and deepen their understanding. Student nurses expertly mentored and tutored while caring for dying patients living at home become, for instance, less apprehensive about facing dying patients than students not so mentored. Nurses need to understand the complexity of nursing care to be able to see the uniqueness of the situation and approach the individual patient on the bases of experience and insight.

Newly graduated nurses use of knowledge sources in clinical decison-making - a qualitative study

DEFF Research Database (Denmark)

Voldbjerg, Siri

of clinical decisions, based on transparent, articulate and reflective use of knowledge sources. Furthermore, it is implied that nurses are able to retrieve, asses, implement and evaluate research evidence. To meet these requirements, nursing educations around the world have organised curricula to educate...... graduated nurses do not work within a framework of evidence-based practice. The overall aim of this thesis was to explore which knowledge sources newly graduated nurses’ use in their clinical decision-making and why they use them in order to understand why newly graduated nurses use research and components...... within evidence-based practice to a limited extent. The thesis is based on a synthesis of findings from two studies. The aim of the first study was to explore which knowledge sources newly graduated nurses use in clinical decision making as reported within international qualitative research. The purpose...

Bridging the gap from prenatal karyotyping to whole-genome array comparative genomic hybridization in Hong Kong: survey on knowledge and acceptance of health-care providers and pregnant women.

Science.gov (United States)

Cheng, Hiu Yee Heidi; Kan, Anita Sik-Yau; Hui, Pui Wah; Lee, Chin Peng; Tang, Mary Hoi Yin

2017-12-01

The use of array comparative genomic hybridization (aCGH) has been increasingly widespread. The challenge of integration of this technology into prenatal diagnosis was the interpretation of results and communicating findings of unclear clinical significance. This study assesses the knowledge and acceptance of prenatal aCGH in Hong Kong obstetricians and pregnant women. The aim is to identify the needs and gaps before implementing the replacement of karyotyping with aCGH. Questionnaires with aCGH information in the form of pamphlets were sent by post to obstetrics and gynecology doctors. For the pregnant women group, a video presentation, pamphlets on aCGH and a self-administered questionnaire were provided at the antenatal clinic. The perception of aCGH between doctors and pregnant women was similar. Doctors not choosing aCGH were more concerned about the difficulty in counseling of variants of unknown significance and adult-onset disease in pregnant women, whereas pregnant women not choosing aCGH were more concerned about the increased waiting time leading to increased anxiety. Prenatal aCGH is perceived as a better test by both doctors and patients. Counseling support, training, and better understanding and communication of findings of unclear clinical significance are necessary to improve doctor-patient experience.

Pooling and expanding registries of familial hypercholesterolaemia to assess gaps in care and improve disease management and outcomes

DEFF Research Database (Denmark)

Vallejo-Vaz, Antonio J; Akram, Asif; Kondapally Seshasai, Sreenivasa Rao

2016-01-01

BACKGROUND: The potential for global collaborations to better inform public health policy regarding major non-communicable diseases has been successfully demonstrated by several large-scale international consortia. However, the true public health impact of familial hypercholesterolaemia (FH...... to integrate individual efforts across the world to tackle the global burden of FH. The information garnered from the registry will help reduce gaps in knowledge, inform best practices, assist in clinical trials design, support clinical guidelines and policies development, and ultimately improve the care of FH...

Terahertz spectroscopy of three-dimensional photonic band-gap crystals

International Nuclear Information System (INIS)

Oezbay, E.; Michel, E.; Tuttle, G.; Biswas, R.; Ho, K.M.; Bostak, J.; Bloom, D.M.

1994-01-01

We have fabricated and built three-dimensional photonic band-gap crystals with band-gap frequencies larger than 500 GHz. We built the crystals by stacking micromachined (110) silicon wafers. The transmission and dispersion characteristics of the structures were measured by an all-electronic terahertz spectroscopy setup. The experimental results were in good agreement with theoretical calculations. To our knowledge, our new crystal has the highest reported photonic band-gap frequency

The quantified self: closing the gap between general knowledge and particular case?

Science.gov (United States)

Thornquist, Eline; Kirkengen, Anna Luise

2015-06-01

This paper addresses the movements 'evidence-based' (EBM) and 'personalized' (PM) medicine. The former is being criticized for failing to do justice to clinical complexity and human individuality. The latter aims at tailoring medical knowledge for every patient in a personalized fashion. Instrumental to this effort is the technological development engendering unlimited amounts of data about bodily fragments. The aim of this article is to stimulate a debate about the notion of the body and knowledge in medicine. An authentic sickness history is used as a vantage point for a more comprehensive account of biomedicine. The analysis of the sickness history demonstrates how biomedical logic guided all approaches in the care for this particular patient. Each problem was identified and treated separately, whereby neglecting the interaction between body parts and systems, and between the woman's bodily condition and her experiences. The specialists involved seemed to look for phenomena that fit categories of disorders 'belonging' to their field. These approaches engendered unintended effects: chronification, poly-pharmacy and multi-morbidity, leading to an unsustainable increase in medical costs. The article elucidates how the status that professionals ascribe to the body has vital implications for what they regard as relevant and how they interpret the information they have collected. On this ground, we challenge both the prevailing and tacitly accepted separation between the physical body and human experience and the view of knowledge underpinning EBM and PM. The growing molecularization of the body veils decisive sources of human illness. © 2014 John Wiley & Sons, Ltd.

Designing healthcare information technology to catalyse change in clinical care

Directory of Open Access Journals (Sweden)

William Lester

2008-05-01

Full Text Available The gap between best practice and actual patient care continues to be a pervasive problem in our healthcare system. Efforts to improve on this knowledge_performance gap have included computerised disease management programs designed to improve guideline adherence. However, current computerised reminder and decision support interventions directed at changing physician behaviour have had only a limited and variable effect on clinical outcomes. Further, immediate pay-for-performance financial pressures on institutions have created an environmentwhere disease management systems are often created under duress, appended to existing clinical systems and poorly integrated into the existing workflow, potentially limiting their realworld effectiveness. The authors present a review of disease management as well as a conceptual framework to guide the development of more effective health information technology (HIT tools for translating clinical information into clinical action.

Introduction to the special issue "The determinants of gender gaps"

OpenAIRE

Casarico, Alessandra; Profeta, Paola

2015-01-01

This volume contributes to advancing our knowledge on the determinants of gender gaps. It focuses on the role of historical factors in shaping persistent gender gaps and on how careful institutional design can allow different outcomes to reflect only differences in abilities rather than differences in gender. The contributions collected in this volume emphasize that there is no unique determinant of the gender gaps and that the gender gap itself is a multidimensional, complex indicator. They ...

Understanding the carbon dioxide gaps.

Science.gov (United States)

Scheeren, Thomas W L; Wicke, Jannis N; Teboul, Jean-Louis

2018-06-01

The current review attempts to demonstrate the value of several forms of carbon dioxide (CO2) gaps in resuscitation of the critically ill patient as monitor for the adequacy of the circulation, as target for fluid resuscitation and also as predictor for outcome. Fluid resuscitation is one of the key treatments in many intensive care patients. It remains a challenge in daily practice as both a shortage and an overload in intravascular volume are potentially harmful. Many different approaches have been developed for use as target of fluid resuscitation. CO2 gaps can be used as surrogate for the adequacy of cardiac output (CO) and as marker for tissue perfusion and are therefore a potential target for resuscitation. CO2 gaps are easily measured via point-of-care analysers. We shed light on its potential use as nowadays it is not widely used in clinical practice despite its potential. Many studies were conducted on partial CO2 pressure differences or CO2 content (cCO2) differences either alone, or in combination with other markers for outcome or resuscitation adequacy. Furthermore, some studies deal with CO2 gap to O2 gap ratios as target for goal-directed fluid therapy or as marker for outcome. CO2 gap is a sensitive marker of tissue hypoperfusion, with added value over traditional markers of tissue hypoxia in situations in which an oxygen diffusion barrier exists such as in tissue oedema and impaired microcirculation. Venous-to-arterial cCO2 or partial pressure gaps can be used to evaluate whether attempts to increase CO should be made. Considering the potential of the several forms of CO2 measurements and its ease of use via point-of-care analysers, it is recommendable to implement CO2 gaps in standard clinical practice.

Nurses experience of using scientific knowledge in clinical practice: a grounded theory study.

Science.gov (United States)

Renolen, Åste; Hjälmhult, Esther

2015-12-01

Guidelines recommend the use of evidence-based practice in nursing. Nurses are expected to give patients care and treatment based on the best knowledge available. They may have knowledge and positive attitudes, but this does not mean that they are basing their work on evidence-based practice. Knowledge is still lacking about what is needed to successfully implement evidence-based practice. The aim of this study was to gain more knowledge about what nurses perceive as the most important challenge in implementing evidence-based practice and to explain how they act to face and overcome this challenge. We used classical grounded theory methodology and collected data through four focus groups and one individual interview in different geographical locations in one large hospital trust in Norway. Fourteen registered clinical practice nurses participated. We analysed the data in accordance with grounded theory, using the constant comparative method. Contextual balancing of knowledge emerged as the core category and explains how the nurses dealt with their main concern, how to determine what types of knowledge they could trust. The nurses' main strategies were an inquiring approach, examining knowledge and maintaining control while taking care of patients. They combined their own experienced-based knowledge and the guidelines of evidence-based practice with a sense of control in the actual situation. The grounded theory contextual balancing of knowledge may help us to understand how nurses detect what types of knowledge they can trust in clinical practice. The nurses needed to rely on what they did, and they seemed to rely on their own experience rather than on research. © 2015 Nordic College of Caring Science.

Knowledge, perceptions and clinical application of the shortened dental arch concept among Malaysian government dentists.

Science.gov (United States)

Kasim, Siti Kamilah Mohd; Razak, Ishak Abdul; Yusof, Zamros Yuzadi Mohd

2018-02-01

To assess the knowledge and perceptions of Malaysian government dentists regarding the shortened dental arch (SDA) concept and its application in clinical practice. The SDA concept refers to a specific type of dentition with intact anterior teeth and a reduction in posterior occlusal pairs. Dentists' knowledge and perceptions of the SDA concept can influence its application in clinical practice. A self-administered questionnaire on the SDA concept was distributed to 326 government dentists in the states of Selangor and Kuala Lumpur, Malaysia. The data were analysed using SPSS version 22 software. The response rate was 84.0%. The majority of respondents had good knowledge on five of six knowledge items and good attitudes towards 10 of 17 perception items. However, only one-fifth (20.4%) reported having applied the SDA concept in the clinic. A larger number of participants who graduated locally than who graduated abroad perceived that patients 5 years of work experience perceived that the SDA concept enables simpler treatment planning (P concept, it is not widely applied in the clinic. Concerted efforts in SDA training of dentists are needed to help to shorten denture waiting lists and reduce costs. © 2017 FDI World Dental Federation.

Canopy and knowledge gaps when invasive alien insects remove foundation species.

Science.gov (United States)

Marler, Thomas E; Lawrence, John H

2013-01-01

The armored scale Aulacaspis yasumatsui invaded the northern range of the cycad Cycas micronesica in 2003, and epidemic tree mortality ensued due to a lack of natural enemies of the insect. We quantified cycad demographic responses to the invasion, but the ecological responses to the selective removal of this foundation species have not been addressed. We use this case to highlight information gaps in our understanding of how alien invasive phytophagous insects force cascading adverse ecosystem changes. The mechanistic role of unique canopy gaps, oceanic island examples and threatened foundation species with distinctive traits are three issues that deserve research efforts in a quest to understand this facet of ecosystem change occurring across multiple settings globally.

3D quantification of clinical marginal and internal gap of porcelain laminate veneers with minimal and without tooth preparation and 2-year clinical evaluation.

Science.gov (United States)

Karagözoğlu, İrem; Toksavul, Suna; Toman, Muhittin

2016-01-01

The aims of this clinical study were to compare internal three-dimensional (3D) adaptation of porcelain laminate veneers (PLV) with minimal tooth preparation and without tooth preparation (prepless) and to evaluate the clinical outcomes at baseline and following 6, 12, and 24 months after luting. Thirty-one prepless PLV and 31 PLV with minimal tooth preparation were fabricated using lithium disilicate glass-ceramic material and placed in 12 patients (8 women, 4 men; 18 to 40 years old). All PLV were luted with an adhesive luting system (Variolink veneer). A silicone replica was obtained to measure internal adaptation of each PLV using a low viscosity polyvinyl siloxane impression material just before luting. Silicone replicas were scanned in x-ray micro computerized tomography (micro CT). Clinical evaluations took place at baseline (2 days after luting) and following 6, 12, and 24 months after luting. Marginal integrity, marginal discoloration, secondary caries, tooth sensitivity, and fracture were evaluated following FDI criteria. Replica scores were analyzed using Mann-Whitney U and Student's t test (α = .05). Kaplan-Meier statistical analysis was done for the survival rate of PLV. FDI criteria scores were analyzed using Pearson's chi-square test (α = .05). The median marginal gaps for PLV-without-tooth-preparation and PLV-with-minimal-tooth-preparation groups were 100 μm and 140 μm respectively. There was a statistically significant difference between the two groups with respect to marginal gap (P = .04). The mean internal adaptation for the PLV-without-tooth-preparation group was 217.17 ± 54.72 μm, and was 170.67 ± 46.54 μm for the PLV-with-minimaltooth- preparation group. There was a statistically significant difference between the two groups (P = .001). Based on FDI criteria, 100% of the PLV were rated satisfactory during the 2-year period. In this in-vivo study, mean and median values of marginal gap and internal adaptation for PLV with minimal tooth

Athletic Trainers' Knowledge Regarding Airway Adjuncts

Science.gov (United States)

Edler, Jessica R.; Eberman, Lindsey E.; Kahanov, Leamor; Roman, Christopher; Mata, Heather Lynne

2015-01-01

Context: Research suggests that knowledge gaps regarding the appropriate use of airway adjuncts exist among various health care practitioners, and that knowledge is especially limited within athletic training. Objective: To determine the relationship between perceived knowledge (PK) and actual knowledge (AK) of airway adjunct use and the…

Long Chain Saturated and Unsaturated Carboxylic Acids: Filling a Large Gap of Knowledge in Their Enthalpies of Formation.

Science.gov (United States)

Rogers, Donald W; Zavitsas, Andreas A

2017-01-06

Despite their abundance in nature and their importance in biology, medicine, nutrition, and in industry, gas phase enthalpies of formation of many long chain saturated and unsaturated fatty acids and of dicarboxylic acids are either unavailable or have been estimated with large uncertainties. Available experimental values for stearic acid show a spread of 68 kJ mol -1 . This work fills the knowledge gap by obtaining reliable values by quantum theoretical calculations using G4 model chemistry. Compounds with up to 20 carbon atoms are treated. The theoretical results are in excellent agreement with well established experimental values when such values exist, and they provide a large number of previously unavailable values.

Managing Low Back Pain in the Primary Care Setting: The Know-Do Gap

Directory of Open Access Journals (Sweden)

N Ann Scott

2010-01-01

Full Text Available OBJECTIVE: To ascertain knowledge gaps in the diagnosis and treatment of acute and chronic low back pain (LBP in the primary care setting to prepare a scoping survey for identifying knowledge gaps in LBP management among Alberta’s primary care practitioners, and to identify potential barriers to implementing a multidisciplinary LBP guideline.

PhoneGap and AngularJS for cross-platform development

CERN Document Server

Liang, Yuxian Eugene

2014-01-01

This book is intended for people who are not familiar with AngularJS and who want to take their PhoneGap development skills further by developing apps using different JavaScript libraries. People with some knowledge of PhoneGap, HTML, CSS, and JavaScript will find this book immediately useful.

Sexual Health Attitudes, Knowledge, and Clinical Behaviors: Implications for Counseling

Science.gov (United States)

Russell, Elizabeth B.

2012-01-01

This article explores the impact of practitioners' attitudes and knowledge of sexual health on clinical behaviors. Sexual health topics are often areas of concern for clients of any age in counseling. Thus, counselors must be trained and equipped to address sexual health across the life span. This study explored whether child and adolescent…

Knowledge Translation: The Bridging Function of Cochrane Rehabilitation.

Science.gov (United States)

Negrini, Stefano; Gimigliano, Francesca; Arienti, Chiara; Kiekens, Carlotte

2017-12-12

Cochrane Rehabilitation is aimed to ensure that all rehabilitation professionals can apply Evidence Based Clinical Practice and take decisions according to the best and most appropriate evidence in this specific field, combining the best available evidence as gathered by high-quality Cochrane systematic reviews, with their own clinical expertise and the values of patients. This mission can be pursued through knowledge translation. The aim of this article is to shortly present what knowledge translation is, how and why Cochrane (previously known as Cochrane Collaboration) is trying to reorganize itself in light of knowledge translation, and the relevance that this process has for Cochrane Rehabilitation and in the end for the whole world of rehabilitation. It is well known how it is difficult to effectively apply in everyday life what we would like to do and to apply the scientific knowledge in the clinical field: this is called the know-do gap. In the field of evidence-based medicine, where Cochrane belongs, it has been proven that high-quality evidence is not consistently applied in practice. A solution to these problems is the so-called knowledge translation. In this context, Cochrane Rehabilitation is organized to provide the best possible knowledge translation in both directions (bridging function), obviously toward the world of rehabilitation (spreading reviews), but also to the Cochrane community (production of reviews significant for rehabilitation). Cochrane is now strongly pushing to improve its knowledge translation activities, and this creates a strong base for Cochrane Rehabilitation work, focused not only on spreading the evidence but also on improving its production to make it more meaningful for the world of rehabilitation. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Black guillemot ecology in relation to tidal stream energy generation: An evaluation of current knowledge and information gaps.

Science.gov (United States)

Johnston, Daniel T; Furness, Robert W; Robbins, Alexandra M C; Tyler, Glen; Taggart, Mark A; Masden, Elizabeth A

2018-03-01

The black guillemot Cepphus grylle has been identified as a species likely to interact with marine renewable energy devices, specifically tidal turbines, with the potential to experience negative impacts. This likelihood is primarily based on the species being a diving seabird, and an inshore, benthic forager often associating with tidal streams. These behavioural properties may bring them into contact with turbine blades, or make them susceptible to alterations to tidal current speed, and/or changes in benthic habitat structure. We examine the knowledge currently available to assess the potential impacts of tidal stream turbines on black guillemot ecology, highlight knowledge gaps and make recommendations for future research. The key ecological aspects investigated include: foraging movements, diving behaviour, seasonal distribution, other sources of disturbance and colony recovery. Relating to foraging behaviour, between studies there is heterogeneity in black guillemot habitat use in relation to season, tide, diurnal cycles, and bathymetry. Currently, there is also little knowledge regarding the benthic habitats associated with foraging. With respect to diving behaviour, there is currently no available research regarding how black guillemots orientate and manoeuvre within the water column. Black guillemots are considered to be a non-migratory species, however little is known about their winter foraging range and habitat. The effect of human disturbance on breeding habitat and the metapopulation responses to potential mortalities are unknown. It is clear further understanding of black guillemot foraging habitat and behaviour is needed to provide renewable energy developers with the knowledge to sustainably locate tidal turbines and mitigate their impacts. Copyright © 2018 Elsevier Ltd. All rights reserved.

Knowledge translation for nephrologists: strategies for improving the identification of patients with proteinuria.

Science.gov (United States)

Hemmelgarn, Brenda R; Manns, Braden J; Straus, Sharon; Naugler, Christopher; Holroyd-Leduc, Jayna; Braun, Ted C; Levin, Adeera; Klarenbach, Scott; Lee, Patrick F; Hafez, Kevin; Schwartz, Daniel; Jindal, Kailash; Ervin, Kathy; Bello, Aminu; Turin, Tanvir Chowdhury; McBrien, Kerry; Elliott, Meghan; Tonelli, Marcello

2012-01-01

For health scientists, knowledge translation refers to the process of facilitating uptake of knowledge into clinical practice or decision making. Since high-quality clinical research that is not applied cannot improve outcomes, knowledge translation is critical for realizing the value and potential for all types of health research. Knowledge translation is particularly relevant for areas within health care where gaps in care are known to exist, which is the case for some areas of management for people with chronic kidney disease (CKD), including assessment of proteinuria. Given that proteinuria is a key marker of cardiovascular and renal risk, forthcoming international practice guidelines will recommend including proteinuria within staging systems for CKD. While this revised staging system will facilitate identification of patients at higher risk for progression of CKD and mortality who benefit from intervention, strategies to ensure its appropriate uptake will be particularly important. This article describes key elements of effective knowledge translation strategies based on the knowledge-to-action cycle framework and describes options for effective knowledge translation interventions related to the new CKD guidelines, focusing on recommendations related to assessment for proteinuria specifically. The article also presents findings from a multidisciplinary meeting aimed at developing knowledge translation intervention strategies, with input from key stakeholders (researchers, knowledge users, decision makers and collaborators), to facilitate implementation of this guideline. These considerations are relevant for dissemination and implementation of guidelines on other topics and in other clinical settings.

