WorldWideScience

Sample records for clinical knowledge gaps

  1. Knowledge Gaps

    DEFF Research Database (Denmark)

    Lyles, Marjorie; Pedersen, Torben; Petersen, Bent

    2003-01-01

    , assimilating, and utilizing knowledge - are crucial determinants ofknowledge gap elimination. In contrast, the two factors deemed essential in traditionalinternationalization process theory - elapsed time of operations and experientiallearning - are found to have no or limited effect.Key words...

  2. The Role of Biomedical Knowledge in Clinical Reasoning: Bridging the Gap between Two Theories

    Directory of Open Access Journals (Sweden)

    Alireza Monajemi

    2014-09-01

    Full Text Available There has been a long-lasting debate on the role of biomedical knowledge in physicians’ clinical reasoning. There are two major views. The two-worlds theory assumes that biomedical knowledge and clinical knowledge are two different worlds and that biomedical knowledge is not involved in clinical reasoning of expert doctors. However, according to the knowledge encapsulation view, biomedical knowledge still has an influential role in doctors’ clinical reasoning and medical problem solving. Based on the illness script theory, it can be concluded that these two views have two different definitions for basic science. In the knowledge encapsulation theory, pathophysiology stands for basic science, while in the two-worlds theory, basic science is equal to normal body function and structure. This is because illness script theory clearly highlights the primacy of practice in medicine, and according to this theoretical framework, bridging the gap between two theories becomes possible.

  3. Closing the gap between knowledge and clinical application: challenges for genomic translation.

    Directory of Open Access Journals (Sweden)

    Wylie Burke

    Full Text Available Despite early predictions and rapid progress in research, the introduction of personal genomics into clinical practice has been slow. Several factors contribute to this translational gap between knowledge and clinical application. The evidence available to support genetic test use is often limited, and implementation of new testing programs can be challenging. In addition, the heterogeneity of genomic risk information points to the need for strategies to select and deliver the information most appropriate for particular clinical needs. Accomplishing these tasks also requires recognition that some expectations for personal genomics are unrealistic, notably expectations concerning the clinical utility of genomic risk assessment for common complex diseases. Efforts are needed to improve the body of evidence addressing clinical outcomes for genomics, apply implementation science to personal genomics, and develop realistic goals for genomic risk assessment. In addition, translational research should emphasize the broader benefits of genomic knowledge, including applications of genomic research that provide clinical benefit outside the context of personal genomic risk.

  4. The gap between available knowledge and its use in clinical psychiatry

    DEFF Research Database (Denmark)

    Munk-Jørgensen, P; Blanner Kristiansen, C; Uwawke, R;

    2015-01-01

    OBJECTIVE: The time span between knowledge becoming available and its integration into daily clinical routine is lengthy. This phenomenon is explored in this study. METHOD: We used the outcomes of our activities for investigating and strengthening the research-based activities to improve physical...... health in the routines of clinical psychiatric wards as examples for our analyses. RESULTS: The time span between new knowledge becoming available and its implementation into general clinical treatment is very long. However, a shortening of this time span is seen through active leadership backup and...

  5. Intimate partner violence and Musculoskeletal injury: bridging the knowledge gap in Orthopaedic fracture clinics

    Directory of Open Access Journals (Sweden)

    Sprague Sheila

    2013-01-01

    Full Text Available Abstract Intimate partner violence (IPV is a serious health issue. There have been widespread research efforts in the area of IPV over the past several decades, primarily focusing on obstetrics, emergency medicine, and primary care settings. Until recently there has been a paucity of research focusing on IPV in surgery, and thus a resultant knowledge gap. Renewed interest in the underlying risk of IPV among women with musculoskeletal injuries has fueled several important studies to determine the nature and scope of this issue in orthopaedic surgery. Our review summarizes the evidence from surgical research in the field of IPV and provides recommendations for developing and evaluating an IPV identification and support program and opportunities for future research.

  6. Closing knowledge gaps in foreign markets

    OpenAIRE

    Bent Petersen; Torben Pedersen; Marjorie A Lyles

    2008-01-01

    Knowledge and learning are ascribed pivotal roles in firms' internationalization processes: perceived market uncertainties, namely knowledge gaps related to business environments in foreign markets, may curb firms' inclinations to commit resources to these markets. This study explores whether knowledge gaps tend to increase or decrease with time when operating in the foreign market, and it discusses which learning components narrow – or widen – the perceived knowledge gap. A theoretical model...

  7. Overcoming Knowledge Gaps in Postmerger Integration

    DEFF Research Database (Denmark)

    Alaranta, Maria Eliisa; Martela, Eero

    2012-01-01

    best facilitate overcoming the gaps in experiential knowledge in these dynamic hybrid organizational situations. We study a case of integration of software-maintenance processes after a megamerger. In the first phase of the integration, the company combined best features of existing knowledge systems....... However, high customer dissatisfaction and low key performance indicators followed. This led to the need to reframe the task into one of creating a new, better process. This led to satisfactory outcomes. Six key elements facilitated the transfer or creation of experiential knowledge: defining content of...

  8. 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, such as...... experiential learning, explains only a very limited part of perceived knowledge gaps. When factors pertaining to the concepts of absorptive capacity and superstitious learning are added, the explanatory power improves significantly. Apparently, our understanding of firms' internationalization processes can be...

  9. 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.…

  10. The Knowledge Gap Versus the Belief Gap and Abstinence-Only Sex Education.

    Science.gov (United States)

    Hindman, Douglas Blanks; Yan, Changmin

    2015-08-01

    The knowledge gap hypothesis predicts widening disparities in knowledge of heavily publicized public affairs issues among socioeconomic status groups. The belief gap hypothesis extends the knowledge gap hypothesis to account for knowledge and beliefs about politically contested issues based on empirically verifiable information. This analysis of 3 national surveys shows belief gaps developed between liberals and conservatives regarding abstinence-only sex education; socioeconomic status-based knowledge gaps did not widen. The findings partially support both belief gap and knowledge gap hypotheses. In addition, the unique contributions of exposure to Fox News, CNN, and MSNBC in this process were investigated. Only exposure to Fox News was linked to beliefs about abstinence-only sex education directly and indirectly through the cultivation of conservative ideology. PMID:25950234

  11. Clinical and Educational Gaps in Diagnosis of Nail Disorders.

    Science.gov (United States)

    Hare, Anna Q; Rich, Phoebe

    2016-07-01

    Dermatologists care for skin, hair, and nails, yet many dermatologists find nail disorders challenging. Practice gaps in knowledge, skill, and attitude in clinical practice and resident education are sometimes impediments to timely medical and surgical diagnosis of nail disorders. Limited resident exposure to diagnosis and management of complicated nail disorders and lack of experience performing diagnostic and surgical procedures impairs progress toward surmounting these gaps. PMID:27363883

  12. 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. PMID:24011564

  13. The Gap between Mapuche Knowledge and School Knowledge in the Mapuche Context

    OpenAIRE

    Segundo Quintriqueo Millán; Héctor Torres Cuevas

    2012-01-01

    This article describes the gap between Mapuche and school knowledge in schools of the Ninth Region of Araucanía, Chile. To that end, we examine the implications of a monocultural curriculum for the education of Mapuche children and youth who present different systems of logic for native knowledge and academic knowledge. The methodology used is educational research, based on the multi-method approach. The results provide a knowledge base for understanding the gap between school knowledge and t...

  14. 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.

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

    OpenAIRE

    Taylor, Michael

    2014-01-01

    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 estima...

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

    OpenAIRE

    Taylor MJ; Garrard TA; O'Donahoo FJ; Ross KE

    2014-01-01

    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 o...

  17. 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.

  18. Pharmacogenomic knowledge gaps and educational resource needs among physicians in selected specialties

    Directory of Open Access Journals (Sweden)

    Johansen Taber KA

    2014-07-01

    Full Text Available Katherine A Johansen Taber, Barry D Dickinson Department of Science and Biotechnology, American Medical Association, Chicago, IL, USA Background: The use of pharmacogenomic testing in the clinical setting has the potential to improve the safety and effectiveness of drug therapy, yet studies have revealed that physicians lack knowledge about the topic of pharmacogenomics, and are not prepared to implement it in the clinical setting. This study further explores the pharmacogenomic knowledge deficit and educational resource needs among physicians. Materials and methods: Surveys of primary care physicians, cardiologists, and psychiatrists were conducted. Results: Few physicians reported familiarity with the topic of pharmacogenomics, but more reported confidence in their knowledge about the influence of genetics on drug therapy. Only a small minority had undergone formal training in pharmacogenomics, and a majority reported being unsure what type of pharmacogenomic tests were appropriate to order for the clinical situation. Respondents indicated that an ideal pharmacogenomic educational resource should be electronic and include such components as how to interpret pharmacogenomic test results, recommendations for prescribing, population subgroups most likely to be affected, and contact information for laboratories offering pharmacogenomic testing. Conclusion: Physicians continue to demonstrate pharmacogenomic knowledge gaps, and are unsure about how to use pharmacogenomic testing in clinical practice. Educational resources that are clinically oriented and easily accessible are preferred by physicians, and may best support appropriate clinical implementation of pharmacogenomics. Keywords: pharmacogenomics, knowledge gap, drug response, educational resource

  19. Investigating the Role of Knowledge gap in enhancing Software Quality

    OpenAIRE

    Ahmed Mehrez

    2013-01-01

    Software quality has always been described as a poorly developed construct. Several reports and much evidence show clear problems related to software quality outputs. Therefore, software quality problems constitute the phenomenon investigated in this research question: Why does quality management not achieve its anticipated outcomes in the software industry? This research empirically tests if a possible existence of knowledge management gaps can be a reason behind a possible existence of qual...

  20. The Gap between Mapuche Knowledge and School Knowledge in the Mapuche Context

    Directory of Open Access Journals (Sweden)

    Segundo Quintriqueo Millán

    2012-05-01

    Full Text Available This article describes the gap between Mapuche and school knowledge in schools of the Ninth Region of Araucanía, Chile. To that end, we examine the implications of a monocultural curriculum for the education of Mapuche children and youth who present different systems of logic for native knowledge and academic knowledge. The methodology used is educational research, based on the multi-method approach. The results provide a knowledge base for understanding the gap between school knowledge and traditional Mapuche knowledge in intercultural educational contexts. The objective is to overcome epistemological issues in the teaching and learning of sciences, through contextualized pedagogical practices that will generate intercultural dialogue in the school-based educational process of Mapuche and non-Mapuche children and youth.

  1. 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

  2. DCS: A Case Study of Identification of Knowledge and Disposition Gaps Using Principles of Continuous Risk Management

    Science.gov (United States)

    Norcross, Jason; Steinberg, Susan; Kundrot, Craig; Charles, John

    2011-01-01

    The Human Research Program (HRP) is formulated around the program architecture of Evidence-Risk-Gap-Task-Deliverable. Review of accumulated evidence forms the basis for identification of high priority risks to human health and performance in space exploration. Gaps in knowledge or disposition are identified for each risk, and a portfolio of research tasks is developed to fill them. Deliverables from the tasks inform the evidence base with the ultimate goal of defining the level of risk and reducing it to an acceptable level. A comprehensive framework for gap identification, focus, and metrics has been developed based on principles of continuous risk management and clinical care. Research towards knowledge gaps improves understanding of the likelihood, consequence or timeframe of the risk. Disposition gaps include development of standards or requirements for risk acceptance, development of countermeasures or technology to mitigate the risk, and yearly technology assessment related to watching developments related to the risk. Standard concepts from clinical care: prevention, diagnosis, treatment, monitoring, rehabilitation, and surveillance, can be used to focus gaps dealing with risk mitigation. The research plan for the new HRP Risk of Decompression Sickness (DCS) used the framework to identify one disposition gap related to establishment of a DCS standard for acceptable risk, two knowledge gaps related to DCS phenomenon and mission attributes, and three mitigation gaps focused on prediction, prevention, and new technology watch. These gaps were organized in this manner primarily based on target for closure and ease of organizing interim metrics so that gap status could be quantified. Additional considerations for the knowledge gaps were that one was highly design reference mission specific and the other gap was focused on DCS phenomenon.

  3. Current knowledge, gaps and challenges in the Southern European Seas

    Science.gov (United States)

    Papathanassiou, Evangelos

    2015-04-01

    New knowledge advances our current understanding on the selection and application of the appropriate tools for assessing the state of the marine environment in the Southern European Seas (SES). Diminishing the lack of knowledge is a prerequisite for sound policy decisions. Although gaps and knowledge are fewer today, the health of marine and coastal ecosystems in the SES is under pressure and shows, in places, some signs of deterioration and declining quality. Overall, there is a lack of data accessibility and long time series in the SES, while in many cases poorly constrained processes cannot really support knowledge-based policy making (e.g. ecosystem functioning, climate change, fisheries management, etc.). New knowledge has to be produced and excellence must be promoted to support sustainable economic growth. At the same time, existing and new capacities have to be upgraded and increased in order to support sustainable convergence between SES countries. There are several gaps that have been identified and processes that have been poorly understood in the SES, mainly from research projects that have been working at basin level. The main research priorities that have been identified from the SeasERA Project for both, the Mediterranean and the Black Sea include: the climate change and its impacts, the hydrological cycle, the ventilation and the inter-basin coupling, the marine biodiversity and the provision of goods and services, the marine protected areas, the deep sea ecosystems, the biological invasions, the marine pollution and the ocean and human health, the renewable energy, the maritime transport, the fisheries and aquaculture activities and the biotechnology and the exploitation of marine resources for industrial application. More important, however, is the fact that the economic, the social and the scientific and the environmental challenges must be collectively tackled. They should have prioritisation and clear objectives as well as data sharing for

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

    OpenAIRE

    2010-01-01

    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 ...

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

    Directory of Open Access Journals (Sweden)

    Edda T. Lwoga

    2010-08-01

    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.

  6. Managing knowledge workers in clinical systems.

    Science.gov (United States)

    Snyder, J R

    2001-01-01

    In Future Work, Coates and colleagues cite seven forces that are reshaping work and the workforce. One is the advent of "knowledge workers," who gather, distribute, and add value to information. In health care, the transition to integrated delivery systems, replete with care plans, critical paths, and assessment of clinical outcomes supported by information technology, is driving the need to reeducate for a knowledge-based workforce. Managers of clinical systems need to be familiar with the characteristics of knowledge workers affecting the delivery environment, organizational structure, and culture of an organization. These same managers will be expected to develop strategies to manage the transition to a knowledge-based workforce. PMID:11299904

  7. 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

  8. 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.

  9. 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...... variable. Generation of trial databases and/or biobanks originating in large randomized clinical trials has successfully increased the knowledge obtained from those trials. At the 10th Cardiovascular Trialist Workshop, possibilities and pitfalls in designing and accessing clinical trial databases were...

  10. 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…

  11. Knowledge gaps between nanotoxicological research and nanomaterial safety.

    Science.gov (United States)

    Hu, Xiangang; Li, Dandan; Gao, Yue; Mu, Li; Zhou, Qixing

    2016-09-01

    With the wide research and application of nanomaterials in various fields, the safety of nanomaterials attracts much attention. An increasing number of reports in the literature have shown the adverse effects of nanomaterials, representing the quick development of nanotoxicology. However, many studies in nanotoxicology have not reflected the real nanomaterial safety, and the knowledge gaps between nanotoxicological research and nanomaterial safety remain large. Considering the remarkable influence of biological or environmental matrices (e.g., biological corona) on nanotoxicity, the situation of performing nanotoxicological experiments should be relevant to the environment and humans. Given the possibility of long-term and low-concentration exposure of nanomaterials, the reversibility of and adaptation to nanotoxicity, and the transgenerational effects should not be ignored. Different from common pollutants, the specific analysis methodology for nanotoxicology need development and exploration furthermore. High-throughput assay integrating with omics was highlighted in the present review to globally investigate nanotoxicity. In addition, the biological responses beyond individual levels, special mechanisms and control of nanotoxicity deserve more attention. The progress of nanotoxicology has been reviewed by previous articles. This review focuses on the blind spots in nanotoxicological research and provides insight into what we should do in future work to support the healthy development of nanotechnology and the evaluation of real nanomaterial safety. PMID:27203780

  12. 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.

  13. Bridging the PSI Knowledge Gap: A Multi-Scale Approach

    Energy Technology Data Exchange (ETDEWEB)

    Wirth, Brian D [University of Tennessee, Knoxville

    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

  14. 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...... variable. Generation of trial databases and/or biobanks originating in large randomized clinical trials has successfully increased the knowledge obtained from those trials. At the 10th Cardiovascular Trialist Workshop, possibilities and pitfalls in designing and accessing clinical trial databases were...... discussed by a group of trialists. This review focuses on the arguments for conducting posttrial database studies and presents examples of studies in which posttrial knowledge generation has been substantial. Possible strategies to ensure successful trial database or biobank generation are discussed, in...

  15. 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.

  16. Filling Knowledge Gaps with Five Fuel Cycle Studies

    Energy Technology Data Exchange (ETDEWEB)

    Steven J. Piet; Jess Gehin; William Halsey; Temitope Taiwo

    2010-11-01

    During FY 2010, five studies were conducted of technology families’ applicability to various fuel cycle strategies to fill in knowledge gaps in option space and to better understand trends and patterns. Here, a “technology family” is considered to be defined by a type of reactor and by selection of which actinides provide fuel. This report summarizes the higher-level findings; the detailed analyses and results are documented in five individual reports, as follows: • Advanced once through with uranium fuel in fast reactors (SFR), • Advanced once through (uranium fuel) or single recycle (TRU fuel) in high temperature gas cooled reactors (HTGR), • Sustained recycle with Th/U-233 in light water reactors (LWRs), • Sustained recycle with Th/U-233 in molten salt reactors (MSR), and • Several fuel cycle missions with Fusion-Fission Hybrid (FFH). Each study examined how the designated technology family could serve one or more designated fuel cycle missions, filling in gaps in overall option space. Each study contains one or more illustrative cases that show how the technology family could be used to meet a fuel cycle mission, as well as broader information on the technology family such as other potential fuel cycle missions for which insufficient information was available to include with an illustrative case. None of the illustrative cases can be considered as a reference, baseline, or nominal set of parameters for judging performance; the assessments were designed to assess areas of option space and were not meant to be optimized. There is no implication that any of the cases or technology families are necessarily the best way to meet a given fuel cycle mission. The studies provide five examples of 1-year fuel cycle assessments of technology families. There is reasonable coverage in the five studies of the performance areas of waste management and uranium utilization. The coverage of economics, safety, and proliferation resistance and physical protection in

  17. 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…

  18. Bridging the gap: strategies to integrate classroom and clinical learning.

    Science.gov (United States)

    Flood, Lisa Sue; Robinia, Kristi

    2014-08-01

    Nursing students often feel their classroom (didactic) learning and clinical (practice) experiences are disconnected which can lead to a rejection of academe and dissatisfaction with the profession. This classroom/clinical divide may be exacerbated because of the increased use of part-time clinical faculty, who are often isolated from their didactic peers. If clinical faculty, either novice or experienced, are disconnected from didactic faculty, is it any wonder students feel their learning is fragmented? The purpose of this paper is to discuss strategies to help bridge the gap between didactic and clinical learning. Specific integration strategies for faculty are presented using examples from a baccalaureate adult nursing didactic course and its related clinical course. The role of a clinical coordinator in facilitating course integration and support for part-time clinical faculty is described. Ideas for using technology to enhance learning and suggestions to promote socialization to decrease faculty isolation are also discussed. PMID:24674949

  19. How writing records reduces clinical knowledge

    DEFF Research Database (Denmark)

    Buus, Niels

    2009-01-01

    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...... 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 to...

  20. 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…

  1. 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…

  2. Measurement error of waist circumference: gaps in knowledge.

    NARCIS (Netherlands)

    Verweij, L.M.; Terwee, C.B.; Proper, K.I.; Hulshof, C.T.J.; Mechelen, W. van

    2013-01-01

    Objective: It is not clear whether measuring waist circumference in clinical practice is problematic because the measurement error is unclear, as well as what constitutes a clinically relevant change. The present study aimed to summarize what is known from state-of-the-art research. Design: To ident

  3. Measurement error of waist circumference: Gaps in knowledge

    NARCIS (Netherlands)

    Verweij, L.M.; Terwee, C.B.; Proper, K.I.; Hulshof, C.T.; Mechelen, W.V. van

    2013-01-01

    Objective It is not clear whether measuring waist circumference in clinical practice is problematic because the measurement error is unclear, as well as what constitutes a clinically relevant change. The present study aimed to summarize what is known from state-of-the-art research. Design To identif

  4. Inter-Industry Gender Wage Gaps by Knowledge Intensity: Discrimination and Technology in Korea

    OpenAIRE

    Horrace, William C.; Ural, Beyza P.; Jin Hwa Jung

    2006-01-01

    A new gender wage gap decomposition methodology is introduced that does not suffer from the identification problem caused by unobserved non-discriminatory wage structure. The methodology is used to measure the relative size of Korean gender wage gaps from 1994 to 2000 across industries, differentiated by industrial knowledge intensity, where knowledge intensity is the extent to which industries produce or employ high-technology products. Korea represents an important case study, since it poss...

  5. Overcoming the gap between academic and pratical knowledge about CSR : a methodological framework

    OpenAIRE

    Avenier, M. J.; Barin Cruz, L.

    2009-01-01

    Overcoming the Gap Between Academic and Practical Knowledge about CSR: A Methodological Framework Whenever researchers contemplate constructing knowledge from practice and managers' experience, they are faced with a number of questions which have not yet been satisfactorily answered in the literature. Although the gap between academia and practice has already been addressed by some scholars, potential solutions are still being discussed. Therefore, this paper has two main objectives: first, t...

  6. 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…

  7. Knowledge Economy Gaps, Policy Syndromes and Catch-up Strategies: Fresh South Korean Lessons to Africa

    OpenAIRE

    Simplice A. Asongu

    2014-01-01

    Africa’s overall knowledge index fell between 2000 and 2009. South Korea’s economic miracle is largely due to a knowledge-based development strategy that holds valuable lessons for African countries in their current pursuit towards knowledge economies. Using updated data (1996-2010), this paper presents fresh South Korean lessons to Africa by assessing the knowledge economy (KE) gaps, deriving policy syndromes and providing catch-up strategies. The 53 African frontier countries are decomposed...

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

    Directory of Open Access Journals (Sweden)

    Anis Bandyopadhyay

    2013-01-01

    Full Text Available Objectives: 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. Materials and Methods: 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. Results: 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. Conclusion: There is glaring knowledge gap among newly passed doctors and integrated oncology postings during undergraduate training and during internship may help seal this gap.

  9. Clinical role modelling: uncovering hidden knowledge.

    Science.gov (United States)

    Davies, E

    1993-04-01

    Those responsible for the education of nurses are well aware of the need to reconcile the art and science of nursing so that future practitioners can be prepared to offer a humanistic and professional service to society. One way to assist students in this integration is to provide them with opportunities for role modelling as a means of discovering the knowledge embedded in clinical practice. A study of first-year undergraduate students undertaking a course which provides such opportunities in a number of practice settings was carried out to determine whether the observation of clinical role models does lead to knowledge discovery. The study, which used a grounded theory approach, indicated that the major aspect of nursing uncovered by the students through observation of clinical role models was that of provision of direct care. They articulated their values in relation to 'good' and 'bad' care and identified those attributes of nurses which they considered contributed to these care positions. In addition, they were able to recognize creativity and flexibility in practitioners and to relate these attributes to the ability to provide individualized, context-specific care. There was some uncovering of aspects of the nurse's role in maintaining their own professional competence, socializing neophytes into the profession and collaborating with the members of the multi-disciplinary health care team. PMID:8496511

  10. Allergic Rhinitis and Associated Comorbidities: Prevalence in Oman with Knowledge Gaps in Literature

    Directory of Open Access Journals (Sweden)

    Rashid Al-Abri

    2014-11-01

    Full Text Available Objectives: Allergic rhinitis (AR is a global health problem and its impact on health related quality of life for patients is substantial, and the economic impact often underestimated. The prevalence of allergic rhinitis in Oman is unknown. This study aimed to estimate the prevalence of AR and associated co-morbidities among adults in Oman. Its secondary objective was to identify knowledge gaps in the literature with the aim of directing future research. Methods: A prospective, cross-sectional study of patients who presented to the outpatient otolaryngology clinic at Sultan Qaboos University Hospital with nasal symptoms between June 2010 and June 2011 was conducted. Results: A total of 887 patients were seen with nasal complaints. Among them 127 patients were diagnosed with non-infective rhinitis, the mean age of presentation was 27 years. AR was noted in 48% of patients, and non-allergic rhinitis in 52%. The prevalence of AR was 7%, with females being more affected than males, and age ranging from 18 to 51 years. Prevalence of perennial AR was 84% compared to seasonal AR which was 16%. The most common perennial antigens were house dust mites (80% followed by cockroaches (67%. All patients diagnosed with seasonal AR were found to be sensitive to Russian thistle. The prevalence of chronic rhinosinusitis in patients with AR was 34%. Conclusion: The prevalence of AR in the adult population presenting with nasal symptoms was found to be 7%, with associated chronic rhinosinusitis present in a third of these patients. However, there appears to be substantial knowledge gaps regarding the association of other comorbidities, like otitis media, bronchitis and bronchial asthma, the long-term outcomes of medical management, and indication of surgical intervention in patients with AR. Future research in AR among Omani patients should aim to address these issues.

  11. Bridging the knowledge gap between Big Data producers and consumers

    Science.gov (United States)

    Peng, G. S.; Worley, S. J.

    2015-12-01

    Most weather data is produced, disseminated and consumed by expert users in large national operational centers or laboratories. Data 'ages' off their systems in days or weeks. While archives exist, would-be users often lack the credentials necessary to obtain an account to access or search its contents. Moreover, operational centers and many national archives lack the mandate and the resources to serve non-expert users. The National Center for Atmospheric Research (NCAR) Research Data Archive (RDA), rda.ucar.edu, was created over 40 years ago to collect data for NCAR's internal Big Science projects such as the NCEP/NCAR Reanalysis Project. Over time, the data holdings have grown to 1.8+ Petabytes spanning 600+ datasets. The user base has also grown; in 2014, we served 1.1 Petabytes of data to over 11,000 unique users. The RDA works with national centers, such as NCEP, ECMWF and JMA to make their data available to worldwide audiences and mutually support data access at the production source. We have become not just an open-access data center, but also a data education center. Each dataset archived at the RDA is assigned to a data specialist (DS) who curates the data. If a user has a question not answered in the dataset information web pages prepared by the DS, they can call or email a skilled DS for further clarification. The RDA's diverse staff—with academic training in meteorology, oceanography, engineering (electrical, civil, ocean and database), mathematics, physics, chemistry and information science—means we likely have someone who "speaks your language." Erroneous data assumptions are the Achilles heel of Big Data. It doesn't matter how much data you crunch if the data is not what you think it is. Data discovery is another difficult Big Data problem; one can only solve problems with data if one can find the right data. Metadata, both machine and human-generated, underpin the RDA data search tools. The RDA has stepped in to fill the gap between data

  12. Mind the gap and bridge the gap: research excellence and diffusion of academic knowledge in Sweden

    OpenAIRE

    Caroline Wigren-Kristoferson, Jonas Gabrielsson and Fumi Kitagawa

    2011-01-01

    This paper aims to highlight the changing and diversifying nature of academic work related to various forms of knowledge production and diffusion. Focusing on the changing research policy landscape in Sweden, three interrelated questions are investigated: what academics do in terms of commercialisation and public dissemination; how they perform these activities; and why they engage in these activities. Based on data from a recent survey with over 10,000 academics in Sweden, we identify and an...

  13. 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.

  14. A Laboratory Study Designed for Reducing the Gap between Information Security Knowledge and Implementation

    Directory of Open Access Journals (Sweden)

    Revital Elitzur

    2010-06-01

    Full Text Available Companies often have the knowledge on procedures to prevent or mitigate against information technology security risks. Yet these companies may not take adequate measures to implement these procedures, and instead, leave themselves vulnerable to security breaches. Potential reasons for this gap between information security knowledge and implementation are provided based on interviews with information technology managers at a global automobile sales and marketing company. Four mechanisms to reduce this gap are proposed, along with a new approach to conduct a laboratory experiment to evaluate the effectiveness of these mechanisms, applied independently and in combinations.

  15. Closing the gap between ethics knowledge and practice through active engagement: an applied model of physical therapy ethics.

    Science.gov (United States)

    Delany, Clare M; Edwards, Ian; Jensen, Gail M; Skinner, Elizabeth

    2010-07-01

    Physical therapist practice has a distinct focus that is holistic (ie, patient centered) and at the same time connected to a range of other providers within health care systems. Although there is a growing body of literature in physical therapy ethics knowledge, including clinical obligations and underlying philosophical principles, less is known about the unique ethical issues that physical therapists encounter, and how and why they make ethical decisions. As moral agents, physical therapists are required to make autonomous clinical and ethical decisions based on connections and relationships with their patients, other health care team members, and health institutions and policies. This article identifies specific ethical dimensions of physical therapist practice and highlights the development and focus of ethics knowledge in physical therapy over the last several decades. An applied ethics model, called the "active engagement model," is proposed to integrate clinical and ethical dimensions of practice with the theoretical knowledge and literature about ethics. The active engagement model has 3 practical steps: to listen actively, to think reflexively, and to reason critically. The model focuses on the underlying skills, attitudes, and actions that are required to build a sense of moral agency and purpose within physical therapist practice and to decrease gaps between the ethical dimensions of physical therapist practice and physical therapy ethics knowledge and scholarship. A clinical case study is provided to illustrate how the ethics engagement model might be used to analyze and provide insight into the ethical dimensions of physical therapist practice. PMID:20448105

  16. Newspaper Coverage of Cancer Prevention: Multilevel Evidence for Knowledge Gap Effects

    OpenAIRE

    Slater, Michael D.; Hayes, Andrew F.; Reineke, Jason B.; Long, Marilee A.; Bettinghaus, Erwin P.

    2009-01-01

    Prior research on knowledge gap effects, in health as well as in other domains, has focused largely on assessing individual-level differences in exposure to news based on self-report of media use. Inherent inferential limitations of this approach are addressed by testing the hypothesis that the relationship between education and cancer prevention knowledge will be moderated by regional differences in U.S. news coverage of cancer prevention. The study also tests, using these methods, findings ...

  17. Ageing research on vertebrates shows knowledge gaps and opportunities for species conservation and management

    DEFF Research Database (Denmark)

    Conde, Dalia Amor

    Ageing theories predict that evolution should inevitably lead to an increase of mortality and decrease of fertility with age. However, a recent study across different species shows that this prediction only applies to really few species. In fact there is a great diversity of mortality trajectorie...... that highlight the urgency to fill up knowledge gaps to manage populations of threatened species....

  18. 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 ...

  19. The Development of Children's Ability to Fill the Gaps in Their Knowledge by Consulting Experts

    Science.gov (United States)

    Aguiar, Naomi R.; Stoess, Caryn J.; Taylor, Marjorie

    2012-01-01

    This research investigated children's ability to recognize gaps in their knowledge and seek missing information from appropriate informants. In Experiment 1, forty-five 4- and 5-year-olds were adept in assigning questions from 3 domains (medicine, firefighting, and farming) to corresponding experts (doctor, firefighter, or farmer). However, when…

  20. Gaps in the knowledge about advancements in rabies vaccines among the undergraduate medical students.

    Science.gov (United States)

    Laskar, Ananya Ray; Singh, Megha Chandra; Saha, S S

    2010-12-01

    Enormous developments have taken place during the past few years in the field of Rabies prevention and control particularly rabies vaccines. Intra-dermal Rabies Vaccination (IDRV) has already emerged as a safe, ethical and cost-effective replacement. However appropriate dissemination of knowledge and implementation by medical fraternity is imperative for effective prevention and control of this fatal disease. Gaps were found in the knowledge of medical students regarding the newer rabies vaccines. This can be resolved to great extent by updating the undergraduate curriculum with the current control strategies used in this field. PMID:22471199

  1. Hyperspectral Remote Sensing of Vegetation:Knowledge Gain and Knowledge Gap after 40 years of research

    Science.gov (United States)

    Thenkabail, P. S.; Huete, A. R.

    2012-12-01

    This presentation summarizes the advances made over 40+ years in understanding, modeling, and mapping terrestrial vegetation as reported in the new book on "Hyperspectral Remote Sensing of Vegetation" (Publisher: Taylor and Francis inc.). The advent of spaceborne hyperspectral sensors or imaging spectroscopy (e.g., NASA's Hyperion, ESA's PROBA, and upcoming Italy's ASI's Prisma, Germany's DLR's EnMAP, Japanese HIUSI, NASA's HyspIRI) as well as the advancements in processing large volumes of hyperspectral data have generated tremendous interest in expanding the hyperspectral applications' knowledge base to large areas. Advances made in using hyperspectral data, relative to broadband spectral data, include: (a) significantly improved characterization and modeling of a wide array of biophysical and biochemical properties of vegetation, (b) the ability to discriminate plant species and vegetation types with high degree of accuracy, (c) reduced uncertainty in determining net primary productivity or carbon assessments from terrestrial vegetation, (d) improved crop productivity and water productivity models, (e) the ability to assess stress resulting from causes such as management practices, pests and disease, water deficit or water excess, and (f) establishing wavebands and indices with greater sensitivity for analyzing vegetation characteristics. Current state of knowledge on hyperspectral narrowbands (HNBs) for agricultural and vegetation studies inferred from the Book entitled hyperspectral remote sensing of vegetation by Thenkabail et al., 2011. Six study areas of the World for which we have extensive data from field spectroradiometers for 8 major world crops (wheat, corn, rice, barley, soybeans, pulses, and cotton). Approx. 10,500 such data points will be used in crop modeling and in building spectral libraries.

  2. Quality registers in professional health care educations: knowledge gaps and proposed actions:

    OpenAIRE

    Nordin Annika M. M.; Ernsäter Torie Palm; Bergman Bo

    2014-01-01

    Background and purpose: The use of quality registers has increased rapidly in Sweden and they are identified as beneficial for health care competitiveness. A quality register is a structured gathering of patient information, to improve health care. However, the introduction of quality registers in health care organisations presupposes that employees know how to use them in quality improvement. Disconnections, or knowledge gaps, concerning quality registers hamper the possibilities to take adv...

  3. Application of Adult-Based Dietary Guidelines to Children: Evidence, Knowledge Gaps, and Policy Implications.

    OpenAIRE

    Ronette R. Briefel; Allison Hedley Dodd; Charlotte Cabili; Carol West Suitor

    2008-01-01

    Recommendations to promote healthy living, such as the Dietary Guidelines for Americans, are intended to translate scientific knowledge into everyday practice. This report assesses the evidence base for child-focused dietary guidance, identifying new evidence as well as topics where there are gaps for developing future direction. Relatively little growth of the science base has occurred since 2004, except on a few topics—added sugars and weight, dairy foods/calcium and bone health, and sodi...

  4. Cyberspace Knowledge Gaps and Boundaries in Sustainability Science: Topics, Regions, Editorial Teams and Journals

    OpenAIRE

    Brunn, Stanley D.

    2014-01-01

    The scholarly world of sustainability science is one that is international and interdisciplinary, but is one, on close reading of research contributions, editoral teams, journal citations, and geographic coverage, that has much unevenness. The focus of this paper is on the cyberspace boundaries between and within fields and disciplines studying sustainability; these boundaries separate knowledge gaps or uneven patterns in sustainability scholarship. I use the volume of hyperlinks on Google Se...

  5. Mechanistic Modeling Reveals the Critical Knowledge Gaps in Bile Acid–Mediated DILI

    OpenAIRE

    Woodhead, J L; Yang, K.; Brouwer, K L R; Siler, S. Q.; Stahl, S H; Ambroso, J L; Baker, D; Watkins, P B; Howell, B A

    2014-01-01

    Bile salt export pump (BSEP) inhibition has been proposed to be an important mechanism for drug-induced liver injury (DILI). Modeling can prioritize knowledge gaps concerning bile acid (BA) homeostasis and thus help guide experimentation. A submodel of BA homeostasis in rats and humans was constructed within DILIsym, a mechanistic model of DILI. In vivo experiments in rats with glibenclamide were conducted, and data from these experiments were used to validate the model. The behavior of DILIs...

  6. An Exploration of the Utility of a Knowledge Utilization Framework to Study the Gap between Reading Disabilities Research and Practice

    Science.gov (United States)

    Davidson, Katherine; Nowicki, Elizabeth

    2012-01-01

    This pre-pilot study explored the usefulness of a knowledge utilization framework comprised of Knott and Wildavsky's (1980) seven stages of knowledge use and Stone's (2002) three routes to knowledge use to investigate the gap between reading disabilities research and teachers' self-reported use of that research. Semi-structured interviews of ten…

  7. Bridging the gap between basic and clinical sciences: A description of a radiological anatomy course.

    Science.gov (United States)

    Torres, Anna; Staśkiewicz, Grzegorz J; Lisiecka, Justyna; Pietrzyk, Łukasz; Czekajlo, Michael; Arancibia, Carlos U; Maciejewski, Ryszard; Torres, Kamil

    2016-05-01

    A wide variety of medical imaging techniques pervade modern medicine, and the changing portability and performance of tools like ultrasound imaging have brought these medical imaging techniques into the everyday practice of many specialties outside of radiology. However, proper interpretation of ultrasonographic and computed tomographic images requires the practitioner to not only hone certain technical skills, but to command an excellent knowledge of sectional anatomy and an understanding of the pathophysiology of the examined areas as well. Yet throughout many medical curricula there is often a large gap between traditional anatomy coursework and clinical training in imaging techniques. The authors present a radiological anatomy course developed to teach sectional anatomy with particular emphasis on ultrasonography and computed tomography, while incorporating elements of medical simulation. To assess students' overall opinions about the course and to examine its impact on their self-perceived improvement in their knowledge of radiological anatomy, anonymous evaluation questionnaires were provided to the students. The questionnaires were prepared using standard survey methods. A five-point Likert scale was applied to evaluate agreement with statements regarding the learning experience. The majority of students considered the course very useful and beneficial in terms of improving three-dimensional and cross-sectional knowledge of anatomy, as well as for developing practical skills in ultrasonography and computed tomography. The authors found that a small-group, hands-on teaching model in radiological anatomy was perceived as useful both by the students and the clinical teachers involved in their clinical education. In addition, the model was introduced using relatively few resources and only two faculty members. Anat Sci Educ 9: 295-303. © 2015 American Association of Anatomists. PMID:26599321

  8. 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. PMID:25052431

  9. 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. PMID:23542965

  10. The cognitive organization of music knowledge: a clinical analysis

    OpenAIRE

    Omar, R.; Hailstone, J. C.; J.E. Warren; Crutch, S.J.; Warren, J. D.

    2010-01-01

    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 o...

  11. 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. PMID:20142334

  12. How an online survey on the treatment of allergic rhinitis and its impact on asthma (ARIA) detected specialty-specific knowledge-gaps

    OpenAIRE

    Larenas Linnemann, Désirée ES; Medina Ávalos, Miguel Alejandro; Lozano Sáenz, José

    2015-01-01

    Background To enhance the dissemination of the ARIA document (Allergic rhinitis (AR) and its impact on asthma) in Mexico, a Working Group composed of 35 specialists of 8 professional medical societies developed a transculturized ARIA México 2014 guideline. The ARIA guidelines use the GRADE system, which builds recommendations and suggestions around clinical questions (CQ). Methods As part of the dissemination strategy and to detect the physicians’ view and knowledge-gaps concerning the treatm...

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

    Directory of Open Access Journals (Sweden)

    Maria Dusinska

    2013-03-01

    Full Text Available 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.

  14. Reflecting on explanatory ability: A mechanism for detecting gaps in causal knowledge.

    Science.gov (United States)

    Johnson, Dan R; Murphy, Meredith P; Messer, Riley M

    2016-05-01

    People frequently overestimate their understanding-with a particularly large blind-spot for gaps in their causal knowledge. We introduce a metacognitive approach to reducing overestimation, termed reflecting on explanatory ability (REA), which is briefly thinking about how well one could explain something in a mechanistic, step-by-step, causally connected manner. Nine experiments demonstrated that engaging in REA just before estimating one's understanding substantially reduced overestimation. Moreover, REA reduced overestimation with nearly the same potency as generating full explanations, but did so 20 times faster (although only for high complexity objects). REA substantially reduced overestimation by inducing participants to quickly evaluate an object's inherent causal complexity (Experiments 4-7). REA reduced overestimation by also fostering step-by-step, causally connected processing (Experiments 2 and 3). Alternative explanations for REA's effects were ruled out including a general conservatism account (Experiments 4 and 5) and a covert explanation account (Experiment 8). REA's overestimation-reduction effect generalized beyond objects (Experiments 1-8) to sociopolitical policies (Experiment 9). REA efficiently detects gaps in our causal knowledge with implications for improving self-directed learning, enhancing self-insight into vocational and academic abilities, and even reducing extremist attitudes. PMID:26999047

  15. 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.

  16. 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

  17. 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. PMID:19036306

  18. 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...

  19. Medical data mining: knowledge discovery in a clinical data warehouse.

    Science.gov (United States)

    Prather, J C; Lobach, D F; Goodwin, L K; Hales, J W; Hage, M L; Hammond, W E

    1997-01-01

    Clinical databases have accumulated large quantities of information about patients and their medical conditions. Relationships and patterns within this data could provide new medical knowledge. Unfortunately, few methodologies have been developed and applied to discover this hidden knowledge. In this study, the techniques of data mining (also known as Knowledge Discovery in Databases) were used to search for relationships in a large clinical database. Specifically, data accumulated on 3,902 obstetrical patients were evaluated for factors potentially contributing to preterm birth using exploratory factor analysis. Three factors were identified by the investigators for further exploration. This paper describes the processes involved in mining a clinical database including data warehousing, data query and cleaning, and data analysis. PMID:9357597

  20. 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. PMID:27371618

  1. 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.

  2. Mechanistic Modeling Reveals the Critical Knowledge Gaps in Bile Acid-Mediated DILI.

    Science.gov (United States)

    Woodhead, J L; Yang, K; Brouwer, K L R; Siler, S Q; Stahl, S H; Ambroso, J L; Baker, D; Watkins, P B; Howell, B A

    2014-01-01

    Bile salt export pump (BSEP) inhibition has been proposed to be an important mechanism for drug-induced liver injury (DILI). Modeling can prioritize knowledge gaps concerning bile acid (BA) homeostasis and thus help guide experimentation. A submodel of BA homeostasis in rats and humans was constructed within DILIsym, a mechanistic model of DILI. In vivo experiments in rats with glibenclamide were conducted, and data from these experiments were used to validate the model. The behavior of DILIsym was analyzed in the presence of a simulated theoretical BSEP inhibitor. BSEP inhibition in humans is predicted to increase liver concentrations of conjugated chenodeoxycholic acid (CDCA) and sulfate-conjugated lithocholic acid (LCA) while the concentration of other liver BAs remains constant or decreases. On the basis of a sensitivity analysis, the most important unknowns are the level of BSEP expression, the amount of intestinal synthesis of LCA, and the magnitude of farnesoid-X nuclear receptor (FXR)-mediated regulation. PMID:25006780

  3. Management of newborn infant born to mother suffering from tuberculosis: Current recommendations & gaps in knowledge

    Directory of Open Access Journals (Sweden)

    Hema Mittal

    2014-01-01

    Full Text Available Tuberculosis (TB is a global disease with increase in concern with growing morbidity and mortality after drug resistance and co-infection with HIV. Mother to neonatal transmission of disease is well known. Current recommendations regarding management of newborns of mothers with tuberculosis are variable in different countries and have large gaps in the knowledge and practices. We compare and summarize here current recommendations on management of infants born to mothers with tuberculosis. Congenital tuberculosis is diagnosed by Cantwell criteria and treatment includes three or four anti-tubercular drug regimen. Prophylaxis with isoniazid (3-6 months is recommended in neonates born to mother with TB who are infectious. Breastfeeding should be continued in these neonates and isolation is recommended only till mother is infectious, has multidrug resistant tuberculosis or non adherent to treatment. BCG vaccine is recommended at birth or after completion of prophylaxis (3-6 months in all neonates.

  4. Engineered Nanomaterials: Knowledge Gaps in Fate, Exposure, Toxicity, and Future Directions

    Directory of Open Access Journals (Sweden)

    Arun Kumar

    2014-01-01

    Full Text Available The aim of this study is to identify current knowledge gaps in fate, exposure, and toxicity of engineered nanomaterials (ENMs, highlight research gaps, and suggest future research directions. Humans and other living organisms are exposed to ENMs during production or use of products containing them. To assess the hazards of ENMs, it is important to assess their physiochemical properties and try to relate them to any observed hazard. However, the full determination of these relationships is currently limited by the lack of empirical data. Moreover, most toxicity studies do not use realistic environmental exposure conditions for determining dose-response parameters, affecting the accurate estimation of health risks associated with the exposure to ENMs. Regulatory aspects of nanotechnology are still developing and are currently the subject of much debate. Synthesis of available studies suggests a number of open questions. These include (i developing a combination of different analytical methods for determining ENM concentration, size, shape, surface properties, and morphology in different environmental media, (ii conducting toxicity studies using environmentally relevant exposure conditions and obtaining data relevant to developing quantitative nanostructure-toxicity relationships (QNTR, and (iii developing guidelines for regulating exposure of ENMs in the environment.

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

    Directory of Open Access Journals (Sweden)

    Barbara L Ignacio

    Full Text Available BACKGROUND: 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. METHODOLOGY/PRINCIPAL FINDINGS: 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. CONCLUSIONS/SIGNIFICANCE: 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

  6. Knowledge Management: Experiences in Academic and Clinic Environments

    Directory of Open Access Journals (Sweden)

    Martha Torres Narváez

    2014-05-01

    Full Text Available This article describes the knowledge management practices derived from clinical research, and some hospitals and academic institutions in Colombia. The profile of these institutions and the variables involved in knowledge management and research are presented. Objective: Exploring the practices that some Colombian institutions have to build or strengthen their capacity to con-duct clinical research. Materials and methods: We conducted an exploratory study by consulting a convenience sample, the use of specific practices in knowledge management. In a documentary analysis on knowledge management. The information was obtained of primary sources by semi-structured interview applied to selected key players. Results: In the institutions that participated in the study, it was observed as determinants in knowledge management: structure and strategic management, intellectual capital, technological resources, and the continuity and sustainability of the processes. Conclusion: Include research processes in services delivery institutions is criti¬cal to improving the quality of health care and encourage their intellectual capital. Colombia has institutions working with determination to the generation of knowledge from clinical practice.

  7. 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.

  8. Review article: Assessing the costs of natural hazards - state of the art and knowledge gaps

    Science.gov (United States)

    Meyer, V.; Becker, N.; Markantonis, V.; Schwarze, R.; van den Bergh, J. C. J. M.; Bouwer, L. M.; Bubeck, P.; Ciavola, P.; Genovese, E.; Green, C.; Hallegatte, S.; Kreibich, H.; Lequeux, Q.; Logar, I.; Papyrakis, E.; Pfurtscheller, C.; Poussin, J.; Przyluski, V.; Thieken, A. H.; Viavattene, C.

    2013-05-01

    Efficiently reducing natural hazard risks requires a thorough understanding of the costs of natural hazards. Current methods to assess these costs employ a variety of terminologies and approaches for different types of natural hazards and different impacted sectors. This may impede efforts to ascertain comprehensive and comparable cost figures. In order to strengthen the role of cost assessments in the development of integrated natural hazard management, a review of existing cost assessment approaches was undertaken. This review considers droughts, floods, coastal and Alpine hazards, and examines different cost types, namely direct tangible damages, losses due to business interruption, indirect damages, intangible effects, and the costs of risk mitigation. This paper provides an overview of the state-of-the-art cost assessment approaches and discusses key knowledge gaps. It shows that the application of cost assessments in practice is often incomplete and biased, as direct costs receive a relatively large amount of attention, while intangible and indirect effects are rarely considered. Furthermore, all parts of cost assessment entail considerable uncertainties due to insufficient or highly aggregated data sources, along with a lack of knowledge about the processes leading to damage and thus the appropriate models required. Recommendations are provided on how to reduce or handle these uncertainties by improving data sources and cost assessment methods. Further recommendations address how risk dynamics due to climate and socio-economic change can be better considered, how costs are distributed and risks transferred, and in what ways cost assessment can function as part of decision support.

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

    International Nuclear Information System (INIS)

    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/Al2O3 nanocomposite (RGO/Al2O3) 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

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

    OpenAIRE

    Ghazaleh Eslamian; Kevan Jacobson; Azita Hekmatdoost

    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 sectio...

  11. 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. PMID:26152955

  12. The Time Is Now: Attention Increases to Transgender Health in the United States but Scientific Knowledge Gaps Remain.

    Science.gov (United States)

    MacCarthy, Sarah; Reisner, Sari L; Nunn, Amy; Perez-Brumer, Amaya; Operario, Don

    2015-12-01

    Attention to transgender health has dramatically increased in the U.S. Scientific knowledge gaps in empirical research, however, remain and act as barriers to achieving transgender-related health equity. We conducted a search using PubMed and PsycINFO to identify gaps in empirical, peer-reviewed publications related to adult transgender health in the U.S. between 1981 and 2013. We synthesized these findings and commented on opportunities for improving health research. Reducing health disparities and advancing transgender-related health equity requires greater investment in research that addresses current gaps to more comprehensively respond to the diverse health needs of transgender people. PMID:26788768

  13. 76 FR 72957 - 4th Annual Trauma Spectrum Conference: Bridging the Gap Between Research and Clinical Practice of...

    Science.gov (United States)

    2011-11-28

    ... HUMAN SERVICES National Institutes of Health 4th Annual Trauma Spectrum Conference: Bridging the Gap... Annual Trauma Spectrum Conference: Bridging the Gap Between Research and Clinical Practice of... conference information, visit the Trauma Spectrum Conference Web site at...

  14. 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.

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

    OpenAIRE

    Brendan M. Tobin

    2013-01-01

    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...

