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PubMed2007

Characteristics of speech errors produced by children with and without delayed phonological awareness skills.

PURPOSE: The purpose of this study was to examine the relationship between the types of speech errors that are produced by children with speech-sound disorders and the children's phonological awareness skills during their prekindergarten and kindergarten years. METHOD: Fifty-eight children with speech-sound disorders were assessed during the spring of their prekindergarten year and then again at the end of their kindergarten year. The children's responses on the Goldman-Fristoe Test of Articulation (R. Goldman & M. Fristoe, 2000) were described in terms of match ratios for the features of each target sound and the type of error produced. Match ratios and error type frequencies were then examined as a function of the child's performance on a test of phonological awareness. RESULTS: Lower match ratios for +distributed and higher frequencies of typical syllable structure errors and atypical segment errors were associated with poorer phonological awareness test performance. However, no aspect of the children's error patterns proved to be a reliable indicator of which individual child would pass or fail the test. The best predictor of test performance at the end of the kindergarten year was test performance 1 year earlier. Children who achieved age-appropriate articulation skills by the end of kindergarten also achieved age-appropriate phonological awareness skills. CONCLUSION: Children who enter kindergarten with delayed articulation skills should be monitored to ensure age-appropriate acquisition of phonological awareness and literacy skills.

Articulation Disorders↗
PubMed2006

Longitudinal predictors of implicit phonological awareness skills.

PURPOSE: The purpose of this study was to examine the longitudinal predictive relationships among variables that may contribute to poor phonological awareness skills in preschool-age children with speech-sound disorders. METHOD: Forty-seven children with speech-sound disorders were assessed during the spring of their prekindergarten year and again at the end of their kindergarten year. Hierarchical multiple regression analysis was used to examine relationships among the children's prekindergarten and kindergarten performance on measures of speech perception, vocabulary, articulation, and phonological awareness skills in order to verify a proposed developmental ordering of these variables during this 1-year period. RESULTS: Prekindergarten speech perception skills and receptive vocabulary size each explained unique variance in phonological awareness at the end of kindergarten. Prekindergarten articulation abilities did not predict unique variance in phonological awareness a year later. Prekindergarten speech perception skills also explained unique variance in articulation skills at the end of kindergarten. CONCLUSIONS: Maximizing children's vocabulary and speech perception skills before they begin school may be an important strategy for ensuring that children with speech-sound disorders begin school with age-appropriate speech and phonological awareness abilities.

Awareness↗
PubMed2005

Phonological awareness in deaf children who use cochlear implants.

A short-term longitudinal study was conducted to investigate possible benefits of cochlear implant (CI) use on the development of phonological awareness in deaf children. Nineteen CI users were tested on 2 occasions. Two groups of deaf children using hearing aids were tested once: 11 profoundly deaf and 10 severely deaf children. A battery of tests was designed to investigate syllable, rhyme, and phoneme awareness. Syllable awareness in the CI users was equivalent to that of the severely deaf group, and rhyme and phoneme awareness was similar to that of the profoundly deaf children using hearing aids. CI use affords some benefit to the development of phonological awareness. The results from this study indicate that this enhancement is first observable at the syllable level.

Awareness↗
PubMed2001

Awareness and understanding of dementia in African/Caribbean and South Asian families.

The objective of this study was to explore awareness, recognition and understanding of dementia symptoms in families of South Asian and African/Caribbean descent in the UK. In-depth, semistructured interviews were carried out with South Asian and African/Caribbean carers. Interview transcripts were analysed by coding the data into themes and investigating links between them, using the constant comparison approach of grounded theory. Thirty carers of a person with dementia of South Asian and African/Caribbean heritage were interviewed. Maximum variation sampling was used to include carers with a broad range of socio-demographic characteristics. Most participants were aware of the condition "dementia", but used different terms to describe the disorder. Many, however, had not heard of the condition before their relative developed it, suggesting general awareness of dementia is low. Difficulties can arise in the caring relationship due to a lack of understanding of the condition--in particular when family members place blame for the symptoms on the person with dementia. Conclusions of the study are that knowledge of dementia is limited, in terms of awareness of the condition as well as understanding of the causes. This research highlights the importance of raising dementia awareness and emphasises the importance of the provision of clear and understandable information, from health and social service providers.

Adult↗
PubMed1995

Tobacco smoking in young adults from 21 European countries: association with attitudes and risk awareness.