Clinical Features and Gaps in the Management of Probable Familial Hypercholesterolemia and Cardiovascular Disease.

Science.gov (United States)

Zafrir, Barak; Jubran, Ayman; Lavie, Gil; Halon, David A; Flugelman, Moshe Y; Shapira, Chen

2017-12-25

Familial hypercholesterolemia (FH) is associated with premature atherosclerotic cardiovascular disease (ASCVD). The introduction of potent therapeutic agents underlies the importance of improving clinical diagnosis and treatment gaps in FH.Methods and Results:A regional database of 1,690 adult patients with high-probability FH based on age-dependent peak-low-density lipoprotein cholesterol (LDL-C) cut-offs and exclusion of secondary causes of severe hypercholesterolemia, was examined to explore the clinical manifestations and current needs in the management of ASCVD, which was present in 248 patients (15%), of whom 83% had coronary artery disease (CAD); 19%, stroke; and 13%, peripheral artery disease. ASCVD was associated with male gender, higher peak LDL-C, lower high-density lipoprotein cholesterol (HDL-C), and traditional risk factor burden. Despite high-intensity statin (prescribed in 83% and combined with ezetimibe in 42%), attainment of LDL-C treatment goals was low, and associated with treatment intensity and drug adherence. Multivessel CAD (adjusted hazard ratios (HR), 3.05; 95% CI: 1.65-5.64), myocardial infarction, and the presence of ≥1 traditional risk factor (HR, 2.59; 95% CI: 1.42-4.71), were associated with repeat coronary revascularizations, in contrast with peak LDL-C >300 mg/dL (HR, 1.13; 95% CI: 0.66-1.91). Main manifestations of ASCVD in FH patients were premature, multivessel CAD with need for recurrent revascularization, associated with classical cardiovascular risk factors but not with peak LDL-C. In spite of intensive therapy with lipid-lowering agents, treatment gaps were significant, with low attainment of LDL-C treatment goals.

Knowledge Mining from Clinical Datasets Using Rough Sets and Backpropagation Neural Network

Directory of Open Access Journals (Sweden)

Kindie Biredagn Nahato

2015-01-01

Full Text Available The availability of clinical datasets and knowledge mining methodologies encourages the researchers to pursue research in extracting knowledge from clinical datasets. Different data mining techniques have been used for mining rules, and mathematical models have been developed to assist the clinician in decision making. The objective of this research is to build a classifier that will predict the presence or absence of a disease by learning from the minimal set of attributes that has been extracted from the clinical dataset. In this work rough set indiscernibility relation method with backpropagation neural network (RS-BPNN is used. This work has two stages. The first stage is handling of missing values to obtain a smooth data set and selection of appropriate attributes from the clinical dataset by indiscernibility relation method. The second stage is classification using backpropagation neural network on the selected reducts of the dataset. The classifier has been tested with hepatitis, Wisconsin breast cancer, and Statlog heart disease datasets obtained from the University of California at Irvine (UCI machine learning repository. The accuracy obtained from the proposed method is 97.3%, 98.6%, and 90.4% for hepatitis, breast cancer, and heart disease, respectively. The proposed system provides an effective classification model for clinical datasets.

Analysis of serum anion gap and osmolal gap in diagnosis and prognosis of acute methanol poisoning: clinical study in 86 patients

Czech Academy of Sciences Publication Activity Database

Zakharov, S.; Navrátil, Tomáš; Pelclová, D.

2015-01-01

Roč. 146, č. 5 (2015), s. 787-794 ISSN 0026-9247 R&D Projects: GA ČR(CZ) GAP208/12/1645 Institutional support: RVO:61388955 Keywords : serum anion gap * osmolal gap * acute methanol poisoning Subject RIV: CG - Electrochemistry Impact factor: 1.131, year: 2015

Gaps in Alzheimer's Knowledge among College Students

Science.gov (United States)

Eshbaugh, Elaine M.

2014-01-01

Despite the prevalence of the disease, it appears that there may be a need for increased education for formal and family caregivers of those with Alzheimer's disease and related dementias. Today's college students will be asked to fill both of these roles in the future. This study examined the level of knowledge of Alzheimer's disease among…

Neonatal resuscitation: a knowledge gap amongst obstetrical trainees. A cross-sectional survey amongst medical graduates of Civil Hospital Karachi.

Science.gov (United States)

Noor, Tooba; Raza, Natasha; Haq, Gulfishan

2014-07-01

To evaluate the neonatal resuscitation competence of obstetrical trainees to assess the gap in knowledge and to determine training needs. The cross-sectional study was conducted at the Department of Gynaecology and Obstetrics, Civil Hospital, Karachi, from January to March 2013 and comprised House Officers and Postgraduate trainees. A questionnaire was used to test the evaluation skills of different conditions and choice of appropriate action required during neonatal resuscitation. Data was collected and analysed through SPSS 17.0. Of the 102 obstetrical trainees, 44 (43.1%) were House Officers and 58 (56.9%) were Postgraduate trainees with an overall mean age 25.69 +/- 2.3 years. Only 19 (18.6%) subjects cleared the test; 8 (42.1%) of them were House Officers and 11 (57.9%) were Postgraduate trainees. The result did not show any significant difference between those who had previous training or those who had performed neonatal resuscitation and those who had no such exposure. Majority, 92 (90.2%) considered their knowledge inadequate and 99 (97%) favoured that updated neonatal resuscitation programmes should be periodically arranged. The study showed inadequate level of knowledge on neonatal resuscitation amongst obstetrical trainees. There is urgent need of formal training programmes which can make doctors skilful enough to face any adverse neonatal outcome professionally.

Supersize me: Cronobacter sakazakii phage GAP32

Energy Technology Data Exchange (ETDEWEB)

Abbasifar, Reza; Griffiths, Mansel W. [Canadian Research Institute for Food Safety, University of Guelph, Guelph, ON, Canada N1G 2W1 (Canada); Sabour, Parviz M. [Agriculture and Agri-Food Canada, Guelph Food Research Centre, Guelph, ON, Canada N1G 5C9 (Canada); Ackermann, Hans-Wolfgang [Department of Microbiology-Infectiology and Immunology, Faculty of Medicine, Université Laval, Quebec, QC (Canada); Vandersteegen, Katrien; Lavigne, Rob [Laboratory of Gene Technology, Katholieke Universiteit Leuven, Leuven (Belgium); Noben, Jean-Paul [Biomedical Research Institute and Transnational University Limburg, School of Life Sciences, Hasselt University, Diepenbeek (Belgium); Alanis Villa, Argentina; Abbasifar, Arash [Canadian Research Institute for Food Safety, University of Guelph, Guelph, ON, Canada N1G 2W1 (Canada); Nash, John H.E. [Public Health Agency of Canada, Laboratory for Foodborne Zoonoses, Guelph, ON, Canada N1G 3W4 (Canada); Kropinski, Andrew M., E-mail: akropins@uoguelph.ca [Public Health Agency of Canada, Laboratory for Foodborne Zoonoses, Guelph, ON, Canada N1G 3W4 (Canada); Department of Molecular and Cellular Biology, University of Guelph, Guelph, ON, Canada N1G 2W1 (Canada)

2014-07-15

Cronobacter sakazakii is a Gram-negative pathogen found in milk-based formulae that causes infant meningitis. Bacteriophages have been proposed to control bacterial pathogens; however, comprehensive knowledge about a phage is required to ensure its safety before clinical application. We have characterized C. sakazakii phage vB{sub C}saM{sub G}AP32 (GAP32), which possesses the second largest sequenced phage genome (358,663 bp). A total of 571 genes including 545 protein coding sequences and 26 tRNAs were identified, thus more genes than in the smallest bacterium, Mycoplasma genitalium G37. BLASTP and HHpred searches, together with proteomic analyses reveal that only 23.9% of the putative proteins have defined functions. Some of the unique features of this phage include: a chromosome condensation protein, two copies of the large subunit terminase, a predicted signal-arrest-release lysin; and an RpoD-like protein, which is possibly involved in the switch from immediate early to delayed early transcription. Its closest relatives are all extremely large myoviruses, namely coliphage PBECO4 and Klebsiella phage vB{sub K}leM-RaK2, with whom it shares approximately 44% homologous proteins. Since the homologs are not evenly distributed, we propose that these three phages belong to a new subfamily. - Highlights: • Cronobacter sakazakii phage vB{sub C}saM{sub G}AP32 has a genome of 358,663 bp. • It encodes 545 proteins which is more than Mycoplasma genitalium G37. • It is a member of the Myoviridae. • It is peripherally related to coliphage PBECO4 and Klebsiella phage vB{sub K}leM-RaK2. • GAP32 encodes a chromosome condensation protein.

Gap Between Clinical Practice and Guidelines: A National Survey of the Knowledge of Recommended Heart Failure Guidelines Among Chinese Physicians.

Science.gov (United States)

Gan, Tianyi; Zhang, Yuhui; Liu, Nini; Huang, Yuhui; Liang, Tuo; Zhao, Xuemei; Zhang, Jian

We investigated the current level of knowledge of Chinese heart failure (HF) guidelines among physicians, as a reference for the promotion and transformation of HF knowledge. Physicians from 88 hospitals in 27 provinces of China completed our survey between July and December 2014. The questions covered the main points included in the Chinese HF diagnosis and treatment guidelines (2014). A total of 2146 physicians, aged 20 to 62 years (35.6 ± 7.6 years), completed the survey. The correctness rate of their answers to the 15 multiple-choice questions in the HF questionnaire was generally low (mean 32.6%). The mean correctness rate for 10 blank-filling questions about the target doses of angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, and β-blockers was 42.5%. On the basis of their responses, physicians whose knowledge of the guidelines was "excellent," "good," "medium," and "bad" accounted for 1.1%, 11.4%, 14.2%, and 73.4%, respectively. Physicians who possessed a higher level of qualifications had significantly greater awareness of HF guidelines than those with relatively low qualifications (P knowledge about HF. There is a need to improve physicians' education about HF in China.

Knowledge of risk factors and the periodontal disease-systemic link in dental students' clinical decisions.

Science.gov (United States)

Friesen, Lynn Roosa; Walker, Mary P; Kisling, Rebecca E; Liu, Ying; Williams, Karen B

2014-09-01

This study evaluated second-, third-, and fourth-year dental students' ability to identify systemic conditions associated with periodontal disease, risk factors most important for referral, and medications with an effect on the periodontium and their ability to apply this knowledge to make clinical decisions regarding treatment and referral of periodontal patients. A twenty-one question survey was administered at one U.S. dental school in the spring semester of 2012 to elicit the students' knowledge and confidence regarding clinical reasoning. The response rate was 86 percent. Periodontal risk factors were accurately selected by at least 50 percent of students in all three classes; these were poorly controlled diabetes, ≥6 mm pockets posteriorly, and lack of response to previous non-surgical therapy. Confidence in knowledge, knowledge of risk factors, and knowledge of medications with an effect on the periodontium improved with training and were predictive of better referral decision making. The greatest impact of training was seen on the students' ability to make correct decisions about referral and treatment for seven clinical scenarios. Although the study found a large increase in the students' abilities from the second through fourth years, the mean of 4.6 (out of 7) for the fourth-year students shows that, on average, those students missed correct treatment or referral on more than two of seven clinical cases. These results suggest that dental curricula should emphasize more critical decision making with respect to referral and treatment criteria in managing the periodontal patient.

A Collaborative Project to Bridging the Gap between Basic and Clinical Teachers: The Opinion of Medical Students

Directory of Open Access Journals (Sweden)

Mariano Sentí

2015-01-01

Full Text Available The organization of medical curricula with a clear distinction between basic and clinical subjects makes it difficult for teachers to collaborate and teach students in an integrated way. We designed a new subject, Integrated Medicine, to overcome such limitations. Here, we describe the evaluation of the first three years of running the experience, as well as the opinion of the first group of students in their sixth year. Three cohorts of first-year medical students (n=158 and eight teachers, as well as a group of students of sixth year (n=41, participated in the experiment. Students worked following the problem-based learning approach. Their satisfaction, their subjective improvement of content knowledge in basic and clinical fields, and their belief about the accomplishment of educational objectives were evaluated. The results showed a high level of satisfaction, increased content knowledge, and improvement in solving problems, searching for relevant information, team working, and oral and written communication skills. Students of sixth year agreed that the subject helped them to better understand the clinical manifestations of disease, the diagnosis process, and therapeutic approaches. In conclusion, experiences such as Integrated Medicine may enhance the integration of knowledge by the joint work of basic and clinical teachers.

Community occupational therapists' clinical reasoning: identifying tacit knowledge.

Science.gov (United States)

Carrier, Annie; Levasseur, Mélanie; Bédard, Denis; Desrosiers, Johanne

2010-12-01

  Occupational therapy interventions in the community, a fast expanding practice setting, are central to an important social priority, the ability to live at home. These interventions generally involve only a small number of home visits, which aim at maximising the safety and autonomy of community-dwelling clients. Knowing how community occupational therapists determine their interventions, i.e. their clinical reasoning, can improve intervention efficacy. However, occupational therapists are often uninformed about and neglect the importance of clinical reasoning, which could underoptimise their interventions.   To synthesise current knowledge about community occupational therapists' clinical reasoning.   A scoping study of the literature on community occupational therapists' clinical reasoning was undertaken.   Fifteen textbooks and 25 articles, including six focussing on community occupational therapists' clinical reasoning, were reviewed. Community occupational therapists' clinical reasoning is influenced by internal and external factors. Internal factors include past experiences, expertise and perceived complexity of a problem. One of the external factors, practice context (e.g. organisational or cultural imperatives, physical location of intervention), particularly shapes community occupational therapists' clinical reasoning, which is interactive, complex and multidimensional. However, the exact influence of many factors (personal context, organisational and legal aspects of health care, lack of resources and increased number of referrals) remains unclear.   Further studies are needed to understand better the influence of internal and external factors. The extent to which these factors mould the way community occupational therapists think and act could have a direct influence on the services they provide to their clients. © 2010 The Authors. Australian Occupational Therapy Journal © 2010 Australian Association of Occupational Therapists.

Clinician Survey to Determine Knowledge of Dengue and Clinical Management Practices, Texas, 2014.

Science.gov (United States)

Adam, Jessica K; Abeyta, Roman; Smith, Brian; Gaul, Linda; Thomas, Dana L; Han, George; Sharp, Tyler M; Waterman, Stephen H; Tomashek, Kay M

2017-03-01

AbstractDengue, a mosquito-borne viral disease, is increasingly being identified as a cause of outbreaks in the United States. During July-December 2013, a total of three south Texas counties reported 53 laboratory-confirmed dengue cases; 26 were locally acquired, constituting the largest outbreak in Texas since 2005. Because dengue outbreaks are expected to continue in south Texas and early case identification and timely treatment can reduce mortality, we sought to determine clinicians' knowledge of dengue and its clinical management. A survey was sent to 2,375 south Texas clinicians; 217 (9%) completed the survey. Approximately half of participants demonstrated knowledge needed to identify dengue cases, including symptoms (56%), early indicators of shock (54%), or timing of thrombocytopenia (48%). Fewer than 20% correctly identified all prevention messages, severe dengue warning signs, or circumstances in which a dengue patient should return for care. Knowledge of clinical management was limited; few participants correctly identified scenarios when plasma leakage occurred (10%) or a crystalloid solution was indicated (7%); however, 45% correctly identified when a blood transfusion was indicated. Because of the ongoing threat of dengue, we recommend clinicians in south Texas receive dengue clinical management training.

Clinician Survey to Determine Knowledge of Dengue and Clinical Management Practices, Texas, 2014

Science.gov (United States)

Adam, Jessica K.; Abeyta, Roman; Smith, Brian; Gaul, Linda; Thomas, Dana L.; Han, George; Sharp, Tyler M.; Waterman, Stephen H.; Tomashek, Kay M.

2017-01-01

Dengue, a mosquito-borne viral disease, is increasingly being identified as a cause of outbreaks in the United States. During July–December 2013, a total of three south Texas counties reported 53 laboratory-confirmed dengue cases; 26 were locally acquired, constituting the largest outbreak in Texas since 2005. Because dengue outbreaks are expected to continue in south Texas and early case identification and timely treatment can reduce mortality, we sought to determine clinicians' knowledge of dengue and its clinical management. A survey was sent to 2,375 south Texas clinicians; 217 (9%) completed the survey. Approximately half of participants demonstrated knowledge needed to identify dengue cases, including symptoms (56%), early indicators of shock (54%), or timing of thrombocytopenia (48%). Fewer than 20% correctly identified all prevention messages, severe dengue warning signs, or circumstances in which a dengue patient should return for care. Knowledge of clinical management was limited; few participants correctly identified scenarios when plasma leakage occurred (10%) or a crystalloid solution was indicated (7%); however, 45% correctly identified when a blood transfusion was indicated. Because of the ongoing threat of dengue, we recommend clinicians in south Texas receive dengue clinical management training. PMID:28138048

Emergency nurses' knowledge, attitude and clinical decision making skills about pain.

Science.gov (United States)

Ucuzal, Meral; Doğan, Runida

2015-04-01

Pain is the most common reason that patients come to the emergency department. Emergency nurses have an indispensable role in the management of this pain. The aim of this study was to examine emergency nurses' knowledge, attitude and clinical decision-making skills about pain. This descriptive study was conducted in a state and a university hospital between September and October 2012 in Malatya, Turkey. Of 98 nurses working in the emergency departments of these two hospitals, 57 returned the questionnaires. The response rate was 58%. Data were collected using the Demographic Information Questionnaire, Knowledge and Attitude Questionnaire about Pain and Clinical Decision Making Survey. Frequency, percentage, mean and standard deviation were used to evaluate data. 75.4% of participant nurses knew that patients' own statement about their pain was the most reliable indicator during pain assessment. Almost half of the nurses believed that patients should be encouraged to endure the pain as much as possible before resorting to a pain relief method. The results also indicate that most of nurses think that a sleeping patient does not have any pain and pain relief should be postponed as it can influence the diagnosis negatively. It is determined that the pain scale was not used frequently. Only 35.1% of nurses reported keeping records of pain. Despite all the recommendations of substantial past research the results of this study indicate that emergency nurses continue to demonstrate inadequate knowledge, clinical decision-making skills and negative attitudes about pain. Copyright © 2014 Elsevier Ltd. All rights reserved.

Smoking cessation advice: Knowledge, attitude, and practice among clinical dental students'

Directory of Open Access Journals (Sweden)

Allama Prabhu

2017-01-01

Full Text Available Background: Smoking is the single most important public health challenge facing the National Health Service. The detrimental effects on the general health of tobacco smoking are well documented. Smoking is a primary risk factor for oral cancer and many oral diseases. Dental professional scan plays an important role in preventing adverse health effects by promoting smoking cessation. Objective: To assess the knowledge, attitude, and practice among clinical dental students in giving smoking cessation advice and to explore the barriers to this activity. Materials and Methods: A total of 262 clinical dental trainee of two dental colleges (College of Dental Sciences and Bapuji Dental College of Davangere city were included in the survey. A self-administered questionnaire was administered to assess the knowledge, attitude, and practice toward Tobacco Cessation Advise. Results: Among the 262 participants in the study, around 51% said they know about Nicotine Replacement Therapy, and among them, only 4.6% were aware of the options available in the market. When asked about 5A's of tobacco cessation, only 35.5% were aware of it. Similarly, when asked about 5R's of tobacco cessation, 48.5% were unaware of it. Conclusions: The respondents did not have sufficient knowledge regarding tobacco cessation advice. With patient's disinterest and lack of time being quoted as the important barriers in providing tobacco cessation advice, it is highly recommended that there is need to incorporate few chapters on tobacco, its effect and cessation of habit in the undergraduate dental curriculum with simultaneous application of the same in clinical practice.

