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At least 163 records · Page 9Linked to original sources

PubMed2002

Awareness under general anesthesia.

OBJECTIVE: To determine the occurrence and associated factors of awareness in the patients undergoing elective surgery under general anesthesia. METHODS: A prospective cohort study of 802 patients, scheduled for elective general and gynecological surgery under endotracheal anesthesia was performed at Siriraj Hospital. Balanced general endotracheal anesthesia was performed as routine practice. Standard monitoring and clinical observation for movement, tear, sweat, and eye-lid opening were obtained. They were interviewed during the first 12 hours after a surgical completion. If the patient was suspected to have awareness, then a second interview was performed on postoperative day 3. RESULTS: The ages of the study population were 16-84 years. There were 659 females and 143 males. Awareness was found in 5 patients (3 females, 2 males) as an occurrence of 0.62 per cent. The only positive clinical observation found was hand movement. The cause of awareness should be inadequate anesthesia. Apart from that, data gathered from interviews with the group who had no awareness (797 patients), the last thing they could remember before unconsciousness was auditory perception. Also hearing someone calling was the first thing upon awakening. Most of the patients did not dream during anesthesia. No serious psychological disorder occurred. CONCLUSION: The occurrence of awareness was 0.62 per cent in the patients undergoing surgery under anesthesia. Inadequate anesthesia was the most likely cause of awareness. No postoperative sequelae of awareness occurred.

Adolescent↗

PubMed2006

[Awareness with recall during general anesthesia: analysis of 2015 cases].

OBJECTIVE: To investigate the incidence of awareness with recall during general anesthesia in elective operation with modern anesthetic methods and to analyze the risk factors thereof. METHODS: 2025 patients, 1001 males and 1024 females, aged 53 +/- 16, underwent general anesthesia during different kinds of elective operation. Interview was conducted 1 - 3 days postoperatively to survey the incidence of awareness during operation. Two weeks later follow-up was conducted again to know if sequelae existed. RESULTS: Twenty-eight patients (1.4%) were identified as with awareness. Multiple regression analysis showed that awareness during operation was associated with being female (OR = 2.836, 95% CI = 1.81 - 6.810), use of laryngeal mask airway (LMA, OR = 19.609, 95% CI = 3.918 - 98.740), not use volatile anesthetics at a time or continuously during maintenance of anesthesia (OR = 3.084, 95% CI = 1.246 - 7.629), and intra-operative blood pressure fluctuation (OR = 10.430, 95% CI = 3.918 - 27.763), Premedicated patients had lower incidence of awareness during operation (OR = 0.326, 95% CI = 0.110 - 0.965). Twenty-three of the 28 patients with awareness during operation (82%) had auditory perception, 2 (7%) had both auditory and visual perception, 7 felt pain at different degrees, and 10 (36%) felt anxiety during operation. After effects appeared in 6 of the 28 patients (21%). CONCLUSION: Awareness occurs in some patients undergoing elective operation. Being female, use of LMA, not using volatile anesthetics at a time or continuously during maintenance of anesthesia, and intra-operative blood pressure fluctuation are risk factors. Premedication may help prevent awareness during operation.

Anesthesia, General↗

PubMed1987

Awareness during bronchoscopy.

The purpose of the study was to assess the incidence of awareness during bronchoscopy and to evaluate the effectiveness of auditory random noise in preventing awareness. All patients were unpremedicated and underwent elective bronchoscopy under thiopentone-suxamethonium anaesthesia. Half the patients received auditory random noise preoperatively. Patients were interviewed postoperatively and the incidence of awareness and dreaming assessed. Eleven patients described awareness, of whom three had received random noise. No relation with awareness could be shown with the age and sex of the patient, nor was awareness related to the dosage of thiopentone. Awareness was associated with a short time interval between removal of the bronchoscope and response to command. Awareness is still an important problem in anaesthesia and the use of random noise stimulation to block auditory input of relevance to the patient merits further investigation.

Adolescent↗

PubMed1996

[Intraoperative awareness and auditory evoked potentials].