Information concerning tobacco smoking was obtained in a survey of 16,483 students aged 18-30 years from 21 European countries. Belief in the benefits to health of not smoking were also assessed. Risk awareness was measured in terms of knowledge of the links between smoking and disease. The overall age-adjusted prevalence of smoking was 33.1% in men and 29.0% in women, but wide variations were observed across country samples. Significant sex differences were found in only a minority of cases. The inclusion of respondents who stated that they had sometimes smoked in the past substantially reduced variations in prevalence across country samples. Beliefs in the health benefits of not smoking were consistently associated with smoking behaviour. Awareness of the link between smoking and lung cancer was uniformly high, but awareness of the role of smoking in heart disease varied considerably across country samples, and averaged only 64.4% in men and 62.9% in women. In the majority of countries, risk awareness was greater among smokers than non-smokers. The results suggest that in this selected sector of the population of young adults in Europe, sex differences in smoking are relatively minor, robust associations between attitudes and smoking behaviour can be identified, and there are major gaps in risk awareness.

Adolescent↗
PubMed2002

An international comparison of tobacco smoking, beliefs and risk awareness in university students from 23 countries.

AIMS: To assess the prevalence of current tobacco smoking, associations with beliefs about the health benefits of not smoking and awareness of risks for lung cancer and heart disease in university students sampled from 23 countries, and to explore the utility of the World Health Organization (WHO) model of the world-wide tobacco epidemic in understanding differences between countries. DESIGN: Anonymous questionnaire survey. PARTICIPANTS: A total of 19 298 university students (8482 men, 10 816 women) aged 17-30 years from 23 countries, studying courses unrelated to health. MEASUREMENTS: Standardized measures of smoking, wish to stop smoking, ratings of beliefs in the importance of not smoking for health and awareness of the influence of smoking on lung cancer and heart disease. FINDINGS: Prevalence varied widely, being highest in samples from South European countries and lowest in developing countries (Thailand, South Africa). The pattern of tobacco use and differences between men and women conformed largely to the WHO model. Health beliefs were associated strongly with smoking behaviour both within and between countries. Awareness of specific health risks of smoking was very variable, with particularly low levels in Asian, South American and developing country samples. Risk awareness was inconsistently related to behaviour. CONCLUSIONS: The pattern of tobacco smoking in well-educated young adults appears to conform with wider international patterns of tobacco use. Awareness of specific health risks is poor, and modifying attitudes must be a central element in modifying tobacco use world-wide.

Adolescent↗
PubMed2002

Awareness during general anaesthesia: a review of 81 cases from the Anaesthetic Incident Monitoring Study.

Because of recent studies suggesting that awareness is still a major issue in anaesthetic practice, we reviewed 8372 incidents reported to the Anaesthetic Incident Monitoring Study. There were 81 cases in which peri-operative recall was consistent with awareness. There were 50 cases of definite awareness and 31 cases with a high probability of awareness. In 13 of the 81 incidents, the patients appeared to receive adequate doses of anaesthetic drugs. Where the cause could be determined, awareness was mainly due to drug error resulting in inadvertent paralysis of an awake patient (n = 32) and failure of delivery of volatile anaesthetic (n = 16). Less common causes included prolonged attempts at intubation of the trachea (n = 5), deliberate withdrawal of volatile anaesthetic (n = 4) or muscle relaxant apnoea with inadequate administration of hypnotic (n = 3). An objective central nervous system depth of anaesthesia monitor may have prevented 42 of these incidents and an improved drug administration system may have prevented 32. On the basis of these reports, we have developed guidelines that may have prevented the majority of these incidents.

Anesthesia, General↗
PubMed2001

Police attitudes toward people with intellectual disability: an evaluation of awareness training.

It is argued that more favourable police attitudes to people with intellectual disability (ID) are essential in meeting the police code of ethics, which stresses impartiality and respect for human dignity. The need to acknowledge and investigate the extent of support for eugenic attitudes in other key professionals who have a significant role in the successful inclusion of people with ID in community settings is discussed. The present paper reports on the evaluation of an awareness training event conducted by the Royal Ulster Constabulary in terms of the impact on attitudes towards people with ID held by police officers. The quasi-experimental design involved the measurement of participants' attitudes prior to and following awareness training, and the comparison of these data with a control group of participants who did not undertake awareness exercises. The Attitudes toward Mental Retardation and Eugenics (AMRE) scale was the instrument used to measure attitudes. Analysis identified the presence of varying degrees of support for the application of eugenic principles to people with ID. Furthermore, the results indicate that participation in the awareness exercise and subsequent discussions is associated with a significant reduction in support for eugenic-based attitudes towards people with ID by the police officers involved. Investment in training events which target attitudes towards people with ID can bring about a shift in reported attitudes. The importance of evaluating such awareness-raising exercises and their impact on police behaviour is highlighted.

