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The concepts awareness, wakefulness, and arousal are compared, and some neurophysiological and neuropsychological studies of awareness are described. The different studies are suggested to show that awareness depends on neural activity of the cerebral cortex, but the relationship between cortical activity and awareness is found to be conditional. Consequently, the presence of awareness can only be established with behavioural methods.
Mass polio immunisation campaign was launched in the national capital territory of Delhi with 2 doses of polio vaccine to be administered to children upto 3 years of age on October and December 4, 1994 respectively. Massive information, education & communication (IEC) efforts through mass media and interpersonal communication preceded the dates of the campaign. A study to assess the awareness of general population was carried out by interviewing 225 adult residents of Delhi using a structured questionnaire. These were drawn by two stage stratified random sampling. Zonewise assembly segments in the first stage and census enumeration blocks in the second stage formed the sampling frame. The study, carried out 3 days prior to date of administration of first dose of oral polio, revealed that 60.4% of population was aware of the programme being launched and 31.6% about aim of the programme. None of the respondents were aware of all the specific parameters put together correctly viz., objective, immunisation days, age group & immunisation status of children. The higher level of awareness was directly proportional to the level of education. The overwhelming success of the programme was indicated by immunisation of > 90% children upto 3 years of age all over Delhi in the first phase of the programme. The key to success of the programme despite low awareness is explained on the basis of unflinching efforts put in by vaccine centre level committees, integrated child development scheme (ICDS) and urban basic service (UBS) functionaries in mobilising people to reach various vaccination centres. Other states planning to launch such mass campaigns should pay attention to social mobilisation in addition to IEC efforts for successful completion of the programme.
Intraoperative awareness has been reported to occur in 0.8-5.0% of paediatric patients undergoing anaesthesia and, therefore, seems to be more common than in adults (incidence 0.1-0.2%). In adult patients, the consequences of intraoperative awareness are well known and can be severe, in children, however, they have not yet been adequately studied. The causes for intraoperative awareness can be divided into three broad categories: First, no or only a light anaesthetic is given on purpose, second, an insufficient dose of an anaesthetic is given inadvertently, third, there is equipment malfunction or the anaesthesiologist makes an error. Unfortunately, especially in young children, painful interventions are still performed without adequate analgesia, e.g. awake intubation or fracture manipulation under midazolam sedation alone. The key issue is, however, that pharmacokinetics and pharmacodynamics change enormously from the 500 g preterm baby to the adolescent patient. Adequate dosing is much more difficult in paediatric patients compared to standard adult surgical patients. Solid knowledge of the pharmacokinetic and pharmacodynamic characteristics of commonly used drugs in different paediatric age groups, as well as aiming for perfection in daily care will help to reduce the incidence of awareness. Methods for monitoring the depth of hypnosis, e.g. the bispectral index, will be used increasingly, at least in children above 1 year of age. In addition to clinical parameters, they will hopefully help to further reduce the incidence of intraoperative awareness.