  16. Programming the brain: Common outcomes and gaps in knowledge from animal studies of IUGR.

    Science.gov (United States)

    Hunter, Damien S; Hazel, Susan J; Kind, Karen L; Owens, Julie A; Pitcher, Julia B; Gatford, Kathryn L

    2016-10-01

    IUGR in humans is associated with impaired pre- and postnatal neurodevelopment, and subsequent postnatal cognition, resulting in lower IQ, poorer memory, visuomotor and executive function skills, as well as behavioural and attentional problems. Experimental models of IUGR are needed to allow direct testing of causality and interventions, and have benefits in reducing both confounding by comorbidities such as prematurity, and variation due to environment and genetics. This review describes and discusses experimental models of IUGR in which neurodevelopmental and cognitive outcomes of IUGR have been reported. We consider the timing of neurodevelopment relative to birth and to the period of restriction, as well as the effects of each experimental perturbation on the fetal environment and development, before discussing neurodevelopmental and cognitive outcomes for progeny as fetuses, neonates and into adolescent and adult life. Experimental IUGR induces broadly similar outcomes to human IUGR, with altered brain morphology, in particular grey matter loss and discordant trajectory of white matter development, and poorer cognition and memory reported in various studies. Nevertheless, there remain gaps in knowledge of neurodevelopment in experimental models. We end the review with recommendations for the design of future studies to further investigate the mechanisms underlying adverse neurodevelopmental consequences of IUGR, and to evaluate interventions that may subsequently improve outcomes of IUGR in humans. PMID:27288225

  17. Environmental Impact on DNA Methylation in the Germline: State of the Art and Gaps of Knowledge

    Directory of Open Access Journals (Sweden)

    Francesca Pacchierotti

    2015-01-01

    Full Text Available The epigenome consists of chemical changes in DNA and chromatin that without modifying the DNA sequence modulate gene expression and cellular phenotype. The epigenome is highly plastic and reacts to changing external conditions with modifications that can be inherited to daughter cells and across generations. Whereas this innate plasticity allows for adaptation to a changing environment, it also implies the potential of epigenetic derailment leading to so-called epimutations. DNA methylation is the most studied epigenetic mark. DNA methylation changes have been associated with cancer, infertility, cardiovascular, respiratory, metabolic, immunologic, and neurodegenerative pathologies. Experiments in rodents demonstrate that exposure to a variety of chemical stressors, occurring during the prenatal or the adult life, may induce DNA methylation changes in germ cells, which may be transmitted across generations with phenotypic consequences. An increasing number of human biomonitoring studies show environmentally related DNA methylation changes mainly in blood leukocytes, whereas very few data have been so far collected on possible epigenetic changes induced in the germline, even by the analysis of easily accessible sperm. In this paper, we review the state of the art on factors impinging on DNA methylation in the germline, highlight gaps of knowledge, and propose priorities for future studies.

  18. 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. PMID:21298585

  19. The "Chugakuryoko" and Hogan's Heroes: The Experience Gap between U.S. and Japanese Students' Knowledge of World War II

    Science.gov (United States)

    Olwell, Russ

    2011-01-01

    Based on his own teaching experiences and findings, the author discusses the experience gap between U.S. and Japanese students' knowledge of World War II. He compares and contrasts how the subject of World War II is taught in the United States versus Japan. While it takes teacher effort to enrich the history experiences of U.S. students, the…

  20. 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

    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...

  1. Mind the Gap: Privileging Epistemic Access to Knowledge in the Transition from Leaving Certificate Music to Higher Education

    Science.gov (United States)

    Moore, Gwen

    2014-01-01

    In recent years, music at Leaving Certificate level has come under increasing focus in media and higher education discourse as an easy option. In particular, scant attention has been paid to the musical knowledge and skills needed in the transition to higher music education within the Irish context. This paper addresses the perceived gap in…

  2. The gap between dental education and clinical treatment in temporomandibular disorders and orofacial pain

    NARCIS (Netherlands)

    Steenks, M. H.

    2007-01-01

    Implementation of research findings in patient care ideally will follow in a continuous cycle, and clinical questions from practitioners should stimulate research. Even in the most optimal situations, there will be a gap between the steady flow of new findings from research and their eventual implem

  3. How to Connect the Gap between Clinical Trials and Clinical Practice

    Institute of Scientific and Technical Information of China (English)

    SHANG Hong-cai; XU Hong-juan; CHEN Jing; ZHANG Bo-li; LI You-ping; Mike J Clarke

    2008-01-01

    Clinical research methods have been rapidly developing, and the design of clinical trials including traditional Chinese medicine is advancing. To a certain extent, all of these ensure that the results of clinical research are objective and scientific, but whether these results and the resulting guidelines or consensus have much practical significance on clinical practice is still controversial. The authors engage in both clinical practice and clinical research; they strongly feel that it is necessary to discuss the relationship between clinical trials and clinical practice. This essay discusses this relationship in four parts.

  4. Clinical knowledge management at the point of care

    Directory of Open Access Journals (Sweden)

    Cheong-Lieng Teng

    2012-07-01

    Full Text Available In the developing world, clinical knowledgemanagement in primary care has a long way to go.Clinical decision support systems, despite its promise torevolutionise healthcare, is slow in its implementationdue to the lack of financial investment in informationtechnology. Point-of-care resources, such ascomprehensive electronic textbooks delivered via theweb or mobile devices, have yet to be fully utilised bythe healthcare organisation or individual clinicians.Increasing amount of applicable knowledge of goodquality (e.g. clinical practice guidelines and otherpre-appraised resources are now available via theinternet. The policy makers and clinicians need tobe more informed about the potential benefits andlimitations of these new tools and resources and makethe necessary budgetary provision and learn how best toharness them for patient care.

  5. Impacts of elevated atmospheric CO2 on forest trees and forest ecosystems: knowledge gaps

    International Nuclear Information System (INIS)

    Atmospheric CO2 is rising rapidly, and options for slowing the CO2 rise are politically charged as they largely require reductions in industrial CO2 emissions for most developed countries. As forests cover some 43% of the Earth's surface, account for some 70% of terrestrial net primary production (NPP), and are being bartered for carbon mitigation, it is critically important that we continue to reduce the uncertainties about the impacts of elevated atmospheric CO2 on forest tree growth, productivity, and forest ecosystem function. In this paper, 1 review knowledge gaps and research needs on the effects of elevated atmospheric CO2 on forest above- and below-ground growth and productivity, carbon sequestration, nutrient cycling, water relations, wood quality, phonology, community dynamics and biodiversity, antioxidants and stress tolerance, interactions with air pollutants, heterotrophic interactions, and ecosystem functioning. Finally, 1 discuss research needs regarding modelling of the impacts of elevated atmospheric CO2 on forests. Even though there has been a tremendous amount of research done with elevated CO2 and forest trees, it remains difficult to predict future forest growth and productivity under elevated atmospheric CO2. Likewise, it is not easy to predict how forest ecosystem processes will respond to enriched CO2. The more we study the impacts of increasing CO2, the more we realize that tree and forest responses are yet largely uncertain due to differences in responsiveness by species, genotype, and functional group, and the complex interactions of elevated atmospheric CO2 with soil fertility, drought, pests, and co-occurring atmospheric pollutants such as nitrogen deposition and O3. Furthermore, it is impossible to predict ecosystem-level responses based on short-term studies of young trees grown without interacting stresses and in small spaces without the element of competition. Long-term studies using free-air CO2 enrichment (FACE) technologies or

  6. Impacts of elevated atmospheric CO{sub 2} on forest trees and forest ecosystems: knowledge gaps

    Energy Technology Data Exchange (ETDEWEB)

    Karnosky, D.F. [Michigan Technological University, Houghton, MI (United States). School of Forest Resources and Environmental Science

    2003-06-01

    Atmospheric CO{sub 2} is rising rapidly, and options for slowing the CO{sub 2} rise are politically charged as they largely require reductions in industrial CO{sub 2} emissions for most developed countries. As forests cover some 43% of the Earth's surface, account for some 70% of terrestrial net primary production (NPP), and are being bartered for carbon mitigation, it is critically important that we continue to reduce the uncertainties about the impacts of elevated atmospheric CO{sub 2} on forest tree growth, productivity, and forest ecosystem function. In this paper, 1 review knowledge gaps and research needs on the effects of elevated atmospheric CO{sub 2} on forest above- and below-ground growth and productivity, carbon sequestration, nutrient cycling, water relations, wood quality, phonology, community dynamics and biodiversity, antioxidants and stress tolerance, interactions with air pollutants, heterotrophic interactions, and ecosystem functioning. Finally, 1 discuss research needs regarding modelling of the impacts of elevated atmospheric CO{sub 2} on forests. Even though there has been a tremendous amount of research done with elevated CO{sub 2} and forest trees, it remains difficult to predict future forest growth and productivity under elevated atmospheric CO{sub 2}. Likewise, it is not easy to predict how forest ecosystem processes will respond to enriched CO{sub 2}. The more we study the impacts of increasing CO{sub 2}, the more we realize that tree and forest responses are yet largely uncertain due to differences in responsiveness by species, genotype, and functional group, and the complex interactions of elevated atmospheric CO{sub 2} with soil fertility, drought, pests, and co-occurring atmospheric pollutants such as nitrogen deposition and O{sub 3}. Furthermore, it is impossible to predict ecosystem-level responses based on short-term studies of young trees grown without interacting stresses and in small spaces without the element of

  7. A short review of fecal indicator bacteria in tropical aquatic ecosystems: knowledge gaps and future directions

    Directory of Open Access Journals (Sweden)

    Emma Jane Rochelle-Newall

    2015-04-01

    Full Text Available Given the high numbers of deaths and the debilitating nature of diseases caused by the use of unclean water it is imperative that we have an understanding of the factors that control the dispersion of water borne pathogens and their respective indicators. This is all the more important in developing countries where significant proportions of the population often have little or no access to clean drinking water supplies. Moreover, and notwithstanding the importance of these bacteria in terms of public health, at present little work exists on the persistence, transfer and proliferation of these pathogens and their respective indicator organisms e.g. fecal indicator bacteria (FIB such as Escherichia coli and fecal coliforms in humid tropical systems, such as are found in South East Asia or in the tropical regions of Africa. Both FIB and the waterborne pathogens they are supposed to indicate are particularly susceptible to shifts in water flow and quality and the predicted increases in rainfall and floods due to climate change will only exacerbate the problems of contamination. This will be furthermore compounded by the increasing urbanization and agricultural intensification that developing regions are experiencing. Therefore, recognizing and understanding the link between human activities, natural process and microbial functioning and their ultimate impacts on human health are prerequisites for reducing the risks to the exposed populations. Most of the existing work in tropical systems has been based on the application of temperate indicator organisms, models and mechanisms regardless of their applicability or appropriateness for tropical environments. Here we present a short review on the factors that control FIB dynamics in temperate systems and discuss their applicability to tropical environments. We then highlight some of the knowledge gaps in order to stimulate future research in this field in the tropics.

  8. A short review of fecal indicator bacteria in tropical aquatic ecosystems: knowledge gaps and future directions.

    Science.gov (United States)

    Rochelle-Newall, Emma; Nguyen, Thi Mai Huong; Le, Thi Phuong Quynh; Sengtaheuanghoung, Oloth; Ribolzi, Olivier

    2015-01-01

    Given the high numbers of deaths and the debilitating nature of diseases caused by the use of unclean water it is imperative that we have an understanding of the factors that control the dispersion of water borne pathogens and their respective indicators. This is all the more important in developing countries where significant proportions of the population often have little or no access to clean drinking water supplies. Moreover, and notwithstanding the importance of these bacteria in terms of public health, at present little work exists on the persistence, transfer and proliferation of these pathogens and their respective indicator organisms, e.g., fecal indicator bacteria (FIB) such as Escherichia coli and fecal coliforms in humid tropical systems, such as are found in South East Asia or in the tropical regions of Africa. Both FIB and the waterborne pathogens they are supposed to indicate are particularly susceptible to shifts in water flow and quality and the predicted increases in rainfall and floods due to climate change will only exacerbate the problems of contamination. This will be furthermore compounded by the increasing urbanization and agricultural intensification that developing regions are experiencing. Therefore, recognizing and understanding the link between human activities, natural process and microbial functioning and their ultimate impacts on human health are prerequisites for reducing the risks to the exposed populations. Most of the existing work in tropical systems has been based on the application of temperate indicator organisms, models and mechanisms regardless of their applicability or appropriateness for tropical environments. Here, we present a short review on the factors that control FIB dynamics in temperate systems and discuss their applicability to tropical environments. We then highlight some of the knowledge gaps in order to stimulate future research in this field in the tropics. PMID:25941519

  9. A meta-analysis of seaweed impacts on seagrasses: generalities and knowledge gaps.

    Directory of Open Access Journals (Sweden)

    Mads S Thomsen

    Full Text Available Seagrasses are important habitat-formers and ecosystem engineers that are under threat from bloom-forming seaweeds. These seaweeds have been suggested to outcompete the seagrasses, particularly when facilitated by eutrophication, causing regime shifts where green meadows and clear waters are replaced with unstable sediments, turbid waters, hypoxia, and poor habitat conditions for fishes and invertebrates. Understanding the situations under which seaweeds impact seagrasses on local patch scales can help proactive management and prevent losses at greater scales. Here, we provide a quantitative review of available published manipulative experiments (all conducted at the patch-scale, to test which attributes of seaweeds and seagrasses (e.g., their abundances, sizes, morphology, taxonomy, attachment type, or origin influence impacts. Weighted and unweighted meta-analyses (Hedges d metric of 59 experiments showed generally high variability in attribute-impact relationships. Our main significant findings were that (a abundant seaweeds had stronger negative impacts on seagrasses than sparse seaweeds, (b unattached and epiphytic seaweeds had stronger impacts than 'rooted' seaweeds, and (c small seagrass species were more susceptible than larger species. Findings (a and (c were rather intuitive. It was more surprising that 'rooted' seaweeds had comparatively small impacts, particularly given that this category included the infamous invasive Caulerpa species. This result may reflect that seaweed biomass and/or shading and metabolic by-products like anoxia and sulphides could be lower for rooted seaweeds. In conclusion, our results represent simple and robust first-order generalities about seaweed impacts on seagrasses. This review also documented a limited number of primary studies. We therefore identified major knowledge gaps that need to be addressed before general predictive models on seaweed-seagrass interactions can be build, in order to effectively

  10. Radiotelemetry and wildlife: Highlighting a gap in the knowledge on radiofrequency radiation effects.

    Science.gov (United States)

    Balmori, Alfonso

    2016-02-01

    Radio transmitters and associated devices may induce negative effects that can bias the results of ongoing research. The main documented effects of radio transmitters on animals include reduced survival, decreased productivity, changes in behaviour and movement patterns and a biased sex ratio. The only factors that have claimed responsibility for these possible damages are the weight of the radio transmitter and associated devices, and the attachment type. The electromagnetic radiation produced by radio transmitters has not been considered so far in research. There have been no studies evaluating the effects of non-ionising electromagnetic radiation (radiofrequency signals) necessary for tracking, although the problems found were significantly associated with the length of time that animals had been carrying their radio transmitters. Similar problems as those in radiotracked animals have been found in numerous studies with animals exposed to radiofrequency radiation for a sufficient amount of time. Laboratory scientists investigating the orientation of animals know they have to shield the place where experiments are performed to prevent interference from man-made radiation, as anthropogenic signals may distort the results. It is paradoxical that, at the same time, field scientists investigating the movements and other aspects of animal biology are providing animals with radio transmitters that emit the same type of radiation, since this may affect the results concerning their orientation and movement. This paper identifies gaps in the knowledge that should be investigated in-depth. The possibility that the radiofrequency radiation from radiotracking devices is responsible for the findings should be considered. Considering this factor may allow researchers to best understand the long-term effects found. PMID:26615484

  11. The Anion Gap is a Predictive Clinical Marker for Death in Patients with Acute Pesticide Intoxication.

    Science.gov (United States)

    Lee, Sun-Hyo; Park, Samel; Lee, Jung-Won; Hwang, Il-Woong; Moon, Hyung-Jun; Kim, Ki-Hwan; Park, Su-Yeon; Gil, Hyo-Wook; Hong, Sae-Yong

    2016-07-01

    Pesticide formulation includes solvents (methanol and xylene) and antifreeze (ethylene glycol) whose metabolites are anions such as formic acid, hippuric acid, and oxalate. However, the effect of the anion gap on clinical outcome in acute pesticide intoxication requires clarification. In this prospective study, we compared the anion gap and other parameters between surviving versus deceased patients with acute pesticide intoxication. The following parameters were assessed in 1,058 patients with acute pesticide intoxication: blood chemistry (blood urea nitrogen, creatinine, glucose, lactic acid, liver enzymes, albumin, globulin, and urate), urinalysis (ketone bodies), arterial blood gas analysis, electrolytes (Na(+), K(+), Cl(-) HCO3 (-), Ca(++)), pesticide field of use, class, and ingestion amount, clinical outcome (death rate, length of hospital stay, length of intensive care unit stay, and seriousness of toxic symptoms), and the calculated anion gap. Among the 481 patients with a high anion gap, 52.2% had a blood pH in the physiologic range, 35.8% had metabolic acidosis, and 12.1% had acidemia. Age, anion gap, pesticide field of use, pesticide class, seriousness of symptoms (all P < 0.001), and time lag after ingestion (P = 0.048) were significant risk factors for death in univariate analyses. Among these, age, anion gap, and pesticide class were significant risk factors for death in a multiple logistic regression analysis (P < 0.001). In conclusions, high anion gap is a significant risk factor for death, regardless of the accompanying acid-base balance status in patients with acute pesticide intoxication. PMID:27366016

  12. Why it is hard to support group work in distributed healthcare organizations: empirical knowledge of the social-technical gap.

    Science.gov (United States)

    Weng, Chunhua

    2005-01-01

    We used a participatory design process to understand and to support the group work of cancer clinical trial protocol design within a distributed organization, the Southwest Oncology Group (SWOG). We also designed a collaborative writing system to facilitate its protocol reviewing and revising processes over the Internet. After a series of iterative prototyping and formative evaluations over the past two years, we identified a social-technical gap in our group work support research at SWOG. This gap consists of technical challenges, expanding user needs, conflicting user needs from different roles, insufficient incentive for using groupware technology by certain members, subtle organizational nuances, and the changing organizational structure. This paper describes our longitudinal evaluations results and elaborates on the social-technical gap. We think this gap may generalize to other healthcare group work settings. PMID:16779151

  13. Cost assessment of natural hazards in Europe - state-of-the-art, knowledge gaps and recommendations

    Science.gov (United States)

    Meyer, V.; Becker, N.; Markantonis, V.; Schwarze, R.; van den Bergh, J. C. J. M.; Bouwer, L. M.; Bubeck, P.; Ciavola, P.; Thieken, A. H.; Genovese, E.; Green, C.; Hallegatte, S.; Kreibich, H.; Lequeux, Q.; Viavattenne, C.; Logar, I.; Papyrakis, E.; Pfurtscheller, C.; Poussin, J.; Przyluski, V.

    2012-04-01

    Effective and efficient reduction of natural hazard risks requires a thorough understanding of the costs of natural hazards in order to develop sustainable risk management strategies. The current methods that assess the costs of different natural hazards employ a diversity of terminologies and approaches for different hazards and impacted sectors. This makes it difficult to arrive at robust, comprehensive and comparable cost figures. The CONHAZ (Costs of Natural Hazards) project aimed to compile and synthesise current knowledge on cost assessment methods in order to strengthen the role of cost assessments in the development of integrated natural hazard management and adaptation planning. In order to achieve this, CONHAZ has adopted a comprehensive approach, considering natural hazards ranging from droughts, floods and coastal hazards to Alpine hazards, as well as different impacted sectors and cost types. Its specific objectives have been 1) to compile the state-of-the-art methods for cost assessment; 2) to analyse and assess these methods in terms of technical aspects, as well as terminology, data quality and availability, and research gaps; and 3) to synthesise resulting knowledge into recommendations and to identify further research needs. This presentation summarises the main results of CONHAZ. CONHAZ differentiates between direct tangible damages, losses due to business interruption, indirect damages, intangible effects, and costs of risk mitigation. It is shown that the main focus of cost assessment methods and their application in practice is on direct costs, while existing methods for assessing intangible and indirect effects are rather rarely applied and methods for assessing indirect effects often cannot be used on the scale of interest (e.g. the regional scale). Furthermore, methods often focus on single sectors and/or hazards, and only very few are able to reflect several sectors or multiple hazards. Process understanding and its use in cost assessment

  14. 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.

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

    Directory of Open Access Journals (Sweden)

    Ghazaleh Eslamian

    2013-09-01

    Full Text Available 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.

  16. 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. PMID:25816698

  17. Serum 25-Hydroxyvitamin D Levels: Variability, Knowledge Gaps, and the Concept of a Desirable Range.

    Science.gov (United States)

    Fuleihan, Ghada El-Hajj; Bouillon, Roger; Clarke, Bart; Chakhtoura, Marlene; Cooper, Cyrus; McClung, Michael; Singh, Ravinder J

    2015-07-01

    Hypovitaminosis D is prevalent worldwide but proportions vary widely between regions, depending on genetic and lifestyle factors, the threshold to define deficiency, and accuracy of 25-hydroxyvitamin D (25OHD) assays used. Latitude, pollution, concealing clothing, sun exposure, gender, dietary habits, and lack of government regulation account for up to 50% in variations in serum 25OHD levels, whereas genetic polymorphisms in the vitamin D pathway account for less than 5%. Organizations/societies have developed guidelines for recommended desirable 25OHD levels and vitamin D doses to reach them, but their applicability across age groups and populations are still debated. This article and the accompanying online Supporting Information highlight sources of variations in circulating 25OHD levels, uncertainties and knowledge gaps, and analytical problems facing 25OHD assays, while keeping efficacy and safety data as the dominant factors when defining a desirable range for 25OHD levels. We propose a desirable range of 20 to 40 ng/mL (50 to 100 nmol/L), provided precise and accurate assays are used. Although slightly lower levels, 15 to 20 ng/mL, may be sufficient for some infants and adults, higher levels, 40 to 60 ng/mL, may still be safe. This desirable range allows physicians to tailor treatment while taking season, lifestyle, vitamin D intake, and other sources of variation into account. We reserve 25OHD measurements for at-risk patients, defined by disease or lifestyle, and the use of 25OHD assays calibrated against the recommended international standards. Most target groups reach desirable target levels by a daily intake of 400 to 600 IU for children and 800 IU for adults. A total daily allowance of vitamin D of up to 1000 IU in the pediatric age groups, and up to 2000 IU in adults, tailored to an individual patient risk profile, is probably safe over long durations. Additional data are needed to validate the proposed range and vitamin D doses

  18. Neonicotinoid Insecticides and Their Impacts on Bees: A Systematic Review of Research Approaches and Identification of Knowledge Gaps

    OpenAIRE

    Lundin, Ola; Rundlöf, Maj; Smith, Henrik G.; Fries, Ingemar; Bommarco, Riccardo

    2015-01-01

    It has been suggested that the widespread use of neonicotinoid insecticides threatens bees, but research on this topic has been surrounded by controversy. In order to synthesize which research approaches have been used to examine the effect of neonicotinoids on bees and to identify knowledge gaps, we systematically reviewed research on this subject that was available on the Web of Science and PubMed in June 2015. Most of the 216 primary research studies were conducted in Europe or North Ameri...

  19. The role of organisms in hyporheic processes : gaps in current knowledge, needs for future research and applications

    OpenAIRE

    Marmonier, Pierre; Archambaud, Gaït; Belaidi,Nouria; Bougon, Nolwenn; Breil, Pascal; Chauvet, Eric; Claret, Cécile; Cornut, Julien; Datry, Thibault; Dole-Olivier, Marie-José; Dumont, Bernard; Flipo, Nicolas; Foulquier, Arnaud; Gérino, Magali; Guilpart, Alexis

    2012-01-01

    Fifty years after the hyporheic zone was first defined (Orghidan, 1959), there are still gaps in the knowledge regarding the role of biodiversity in hyporheic processes. First, some methodological questions remained unanswered regarding the interactions between biodiversity and physical processes, both for the study of habitat characteristics and interactions at different scales. Furthermore, many questions remain to be addressed to help inform our understanding of invertebrate community dyna...

  20. Bridging knowledge translation gap in health in developing countries: visibility, impact and publishing standards in journals from the Eastern Mediterranean

    Directory of Open Access Journals (Sweden)

    Utrobičić Ana

    2012-05-01

    Full Text Available Abstract Background Local and regional scientific journals are important factors in bridging gaps in health knowledge translation in low-and middle-income countries. We assessed indexing, citations and publishing standards of journals from the Eastern Mediterranean region. Methods For journals from 22 countries in the collection of the Index Medicus for the Eastern Mediterranean Region (IMEMR, we analyzed indexing in bibliographical databases and citations during 2006–2009 to published items in 2006 in Web of Science (WoS and SCOPUS. Adherence to editorial and publishing standards was assessed using a special checklist. Results Out of 419 journals in IMEMR, 19 were indexed in MEDLINE, 23 in WoS and 46 in SCOPUS. Their impact factors ranged from 0.016 to 1.417. For a subset of 175 journals with available tables of contents from 2006, articles published in 2006 from 93 journals received 2068 citations in SCOPUS (23.5% self-citations and articles in 86 journals received 1579 citations in WoS (24.3% self-citations during 2006–2009. Citations to articles came mostly from outside of the Eastern Mediterranean region (76.8% in WoS and 75.4% in SCOPUS. Articles receiving highest number of citations presented topics specific for the region. Many journals did not follow editorial and publishing standards, such addressing requirements about the patient’s privacy rights (68.0% out of 244 analyzed, policy on managing conflicts of interest (66.4%, and ethical conduct in clinical and animal research (66.4%. Conclusion Journals from the Eastern Mediterranean are visible in and have impact on global scientific community. Coordinated effort of all stakeholders in journal publishing, including researchers, journal editors and owners, policy makers and citation databases, is needed to further promote local journals as windows to the research in the developing world and the doors for valuable regional research to the global scientific community.

  1. 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. PMID:25954420

  2. 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.

  3. 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

  4. The Communication Skills of Accountants: What We Know and the Gaps in Our Knowledge

    Science.gov (United States)

    Siriwardane, Harshini P.; Durden, Chris H.

    2014-01-01

    This paper critically reviews 19 studies published between 1972 and 2012 that investigated the written and/or oral communication skills of practicing accountants. The core aim of the review was to identify skills considered important and highlight gaps regarding what is known about existing and desired communication skills in the accounting…

  5. Examine the Gaps between Current and Ideal State of Knowledge Management in the Department of Physical Education

    Directory of Open Access Journals (Sweden)

    Kaveh Hasani

    2013-02-01

    Full Text Available In today's competitive world, knowledge has become the strategic resource in many organizations. Nonaka believes that in today's volatile situation, the only viable source of sustainable competitive advantage is knowledge. Thus, the knowledge management has become a major task for organizations that are looking to take advantage of this valuable asset. In this case the goal of this study is to examine the gaps between current and ideal state of knowledge management in the Department of Physical Education in Iran. Research's method was descriptive-menstruation. Study sample consisted of all employees of the Department of Physical Education of Kurdistan that were 320 members and it was selected by using Morgan table that were 175 members. The reliability of the questionnaire was measured and verified based on Cronbach's Alpha for the knowledge management dimension equals 0/89. Also a questionnaire to be standardized and be normalized in internal research, ensure validity of test. Used statistical methods in current study is use SPSS software and descriptive statistics to describe sex, age, education level and staff's job precedence variables and Kolmogorov – Smirnov test (K-S to verify data to be normal and to verify or reject hypothesis, Paired t-test is been used. Research results showed, there are meaningful differences among knowledge management Dimensions, including Technology infrastructure, organizational culture and organizational structure from the perspective of the Kurdistan's physical education staff in current situation with the ideal situation.

  6. Perceptions of Supervisors Regarding Essential Knowledge Domains for Clinical Supervision in Rehabilitation

    Science.gov (United States)

    Grayson, Keisha

    2011-01-01

    This study investigates the level of knowledge of clinical supervision among rehabilitation supervisors who provide clinical, administrative, and both clinical and administrative supervision. Moreover, the study intends to identify the knowledge domains that are important to providing clinical supervision in rehabilitation. In examining the…

  7. Feasibility of incorporating genomic knowledge into electronic medical records for pharmacogenomic clinical decision support

    Directory of Open Access Journals (Sweden)

    Hoath James I

    2010-10-01

    Full Text Available Abstract In pursuing personalized medicine, pharmacogenomic (PGx knowledge may help guide prescribing drugs based on a person’s genotype. Here we evaluate the feasibility of incorporating PGx knowledge, combined with clinical data, to support clinical decision-making by: 1 analyzing clinically relevant knowledge contained in PGx knowledge resources; 2 evaluating the feasibility of a rule-based framework to support formal representation of clinically relevant knowledge contained in PGx knowledge resources; and, 3 evaluating the ability of an electronic medical record/electronic health record (EMR/EHR to provide computable forms of clinical data needed for PGx clinical decision support. Findings suggest that the PharmGKB is a good source for PGx knowledge to supplement information contained in FDA approved drug labels. Furthermore, we found that with supporting knowledge (e.g. IF age

  8. Key success factors for clinical knowledge management systems: Comparing physician and hospital manager viewpoints.

    Science.gov (United States)

    Chang, Sho-Fang; Hsieh, Ping-Jung; Chen, Hui-Fang

    2015-01-01

    The study explores the perceptions of physicians and hospital managers regarding the key success factors (KSFs) of a clinical knowledge management system (CKMS). It aims to eliminate the perception gap and gain more insights for a successful CKMS.A survey was conducted in four medical centers in Taiwan. A total of 340 questionnaires, including 15 for hospital managers and 70 for physicians in each hospital, were administered. The effective response rates are 78.3% and 56.1% respectively. Partial least square (PLS) were used to analyze the data.The results identified six KSFs of CKMS including system software and hardware, knowledge quality, system quality, organizational factors, user satisfaction, and policy factors. User satisfaction and policy factors have direct effects on perceived CKMS performance. Knowledge quality is regarded as an antecedent to user satisfaction, while system quality is the antecedent to both user satisfaction and policy factors. System software and hardware was supported only by managers, and organizational factors were supported only by physicians.Among the factors, this study highlighted the policy factor. Besides, the study provides hospital managers additional insights into physician requirements for organizational support. Third, more physician participation and involvement are recommended when introducing and developing a CKMS. PMID:26444813

  9. 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.

  10. Larger Latino populations are linked to smaller knowledge gaps between citizen and non-citizen Latinos

    OpenAIRE

    Perry, Brittany N.; DeSante, Christopher D.

    2015-01-01

    Past research has shown that the political participation of minorities in America is influenced by where they live and work, but few have tested exactly what drives this relationship. In new research, Brittany N. Perry and Christopher D. DeSante assess one possible mechanism: the effect of co-ethnic population size on the acquisition of political knowledge. They find that ethnic context helps condition how people acquire knowledge among people in the same ethnic group, which in turn, affects ...

  11. Information Competencies: Bridging the North-South Knowledge Gap (Mortenson Distinguished Lecture)

    OpenAIRE

    Lau, Jesús

    2003-01-01

    Knowledge is readily available in middle-income developing countries through international information repositories on the Internet. However, most citizens from the Southern Hemisphere do not possess the information skills or information competencies to access, use and understand such knowledge wealth. Most economically evolving developing countries have made progress in education in recent decades, but they still lag behind in information use/generation, such as book and serials production...

  12. Knowledge-based Systems and Interestingness Measures: Analysis with Clinical Datasets

    OpenAIRE

    Christopher, Jabez J.; Khanna H. Nehemiah; Kannan Arputharaj

    2016-01-01

    Knowledge mined from clinical data can be used for medical diagnosis and prognosis. By improving the quality of knowledge base, the efficiency of prediction of a knowledge-based system can be enhanced. Designing accurate and precise clinical decision support systems, which use the mined knowledge, is still a broad area of research. This work analyses the variation in classification accuracy for such knowledge-based systems using different rule lists. The purpose of this work is not to improve...

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

    International Nuclear Information System (INIS)

    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

  14. Hyperspectral remote sensing of vegetation and agricultural crops: knowledge gain and knowledge gap after 40 years of research

    Science.gov (United States)

    Thenkabail, Prasad S.; Lyon, John G.; Huete, Alfredo

    2011-01-01

    The focus of this chapter was to summarize the advances made over last 40+ years, as reported in various chapters of this book, in understanding, modeling, and mapping terrestrial vegetation using hyperspectral remote sensing (or imaging spectroscopy) using sensors that are ground-based, truck-mounted, airborne, and spaceborne. As we have seen in various chapters of this book and synthesized in this chapter, the advances made include: (a) significantly improved characterization and modeling of a wide array of biophysical and biochemical properties of vegetation, (b) ability to discriminate plant species and vegetation types with high degree of accuracies (c) reducing uncertainties in determining net primary productivity or carbon assessments from terrestrial vegetation, (d) improved crop productivity and water productivity models, (b), (e) ability to access stress resulting from causes such as management practices, pests and disease, water deficit or excess; , and (f) establishing more sensitive wavebands and indices to detect plant water\\moisture content. The advent of spaceborne hyperspectral sensors (e.g., NASA’s Hyperion, ESA’s PROBA, and upcoming NASA’s HyspIRI) and numerous methods and techniques espoused in this book to overcome Hughes phenomenon or data redundancy when handling large volumes of hyperspectral data have generated tremendous interest in advancing our hyperspectral applications knowledge base over larger spatial extent such as region, nation, continent, and globe.

  15. "Big Data": Big Knowledge Gaps in the Field of Internet Science

    Directory of Open Access Journals (Sweden)

    Ulf-Dietrich Reips

    2012-01-01

    Full Text Available Research on so-called ‘Big Data’ has received a considerable momentum and is expected to grow in the future. One very interesting stream of research on Big Data analyzes online networks. Many online networks are known to have some typical macro-characteristics, such as ‘small world’ properties. Much less is known about underlying micro-processes leading to these properties. The models used by Big Data researchers usually are inspired by mathematical ease of exposition. We propose to follow in addition a different strategy that leads to knowledge about micro-processes that match with actual online behavior. This knowledge can then be used for the selection of mathematically-tractable models of online network formation and evolution. Insight from social and behavioral research is needed for pursuing this strategy of knowledge generation about micro-processes. Accordingly, our proposal points to a unique role that social scientists could play in Big Data research. ...

  16. Prevalence of HBV Infection and Knowledge of Hepatitis B Among Patients Attending Primary Care Clinics in Poland.

    Science.gov (United States)

    Ganczak, Maria; Dmytrzyk-Daniłów, Gabriela; Korzeń, Marcin; Drozd-Dąbrowska, Marzena; Szych, Zbigniew

    2016-06-01

    It is well known that community awareness of hepatitis B (HB) can lead to vaccination and testing. The study objectives were to assess the prevalence of HBV infection and knowledge of HB among adult patients attending randomly selected primary care clinics. A cross-sectional sero-survey was conducted in March 2013 in the Zgorzelec region, Poland, with the use of an investigator-developed questionnaire containing 22 questions regarding HB knowledge. Serum samples were assayed for anti-HBc total and anti-HBs with enzyme immunoassay. The prevalence of anti-HBc total among 410 participants (median age 56 years) was 10.3 % (95 % CI 7.6-13.8 %), nobody was aware of an infection. The main sources of HB knowledge were the media and medical staff. The mean knowledge score was 14.8 ± 4.9; 76.7 % of the respondents had scores >50 %. Particular gaps were detected relating to knowledge of unprotected sexual intercourse and MTCT; 45.6 % patients were not aware of the potential asymptomatic course of HBV infection, 41.2 % about chronic HB treatment. A patient's low educational level was negatively associated with a high knowledge level; the willingness for further education on HB and HBV vaccination in the past were independently associated with good knowledge. In conclusion, the HBV infection remains a public health threat in Poland, since the prevalence of infection markers in asymptomatic adult patients was high. Knowledge gaps call for awareness campaigns which may increase testing and diagnosis, audiences representing lower education level should be targeted first. Knowledge on HB might serve as an effective tool in decision making regarding vaccination. PMID:26699149

  17. 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.

  18. Experience of targeting subsidies on insecticide-treated nets: what do we know and what are the knowledge gaps?

    Science.gov (United States)

    Worrall, Eve; Hill, Jenny; Webster, Jayne; Mortimer, Julia

    2005-01-01

    Widespread coverage of vulnerable populations with insecticide-treated nets (ITNs) constitutes an important component of the Roll Back Malaria (RBM) strategy to control malaria. The Abuja Targets call for 60% coverage of children under 5 years of age and pregnant women by 2005; but current coverage in Africa is unacceptably low. The RBM 'Strategic Framework for Coordinated National Action in Scaling-up Insecticide-Treated Netting Programmes in Africa' promotes coordinated national action and advocates sustained public provision of targeted subsidies to maximise public health benefits, alongside support and stimulation of the private sector. Several countries have already planned or initiated targeted subsidy schemes either on a pilot scale or on a national scale, and have valuable experience which can inform future interventions. The WHO RBM 'Workshop on mapping models for delivering ITNs through targeted subsidies' held in Zambia in 2003 provided an opportunity to share and document these country experiences. This paper brings together experiences presented at the workshop with other information on experiences of targeting subsidies on ITNs, net treatment kits and retreatment services (ITN products) in order to describe alternative approaches, highlight their similarities and differences, outline lessons learnt, and identify gaps in knowledge. We find that while there is a growing body of knowledge on different approaches to targeting ITN subsidies, there are significant gaps in knowledge in crucial areas. Key questions regarding how best to target, how much it will cost and what outcomes (levels of coverage) to expect remain unanswered. High quality, well-funded monitoring and evaluation of alternative approaches to targeting ITN subsidies is vital to develop a knowledge base so that countries can design and implement effective strategies to target ITN subsidies. PMID:15655010

  19. Boundaries, gaps, and overlaps: defining roles in a multidisciplinary nephrology clinic

    Directory of Open Access Journals (Sweden)

    Stenfors-Hayes T

    2014-10-01

    Full Text Available Terese Stenfors-Hayes,1 Helen H Kang2 1Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden; 2BC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada Abstract: This study aims to explore how health care professionals in a multidisciplinary chronic kidney disease clinic interact with one another, patients, families, and caregivers to expand understanding of how this increasingly common form of chronic disease management functions in situ. Nonparticipatory observations were conducted of 64 consultations between patients and health care professionals and end-of-day rounds at a multidisciplinary chronic kidney disease clinic. Key themes in our findings revolved around the question of boundaries between the health professions that were expected to work cooperatively within the clinic, between medical specialties in the management of complex patients, and between caregivers and patients. Understanding the importance of various professional roles and how they are allocated, either formally as part of care design or organically as a clinical routine, may help us understand how multidisciplinary care teams function in real life and help us identify gaps in practice. This study highlights two areas for further study and reflection: the effect of discrepancies in health information and the role of caregivers in patient care. Keywords: clinical medicine, interprofessional relations, observation, qualitative research

  20. The Distribution of Pedagogical Content Knowledge in Cambodia: Gaps and Thresholds in Math Achievement

    Science.gov (United States)

    Ngo, Federick J.

    2013-01-01

    Increasing teacher quality is a major objective of recent Cambodian education policy. In mathematics education literature, pedagogical content knowledge (PCK) has emerged as a critical component of teacher quality that is strongly linked to student achievement. In this study I use data from a large survey of Cambodian schools to investigate the…

  1. Lost in Translation: The Gap in Scientific Advancements and Clinical Application

    OpenAIRE

    Fernandez-Moure, Joseph S.

    2016-01-01

    The evolution of medicine and medical technology hinges on the successful translation of basic science research from the bench to clinical implementation at the bedside. Out of the increasing need to facilitate the transfer of scientific knowledge to patients, translational research has emerged. Significant leaps in improving global health, such as antibiotics, vaccinations, and cancer therapies, have all seen successes under this paradigm, yet today, it has become increasingly difficult to r...

  2. Lost in Translation: The Gap in Scientific Advancements and Clinical Application

    OpenAIRE

    Joseph eFernandez-Moure

    2016-01-01

    The evolution of medicine and medical technology hinges on the successful translation of basic science research from the bench to clinical implementation at the bedside. Born out of the increasing need to facilitate the transfer of scientific knowledge to patients, translational research has emerged. Significant leaps in improving global health such as antibiotics, vaccinations, and cancer therapies have all seen successes under this paradigm yet today it has become increasingly difficult to ...

  3. The Role of Biomedical Knowledge in Diagnosis of Difficult Clinical Cases

    Science.gov (United States)

    Woods, Nicole N.; Brooks, Lee R.; Norman, Geoffrey R.

    2007-01-01

    Although biomedical knowledge is believed to be of little value in diagnosis of routine clinical cases, studies of clinical reasoning have found that physicians revert to use of basic biomedical knowledge when faced with challenging clinical problems. The current paper presents two experiments that empirically examine the role of biomedical…

  4. Disinfection of stethoscopes: Gap between knowledge and practice in an Indian tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Anshu Jain

    2013-01-01

    Full Text Available Context: Stethoscopes are used primarily to assess the health of patients and are one of the most commonly used medical devices. Thus, are the prominent tools for the spread of health-care associated infections (HAIs. Aims: The study was conducted to assess the knowledge and awareness about handling of the stethoscope and cleaning practices followed among the healthcare workers (HCWs. Materials and Methods: A total of 80 participants were included during a 4-month study period at a tertiary care hospital in Ujjain. A semi-structured questionnaire was distributed to HCWs and the surface of the diaphragm of their stethoscopes were swabbed for bacteriological analysis using standard techniques. Results: Out of total 80 stethoscopes, 69 (86% were found to be contaminated with at least one type of microorganism. Pseudomonas aeruginosa was the most predominant bacterial species found on 58 stethoscopes, followed by Bacillus subtilis (n = 21 and Staphylococcus spp. (n = 16. Out of total 10 S. aureus isolated, 3 were methicillin-resistant S. aureus ( MRSA. Majority (97% of the HCWs had good knowledge about the topic, but only 22 (27% reported to apply it in the practice. Conclusions: Our study confirmed that majority of the stethoscopes were contaminated with microorganisms. Besides having knowledge about the importance of cleaning the stethoscopes, lower percentage of HCWs reported to follow it in practice. Thus, the authors recommend regularization of reminders such as circulars, motivating posters for the HCWs to clean the diaphragm of the stethoscopes.

  5. Team Learning to Narrow the Gap between Healthcare Knowledge and Practice

    Science.gov (United States)

    Anand, Tejwansh S.

    2014-01-01

    This study explored team-based learning in teams of healthcare professionals working on making meaning of evidence-based clinical guidelines in their field to apply them within their practice setting. The research based team learning models posited by Kasl, Marsick, and Dechant (1997) and Edmondson, Dillon, and Roloff (2007) were used as the…

  6. Review of the effects of protection in marine protected areas: current knowledge and gaps

    Directory of Open Access Journals (Sweden)

    Ojeda–Martínez, C.

    2011-06-01

    Full Text Available The effectiveness of marine protected areas (MPAs and the conservation of marine environments must be based on reliable information on the quality of the marine environment that can be obtained in a reasonable timeframe. We reviewed studies that evaluated all aspects related to the effectiveness of MPAs in order to describe how the studies were conducted and to detect fields in which research is lacking. Existing parameters used to evaluate the effectiveness of MPAs are summarised. Two-hundred and twenty-two publications were reviewed. We identified the most commonly used study subjects and methodological approaches. Most of the studies concentrated on biological parameters. Peer reviewed studies were based on control vs. impact design. BACI and mBACI designs were used in very few studies. Through this review, we have identified gaps in the objectives assigned to MPAs and the way in which they have been evaluated. We suggest some guidelines aimedat improving the assessment of the effects of protection in MPAs.

  7. Critical maternal health knowledge gaps in low- and middle-income countries for the post-2015 era.

    Science.gov (United States)

    Kendall, Tamil; Langer, Ana

    2015-01-01

    Effective interventions to promote maternal health and address obstetric complications exist, however 800 women die every day during pregnancy and childbirth from largely preventable causes and more than 90% of these deaths occur in low and middle income countries (LMIC). In 2014, the Maternal Health Task Force consulted 26 global maternal health researchers to identify persistent and critical knowledge gaps to be filled to reduce maternal morbidity and mortality and improve maternal health. The vision of maternal health articulated was comprehensive and priorities for knowledge generation encompassed improving the availability, accessibility, acceptability, and quality of institutional labor and delivery services and other effective interventions, such as contraception and safe abortion services. Respondents emphasized the need for health systems research to identify models that can deliver what is known to be effective to prevent and treat the main causes of maternal death at scale in different contexts and to sustain coverage and quality over time. Researchers also emphasized the development of tools to measure quality of care and promote ongoing quality improvement at the facility, district, and national level. Knowledge generation to improve distribution and retention of healthcare workers, facilitate task shifting, develop and evaluate training models to improve "hands-on" skills and promote evidence-based practice, and increase managerial capacity at different levels of the health system were also prioritized. Interviewees noted that attitudes, behavior, and power relationships between health professionals and within institutions must be transformed to achieve coverage of high-quality maternal health services in LMIC. The increasing burden of non-communicable diseases, urbanization, and the persistence of social and economic inequality were identified as emerging challenges that require knowledge generation to improve health system responses and evaluate

  8. Neurocognitive Adverse Effects of Anesthesia in Adults and Children: Gaps in Knowledge.

    Science.gov (United States)

    Ward, Christopher G; Eckenhoff, Roderic G

    2016-07-01

    Numerous preclinical and clinical studies investigating the neurodevelopmental and neurocognitive effects of exposure to anesthesia and the combination of anesthesia and surgery have demonstrated histopathological and both temporary and long-term cognitive and behavioral effects at the extremes of the human age spectrum. Increasing coverage in the lay press for both our youngest and oldest patient populations has led to heightened concerns regarding the potential harmful side effects of almost all commonly used anesthetic drug regimens. Although the majority of information regarding anesthetic risks in the developing brain derives from preclinical work in rodents, research involving the aged brain has identified a well-defined postoperative cognitive phenotype in humans. While preclinical and clinical data appear to support some association between anesthesia and surgery and the development of detrimental cognitive changes in both the developing and the aged brain, correlation between anesthesia and surgery and poor neurological outcomes does not imply causation. Given this information, no single anesthetic or group of anesthetics can be recommended over any other in terms of causing or preventing negative neurocognitive outcomes in either population. This review summarizes the growing body of preclinical and clinical literature dedicated to the detrimental effects of anesthesia on both the developing and the aging brain. PMID:27098249

  9. Comparisons of Prognosis between Surgically and Clinically Diagnosed Idiopathic Pulmonary Fibrosis Using Gap Model

    Science.gov (United States)

    Lee, Sang Hoon; Kim, Song Yee; Kim, Dong Soon; Kim, Young Whan; Chung, Man Pyo; Uh, Soo Taek; Park, Choon Sik; Jeong, Sung Hwan; Park, Yong Bum; Lee, Hong Lyeol; Shin, Jong Wook; Lee, Eun Joo; Lee, Jin Hwa; Jegal, Yangin; Lee, Hyun Kyung; Kim, Yong Hyun; Song, Jin Woo; Park, Moo Suk

    2016-01-01

    Abstract Although a multidisciplinary approach has become an important criterion for an idiopathic pulmonary fibrosis (IPF) diagnosis, lung biopsies remain crucial. However, the prognosis of patients with surgically diagnosed IPF (sIPF) is uncertain. We aimed to investigate the prognosis of patients with clinically diagnosed IPF (cIPF) and sIPF. In this retrospective observational study, the Korean Interstitial Lung Disease Study Group conducted a national survey to evaluate the clinical, physiological, radiological, and survival characteristics of patients with IPF from January 1, 2003 to December 31, 2007. Patients were recruited from 54 universities and teaching hospitals across the Republic of Korea. IPF diagnoses were established according to the 2002 American Thoracic Society (ATS)/European Respiratory Society criteria (ERS) guideline. A total of 1685 patients with IPF (1027 cIPF and 658 sIPF) were enrolled. Patients with sIPF were significantly younger, predominantly female, and nonsmokers (all P < 0.001). sIPF group had significantly better initial pulmonary function. The proportion of computed tomography-based honeycomb findings of patients with cIPF was higher than in those with sIPF (P < 0.001). A Kaplan-Meier analysis showed that the sIPF group had a better prognosis (P = 0.001). A survival analysis showed that age, pulmonary function parameters, pulmonary oxygen tension, honeycombing change, and combined lung cancer had a significant influence on patient prognosis. However, there was no significant difference in prognosis between the cIPF and sIPF groups after adjusting for GAP (gender, age, physiology) stage. The patients with sIPF had better clinical features than those with cIPF. However, after adjusting for GAP stage, the sIPF group showed similar prognoses as the cIPF group. This study showed that after adjusting for GAP stage, the prognosis of patients with IPF is the same regardless of the diagnostic method used. PMID:26986154

  10. Knowledge Gaps in Cardiovascular Care of the Older Adult Population: A Scientific Statement From the American Heart Association, American College of Cardiology, and American Geriatrics Society.

    Science.gov (United States)

    Rich, Michael W; Chyun, Deborah A; Skolnick, Adam H; Alexander, Karen P; Forman, Daniel E; Kitzman, Dalane W; Maurer, Mathew S; McClurken, James B; Resnick, Barbara M; Shen, Win K; Tirschwell, David L

    2016-05-24

    The incidence and prevalence of most cardiovascular disorders increase with age, and cardiovascular disease is the leading cause of death and major disability in adults ≥75 years of age; however, despite the large impact of cardiovascular disease on quality of life, morbidity, and mortality in older adults, patients aged ≥75 years have been markedly underrepresented in most major cardiovascular trials, and virtually all trials have excluded older patients with complex comorbidities, significant physical or cognitive disabilities, frailty, or residence in a nursing home or assisted living facility. As a result, current guidelines are unable to provide evidence-based recommendations for diagnosis and treatment of older patients typical of those encountered in routine clinical practice. The objectives of this scientific statement are to summarize current guideline recommendations as they apply to older adults, identify critical gaps in knowledge that preclude informed evidence-based decision making, and recommend future research to close existing knowledge gaps. To achieve these objectives, we conducted a detailed review of current American College of Cardiology/American Heart Association and American Stroke Association guidelines to identify content and recommendations that explicitly targeted older patients. We found that there is a pervasive lack of evidence to guide clinical decision making in older patients with cardiovascular disease, as well as a paucity of data on the impact of diagnostic and therapeutic interventions on key outcomes that are particularly important to older patients, such as quality of life, physical function, and maintenance of independence. Accordingly, there is a critical need for a multitude of large population-based studies and clinical trials that include a broad spectrum of older patients representative of those seen in clinical practice and that incorporate relevant outcomes important to older patients in the study design. The

  11. 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.

  12. Knowledge of sexually transmitted infections among women attending primary health care clinics in Moshi, Tanzania.

    OpenAIRE

    2011-01-01

    Introduction Untreated STIs may have serious complications. Knowledge of STIs is important in order to prevent this, and to promote care seeking and treatment. Previous studies have found knowledge to be associated with sexual behavior and socioeconomical factors. The aim of our study was to describe the knowledge of STIs among women attending primary health care clinics in Moshi, Tanzania, to identify their sources of knowledge and evaluate if the level of knowledge is associated with soc...