Adult↗
PubMed2001

Spatial awareness in urologists: are they different?

OBJECTIVE: To compare innate spatial awareness skills, using the MIST-VR system (Ethicon Ltd, Edinburgh, a computer-based virtual reality system that objectively tests spatial awareness) among three groups of people (consultant urologists, urological trainees and controls who were not surgeons), because urological surgeons require spatial awareness for endoscopic and laparoscopic surgery, but trainees are selected by academic prowess rather than surgical aptitude. SUBJECTS AND METHODS: The MIST-VR system was used to test 122 volunteers in three groups, i.e. 39 consultant urologists, 46 urological trainees and 37 controls (not surgeons). The demographic data recorded for each group included age, sex, eyesight, handedness, and endoscopic and laparoscopic experience. Volunteers performed a repetitive series of three tasks using the system. Their performance was measured in terms of time, errors and economy of movement, as well as the duration and accuracy of diathermy in Task 3. RESULTS: The consultants were significantly older than the trainees and controls (both P<0.001) and had more endoscopic experience (P=0.005). In Task 1, the trainees made significantly fewer errors (P=0.045) and had a greater economy of movement (P=0.03) than the controls. In Task 2 the trainees performed the task more rapidly than the consultants (P=0.04) and controls (P=0.02). Trainees were more economical in movement than were consultants (P=0.031) and controls (P=0.046). In the more complex Task 3, trainees outperformed consultants in terms of errors (P=0.03), economy of movement (P=0.046), total diathermy time (P=0.005) and diathermy error (P=0.03). Controls performed similarly to the consultants. Although there was a trend towards better performance by trainees over controls, this was only significant for time (P=0.04) and total diathermy time (P=0.011). A few participants had results that were >2 SD above the mean and several people could not complete Task 3. CONCLUSIONS: Urologists do not differ from the general population in terms of innate spatial ability in this setting. There are several people who may have a defect in spatial awareness but the incidence was the same in each group. Urological trainees outperformed consultants in these tasks; the reasons for this are unclear. The MIST-VR system is of no help in aptitude testing for urological trainees, although it may have a role in teaching laparoscopic surgery. Testing other psychometric components may be more important for acquiring surgical skills than innate spatial-awareness skills. Further studies are required to investigate this possibility.

Adult↗
PubMed2003

Hypoglycaemia in insulin-treated Type 2 diabetes: frequency, symptoms and impaired awareness.

AIMS: Hypoglycaemia is considered to be less common in people with insulin-treated Type 2 diabetes than in Type 1 diabetes. A retrospective survey was made of 215 people with insulin-treated Type 2 diabetes to quantify the frequency and nature of hypoglycaemia experienced. METHODS: The frequencies of mild (self-treated) and severe (required assistance) hypoglycaemia during the preceding year were estimated retrospectively. The usual symptoms of hypoglycaemia and state of awareness of hypoglycaemia were scored using validated questionnaires and any history suggestive of impaired hypoglycaemia awareness was documented. RESULTS: In this cohort, 157 (73%) had experienced hypoglycaemia since commencing insulin, the frequency of which increased with duration of diabetes and of insulin therapy and was inversely related to current HbA1c (all P < 0.05). During the preceding year, 32 individuals (15%) had experienced severe hypoglycaemia, with an estimated incidence for the entire group of 0.28 episodes/patient/year. Principal components analysis revealed two underlying symptom groups (autonomic and neuroglycopenic), similar to those reported previously by young adults with Type 1 diabetes, but the total symptom score declined with advancing age. Of the 157 with a history of hypoglycaemia, the 13 (8%) individuals who gave a history of impaired awareness of hypoglycaemia had experienced a ninefold higher incidence of severe hypoglycaemia than those with normal awareness, and reported experiencing mainly neuroglycopenic symptoms. CONCLUSIONS: While the overall frequencies of mild and severe hypoglycaemia were lower in insulin-treated Type 2 diabetes than have been reported previously in Type 1 diabetes, the risk of hypoglycaemia was greater with increasing duration of diabetes and of insulin therapy. Although impaired awareness of hypoglycaemia was uncommon, it was associated with a higher incidence of severe hypoglycaemia.

Adult↗
PubMed2002

Hyperventilation-induced high-amplitude rhythmic slowing with altered awareness: a video-EEG comparison with absence seizures.

