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PubMed1982

The interactive effects of typical-maximal measures of aggression on private and public self-consciousness.

Recent reports have suggested that both self-consciousness and typical-maximal measures interact with the accuracy of subject-peer agreement. The current paper investigated (a) whether differing levels of a peer's private and public self-consciousness would also interact with subject-peer agreement, and (b) whether typical-maximal measures would interact with subject and peer self-consciousness. Results indicated that in every case in which there was a significant self-consciousness effect, there was also a corresponding interaction of self-consciousness with typical-maximal. These results suggest that maximal ratings may be preferable to typical ratings in the prediction of criterion behaviors.

Adolescent↗
PubMed2002

The minimally conscious state: definition and diagnostic criteria.

OBJECTIVE: To establish consensus recommendations among health care specialties for defining and establishing diagnostic criteria for the minimally conscious state (MCS). BACKGROUND: There is a subgroup of patients with severe alteration in consciousness who do not meet diagnostic criteria for coma or the vegetative state (VS). These patients demonstrate inconsistent but discernible evidence of consciousness. It is important to distinguish patients in MCS from those in coma and VS because preliminary findings suggest that there are meaningful differences in outcome. METHODS: An evidence-based literature review of disorders of consciousness was completed to define MCS, develop diagnostic criteria for entry into MCS, and identify markers for emergence to higher levels of cognitive function. RESULTS: There were insufficient data to establish evidence-based guidelines for diagnosis, prognosis, and management of MCS. Therefore, a consensus-based case definition with behaviorally referenced diagnostic criteria was formulated to facilitate future empirical investigation. CONCLUSIONS: MCS is characterized by inconsistent but clearly discernible behavioral evidence of consciousness and can be distinguished from coma and VS by documenting the presence of specific behavioral features not found in either of these conditions. Patients may evolve to MCS from coma or VS after acute brain injury. MCS may also result from degenerative or congenital nervous system disorders. This condition is often transient but may also exist as a permanent outcome. Defining MCS should promote further research on its epidemiology, neuropathology, natural history, and management.

Humans↗
PubMedDate not supplied

Intra- and extracranial causes alteration in level of consciousness.

Acutely ill patients often demonstrate an altered level of consciousness. However, there are a variety of different reasons that may cause this alteration and nurses caring for patients without a defined cerebral event need to be aware of situations that can alter a patient's level of consciousness so that care strategies can be implemented. This article explains the concepts of consciousness and intracranial pressure and what is meant by an 'altered level of consciousness'. Assessment strategies are identified and a simple alternative to the Glasgow Coma Scale is identified that can be used as an initial assessment tool. This then allows the nurse caring for the patient with an altered level of consciousness to rationalize his/her intervention in relation to that patient.

Brain Diseases↗
PubMed2003

Relationship between social support, mental health and health care consciousness in developing the industrial health education of male employees.

The purpose of the study is to elucidate the relationship between social support, health care consciousness and mental health in developing the industrial health education aimed at improving the health habits of male employees. A questionnaire survey concerning health practices, mental health based on the General Health Questionnaire, social support from social support networks, and health care consciousness based on the Health Locus of Control was conducted on male employees in three companies in Osaka Prefecture. A total of 1,634 questionnaires were collected. Analyses by age group showed that in all age groups, the higher the social support score, the more favorable the mental health became and the stronger the family care in health care consciousness became. The better the mental health, the greater the number of good health practices was and the lower the fortune dependence in health care consciousness tended to be. The results of the study reconfirm the previous findings that it is necessary to put the mental health of male employees in good condition before everything else in effectively developing health education aimed at improving their health habits. This study also indicates that the level of perception of social support and their internal control of self and family in health care consciousness are definitely related to the stability of subjects' mental health. It is therefore presumed that measures to raise the revel of perception of social support are important since they may improve the mental health of subjects.

Adolescent↗
PubMedDate not supplied

Involvement of cholinergic motor neurons in pharmacological regulation of gastrointestinal motility by glucagon in conscious dogs.

