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[Prevalence, awareness, treatment and control of hypertension in Chinese adults].

OBJECTIVE: To identify the prevalence, distribution, current status of awareness and control of hypertension in Chinese adult population. METHODS: A cross-sectional survey was conducted in mainland of China in 2000 - 2001 as a part of work coordinated with InterASIA Program. A total of 15,838 nationally representative subjects aged 35 to 74 were selected with multistage cluster sampling. Measurement of blood pressure was taken for all of them with three readings in a mercuric-column sphygmomanometer after resting for five minutes. Standard structured questionnaire was used to collect their histories and treatment and prevention for hypertension. A case of hypertension was defined as any person with systolic blood pressure equal to or greater than 140 mmHg, or with diastolic blood pressure equal to or greater than 90 mmHg, or being administered with antihypertensive agents. RESULTS: A total of 15,838 adults aged 35 - 74 years were included in this survey. Overall, the prevalence of hypertension was 27.2%, representing 130 million persons with hypertension nationwide as estimated. Age-specific prevalence of hypertension was 10.7%, 26.8%, 38.9% and 50.2% for women and 17.4%, 28.2%, 40.7% and 47.3% for men aged 35 - 44, 45 - 54, 55 - 64 and 65 - 74 years, respectively. Among hypertensive patients, 44.7% were aware of their high blood pressure, 28.2% were taking antihypertensive medication, and 8.1% achieved their blood pressure under control (< 140/90 mm Hg). All these data indicated that percentages of awareness, treatment and control of hypertension increased by 86.2%, 92.6% and 145.4%, respectively in the past ten years, as compared with the data in 1991. CONCLUSIONS: In the past ten years, percentages of awareness, treatment and control of hypertension in Chinese adults increased significantly, who had a relatively high prevalence of hypertension, but lower awareness and much lower percentages of treatment and control of hypertension. It is urgently needed to improve prevention, detection and treatment for hypertension in adults.

Adult↗

Awareness under general anesthesia.

General anesthesia aims to eliminate patients' awareness of excruciating pain during surgery. Nevertheless, rare occurrences of patient awareness continue because the problem is not yet completely preventable. One study puts the incidence of awareness at 0.18% for patients receiving muscle relaxants and at 0.10% for patients not given relaxant drugs. Awareness experiences frighten patients and impact their implicit and explicit memories in ways that can leave a lifetime of residual emotional and psychological problems ranging from sleep disturbances, nightmares, and daytime anxiety that may subside with time to development of post-traumatic stress disorder. Most anesthetists monitor depth of anesthesia by assessing intraoperative hemodynamic responses to surgical stimuli--an approach questioned by some authors. Several depth-of-anesthesia monitors are available, but there is no ideal monitor that is 100% reliable. This review provides an overview of literature that reports findings associated with the monitoring and occurrence of intraoperative awareness. These studies indicate assessment methods that can be trusted when we provide general anesthesia and what measures can be taken to prevent recall by patients under general anesthesia.

Anesthesia, General↗

[Awareness and periconceptional use of folic acid among non-western and western women in the Netherlands following the 1995 publicity campaign].