RATIONALE: Explicit memory (EM) is the memory for events which occurs with full awareness of where and how the recalled events took place, whereas implicit memory (IM) is the memory which is unfolded without any awareness of these events and usually becomes apparent when performance is facilitated by its presence. These two types of memory can be understood as different systems. Findings attempting to differentiate between the two systems in normal subjects have been controversial, with some researchers arguing that there is a single memory system and only the match in processes used during learning and later at retrieval can be important. OBJECTIVES: The present study compared the effects of alcohol (0.8 g/kg) or placebo administered prior to encoding and/or retrieval on measures of explicit and implicit memory in terms of recollective experience and familiarity. METHODS: At encoding subjects studied a list of 80 words presented in pairs. At retrieval, participants first carried out an implicit stem completion task, followed by an explicitly cued recall task (stem completion) which measured IM and EM respectively. After stem completion participants were required to indicate whether the items from the studied list were consciously recollected ("remember" response) or was known for a fact that were presented in the studied list ("know" response). In the IM task completed items from the studied list but not recognised by the subjects as such indicated memory without awareness. Studied items were of high and low associations. Forty-eight participants were tested in one of four drug conditions: alcohol-alcohol, placebo-placebo, placebo-alcohol, alcohol-placebo. RESULTS: In the implicit stem completion task, alcohol did not affect overall correct completion rates. However, participants who received alcohol prior to encoding reported lower awareness of correctly completed study items. In the cued recall task, alcohol also did not affect overall performance. However, participants in the same drug-state conditions (SS) reported greater recollection than familiarity with study material, whereas participants who encoded and retrieved material in different drug-state conditions (DS) reported recollection and familiarity to the same extent. In addition, DS participants showed more familiarity with study material compared to SS participants. Direct comparisons between IM and EM tasks demonstrated that alcohol at retrieval decreased the cued recall of items from high associations compared to placebo, but did not have any effect on implicit stem completion. CONCLUSIONS: In summary, these results demonstrate a dissociation of alcohol effects on measures of EM and IM. Alcohol administered prior to encoding reduced awareness of implicitly retrieved material, but did not impair IM per se, confirming previous findings with alcohol. In addition, the data provided new evidence for state-dependent retrieval effects on EM but not IM. It was also shown that for explicitly retrieved items, recollective experience benefits from same drug state, whereas familiarity benefits from different drug state between encoding and retrieval.
Subjects' awareness of motor corrections was investigated in a double-step pointing task. An unpredictable lateral target displacement of 10 cm, either left or right, during an ongoing reaching movement led to corrections of the trajectory. Subjects were required either to follow the target (pointing) or move in the opposite direction (anti-pointing). The target jump elicited rapid corrections to the movement in the direction of the target shift. These corrections were in some sense involuntary as they sometimes occurred in anti-point trials, when subjects were instructed to correct in the opposite direction to the target jump. The instructed correction away from the target in anti-point trials occurred later than the correction towards the target in standard pointing. Subjects were also asked to report their awareness of the motor correction they had just made by immediately reproducing each movement. In normal pointing, subjects showed reduced and delayed awareness, suggesting that the corrections were at least partly automatic. Anti-pointing corrections did not show this dissociation between performance and awareness. We suggest that anti-point corrections, but not standard pointing corrections, involve an additional supervisory system. This system is characterised by its slow operation and its access to conscious awareness.
An experiment was conducted to evaluate whether awareness of change in frontalis muscle activity was necessary and sufficient for voluntary control over the muscle. Forty subjects were required to relax, tense and complete both a test of awareness and an isometric magnitude production task, using the frontalis muscle. Following the completion of these pre-training assessment procedures, one group of subjects underwent either: Training in muscular awareness; biofeedback training in muscular control; both awareness and muscular control training; or a non-training control procedure. Following training, all subjects were again evaluated using the pre-training assessment procedures. The results indicated that an increase in awareness was not sufficient to produce an increase in muscular control, nor was it necessary for an increase in the ability to tense the frontalis muscle. These results suggest that Brener's model of voluntary control needs to be re-examined.
Using the dipole-tracing method, the source generators of N18, P22 and P40 of the somatosensory evoked potential (SEP) were estimated as the equivalent dipole. After voluntary action of the thumb flexion, no changes were observed in N18 or P40, but the amplitude of P22 was suppressed. The after-effects of intention accompanied by a voluntary action or the subject's awareness that electrical stimulation will be given after the voluntary action were treated as 'awareness'. By subtracting the pure SEP from SEP during 'awareness', it was found that the equivalent dipole of 'awareness' of P22 was located at the same region of pure P22, but the vector was of opposite orientation. 'Awareness' attenuated the perceptive potential of SEP like P22 generated in the cortex.