  13. Biological transfer of radionuclides in marine environments - Identifying and filling knowledge gaps for environmental impact assessments

    International Nuclear Information System (INIS)

    A review on concentration factors (CF) for the marine environment was conducted in order to consider the relevance of existing data from the perspective of environmental protection and to identify areas of data paucity. Data have been organised in a format compatible with a reference organism approach, for selected radionuclides, and efforts have been taken to identify the factors that may be of importance in the context of dosimetric and dose-effects analyses. These reference organism categories had been previously selected by identifying organism groups that were likely to experience the highest levels of radiation exposure, owing to high uptake levels or residence in a particular habitat, for defined scenarios. Significant data gaps in the CF database have been identified, notably for marine mammals and birds. Most empirical information pertains to a limit suite of radionuclides, particularly 137Cs, 210Po and 99Tc. A methodology has been developed to help bridge this information deficit. This has been based on simple dynamic, biokinetic models that mainly use parameters derived from laboratory-based study and field observation. In some cases, allometric relationships have been employed to allow further model parameterization. Initial testing of the model by comparing model output with empirical data sets suggest that the models provide sensible equilibrium CFs. Furthermore, analyses of modelling results suggest that for some radionuclides, in particularly those with long effective half-lives, the time to equilibrium can be far greater than the life-time of an organism. This clearly emphasises the limitations of applying a universal equilibrium approach. The methodology, therefore, has an added advantage that non-equilibrium scenarios can be considered in a more rigorous manner. Further refinements to the modelling approach might be attained by exploring the importance of various model parameters, through sensitivity analyses, and by identifying those parameters

  14. Health effects and toxicity mechanisms of rare earth elements-Knowledge gaps and research prospects.

    Science.gov (United States)

    Pagano, Giovanni; Guida, Marco; Tommasi, Franca; Oral, Rahime

    2015-05-01

    In the recent decades, rare earth elements (REE) have undergone a steady spread in several industrial and medical applications, and in agriculture. Relatively scarce information has been acquired to date on REE-associated biological effects, from studies of bioaccumulation and of bioassays on animal, plant and models; a few case reports have focused on human health effects following occupational REE exposures, in the present lack of epidemiological studies of occupationally exposed groups. The literature is mostly confined to reports on few REE, namely cerium and lanthanum, whereas substantial information gaps persist on the health effects of other REE. An established action mechanism in REE-associated health effects relates to modulating oxidative stress, analogous to the recognized redox mechanisms observed for other transition elements. Adverse outcomes of REE exposures include a number of endpoints, such as growth inhibition, cytogenetic effects, and organ-specific toxicity. An apparent controversy regarding REE-associated health effects relates to opposed data pointing to either favorable or adverse effects of REE exposures. Several studies have demonstrated that REE, like a number of other xenobiotics, follow hormetic concentration-related trends, implying stimulatory or protective effects at low levels, then adverse effects at higher concentrations. Another major role for REE-associated effects should be focused on pH-dependent REE speciation and hence toxicity. Few reports have demonstrated that environmental acidification enhances REE toxicity; these data may assume particular relevance in REE-polluted acidic soils and in REE mining areas characterized by concomitant REE and acid pollution. The likely environmental threats arising from REE exposures deserve a new line of research efforts. PMID:25679485

  15. 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.

  16. Guest Editorial: Evidence-based practice in wound care: Toward addressing our knowledge gaps

    Directory of Open Access Journals (Sweden)

    Kath M. Bogie, DPhil

    2011-03-01

    Full Text Available Chronic nonhealing wounds are a major complication for many veterans. Particularly at risk are veterans with reduced mobility, such as those who have suffered a spinal cord injury (SCI. Chronic wounds cause significant suffering, including profound negative effects on general physical health, socialization, financial status, body image, level of independence, and control. For individuals with SCI, the development of a pressure ulcer is one of the leading causes of readmission to the hospital after acute rehabilitation and a major source of morbidity and even mortality. The management of chronic wounds is also extremely costly for clinical facilities, from the acute care setting to long-term care.

  17. Bicuspid Aortic Valve Disease and Ascending Aortic Aneurysms: Gaps in Knowledge

    Directory of Open Access Journals (Sweden)

    Katie L. Losenno

    2012-01-01

    Full Text Available The bicuspid aortic valve is the most common congenital cardiac anomaly in developed nations. The abnormal bicuspid morphology of the aortic valve results in valvular dysfunction and subsequent hemodynamic derangements. However, the clinical presentation of bicuspid aortic valve disease remains quite heterogeneous with patients presenting from infancy to late adulthood with variable degrees of valvular stenosis and insufficiency and associated abnormalities including aortic coarctation, hypoplastic left heart structures, and ascending aortic dilatation. Emerging evidence suggests that the heterogeneous presentation of bicuspid aortic valve phenotypes may be a more complex matter related to congenital, genetic, and/or connective tissue abnormalities. Optimal management of patients with BAV disease and associated ascending aortic aneurysms often requires a thoughtful approach, carefully assessing various risk factors of the aortic valve and the aorta and discerning individual indications for ongoing surveillance, medical management, and operative intervention. We review current concepts of anatomic classification, pathophysiology, natural history, and clinical management of bicuspid aortic valve disease with associated ascending aortic aneurysms.

  18. Bionomics of temperate and tropical Culicoides midges: knowledge gaps and consequences for transmission of Culicoides-borne viruses.

    Science.gov (United States)

    Purse, B V; Carpenter, S; Venter, G J; Bellis, G; Mullens, B A

    2015-01-01

    Culicoides midges are abundant hematophagous flies that vector arboviruses of veterinary and medical importance. Dramatic changes in the epidemiology of Culicoides-borne arboviruses have occurred since 1998, including the emergence of exotic viruses in northern temperate regions, increases in global disease incidence, and enhanced virus diversity in tropical zones. Drivers may include changes in climate, land use, trade, and animal husbandry. New Culicoides species and new wild reservoir hosts have been implicated in transmission, highlighting the dynamic nature of pathogen-vector-host interactions. Focusing on potential vector species worldwide and key elements of vectorial capacity, we review the sensitivity of Culicoides life cycles to abiotic and biotic factors. We consider implications for designing control measures and understanding impacts of environmental change in different ecological contexts. Critical geographical, biological, and taxonomic knowledge gaps are prioritized. Recent developments in genomics and mathematical modeling may enhance ecological understanding of these complex arbovirus systems. PMID:25386725

  19. Gaming as an Educational Strategy to Enhance Clinical Judgment and Knowledge Retention

    Science.gov (United States)

    Lane, Jodie

    2011-01-01

    Classroom lecture methods in nursing education are falling short of providing long-term retention of knowledge and do not enhance problem solving skills or clinical judgment at the bedside. This problem impacts the health care recipients because applied knowledge and an enhanced skill set can provide nurses with confident clinical judgment to…

  20. Health Care Providers' Knowledge and Practice Gap towards Joint Zoonotic Disease Surveillance System: Challenges and Opportunities, Gomma District, Southwest Ethiopia.

    Science.gov (United States)

    Gemeda, Desta Hiko; Sime, Abiot Girma; Hajito, Kifle Woldemichael; Gelalacha, Benti Deresa; Tafese, Wubit; Gebrehiwot, Tsegaye Tewelde

    2016-01-01

    Background. Health care providers play a crucial role for realization of joint zoonotic diseases surveillance by human and animal health sectors, yet there is limited evidence. Hence, this study aimed to determine knowledge and practice gap of health care providers towards the approach for Rabies and Anthrax in Southwest Ethiopia. Methods. A cross-sectional survey was conducted from December 16, 2014, to January 14, 2015. Eligible health care providers were considered for the study. Data were entered in to Epi-data version 3.1 and analyzed using SPSS version 20. Results. A total of 323 (92.02%) health care providers participated in the study. Three hundred sixteen (97.8%) of participants reported that both human and animal health sectors can work together for zoonotic diseases while 96.9% of them replied that both sectors can jointly conduct surveillance. One hundred seventeen (36.2%) of them reported that their respective sectors had conducted joint surveillance for zoonotic diseases. Their involvement was, however, limited to joint outbreak response. Conclusion. There is good opportunity in health care providers' knowledge even though the practice was unacceptably low and did not address all surveillance components. Therefore, formal joint surveillance structure should be in place for optimal implementation of surveillance. PMID:27579311

  1. 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. PMID:26829187

  2. Evaluation of water, sanitation and hygiene program outcomes shows knowledge-behavior gaps in Coast Province, Kenya

    Science.gov (United States)

    Schlegelmilch, Michael Paul; Lakhani, Amyn; Saunders, Leslie Duncan; Jhangri, Gian Singh

    2016-01-01

    Introduction Water related diseases constitute a significant proportion of the burden of disease in Kenya. Water, sanitation and hygiene (WASH) programs are in operation nation-wide to address these challenges. This study evaluated the impact of the Sombeza Water and Sanitation Improvement Program (SWASIP) in Coast Province, Kenya. Methods This study is a cluster randomized, follow-up evaluation that compared baseline (2007) to follow-up (2013) indicators from 250 households. Twenty-five villages were selected with probability proportional to size sampling, and ten households were selected randomly from each village. Follow-up data were collected by in-person interviews using pre-tested questionnaires, and analyzed to compare indicators collected at baseline. Cross-sectional results from the follow-up data were also reported. Results Statistically significant improvements from baseline were observed in the proportions of respondents with latrine access at home, who washed their hands after defecation, who treated their household drinking water and the average time to collect water in the dry season. However, this study also observed significant decreases in the proportion of respondents who washed their hands before preparing their food, or feeding their children, and after attending to a child who has defecated. The analysis also revealed a knowledge-behavior gap in WASH behaviors. Conclusion SWASIP contributed to improvements from baseline, but further progress still needs to be seen. The findings challenge the assumption that providing infrastructure and knowledge will result in behavior change. Further understanding of specific, non-knowledge predictors of WASH related behavior is needed. PMID:27279970

  3. Evaluation of PICO as a Knowledge Representation for Clinical Questions

    OpenAIRE

    Huang, Xiaoli; Lin, Jimmy; Demner-Fushman, Dina

    2006-01-01

    The paradigm of evidence-based medicine (EBM) recommends that physicians formulate clinical questions in terms of the problem/population, intervention, comparison, and outcome. Together, these elements comprise a PICO frame. Although this framework was developed to facilitate the formulation of clinical queries, the ability of PICO structures to represent physicians’ information needs has not been empirically investigated. This paper evaluates the adequacy and suitability of PICO frames as a ...

  4. Filling Gaps in Biodiversity Knowledge for Macrofungi: Contributions and Assessment of an Herbarium Collection DNA Barcode Sequencing Project

    Science.gov (United States)

    Osmundson, Todd W.; Robert, Vincent A.; Schoch, Conrad L.; Baker, Lydia J.; Smith, Amy; Robich, Giovanni; Mizzan, Luca; Garbelotto, Matteo M.

    2013-01-01

    Despite recent advances spearheaded by molecular approaches and novel technologies, species description and DNA sequence information are significantly lagging for fungi compared to many other groups of organisms. Large scale sequencing of vouchered herbarium material can aid in closing this gap. Here, we describe an effort to obtain broad ITS sequence coverage of the approximately 6000 macrofungal-species-rich herbarium of the Museum of Natural History in Venice, Italy. Our goals were to investigate issues related to large sequencing projects, develop heuristic methods for assessing the overall performance of such a project, and evaluate the prospects of such efforts to reduce the current gap in fungal biodiversity knowledge. The effort generated 1107 sequences submitted to GenBank, including 416 previously unrepresented taxa and 398 sequences exhibiting a best BLAST match to an unidentified environmental sequence. Specimen age and taxon affected sequencing success, and subsequent work on failed specimens showed that an ITS1 mini-barcode greatly increased sequencing success without greatly reducing the discriminating power of the barcode. Similarity comparisons and nonmetric multidimensional scaling ordinations based on pairwise distance matrices proved to be useful heuristic tools for validating the overall accuracy of specimen identifications, flagging potential misidentifications, and identifying taxa in need of additional species-level revision. Comparison of within- and among-species nucleotide variation showed a strong increase in species discriminating power at 1–2% dissimilarity, and identified potential barcoding issues (same sequence for different species and vice-versa). All sequences are linked to a vouchered specimen, and results from this study have already prompted revisions of species-sequence assignments in several taxa. PMID:23638077

  5. Filling gaps in biodiversity knowledge for macrofungi: contributions and assessment of an herbarium collection DNA barcode sequencing project.

    Directory of Open Access Journals (Sweden)

    Todd W Osmundson

    Full Text Available Despite recent advances spearheaded by molecular approaches and novel technologies, species description and DNA sequence information are significantly lagging for fungi compared to many other groups of organisms. Large scale sequencing of vouchered herbarium material can aid in closing this gap. Here, we describe an effort to obtain broad ITS sequence coverage of the approximately 6000 macrofungal-species-rich herbarium of the Museum of Natural History in Venice, Italy. Our goals were to investigate issues related to large sequencing projects, develop heuristic methods for assessing the overall performance of such a project, and evaluate the prospects of such efforts to reduce the current gap in fungal biodiversity knowledge. The effort generated 1107 sequences submitted to GenBank, including 416 previously unrepresented taxa and 398 sequences exhibiting a best BLAST match to an unidentified environmental sequence. Specimen age and taxon affected sequencing success, and subsequent work on failed specimens showed that an ITS1 mini-barcode greatly increased sequencing success without greatly reducing the discriminating power of the barcode. Similarity comparisons and nonmetric multidimensional scaling ordinations based on pairwise distance matrices proved to be useful heuristic tools for validating the overall accuracy of specimen identifications, flagging potential misidentifications, and identifying taxa in need of additional species-level revision. Comparison of within- and among-species nucleotide variation showed a strong increase in species discriminating power at 1-2% dissimilarity, and identified potential barcoding issues (same sequence for different species and vice-versa. All sequences are linked to a vouchered specimen, and results from this study have already prompted revisions of species-sequence assignments in several taxa.

  6. 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

    2016-01-01

    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

  7. Occupational therapists and patients’ rights: their level of Clinical knowledge

    OpenAIRE

    Dehghan, Leila; Dalvand, Hamid; Haghgoo, Hojjat Allah; Hosseini, Seyed Ali; Karimlou, Masoud

    2013-01-01

    Addressing patients’ rights issues brings occupational therapists ethical and political responsibilities that involve patients’ privileges and new facilitating factors which influence their needs. The goal of this study was to determine the level of occupational therapists’ knowledge about patients’ rights. The present research was a cross-sectional study which involved 125 occupational therapists chosen by a convenience sampling strategy in Tehran during the year of 2012. A four-part questio...

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

    Directory of Open Access Journals (Sweden)

    Huser V

    2014-09-01

    Full Text Available Vojtech Huser,1 Murat Sincan,2,3 James J Cimino1,4 1Laboratory for Informatics Development, National Institutes of Health Clinical Center, Bethesda, MD, USA; 2Undiagnosed Diseases Program, 3Office of the Clinical Director, National Human Genome Research Institute, National Institutes of Health, MD, USA; 4National Library of Medicine, National Institutes of Health, MD, USA Abstract: 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. Keywords: personalized medicine, knowledge bases, databases, clinical decision support, clinical informatics

  9. Gaps in Menopause Knowledge

    OpenAIRE

    Yum, Sun Kyoung; Kim, Tak

    2014-01-01

    The average middle aged woman goes through a volatile period of endocrine fluctuations as she passes through menopause and the stages that precede and follow it. Ovarian hormones are steroid hormones. They readily cross the cell and nuclear membranes and influence transcription of numerous genes. Such influences are tissue specific and state specific. In short, changes in ovarian hormones mean that a women will experience changes in her entire body systems. When an individual woman's constitu...

  10. Barriers to Clinical Trial Participation: Comparing Perceptions and Knowledge of African American and White South Carolinians.

    Science.gov (United States)

    Kim, Sei-Hill; Tanner, Andrea; Friedman, Daniela B; Foster, Caroline; Bergeron, Caroline

    2015-01-01

    Analyzing data from a survey of African American and White residents in South Carolina, this study attempts to understand how to better promote clinical trial participation specifically within the African American population. To explore why participation is lower in the African American population, the authors examined two sets of potential barriers: structural/procedural (limited accessibility, lack of awareness, doctors not discussing clinical trial options, lack of health insurance) and cognitive/psychological (lack of subjective and factual knowledge, misperceptions, distrust, fear, perceived risk). Findings revealed that African Americans were significantly less willing than Whites to participate in a clinical trial. African Americans also had lower subjective and factual knowledge about clinical trials and perceived greater risk involved in participating in a clinical trial. The authors found that lack of subjective knowledge and perceived risk were significant predictors of African Americans' willingness to participate in a clinical trial. Implications of the findings are discussed in detail. PMID:26042496

  11. Bridging the Gap between Scientific and Indigenous knowledge to Better Understand Social Impacts of Changing Rainfall Regimes

    Science.gov (United States)

    Lynch, A. H.; Joachim, L.; Zhu, X.; Hammer, C.; Harris, M.; Griggs, D.

    2011-12-01

    The Murray-Darling Basin incorporates Australia's three longest rivers and is important for an agricultural industry worth more than $9 billion per annum, a rich biodiversity of habitat and species, and the very life of its traditional owners. The complex and sometimes enigmatic relationships between modes of variability and Australian regional rainfall distribution means that reliable projections of future water availability remain highly uncertain. Persistent drought, with associated heat stress and high fire danger, and episodic flooding rains present further challenges. Indeed, recent extremes likely herald a tipping point for the communities and ecosystems that rely on the river system. The Barmah-Millewa region in the Murray-Darling Basin is the heart of Yorta Yorta Traditional Tribal Lands. The Yorta Yorta continue to assert their inherent rights to country and have shown through oral, documentary and material evidence, that their social, spiritual, economic and cultural links with country have never been broken. Current water policy and practice, highly contested community consultation processes, cross-border governance issues and a changing social landscape create in this region a microcosm for understanding the complex demands of economic, environmental and cultural security along the Murray-Darling Basin as the climate changes. New approaches to bridging the gap between scientific and Indigenous epistemologies have emerged in recent years, including for example ecosystem-based adaptation (Vignola et al. 2009) and the analysis of cultural water flows (Weir 2010). The potential for innovation using these approaches has informed a study that investigates how the deep knowledge of country of the Yorta Yorta people can be combined with state of the art climate science to develop a better understanding of the competing demands on water resources in the Barmah-Millewa region now and in the future. An important dimension of this collaborative work with the Yorta

  12. Knowledge-data integration for temporal reasoning in a clinical trial system.

    Science.gov (United States)

    O'Connor, Martin J; Shankar, Ravi D; Parrish, David B; Das, Amar K

    2009-04-01

    Managing time-stamped data is essential to clinical research activities and often requires the use of considerable domain knowledge. Adequately representing and integrating temporal data and domain knowledge is difficult with the database technologies used in most clinical research systems. There is often a disconnect between the database representation of research data and corresponding domain knowledge of clinical research concepts. In this paper, we present a set of methodologies for undertaking ontology-based specification of temporal information, and discuss their application to the verification of protocol-specific temporal constraints among clinical trial activities. Our approach allows knowledge-level temporal constraints to be evaluated against operational trial data stored in relational databases. We show how the Semantic Web ontology and rule languages OWL and SWRL, respectively, can support tools for research data management that automatically integrate low-level representations of relational data with high-level domain concepts used in study design. PMID:18789876

  13. Gap between evidence and physicians' knowledge and practice regarding hypertension and its drug treatment: a survey in a Chinese city

    Institute of Scientific and Technical Information of China (English)

    WANG Wei-zhong; TANG Jin-ling; HU Yong-hua; AN Jian-gang; WANG Yan-ling; REN Zhong-he; ZHANG Hong; Sian Griffiths

    2011-01-01

    Background Evidence-based medicine has come into its second decade. How prepared clinicians are in practicing it in particular in developing countries remains unclear. Thus we conducted this survey of physicians in urban hospitals in China to determine the size of the gap between research evidence and physicians' knowledge and practice regarding antihypertensive drugs for primary prevention of cardiovascular diseases in China.Methods A cross sectional survey by a face-to-face interview was conducted in 20 tertiary general hospitals in China in 2005. A total of 444 physicians (mostly cardiologists) in internal medicine who had treated at least one hypertensive patient in the past 12 months were invited for the interview on their perception of the cardiovascular risk of hypertension,the magnitude of the benefit of antihypertensive drugs, knowledge on the overall risk approach, first-line drugs used, the risk above which drug treatment is recommended, and knowledge on evidence-based medicine.Results A total of 444 of the 468 eligible physicians were successfully interviewed with a response rate of 94.9%. They estimated that a hypertensive man with an actual 5-year cardiovascular risk of 8.4% would have a 5-year cardiovascular risk of 40% (95% CI: 38% to 42%) if not treated, and have an absolute risk reduction and relative risk reduction from drug treatment by 20% (95% CI. 18% to 22%) and 39% (95% CI: 37% to 42%) respectively, as compared to 3.3% and 33%respectively shown in research evidence. On average, the physicians would recommend drug treatment at a number needed to treat (NNT) of 368 or smaller, as compared to the actual NNT of 50 for drug treatment in an average hypertensive Chinese. Fifty-five percent (95% CI: 50% to 59%) of them had never intently used the national hypertension guidelines. The majority still prescribed drugs primarily based on blood pressure alone by ignoring other risk factors or the overall risk and 78% (95 % C/. 76% to 83%) used new

  14. Eating disorders - knowledge, attitudes, management and clinical experience of Norwegian dentists

    OpenAIRE

    Johansson, Ann-Katrin; Johansson, Anders; Nohlert, Eva; Norring, Claes; Åstrøm, Anne N; Tegelberg, Åke

    2015-01-01

    Background: The purpose of this study was to investigate knowledge, attitudes and clinical experience with regard to patients with eating disorders (ED) among Norwegian dentists. Methods: In 2010, a questionnaire was sent to all dentists in Norway (N = 4282) comprising 33 questions related to demographics of the participating dentists, their knowledge of ED (general and oral health aspects), clinical experience, attitudes and perceived management preferences. Results: The participation rate w...

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

    OpenAIRE

    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 inhouse complementary knowledge in firm decision to license an invention from an Academic Medical Center. By using patent data to describe the technology portfolio of firms who look at...

  16. Knowledge systems, health care teams, and clinical practice: a study of successful change

    OpenAIRE

    Olson, Curtis A.; Tooman, Tricia R.; Alvarado, Carla J.

    2010-01-01

    Clinical teams are of growing importance to healthcare delivery, but little is known about how teams learn and change their clinical practice. We examined how teams in three US hospitals succeeded in making significant practice improvements in the area of antimicrobial resistance. This was a qualitative cross-case study employing Soft Knowledge Systems as a conceptual framework. The purpose was to describe how teams produced, obtained, and used knowledge and information to bring about success...

  17. Eating disorders - knowledge, attitudes, management and clinical experience of Norwegian dentists

    OpenAIRE

    Johansson, Ann-Katrin; Johansson, Anders; Nohlert, Eva; Norring, Claes; Åstrøm, Anne N; Tegelberg, Åke

    2015-01-01

    Background The purpose of this study was to investigate knowledge, attitudes and clinical experience with regard to patients with eating disorders (ED) among Norwegian dentists. Methods In 2010, a questionnaire was sent to all dentists in Norway (N = 4282) comprising 33 questions related to demographics of the participating dentists, their knowledge of ED (general and oral health aspects), clinical experience, attitudes and perceived management preferences. Results The participation rate was ...

  18. Knowledge Creation in Clinical Product Development Management Research

    DEFF Research Database (Denmark)

    Karlsson, Christer; Sköld, Martin

    2012-01-01

    This paper explores the clinical approach to management research and positions it in relation to other similar approaches. It achieves this by pointing out the most important historical milestones in the development of such approaches. The literature on the approach is mapped, including that on the...... most adjacent approaches, in order to characterize and position the different approaches. Field or application data are used to identify how the approach has been used and developed in publications in major journals in the field. After the introduction, which presents the brief characteristics of the...

  19. Retention of Basic Sciences Knowledge at Clinical Years of Medical Curriculum

    OpenAIRE

    Lazić, Elvira; Dujmović, Josip; Hren, Darko

    2006-01-01

    Aim: To explore the association between the knowledge of basic (physiology and biochemistry) and clinical sciences (internal medicine) among medical students, and determine the level of retained basic science knowledge at the fifth year of medical studies. Methods: Medical students attending the second (n = 145, response rate 60%) or the fifth year (n = 176, response rate 73%) of medical studies at the Zagreb University School of Medicine in Croatia were given an anonymous knowledge test w...

  20. AMSSM Position Statement on Cardiovascular Preparticipation Screening in Athletes: Current Evidence, Knowledge Gaps, Recommendations, and Future Directions.

    Science.gov (United States)

    Drezner, Jonathan A; OʼConnor, Francis G; Harmon, Kimberly G; Fields, Karl B; Asplund, Chad A; Asif, Irfan M; Price, David E; Dimeff, Robert J; Bernhardt, David T; Roberts, William O

    2016-09-01

    Cardiovascular (CV) screening in young athletes is widely recommended and routinely performed before participation in competitive sports. While there is general agreement that early detection of cardiac conditions at risk for sudden cardiac arrest and death (SCA/D) is an important objective, the optimal strategy for CV screening in athletes remains an issue of considerable debate. At the center of the controversy is the addition of a resting electrocardiogram (ECG) to the standard preparticipation evaluation using history and physical examination. The American Medical Society for Sports Medicine (AMSSM) formed a task force to address the current evidence and knowledge gaps regarding preparticipation CV screening in athletes from the perspective of a primary care sports medicine physician. The absence of definitive outcomes-based evidence at this time precludes AMSSM from endorsing any single or universal CV screening strategy for all athletes including legislative mandates. This statement presents a new paradigm to assist the individual physician in assessing the most appropriate CV screening strategy unique to their athlete population, community needs, and resources. The decision to implement a CV screening program, with or without the addition of ECG, necessitates careful consideration of the risk of SCA/D in the targeted population and the availability of cardiology resources and infrastructure. Importantly, it is the individual physician's assessment in the context of an emerging evidence base that the chosen model for early detection of cardiac disorders in the specific population provides greater benefit than harm. American Medical Society for Sports Medicine is committed to advancing evidenced-based research and educational initiatives that will validate and promote the most efficacious strategies to foster safe sport participation and reduce SCA/D in athletes. PMID:27598018

  1. Neonicotinoid Insecticides and Their Impacts on Bees: A Systematic Review of Research Approaches and Identification of Knowledge Gaps.

    Science.gov (United States)

    Lundin, Ola; Rundlöf, Maj; Smith, Henrik G; Fries, Ingemar; Bommarco, Riccardo

    2015-01-01

    It has been suggested that the widespread use of neonicotinoid insecticides threatens bees, but research on this topic has been surrounded by controversy. In order to synthesize which research approaches have been used to examine the effect of neonicotinoids on bees and to identify knowledge gaps, we systematically reviewed research on this subject that was available on the Web of Science and PubMed in June 2015. Most of the 216 primary research studies were conducted in Europe or North America (82%), involved the neonicotinoid imidacloprid (78%), and concerned the western honey bee Apis mellifera (75%). Thus, little seems to be known about neonicotinoids and bees in areas outside Europe and North America. Furthermore, because there is considerable variation in ecological traits among bee taxa, studies on honey bees are not likely to fully predict impacts of neonicotinoids on other species. Studies on crops were dominated by seed-treated maize, oilseed rape (canola) and sunflower, whereas less is known about potential side effects on bees from the use of other application methods on insect pollinated fruit and vegetable crops, or on lawns and ornamental plants. Laboratory approaches were most common, and we suggest that their capability to infer real-world consequences are improved when combined with information from field studies about realistic exposures to neonicotinoids. Studies using field approaches often examined only bee exposure to neonicotinoids and more field studies are needed that measure impacts of exposure. Most studies measured effects on individual bees. We suggest that effects on the individual bee should be linked to both mechanisms at the sub-individual level and also to the consequences for the colony and wider bee populations. As bees are increasingly facing multiple interacting pressures future research needs to clarify the role of neonicotinoids in relative to other drivers of bee declines. PMID:26313444

  2. Preventing introduction of livestock associated MRSA in a pig population--benefits, costs, and knowledge gaps from the Swedish perspective.

    Directory of Open Access Journals (Sweden)

    Sören Höjgård

    Full Text Available Antibiotic resistance is a growing concern in human, as well as in veterinary medicine. Part of the problem concerns how to respond to the risk presented by animal reservoirs of resistant bacteria with the potential of spreading to humans. One example is livestock associated methicillin-resistant Staphylococcus aureus (LA-MRSA. In countries where LA-MRSA is endemic in the pig population, people in contact with pigs have a higher risk of being colonised with LA-MRSA, and persons from this group are subjected to precautionary measures when visiting health care facilities. In the present study, it is assumed that, if LA-MRSA was introduced to the Swedish pig population, the prevalence in the risk groups would be the same as in Denmark or the Netherlands (two countries with low human prevalence that have implemented measures to detect, trace and isolate human LA-MRSA cases and, therefore, have comprehensive data with good coverage regarding prevalence of LA-MRSA, and that similar interventions would be taken in Swedish health care facilities. It is also assumed that the Swedish pig population is free of MRSA or that the prevalence is very low. We analyse if it would be efficient for Sweden to prevent its introduction by testing imported live breeding pigs. Given that quarantining and testing at import will prevent introduction to the pig population, the study shows that the preventive measures may indeed generate a societal net benefit. Benefits are estimated to be between € 870 720 and € 1 233 511, and costs to € 211 129. Still, due to gaps in knowledge, the results should be confirmed when more information become available.

  3. Lost in Translation: The Gap in Scientific Advancements and Clinical Application.

    Science.gov (United States)

    Fernandez-Moure, Joseph S

    2016-01-01

    The evolution of medicine and medical technology hinges on the successful translation of basic science research from the bench to clinical implementation at the bedside. Out of the increasing need to facilitate the transfer of scientific knowledge to patients, translational research has emerged. Significant leaps in improving global health, such as antibiotics, vaccinations, and cancer therapies, have all seen successes under this paradigm, yet today, it has become increasingly difficult to realize this ideal scenario. As hospital revenue demand increases, and financial support declines, clinician-protected research time has been limited. Researchers, likewise, have been forced to abandon time- and resource-consuming translational research to focus on publication-generating work to maintain funding and professional advancement. Compared to the surge in scientific innovation and new fields of science, realization of transformational scientific findings in device development and materials sciences has significantly lagged behind. Herein, we describe: how the current scientific paradigm struggles in the new health-care landscape; the obstacles met by translational researchers; and solutions, both public and private, to overcoming those obstacles. We must rethink the old dogma of academia and reinvent the traditional pathways of research in order to truly impact the health-care arena and ultimately those that matter most: the patient. PMID:27376058

  4. Lost in Translation: The Gap in Scientific Advancements and Clinical Application

    Directory of Open Access Journals (Sweden)

    Joseph eFernandez-Moure

    2016-06-01

    Full Text Available The evolution of medicine and medical technology hinges on the successful translation of basic science research from the bench to clinical implementation at the bedside. Born out of the increasing need to facilitate the transfer of scientific knowledge to patients, translational research has emerged. Significant leaps in improving global health such as antibiotics, vaccinations, and cancer therapies have all seen successes under this paradigm yet today it has become increasingly difficult to realize this ideal scenario. As hospital revenue demand increase, and financial support declines, clinician protected research time has been limited. Researchers, likewise, have been forced to abandon time and resource consuming translational research to focus on publication generating work to maintain funding and professional advancement. Compared to the surge in scientific innovation and new fields of science have surged, realization of transformational scientific findings in device development and materials sciences has significantly lagged behind. Herein, we describe: how the current scientific paradigm struggles in the new health-care landscape; the obstacles met by translational researchers; and solutions, both public and private, to overcoming those obstacles. We must rethink the old dogma of academia and reinvent the traditional pathways of research in order to truly impact the health-care arena and ultimately those that matter most: the patient.

  5. PSYCHIATRIC CLINICAL PLACEMENT UPON NURSING STUDENTS PERCEIVED KNOWLEDGE IN CARING FOR MENTALLY ILL

    OpenAIRE

    Herry Prasetyo

    2012-01-01

    Background: The implementation of a psychiatric clinical placement has been an integral component in Indonesia Nursing Academies. Purpose: The research was to investigate how nursing students’ perceived knowledge in caring for mentally ill patients as a result of their psychiatric clinical placement. Method: A descriptive survey design commonly called non-experimental design was used in this research. Students, who had completed two weeks in a psychiatric clinical placement as a component of ...

  6. 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 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 was highly dependent on the individual nurses' practical ability to participate in the game. Furthermore, the nurses colluded in their mutual communication to enable the collective display and sense of knowing that protected them against explicit signs of uncertainty about the clinic...

  7. Comparisons of Prognosis between Surgically and Clinically Diagnosed Idiopathic Pulmonary Fibrosis Using Gap Model: A Korean National Cohort Study.

    Science.gov (United States)

    Lee, Sang Hoon; Kim, Song Yee; Kim, Dong Soon; Kim, Young Whan; Chung, Man Pyo; Uh, Soo Taek; Park, Choon Sik; Jeong, Sung Hwan; Park, Yong Bum; Lee, Hong Lyeol; Shin, Jong Wook; Lee, Eun Joo; Lee, Jin Hwa; Jegal, Yangin; Lee, Hyun Kyung; Kim, Yong Hyun; Song, Jin Woo; Park, Moo Suk

    2016-03-01

    Although a multidisciplinary approach has become an important criterion for an idiopathic pulmonary fibrosis (IPF) diagnosis, lung biopsies remain crucial. However, the prognosis of patients with surgically diagnosed IPF (sIPF) is uncertain. We aimed to investigate the prognosis of patients with clinically diagnosed IPF (cIPF) and sIPF.In this retrospective observational study, the Korean Interstitial Lung Disease Study Group conducted a national survey to evaluate the clinical, physiological, radiological, and survival characteristics of patients with IPF from January 1, 2003 to December 31, 2007. Patients were recruited from 54 universities and teaching hospitals across the Republic of Korea. IPF diagnoses were established according to the 2002 American Thoracic Society (ATS)/European Respiratory Society criteria (ERS) guideline. A total of 1685 patients with IPF (1027 cIPF and 658 sIPF) were enrolled.Patients with sIPF were significantly younger, predominantly female, and nonsmokers (all P influence on patient prognosis. However, there was no significant difference in prognosis between the cIPF and sIPF groups after adjusting for GAP (gender, age, physiology) stage.The patients with sIPF had better clinical features than those with cIPF. However, after adjusting for GAP stage, the sIPF group showed similar prognoses as the cIPF group. This study showed that after adjusting for GAP stage, the prognosis of patients with IPF is the same regardless of the diagnostic method used. PMID:26986154

  8. 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: 1.222, year: 2014

  9. 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)

    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

  10. Report on current state of the art and major knowledge gaps to characterize water stress in different sectors. Aquastress D2.1.2 - Final report

    OpenAIRE

    Manez, M.; Inman, D.; S. Schmidt; Tarnacki, K.; Preziosi, E.; Koundouri, P.; S. Loubier; Sullivan, C.; Panebianco, S.; Van den Wyngaert, I.; Bauer, M.; Moors, E.; Olsthoorn, A.

    2006-01-01

    With this report we have tried to rise the awareness within the project on the still existing knowledge gaps in the different sectors of the water consumers: domestic sector, agricultural sector, environmental sector and industrial sector (including tourism). Our internal experts have dedicated an extra chapter to every sector. This report summarizes the state of the art of water stress in the sectors and represents the basis for the development of the test-site reports delivered by WP 2.2

  11. Review of carbon flux estimates and other greenhouse gas emissions from oil palm cultivation on Tropical peatlands - Identifying the gaps in Knowledge

    OpenAIRE

    Verwer, C.C.; Meer, van der, P.J.; Nabuurs, G.J.

    2008-01-01

    This report provides an independent review that clarifies current confusion on carbon dioxide emissions resulting from oil palm cultivation on tropical peatlands in Malaysia, that was brought about by two recent publications. It describes the processes of carbon flow in forests, degraded forests and oil palm plantations on peat and depicts uncertainties in existing datasets. The report identifies the gaps of knowledge and offers recommendations for further research to be commissioned by the J...

  12. Hegemonic structure of basic, clinical and patented knowledge on Ebola research: a US army reductionist initiative

    OpenAIRE

    Fajardo-Ortiz, David; Ortega-Sánchez-de-Tagle, José; Castaño, Victor M

    2015-01-01

    Background Ebola hemorrhagic fever (Ebola) is still a highly lethal infectious disease long affecting mainly neglected populations in sub-Saharan Africa. Moreover, this disease is now considered a potential worldwide threat. In this paper, we present an approach to understand how the basic, clinical and patent knowledge on Ebola is organized and intercommunicated and what leading factor could be shaping the evolution of the knowledge translation process for this disease. Methodology A combina...

  13. Do knowledge brokers facilitate implementation of the stroke guideline in clinical practice?

    OpenAIRE

    Willems, Mia; Schröder, Carin; Post, Marcel; Weijden, Trudy; Visser-Meily, Anne

    2013-01-01

    Background The implementation of clinical practice guidelines in rehabilitation practice is often troublesome and incomplete. An intervention to enhance the implementation of guidelines is the knowledge transfer program built around the activities of a knowledge broker (KB). This study investigates the use of KBs to implement guideline recommendations for intensive therapy and physical activity for patients post-stroke in 22 stroke units in hospitals and rehabilitation centers in The Netherla...

  14. 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. PMID:25179920

  15. Knowledge-level querying of temporal patterns in clinical research systems.

    Science.gov (United States)

    O'Connor, Martin J; Shankar, Ravi D; Parrish, David B; Das, Amar K

    2007-01-01

    Managing time-stamped data is essential to clinical research activities and often requires the use of considerable domain knowledge. Adequately representing this domain knowledge is difficult in relational database systems. As a result, there is a need for principled methods to overcome the disconnect between the database representation of time-oriented research data and corresponding knowledge of domain-relevant concepts. In this paper, we present a set of methodologies for undertaking knowledge level querying of temporal patterns, and discuss its application to the verification of temporal constraints in clinical-trial applications. Our approach allows knowledge generated from query results to be tied to the data and, if necessary, used for further inference. We show how the Semantic Web ontology and rule languages, OWL and SWRL, respectively, can support the temporal knowledge model needed to integrate low-level representations of relational data with high-level domain concepts used in research data management. We present a scalable bridge-based software architecture that uses this knowledge model to enable dynamic querying of time-oriented research data. PMID:17911729

  16. Forms of Knowledge Incorporated in Clinical Decision-making among Newly-Graduated Nurses: A Metasynthesis

    DEFF Research Database (Denmark)

    Voldbjerg, Siri; Elgaard Sørensen, Erik; Grønkjær, Mette;

    2013-01-01

    Clinical-decision-making is of decisive importance to how evidence-based practice is put into practice. Schools of Nursing have a responsibility to teach and train nursing students to make clinical decisions within a frame of evidence-based practice. Clinical decision-making among nurses has been...... knowledge that informs clinical decision-making among newly-graduated nurses. Qualitative studies were retrieved from CINAHL, PubMed, SCOPE, ERIC and GOOGLE-Scholar and subsequently selected by pre-defined inclusion criteria and critically appraised using CASP. Metaphors identified in the analytical process...... will contribute to theory development and have implications for clinical and educational practice regarding the professional development of clinical decision making within a frame of evidence-based practice. The presentation highlights the main findings from the metasynthesis and provides perspectives...

  17. Curriculum gaps in teaching clinical skills to Iranian undergraduate medical students

    OpenAIRE

    Mirzazadeh, Azim; Bavarian, Behrouz; Labaf, Ali; Afshari, Ali; Nikoo, Mohammad; Meshkani, Zahra Sadat; Khashayar, Patricia

    2013-01-01

    Introduction The inefficacy of clinical skill education during the clerkship has been reported in several studies. The present study was conducted to evaluate the competency of medical students in performing several clinical skills through an Objective Structured Clinical Examination (OSCE), aiming to evaluate the quality of the existing curriculum in the clerkship phase. Material and methods The cross sectional study was conducted at the end of the clerkship period, before the students had e...

  18. Testicular Self Examination--Knowledge of Men Attending a Large Genito Urinary Medicine Clinic

    Science.gov (United States)

    Handy, Pauline; Sankar, K. Nathan

    2008-01-01

    Objective: To elicit the level of knowledge, training and preferences of men in relation to Testicular Self Examination (TSE). Setting: The Genito Urinary Medicine (GUM) department of a large teaching hospital in the North East of England. The open access clinic serves patients from Newcastle upon Tyne, Northumberland, Gateshead and surrounding…

  19. First-Year Residents' Caring, Medical Knowledge, and Clinical Judgment in Relation to Laboratory Utilization.

    Science.gov (United States)

    Yarnold, Paul R.; And Others

    1994-01-01

    A study of 36 first-year Northwestern University (Illinois) medical residents found that students' medical knowledge was a predictor of increased laboratory test use, that clinical judgment was a predictor of decreased laboratory use, and that level of caring was statistically unrelated to amount of laboratory use. (Author/MSE)

  20. Framing in Cognitive Clinical Interviews about Intuitive Science Knowledge: Dynamic Student Understandings of the Discourse Interaction

    Science.gov (United States)

    Russ, Rosemary S.; Lee, Victor R.; Sherin, Bruce L.

    2012-01-01

    Researchers in the science education community make extensive use of cognitive clinical interviews as windows into student knowledge and thinking. Despite our familiarity with the interviews, there has been very limited research addressing the ways that students understand these interactions. In this work, we examine students' behaviors and speech…

  1. Dogmatism and the "Knowledge Gap" among Users of the Mass Media of Communication: A Study in Brasilia, Brasil.

    Science.gov (United States)

    Simmons, Robert E.; Garda, Eduardo Carlos

    A study was conducted to discover whether (1) use of each of the print and broadcast media could be correlated with subjects' knowledge level, and (2) whether controlling for dogmatism would increase the proportion of media users, with higher levels of knowledge among those less dogmatic, and decrease the proportion among the more dogmatic.…

  2. Maximizing the Nutritional Value of Produce Post-Harvest: Consumer Knowledge Gaps, Interests, and Opinions Regarding Nutrition Education Strategies

    Science.gov (United States)

    Remley, Dan; Goard, Linnette Mizer; Taylor, Christopher A.; Ralston, Robin A.

    2015-01-01

    Although many consumers perceive locally produced, fresh fruits and vegetables to be healthier, they might not have the knowledge and skills to retain optimal nutritional quality following harvest or purchase. We surveyed Ohio farmers market consumers' and managers' knowledge and interests related to maximizing nutritional value of produce.…

  3. A More Transparent System for Clinical Trials Data in Europe – Mind the Gaps!

    DEFF Research Database (Denmark)

    Minssen, Timo

    2014-01-01

    on medicinal products for human use” repealing Directive 2001/20/EC. As described in a press-release, the new law: “aims to remedy the shortcomings of the existing Clinical Trials Directive by setting up a uniform framework for the authorization of clinical trials by all the member states concerned...... with a given single assessment outcome. Simplified reporting procedures, and the possibility for the Commission to do checks, are among the law’s key innovations.” Moreover, and very importantly, the Regulation seeks to improve transparency by requiring pharmaceutical companies and academic researchers...... to publish the results of all their European clinical trials in a publicly-accessible EU database. In contrast to earlier stipulations which only obliged sponsors to publish the end-results of their clinical trials, the new law requires full clinical study reports to be published after a decision...

  4. 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.

  5. Bridging the gap between education and appropriate use of benzodiazepines in psychiatric clinical practice

    Directory of Open Access Journals (Sweden)

    Dell’Osso B

    2015-07-01

    Full Text Available Bernardo Dell’Osso,1,2,* Umberto Albert,3,* Anna Rita Atti,4 Claudia Carmassi,5 Giuseppe Carrà,6 Fiammetta Cosci,7 Valeria Del Vecchio,8 Marco Di Nicola,9 Silvia Ferrari,10 Arianna Goracci,11 Felice Iasevoli,12 Mario Luciano,8 Giovanni Martinotti,13 Maria Giulia Nanni,14 Alessandra Nivoli,15,16 Federica Pinna,17 Nicola Poloni,18 Maurizio Pompili,19 Gaia Sampogna,8 Ilaria Tarricone,20 Sarah Tosato,21 Umberto Volpe,8 Andrea Fiorillo8 1Department of Psychiatry, University of Milan, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy; 2Bipolar Disorders Clinic, Stanford Medical School, Stanford University, CA, USA; 3Rita Levi Montalcini Department of Neuroscience, University of Turin, Torino, 4Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, 5Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; 6Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK; 7Department of Health Sciences, University of Florence, Florence, 8Department of Psychiatry, University of Naples SUN, Naples, 9Institute of Psychiatry and Psychology, Catholic University of Sacred Heart, Rome, 10Department of Diagnostic-Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Modena, 11Department of Molecular Medicine and Clinical Department of Mental Health, University of Siena, Siena, 12Department of Neuroscience, Reproductive Sciences and Odontostomatology, University Federico II of Naples, Naples, 13Department of Neuroscience, Imaging, and Clinical Science, University G.d Annunzio, Chieti-Pescara, 14Section of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, 15Psychiatric Institute, Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy; 16Bipolar Disorder Unit, CIBERSAM, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain; 17Department of

  6. Transition to clinical training : influence of pre-clinical knowledge and skills, and consequences for clinical performance

    NARCIS (Netherlands)

    van Hell, Elisabeth A.; Kuks, Jan B. M.; Schonrock-Adema, Johanna; van Lohuizen, Mirjam T.; Cohen-Schotanus, Janke

    2008-01-01

    CONTEXT Many students experience a tough transition from pre-clinical to clinical training and previous studies suggest that this may constrict students' progress. However, clear empirical evidence of this is lacking. The aim of this study was to determine: whether the perceived difficulty of transi

  7. 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.

  8. A systematic review to identify gaps that limit translating knowledge on dairy products and inflammation into nutritional guidelines

    OpenAIRE

    Bordoni, A; Danesi, F.; Dardevet, Dominique; Gille, D.; Nunes dos Santos, C.; Pinto R, Re; Remond, Didier; Shahar, DR; Vergères, G.

    2014-01-01

    The challenge of translating knowledge on food composition into dietary guidelines that promote health is compounded by the process of food digestion. INFOGEST tackles this issue by promoting research on this topic. The digestive system is highly interconnected with the gut microbiota and immune system. Knowledge on digestion must therefore integrate these additional processes in order to link food composition to the nutritional signals finally sensed by the human organism. This issue can be ...

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

    International Nuclear Information System (INIS)

    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)

  10. Extensive gaps and biases in our knowledge of a well-known fauna: Implications for integrating biological traits into macroecology

    KAUST Repository

    Tyler, Elizabeth

    2011-12-09

    Aim Ecologists seeking to describe patterns at ever larger scales require compilations of data on the global abundance and distribution of species. Comparable compilations of biological data are needed to elucidate the mechanisms behind these patterns, but have received far less attention. We assess the availability of biological data across an entire assemblage: the well-documented demersal marine fauna of the United Kingdom. We also test whether data availability for a species depends on its taxonomic group, maximum body size, the number of times it has been recorded in a global biogeographic database, or its commercial and conservation importance. Location Seas of the United Kingdom. Methods We defined a demersal marine fauna of 973 species from 15 phyla and 40 classes using five extensive surveys around the British Isles. We then quantified the availability of data on eight key biological traits (termed biological knowledge) for each species from online databases. Relationships between biological knowledge and our predictors were tested with generalized linear models. Results Full data on eight fundamental biological traits exist for only 9% (n= 88) of the UK demersal marine fauna, and 20% of species completely lack data. Clear trends in our knowledge exist: fish (median biological knowledge score = six traits) are much better known than invertebrates (one trait). Biological knowledge increases with biogeographic knowledge and (to a lesser extent) with body size, and is greater in species that are commercially exploited or of conservation concern. Main conclusions Our analysis reveals deep ignorance of the basic biology of a well-studied fauna, highlighting the need for far greater efforts to compile biological trait data. Clear biases in our knowledge, relating to how well sampled or \\'important\\' species are suggests that caution is required in extrapolating small subsets of biologically well-known species to ecosystem-level studies. © 2011 Blackwell

  11. Contextualisation of Biomedical Knowledge through Large-scale Processing of Literature, Clinical Narratives and Social Media

    OpenAIRE

    Nenadic, Goran

    2015-01-01

    Medicine is often pictured as one of the main examples of “big data science” with a number of challenges and successful stories where data have saved lives [1]. In addition to structured databases that store expert-curated information, unstructured and semi-structured data is a huge and often most up-to-date resource of medical knowledge. These include scientific literature, clinical narratives and social media, which typically capture findings, knowledge and experience of the three main “sta...

  12. Transition to clinical training: influence of pre-clinical knowledge and skills, and consequences for clinical performance

    OpenAIRE

    van Hell, Elisabeth A.; Kuks, Jan B. M.; Schonrock-Adema, Johanna; van Lohuizen, Mirjam T.; Cohen-Schotanus, Janke

    2008-01-01

    CONTEXT Many students experience a tough transition from pre-clinical to clinical training and previous studies suggest that this may constrict students' progress. However, clear empirical evidence of this is lacking. The aim of this study was to determine: whether the perceived difficulty of transition influences student performance during the first 2 weeks of clerkships; whether it influences students' overall performance in their first clerkship, and the degree to which the difficulty of t...

  13. No shit, there I was: the case for narrative-based clinical knowledge.

    Science.gov (United States)

    Froede, Kate

    2011-01-01

    Relevant literature demonstrates the absolute necessity of Special Operations Forces (SOF) clinical narratives to the medics they teach and care they deliver, and discusses the concept of narrative pedagogy via review of extant literature and also SOF-specific clinical literature. SOF clinicians (medics, physicians? assistants, physicians, etc.) provide advanced trauma, clinical, and preventive care in the most austere of combat environments. SOF clinicians have adopted specific paradigms for schooling, teaching, learning, and practice. An overarching theme within SOF-generated clinical literature is that of hermeneutics and the narrative pedagogy; SOF clinicians generate their evidence from experience and frequently tell stories to educate their peers, colleagues, and student medics to increase the knowledge of the entire community. PMID:22113722

  14. 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.

  15. Bats - findings and knowledge gaps in the field of bat behaviour; Perspektive Fledermaeuse - Erkenntnisse und Wissensluecken zum Verhalten

    Energy Technology Data Exchange (ETDEWEB)

    Bergen, F. [ecoda Umweltgutachten GbR, Dortmund (Germany)

    2005-07-01

    There may be conflicts between wind power utilisation and the behaviour patterns of bats resp. the need for bat protection. The subject should be discussed free of emotions. Research is still required as there is still a lack of knowledge concerning the effects of wind power systems on bats. (orig.)

