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PubMed2003

Awareness of vaccination status and its predictors among working people in Switzerland.

BACKGROUND: Adult vaccination status may be difficult to obtain, often requiring providers to rely on individual patient recall. To determine vaccination status awareness and the sociodemographic predictors of awareness for tetanus, hepatitis A and B, tick born encephalitis (TBE) and influenza vaccination. METHODS: Multivariate analyses were used to evaluate a questionnaire survey of 10,321 employees (4070 women and 6251 men aged 15-72 years) of two companies in Switzerland. RESULTS: Among 10,321 respondents, 75.5% reported knowing their tetanus vaccination status, 64.1% hepatitis A, 61.1% hepatitis B, 64.3% TBE and 71.9% influenza. Between 1 in 4 and 1 in 3 employees were not aware of their vaccination status. Differences in awareness for the five vaccinations considered correlated with gender and language. These differences persisted in multivariate analyses. CONCLUSION: Women employees, German-speaking employees and employees who paid more attention to their diet were more often aware of their vaccination status. A more reliable and readily accessible data source for vaccination status is needed in order to capitalize on opportunities to update vaccinations among Swiss employees.

Adolescent↗
PubMed1999

Communication and awareness about dying in the 1990s.

Since the 1960s communication and awareness about dying in modern western societies have been topics for debate, with a considerable amount of literature on the need for open communication and the strategies which can be used by health professionals to improve their communication with patients facing a terminal prognosis. Despite the difficulties of comparing studies using different methodologies and the additional problems of ascertaining patients' knowledge and awareness about their impending deaths, the trend is clear. In advanced industrial societies there is increasing evidence that doctors have shifted from a policy of 'withholding' to a policy of 'revealing' to the patient his or her terminal prognosis. This change in medical practice is further supported by other data which show an increase in the percentage of those patients who were aware they were dying from chronic diseases, especially cancer. However, despite the perceived trend towards open disclosure of the patient's terminal illness, recent studies have suggested that in their daily encounters with dying patients health workers employ 'conditional' rather than 'full open disclosure'. Such moderating strategies in discussing the patient's prognosis may be employed despite open awareness of a patient's prognosis. This paper examines this apparent paradox by analysing the complex tensions and conflicts of such communication through a discussion of existing literature on modes of communication and patient awareness.

Attitude to Death↗
PubMed1999

The progress of awareness and acceptance of dying assessed in cancer patients and their caring relatives.

Awareness and acceptance of dying were assessed weekly by semistructured interviews in a randomized sample of 76 hospice cancer patients and caring relatives. During the final eight weeks of the study, patients' awareness showed only slight increase (about 42% fully certain) while relatives' certainty clearly progressed (from 53% to 81% certain). Depression was linked with greater awareness in relatives but not patients. Patients were more anxious if death seemed probable rather than certain or no more than possible. Acceptance usually increased, with 51% of patients and 69% of relatives becoming nearly/fully accepting. Many individuals diverged from the average progress of awareness and acceptance; 18% of patients and 24% of relatives showed fluctuating or falling acceptance. Patients' and relatives' levels of awareness were positively correlated (r = 0.46), as was acceptance (r = 0.47). Relatives accepted more if patients were over 70 years, weak, unable to concentrate or had a quality of life index (QLI) below five, but patients were more accepting if female and if the QLI was above five. Pain did not increase acceptance. Acceptance was described in terms of death's inevitability, faith and spiritual values, life's diminishing rewards, completing life, final benefits, humour, sharing, etc. Individuals often used more than one concept. Generalizing exact figures from this sample needs caution, but some patterns of progress, possible influential factors and ways of acceptance may apply widely.

Adaptation, Psychological↗
PubMed1996

Patient awareness of seizures.

In 31 consecutive patients who were admitted to an epilepsy monitoring unit, we prospectively determined whether the patients were aware of having seizures. On admission, all patients stated that they knew of at least some of their seizures. Eight of 23 with classifiable epileptic seizures recognized that they were occasionally unaware of their seizures. During telemetry, following full recovery of consciousness after each seizure, we asked the patients whether they had recently had a seizure. For control purposes, we asked the patients the same question at random times. Among patients with seizures, there were no false-positive answers. Only 6 of 23 (26%) of the patients with epilepsy were always aware of their seizures, including complex partial and secondarily generalized events, and 7 of 23 (30%) were never aware of any seizures. Self-reporting of seizures was unreliable: Patients reporting the lowest baseline frequency of seizures had the highest fraction of unrecognized seizures. Seizure awareness was lowest for patients with temporal lobe foci, especially on the left side. Patients with primarily generalized epilepsy were more likely to be aware of tonic-clonic seizures than were patients with secondarily generalized partial seizures. All four patients with nonepileptic attacks believed that they always knew of their seizures, but only three of the four patients actually did always know. Unrecognized seizures are frequent and should be considered in patient management and in studies.