UNLABELLED: To clarify the exact mechanisms of the pharmacological effects of glucagon on gastrointestinal motility, the following experiments were performed on the conscious and anesthetized dogs. 1) During phase I of interdigestive migrating contractions (IMC), glucagon (5 approximately 50 microg/kg, drip infusion for 5 minutes) induced phasic contractions in the duodenum, jejunum and ileum, but not in the antrum. These excitatory responses were also observed in the truncal vagotomized dogs. These contractions were abolished by atropine or hexamethonium in the conscious dogs, and also by tetrodotoxin in the anesthetized dogs. 2) Glucagon inhibited cisapride-induced contractions only in the antrum in the conscious dogs. After pre treatment with hexamethonium, glucagon inhibited these contractions in the duodenum, jejunum and ileum as well as in the antrum. After pre treatment with tetrodotoxin in the anesthetized dogs, glucagon did not affect acetylcholine induced contractions in any region. 3) Glucagon inhibited spontaneous phase III contractions and erythromycin induced phase III like contractions in the antrum, but did not inhibit either contractions in the other regions in the conscious dogs. These paradoxical effects of glucagon between the antrum and intestine were similar to those involved in the blockade of 5-hydroxytryptamine 3 receptors. After pre-treatment with hexamethonium, glucagon inhibited these contractions in the duodenum, jejunum and ileum as well as in the antrum. IN CONCLUSION: 1) Glucagon latently inhibits cholinergic motor activities in the antrum and intestine not directly, by binding to either receptor on the smooth muscle cells, but through postganglionic cholinergic neurons and possibly through 5-hydroxytryptamine neurons. 2) On the other hand, in the intestine the reverse effects through preganglionic cholinergic neurons involving nicotinic and muscarinic receptors are more potent. 3) As a result, glucagon inhibits antral contractions and does not affect intestinal contractions in a conscious state.

Animals↗
PubMed2005

Ketamine for conscious sedation in pediatric emergency care.

The literature concerning the efficacy and safety of ketamine for conscious sedation during procedures in pediatric emergency departments was reviewed. Data were obtained from the Guidelines for Monitoring and Management of Pediatric Patients During and After Sedation for Diagnostic and Therapeutic Procedures developed by the American Academy of Pediatrics Committee on Drugs, and from a MEDLINE search (January 1966-July 2004). Search terms were conscious sedation, ketamine, and emergency department; articles relevant to pediatric age group were selected. Clinical end points were efficacy and adverse effects associated with ketamine. Ketamine was effective for conscious sedation in 89-100% of patients in various studies using intravenous, intramuscular, or oral routes of administration. The efficacy of ketamine was similar to or greater than that of other drugs, such as midazolam and the combination of meperidine, promethazine, and chlorpromazine. The main adverse effects of ketamine were emesis, recovery agitation, and emergence phenomena. Ketamine appears to be an effective and well-tolerated agent for conscious sedation in pediatric patients. Overall physician and parent satisfaction with the administration of this agent for conscious sedation was high.

Anesthetics, Dissociative↗
PubMed1990

[Masticatory area in the persons who become conscious of temporomandibular joint sound].

Using subjects conscious of temporomandibular joint sound and normal subjects, the ratio of the masticatory area to the mandibular border movement area was measured. Also, splints were fitted to subjects conscious of TMJ sound and changes of sound and masticatory areas were measured. 1. In normal subjects, the ratio tended to vary little with any of the test foods. 2. In subjects conscious of the TMJ sound, the ratio decreased in the case of all test foods when compared with the normal subjects. 3. In subjects conscious of TMJ sound, it was observed that the TMJ sound occurred in some subjects but not in others during mastication. 4. The decrease in the ratio of the subjects with no TMJ sound during mastication was more outstanding than that of subjects in which TMJ sound occurred during mastication. 5. After fitting splints, the change in the TMJ sound was accompanied by a change in the masticatory area. 6. These findings suggest that the decrease in the mastication area experienced by subjects conscious of TMJ sound, when compared with normal subjects, may be caused by the TMJ sound.

Humans↗
PubMed2002

Relations among self-talk, self-consciousness, and self-knowledge.