  16. Integrative Technologies and Knowledge Gatekeepers: Bridging the Gap between Epistemic Communities in the Case of Stem Cell Science

    Science.gov (United States)

    Wink, Rudiger

    2008-01-01

    The article analyses the role of gatekeepers between regional and disciplinary innovation systems in stem cell research as a case of integrative technologies. Which kind of gatekeepers is needed and which function can be fulfilled, differs along the knowledge value chain. Empirical results are used to explain the rationality of stem cell policies…

  17. Clinical asthma phenotyping: A trial for bridging gaps in asthma management

    OpenAIRE

    Zedan, Magdy Mohamed; Laimon, Wafaa Nabil; Osman, Amal Mohamed; Zedan, Mohamed Magdy

    2015-01-01

    Asthma is a common disease affecting millions of people worldwide and exerting an enormous strain on health resources in many countries. Evidence is increasing that asthma is unlikely to be a single disease but rather a series of complex, overlapping individual diseases or phenotypes, each defined by its unique interaction between genetic and environmental factors. Asthma phenotypes were initially focused on combinations of clinical characteristics, but they are now evolving to link pathophys...

  18. The Medical Use of Wheatgrass: Review of the Gap Between Basic and Clinical Applications.

    Science.gov (United States)

    Bar-Sela, Gil; Cohen, Miri; Ben-Arye, Eran; Epelbaum, Ron

    2015-01-01

    A wide range of health benefits have been attributed to wheatgrass, the young grass of the common wheat plant Triticum aestivum. Its components include chlorophyll, flavonoids, and vitamins C and E. Forms of wheatgrass include fresh juice, frozen juice, tablets, and powders, with compositions varying according to their production processes, as well as to the growing conditions of the wheatgrass. Laboratory in vitro studies, mostly using the fermented wheat germ extract, have demonstrated anti-cancer potential and have identified apoptosis as a possible mechanism. In animal experiments, wheatgrass demonstrated benefits in cancer prevention and as an adjunct to cancer treatment, as well as benefits to immunological activity and oxidative stress. Clinical trials show that wheatgrass may induce synergistic benefits to chemotherapy and may attenuate chemotherapy-related side effects, as well as benefit rheumatoid arthritis, ulcerative colitis, hematological diseases, diabetes, obesity, and oxidative stress. However, all the trials were small and a number of methodological problems arose. No adverse events of wheatgrass have been reported, although some forms pose problems of tolerability. The popularity of wheatgrass continues to grow. Nevertheless, the advantages seen in the clinical trials need to be proved in larger studies before clinical recommendations for the public can be given. PMID:26156538

  19. Relational Network for Knowledge Discovery through Heterogeneous Biomedical and Clinical Features.

    Science.gov (United States)

    Chen, Huaidong; Chen, Wei; Liu, Chenglin; Zhang, Le; Su, Jing; Zhou, Xiaobo

    2016-01-01

    Biomedical big data, as a whole, covers numerous features, while each dataset specifically delineates part of them. "Full feature spectrum" knowledge discovery across heterogeneous data sources remains a major challenge. We developed a method called bootstrapping for unified feature association measurement (BUFAM) for pairwise association analysis, and relational dependency network (RDN) modeling for global module detection on features across breast cancer cohorts. Discovered knowledge was cross-validated using data from Wake Forest Baptist Medical Center's electronic medical records and annotated with BioCarta signaling signatures. The clinical potential of the discovered modules was exhibited by stratifying patients for drug responses. A series of discovered associations provided new insights into breast cancer, such as the effects of patient's cultural background on preferences for surgical procedure. We also discovered two groups of highly associated features, the HER2 and the ER modules, each of which described how phenotypes were associated with molecular signatures, diagnostic features, and clinical decisions. The discovered "ER module", which was dominated by cancer immunity, was used as an example for patient stratification and prediction of drug responses to tamoxifen and chemotherapy. BUFAM-derived RDN modeling demonstrated unique ability to discover clinically meaningful and actionable knowledge across highly heterogeneous biomedical big data sets. PMID:27427091

  20. Relational Network for Knowledge Discovery through Heterogeneous Biomedical and Clinical Features

    Science.gov (United States)

    Chen, Huaidong; Chen, Wei; Liu, Chenglin; Zhang, Le; Su, Jing; Zhou, Xiaobo

    2016-07-01

    Biomedical big data, as a whole, covers numerous features, while each dataset specifically delineates part of them. “Full feature spectrum” knowledge discovery across heterogeneous data sources remains a major challenge. We developed a method called bootstrapping for unified feature association measurement (BUFAM) for pairwise association analysis, and relational dependency network (RDN) modeling for global module detection on features across breast cancer cohorts. Discovered knowledge was cross-validated using data from Wake Forest Baptist Medical Center’s electronic medical records and annotated with BioCarta signaling signatures. The clinical potential of the discovered modules was exhibited by stratifying patients for drug responses. A series of discovered associations provided new insights into breast cancer, such as the effects of patient’s cultural background on preferences for surgical procedure. We also discovered two groups of highly associated features, the HER2 and the ER modules, each of which described how phenotypes were associated with molecular signatures, diagnostic features, and clinical decisions. The discovered “ER module”, which was dominated by cancer immunity, was used as an example for patient stratification and prediction of drug responses to tamoxifen and chemotherapy. BUFAM-derived RDN modeling demonstrated unique ability to discover clinically meaningful and actionable knowledge across highly heterogeneous biomedical big data sets.

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

    International Nuclear Information System (INIS)

    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)

  2. Knowledges

    DEFF Research Database (Denmark)

    Berling, Trine Villumsen

    2012-01-01

    Scientific knowledge in international relations has generally focused on an epistemological distinction between rationalism and reflectivism over the last 25 years. This chapter argues that this distinction has created a double distinction between theory/reality and theory/practice, which works as...... a ghost distinction structuring IR research. While reflectivist studies have emphasised the impossibility of detached, objective knowledge production through a dissolution of the theory/reality distinction, the theory/practice distinction has been left largely untouched by both rationalism and...... reflectivism. Bourdieu, on the contrary, lets the challenge to the theory/reality distinction spill over into a challenge to the theory/practice distinction by thrusting the scientist in the foreground as not just a factor (discourse/genre) but as an actor. In this way, studies of IR need to include a focus on...

  3. 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. PMID:26948720

  4. Poststroke Hip Fracture: Prevalence, Clinical Characteristics, Mineral-Bone Metabolism, Outcomes, and Gaps in Prevention

    OpenAIRE

    Alexander Fisher; Wichat Srikusalanukul; Michael Davis; Paul Smith

    2013-01-01

    Objective. To assess the prevalence, clinical and laboratory characteristics, and short-term outcomes of poststroke hip fracture (HF). Methods. A cross-sectional study of 761 consecutive patients aged ≥60 years (82.3 ± 8.8 years; 75% females) with osteoporotic HF. Results. The prevalence of poststroke HF was 13.1% occurring on average 2.4 years after the stroke. The poststroke group compared to the rest of the cohort had a higher proportion of women, subjects with dementia, history of TIA, hy...

  5. Knowledge Gaps in Rodent Pancreas Biology: Taking Human Pluripotent Stem Cell-Derived Pancreatic Beta Cells into Our Own Hands

    OpenAIRE

    Santosa, Munirah Mohamad; Low, Blaise Su Jun; Pek, Nicole Min Qian; Teo, Adrian Kee Keong

    2016-01-01

    In the field of stem cell biology and diabetes, we and others seek to derive mature and functional human pancreatic β cells for disease modeling and cell replacement therapy. Traditionally, knowledge gathered from rodents is extended to human pancreas developmental biology research involving human pluripotent stem cells (hPSCs). While much has been learnt from rodent pancreas biology in the early steps toward Pdx1+ pancreatic progenitors, much less is known about the transition toward Ngn3+ p...

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

    OpenAIRE

    Rabbi Sifat E; Dey Nepal C

    2013-01-01

    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 5...

  7. Mathematical knowledge and drug dosage calculation: Necessary clinical skills for the nurse

    Directory of Open Access Journals (Sweden)

    Athanasakis Efstratios

    2013-01-01

    Full Text Available When nurses perform their tasks, they manage situations where maths knowledge is required. Such a situation is the calculation of medication dosage. Aim: The literature review of papers relevant with the mathematical knowledge and drug calculation skills of nurses and nursing students. Material-Method: A search of published research and review articles from January 1989 until March 2012, has been conducted in Pubmed database. The search terms used were: nurses, mathematics skills, numeracy skills and medication dosology calculation skills. Results: Literature review showed that many studies focus in the mathematical knowledge and drug dosage calculation competency of nursing students. Results from these studies revealed that nursing students had poor mathematical knowledge and drug dosage calculation skills. In contrast with students, professional nurses are more likely to have sufficient skills in drug calculations. Apart from the papers analyzing calculation skills' assessment, several studies examined educational interventions in the context of calculation skills enhancement. Accuracy and proficiency in the dosage calculation of medications is a preventive factor of errors made at medication preparation and administration. Conclusion: Mathematical knowledge and drug dosage calculation abilities are interrelated concepts and essential clinical skills for the nurse. The fact that nursing students do not have adequate skills for calculating medications' dosage, might be an issue that schools of nursing education should focus in. Further research of the drug dosage calculation skills is considered essential.

  8. Recommended practices for computerized clinical decision support and knowledge management in community settings: a qualitative study

    Directory of Open Access Journals (Sweden)

    Ash Joan S

    2012-02-01

    Full Text Available Abstract Background The purpose of this study was to identify recommended practices for computerized clinical decision support (CDS development and implementation and for knowledge management (KM processes in ambulatory clinics and community hospitals using commercial or locally developed systems in the U.S. Methods Guided by the Multiple Perspectives Framework, the authors conducted ethnographic field studies at two community hospitals and five ambulatory clinic organizations across the U.S. Using a Rapid Assessment Process, a multidisciplinary research team: gathered preliminary assessment data; conducted on-site interviews, observations, and field surveys; analyzed data using both template and grounded methods; and developed universal themes. A panel of experts produced recommended practices. Results The team identified ten themes related to CDS and KM. These include: 1 workflow; 2 knowledge management; 3 data as a foundation for CDS; 4 user computer interaction; 5 measurement and metrics; 6 governance; 7 translation for collaboration; 8 the meaning of CDS; 9 roles of special, essential people; and 10 communication, training, and support. Experts developed recommendations about each theme. The original Multiple Perspectives framework was modified to make explicit a new theoretical construct, that of Translational Interaction. Conclusions These ten themes represent areas that need attention if a clinic or community hospital plans to implement and successfully utilize CDS. In addition, they have implications for workforce education, research, and national-level policy development. The Translational Interaction construct could guide future applied informatics research endeavors.

  9. Nosocomial infections: knowledge and source of information among clinical health care students in Ghana

    Directory of Open Access Journals (Sweden)

    Bello AI

    2011-08-01

    Full Text Available Ajediran I Bello1, Eunice N Asiedu1, Babatunde OA Adegoke2, Jonathan NA Quartey1, Kwadwo O Appiah-Kubi1, Bertha Owusu-Ansah11Department of Physiotherapy, School of Allied Health Sciences, College of Health Sciences, University of Ghana, Accra, Ghana; 2Department of Physiotherapy, College of Medicine, University of Ibadan, Ibadan, NigeriaBackground: This study determined and compared the knowledge of nosocomial infections among clinical health care students at the College of Health Sciences, University of Ghana.Methods: Two hundred undergraduate health care students from four academic programs participated in the study. The study sample was drawn from each academic program by a simple random sampling technique using the class directory from each course. The Infection Control Standardized Questionnaire (ICSQ was used to assess the knowledge of students about three main domains, ie, hand hygiene, nosocomial infections, and standard precautions. A maximum score of 50 was obtainable, and respondents with scores ≥70% were classified as having a satisfactory knowledge. The response on each item was coded numerically to generate data for statistical analysis. Comparison of knowledge on the domains among categories of students was assessed using the Kruskal–Wallis test, while associations between courses of study and knowledge about nosocomial infections were determined using the Chi-square test. All statistical tests had a significant level of 5% (P < 0.05Results: Overall mean percentage score of the participants on ICSQ was 65.4 ± 2.58, with medical, physiotherapy, radiography, and nursing students recording mean percentage scores of 70.58 ± 0.62, 65.02 ± 2.00, 64.74 ± 1.19, and 61.31 ± 2.35, respectively. The main source of information about the prevention of nosocomial infections as cited by participants was their routine formal training in class. There was no significant association (P > 0.05 between course of study and knowledge of

  10. Knowledge of causes, clinical features and diagnosis of common zoonoses among medical practitioners in Tanzania

    Directory of Open Access Journals (Sweden)

    Mfinanga Godfrey S

    2008-12-01

    Full Text Available Abstract Background Many factors have been mentioned as contributing to under-diagnosis and under-reporting of zoonotic diseases particularly in the sub-Sahara African region. These include poor disease surveillance coverage, poor diagnostic capacity, the geographical distribution of those most affected and lack of clear strategies to address the plight of zoonotic diseases. The current study investigates the knowledge of medical practitioners of zoonotic diseases as a potential contributing factor to their under-diagnosis and hence under-reporting. Methods The study was designed as a cross-sectional survey. Semi-structured open-ended questionnaire was administered to medical practitioners to establish the knowledge of anthrax, rabies, brucellosis, trypanosomiasis, echinococcosis and bovine tuberculosis in selected health facilities within urban and rural settings in Tanzania between April and May 2005. Frequency data were analyzed using likelihood ratio chi-square in Minitab version 14 to compare practitioners' knowledge of transmission, clinical features and diagnosis of the zoonoses in the two settings. For each analysis, likelihood ratio chi-square p-value of less than 0.05 was considered to be significant. Fisher's exact test was used where expected results were less than five. Results Medical practitioners in rural health facilities had poor knowledge of transmission of sleeping sickness and clinical features of anthrax and rabies in humans compared to their urban counterparts. In both areas the practitioners had poor knowledge of how echinococcosis is transmitted to humans, clinical features of echinococcosis in humans, and diagnosis of bovine tuberculosis in humans. Conclusion Knowledge of medical practitioners of zoonotic diseases could be a contributing factor to their under-diagnosis and under-reporting in Tanzania. Refresher courses on zoonotic diseases should be conducted particularly to practitioners in rural areas. More emphasis

  11. Aerosol-Radiation-Cloud Interactions in the South-East Atlantic: Future Suborbital Activities to Address Knowledge Gaps in Satellite and Model Assessments

    Science.gov (United States)

    Redemann, Jens; Wood, R.; Zuidema, P.; Haywood, J.; Piketh, S.; Formenti, P.; L'Ecuyer, T.; Kacenelenbogen, M.; Segal-Rosenheimer, M.; Shinozuka, Y.; LeBlanc, S.; Vaughan, M.; Schmidt, S.; Flynn, C.; Schmid, B.; Luna, B.; Abel, S.

    2016-01-01

    Southern Africa produces almost a third of the Earth's biomass burning (BB) aerosol particles. Particles lofted into the mid-troposphere are transported westward over the South-East (SE) Atlantic, home to one of the three permanent subtropical stratocumulus (Sc) cloud decks in the world. The SE Atlantic stratocumulus deck interacts with the dense layers of BB aerosols that initially overlay the cloud deck, but later subside and may mix into the clouds. These interactions include adjustments to aerosol-induced solar heating and microphysical effects, and their global representation in climate models remains one of the largest uncertainties in estimates of future climate. Hence, new observations over the SE Atlantic have significant implications for global climate change scenarios. Our understanding of aerosol-cloud interactions in the SE Atlantic is hindered both by the lack of knowledge on aerosol and cloud properties, as well as the lack of knowledge about detailed physical processes involved. Most notably, we are missing knowledge on the absorptive and cloud nucleating properties of aerosols, including their vertical distribution relative to clouds, on the locations and degree of aerosol mixing into clouds, on the processes that govern cloud property adjustments, and on the importance of aerosol effects on clouds relative to co-varying synoptic scale meteorology. We discuss the current knowledge of aerosol and cloud property distributions based on satellite observations and sparse suborbital sampling. Recent efforts to make full use of A-Train aerosol sensor synergies will be highlighted. We describe planned field campaigns in the region to address the existing knowledge gaps. Specifically, we describe the scientific objectives and implementation of the five synergistic, international research activities aimed at providing some of the key aerosol and cloud properties and a process-level understanding of aerosol-cloud interactions over the SE Atlantic: NASA

  12. 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

  13. Poststroke Hip Fracture: Prevalence, Clinical Characteristics, Mineral-Bone Metabolism, Outcomes, and Gaps in Prevention

    Directory of Open Access Journals (Sweden)

    Alexander Fisher

    2013-01-01

    Full Text Available Objective. To assess the prevalence, clinical and laboratory characteristics, and short-term outcomes of poststroke hip fracture (HF. Methods. A cross-sectional study of 761 consecutive patients aged ≥60 years (82.3±8.8 years; 75% females with osteoporotic HF. Results. The prevalence of poststroke HF was 13.1% occurring on average 2.4 years after the stroke. The poststroke group compared to the rest of the cohort had a higher proportion of women, subjects with dementia, history of TIA, hypertension, coronary artery disease, secondary hyperparathyroidism, higher serum vitamin B12 levels (>350 pmol/L, walking aid users, and living in residential care facilities. The majority of poststroke HF patients had vitamin D insufficiency (68% and excess bone resorption (90%. This group had a 3-fold higher incidence of postoperative myocardial injury and need for institutionalisation. In multivariate analysis, independent indicators of poststroke HF were female sex (OR 3.6, history of TIA (OR 5.2, dementia (OR 4.1, hypertension (OR 3.2, use of walking aid (OR 2.5, and higher vitamin B12 level (OR 2.3. Only 15% of poststroke patients received antiosteoporotic therapy prior to HF. Conclusions. Approximately one in seven HFs occurs in older stroke survivors and are associated with poorer outcomes. Early implementation of fracture prevention strategies is needed.

  14. Criterion-based clinical audit in obstetrics: bridging the quality gap?

    Science.gov (United States)

    Graham, W J

    2009-06-01

    The Millennium Development Goal 5 - reducing maternal mortality by 75% - is unlikely to be met globally and for the majority of low-income countries. At this time of heightened concern to scale-up services for mothers and babies, it is crucial that not only shortfalls in the quantity of care - in terms of location and financial access - are addressed, but also the quality. Reductions in maternal and perinatal mortality in the immediate term depend in large part on the timely delivery of effective practices in the management of life-threatening complications. Such practices require a functioning health system - including skilled and motivated providers engaged with the women and communities whom they serve. Assuring the quality of this system, the services and the care that women receive requires many inputs, including effective and efficient monitoring mechanisms. The purpose of this article is to summarise the practical steps involved in applying one such mechanism, criterion-based clinical audit (CBCA), and to highlight recent lessons from its application in developing countries. Like all audit tools, the ultimate worth of CBCA relates to the action it stimulates in the health system and among providers. PMID:19299203

  15. 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. PMID:27259126

  16. The gap between knowledge and practice of risky sexual behaviors for HIV among University students and staff in Moshi Town in Tanzania

    Directory of Open Access Journals (Sweden)

    Edith Kwigizile

    2013-08-01

    Full Text Available Knowledge on HIV spread is important in combating HIV/AIDS, however its impact can only be realized if put into practice. This study was carried out in a Higher Learning Institution in Moshi Township in Kilimanjaro Region to assess the level of awareness of university communities about HIV/AIDs and its link with practice of risky sexual behaviors (RSB. We have found an adequate level of knowledge on the spread, risk behaviors and methods for protection leading to attendance to voluntary testing and counseling by 61% of respondents. Conversely, we have observed great extent of practice of RSBs including early sexual debut (16.7 years, having multiple and extramarital partners, involvement in practices that lead to unprotected sexual intercourse. We report an obvious gap between knowledge and behavior. This study therefore recommends that serious operational interventions must be put in place targeting the most sexually active groups, the youth in preliminary schools to sensitize on RSBs and ways to avoid them before they are engaged in sexual activities.

  17. Knowledge and Perception about Clinical Research Shapes Behavior: Face to Face Survey in Korean General Public

    Science.gov (United States)

    2016-01-01

    Considering general public as potential patients, identifying factors that hinder public participation poses great importance, especially in a research environment where demands for clinical trial participants outpace the supply. Hence, the aim of this study was to evaluate knowledge and perception about clinical research in general public. A total of 400 Seoul residents with no previous experience of clinical trial participation were selected, as representative of population in Seoul in terms of age and sex. To minimize selection bias, every fifth passer-by was invited to interview, and if in a cluster, person on the very right side was asked. To ensure the uniform use of survey, written instructions have been added to the questionnaire. Followed by pilot test in 40 subjects, the survey was administered face-to-face in December 2014. To investigate how perception shapes behavior, we compared perception scores in those who expressed willingness to participate and those who did not. Remarkably higher percentage of responders stated that they have heard of clinical research, and knew someone who participated (both, P < 0.001) compared to India. Yet, the percentage of responders expressed willingness to participate was 39.3%, a significantly lower rate than the result of the India (58.9% vs. 39.3%, P < 0.001). Treatment benefit was the single most influential reason for participation, followed by financial gain. Concern about safety was the main reason for refusal, succeeded by fear and lack of trust. Public awareness and educational programs addressing these negative perceptions and lack of knowledge will be effective in enhancing public engaged in clinical research.

  18. Towards symbiosis in knowledge representation and natural language processing for structuring clinical practice guidelines.

    Science.gov (United States)

    Weng, Chunhua; Payne, Philip R O; Velez, Mark; Johnson, Stephen B; Bakken, Suzanne

    2014-01-01

    The successful adoption by clinicians of evidence-based clinical practice guidelines (CPGs) contained in clinical information systems requires efficient translation of free-text guidelines into computable formats. Natural language processing (NLP) has the potential to improve the efficiency of such translation. However, it is laborious to develop NLP to structure free-text CPGs using existing formal knowledge representations (KR). In response to this challenge, this vision paper discusses the value and feasibility of supporting symbiosis in text-based knowledge acquisition (KA) and KR. We compare two ontologies: (1) an ontology manually created by domain experts for CPG eligibility criteria and (2) an upper-level ontology derived from a semantic pattern-based approach for automatic KA from CPG eligibility criteria text. Then we discuss the strengths and limitations of interweaving KA and NLP for KR purposes and important considerations for achieving the symbiosis of KR and NLP for structuring CPGs to achieve evidence-based clinical practice. PMID:24943582

  19. Combining knowledge- and data-driven methods for de-identification of clinical narratives.

    Science.gov (United States)

    Dehghan, Azad; Kovacevic, Aleksandar; Karystianis, George; Keane, John A; Nenadic, Goran

    2015-12-01

    A recent promise to access unstructured clinical data from electronic health records on large-scale has revitalized the interest in automated de-identification of clinical notes, which includes the identification of mentions of Protected Health Information (PHI). We describe the methods developed and evaluated as part of the i2b2/UTHealth 2014 challenge to identify PHI defined by 25 entity types in longitudinal clinical narratives. Our approach combines knowledge-driven (dictionaries and rules) and data-driven (machine learning) methods with a large range of features to address de-identification of specific named entities. In addition, we have devised a two-pass recognition approach that creates a patient-specific run-time dictionary from the PHI entities identified in the first step with high confidence, which is then used in the second pass to identify mentions that lack specific clues. The proposed method achieved the overall micro F1-measures of 91% on strict and 95% on token-level evaluation on the test dataset (514 narratives). Whilst most PHI entities can be reliably identified, particularly challenging were mentions of Organizations and Professions. Still, the overall results suggest that automated text mining methods can be used to reliably process clinical notes to identify personal information and thus providing a crucial step in large-scale de-identification of unstructured data for further clinical and epidemiological studies. PMID:26210359

  20. Designing m-learning for junior registrars--activation of a theoretical model of clinical knowledge.

    Science.gov (United States)

    Kanstrup, Anne Marie; Boye, Niels; Nøhr, Christian

    2007-01-01

    The MINI-project aims at supporting junior registrars in the learning process of how to utilize their theoretical knowledge from Medical School in everyday clinical reasoning and practice. Due to the nature of the work--concurrent moving, learning and producing--we designed an m-learning application. This paper introduces the possibilities and challenges for design of the m-learning application based on a) analytical findings on learning and mobility as derived from the design case--an emergency medical ward b) theoretical perspectives on medical knowledge, and c) presentation of the design of an m-learning application. The design process was based on user-driven innovation and the paper discusses considerations on how to combine user-drive and generic models. PMID:17911938

  1. Antibiotic prescribing and resistance: knowledge level of medical students of clinical years of University Sultan Zainal Abidin, Malaysia

    Directory of Open Access Journals (Sweden)

    Haque M

    2016-03-01

    Full Text Available Mainul Haque, Nor Iza A Rahman, Zainal Zulkifli, Salwani Ismail Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia Abstract: The innovation of penicillin by Dr Alexander Fleming in 1928 and its use in clinical practice saved many lives, especially during the Second World War. Tuberculosis still carries a significant public health threat and has re-emerged over the past two decades, even in modern countries where tuberculosis was thought to be eliminated. The World Health Organization defines antimicrobial resistance as the resistance of a microorganism to an antimicrobial drug that was initially effective for treatment of infections caused by the microbe. Therefore, the findings of the current study will provide data to enable the design of a new educational program to better equip our students in confronting antimicrobial resistance. This study was a cross-sectional, questionnaire-based survey, which was undertaken in the Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia. The study participants were students of the Bachelor of Medicine and Bachelor of Surgery program (MBBS of Year III, IV, and V. A total of 142 out of 164 (86% medical students returned the questionnaire. Specifically, the year-wise breakdown of responses was 29% (41, 39% (55, and 32% (45 for Year III, IV, and V, respectively. Among the study respondents, 28% (40 were male, and the remaining 72% (102 were female. In all, 67% of the participants felt more confident in “making an accurate diagnosis of infection/sepsis.” The majority (88% of the study participants stated that they would like more training on antibiotic selection. This research has found that there is a gap between theoretical input and clinical practice; the students are demanding more educational intervention to face the threat of antimicrobial resistance. Keywords: antibiotic, prescribing, resistance, medical students, knowledge

  2. Population-based study of epilepsy in Cambodia associated factors, measures of impact, stigma, quality of life, knowledge-attitude-practice, and treatment gap.

    Directory of Open Access Journals (Sweden)

    Devender Bhalla

    Full Text Available PURPOSE: Identify epilepsy-associated factors and calculate measures of impact, stigma, quality of life (QOL, knowledge-attitude-practice (KAP and treatment gap in Prey Veng, Cambodia. METHODS: This first Cambodian population-based case-control study had 96 epileptologist-confirmed epilepsy cases and 192 randomly selected matched healthy controls. Standard questionnaires, which have been used in similar settings, were used for collecting data on various parameters. Univariate and multivariate regression was done to determine odds ratios. Jacoby stigma, 31-item QOL, KAP etc were determined and so were the factors associated with them using STATA software. Treatment gap was measured using direct method. KEY FINDINGS: Multivariate analyses yielded family history of epilepsy, difficult or long delivery, other problems beside seizures (mainly mental retardation, hyperthermia, and eventful pregnancy of the subject's mother as factors associated with epilepsy. There was high frequency of seizure precipitants esp. those related to sleep. Population attributable risk (% was: family history (15.0, eventful pregnancy of subject's mother (14.5, long/difficult birth (6.5, and other problem beside seizures (20.0. Mean stigma (1.9±1.1, on a scale of 3 was mainly related to treatment efficacy. Mean QOL (5.0±1.4 on a scale of 10 was mainly related to treatment regularity. Cause or risk factor could be determined in 56% of cases. Treatment gap was 65.8%. SIGNIFICANCE: Factors in pre- and perinatal period were found to be most crucial for epilepsy risk in Cambodia which inturn provides major prevention opportunities. A global action plan for treatment, stigma reduction and improvement of QOL should be set-up in this country.

  3. Global Health Education: a cross-sectional study among German medical students to identify needs, deficits and potential benefits (Part 2 of 2: Knowledge gaps and potential benefits

    Directory of Open Access Journals (Sweden)

    Schubert Kirsten

    2010-10-01

    Full Text Available Abstract Background In Germany, educational deficits or potential benefits involved in global health education have not been analysed till now. Objective We assess the importance medical students place on learning about social determinants of health (SDH and assess their knowledge of global health topics in relation to (i mobility patterns, their education in (ii tropical medicine or (iii global health. Methods Cross-sectional study among medical students from all 36 medical schools in Germany using a web-based, semi-structured questionnaire. Participants were recruited via mailing-lists of students' unions, all medical students registered in 2007 were eligible to participate in the study. We captured international mobility patterns, exposure to global health learning opportunities and attitudes to learning about SDH. Both an objective and subjective knowledge assessment were performed. Results 1126 online-replies were received and analysed. International health electives in developing countries correlated significantly with a higher importance placed on all provided SDH (p ≤ 0.006. Participation in tropical medicine (p In the knowledge assessment students achieved an average score of 3.6 (SD 1.5; Mdn 4.0, 75% achieved a score of 4.0 or less (Q25 = 3.0; Q75 = 4.0 from a maximum achievable score of 8.0. A better performance was associated with international health electives (p = 0.032, participation in tropical medicine (p = 0.038 and global health (p = 0.258 courses. Conclusion The importance medical students in our sample placed on learning about SDH strongly interacts with students' mobility, and participation in tropical medicine and global health courses. The knowledge assessment revealed deficits and outlined needs to further analyse education gaps in global health. Developing concerted educational interventions aimed at fostering students' engagement with SDH could make full use of synergy effects inherent in student mobility, tropical

  4. Using the core curriculum on childhood trauma to strengthen clinical knowledge in evidence-based practitioners.

    Science.gov (United States)

    Layne, Christopher M; Strand, Virginia; Popescu, Marciana; Kaplow, Julie B; Abramovitz, Robert; Stuber, Margaret; Amaya-Jackson, Lisa; Ross, Leslie; Pynoos, Robert S

    2014-01-01

    The high prevalence of trauma exposure in mental health service-seeking populations, combined with advances in evidence-based practice, competency-based training, common-elements research, and adult learning make this an opportune time to train the mental health workforce in trauma competencies. The Core Curriculum on Childhood Trauma (CCCT) utilizes a five-tiered conceptual framework (comprising Empirical Evidence, Core Trauma Concepts, Intervention Objectives, Practice Elements, and Skills), coupled with problem-based learning, to build foundational trauma knowledge and clinical reasoning skills. We present findings from three studies: Study 1 found that social work graduate students' participation in a CCCT course (N = 1,031) was linked to significant pre-post increases in self-reported confidence in applying core trauma concepts to their clinical work. Study 2 found significant pre-post increases in self-reported conceptual readiness (N = 576) and field readiness (N = 303) among social work graduate students participating in a "Gold Standard Plus" educational model that integrated classroom instruction in core trauma concepts, training in evidence-based trauma treatment (EBTT), and implementation of that EBTT in a supervised field placement. Students ranked the core concepts course as an equivalent or greater contributor to field readiness compared to standard EBTT training. Study 3 used qualitative methods to "distill" common elements (35 intervention objectives, 59 practice elements) from 26 manualized trauma interventions. The CCCT is a promising tool for educating "next-generation" evidence-based practitioners who possess competencies needed to implement modularized, individually tailored trauma interventions by strengthening clinical knowledge, clinical reasoning, and familiarity with common elements. PMID:24484506

  5. Improving Decision Making about Genetic Testing in the Clinic: An Overview of Effective Knowledge Translation Interventions

    Science.gov (United States)

    Légaré, France; Robitaille, Hubert; Gane, Claire; Hébert, Jessica; Labrecque, Michel; Rousseau, François

    2016-01-01

    Background Knowledge translation (KT) interventions are attempts to change behavior in keeping with scientific evidence. While genetic tests are increasingly available to healthcare consumers in the clinic, evidence about their benefits is unclear and decisions about genetic testing are thus difficult for all parties. Objective We sought to identify KT interventions that involved decisions about genetic testing in the clinical context and to assess their effectiveness for improving decision making in terms of behavior change, increased knowledge and wellbeing. Methods We searched for trials assessing KT interventions in the context of genetic testing up to March 2014 in all systematic reviews (n = 153) published by two Cochrane review groups: Effective Practice and Organisation of Care (EPOC) and Consumers and Communication. Results We retrieved 2473 unique trials of which we retained only 28 (1%). Two EPOC reviews yielded two trials of KT interventions: audit and feedback (n = 1) and educational outreach (n = 1). Both targeted health professionals and the KT intervention they assessed was found to be effective. Four Consumers and Communication reviews yielded 26 trials: decision aids (n = 15), communication of DNA-based disease risk estimates (n = 7), personalized risk communication (n = 3) and mobile phone messaging (n = 1). Among these, 25 trials targeted only health consumers or patients and the KT interventions were found to be effective in four trials, partly effective in seven, and ineffective in four. Lastly, only one trial targeted both physicians and patients and was found to be effective. Conclusions More research on the effectiveness of KT interventions regarding genetic testing in the clinical context may contribute to patients making informed value-based decisions and drawing the maximum benefit from clinical applications of genetic and genomic innovations. PMID:26938633

  6. Differences in trial knowledge and motives for participation among cancer patients in phase 3 clinical trials.

    Science.gov (United States)

    Godskesen, T M; Kihlbom, U; Nordin, K; Silén, M; Nygren, P

    2016-05-01

    While participants in clinical oncology trials are essential for the advancement of cancer therapies, factors decisive for patient participation have been described but need further investigation, particularly in the case of phase 3 studies. The aim of this study was to investigate differences in trial knowledge and motives for participation in phase 3 clinical cancer trials in relation to gender, age, education levels and former trial experience. The results of a questionnaire returned from 88 of 96 patients (92%) were analysed using the Mann-Whitney U-test. There were small, barely relevant differences in trial knowledge among patients when stratified by gender, age or education. Participants with former trial experience were less aware about the right to withdraw. Male participants and those aged ≥65 years were significantly more motivated by a feeling of duty, or by the opinions of close ones. Men seem more motivated than women by external factors. With the awareness that elderly and single male participants might be a vulnerable group and participants with former trial experience are less likely to be sufficiently informed, the information consent process should focus more on these patients. We conclude that the informed consent process seems to work well, with good results within most subgroups. PMID:25904313

  7. The Immunology of Neuromyelitis Optica-Current Knowledge, Clinical Implications, Controversies and Future Perspectives.

    Science.gov (United States)

    Jasiak-Zatonska, Michalina; Kalinowska-Lyszczarz, Alicja; Michalak, Slawomir; Kozubski, Wojciech

    2016-01-01

    Neuromyelitis optica (NMO) is an autoimmune, demyelinating disorder of the central nervous system (CNS) with typical clinical manifestations of optic neuritis and acute transverse myelitis attacks. Previously believed to be a variant of multiple sclerosis (MS), it is now considered an independent disorder which needs to be differentiated from MS. The discovery of autoantibodies against aquaporin-4 (AQP4-IgGs) changed our understanding of NMO immunopathogenesis and revolutionized the diagnostic process. AQP4-IgG is currently regarded as a specific biomarker of NMO and NMO spectrum disorders (NMOsd) and a key factor in its pathogenesis. Nevertheless, AQP4-IgG seronegativity in 10%-25% of NMO patients suggests that there are several other factors involved in NMO immunopathogenesis, i.e., autoantibodies against aquaporin-1 (AQP1-Abs) and antibodies against myelin oligodendrocyte glycoprotein (MOG-IgGs). This manuscript reviews current knowledge about NMO immunopathogenesis, pointing out the controversial issues and showing potential directions for future research. Further efforts should be made to broaden our knowledge of NMO immunology which could have important implications for clinical practice, including the use of potential novel biomarkers to facilitate an early and accurate diagnosis, and modern treatment strategies improving long-term outcome of NMO patients. PMID:26950113

  8. The Immunology of Neuromyelitis Optica—Current Knowledge, Clinical Implications, Controversies and Future Perspectives

    Science.gov (United States)

    Jasiak-Zatonska, Michalina; Kalinowska-Lyszczarz, Alicja; Michalak, Slawomir; Kozubski, Wojciech

    2016-01-01

    Neuromyelitis optica (NMO) is an autoimmune, demyelinating disorder of the central nervous system (CNS) with typical clinical manifestations of optic neuritis and acute transverse myelitis attacks. Previously believed to be a variant of multiple sclerosis (MS), it is now considered an independent disorder which needs to be differentiated from MS. The discovery of autoantibodies against aquaporin-4 (AQP4-IgGs) changed our understanding of NMO immunopathogenesis and revolutionized the diagnostic process. AQP4-IgG is currently regarded as a specific biomarker of NMO and NMO spectrum disorders (NMOsd) and a key factor in its pathogenesis. Nevertheless, AQP4-IgG seronegativity in 10%–25% of NMO patients suggests that there are several other factors involved in NMO immunopathogenesis, i.e., autoantibodies against aquaporin-1 (AQP1-Abs) and antibodies against myelin oligodendrocyte glycoprotein (MOG-IgGs). This manuscript reviews current knowledge about NMO immunopathogenesis, pointing out the controversial issues and showing potential directions for future research. Further efforts should be made to broaden our knowledge of NMO immunology which could have important implications for clinical practice, including the use of potential novel biomarkers to facilitate an early and accurate diagnosis, and modern treatment strategies improving long-term outcome of NMO patients. PMID:26950113

  9. The Immunology of Neuromyelitis Optica—Current Knowledge, Clinical Implications, Controversies and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Michalina Jasiak-Zatonska

    2016-03-01

    Full Text Available Neuromyelitis optica (NMO is an autoimmune, demyelinating disorder of the central nervous system (CNS with typical clinical manifestations of optic neuritis and acute transverse myelitis attacks. Previously believed to be a variant of multiple sclerosis (MS, it is now considered an independent disorder which needs to be differentiated from MS. The discovery of autoantibodies against aquaporin-4 (AQP4-IgGs changed our understanding of NMO immunopathogenesis and revolutionized the diagnostic process. AQP4-IgG is currently regarded as a specific biomarker of NMO and NMO spectrum disorders (NMOsd and a key factor in its pathogenesis. Nevertheless, AQP4-IgG seronegativity in 10%–25% of NMO patients suggests that there are several other factors involved in NMO immunopathogenesis, i.e., autoantibodies against aquaporin-1 (AQP1-Abs and antibodies against myelin oligodendrocyte glycoprotein (MOG-IgGs. This manuscript reviews current knowledge about NMO immunopathogenesis, pointing out the controversial issues and showing potential directions for future research. Further efforts should be made to broaden our knowledge of NMO immunology which could have important implications for clinical practice, including the use of potential novel biomarkers to facilitate an early and accurate diagnosis, and modern treatment strategies improving long-term outcome of NMO patients.

  10. Pilot Study of Blood Pressure in Girls With Turner Syndrome: An Awareness Gap, Clinical Associations, and New Hypotheses.

    Science.gov (United States)

    Los, Evan; Quezada, Emilio; Chen, Zunqiu; Lapidus, Jodi; Silberbach, Michael

    2016-07-01

    Cardiovascular disease is the major factor that reduces lifespan in Turner syndrome. High blood pressure (BP) is common in Turner syndrome and is the most easily treatable cardiovascular risk factor. We studied the prevalence of elevated screening systemic BP, awareness of the problem, and its clinical associations in a large group of girls attending the annual meeting of the Turner Syndrome Society of the United States. Among 168 girls aged 2 to 17 years, 42% had elevated screening BP (systolic and diastolic), yet only 8% reported a previous diagnosis of hypertension. History of aortic coarctation repair (17%) was positively associated with elevated systolic BP (52% versus 32%; P<0.05). Elevated systolic BP was positively associated with obesity (56% versus 31%; P<0.05). Because the prevalence of obesity in the studied population was similar to Center for Disease Control published data for obesity in all girls and the prevalence of increased BP is approximately twice that of the general population, the Turner syndrome phenotype/genotype probably includes an intrinsic risk for hypertension. Obesity and repaired aortic coarctation increase this risk further. There seems to be a BP awareness gap in girls with Turner syndrome. Because girls living with Turner syndrome are a sensitized population for hypertension, further study may provide clues to genetic factors leading to a better understanding of essential hypertension in the general population. PMID:27217413

  11. Breast-conserving therapy as a model for creating new knowledge in clinical oncology

    International Nuclear Information System (INIS)

    New knowledge can be derived from various kinds of studies. Studies of innovative approaches are the basis for progress. Some advances in treatment are so obvious that they do not need formal testing; e.g., penicillin for pneumococcal infection. For comparing interventions with small differences in efficacy or in groups without predictable outcome, prospective randomized trials are the 'gold standard'. However, randomized trials are cumbersome, expensive, and potentially difficult for both patients and physicians. Retrospective studies are less valid scientifically because they are more likely to suffer from bias, misclassification, confounding variables, and the use of multiple comparisons. Retrospective studies can be made more valid by first specifying the study design and analysis, but are generally most useful to generate hypotheses to be tested more formally. Retrospective studies can be particularly useful in improving outcome by identifying 'problems' and their causes. An important issue for radiation oncologists in doing retrospective studies is the difficulty of assessing an effect on local tumor control in diseases in which there are competing risks of local and distant failure. Many of these points will be illustrated in studies from the Joint Center for Radiation Therapy. Studies of innovative approaches, retrospective reviews and prospective randomized clinical trials have all been useful in establishing breast-conserving therapy as a safe and effective treatment for patients with early-stage breast cancer. Several studies of innovative breast-conserving therapy beginning in the 1960's showed favorable results. Based on this experience, a series of randomized clinical trials were initiated, beginning in the early 1970's, formally comparing mastectomy and breast-conserving therapy. These trials firmly established that the two forms of local treatment provide equivalent survival. Additional retrospective studies have also been useful in establishing

  12. Clinical and subclinical mastitis in smallholder dairy farms in Tanzania: risk, intervention and knowledge transfer.

    Science.gov (United States)

    Karimuribo, E D; Fitzpatrick, J L; Bell, C E; Swai, E S; Kambarage, D M; Ogden, N H; Bryant, M J; French, N P

    2006-04-17

    In a cross-sectional study of 400 randomly selected smallholder dairy farms in the Tanga and Iringa regions of Tanzania, 14.2% (95% confidence interval (CI)=11.6-17.3) of cows had developed clinical mastitis during the previous year. The point prevalence of subclinical mastitis, defined as a quarter positive by the California Mastitis Test (CMT) or by bacteriological culture, was 46.2% (95% CI=43.6-48.8) and 24.3% (95% CI=22.2-26.6), respectively. In a longitudinal disease study in Iringa, the incidence of clinical mastitis was 31.7 cases per 100 cow-years. A randomised intervention trial indicated that intramammary antibiotics significantly reduced the proportion of bacteriologically positive quarters in the short-term (14 days post-infusion) but teat dipping had no detectable effect on bacteriological infection and CMT positive quarters. Other risk and protective factors were identified from both the cross-sectional and longitudinal included animals with Boran breeding (odds ratio (OR)=3.40, 95% CI=1.00-11.57, Pmastitis, and OR=3.51, 95% CI=1.29-9.55, PCMT positive quarter), while the practice of residual calf suckling was protective for a bacteriologically positive quarter (OR=0.63, 95% CI=0.48-0.81, PCMT positive quarter (OR=0.69, 95% CI=0.63-0.75, Pmastitis training course for farmers and extension officers was held, and the knowledge gained and use of different methods of dissemination were assessed over time. In a subsequent randomised controlled trial, there were strong associations between knowledge gained and both the individual question asked and the combination of dissemination methods (village meeting, video and handout) used. This study demonstrated that both clinical and subclinical mastitis is common in smallholder dairying in Tanzania, and that some of the risk and protective factors for mastitis can be addressed by practical management of dairy cows following effective knowledge transfer. PMID:16488030

  13. 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

  14. Aging Q3: an initiative to improve internal medicine residents' geriatrics knowledge, skills, and clinical performance.

    Science.gov (United States)

    Moran, William P; Zapka, Jane; Iverson, Patty J; Zhao, Yumin; Wiley, M Kathleen; Pride, Pamela; Davis, Kimberly S

    2012-05-01

    A growing number of older adults coupled with a limited number of physicians trained in geriatrics presents a major challenge to ensuring quality medical care for this population. Innovations to incorporate geriatrics education into internal medicine residency programs are needed. To meet this need, in 2009, faculty at the Medical University of South Carolina developed Aging Q(3)-Quality Education, Quality Care, and Quality of Life. This multicomponent initiative recognizes the need for improved geriatrics educational tools and faculty development as well as systems changes to improve the knowledge and clinical performance of residents. To achieve these goals, faculty employ multiple intervention strategies, including lectures, rounds, academic detailing, visual cues, and electronic medical record prompts and decision support. The authors present examples from specific projects, based on care areas including vision screening, fall prevention, and caring for patients with dementia, all of which are based on the Assessing Care of Vulnerable Elders quality indicators. The authors describe the principles driving the design, implementation, and evaluation of the Aging Q(3) program. They present data from multiple sources that illustrate the effectiveness of the interventions to meet the knowledge, skill level, and behavior goals. The authors also address major challenges, including the maintenance of the teaching and modeling interventions over time within the context of demanding primary care and inpatient settings. This organized, evidence-based approach to quality improvement in resident education, as well as faculty leadership development, holds promise for successfully incorporating geriatrics education into internal medicine residencies. PMID:22450181

  15. Practice and Educational Gaps in Dermatology: Disorders of the Hair.

    Science.gov (United States)

    Colavincenzo, Maria L

    2016-07-01

    Clinical practice gaps exist in the care of hair patients. Attitude gaps include a relative lack of dermatologists interested in caring for patients with hair complaints, a potential underestimation of the effect of hair disorders on the quality of patients' lives, and potential failure to recognize the presentation of body dysmorphic disorder among patients with hair complaints. Knowledge gaps regarding the prevalence and presentation of hair loss disorders may lead to a delay in diagnosis and treatment of hair patients. Skill gaps in physical examination, particularly with dermoscopy of the scalp and hair, may affect the care of hair patients. PMID:27363884

  16. Idea Gaps, Object Gaps, and Trust Gaps in Economic Development

    OpenAIRE

    Barrett, Christopher B.

    1995-01-01

    Growth theory emphasizes capital accumulation and technological change or, as Romer [1993] describes them, idea gaps and object gaps. This paper makes the case for a third and final crucial element: trust. Trust has both direct effects on the process of economic development, especially in facilitating increased exchange, and indirect effects through its influence on incentives to investment in human and physical capital (objects) and to the acquisition and processing of knowledge (ideas). Int...

  17. Vector-borne diseases of small companion animals in Namibia: Literature review, knowledge gaps and opportunity for a One Health approach

    Directory of Open Access Journals (Sweden)

    Bruce H. Noden

    2015-03-01

    Full Text Available Namibia has a rich history in veterinary health but little is known about the vector-borne diseases that affect companion dogs and cats. The aim of this review is to summarise the existing published and available unpublished literature, put it into a wider geographical context, and explore some significant knowledge gaps. To date, only two filarial pathogens (Dirofilaria repens and Acanthocheilonema dracunculoides and three tick-borne pathogens (Babesia canis vogeli, Hepatozoon canis and Ehrlichia canis have been reported. Most studies have focused solely on dogs and cats in the urban Windhoek and surrounding areas, with almost nothing reported in rural farming areas, in either the populous northern regions or the low-income urban areas where animal owners have limited access to veterinary services. With the development of several biomedical training programmes in the country, there is now an excellent opportunity to address zoonotic vector-borne diseases through a One Health approach so as to assess the risks to small companion animals as well as diseases of public health importance.

  18. The application of fDOM sensors in freshwater systems: Limitations, knowledge gaps and recommendations for future enhancement and novel development

    Science.gov (United States)

    Downing, B. D.; Bergamaschi, B. A.; Pellerin, B. A.; Saraceno, J.; Kraus, T. E.

    2010-12-01

    Commercially-available, field deployable sensors designed to measure colored or chromophoric dissolved organic matter fluorescence (fDOM; ex370/em460 nm) in-situ are of considerable interest to researchers owing to their potential to serve as a proxy for continuous DOC concentrations in many freshwater environments. The major challenge with these sensors stems from non-linearity effects between measured fDOM and DOC concentration over the range of DOC encountered as well as interferences from organic and inorganic particles and temperature effects. A series of laboratory based evaluations were designed to compare inherent sensor optical geometries as well as reveal non-linearity effects due to (1) high fDOM concentrations (inner filter effects), (2), particle interference, and (3) temperature effects. In addition to evaluating the correlation between DOC concentration and fDOM, we considered sensor dynamic range and gain settings as well as data output protocol (e.g. analog or digital). Previous studies have illustrated the role of particle interference, which results in underestimates of fDOM greater than 50% at turbidities observed in many rivers and streams. Here, we present the results from the array of laboratory evaluations and discuss the practical limitations, propose correction methods and highlight knowledge gaps.

  19. Knowledge, attitude and practice towards child adoption amongst women attending infertility clinics in Lagos State, Nigeria

    Directory of Open Access Journals (Sweden)

    Adenike O. Omosun

    2011-02-01

    Full Text Available Background: Child adoption is a recommended alternative form of infertility management. Infertility is of public health importance in Nigeria and many other developing nations. This is a result of its high prevalence and especially because of its serious social implications as the African society places a passionate premium on procreation in any family setting. Objectives: The aim of this study was to determine the knowledge, attitude and practice of child adoption amongst women attending infertility clinics in teaching hospitals in Lagos State and to determine the factors that influence their attitude and practice towards it.Method: A cross-sectional descriptive design was used. Data were collected by using a structured questionnaire which was interviewer-administered. The study was conducted in the two teaching hospitals in Lagos State (LUTH [Lagos University Teaching Hospital] and LASUTH [Lagos State University Teaching Hospital] from amongst 350 women attending the gynaecological clinics. All the patients under management for infertility at the gynaecology clinics during the period of the study were interviewed.Results: Many respondents (85.7% had heard of child adoption and 59.3% of them knew the correct meaning of the term. More than half of the respondents (68.3% said that they could love an adopted child but less than half of them (33.7% were willing to consider adoption. Only 13.9% has ever adopted a child. The major reason given for their unwillingness to adopt was their desire to have their own biological child. Factors that were favourable towards child adoption were Igbo tribe identity, an age above 40 years, duration of infertility above 15 years, and knowing the correct meaning of child adoption.Conclusion: There is a poor attitude to adoption even amongst infertile couples. Interventions need to be implemented to educate the public on child adoption, to improve their attitude towards adoption and to make it more acceptable.

  20. 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)

  1. 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)

    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)

  2. The relationship between knowledge of hiv, self-perceived vulnerability and sexual risk behavior among community clinic workers in chile

    OpenAIRE

    Cabieses, Baltica; Ferrer, Lilian; Villarroel, Luis; Tunstall, Helena; Norr, Kathleen

    2012-01-01

    Objective Testing the hypothesis of an association between knowledge and sexual risk behaviour (SRB) amongst community-clinic workers in Chile, explained by the confounding effect of self-perceived vulnerability to HIV. Methods A cross-sectional survey was analyzed; it was nested within a quasiexperimental study of 720 community-clinic workers in Santiago. The SRB score combined the number of sexual partners and condom use (coded as “high”/”low” SRB). Knowledge of HIV (a 25-item index) was co...