PURPOSE: Hyperventilation-induced high-amplitude rhythmic slowing (HIHARS) in children may be associated with clinical episodes of altered awareness. The presence of automatisms has been proposed as a distinguishing feature that helps to differentiate absence seizures from nonepileptic causes of decreased responsiveness. This retrospective, controlled, video-EEG study compared the clinical characteristics of episodes of HIHARS with loss of awareness with those of absence seizures. METHODS: The database of a tertiary Children's Hospital was searched for patients studied between April 1993 and April 1997 who had at least one episode of HIHARS with loss of awareness. The absence control group was obtained by selecting the next patient, after an HIHARS study subject, who met the following criteria: (a) had at least one absence seizure occurred during hyperventilation in the EEG recording, and (b) had a diagnosis of idiopathic generalized epilepsy. The video-EEG and medical histories of all patients were reviewed and summarized. RESULTS: We reviewed video-EEG recordings of 77 episodes of HIHARS with loss of awareness from 22 children and 107 absence seizures during hyperventilation from 22 children. Eye opening and eyelid flutter were seen more frequently in absence seizures, whereas fidgeting, smiling, and yawning occurred more frequently during HIHARS episodes. Arrest of activity, staring, and oral and manual automatisms were observed in both groups. CONCLUSIONS: Automatisms are common in both HIHARS and absence seizures. Yawning, smiling, and particularly fidgeting occur more commonly and eye opening and eyelid flutter less commonly in HIHARS. However, episodes of HIHARS with loss of awareness clinically mimic absence seizures, and these conditions can be distinguished reliably only by EEG.

Awareness↗
PubMed2000

Blood pressure awareness in Austria. A 20-year evaluation, 1978-1998.

AIM: To evaluate public awareness following a nationwide educational campaign on hypertension. METHODS AND RESULTS: In 1978 the Austrian Heart Foundation conducted a nationwide educational campaign to increase the awareness of the population regarding the importance of recognizing and treating high blood pressure. Following this campaign, five opinion polls of random and representative samples were conducted to measure the awareness and knowledge of the population relating to issues of high blood pressure. The poll results indicated that during the period immediately following the awareness campaign, knowledge and perception of the dangers of high blood pressure increased. However, this effect dissipated during subsequent years. In 1978, 14% of the population were reported to be hypertensive and 10% had no relevant information about their blood pressure status. In 1998, those who labelled themselves as hypertensive dropped to 12%, while those who did not know their blood pressure values, increased to 14%. The percentage of the population who recalled having their blood pressure measured during the last 3 months dropped from 49% in 1978, to 34% in 1993, and remained at 34% in 1998. CONCLUSION: We conclude that the intensive blood pressure education campaign had only a temporary effect on improving blood pressure awareness. Improved strategies are needed to achieve better community control of hypertension.

Adult↗
PubMed1997

The neural basis of aware and unaware forms of memory.

Information regarding the nature of phenomenal awareness in memory comes from a direct comparison of explicit and implicit memory tasks. Explicit memory tasks require conscious awareness of a prior episode, whereas implicit memory tasks do not. This paper reviews evidence regarding the neural basis of aware and unaware forms of memory as obtained from patient studies and functional neuroimaging work. These studies suggest the existence of a memory system centered in the medial temporal and frontal lobes that is dedicated to the storage and retrieval of episodes and several neocortical memory systems that are dedicated to the processing and representation of perceptual and semantic information. Different hypotheses are discussed as to how the phenomenal awareness that accompanies episodic memories may arise within the hippocampal-frontal memory system. These views have in common the notion that various forms of information need to be bound together to be retrievable as an aware memory, and that the hippocampus is critical to this binding function.

Awareness↗
PubMed2006

Attentional modulation of sensorimotor processes in the absence of perceptual awareness.

Attention modulates visual perception and is generally considered inextricably linked with conscious awareness: we become aware of stimuli as we attend to them, and we attend to stimuli as we become aware of them. Recent evidence suggests that attention can also modulate the effects of stimuli that remain invisible, and a natural explanation is that attention enhances weak perceptual representations, bringing them closer to conscious threshold even if they do not reach that threshold. However, there is also the possibility that attention may modulate neural processes that are entirely separate from those supporting conscious perception: sensorimotor mechanisms that do not create awareness however much they are enhanced. Here we provide evidence in support of this second hypothesis by showing that attentional cueing can modulate the behavioral response to invisible stimuli in a way that is distinct from enhancing their visibility. We used a masked-prime paradigm that produces a negative or positive compatibility effect depending on the perceptual strength (duration or brightness) of the prime. We found that attention enhanced the effect of both visible and invisible primes and also increased the likelihood of detecting the prime (i.e., boosted perceptual strength). Crucially, the pattern of attentional influence on priming could not be explained by attentional modulation of the prime's perceptual strength but was predicted by a direct attentional influence on the nonconscious priming process itself. Therefore, in addition to regulating what we perceive, attention seems to influence our behavior through sensorimotor processes that are not involved in conscious awareness.