OBJECTIVE: To investigate the influence of ethnicity on the awareness and use of folic acid by pregnant women. DESIGN: Secondary data analysis. METHOD: Using the data on 1555 women, collected during a cross-sectional study conducted among pregnant women with good knowledge of the Dutch language in 1996, the authors determined what was known about the recommendation to use folic acid around the time of conception and what the actual use was. Women were defined as either 'western' or 'non-western' on the basis of the place of birth of the woman and her parents. RESULTS: Of the 1555 pregnant women, 74 (5%) were non-western or of non-western descent. Non-western women more often had a lower educational level than western women (51% versus 34%; p = 0.002) and more often had an unintended pregnancy (24% versus 8%; p < 0.0001). 41% of the non-western women had heard of the recommendation to use folic acid before pregnancy, compared to 79% of the western women (p < 0.0001). However, the use of folic acid was not significantly different between non-western and western women (56% versus 69%) if they had been aware of the recommendation to use folic acid before pregnancy. Awareness of the recommendation to use folic acid was higher in older women (OR: 1.46; 95% CI: 1.13-1.89), women of western descent (0.27; 0.16-0.47), women with a higher level of education (0.35; 0.27-0.45) and in case of planned pregnancy (0.45; 0.31-0.67). The use of folic acid, restricted to women who were aware of the recommendation to use folic acid before their pregnancy, was higher in older women (1.37; 1.05-1.80) and lower in those with more previous pregnancies (0.57; 0.43-0.75) and in case of an unplanned pregnancy (0.55; 0.34-0.88). CONCLUSION: Although non-western women had less knowledge of the recommendation to use folic acid than western women, the use of folic acid was not significantly different from that by western women if they had been aware of the recommendation to use folic acid before pregnancy. Continued education on folic acid targeting non-western and western women is important.

Adolescent↗

Knowledge and awareness of hypertension among patients with systemic hypertension.

BACKGROUND: In Nigeria, systemic hypertension is the commonest noncommunicable disease, and public awareness about hypertension and its determinants is poor. This study aims to assess the knowledge and level of awareness of the disease among hypertensive patients attending the medical outpatient clinic of Olabisi Onabanjo University Teaching Hospital (OOUTH). METHODOLOGY: Hypertensive patients who attended the medical outpatient clinic during the one-year study period and gave their consent were recruited into the study. Response to a questionnaire on various aspects of hypertension was analyzed using the STATA for Windows software. RESULTS: There were 254 hypertensive patients, of which 111 were males and 143 were females, giving a male: female ratio of 1:1.3. The mean age (SD) of the patients was 51 years +/- 12.2; 52.4% of the participants were aware that hypertension was the commonest noncommunicable disease in Nigeria. About one in 10 patients (11.4%) was aware that "nil symptom" is the commonest symptom of hypertension, while 37% were not aware that hypertension could cause renal failure. Only about one-third (35.4%) of the patients knew that hypertension should ideally be treated for life, while 58.3% believed that antihypertensive drugs should be used only when there are symptoms. The remaining 6.3% believed that the treatment of hypertension should be for periods ranging from two weeks to five years but not for life. CONCLUSION: This study has demonstrated inadequate knowledge of hypertension in patients with hypertension in our study population. Conscious efforts should be made and time set aside to health educate hypertensive patients. Organization of "hypertensive club or society" could be encouraged. These will reduce dissemination of false or inaccurate information by hypertensive patients to the public and its attendant dangers.

Adult↗

Self-reported awareness of unrestored dental caries. Survey of the Oral Health Status of Maryland Schoolchildren, 2000--2001.

PURPOSE: The purpose of this study was to assess and compare parental awareness of unrestored dental caries needs in a schoolchildren population according to socioeconomic status. METHODS: Subjective and normative unrestored dental caries data of kindergarten and third-grade children were collected from parental awareness questionnaires and clinical examinations, respectively, used in a 2000--2001 statewide survey of Maryland schoolchildren. Descriptive, bivariate, and multivariate analyses were performed to assess awareness of unrestored dental caries. Parental perceived need also was compared to clinical findings of unrestored dental caries. RESULTS: Actual (clinically assessed) unrestored dental caries (21%) was found to be 2 times the level of self-reported awareness of dental caries (11%). Those most likely to have significantly incorrect awareness of unrestored dental caries were: (1) low-income populations; (2) residents of the Maryland Eastern Shore. Sensitivity was 34% and specificity 96% in comparing self-assessed, unrestored dental caries need with the clinical findings. CONCLUSIONS: An incorrect perceived oral health need is high in poorer populations and may serve as a barrier to their achieving optimal oral health, given that disease prevalence is higher and access to oral health care services is lower in this population group.

Attitude to Health↗

[A retrospective study on awareness in 1922 cases during induction of general anesthesia].