  3. Relationship between knowledge of hiv, self-perceived vulnerability and sexual risk behaviours among community clinic workers in chile

    OpenAIRE

    Cabieses Valdes, Baltica; Ferrer Lagunas, Lilian; Villarroel del Pino, Luis; Tunstall, Helena; Norr, Kathleen

    2014-01-01

    Objective: To test the hypothesis of an association between knowledge and sexual risk behaviours (SRB) among community-clinic workers in Chile, explained by the confounding effect of self-perceived vulnerability to HIV. Methods: Analysis of a cross-sectional survey, nested within a quasi-experimental study of 720 community-clinic workers in Santiago. The SRB score combined number of sexual partners and condom use, coded as “high”/“low” SRB. The Knowledge of HIV, a 25-item index, was coded as ...

  4. A Study of the Competency of Third Year Medical Students to Interpret Biochemically Based Clinical Scenarios Using Knowledge and Skills Gained in Year 1 and 2

    Science.gov (United States)

    Gowda, Veena Bhaskar S.; Nagaiah, Bhaskar Hebbani; Sengodan, Bharathi

    2016-01-01

    Medical students build clinical knowledge on the grounds of previously obtained basic knowledge. The study aimed to evaluate the competency of third year medical students to interpret biochemically based clinical scenarios using knowledge and skills gained during year 1 and 2 of undergraduate medical training. Study was conducted on year 3 MBBS…

  5. Oral health knowledge among pre-clinical students of International Branch of Shiraz University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    2015-01-01

    Full Text Available   Background and Aims: Oral health is an important issue in public health with a great impact on individuals’ general health status. A good access to oral healthcare services and a good knowledge of it play a key role in the oral disease prevention. A better health attitude and practice require a better knowledge. The aims of this study was to evaluate the oral health knowledge among the International students branch (Kish of Shiraz University of Medical Sciences in 2011-12.   Materials and Methods: 159 pre-clinical students in medicine (54 students, dentistry (69 students and pharmacy (36 students participated in this research. A standard questionnaire was used as the main tool of research to evaluate the attitude and knowledge of students about the oral health. Data were analyzed using Chi-square test.   Results: According to the results, dental students had the best level of knowledge and pharmacy students had a better knowledge level compared to the medical students. The results also showed a significant relationship between students’ oral health knowledge and their field and duration of study and the place of their secondary school (P0.05.   Conclusion: The results showed that the students at the International Branch of Shiraz University of Medical Sciences had a relatively good knowledge of oral health. Students’ knowledge level can be improved by providing students with educational materials, organized workshops and seminars.

  6. Nutrition related knowledge and practices of hypertensive adults attending hypertensive clinics at day hospitals in the Cape Metropole

    OpenAIRE

    Becker, H; Bester, M.; N. Reyneke; Labadarios, D; Monyeki, K.D.; N.P. Steyn

    2004-01-01

    The aim of this study was to determine nutrition knowledge and dietary practices of hypertensive adults attending hypertensive clinics at Day Hospitals in the Cape Metropole. Ten Day Hospitals were randomly selected from a total of 31 Day Hospitals and the first participants attending the hypertension clinics per day were recruited. A total of 85 participants were evaluated. The weight, height, waist and hip circumference of each participant was measured, as well as their blood pressure. Know...

  7. School based oral health promotional intervention: Effect on knowledge, practices and clinical oral health related parameters

    Directory of Open Access Journals (Sweden)

    Arjun Gauba

    2013-01-01

    Full Text Available Background: No organized school oral health program is existent in India. Aim: The aim of this study is to test the feasibility and efficacy of an economical school oral health promotional intervention with educational and preventive components. Settings and Design: School oral health promotional intervention carried out in one of the randomly selected school and evaluated through short duration prospective model. Materials and Methods: A total of 100 children with an age range of 10-12 years with no previous history of dental intervention were enrolled. Interventions comprised of oral health education (delivered through lecture and demonstrations by an undergraduate dental student and topical antibacterial therapy (fluoride varnish and povidone iodine. Outcomes consisted of Knowledge and practices (KAP regarding oral health, clinical oral health related parameters such as plaque index (PI, gingival index (GI and caries activity as per Modified Snyder′s test. These were reported at baseline, 3 weeks and 6 months follow-up examination by a calibrated examiner. Statistical Analysis: McNemar Bowker′s test, Student′s t-test, Pearson Chi-square tests were used. Results: Highly significant (P < 0.001 improvements in KAP scores, PI scores, GI scores and caries activity were reported at 3 weeks and 6 months follow-up examination. Conclusion: This small economical school oral health program positively influenced oral health related practices and parameters of oral health such as oral cleanliness, gingival health and caries activity.

  8. Assessing anthropogenic pressures on coastal marine ecosystems using stable CNS isotopes: State of the art, knowledge gaps, and community-scale perspectives

    Science.gov (United States)

    Mancinelli, Giorgio; Vizzini, Salvatrice

    2015-04-01

    In recent decades, the analysis of carbon, nitrogen and sulfur stable isotopes (SIA) has emerged as a powerful, viable methodology for examining food web structure and dynamics, as well as addressing a number of applied issues. Here, we provide a state-of-the-art review of the use of SIA for assessing anthropogenic pressures on natural ecosystems, in order to establish current knowledge gaps and identify promising applications for evaluating the ecological status of marine coastal waters. Specifically, the potential of SIA to provide food web-scale indicators for estimating cumulative anthropogenic pressures is addressed. The review indicates that the methodology has been used for virtually the whole spectrum of human pressures known to influence marine ecosystems. However, only the effects of chemical pollution, release of dissolved and particulate nutrients, and invasive species have been extensively investigated. For the first two pressures, substantial efforts have been made to implement isotopic quantitative approaches and metrics for inter-system comparisons; however, with the exception of nutrient release, the majority of aquatic studies have been carried out in freshwater systems, and only limited information is available on marine environments. In particular, the effects of invasive species on coastal habitats have received scant attention. Trophic position of indicator species emerges as the isotopic metric most ubiquitously adopted for measuring the impact of anthropogenic pressures. Conversely, the application of other recently implemented metrics, proven to be highly effective in integrating information on the spatial-temporal dynamics of aquatic food webs, is to date still limited. The potential of stable isotope analysis to provide a unifying methodological-theoretical framework for effective, inter-ecosystem comparisons of both single and multiple anthropogenic pressures is emphasised. Additionally, a plea for the implementation and intercalibration

  9. Expanding the Basic Science Debate: The Role of Physics Knowledge in Interpreting Clinical Findings

    Science.gov (United States)

    Goldszmidt, Mark; Minda, John Paul; Devantier, Sarah L.; Skye, Aimee L.; Woods, Nicole N.

    2012-01-01

    Current research suggests a role for biomedical knowledge in learning and retaining concepts related to medical diagnosis. However, learning may be influenced by other, non-biomedical knowledge. We explored this idea using an experimental design and examined the effects of causal knowledge on the learning, retention, and interpretation of medical…

  10. The music therapy clinical intern: performance skills, academic knowledge, personal qualities, and interpersonal skills necessary for a student seeking clinical training.

    Science.gov (United States)

    Brookins, L M

    1984-01-01

    The music therapy curriculum consists of two distinct parts: the academic phase and the internship. The music therapy student must apply for a clinical internship during the last year of the academic phase, and the student is expected to evolve from student to professional music therapist during the internship phase. The present study sought to determine the skills, knowledge, and qualities clinical training directors considered most important for a prospective intern to possess. The sample population of the survey consisted of 25 clinical training directors from the Great Lakes Region. Results of the survey indicated that piano skills, knowledge of psychology, emotional maturity, and the ability to express needs and feelings were considered most important for the prospective intern to possess. PMID:10269791

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

    NARCIS (Netherlands)

    Driessen Mareeuw, F.A. van den; Vaandrager, L.; Klerkx, L.; Naaldenberg, J.; Koelen, M.

    2015-01-01

    BACKGROUND: 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

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

    NARCIS (Netherlands)

    Driessen Mareeuw, van den F.; Vaandrager, L.; Klerkx, L.W.A.; Naaldenberg, J.; Koelen, M.

    2015-01-01

    Background: 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

  13. Ontology-supported processing of clinical text using medical knowledge integration for multi-label classification of diagnosis coding

    CERN Document Server

    Waraporn, Phanu; Clayton, Gareth

    2010-01-01

    This paper discusses the knowledge integration of clinical information extracted from distributed medical ontology in order to ameliorate a machine learning-based multi-label coding assignment system. The proposed approach is implemented using a decision tree based cascade hierarchical technique on the university hospital data for patients with Coronary Heart Disease (CHD). The preliminary results obtained show a satisfactory finding.

  14. Promoting Clinical Knowledge, Skills, and Empathy via a Creative Self-Suicide Assignment: Rationale, Purpose, and Student Responses

    Science.gov (United States)

    Cook, Katrina; Juhnke, Gerald A.; Peters, Scott W.; Marbach, Christina R.; Day, Sally; Choucroun, Pierre; Baker, Ria E.

    2007-01-01

    Suicide is a leading cause of American deaths. Given suicide's overall frequency and negative effects, specialized suicide training is warranted. This article describes a creative self-suicide assignment designed to enhance doctoral students' suicide assessment and intervention knowledge and clinical skills, and promote greater counselor empathy…

  15. Development and Analysis of an Instrument to Assess Student Understanding of GOB Chemistry Knowledge Relevant to Clinical Nursing Practice

    Science.gov (United States)

    Brown, Corina E.; Hyslop, Richard M.; Barbera, Jack

    2015-01-01

    The General, Organic, and Biological Chemistry Knowledge Assessment (GOB-CKA) is a multiple-choice instrument designed to assess students' understanding of the chemistry topics deemed important to clinical nursing practice. This manuscript describes the development process of the individual items along with a psychometric evaluation of the…

  16. Supersize me: Cronobacter sakazakii phage GAP32.

    OpenAIRE

    Abbasifar, Reza; Griffiths, Mansel W; Sabour, Parviz M.; Ackermann, Hans-Wolfgang; Vandersteegen, Katrien; Lavigne, Rob; Noben, Jean-Paul; Alanis Villa, Argentina; Abbasifar, Arash; Nash, John H E; Kropinski, Andrew M.

    2014-01-01

    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_CsaM_GAP32 (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 wer...

  17. Knowledge of family history as a clinically useful index of psychological well-being and prognosis: A brief report.

    Science.gov (United States)

    Duke, Marshall P; Lazarus, Amber; Fivush, Robyn

    2008-06-01

    Based on an instance of "clinical lore" we assess the efficacy of children's and adolescents' knowledge of family history as an index of psychological well-being and potential for positive change in clinical and educational settings. We report that knowledge of family history is significantly correlated with internal locus of control, higher self-esteem, better family functioning, greater family cohesiveness, lower levels of anxiety, and lower incidence of behavior problems. We suggest that through the use of a brief measure of family knowledge, practicing clinicians can rapidly generate a data-based correlate of children's well-being and likelihood of overcoming psychological and educational challenges. (PsycINFO Database Record (c) 2010 APA, all rights reserved). PMID:22122420

  18. Learning in context: identifying gaps in research on the transfer of medical communication skills to the clinical workplace.

    NARCIS (Netherlands)

    Eertwegh, V. van den; Dulmen, S. van; Dalen, J. van; Scherpbier, A.J.J.A.; Vleuten, C.P.M. van der

    2013-01-01

    Objective: In order to reduce the inconsistencies of findings and the apparent low transfer of communication skills from training to medical practice, this narrative review identifies some main gaps in research on medical communication skills training and presents insights from theories on learning

  19. Learning in context: identifying gaps in research on the transfer of medical communication skills to the clinical workplace

    NARCIS (Netherlands)

    Eertwegh, V. van den; Dulmen, S. van; Dalen, J. Van; Scherpbier, A.J.J.A.; Vleuten, C.P.M. van der

    2013-01-01

    OBJECTIVE: In order to reduce the inconsistencies of findings and the apparent low transfer of communication skills from training to medical practice, this narrative review identifies some main gaps in research on medical communication skills training and presents insights from theories on learning

  20. Knowledge Toward Cancer Pain and the Use of Opioid Analgesics Among Medical Students in their Integrated Clinical Clerkship

    Directory of Open Access Journals (Sweden)

    Maria Fidelis C. Manalo

    2008-01-01

    Full Text Available Introduction: Among the focal issues of barriers to pain management include the physicians’ lack of knowledge about cancer pain and negative attitudes towards opioids. Many physicians and educators attribute this, at least in part, to limited exposure to pain and palliative care education during medical school.Aim: The researcher investigated the medical students’ knowledge about cancer pain and the use of opioid analgesics.Methods: The subjects were a sample of 50 students of the University of the Philippines College of Medicine in their integrated clinical clerkship year. Descriptive statistics (frequencies, means, standard deviation, rating scales were used to determine mean knowledge score and level of confidence with opioid use. The study also identified specific areas where students exhibited good or poor knowledge of opioids.Results: Approximately sixty-nine (69% of the study respondents mentioned that pain management was given to them during their Anesthesiology lectures while a few recalled that they had these lectures during their Family Medicine rotation in Supportive, Palliative and Hospice Care. More than a third (35% of the respondents admitted to not being confident with morphine use at present. The top three reasons cited as limitations in choice of opioids for cancer pain include fear of addiction, lack of adequate knowledge and experience and fear of side effects and complications. Out of a maximum of 13 correct answers, the mean knowledge score of the medical students was 6.6 ± 2.9. Less than 16% of the respondents had adequate knowledge on cancer pain and opioid use.Conclusions: The results show that basic knowledge of the role of opioids in cancer pain management among medical students in their integrated clinical clerkship year at the University of the Philippines is poor. The findings imply a need to look into making revisions in the medical curriculum to include a training program that will enable all students to

  1. Using Health Technology Assessment to Identify Research Gaps: An Unexploited Resource for Increasing the Value of Clinical Research

    OpenAIRE

    Scott, N Ann; Moga, Carmen; Harstall, Christa; Magnan, Jacques

    2008-01-01

    Health technology assessments (HTAs) are an as yet unexploited source of comprehensive, systematically generated information that could be used by research funding agencies to formulate researchable questions that are relevant to decision-makers. We describe a process that was developed for distilling evidence gaps identified in HTAs into researchable questions that a provincial research funding agency can use to inform its research agenda. The challenges of moving forward with this initiativ...

  2. The Lack Of Effective Hand Washing Practice Despite High Level Of Knowledge And Awareness In Medical Students Of Clinical Years

    Directory of Open Access Journals (Sweden)

    S Sulaiha S A

    2010-12-01

    Full Text Available Background: Nosocomial infection is among the leading problem in many major hospitals resulting in soaring cost expenditure in managing its affect.Hand washing practice is a crucial preventive way to contain such mischief but many ignored its importance. This is perhaps due to lack of appropriate role modeling from senior practitioners.Subjects and methods: Our study examined the prevalence of hand washing practice among medical students from year 3 to 5 and compared it to their knowledge and level of awareness on its importance in clinical practice. 142 students were randomly observed during their clinical work in the wards on this practice and questionnaires were later distributed to 268 students from all semesters on their knowledge on the technique and awareness on its importance.Results: Out of 142, almost 80% washed their hands but only 41.6% performed effective hand washing. In contrary, 80 to 90% showed good level of knowledge and awareness as well as perception about its importance in clinical practice.Conclusions: The contradictory findings between the actual practice of hand washing and knowledge as well as awareness suggest that enforcement on the practice is necessary. This requires motivation and cooperation from all health alliances and higher authority in the health system. Remedial measures are much needed in order to contain high.

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

    OpenAIRE

    Driessen Mareeuw, F.A. van den; Vaandrager, L; Klerkx, L.; Naaldenberg, J.; Koelen, M

    2015-01-01

    BACKGROUND: 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. METHODS: An exploratory qualitative design including in-depth semi-structured interviews was used, with 3...

  4. Road map towards a climate-proof Netherlands. Quickscan. Knowledge supply and gaps in climate stability. Effects, adaptation strategies and societal embedding

    International Nuclear Information System (INIS)

    This quick scan provides an overview of knowledge development with regard to adaptation to climate change within the Dutch BSIK schemes (Investing in Knowledge Infrastructure Scheme) and related research at knowledge institutes. This is done for the National Programme 'Spatial Planning and Adaptation to Climate Change' (ARK). [mk

  5. Assessment of Genetics Knowledge and Skills in Medical Students: Insight for a Clinical Neurogenetics Curriculum

    Science.gov (United States)

    Pearl, Phillip L.; Pettiford, Jennifer M.; Combs, Susan E.; Heffron, Ari; Healton, Sean; Hovaguimian, Alexandra; Macri, Charles J.

    2011-01-01

    The pace of discovery in biochemistry and genetics and its effect on clinical medicine places new curricular challenges in medical school education. We sought to evaluate students' understanding of neurogenetics and its clinical applications to design a pilot curriculum into the clinical neurology clerkship. We utilized a needs assessment and a…

  6. Pharmacy Education Reaction to Presentations on Bridging the Gap Between the Basic Sciences and Clinical Practice: Teaching, Research, and Service.

    Science.gov (United States)

    Doluisio, James T.

    1980-01-01

    Issues in the conflict between clinical practice and basic research in pharmacy are reviewed: professional associations' role, curriculum needs and traditions, internal strains and diversity in the profession, computer use, scholarly work of faculty, using the medical profession as a model, and misperceptions of what clinical and basic sciences…

  7. Primary healthcare provider knowledge, beliefs and clinic-based practices regarding alternative tobacco products and marijuana: a qualitative study.

    Science.gov (United States)

    Bascombe, Ta Misha S; Scott, Kimberly N; Ballard, Denise; Smith, Samantha A; Thompson, Winifred; Berg, Carla J

    2016-06-01

    Use prevalence of alternative tobacco products and marijuana has increased dramatically. Unfortunately, clinical guidelines have focused on traditional cigarettes with limited attention regarding these emerging public health issues. Thus, it is critical to understand how healthcare professionals view this issue and are responding to it. This qualitative study explored knowledge, beliefs and clinic-based practices regarding traditional and alternative tobacco products (cigar-like products, smokeless tobacco, hookah, e-cigarettes) and marijuana among rural and urban Georgia primary healthcare providers. The sample comprised 20 healthcare providers in primary care settings located in the Atlanta Metropolitan area and rural southern Georgia who participated in semi-structured interviews. Results indicated a lack of knowledge about these products, with some believing that some products were less harmful than traditional cigarettes or that they may be effective in promoting cessation or harm reduction. Few reported explicitly assessing use of these various products in clinic. In addition, healthcare providers reported a need for empirical evidence to inform their clinical practice. Healthcare providers must systematically assess use of the range of tobacco products and marijuana. Evidence-based recommendations or information sources are needed to inform clinical practice and help providers navigate conversations with patients using or inquiring about these products. PMID:26802106

  8. Mathematical knowledge and drug dosage calculation: Necessary clinical skills for the nurse

    OpenAIRE

    Athanasakis Efstratios

    2013-01-01

    When nurses perform their tasks, they manage situations where maths knowledge is required. Such a situation is the calculation of medication dosage. Aim: The literature review of papers relevant with the mathematical knowledge and drug calculation skills of nurses and nursing students. Material-Method: A search of published research and review articles from January 1989 until March 2012, has been conducted in Pubmed database. The search terms used were: nurses, mathematics skills, numeracy sk...

  9. A UMLS-based knowledge acquisition tool for rule-based clinical decision support system development.

    OpenAIRE

    Achour, Soumeya,; Dojat, Michel; Rieux, Claire; Bierling, Philippe; Lepage, Eric

    2001-01-01

    International audience Decision support systems in the medical field have to be easily modified by medical experts themselves. The authors have designed a knowledge acquisition tool to facilitate the creation and maintenance of a knowledge base by the domain expert and its sharing and reuse by other institutions. The Unified Medical Language System (UMLS) contains the domain entities and constitutes the relations repository from which the expert builds, through a specific browser, the expl...

  10. The clinical application of Photoshop in image post-processing of no-gap-lower-limb digital photography

    International Nuclear Information System (INIS)

    Objective: To explore the value of Photoshop in image post-processing of digital total lower-limb X-ray photography, so as to obtain a more reasonable and accurate photography. Methods: Digital total lower-limb X-ray photography was performed in 34 patients, and the films were printed. Then the digital imaging were converted to a total no-gap-tower-limb photography by Adobe Photoshop CS software and were printed in A4 sheets. The Q angles ( the angle between the line of femoral axis and the line of central points of femoral head, knee joint and ankle joint) were measured by radiologists and orthopedists. The films and pages were evaluated separately by radiologists and orthopedists. The Q angles were compared. Results: There were 25 cases retrograde osteoarthritis of knee joints inl9 patients (6 patients were involved two sides), 15 cases of rheumatoid osteoarthritis in 12 patients, 1 case of malformation, 1 case of traumatic osteoarthritis, and 1 case of TB. Twenty-six of these patients were performed the knee joint replacement operations. The Q angle in films were (6.3±0.8) degree, and (6.1±0.3) degree in sheets. There was no significant difference between the two methods (paired-t-test, t=0.022, P>0.5). Conclusion: Photoshop software could be used readily to obtain a optional total no-gap-lower limb photography satisfying diagnostic and operational needs of orthopedics. (authors)

  11. Defining the effect and mediators of two knowledge translation strategies designed to alter knowledge, intent and clinical utilization of rehabilitation outcome measures: a study protocol [NCT00298727

    Directory of Open Access Journals (Sweden)

    Law Mary

    2006-07-01

    Full Text Available Abstract Background A substantial number of valid outcome measures have been developed to measure health in adult musculoskeletal and childhood disability. Regrettably, national initiatives have merely resulted in changes in attitude, while utilization remains unacceptably low. This study will compare the effectiveness and mediators of two different knowledge transfer (KT interventions in terms of their impact on changing knowledge and behavior (utilization and clinical reasoning related to health outcome measures. Method/Design Physical and occupational therapists (n = 144 will be recruited in partnership with the national professional associations to evaluate two different KT interventions with the same curriculum: 1 Stakeholder-Hosted Interactive Problem-Based Seminar (SHIPS, and 2 Online Problem-Based course (e-PBL. SHIPS will consist of face-to-face problem-based learning (PBL for 2 1/2 days with outcome measure developers as facilitators, using six problems generated in consultation with participants. The e-PBL will consist of a 6-week web-based course with six generic problems developed by content experts. SHIPS will be conducted in three urban centers in Canada. Participants will be block-allocated by a minimization procedure to either of the two interventions to minimize any prognostic differences. Trained evaluators at each site will conduct chart audits and chart-stimulated recall. Trained interviewers will conduct semi-structured interviews focused on identifying critical elements in KT and implementing practice changes. Interviews will be transcribed verbatim. Baseline predictors including demographics, knowledge, attitudes/barriers regarding outcome measures, and Readiness to Change will be assessed by self-report. Immediately post-intervention and 6 months later, these will be re-administered. Primary qualitative and quantitative evaluations will be conducted 6-months post-intervention to assess the relative effectiveness of KT

  12. Integrating knowledge-driven and data-driven approaches in the derivation of clinical prediction rules

    OpenAIRE

    Kwiatkowska, Bogumila

    2006-01-01

    Clinical prediction rules play an important role in medical practice. They expedite diagnosis and treatment for the serious cases and limit unnecessary tests for low-probability cases. However, the creation process for prediction rules is costly, lengthy, and involves several steps: initial clinical trials, rule generation and refinement, validation, and evaluation in clinical settings. With the current development of efficient data mining algorithms and growing accessibility to a vast amount...

  13. Clinical practice guidelines for translating pharmacogenomic knowledge to bedside. Focus on anticancer drugs.

    OpenAIRE

    Agúndez, José A. G.; Gara eEsguevillas; Gemma eAmo; Elena eGarcía-Martín

    2014-01-01

    The development of clinical practice recommendations or guidelines for the clinical use of pharmacogenomics data is an essential issue for improving drug therapy, particularly for drugs with high toxicity and/or narrow therapeutic index such as anticancer drugs. Although pharmacogenomic-based recommendations have been formulated for over 40 anticancer drugs, the number of clinical practice guidelines available is very low. The guidelines already published indicate that pharmacogenomic testing...

  14. Clinical practice guidelines for translating pharmacogenomic knowledge to bedside. Focus on anticancer drugs

    OpenAIRE

    Agúndez, José A. G.; Esguevillas, Gara; Amo, Gemma; García-Martín, Elena

    2014-01-01

    The development of clinical practice recommendations or guidelines for the clinical use of pharmacogenomics data is an essential issue for improving drug therapy, particularly for drugs with high toxicity and/or narrow therapeutic index such as anticancer drugs. Although pharmacogenomic-based recommendations have been formulated for over 40 anticancer drugs, the number of clinical practice guidelines available is very low. The guidelines already published indicate that pharmacogenomic testing...

  15. Knowledge and perception regarding clinical trials among doctors of government medical colleges: A questionnaire-based study

    Directory of Open Access Journals (Sweden)

    Supriyo Choudhury

    2016-01-01

    Full Text Available Aims: By virtue of being a specialized field by itself, the science of clinical trials (CTs may not be well understood by doctors who are not specifically trained in it. A lack of knowledge may translate to a negative perception toward CT. With the idea of getting a situational snapshot, we estimated the knowledge and perception of CTs among doctors from government medical colleges of West Bengal who are not trained on CT in their postgraduate curriculum. Several determinants of knowledge and perception regarding CT were also evaluated. Methods: We have quantified the knowledge and perception of CTs by a structured validated questionnaire. Development and validation of the questionnaire was performed prior to the study. Results: Among 133 participants, 7.5% received focused training on CT and 16.5% participated in CTs as investigators. Majority of the doctors were unfamiliar with the basic terminologies such as, “adverse event” and “good clinical practice.” Encouragingly, 93.3% doctors advised that a detailed discussion of CT methodology should be incorporated in the under graduate medical science curriculum. They had an overall positive attitude toward CTs conducted in India, with a mean score that is 72.6% of the maximum positive score. However, a large number of the doctors were skeptical about the primary motivation and operations of pharmaceutical industry sponsored CTs, with 45% of them believing that patients are exploited in these sponsored CTs. Conclusion: Participant doctors had a basic knowledge of CT methodology. The study has revealed specific areas of deficient knowledge, which might be emphasized while designing focused training on CT methodology.

  16. Gap Junctions

    OpenAIRE

    Goodenough, Daniel A.; Paul, David L.

    2009-01-01

    Gap junctions are aggregates of intercellular channels that permit direct cell–cell transfer of ions and small molecules. Initially described as low-resistance ion pathways joining excitable cells (nerve and muscle), gap junctions are found joining virtually all cells in solid tissues. Their long evolutionary history has permitted adaptation of gap-junctional intercellular communication to a variety of functions, with multiple regulatory mechanisms. Gap-junctional channels are composed of hex...

  17. Gap Junctions

    OpenAIRE

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

    2012-01-01

    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 ...

  18. Exercise and Fall Prevention: Narrowing the Research-to-Practice Gap and Enhancing Integration of Clinical and Community Practice.

    Science.gov (United States)

    Li, Fuzhong; Eckstrom, Elizabeth; Harmer, Peter; Fitzgerald, Kathleen; Voit, Jan; Cameron, Kathleen A

    2016-02-01

    Falls in older adults are a global public health crisis, but mounting evidence from randomized controlled trials shows that falls can be reduced through exercise. Public health authorities and healthcare professionals endorse the use of evidence-based, exercise-focused fall interventions, but there are major obstacles to translating and disseminating research findings into healthcare practice, including lack of evidence of the transferability of efficacy trial results to clinical and community settings, insufficient local expertise to roll out community exercise programs, and inadequate infrastructure to integrate evidence-based programs into clinical and community practice. The practical solutions highlighted in this article can be used to address these evidence-to-practice challenges. Falls and their associated healthcare costs can be reduced by better integrating research on exercise intervention into clinical practice and community programs. PMID:26825429

  19. Considering Human Capital Theory in Assessment and Training: Mapping the Gap between Current Skills and the Needs of a Knowledge-Based Economy in Northeast Iowa

    Science.gov (United States)

    Mihm-Herold, Wendy

    2010-01-01

    In light of the current economic downturn, thousands of Iowans are unemployed and this is the ideal time to build the skills of the workforce to compete in the knowledge-based economy so businesses and entrepreneurs can compete in a global economy. A tool for assessing the skills and knowledge of dislocated workers and students as well as…

  20. SysBank: A Knowledge Base for Systematic Reviews of Randomized Clinical Trials

    OpenAIRE

    Carini, Simona; Sim, Ida

    2003-01-01

    The Systematic Review Bank (SysBank) is a structured knowledge base that captures information about the design, execution, and results of systematic reviews of randomized controlled trials (RCTs). The SysBank data model has been adapted from RCT Bank, a knowledge base of randomized trials, and refined using three published systematic reviews. SysBank links directly to the RCT Bank entries of studies included in the systematic review. SysBank builds upon RCT Bank to support computer-assisted e...

  1. Health and nutrition knowledge, attitudes and practices of pregnant women attending and not-attending ANC clinics in Western Kenya: a cross-sectional analysis

    OpenAIRE

    Perumal, Nandita; Cole, Donald C; Ouédraogo, Hermann Z; Sindi, Kirimi; Loechl, Cornelia; Low, Jan; Levin, Carol; Kiria, Christine; Kurji, Jaameeta; Oyunga, Mary

    2013-01-01

    Background Antenatal care (ANC) is a key strategy to decreasing maternal mortality in low-resource settings. ANC clinics provide resources to improve nutrition and health knowledge and promote preventive health practices. We sought to compare the knowledge, attitude and practices (KAP) among women seeking and not-seeking ANC in rural Kenya. Methods Data from a community-based cross-sectional survey conducted in Western Province, Kenya were used. Nutrition knowledge (NKS), health knowledge (HK...

  2. Semi-automatic Generation of a Patient Preoperative Knowledge-Base from a Legacy Clinical Database

    Science.gov (United States)

    Bouamrane, Matt-Mouley; Rector, Alan; Hurrell, Martin

    We discuss our practical experience of automating the process of migrating a clinical database with a weak underlying information model towards a high level representation of a patient medical history information in the Web Ontology Language (OWL). The purpose of this migration is to enable sophisticated clinical decision support functionalities based on semantic-web technologies, i.e. reasoning on a clinical ontology. We discuss the research and practical motivation behind this process, including improved interoperability and additional classification functionalities. We propose a methodology to optimise the efficiency of this process and provide practical implementation examples.

  3. Nigerian dentists′ knowledge of aggressive periodontitis

    Directory of Open Access Journals (Sweden)

    Solomon Olusegun Nwhator

    2014-01-01

    Full Text Available Objective: To assess the general knowledge of Nigerian dentists on aggressive periodontitis (AgP and specific knowledge of distinguishing between the clinical features of localized aggressive periodontitis (LAP and generalized aggressive periodontitis (GAP. Materials and Methods: A cross-sectional, non-random convenience survey was done on 200 dentists, in three geopolitical zones of Nigeria, using pre-tested, closed question– type questionnaires. Eventually, only 133 questionnaires were analyzed. Relationships between six outcome variables namely clinical features of LAP, clinical features of GAP, LAP oral hygiene, GAP oral hygiene, laser therapy option and type of laser therapy, and the explanatory variables of gender and experience were analyzed. Results: A total of 33.8% of the dentists had poor general knowledge, 16.5% had fair knowledge, 31.9% had good knowledge, while 10.5% had excellent knowledge. Gender- and experience-related differences were found, but they were not statistically signifi cant. Conclusion: Both the general and specifi c knowledge of aggressive periodontitis among Nigerian dentists is less than expected and needs improvement through targeted, continuing dental education.

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

    OpenAIRE

    Huser V; Sincan M; Cimino JJ

    2014-01-01

    Vojtech Huser,1 Murat Sincan,2,3 James J Cimino1,4 1Laboratory for Informatics Development, National Institutes of Health Clinical Center, Bethesda, MD, USA; 2Undiagnosed Diseases Program, 3Office of the Clinical Director, National Human Genome Research Institute, National Institutes of Health, MD, USA; 4National Library of Medicine, National Institutes of Health, MD, USA Abstract: Personalized medicine, the ability to tailor diagnostic and treatment decisions for individual patients, is seen...

  5. Bridging the Gap between the Regional Systems of Innovation Approach and Knowledge Creation Theory : A Survey of Viewpoints and a Framework towards Understanding and Enhancing Regional Knowledge Creation <資料>

    OpenAIRE

    Argüero, Luis Ignacio

    2009-01-01

    In the last decades, two issues have gained a lot of attention in papers dealing with the knowledge based economy and society: on the one hand, the studies on how the local environment promotes innovation; on the other hand, the SECI model knowledge creation theory, mostly based in the firm level. Both approaches present interesting and original points but lack a bridge that could unify the concepts towards a better understanding of the knowledge creation process at the regional level. In thi...

  6. Clinical practice guidelines for translating pharmacogenomic knowledge to bedside. Focus on anticancer drugs.

    Directory of Open Access Journals (Sweden)

    José A G Agúndez

    2014-08-01

    Full Text Available The development of clinical practice recommendations or guidelines for the clinical use of pharmacogenomics data is an essential issue for improving drug therapy, particularly for drugs with high toxicity and/or narrow therapeutic index such as anticancer drugs. Although pharmacogenomic-based recommendations have been formulated for over 40 anticancer drugs, the number of clinical practice guidelines available is very low. The guidelines already published indicate that pharmacogenomic testing is useful for patient selection, but final dosing adjustment should be carried out on the basis of clinical or analytical parameters rather than on pharmacogenomic information.Patient selection may seem a modest objective, but it constitutes a crucial improvement with regard to the pre-pharmacogenomics situation and it saves patients’ lives. However we should not overstate the current power of pharmacogenomics. At present the pharmacogenomics of anticancer drugs is not sufficiently developed for dose adjustments based on pharmacogenomics only, and no current guidelines recommend such adjustments without considering clinical and/or analytical parameters.

  7. The art of self-knowledge and deduction in clinical practice.

    Science.gov (United States)

    Gardiner, Fergus William

    2016-09-01

    Clinical reasoning involves interviewing the patient, taking a history, and carefully scrutinising objects in the environment, via a physical examination, and the interpretation of medical results. Developments in medicine are trending towards the routine use of sophisticated diagnostic tools. While important, these trends may be leading clinicians to rely on expensive tests, while not using or improving the art of clinical deduction. The ideal clinician knows themselves and their environment, truly observes, imagines the possibilities, deduces from what they observe, and continually learns. This allows the clinician to use all of their senses, while not primarily relying on a diagnostic test. PMID:27489620

  8. Establishing the role of honest broker: bridging the gap between protecting personal health data and clinical research efficiency.

    Science.gov (United States)

    Choi, Hyo Joung; Lee, Min Joung; Choi, Chang-Min; Lee, JaeHo; Shin, Soo-Yong; Lyu, Yungman; Park, Yu Rang; Yoo, Soyoung

    2015-01-01

    Background. The objective of this study is to propose the four conditions for the roles of honest brokers through a review of literature published by ten institutions that are successfully utilizing honest brokers. Furthermore, the study aims to examine whether the Asan Medical Center's (AMC) honest brokers satisfy the four conditions, and examine the need to enhance their roles. Methods. We analyzed the roles, tasks, and types of honest brokers at 10 organizations by reviewing the literature. We also established a Task Force (TF) in our institution for setting the roles and processes of the honest broker system and the honest brokers. The findings of the literature search were compared with the existing systems at AMC-which introduced the honest broker system for the first time in Korea. Results. Only one organization employed an honest broker for validating anonymized clinical data and monitoring the anonymity verifications of the honest broker system. Six organizations complied with HIPAA privacy regulations, while four organizations did not disclose compliance. By comparing functions with those of the AMC, the following four main characteristics of honest brokers were determined: (1) de-identification of clinical data; (2) independence; (3) checking that the data are used only for purposes approved by the IRB; and (4) provision of de-identified data to researchers. These roles were then compared with those of honest brokers at the AMC. Discussion. First, guidelines that regulate the definitions, purposes, roles, and requirements for honest brokers are needed, since there are no currently existing regulations. Second, Korean clinical research institutions and national regulatory departments need to reach a consensus on a Korean version of Limited Data Sets (LDS), since there are no lists that describe the use of personal identification information. Lastly, satisfaction surveys on honest brokers by researchers are necessary to improve the quality of honest

  9. Knowledge, attitudes and practices of HIV-positive patients regarding disclosure of HIV results at Betesda Clinic in Namibia

    Directory of Open Access Journals (Sweden)

    Penelope Tom

    2013-01-01

    Full Text Available Background: This study examined the practices, knowledge, attitudes, and the reasons for disclosure and non-disclosure of HIV-positive patients with regard to the disclosure of HIV results at Betesda Clinic in Windhoek, Namibia.Objectives: The objectives of the study were to determine knowledge, attitudes, and practices of HIV-positive patients regarding the disclosure of HIV status at Betesda Clinic in Namibia, and to determine the reasons for disclosure and non-disclosure.Methods: This was a cross-sectional descriptive study and 263 HIV-positive patients were enrolled in the study.Results: Analyses revealed that knowledge on disclosure was good, with 68% who thought it was important. The majority (73% have disclosed and 60% disclosed within 1 week of receiving their results. The most common reasons for disclosure were that 32% needed help, 25% wanted his or her partner to go for testing, and 20% wanted to let relatives know. Reasons for non-disclosure were mainly the fear of gossip (79%. Seventy-three per cent had disclosed to their partners, and 23% had disclosed to more than one person. People’s reactions were supportive in 43%, whereas 29% understood, 9% accepted and 6% were angry. Upon disclosure 40% received help, 24% of partners were tested, 23% received psychological support and 5% were stigmatised. Disclosure was higher amongst the married and cohabitating.Conclusion: The attitude was positive with regard to knowledge of disclosure, with most participants thinking that disclosure was important and good. The attitudes and actual practices of disclosure were encouraging; however, people are disclosing only to trusted individuals in the society and the fear of stigma is still present although the actual stigma was very low.

  10. Knowledge, attitudes and practices of HIV-positive patients regarding disclosure of HIV results at Betesda Clinic in Namibia

    Directory of Open Access Journals (Sweden)

    Penelope Tom

    2013-02-01

    Full Text Available Background: This study examined the practices, knowledge, attitudes, and the reasons for disclosure and non-disclosure of HIV-positive patients with regard to the disclosure of HIV results at Betesda Clinic in Windhoek, Namibia.Objectives: The objectives of the study were to determine knowledge, attitudes, and practices of HIV-positive patients regarding the disclosure of HIV status at Betesda Clinic in Namibia, and to determine the reasons for disclosure and non-disclosure.Methods: This was a cross-sectional descriptive study and 263 HIV-positive patients were enrolled in the study.Results: Analyses revealed that knowledge on disclosure was good, with 68% who thought it was important. The majority (73% have disclosed and 60% disclosed within 1 week of receiving their results. The most common reasons for disclosure were that 32% needed help, 25% wanted his or her partner to go for testing, and 20% wanted to let relatives know. Reasons for non-disclosure were mainly the fear of gossip (79%. Seventy-three per cent had disclosed to their partners, and 23% had disclosed to more than one person. People’s reactions were supportive in 43%, whereas 29% understood, 9% accepted and 6% were angry. Upon disclosure 40% received help, 24% of partners were tested, 23% received psychological support and 5% were stigmatised. Disclosure was higher amongst the married and cohabitating.Conclusion: The attitude was positive with regard to knowledge of disclosure, with most participants thinking that disclosure was important and good. The attitudes and actual practices of disclosure were encouraging; however, people are disclosing only to trustedindividuals in the society and the fear of stigma is still present although the actual stigma was very low.

  11. Nutrition related knowledge and practices of hypertensive adults attending hypertensive clinics at day hospitals in the Cape Metropole

    Directory of Open Access Journals (Sweden)

    H. Becker

    2004-09-01

    Full Text Available The aim of this study was to determine nutrition knowledge and dietary practices of hypertensive adults attending hypertensive clinics at Day Hospitals in the Cape Metropole. Ten Day Hospitals were randomly selected from a total of 31 Day Hospitals and the first participants attending the hypertension clinics per day were recruited. A total of 85 participants were evaluated. The weight, height, waist and hip circumference of each participant was measured, as well as their blood pressure. Knowledge of dietary intake was obtained by completing a questionnaire, during an interview with the patient. Knowledge regarding salt usage indicated that a large percentage (34.1 % of participants believed that flavour enhancers like Aromat or Fondor could safely be used instead of table salt. Furthermore, 23.5% reported that tinned and smoked meat or fish have a low sodium (salt content. Fruit and vegetables were perceived as having a positive effect on hypertension by 74.1 % of participants. However, only 15% of the group knew that the recommendation for their usage was five or more servings per day. Only 12.9% of participants in this study had a normal weight (body mass index (BMI < 25, 25.9% were overweight (BMI 25 - 29.9 and 61.2% were obese (BMI ≥ 30; 84.7% recognized the association between obesity and hypertension. A large waist circumference (> 88cm in women; 102cm in men was found in 61.2% of participants, however, only 18.2% of black men had such a measurement. Uncontrolled blood pressure readings (> 140/90mm Hg were found in 61.2% of these patients at the hypertension clinics.

  12. Building a Bridge or Digging a Pipeline? Clinical Data Mining in Evidence-Informed Knowledge Building

    Science.gov (United States)

    Epstein, Irwin

    2015-01-01

    Challenging the "bridge metaphor" theme of this conference, this article contends that current practice-research integration strategies are more like research-to-practice "pipelines." The purpose of this article is to demonstrate the potential of clinical data-mining studies conducted by practitioners, practitioner-oriented PhD…

  13. Creating Positive Attitudes: The Effects of Knowledge and Clinical Experience of Psychiatry in Student Nurse Education.

    Science.gov (United States)

    Chan, Sally; Cheng, Bing-shu

    2001-01-01

    Students (n=90) enrolled in mental health nursing in Hong Kong completed the Opinion about Mental Illness Scale before and after the course and clinical placements. Postcourse results showed more positive attitudes toward clients with mental health problems. (Contains 37 references.) (SK)

  14. 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....

  15. Nuclear medicine. Basic knowledge and clinical applications. 7. rev. and enl. ed.; Nuklearmedizin. Basiswissen und klinische Anwendung

    Energy Technology Data Exchange (ETDEWEB)

    Schicha, Harald [Universitaetsklinikum Koeln (Germany). Medizinisches Versorgungszentrum II; Schober, Otmar [Universitaetsklinikum Muenster (Germany). Klinik fuer Nuklearmedizin

    2013-11-01

    The book on basic knowledge and clinical applications of nuclear medicine covers the following issues: The first general part: principles of nuclear medicine; physical fundamentals; radiopharmaceutical chemistry; measuring techniques: gamma detectors, gamma spectrometry, gamma camera, SPECT, PET, PET/CT, PET/NMR, image processing and communication; nuclear medical examinations: metabolic and pharmacological kinetics, scintigraphic methods, criteria for the use; quality assurance; dosimetry and radiation protection, radiation risks and patients exposure, benefit-risk considerations. The second part covers endocrine organs, carcinomas, skeleton and bone joints, inflammations, lymph system, cardiovascular system, lungs, central nervous system, kidneys and urinary system, gastrointestinal tract, other scintigraphic examinations.

  16. Treatmnent Patterns for Pediatric Acute CHUs Media: A Gap in Evidence-Based Theory and Clinical Practice.

    Science.gov (United States)

    Boatright, Courtney; Holcomb, Lygia; Replogle, William

    2015-01-01

    Unnecessary prescribing of antibiotics is costly, leads to serious unintended side effects, and increases the risk of developing antibiotic resistance. Children are at high risk of receiving unnecessary antibiotics because they consume more antibiotics than any other age group, likely due to inaccurate prescribing by health care providers. Treatment of acute otitis media is the most common reason children are prescribed antibiotics. Evidence-based guidelines regarding the appropriate treatment of nonsevere acute otitis media in children have been established. A retrospective, descriptive, chart review project was completed comparing the diagnosis and treatment of acute otitis media in children six months to 12 years of age in clinics and the emergency department of a large academic medical center with the American Academy of Pediatrics' treatment guidelines. Findings of the chart review included 100 patient encounters. Documentation indicated that although none of these children with acute otitis media met the guideline criteria for antibiotics, 92 of the 100 children were prescribed antibiotics. PMID:26837096

  17. The state of the art in organizational cognitive neuroscience: the therapeutic gap and possible implications for clinical practice.

    Science.gov (United States)

    Senior, Carl; Lee, Nick

    2013-01-01

    In the last decade, researchers in the social sciences have increasingly adopted neuroscientific techniques, with the consequent rise of research inspired by neuroscience in disciplines such as economics, marketing, decision sciences, and leadership. In 2007, we introduced the term organizational cognitive neuroscience (OCN), in an attempt to clearly demarcate research carried out in these many areas, and provide an overarching paradigm for research utilizing cognitive neuroscientific methods, theories, and concepts, within the organizational and business research fields. Here we will revisit and further refine the OCN paradigm, and define an approach where we feel the marriage of organizational theory and neuroscience will return even greater dividends in the future and that is within the field of clinical practice. PMID:24367310

  18. The state of the art in organisational cognitive neuroscience: The therapeutic gap and possible implications for clinical practice

    Directory of Open Access Journals (Sweden)

    Carl eSenior

    2013-12-01

    Full Text Available In the last decade, researchers in the social sciences have increasingly adopted neuroscientific techniques, with the consequent rise of research inspired by neuroscience in disciplines such as economics, marketing, decision sciences, and leadership. In 2007, we introduced the term organizational cognitive neuroscience (OCN, in an attempt to clearly demarcate research carried out in these many areas, and provide an overarching paradigm for research utilising cognitive neuroscientific methods, theories, and concepts, within the organizational and business research fields. Here we will revisit and further refine the OCN paradigm, and define an approach where we feel the marriage of organisational theory and neuroscience will return even greater dividends in the future and that is within the field of clinical practice.

  19. Closing the gap between coil and balloon in the neurointerventional armamentarium? Initial clinical experience with a nitinol vascular occlusion plug

    Energy Technology Data Exchange (ETDEWEB)

    Gralla, Jan; Schroth, Gerhard; El-Koussy, Marwan; Brekenfeld, Caspar [University of Bern, Department of Diagnostic and Interventional Neuroradiology, Inselspital, Bern (Switzerland); Kickuth, Ralph [Interventional and Pediatric Radiology, Department of Diagnostic, Bern (Switzerland); Do, Dai-Do [University of Bern, Department of Angiology, Inselspital, Bern (Switzerland)

    2008-08-15

    The use of vascular plug devices for the occlusion of high-flow lesions is a relatively new and successful procedure in peripheral and cardiopulmonary interventions. We report on the use and efficiency of the Amplatzer vascular plug in a small clinical series and discuss its potential for occlusion of large vessels and high-flow lesions in neurointerventions. Between 2005 and 2007 four patients (mean age 38.5 years, range 16-62 years) were treated with the device, in three patients to achieve parent artery occlusion of the internal carotid artery, in one patient to occlude a high-flow arteriovenous fistula of the neck. The application, time to occlusion, and angiographic and clinical results and the follow-up were evaluated. Navigation, positioning and detachment of the device were satisfactory in all cases. No flow-related migration of the plug was seen. The cessation of flow was delayed by a mean of 10.5 min after deployment of the first device. In the procedures involving vessel sacrifice, two devices had to be deployed to achieve total occlusion. No patient experienced new neurological deficits; the 3-month follow-up revealed stable results. The Amplatzer vascular plug can be adapted for the treatment of high-flow lesions and parent artery occlusions in the head and neck. In this small series the use of the devices was uncomplicated and safe. The rigid and large delivery device and the delayed cessation of flow currently limit the device's use in neurointerventions. (orig.)

  20. The Morningside Initiative: Collaborative Development of a Knowledge Repository to Accelerate Adoption of Clinical Decision Support

    OpenAIRE

    Greenes, Robert; Bloomrosen, Meryl; Brown-Connolly, Nancy E.; Curtis, Clayton; Detmer, Don E.; Enberg, Robert; Fridsma, Douglas; Fry, Emory; Goldstein, Mary K.; Haug, Peter; Hulse, Nathan; Hongsermeier, Tonya; Maviglia, Saverio; Robbins, Craig W; Shah, Hemant

    2010-01-01

    The Morningside Initiative is a public-private activity that has evolved from an August, 2007, meeting at the Morningside Inn, in Frederick, MD, sponsored by the Telemedicine and Advanced Technology Research Center (TATRC) of the US Army Medical Research Materiel Command. Participants were subject matter experts in clinical decision support (CDS) and included representatives from the Department of Defense, Veterans Health Administration, Kaiser Permanente, Partners Healthcare System, Henry Fo...

  1. Architecture for Knowledge-Based and Federated Search of Online Clinical Evidence

    OpenAIRE

    Coiera, Enrico; Walther, Martin; Nguyen, Ken; Lovell, Nigel H.

    2005-01-01

    Background It is increasingly difficult for clinicians to keep up-to-date with the rapidly growing biomedical literature. Online evidence retrieval methods are now seen as a core tool to support evidence-based health practice. However, standard search engine technology is not designed to manage the many different types of evidence sources that are available or to handle the very different information needs of various clinical groups, who often work in widely different settings. Objectives The...

  2. Matrix metalloproteinases and their inhibitors in cardiovascular pathologies: current knowledge and clinical potential

    OpenAIRE

    Johnson, Jason

    2014-01-01

    Jason Lee Johnson Laboratory of Cardiovascular Pathology, School of Clinical Sciences, University of Bristol, Bristol, UK Abstract: Matrix metalloproteinases (MMPs) constitute a family of endopeptidases that harbor matrix-degrading potential, but also modulate the proliferation, migration, and apoptosis of resident blood-vessel cells and recruited inflammatory cells. Accordingly, they are proposed to play a major regulatory role in numerous cardiovascular pathologies, including restenosis, a...

  3. Knowledge Translation in Audiology: Promoting the Clinical Application of Best Evidence

    OpenAIRE

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

    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 mandat...

  4. Falls after Discharge from Hospital: Is There a Gap between Older Peoples' Knowledge about Falls Prevention Strategies and the Research Evidence?

    Science.gov (United States)

    Hill, Anne-Marie; Hoffmann, Tammy; Beer, Christopher; McPhail, Steven; Hill, Keith D.; Oliver, David; Brauer, Sandra G.; Haines, Terry P.

    2011-01-01

    Purpose: The aim of this study was to examine whether older people are prepared to engage in appropriate falls prevention strategies after discharge from hospital. Design and Methods: We used a semi-structured interview to survey older patients about to be discharged from hospital and examined their knowledge regarding falls prevention strategies…

  5. 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...