Adult↗
PubMed2004

Trends in prevalence, awareness, treatment and control of hypertension in the middle-aged population of China, 1992-1998.

The objective of this study was to analyze the trends in prevalence, awareness, treatment and control of hypertension in the middle-aged population of China. There were about 1,000 participants each from 13 different study populations that were examined in surveys conducted from 1992-1994 (n=18,746) and in 1998 (n=13,504) in conjunction with the China Multi-Center Study of Cardiovascular Epidemiology. Half the subjects were men and half were women; their ages ranged from 35 to 59 years. Hypertension was defined as systolic blood pressure > or =140 mmHg, diastolic blood pressure > or =90 mmHg, and/or current treatment with antihypertensive medications. Hypertension awareness and treatment were assessed with a standardized questionnaire. Hypertension control was defined as blood pressure measurements of less than 140/90 mmHg. The results showed that 24.0% of participants had hypertension in 1998, an increase of 2.3% from 1992-1994 (p <0.05). The prevalence of hypertension was 25.4% higher in urban than in rural areas, and was higher in men than in women. Among hypertensives, 42.6% were aware of their hypertension (a 5.3% increase compared with 1992-1994, p <0.05), 31.1% were treated (a 3.8% increase, p <0.05), and 6.0% were controlled (a 2.6% increase, p <0.05). The rates of awareness, treatment and control were higher in women than men, and higher in urban than rural areas. For treated hypertensives, the rate of control increased from 12.7% in 1992-1994 to 19.9% in 1998 (p <0.05). These findings indicate that hypertension prevalence is increasing in China. Control rates, while improving, still remain low. This implies that effective public health measures are needed to enhance the awareness, treatment, and control rates in the Chinese population.

Adult↗
PubMed2004

Predicting curriculum and test performance at age 7 years from pupil background, baseline skills and phonological awareness at age 5.

BACKGROUND: Phonological awareness tests are known to be amongst the best predictors of literacy; however their predictive validity alongside current school screening practice (baseline assessment, pupil background data) and to National Curricular outcome measures is unknown. AIM: We explored the validity of phonological awareness and orthographic measures, the Infant Index baseline assessment (Desforges & Lindsay, 1995), gender, free school dinners, and SEN status taken at age 5 in the prediction of English, Maths, and Science performance in Key Stage 1 of the National Curriculum in England. SAMPLE: 435 children from nine schools in one Local Educational Authority (LEA) were screened at entry aged 4 or 5, and at 5:8, and age 7. METHOD: We trained schools Learning Support Assistants (LSAs) to administer orthographic and phonological awareness measures. Teachers collected data on all baseline and Key Stage 1 performance measures. RESULTS: A series of 13 logistic regression analyses revealed that phonological awareness and orthographic knowledge best predicted 12 of 13 measures of performance at Key Stage 1. Additional variance was nearly always explained by SEN status. In 11 analyses the Infant Index baseline score predicted performance at age 7 and was the best predictor of maths test performance. Gender was an occasional additional predictor. CONCLUSION: School LSAs can be readily trained to administer phonological awareness measures to cohorts of 5-year-old children. Such measures used in conjunction with baseline measures significantly enhance prediction of Key Stage 1 performance. Deploying LSAs in this fashion significantly enhances a school's capacity to identify young children for whom additional support may be necessary.

Awareness↗
PubMed2005

[Awareness of disease in dementia: preliminary results in patients with mild and moderate Alzheimer's disease].

OBJECTIVE: To evaluate the presence and the level of awareness of disease in mild and moderate Alzheimer's disease (AD). METHOD: Cross-sectional evaluation of patients with mild/moderate AD (n=42) assessed by Assessment of Psychosocial Impact of the Dementia Diagnosis (APSID), Mini-mental State Examination (MMSE) and Clinical Dementia Rating Scale (CDR). RESULTS: Awareness of disease and its consequences were present in 66.7% patients with mild AD (n=18). In moderate AD (n=24), 20.8% presented total awareness, 45.8% presented only awareness of cognitive symptoms. Unawareness of disease was observed in 33.3%. CONCLUSIONS: The present data show association between awareness and level of severity of disease. CDR 1 patients show a better recognition of cognitive and daily life activity symptoms, whereas CDR 2 patients recognized their cognitive symptoms but failed to appraise their severity and consequences in daily life activities.