Gaps in the knowledge and skills of Portuguese mothers associated with newborn health care

Directory of Open Access Journals (Sweden)

Alexandrina Maria Ramos Cardoso

2018-05-01

Full Text Available ABSTRACT Objectives: assess mothers’ parenting knowledge and skills associated with the parental competence health promotion and monitoring for newborns and infants aged up to six months and determine the key characteristics of mothers who are better prepared for parenting. Method: cross-sectional study conducted in three health centers belonging to a Local Health Unit in the Northern Region of Portugal. Data was collected using clinical interviews conducted with pregnant women or mothers with a child aged up to six months. The tool used contained 21 child health promotion and monitoring indicators associated with different assessment moments: pregnancy, 1st/2nd week, 1st/2nd month, 3rd/4th month, and 5th/6th month. Results: we assessed the knowledge and skills of 629 women. Learning needs were identified for each of the indicators. The mothers who were better prepared for parenting tended to have a higher level of schooling, resided with the child’s father, had other children, had planned pregnancy, and intended to breastfeed. Conclusions: the results showed that knowledge and skills were lacking for each of the periods assessed by this study. First-time single mothers whose pregnancy was unplanned and who did not prepare themselves for parenthood may be considered a vulnerable group.

Knowledge creation through total clinical outcomes management: a practice-based evidence solution to address some of the challenges of knowledge translation.

Science.gov (United States)

Lyons, John S

2009-02-01

The challenges of knowledge translation in behavioural health care are unique to this field for a variety of reasons including the fact that effective treatment is invariably embedded in a strong relationship between practitioners and the people they serve. Practitioners' knowledge gained from experience and intuition become an even more important consideration in the knowledge translation process since clinicians are, in fact, a component of most treatments. Communication of findings from science must be conceptualized with sensitivity to this reality. Considering knowledge translation as a communication process suggests the application of contemporary theories of communication which emphasize the creation of shared meaning over the transmission of knowledge from one person to the next. In this context outcomes management approaches to create a learning environment within clinical practices that facilitate the goals of knowledge transfer while respecting that the scientific enterprise is neither the sole nor primary repository of knowledge.

Knowledge and practices related to plague in an endemic area of Uganda

Directory of Open Access Journals (Sweden)

Kiersten J. Kugeler

2017-11-01

Full Text Available Background: Plague is a virulent zoonosis reported most commonly from Sub-Saharan Africa. Early treatment with antibiotics is important to prevent mortality. Understanding knowledge gaps and common behaviors informs the development of educational efforts to reduce plague mortality. Methods: A multi-stage cluster-sampled survey of 420 households was conducted in the plague-endemic West Nile region of Uganda to assess knowledge of symptoms and causes of plague and health care-seeking practices. Results: Most (84% respondents were able to correctly describe plague symptoms; approximately 75% linked plague with fleas and dead rats. Most respondents indicated that they would seek health care at a clinic for possible plague; however plague-like symptoms were reportedly common, and in practice, persons sought care for those symptoms at a health clinic infrequently. Conclusions: Persons in the plague-endemic region of Uganda have a high level of understanding of plague, yet topics for targeted educational messages are apparent. Keywords: Plague, Yersinia pestis, Knowledge, Practices, Behaviors, Africa

Medical and psychology students' knowledge of and attitudes towards mindfulness as a clinical intervention.

Science.gov (United States)

McKenzie, Stephen P; Hassed, Craig S; Gear, Jacqui L

2012-01-01

Mindfulness is a technique for training people to pay full attention and to fully accept the reality of what they are paying attention to. The clinical efficacy of mindfulness has been increasingly demonstrated during the last two decades. Very little research, however, has been undertaken on health professionals' and students of health professions' knowledge of and attitudes towards mindfulness. These may affect the current and future level of use of a technique that offers important clinical advantages. We aimed to compare knowledge of and attitudes towards mindfulness of medical students without exposure to it in their training with psychology students without exposure and with medical students with exposure to mindfulness in their training. A total of 91 medical students from Monash University, 49 medical students from Deakin University, and 31 psychology students from Deakin University were given a questionnaire that elicited quantitative and qualitative responses about level of knowledge of mindfulness and willingness to administer or recommend it to their future patients. Psychology students without exposure to mindfulness in their training have a greater knowledge of it and are more likely to administer it or recommend it than are medical students without exposure to it in their training. Medical students with exposure to mindfulness in their course have a greater knowledge of it and are more likely to administer it or recommend it than are medical students without exposure. Knowledge of mindfulness is positively correlated with students' willingness to use or recommend it. Possible implications of the findings of this study are that if future doctors are routinely instructed in mindfulness as a clinical intervention they may be more likely to form a more positive attitude towards it, that is more consistent with that of nonmedical health professions such as psychologists, and that they therefore may be more likely to administer it or refer its use. The

Assessment of physicians' awareness and knowledge of familial hypercholesterolemia in Saudi Arabia: Is there a gap?

Science.gov (United States)

Batais, Mohammed Ali; Almigbal, Turky H; Bin Abdulhak, Aref A; Altaradi, Hani B; AlHabib, Khalid F

2017-01-01

The scarcity of familial hypercholesterolemia (FH) cases reported in Saudi Arabia might be indicative of a lack of awareness of this common genetic disease among physicians. To assess physicians' awareness, practice, and knowledge of FH in Saudi Arabia. This is a cross-sectional study conducted among physicians at four tertiary hospitals in Riyadh, Saudi Arabia between March 2016 and May 2016 using a self-administered questionnaire. A total of 294 physicians completed the survey (response rate 90.1%). Overall, 92.9% of the participants have poor knowledge of FH while only 7.1% have acceptable knowledge. The majority (68.7%) of physicians rated their familiarity with FH as average or above average, and these had higher mean knowledge scores than participants with self-reported below average familiarity (mean 3.4 versus 2.6) (P knowledge scores compared to those without FH patients in their care (3.5 versus 2.9) (P = 0.006). In addition, there were statistically significant differences between physicians' mean knowledge scores and their ages, levels of training, and years in practice. Moreover, a substantial deficit was identified in the awareness of various clinical algorithms to diagnose patients with FH, cascade screening, specialist lipid services, and the existence of statin alternatives, such as proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. A substantial deficit was found in the awareness, knowledge, practice, and detection of FH among physicians in Saudi Arabia. Extensive educational programs are required to raise physician awareness and implement best practices; only then can the impact of these interventions on FH management and patient outcome be assessed.

Cernavoda NPP Knowledge Transfer

International Nuclear Information System (INIS)

Valache, C. M.

2016-01-01

Full text: The paper presents a description of the Knowledge Transfer (KT) process implemented at Cernavoda NPP, its designing and implementation. It is underlined that applying a KT approach should improve the value of existing processes of the organization through: • Identifying business, operational and safety risks due to knowledge gaps, • Transfer of knowledge from the ageing workforce to the peers and/or the organization, • Continually learning from successes and failures of individual or teams, • Convert tacit knowledge to explicit knowledge, • Improving operational and safety performance through creating both new knowledge and better access to existing knowledge. (author

Knowledge, attitudes, and practices regarding travel health among Muscat International Airport travelers in Oman: Identifying the gaps and addressing the challenges.

Science.gov (United States)

Al-Abri, Seif S; Abdel-Hady, Doaa M; Al-Abaidani, Idris S

2016-06-01

Although the majority of travel-associated communicable diseases can be prevented, the public health burden of these diseases remains significant. Relatively little is known about how travelers know and perceive the health risks associated with travel and how they utilize preventive measures before and while traveling abroad. This study was conducted to determine the level of the knowledge, attitudes, and practices (KAP) of Muscat International Airport travelers about travel health in order to assess the knowledge gap and the need for travel health services in Oman. A cross-sectional study was conducted over a period of 1week using a self-administered questionnaire. The overall level of knowledge about vaccine-preventable diseases, food safety, and preventive measures against insect bites of the participants was inadequate. The practice concerning preventive travel health measures, such as the use of specific immunizations and antimalarial prophylaxis, was very limited, and influenced by some personal and travel-related factors. The inadequate level of travelers' knowledge and poor utilization of travel medicine services highlights the need for the provisions of specialized travel medicine services at the national level and to develop educational materials promoting the importance of pre-travel health advice. Copyright © 2016 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Strategi Pengembangan Good Agricultural Practices (GAP di Kabupaten Bangka, Provinsi Kepulauan Bangka Belitung

Directory of Open Access Journals (Sweden)

Fournita Agustina

2017-08-01

Full Text Available The purpose of this study is to identify the problems faced by agricultural extension workers and to formulate alternative of extension strategies in realizing the application of horticultural GAP by farmers in Bangka Regency. This study was conducted in Bangka Regency of Bangka Belitung Province in February 2014. The data obtained in the field were analyzed using qualitative descriptive analysis and SWOT analysis method. The results of this study indicate that: (1 The problems faced by agricultural extension workers in realizing the application of horticultural GAP by farmers in Kabupaten Bangka are low knowledge and skill about GAP horticulture, the existence of agricultural extension workers that have heavy work load, programme extension does not correspond to the need of farmer horticulture; (2 The strategy of agricultural extension workers in realizing the application of GAP horticulture by farmers in Bangka Regency is to increase the training and visit and demonstration plot (plots GAP horticulture, applying to the Food Security Agency of Bangka Regency related to the lack of education and learning tools horticulture, increasing knowledge and skills on horticultural GAP. Enhance interaction with universities and research institutions, knowledge and skills based on experience farming horticultural crops farmers as well as keeping exercise routines and visits to horticultural farmers

Filling Knowledge Gaps for Mimivirus Entry, Uncoating, and Morphogenesis.

Science.gov (United States)

Andrade, Ana Cláudia Dos Santos Pereira; Rodrigues, Rodrigo Araújo Lima; Oliveira, Graziele Pereira; Andrade, Kétyllen Reis; Bonjardim, Cláudio Antônio; La Scola, Bernard; Kroon, Erna Geessien; Abrahão, Jônatas Santos

2017-11-15

Since the discovery of mimivirus, its unusual structural and genomic features have raised great interest in the study of its biology; however, many aspects concerning its replication cycle remain uncertain. In this study, extensive analyses of electron microscope images, as well as biological assay results, shed light on unclear points concerning the mimivirus replication cycle. We found that treatment with cytochalasin, a phagocytosis inhibitor, negatively impacted the incorporation of mimivirus particles by Acanthamoeba castellanii , causing a negative effect on viral growth in amoeba monolayers. Treatment of amoebas with bafilomicin significantly impacted mimivirus uncoating and replication. In conjunction with microscopic analyses, these data suggest that mimiviruses indeed depend on phagocytosis for entry into amoebas, and particle uncoating (and stargate opening) appears to be dependent on phagosome acidification. In-depth analyses of particle morphogenesis suggest that the mimivirus capsids are assembled from growing lamellar structures. Despite proposals from previous studies that genome acquisition occurs before the acquisition of fibrils, our results clearly demonstrate that the genome and fibrils can be acquired simultaneously. Our data suggest the existence of a specific area surrounding the core of the viral factory where particles acquire the surface fibrils. Furthermore, we reinforce the concept that defective particles can be formed even in the absence of virophages. Our work provides new information about unexplored steps in the life cycle of mimivirus. IMPORTANCE Investigating the viral life cycle is essential to a better understanding of virus biology. The combination of biological assays and microscopic images allows a clear view of the biological features of viruses. Since the discovery of mimivirus, many studies have been conducted to characterize its replication cycle, but many knowledge gaps remain to be filled. In this study, we conducted a

Knowledge of midwives about hypertensive disorders during pregnancy in primary healthcare

Directory of Open Access Journals (Sweden)

Ethelwynn L. Stellenberg

2016-04-01

Full Text Available Background: Many factors or medical conditions may influence the outcome of pregnancy,which in turn, may increase infant and maternal morbidity and mortality. One such condition is an increase in blood pressure (BP. Setting: The study was conducted in maternity obstetrical units (MOUs in primary healthcare clinics (PHCs in the Eastern Cape, South Africa. Objectives: To determine the knowledge about hypertensive disorders during pregnancy (HDPs of registered midwives working in MOUs in PHCs. Methods: A quantitative descriptive correlation research design was applied. A simple random sample of 43 (44% rural and urban clinics was selected, and all registered midwives (n = 101 working in these clinics completed a self-administered questionnaire. Data were collected over a period of 1 month. The reliability and validity of the methodology were supported by experts and a pilot study. Descriptive statistics including various statistical tests to determine any associations between variables using a 95% confidence interval were applied. Results: A gap in the knowledge of midwives about HDPs was identified. Only 56.4% of the participants correctly answered the questions on the clinical manifestations of severe pre-eclampsia and 68.3% on the factors affecting BP, whereas 27.7% had no understanding about pre-eclampsia. Significant statistical differences were identified in the knowledge of staff in clinics where doctors visit regularly versus those in clinics where there are no visits (p = 0.04, and between experience of midwives and management of HDPs (p = 0.02. Conclusion: The knowledge of midwives is deficient regarding HDPs. Continuous professional development is critical in midwifery both in theory and in clinical practice. Keywords: Midwives; Hypertension; Eclampsia; Pre-eclampsia; Pregnancy

Research Networks, Mentorship and Sustainability Knowledge

Science.gov (United States)

Kafle, A.; Mukhopadhyay, P.; Nepal, M.; Shyamsundar, P.

2015-12-01

In South Asia, a majority of institutions are ill-equipped to undertake research on multi-disciplinary environmental problems, though these problems are increasing at a fast rate and connected to the region's poverty and growth objectives. In this context, the South Asian Network for Development and Environmental Economics (SANDEE) tries to fill a research, training and knowledge gap by building skills in the area of Environment and Development Economics. In this paper, the authors argue that research networks contribute to the growth of sustainability knowledge through (a) knowledge creation, (b) knowledge transfer and (c) knowledge deepening. The paper tries to show the relationship between capacity building, mentorship and research scholarship. It demonstrates that researchers, by associating with the network and its multiple training and mentoring processes, are able to build skills, change curricula and deliver useful knowledge products. The paper discusses the need for interdisciplinary research and the challenges of bridging the gap between research outputs and policy reforms.

Knowledge and critical thinking skills increase clinical reasoning ability in urogenital disorders: a Universitas Sriwijaya Medical Faculty experience

Directory of Open Access Journals (Sweden)

Irfannuddin Irfannuddin

2009-03-01

Full Text Available Aim Clinical reasoning is one of the essential competencies for medical practitioners, so that it must be exercised by medical students. Studies on quantitative evidence of factors influencing clinical reasoning abilicy of students are limited. The aim of this study was to determine the influence of knowledge and other factors on the clinical reasoning abiliry ofthe students, which can serve as reference to establish methods for learning ctinical reasoning.Methods This is a cross-sectional study on fourth semester students enrolled in the Competency-based Curriculum of the Medical Faculty, University of Sriwijaya. Data on clinical reasoning abilily and risk factors during urogenital blockwere collected inApril 2008, when the students have just completed the btock. Clinical reasoning abiliry was tested using the Script Concordance test and the risk factors were evaluated based on formative tests, block summative assessments, and student characteristics. Data were analyzed by Cox regression.Results The prevalence of low clinical reasoning ability of the 132 students was 38.6%. The group with low basic knowledge was found to have 63% risk ol low clinical reasoning abiliry when compared to those with high basic knowledge (adjusted RR = 1.63; 95% conidence intewal (Ct: 1.10 -2.42. When compared to students with high critical thinking skitls, those with lory critical thinking skills had 2.3 time to be low clinical reasoning abitity (adjusted RR : 2.30; 95% CI: 1.55 - 3.41.Conclusion Students with low critical thinking skills or with inadequate knowledge had a higher risk of low clinical reasoning ability. (Med J Indones 2009; 18: 53-9Keywords: clinical reasoning, basic knowledge, critical thinking, competency-based curriculum

Ambulatory and home blood pressure monitoring: gaps between clinical guidelines and clinical practice in Singapore

Directory of Open Access Journals (Sweden)

Setia S

2017-07-01

only 55% said that they had the ability to provide education on HBPM and BPV. Patient inertia, poor patient compliance, lack of medical consultation time, and poor patient access to a BP machine were the most common challenges for implementing out-of-office BP monitoring. Conclusion: Although physicians from Singapore do recommend out-of-office BP measurement to patients with hypertension, this survey identified several important gaps in knowledge and clinical practice. Keywords: hypertension, blood pressure monitoring, blood pressure variability, guidelines

Preparing for Humans at Mars, MPPG Updates to Strategic Knowledge Gaps and Collaboration with Science Missions

Science.gov (United States)

Baker, John; Wargo, Michael J.; Beaty, David

2013-01-01

The Mars Program Planning Group (MPPG) was an agency wide effort, chartered in March 2012 by the NASA Associate Administrator for Science, in collaboration with NASA's Associate Administrator for Human Exploration and Operations, the Chief Scientist, and the Chief Technologist. NASA tasked the MPPG to develop foundations for a program-level architecture for robotic exploration of Mars that is consistent with the President's challenge of sending humans to the Mars system in the decade of the 2030s and responsive to the primary scientific goals of the 2011 NRC Decadal Survey for Planetary Science. The Mars Exploration Program Analysis Group (MEPAG) also sponsored a Precursor measurement Strategy Analysis Group (P-SAG) to revisit prior assessments of required precursor measurements for the human exploration of Mars. This paper will discuss the key results of the MPPG and P-SAG efforts to update and refine our understanding of the Strategic Knowledge Gaps (SKGs) required to successfully conduct human Mars missions.

Synthesis maps: visual knowledge translation for the CanIMPACT clinical system and patient cancer journeys.

Science.gov (United States)

Jones, P H; Shakdher, S; Singh, P

2017-04-01

Salient findings and interpretations from the canimpact clinical cancer research study are visually represented in two synthesis maps for the purpose of communicating an integrated presentation of the study to clinical cancer researchers and policymakers. Synthesis maps integrate evidence and expertise into a visual narrative for knowledge translation and communication. A clinical system synthesis map represents the current Canadian primary care and cancer practice systems, proposed as a visual knowledge translation from the mixed-methods canimpact study to inform Canadian clinical research, policy, and practice discourses. Two synthesis maps, drawn together from multiple canimpact investigations and sources, were required to articulate critical differences between the clinical system and patient perspectives. The synthesis map of Canada-wide clinical cancer systems illustrates the relationships between primary care and the full cancer continuum. A patient-centred map was developed to represent the cancer (and primary care) journeys as experienced by breast and colorectal cancer patients.

practice gap in critical care nursing students

African Journals Online (AJOL)

Guided reflection as a tool to deal with the theory– practice gap in critical care ... was used during semi-structured interviews during the data collection process. ... a description of incidents experienced, critical analysis of knowledge, critical ...

Eating disorders in the context of preconception care: fertility specialists' knowledge, attitudes, and clinical practices.

Science.gov (United States)

Rodino, Iolanda S; Byrne, Susan M; Sanders, Katherine A

2017-02-01

To gauge fertility specialists' knowledge, clinical practices, and training needs in regard to eating disorders. Cross-sectional study. Fertility clinics. Eighty Australian and New Zealand fertility specialists who were members of the Fertility Society of Australia. None. Responses to an anonymously completed online questionnaire. Approximately 54% of doctors correctly identified the body mass index relevant to anorexia nervosa, and 30% identified menstrual disturbances for anorexia, while 63.8% of doctors incorrectly nominated maladaptive weight control behaviors as a characteristic of binge eating disorder. While clinicians (83.7%) agreed it was important to screen for eating disorders during preconception assessments, 35% routinely screened for eating disorders and 8.8% indicated that their clinics had clinical practice guidelines for management of eating disorders. A minority of participants (13.8%) felt satisfied with their level of university training in eating disorders, 37.5% of doctors felt confident in their ability to recognize symptoms of an eating disorder, and 96.2% indicated a need for further education and clinical guidelines. On most items examined, knowledge and clinical practices regarding eating disorders did not differ according to doctor gender or years of clinical experience working as a fertility specialist. Knowledge about eating disorders in the context of fertility treatment is important. This study highlights the uncertainty among fertility specialists in detecting features of eating disorders. The findings point to the importance of further education and training, including the development of clinical guidelines specific to fertility health care providers. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Mind the Gap: Gaps in Antidepressant Treatment, Treatment Adjustments, and Outcomes among Patients in Routine HIV Care in a Multisite U.S. Clinical Cohort.