Midlatency auditory evoked potentials (MLAEP) are suppressed dose-dependently during anaesthesia with a variety of general anaesthetics. Therefore, MLAEP have been proposed to measure depth of anaesthesia and to indicate intraoperative awareness. Several studies give evidence of a close relationship between MLAEP and motor signs of wakefulness, intraoperative awareness, and explicit and implicit memory functions during general anaesthesia. Summarising these data, one may conclude that there is a close hierarchical relation between cognitive function, memory and wakefulness during anaesthesia, and MLAEP latencies. A short Nb latency below 45 ms is consistent with conscious awareness and unimpaired memory function with explicit recall and adequate response to commands. When Nb latency increases to 45-50 ms, it may be associated with conscious awareness. Patients still respond to commands, but memory formation is impaired and explicit recall is lost. A further increase of Nb latencies seems to be consistent with unconscious awareness, characterised by implicit memory of intraoperative events; 60 ms seems to be the threshold value for motor signs of wakefulness during anaesthesia. With a further increase of MLAEP latency during anaesthesia, conscious awareness and memory formation, explicit and implicit recall, response to commands, and spontaneous purposeful movements during anaesthesia are blocked. The new volatile anaesthetic sevoflurane leads to a dose-dependent increase in MLAEP peak latencies and a decrease in MLAEP amplitudes. At about 1.5 vol.% end-expiratory sevoflurane concentration, MLAEP are significantly suppressed and Nb latency is in the range of 68-80 ms. Therefore, from the present data and those from the literature, one may expect that sevoflurane at concentrations greater than 1.5 vol.% for general anaesthesia would be able to suppress awareness phenomena such as purposeful movements, auditory perception, intraoperative wakefulness and awareness, memory formation, and explicit and implicit recall of intraoperative events.

Anesthetics, Inhalation↗

PubMed2005

Self-awareness after acquired brain injury--predictors and rehabilitation.

OBJECTIVE: To investigate the factors contributing to deficit in self-awareness following acquired brain injury and to study change in self-awareness during a group support program. METHODS: Sixty-two patients (mean age: 35.4 +/- 15.3 years) attending our Service (295 +/- 525 days after injury) were included in the study (41 of them had sustained a head injury). Thirty-six patients were admitted to a multidisciplinary rehabilitation program including a group support program designed to improve self-awareness deficits. All patients were assessed with the Patient Competency Rating Scale as a measure of self-awareness and with a broad range of neuropsychological tests, checklists of psychopathological symptoms, and several functional scales. RESULTS: Thirty patients showed high levels of self-awareness while 32 showed impaired self-awareness. Patients with appropriate perception of their deficits showed less psychopathological symptoms, better neuropsychological function and higher functional independence than those with impaired SA (Student's t test, p < 0.05). Both groups improved, but with different patterns, after rehabilitation (MANOVA, p < 0.05). Multiple regression analysis revealed that cognitive status was predictive of level of self-awareness. CONCLUSION: The level of self-awareness after acquired brain injury is a useful prognostic index of the neuropsychological, psychopathological and functional status of the patient. We recommend the evaluation of this symptom after acquired brain injury due to its clinical relevance.

Activities of Daily Living↗

PubMed1990

Awareness of an AIDS campaign directed at Norwegian adolescents.

Awareness of a condom campaign directed at Norwegian adolescents was studied in terms of individual characteristics and social processes. The material comprised a representative sample of 3000 Norwegians aged 17 through 19 years. The response rate was 60.9%. Data were collected by self-administered, anonymous, questionnaires. The campaign consisted of five different elements. The awareness of the elements varied between 50% and 9%. Forty-eight percent reported awareness of at least one element. Six background variables included in a multiple regression model explained only 6% of the variance in awareness of the campaign. In order to illustrate social processes leading to awareness of the campaign, a path model was constructed. Coitus experience, educational aspirations and sex seemed to influence awareness of the campaign through three different paths, in which IPC was included in each path as a intervening variable. Thus, through indirect processes, IPC was mediating the main effects of the three independent variables on awareness. IPC served as a mediating variable between personal characteristics and awareness of the campaign. The results from this study indicate that increasing the adolescents' ability to communicate about sexual topics, are important educational tasks for future prevention of HIV/AIDS.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Low intensity phonological awareness training in a preschool classroom for children with communication impairments.

UNLABELLED: Phonological awareness is a term that refers to one's knowledge of the sound structure of spoken language. Children who understand that sounds in language represent the letters used in reading and writing typically learn to read more easily than children who do not. Children with language and/or speech impairments often demonstrate a lack of phonological awareness. Thus, it is important to identify problems in phonological awareness and to implement intervention programs early. The purpose of this study was to determine if a low intensity, classroom phonological awareness program improved phonological awareness skills for preschool children with language and/or speech impairments. Results suggested that children made significant gains in phonological awareness after participating in the intervention. LEARNING OUTCOMES: As a result of this activity, the reader will be able to: (1) identify components of phonological awareness program; (2) evaluate effectiveness of phonological awareness intervention.

