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PubMed2004

Increased awareness, knowledge and utilization of preconceptional folic acid in Israel following a national campaign.

BACKGROUND: To decrease the risk of neural tube defects (NTDs), the Israeli Ministry of Health (MOH) issued guidelines in August 2000 recommending daily folic acid (FA) supplementation for women in their childbearing age, and concurrently launched a national FA campaign. Campaign effects were assessed by comparing the results of a survey done in 2002 with a baseline survey done in June 2000. METHODS: Both surveys were done within the network of the Public Health Services' Mother and Child Health Clinics (MCHC). Nursing staff conducted structured interviews of pregnant women and mothers of newborn infants. RESULTS: In the 2002 survey (n = 1661), awareness was 85%, correct knowledge was 77.7% and 30.5% utilized FA preconceptionally. Ratios of awareness, knowledge and utilization were highest among women with post-university education (93%, 84%, 46%), and awareness and utilization were significantly higher in the 25-29 year age bracket (90%, 35%). In the baseline 2000 survey (n = 1719), FA awareness had been 54.6%, knowledge of the benefits of FA was 17.6% and preconceptional utilization was reported by a mere 5.2%. CONCLUSIONS: A national periconceptional FA campaign in Israel resulted in significant increases in awareness and correct knowledge, and a sixfold increase in its intake.

Age Factors↗
PubMed2004

Greek employee awareness of carcinogenic exposure.

BACKGROUND: Occupational risk factors contribute significantly to the development of lung cancer; however, little is known about the extent to which employees are informed of occupational exposure to carcinogenic substances. METHODS: Through a case-control study, we estimated the level of awareness among Greek employees potentially exposed to known carcinogenic substances within various occupational settings. RESULTS: Only 6.6% of men (n = 482) employed in occupations with potential exposure to carcinogenic substances were aware of such occupational exposures. Age, education, and residence were significantly associated with awareness. Employees having at least a secondary level of education were 3.5 times more aware than those having at most 6 years of educational training. CONCLUSIONS: Assessing awareness among workers potentially exposed to occupational risk factors and promoting occupational health education are important steps for increasing health and safety at the workplace.

Arsenic↗
PubMed1997

Menopausal hormone therapy: physician awareness of patient attitudes.

BACKGROUND: Physicians need to be aware of their patients' attitudes toward menopause when counseling women regarding hormone therapy, because menopausal attitudes may affect women's satisfaction with their decisions to use or not to use hormone therapy. Our objectives were to assess physician awareness of patient attitudes on issues surrounding the menopause and hormone therapy, and to determine the prevalence and correlates of hormone use. METHODS: This cross-sectional survey study was conducted in the primary care outpatient practices of an academic medical center. Surveys were simultaneously administered to female patients aged 50 to 70 years (n = 182) and their primary care physicians immediately after clinical encounters. The surveys contained questions from four established (five-point) attitudinal scales (autonomy, desire for information, philosophy of the menopause, barriers to use of hormone therapy), and questions addressing patients' degree of concern about developing various conditions. Physicians were asked to estimate their patients' attitudes. PATIENTS AND METHODS: Physicians were generally aware of patients' desire for autonomy (3.2 versus 3.2, P = 1.0), but tended to underestimate patients' desire for information (3.7 versus 4.5, P = 0.0001) and patients' perceptions of barriers to using hormone therapy (3.2 versus 3.4, P = 0.0001). They also underestimated the extent to which patients view menopause as a medical problem (3.0 versus 3.2, P = 0.0001). Physicians overestimated patients' general concern about heart disease (scale difference 0.40, P = 0.0001) and breast cancer (difference 0.23, P = 0.02). Physicians were less aware of their patients' attitudes when they were male (versus female), interns/residents (versus faculty/fellows), and less knowledgeable about menopausal hormone therapy (versus more knowledgeable). The significant predictors of hormone use on multivariate analysis were past hysterectomy, urinary incontinence, alcohol intake, and possession of knowledge regarding hormone therapy. CONCLUSIONS: Physicians incorrectly estimate some aspects of their patients' attitudes regarding menopause and hormone therapy, and certain physician characteristics may be associated with decreased awareness. To optimize hormone therapy counseling, physicians may need to increase their attention to patients' menopausal attitudes.

Adult↗
PubMed2001

Perceptual awareness and its loss in unilateral neglect and extinction.

