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PubMed2003

Effects of bite raising and occlusal awareness on tongue thrust in untreated children.

The purpose of this study was to determine the influence of conscious bite (occlusal awareness), with or without immediate bite raising, on tongue thrust during swallowing and speech. A total of 110 untreated children (age range, 7-12 years; mean, 9 years 8 months) were examined with various extraoral and intraoral observation tests. Subjects were divided according to sex and score on the labiolingual dysfunction index (LLDI) into high (LLDI-H) and weak (LLDI-W) dysfunction groups. A special, previously tested chocolate paste was used to map tongue and tooth contacts during task performance, including conscious bite (occlusal awareness) with and without bite raising. The bite was raised with an overlay or provisional occlusal plane placed unilaterally on the maxillary right molar. The results did not show any difference between boys and girls, but other findings were related to the LLDI score. Habitual mouth closure and swallowing without the provisional occlusal plane produced less pronounced bite contact in the LLDI-H group. Swallowing with conscious bite increased the bite contact in both groups but predominantly in the LLDI-H group. Tongue thrust reacted inversely to bite contacts: it was reduced when occlusion was perceived with and without bite raise but somewhat more with the provisional occlusal plane. The LLDI-W group was less affected. Tongue thrust was inhibited in both groups during speaking with bite raising and occlusal awareness. These results indicate that conscious bite helps to control the tongue. Slight raising of the bite increases occlusal awareness and its inhibiting effect on tongue thrust. A provisional occlusal plane or a similar overlay might be a useful adjunct in training the tongue to retrude in subjects with oral dysfunction.

Child↗
PubMed1997

How do we increase awareness of osteoporosis?

In the UK and throughout Europe 10 years ago, osteoporosis was not a word that existed in the vocabulary of the general public. The majority of doctors had dismissed osteoporosis as a normal process of ageing, affecting only the very elderly and about which nothing could be done. Why should it matter that awareness of osteoporosis was so low among the general public and the medical professions? For the newly launched National Osteoporosis Society in the UK, several questions needed to be answered: if osteoporosis was not an inevitable part of growing old, was it really a disease and how could action be implemented to treat it and prevent it? If fracture numbers and their costs were so much higher than had been thought, who should be informed of this? And if there were ways of treating and preventing osteoporosis, who should be made more aware, what should they be told, and how could such awareness-raising be done and paid for? Before real action could be undertaken, a considerable awareness programme would be needed to radically-alter traditional beliefs about bone health.

Clinical Competence↗
PubMed1999

Emergency contraception: lack of awareness among patients presenting for pregnancy termination.

STUDY OBJECTIVE: Emergency contraception, otherwise known as postcoital contraception, refers to a group of birth control modalities that, when used after unprotected intercourse within defined time constraints, can markedly reduce the risk of a resultant unintended pregnancy. The English literature, using British and American awareness data, consistently claims that these contraceptive options are underutilized in the United States because of a lack of patient and physician awareness of their existence. The objective of this study was to determine the level of awareness of postcoital contraceptive techniques in a population of American women who were presenting for pregnancy termination. The secondary goal was to calculate (theoretically) how many of these surgical terminations could have been prevented through the use of postcoital contraception. METHODS: A questionnaire was administered to patients presenting to an abortion clinic. It was intended to anonymously identify patient demographics and knowledge of the various emergency contraceptive options and, in hindsight, to determine what percentage of these women would have been willing candidates for one of these medical modalities. On completing the questionnaire, all patients received an emergency contraceptive information sheet for future consideration. RESULTS: Eighty-three patients completed the study. They ranged in age from 15 to 44 years (mean, 24 years). Forty-six percent of the patients were 21 years of age or younger. A total of 71% of all patients had no real knowledge of the existence of emergency contraceptive options; 26% had some limited knowledge, and only 3% had somewhat complete and valuable information. Fifty-one percent of the patients would have been appropriate, realistic, and willing candidates for at least the emergency contraceptive pill. Assuming at least a 75% effectiveness rate for the emergency contraceptive pill, 38% of the surgical pregnancy terminations performed on this population of women could have been avoided. CONCLUSION: Our data confirm that emergency contraceptive options are underutilized because of a lack of patient awareness. Contraception education, especially directed toward adolescents, should include disseminating enhanced information about postcoital contraception options.

Abortion, Legal↗
PubMed1998

How to create awareness and ensure broad dissemination of health informatics standards.