Directory of Open Access Journals (Sweden)

Rushina Cholera

Full Text Available Depression affects 20-30% of HIV-infected patients and is associated with worse HIV outcomes. Although effective depression treatment is available, depression is largely untreated or undertreated in this population.We quantified gaps in antidepressant treatment, treatment adjustments, and outcomes among US patients in routine HIV care in the nationally distributed CNICS observational clinical cohort. This cohort combines detailed clinical data with regular, self-reported depressive severity assessments (Patient Health Questionnaire-9, PHQ-9. We considered whether participants with likely depression received antidepressants, whether participants on antidepressants with persistently high depressive symptoms received timely dose adjustments, and whether participants achieved depression remission. We considered a cross-sectional analysis (6,219 participants in care in 2011-2012 and a prospective analysis (2,936 participants newly initiating CNICS care when PHQ-9 screening was active.The cross-sectional sample was 87% male, 53% Caucasian, 25% African American, and 18% Hispanic; the prospective sample was similar. In both samples, 39-44% had likely depression, with 44-60% of those receiving antidepressants. Of participants receiving antidepressants, 20-26% experienced persistently high depressive symptoms; only a small minority of those received antidepressant dose adjustments. Overall, 35-40% of participants on antidepressants achieved full depression remission. Remission among participants with persistently high depressive symptoms was rare regardless of dose adjustments.In this large, diverse cohort of US patients engaged in routine HIV care, we observed large gaps in antidepressant treatment, timely dose adjustment to address persistently high depressive symptoms, and antidepressant treatment outcomes. These results highlight the importance of more effective pharmacologic depression treatment models for HIV-infected patients.

Examining the Gender Gap in Introductory Physics

Science.gov (United States)

Kost, Lauren; Pollock, Steven; Finkelstein, Noah

2009-05-01

Our previous research[1] showed that despite the use of interactive engagement techniques in the introductory physics course, the gap in performance between males and females on a mechanics conceptual learning survey persisted from pre- to post-test, at our institution. Such findings were counter to previously published work[2]. Follow-up studies[3] identified correlations between student performance on the conceptual learning survey and students' prior physics and math knowledge and their incoming attitudes and beliefs about physics and learning physics. The results indicate that the gender gap at our institution is predominantly associated with differences in males' and females' previous physics and math knowledge, and attitudes and beliefs. Our current work extends these results in two ways: 1) we look at the gender gap in the second semester of the introductory sequence and find results similar to those in the first semester course and 2) we identify ways in which males and females differentially experience several aspects of the introductory course. [1] Pollock, et al, Phys Rev: ST: PER 3, 010107. [2] Lorenzo, et al, Am J Phys 74, 118. [3] Kost, et al, PERC Proceedings 2008.

Assessments of the Veteran Medication Allergy Knowledge Gap and Potential Safety Improvements with the Veteran Health Information Exchange (VHIE).

Science.gov (United States)

Pan, Eric; Botts, Nathan; Jordan, Harmon; Olinger, Lois; Donahue, Margaret; Hsing, Nelson

2016-01-01

The U.S. Department of Veterans Affairs (VA) Veteran Health Information Exchange (VHIE, formerly Virtual Lifetime Electronic Record, or VLER) had been deployed at all VA sites and used to exchange clinical information with private sector healthcare partners nationally. This paper examined VHIE's effect on allergy documentation. Review of all inbound VHIE transactions in FY14 showed that VHIE use was associated with a nearly eight-fold increase in allergy documentation rate. Preliminary manual document review further showed that VA and partners had shared knowledge of only 38% ofpatient allergies, while VA had exclusive knowledge of another 58% ofpatient allergies, and partners had exclusive knowledge of the last 5% of patient allergies. To our knowledge, this is the first study that examined the effect of HIE on allergy documentation.

Surveying the Knowledge and Practices of Health Professionals in China, India, Iran, and Mexico on Treating Tuberculosis.

Science.gov (United States)

Hoffman, Steven J; Guindon, G Emmanuel; Lavis, John N; Randhawa, Harkanwal; Becerra-Posada, Francisco; Dejman, Masoumeh; Falahat, Katayoun; Malek-Afzali, Hossein; Ramachandran, Parasurama; Shi, Guang; Yesudian, C A K

2016-05-04

Research evidence continues to reveal findings important for health professionals' clinical practices, yet it is not consistently disseminated to those who can use it. The resulting deficits in knowledge and service provision may be especially pronounced in low- and middle-income countries that have greater resource constraints. Tuberculosis treatment is an important area for assessing professionals' knowledge and practices because of the effectiveness of existing treatments and recognized gaps in professionals' knowledge about treatment. This study surveyed 384 health professionals in China, India, Iran, and Mexico on their knowledge and practices related to tuberculosis treatment. Few respondents correctly answered all five knowledge questions (12%) or self-reported performing all five recommended clinical practices "often or very often" (3%). Factors associated with higher knowledge scores included clinical specialization and working with researchers. Factors associated with better practices included training in the care of tuberculosis patients, being based in a hospital, trusting systematic reviews of randomized controlled double-blind trials, and reading summaries of articles, reports, and reviews. This study highlights several strategies that may prove effective in improving health professionals' knowledge and practices related to tuberculosis treatment. Facilitating interactions with researchers and training in acquiring systematic reviews may be especially helpful. © The American Society of Tropical Medicine and Hygiene.

Towards Ubiquitous Peer Review Strategies to Sustain and Enhance a Clinical Knowledge Management Framework

Science.gov (United States)

Rocha, Roberto A.; Bradshaw, Richard L.; Bigelow, Sharon M.; Hanna, Timothy P.; Fiol, Guilherme Del; Hulse, Nathan C.; Roemer, Lorrie K.; Wilkinson, Steven G.

2006-01-01

Widespread cooperation between domain experts and front-line clinicians is a key component of any successful clinical knowledge management framework. Peer review is an established form of cooperation that promotes the dissemination of new knowledge. The authors describe three peer collaboration scenarios that have been implemented using the knowledge management infrastructure available at Intermountain Healthcare. Utilization results illustrating the early adoption patterns of the proposed scenarios are presented and discussed, along with succinct descriptions of planned enhancements and future implementation efforts. PMID:17238422

Africa Centre for Systematic Reviews and Knowledge Translation ...

International Development Research Centre (IDRC) Digital Library (Canada)

Several initiatives focused on bridging the "know-do" gap emphasize ... and knowledge translation to bridge the gaps between research and health policy. ... International Water Resources Association, in close collaboration with IDRC, ...

Uncertainty, probability and information-gaps

International Nuclear Information System (INIS)

Ben-Haim, Yakov

2004-01-01

This paper discusses two main ideas. First, we focus on info-gap uncertainty, as distinct from probability. Info-gap theory is especially suited for modelling and managing uncertainty in system models: we invest all our knowledge in formulating the best possible model; this leaves the modeller with very faulty and fragmentary information about the variation of reality around that optimal model. Second, we examine the interdependence between uncertainty modelling and decision-making. Good uncertainty modelling requires contact with the end-use, namely, with the decision-making application of the uncertainty model. The most important avenue of uncertainty-propagation is from initial data- and model-uncertainties into uncertainty in the decision-domain. Two questions arise. Is the decision robust to the initial uncertainties? Is the decision prone to opportune windfall success? We apply info-gap robustness and opportunity functions to the analysis of representation and propagation of uncertainty in several of the Sandia Challenge Problems

Integrating complex business processes for knowledge-driven clinical decision support systems.

Science.gov (United States)

Kamaleswaran, Rishikesan; McGregor, Carolyn

2012-01-01

This paper presents in detail the component of the Complex Business Process for Stream Processing framework that is responsible for integrating complex business processes to enable knowledge-driven Clinical Decision Support System (CDSS) recommendations. CDSSs aid the clinician in supporting the care of patients by providing accurate data analysis and evidence-based recommendations. However, the incorporation of a dynamic knowledge-management system that supports the definition and enactment of complex business processes and real-time data streams has not been researched. In this paper we discuss the process web service as an innovative method of providing contextual information to a real-time data stream processing CDSS.

The International Certification of Addiction Medicine: Validating Clinical Knowledge across Borders

Science.gov (United States)

el-Guebaly, Nady; Violato, Claudio

2011-01-01

The experience of the International Society of Addiction Medicine in setting up the first international certification of clinical knowledge is reported. The steps followed and the results of a psychometric analysis of the tests from the first 65 candidates are reported. Lessons learned in the first 5 years and challenges for the future are…

Community knowledge and information communication gaps on HIV ...

African Journals Online (AJOL)

community needs and address economic and socio-cultural barriers to facilitate education utilisation and behavioural changes required in HIV/AIDS prevention and control in Tanzania. Keywords: HIV/AIDS, knowledge, information communication, Tanzania Tanzania Health Research Bulletin Vol. 8 (2) 2006: pp. 101-108 ...

Knowledge management: organizing nursing care knowledge.

Science.gov (United States)

Anderson, Jane A; Willson, Pamela

2009-01-01

Almost everything we do in nursing is based on our knowledge. In 1984, Benner (From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Menlo Park, CA: Addison-Wesley; 1984) described nursing knowledge as the culmination of practical experience and evidence from research, which over time becomes the "know-how" of clinical experience. This "know-how" knowledge asset is dynamic and initially develops in the novice critical care nurse, expands within competent and proficient nurses, and is actualized in the expert intensive care nurse. Collectively, practical "know-how" and investigational (evidence-based) knowledge culminate into the "knowledge of caring" that defines the profession of nursing. The purpose of this article is to examine the concept of knowledge management as a framework for identifying, organizing, analyzing, and translating nursing knowledge into daily practice. Knowledge management is described in a model case and implemented in a nursing research project.

Importance of clinical toxicology teaching and its impact in improving knowledge: sharing experience from a workshop

International Nuclear Information System (INIS)

Khan, N.U.; Fayyaz, J.; Khan, U.R.; Feroze, A.

2013-01-01

Objective: To assess the impact of a one-day clinical toxicology workshop in improving knowledge. Methods: A one-day clinical toxicology workshop was conducted as a pre-conference workshop of the Annual Emergency Medicine Conference at the Aga Khan University Hospital, Karachi, in April 2012. The course was composed of poisoning-related common clinical scenarios. The pre-test and post-test understanding was used to assess the impact of the course in improving knowledge. The participants also evaluated the workshop as a whole thorough written evaluation forms. SPSS 19 was used for statistical analysis of the data. Result: There were 22 participants in the course. The pre-test mean score was 31.6+-15.1% (95% CI; 24-40; n=19) compared to the post-test the mean score of 56.0+-10.8% (95% CI; 47- 61; n=17). The positive difference was also statistically significant (p<0.001). The overall workshop was evaluated as excellent by 08 (47.46%) and very good by 10 (52.63%) participants. Conclusion: Short training in clinical toxicology improved knowledge of the participants. (author)

New graduate registered nurses' knowledge of patient safety and practice: A literature review.

Science.gov (United States)

Murray, Melanie; Sundin, Deborah; Cope, Vicki

2018-01-01

To critically appraise available literature and summarise evidence pertaining to the patient safety knowledge and practices of new graduate registered nurses. Responsibility for patient safety should not be limited to the practice of the bedside nurses, rather the responsibility of all in the healthcare system. Previous research identified lapses in safety across the health care, more specifically with new practitioners. Understanding these gaps and what may be employed to counteract them is vital to ensuring patient safety. A focused review of research literature. The review used key terms and Boolean operators across a 5-year time frame in CINAHL, Medline, psycINFO and Google Scholar for research articles pertaining to the area of enquiry. Eighty-four articles met the inclusion criteria, 39 discarded due to irrelevant material and 45 articles were included in the literature review. This review acknowledges that nursing has different stages of knowledge and practice capabilities. A theory-practice gap for new graduate registered nurses exists, and transition to practice is a key learning period setting new nurses on the path to becoming expert practitioners. Within the literature, there was little to no acknowledgement of patient safety knowledge of the newly registered nurse. Issues raised in the 1970s remain a concern for today's new graduate registered nurses. Research has recognised several factors affecting transition from nursing student to new graduate registered nurse. These factors are leaving new practitioners open to potential errors and risking patient safety. Understanding the knowledge of a new graduate registered nurse upon entering clinical practice may assist in organisations providing appropriate clinical and theoretical support to these nurses during their transition. © 2017 John Wiley & Sons Ltd.

Development, validation and clinical assessment of a short questionnaire to assess disease-related knowledge in inflammatory bowel disease patients.

LENUS (Irish Health Repository)

Keegan, Denise

2013-02-01

Only two inflammatory bowel disease (IBD) knowledge scales are available, both primarily aimed at evaluating the effectiveness of clinical education programs. The aim of this study was to develop and validate a short knowledge questionnaire for clinical and academic research purposes.

Effect of Performance Feedback on Perceived Knowledge and Likelihood to Pursue Continuing Education

Science.gov (United States)

Eberman, Lindsey E.; Tripp, Brady L.

2011-01-01

Context: For practicing health care professionals, waiting for a teachable moment to identify a gap in knowledge could prove critical. Other methods are needed to help health care professionals identify their knowledge gaps. Objective: To assess the effect of performance feedback on Athletic Trainers' (AT) perceived knowledge (PK) and likelihood…

PARTAKE Survey of Public Knowledge and Perceptions of Clinical Research in India

Science.gov (United States)

Burt, Tal; Dhillon, Savita; Sharma, Pooja; Khan, Danish; MV, Deepa; Alam, Sazid; Jain, Sarika; Alapati, Bhavana; Mittal, Sanjay; Singh, Padam

2013-01-01

Background A public that is an informed partner in clinical research is important for ethical, methodological, and operational reasons. There are indications that the public is unaware or misinformed, and not sufficiently engaged in clinical research but studies on the topic are lacking. PARTAKE – Public Awareness of Research for Therapeutic Advancements through Knowledge and Empowerment is a program aimed at increasing public awareness and partnership in clinical research. The PARTAKE Survey is a component of the program. Objective To study public knowledge and perceptions of clinical research. Methods A 40-item questionnaire combining multiple-choice and open-ended questions was administered to 175 English- or Hindi-speaking individuals in 8 public locations representing various socioeconomic strata in New Delhi, India. Results Interviewees were 18–84 old (mean: 39.6, SD±16.6), 23.6% female, 68.6% employed, 7.3% illiterate, 26.3% had heard of research, 2.9% had participated and 58.9% expressed willingness to participate in clinical research. The following perceptions were reported (% true/% false/% not aware): ‘research benefits society’ (94.1%/3.5%/2.3%), ‘the government protects against unethical clinical research’ (56.7%/26.3%/16.9%), ‘research hospitals provide better care’ (67.2%/8.7%/23.9%), ‘confidentiality is adequately protected’ (54.1%/12.3%/33.5%), ‘participation in research is voluntary’ (85.3%/5.8%/8.7%); ‘participants treated like ‘guinea pigs’’ (20.7%/53.2%/26.0%), and ‘compensation for participation is adequate’ (24.7%/12.9%/62.3%). Conclusions Results suggest the Indian public is aware of some key features of clinical research (e.g., purpose, value, voluntary nature of participation), and supports clinical research in general but is unaware of other key features (e.g., compensation, confidentiality, protection of human participants) and exhibits some distrust in the conduct and reporting of clinical trials

PARTAKE survey of public knowledge and perceptions of clinical research in India.

Directory of Open Access Journals (Sweden)

Tal Burt

Full Text Available BACKGROUND: A public that is an informed partner in clinical research is important for ethical, methodological, and operational reasons. There are indications that the public is unaware or misinformed, and not sufficiently engaged in clinical research but studies on the topic are lacking. PARTAKE - Public Awareness of Research for Therapeutic Advancements through Knowledge and Empowerment is a program aimed at increasing public awareness and partnership in clinical research. The PARTAKE Survey is a component of the program. OBJECTIVE: To study public knowledge and perceptions of clinical research. METHODS: A 40-item questionnaire combining multiple-choice and open-ended questions was administered to 175 English- or Hindi-speaking individuals in 8 public locations representing various socioeconomic strata in New Delhi, India. RESULTS: Interviewees were 18-84 old (mean: 39.6, SD ± 16.6, 23.6% female, 68.6% employed, 7.3% illiterate, 26.3% had heard of research, 2.9% had participated and 58.9% expressed willingness to participate in clinical research. The following perceptions were reported (% true/% false/% not aware: 'research benefits society' (94.1%/3.5%/2.3%, 'the government protects against unethical clinical research' (56.7%/26.3%/16.9%, 'research hospitals provide better care' (67.2%/8.7%/23.9%, 'confidentiality is adequately protected' (54.1%/12.3%/33.5%, 'participation in research is voluntary' (85.3%/5.8%/8.7%; 'participants treated like 'guinea pigs'' (20.7%/53.2%/26.0%, and 'compensation for participation is adequate' (24.7%/12.9%/62.3%. CONCLUSIONS: Results suggest the Indian public is aware of some key features of clinical research (e.g., purpose, value, voluntary nature of participation, and supports clinical research in general but is unaware of other key features (e.g., compensation, confidentiality, protection of human participants and exhibits some distrust in the conduct and reporting of clinical trials. Larger, cross

Gaps in knowledge: tracking and explaining gender differences in health information seeking.

Science.gov (United States)

Manierre, Matthew J

2015-03-01

Self-directed health information seeking has become increasingly common in recent years, yet there is a substantial body of evidence suggesting that females are more likely to engage in information seeking than males. Previous research has largely ignored the significance of this difference as both an empirical and a theoretical finding. The current study has two goals, seeking to track this sex gap over time and to test explanations for its existence. The three explanations tested are based in past findings of gendered division of childcare labor, gendered reactivity to illness, and gendered perceived risk of illness. These were tested using multiple dependent variables from both repeated cross sectional data and 2012 data from the Health Information Trends Survey (HINTS). Results show that females are significantly more likely to look for cancer information, information in general, and information over the Internet over time than males, though the gap may be closing in the case of cancer information. The three explanations also received little clear support though perceived risk of getting cancer acted as a mediator through which men may be less likely to look for cancer information. Based on this analysis it is clear that a sex gap in information seeking is present and theories of masculinity and health may hold promise in some contexts but additional explanations are needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Reactor Safety Gap Evaluation of Accident Tolerant Components and Severe Accident Analysis

International Nuclear Information System (INIS)

Farmer, Mitchell T.; Bunt, R.; Corradini, M.; Ellison, Paul B.; Francis, M.; Gabor, John D.; Gauntt, R.; Henry, C.; Linthicum, R.; Luangdilok, W.; Lutz, R.; Paik, C.; Plys, M.; Rabiti, Cristian; Rempe, J.; Robb, K.; Wachowiak, R.

2015-01-01

The overall objective of this study was to conduct a technology gap evaluation on accident tolerant components and severe accident analysis methodologies with the goal of identifying any data and/or knowledge gaps that may exist, given the current state of light water reactor (LWR) severe accident research, and additionally augmented by insights obtained from the Fukushima accident. The ultimate benefit of this activity is that the results can be used to refine the Department of Energy's (DOE) Reactor Safety Technology (RST) research and development (R&D) program plan to address key knowledge gaps in severe accident phenomena and analyses that affect reactor safety and that are not currently being addressed by the industry or the Nuclear Regulatory Commission (NRC).