Articulation Disorders↗

PubMed2004

Levels of phonological awareness in three cultures.

This study focused on syllable phoneme onset levels of phonological awareness in relation to reading of Chinese and English in kindergarten and first-grade children from Xian (China), Hong Kong, and Toronto, cultures that differ substantially in approaches to reading instruction. English syllable awareness among native Chinese speakers was as good as or better than that among English speakers, indicating that the Chinese language may promote syllable-level awareness in children. Hong Kong children recognized significantly more words in both English and Chinese but were significantly poorer than the Xian children in both syllable and phoneme onset deletion tasks, suggesting that Pinyin training (given in Xian only) may promote phonological awareness even at the syllable level. In both Xian and Hong Kong, measures of syllable awareness consistently predicted Chinese character recognition better than did phoneme onset awareness. In contrast, English word recognition was predicted differently by syllable and phoneme onset awareness across cultures. These results underscore the roles of both language and writing system in understanding levels of phonological awareness.

Child↗

PubMed2002

Modest contribution of psychosocial variables to hypoglycaemic awareness in Type 1 diabetes.

OBJECTIVE: To assess relationships between hypoglycaemic awareness and diabetes-related, psychosocial and demographic characteristics. METHOD: Ninety-eight type 1 diabetic patients completed questionnaires on somatic awareness (Somatic Awareness Questionnaire, SAQ), negative affectivity (Positive And Negative Affectivity Schedule, PANAS), symptom beliefs, bustle and variety of daily life. They then performed up to 70 measurements on a hand-held computer, during 4 to 6 weeks, at home. During every measurement, they rated the presence of 20 symptoms on a 0-6 scale, and estimated and measured their blood glucose level. The percentage of recognised hypoglycaemic episodes was calculated from these data, and used as a measure of hypoglycaemic awareness. RESULTS: Hypoglycaemic awareness was negatively associated with disease duration and antecedent hypoglycaemia, and positively associated with the use of an insulin pump instead of injections, variety in the daily life, somatic awareness, sensitivity of the symptom beliefs and female gender. However, only 17% of the variance in hypoglycaemic awareness was explained. CONCLUSIONS: Psychosocial variables contribute to hypoglycaemic awareness, to a moderate but statistically significant extent.

Activities of Daily Living↗

PubMed2002

Awareness of naturalistic action errors in dementia.

Unawareness of deficit is a common feature of degenerative dementia. The present study explored awareness and correction of naturalistic action errors in 54 dementia participants and 10 healthy controls while they performed a series of everyday tasks, such as toast preparation and gift-wrapping. Awareness for everyday task performance and cognitive functioning was also assessed with questionnaire discrepancy scores, and a neuropsychological test protocol was administered. Dementia participants were aware of and corrected a significantly smaller proportion of errors compared to controls (z = -4.59, p < .001). Awareness and correction of action errors was not significantly correlated with the number of naturalistic errors committed, questionnaire discrepancy scores, or neuropsychological test data. Within-group analyses showed awareness differed across error types, such that participants were aware of a greater proportion of substitution and sequence errors compared to omissions, perseverations, and action addition (i.e., utilization behavior) errors (z < or = -3.2, p < or = .002 for all analyses). Taken together these data suggest that error awareness and correction during the course of action is not related to error production or awareness measured via questionnaire discrepancy scores. Rather, direct assessment of error detection and correction may provide novel information about behavioral monitoring that can not be extrapolated from measures of dementia severity or traditional neuropsychological assessment.

Activities of Daily Living↗

PubMed2006

Longitudinal assessment of awareness in early-stage Alzheimer's disease using comparable questionnaire-based and performance-based measures: a prospective one-year follow-up study.

Few studies of awareness in dementia have taken a longitudinal perspective, yet exploring the ways in which awareness changes over time may offer important information about the processes involved and the relationship between awareness and other variables. The present study explored in detail the patterns of change in awareness scores over time for a group of 12 participants with early-stage Alzheimer's disease using a multi-dimensional measure giving comparable participant-carer and post diction-performance discrepancy scores. There were small, non-significant increases in mean discrepancy scores for each of these components of the assessment, with similar patterns for questionnaire-based and performance-based ratings. The small changes that were observed reflected both participant and informant factors. The majority of participants showed only very minor changes; others showed changes in the direction of either reduced or increased awareness. There was no significant association between change in mean discrepancy score and change in MMSE score over time, although there was a significant decline in MMSE scores at follow-up. The observation of different longitudinal trajectories for awareness scores, reflecting increased or decreased awareness or no change, may indicate the operation of different processes affecting the expression of explicit awareness that can be understood within a biopsychosocial formulation of this complex construct.