BACKGROUND: There are some reports on the incidence of awareness during general anesthesia that is usually stable at the maintenance period. The aim of this study is to evaluate the incidence of awareness during the induction period of general anesthesia in which the effects of anesthetics are unstable. METHODS: The research-nurses interviewed the patients, who had undergone general anesthesia, on the awareness during anesthesia within a week after operation. The patients were excluded from the study if they were in deep sedation or unconscious because of the medical reasons. We defined the induction period from the administration of hypnotic drugs to the tracheal intubation. RESULTS: Seven cases with ages from 20 s to 70 s out of 1922 cases were identified as the residual awareness cases during the induction period. Six cases were managed with low concentrations of inhalation anesthetics after injection of intravenous hypnotics. The incidence was lower, but not significant, if they were managed with total intravenous technique. The BIS values were above 60 in all these cases if the monitor was attached. CONCLUSIONS: The incidence of awareness during the induction was 0.36%. We have to pay more attention to the disappearance of the hypnotic effect at the induction period.

Adult↗

Awareness and misconception of hypertension in Canada: results of a national survey.

BACKGROUND: The Canadian Heart Health Surveys were the last Canadian population-based physical measures surveys (conducted between 1988 and 1992) that determined that hypertension in Canada was poorly managed. Hypertension was undetected in almost one-half of all hypertensive Canadians surveyed, and only 13% of those with hypertension were treated and controlled to recommended blood pressure targets. The reasons for poor control are likely multifactorial; however, a lack of public awareness and understanding of hypertension may contribute to the epidemic of uncontrolled hypertension in Canada. METHODS: A national telephone survey was conducted comprising 1001 randomly selected men and women older than 40 years of age to determine the level of public awareness, understanding and misconception of hypertension in Canada. The survey was balanced for region, age and sex. RESULTS: Thirty-four per cent of respondents had been diagnosed with high blood pressure or hypertension by a health care professional, but only 58% of respondents had ever discussed their blood pressure with a physician, and only 44% were able to identify their own blood pressure or differentiate blood pressure levels considered to be above or below recommended targets. Overall, respondents had a poor understanding of the consequences of high blood pressure or hypertension. The majority were unaware of the association between hypertension and heart disease (80%), heart attack (66%), kidney disease (98%), damage to blood vessels (95%) and premature death (74%). Respondents also had limited knowledge of lifestyle issues affecting hypertension, despite 44% indicating that they were overweight and 18% identifying themselves as smokers. Almost two-thirds (63%) thought hypertension had clearly identifiable signs or symptoms, although they believed that hypertension was not a serious medical condition. Most respondents (59%) falsely believed that they would not develop hypertension and 38% thought that they would be able to control hypertension without the aid of a physician if they did have hypertension. CONCLUSIONS: While hypertension-related complications are preventable, lack of public awareness and misconceptions about hypertension and hypertensive complications are common and may, in part, be associated with ongoing inadequate Canadian awareness, treatment and control rates for hypertension. Increasing public awareness of hypertension using public education and health provider strategies should be a high national health priority.

Adult↗

An assessment of the awareness of sexual and reproductive rights among adolescents in south western Nigeria.

This study, conducted in Ikeja and Ikorodu Local Government Areas of Lagos State, examined the awareness of sexual and reproductive rights among adolescents in south-western Nigeria. A total of 600 in-school and out-of-school adolescents were interviewed using quantitative and qualitative methods. The study revealed that majority of the adolescents were aware of sexual and reproductive health rights (60.3% in Ikeja LGA and 62.3% in Ikorodu LGA) but lacked knowledge of contents of the rights. Majority of them in various categories (by school condition and type of settlement) were not aware of sexual and reproductive health programmes being implemented for adolescents. In addition, those who were aware of such intervention programmes could not access or use the services due to certain sociocultural barriers. The study recommends formulation of appropriate intervention strategies and programmes for adolescents so that they may be aware and knowledgeable of their sexual and reproductive rights.