Reactor Safety Gap Evaluation of Accident Tolerant Components and Severe Accident Analysis

Energy Technology Data Exchange (ETDEWEB)

Farmer, Mitchell T. [Argonne National Lab. (ANL), Argonne, IL (United States); Bunt, R. [Southern Nuclear, Atlanta, GA (United States); Corradini, M. [Univ. of Wisconsin, Madison, WI (United States); Ellison, Paul B. [GE Power and Water, Duluth, GA (United States); Francis, M. [Argonne National Lab. (ANL), Argonne, IL (United States); Gabor, John D. [Erin Engineering, Walnut Creek, CA (United States); Gauntt, R. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Henry, C. [Fauske and Associates, Burr Ridge, IL (United States); Linthicum, R. [Exelon Corp., Chicago, IL (United States); Luangdilok, W. [Fauske and Associates, Burr Ridge, IL (United States); Lutz, R. [PWR Owners Group (PWROG); Paik, C. [Fauske and Associates, Burr Ridge, IL (United States); Plys, M. [Fauske and Associates, Burr Ridge, IL (United States); Rabiti, Cristian [Idaho National Lab. (INL), Idaho Falls, ID (United States); Rempe, J. [Rempe and Associates LLC, Idaho Falls, ID (United States); Robb, K. [Argonne National Lab. (ANL), Argonne, IL (United States); Wachowiak, R. [Electric Power Research Inst. (EPRI), Knovville, TN (United States)

2015-01-31

The overall objective of this study was to conduct a technology gap evaluation on accident tolerant components and severe accident analysis methodologies with the goal of identifying any data and/or knowledge gaps that may exist, given the current state of light water reactor (LWR) severe accident research, and additionally augmented by insights obtained from the Fukushima accident. The ultimate benefit of this activity is that the results can be used to refine the Department of Energy’s (DOE) Reactor Safety Technology (RST) research and development (R&D) program plan to address key knowledge gaps in severe accident phenomena and analyses that affect reactor safety and that are not currently being addressed by the industry or the Nuclear Regulatory Commission (NRC).

A square peg in a round hole: Theory-practice gap from the lens of Filipino student nurses.

Science.gov (United States)

Factor, Elisa Monette R; Matienzo, Evangeline T; de Guzman, Allan B

2017-10-01

Previous studies suggest that theory-practice gap has remained to be a formidable task and a challenge to the nursing profession. While efforts to understand the nature and dynamics of theory-practice gap have been undertaken across the globe, a dearth in literature exists in the context of a developing country like the Philippines. Seemingly, no research has ventured yet to explore the theory-practice gap experiences of Filipino student nurses. Hence, the major intent of this qualitative investigation is to describe and capture how theory-practice gap is viewed by a select group of senior nursing students (n=10) in a comprehensive university in the Philippines. From the thickness and richness of the descriptions of the field text gathered in this study, an interesting conceptualization labeled as the Theory-Practice Gap Deficit Triad which consists of (a) structural, (b) pedagogical, and (c) relational deficits was emerged. Interestingly, the said model describes a clear intersection of the various concerns and dilemmas encountered by student nurses in their clinical exposures. Findings of this paper are valuable inputs to nursing educators, practitioners, and administrators in initiating realignment efforts geared toward developing nurses whose knowledge, skills and attitudes are responsive to the ever changing professional practice landscape. Copyright © 2017 Elsevier Ltd. All rights reserved.

Clinical simulation practise framework.

Science.gov (United States)

Khalili, Hossein

2015-02-01

Historically, simulation has mainly been used to teach students hands-on skills in a relatively safe environment. With changes in the patient population, professional regulations and clinical environments, clinical simulation practise (CSP) must assist students to integrate and apply their theoretical knowledge and skills with their critical thinking, clinical judgement, prioritisation, problem solving, decision making, and teamwork skills to provide holistic care and treatment to their patients. CSP holds great potential to derive a positive transformation in students' transition into the workplace, by associating and consolidating learning from classrooms to clinical settings, and creating bridges between theory and practice. For CSP to be successful in filling the gap, the design and management of the simulation is crucial. In this article a new framework called 'Clinical simulation practise framework: A knowledge to action strategy in health professional education' is being introduced that aims to assist educators and curriculum developers in designing and managing their simulations. This CSP framework theorises that simulation as an experiential educational tool could improve students' competence, confidence and collaboration in performing professional practice in real settings if the CSP provides the following three dimensions: (1) a safe, positive, reflective and fun simulated learning environment; (2) challenging, but realistic, and integrated simulated scenarios; and (3) interactive, inclusive, interprofessional patient-centred simulated practise. © 2015 John Wiley & Sons Ltd.

Knowledge and attitudes of low back pain in physicians based in clinical practice guidelines

Directory of Open Access Journals (Sweden)

Jorge Ruiz Sabido

2014-01-01

Full Text Available Objective: To determine the level of knowledge and attitudes of physicians in Tijuana based on Clinical Practice Guidelines (CPG for the prevention, diagnosis and treatment of Nonspecific Low Back Pain (NLBP. Methods: Prospective, cross-sectional, descriptive study. Data were obtained from doctors who practice in clinics, private surgeries, and/or government institutions. Results: Of a total of 56 doctors surveyed, 37 were men and 19 women. None of the doctors said they had not seen a patient with Back Pain. 49% knew the GPC, and 51% did not know of its existence. Conclusions: Although some physicians reported knowledge of the GPC, according to the results, there was a lack of full knowledge of, and adherence to these guidelines. Not knowing the GPC did not make it impossible to complete the questionnaire. The doctors felt more connected to the health system, but with less confidence in the management of cases of NLBP.

Avoiding a knowledge gap in a multiethnic statewide social marketing campaign: is cultural tailoring sufficient?

Science.gov (United States)

Buchthal, O Vanessa; Doff, Amy L; Hsu, Laura A; Silbanuz, Alice; Heinrich, Katie M; Maddock, Jay E

2011-03-01

In 2007, the State of Hawaii, Healthy Hawaii Initiative conducted a statewide social-marketing campaign promoting increased physical activity and nutrition. The campaign included substantial formative research to develop messages tailored for Hawaii's multiethnic Asian and Pacific Islander populations. The authors conducted a statewide random digital dialing telephone survey to assess the campaign's comparative reach among individuals with different ethnicities and different levels of education and income. This analysis suggests that the intervention was successful in reaching its target ethnic audiences. However, a knowledge gap related to the campaign appeared among individuals with incomes less than 130% of the poverty level and those with less than a high school education. These results varied significantly by message and the communication channel used. Recall of supermarket-based messages was significantly higher among individuals below 130% of the poverty level and those between 18 and 35 years of age, 2 groups that showed consistently lower recall of messages in other channels. Results suggest that cultural tailoring for ethnic audiences, although important, is insufficient for reaching low-income populations, and that broad-based social marketing campaigns should consider addressing socioeconomic status-related channel preferences in formative research and campaign design.

Security Gaps In Authentication Factor Credentials

Directory of Open Access Journals (Sweden)

Neeraj A. Sharma

2015-08-01

Full Text Available Authentication factors refer to user login credentials that a user supplies to an authentication process for it to decide whether to grant or deny access. While two-factor and three-factor authentication generally provides better security than one-factor authentication the aim of this paper is to review security in individual authentication factor credentials that are in use nowadays. These credentials will be discussed in factor categories knowledge factor possession factor and inherence factor. The paper details current security gaps and some novel approaches to diminish the gaps in these authentication factors. We believe that our recommendations will inspire development of better authentication credentials and systems.

Bridging the Measurement Gap Between Research and Clinical Care in Schizophrenia: Positive and Negative Syndrome Scale-6 (PANSS-6) and Other Assessments Based on the Simplified Negative and Positive Symptoms Interview (SNAPSI).

Science.gov (United States)

Østergaard, Søren D; Opler, Mark G A; Correll, Christoph U

2017-12-01

There is currently a "measurement gap" between research and clinical care in schizophrenia. The main reason behind this gap is that the most widely used rating scale in schizophrenia research, the 30-item Positive and Negative Syndrome Scale (PANSS), takes so long to administer that it is rarely used in clinical practice. This compromises the translation of research findings into clinical care and vice versa. The aim of this paper is to discuss how this measurement gap can be closed. Specifically, the main points of discussion are 1) the practical problems associated with using the full 30-item PANSS in clinical practice; 2) how the brief, six-item version of the Positive and Negative Syndrome Scale (PANSS-6) was derived empirically from the full 30-item PANSS and what the initial results obtained with PANSS-6 entail; and 3) how PANSS-6 ratings, guided by the newly developed, 15-25-minute, stand-alone Simplified Negative and Positive Symptoms Interview (SNAPSI), might help bridge the measurement gap between research and clinical care in schizophrenia. The full 30-item PANSS is often used in research studies, but is too time consuming to allow for routine clinical use. Recent studies suggest that the much briefer PANSS-6 is a psychometrically valid measure of core positive and negative symptoms of schizophrenia and that the scale is sensitive to symptom improvement following pharmacological treatment. SNAPSI is a brief interview that yields the information needed to rate PANSS-6 (and other brief rating scales). We believe that PANSS-6 ratings guided by SNAPSI will help bridge the measurement gap between research and clinical care in schizophrenia.

Clinical nutrition knowledge of gastroenterology fellows: is there anything omitted?

Science.gov (United States)

Eslamian, Ghazaleh; Jacobson, Kevan; Hekmatdoost, Azita

2013-01-01

Despite the increased emphasis on chronic non-communicable diseases, there are notable deficits about nutrition education in many medicine training programs particularly gastroenterology fellowship programs. In the present cross-sectional study, we examined the nutritional knowledge related to clinical nutrition among Iranian gastroenterology fellows. Thirty-six gastroenterology fellows currently enrolled in a gastroenterology fellowship program completed a questionnaire, including two sections. The first of which assessed the gastroenterology fellows experience about nutrition training, nutrition management of patients with gastrointestinal (GI) disorders and evaluating perceived nutrition education needs. The second section consisted of multiple choice questions that assessed nutritional knowledge. A total of 32 gastroenterology fellows completed the first section. The majority of gastroenterology fellows failed to partake in any nutrition education during their fellowship training particularly for inpatients despite the availability to participate in the nutrition training especially for the purpose of nutrition support. Mean correct response rates for the second section was 38%. The highest mean score was seen in nutrition assessment (48.1%), followed by scores of 40.5% in nutrition support, 37.0% nutrition in GI disease, and 25.0% in micro and macronutrients. Iranian gastroenterology fellows have serious deficits in their nutrition knowledge. This study paves the way for the development of an education program to improve nutritional knowledge of gastroenterology fellows.

Clinical Knowledge Governance Framework for Nationwide Data Infrastructure Projects.

Science.gov (United States)

Wulff, Antje; Haarbrandt, Birger; Marschollek, Michael

2018-01-01

The availability of semantically-enriched and interoperable clinical information models is crucial for reusing once collected data across institutions like aspired in the German HiGHmed project. Funded by the Federal Ministry of Education and Research, this nationwide data infrastructure project adopts the openEHR approach for semantic modelling. Here, strong governance is required to define high-quality and reusable models. Design of a clinical knowledge governance framework for openEHR modelling in cross-institutional settings like HiGHmed. Analysis of successful practices from international projects, published ideas on archetype governance and own modelling experiences as well as modelling of BPMN processes. We designed a framework by presenting archetype variations, roles and responsibilities, IT support and modelling workflows. Our framework has great potential to make the openEHR modelling efforts manageable. Because practical experiences are rare, prospectively our work will be predestinated to evaluate the benefits of such structured governance approaches.

Tacit knowledge as the unifying factor in evidence based medicine and clinical judgement.

Science.gov (United States)

Thornton, Tim

2006-03-17

The paper outlines the role that tacit knowledge plays in what might seem to be an area of knowledge that can be made fully explicit or codified and which forms a central element of Evidence Based Medicine. Appeal to the role the role of tacit knowledge in science provides a way to unify the tripartite definition of Evidence Based Medicine given by Sackett et al: the integration of best research evidence with clinical expertise and patient values. Each of these three elements, crucially including research evidence, rests on an ineliminable and irreducible notion of uncodified good judgement. The paper focuses on research evidence, drawing first on the work of Kuhn to suggest that tacit knowledge contributes, as a matter of fact, to puzzle solving within what he calls normal science. A stronger argument that it must play a role in research is first motivated by looking to Collins' first hand account of replication in applied physics and then broader considerations of replication in justifying knowledge claims in scientific research. Finally, consideration of an argument from Wittgenstein shows that whatever explicit guidelines can be drawn up to guide judgement the specification of what counts as correctly following them has to remain implicit.Overall, the paper sets out arguments for the claim that even though explicit guidelines and codifications can play a practical role in informing clinical practice, they rest on a body of tacit or implicit skill that is in principle ineliminable. It forms the bedrock of good judgement and unites the integration of research, expertise and values.

The Research of Clinical Decision Support System Based on Three-Layer Knowledge Base Model

Directory of Open Access Journals (Sweden)

Yicheng Jiang

2017-01-01

Full Text Available In many clinical decision support systems, a two-layer knowledge base model (disease-symptom of rule reasoning is used. This model often does not express knowledge very well since it simply infers disease from the presence of certain symptoms. In this study, we propose a three-layer knowledge base model (disease-symptom-property to utilize more useful information in inference. The system iteratively calculates the probability of patients who may suffer from diseases based on a multisymptom naive Bayes algorithm, in which the specificity of these disease symptoms is weighted by the estimation of the degree of contribution to diagnose the disease. It significantly reduces the dependencies between attributes to apply the naive Bayes algorithm more properly. Then, the online learning process for parameter optimization of the inference engine was completed. At last, our decision support system utilizing the three-layer model was formally evaluated by two experienced doctors. By comparisons between prediction results and clinical results, our system can provide effective clinical recommendations to doctors. Moreover, we found that the three-layer model can improve the accuracy of predictions compared with the two-layer model. In light of some of the limitations of this study, we also identify and discuss several areas that need continued improvement.

Does bridging the gap between knowledge and practice help? Example of patient dose reduction in radiology

International Nuclear Information System (INIS)

Rehani, M.M.; Kaul, Rashmi; Kumar, Pratik; Berry, M.

1995-01-01

The paper is aimed at bridging the gap between knowledge and practice and evaluating the impact of this activity on reduction of patient dose. While enormous data on radiation doses in diagnostic radiology exists, there is absolute lack of information at user's level. For example, the implications on patient dose from 1cm error in x-ray field size or error of 5 kVp or 5mAs is invariably not known. We estimated that 1 cm increase in field size results in irradiation of 600-900cc of extra volume of patient which may contain sensitive tissue, 5 kVp increase results in exposure of 35-65 mR, with more effect in case of lumbar spine and abdomen x-ray and lesser for chest and D-spine, 5 mAs error results in 4-25 mR. The impact of information supply to users was evaluated and it was found that information based approach results in dose reduction to patient and improved image quality. (author). 3 refs., 4 figs., 3 tabs

The Role of Knowledge Objects in Participatory Ergonomics Simulation

DEFF Research Database (Denmark)

Andersen, Simone Nyholm

2015-01-01

Participatory ergonomics simulations, taking place in simulation labs, have the tendency to get detached from the surrounding design process, resulting in a knowledge gap. Few studies in the human factors and ergonomics field have applied knowledge management based object concepts in the study...... of knowledge generation and transfer over such gaps. This paper introduces the concept of knowledge object to identify the roles of objects in an exploratory case study of five participatory simulation activities. The simulations had the purpose of contributing to room design of a new Danish hospital....... The analysis showed sequences and transitions of the knowledge objects revealing the process behind the knowledge interpretations and development of the future hospital rooms. Practitioner Summary: When planning participatory simulation in a lab context, the ergonomist should consider the role of objects...

Polonium-210 and other radionuclides in terrestrial, freshwater and brackish environments Results from the NKS project GAPRAD (Filling knowledge gaps in radiation protection methodologies for non-human biota)

Energy Technology Data Exchange (ETDEWEB)

Gjelsvik, R; Brown, J; Holm, E; Roos, P; Saxen, R; Outola, I

2012-01-15

The background and rationale to filling knowledge gaps in radiation protection methodologies for biota are presented. Concentrations of Po-210 and Pb-210 are reported for biota sampled in Dovrefjell, Norway and selected lake and brackish ecosystems in Finland. Furthermore, details in relation to Po-210 uptake and biokinetics in humans based on experimental studies are recounted. (Author)

Polonium-210 and other radionuclides in terrestrial, freshwater and brackish environments Results from the NKS project GAPRAD (Filling knowledge gaps in radiation protection methodologies for non-human biota)

International Nuclear Information System (INIS)

Gjelsvik, R.; Brown, J.; Holm, E.; Roos, P.; Saxen, R.; Outola, I.

2012-01-01

The background and rationale to filling knowledge gaps in radiation protection methodologies for biota are presented. Concentrations of Po-210 and Pb-210 are reported for biota sampled in Dovrefjell, Norway and selected lake and brackish ecosystems in Finland. Furthermore, details in relation to Po-210 uptake and biokinetics in humans based on experimental studies are recounted. (Author)

Metformin and breast cancer: basic knowledge in clinical context.

Science.gov (United States)

Pizzuti, Laura; Vici, Patrizia; Di Lauro, Luigi; Sergi, Domenico; Della Giulia, Marina; Marchetti, Paolo; Maugeri-Saccà, Marcello; Giordano, Antonio; Barba, Maddalena

2015-05-01

Although preclinical work is vital in unraveling the molecular tenets which apply to metformin action in breast cancer, it is by nature unable to capture the host's response to metformin in terms of insulin-mediated effects and related changes in the hormonal and metabolic asset at the systemic level. The latter might sound seemingly paradoxical when considering the inveterate use of metformin in dysmetabolisms and pathologic conditions with underlying hormonal disruption. Bridging the gap between the molecular target and characteristics of breast cancer patients may help lab-based experiments and clinical work converge into one or more well characterized sub-populations instead of a sub optimally selected one. An appropriate patient selection is the main key to the most suitable outcome interpretation and amelioration, in an attempt to meet our patients needs midway between overestimation of benefits and efficacy dilution for any given intervention and/or co-intervention. Copyright © 2015 Elsevier Ltd. All rights reserved.

Heterogeneous technologies, strategic groups and environmental efficiency technology gaps for European countries

International Nuclear Information System (INIS)

Kounetas, Konstantinos

2015-01-01

This paper measures technology (TG) and environmental efficiency technology gaps (EETGs) in 25 European countries over two distinct periods 2002 and 2008 examining the possible effect of adopted environmental regulations and the Kyoto protocol commitments on environmental efficiency technology gaps. However, the introduction of the metafrontier in our analysis puts into our discussion the role of heterogeneous technologies and its effect on the above-mentioned measures. Employing a directional distance function, we investigate whether there is an actual difference, in terms of environmental efficiency and efficiency performance, among European countries considering the technological frontiers under which they operate. The construction of individual frontiers has been realized employing a large number of variables that are highly correlated with countries' learning and absorbing capacity, new technological knowledge and using economic theory and classical frontier discrimination like developed vs. developing, North vs. South and participation in the Eurozone or not. The overall results indicate a crucial role of heterogeneous technologies for technology gaps in both periods. Moreover, a significant decrease for both measures, although in different percent, has been recorded emphasizing the key role of knowledge spillovers. -- Highlights: •We estimate technology gaps (TGs) for 25 EU countries in two distinct periods. •We estimate environmental efficiency technology gaps (EETGs). •We consider countries' technological capabilities with R&D, innovation and eco-innovation. •We test the effect of different frontier constitutions on TGs-EETGs. •We denote the specific role of knowledge spillovers

Business knowledge in surgeons.

Science.gov (United States)

Satiani, Bhagwan

2004-07-01

Surgeons and residents in training receive little, if any, formal education in the economic side of clinical practice during medical school or residency. As medical professionals face shrinking reimbursement, loss of control over health care decisions, and limited resources, surgical specialties must reevaluate the need to teach their members business survival skills. Before designing business related-teaching modules, educators must know the exact gaps in knowledge that exist among surgeons. This article reports a survey of 133 surgeons in the Midwest who were asked to rate their knowledge base in 11 business topics relevant to the practice of medicine. The survey showed that the average surgeon perceives himself or herself to be poorly equipped to understand basic financial accounting principles, financial markets, economics of health care, tools for evaluating purchases, marketing, budgets, antitrust and fraud and abuse regulations, and risk and return on investments. Armed with this data, teaching faculty, health care systems, and medical specialty societies should design business education seminars to better position surgical specialists and trainees to communicate with insurers, hospital administrators, health care organizations, and their own personal financial advisors.