Activities of Daily Living↗
PubMed2002

Awareness, treatment and control of hyperlipidaemia in middle-aged men in France and northern ireland in 1991-1993: the PRIME study. Prospective epidemiological study of myocardial infarction.

OBJECTIVE: To assess how well screening and preventive measures are implemented in the general population. METHODS AND RESULTS: Sample of 9,609 men aged 50-59 devoid of history of CHD living in France and Northern Ireland. Hyperlipidaemia was defined as total cholesterol > or = 240 mg/dl or triglycerides > or = 200 mg/dl or HDL cholesterol < 0.35 mg/dl or hypolipidaemic drug treatment. Treated subjects were considered as controlled if total cholesterol was < 200 mg/dland triglycerides < 200 mg/dl and HDL cholesterol > or = 0.35 mg/dl. The prevalence of hyperlipidaemia was higher in Northern Ireland, whereas awareness, treatment and control rates were higher in France. Only one third of aware subjects had a hypolipidaemic diet, and less than half of treated subjects was adequately controlled. Lower educational level, smoking, obesity and a history of hypertension were significantly related to higher rates of hyperlipidaemia in both countries. In France, history of hypertension or diabetes, and ex- or non-smoking status were related to higher levels of awareness and treatment. In Northern Ireland, awareness of hyperlipidaemia was positively related to educational level. CONCLUSIONS: Awareness, treatment and control rates for hyperlipidaemia are low in Northern Ireland compared to France, and implementation of preventive measures should be performed in both countries.

Awareness↗
PubMed2003

The impact of severe hypoglycemia and impaired awareness of hypoglycemia on relatives of patients with type 1 diabetes.

OBJECTIVE: Severe hypoglycemia is a major problem for patients with type 1 diabetes and their relatives. The aim of this study was to compare patients' and relatives' assessments of rates of severe hypoglycemia and state of awareness and to explore the influence on involvement and concern of relatives. RESEARCH DESIGN AND METHODS: A cross-sectional paired questionnaire survey on hypoglycemia and the state of awareness was used in our study comprising 284 unselected adult patients with type 1 diabetes and their closest cohabitant. The cohabitant questionnaires also addressed involvement and concern. RESULTS: The agreement between assessments of rates of severe hypoglycemia and state of awareness made by patients and cohabitants was weak (kappa 0.404 and 0.442, respectively; P < 0.001). Cohabitants recalled more episodes of severe hypoglycemia than patients (2.7 vs. 1.6 episodes/patient-year; P < 0.001). Degree of involvement was positively related to the rate of severe hypoglycemia (P = 0.002) and negatively related to the state of awareness (P = 0.007) but not to level of HbA(1c), duration of diabetes, or presence of late complications, except for peripheral neuropathy (P = 0.01). CONCLUSIONS: Cohabitants of patients with type 1 diabetes recall significantly more episodes of severe hypoglycemia than the patients. The rate of severe hypoglycemia and state of hypoglycemic awareness are the principal determinants of degree of cohabitants' involvement in their partners' disease.

Adult↗
PubMed2005

Dispositional optimism and self-assessed situation awareness in a Norwegian military training exercise.

The current study examined the relationship between dispositional optimism and situation awareness. A sample of 77 Royal Norwegian Naval Academy and 57 Royal Norwegian Army Academy cadets were administered the Life Orientation Test prior to participating in a field-training exercise involving a series of challenging missions. Following an infantry mission component of the exercise, situation awareness was measured using the Mission Awareness Rating Scale (MARS), a self-assessment tool. The analysis indicated that dispositional optimism correlated negatively with situation awareness under these conditions. The role of intrapersonal variables in mediating situation awareness and decision-making in stressful situations is discussed.

Adaptation, Psychological↗
PubMed1977

Influences of alcohol upon performance and performance awareness.