We review recent evidence from studies of patients with unilateral neglect and/or extinction, who suffer from a loss of awareness for stimuli towards the affected side of space. We contrast their deficit with the effects of damage to primary sensory areas, noting that such areas can remain structurally intact in neglect, with lesions typically centred on the right inferior parietal lobe. In keeping with preservation of initial sensory pathways, many recent studies have shown that considerable residual processing can still take place for neglected or extinguished stimuli, yet without reaching the patient's awareness. This ranges from preserved visual grouping processes through to activation of identity, semantics and emotional significance. Similarly to 'preattentive' processing in normals, such residual processing can modulate what will enter the patient's awareness. Recent studies have used measures such as ERPs and fMRI to determine the neural correlates of conscious versus unconscious perception in the patients, which in turn can be related to the anatomy of their lesions. We relate the patient findings to neurophysiological data from areas in the monkey parietal lobe, which indicate that these serve as cross-modal and sensorimotor interfaces highlighting currently relevant locations as targets for intentional action. We speculate on the special role such brain regions may play in perceptual awareness, seeking to explain how damage to a system which appears primarily to code space could eliminate awareness even for non-spatial stimulus properties at affected locations. This may relate to the extreme nature of 'winner-takes-all' functions within the parietal lobe, and their correspondingly strong influence on other brain areas.

Awareness↗
PubMed1998

Awareness of diagnosis and psychiatric morbidity among cancer patients--a study from South India.

Awareness regarding cancer diagnosis and its relationship to psychiatric morbidity was studied in 294 newly admitted cancer patients at an oncology center in South India. Fifty-four percent of patients were aware that they had cancer and were able to discuss their diagnosis; 46% of patients reported nonawareness of diagnosis. Discriminant function analysis revealed that oral cancers and relatives' awareness of the cancer was more prevalent in the group aware of diagnosis. More patients in the "unaware" group refused treatment for psychological distress. There was no difference between the two groups in patterns and prevalence of psychiatric morbidity. The study emphasizes the complexities in assessing awareness in cancer patients and a need to study its various components and relationship to psychological distress.

Adaptation, Psychological↗
PubMed1999

Patient knowledge, awareness, and delay in seeking medical attention for malignant melanoma.

We investigated the relationship between patient knowledge, awareness, and delay in seeking medical attention for melanoma. The study population was comprised of 255 cases with cutaneous melanoma newly diagnosed during January 15, 1987 to May 15, 1989, who were part of a population-based case control study. Personal interviews were conducted to obtain information on patient's knowledge of melanoma signs and symptoms, skin awareness, delay in seeking medical attention, and related covariates. The adjusted odds ratio for the association between skin awareness and delay was 0.30 (95% confidence interval 0.12-0.71). Odds ratios ranged from 0.43 to 0.81 for knowledge and delay. Awareness of skin changes was associated with a reduced Breslow depth for stage I melanomas. Individuals who are aware of skin changes and abnormalities appear to be less likely to delay seeking medical attention for melanoma. Knowledge of melanoma signs and symptoms may also contribute to a decreased delay in melanoma diagnosis.

Adolescent↗
PubMed2002

Semantic priming: on the role of awareness in visual word recognition in the absence of an expectancy.

By hypothesis, awareness is involved in the modulation of feedback from semantics to the lexical level in the visual word recognition system. When subjects are aware of the fact that there are many related prime-target pairs in a semantic priming experiment, this knowledge is used to configure the system to feed activation back from semantics to the lexical level so as to facilitate processing. When subjects are unaware of this fact, the default set is maintained in which activation is not fed back from semantics to the lexical level so as to conserve limited resources. Qualitative differences in the pattern of data from two lexical decision experiments that employ masked priming are consistent with this hypothesis. Semantic context and stimulus quality interact when the prime is processed with awareness whereas these same two factors produce additive effects on RT when the prime is unlikely to have been processed with awareness. These experiments thus illustrate one way in which awareness (or lack thereof) affects the dynamics of visual word recognition.

Adult↗
PubMed2002

Right hemispheric self-awareness: a critical assessment.