The aim of this study was to examine the relations among self-talk, self-consciousness, and self-knowledge through an exploratory principal component analysis and to test the hypothesis that only the functional and reflective aspects of self-consciousness contribute to self-knowledge. A self-report questionnaire including 6 scales assessing different aspects of self-talk, self-consciousness, and self-knowledge was administered to 203 German undergraduate university students. A principal component analysis of the scales yielded a two-factor solution, supporting the distinction between functional and dysfunctional self-consciousness. In a stepwise multiple regression analysis, only functional self-consciousness was a significant predictor of self-knowledge. Limitations of the present measures of inner speech are addressed.

Adult↗
PubMed2004

Moderation of automatic achievement goals by conscious monitoring.

The aim of this study was to test the assumption that nonconscious goal pursuit guides behavior more efficiently and produces better performance, only when the conscious monitoring of the task is low. Some studies have documented that goals can be activated and guide behaviors outside of awareness. 66 students, 22 men and 44 women with a mean age of 18.3 yr. (SD=0.9) years, were randomly assigned to Achievement Goal Priming or Neutral Priming conditions. In the Achievement Goal Priming condition, concepts associated with high performance were activated outside of their awareness via a scrambled sentence task. All participants were then given a calculation task to complete. To manipulate conscious monitoring, half of the participants were presented the task as a fun filler task, and the rest were presented the task as a measure of ability and were encouraged to monitor their performance on the task consciously. Analysis showed, among participants who were presented the task as a fun filler task, the Achievement Goal Priming group completed more tasks relative to the Neutral Priming group. Those who were encouraged to monitor their performance consciously did not benefit from Achievement Goal priming. The results implied that consciously monitored behavior might be counterproductive.

Achievement↗
PubMed2005

Cognitive self-consciousness and meta-worry and their relations to symptoms of worry and obsessional thoughts.

The relation between cognitive self-consciousness and meta-worry, and their association with symptoms of worry and obsessional thoughts were examined. 53 undergraduate students completed the expanded version of the Cognitive Self-consciousness Scale, the Meta-worry subscale of the Anxious Thoughts Inventory, the Penn State Worry Questionnaire, and the Padua Inventory-Revised. Analysis showed that cognitive self-consciousness and meta-worry were moderately correlated (r =.57). Further, both constructs were positively associated with symptoms of worry and obsessional thoughts. When controlling for cognitive self-consciousness, metaworry remained significantly correlated to both types of symptoms. Yet, when controlling for meta-worry, correlations between cognitive self-consciousness and symptoms of worry and obsessional thoughts clearly attuned and were no longer significant. These findings suggest that meta-worry is more important for understanding excessive, intrusive thought patterns than the mere tendency to monitor one's thoughts.

Adult↗
PubMed2005

Does self-consciousness mediate the relation between self-talk and self-knowledge?

Building on Morin's understanding of the relations among self-talk, self-consciousness, and self-knowledge, this study examined the hypothesis that functional and dysfunctional self-consciousness mediate between self-talk and self-knowledge. A self-report questionnaire including 10 scales assessing different aspects of Self-talk, Self-consciousness, and Self-knowledge was administered to 200 German undergraduate university students (95 women, 105 men). Mediation analysis showed that the observed negative relationship between Self-talk and Self-knowledge was mediated by Dysfunctional Self-consciousness, while Functional Self-consciousness acted like a supressor variable. The discussion focuses on limitations of the present measures of Self-talk.

Adolescent↗
PubMed2006

[Nourishment of patients with persistent disturbance of consciousness and nutritional markers to simplify evaluation].