BACKGROUND: This study examines the relationship between awareness, treatment and control of hypertension, and health-related quality of life (HRQL) among older adults in Spain. METHODS: We conducted a cross-sectional study that included 3368 subjects representative of the Spanish population > or = 60 years of age. We assessed HRQL using the MOS 36-Item Short Form (SF-36) questionnaire, and blood pressure (BP) was measured under standardized conditions. Data were analyzed using linear regression, adjusted for HRQL predictors (age, educational level, tobacco use, alcohol consumption, body mass index, physical activity, number of chronic diseases, and social support). RESULTS: Neither hypertension nor antihypertensive drug treatment or control were associated with worse HRQL. These results were also observed for awareness of hypertension among men, but in women awareness of hypertension was associated with a statistically significant (P < .01) and clinically relevant reduction (a 4- to 7-point lower score) in all HRQL dimensions. This association remained in evidence on many SF-36 scales, even after additional adjustment for medical advice to lose weight, reduce salt intake, increase physical activity, and moderate alcohol consumption. After further adjustment for prescription of antihypertensive drugs, however, the association between hypertension awareness and HRQL lost statistical significance, declining by >30% on most SF-36 scales. CONCLUSIONS: Neither hypertension nor antihypertensive drug treatment or control appears to lower HRQL in the elderly Spanish population. Yet, among women, awareness of hypertension is associated with lower HRQL, irrespective of change of lifestyle recommended by the physician. The impact of hypertension labeling on HRQL might be attributable in part to prescription of antihypertensive drugs.
Several forms of dietary learning have been identified in humans. These include flavor-flavor learning, flavor-postingestive learning (including flavor-caffeine learning), and learned satiety. Generally, learning is thought to occur in the absence of contingency (CS-US) or demand awareness. However, a review of the literature suggests that this conclusion may be premature because measures of awareness lack the rigor that is found in studies of other kinds of human learning. If associations do configure outside awareness then this should be regarded as a rare instance of automatic learning. Conversely, if awareness is important, then successful learning may be governed by an individual's beliefs and predilection to attend to stimulus relationships. For researchers of dietary learning this could be critical because it might explain why learning paradigms have a reputation for being unreliable. Since most food preferences are learned, asking questions about awareness can also tell us something fundamental about everyday dietary control.
The present experiment investigates the involvement of awareness in functional dissociations between explicit and implicit tests. In the explicit condition, participants attempted to recall lexically or semantically studied words using word stems. In the implicit condition, they were instructed to complete each stem with the first word which came to mind. Subjective awareness was subsequently measured on an item-by-item basis. As voluntary retrieval strategies are known to be time consuming, the time taken to complete each stem was recorded. In the explicit task, semantically studied words were associated with higher levels of recall and faster response times than lexically studied words. By contrast, in the implicit task, these effects failed to reach significance, although deep encoding made the contents of memory more accessible to awareness. As expected, performance was slower in the explicit than in the implicit task, but in the latter condition, times to produce old words with and without awareness were comparable, and both of these responses were produced more quickly than control words. This finding suggests that although participants may become aware in implicit paradigms, they do not adopt voluntary retrieval strategies.
have shown a small but significant impairment of autonoetic awareness or remembering involved in the episodic memory experiences of adults with Asperger's syndrome. This was compensated by an increase in experiences of noetic awareness or knowing. The question remains as to whether the residual autonoetic awareness in Asperger individuals is qualitatively the same as that of typical comparison participants. Three experiments are presented in which manipulations that have shown differential effects on different kinds of conscious awareness in memory in typical populations are employed with a sample of adults with Asperger's syndrome. The results suggest that the experiences of remembering reported by such individuals, although reduced in quantity, are qualitatively similar to those seen in the typical population. The results are discussed in the context of current theories of awareness in episodic memory.
OBJECTIVE: To determine critical issues for future awareness programmes on peripheral arterial disease (PAD). DESIGN: National Dutch survey. MATERIALS AND METHODS: A representative sample of 1294 members of the general population, and 281 patients with PAD from the Capi@home database were administered a questionnaire concerning awareness of PAD. RESULTS: The response rate was 81% for the general population and 78% for patients with PAD. The familiarity with PAD terminology and symptoms amongst the general population was low. Few patients (20%) were aware that PAD was a disease of arteries. Amongst both the general population and the patient populations, PAD risk factors identification was low: hypertension (4% versus 0%); hypercholesterolaemia (9% versus 12%), diabetes (2% versus 8%), and smoking (27% versus 52%). Knowledge was moderate in both populations about treatment with exercise, but low for smoking cessation. The general population was unaware of the central role of general practitioners in the treatment of PAD. CONCLUSIONS: The awareness of symptoms, risk factors, and treatment options for PAD is low. Both population and patients needed only minimal information to relate PAD to other atherosclerotic diseases. Based on the results of this survey the Dutch Platform of Peripheral Arterial Disease together with the Dutch Heart Foundation are initiating the first awareness campaign on atherosclerosis.