  6. CLINICAL KNOWLEDGE AND ATTITUDES OF CLINICIANS TOWARD RABIES CAUSED BY ANIMAL BITES

    Directory of Open Access Journals (Sweden)

    Naveen Kumar

    2013-12-01

    Full Text Available ABSTRACT: INTRODUCTION : Rabies is a zoonotic disease that is typically transmitted through bites from infected animals. The majority of reported cases involve wild animals like bats , raccoons and skunks , but domesticated animals like dogs and cats are also a risk. Humans are equ ally susceptible to the rabies virus if bitten by an infected animal. Once the symptoms have appeared , Rabies is always fatal. Death usually occurs less than a week after the onset of signs. METHODOLOGY: A cross - sectional study was conducted in which all th e doctors including JRs , Interns , PG students and SRs and Consultants in the department of Surgery , Medicine , Pediatrics and Emergency Medical Officers were taken . Selection was done on the basis of consent to participate in the study by doctors of the var ious departments handling or required to handle dog /animal bite cases. RESULTS : It can be seen that only 76.92% knew all the Reservoirs of Rabies infection , and the difference in knowledge of senior doctor , 43(41.34 is comparable to junior doctors , 37(35. 57 and the difference is statistically not significant. Regarding different Modes ofTransmission , 90.38% had correct knowledge. The Junior doctors , i.e , 39(37.50 had correct answer whereas , 55(52.88 senior doctors i.e all answered correctlywhich is sta tistically significant . CONCLUSION: There is an apparent lack of awareness among doctors regarding appropriate animal wound management and vaccine administration. Reorientation programmes and continued medical education (CME for the medical practitioners are required to highlight WHO guidelines regarding treatment of animal bite

  7. Can we bridge the gap? Knowledge and practices related to Diabetes Mellitus among general practitioners in a developing country: A cross sectional study

    Directory of Open Access Journals (Sweden)

    Katulanda Prasad

    2011-11-01

    Full Text Available Abstract Background Diabetes mellitus is becoming a serious public health problem in Sri Lanka and many other developing countries in the region. It is well known that effective management of diabetes reduces the incidence and progression of many diabetes related complications, thus it is important that General Practitioners (GPs have sound knowledge and positive attitudes towards all aspects of its management. This study aims to assess knowledge, awareness and practices relating to management of Diabetes Mellitus among Sri Lankan GPs. Methods A cross-sectional study was conducted among all 246 GPs registered with the Ceylon College of General Practitioners using a pre-validated self-administered questionnaire. Results 205 responded to the questionnaire(response rate 83.3%. Their mean duration of practice was 28.7 ± 11.2 years. On average, each GP had 27 ± 25 diabetic-patient consultations per-week. 96% managed diabetic patients and 24% invariably sought specialist opinion. 99.2% used blood glucose to diagnose diabetes but correct diagnostic cut-off values were known by only 48.8%. Appropriate use of HbA1c and urine microalbumin was known by 15.2% and 39.2% respectively. 84% used HbA1c to monitor glyceamic control, while 90.4% relied on fasting blood glucose to monitor glyceamic control. Knowledge on target control levels was poor. Nearly 90% correctly selected the oral hypoglyceamic treatment for obese as well as thin type 2 diabetic patients. Knowledge on the management of diabetes in pregnancy was poor. Only 23.2% knew the correct threshold for starting lipid-lowering therapy. The concept of strict glycaemic control in preference to symptom control was appreciated only by 68%. The skills for comprehensive care in subjects with multiple risk factors were unsatisfactory. Conclusions The study was done among experienced members of the only professional college dedicated to the specialty. However, we found that there is room for improvement in

  8. Guest Editorial: Treatment for PTSD: Clinical Practice Guidelines and steps toward further knowledge

    Directory of Open Access Journals (Sweden)

    Antonette M. Zeiss, PhD

    2012-06-01

    Full Text Available The Department of Veterans Affairs (VA has an overall commitment to providing evidence-based treatment in a context in which the clinician and patient together explore the symptoms and diagnosis, the goals of the patient, the array of possible interventions that may be helpful, and the patient’s preference among interventions that can be recommended based on the available evidence. VA develops Clinical Practice Guidelines (CPGs in conjunction with the Department of Defense (DOD on a wide array of healthcare issues, including several mental health diagnoses and problems. This process is exemplary—it is fully interdisciplinary as well as interdepartmental across VA and DOD, input from stakeholders is invited in the process, and the process has a clearly defined methodology for identifying all evidence that should be reviewed in developing the CPG and for evaluating the level of evidence found in all relevant literature. The resulting CPGs are thoughtful, data-driven documents that guide assessment and disease management and, when possible, prevention of disorders. Thus, VA, in full collaboration with DOD, has been a leader in organizing important documents to guide clinical decision-making.

  9. 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.

  10. Knowledge, attitudes and practices among people with chronic hepatitis B attending a hepatology clinic in Malaysia: A cross sectional study

    Directory of Open Access Journals (Sweden)

    Mohamed Rosmawati

    2012-08-01

    Full Text Available Abstract Background Hepatitis B (HBV is the leading cause of cirrhosis and hepatocellular carcinoma worldwide. This study assessed the knowledge, attitudes and practices of people with chronic HBV and the associated factors. Methods This cross-sectional study was conducted at an outpatient adult hepatology clinic at a tertiary hospital in Kuala Lumpur. A self-administered questionnaire was administered on a one-to-one basis to assess knowledge, attitudes, and lifestyle practices of people with chronic HBV. Results The response rate was 89% (n = 483/543. Participants had a mean age of 46.3 (±14.7 years and the mean duration of HBV from time of diagnosis was 12.2 (±8.8 years. The mean knowledge score was 12.57/20 (standard deviation: ±4.4, range: 0–19. Participants aged 30–39 years, with higher educational attainment, employed in professional jobs, longer duration of diagnosis and those without cirrhosis had significantly higher knowledge scores. Age, education level and duration of diagnosis were significant predictors of the knowledge score on standard multiple regression analysis. More than half of the participants were worried of spreading HBV infection to family and friends and worried since the diagnosis. A third of the participants (33.5% were embarrassed to reveal their diagnosis to the public but most of them (93.6% would inform their family. Those who reported feeling worried since their diagnosis were more likely to be middle-aged, of Malay ethnicity, have shorter duration of diagnosis of less than 10 years and have received therapy. About half of the participants (50.6% did not share dining utensils and the majority (93.2% believed that HBV can be transmitted by sharing of eating and drinking utensils. Older patients were significantly less likely to share utensils. Those who felt worried since diagnosis had significant higher knowledge of HBV. Conclusion The findings highlight the stigma and misconceptions that still

  11. International challenges in patient-centred care in fertility clinics offering assisted reproductive technology: providers' gaps and attitudes towards addressing the patients' psychological needs

    Directory of Open Access Journals (Sweden)

    Suzanne Murray

    2015-06-01

    Full Text Available Introduction. Psychosocial care provided to patients undergoing fertility treatment has focused on a small proportion of patients with major psychosocial problems, leaving the remaining patients impacted by psychosocial stressors without follow-up. Factors that could influence the ability or willingness of physicians treating infertility to assess and address patients’ psychosocial needs have not been investigated. This study aimed to identify the practice gaps and educational needs of physicians treating and managing patients with infertility, with the aim of informing future educational interventions. Methods. A cross-sectional, exploratory, mixed-methods study incorporating semi-structured qualitative telephone interviews and a quantitative online survey was designed and deployed to actively practising physicians treating infertile couples from 15 countries across the Americas, Europe, Asia, and the Middle East Region. Triangulation of qualitative and quantitative data was used to increase trustworthiness of findings. Results. Forty-five participants completed a qualitative interview and 271 participants completed the quantitative online survey (response rates were 4 and 9%, respectively. A majority (74% of respondents reported needing improvement in their psychological assessment skill, which was considered essential to the provision of optimal care by less than half (41% of respondents. A need for improvement in their skill to assess patients’ parenting skills was reported in 72% of respondents, and this skill was considered as essential by 32% of participants. Similarly, 72% reported needing improvement in their ability to identify the needs of patients for psychological and emotional support, and this ability was considered essential by 45%. Statistical differences were observed between countries (p<0.05. Conclusion. Addressing the gaps highlighted in this study, through educational or performance improvement activities, could

  12. Mythic gaps

    Directory of Open Access Journals (Sweden)

    William Hansen

    2014-11-01

    Full Text Available Different kinds of omissions sometimes occur, or are perceived to occur, in traditional narratives and in tradition-inspired literature. A familiar instance is when a narrator realizes that he or she does not fully remember the story that he or she has begun to tell, and so leaves out part of it, which for listeners may possibly result in an unintelligible narrative. But many instances of narrative gap are not so obvious. From straightforward, objective gaps one can distinguish less-obvious subjective gaps: in many cases narrators do not leave out anything crucial or truly relevant from their exposition, and yet readers perceive gaps and take steps to fill them. The present paper considers four examples of subjective gaps drawn from ancient Greek literature (the Pandora myth, ancient Roman literature (the Pygmalion legend, ancient Hebrew literature (the Joseph legend, and early Christian literature (the Jesus legend. I consider the quite varied ways in which interpreters expand the inherited texts of these stories, such as by devising names, manufacturing motives, creating backstories, and in general filling in biographical ellipses. Finally, I suggest an explanation for the phenomenon of subjective gaps, arguing that, despite their variety, they have a single cause.

  13. Lithium: updated human knowledge using an evidence-based approach: part III: clinical safety.

    Science.gov (United States)

    Grandjean, Etienne Marc; Aubry, Jean-Michel

    2009-01-01

    Lithium use in mental diseases has changed over the years but remains a cornerstone of treatment in bipolar disorders. In two companion papers, we have reviewed existing (and especially recent) data on lithium efficacy and updated basic knowledge regarding the practical fundamentals of lithium therapy. The present paper reviews safety data on lithium available to date. Gastrointestinal pain or discomfort, diarrhoea, tremor, polyuria, nocturnal urination, weight gain, oedema, flattening of affect and exacerbation of psoriasis are typical complaints of patients receiving long-term lithium therapy. Renal involvement results in a reduced urinary concentrating capacity, expressed as obligate polyuria, with secondary thirst. With long-term therapy, this may result in nephrogenic diabetes insipidus. In addition, glomerular filtration rate falls slightly in about 20% of patients. The view that only a few patients receiving long-term lithium are at increased risk of glomerular impairment and progressive renal insufficiency should be regarded with caution. The risk is increased in case of concomitant diseases or medications. Lithium treatment may inhibit thyroid hormone release and induce goitre. Consequently, the prevalence of both overt and subclinical hypothyroidism is increased, with circulating thyroid auto-antibodies frequently being found. Much less commonly, thyrotoxicosis may also develop in association with lithium therapy. Long-term lithium treatment may also be associated with persistent hyperparathyroidism and hypercalcaemia, as well as with hypermagnesaemia. Overweight of up to 4-10 kg is found in approximately 30% of lithium-treated patients. Most neurological manifestations are benign, for example, the fine postural and/or action tremor present in 4-20% of patients. This is increased by high caffeine consumption and concomitant use of other psychotropic agents. A number of rare, potentially serious neurological adverse effects have been reported, including

  14. 應用於國民小學的創新架構:知識管理缺口之個案分析 An Innovative Framework Applied to Elementary Schools: A Case Study of the Gaps Knowledge Management

    Directory of Open Access Journals (Sweden)

    陳建志 Chien-Chin Chen

    2009-06-01

    Full Text Available 目前國民小學正值大力推動知識管理之際,而且學校領導者也越來越注重知識管理活動的實行,期望透過知識管理活動來提升學校效能。然而,當執行知識管理時,卻會有一些類似缺口的障礙因素影響學校效能。因此,本研究提出「知識管理缺口」之創新性架構,詳細闡述執行知識管理時在管理上會遇到的缺口。運用主題之內容分析取徑來加以研究,透過訪談6 所學校的校長或主任,發覺這些缺口的成因及消弭這些缺口的方式。根據管理的觀點定義出可能會潛在影響這些缺口強度及方向之完整因子,並找出增加知識管理有效性的相關作為。期許能提供學校定義知識管理缺口更便利的方式,使其執行知識管理時,能據此找出提升知識管理的有效方式及因應策略。 While school principals and directors are putting more emphasis on knowledge management activities, it is the right time for elementary schools to put knowledge management (KM into practice. The school administrators hope to improve school effectiveness through the activities KM. However, when implementing KM, there are some obstacles leading to gaps that may influence school effectiveness. In view of such problems, this research proposed an innovative framework of ‘‘the gaps KM’’ to fully illustrate the management gaps that might occur during the process of KM. The content-analysis approach combined with the thematic analysis was implemented in the study. Through in-depth interviews with principals and directors of six schools, we explored the cause of these gaps and approaches to reducing these gaps. This research identified a comprehensive set of factors according to the management point of view that could potentially impact the magnitude or direction of these gaps and the corrective action for enhancing the success of the process of KM. This framework is expected to

  15. 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

  16. Knowledge gaps in relation to radionuclide levels and transfer to wild plants and animals, in the context of environmental impact assessments, and a strategy to fill them

    Energy Technology Data Exchange (ETDEWEB)

    Brown, J.E. (ed.); Gjelsvik, R. (Norwegian Radiation Protection Authority (Norway)); Saxen, R.; Mattila, J. (STUK - Radiation and Nuclear Safety Authority (Finland))

    2009-01-15

    International activities with regards the development of methods for assessing impacts on the environment from ionising radiation have been substantial in recent years. In developing these methods, there are requirements (i) to determine the transfer of radionuclides within ecosystems and (ii) to determine background dose-rates arising from the presence of naturally occurring radionuclides, in a satisfactory manner. It has quickly become evident that fulfilling these 2 requirements is not entirely straightforward reflecting a lack of data in many cases. This report specifies exactly where these data-gaps lie through analyses of data generated from the most recent studies conducted internationally on this topic. It is evident that information is limited for numerous radionuclides from U-238 and Th-232 decay series and notably, in view of its importance as a contributor to dose-rates in plants and animals, Po-210. The simple way to rectify these data deficiencies is to organise target field campaigns focusing on particular species and radionuclides where information is lacking. To this end, field sampling has been conducted in a semi-natural mountain ecosystem in Norway and freshwater aquatic systems in Finland. It is envisaged that the data derived from the studies briefly described in this report will provide fundamental information for our understanding of the behaviour and fate of natural decay series radionuclides in terrestrial and aquatic systems and provide the basis for more robust way. (au)

  17. Knowledge gaps in relation to radionuclide levels and transfer to wild plants and animals, in the context of environmental impact assessments, and a strategy to fill them

    International Nuclear Information System (INIS)

    International activities with regards the development of methods for assessing impacts on the environment from ionising radiation have been substantial in recent years. In developing these methods, there are requirements (i) to determine the transfer of radionuclides within ecosystems and (ii) to determine background dose-rates arising from the presence of naturally occurring radionuclides, in a satisfactory manner. It has quickly become evident that fulfilling these 2 requirements is not entirely straightforward reflecting a lack of data in many cases. This report specifies exactly where these data-gaps lie through analyses of data generated from the most recent studies conducted internationally on this topic. It is evident that information is limited for numerous radionuclides from U-238 and Th-232 decay series and notably, in view of its importance as a contributor to dose-rates in plants and animals, Po-210. The simple way to rectify these data deficiencies is to organise target field campaigns focusing on particular species and radionuclides where information is lacking. To this end, field sampling has been conducted in a semi-natural mountain ecosystem in Norway and freshwater aquatic systems in Finland. It is envisaged that the data derived from the studies briefly described in this report will provide fundamental information for our understanding of the behaviour and fate of natural decay series radionuclides in terrestrial and aquatic systems and provide the basis for more robust way. (au)

  18. Fast T Wave Detection Calibrated by Clinical Knowledge with Annotation of P and T Waves

    Directory of Open Access Journals (Sweden)

    Mohamed Elgendi

    2015-07-01

    Full Text Available Background: There are limited studies on the automatic detection of T waves in arrhythmic electrocardiogram (ECG signals. This is perhaps because there is no available arrhythmia dataset with annotated T waves. There is a growing need to develop numerically-efficient algorithms that can accommodate the new trend of battery-driven ECG devices. Moreover, there is also a need to analyze long-term recorded signals in a reliable and time-efficient manner, therefore improving the diagnostic ability of mobile devices and point-of-care technologies. Methods: Here, the T wave annotation of the well-known MIT-BIH arrhythmia database is discussed and provided. Moreover, a simple fast method for detecting T waves is introduced. A typical T wave detection method has been reduced to a basic approach consisting of two moving averages and dynamic thresholds. The dynamic thresholds were calibrated using four clinically known types of sinus node response to atrial premature depolarization (compensation, reset, interpolation, and reentry. Results: The determination of T wave peaks is performed and the proposed algorithm is evaluated on two well-known databases, the QT and MIT-BIH Arrhythmia databases. The detector obtained a sensitivity of 97.14% and a positive predictivity of 99.29% over the first lead of the validation databases (total of 221,186 beats. Conclusions: We present a simple yet very reliable T wave detection algorithm that can be potentially implemented on mobile battery-driven devices. In contrast to complex methods, it can be easily implemented in a digital filter design.

  19. Can Clinical Scenario Videos Improve Dental Students' Perceptions of the Basic Sciences and Ability to Apply Content Knowledge?

    Science.gov (United States)

    Miller, Cynthia Jayne; Metz, Michael James

    2015-12-01

    Dental students often have difficulty understanding the importance of basic science classes, such as physiology, for their future careers. To help alleviate this problem, the aim of this study was to create and evaluate a series of video modules using simulated patients and custom-designed animations that showcase medical emergencies in the dental practice. First-year students in a dental physiology course formatively assessed their knowledge using embedded questions in each of the three videos; 108 to 114 of the total 120 first-year students answered the questions, for a 90-95% response rate. These responses indicated that while the students could initially recognize the cause of the medical emergency, they had difficulty in applying their knowledge of physiology to the scenario. In two of the three videos, students drastically improved their ability to answer high-level clinical questions at the conclusion of the video. Additionally, when compared to the previous year of the course, there was a significant improvement in unit exam scores on clinically related questions (6.2% increase). Surveys were administered to the first-year students who participated in the video modules and fourth-year students who had completed the course prior to implementation of any clinical material. The response rate for the first-year students was 96% (115/120) and for the fourth-year students was 57% (68/120). The first-year students indicated a more positive perception of the physiology course and its importance for success on board examinations and their dental career than the fourth-year students. The students perceived that the most positive aspects of the modules were the clear applications of physiology to real-life dental situations, the interactive nature of the videos, and the improved student comprehension of course concepts. These results suggest that online modules may be used successfully to improve students' perceptions of the basic sciences and enhance their ability to

  20. GAP Analysis Program (GAP) Raster

    Data.gov (United States)

    Kansas Data Access and Support Center — The Kansas GAP Land Cover database depicts 43 land cover classes for the state of Kansas. The database was generated using a two-stage hybrid classification of...

  1. The knowledge and attitude about HIV/AIDS among Jordanian dental students: (Clinical versus pre clinical students at the University of Jordan

    Directory of Open Access Journals (Sweden)

    Shayyab Mohammad H

    2011-06-01

    Full Text Available Abstract Background The present study aimed to address the suspected deficiency in the level of understanding of HIV/AIDS among clinical and pre clinical dental students at the University of Jordan. In this cross-sectional study, structured questionnaires were distributed to fifth year dental students (n = 121 and to third year dental students (n = 144 in the academic year 2008/2009. Findings Significantly higher percentage of fifth-year students compared to third-year students felt that the teaching they received on cross-infection precautions and barrier dentistry was adequate (P Significantly higher proportion of third-year students compared to fifth-year (39.2% vs. 26.3% thought that HIV patients should be referred to other centers or support groups for treatment (P = 0.04. Conclusions The level of knowledge of Jordanian dental students about HIV and AIDS was generally acceptable; there were inadequacies, however, in their understanding regarding some aspects of AIDS epidemic which demands that dental school curriculum needs some improvement.

  2. Antibiotic prescribing and resistance: knowledge level of medical students of clinical years of University Sultan Zainal Abidin, Malaysia.

    Science.gov (United States)

    Haque, Mainul; Rahman, Nor Iza A; Zulkifli, Zainal; Ismail, Salwani

    2016-01-01

    The innovation of penicillin by Dr Alexander Fleming in 1928 and its use in clinical practice saved many lives, especially during the Second World War. Tuberculosis still carries a significant public health threat and has re-emerged over the past two decades, even in modern countries where tuberculosis was thought to be eliminated. The World Health Organization defines antimicrobial resistance as the resistance of a microorganism to an antimicrobial drug that was initially effective for treatment of infections caused by the microbe. Therefore, the findings of the current study will provide data to enable the design of a new educational program to better equip our students in confronting antimicrobial resistance. This study was a cross-sectional, questionnaire-based survey, which was undertaken in the Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Malaysia. The study participants were students of the Bachelor of Medicine and Bachelor of Surgery program (MBBS) of Year III, IV, and V. A total of 142 out of 164 (86%) medical students returned the questionnaire. Specifically, the year-wise breakdown of responses was 29% (41), 39% (55), and 32% (45) for Year III, IV, and V, respectively. Among the study respondents, 28% (40) were male, and the remaining 72% (102) were female. In all, 67% of the participants felt more confident in "making an accurate diagnosis of infection/sepsis." The majority (88%) of the study participants stated that they would like more training on antibiotic selection. This research has found that there is a gap between theoretical input and clinical practice; the students are demanding more educational intervention to face the threat of antimicrobial resistance. PMID:27042083

  3. Increasing business resilience to flood risk: Developing an effective e-learning tool to bridge the knowledge gap between policy, practice and business owners

    Science.gov (United States)

    Wragg, Amanda; McEwen, Lindsey; Harries, Tim

    2015-04-01

    part that their knowledges and learning play in decision-making have been explored. The co-production process engages regional/national stakeholders who form a Stakeholder Competency Group (from policy and practice), and, a Business Research Partnership Group comprising local business participants. The two groups have opportunities to liaise and network in discussing the prototype for the learning tool. Whatmore et al (2008) and McEwen et al (2014) show that stakeholder views, experience and expertise can strengthen research outputs. The approach reflects current ethics and practices of stakeholder participation in that alongside an academic approach to the research, other equally valid forms of knowledge are recognised: 'a lot can be learned from exploring parallels, controversies and frictions between different forms of competency and knowledge (McEwen et al, 2014), for example, scientific, local, tacit and embedded. This paper presents concerns identified by businesses and wider stakeholders in relation to how the tool is framed and its key design premises. The tool is planned as a living resource that can support a community of learning practice among SMEs to increase flood resilience in the face of increased risk. References Federation of Small Businesses (2014) http://www.fsb.org.uk/stats Whatmore, Lane and Ward et al (2007-2010) Understanding Environmental Knowledge Controversies ESRC/NERC funded interdisciplinary research project (2007-2010) McEwen et al (2014) https://floodmemories.wordpress.com/2011/04/06/advice-from-competent-stakeholders/.

  4. Plant-Derived Anti-Inflammatory Compounds: Hopes and Disappointments regarding the Translation of Preclinical Knowledge into Clinical Progress

    Directory of Open Access Journals (Sweden)

    Robert Fürst

    2014-01-01

    Full Text Available Many diseases have been described to be associated with inflammatory processes. The currently available anti-inflammatory drug therapy is often not successful or causes intolerable side effects. Thus, new anti-inflammatory substances are still urgently needed. Plants were the first source of remedies in the history of mankind. Since their chemical characterization in the 19th century, herbal bioactive compounds have fueled drug development. Also, nowadays, new plant-derived agents continuously enrich our drug arsenal (e.g., vincristine, galantamine, and artemisinin. The number of new, pharmacologically active herbal ingredients, in particular that of anti-inflammatory compounds, rises continuously. The major obstacle in this field is the translation of preclinical knowledge into evidence-based clinical progress. Human trials of good quality are often missing or, when available, are frequently not suitable to really prove a therapeutical value. This minireview will summarize the current situation of 6 very prominent plant-derived anti-inflammatory compounds: curcumin, colchicine, resveratrol, capsaicin, epigallocatechin-3-gallate (EGCG, and quercetin. We will highlight their clinical potential and/or pinpoint an overestimation. Moreover, we will sum up the planned trials in order to provide insights into the inflammatory disorders that are hypothesized to be beneficially influenced by the compound.

  5. Massive Access Control Aided by Knowledge-Extraction for Co-Existing Periodic and Random Services over Wireless Clinical Networks.

    Science.gov (United States)

    Du, Qinghe; Zhao, Weidong; Li, Weimin; Zhang, Xuelin; Sun, Bo; Song, Houbing; Ren, Pinyi; Sun, Li; Wang, Yichen

    2016-07-01

    The prosperity of e-health is boosted by fast development of medical devices with wireless communications capability such as wearable devices, tiny sensors, monitoring equipments, etc., which are randomly distributed in clinic environments. The drastically-increasing population of such devices imposes new challenges on the limited wireless resources. To relieve this problem, key knowledge needs to be extracted from massive connection attempts dispersed in the air towards efficient access control. In this paper, a hybrid periodic-random massive access (HPRMA) scheme for wireless clinical networks employing ultra-narrow band (UNB) techniques is proposed. In particular, the proposed scheme towards accommodating a large population of devices include the following new features. On one hand, it can dynamically adjust the resource allocated for coexisting periodic and random services based on the traffic load learned from signal collision status. On the other hand, the resource allocation within periodic services is thoroughly designed to simultaneously align with the timing requests of differentiated services. Abundant simulation results are also presented to demonstrate the superiority of the proposed HPRMA scheme over baseline schemes including time-division multiple access (TDMA) and random access approach, in terms of channel utilization efficiency, packet drop ratio, etc., for the support of massive devices' services. PMID:27240842

  6. Beyond the gap

    OpenAIRE

    Büger, Christian; Villumsen, Trine

    2015-01-01

    International Relations (IR) has cultivated the idea of a gap between the theory and the practice/praxis of IR. This division into two different spheres of knowledge is related to the predominant objectivist conception of science in IR, where the scientist is said to be observing reality from a distance without affecting it. Poststructuralists have denied that this distinction is meaningful and have even argued that it is dangerous to be oblivious to the structuring effects science may have o...

  7. 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 iden...

  8. Aerosol-Cloud Interactions in the South-East Atlantic: Knowledge Gaps, Planned Observations to Address Them, and Implications for Global Climate Change Modeling

    Science.gov (United States)

    Redemann, Jens; Wood, R.; Zuidema, P.; Haywood, J.; Luna, B.; Abel, S.

    2015-01-01

    Southern Africa produces almost a third of the Earth's biomass burning (BB) aerosol particles, yet the fate of these particles and their influence on regional and global climate is poorly understood. Particles lofted into the mid-troposphere are transported westward over the South-East (SE) Atlantic, home to one of the three permanent subtropical Stratocumulus (Sc) cloud decks in the world. The stratocumulus "climate radiators" are critical to the regional and global climate system. They interact with dense layers of BB aerosols that initially overlay the cloud deck, but later subside and are mixed into the clouds. These interactions include adjustments to aerosol-induced solar heating and microphysical effects. As emphasized in the latest IPCC report, the global representation of these aerosol-cloud interaction processes in climate models is one of the largest uncertainty in estimates of future climate. Hence, new observations over the SE Atlantic have significant implications for global climate change scenarios. We discuss the current knowledge of aerosol and cloud property distributions based on satellite observations and sparse suborbital sampling, and describe planned field campaigns in the region. Specifically, we describe the scientific objectives and implementation of the following four synergistic, international research activities aimed at providing a process-level understanding of aerosol-cloud interactions over the SE Atlantic: 1) ORACLES (Observations of Aerosols above Clouds and their interactions), a five-year investigation between 2015 and 2019 with three Intensive Observation Periods (IOP), recently funded by the NASA Earth-Venture Suborbital Program, 2) CLARIFY-2016 (Cloud-Aerosol-Radiation Interactions and Forcing: Year 2016), a comprehensive observational and modeling programme funded by the UK's Natural Environment Research Council (NERC), and supported by the UK Met Office. 3) LASIC (Layered Atlantic Smoke Interactions with Clouds), a funded

  9. Does GEM-Encoding Clinical Practice Guidelines Improve the Quality of Knowledge Bases? A Study with the Rule-Based Formalism

    OpenAIRE

    Georg, Gersende; Séroussi, Brigitte; Bouaud, Jacques

    2003-01-01

    The aim of this work was to determine whether the GEM-encoding step could improve the representation of clinical practice guidelines as formalized knowledge bases. We used the 1999 Canadian recommendations for the management of hypertension, chosen as the knowledge source in the ASTI project. We first clarified semantic ambiguities of therapeutic sequences recommended in the guideline by proposing an interpretative framework of therapeutic strategies. Then, after a formalization step to stand...

  10. The effect of songwriting on knowledge of coping skills and working alliance in psychiatric patients: a randomized clinical effectiveness study.

    Science.gov (United States)

    Silverman, Michael J

    2011-01-01

    The purpose of this study was to determine the effects of a songwriting intervention on psychiatric patients' knowledge of coping skills and working alliance. Participants were randomly assigned to scripted and manualized experimental (n=48) or control (n=41) conditions. The experimental condition was a group psychoeducational music therapy songwriting session concerning coping skills while the control condition was a group psychoeducational session concerning coping skills. Both conditions were single-session therapy with patients on an acute adult psychiatric unit. Results indicated no significant between group differences in measures of knowledge of coping skills, consumer working alliance, or perception of enjoyment (p>.05), although the experimental condition tended to have slightly higher mean scores than the control group for these measures. There was a significant between group difference in measures of therapist working alliance (pgroup higher than the control group. Although the music therapy group had a higher mean rate of previous psychiatric hospitalizations, their perception of enjoyment scores were still higher than those of the control condition, a finding incongruent in the literature. Furthermore, despite the increased number of previous hospitalizations, the music therapy condition had higher attendance rates than the control condition, thus possibly providing incentives for funding. It seems that group songwriting about coping skills can be as effective a psychosocial intervention as traditional talk-based psychoeducation to teach psychiatric inpatients how to proactively manage their illness. Additionally, music therapy can be as effective as talk-based psychoeducation in establishing working alliance. Implications for clinical practice, limitations, and suggestions for future research are provided. PMID:21866716

  11. Interns' knowledge of clinical pharmacology and therapeutics after undergraduate and on-going internship training in Nigeria: a pilot study

    Directory of Open Access Journals (Sweden)

    Senbanjo Idowu O

    2009-07-01

    Full Text Available Abstract Background A sound knowledge of pathophysiology of a disease and clinical pharmacology and therapeutics (CPT of a drug is required for safe and rational prescribing. The aim of this study was therefore to assess how adequately the undergraduate CPT teaching had prepared interns in Nigeria for safe and rational prescribing and retrospectively, to know how they wanted the undergraduate curriculum to be modified so as to improve appropriate prescribing. The effect of internship training on the prescribing ability of the interns was also sought. Methods A total of 100 interns were randomly selected from the Lagos State University Teaching Hospital (LASUTH, Ikeja; Lagos University Teaching Hospital (LUTH, Idiaraba; General Hospital Lagos (GHL; the EKO Hospital, Ikeja; and Havana Specialist Hospital, Surulere. A structured questionnaire was the instrument of study. The questionnaire sought information about the demographics of the interns, their undergraduate CPT teaching, experience of adverse drug reactions (ADRs and drug interactions since starting work, confidence in drug usage and, in retrospect; any perceived deficiencies in their undergraduate CPT teaching. Results The response rate was 81%. All the respondents graduated from universities in Nigeria. The ability of the interns to prescribe rationally (66, 81.4% and safely (47, 58% was provided by undergraduate CPT teaching. Forty two (51.8% respondents had problems with prescription writing. The interns would likely prescribe antibiotics (71, 87.6%, nonsteroidal analgesics (66, 81.4%, diuretics (55, 67.9%, sedatives (52, 62.9%, and insulin and oral hypoglycaemics (43, 53% with confidence and unsupervised. The higher the numbers of clinical rotations done, the more confident were the respondents to prescribe unsupervised (χ2 = 19.98, P 2 = 11.57, P 2 = 11.25, P Conclusion Undergraduate CPT teaching in Nigeria appears to be deficient. Principles of rational prescribing, drug dose

  12. Translating clinical findings into knowledge in drug safety evaluation--drug induced liver injury prediction system (DILIps.

    Directory of Open Access Journals (Sweden)

    Zhichao Liu

    2011-12-01

    Full Text Available Drug-induced liver injury (DILI is a significant concern in drug development due to the poor concordance between preclinical and clinical findings of liver toxicity. We hypothesized that the DILI types (hepatotoxic side effects seen in the clinic can be translated into the development of predictive in silico models for use in the drug discovery phase. We identified 13 hepatotoxic side effects with high accuracy for classifying marketed drugs for their DILI potential. We then developed in silico predictive models for each of these 13 side effects, which were further combined to construct a DILI prediction system (DILIps. The DILIps yielded 60-70% prediction accuracy for three independent validation sets. To enhance the confidence for identification of drugs that cause severe DILI in humans, the "Rule of Three" was developed in DILIps by using a consensus strategy based on 13 models. This gave high positive predictive value (91% when applied to an external dataset containing 206 drugs from three independent literature datasets. Using the DILIps, we screened all the drugs in DrugBank and investigated their DILI potential in terms of protein targets and therapeutic categories through network modeling. We demonstrated that two therapeutic categories, anti-infectives for systemic use and musculoskeletal system drugs, were enriched for DILI, which is consistent with current knowledge. We also identified protein targets and pathways that are related to drugs that cause DILI by using pathway analysis and co-occurrence text mining. While marketed drugs were the focus of this study, the DILIps has a potential as an evaluation tool to screen and prioritize new drug candidates or chemicals, such as environmental chemicals, to avoid those that might cause liver toxicity. We expect that the methodology can be also applied to other drug safety endpoints, such as renal or cardiovascular toxicity.

  13. The Effect of Two Educational Methods on Knowledge and Adherence to Treatment in Hemodialysis Patients: Clinical Trial

    Directory of Open Access Journals (Sweden)

    Kobra Parvan

    2015-03-01

    Full Text Available Introduction: Patients with chronic renal disease (CRD deal with many potential problems with hemodialysis for all their life. Regarding the importance of preventing dialysis adverse effects, which are in close connection with lack of knowledge and report on how to train the patients? This study aims at comparing the impact of two methods of face to face training and training pamphlet on complying and informing of hemodialysis treatments. Methods: This clinical trial study was conducted on 58 hemodialysis patients who visited Shahid Rahnemun Teaching hospital, Yazd, Iran, and had required conditions of the research. Data were collected through a questionnaire including personal-social information, several questions to assess the level of compliance and to inform the treatment method. The quantitative analysis of this study used the Statistical Package for Social Sciences SPSS version 13 and descriptive (frequency, mean, standard deviation and inferential (Chi-square, paired t-test, ANOVA, ANCOVA statistics were employed. Results: The mean scores for informing both groups (face to face and training pamphlet were significantly increased. The mean score for adherence to treatments was also significant.Conclusion: In this research, face to face training was found to be more effective than training pamphlet. It seemed to have more strong effect on increasing the level of information and adherence to treatment. To train these people, face to face training should be, thus, preferred.

  14. Is the endocrine research pipeline broken? A systematic evaluation of the Endocrine Society clinical practice guidelines and trial registration

    OpenAIRE

    Singh Ospina, Naykky; Rodriguez-Gutierrez, Rene; Juan P. Brito; Young, William F.; Victor M Montori

    2015-01-01

    Background Very low quality (VLQ) evidence translates into very low confidence in the balance of risk and benefits based on the estimates drawn from the body of evidence. Consequently, this assessment highlights gaps in the research evidence, i.e. knowledge gaps, for important clinical questions. In this way, expert guideline panels identify priority knowledge gaps that, arguably, should inform the research agenda and prioritize scarce research economical resources. The extent to which the re...

  15. Intern’s knowledge of clinical pharmacology and therapeutics at Puducherry: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Nitya S

    2013-10-01

    Full Text Available Background: Internship is the intermediate period between under-graduation and general practice. The dexterity of health professional relies upon prescribing practices. Clinical pharmacology and therapeutics (CPT is a crucial discipline for interns to acquire safe and rational prescription of drugs. Cultivating sound knowledge about CPT during under graduation is, henceforth, mandatory. Aims and objectives: 1.To assess whether the undergraduate CPT teaching and internship training had prepared interns adequately for safe and rational prescription. 2.To assess the awareness and reporting of adverse drug reaction (ADR. Methods: 110 interns were enrolled after obtaining informed written consent. A structured questionnaire was given to them including basic demographic information, undergraduate CPT teaching, experience of ADR and any deficiency in the under-graduate CPT teaching. Results: Response rate was 91 % in which 53 were males and 47 females. 81 considered themselves aware of CPT. 56% & 57% interns were able to prescribe drug safely and rationally respectively. Without supervision, they were confident to prescribe antacids (93%, vitamins and minerals (90%, NSAIDS (85%, antihistamines (82%, antibiotics (75%, antiemetics (62% and antiasthmatics (52%. Only 22% had reported ADR and opined that it could lead to hospitalization (51%, prolonged hospital stay (33%, morbidity (16% and death (21%. According to interns, the topics where more emphasis needed were ADR, dosage calculation, pediatric and emergency medicine and therapeutic drug monitoring during undergraduate CPT teaching. Conclusion: CPT teaching should be improved at undergraduate level for safe and rational prescribing including ADR monitoring, ADR reporting and dosage calculation. [Int J Basic Clin Pharmacol 2013; 2(5.000: 622-628

  16. Awareness and knowledge of Human Papillomavirus (HPV infection among high-risk men of Hispanic origin attending a Sexually Transmitted Infection (STI clinic

    Directory of Open Access Journals (Sweden)

    Colón-López Vivian

    2012-12-01

    Full Text Available Abstract Background Genital Human papilloma virus (HPV is one of the most commonly diagnosed Sexually Transmitted Infection (STIs in men and women. Knowledge about HPV infection among men is limited. This study aims to determine correlates of adequate knowledge of HPV infection among men who attend an STI clinic in Puerto Rico. Methods A cross-sectional study of 206 men was conducted at an STI clinic in San Juan, PR. Adequate knowledge was defined as a score of at least 70% of correct responses among those men who reported having ever heard of HPV. Variables that achieved statistical significance in the bivariate analysis (p Results Although 52.5% of men reported having heard of HPV infection before the survey, only 29.3% of this sub-group had an adequate knowledge of HPV. Most men did not know that HPV is a risk factor for anal (38.7%, penile (50.0% and oral (72.6% cancer. Factors associated with adequate knowledge of HPV in age-adjusted models were being men who have sex with men (MSM (OR=2.6;95%CI=1.1-6.1, self-report of genital warts (OR=3.2;95%CI=1.3-7.9 and herpes (OR=7.4;95% CI=2.2-25.1. MSM was marginally associated with adequate knowledge (OR=2.3;95% CI=0.9-5.9 and self-report of herpes remained significantly associated (OR=5.0;95%CI=1.3-18.4 in multivariate logistic regression analysis. Conclusions Awareness and knowledge of HPV was very low in this group of men. Interventions to increase knowledge and awareness in this group are necessary to promote preventive practices for HPV-related cancers in high-risk groups.

  17. Exposing the gaps in awareness, knowledge and estimation of risk for anal cancer in men who have sex with men living with HIV: a cross-sectional survey in Australia

    Directory of Open Access Journals (Sweden)

    Jason J Ong

    2015-03-01

    Full Text Available Introduction: The incidence of anal cancer is significantly higher in men who have sex with men (MSM living with HIV when compared to the general population. We aimed to assess their awareness, knowledge and perceived level of personal risk for anal cancer to help inform educational strategies targeting this group. Methods: A cross-sectional study of 327 HIV positive MSM in Melbourne, Australia, attending clinical settings (a sexual health centre, tertiary hospital HIV outpatients and high HIV caseload general practices completed a written questionnaire in 2013/14. Poor knowledge was defined as those who had never heard of anal cancer, or scored 5 or less out of 10 in knowledge questions amongst those who reported ever hearing about anal cancer. Underestimation of risk was defined as considering themselves as having the same or lower risk for anal cancer compared to the general population. Results: Of 72% (95% confidence interval (CI: 67–77 who had heard of anal cancer, 47% (95% CI: 41–53 could not identify any risk factors for anal cancer. Of total men surveyed, 51% (95% CI: 46–57 underestimated their risk for anal cancer. Multivariate analysis showed that men who underestimated their risk were older (OR 1.04 (per year increase in age, 95% CI: 1.01–1.07, had poor anal cancer knowledge (OR 2.06, 95% CI: 1.21–3.51, and more likely to have ever had an anal examination (OR 2.41, 95% CI: 1.18–4.93. They were less likely to consult a physician if they had an anal abnormality (OR 0.54, 95% CI: 0.31–0.96, to have had receptive anal sex (OR 0.12, 95% CI: 0.02–0.59 or speak English at home (OR 0.28, 95% CI: 0.09–0.90. Conclusions: This survey of MSM living with HIV demonstrated limited awareness, knowledge level and estimation of risk for anal cancer. Further educational and public health initiatives are urgently needed to improve knowledge and understanding of anal cancer risk in MSM living with HIV.

  18. 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

    information on fluorochemicals. Polyfluorinated alkyl phosphate ester surfactants (PAPs) belong to the group of polyfluorinated alkyl surfactants. They have been detected in indoor dust and are widely used in food-contact materials, from which they have the ability to migrate into food. Toxicological data on...

  19. Knowledge and perception of Prevention of Mother to Child services amongst pregnant women accessing antenatal clinic in a Primary Health Care centre in Nigeria

    OpenAIRE

    Owoaje, Eme T.; Adedoyin D. Omidokun; Ige, Olusimbo K.

    2012-01-01

    Background: Few studies have assessed pregnant women’s perceptions regarding prevention of mother to child of HIV and the available services at the primary health care level in Nigeria.Objective: Assessment of knowledge and perception of antenatal clinic (ANC) attendees regarding Prevention of Mother to Child Transmission (PMTCT) of HIV at primary health care facilities in south-west Nigeria.Method: A cross-sectional survey was conducted amongst 400 antenatal attendees in a Primary Health Car...

  20. Assessment and evaluation efficacy of a clinical pharmacist-led inpatient warfarin knowledge education program and follow-up at a Chinese tertiary referral teaching hospital

    OpenAIRE

    Guy-Armel Bounda; Cosette Ngarambe; Wei Hong Ge; Feng Yu

    2013-01-01

    Background: Oral anticoagulation therapy with warfarin is used to prevent and to treat venous and arterial thrombosis and embolism. Its narrow therapeutic index should be monitored carefully in order to reach the desired outcomes. Objective: This study aims to evaluate the clinical pharmacist-led in-patient warfarin′s knowledge education program and to assess a follow-up efficacy in a Chinese tertiary referral teaching hospital. Design and Setting: A cross-sectional and observational ...

  1. Data-mining to build a knowledge representation store for clinical decision support. Studies on curation and validation based on machine performance in multiple choice medical licensing examinations.

    Science.gov (United States)

    Robson, Barry; Boray, Srinidhi

    2016-06-01

    Extracting medical knowledge by structured data mining of many medical records and from unstructured data mining of natural language source text on the Internet will become increasingly important for clinical decision support. Output from these sources can be transformed into large numbers of elements of knowledge in a Knowledge Representation Store (KRS), here using the notation and to some extent the algebraic principles of the Q-UEL Web-based universal exchange and inference language described previously, rooted in Dirac notation from quantum mechanics and linguistic theory. In a KRS, semantic structures or statements about the world of interest to medicine are analogous to natural language sentences seen as formed from noun phrases separated by verbs, prepositions and other descriptions of relationships. A convenient method of testing and better curating these elements of knowledge is by having the computer use them to take the test of a multiple choice medical licensing examination. It is a venture which perhaps tells us almost as much about the reasoning of students and examiners as it does about the requirements for Artificial Intelligence as employed in clinical decision making. It emphasizes the role of context and of contextual probabilities as opposed to the more familiar intrinsic probabilities, and of a preliminary form of logic that we call presyllogistic reasoning. PMID:27089305

  2. The Case Anatomical Knowledge Index (CAKI): A Novel Method Used to Assess Anatomy Content in Clinical Cases

    Science.gov (United States)

    Banda, Sekelani S.

    2009-01-01

    There are concerns in the literature that the use of case-based teaching of anatomy could be compromising the depth and scope of anatomy learned by students in a problem-based learning curriculum. Poor selection of clinical cases that are used as vehicles for teaching/learning anatomy may be the root problem because some clinical cases do not…

  3. Sexual Knowledge among Norwegian Adolescents.

    Science.gov (United States)

    Kraft, Pal

    1993-01-01

    Studied sexual knowledge among Norwegian adolescents (n=1,855) aged 17-19 years. Found knowledge gaps among adolescents on sexual physiology and anatomy, sexually transmitted diseases, and fecundation/contraception. Level of sexual knowledge was higher among girls than boys and increased with increasing age. Sexual knowledge did not predict…

  4. 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.

  5. XML Comparison of Knowledge and Practice of Private Clinical Laboratories and Educational Centers Staff in Shiraz about AIDS,2011

    Directory of Open Access Journals (Sweden)

    Rezaei MA

    2011-01-01

    Full Text Available Abstract Background and objectives: Acquired immune deficiency syndrome(AIDS is one of the most well-known disease in the world .It is not only A heaththrapeutic problem but also with politic ,social, cultural and economic aspects. Paying attention to high-risk groups such as Lab staff is important. we decided to study and compare the knowledge of public and private Laboratories staff. Material and Methods: This cross sectional study, descriptive-analytic,was conducted on 350 personnel of private laboratories and educational centers of Shiraz University of Medical Sciences,2011.We collected Information by using a questionnaire including three parts of demographic characteristic questions, questions about knowledge in different fields of AIDS and those related to the performance of personnel. The results were reported as tables and graphs and analyzed by ANOVA,t-test and square. Results: The data, in different areas of AIDS, in public and private laboratories are similar and the difference statistically is not significant. Regarding to symptoms and treatment, the knowledge of privale Lab staff is higher than stste ones and this difference is significant (P=0.01.As a whole,the results show the knowledge of staff about the transmission modes(92.7%,the pathologic agent(99.2%,at risk people (61.2%and preventive measure (53.1%.both group have good practice in wearing gloves and using disposable syringes.Regarding to disposing infectious waste material,private and state center practice are 92.6% and 77%,respectively. Conclusion: Based on the result,the knowledge relating to preventive procedures and at risk people of AIDS is not enough.Therefore;it is a necessity to hold in service training for Lab staff,stressing on disposing infectious waste materials. Key words: AIDS, laboratory personnel, knowledge, practice

  6. Tuberculosis in hospital environment: clinical profile in a tertiary hospital from Ceará and level of knowledge of health personnel about control measures

    Directory of Open Access Journals (Sweden)

    Roberto da Justa Pires Neto

    2010-09-01

    Full Text Available Objectives: To describe clinical and epidemiological characteristics of inpatients with tuberculosis (TB and to assess the knowledge of health personnel on fundamental concepts about TB and control measures for pulmonary tuberculosis in a hospital environment. Methods: The study was conducted in a tertiary hospital in Fortaleza-CE and involved patients admitted with TB and health professionals responsible for assistance. A first phase was characterized by a retrospective study of medical records of patients admitted with suspected TB. In a second stage, a cross-sectional study with application of a structured questionnaire assessed the knowledge of health personnel on TB control measures in a hospital environment. Results: Sixty-seven patients admitted with suspected TB had their medical records assessed. Among the confirmed cases, the most frequent clinical form was pulmonary (81.3%. Out of 55 patients admitted with suspected pulmonary tuberculosis, only 29 (52.7% were admitted in a respiratory isolation bed. Twenty-six patients with suspected pulmonary tuberculosis on admission stayed a total of 148 days out of a respiratory isolation bed (average 4.1 days / patient. The knowledge of 159 health professionals about TB was assessed. Regarding the transmission of TB, 107 (67.2% were unaware of airborne transmission and 109 (68.5% ignored the clinical forms that require respiratory isolation. Conclusions: Pulmonary tuberculosis is the most frequent clinical form among inpatients in a tertiary hospital in Fortaleza-CE. Considerable fraction of health personnel doesn’t know key concepts related to tuberculosis and essential for the proper and safe care. Descriptors: Tuberculosis; Infectious Disease Transmission; Exposure to Biological Agents; Health personnel.

  7. Integrating clinical research into clinical decision making

    Directory of Open Access Journals (Sweden)

    Mark R Tonelli

    2011-01-01

    Full Text Available Evidence-based medicine has placed a general priority on knowledge gained from clinical research for clinical decision making. However, knowledge derived from empiric, population-based research, while valued for its ability to limit bias, is not directly applicable to the care of individual patients. The gap between clinical research and individual patient care centers on the fact that empiric research is not generally designed to answer questions of direct relevance to individual patients. Clinicians must utilize other forms of medical knowledge, including pathophysiologic rationale and clinical experience, in order to arrive at the best medical decision for a particular patient. In addition, clinicians must also elucidate and account for the goals and values of individual patients as well as barriers and facilitators of care inherent in the system in which they practice. Evidence-based guidelines and protocols, then, can never be prescriptive. Clinicians must continue to rely on clinical judgment, negotiating potentially conflicting warrants for action, in an effort to arrive at the best decision for a particular patient.

  8. Bridging the Gap between Preclinical and Clinical Microbicide Trials: Blind Evaluation of Candidate Gels in Murine Models of Efficacy and Safety

    OpenAIRE

    Theodore J Segarra; Esra Fakioglu; Natalia Cheshenko; Wilson, Sarah S; Pedro M M Mesquita; Doncel, Gustavo F.; Herold, Betsy C.

    2011-01-01

    BACKGROUND: Despite significant protection in preclinical studies, cellulose sulfate (CS) failed to protect women against HIV-1/2 and was associated with a trend toward increased HIV-1 acquisition in one of the clinical trials. These results highlight the need for preclinical tests more predictive of clinical outcomes. The objective of this study was to test coded vaginal gels, including CS, in murine models of safety and efficacy to determine the models' utility for evaluating future product...

  9. Exploration of knowledge, attitudes and percepions regarding sexually transmitted infections among patients attending a primary health care clinic in Gauteng - Part 1

    Directory of Open Access Journals (Sweden)

    T.J. Molapo

    2007-09-01

    Full Text Available Sexually transmitted infections are a major public health problem in South Africa. The high incidence and prevalence of sexually transmitted infections in South Africa pose a serious threat to public health for two main reasons. Firstly, the long-term consequences of these infections are a major cause of loss of health or life, and secondly, sexually transmitted infections are important co-factors in driving the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS epidemic. The control and prevention of sexually transmitted infections has become an urgent priority. At a primary health care clinic, the nursing personnel experienced an increasing number of persons daily seeking treatment for sexually transmitted infections. The purpose of the study was therefore to investigate the knowledge, attitudes and perceptions of people seeking treatment at Stanza Bopape Clinic regarding sexually transmitted infections. The study was a contextual, quantitative survey. The population was all patients (15 years and older who visited the clinic for a health-related problem during November 2004 to January 2005. The sampling method was convenient. The data gathering method was self-report using a structured questionnaire basic on current knowledge. The data analysis was done with descriptive statistics.

