822 resultados para current medical knowledge


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The quality of environmental decisions are gauged according to the management objectives of a conservation project. Management objectives are generally about maximising some quantifiable measure of system benefit, for instance population growth rate. They can also be defined in terms of learning about the system in question, in such a case actions would be chosen that maximise knowledge gain, for instance in experimental management sites. Learning about a system can also take place when managing practically. The adaptive management framework (Walters 1986) formally acknowledges this fact by evaluating learning in terms of how it will improve management of the system and therefore future system benefit. This is taken into account when ranking actions using stochastic dynamic programming (SDP). However, the benefits of any management action lie on a spectrum from pure system benefit, when there is nothing to be learned about the system, to pure knowledge gain. The current adaptive management framework does not permit management objectives to evaluate actions over the full range of this spectrum. By evaluating knowledge gain in units distinct to future system benefit this whole spectrum of management objectives can be unlocked. This paper outlines six decision making policies that differ across the spectrum of pure system benefit through to pure learning. The extensions to adaptive management presented allow specification of the relative importance of learning compared to system benefit in management objectives. Such an extension means practitioners can be more specific in the construction of conservation project objectives and be able to create policies for experimental management sites in the same framework as practical management sites.

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An increasing amount of people seek health advice on the web using search engines; this poses challenging problems for current search technologies. In this paper we report an initial study of the effectiveness of current search engines in retrieving relevant information for diagnostic medical circumlocutory queries, i.e., queries that are issued by people seeking information about their health condition using a description of the symptoms they observes (e.g. hives all over body) rather than the medical term (e.g. urticaria). This type of queries frequently happens when people are unfamiliar with a domain or language and they are common among health information seekers attempting to self-diagnose or self-treat themselves. Our analysis reveals that current search engines are not equipped to effectively satisfy such information needs; this can have potential harmful outcomes on people’s health. Our results advocate for more research in developing information retrieval methods to support such complex information needs.

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BACKGROUND Traumatic brain injury (TBI) is associated with mo st trauma-related deaths. Secondary brain injury is the leading cause of in-hospital deaths after traumatic brain injury. By early prevention and slowing of the initial pathophysiological mechanism of secondary brain injury, pre- hospital service can signifi cantly reduce case-fata lity rates of TBI. In China, the incidence of TBI is increasing and the proportion of severe TBI is much higher than that in other countries. The objective of this paper is to review the pre-hospital management of TBI in China. DATA SOURCES A literature search was conducted in January 2014 using the China National Knowledge Infrastructure (CNKI). Articles on the assessment and treatment of TBI in pre-hospital settings practiced by Chinese doctors were identified. The information on the assessment and treatment of hypoxemia, hypotension, and brain hern iation was extracted from the identifi ed articles. RESULTS Of the 471 articles identified, 65 met the selecti on criteria. The existing literature indicated that current practices of pre-hospital TBI management in China were sub-optimal and varied considerably across different regions. CONCLUSION Since pre-hospital care is the weakest part of Chinese emergency care, appropriate training programs on pre-hospital TBI management are urgently needed in China.

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Aims: The Medical Imaging Training Immersive Environment(MITIE) Computed Tomography(CT) system is an innovative virtual reality (VR) platform that allows students to practice a range of CT techniques. The aim of this pilot study was to harvest user feedback about the educational value of teh application and inform future pedagogical development. This presentation explores the use of this technology for skills training. Background: MITIE CT is a 3D VR environment that allows students to position a patient,and set CT technical parameters including IV contrast dose and dose rate. As with VR initiatives in other health disciplines the software mimics clinical practice as much as possible and uses 3D technology to enhance immersion and realism. The software is new and was developed by the Medical Imaging Course Team at a provider University with funding from a Health Workforce Australia 'Simulated Learning Environments' grant Methods: Current third year medical imaging students were provided with additional 1 hour MITIE laboratory tutorials and studnet feedback was collated with regard to educational value and performance. Ethical approval for the project was provided by the university ethics panel Results: This presentation provides qualitative analysis of student perceptions relating to satisfaction, usability and educational value. Students reported high levels of satisfaction and both feedback and assessment results confirmed the application's significance as a pre-clinical tool. There was a clear emerging theme that MITIE could be a useful learning tool that students could access to consolidate their clinical learning, either on campus or during their clinical placement. Conclusion: Student feedback indicates that MITIE CT has a valuable role to play in the clinial skills training for medical imaging students both in the academic and clinical environment. Future work will establish a framework for an appropriate supprting pedagogy that can cross the boundary between the two environments

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Advances in neural network language models have demonstrated that these models can effectively learn representations of words meaning. In this paper, we explore a variation of neural language models that can learn on concepts taken from structured ontologies and extracted from free-text, rather than directly from terms in free-text. This model is employed for the task of measuring semantic similarity between medical concepts, a task that is central to a number of techniques in medical informatics and information retrieval. The model is built with two medical corpora (journal abstracts and patient records) and empirically validated on two ground-truth datasets of human-judged concept pairs assessed by medical professionals. Empirically, our approach correlates closely with expert human assessors ($\approx$ 0.9) and outperforms a number of state-of-the-art benchmarks for medical semantic similarity. The demonstrated superiority of this model for providing an effective semantic similarity measure is promising in that this may translate into effectiveness gains for techniques in medical information retrieval and medical informatics (e.g., query expansion and literature-based discovery).