Adolescent↗

Health professions career awareness program for seventh- and eighth-grade African-American students: a pilot study.

This exploratory, cross-sectional study was designed to gauge the interest and health career choices of African-American students before high school and to determine their level of satisfaction with a health career awareness program. Over a three-year period, 133 seventh-grade students (47%) and eighth-grade students (53%) enrolled in a Southside Chicago Catholic school were recruited; 98% were African-American. The students participated in a career awareness program, which consisted of lectures, video presentation, interactive discussion, and college campus visits. Each student completed a questionnaire that sought demographic information, health career choice, career preference, and level of satisfaction with the awareness program implemented. For career choice, 39% of the students selected "doctor" and dentist, 28% selected occupational therapy, 15% selected social work, 11% selected nursing, and 7% selected health information administration. The majority of the students (51%) were "very satisfied" and 49% were "satisfied" with the program that was implemented. We found no discernable difference in the health career interest and career choice of the study participants over the three-year period. Our findings reconfirmed a continuing limited level of awareness about allied health professions among African-American students before high school. Follow-up studies should expand the scope and contents of the awareness program to include other health professions, field trips, and mentoring by health care providers or health professional students.

Adolescent↗

Evaluation of a cancer awareness campaign: experience with a selected population in Karachi.

The incidence and prevalence of cancer is rapidly increasing in both developed and developing countries. The most common cancers reported in Pakistan are breast and cervical cancers in females, and lung and oral cancers in males. Public awareness of cancer can play a vital role in its prevention, early diagnosis and treatment. A pilot survey conducted by the Cancer Support Group (CSG) of Aga Khan University Hospital from 2001 till 2004 to gauge the public awareness of cancer in Pakistan revealed that people were afraid of cancer and had little knowledge about its prevention and early detection. The survey also identified several social, religious and cultural misconceptions which hinder cancer screening and treatment. In order to create awareness amongst the general public, especially the young generation, members of the CSG also organized fifteen health education sessions in schools, colleges, hospitals and communities in Karachi which were attended by more than 1,500 people. With the help of the results generated in the pilot project, education material was designed and developed for these health education sessions. Ten percent of the participants contacted CSG members for some unusual finding after administering a self screening tests taught in these sessions. This indicates the importance of holding cancer awareness sessions and the positive feedback obtained suggests that people would like to have cancer awareness sessions continued.

Adolescent↗

Awareness during anaesthesia: a review.

Following the introduction of muscle relaxants into anaesthesia there became recognised a state in which patients may be aware of their surroundings but unable to communicate their plight. This state of awareness is more likely to occur during light inhalational or total intravenous anaesthesia. Detection of awareness is difficult and several methods have been described. Measurement of the depth of anaesthesia is also difficult as clinical signs are unreliable and even sophisticated monitoring equipment is unhelpful. Awareness can occur without patient recall and may be due to equipment failure or anaesthetic failure. The former is avoidable and the latter ought to be. Recommendations have been made regarding the use of premedicant drugs and volatile anaesthetic agents to reduce the incidence of awareness.

Anesthesia, General↗

Trends in cholesterol knowledge and screening and hypercholesterolemia awareness and treatment, 1980-1992. The Minnesota Heart Survey.