There is a range of organisations with responsibility for information standards development within Australia. These include Standards Australia, which is formally linked to the International Organisation for Standards (ISO), the National Health Information Management Group, which deals with the government sector and several statutory organisations such as the Australian Institute of Health and Welfare and the National Centre for Classification in Health. The different constituencies involved with each of these organisations, the scope of healthcare informatics and the rate of organisational and technological change in the industry present a significant challenge in ensuring that the standard setting process is highly visible, responsive and capable of demonstrating its value through effective implementation. Creating awareness and ensuring broad dissemination of healthcare informatics standards is a key component in meeting this challenge. This can operate at a number of levels from strategic to operational. At the strategic level, it requires active engagement and commitment of the key decision-makers, both political and professional. This may require directly lobbying and promoting the benefits of standardisation to those decision-makers but can be achieved even more effectively by creating industry awareness and demand through carefully targeted presentations on the impact of standards to broader health industry forums. At the tactical level, the standards development medium itself can be used to engage and gain commitment from government, professionals, vendors and the health industry by operating as an inclusive, open and effective process. At the operational level, there is the opportunity for much more efficient use of technology to create awareness of both these processes and their outcomes. The establishment in Australia of a web enabled National Health Information Knowledge base built around ISO standards is one example of the type of development which will assist in the acceleration of awareness of standards and standardisation, which is needed to cope with the increasing demand.

Australia↗
PubMedDate not supplied

Expanding the availability and improving delivery of natural family planning services and fertility awareness education: providers' perspectives.

Despite the recognized benefits for clients and programs of providing natural family planning (NFP) services, few family planning programs offer NFP and few provide fertility awareness education. Furthermore, many non-governmental organizations (NGOs) that provide only NFP actually reach a very small percentage of the potential NFP users in the areas they serve. This paper discusses the results of interviews with selected family planning providers that were conducted to explore reasons why NFP and fertility awareness education are not offered in their programs, and with NFP providers to get their opinions on how to improve service delivery. The interviews were structured around some of the lessons learned from the successful incorporation of the lactational amenorrhea method (LAM) into several multimethod family planning programs. There is agreement that the need for NFP services* is far from being met and that most clients lack the information and skills they could learn through fertility awareness education. The providers interviewed also acknowledged that offering these services would improve the quality of reproductive health services in general. Presented here are some ideas about why these services are not offered, as well as suggestions for integrating NFP and fertility awareness education into existing family planning programs.

Attitude of Health Personnel↗
PubMed1998

Prevalence, awareness, treatment, and control of hypertension in a Spanish population.

A cross-sectional population survey using a random, stratified sample into phases was conducted in order to assess the prevalence, awareness, treatment, and control of hypertension in Albacete (a south-eastern province in Spain) with 248000 inhabitants over 18 years of age. The sample size was of 1322 people. Both systolic and diastolic BP were higher in men than in women and showed an increasing trend with age independently of gender. Assuming a cut-off for hypertension of <140/90 mm Hg and <160/95 mm Hg, we found a prevalence of hypertension of 32.7% and 23.1%, respectively. Overall, 56.5% of hypertensive subjects were aware of their condition. The degree of this awareness was significantly higher in women and in the elderly. The percentage of patients who were receiving antihypertensive treatment was 49.1%. This proportion was also higher among women, elderly people, and subjects living in urban areas. High BP was successfully controlled in 10.9% of the total hypertensive population which accounted for 24.4% of the treated patients. The corresponding figures for the <160/95 mm Hg cut-off were 38.5% and 60.6%, respectively. In the logistic regression model, male gender and size of the local community were significantly associated with a better pharmacological control of hypertension. We found a high prevalence of hypertension with low degree of awareness and control, despite the general progress made in the diagnosis and treatment of hypertension in Spain. Specific intervention programs are necessary to increase the extent of control of hypertension in our country.

Adult↗
PubMed2004

Effectiveness of a community-based oral cancer awareness campaign (United States).