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Study/Objective This study examines the current state of disaster response education for Australian paramedics from a national and international perspective and identifies both potential gaps in content and challenges to the sustainability of knowledge acquired through occasional training. Background As demands for domestic and international disaster response increase, experience in the field has begun to challenge traditional assumptions that response to mass casualty events requires little specialist training. The need for a “streamlined process of safe medical team deployment into disaster regions”1 is generally accepted and, in Australia, the emergence of national humanitarian aid training has begun to respond to this gap. However, calls for a national framework for disaster health education2 haven’t received much traction. Methods A critical analysis of the peer reviewed and grey literature on the core components/competencies and training methods required to prepare Australian paramedics to contribute to effective health disaster response has been conducted. Research from the past 10 years has been examined along with federal and state policy with regard to paramedic disaster education. Results The literature shows that education and training for disaster response is variable and that an evidence based study specifically designed to outline sets of core competencies for Australian health care professionals has never been undertaken. While such competencies in disaster response have been developed for the American paradigm it is suggested that disaster response within the Australian context is somewhat different to that of the US, and therefore a gap in the current knowledge base exists. Conclusion Further research is needed to develop core competencies specific to Australian paramedics in order to standardise teaching in the area of health disaster management. Until this occurs the task of evaluating or creating disaster curricula that adequately prepares and maintains paramedics for an effective all hazards disaster response is seen as largely unattainable.

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There is debate around the scope of physical assessment skills that should be taught in undergraduate nursing programs. Yet this debate is largely uninformed by evidence on what is learned and practiced by nursing students. This study examined the pattern and correlates of physical assessment skill utilization by 208 graduating nursing students at an Australian university, including measures of knowledge, frequency of use and perceived barriers to physical assessment skills during clinical practice. Of the 126 skills surveyed, on average only five were used every time students practiced. Core skills reflected inspection or general observation of the patient; none involved complex palpation, percussion or auscultation. Skill utilization was also shaped by specialty area. Most skills (70%) were, on average, never performed or learned and students perceived nursing physical assessment was marginalized in both university and workplace contexts. Lack of confidence was thus a significant barrier to use of skills. Based on these findings we argue that the current debate must shift to how we might best support students to integrate comprehensive physical assessment into nursing practice.

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Contemporary higher education institutions are making significant efforts to develop cohesive, meaningful and effective learning experiences for Science, Technology, Engineering and Mathematics (STEM) curricula to prepare graduates for challenges in the modern knowledge economy, thus enhancing their employability (Carnevale et al, 2011). This can inspire innovative redesign of learning experiences embedded in technology-enhanced educational environments and the development of research-informed, pedagogically reliable strategies fostering interactions between various agents of the learning-teaching process. This paper reports on the results of a project aimed at enhancing students’ learning experiences by redesigning a large, first year mathematics unit for Engineering students at a large metropolitan public university. Within the project, the current study investigates the effectiveness of selected, technology-mediated pedagogical approaches used over three semesters. Grounded in user-centred instructional design, the pedagogical approaches explored the opportunities for learning created by designing an environment containing technological, social and educational affordances. A qualitative analysis of mixed-type questionnaires distributed to students indicated important inter-relations between participants’ frames of references of the learning-teaching process and stressed the importance (and difficulty) of creating appropriate functional context. Conclusions drawn from this study may inform instructional design for blended delivery of STEM-focused programs that endeavor to enhance students’ employability by educating work-ready graduates.

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Science, technology, engineering, and mathematics (STEM) education is an emerging initiative in Australia, particularly in primary schools. This qualitative research aimed to understand Year 4 students' involvement in an integrated STEM education unit that focused on science concepts (e.g., states of matter, testing properties of materials) and mathematics concepts (e.g., 3D shapes and metric measurements) for designing, making and testing a strong and safe medical kit to insulate medicines (ice cubes) at desirable temperatures. Data collection tools included student work samples, photographs, written responses from students and the teacher, and researcher notes. In a post-hoc analysis, a pedagogical knowledge practice framework (i.e., planning, timetabling, preparation, teaching strategies, content knowledge, problem solving, classroom management, questioning, implementation, assessment, and viewpoints) was used to explain links to student outcomes in STEM education. The study showed how pedagogical knowledge practices may be linked to student outcomes (knowledge, understanding, skill development, and values and attitudes) for a STEM education activity.