Attention↗
PubMed1990

Toward a cognitive neuropsychology of awareness: implicit knowledge and anosognosia.

Although a systematic cognitive neuropsychology of awareness has not yet emerged, a number of phenomena reported in the literature provide an empirical basis for developing it. The present discussion focusses on two such phenomena: implicit knowledge, which refers to knowledge that is expressed in task performance unintentionally and with little phenomenal awareness; and anosognosia, which refers to unawareness of neuropsychological deficits. Two types of theoretical accounts of these phenomena are discussed. A first order theoretical account entails postulating damage to, or disconnection of, a system or process that generates awareness across multiple domains. A second-order account does not postulate disruption of a cross-domain awareness mechanism, but instead appeals to difficulties in gaining access to particular kinds of domain-specific information that are associated with aware expressions of knowledge in individual domains. Instances of first- and second-order accounts are illustrated with examples from studies of memory and amnesia. The relation between implicit knowledge and anosognosia is also discussed.

Agnosia↗
PubMed2006

The development of the therapeutic working alliance, patients' awareness and their compliance during the process of brain injury rehabilitation.

PURPOSE: To examine the development and interaction of the therapeutic alliance, patients' compliance and awareness during the process of brain injury rehabilitation and the role of demographic and injury related variables in this process. Subjects were 86 patients who underwent a holistic neuropsychological outpatient rehabilitation programme. Patients had suffered a traumatic brain injury (n = 27), a cerebrovascular accident (n = 49) or another neurological insult (n = 10). MEASURES: The therapeutic alliance between clients and their primary therapists, clients' awareness and their compliance were rated four times during the 14-week rehabilitation programme. The therapeutic alliance was rated by both clients and therapist using the Working Alliance Inventory (WAI), awareness and compliance were rated by the therapists. RESULTS: The development of the process measures over time is described in the article. Clients' and therapists' perspectives on their alliance tended to converge over time. Clients' experience of their emotional bond with their therapist added as much to the prediction of clients' awareness as the localization of their brain injury. Clients' awareness was related to their compliance and mediated the impact of the therapeutic alliance on their compliance. DISCUSSION: A good working alliance is the basis of successful rehabilitative work. The article discusses therapeutic implications of the results.

Adult↗
PubMed2006

Management of impaired self-awareness in persons with traumatic brain injury.

AIM: To develop and evaluate a systematic intervention programme for the management of impaired self-awareness (ISD) in people with traumatic brain injury. METHODS: This study adopted a pre-test-post-test control group design. Twenty-one patients with traumatic brain injury were randomly assigned to an experimental group and a control group according to their admission sequence. The groups joined a newly developed Awareness Intervention Programme (AIP) and a conventional rehabilitation programme respectively for 4 weeks. Pre- and post-intervention outcome measures taken from the two groups were compared. Wilcoxon Signed-Ranks Tests were conducted to compare the within-group changes of the outcome measures of the Self-Awareness of Deficits Interview (SADI), the Functional Independence Measure (FIM) and the Lawton Instrumental Activities of Daily Living Score (Lawton IADL) in the control and experimental groups. Mann Whitney U-tests were conducted to compare the across-group differences of improvements of outcome measures between the participants in the two groups. RESULTS: After AIP training, the participants in the experimental group demonstrated significant improvement in their level of awareness as compared to the control group. However, the functional outcomes of the participants in experimental group did not show significant differences. CONCLUSION: The AIP can promote improvement in the level of self-awareness of people with traumatic brain injury. This new programme can be further developed to extend a better carryover treatment effect to functional improvement in daily activities.

Adult↗
PubMed1998

Survey of food safety awareness among HIV positive individuals.

A survey was carried out by personal interview to assess the awareness of basic food hygiene and food safety amongst 77 HIV-positive individuals attending a single hospital. There was some confusion and lack of knowledge about aspects of food storage and despite the fact that 74% of subjects had modified their diet since learning their HIV status (mainly for nutritional reasons) only 25% reported receiving information on food safety. Of the subjects interviewed 96%, 66% and 23% were aware of the risks of infection from Salmonella, Listeria monocytogenes and Cryptosporidium, respectively; although most were not aware of the UK Government's advice on the consumption of eggs, soft cheese, pâté and cook-chill foods. Over 40% of those interviewed reported that they did not drink tap water (most drank bottled water instead), but few were aware of infections potentially transmitted through water. Although pets represent a potential source of a wide variety of infectious agents, there was a high level of awareness of this problem. This study highlights the need for improving the availability of information on food hygiene and infections acquired through food and water to HIV-positive individuals.

Awareness↗