In this commentary I evaluate the claim made by that since self-recognition results from right hemispheric activity, self-awareness too is likely to be produced by the activity of the same hemisphere. This reasoning is based on the assumption that self-recognition represents a valid operationalization of self-awareness; I present two views that challenge this rationale. Keenan et al. also support their claim with published evidence relating brain activity and self-awareness; I closely examine their analysis of one specific review of literature and conclude that it appears to be biased. Finally, recent research suggests that inner speech (which is associated with left hemispheric activity) is linked to self-awareness-an observation that further casts doubt on the existence of a right hemispheric self-awareness.

Awareness↗
PubMedDate not supplied

Reproductive health awareness: an important dimension to be integrated into existing sexual and reproductive health programs.

The ultimate goal of any sexual and reproductive health program is to ensure cost effectiveness, quality and sustainability. Reproductive health awareness is an educational approach which is both relevant and sensitive to many communities' existing sexual and reproductive health needs and concerns. When working with community groups, a participatory approach that includes reproductive health awareness concepts is a simple non-threatening way for programs to quickly expand beyond pure information giving and explore what reproductive health means to people. Although many community sexual and reproductive health programs do not the term reproductive health awareness, they use techniques similar to the reproductive health awareness education approach, when facilitating discussions about sexual or reproductive health. If reproductive health awareness is identified and included as one of the dimensions of future sexual and reproductive health programs, this will hopefully strengthen the program's overall quality and effectiveness.

Awareness↗
PubMed2003

Awareness of cancer information among Asian Americans.

The present study aimed to find the awareness level of cancer information among Asian Americans in the Delaware Valley region (Pennsylvania and South Jersey). A cross-sectional self-report survey was conducted with a sample of 1374 Asian Americans including Chinese, Korean, Vietnamese and Cambodians. The sample was collected by using a stratified-cluster proportional sampling technique. This paper assessed self-reported smoking behaviors, knowledge of smoking cessation methods, availability of health professional's advice in quitting smoking in the past 12 months, awareness of the National Cancer Institute's Cancer Information Service, knowledge of, and interest in participation in cancer clinical trials for identified Asian smokers. Overall, the level of awareness of cancer information services among the four subgroups was low. Among current and former smokers, only 31% had been advised by a health care professional to quit smoking. Forty-three percent used at least one smoking cessation method to quit in the past. The results also reveal an increased awareness level among those who had health insurance, higher education and were less likely to speak their native language. Significant differences on cancer awareness existed among the four ethnic groups as well. This study suggests urgent needs to educate Asian Americans about important cancer control issues and services and highlights the differences in baseline knowledge and attitudes among the various ethnic groups.

Asian↗
PubMed2003

Awareness, prior use, and intent to use emergency contraception among Montana women at the time of pregnancy testing.

OBJECTIVES: To identify factors associated with awareness of emergency contraception (EC), prior use of EC, and intent to use EC in the future among women at the time of pregnancy testing. METHODS: A convenience sample of women presenting for pregnancy testing and being found to be pregnant in 38 primary health care facilities completed a self-administered, anonymous questionnaire. Information regarding demography, pregnancy intentions, use of any contraception, awareness of EC, prior use of EC, and intent to use EC in the future was collected. RESULTS: Of the 583 women that completed the questionnaire, 62% were aware of EC, 4% had previously used EC, and 13% considered using EC in the future. Women aware of EC were more likely to be white, have > or = 12 years of education, and report use of birth control prior to the current pregnancy. Younger women, those with < 12 years of education, and those not currently living with a partner were more likely to have previously used EC. Women who considered using EC in the future were more likely to be younger, non-white, have < 12 years of education, not currently living with a partner, and their usual source of care was a public clinic. Women who considered using EC in the future were also more likely to not want to be pregnant now or ever (21%) compared to women who wanted to be pregnant now or sooner (12%), or with those who were unsure of their current pregnancy (7%). CONCLUSION: Strategies need to be developed to increase the awareness of EC and determine the factors that would assist in enhancing its utilization.

Adolescent↗
PubMed2004

A comparison of phonological awareness skills in early French immersion and English children.

This 2-year study examined the effects of early second language exposure on phonological awareness skills. Syllable, onset-rime and phoneme awareness skills of 72 anglophone children attending English or French immersion programs in primary and grade 1 were investigated. Three-way mixed ANOVAS revealed the following effects and interactions. In terms of grade effect, grade 1 students performed significantly better than primary students on phoneme and onset-rime tasks. A stimulus language effect was observed for the three levels of phonological awareness. All children performed better on English tasks than on French ones. Interaction effects of stimulus language by program were revealed for phoneme as well as syllable tasks. Posthoc analyses revealed that French students performed better on English phoneme and syllable tasks than on French, while English students performed better than French immersion students on French syllable tasks. Correlational analyses revealed significant relationships between reading and phoneme and onset-rime phonological awareness tasks regardless of program of instruction (English, French immersion) or language of reading test (English, French). Syllable awareness was only significantly correlated with the French non-word reading task for the French immersion students.