AIM: This study was aimed to evaluate the nourishment of patients with a disturbance of consciousness who received tube feeding, and to discuss nutritional markers to simplify evaluation in these patients at home or at facilities for the elderly. METHODS: The nourishment of 46 patients with a disturbance of consciousness who received tube feeding was evaluated by performing 1) physical measurements, 2) blood test, and 3) measurement of resting metabolic rate. Furthermore, the anemia-like symptoms of the palpebral conjunctiva, which were supposed to be related with nourishment, were subjectively evaluated to clarify their relevance to the results of physical measurements and blood test. RESULTS: The average of triceps skinfold thickness (%TSF), which shows relative physical measurement data of patients with a disturbance of consciousness when compared to those of healthy people, was 105.7 +/- 39.8, which was almost equivalent to that of healthy people. The arm muscle circumference (%AMC) and calf circumference (%CC) were 87.5 +/- 11.5 and 73.6 +/- 9.4, respectively. In the blood test, the average Alb value was 3.3 +/- 0.5 g/dl, suggesting that 35 (76.1%) of the 46 patients with disturbance of consciousness had protein energy malnutrition (PEM). Since the relationship between anemia-like symptoms of the palpebral conjunctiva and Hb/Ht (p < 0.01, p < 0.01) and Alb (p < 0.05) was confirmed, there is a high possibility that these markers can be useful for easy evaluation of nourishment. CONCLUSION: Because hypoalimentation is a more serious problem than overnutrition in patients with a disturbance of consciousness, we consider that the calorie count should be adjusted based on the measurement results of resting energy expenditure (REE) in individual patients, although the count for patients with tube feeding was set at individual levels of basal metabolism in the conventional method. Moreover, further discussion is required regarding alternative markers for nutritional evaluation to blood test data.

Aged↗
PubMed2003

Preoperative anxiety and propofol requirement in conscious sedation for ovum retrieval.

The purpose of the present study was to evaluate the correlation among the trial number of in vitro fertilization (IVF), preoperative anxiety, and propofol requirement for conscious sedation. One hundred and twenty six Korean women undergoing oocyte retrieval were enrolled. The target-controlled infusion by the anesthesiologist was conducted with initial target propofol concentration of 2.5 microg/mL, which was manipulated until the sedation score 3 and desired clinical end point were achieved. A weak correlation was observed between visual analogue scale (VAS) anxiety and the dose of propofol required for the induction of conscious sedation (r=0.22, p=0.0192). A weak correlation was also found between VAS anxiety and the sedation time needed to reach the proper conscious sedation level for the procedure (r=0.181, p=0.0484). Multiple regression analysis showed that VAS anxiety, preoperative baseline prolactin level, and cortisol level had statistically significant effects on the propofol induction dose for target controlled conscious sedation. We concluded that the induction dose and time requirements for propofol in anesthesiologist-controlled conscious sedation be modified based on the preoperative anxiety level and the baseline blood concentration of stress hormone, cortisol and prolactin.

Adult↗
PubMed2004

Identification of factors that influence conscious sedation in gastrointestinal endoscopy.

Although several studies examined factors that influence conscious sedation, investigation was limited into the gender and age. The aim of this prospective study is to identify the clinical variables of successful conscious sedation during gastrointestinal endoscopy. A total of 300 subjects who underwent gastrointestinal endoscopy were enrolled in a prospective fashion. They completed a questionnaire to assess height, weight, drinking, smoking, education level, recent medication, past medical history, previous experience of conscious sedation, preprocedural anxiety, and apprehension about the procedure. Efficacy of sedation and amnesia were evaluated by the subject and the endoscopist. Amnesic and sedative effects were proportionally related with age (p<0.0001). Preprocedural anxiety level was higher in women (p=0.0062), younger subjects (p=0.035), slender subjects (p=0.041), and in those without previous experience of conscious sedation (p=0.0034). This anxiety level was also related to increased pain (p=0.0026) and alertness (p=0.0003) during the procedure. Lower dose of midazolam is needed for sedation in older subjects. Subjects with a high level of preprocedural anxiety such as women, younger subjects, slender subjects, and those without previous experience of conscious sedation should be sedated with great caution because generally, they complain of much more severe pain and alertness during the procedure.

Age Factors↗
PubMed2002

[The effect of public self-consciousness on forced laughter].

The purpose of this study was to investigate the effect of public self-consciousness on forced laughter. Participants (N = 409) were asked to imagine a group of either friends or acquaintances, and then to indicate how often he or she exhibited forced laughter toward the group members. They also completed Self-Consciousness Scale (Fenigstein, Scheier, & Buss, 1975). Results indicated that persons with high public self-consciousness reported more frequent expressions of all types of forced laughter--expression control, intimacy maintenance, action control, and affect manipulation--than those who were low, regardless of interpersonal intimacy level. Besides public self-consciousness, both gender and intimate feeling toward group members influenced frequency of forced laughter. Implications for the nature of public self-consciousness and forced laughter were discussed.