PURPOSE: The purpose of this study was to examine exposure, response to, and awareness of beer advertising in 2 age groups, including awareness of a Budweiser advertisement (ad) that portrayed lizards and an animated ferret. METHODS: In the spring of 2000, 1,996 fourth graders and 1,525 ninth graders attending 1 of 60 South Dakota schools participated in an in-school survey. Several indicators of advertising awareness, exposure, and response were assessed: recognition, product naming, brand naming, and liking in response to stills drawn from 4 masked television beer ads, listing of beer brands, exposure, attention to, and skepticism toward television beer ads. RESULTS: Fourteen percent of 4th graders and 20% of 9th graders recognized at least 3 of 4 sample beer ads. Seventy-five percent of 4th graders and 87% of 9th graders recognized the Budweiser ferret ad; about one in three 4th graders could name the brand it advertised, whereas more than three in four 9th graders could do so. When asked to list as many beer brands as they could, almost 29% of 4th graders listed 3 or more beer brands and 82% of 9th graders did so. Ninth graders liked beer advertisements more and paid greater attention to them, but 4th graders were exposed to them more often. CONCLUSION: Television beer ads result in high levels of beer advertising awareness in children as young as age 9, and even higher awareness among 14-year-olds. Practices that expose or appeal to youth, including use of animated characters, should be avoided by beer advertisers.
Using Mennin, Heimberg, Turk, and Fresco's [Emotion regulation deficits as a key feature of generalized anxiety disorder: Testing a theoretical model, submitted for publication] conceptualization of generalized anxiety disorder (GAD) as a syndrome involving emotion dysregulation and an overuse of cognitive control strategies, this study sought to differentiate individuals with GAD from controls by offering differences in emotional awareness as one of the central distinctions between these groups. This study employs the Levels of Emotional Awareness Scale (LEAS) [Lane et al., 1990Lane, R. D., Quinlan, D. M., Schwartz, G. E., Walker, P. A., & Zeitlin, S. B. (1990). The Levels of Emotional Awareness Scale: a cognitive-developmental measure of emotion. Journal of Personality Assessment, 55, 124-134] a rater-coded measure, to assess level of emotional awareness, a methodological improvement over previous tests of the model, which relied upon self-report. Individuals with GAD scored significantly higher than controls on emotional awareness. These findings are discussed in light of the theoretical implications for GAD.
BACKGROUND: There has been increasing recognition of the detrimental effect of peripheral arterial disease (PAD) on the health of Americans, and yet there is no common national program of public PAD education designed to diminish this effect. FORMAT: To heighten awareness of this problem, a 2-day PAD Public Education Strategy Meeting was recently attended by representatives of 17 professional societies and public health associations whose missions support the prevention, diagnosis, treatment, and rehabilitation of vascular diseases. This Public Education Strategy Meeting was intended to provide the rationale and structure to create a national PAD public awareness campaign to diminish the health effect of PAD and to improve cardiovascular outcomes in the United States. This document (1). provides the rationale for creation of a national PAD public education program; (2). reviews the development and success of national hypertension, hypercholesterolemia, and Women's Heart Health public education programs as models of educational efficacy; (3). elucidates how the work of many vascular professionals has led to a national consensus for creation of a national PAD public educational program; (4). provides an overview of the National Heart, Lung, and Blood Institute PAD education meeting; and (5). outlines the "next steps" required to accomplish these goals. OUTCOME: This meeting achieved consensus that we share responsibility for developing accurate, unified messages to promote PAD awareness and improved care. Participants agreed that the creation of such messages should be linked to plans to disseminate them to all Americans at risk. A consensus was reached that such messages, when commonly created and offered to the public, are most likely to achieve the rewards in better health that all Americans deserve. The Vascular Disease Foundation, a not-for-profit foundation whose mission includes public education about the prevention, diagnosis, treatment, and rehabilitation of PAD, will devote its resources to guide a new coalition in this process and to create a national PAD awareness campaign. During 2003 and 2004, the coalition will create the organizational underpinnings and time line for what will undoubtedly be a multiyear effort. CONCLUSION: Participants of the Public Education Strategy Meeting agreed to create a broad coalition to develop a National PAD Public Awareness Program, with the objectives to develop and disseminate public education massages on PAD. A successful national PAD education program will contribute to creation of a broader mandate to improve global cardiovascular health in the United States.