Age Factors↗
PubMed1997

A neuropsychological model relating self-awareness to hostility.

Neuropsychological advances may help researchers better understand the relationship between psychological constructs. This paper proposes a neuropsychological model explaining the negative relationship between hostility and "self-awareness," which has been suggested by previous research [H. A. Demaree and D. W. Harrison (1995a) "Behavioral, Physiological, and Neuropsychological Correlates of Hostility," manuscript submitted for publication; L. H. Epstein and P. A. Cluss (1982) "A Behavioral Medicine Perspective on Adherence to Long-Term Medical Regimes," Journal of Consulting and Clinical Psychology, Vol. 50, pp. 950-971; M. F. Scheier et al. (1974) "Self-Awareness and Physical Aggression," Journal of Experimental and Social Psychology, Vol. 10, pp. 254-273]. The authors review the role of the right cerebrum in both hostility and "self-awareness"--including arousal, perceptual, expressive, and integrative processes. Using identifiable tracts in the brain, the model suggests how deficits in "self-awareness"--poor awareness of physiological arousal, natural and emotional environment, etc.--may enhance the probability of hostility expression. This model is supported by previous empirical research and provides direction for future neuropsychological investigation.

Awareness↗
PubMed1979

Self-awareness and transgression in children: two field studies.

Two field studies explored the relationship between self-awareness and transgressive behavior. In the first study, 363 Halloween trick-or-treaters were instructed to only take one candy. Self-awareness induced by the presence of a mirror placed behind the candy bowl decreased transgression rates for children who had been individuated by asking them their name and address, but did not affect the behavior of children left anonymous. Self-awareness influenced older but not younger children. Naturally occurring standards instituted by the behavior of the first child to approach the candy bowl in each group were shown to interact with the experimenter's verbally stated standard. The behavior of 349 subjects in the second study replicated the findings in the first study. Additionally, when no standard was stated by the experimenter, children took more candy when not self-aware than when self-aware.

Awareness↗
PubMed1998

Parietal neglect and visual awareness.

The last decade has seen a resurgence of interest in the neural correlates of conscious vision, with most discussion focused on the 'blindsight' that can follow damage to primary visual cortex, in the occipital lobe. We suggest that new insights into the neural basis of visual awareness may be gleaned from a different neuropsychological phenomenon, namely visual 'neglect' after injury to regions in the parietal lobe. Neglect provides several revealing contrasts with occipital blindsight. Here we summarise four key findings. First, unlike the deficits caused by damage to primary visual cortex, the loss of awareness in parietal neglect is characteristically not strictly retinotopic. Second, visual segmentation processes are preserved in neglect, and can influence what will reach the patient's awareness. Third, extensive unconscious processing takes place for those stimuli on the neglected side which escape awareness, including some degree of object identification. Finally, parietal damage affects initial stages of motor planning as well as perception. These findings are consistent with recent data on single-cell activity in the monkey brain. They also suggest why areas in the inferior parietal lobe may play a prominent role in visual awareness.

Animals↗
PubMed2003

Awareness of hypertension guidelines in primary care: results of a regionwide survey in Italy.