BACKGROUND: National cholesterol education initiatives were implemented in the middle to late 1980s. This study examines whether there were significant increases in population cholesterol knowledge and screening and hypercholesterolemia awareness and treatment from 1980 to 1992. METHODS: Three population-based surveys were conducted among adults aged 25 to 74 years in 1980-1982 (N = 4086), 1985-1987 (N = 5735) and 1990-1992 (N = 6305) in the Minneapolis-St Paul, Minn, metropolitan area as part of the Minnesota Heart Survey. Personal interviews about knowledge of cholesterol level and hypercholesterolemia awareness and treatment were conducted. Total serum cholesterol was measured; hypercholesterolemia was defined as having a total cholesterol level of 6.21 mmol/L or more (> or = 240 mg/dL) or current use of cholesterol-lowering medications. Hypercholesterolemia awareness was defined as the belief of a participant with hypercholesterolemia that her or his total cholesterol was high. RESULTS: Knowledge increased from 15% in 1980-1982 to 17% in 1985-1987 to 55% in 1990-1992 (P < .001) in women; similar trends were observed for men (19%, 22%, and 47%, respectively; P < .001). Hypercholesterolemia awareness doubled during the decade (women: 17%, 1980-1982; 24%, 1985-1987; 60%, 1990-1992; P < .001; men: 25%, 30%, and 55%, respectively; P < .001). Among participants who reported physician-diagnosed hypercholesterolemia, the prevalence of current pharmacological treatment increased from 9% in 1980-1982 to 14% in 1990-1992 in women, and from 7% to 13%, respectively, in men. CONCLUSIONS: Cholesterol knowledge and hypercholesterolemia awareness and treatment increased substantially during the 1980s, concurrent with educational initiatives of the National Cholesterol Education Program and other efforts.

Adult↗

Hypertension management in Zimbabwe--awareness, treatment and blood pressure control. A community-based study.

OBJECTIVE: To evaluate the level of awareness of hypertension, treatment and blood pressure control in rural and urban communities in Zimbabwe. DESIGN: Community-based cross-sectional survey. SUBJECTS AND SETTING: 749 male and female heads of households aged > 34 years recruited from alternate households of randomly selected villages in two adjacent rural areas and randomly selected streets in an urban area. MAIN OUTCOME MEASURES: Blood pressure, awareness of hypertension, treatment and control for those on drug therapy. RESULTS: 250 subjects were found to have a diastolic blood pressure (DBP) > 94 mmHg or were on treatment with a DBP < 95 mmHg. Only 56 (22.4%) were on treatment. Of those not on treatment, 73.9% were not aware that they were hypertensive, while only 26.1% were aware but were untreated. Of those on treatment, control was inadequate in 24 (52.2%). CONCLUSION: Awareness is low and treatment and control of hypertension are inadequate in this population. There is an urgent need to set up a national policy for the prevention and control of hypertension in Zimbabwe. The main focus should be on prevention, as this may be more cost-effective for a developing country with limited resources.

Adult↗

Drug use problem awareness and treatment readiness in dual-diagnosis patients.

Problem awareness and treatment readiness are factors that influence treatment-seeking behavior, and thus, morbidity and outcome. The authors elucidated patterns of problem awareness and treatment readiness among hospitalized dually diagnosed patients by administering the Problem Awareness and Readiness for Treatment subscales of the Alcohol Use Inventory to 67 psychiatric inpatients with comorbid substance-related disorders and using a multivariate model approach to data analysis. The results suggested differential and interactive effects of gender, ethnicity, voluntary admission status, and a diagnosis of major depression (MDD) on drug abuse problem awareness and treatment readiness. Female gender, voluntary admission status, and a comorbid diagnosis of MDD were associated with increased awareness and readiness for treatment.

Adult↗

Awareness of sources of peer-reviewed research evidence on the internet.

CONTEXT: Peer-reviewed research evidence that was once available only to clinicians is now posted on the Internet and accessible to everyone, but levels of awareness of this evidence among patients and clinicians is not known. METHODS: Cross-sectional survey, conducted from July 1998 through January 2000, of cancer patients (n = 1998), their family physicians (n = 871), and all oncologists (n = 30) and oncology nurses (n = 44) at the Hamilton Regional Cancer Centre, Hamilton, Ontario. Comparisons made between and within groups to examine use of the Internet by patients and clinicians to find health information, and their awareness of organizations using Internet-based resources to promote evidence-based decision making. RESULTS: Response rates were 72%, 44%, 97%, and 84% for patients, family physicians, oncologists, and nurses, respectively; 47% of patients, 64% of family physicians, 100% of oncologists, and 72% of nurses reported that they used the Internet. Few patients were aware of the existence of the Cochrane Collaboration (1%), MEDLINE (13%), or the Program in Evidence-Based Care of Cancer Care Ontario (3%). Oncologists had the highest reported levels of awareness of the sources of evidence on the Internet. Most family physicians had not heard of any of the sources. CONCLUSIONS: The awareness of evidence sources on the Internet varies between patients and clinicians and across groups of clinicians, and some of the most rigorously developed sources of information are still unknown.