  10. Mining Clinical Data using Minimal Predictive Rules

    OpenAIRE

    Batal, Iyad; Hauskrecht, Milos

    2010-01-01

    Modern hospitals and health-care institutes collect huge amounts of clinical data. Those who deal with such data know that there is a widening gap between data collection and data comprehension. Thus, it is very important to develop data mining techniques capable of automatically extracting useful knowledge to support clinical decision-making in various diagnostic and patient-management tasks. In this paper, we develop a new framework for rule mining based on minimal predictive rules (MPR). O...

  11. Gaps in Political Interest

    DEFF Research Database (Denmark)

    Robison, Joshua

    2015-01-01

    sought to measure respondents’ general interest in politics by asking them how often they follow public affairs. In this article, we uncover novel sources of measurement error concerning this question. We first show that other nationally representative surveys that frequently use this item deliver......Political interest fundamentally influences political behavior, knowledge, and persuasion (Brady, Verba, & Schlozman, 1995; Delli Carpini & Keeter, 1996; Luskin, 1990; Zukin, Andolina, Keeter, Jenkins, & Delli Carpini, 2006). Since the early 1960s, the American National Election Studies (ANES) has...... drastically higher estimates of mass interest. We then use a survey experiment included on a wave of the ANES’ Evaluating Government and Society Surveys (EGSS) to explore the influence of question order in explaining this systemic gap in survey results. We show that placing batteries of political...

  12. Clinical evidence continuous medical education: a randomised educational trial of an open access e-learning program for transferring evidence-based information – ICEKUBE (Italian Clinical Evidence Knowledge Utilization Behaviour Evaluation – study protocol

    Directory of Open Access Journals (Sweden)

    Satolli Roberto

    2008-07-01

    Full Text Available Abstract Background In an effort to ensure that all physicians have access to valid and reliable evidence on drug effectiveness, the Italian Drug Agency sponsored a free-access e-learning system, based on Clinical Evidence, called ECCE. Doctors have access to an electronic version and related clinical vignettes. Correct answers to the interactive vignettes provide Continuing Medical Education credits. The aims of this trial are to establish whether the e-learning program (ECCE increases physicians' basic knowledge about common clinical scenarios, and whether ECCE is superior to the passive diffusion of information through the printed version of Clinical Evidence. Design All Italian doctors naïve to ECCE will be randomised to three groups. Group one will have access to ECCE for Clinical Evidence chapters and vignettes lot A and will provide control data for Clinical Evidence chapters and vignettes lot B; group two vice versa; group three will receive the concise printed version of Clinical Evidence. There are in fact two designs: a before and after pragmatic trial utilising a two by two incomplete block design (group one versus group two and a classical design (group one and two versus group three. The primary outcome will be the retention of Clinical Evidence contents assessed from the scores for clinical vignettes selected from ECCE at least six months after the intervention. To avoid test-retest effects, we will randomly select vignettes out of lot A and lot B, avoiding repetitions. In order to preserve the comparability of lots, we will select vignettes with similar, optimal psychometric characteristics. Trial registration ISRCTN27453314

  13. Knowledge about knowledge

    International Nuclear Information System (INIS)

    Technology and knowledge make up the knowledge capital that has been so essential to the oil and gas industry's value creation, competitiveness and internationalization. Report prepared for the Norwegian Oil Industry Association (OLF) and The Norwegian Society of Chartered Technical and Scientific Professionals (Tekna), on the Norwegian petroleum cluster as an environment for creating knowledge capital from human capital, how fiscal and other framework conditions may influence the building of knowledge capital, the long-term perspectives for the petroleum cluster, what Norwegian society can learn from the experiences in the petroleum cluster, and the importance of gaining more knowledge about the functionality of knowledge for increased value creation (author) (ml)

  14. Knowledge, attitude, perception of malaria and evaluation of malaria parasitaemia among pregnant women attending antenatal care clinic in metropolitan Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    N.C. Iriemenam, A.O. Dosunmu, W.A. Oyibo & A.F. Fagbenro-Beyioku

    2011-03-01

    Full Text Available Background & objectives: Little information exists on the compliance of pregnant women to malaria managementin malaria endemic countries. This study was designed to access knowledge, attitude, perception and homemanagement of malaria among consenting pregnant women attending antenatal care (ANC clinic.Methods: In total, 350 pregnant women were randomly recruited during their ANC Clinic in Lagos. Structuredquestionnaires were administered in a two-stages research design; first during their early months of ANC visitand the second approximately 1–2 months before delivery. Information on occupation, parity, symptoms used torecognise malaria, treatment sources, control measures, knowledge factors, anti-vector measures, health-seekingpractices, malaria parasitaemia and packed cell volume (PCV were recorded.Results: The results revealed that 78.9% of the pregnant women identified infected mosquitoes as the cause ofmalaria while 86% of the pregnant women identified stagnant water as its breeding sites. Knowledge of thebenefit of insecticide-treated mosquito bednets was less prominent as most of the selected subjects decried itshigh market price. Our data also showed that educational programme targeted on potential mothers is beneficial.Overall, 27.4% (96/350 of the pregnant women had peripheral malaria infection with 88.5% (85/96 of theparasite positive women infected with Plasmodium falciparum and 11.5% (11/96 with P. malariae. PCV rangedfrom 20–40% (median 33.9% with 25.7% (90/350 of the pregnant women being anaemic with PCV <33%. Wefound an association between malaria infection and occupation, and this association was not influenced byparity.Interpretation & conclusion: Our findings revealed that improvement in knowledge and education of women ofchild-bearing age has an influential impact on malaria control

  15. Conflicts Between Parents and Health Professionals About a Child's Medical Treatment: Using Clinical Ethics Records to Find Gaps in the Bioethics Literature.

    Science.gov (United States)

    McDougall, Rosalind; Notini, Lauren; Phillips, Jessica

    2015-09-01

    Clinical ethics records offer bioethics researchers a rich source of cases that clinicians have identified as ethically complex. In this paper, we suggest that clinical ethics records can be used to point to types of cases that lack attention in the current bioethics literature, identifying new areas in need of more detailed bioethical work. We conducted an analysis of the clinical ethics records of one paediatric hospital in Australia, focusing specifically on conflicts between parents and health professionals about a child's medical treatment. We identified, analysed, and compared cases of this type from the clinical ethics records with cases of this type discussed in bioethics journals. While the cases from journals tended to describe situations involving imminent risk to the child's life, a significant proportion of the clinical ethics records cases involved different stakes for the child involved. These included distress, poorer functional outcome, poorer psychosocial outcome, or increased risk of surgical complications. Our analysis suggests that one type of case that warrants more detailed ethics research is parental refusal of recommended treatment, where the refusal does not endanger the child's life but rather some other aspect of the child's well-being. PMID:26133890

  16. Wing muscles in blue-and-yellow Macaw (Ara ararauna, Linnaeus, 1758: basic knowledge applied to the clinic of wild animals

    Directory of Open Access Journals (Sweden)

    Kamal Achôa Filho

    2014-06-01

    Full Text Available This paper aimed to describe the wing muscles in blue-and-yellow Macaw (Ara ararauna, in order to contribute to increase knowledge on its anatomy and help the clinical practice with this species. Five macaws from the Screening Center for Wild Animals in Paraíba (CETAS-PB were used, and the muscles were identified by direct dissection. Flexor muscles, as well as extensor muscles, were well defined, had a good caliber and development, thus contributing to a detailed anatomical description and to a definition of their origin, insertion, and functionality in the wings of macaws.

  17. Evaluation of Kidney Disease Education on Clinical Outcomes and Knowledge of Self-Management Behaviors of Patients with Chronic Kidney Disease.

    Science.gov (United States)

    Enworom, Chinyere D; Tabi, Marian

    2015-01-01

    Chronic kidney disease (CKD) is a public health problem in United States. Providing kidney disease education (KDE) is an effective and integral part of CKD management. This two-part non-experimental study retrospectively evaluated clinical outcomes of participants of a Medicare Kidney Disease Education (KDE) program and prospectively evaluated kidney disease knowledge of survey participants from the general population of patients with CKD. Results showed that participants of a KDE program demonstrated slower decline in GFR compared to non-participants (M = 18.3 mL/min/1.73m2, SD = 8.3 mL/min/1.73m2 vs. M = 15.0 mL/min/1.73m2, SD = 6.1 mL/min/1.73m2). Providing KDE to individuals with CKD Stage 4 was associated with improved clinical outcomes. PMID:26462309

  18. Prescribing knowledge in the light of undergraduate clinical pharmacology and therapeutics teaching in India: views of first-year postgraduate students

    Directory of Open Access Journals (Sweden)

    Upadhyaya P

    2012-06-01

    Full Text Available Prerna Upadhyaya,1 Vikas Seth,2 Monika Sharma,1 Mushtaq Ahmed,1 Vijay Vasant Moghe,1 Zafar Yab Khan,1 Vinay Kumar Gupta,1 Shipra Vikram Jain,1 Utkarsh Soni,1 Manohar Bhatia,1 Kumar Abhijit,1 Jaswant Goyal11Department of Pharmacology, Mahatma Gandhi Medical College, Jaipur, 2Department of Pharmacology, Hind Institute of Medical Sciences, Lucknow, IndiaObjectives: The study aimed to review the prescribing knowledge of first-year postgraduate doctors in a medical college in India, using the principles of good prescribing, to suggest strategies to improve rational prescribing, and to recommend what curriculum planners can do to accomplish this objective.Methods: Fifty first-year postgraduate doctors were asked to fill in a structured questionnaire that sought information regarding their undergraduate training in clinical pharmacology and therapeutics, prescribing habits, and commonly consulted drug information sources. Also, the questionnaire assessed any perceived deficiencies in their undergraduate clinical pharmacology teaching and sought feedback regarding improvement in the teaching.Results: Eighty-eight percent of residents said that they were taught prescription writing in undergraduate pharmacology teaching; 48% of residents rated their prescribing knowledge at graduation as average, 28% good, 4% excellent, 14% poor, and 4% very poor; 58% felt that their undergraduate training did not prepare them to prescribe safely, and 62% felt that their training did not prepare them to prescribe rationally. Fifty-eight percent of residents felt that they had some specific problems with writing a prescription during their internship training, while 92% thought that undergraduate teaching should be improved. Their suggestions for improving teaching methods were recorded.Conclusions: This study concludes that efforts are needed to develop a curriculum that encompasses important aspects of clinical pharmacology and therapeutics along with incorporation of

  19. Knowledge of Fecal Calprotectin and Infliximab Trough Levels Alters Clinical Decision-making for IBD Outpatients on Maintenance Infliximab Therapy

    OpenAIRE

    Huang, Vivian W; Prosser, Connie; Kroeker, Karen I.; Wang, Haili; Shalapay, Carol; Dhami, Neil; Fedorak, Darryl K; Halloran, Brendan; Dieleman, Levinus A.; Goodman, Karen J; Richard N Fedorak

    2015-01-01

    Background: Infliximab is an effective therapy for inflammatory bowel disease (IBD). However, more than 50% of patients lose response. Empiric dose intensification is not effective for all patients because not all patients have objective disease activity or subtherapeutic drug level. The aim was to determine how an objective marker of disease activity or therapeutic drug monitoring affects clinical decisions regarding maintenance infliximab therapy in outpatients with IBD. Methods: Consecutiv...

  20. 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…

  1. Bridging the gap between preclinical and clinical microbicide trials: blind evaluation of candidate gels in murine models of efficacy and safety.

    Directory of Open Access Journals (Sweden)

    Theodore J Segarra

    Full Text Available BACKGROUND: Despite significant protection in preclinical studies, cellulose sulfate (CS failed to protect women against HIV-1/2 and was associated with a trend toward increased HIV-1 acquisition in one of the clinical trials. These results highlight the need for preclinical tests more predictive of clinical outcomes. The objective of this study was to test coded vaginal gels, including CS, in murine models of safety and efficacy to determine the models' utility for evaluating future products. METHODS: Four coded formulations, including 6% CS, 2% PRO 2000 and two placebo gels, were administered intravaginally to medroxyprogesterone-treated mice and their ability to prevent genital herpes (efficacy or to alter the susceptibility to low dose HSV challenge (safety was determined. Nonoyxnol-9 served as a positive toxicity control. RESULTS: CS and PRO 2000 significantly protected mice from genital herpes following infection with a laboratory or clinical isolate of HSV-2 introduced in buffer (p<0.001. However, protection was reduced when virus was introduced in seminal plasma. Moreover, mice were significantly more susceptible to infection with low doses of HSV-2 when challenged 12 h after the 7th daily dose of CS or nonoxynol-9 (p<0.05. The increased susceptibility was associated with alterations in epithelial architecture. CONCLUSIONS: CS prevented genital herpes when present at the time of viral challenge, but increased the rate of infection when gel was applied daily for 7 days with a vaginal wash prior to viral inoculation. The findings presumably reflect altered epithelial architecture, which may have contributed to the trend towards increased HIV observed clinically.

  2. A Comparison Between Caucasians and African Americans in Willingness to Participate in Cancer Clinical Trials: The Roles of Knowledge, Distrust, Information Sources, and Religiosity.

    Science.gov (United States)

    Meng, Jingbo; McLaughlin, Margaret; Pariera, Katrina; Murphy, Sheila

    2016-06-01

    This study aims to (a) examine the roles of knowledge, distrust in medical professionals, information sources, and 2 dimensions of religiosity (i.e., religious activity and religious belief) in influencing willingness to participate (WTP) in cancer clinical trials and to (b) compare the results for Caucasians and African Americans in order to inform future recruitment. An online survey was fielded via a Knowledge Networks panel with a nationally representative sample including 478 Caucasians and 173 African Americans. The results showed that distrust in medical professionals was a strong barrier to WTP for both ethnic groups, whereas factual knowledge about trial procedures was not associated with WTP for either ethnic group. Seeking trial information from doctors was positively associated with WTP for Caucasians; seeking trial information from hospitals was positively associated with WTP for African Americans. More interestingly, levels of religious activity negatively predicted WTP for Caucasians but positively predicted WTP for African Americans. Self-reported religious belief was not associated with WTP for either ethnic group. In sum, although distrust is a common barrier to WTP, the influence of preferred information sources and religious activity on WTP varies as a function of ethnicity. PMID:27175604

  3. Closing the gap between clinic and cage: sensori-motor and cognitive behavioural testing regimens in neurotoxin-induced animal models of Parkinson's disease.

    Science.gov (United States)

    Pienaar, Ilse S; Lu, Bingwei; Schallert, Timothy

    2012-11-01

    Animal models that make use of chemical toxins to adversely affect the nigrostriatal dopaminergic pathway of rodents and primates have contributed significantly towards the development of symptomatic therapies for Parkinson's disease (PD) patients. Although their use in developing neuro-therapeutic and -regenerative compounds remains to be ascertained, toxin-based mammalian and a range of non-mammalian models of PD are important tools in the identification and validation of candidate biomarkers for earlier diagnosis, as well as in the development of novel treatments that are currently working their way into the clinic. Toxin models of PD have and continue to be important models to use for understanding the consequences of nigrostriatal dopamine cell loss. Functional assessment of these models is also a critical component for eventual translational success. Sensitive behavioural testing regimens for assessing the extent of dysfunction exhibited in the toxin models, the degree of protection or improvement afforded by potential treatment modalities, and the correlation of these findings with what is observed clinically in PD patients, ultimately determines whether a potential treatment moves to clinical trials. Here, we review existing published work that describes the use of such behavioural outcome measures associated with toxin models of parkinsonism. In particular, we focus on tests assessing sensorimotor and cognitive function, both of which are significantly and progressively impaired in PD. PMID:22910679

  4. Safe medication use based on knowledge of information about contraindications concerning cross allergy and comprehensive clinical intervention

    Directory of Open Access Journals (Sweden)

    Li W

    2013-02-01

    Full Text Available Wei Li,1 Ling-Ling Zhu,2 Quan Zhou31Division of Medical Affairs, 2Cadre Department, Division of Nursing, 3Department of Pharmacy, Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, People's Republic of ChinaBackground: An investigation of safety issues regarding information on contraindications related to cross allergy was conducted to promote clinical awareness and prevent medical errors in a 2200-bed tertiary care teaching hospital.Methods: Prescribing information on contraindications concerning cross allergy was collected from an information system and package inserts. Data mining and descriptive analysis were performed. A risk register was used for project management and risk assessment. A Plan, Do, Check, Act cycle was used as part of continuous quality improvement. Records of drug counseling and medical errors were collected from an online reporting system. A pharmacist-led multidisciplinary team initiated an intervention program on cross allergy in August 2008.Results: Four years of risk management at our hospital achieved successful outcomes, ie, the number of medical errors related to cross allergies decreased by 97% (10 cases monthly before August 2008 versus three cases yearly in 2012 and risk rating decreased significantly [initial risk rating:25 (high-risk before August 2008 versus final risk rating:6 (medium-risk in December 2012].Conclusion: We conclude that comprehensive clinical interventions are very effective through team cooperation. Medication use has potential for safety risks if sufficient attention is not paid to contraindications concerning cross allergy. The potential for cross allergy involving drugs which belong to completely different pharmacological classes is easily overlooked and can be dangerous. Pharmacists can play an important role in reducing the risk of cross allergy as well as recommending therapeutic alternatives.Keywords: clinical pharmacy, contraindications, cross allergy

  5. Between the Gap

    OpenAIRE

    McDevitt, Mary Jean

    2009-01-01

    The reveal is an important architectural element. In many buildings, reveals define transitions between dissimilar materials, textures, finishes or planes. A reveal can also be thought of as a gap. Webster's dictionary defines a gap as "an opening made by breaking or parting." Often the word "gap" is associated with a deficiency or failure, but a gap similar to a reveal, can be intentional and essential to the success of a building. The visually impaired experience a "gap" with the sight...

  6. The implementation of a community-based aerobic walking program for mild to moderate knee osteoarthritis: A knowledge translation randomized controlled trial: Part II: Clinical outcomes

    Directory of Open Access Journals (Sweden)

    Brosseau Lucie

    2012-12-01

    Full Text Available Abstract Background Osteoarthritis (OA is the most common joint disorder in the world, as it is appears to be prevalent among 80% of individuals over the age of 75. Although physical activities such as walking have been scientifically proven to improve physical function and arthritic symptoms, individuals with OA tend to adopt a sedentary lifestyle. There is therefore a need to improve knowledge translation in order to influence individuals to adopt effective self-management interventions, such as an adapted walking program. Methods A single-blind, randomized control trial was conducted. Subjects (n = 222 were randomized to one of three knowledge translation groups: 1 Walking and Behavioural intervention (WB (18 males, 57 females which included the supervised community-based aerobic walking program combined with a behavioural intervention and an educational pamphlet on the benefits of walking; 2 Walking intervention (W (24 males, 57 females wherein participants only received the supervised community-based aerobic walking program intervention and the educational pamphlet; 3 Self-directed control (C (32 males, 52 females wherein participants only received the educational pamphlet. One-way analyses of variance were used to test for differences in quality of life, adherence, confidence, and clinical outcomes among the study groups at each 3 month assessment during the 12-month intervention period and 6-month follow-up period. Results The clinical and quality of life outcomes improved among participants in each of the three comparative groups. However, there were few statistically significant differences observed for quality of life and clinical outcomes at long-term measurements at 12-months end of intervention and at 6- months post intervention (18-month follow-up. Outcome results varied among the three groups. Conclusion The three groups were equivalent when determining the effectiveness of knowledge uptake and improvements in quality of life

  7. The prototype GAPS (pGAPS) experiment

    International Nuclear Information System (INIS)

    The General Antiparticle Spectrometer (GAPS) experiment is a novel approach for the detection of cosmic ray antiparticles. A prototype GAPS (pGAPS) experiment was successfully flown on a high-altitude balloon in June of 2012. The goals of the pGAPS experiment were: to test the operation of lithium drifted silicon (Si(Li)) detectors at balloon altitudes, to validate the thermal model and cooling concept needed for engineering of a full-size GAPS instrument, and to characterize cosmic ray and X-ray backgrounds. The instrument was launched from the Japan Aerospace Exploration Agency's (JAXA) Taiki Aerospace Research Field in Hokkaido, Japan. The flight lasted a total of 6 h, with over 3 h at float altitude (∼33km). Over one million cosmic ray triggers were recorded and all flight goals were met or exceeded

  8. Inhibition of the PI3K/Akt/mTOR Signaling Pathway in Diffuse Large B-Cell Lymphoma: Current Knowledge and Clinical Significance

    Directory of Open Access Journals (Sweden)

    Agata Majchrzak

    2014-09-01

    Full Text Available Diffuse large B-cell lymphoma (DLBCL is one of the most common non-Hodgkin lymphomas in adults. The disease is very heterogeneous in its presentation, that is DLBCL patients may differ from each other not only in regard to histology of tissue infiltration, clinical course or response to treatment, but also in respect to diversity in gene expression profiling. A growing body of knowledge on the biology of DLBCL, including abnormalities in intracellular signaling, has allowed the development of new treatment strategies, specifically directed against lymphoma cells. The phosphoinositide 3-kinase (PI3K/protein kinase B (Akt/mammalian target of rapamycin (mTOR signaling pathway plays an important role in controlling proliferation and survival of tumor cells in various types of malignancies, including DLBCL, and therefore it may be a promising target for therapeutic intervention. Currently, novel anticancer drugs are undergoing assessment in different phases of clinical trials in aggressive lymphomas, with promising outcomes. In this review we present a state of art review on various classes of small molecule inhibitors selectively involving PI3K/Akt/mTOR pathway and their clinical potential in this disease.

  9. Lexical Gap-Filling Mechanisms in Foreign Language Writing

    Science.gov (United States)

    Llach, M[a]. Pilar Agustin

    2010-01-01

    The present paper intends to investigate the lexical gap-filling behaviour of primary and secondary Spanish learners of English. When there is a mismatch between the learners lexical knowledge and their communicative needs, then a lexical gap arises. Learners resort to different mechanisms to compensate for that lack of lexical knowledge.…

  10. 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

  11. 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

    2016-07-01

    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

  12. International Meeting on Needs and Challenges in Translational Medicine: filling the gap between basic research and clinical applications. Book of abstract

    International Nuclear Information System (INIS)

    This multidisciplinary international meeting is organized by the Istituto Superiore di Sanita, in collaboration with Alleanza Contro il Cancro (Alliance Against Cancer, the Network of the Italian Comprehensive Cancer Centres) and EATRIS (European Advanced Translational Research Infrastructure in Medicine). The primary goal of the meeting is to provide a scientific forum to discuss the recent progress in translational research. Moreover, a particular focus will be devoted to the identification of needs, obstacles and new opportunities to promote translational research in biomedicine. The scientific programme will cover a broad range of fields including: cancer; neurosciences; rare diseases; cardiovascular diseases and infectious and autoimmune diseases. Furthermore, special attention will be given to the discussion of how comprehensive initiatives for addressing critical regulatory issues for First-In-Man - Phase I clinical studies can potentially improve the efficiency and quality of biomedical and translational research at an international level

  13. Clinical Practice and Knowledge in Caring: Breastfeeding Ties and the Impact on the Health of Latin-American Minor Migrants.

    Science.gov (United States)

    Castaldo, Miriam; Marrone, Rosalia; Costanzo, Gianfranco; Mirisola, Concetta

    2015-10-01

    In the context of the project "Clinical and social evaluation of medical practices in the treatment of infectious diseases in pediatrics for children of vulnerable population" carried out in 2013 by a multidisciplinary team at the National Institute for Health, Migration and Poverty (NIHMP) in Rome, a study in medical anthropology on the incorporation of illnesses that mothers feel they transmit to their children through breastfeeding was conducted. The results of the anthropological study, that targeted 34 children and adolescents from the age of 3 to the age of 17, all immigrants from Latin America residing in Italy, show that some forms of suffering in minors are described by women as being connected to factors such as susto ("fright"), coraje, muina, enojo ("anger") and mal de ojo ("evil eye"), and are in relation to a specific cultural frame. It is clear that barriers that prevent the access to the healthcare system must be removed, barriers that are accentuated by linguistic and cultural incomprehension, through adequate multidisciplinary healthcare settings such as the one we are presenting, composed of a medical doctor, an anthropologist and a cultural mediator. PMID:25164619

  14. Knowledge management

    OpenAIRE

    Jarošová, Milena

    2010-01-01

    Theoretical part: Basic terms of knowledge management, knowledge worker, knowledge creation and conversion process, prerequisites and benefits of knowledge management. Knowledge management and it's connection to organizational culture and structure, result measurements of knowledge management, learning organization and it's connection to knowledge management. Tacit knowledge management tools -- stories -- types, how to create, practical use, communities, coaching. Value Based Organization. Pr...

  15. 强化临床护理教师对默会知识的认知和培养%To strengthen cognition and cultivation of clinical nursing teachers about tacit knowledge

    Institute of Scientific and Technical Information of China (English)

    李霞; 李莉

    2009-01-01

    It probed into clinical nursing teachers' cognition toward tacit knowledge.It proposed ways and cultivation of strengthening clinical nursing teachers' learning toward tacit knowledge,so as to enhance their clinical teaching level.%探讨了临床护理教师对带教过程中默会知识的认识,提出了强化临床护理教师习得默会知识的途径,从而提高临床教学水平.

  16. Assessing the development gap

    OpenAIRE

    Sinitsina, Irina; Chubrik, Alexander; Denisova, Irina; Dubrovskiy, Vladimir; Kartseva, Marina; Makenbaeva, Irina; Rokicka, Magdalena; Tokmazishvili, Michael

    2007-01-01

    Current report aims to identify major existing gaps in the four socio-economic dimensions (economic, human, environmental, and institutional) and to reveal those gaps which could potentially hinder social and economic integration of neighbor states with the EU. To achieve this, the authors aim to assess the existing trends in the size of the gaps across countries and problem areas, taking into consideration the specific origin of the gap between EU15/EU12, on the one hand, and FSU republics, ...

  17. SUPPORTING PRODUCT INNOVATION THROUGH KNOWLEDGE AUDIT

    OpenAIRE

    Chowdhury, Naguib

    2015-01-01

    Knowledge audit is considered as one of the first steps towards designing a knowledge management strategy for an organization. Knowledge audit opens up the eye of an organization in terms of understanding its current knowledge capabilities, future knowledge requirements and critical knowledge gaps.. This paper focuses on how various knowledge audit tools can be used as an effective mechanism for organizational innovation process, specially understanding market needs, assessing ...

  18. Degradation of connexins and gap junctions

    OpenAIRE

    Falk, Matthias M.; Kells, Rachael M.; Berthoud, Viviana M.

    2014-01-01

    Connexin proteins are short-lived within the cell, whether present in the secretory pathway or in gap junction plaques. Their levels can be modulated by their rate of degradation. Connexins, at different stages of assembly, are degraded through the proteasomal, endo-/lysosomal, and phago-/lysosomal pathways. In this review, we summarize the current knowledge about connexin and gap junction degradation including the signals and protein-protein interactions that participate in their targeting f...

  19. Behind the Pay Gap

    Science.gov (United States)

    Dey, Judy Goldberg; Hill, Catherine

    2007-01-01

    Women have made remarkable gains in education during the past three decades, yet these achievements have resulted in only modest improvements in pay equity. The gender pay gap has become a fixture of the U.S. workplace and is so ubiquitous that many simply view it as normal. "Behind the Pay Gap" examines the gender pay gap for college graduates.…

  20. 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...

  1. Knowledge worker training in Malaysia

    OpenAIRE

    Zulkifli, Izyani

    2010-01-01

    An increasing number of countries have shifted, or are shifting, towards the knowledge-based economy. For these countries, including Malaysia, the quality of knowledge workers is extremely important in determining the pace and success of such transition. Thus, training is often carried out to improve the skills of knowledge workers at the workplace. But despite its importance, research on knowledge worker training is extremely limited. This study seeks to partially fill this gap in the litera...

  2. Lithium: updated human knowledge using an evidence-based approach. Part II: Clinical pharmacology and therapeutic monitoring.

    Science.gov (United States)

    Grandjean, Etienne Marc; Aubry, Jean-Michel

    2009-01-01

    After a single dose, lithium, usually given as carbonate, reaches a peak plasma concentration at 1.0-2.0 hours for standard-release dosage forms, and 4-5 hours for sustained-release forms. Its bioavailability is 80-100%, its total clearance 10-40 mL/min and its elimination half-life is 18-36 hours. Use of the sustained-release formulation results in 30-50% reductions in peak plasma concentrations without major changes in the area under the plasma concentration curve. Lithium distribution to the brain, evaluated using 7Li magnetic resonance spectroscopy, showed brain concentrations to be approximately half those in serum, occasionally increasing to 75-80%. Brain concentrations were weakly correlated with serum concentrations. Lithium is almost exclusively excreted via the kidney as a free ion and lithium clearance is considered to decrease with aging. No gender- or race-related differences in kinetics have been demonstrated. Renal insufficiency is associated with a considerable reduction in renal clearance of lithium and is considered a contraindication to its use, especially if a sodium-poor diet is required. During the last months of pregnancy, lithium clearance increases by 30-50% as a result of an increase in glomerular filtration rate. Lithium also passes freely from maternal plasma into breast milk. Numerous kinetic interactions have been described for lithium, usually involving a decrease in the drug's clearance and therefore increasing its potential toxicity. Clinical pharmacology studies performed in healthy volunteers have investigated a possible effect of lithium on cognitive functions. Most of these studies reported a slight, negative effect on vigilance, alertness, learning and short-term memory after long-term administration only. Because of the narrow therapeutic range of lithium, therapeutic monitoring is the basis for optimal use and administration of this drug. Lithium dosages should be adjusted on the basis of the serum concentration drawn

  3. Survey of knowledge and perception on the access to evidence-based practice and clinical practice change among maternal and infant health practitioners in South East Asia

    Directory of Open Access Journals (Sweden)

    Crowther Caroline A

    2008-08-01

    Full Text Available Abstract Background Evidence-based practice (EBP can provide appropriate care for women and their babies; however implementation of EBP requires health professionals to have access to knowledge, the ability to interpret health care information and then strategies to apply care. The aim of this survey was to assess current knowledge of evidence-based practice, information seeking practices, perceptions and potential enablers and barriers to clinical practice change among maternal and infant health practitioners in South East Asia. Methods Questionnaires about IT access for health information and evidence-based practice were administered during August to December 2005 to health care professionals working at the nine hospitals participating in the South East Asia Optimising Reproductive and Child Health in Developing countries (SEA-ORCHID project in Indonesia, Malaysia, Thailand and The Philippines. Results The survey was completed by 660 staff from six health professional groups. Overall, easy IT access for health care information was available to 46% of participants. However, over a fifth reported no IT access was available and over half of nurses and midwives never used IT health information. Evidence-based practice had been heard of by 58% but the majority did not understand the concept. The most frequent sites accessed were Google and PubMed. The Cochrane Library had been heard of by 47% of whom 51% had access although the majority did not use it or used it less than monthly. Only 27% had heard of the WHO Reproductive Health Library and 35% had been involved in a clinical practice change and were able to identify enablers and barriers to change. Only a third of participants had been actively involved in practice change with wide variation between the countries. Willingness to participate in professional development workshops on evidence-based practice was high. Conclusion This survey has identified the need to improve IT access to health care

  4. Understanding clinical nursing education: An exploratory study.

    Science.gov (United States)

    Dahlke, Sherry; O'Connor, Maureen; Hannesson, Teresa; Cheetham, Karleen

    2016-03-01

    Clinical experiences are recognized as a critical aspect of nursing education, highlighting the importance of the perspectives of those providing clinical instruction. The aim of this mixed methods descriptive study was to discover the knowledge and guidance needs of preceptors and clinical faculty who provide clinical instruction to Bachelor of Science in Nursing (BSN) students. Fifteen clinical faculty and 17 preceptors were surveyed using a questionnaire developed and piloted by the researchers. Although preceptors and clinical faculty reported a high level of knowledge and confidence in their ability to guide student nurses, they also identified the need for additional support for their teaching roles. Analysis of the qualitative data provided insights into what helped and what hindered clinical instruction, as well as what could enhance clinical instruction. The development, implementation, and evaluation of formal education and mentorship processes for preceptors and clinical faculty are recommended in order to meet these knowledge and guidance gaps. Further research is also needed to explore how to clinical instruction could be tailored to the capacity of those engaged in the experiences and to clinical environments. PMID:26775165

  5. 活动翼矫治技术关闭拔牙间隙的临床研究%Clinical study on technical activities wing correction closing tooth extraction gap of

    Institute of Scientific and Technical Information of China (English)

    吴惠平

    2015-01-01

    Objective To study the clinical effect of the treatment of the closed tooth extraction with the active wing. Methods A total of 2013 during January to December 2013 in our hospital accepted treatment of 60 cases of canine orthodontic patients as the research object,randomly divided into treatment group and control group,two groups with 30 cases in each patient.Treatment group were used active wing appliance treatment,the control group were treated with edgewise appliance,the variation in the canine root length of two groups of patients,canine alveolar bone height changes,the gap closed speed,patient satisfaction,and other indicators were compared.Observation and comparison of two groups of patients with specific treatment effect,including treatment time, effective time, there is no recurrence,etc. Results in closing the gap rate,treatment group were(0.95±0.03) months,control group (0.80 ± 0.03)months,the two groups of patients with significant difference compared,with statistical significance(P0.05) compared to the;in patient satisfaction,the satisfaction rate of patients of the treatment group was 93.33,the control group of patients satisfaction was 73.33%,two groups in patient satisfaction compared with significant difference, with statistical significance(P0.05);在患者满意度上,治疗组患者满意度为93.33%,对照组患者满意度为73.33%,差异有统计学意义(P<0.05).结论:活动翼矫治技术能更加快速地关闭拔牙间隙,而且比较安全,疼痛感也较少,值得临床推广应用.

  6. "Tacit Knowledge" versus "Explicit Knowledge"

    OpenAIRE

    Sanchez, Ron

    2004-01-01

    This paper explains two fundamental approaches to knowledge management. The tacit knowledge approach emphasizes understanding the kinds of knowledge that individuals in an organization have, moving people to transfer knowledge within an organization, and managing key individuals as knowledge creators and carriers. By contrast, the explicit knowledge approach emphasizes processes for articulating knowledge held by individuals, the design of organizational approaches for creating...

  7. Feedback and assessment for clinical placements: achieving the right balance

    OpenAIRE

    Burgess, Annette

    2015-01-01

    Annette Burgess, Craig Mellis Central Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia Abstract: During clinical placements, the provision of feedback forms an integral part of the learning process and enriches students' learning experiences. The purpose of feedback is to improve the learner's knowledge, skills, or behavior. Receipt of accurate feedback can help to narrow the gap between actual and desired performance. Effective and reg...

  8. Feedback and assessment for clinical placements: achieving the right balance

    OpenAIRE

    Burgess A; Mellis C

    2015-01-01

    Annette Burgess, Craig Mellis Central Clinical School, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia Abstract: During clinical placements, the provision of feedback forms an integral part of the learning process and enriches students' learning experiences. The purpose of feedback is to improve the learner's knowledge, skills, or behavior. Receipt of accurate feedback can help to narrow the gap between actual and desired performance. Effective and regular fee...

  9. Supersize me: Cronobacter sakazakii phage GAP32

    International Nuclear Information System (INIS)

    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 vBCsaMGAP32 (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 vBKleM-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 vBCsaMGAP32 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 vBKleM-RaK2. • GAP32 encodes a chromosome condensation protein

  10. Specialty clinic's influence on parents' asthma knowledge%专科门诊对患儿家长哮喘知识掌握的影响

    Institute of Scientific and Technical Information of China (English)

    王娟梅; 李云; 方亦兵

    2011-01-01

    Objective: To explore the most effective control methods of asthma in the comparison between the parents of the first visit children and the return visit children, who had known well in the asthma knowledge. Methods: We made a investigation of the parents' asthma knowledge and behavior between 62 first visit children and 85 return visit children who have been done treatment for more than 3 months, the differences of two groups were evaluated and compared. Results: On the nature of the asthma, symptoms, incitingfactors, acute performance and the connections between asthma and rhinitis, passive smoking and access to plush toys, as well as whether they could participate in sports during asthma control period and whether to insist in using medicines, the parents of the return visit children knew more and done better than the parents of the first visit children (ρ<0.05). But parents of two groups did not know enough about the knowledge of whether regular use of inhaled steroid would affect the growth and development of the children and how to do emergency treatment of acute attacks, there was no significant differences in the groups (ρ>0.05). Conclusion: Continuous education on the parents of asthma children in the specialty clinic can deepen the understanding about asthma, but strengthen education repeatedly is necessary.%目的:通过对比哮喘门诊复诊与首诊患儿家长对哮喘知识的掌握,探索有利的哮喘防治方式.方法:对85例治疗>3个月的复诊患儿家长及62例首诊患儿家长进行哮喘知识及行为调查,评价并比较两组的差异.结果:通过调查家长对哮喘本质、症状、诱发因素、急性发作表现,其与鼻炎、被动吸烟、接触毛绒玩具的关系及哮喘控制可否参加运动、是否坚持用药等方面的知识的掌握情况,两组比较差异有统计学意义(P0.05).结论:哮喘门诊的不断教育可加深患儿家长对哮喘的认识,但仍需反复加强教育.

  11. 经多裂肌间隙入路治疗腰椎间盘突出症的临床疗效分析%Clinical effect analysis of lumbar disc herniation through multifidus muscle gap approach

    Institute of Scientific and Technical Information of China (English)

    朱建举

    2015-01-01

    目的:观察经多裂肌间隙入路治疗腰椎间盘突出症的临床效果。方法选取我院在2013年2—9月收治的腰椎间盘突出症患者124例,按照治疗方法的不同分为实验组和对照组各62例,实验组患者采用经多裂肌间隙入路手术方法治疗,对照组患者采用传统腰椎后路正中切口入路治疗,观察两组患者在手术前、手术后的疼痛评分和手术相关情况。结果在手术前两组患者的手术评分相似,手术后实验组患者的疼痛情况明显改善,并且好于对照组患者(P<0.05),从手术相关情况上看,实验组患者也要好于对照组患者( P<0.05)。结论采用经多裂肌间隙入路治疗腰椎间盘突出具有非常好的效果,手术的创伤小、出血量少,并且术后恢复的快,治疗安全,可以在临床的治疗中推广和应用。%Objective To observe the multifidus muscle gap approach clinical effect of lumbar disc herniation .Methods Our hospital patients with lumbar disc herniation in February 2013 to September were treated 124 cases, according to the method of treatment were divided into experimental group and the control group of 62 patients in the experimental group were treated with surgical treatment approach by multifidus muscle gap the control group were treated with traditional median incision posterior lumbar therapy , were observed in the pre-operative, post-operative pain scores and surgery-related cases.Results Two groups of patients before surgery surgical score similar situation post-operative pain in patients in the experimental group was significantly improved, and better than the control group of patients (P<0.05), from the surgical point of view of the relevant circumstances, the experimental group were also better than the control group of patients ( P <0.05 ). Conclusions Adopted by the multifidus muscle gap approach for the treatment of lumbar disc herniation with very good results

  12. Bridging the Gap

    DEFF Research Database (Denmark)

    Kramer Overgaard, Majken; Broeng, Jes; Jensen, Monika Luniewska;

    Bridging the Gap (BtG) is a 2-year project funded by The Danish Industry Foundation. The goal of Bridging the Gap has been to create a new innovation model which will increase the rate at which Danish universities can spinout new technology ventures.......Bridging the Gap (BtG) is a 2-year project funded by The Danish Industry Foundation. The goal of Bridging the Gap has been to create a new innovation model which will increase the rate at which Danish universities can spinout new technology ventures....

  13. Bridging the Gap

    OpenAIRE

    Kramer Overgaard, Majken; Broeng, Jes; Jensen, Monika Luniewska; Murdock, Karen; Schmidt, Iben Julie

    2015-01-01

    Bridging the Gap (BtG) is a 2-year project funded by The Danish Industry Foundation. The goal of Bridging the Gap has been to create a new innovation model which will increase the rate at which Danish universities can spinout new technology ventures. Bridging the Gap (BtG) is a 2-year project funded by The Danish Industry Foundation. The goal of Bridging the Gap has been to create a new innovation model which will increase the rate at which Danish universities can spinout new technology ve...

  14. Fios ortodônticos: conhecer para otimizar a aplicação clínica Orthodontic wires: knowledge to optimize clinical application

    Directory of Open Access Journals (Sweden)

    Cátia Cardoso Abdo Quintão

    2009-12-01

    Full Text Available A grande variedade de fios ortodônticos presente no mercado pode gerar dúvidas quanto à melhor escolha para situações clínicas. Assim, o conhecimento das propriedades mecânicas dos mesmos facilita a escolha para aplicação do movimento ortodôntico na dependência da fase em que o tratamento se encontra. A evolução da tecnologia de manufatura dos fios e a elaboração de novas técnicas ortodônticas geraram a busca por uma melhor qualidade das ligas, a fim de torná-los biologicamente mais efetivos no que diz respeito aos dentes e tecidos de suporte. O presente artigo resume as principais características dos fios utilizados em Ortodontia, em relação ao histórico, propriedades mecânicas e aplicação clínica, de acordo com fases específicas de tratamento.The huge variety of orthodontic wires brands available in market might generate confusion as regard to the best choice for clinical application. Therefore mechanical properties knowledge about wires would help the professional to apply the best orthodontic technique depending on the treatment phase. The wires manufacturing evolution and the new orthodontic techniques proposed guided the market into the search for better quality alloys, in order to make them biologically more effective to teeth and support tissues. This paper aims to summarize some main characteristics of orthodontic wires related to their history, mechanical properties and clinical application as regard to individual phase of treatment.

  15. Knowledge crash and knowledge management

    OpenAIRE

    Ermine, Jean-Louis

    2010-01-01

    This article, by including the problem of “Knowledge Crash” in the more general framework of “Knowledge Management”, enlarges the concepts of knowledge, generation and knowledge transfer. It proposes a global approach, starting from a strategic analysis of a knowledge capital and ending in the implementation of socio-technical devices for inter-generational knowledge transfer.

  16. From the description of activities to the identification of risks for clinical management: a proposal of building, merging and sharing knowledge representations of care processes.

    Science.gov (United States)

    Staccini, Pascal; Joubert, Michel; Collomp, Rémy; Quaranta, Jean-François; Fieschi, Marius

    2007-01-01

    Management of clinical processes and hospital activities takes advantage of business process reengineering methodology. It is now recognized that care process modeling must integrate the definition of goals and the assessment of risk. Two kinds of issues have been outlined: 1) the lack of an integrated model to identify and describe processes and their components according to a functional point of view; and 2) an increasing amount of documents that hospital staff members have to create, collect, index and maintain. As initial models focused only on a structural view of activities, we reviewed different sources of standards and norms to extract and classify a set of metadata aimed at describing any activity and its outcomes. The model includes links to structured terminologies to name attributes or value them. An object-oriented information model has been created and implemented to test the relevance and the feasibility of the modeling approach. Conceptually speaking, this model gives opportunity to bridge tacit and explicit knowledge. Practically speaking, limits to generalization remain partly due to the lack of a template processes database. PMID:17911723

  17. Architecture and Workflow of Medical Knowledge Repository

    Science.gov (United States)

    Choi, Hyunsook; Kim, Jeong Ah; Cho, Insook

    Recently, clinical field builds various forms of computerized medical knowledge and tries to use it efficiently. In general, to build and reuse knowledge easily, it is needed to build a knowledge repository. Especially, the credibility of knowledge is important in clinical domain. This paper proposes methods for supporting it. To perform it systematically, we propose the method of the knowledge management processes. The methods for knowledge management can serve equal quality, usability and credibility of knowledge. Knowledge management methods consist of 2 methods. They are the knowledge management processes and the specification of the management targets. And this paper proposes the requirement of a knowledge repository and the architecture of the knowledge repository.

  18. Knowledge Management and Transfer

    International Nuclear Information System (INIS)

    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)

  19. Knowledge management

    OpenAIRE

    Lubojacký, Roman

    2012-01-01

    Knowledge management is a way to effectively manage corporate knowledge. Goal of the thesis is to analyze tasks and ways of knowledge management and technological means to support it and test chosen software tools for creation of knowledge base of business terms. First part of the work is dealing with analysis of knowledge management, technics and tools, which are used and technologies for its support. Second part is focused on testing tools for creation of business terms knowledge base for n...

  20. SPARK GAP SWITCH

    Science.gov (United States)

    Neal, R.B.

    1957-12-17

    An improved triggered spark gap switch is described, capable of precisely controllable firing time while switching very large amounts of power. The invention in general comprises three electrodes adjustably spaced and adapted to have a large potential impressed between the outer electrodes. The central electrode includes two separate elements electrically connected togetaer and spaced apart to define a pair of spark gaps between the end electrodes. Means are provided to cause the gas flow in the switch to pass towards the central electrode, through a passage in each separate element, and out an exit disposed between the two separate central electrode elements in order to withdraw ions from the spark gap.

  1. Filling the Income Gap

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    @@ Income distribution has become one of the people's main concerns in China where more than 30years of reform and opening up have also resulted in an ever-expanding wealth gap.But narrowing down the rich-poor disparity will prove to be no easy task.Wei Zhong,a researcher with the Institute of Economics under the Chinese Academy of Social Sciences,elaborated on the origins and trends of China's widening income gap,and discussed solutions to curb the gap,in a recent article.Edited excerpts follow:

  2. Modelling Gender Pay Gaps

    OpenAIRE

    Olsen, W K., Jamie Morgan.

    2004-01-01

    EXECUTIVE SUMMARYIntroductionThere has been little change in the full-time gender pay gap since the mid 1990s andin the female part-time/male full-time pay gap since the mid 1970s. The gender gapin hourly earnings for those employed full-time in Britain in 2003 was 18 per cent,while that between women working part-time and men working full-time was 40 percent.This research uses statistical methods to identify how much of the gender pay gap isassociated with different factors. The data set ana...

  3. Clinical Holistic Medicine: Factors Influencing The Therapeutic Decision-Making. From Academic Knowledge to Emotional Intelligence and Spiritual “Crazy” Wisdom

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2007-01-01

    Full Text Available Scientific holistic medicine is built on holistic medical theory, on therapeutic and ethical principles. The rationale is that the therapist can take the patient into a state of salutogenesis, or existential healing, using his skills and knowledge. But how ever much we want to make therapy a science it remains partly an art, and the more developed the therapist becomes, the more of his/her decisions will be based on intuition, feeling and even inspiration that is more based on love and human concern and other spiritual motivations than on mental reason and rationality in a simple sense of the word. The provocative and paradoxal medieval western concept of the “truth telling clown”, or the eastern concepts of “crazy wisdom” and “holy madness” seems highly relevant here. The problem is how we can ethically justify this kind of highly “irrational” therapeutic behavior in the rational setting of a medical institution. We argue here that holistic therapy has a very high success rate and is doing no harm to the patient, and encourage therapists, psychiatrists, psychologist and other academically trained “helpers” to constantly measure their own success-rate. This paper discusses many of the important factors that influence clinical holistic decision-making. Sexuality could, as many psychoanalysts from Freud to Reich and Searles have believed, be the most healing power that exists and also the most difficult for the mind to comprehend, and thus the most “crazy-wise” tool of therapy.

  4. Terminology support for development of sharable knowledge modules.

    Science.gov (United States)

    Carlsson, M; Ahlfeldt, H; Thurin, A; Wigertz, O

    1996-01-01

    Lack of an agreed infrastructure for terminology is identified as one of the major barriers to interchange of knowledge modules and integration of knowledge bases with other clinical information systems. The goal of the GALEN project is to bridge this gap between different terminology systems through the construction of a terminology server, which is based on a rich conceptual model with mapping facilities to natural language expressions and coding schemas. The long term goal is to support communication between medical information systems. Arden Syntax is a standard format for the creation of knowledge modules, with sharability as one of the main objectives. Since Arden Syntax is based on a data-driven approach, the data items used need to be adapted to locally available terminology. The GALEN approach appears to be complementary to Arden Syntax and to the development of sharable knowledge modules. The major theme of this paper is utilization of the GALEN terminology server for knowledge module authoring. Two systems are presented, a knowledge base manager and a client to the terminology server, allowing the user to navigate in the semantic network and to import concept definitions and terms into the knowledge modules. The benefit of the terminology server, allowing the user to navigate in the semantic network and to import concept definitions and terms into the knowledge modules. The benefit of the terminology services is discussed. PMID:9062883

  5. A perspective on progress and gaps in HIV prevention science.

    Science.gov (United States)

    Kiser, Patrick F; Mesquita, Pedro M M; Herold, Betsy C

    2012-11-01

    In the past few years, the transdisciplinary field of HIV prevention has reached several milestones. Topically applied tenofovir gel provided significant protection from sexual transmission of HIV in a large-scale clinical trial and oral Truvada (emtricitabine/tenofovir disoproxil fumarate) was recently approved for preexposure prophylaxis (PrEP) following two successful clinical trials in men and women. These achievements are tempered by the disappointing results of other clinical trials, which highlight the complexities of prevention research. In this perspective, we discuss scientific and developmental gaps for topical chemoprophylaxis of the sexual transmission of HIV, which depends on the complex interactions between the pharmacokinetics and pharmacodynamics of drugs, formulation and delivery systems, anatomic site of transmission, and host mucosal immune defenses. Despite the considerable time and resources devoted to unraveling the initial steps in sexual transmission of HIV, current knowledge is based on animal models and human explanted tissue, which may not fully recapitulate what happens clinically. Understanding these events, including the role that sex hormones, semen, and mucosal secretions play in transmission, and the interplay between innate immunity, the mucosal environment, and drug efficacy is paramount. This drives some of the most pressing questions in the field. PMID:22966871

  6. 以"归零"的心态寻找"差距"促进人才知识和文化融合%Looking for the gap with the mind-set of 'Return to Zero' to promote knowledge and cultural integration of introduced talents

    Institute of Scientific and Technical Information of China (English)

    陈莉

    2011-01-01

    探析了人才引进和使用存在的误区,提出通过建立"归零"心态、"差距观"以及合理的人力资源管理体系,促进对引进人才的激励、使用和知识、文化的融合,使人才引进真正成为提高医院的核心竞争力的手段,促进医院文化和谐发展.%By Exploring and analyzing the mistaken ideas in the talent introduction and management,the mind set of'return to zero'and the sense of gap should be proposed,also the rationality of hospital talent management should be established to promote knowledge and cultureintegration in order to promote hospital core competitiveness and harmonious hospital cultural construction so as to better service the patients.