The effects of alcohol and performance feedback on reaction time, judgments of response speed, and awareness of performance were examined with 15 male subjects. It was suggested that the dose of alcohol which impaired performance would also reduce the awareness of the impairment. In response to extrafoveal visual signals, a series of RTs and response-speed judgments were recorded over three experimental sessions which differed in target blood alcohol concentration, i.e., placebo, .05, .10. The spurious performance feedback presented to five subjects in each of three groups represented either fast, average, or slow RTs. Data support the hypothesis that alcohol impairs both performance and performance awareness. In all groups alcohol significantly increased RTs and significantly impaired the accuracy of response speed judgments. The measures of awareness, i.e., correlations between RTs and response speed judgments, showed that alcohol and spurious feedback significantly impaired performance awareness.

Adolescent↗
PubMed1990

Relationship of therapists' sex, sex-role, and age to awareness of the salience of gender-related concepts in analogue research: a preliminary finding regarding distribution of therapists by sex-role.

In response to speculation that awareness of feminist concerns had made patient analogue studies transparent, the present study was done to estimate the extent and correlates of therapists' awareness of the gender-related characteristics of such a sex-role questionnaire. A national sample of 131 male and 120 female therapists showed that male therapists tend to be sex-typed and female therapists are predominantly androgynous. No significant relationship obtained between the therapists' sex-role and their awareness that this experiment involved gender. The relationship between sex of therapist and awareness only approached significance. Younger therapists tended to be more aware than older ones.

Awareness↗
PubMed1991

[Awareness and electromyograph biofeedback in the acquisition of control of a novel muscular activity].

Two experiments were conducted to examine what kind of awareness to the internal control process should be encouraged in order to effectively acquire the control of a novel muscular activity with electromyograph (EMG) biofeedback. The m. auricularis posterior (the muscle to draw an ear backward) was selected as the target muscle of this study. Experiment I investigated the relation between control ability and awareness of the target muscle activity. Results showed that subjects who were able to move their ears could be aware of the target muscle activity more precisely than those who were unable to do it. In experiment II, 32 undergraduate and graduate students who could not move their ears were required to activate their left m. auricularis posterior. Results provided evidences supporting the hypothesis that, in the initial stage of the acquisition of control, subjects who were encouraged to be aware of ways and feelings of striving (efferent process) and were given EMG feedback signals from the target muscle could acquire the control of the target muscle activity more effectively than those who were encouraged to be aware of a bodily feeling brought about by the striving (afferent process) and who were given no EMG feedback signals.

Awareness↗
PubMed1999

HIV seroprevalence & awareness about AIDS among pregnant women in rural areas of Pune district, Maharashtra, India.

The present unlinked anonymous study was done among sexually active rural women to assess the extent of spread of HIV and its awareness. Peripheral blood samples were collected on filter paper strips from 1251 pregnant women residing in villages in three Primary Health Centres in Pune district of Maharashtra. Elutes were tested for HIV antibodies in two different ELISA systems. Awareness on HIV/AIDS was assessed using a structured questionnaire. Fifteen (1.2%) samples were detected to be HIV seropositive. HIV seroprevalence was significantly higher among villages situated close to highways (P < 0.025). Majority (> 95%) of the participating women were housewives. Although 70 per cent were aware of the existence of AIDS, only 33 per cent knew about all the main modes of HIV transmission. Their main sources of information on AIDS were health camps, health workers (70%) and television (45%). Awareness was associated with higher level of literacy (P < 0.001). Many women had misconceptions about the modes of spread of HIV. Greater emphasis needs to be placed on instituting long-term and sustainable strategies to create awareness among young couples with an emphasis on involvement of health workers in rural areas.

Acquired Immunodeficiency Syndrome↗
PubMed2001

[The Denial and Awareness Scale (DAS)].

Focusing on denial of drinking problems and raising awareness are two important treatment tasks at the initial stage of alcoholism treatment. However, an objective and clinically practical measure to assess patients' and family members' denial and awareness of alcohol-related problems has not yet been available. The DAS (Denial and Awareness Scale by Aro Ino and Shigeo Tatsuki) was developed in order to predict prognosis and evaluate treatment outcomes of alcoholism patients. The preliminary (DAS-1) patient scale was administered to 370 alcoholism patients. Their family members responded to the DAS-1 family member subscales. The abstinence period was then triangulated among the patient, a family member, and treatment staff members. For the purpose of the current study, 218 responses were used for item analyses and prediction of abstinence periods. Stepwise regression analyses of preliminary (DAS-1) sub-scales demonstrated that several sub-scales significantly predicted abstinence periods. After factor-analytic item re-classification of DAS-I items, DAS-2 was constructed. DAS-2 sub-scales were then regressed onto abstinence periods by a backward stepwise regression method. The analysis using the entire complete sample (N = 189) where both patients and their family members' responses were available demonstrated significantly that "Patient's Awareness" increased abstinence periods while "Family Troubled Feelings" decreased it, and that "Patient's Awareness" also galvanized "Changes in Patient's Mindset". Additional analyses were conducted in order to examine if predictive values of DAS-2 subscales differ according to varying stages of abstinence periods among the study subjects. The results showed that different sets of subscales predicted the abstinence periods depending on the treatment stages, i.e., abstinence within 1 year, 2 years, 3 years, and 4 years. These findings corresponded with the authors' clinical experiences. The current study produced several regression prediction equations utilizing the DAS-2. Further evaluation studies shall examine the effectiveness of the DAS-based prediction/prognosis of the abstinence period of alcoholism patients.