Unsatisfactory blood pressure (BP) control so often described in treated hypertensive populations is also explained by insufficient physicians' awareness of experts' guidelines. We assessed awareness of current recommendations about hypertension management in a general practice setting, using the World Health Organization/International Society of Hypertension (WHO/ISH) 1999 guidelines as reference. In a regionwide survey, a total of 5133 physicians (three-quarters of all active general practitioners in Lombardy, a region of north-western Italy) were contacted by letter and received a multiple choice 10-item questionnaire. Data on physicians' demographic characteristics, information on hypertension prevalence and their perception of BP control among their patients were also requested in an additional form. The number of answers in agreement with WHO/ISH guidelines was used as an awareness measure. This was considered adequate if correct answers to six out of 10 questions, including an appropriate definition of hypertension, were provided. Of the 1256 returned questionnaires (a 24.5% response rate), 1162 were suitable for analysis. The mean score of correct answers was 5.3 points and only 20.1% of the study population correctly answered at least six of the questions (including that on the definition of hypertension in the elderly). Guidelines awareness was negatively related to increase in physicians' age and duration of clinical practice and by the male gender. Finally, the physicians reported a high rate of achieved BP control, and those who were considered to have achieved highest rates (>75%) of control in their patients had a lower rate of adequate knowledge than those who reported less-successful therapeutic results (18 vs 25%, P<0.01), suggesting that they ignored or disregarded the goal BP recommended by the guidelines. This large regional survey shows that a sufficient degree of guidelines awareness is present in a minority of primary-care physicians in the Italian region of Lombardy. Therefore, further efforts are required to intensify information strategies for improving professional education, training and practice organization aimed at achieving therapeutic goals. Physicians with longer duration of clinical practice represent a particularly relevant target group for these interventions.

Awareness↗
PubMed2006

Factors associated with hypertension awareness, treatment, and control in Ghana, West Africa.

Hypertension is rapidly becoming a major public health burden in sub-Saharan/Africa but awareness, treatment, and control is lagging behind. We analysed cross-sectional data from Ghana (West-Africa) to examine factors associated with awareness, treatment, and control of hypertension. The overall prevalence of hypertension was 29.4%. Of these, 34% were aware of their condition, 28% were receiving treatment, and 6.2% were controlled below SBP/DBP <140/90 mmHg. Multivariate analysis showed that old age was independently associated with higher hypertension awareness: 35-49-year-olds (odds ratio (OR) = 2.57, 95% (confidence interval) CI: 1.26-5.22), > or =50-year-olds (OR = 6.14, CI: 2.98-12.64) compared with 16-34-year-olds. Old age: > or =50-year-olds (OR: 6.25, 95% CI: 2.87-13.62), trading (OR = 2.46, 95% CI: 1.17-5.17), and overweight (OR = 1.85, 95% CI: 1.02, 3.34) were independently associated with pharmacological treatment of hypertension. Trading (OR = 2.51, 95% CI: 1.03-7.40) was independently associated with adequate blood pressure (BP) control but old age: > or =50-year-olds (OR = 0.11, 95% CI: 0.01-0.60) was independently associated with inadequate BP control. The identified factors provide important information for improving BP control among this population. Given the high cost of hypertension medication relative to income, increasing awareness and simple preventive measures such as promotion of physical activity, normalising body weight and reduction of salt intake, present the best hope for reducing the impact of hypertension on morbidity and mortality.

Adolescent↗
PubMed2006

Factors associated with hypertension awareness, treatment and control among ethnic groups in Amsterdam, the Netherlands: the SUNSET study.

We sought to determine factors associated with hypertension awareness, pharmacological treatment and control among ethnic groups in Amsterdam, The Netherlands. We analysed data on hypertensive subjects (Dutch n=130, Hindustani n=115 and African Surinamese n=225). After adjustments for important covariates, hypertension awareness was more common in Dutch people with abdominal obesity and family history of hypertension (FHH). Abdominal obesity was also associated with higher level of awareness in African Surinamese. Female sex, FHH and recent physician (general practitioner (GP)) visit were associated with higher level of awareness in both African and Hindustani Surinamese. Among the Dutch, hypertension treatment was more common in those with abdominal obesity, FHH and GP visit. Among Hindustanis, female sex, abdominal obesity and GP visit were positively associated with treatment of hypertension. Old age, female sex, FHH and GP visit were positively associated, whereas smoking was negatively associated with lower treatment in African Surinamese. High education and more physical activity were associated with better blood pressure (BP) control, whereas obesity was associated with poor BP control among the Dutch. Among African Surinamese, female sex and FHH were associated with better BP control, whereas abdominal obesity was associated with poor BP control. Only old age was associated with poor BP control in Hindustanis. In conclusion, our findings indicate that more attention is needed in promoting awareness and treatment among those with lower hypertension risk (i.e., normal body weight people and those without FHH), those without recent GP visits in all ethnic groups and African and Hindustani Surinamese men and smokers. More effort is also needed in hypertension control among Dutch people with low education, obesity and inadequate physical activity, African Surinamese men and those without FHH and old Hindustani people.

Adult↗