Adult↗

Awareness of folic acid for neural tube defect prevention among Israeli women.

The failure of neural tube closure during early embryogenesis results in a range of neural tube defects (NTD), the most common of which is spina bifida. The role of folic acid in reducing the rate of NTD has been well-established. Three recent cases of infants with NTD inspired this investigative study into the level of awareness and knowledge of folic acid and its function in the prevention of NTD among Israeli women. Of 920 women interviewed, only 51 (5.5%) had heard of folic acid, and 27 (2.8%) were reported to have taken it. The source of information and the motivation for self-medication were also explored with regard to socioeconomic and health profile. Awareness of folic acid was significant among women aged 17-29 years (P = 0.005) and those aged 30-39 years (P = 0.009), and among semireligious and nonreligious women (P = 0.008 and 0.01, respectively). Among women who were aware of folic acid, only nonreligious women tended to take it. No correlation was found between folic acid intake and age, religiosity, nationality, number of pregnancies, and health status among women who were aware of folic acid intake. The poor level of awareness, evident in our study, demands that the medical community broadcast the benefit of folic acid. Furthermore, government health initiatives, such as the addition of folic acid to flour preparations, may effectively ensure its appropriate daily intake. These improved education and prevention programs may forcibly reduce the rate of NTD-affected pregnancies.

Adolescent↗

Asian American Network for Cancer Awareness, Research, and Training's legacy. The first 5 years.

The Asian American Network for Cancer Awareness, Research, and Training (AANCART) is the first special populations network for Asian Americans on a national basis and includes collaborating organizations from Boston, New York, Houston, Seattle, San Francisco, Los Angeles, Hawaii, and Sacramento (where it is headquartered at the University of California, Davis). NCI funding of AANCART in 2000 brought together investigators and leaders from 9 cities across 6 states to establish an infrastructure for addressing cancer awareness, research, and training. Since 2000, AANCART has conducted needs assessments, held community awareness activities and trainings, trained trainees, sponsored National Asian American Cancer Control Academies, and produced presentations, publications, and grants. All specific aims have been attained, including the establishment of an infrastructure to promote Asian American cancer awareness, research, and training in 4 targeted regions; the establishment of partnerships to promote accrual to clinical trials, training, and pilot studies; and the formulation and successful implementation of grant-funded research to reduce the cancer burden among Asian Americans. AANCART's first 5 years have increased cancer awareness, trained special populations scientists, and advanced the field of Asian American cancer control research. Cancer 2006. (c) 2006 American Cancer Society.

Asian↗

Neural systems connecting interoceptive awareness and feelings.

In many theories of emotions the representations of bodily responses play an important role for subjective feelings. We tested the hypothesis that the perception of bodily states is positively related to the experienced intensity of feelings as well as to the activity of first-order and second-order brain structures involved in the processing of feelings. Using a heartbeat perception task, subjects were separated into groups with either high or poor interoceptive awareness. During emotional picture presentation we measured high-density EEG and used spatiotemporal current density reconstruction to identify regions involved in both interoceptive awareness and emotion processing. We observed a positive relation between interoceptive awareness and the experienced intensity of emotions. Furthermore, the P300 amplitudes to pleasant and unpleasant pictures were enhanced for subjects with high interoceptive awareness. The source reconstruction revealed that interoceptive awareness is related to an enhanced activation in both first-order structures (insula, somatosensory cortices) and second-order structures (anterior cingulate, prefrontal cortices). We conclude that the perception of bodily states is a crucial determinant for the processing and the subjective experience of feelings.

Adolescent↗