The ability to detect an error in one's own performance and then to improve ongoing performance based on this error processing is critical for effective behaviour. In our event-related fMRI experiment, we show that explicit awareness of a response inhibition commission error and subsequent post-error behaviour were associated with bilateral prefrontal and parietal brain activation. Activity in the anterior cingulate region, typically associated with error detection, was equivalent for both errors subjects were aware of and those they were not aware of making. While anterior cingulate activation has repeatedly been associated with error-related processing, these results suggest that, in isolation, it is not sufficient for conscious awareness of errors or post-error adaptation of response strategies. Instead, it appears, irrespective of awareness, to detect information about stimuli/responses that requires interpretation in other brain regions for strategic implementation of post-error adjustments of behaviour.
OBJECTIVE: As in all chronic diseases, providing patients with necessary information about Diabetes Mellitus (DM) and educating them are the best method of control of DM and preventing further complication. The aim of this study was to investigate the awareness of DM and related factors in diabetics. METHODS: This cross-sectional study was conducted in four health centre areas of Ankara (n = 96,348) between 1997 and 2000. In these areas, the researches were visited every home and detected the total of 2136 diagnosed patients with DM. 62.5% of diabetics (1334) participated in the study in which a face-to-face interview was conducted to fill in a questionnaire followed by eye examination and fasting blood glucose level testing. Chi-square test and logistic regression analyses were performed to investigate the relationships between factors. RESULTS: Statistical analysis has shown that mean age of respondents was 57.4 +/- 10.9 years and majority were female (67.9%) and older onset DM (96.6%). Mean duration of DM was 7.8 +/- 6.5 years. Only 28.6% of patients (n = 382) have had informed about DM. The main information resource was found to be hospitals (76.4%), then media 19.1% and primary health care centers (PHCC) 3.9%. Patients who graduated from university were 13.5 times; who were under 50 years of age were 1.92 times; who have had prior eye examination were 1.84 times and who had co-morbidities were 1.52 times more likely to have informed about DM than the other groups. CONCLUSION: Awareness of DM amongst diabetics is very low and mainly determined by their education levels. The PHCC play a very small role in dissemination of information towards diabetics. PRACTICE IMPLICATIONS: Results from this study have implications for patient education efforts. Accurately, clinicians need to strive to improve overall levels of patients' awareness and knowledge of their specific conditions, regardless of their literacy. Many opportunities exist for raising diabetic's awareness of their disease and linking diabetic's growing health awareness with those health promoting behaviors known to reduce morbidity and mortality.
The input to visual processing consists of an undifferentiated array of features which must be parsed into discrete units. Here we explore the degree to which conscious awareness is important for forming such object representations, and for updating them in the face of changing visual scenes. We do so by exploiting the phenomenon of motion-induced blindness (MIB), wherein salient (and even attended) objects fluctuate into and out of conscious awareness when superimposed onto certain global motion patterns. By introducing changes to unseen visual stimuli during MIB, we demonstrate that object representations can be formed and updated even without conscious access to those objects. Such changes can then influence not only how stimuli reenter awareness, but also what reenters awareness. We demonstrate that this processing encompasses simple object representations and also several independent Gestalt grouping cues. We conclude that flexible visual parsing over time and visual change can occur even without conscious perception. Methodologically, we conclude that MIB may be an especially useful tool for studying the role of awareness in visual processing and vice versa.