Aged↗

PubMed2007

Awareness of non-occupational HIV postexposure prophylaxis among French people living with HIV: the need for better targeting.

BACKGROUND: Since 1998, French HIV prevention guidelines have recommended the use of HIV post-exposure prophylaxis (PEP) after unprotected sex with a HIV-positive partner who should be informed about this option. This study analysed factors associated with PEP awareness in a population of individuals living with HIV/AIDS (PLHAs). METHODS: In 2003, a face-to-face survey was conducted among PLHAs selected from a random stratified sample of 102 French hospital departments delivering HIV care. Those who knew about PEP and those who did not were compared to identify factors related to PEP awareness in the sub-sample who reported that they had been sexually active in the prior 12 months. RESULTS: Among the 2,280 sexually active PLHAs, the median age was 40 years. Women comprised 26% of the sample, 41% were homosexual men and 16% were immigrants. Thirty percent of individuals reported not being aware of the availability of PEP. After multiple adjustment, factors associated with lack of PEP awareness were a low educational level, unemployment, older age, and CD4 cell counts<200. In addition, homosexual men showed a higher level of PEP awareness compared with the other participants, especially when compared with immigrant heterosexual men and women. Individuals who reported having unprotected sex with a non-HIV-positive steady partner also independently showed lower levels of PEP awareness. Finally, reporting having casual partners was associated with better awareness. CONCLUSION: Awareness of PEP is insufficient among PLHAs, especially among immigrants. Programmes aimed at improving positive prevention among PLHAs are much needed and should be promoted.

Adult↗

PubMed2001

Cross sectional study of young people's awareness of and involvement with tobacco marketing.

OBJECTIVES: To examine young people's awareness of and involvement with tobacco marketing and to determine the association, if any, between this and their smoking behaviour. DESIGN: Cross sectional, quantitative survey, part interview and part self completion, administered in respondents' homes. SETTING: North east England. PARTICIPANTS: Stratified random sample of 629 young people aged 15 and 16 years who had "opted in" to research through a postal consent procedure. RESULTS: There was a high level of awareness of and involvement in tobacco marketing among the 15-16 year olds sampled in the study: around 95% were aware of advertising and all were aware of some method of point of sale marketing. Awareness of and involvement with tobacco marketing were both significantly associated with being a smoker: for example, 30% (55/185) of smokers had received free gifts through coupons in cigarette packs, compared with 11% (21/199) of non-smokers (P<0.001). When other factors known to be linked with teenage smoking were held constant, awareness of coupon schemes, brand stretching, and tobacco marketing in general were all independently associated with current smoking status. CONCLUSIONS: Teenagers are aware of, and are participating in, many forms of tobacco marketing, and both awareness and participation are associated with current smoking status. This suggests that the current voluntary regulations designed to protect young people from smoking are not working, and that statutory regulations are required.

Adolescent↗

PubMedDate not supplied

Training to improve awareness of disabilities in clients with unilateral neglect.

OBJECTIVE: Awareness of disabilities is known to be a central problem of rehabilitation among clients with large right cerebrovascular lesions and unilateral neglect. The aim of this study was to evaluate the effect of an intervention program focused on improving the awareness of disabilities in four participants with unilateral neglect. The intervention program developed for this study was based on the assumption that awareness of disabilities is a prerequisite for being able to learn and use compensatory techniques in the performance of activities of daily living (ADL). METHOD: The study followed a single-case experimental ABA design. The Assessment of Awareness of Disability was used to measure awareness of disabilities; the Assessment of Motor and Process Skills was used to measure ADL ability; and neuropsychological tests were used to assess unilateral neglect and sustained attention. The intervention program used meaningful and purposeful occupations as therapeutic change agents to improve awareness of disabilities. RESULTS: Awareness of disabilities and ADL ability improved in all four participants; unilateral neglect decreased in three participants; and sustained attention improved in two participants. CONCLUSION: The preliminary findings indicate that training to improve awareness of disabilities might improve the ability to learn the use of compensatory techniques in the performance of ADL in clients with unilateral neglect. The effects of the intervention strategy need to be evaluated further in future research.

Aged↗

PubMedDate not supplied

The awareness and use of Canada's Physical Activity Guide to Healthy Active Living.