Establishing a national knowledge translation and generation network in kidney disease: the CAnadian KidNey KNowledge TraNslation and GEneration NeTwork.

Science.gov (United States)

Manns, Braden; Barrett, Brendan; Evans, Michael; Garg, Amit; Hemmelgarn, Brenda; Kappel, Joanne; Klarenbach, Scott; Madore, Francois; Parfrey, Patrick; Samuel, Susan; Soroka, Steven; Suri, Rita; Tonelli, Marcello; Wald, Ron; Walsh, Michael; Zappitelli, Michael

2014-01-01

Patients with chronic kidney disease (CKD) do not always receive care consistent with guidelines, in part due to complexities in CKD management, lack of randomized trial data to inform care, and a failure to disseminate best practice. At a 2007 conference of key Canadian stakeholders in kidney disease, attendees noted that the impact of Canadian Society of Nephrology (CSN) guidelines was attenuated given limited formal linkages between the CSN Clinical Practice Guidelines Group, kidney researchers, decision makers and knowledge users, and that further knowledge was required to guide care in patients with kidney disease. The idea for the Canadian Kidney Knowledge Translation and Generation Network (CANN-NET) developed from this meeting. CANN-NET is a pan-Canadian network established in partnership with CSN, the Kidney Foundation of Canada and other professional societies to improve the care and outcomes of patients with and at risk for kidney disease. The initial priority areas for knowledge translation include improving optimal timing of dialysis initiation, and increasing the appropriate use of home dialysis. Given the urgent need for new knowledge, CANN-NET has also brought together a national group of experienced Canadian researchers to address knowledge gaps by encouraging and supporting multicentre randomized trials in priority areas, including management of cardiovascular disease in patients with kidney failure.

The Role of Oncology Nurses in Discussing Clinical Trials.

Science.gov (United States)

Flocke, Susan A; Antognoli, Elizabeth; Daly, Barbara J; Jackson, Brigid; Fulton, Sarah E; Liu, Tasnuva M; Surdam, Jessica; Manne, Sharon; Meropol, Neal J

2017-09-01

To describe oncology nurses' experiences discussing clinical trials with their patients, and to assess barriers to these discussions.
. A qualitative study designed to elicit narratives from oncology nurses. 
. Community- and academic-based oncology clinics throughout the United States.
. 33 oncology nurses involved in direct patient care in community-based and large hospital-based settings. The sample was drawn from members of the Oncology Nursing Society. 
. In-depth interviews were conducted and analyzed using a 
immersion/crystallization approach to identify themes and patterns. The analyses highlight specific issues, examples, and contexts that present challenges to clinical trial discussions with patients.
. Oncology nurses view their roles as patient educators and advocates to be inclusive of discussion of clinical trials. Barriers to such discussions include lack of knowledge and strategies for addressing patients' common misconceptions and uncertainty about the timing of discussions.
. These data indicate that enabling nurses to actively engage patients in discussions of clinical trials requires educational interventions to build self-efficacy and close knowledge gaps. 
. Oncology nurses can play a critical role in advancing cancer care by supporting patients in decision making about clinical trial participation. This will require training and education to build their knowledge, reduce barriers, and increase their self-efficacy to fulfill this responsibility in various clinical settings.

Managing caries: the need to close the gap between the evidence base and current practice.

Science.gov (United States)

Schwendicke, F; Doméjean, S; Ricketts, D; Peters, M

2015-11-13

Underpinned by a changing knowledge of the aetiology of caries and its sequelae, and assisted by established and advancing dental materials, there is growing evidence supporting less invasive management of dental caries based on the principles of minimal intervention dentistry. This narrative review assesses both the evidence and the adoption of less invasive caries management strategies and describes ways in which the gap between evidence and practice might be overcome. While there is increasing data supporting less invasive management of carious lesions, these are not standard in most dental practices worldwide. Usually, clinical studies focused on efficacy as outcome, and did not take into consideration the views and priorities of other stakeholders, such as primary care dentists, educators, patients and those financing services. Involving these stakeholders into study design and demonstrating the broader advantages of new management strategies might improve translation of research into practice. In theory, clinical dentists can rely on a growing evidence in cariology regarding less invasive management options. In practice, further factors seem to impede adoption of these strategies. Future research should address these factors by involving major stakeholders and investigating their prioritised outcomes to narrow or close the evidence gap.

Bridging the gap between human knowledge and machine learning

Directory of Open Access Journals (Sweden)

Juan Carlos ALVARADO-PÉREZ

2015-12-01

Full Text Available Nowadays, great amount of data is being created by several sources from academic, scientific, business and industrial activities. Such data intrinsically contains meaningful information allowing for developing techniques, and have scientific validity to explore the information thereof. In this connection, the aim of artificial intelligence (AI is getting new knowledge to make decisions properly. AI has taken an important place in scientific and technology development communities, and recently develops computer-based processing devices for modern machines. Under the premise, the premise that the feedback provided by human reasoning -which is holistic, flexible and parallel- may enhance the data analysis, the need for the integration of natural and artificial intelligence has emerged. Such an integration makes the process of knowledge discovery more effective, providing the ability to easily find hidden trends and patterns belonging to the database predictive model. As well, allowing for new observations and considerations from beforehand known data by using both data analysis methods and knowledge and skills from human reasoning. In this work, we review main basics and recent works on artificial and natural intelligence integration in order to introduce users and researchers on this emergent field. As well, key aspects to conceptually compare them are provided.

Evidence-based practice, research utilization, and knowledge translation in chiropractic: a scoping review.

Science.gov (United States)

Bussières, André E; Al Zoubi, Fadi; Stuber, Kent; French, Simon D; Boruff, Jill; Corrigan, John; Thomas, Aliki

2016-07-13

Evidence-based practice (EBP) gaps are widespread across health disciplines. Understanding factors supporting the uptake of evidence can inform the design of strategies to narrow these EBP gaps. Although research utilization (RU) and the factors associated with EBP have been reported in several health disciplines, to date this area has not been reviewed comprehensively in the chiropractic profession. The purpose of this review was to report on the current state of knowledge on EBP, RU, and knowledge translation (KT) in chiropractic. A scoping review using the Arksey and O'Malley framework was used to systematically select and summarize existing literature. Searches were conducted using a combination of keywords and MeSH terms from the earliest date available in each database to May 2015. Quantitative and thematic analyses of the selected literature were conducted. Nearly 85 % (56/67) of the included studies were conducted in Canada, USA, UK or Australia. Thematic analysis for the three categories (EBP, RU, KT) revealed two themes related to EBP (attitudes and beliefs of chiropractors; implementation of EBP), three related to RU (guideline adherence; frequency and sources of information accessed; and perceived value of websites and search engines), and three related to KT (knowledge practice gaps; barriers and facilitators to knowledge use; and selection, tailoring, and implementation of interventions). EBP gaps were noted in the areas of assessment of activity limitation, determination of psychosocial factors influencing pain, general health indicators, establishing a prognosis, and exercise prescription. While most practitioners believed EBP and research to be important and a few studies suggested that traditional and online educational strategies could improve patient care, use of EBP and guideline adherence varied widely. Findings suggest that the majority of chiropractors hold favourable attitudes and beliefs toward EBP. However, much remains to be done for

Protocol of a scoping review on knowledge translation competencies.

Science.gov (United States)

Mallidou, Anastasia A; Atherton, Pat; Chan, Liza; Frisch, Noreen; Glegg, Stephanie; Scarrow, Gayle

2017-05-02

Knowledge translation (KT) activities can reduce the gap between "what is known" and "what is done". Several factors hinder or facilitate KT activities including individual characteristics and organizational attributes; we will focus on individual healthcare professional modifiable characteristics. The purpose of this scoping review is to summarize knowledge on KT competencies for knowledge users, knowledge brokers, and knowledge producers/researchers to support evidence-based practice (EBP) and inform policy and research in health. Our objectives are to explore the relevant theoretical and empirical literature; map the publications for key themes and research gaps of KT competencies, and interventions for enhancing KT competencies; summarize and disseminate findings; produce an action plan and research agenda; and develop self-assessment tools (the KT Pathways) for professional development for our three target audiences. The scoping review method will guide our study by following six stages: formulating the research question; identifying relevant studies; selecting the literature; charting the data; collating, summarizing, and reporting the results; and developing a KT plan and consulting stakeholders involved in the fields of KT, EBP, evidence-informed policy-making, and/or research. We will include empirical and theoretical/conceptual peer-reviewed and grey literature in health that examine knowledge user, knowledge broker and knowledge producer KT competencies. Publications written in the English language and published after 2003 only will be considered. Our multidisciplinary research team will collaborate using technology (i.e., WebEx for discussions and a Web 2.0 website for storing documents). Our KT plan consists of an Advisory Group and dissemination plan of the findings. We expect the identified KT competencies to contribute to the KT science by providing positive outcomes in practice, policy, education, and future research. Incorporation of the core KT

Collaborative work and medical talk: opportunities for learning through knowledge sharing.

Science.gov (United States)

Nilsen, Line Lundvoll; Ludvigsen, Sten R

2010-01-01

Teleconsultations provide new opportunities for learning in medical settings. This study explores the conditions under which learning among physicians takes place. The empirical context is 47 real-time video conferences carried out to examine collaborative work and the medical talk involved. Sixteen of the observations were consultations wherein general practitioners (GPs) and specialists shared knowledge with the purpose of solving a medical problem related to a patient under treatment. In this exploratory study, the learning opportunities are seen as what medical practitioners with different types of expertise achieve through interaction while working with patients over periods of time. The analysis of medical talk in consultations shows that collaborative work among GPs and specialists creates a shared understanding of the patient's clinical history and treatment trajectory. As knowledge is demanded and attributed and gaps of knowledge become shared, consultations create a work tool that expands the medical work and talk. Collaborative work in and between different levels of the health care service expands knowledge, creates opportunities for learning in everyday settings, and improves the quality of knowledge distribution in the health care system.

Knowledge and screening of head and neck cancer among American Indians in South Dakota.

Science.gov (United States)

Dwojak, Sunshine; Deschler, Daniel; Sargent, Michele; Emerick, Kevin; Guadagnolo, B Ashleigh; Petereit, Daniel

2015-06-01

We established the level of awareness of risk factors and early symptoms of head and neck cancer among American Indians in South Dakota and determined whether head and neck cancer screening detected clinical findings in this population. We used the European About Face survey. We added questions about human papillomavirus, a risk factor for head and neck cancer, and demographics. Surveys were administered at 2 public events in 2011. Participants could partake in a head and neck cancer screening at the time of survey administration. Of the 205 American Indians who completed the survey, 114 participated in the screening. Mean head and neck cancer knowledge scores were 26 out of 44. Level of education was the only factor that predicted higher head and neck cancer knowledge (b = 0.90; P = .01). Nine (8%) people had positive head and neck cancer screening examination results. All abnormal clinical findings were in current or past smokers (P = .06). There are gaps in American Indian knowledge of head and neck cancer risk factors and symptoms. Community-based head and neck cancer screening in this population is feasible and may be a way to identify early abnormal clinical findings in smokers.

Knowledge Management in Startups: Systematic Literature Review and Future Research Agenda

Directory of Open Access Journals (Sweden)

Piera Centobelli

2017-03-01

Full Text Available This paper conducts a systematic literature review on knowledge management (KM in the context of startups in order to analyze the state of the art, identify research gaps and define a future research agenda. The main findings highlight that, even though there is an increasing number of papers on the topic of KM in startups, several issues are still neglected. Specifically, the paper identifies four main gaps in the body of literature. The first gap deals with the environmental and socio-political factors influencing the adoption of KM in startups. The second gap regards the lack of a comprehensive taxonomy of knowledge management systems (KMSs that may support the processes of knowledge creation, acquisition, storage, transfer, sharing and application. This second gap allows us to identify a third gap concerning the level of alignment between startup’s strategies and technologies adopted. Finally, the fourth gap deals with the issue of the impact of KM on startup’s performances with regard to economic, financial, market, technical, technological, organizational, human and relational performance. From these four gaps, six research questions (RQs have been proposed. These RQs allow us to identify possible areas of analysis to define a future research agenda. Neglecting these issues means underestimating all the possible advantages of KM adoption for a startup to achieve efficiency, effectiveness and scalability goals.

Evidence and knowledge gaps on the disease burden in sexual and gender minorities: a review of systematic reviews.

Science.gov (United States)

Blondeel, Karel; Say, Lale; Chou, Doris; Toskin, Igor; Khosla, Rajat; Scolaro, Elisa; Temmerman, Marleen

2016-01-22

Sexual and gender minorities (SGM) include individuals with a wide range of sexual orientations, physical characteristics, and gender identities and expressions. Data suggest that people in this group face a significant and poorly understood set of additional health risks and bear a higher burden of some diseases compared to the general population. A large amount of data is available on HIV/AIDS, but far less on other health problems. In this review we aimed to synthesize the knowledge on the burden of communicable and non-communicable diseases, mental health conditions and violence experienced by SGM, based on available systematic reviews. We conducted a global review of systematic reviews, including searching the Cochrane and the Campbell Collaboration libraries, as well as PubMed, using a range of search terms describing the populations of interest, without time or language restrictions. Google Scholar was also scanned for unpublished literature, and references of all selected reviews were checked to identify further relevant articles. We found 30 systematic reviews, all originally written in English. Nine reviews provided data on HIV, 12 on other sexually transmitted infections (STIs), 4 on cancer, 4 on violence and 3 on mental health and substance use. A quantitative meta-analysis was not possible. The findings are presented in a narrative format. Our review primarily showed that there is a high burden of disease for certain subpopulations of SGM in HIV, STIs, STI-related cancers and mental health conditions, and that they also face high rates of violence. Secondly, our review revealed many knowledge gaps. Those gaps partly stem from a lack of original research, but there is an equally urgent need to conduct systematic and literature reviews to assess what we already know on the disease burden in SGM. Additional reviews are needed on the non-biological factors that could contribute to the higher disease burden. In addition, to provide universal access to

An RDF/OWL knowledge base for query answering and decision support in clinical pharmacogenetics.

Science.gov (United States)

Samwald, Matthias; Freimuth, Robert; Luciano, Joanne S; Lin, Simon; Powers, Robert L; Marshall, M Scott; Adlassnig, Klaus-Peter; Dumontier, Michel; Boyce, Richard D

2013-01-01

Genetic testing for personalizing pharmacotherapy is bound to become an important part of clinical routine. To address associated issues with data management and quality, we are creating a semantic knowledge base for clinical pharmacogenetics. The knowledge base is made up of three components: an expressive ontology formalized in the Web Ontology Language (OWL 2 DL), a Resource Description Framework (RDF) model for capturing detailed results of manual annotation of pharmacogenomic information in drug product labels, and an RDF conversion of relevant biomedical datasets. Our work goes beyond the state of the art in that it makes both automated reasoning as well as query answering as simple as possible, and the reasoning capabilities go beyond the capabilities of previously described ontologies.

Impact of education and network for avian influenza H5N1 in human: knowledge, clinical practice, and motivation on medical providers in Vietnam.

Science.gov (United States)

Manabe, Toshie; Pham, Thi Phuong Thuy; Kudo, Koichiro; Vu, Thi Tuong Van; Takasaki, Jin; Nguyen, Dang Tuan; Dao, Xuan Co; Dang, Hung Minh; Izumi, Shinyu; Nguyen, Gia Binh; Ngo, Quy Chau; Tran, Thuy Hanh

2012-01-01

Knowledge, clinical practice, and professional motivation of medical providers relating to H5N1 infection have an important influence on care for H5N1 patients who require early diagnosis and early medical intervention. Novel educational programs including training and workshops for medical providers relating to H5N1 infection in Vietnam were originally created and implemented in 18 provincial hospitals in northern Vietnam between 2008 and 2010. A self-administered, structured questionnaire survey was conducted in 8 provincial hospitals where both educational training and workshops were previously provided. A total of 326 medical providers, including physicians, nurses, and laboratory technicians who attended or did not attend original programs were enrolled in the survey. Knowledge, clinical attitudes and practice (KAP), including motivation surrounding caring for H5N1 patients, were evaluated. The study indicated a high level of knowledge and motivation in all professional groups, with especially high levels in laboratory technicians. Conferences and educational programs were evaluated to be the main scientific information resources for physicians, along with information from colleagues. The chest radiographs and the initiation of antiviral treatment in the absence of RT-PCR result were identified as gaps in education. Factors possibly influencing professional motivation for caring for H5N1 patients included healthcare profession, the hospital where the respondents worked, age group, attendance at original educational programs and at educational programs which were conducted by international health-related organizations. Educational programs provide high knowledge and motivation for medical providers in Vietnam caring for H5N1 patients. Additional educational programs related to chest radiographs and an initiation of treatment in the absence of RT-PCR are needed. Networking is also necessary for sharing updated scientific information and practical experiences

Knowledge Map of Facilities Management

DEFF Research Database (Denmark)

Nenonen, Suvi; Jensen, Per Anker; Lindahl, Göran

2014-01-01

both the research community and FM-practitioners can develop new models for identifying knowledge needs and gaps and to improve knowledge sharing and knowledge flow and thus the fulfilment of their mission and goals. Knowledge maps can also help in organizing research activities and analysing......Purpose This paper aims to draft a knowledge map of the fragmented and multidisciplinary research of and relevant to FM. Facilities management knowledge map is a tool for presenting what relevant data and knowledge, a.k.a. knowledge, resides in different disciplines. Knowledge mapping is a step...... in creating an inventory of knowledge (i.e. the knowledge base) and developing/improving the processes of knowledge sharing in research, education and practice. Theory Knowledge mapping is discussed in terms of knowledge management. The research is connected to knowledge mapping in the facilities management...

Empirical Research on Spatial Diffusion Process of Knowledge Spillovers

Science.gov (United States)

Jin, Xuehui

2018-02-01

Firstly, this paper gave a brief review of the core issues of previous studies on spatial distribution of knowledge spillovers. That laid the theoretical foundation for further research. Secondly, this paper roughly described the diffusion process of solar patents in Bejing-Tianjin-Hebei and the Pearl River Delta regions by means of correlation analysis based on patent information of the application date and address of patentee. After that, this paper introduced the variables of spatial distance, knowledge absorptive capacity, knowledge gap and pollution control and built the empirical model of patent, and then collecting data to test them. The results showed that knowledge absorptive capacity was the most significant factor than the other three, followed by the knowledge gap. The influence of spatial distance on knowledge spillovers was limited and the most weak influence factor was pollution control.

Should Nurses Be Knowledge Brokers? Competencies and Organizational Resources to Support the Role.

Science.gov (United States)

Catallo, Cristina

2015-03-01

Registered nurses with graduate preparation are in a unique position to act as knowledge brokers owing to their extensive clinical experience and ability to be seen as a credible and respected resource by their peers. Nurse knowledge brokers can bridge the gap between research producers and those that need evidence for decision-making and support capacity development for evidence-informed decision-making (EIDM). Knowledge broker competencies include graduate-level education with exposure to research methods; experience with the EIDM process; and established networking skills to bring researchers, decision-makers, stakeholders and policymakers together. For the knowledge broker to be successful, the nurse leader can cultivate an organizational culture supportive of evidence use with advocacy for mandates that require evidence for decisions, structures in place for each stage of the EIDM process, and physical resources such as library services for evidence retrieval. Copyright © 2015 Longwoods Publishing.

Bridging the gap between basic science and clinical practice: a role for community clinicians

Directory of Open Access Journals (Sweden)

Cho Michelle

2011-04-01

Full Text Available Abstract Background Translating the extraordinary scientific and technological advances occurring in medical research laboratories into care for patients in communities throughout the country has been a major challenge. One contributing factor has been the relative absence of community practitioners from the US biomedical research enterprise. Identifying and addressing the barriers that prevent their participation in research should help bridge the gap between basic research and practice to improve quality of care for all Americans. Methods We interviewed over 200 clinicians and other healthcare stakeholders from 2004 through 2005 to develop a conceptual framework and set of strategies for engaging a stable cadre of community clinicians in a clinical research program. Results Lack of engagement of community practitioners, lack of necessary infrastructure, and the current misalignment of financial incentives and research participation emerged as the three primary barriers to community clinician research participation. Although every effort was made to learn key motivators for engagement in clinical research from interviewees, we did not observe their behavior and self-report by clinicians does not always track with their behavior. Conclusions A paradigm shift involving acknowledgement of the value of clinicians in the context of community research, establishment of a stable infrastructure to support a cohort of clinicians across time and research studies, and realignment of incentives to encourage participation in clinical research is required.