Adult↗
PubMed2003

[The effects of hostility on blood pressure and depression: role of conscious defensiveness].

This study used the approach-avoidance interpersonal conflict model to test the hypothesis that conscious defensiveness would enhance the effects of hostility on casual blood pressure and depression. The subjects were healthy schoolteachers (56 males and 48 females), aged 22 to 59 years. They completed a battery of questionnaires that contained the Japanese version of the Japanese version of Buss-Perry Aggression Questionnaire (BAQ) for hostility, the Conscious Defensiveness Questionnaire (CDQ) for conscious defensiveness, and the Center for Epidemiologic Studies Depression Scale (CES-D) for depression. Conscious defensiveness had no significant influence on the relationship between hostility and blood pressure. In contrast to earlier studies, hostility was a predictor of lower diastolic blood pressure in men. In addition, the hypothesis on depression was not supported. In order to prevent from developing cardiovascular disease and depression, future studies should investigate the role of conscious defensiveness in the effects of hostility on casual blood pressure and depression as well as the alleviating influence of hostility on casual diastolic blood pressure using a large sample.

Adult↗
PubMed1994

Been there, done that? Consciousness raising, critical theory and nurses.

The concept of consciousness raising has become somewhat tired and jaded in nursing literature. Indeed the notion of consciousness raising and its associated catchcry of 'making the personal political', is almost so hackneyed as to be somewhat unfashionable and clichéd in the 1990s. This is due, at least in part, to the fact that consciousness raising emanated from the women's movement of the 1960s and was originally directed at linking the personal and the political, but in nursing emphasis has often been given to the personal with little recourse to the political. It is thus timely and important to draw on insights afforded by critical perspectives and synthesize them anew with the tenets of consciousness raising in order to make explicit the power relations and structural oppression implicit in the nursing context. If consciousness raising, and the making of the personal political, are combined with the theoretical insights provided by critical theorists such as Faoucault (1977, 1980), it is possible to re-orient and re-energise the somewhat trite and worn catchcry of the personal as political.

Awareness↗
PubMed1991

Incidence of loss of consciousness during automatic implantable cardioverter-defibrillator shocks.

OBJECTIVE: To determine the incidence of loss of consciousness occurring in association with shocks delivered by automatic implantable cardioverter-defibrillators (AICD) in patients who had undergone implantation as treatment for ventricular tachycardia or ventricular fibrillation. DESIGN: Cohort study. SETTING: Two major tertiary medical care facilities. PATIENTS: A total of 180 patients who had undergone implantation of an AICD for treatment of ventricular tachycardia or ventricular fibrillation. INTERVENTION: Implantation of an AICD that delivered only high-energy shock. MEASUREMENTS: During a mean (+/- SD) follow-up period of 16 +/- 12 months, the incidence of loss of consciousness occurring in association with spontaneous AICD shocks was determined. Various clinical factors were analyzed to identify predictors of loss of consciousness that occurred during AICD shocks. MAIN RESULTS: Of the 180 patients who received an AICD, 106 patients (59%) experienced AICD shocks during follow-up. Sixteen of the 180 patients (9%) experienced loss of consciousness; 13 of these 16 patients had syncope and 3 died suddenly, in association with AICD shocks. The absence of syncope during one AICD shock did not always predict the absence of syncope during subsequent shocks. Syncope could not be predicted by age, sex, history of syncope, left ventricular function, type of underlying heart disease, electrophysiologic findings, rate of ventricular tachycardia, antiarrhythmic medications, and type of pulse generator implanted. CONCLUSIONS: Patients with sustained ventricular tachycardia or ventricular fibrillation who receive an AICD that delivers only high-energy shock therapy are at moderate risk for experiencing loss of consciousness during AICD shocks. No clinical variables were found to be predictors of syncope. Therefore, driving and other activities that require patients to be extra vigilant should not be assumed to be safe after implantation of an AICD that delivers only high-energy shock.

Adult↗