BACKGROUND: With the recent release of Canada's Physical Activity Guide to Healthy Active Living (CPAG), there is a need to identify the extent to which the population is aware of and using the guide. The purpose of this study was to report on population awareness and use of the CPAG, and secondarily to determine if demographic variables (i.e., age, sex, ethnicity, household income, educational level) moderate the awareness and use of the CPAG. METHODS: In a large recreation survey, questionnaires were mailed to 10,000 randomly selected households in Alberta. A respondent from each household was self-selected based on which member, 18 years or older, would celebrate the next birthday. Two questions pertaining to the awareness and use of the CPAG were included. RESULTS: Responses were received from 2,719 Albertans. Of those responding, 20.7% (95% CI, 19.2-22.2) stated they were aware of the CPAG and 5.5% (95% CI, 4.7-6.3) had actually followed the recommendations in the guide. Gender and educational level were significant moderators of awareness and use of the CPAG. CONCLUSIONS: The implications of these findings are that the majority of the Canadian population is not aware of the CPAG. Furthermore, certain segments of the population are less aware of the guide than others.

Adolescent↗

PubMedDate not supplied

Awareness about the persons with disability act among leprosy patients and other disabled persons.

To assess the level of awareness about the different provisions of the Persons with Disability Act (PWD Act) among leprosy patients and other disabled, 233 disabled persons from the self-help groups formed by Vadathorasalur Leprosy Control Unit have been interviewed using a structured interview checklist. The results show that 74.7% of the respondents were aware that identity cards are available for the disabled, 56.2% were aware of the free education benefit to the disabled, as low as 35.6% were aware of the scholarships, 33% knew about the employment reservations, 24.9% heard about the housing scheme of the government for the disabled, but 24.5% only knew about law against discrimination, 31.8% came in contact with institutions for the severely disabled and only 16% were aware of the unemployment allowance to the disabled. The level of awareness is low among women with regard to all components of the Act. It was found that students studying up to secondary level were not aware of the availability of scholarships and free education, which needs to be seriously looked into, especially by educational institutions. The level of formal education played a significant role in increasing awareness about the Act among literates. The knowledge is low among persons of all occupations. The study showed that there is a great need for an educational intervention programme to publicize the provisions of the Act among the disabled and their families.

Adolescent↗

PubMed1988

Syrup of ipecac awareness: the use of a survey to direct future education efforts.

Syrup of ipecac awareness has been a major educational endeavor of our poison center for nearly 15 years. Educational efforts have been widespread and not directed specifically at any demographic population. A telephone survey was developed to determine our effectiveness in creating awareness and to identify demographic trends which would direct our future efforts. Respondents were randomly selected from the metropolitan telephone directory. Four hundred surveys were completed. The data was analyzed for statistical significance using chi square. The demographic background of the respondents compared favorably with that published by the Census Bureau. Fifty and six tenths percent were aware of syrup of ipecac. Age groups between 30-59 were more aware of ipecac than younger or older groups. Females were more aware of ipecac than males (37% vs 2%). There was a direct relationship between the number of years of education and ipecac awareness (college 62%, high school 49%, non-high school 37%). Married and divorced respondents had a higher awareness than single individuals (56% vs 38%). Respondents with working spouses had greater awareness than those with unemployed spouses (65% vs 43%). Twenty-four percent claimed to have ipecac in their home at the time of the survey. This provides significant insight for future direction with our educational efforts.

Adult↗

PubMed1998

Conditioning, awareness, and the hippocampus.

For the past 50 years, psychologists have wrestled with questions regarding the relationship between conscious awareness and human conditioned behavior. A recent proposal that the hippocampus mediates awareness during trace conditioning (Clark, Squire, Science 1998;280:77-81) has extended the awareness-conditioning debate to the neuroscience arena. In the following commentary, we raise specific theoretical and methodological issues regarding the Clark and Squire study and place their finding into a broader context. Throughout our discussion, we consider the difficulties in assessing subjective awareness, the importance of establishing necessary and sufficient conditions for cognitive mediation effects, the influence of conditioned response modality, and the nature of hippocampal requirements across conditioning protocols. It is clear that trace eyeblink conditioning is a hippocampal-dependent task, but whether awareness is a necessary component of trace conditioning is not definitively proven. We propose that future functional neuroimaging studies and behavioral experiments using on-line measures of awareness may help clarify the relationship among classical conditioning, awareness, and the hippocampus.

Animals↗