Closing the Gap between Research Evidence and Clinical Practice: Jordanian Nurses' Perceived Barriers to Research Utilisation

Science.gov (United States)

Al Khalaileh, Murad; Al Qadire, Mohammad; Musa, Ahmad S.; Al-Khawaldeh, Omar A.; Al Qudah, Hani; Alhabahbeh, Atalla

2016-01-01

Background: The nursing profession is a combination of theory and practical skill, and nurses are required to generate and develop knowledge through implementing research into clinical practice. Considerable number of barriers could hind implementing research findings into practice. Barriers to research utilisation are not identified in the…

Conventionalized knowledge

DEFF Research Database (Denmark)

Buus, Niels

2006-01-01

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....

Synthesis maps: visual knowledge translation for the CanIMPACT clinical system and patient cancer journeys

OpenAIRE

Jones, P.H.; Shakdher, S.; Singh, P.

2017-01-01

Salient findings and interpretations from the canimpact clinical cancer research study are visually represented in two synthesis maps for the purpose of communicating an integrated presentation of the study to clinical cancer researchers and policymakers. Synthesis maps integrate evidence and expertise into a visual narrative for knowledge translation and communication. A clinical system synthesis map represents the current Canadian primary care and cancer practice systems, proposed as a visu...

Nuclear Knowledge Innovations Assimilation: The Impact of Organizational Knowledge Frames and Triple Helix Dynamics of Knowledge Base

International Nuclear Information System (INIS)

Hossain, M. D.; Sultana, T.

2016-01-01

Full text: Previous research did not investigate the impact of the TH dynamics of knowledge innovations on the nuclear knowledge innovations adoption/assimilation in the organizational context. Hence, the recommendation of R&D policy reformulation seems too broad. These gaps are the prime motivators for the research. In the organizational context, we posit that TH dynamics of knowledge base innovation serves as complements to managers’ knowledge frames related to a technology innovation. We examine interactions between three knowledge frames—integration frame, opportunism frame, and policy knowledge frame, and two TH dynamics of knowledge innovations—bilateral TH dynamics of knowledge innovations and trilateral TH dynamics of knowledge innovations, and their relationship with the assimilation of nuclear knowledge innovations. We aim to research on the issues of the dynamics of knowledge base of innovations involving TH collaborations (university, industry and government) in Bangladesh as a new build nuclear project. As a result, we can find out the impact of TH collaborations on organizational nuclear knowledge innovations management as well as core institutional problems of the knowledge base of innovation systems in terms of R&D policy. Finally, findings identify lack in production of nuclear knowledge innovations and concrete recommendation of R&D policy reformulation. (author

Knowledge and practices related to plague in an endemic area of Uganda.

Science.gov (United States)

Kugeler, Kiersten J; Apangu, Titus; Forrester, Joseph D; Griffith, Kevin S; Candini, Gordian; Abaru, Janet; Okoth, Jimmy F; Apio, Harriet; Ezama, Geoffrey; Okello, Robert; Brett, Meghan; Mead, Paul

2017-11-01

Plague is a virulent zoonosis reported most commonly from Sub-Saharan Africa. Early treatment with antibiotics is important to prevent mortality. Understanding knowledge gaps and common behaviors informs the development of educational efforts to reduce plague mortality. A multi-stage cluster-sampled survey of 420 households was conducted in the plague-endemic West Nile region of Uganda to assess knowledge of symptoms and causes of plague and health care-seeking practices. Most (84%) respondents were able to correctly describe plague symptoms; approximately 75% linked plague with fleas and dead rats. Most respondents indicated that they would seek health care at a clinic for possible plague; however plague-like symptoms were reportedly common, and in practice, persons sought care for those symptoms at a health clinic infrequently. Persons in the plague-endemic region of Uganda have a high level of understanding of plague, yet topics for targeted educational messages are apparent. Published by Elsevier Ltd.

Oral Cancer Knowledge Assessment: Newly Graduated versus Senior Dental Clinicians

Science.gov (United States)

Salgado de Souza, Ricardo; Gallego Arias Pecorari, Vanessa; Lauria Dib, Luciano

2018-01-01

The present study assessed the level of dentists' knowledge regarding oral cancer in the city of São Paulo, Brazil. A questionnaire was used to compare the level of knowledge among newly graduated and senior clinicians. A total of 20,154 e-mails were correctly delivered to the dentists registered in the database of the Regional Dentistry Council of São Paulo, and 477 (2.36%) responses were received. This sample consisted of 84 newly graduated clinicians and 105 senior clinicians. For the statistical analysis, the chi-square test and the logistic regression analysis were performed with α = 0.05, and the results were described herein. According to their knowledge level, the results were statistically different between the groups, since 19% of the newly graduated clinicians were evaluated with knowledge grade A (excellent) in comparison to 6.7% of the senior clinicians. In spite of the results indicated that newly graduated clinicians' knowledge regarding oral cancer was 2.1 times higher, 34.5% of the professionals in this group had regular or poor knowledge on the subject, and several questions relating to clinical characteristics and risk factors indicated that there still exist some knowledge gaps, demonstrating that there is a need for further studies and information activities addressing oral cancer. PMID:29666649

Knowledge and perception of stroke amongst hospital workers in an African community.

Science.gov (United States)

Akinyemi, R O; Ogah, O S; Ogundipe, R F; Oyesola, O A; Oyadoke, A A; Ogunlana, M O; Otubogun, F M; Odeyinka, T F; Alabi, B S; Akinyemi, J O; Osinfade, J K; Kalaria, R N

2009-09-01

Stroke is a growing public health problem worldwide. Hospital workers are sources of knowledge on health issues including stroke. The present study aimed at assessing the knowledge and perception of a sample of Nigerian hospital workers about stroke. Hospital-based, cross-sectional survey. Respondents selected by systematic random sampling were interviewed using a 29-item pre-tested, structured, semi-closed questionnaire. There were 370 respondents (63% female, mean age: 34.4 +/- 7.5 years; 61% non-clinical workers). Twenty-nine per cent of respondents did not recognize the brain as the organ affected. Hypertension (88.6%) was the commonest risk factor identified; 13.8% identified evil spirit/witchcraft as a cause of stroke, whilst one-sided body weakness (61.9%) was most commonly identified as warning symptom. Hospital treatment was most preferred by 61.1% of respondents whilst spiritual healing was most preferred by 13.0%. In the bivariate analysis, higher level of education and being a clinical worker correlated with better stroke knowledge (P < 0.001). This study demonstrates gaps in the knowledge of these hospital workers about stroke, and treatment choice influenced by cultural and religious beliefs. Health education is still important, even, amongst health workers and stroke awareness campaigns may need to involve faith-based organizations.

Gap size and wall lesion development next to composite

NARCIS (Netherlands)

Kuper, N.K.; Opdam, N.J.M.; Ruben, J.L.; de Soet, J.J.; Cenci, M.S.; Bronkhorst, E.M.; Huysmans, M.C.D.N.J.M.

2014-01-01

This in situ study investigated whether there is a relationship between gap size and wall lesion development in dentin next to 2 composite materials, and whether a clinically relevant threshold for the gap size could be established. For 21 days, 14 volunteers wore a modified occlusal splint

Power relations and reciprocity: dialectics of knowledge construction.

Science.gov (United States)

Ben-Ari, Adital; Enosh, Guy

2013-03-01

In this article we suggest a theoretical framework of knowledge construction by employing the concept of dialectics to power relationships between researcher and participants. Power distribution in research is perceived as dichotomous and asymmetrical in favor of the researcher, creating unequal power relations that make exploitation possible. Acknowledging such exploitation has led to a critical stance and attempts to bridge gaps through egalitarianism and empowerment of participants. Some scholars have focused on shifting expert knowledge differentials between researcher and participants throughout the research project. Others have evaluated such gaps as a source of knowledge construction. In the present work we applied a dialectical approach to understanding research relationships, suggesting reciprocity as their defining attribute, regardless of symmetry or asymmetry and as a source of knowledge construction. In this article we recommend avoiding a taken-for-granted attitude, because we see it as a direct obstacle to the construction of knowledge.

Familiarity, knowledge, and attitudes towards epilepsy among attendees of a family clinic in Amman, Jordan.

Science.gov (United States)

Masri, Amira T; Shakhatreh, Farouq M; Yasein, Nada A; Barghouti, Farihan F; Al-Qudah, Abdelkarim A

2008-01-01

To investigate the present familiarity, knowledge, and attitudes of Jordanians towards epilepsy. This is a cross-sectional study that was conducted over a 6-month period, from April 2006 to October 2006 at the family clinic of Jordan University Hospital, Amman, Jordan. A face-to-face questionnaire interview was conducted with 600 non-epileptic adults who visited the clinic during the study period. The sample matched the overall Jordanian population for literacy rate, however, included a higher proportion of females, and consequently findings may be taken as being only moderately representative of the Jordanian population. Ninety-eight percent of the respondents had heard about epilepsy, 47.3% knew someone with epilepsy, and 39.7% had witnessed a seizure. The major source of knowledge was word of mouth; knowledge about causes and treatment were far below the results reported in western countries. In addition, negative attitudes were present with regard to marriage and employment of epileptic patients (86.8% objected to marriage and 50.8% objected to employment). Eighty-three percent of respondents admitted that their knowledge of epilepsy was not satisfactory and were willing to learn more about epilepsy. The television was believed to be the most efficient and preferred way to disseminate knowledge about epilepsy. Although this study does not represent the whole Jordanian population, however, it demonstrated lack of knowledge and emphasized the extent of negative as well as positive attitudes towards epilepsy in Jordan.

Collective Construction of Knowledge in Clinical Biochemistry

Directory of Open Access Journals (Sweden)

S.B. Barreto

2010-05-01

Full Text Available The collective construction of knowledge occurs by the convergence of ideas and semantic. This paper was made for a graduation discipline, in 2009-2, with 240students who were separated into 4 groups: morning period (M1,M2 and night period (N1,N2. This study aims the collective construction of a abstract-manual of clinical biochemistry tests, due the difficulty in comprehension of certain concepts by the students; it intends to help them in the process of knowledge acquirement. The constructivist approach was adopted and the matters of the discipline were available in a “Student Group e-mail account”, a functional communication tool. The instructions were reachable on the web. M1,M2 and N1 made one part of the study at the first period. N2 did not conclude the study at the same time period of the other groups; therefore they received a new responsibility: they were supposed to conclude and correct the manual and its application which included 90 different kinds of labor exams. A textbook has been defined containing illustrative pictures of blood collection and biosecurity. Three banners were exposed inside the hall of the institution. Collective work is important for the effective arrangement in health area. In the process of teaching/learning, the teacher must proceed on practices and methodologies aiming the development of the student competences and skills which represent its professional identity.

American Psychiatric Nurses Association-Transitions in Practice Certificate Program: Bridging the Knowledge Gap in Caring for Psychiatric Patients Within the General Nursing Workforce.

Science.gov (United States)

Adams, Susie M; Black, Patricia

2016-01-01

The purpose of this article is to publicize an important new Web-based educational program. Recognizing the growing gap in psychiatric-mental health knowledge and the need to better prepare new graduates and nurses transitioning from other service lines into psychiatric inpatient nursing settings, the American Psychiatric Nurses Association developed a 15-hour, modularized curriculum to provide foundational psychiatric-mental health knowledge. This modularized curriculum, called American Psychiatric Nurses Association Transitions in Practice (ATP) focuses on the knowledge and skills to insure the success of nurses new to psychiatric-mental health nursing settings and to improve the overall care for persons with mental health and substance use disorders. The ATP program is also proving to be useful content for nurses in emergency departments, hospitals, and other health settings to improve their care of patients with psychiatric and mental health needs. A summary of the program modules and a toolkit with suggested measures for nurses, patients, and agency outcomes is described. Feedback from participants completing the ATP program within the first 6 months is overwhelmingly positive and holds promise for widespread application across a variety of health care settings.

Knowledge translation is the use of knowledge in health care decision making.

Science.gov (United States)

Straus, Sharon E; Tetroe, Jacqueline M; Graham, Ian D

2011-01-01

To provide an overview of the science and practice of knowledge translation. Narrative review outlining what knowledge translation is and a framework for its use. Knowledge translation is defined as the use of knowledge in practice and decision making by the public, patients, health care professionals, managers, and policy makers. Failures to use research evidence to inform decision making are apparent across all these key decision maker groups. There are several proposed theories and frameworks for achieving knowledge translation. A conceptual framework developed by Graham et al., termed the knowledge-to-action cycle, provides an approach that builds on the commonalities found in an assessment of planned action theories. Review of the evidence base for the science and practice of knowledge translation has identified several gaps including the need to develop valid strategies for assessing the determinants of knowledge use and for evaluating sustainability of knowledge translation interventions. Copyright © 2011 Elsevier Inc. All rights reserved.

Anti-NMDA receptor encephalitis: clinical characteristics, predictors of outcome and the knowledge gap in southwest China.

Science.gov (United States)

Wang, W; Li, J-M; Hu, F-Y; Wang, R; Hong, Z; He, L; Zhou, D

2016-03-01

The aim was to analyse the clinical profiles and outcomes of patients with anti- N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis in China. A retrospective study of anti-NMDAR encephalitis in China was performed between June 2011 and June 2014. The clinical characteristics and predictors of poor outcome were determined. A total of 51 patients with a definitive diagnosis of anti-NMDAR encephalitis were included in this study. Four of them were surgically confirmed to have a neoplasm. Thirty-two patients, amongst whom 24 were female, presented with psychiatric disorder as the initial symptom, whereas 14 patients, of whom nine were male, presented with seizure as the initial symptom (P = 0.011). Twenty-nine patients (56.86%) were initially misdiagnosed with psychosis, viral encephalitis or other diseases, and 58.8% of the patients experienced at least one type of complication. It typically took 3 weeks before these patients were admitted to our hospital and another 2 weeks before the correct diagnosis was made. Forty-one patients (80%) reached a good outcome; 10 patients (20%) had a poor outcome. Older age, extended hospital stay, memory deficits, decreased consciousness, central hypoventilation, complications and abnormal cerebrospinal fluid results were associated with poor outcome (P < 0.05). Female patients more frequently initially present with psychiatric disorder but male patients more frequently initially present with seizure. Patients with anti-NMDAR encephalitis in China have a lower incidence of neoplasm. Nevertheless, this study reveals several challenges in treating anti-NMDAR encephalitis in China that may contribute to poor outcome. © 2015 EAN.

Breast ultrasound tomography: bridging the gap to clinical practice

Science.gov (United States)

Duric, Neb; Littrup, Peter; Li, Cuiping; Roy, Olivier; Schmidt, Steven; Janer, Roman; Cheng, Xiaoyang; Goll, Jeffrey; Rama, Olsi; Bey-Knight, Lisa; Greenway, William

2012-03-01

Conventional sonography, which performs well in dense breast tissue and is comfortable and radiation-free, is not practical for screening because of its operator dependence and the time needed to scan the whole breast. While magnetic resonance imaging (MRI) can significantly improve on these limitations, it is also not practical because it has long been prohibitively expensive for routine use. There is therefore a need for an alternative breast imaging method that obviates the constraints of these standard imaging modalities. The lack of such an alternative is a barrier to dramatically impacting mortality (about 45,000 women in the US per year) and morbidity from breast cancer because, currently, there is a trade-off between the cost effectiveness of mammography and sonography on the one hand and the imaging accuracy of MRI on the other. This paper presents a progress report on our long term goal to eliminate this trade-off and thereby improve breast cancer survival rates and decrease unnecessary biopsies through the introduction of safe, cost-effective, operatorindependent sonography that can rival MRI in accuracy. The objective of the study described in this paper was to design and build an improved ultrasound tomography (UST) scanner in support of our goals. To that end, we report on a design that builds on our current research prototype. The design of the new scanner is based on a comparison of the capabilities of our existing prototype and the performance needed for clinical efficacy. The performance gap was quantified by using clinical studies to establish the baseline performance of the research prototype, and using known MRI capabilities to establish the required performance. Simulation software was used to determine the basic operating characteristics of an improved scanner that would provide the necessary performance. Design elements focused on transducer geometry, which in turn drove the data acquisition system and the image reconstruction engine

The cancer precision medicine knowledge base for structured clinical-grade mutations and interpretations

Science.gov (United States)

Huang, Linda; Fernandes, Helen; Zia, Hamid; Tavassoli, Peyman; Rennert, Hanna; Pisapia, David; Imielinski, Marcin; Sboner, Andrea; Rubin, Mark A; Kluk, Michael

2017-01-01

Objective: This paper describes the Precision Medicine Knowledge Base (PMKB; https://pmkb.weill.cornell.edu), an interactive online application for collaborative editing, maintenance, and sharing of structured clinical-grade cancer mutation interpretations. Materials and Methods: PMKB was built using the Ruby on Rails Web application framework. Leveraging existing standards such as the Human Genome Variation Society variant description format, we implemented a data model that links variants to tumor-specific and tissue-specific interpretations. Key features of PMKB include support for all major variant types, standardized authentication, distinct user roles including high-level approvers, and detailed activity history. A REpresentational State Transfer (REST) application-programming interface (API) was implemented to query the PMKB programmatically. Results: At the time of writing, PMKB contains 457 variant descriptions with 281 clinical-grade interpretations. The EGFR, BRAF, KRAS, and KIT genes are associated with the largest numbers of interpretable variants. PMKB’s interpretations have been used in over 1500 AmpliSeq tests and 750 whole-exome sequencing tests. The interpretations are accessed either directly via the Web interface or programmatically via the existing API. Discussion: An accurate and up-to-date knowledge base of genomic alterations of clinical significance is critical to the success of precision medicine programs. The open-access, programmatically accessible PMKB represents an important attempt at creating such a resource in the field of oncology. Conclusion: The PMKB was designed to help collect and maintain clinical-grade mutation interpretations and facilitate reporting for clinical cancer genomic testing. The PMKB was also designed to enable the creation of clinical cancer genomics automated reporting pipelines via an API. PMID:27789569

CDS, UX, and System Redesign - Promising Techniques and Tools to Bridge the Evidence Gap.

Science.gov (United States)

McGinn, Thomas

2015-01-01

In this special issue of eGEMs, we explore the struggles related to bringing evidence into day-to-day practice, what I define as the "evidence gap." We are all aware of high quality evidence in the form of guidelines, randomized clinical trials for treatments and diagnostic tests, and clinical prediction rules, which are all readily available online. We also know that electronic health records (EHRs) are now ubiquitous in health care and in most practices across the country. How we marry this high quality evidence and the practice of medicine through effective decision support is a major challenge. All of the articles in this issue explore, in some fashion, CDS systems and how we can best bring providers and their work environment to the evidence. We are at the very early stages of the science of usability. Much more research and funding is needed in this area if we hope to improve the dissemination and implementation of evidence in practice. While the featured examples, techniques, and tools in the special issue are a promising start to improving usability and CDS, many of the papers highlight current gaps in knowledge and a great need for generalizable approaches. The great promise is for "learning" approaches to generate new evidence and to integrate this evidence in reliable, patient-centered ways at scale using new technology. Closing the evidence gap is a real possibility, but only if the community works together to innovate and invest in research on the best ways to disseminate, communicate, and implement evidence in practice.

An Innovative Clinical Skills “Boot Camp” for Dental Medicine Residents

Directory of Open Access Journals (Sweden)

Jenny Castillo

2017-05-01

Full Text Available During a 1-year hospital-based residency, dental residents are required to rotate through many departments including surgery, medicine, and emergency medicine. It became apparent that there was a gap between clinical skills knowledge taught in dental school curriculum and skills required for hospital-based patient care. In response, a simulation-based intensive clinical skill “boot camp” was created. The boot camp provided an intensive, interactive 3-day session for the dental residents. During the 3 days, residents were introduced to medical knowledge and skills that were necessary for their inpatient hospital rotations but were lacking in traditional dental school curriculum. Effectiveness of the boot camp was assessed in terms of knowledge base and comfort through presession and postsession surveys. According to resident feedback, this intensive introduction for the dental residents improved their readiness for their inpatient hospital-based residency.