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Background: To effectively care for people who are terminally ill, including those without decision-making capacity, palliative care physicians must know and understand the legal standing of Advance Care Planning (ACP) in their jurisdiction of practice. This includes the use of advance directives/living wills (ADs) and substitute decision-makers (SDMs) who can legally consent to or refuse treatment if there is no valid AD. Aim: The study aimed to investigate the knowledge, attitudes and practices of medical specialists most often involved in end-of-life care in relation to the law on withholding/ withdrawing life-sustaining treatment (WWLST) from adults without decision-making capacity. Design/participants: A pre-piloted survey was posted to specialists in palliative, emergency, geriatric, renal and respiratory medicine, intensive care and medical oncology in three Australian States. Surveys were analysed using SPSS20 and SAS 9.3. Results: The overall response rate was 32% (867/2702); 52% from palliative care specialists. Palliative Care specialists and Geriatricians had significantly more positive attitudes towards the law (χ242 = 94.352; p < 0.001) and higher levels of knowledge about the WWLST law (χ27 = 30.033; p < 0.001), than did the other specialists, while still having critical gaps in their knowledge. Conclusions: A high level of knowledge of the law is essential to ensure that patients’ wishes and decisions, expressed through ACP, are respected to the maximum extent possible within the law, thereby according with the principles and philosophy of palliative care. It is also essential to protect health professionals from legal action resulting from unauthorised provision or removal of treatment.

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This thesis provides a review of 199 papers published on Green IT/IS between 2007−2014, in order to present taxonomy of segments in Green IT/IS publications, where the segments are later used for multiple analyses to facilitate future research and to provide a retrospective analysis of existing knowledge and gaps thereof. This research also attempts to make a unique contribution to our understanding of Green IT/IS, by consolidating papers it observes current patterns of literature through approach analysis and segmentation, as well as allocating studies to the technology, process, or outcome (TPO) stage. Highlighting the necessity of a consolidated approach, these classification systems have been combined into a TPO matrix so that the studies could be arranged according to which stage of the Green IT/IS cycle they were focused on. We believe that these analyses will provide a solid platform from which future Green IT/IS research can be launched.

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Predictors of people’s intention to register with a body bequest program for donating their deceased body to medical science and research were examined using standard theory of planned behavior (TPB) predictors (attitude, subjective norm, perceived behavioral control) and adding moral norm, altruism, and knowledge. Australian students (N = 221) at a university with a recently established body bequest program completed measures of the TPB’s underlying beliefs (behavioral, normative, and control beliefs) and standard and extended TPB predictors, with a sub-sample reporting their registration-related behavior 2 months later. The standard TPB accounted for 43.6%, and the extended predictors an additional 15.1% of variance in intention. The significant predictors were attitude, subjective norm, and moral norm, partially supporting an extended TPB in understanding people’s body donation intentions. Further, important underlying beliefs can inform strategies to target prospective donors.

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Background: Nurses have a pivotal role in providing, facilitating, advocating and promoting the best possible care and outcome for the client. To ensure decisions and actions are based on current standards of practice, nurses must be accountable for participation in ongoing education in their area of practice. Aim: To present a description of the current state of Polish nursing education and specialized model for neurological and neurosurgical nursing that can be utilized for both undergraduate and postgraduate continuing education in Poland. Data sources: The model of postgraduate training introduced in Poland in 2000 was taken into consideration in developing the framework for neuroscience nursing postgraduate continuing education presented here. The framework for neurological continuing education is also based on a review of the literature and is consistent with Poland’s legally binding professional nursing regulations (normative and implementing regulations). Conclusion: The model demonstrates the need for the content of pre- and post-undergraduate degree education in neurological nursing to be graduated, based on the frameworks for undergraduate education (acquiring the knowledge and basic skills for performing the work of nurses) and postgraduate education (acquiring knowledge and specialist skills necessary for providing advanced nursing care including medical acts on patients with nervous system diseases). Implications for nursing: New and advanced skills gained in specialization training can be applied to complex functions, roles and professional tasks undertaken by nurses in relation to care of patients with neurological dysfunctions.

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The purpose of this paper is to investigate how social media may support information encountering (i.e., where individuals encounter useful and interesting information while seeking or browsing for some other information) and how this may lead to facilitation of tacit knowledge creation and sharing. The study employed a qualitative survey design that interviewed twenty-four physicians who were active users of social media to better understand the phenomenon of information encountering on social media. The data was analysed using the thematic analysis approach. The study found six main ways through which social media supports information encountering. Furthermore, drawing upon knowledge creation theories, the study concluded that information encountering on social media facilitates tacit knowledge creation and sharing among individuals. The study provides new directions for further empirical investigations to examine whether information encountering on social media actually leads to tacit knowledge creation and sharing. The findings of the study may also provide opportunities for users to adopt social media effectively or gain greater value from social media use.

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This thesis is an exploratory study to scrutinise Project Knowledge Management in Project-Based Organisations, specifically in the Project Management Office (PMO). It is the first attempt to investigate the maturity of Project Management, from a Knowledge Management perspective. The findings of this study address multiple Knowledge Management processes and practices to both assess the level of Knowledge Management Maturity in PMOs, and improve the capability of Project Knowledge Management in Project-based Organisations. This research significantly contributes to bridge the current gap in the existing Project Management Maturity Models.