  7. Knowledge Sharing is Knowledge Creation

    DEFF Research Database (Denmark)

    Greve, Linda

    2015-01-01

    Knowledge sharing and knowledge transfer are important to knowledge communication. However when groups of knowledge workers engage in knowledge communication activities, it easily turns into mere mechanical information processing despite other ambitions. This article relates literature of knowledge...... communication and knowledge creation to an intervention study in a large Danish food production company. For some time a specific group of employees uttered a wish for knowledge sharing, but it never really happened. The group was observed and submitted to metaphor analysis as well as analysis of co...... reducing complexity and dividing knowledge into to dichotomies or hierarchies, knowledge workers should be enabled to use different strategies for knowledge sharing, -transfer and –creation depending on the task and the nature of the knowledge. However if the ambition is to have a strategy for sharing...

  8. Wide-Gap Chalcopyrites

    CERN Document Server

    Siebentritt, Susanne

    2006-01-01

    Chalcopyrites, in particular those with a wide band gap, are fascinating materials in terms of their technological potential in the next generation of thin-film solar cells and in terms of their basic material properties. They exhibit uniquely low defect formation energies, leading to unusual doping and phase behavior and to extremely benign grain boundaries. This book collects articles on a number of those basic material properties of wide-gap chalcopyrites, comparing them to their low-gap cousins. They explore the doping of the materials, the electronic structure and the transport through interfaces and grain boundaries, the formation of the electric field in a solar cell, the mechanisms and suppression of recombination, the role of inhomogeneities, and the technological role of wide-gap chalcopyrites.

  9. Filling the Income Gap

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Income distribution has become one of the people’s main concerns in China where more than 30 years of reform and opening up have also resulted in an ever-expanding wealth gap. But narrowing down the

  10. Tail gap grouting

    Czech Academy of Sciences Publication Activity Database

    Kolymbas, D.; Maehr, M.; Herle, Ivo

    Torino: Associazione Georisorse e Ambiente , 2002, s. -. [International Conference ACUUS 2002. Torino (IT), 14.11.2002-16.11.2002] Institutional research plan: CEZ:AV0Z2071913 Keywords : tunnel construction, tail gap, grouting Subject RIV: JM - Building Engineering

  11. Gaps in Oncology

    Science.gov (United States)

    The first plenary of the EPEC-O (Education in Palliative and End-of-Life Care for Oncology) Self-Study Original Version provides background for the curriculum and identifies gaps in current and desired comprehensive cancer care.

  12. Photonic band gap materials

    International Nuclear Information System (INIS)

    An overview of the theoretical and experimental efforts in obtaining a photonic band gap, a frequency band in three-dimensional dielectric structures in which electromagnetic waves are forbidden, is presented

  13. The Gender Pay Gap

    OpenAIRE

    Alan Manning

    1996-01-01

    Empirical research on gender pay gaps has traditionally focused on the role of gender-specific factors, particularly gender differences in qualifications and differences in the treatment of otherwise equally qualified male and female workers (i.e., labor market discrimination). This paper explores the determinants of the gender pay gap and argues for the importance of an additional factor, wage structure, the array of prices set for labor market skills and the rewards received for employment ...

  14. Gap polariton solitons

    CERN Document Server

    Gorbach, A V; Skryabin, D V

    2009-01-01

    We report the existence, and study mobility and interactions of gap polariton solitons in a microcavity with a periodic potential, where the light field is strongly coupled to excitons. Gap solitons are formed due to the interplay between the repulsive exciton-exciton interaction and cavity dispersion. The analysis is carried out in an analytical form, using the coupled-mode (CM) approximation, and also by means of numerical methods.

  15. Iran’s Approach to Knowledge Translation

    OpenAIRE

    Majdzadeh, R; S Nedjat; Fotouhi, A; Malekafzali, H

    2009-01-01

    "nKnowledge translation was created in response to the knowledge-do gap. With the growing number of research projects, utilization of research knowledge roused interest. One of its defects, which are seen more in developing countries, is the scarcity of recognized practical knowledge translation applications. The actions taken to strengthen knowledge translation can be classified into three categories of ‘push, pull and exchange'. In Iran, some of the interventions effecti...

  16. A descriptive study of knowledge of Pharmacovigilance and adverse drug reactions among second professional undergraduate medical students in a teaching hospital

    Directory of Open Access Journals (Sweden)

    Rehana Tabassum

    2015-10-01

    Conclusions: Our study revealed that there are gaps between knowledge regarding ADRs and Pharmacovigilance that needs to be addressed on priority basis for the success of the Pharmacovigilance program and better clinical management of patients in general. [Int J Basic Clin Pharmacol 2015; 4(5.000: 1016-1020

  17. Knowledge Management.

    Science.gov (United States)

    1999

    The first of the four papers in this symposium, "Knowledge Management and Knowledge Dissemination" (Wim J. Nijhof), presents two case studies exploring the strategies companies use in sharing and disseminating knowledge and expertise among employees. "A Theory of Knowledge Management" (Richard J. Torraco), develops a conceptual framework for…

  18. Knowledge Management

    CERN Document Server

    Gerami, Mohsen

    2010-01-01

    This paper discusses the important process of knowledge and its management, and differences between tacit and explicit knowledge and understanding the culture as a key issue for the successful implementation of knowledge management, in addition to, this paper is concerned with the four-stage model for the evolution of information technology (IT) support for knowledge management in law firms.

  19. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis

    DEFF Research Database (Denmark)

    Caforio, Alida L P; Pankuweit, Sabine; Arbustini, Eloisa;

    2013-01-01

    In this position statement of the ESC Working Group on Myocardial and Pericardial Diseases an expert consensus group reviews the current knowledge on clinical presentation, diagnosis and treatment of myocarditis, and proposes new diagnostic criteria for clinically suspected myocarditis and its...... distinct biopsy-proven pathogenetic forms. The aims are to bridge the gap between clinical and tissue-based diagnosis, to improve management and provide a common reference point for future registries and multicentre randomised controlled trials of aetiology-driven treatment in inflammatory heart muscle...

  20. 基于本体的智能临床路径知识库构建研究%Research of the Construction of ontology-based intelligent Clinical Pathway Knowledge Base

    Institute of Scientific and Technical Information of China (English)

    冯贞贞; 郑西川

    2012-01-01

    Objective: Make use of the advantages of semantic logic to build ontology-based clinical knowledge base which can help to optimize electronic clinical pathway and realize individual diagnosis and treat through reasoning. Method: Study the knowledge representation of clinical pathway according to its data source. Build the clinical pathway ontology using Prot e g e ontology tool and write relevant rules using SWRL rule language. Finally we made a experimental realization of reasoning. Conclusion: The construction of knowledge base is the core for the application of electronic clinical pathway and can improve the quality of clinical treatment and extend the use ratio of clinical data.%目的:利用语义逻辑的优点,构建基于本体的可推理临床路径知识库,进一步优化临床路径电子化,智能化实现患者的个性化诊疗.方法:首先结合临床路径的数据源,研究临床路径的知识表达,然后采用Protégé本体编辑工具进行本体构建,再利用SWRL规则语言编写相关规则,最后进行实验性推理实现.结论:临床路径知识库建设是临床路径电子化应用的核心,通过构建临床路径知识库可以提高患者的诊疗质量和临床数据的利用率.

  1. Nutrition Training Improves Health Workers' Nutrition Knowledge and Competence to Manage Child Undernutrition: A Systematic Review.

    OpenAIRE

    Sunguya, Bruno F.; Poudel, Krishna C.; Mlunde, Linda B.; Urassa, David P; Yasuoka, Junko; Jimba, Masamine

    2013-01-01

    Background: Medical and nursing education lack adequate practical nutrition training to fit the clinical reality that health workers face in their practices. Such a deficit creates health workers with poor nutrition knowledge and child undernutrition management practices. In-service nutrition training can help to fill this gap. However, no systematic review has examined its collective effectiveness. We thus conducted this study to examine the effectiveness of in-service nutrition training on ...

  2. Nutrition training improves health workers’ nutrition knowledge and competence to manage child undernutrition: a systematic review

    OpenAIRE

    Sunguya, Bruno F.; Poudel, Krishna C.; Mlunde, Linda B.; Urassa, David P; Junko eYasuoka; Masamine eJimba

    2013-01-01

    Background: Medical and nursing education lack adequate practical nutrition training to fit the clinical reality that health workers face in their practices. Such a deficit creates health workers with poor nutrition knowledge and child undernutrition management practices. In-service nutrition training can help to fill this gap. However, no systematic review has examined its collective effectiveness. We thus conducted this study to examine the effectiveness of in-service nutrition training on ...

  3. Knowledge Sharing

    DEFF Research Database (Denmark)

    Holdt Christensen, Peter

    The concept of knowledge management has, indeed, become a buzzword that every single organization is expected to practice and live by. Knowledge management is about managing the organization's knowledge for the common good of the organization -but practicing knowledge management is not as simple as...... that. This article focuses on knowledge sharing as the process seeking to reduce the resources spent on reinventing the wheel.The article introduces the concept of time sensitiveness; i.e. that knowledge is either urgently needed, or not that urgently needed. Furthermore, knowledge sharing is...... considered as either a push or pull system. Four strategies for sharing knowledge - help, post-it, manuals and meeting, and advice are introduced. Each strategy requires different channels for sharing knowledge. An empirical analysis in a production facility highlights how the strategies can be practiced....

  4. Knowledge Technologies

    CERN Document Server

    Milton, Nick

    2008-01-01

    Several technologies are emerging that provide new ways to capture, store, present and use knowledge. This book is the first to provide a comprehensive introduction to five of the most important of these technologies: Knowledge Engineering, Knowledge Based Engineering, Knowledge Webs, Ontologies and Semantic Webs. For each of these, answers are given to a number of key questions (What is it? How does it operate? How is a system developed? What can it be used for? What tools are available? What are the main issues?). The book is aimed at students, researchers and practitioners interested in Knowledge Management, Artificial Intelligence, Design Engineering and Web Technologies. During the 1990s, Nick worked at the University of Nottingham on the application of AI techniques to knowledge management and on various knowledge acquisition projects to develop expert systems for military applications. In 1999, he joined Epistemics where he worked on numerous knowledge projects and helped establish knowledge management...

  5. Knowledge typology for imprecise probabilities.

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, G. D. (Gregory D.); Zucker, L. J. (Lauren J.)

    2002-01-01

    When characterizing the reliability of a complex system there are often gaps in the data available for specific subsystems or other factors influencing total system reliability. At Los Alamos National Laboratory we employ ethnographic methods to elicit expert knowledge when traditional data is scarce. Typically, we elicit expert knowledge in probabilistic terms. This paper will explore how we might approach elicitation if methods other than probability (i.e., Dempster-Shafer, or fuzzy sets) prove more useful for quantifying certain types of expert knowledge. Specifically, we will consider if experts have different types of knowledge that may be better characterized in ways other than standard probability theory.

  6. "Tacit Knowledge" versus "Explicit Knowledge"

    DEFF Research Database (Denmark)

    Sanchez, Ron

    2004-01-01

    This paper explains two fundamental approaches to knowledge management. The tacitknowledge approach emphasizes understanding the kinds of knowledge that individualsin an organization have, moving people to transfer knowledge within an organization,and managing key individuals as knowledge creator...... organization. The relative advantages and disadvantages of bothapproaches to knowledge management are summarized. A synthesis of tacit andknowledge management approaches is recommended to create a hybrid design for theknowledge management practices in a given organization....

  7. Knowledge management

    DEFF Research Database (Denmark)

    Foss, Nicolai Juul; Mahnke, Volker

    2003-01-01

    Knowledge management has emerged as a very successful organization practice and has beenextensively treated in a large body of academic work. Surprisingly, however, organizationaleconomics (i.e., transaction cost economics, agency theory, team theory and property rightstheory) has played no role in...... the development of knowledge management. We argue thatorganizational economics insights can further the theory and practice of knowledge managementin several ways. Specifically, we apply notions of contracting, team production,complementaries, hold-up, etc. to knowledge management issues (i.......e., creating and integrationknowledge, rewarding knowledge workers, etc.) , and derive refutable implications that are novelto the knowledge management field from our discussion....

  8. Knowledge Management

    International Nuclear Information System (INIS)

    In 2001, SCK-CEN decided to adopt and implement a practical knowledge management approach. Knowledge management activities were identified within the organisation and a co-ordinated approach to knowledge management was applied. Such an approach requires an efficient reuse of recorded knowledge and an effective transfer of the available knowledge. This approach ensures an added value to our research work and guarantees the long-term preservation of the institutional memory. Principle results and future developments regarding knowledge management at SCK-CEN are summarised

  9. The Adaptation Finance Gap Update - with insights from the INDCs

    DEFF Research Database (Denmark)

    Olhoff, Anne; Bee, Skylar; Puig, Daniel

    In 2014 the United Nations Environment Programme (UNEP) published its first global Adaptation Gap Report (AGR 2014) (UNEP, 2014), which put forward a preliminary framework for assessing adaptation gaps along with an initial assessment in three selected areas: finance, technology and knowledge....... Further to the positive reception of this report, several countries requested UNEP to produce follow up reports focusing on specific adaptation gaps. In response to these requests, UNEP has commissioned a new report with a special focus on finance gaps and options to bridge them. The report will be...

  10. Bridging a cultural gap

    Science.gov (United States)

    Leviatan, Talma

    2008-09-01

    There has been a broad wave of change in tertiary calculus courses in the past decade. However, the much-needed change in tertiary pre-calculus programmes—aimed at bridging the gap between high-school mathematics and tertiary mathematics—is happening at a far slower pace. Following a discussion on the nature of the gap and the objectives of a potential bridging programme, this paper aims at demonstrating that the gap can be bridged, by presenting an ongoing modular bridging programme especially designed for the diverse types of student populations in teachers training colleges. We also present here some innovative teaching and assessment methods that were judged essential for the success of these programmes—focusing mainly on the "Questionnaire Based Instruction Method". Finally we suggest directions of follow up and research.

  11. Erraticity of rapidity gaps

    International Nuclear Information System (INIS)

    The use of rapidity gaps is proposed as a measure of the spatial pattern of an event. When the event multiplicity is low, the gaps between neighboring particles carry far more information about an event than multiplicity spikes, which may occur very rarely. Two moments of the gap distribution are suggested for characterizing an event. The fluctuations of those moments from event to event are then quantified by an entropy-like measure, which serves to describe erraticity. We use ECOMB to simulate the exclusive rapidity distribution of each event, from which the erraticity measures are calculated. The dependences of those measures on the order q of the moments provide single-parameter characterizations of erraticity. (c) 2000 The American Physical Society

  12. Knowledge Management

    International Nuclear Information System (INIS)

    Knowledge management is an evolving subject area based on two notions: - That knowledge is a fundamental aspect of effective organizational performance; - That specific steps need to be actively taken to promote knowledge creation and use. Two common approaches to knowledge management that are often used in combination include: - Knowledge management focused on the capture of explicit knowledge and sharing this via technology; - Knowledge management focused on managing tacit knowledge without necessarily making it explicit, and creating new knowledge as well as sharing existing knowledge. In the context of human resources development, knowledge management is strongly tied to strategy and is activity oriented. Properly applied knowledge management improves organizational efficiency and productivity through reducing process times, introducing technology to assist finding relevant information and instituting techniques to remedy poor quality outputs. Knowledge management also promotes innovations, which can result from initiatives such as developing social networks for knowledge exchange, providing leadership to encourage risk taking and capturing the lessons learned from past activities. Both of these benefits require openness to change and a drive for continual improvement. Other benefits of knowledge management include improved decision making, retaining organizational memory and organizational learning, as well as improving morale. Knowledge management can be used on its own or in collaboration with other management disciplines and tools to establish an environment that will enable the organization to realize these benefits. Summarizing the effective management of nuclear knowledge includes ensuring the continued availability of qualified personnel. As the nuclear workforce ages and retires, and with support uncertain for university programmes in nuclear science and engineering, this issue has become critical to ensuring safety and security, encouraging innovation

  13. Designing healthcare information technology to catalyse change in clinical care.

    Science.gov (United States)

    Lester, William T; Zai, Adrian H; Grant, Richard W; Chueh, Henry C

    2008-01-01

    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 environment where disease management systems are often created under duress, appended to existing clinical systems and poorly integrated into the existing workflow, potentially limiting their real-world 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. PMID:18534073

  14. 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.

  15. The Gamma Gap and All-Cause Mortality

    OpenAIRE

    Juraschek, Stephen P.; Alison R Moliterno; William Checkley; Miller, Edgar R

    2015-01-01

    Background The difference between total serum protein and albumin, i.e. the gamma gap, is a frequently used clinical screening measure for both latent infection and malignancy. However, there are no studies defining a positive gamma gap. Further, whether it is an independent risk factor of mortality is unknown. Methods and Findings This study examined the association between gamma gap, all-cause mortality, and specific causes of death (cardiovascular, cancer, pulmonary, or other) in 12,260 pa...

  16. The longevity gender gap

    DEFF Research Database (Denmark)

    Aviv, Abraham; Shay, Jerry; Christensen, Kaare;

    2005-01-01

    In this Perspective, we focus on the greater longevity of women as compared with men. We propose that, like aging itself, the longevity gender gap is exceedingly complex and argue that it may arise from sex-related hormonal differences and from somatic cell selection that favors cells more...... resistant to the ravages of time. We discuss the interplay of these factors with telomere biology and oxidative stress and suggest that an explanation for the longevity gender gap may arise from a better understanding of the differences in telomere dynamics between men and women....

  17. Accessible Knowledge - Knowledge on Accessibility

    DEFF Research Database (Denmark)

    Kirkeby, Inge Mette

    2015-01-01

    Although serious efforts are made internationally and nationally, it is a slow process to make our physical environment accessible. In the actual design process, architects play a major role. But what kinds of knowledge, including research-based knowledge, do practicing architects make use of when...... designing accessible environments? The answer to the question is crucially important since it affects how knowledge is distributed and how accessibility can be ensured. In order to get first-hand knowledge about the design process and the sources from which they gain knowledge, 11 qualitative interviews...... were conducted with architects with experience of designing for accessibility. The analysis draws on two theoretical distinctions. The first is research-based knowledge versus knowledge used by architects. The second is context-independent knowledge versus context-dependent knowledge. The practitioners...

  18. Knowledge Technologies

    OpenAIRE

    Milton, Nick

    2008-01-01

    Several technologies are emerging that provide new ways to capture, store, present and use knowledge. This book is the first to provide a comprehensive introduction to five of the most important of these technologies: Knowledge Engineering, Knowledge Based Engineering, Knowledge Webs, Ontologies and Semantic Webs. For each of these, answers are given to a number of key questions (What is it? How does it operate? How is a system developed? What can it be used for? What tools are available? Wha...

  19. Knowledge management

    OpenAIRE

    Nádvorník, Pavel

    2011-01-01

    The main goal of this thesis is to describe implementation of the information system that will support knowledge management using KM-Beat-it methodology in Helpdesk department of the Wincor Nixdorf, Ltd. company. Due to lack of knowledge management principles usage this system will support procedures and processes of knowledge management. Setup and implementation of this system was performed using and combining of two methodologies, methodology for knowledge management implementation KM-Beat-...

  20. The role of advanced practice nurses in knowledge brokering as a means of promoting evidence-based practice among clinical nurses

    OpenAIRE

    Gerrish, Kate; Nolan, Mike; Kirshbaum, Marilyn; McDonnell, Ann; Tod, Angela; Guillaume, Louise

    2011-01-01

    Aim: To identify approaches used by advanced practice nurses to promote evidence-based practice among clinical nurses. Background: Barriers encountered at individual and organizational levels hinder clinical nurses in their ability to deliver evidence-based practice. Advanced practice nurses are well placed to promote evidence-based practice through interactions with clinical nurses. However, little is understood about how advanced practice nurses might realise this potential. Met...

  1. Knowledge, perceived stigma, and care-seeking experiences for sexually transmitted infections: a qualitative study from the perspective of public clinic attendees in Rio de Janeiro, Brazil

    OpenAIRE

    Cunnigham Shayna D; Strathdee Steffanie A; Bastos Francisco I; Malta Monica; Pilotto Jose; Kerrigan Deanna

    2007-01-01

    Abstract Background An estimated 12 million sexually transmitted infections (STIs) are documented in Brazil per year. Given the scope of this public health challenge and the importance of prompt treatment and follow-up counseling to reduce future STI/HIV-related risk behavior, we sought to qualitatively explore STI clinic experiences among individuals diagnosed with STIs via public clinics in Rio de Janeiro, Brazil. The study focused on eliciting the perspective of clinic users with regard to...

  2. Knowledge management at ELETRONUCLEAR

    International Nuclear Information System (INIS)

    ELETRONUCLEAR, a state-owned company responsible for design, construction, ownership and operation of nuclear power plants in Brazil, is applying systematic measures to preserve its essential technological know-how. A special project called 'Determination of Technological Know-How of ELETRONUCLEAR' was established in January 2001 for this purpose. The extent and location of the existing know-how was identified and the gaps in the essential know-how were evaluated. A multidisciplinary team was established to implement the project. The team interacted with experts both in Brazil and abroad to achieve a sound technical basis as far as knowledge identification and preservation techniques are concerned. The results of this know-how survey were stored in an electronic data bank, which facilitated the creation of several types of reports, according to various criteria. An in-depth analysis of the survey pointed to the gaps in essential know-how. Proposals for solutions to fill in the know-how gaps were set up, comprising both short-term, as well as long-term, solutions. This project was the first work by ELETRONUCLEAR in the field of Knowledge Management. An indirect consequence was the creation of a nucleus of personnel competent in this new discipline, which had a multiplying effect throughout ELETRONUCLEAR, allowing the execution of other new projects in KM. (author)

  3. 'Mind the Gap!'

    DEFF Research Database (Denmark)

    Persson, Karl Gunnar

    This paper challenges the widely held view that sharply falling real transport costs closed the transatlantic gap in grain prices in the second half of the 19th century. Several new results emerge from an analysis of a new data set of weekly wheat prices and freight costs from New York to UK mark...

  4. Estimating Gender Wage Gaps

    Science.gov (United States)

    McDonald, Judith A.; Thornton, Robert J.

    2011-01-01

    Course research projects that use easy-to-access real-world data and that generate findings with which undergraduate students can readily identify are hard to find. The authors describe a project that requires students to estimate the current female-male earnings gap for new college graduates. The project also enables students to see to what…

  5. Knowledge spaces

    CERN Document Server

    Doignon, Jean-Paul

    1999-01-01

    Knowledge spaces offer a rigorous mathematical foundation for various practical systems of knowledge assessment. An example is offered by the ALEKS system (Assessment and LEarning in Knowledge Spaces), a software for the assessment of mathematical knowledge. From a mathematical standpoint, knowledge spaces generalize partially ordered sets. They are investigated both from a combinatorial and a stochastic viewpoint. The results are applied to real and simulated data. The book gives a systematic presentation of research and extends the results to new situations. It is of interest to mathematically oriented readers in education, computer science and combinatorics at research and graduate levels. The text contains numerous examples and exercises and an extensive bibliography.

  6. Uncovering Tacit Knowledge: A Pilot Study to Broaden the Concept of Knowledge in Knowledge Translation

    Directory of Open Access Journals (Sweden)

    Edwards Nancy

    2011-08-01

    Full Text Available Abstract Background All sectors in health care are being asked to focus on the knowledge-to-practice gap, or knowledge translation, to increase service effectiveness. A social interaction approach to knowledge translation assumes that research evidence becomes integrated with previously held knowledge, and practitioners build on and co-create knowledge through mutual interactions. Knowledge translation strategies for public health have not provided anticipated positive changes in evidence-based practice, possibly due in part to a narrow conceptualization of knowledge. More work is needed to understand the role of tacit knowledge in decision-making and practice. This pilot study examined how health practitioners applied tacit knowledge in public health program planning and implementation. Methods This study used a narrative approach, where teams from two public health units in Ontario, Canada were conveniently selected. Respondents participated in individual interviews and focus groups at each site. Questions were designed to understand the role of tacit knowledge as it related to the program planning process. Data were analyzed through a combination of content analysis and thematic comparison. Results The findings highlighted two major aspects of knowledge that arose: the use of tacit knowledge and the integration of tacit and explicit knowledge. Tacit knowledge included: past experiences, organization-specific knowledge, community contextual knowledge, and the recognition of the tacit knowledge of others. Explicit knowledge included: research literature, the Internet, popular magazines, formal assessments (surveys and interviews, legislation and regulations. Participants sometimes deliberately combined tacit and explicit knowledge sources in planning. Conclusions This pilot demonstrated that front-line public health workers draw upon both tacit knowledge and explicit knowledge in their everyday lived reality. Further, tacit knowledge plays an

  7. Knowledge Management

    Science.gov (United States)

    Shariq, Syed Z.; Kutler, Paul (Technical Monitor)

    1997-01-01

    The emergence of rapidly expanding technologies for distribution and dissemination of information and knowledge has brought to focus the opportunities for development of knowledge-based networks, knowledge dissemination and knowledge management technologies and their potential applications for enhancing productivity of knowledge work. The challenging and complex problems of the future can be best addressed by developing the knowledge management as a new discipline based on an integrative synthesis of hard and soft sciences. A knowledge management professional society can provide a framework for catalyzing the development of proposed synthesis as well as serve as a focal point for coordination of professional activities in the strategic areas of education, research and technology development. Preliminary concepts for the development of the knowledge management discipline and the professional society are explored. Within this context of knowledge management discipline and the professional society, potential opportunities for application of information technologies for more effectively delivering or transferring information and knowledge (i.e., resulting from the NASA's Mission to Planet Earth) for the development of policy options in critical areas of national and global importance (i.e., policy decisions in economic and environmental areas) can be explored, particularly for those policy areas where a global collaborative knowledge network is likely to be critical to the acceptance of the policies.

  8. Expected gaps between prime numbers

    OpenAIRE

    Holt, Fred B.

    2007-01-01

    We study the gaps between consecutive prime numbers directly through Eratosthenes sieve. Using elementary methods, we identify a recursive relation for these gaps and for specific sequences of consecutive gaps, known as constellations. Using this recursion we can estimate the numbers of a gap or of a constellation that occur between a prime and its square. This recursion also has explicit implications for open questions about gaps between prime numbers, including three questions posed by Erd\\...

  9. Pandemic Influenza A (H1N1) and Its Prevention: A Cross Sectional Study on Patients’ Knowledge, Attitude and Practice among l study on Patients’ Knowledge, Attitude and Practice among patients attending Primary Health Care Clinic in Kuala Lumpur, Malaysia

    OpenAIRE

    Latiffah Abdul Latiff; Saadat Parhizkar; Huda Zainuddin; Goh M Chun; Mohammad Ali A Rahiman; Nur Liyana N Ramli; Kerk L Yun

    2012-01-01

    The World Health Organization confirmed that the novel influenza A, H1N1 as a pandemic on 11 June 2009. After less than three months, 182 countries were affected by the pandemic accounting for about 150,000 infected cases and 3000 mortality. Successful H1N1 pandemic management strategies’ shaped by making changes in health behavior. The aim of this study was to document patients’ knowledge, attitudes and practices (KAP) regarding the pandemic influenza A (H1N1) and its prevention. We performe...

  10. 基于知识共享的临床路径管理系统研究与实现%Study and Realization of Clinical Pathway Management System based on the Knowledge Sharing

    Institute of Scientific and Technical Information of China (English)

    殷俊华; 黄刊迪

    2012-01-01

    推广临床路径管理是公立医院改革的核心内容之一,建设基于知识共享的临床路径管理系统,牢牢抓住数字化医院建设的四个核心要素:数据、过程、知识库、系统,实现电子病历与临床路径的有机结合,既可以为医院的可持续发展打下坚实基础,也可为临床路径的加速推广破解技术障碍.%The promotion of clinical pathway management is one of the cores of the reform of public hospitals. The construction of clinical pathway management system based on the knowledge sharing has to grasp four cores of the digital hospital construction: data, processes, knowledge base and system. The combination of Electronic Medical Record and clinical pathway may provide a solid foundation for the sustainable development of the hospital and also crack the technical barriers to the accelerated promotion of the clinical pathway.

  11. Knowledge cycle and strategic knowledge within company

    OpenAIRE

    Ovidiu NICOLESCU

    2007-01-01

    In the knowledge-based economy, a company performs a set of activities focused on knowledge: identifying necessary knowledge, buying knowledge, learning, acquiring knowledge, creating knowledge, storing knowledge, sharing knowledge, using knowledge, protection of knowledge, capitalizing knowledge. As a result, a new function emerge: the knowledge function. In the knowledge-based companies, not every knowledge has the same impact. The analysis of the actual situations in the most developed an...

  12. Deterministic multidimensional nonuniform gap sampling

    Science.gov (United States)

    Worley, Bradley; Powers, Robert

    2015-12-01

    Born from empirical observations in nonuniformly sampled multidimensional NMR data relating to gaps between sampled points, the Poisson-gap sampling method has enjoyed widespread use in biomolecular NMR. While the majority of nonuniform sampling schemes are fully randomly drawn from probability densities that vary over a Nyquist grid, the Poisson-gap scheme employs constrained random deviates to minimize the gaps between sampled grid points. We describe a deterministic gap sampling method, based on the average behavior of Poisson-gap sampling, which performs comparably to its random counterpart with the additional benefit of completely deterministic behavior. We also introduce a general algorithm for multidimensional nonuniform sampling based on a gap equation, and apply it to yield a deterministic sampling scheme that combines burst-mode sampling features with those of Poisson-gap schemes. Finally, we derive a relationship between stochastic gap equations and the expectation value of their sampling probability densities.

  13. Bridging the Knowledge Gap between Secondary and Higher Education.

    Science.gov (United States)

    Ercegovac, Zorana

    2003-01-01

    Discussion of educational partnerships between educational levels focuses on collaborative work between a high school physics teacher and a high school librarian that included science-integrated information literacy competencies that may be expanded for higher education. Suggests further study and a crossover between information literacy standards…

  14. Heart Failure: Gaps in Knowledge and Failures in Treatment

    OpenAIRE

    Callender, Thomas; Woodward, Mark; Roth, Gregory; Farzadfar, Farshad; Lemarie, Jean-Christophe; Gicquel, Stéphanie; Atherton, John; Rahimzadeh, Shadi; Ghaziani, Mehdi; Shaikh, Maaz; Bennett, Derrick; Patel, Anushka; Lam, Carolyn S.P.; Sliwa, Karen; Barretto, Antonio

    2014-01-01

    Editors' Summary Background A healthy heart pumps about 23,000 liters of blood around the body every day. This blood delivers oxygen and nutrients to the rest of the body and carries carbon dioxide and waste products away from the tissues and organs. A healthy heart is therefore essential for life. Unfortunately, many people (particularly elderly people) develop heart failure, a life-threatening condition in which the heart no longer pumps enough blood to meet all the body's needs because it ...

  15. Landscape Design Dialogue. Bridging the gap between knowledge and action

    OpenAIRE

    Jonge, de, B.; Valk, van der, L.J.M.

    2010-01-01

    Spatial planners and landscape architects do not excel in theory development. The authors, being a practicing landscape architect-planner and a planning scholar, explore new roads to a middle range theory of landscape design and planning. Building on theories-in-use in regional planning practice they develop an empirically grounded methodology for planning and design. The process of theory building is part of a process of methodical reflection on best and worst practices. It focuses on an ana...

  16. Ebola vaccine R&D: Filling the knowledge gaps.

    Science.gov (United States)

    Medaglini, Donata; Harandi, Ali M; Ottenhoff, Tom H M; Siegrist, Claire-Anne

    2015-12-01

    With an emphasis on systems analyses, the VSV-EBOVAC project harnesses state-of-the-art technologies that illuminate mechanisms behind the observed immunogenicity and reactogenicity of the rVSV-ZEBOV vaccine and ensures that such information is shared among stakeholders. PMID:26659569

  17. South American mega cities: Knowledge gaps and collaboration opportunities

    Science.gov (United States)

    Gallardo, L.

    2012-04-01

    Urbanization and population concentration are outstanding phenomena in South America. About 83% of the 530 million South Americans live already in large coastal or near coastal cities (> 750 k inhabitants), many of which are heavily polluted. Curbing measures have been implemented on a relatively fast pace taking advantage of lessons learned elsewhere. However, as environmental objectives become more ambitious, considering for instance chronic health effects, impacts on ecosystems and agriculture, addressing secondary particles and climatic impacts, the need for cost-effective measures requires of more reliable and locally representative data. Such data include: emission fluxes (both natural and anthropogenic) and emission scenarios; characterization of vertical mixing; speciation and distribution of pollutants and precursors. In this presentation, we review the current situation in terms of atmospheric modeling, emission modeling, measuring and observations in a number of South American cities. Also, we describe low-cost actions oriented towards improving our understanding of: 1) vertical mixing by means of a modeling inter comparison exercise using data already collected in Santiago de Chile; 2) aerosol composition and speciation of volatile organic compounds by means of a coordinated sampling of filters and canisters at various locations highlighting the diversity of our cities. These actions were collectively convened by ca. 50 leading scientists and local policy makers during an international symposium held in Santiago in January 2012 (http://ossaf.cmm.uchile.cl/). This activity marked the closure of a five year project sponsored by the Inter American Institute on Global Change Research that tackled South American Emissions Megacities and Climate (SAEMC, CRN 2017). It was also a regional activity promoted and sponsored by the international Commission on Atmospheric Chemistry and Global Pollution (iCACGP), and by the World Meteorological Organization, Global Atmospheric Watch (GAW) Urban Research Meteorology and Environment (GURME).

  18. Assessing the Gap: The MBA and Information Technology Management Knowledge

    Science.gov (United States)

    Murphy, John B.

    2012-01-01

    One of the most prevalent themes for managers in nearly all industries is the impact of Information Technology on the organization's value chain. Direct and indirect IT costs comprise a significant portion of operating expenses for most businesses and constitute an estimated 50% of all capital expenditures. Understanding whether and to what…

  19. Traumatic Brain Injury: Persistent Misconceptions and Knowledge Gaps among Educators

    Science.gov (United States)

    Ettel, Deborah; Glang, Ann E.; Todis, Bonnie; Davies, Susan C.

    2016-01-01

    Each year approximately 700,000 U.S. children aged 0-19 years sustain a traumatic brain injury (TBI) placing them at risk for academic, cognitive, and behavioural challenges. Although TBI has been a special education disability category for 25 years, prevalence studies show that of the 145,000 students each year who sustain long-term injury from…

  20. Nanoparticle toxicity by the gastrointestinal route: evidence and knowledge gaps.

    Science.gov (United States)

    Bergin, Ingrid L; Witzmann, Frank A

    2013-01-01

    The increasing interest in nanoparticles for advanced technologies, consumer products, and biomedical applications has led to great excitement about potential benefits but also concern over the potential for adverse human health effects. The gastrointestinal tract represents a likely route of entry for many nanomaterials, both directly through intentional ingestion or indirectly via nanoparticle dissolution from food containers or by secondary ingestion of inhaled particles. Additionally, increased utilisation of nanoparticles may lead to increased environmental contamination and unintentional ingestion via water, food animals, or fish. The gastrointestinal tract is a site of complex, symbiotic interactions between host cells and the resident microbiome. Accordingly, evaluation of nanoparticles must take into consideration not only absorption and extraintestinal organ accumulation but also the potential for altered gut microbes and the effects of this perturbation on the host. The existing literature was evaluated for evidence of toxicity based on these considerations. Focus was placed on three categories of nanomaterials: nanometals and metal oxides, carbon-based nanoparticles, and polymer/dendrimers with emphasis on those particles of greatest relevance to gastrointestinal exposures. PMID:24228068

  1. Nanoparticle toxicity by the gastrointestinal route: evidence and knowledge gaps

    OpenAIRE

    Bergin, Ingrid L; Witzmann, Frank A.

    2013-01-01

    The increasing interest in nanoparticles for advanced technologies, consumer products, and biomedical applications has led to great excitement about potential benefits but also concern over the potential for adverse human health effects. The gastrointestinal tract represents a likely route of entry for many nanomaterials, both directly through intentional ingestion or indirectly via nanoparticle dissolution from food containers or by secondary ingestion of inhaled particles. Additionally, inc...

  2. Nanoparticle toxicity by the gastrointestinal route: evidence and knowledge gaps

    Science.gov (United States)

    Bergin, Ingrid L.; Witzmann, Frank A.

    2013-01-01

    The increasing interest in nanoparticles for advanced technologies, consumer products, and biomedical applications has led to great excitement about potential benefits but also concern over the potential for adverse human health effects. The gastrointestinal tract represents a likely route of entry for many nanomaterials, both directly through intentional ingestion or indirectly via nanoparticle dissolution from food containers or by secondary ingestion of inhaled particles. Additionally, increased utilisation of nanoparticles may lead to increased environmental contamination and unintentional ingestion via water, food animals, or fish. The gastrointestinal tract is a site of complex, symbiotic interactions between host cells and the resident microbiome. Accordingly, evaluation of nanoparticles must take into consideration not only absorption and extraintestinal organ accumulation but also the potential for altered gut microbes and the effects of this perturbation on the host. The existing literature was evaluated for evidence of toxicity based on these considerations. Focus was placed on three categories of nanomaterials: nanometals and metal oxides, carbon-based nanoparticles, and polymer/dendrimers with emphasis on those particles of greatest relevance to gastrointestinal exposures. PMID:24228068

  3. The correlation between knowledge management of nursing student and clinical performance%护生知识管理与临床实习表现的相关性研究

    Institute of Scientific and Technical Information of China (English)

    陈玉文; 刘廷扬

    2011-01-01

    Objective: To explore knowledge management of nursing students and initiate training the clinical contingency ability. Methods: A total of 135 full-time nursing students and their academic score were investigated. Results: Significant difference was found on KM behavior of participants , academic tutor scoring and clinical mentor scoring in different clinical practicum of varies subjects (P<0.05). It is also the significant positive correlation between the cognition of KM and the score of academic tutor (PO.Oi). Conclusions: Knowledge management is a humanistic working system, in order to solve clinical problems and the enhancement of care, knowledge must be exerted to maximum effectiveness.%目的:旨在探讨护生知识管理与临床实习表现的关系.方法:对135位护生进行问卷及临床实习成绩调查及分析.结果:不同年级研究对象知识管理行为与学校导师评分及临床导师评分有统计学差异(P<0.05);知识管理认知与学校导师评分呈正相关(P<0.01).结论:知识管理是一个有效的工作系统,为解决临床实务问题,提高护理服务质量,必须发挥知识的最大效能.

  4. Mind the Gap!

    DEFF Research Database (Denmark)

    Schmidt, Kjeld; Simone, Carla

    2000-01-01

    CSCW at large seems to be pursuing two diverging strategies: on one hand a strategy aiming at coordination technologies that reduce the complexity of coordinating cooperative activities by regulating the coordinative interactions, and on the other hand a strategy that aims at radically flexible m...... and blended in the course of real world cooperative activities. On the basis of this discussion the paper outlines an approach which may help CSCW research to bridge this gap....... means of interaction which do not regulate interaction but rather leave it to the users to cope with the complexity of coordinating their activities. As both strategies reflect genuine requirements, we need to address the issue of how the gap can be bridged, that is, how the two strategies can...

  5. Governing Knowledge

    OpenAIRE

    Nicolai J Foss; Dana B Minbaeva

    2009-01-01

    SHRM increasingly emphasizes HRM practices as means to build strategic knowledge resources such as superior capabilities. While the knowledge-based view increasingly pays attention to micro-foundations, the SHRM field neglects these and emphasizes collective constructs such as “human capital pools,” “HRM architectures”, etc. As a result, causal links between HRM practices, knowledge and organizational performance are black-boxed. We propose a program for research and identify s...

  6. 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.

  7. Mind the Gap

    OpenAIRE

    SMITH, KIRK R.; Peel, Jennifer L.

    2010-01-01

    Background Recent analysis has demonstrated a remarkably consistent, nonlinear relationship between estimated inhaled dose of combustion particles measured as PM2.5 (particulate matter with aerodynamic diameter ≤ 2.5 μm) and cardiovascular disease mortality over several orders of magnitude of dose—from cigarette smoking, environmental tobacco smoke (ETS) exposure, and ambient air pollution exposure. Objectives Here we discuss the implications of this relationship and point out the gaps in our...

  8. BRIDGING SERVICE QUALITY GAPS

    OpenAIRE

    BARKATH UNISSA

    2012-01-01

    Bridging the Service quality gaps is one of the foremost areas of concern for amarketer. Service marketing is inherently different from product or goods marketing.Services are distinctively characterized by their intangible, heterogeneous, inseparableand perishable nature. The importance of the service sector in today's world is a verywidely accepted and renowned idea. “We are already experiencing a service society“services do have some basic characteristics which make them fundamentally diff...

  9. Gapped Ferromagnetic Graphene Nanoribbons

    OpenAIRE

    Hou, D.; J. H. Wei; Xie, S. J.

    2010-01-01

    We theoretically design a graphene-based all-organic ferromagnetic semiconductor by terminating zigzag graphene nanoribbons (ZGNRs) with organic magnets. A large spin-split gap with 100% spin polarized density of states near the Fermi energy is obtained, which is of potential application in spin transistors. The interplays among electron, spin and lattice degrees of freedom are studied using the first-principles calculations combined with fundamental model analysis. All of the calculations co...

  10. Knowledge Economy

    OpenAIRE

    Kerr, Aphra; O'riain, Sean

    2009-01-01

    We examine a number of key questions regarding this knowledge economy. First, we look at the origin of the concept as well as early attempts to define and map the knowledge economy empirically. Second, we examine a variety of perspectives on the socio-spatial organisation of the knowledge economy and approaches which link techno-economic change and social-spatial organisation. Building on a critique of these perspectives, we then go on to develop a view of a knowledge economy that is conteste...

  11. Placing knowledge

    DEFF Research Database (Denmark)

    Adriansen, Hanne Kirstine; Valentin, Karen; Nielsen, Gritt B.

    Internationalisation of higher education is premised by a seeming paradox: On the one hand, academic knowledge strives to be universal in the sense that it claims to produce generalizable, valid and reliable knowledge that can be used, critiqued, and redeveloped by academics from all over the world......; on the other hand, the rationale for strengthening mobility through internationalisation is based on an imagination of the potentials of particular locations (academic institutions). Intrigued by this tension between universality and particularity in academic knowledge production, this paper presents...... for studying what comes to count as e.g. relevant, good, true knowledge, to whom, where and why....

  12. SUBORDINATE GAPS IN MANDARIN CHINESE

    Directory of Open Access Journals (Sweden)

    Ting-Chi Wei

    2011-06-01

    Full Text Available The existence of subordinate gaps in Mandarin Chinese casts doubt on analyses built on canonical coordinate gapping. We observe that the minimality of contrastive focus and the type of subordinate clause determine the acceptability of a missing gap in subordinate structure. Along this vein, we propose that a semantic-based deletion account can be used to interpret gapping in Mandarin. Such account relies on two violable constraints, AvoidF and Focus condition on gapping (Schwarzchild 1999, Merchant 2001 to compute the acceptability of a gap.

  13. Knowledge, Skills, and Practices Concerning Phonological Awareness among Early Childhood Education Teachers

    Science.gov (United States)

    Alghazo, Emad M.; Al-Hilawani, Yasser A.

    2010-01-01

    A sample of 83 kindergarten teachers participated in this study to examine their knowledge, skills, and classroom practices concerning phonological awareness. Analyses of data revealed significant gaps between knowledge and practice, knowledge and skills, and skills and practice. The gap between knowledge and skills, on one hand, and classroom…

  14. GapBlaster—A Graphical Gap Filler for Prokaryote Genomes

    Science.gov (United States)

    Veras, Adonney; de Melo, Diego Magalhães; Soares, Siomar; Pinheiro, Kenny; Guimarães, Luis; Azevedo, Vasco; Silva, Artur; Ramos, Rommel T. J.

    2016-01-01

    The advent of NGS (Next Generation Sequencing) technologies has resulted in an exponential increase in the number of complete genomes available in biological databases. This advance has allowed the development of several computational tools enabling analyses of large amounts of data in each of the various steps, from processing and quality filtering to gap filling and manual curation. The tools developed for gap closure are very useful as they result in more complete genomes, which will influence downstream analyses of genomic plasticity and comparative genomics. However, the gap filling step remains a challenge for genome assembly, often requiring manual intervention. Here, we present GapBlaster, a graphical application to evaluate and close gaps. GapBlaster was developed via Java programming language. The software uses contigs obtained in the assembly of the genome to perform an alignment against a draft of the genome/scaffold, using BLAST or Mummer to close gaps. Then, all identified alignments of contigs that extend through the gaps in the draft sequence are presented to the user for further evaluation via the GapBlaster graphical interface. GapBlaster presents significant results compared to other similar software and has the advantage of offering a graphical interface for manual curation of the gaps. GapBlaster program, the user guide and the test datasets are freely available at https://sourceforge.net/projects/gapblaster2015/. It requires Sun JDK 8 and Blast or Mummer. PMID:27171416

  15. GapBlaster-A Graphical Gap Filler for Prokaryote Genomes.

    Directory of Open Access Journals (Sweden)

    Pablo H C G de Sá

    Full Text Available The advent of NGS (Next Generation Sequencing technologies has resulted in an exponential increase in the number of complete genomes available in biological databases. This advance has allowed the development of several computational tools enabling analyses of large amounts of data in each of the various steps, from processing and quality filtering to gap filling and manual curation. The tools developed for gap closure are very useful as they result in more complete genomes, which will influence downstream analyses of genomic plasticity and comparative genomics. However, the gap filling step remains a challenge for genome assembly, often requiring manual intervention. Here, we present GapBlaster, a graphical application to evaluate and close gaps. GapBlaster was developed via Java programming language. The software uses contigs obtained in the assembly of the genome to perform an alignment against a draft of the genome/scaffold, using BLAST or Mummer to close gaps. Then, all identified alignments of contigs that extend through the gaps in the draft sequence are presented to the user for further evaluation via the GapBlaster graphical interface. GapBlaster presents significant results compared to other similar software and has the advantage of offering a graphical interface for manual curation of the gaps. GapBlaster program, the user guide and the test datasets are freely available at https://sourceforge.net/projects/gapblaster2015/. It requires Sun JDK 8 and Blast or Mummer.

  16. GapBlaster-A Graphical Gap Filler for Prokaryote Genomes.

    Science.gov (United States)

    de Sá, Pablo H C G; Miranda, Fábio; Veras, Adonney; de Melo, Diego Magalhães; Soares, Siomar; Pinheiro, Kenny; Guimarães, Luis; Azevedo, Vasco; Silva, Artur; Ramos, Rommel T J

    2016-01-01

    The advent of NGS (Next Generation Sequencing) technologies has resulted in an exponential increase in the number of complete genomes available in biological databases. This advance has allowed the development of several computational tools enabling analyses of large amounts of data in each of the various steps, from processing and quality filtering to gap filling and manual curation. The tools developed for gap closure are very useful as they result in more complete genomes, which will influence downstream analyses of genomic plasticity and comparative genomics. However, the gap filling step remains a challenge for genome assembly, often requiring manual intervention. Here, we present GapBlaster, a graphical application to evaluate and close gaps. GapBlaster was developed via Java programming language. The software uses contigs obtained in the assembly of the genome to perform an alignment against a draft of the genome/scaffold, using BLAST or Mummer to close gaps. Then, all identified alignments of contigs that extend through the gaps in the draft sequence are presented to the user for further evaluation via the GapBlaster graphical interface. GapBlaster presents significant results compared to other similar software and has the advantage of offering a graphical interface for manual curation of the gaps. GapBlaster program, the user guide and the test datasets are freely available at https://sourceforge.net/projects/gapblaster2015/. It requires Sun JDK 8 and Blast or Mummer. PMID:27171416

  17. The gap between knowledge on HIV/AIDS and sexual behavior: a study of teenagers in Vespasiano, Minas Gerais State, Brazil La laguna entre el conocimiento sobre VIH/SIDA y el comportamiento sexual: una investigación con adolescentes de Vespasiano, Minas Gerais, Brasil A lacuna entre o conhecimento sobre HIV/AIDS e o comportamento sexual: uma investigação com adolescentes de Vespasiano, Minas Gerais, Brasil

    OpenAIRE

    Eugênio Marcos Andrade Goulart; Jorge Andrade Pinto; Maria Tereza Cordeiro Beling; Júlia Mesquita Duarte; Patrícia Regina Guimarães; Luciana Ramos de Moura; Joyce Romano Lamounier; Cristiane de Freitas Cunha Grillo

    2013-01-01

    The aim of this study was to investigate gaps between knowledge on HIV/AIDS and sexual behavior among teenagers. The study used a cross-sectional design with a representative random sample of 1,158 teenagers (14 to 19 years of age) enrolled in nine public secondary schools and who answered validated questionnaires. Data analysis included descriptive statistics and tests of hypotheses (chi-square, Mann-Whitney and Kruskal-Wallis, Kendall, and Fisher's exact test). The vast majority of the teen...

  18. Knowledge Management

    Science.gov (United States)

    Deepak

    2005-01-01

    Knowledge Management (KM) is the process through which organizations generate value from their intellectual and knowledge-based assets. Frequently generating value from such assets means sharing them among employees, divisions and even with other companies in order to develop best practices. This article discusses three basic aspects of…

  19. Determinations of the First Aid-Related Knowledge Levels of the Mothers Having Children at the Age of 0-6 and Who Live in The Mugla Number Two Health Clinic District

    Directory of Open Access Journals (Sweden)

    Nilgun Turasay

    2010-06-01

    Full Text Available AIM: The study was planned to determinate the first-aid-related knowledge levels of the mothers with a child aged 0-6. METHOD: The universe of the study consist of 772 mothers having a child aged 0-6 and living in Mugla II Number Health Clinic district. Study was carried out on 561 mothers who accepted. The questionnaire which applied used consist of 64 questions in sum, 8 of which are to solicit personal information and 54 to solicit first-aid-related knowledge level. RESULTS: In the study, first–aid related knowledge situation of mothers having a child aged 0-6 was found 28.74 9.44 out of 54 points and was ascertained that they known first-aid. Statistically significant difference was found between their age groups, their levels of education, their working situations, their situations about obtaining information, their experiments of cases requiring first-aid and knowledge points (p<0.05. CONLUSION: The first-aid topics best know by the mothers were found to be; burn, sun stroke and frost, and the least know were animal savages and insect bites. [TAF Prev Med Bull 2010; 9(3.000: 217-224

  20. Enhanced Counseling for Women Undergoing BRCA1/2 Testing: Impact on Knowledge and Psychological Distress – Results From a Randomized Clinical Trial

    OpenAIRE

    Roussi, Pagona; Sherman, Kerry Anne; Miller, Suzanne; Buzaglo, Joanne; Daly, Mary; Taylor, Alan; Ross, Eric; Godwin, Andrew

    2010-01-01

    This randomized controlled trial evaluated the impact of an enhanced counseling intervention on knowledge about the heritability of breast and ovarian cancer and distress, as a function of BRCA test result, among high-risk women. Before deciding about whether or not to undergo genetic testing, participants were randomly assigned to the enhanced counseling intervention (N = 69), designed to promote cognitive and affective processing of cancer risk information (following the standard individual...