Closing global knowledge gaps : Producing generalized knowledge from case studies of social-ecological systems

NARCIS (Netherlands)

Magliocca, Nicholas R.; Ellis, Erle C.; Allington, Ginger R.H.; de Bremond, Ariane; Dell'Angelo, Jampel; Mertz, Ole; Messerli, Peter; Meyfroidt, Patrick; Seppelt, Ralf; Verburg, Peter H.

2018-01-01

Concerns over rapid widespread changes in social-ecological systems and their consequences for biodiversity, ecosystem functioning, food security, and human livelihoods are driving demands for globally comprehensive knowledge to support decision-making and policy development. Claims of regional or

Knowledge, risk perception and mitigation measures towards Ebola virus disease by potentially exposed bushmeat handlers in north-central Nigeria: Any critical gap?

Science.gov (United States)

Alhaji, N B; Yatswako, S; Oddoh, E Y

2018-02-01

The bushmeat industry has been a topic of increasing importance among public health officials for its influence on zoonotic diseases transmission, such as Ebola virus disease (EVD), a rare and severe infectious disease of humans and non-human primates. This survey assessed knowledge/awareness, risk perceptions and mitigation practices towards EVD among bushmeat handlers in north-central Nigeria. These characteristics are premise to level of preparedness against appropriate risk prevention and control. A questionnaire-based cross-sectional study was conducted between January and December 2015 on 395 bushmeat handlers. Descriptive and analytical statistical analyses were performed using Epi-Info 3.5.3 software, and p knowledge than the hunters. Handlers with tertiary education were more likely (OR 3.22; 95% CI: 1.56-6.67) to possess significant satisfactory knowledge/awareness about EVD. Also, vendors were more likely (OR 1.85; 95% CI: 1.01-3.42) to practice satisfactory mitigation measures than the hunters. Only handlers with tertiary education were more likely (OR 2.48; 95% CI: 1.26-4.89) to significantly practice satisfactory mitigation measures against EVD. Although most of the handlers possessed significant knowledge/awareness about EVD, few applied mitigation measures against its infection, which is the challenging gap. There is a need for collaborations between the public health, veterinary and wildlife authorities in the provision of health information to bushmeat handlers on better management of emerging and re-emerging zoonotic viral diseases of wildlife origin. © 2017 Blackwell Verlag GmbH.

Knowledge, attitudes and clinical practice of blood products prescribers in Niamey.

Science.gov (United States)

Mayaki, Z; Kabo, R; Moutschen, M; Albert, A; Dardenne, N; Sondag, D; Gérard, C

2016-05-01

The lack of traceability and monitoring of blood donors and transfused patients constitute a barrier to the most basic rules of haemovigilance and overall good transfusion practices. This study draws up an inventory of knowledge, attitudes and clinical practice of blood prescribers in Niamey. A questionnaire was administered to 180 prescribers of blood products in Niamey in 2011. Questions were related to basic informations on blood transfusion and clinical use of blood. Analyses were performed using SAS 9.3 version. The sample consisted of 180 respondents from several professional categories: 51 physicians (28.33%), 10 medical students (5.56%), 84 nurses (46.67%), 15 anaesthesiologist assistant (8.33%) and 20 midwives (11.11%). Among these, 22.2% received training in blood transfusion safety. Half of the respondents (50.8%) got between 50 and 75% of correct answers, 45.8% got less than 50% correct while 3.35% scored more than 75% correct answers. The overall quality of responses was higher among physicians compared to other prescribers (Ptransfusion safety (Ptransfusion practices is necessary for prescribers of blood products. Accompanying measures to improve transfusion practice must be considered or strengthened through assessments, knowledge update/upgrade (regular, ongoing training) and establishment of active and motivated hospital transfusion committees. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

"Mind the gap!" Evaluation of the performance gap attributable to exception reporting and target thresholds in the new GMS contract: National database analysis

Directory of Open Access Journals (Sweden)

Cookson Richard

2008-06-01

Full Text Available Abstract Background The 2003 revision of the UK GMS contract rewards general practices for performance against clinical quality indicators. Practices can exempt patients from treatment, and can receive maximum payment for less than full coverage of eligible patients. This paper aims to estimate the gap between the percentage of maximum incentive gained and the percentage of patients receiving indicated care (the pay-performance gap, and to estimate how much of the gap is attributable respectively to thresholds and to exception reporting. Methods Analysis of Quality Outcomes Framework data in the National Primary Care Database and exception reporting data from the Information Centre from 8407 practices in England in 2005 – 6. The main outcome measures were the gap between the percentage of maximum incentive gained and the percentage of patients receiving indicated care at the practice level, both for individual indicators and a combined composite score. An additional outcome was the percentage of that gap attributable respectively to exception reporting and maximum threshold targets set at less than 100%. Results The mean pay-performance gap for the 65 aggregated clinical indicators was 13.3% (range 2.9% to 48%. 52% of this gap (6.9% of eligible patients is attributable to thresholds being set at less than 100%, and 48% to patients being exception reported. The gap was greater than 25% in 9 indicators: beta blockers and cholesterol control in heart disease; cholesterol control in stroke; influenza immunization in asthma; blood pressure, sugar and cholesterol control in diabetes; seizures in epilepsy and treatment of hypertension. Conclusion Threshold targets and exception reporting introduce an incentive ceiling, which substantially reduces the percentage of eligible patients that UK practices need to treat in order to receive maximum incentive payments for delivering that care. There are good clinical reasons for exception reporting, but after

Enhancing clinical learning in the workplace: a qualitative study.

Science.gov (United States)

Magnier, K; Wang, R; Dale, V H M; Murphy, R; Hammond, R A; Mossop, L; Freeman, S L; Anderson, C; Pead, M J

Workplace learning (WPL) is seen as an essential component of clinical veterinary education by the veterinary profession. This study sought to understand this type of learning experience more deeply. This was done utilising observations of students on intramural rotations (IMR) and interviews with students and clinical staff. WPL was seen as an opportunity for students to apply knowledge and develop clinical and professional skills in what is generally regarded as a safe, authentic environment. Clinical staff had clear ideas of what they expected from students in terms of interest, engagement, professionalism, and active participation, where this was appropriate. In contrast, students often did not know what to expect and sometimes felt under-prepared when entering the workplace, particularly in a new species area. With the support of staff acting as mentors, students learned to identify gaps in their knowledge and skills, which could then be addressed during specific IMR work placements. Findings such as these illustrate both the complexities of WPL and the diversity of different workplace settings encountered by the students.

[Qualitative translational science in clinical practice].

Science.gov (United States)

Mu, Pei-Fan

2013-10-01

Qualitative translational research refers to the "bench-to-bedside" enterprise of harnessing knowledge from the basic sciences to produce new treatment options or nursing interventions for patients. Three evidence-based translational problems related to qualitative translational research discussed this year address the interfaces among the nursing paradigm, the basic sciences, and clinical nursing work. This article illustrates the definition of translational science and translational blocks of evidence-based practice; discusses the qualitative research perspective in evidence synthesis, evidence translation and evidence utilization; and discusses the research questions that must be answered to solve the problems of the three translational gaps from the qualitative research perspective. Qualitative inquiry has an essential role to play in efforts to improve current healthcare-provider nursing interventions, experiences, and contexts. Thus, it is vital to introduce qualitative perspectives into evidence-based practice from the knowledge discovery through to the knowledge implementation process.

Hypertension detection and control in Port Harcourt: knowledge gap ...

African Journals Online (AJOL)

... on continuing medical education on hypertension in Port Harcourt, Nigeria was conducted in June 2013. Post test was also administered. Participants were drawn from both private and public medical practice. The questionnaire contained demographic data and knowledge of diagnosis and treatment of hypertension.

Tire Crumb Research Study Literature Review / Gap ...

Science.gov (United States)

In order to more fully understand data gaps in human exposure and toxicity to tire crumb materials, ATSDR, CPSC and EPA undertook a collaborative effort in the form of a scientific literature review and subsequent gaps analysis. The first objective of the Literature Review and Gap Analysis (LRGA) collaboration was to identify the existing body of literature related specifically to human exposure to tire crumb materials through the use of synthetic turf athletic fields and playgrounds. The second objective was to characterize and summarize the relevant data from the scientific literature. The final objective was to review the summary information and identify data gaps to build on the current understanding of the state-of-the-science and inform the development of specific research efforts that would be most impactful in the near-term. Because of the need for additional information, the U.S. Environmental Protection Agency (EPA), the Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry (ATSDR), and the U.S. Consumer Product Safety Commission (CPSC) launched a multi-agency action plan to study key environmental human health questions. The Federal Research Action Plan includes numerous activities, including research studies (U.S. EPA, 2016). A key objective of the Action Plan is to identify key knowledge gaps.

E-learning and nursing assessment skills and knowledge - An integrative review.

Science.gov (United States)

McDonald, Ewan W; Boulton, Jessica L; Davis, Jacqueline L

2018-07-01

This review examines the current evidence on the effectiveness of digital technologies or e-based learning for enhancing the skills and knowledge of nursing students in nursing assessment. This integrative review identifies themes emerging from e-learning and 'nursing assessment' literature. Literature reviews have been undertaken in relation to digital learning and nursing education, including clinical skills, clinical case studies and the nurse-educator role. Whilst perceptions of digital learning are well covered, a gap in knowledge persists for understanding the effectiveness of e-learning on nursing assessment skills and knowledge. This is important as comprehensive assessment skills and knowledge are a key competency for newly qualified nurses. The MEDLINE, CINAHL, Cochrane Library and ProQuest Nursing and Allied Health Source electronic databases were searched for the period 2006 to 2016. Hand searching in bibliographies was also undertaken. Selection criteria for this review included: FINDINGS: Twenty articles met the selection criteria for this review, and five major themes for e-based learning were identified (a) students become self-evaluators; (b) blend and scaffold learning; (c) measurement of clinical reasoning; (d) mobile technology and Facebook are effective; and (e) training and preparation is vital. Although e-based learning programs provide a flexible teaching method, evidence suggests e-based learning alone does not exceed face-to-face patient simulation. This is particularly the case where nursing assessment learning is not scaffolded. This review demonstrates that e-based learning and traditional teaching methods used in conjunction with each other create a superior learning style. Copyright © 2018 Elsevier Ltd. All rights reserved.

Establishing a National Knowledge Translation and Generation Network in Kidney Disease: The CAnadian KidNey KNowledge TraNslation and GEneration NeTwork

Directory of Open Access Journals (Sweden)

Braden Manns

2014-04-01

Full Text Available Patients with chronic kidney disease (CKD do not always receive care consistent with guidelines, in part due to complexities in CKD management, lack of randomized trial data to inform care, and a failure to disseminate best practice. At a 2007 conference of key Canadian stakeholders in kidney disease, attendees noted that the impact of Canadian Society of Nephrology (CSN guidelines was attenuated given limited formal linkages between the CSN Clinical Practice Guidelines Group, kidney researchers, decision makers and knowledge users, and that further knowledge was required to guide care in patients with kidney disease. The idea for the Canadian Kidney Knowledge Translation and Generation Network (CANN-NET developed from this meeting. CANN-NET is a pan-Canadian network established in partnership with CSN, the Kidney Foundation of Canada and other professional societies to improve the care and outcomes of patients with and at risk for kidney disease. The initial priority areas for knowledge translation include improving optimal timing of dialysis initiation, and increasing the appropriate use of home dialysis. Given the urgent need for new knowledge, CANN-NET has also brought together a national group of experienced Canadian researchers to address knowledge gaps by encouraging and supporting multicentre randomized trials in priority areas, including management of cardiovascular disease in patients with kidney failure.

Key principles for a national clinical decision support knowledge sharing framework: synthesis of insights from leading subject matter experts.

Science.gov (United States)

Kawamoto, Kensaku; Hongsermeier, Tonya; Wright, Adam; Lewis, Janet; Bell, Douglas S; Middleton, Blackford

2013-01-01

To identify key principles for establishing a national clinical decision support (CDS) knowledge sharing framework. As part of an initiative by the US Office of the National Coordinator for Health IT (ONC) to establish a framework for national CDS knowledge sharing, key stakeholders were identified. Stakeholders' viewpoints were obtained through surveys and in-depth interviews, and findings and relevant insights were summarized. Based on these insights, key principles were formulated for establishing a national CDS knowledge sharing framework. Nineteen key stakeholders were recruited, including six executives from electronic health record system vendors, seven executives from knowledge content producers, three executives from healthcare provider organizations, and three additional experts in clinical informatics. Based on these stakeholders' insights, five key principles were identified for effectively sharing CDS knowledge nationally. These principles are (1) prioritize and support the creation and maintenance of a national CDS knowledge sharing framework; (2) facilitate the development of high-value content and tooling, preferably in an open-source manner; (3) accelerate the development or licensing of required, pragmatic standards; (4) acknowledge and address medicolegal liability concerns; and (5) establish a self-sustaining business model. Based on the principles identified, a roadmap for national CDS knowledge sharing was developed through the ONC's Advancing CDS initiative. The study findings may serve as a useful guide for ongoing activities by the ONC and others to establish a national framework for sharing CDS knowledge and improving clinical care.

Identification of gaps in the current knowledge on pulmonary hypertension in extremely preterm infants: A systematic review and meta-analysis.

Science.gov (United States)

Arjaans, Sanne; Zwart, Elvira A H; Ploegstra, Mark-Jan; Bos, Arend F; Kooi, Elisabeth M W; Hillege, Hans L; Berger, Rolf M F

2018-01-17

Pulmonary hypertension complicates the clinical course of extremely preterm infants and is associated with bronchopulmonary dysplasia (BPD). However, prevalence, risk factors, and outcome of pulmonary hypertension in these infants are insufficiently known. This systematic review and meta-analysis aims to provide an up-to-date overview of available data on prevalence, risk factors, and outcome of pulmonary hypertension and to identify current knowledge gaps. Medline, EMBASE, and the Cochrane Library databases were searched in July 2017. Two authors reviewed titles/abstracts and full-texts. Eligible studies reported prevalence, patient characteristics or mortality of infants with/without pulmonary hypertension. Studies were excluded if they did not include extremely preterm infants. Only similar study samples (selected infants with BPD or infants both with/without BPD) were compared in the meta-analyses. Of 1829 unique articles identified, 25 were eligible for inclusion. Pulmonary hypertension was observed in infants with BPD (20%, 95% confidence interval [CI] 14, 25), but also in those without BPD (2%, 95% CI 0, 8). Infants with severe BPD were most at risk of pulmonary hypertension (risk ratio [RR] 2.7, 95% CI 1.7, 4.2). Infants with pulmonary hypertension were more at risk of mortality (RR 4.7, 95% CI 2.7, 8.3). Pulmonary hypertension occurs in particularly in infants with severe BPD, and increases risk of mortality. Due to selected study populations, heterogeneous pulmonary hypertension-definitions and poorly reported timing of pulmonary hypertension assessments, however, data available in current reports are insufficient to allow accurate assessment of true prevalence, risk factors, and time-related outcome. Prospective studies, with standardised methodology and follow-up are needed to determine these factors. © 2018 John Wiley & Sons Ltd.

A Gap in Time: Extending our Knowledge of Temporal Processing Deficits in the HIV-1 Transgenic Rat.

Science.gov (United States)

McLaurin, Kristen A; Moran, Landhing M; Li, Hailong; Booze, Rosemarie M; Mactutus, Charles F

2017-03-01

Approximately 50 % of HIV-1 seropositive individuals develop HIV-1 associated neurocognitive disorders (HAND), which commonly include alterations in executive functions, such as inhibition, set shifting, and complex problem solving. Executive function deficits in HIV-1 are fairly well characterized, however, relatively few studies have explored the elemental dimensions of neurocognitive impairment in HIV-1. Deficits in temporal processing, caused by HIV-1, may underlie the symptoms of impairment in higher level cognitive processes. Translational measures of temporal processing, including cross-modal prepulse inhibition (PPI), gap-prepulse inhibition (gap-PPI), and gap threshold detection, were studied in mature (ovariectomized) female HIV-1 transgenic (Tg) rats, which express 7 of the 9 HIV-1 genes constitutively throughout development. Cross-modal PPI revealed a relative insensitivity to the manipulation of interstimulus interval (ISI) in HIV-1 Tg animals in comparison to control animals, extending previously reported temporal processing deficits in HIV-1 Tg rats to a more advanced age, suggesting the permanence of temporal processing deficits. In gap-PPI, HIV-1 Tg animals exhibited a relative insensitivity to the manipulation of ISI in comparison to control animals. In gap-threshold detection, HIV-1 Tg animals displayed a profound differential sensitivity to the manipulation of gap duration. Presence of the HIV-1 transgene was diagnosed with 91.1 % accuracy using gap threshold detection measures. Understanding the generality and permanence of temporal processing deficits in the HIV-1 Tg rat is vital to modeling neurocognitive deficits observed in HAND and provides a key target for the development of a diagnostic screening tool.

Knowledge Management and Transfer

Energy Technology Data Exchange (ETDEWEB)

Sennanye, D.M.; Thugwane, S.J.; Rasweswe, M.A. [South African Young Nuclear Professionals Society, South African Nuclear Energy Cooperation, National Nuclear Regulator, P O Box 7106, Centurion 0046 (South Africa)

2008-07-01

Knowledge management has become an important concept in the nuclear industry globally. This has been driven by the fact that new reactors are commissioned and some are decommissioned. Since most old experts are near retirement then there is a need to capture the nuclear knowledge and expertise and transfer it to the new generation. Knowledge transfer is one of the important building blocks of knowledge management. Processes and strategies need to be developed in order to transfer this knowledge. South African Young Nuclear Professionals Society (SAYNPS) has established a document to address strategies that can be used to close the knowledge gap between the young less experienced and experts in the field. This action will help the young generation to participate in knowledge management. The major challenges will be the willingness of the experts to share and making sure that all knowledge is captured, stored and kept up to date. The paper presents the SAYNPS point of view with regard to knowledge transfer. (authors)

Knowledge Management and Transfer

International Nuclear Information System (INIS)

Sennanye, D.M.; Thugwane, S.J.; Rasweswe, M.A.

2008-01-01

Knowledge management has become an important concept in the nuclear industry globally. This has been driven by the fact that new reactors are commissioned and some are decommissioned. Since most old experts are near retirement then there is a need to capture the nuclear knowledge and expertise and transfer it to the new generation. Knowledge transfer is one of the important building blocks of knowledge management. Processes and strategies need to be developed in order to transfer this knowledge. South African Young Nuclear Professionals Society (SAYNPS) has established a document to address strategies that can be used to close the knowledge gap between the young less experienced and experts in the field. This action will help the young generation to participate in knowledge management. The major challenges will be the willingness of the experts to share and making sure that all knowledge is captured, stored and kept up to date. The paper presents the SAYNPS point of view with regard to knowledge transfer. (authors)

Fortify Your Knowledge about Vitamins

Science.gov (United States)

... Consumers Home For Consumers Consumer Updates Fortify Your Knowledge About Vitamins Share Tweet Linkedin Pin it More ... useful when they fill a specific identified nutrient gap that cannot or is not otherwise being met ...

Refinement of an Instrument to Assess Readiness for Knowledge Management

National Research Council Canada - National Science Library

Bailey, Landon C

2007-01-01

... for knowledge management. This study culminates in the development and field-testing of the resultant knowledge management readiness instrument, filling in an important gap in contemporary literature.

Dress code: sustainable fashion : Bridging the attitude-behaviour gap

OpenAIRE

Billeson, Kristin; Klasander, Karolina

2015-01-01

This study investigates previous research on four barriers that hinder consumers from buying sustainable fashion; style/design, price, convenience and information/knowledge. Using a mixed methods approach, a survey has been performed on members of the general public in London as well as interviews with two professionals in the fashion industry with knowledge on sustainability in fashion. Looking through the lens of the attitude-behaviour gap the consumers’ attitude and behaviour towards susta...

Personalized cancer therapy—leveraging a knowledge base for clinical decision-making