Alcoholism↗
PubMed2002

Family practice residents' awareness of medical care costs in British Columbia.

BACKGROUND AND OBJECTIVES: Health economics continues to be an important issue, and past studies in the United States and Europe have found that physicians and physicians in training have a limited understanding of medical care costs. No medical care cost-awareness studies have been done in Canada. In this study, the costs of 46 commonly used diagnostic tests and therapeutics were determined, and family practice residents' awareness of these costs was assessed. METHODS: Ninety-seven first- and second-year residents of the University of British Columbia Family Practice Program were surveyed using the modified Dillman Total Design Method. Resident cost estimations were considered correct if within 25% or 50% of actual costs, and awareness was correlated with training location, gender, residency year, and importance ratings for ordering behavior. Degree of error was assessed by calculating median percent errors and confidence intervals for each therapeutic and diagnostic test. RESULTS: Costs were determined from the British Columbia Medical Association Guide to Fees, British Columbia Centre for Disease Control, hospital finance departments, and pharmaceutical wholesalers. A total of 82 (85%) residents completed the survey, but 11 were only partially completed. Few residents could estimate the cost of diagnostic tests or therapeutics to within 25% of the true cost, and the estimations were highly variable. Residents underestimated the cost of expensive drugs and overestimated the cost of inexpensive drugs. There was no relationship between cost awareness and training location, gender, residency year, or residents rating cost as important in ordering behaviour. CONCLUSION: Resident physicians in British Columbia, Canada have limited awareness of medical care costs.

Awareness↗
PubMedDate not supplied

Awareness of post-exposure prophylaxis guidelines against occupational exposure to HIV in a Mumbai hospital.

BACKGROUND: Exposure to the human immunodeficiency virus (HIV) is a matter of concern for healthcare workers. We conducted a survey to determine the level of awareness amongst operating room personnel regarding post-exposure prophylaxis in case of needlestick injuries from confirmed or suspected cases of HIV. METHODS: A structured questionnaire was presented to 39 anaesthetists and 31 surgical residents. Questions were related to identification of high risk fluids, risk of transmission, drugs, costs and procedure to be adopted for post-exposure prophylaxis. RESULTS: Fourteen respondents (20%) were aware of the true risk of transmission. About one-third identified all high risk fluids correctly. Fifty-five respondents (78%) correctly stated that washing the site with soap and water was the initial measure, but less than a third knew whom to contact immediately after a needlestick injury. Though 45 respondents (64%) correctly stated that prophylaxis should be initiated within 1 hour of injury, none knew exactly which drugs were to be used. Thirty respondents (42%) were aware of the use of zidovudine but none were aware of the second or third drugs used for post-exposure prophylaxis. Only 4 respondents (6%) knew the correct duration of post-exposure prophylaxis. Five respondents (7%) knew that the drugs were available in medical stores and 7 knew the approximate cost of therapy. CONCLUSION: There is surprisingly poor knowledge of post-exposure prophylaxis against HIV. Ongoing awareness and training programmes are necessary to improve the same.

Anti-HIV Agents↗
PubMed2003

Involuntary aware memory enhances priming on a conceptual implicit memory task.

This study investigated the role of involuntary aware memory (phenomenological awareness of the study episode) on a conceptual implicit memory task. Subjects studied words under levels of processing conditions (LOP: nonsemantic vs. semantic) and then received a category exemplar generation priming task. Subjects were either aware or unaware of the study test relationship. Subjects who were study test aware showed more priming for semantic study than subjects who were study test unaware, thus producing an LOP dissociation between them. The findings suggest that involuntary aware memory can enhance performance on conceptual implicit memory tasks, thus having theoretical implications for implicit and explicit memory.

Awareness↗