OBJECTIVE: The purpose of this study was to provide the first systematic evaluation in the United States of a community-based oral cancer awareness campaign. METHODS: We used a non-equivalent control group design and random-digit-dialing methods to examine billboard effectiveness and pre- and post-billboard impact between intervention and control counties in adult probability samples in Florida, USA. RESULTS: Respondents in the intervention county were more likely than controls to correctly identify the billboard message to get tested for oral cancer, and less likely than controls to report ever having an oral cancer examination, or to have heard of oral cancer. Results of pre-post analyses within each county showed that oral cancer examinations were significantly more frequent in both counties after the campaign. There were no significant differences between counties on the proportion of individuals who reported having seen the campaign or on any other item measuring billboard awareness or impact. CONCLUSIONS: Results suggest the Florida billboard campaign had limited success in increasing public awareness. Future cancer awareness campaigns should incorporate theoretical models, target high-risk groups and the broader community and provide culturally relevant messages as part of a multi-media campaign.

Adolescent↗
PubMed2005

Acquisition of differential delay eyeblink classical conditioning is independent of awareness.

There has been debate about whether differential delay eyeblink conditioning can be acquired without awareness of the stimulus contingencies. In 4 experiments, the authors reexamined this question. Older participants were tested with a tone and white noise (Experiment 1) or with 2 tones (Experiment 2). In addition, younger participants were tested with 2 tones (Experiment 3) or with 2 tones plus the parameters from an earlier study that had reported a relationship between conditioning and awareness (Experiment 4). Participants who were designated aware of the stimulus contingencies and participants who were designated unaware exhibited equivalent levels of differential eyeblink conditioning. Awareness of stimulus contingencies is not required for differential delay eyeblink conditioning when simple conditioned stimuli are used.

Adult↗
PubMed2004

Fear and the amygdala: manipulation of awareness generates differential cerebral responses to phobic and fear-relevant (but nonfeared) stimuli.

Rapid response to danger holds an evolutionary advantage. In this positron emission tomography study, phobics were exposed to masked visual stimuli with timings that either allowed awareness or not of either phobic, fear-relevant (e.g., spiders to snake phobics), or neutral images. When the timing did not permit awareness, the amygdala responded to both phobic and fear-relevant stimuli. With time for more elaborate processing, phobic stimuli resulted in an addition of an affective processing network to the amygdala activity, whereas no activity was found in response to fear-relevant stimuli. Also, right prefrontal areas appeared deactivated, comparing aware phobic and fear-relevant conditions. Thus, a shift from top-down control to an affectively driven system optimized for speed was observed in phobic relative to fear-relevant aware processing.

Adult↗
PubMed2006

Awareness of mouth cancer in Great Britain.

OBJECTIVE: There are more than 2,000 new cases of mouth cancer each year in Britain. Early detection is important yet little is known about population awareness of this disease and ability to recognise early signs, particularly among high risk groups. This study aimed to address this issue. METHODS: Data were collected by means of household survey. A total of 3,384 adults were questioned using a national probability sample. Respondents provided information on demographic characteristics, smoking status, and frequency of alcohol use. They were asked whether they had heard of mouth cancer. Their knowledge of early signs and risk factors was assessed. RESULTS: Whereas 95.6% of respondents said they had heard of mouth cancer, their awareness of early signs was low; for example, only 33.8% recognised that white patches in the mouth were a sign. The large majority understood that smoking and chewing tobacco were risk factors (84.7% and 80.1% respectively) but only 19.4% recognised alcohol use as a risk factor. In multiple logistic regression analyses controlling for relevant demographic factors, smokers and those with more frequent alcohol consumption were less likely to recognise early signs. CONCLUSIONS: Awareness of early signs of mouth cancer is low and lower in people who as a result of their behaviour are at higher risk. There is a need to raise awareness in those at most risk.

Adult↗
PubMed1996

The relation between speech perception and phonemic awareness: evidence from low-SES children and children with chronic OM.

The Developmental Weighting Shift (DWS) suggests that children adjust the weights they assign to the acoustic parameters of the speech signal as they gain experience with a native language, and that this developmental shift in perceptual weighting strategies is related to another developmental change: increased sensitivity to the phonetic structure of the speech signal. To test these claims, children presumed to differ in the amount of linguistic experience they had received during their preschool years participated in two kinds of tasks: a labeling task designed to estimate differences among groups in the weights assigned to various acoustic parameters, and tasks of phonemic awareness. The experimental groups were children from low-socioeconomic (low-SES) backgrounds, children with histories of chronic otitis media (OM), and children who experienced both conditions. A control group of children who experienced neither of these conditions also participated. The hypotheses were that, because of their diminished linguistic experience, children in the three experimental groups would display both more immature weighting strategies and poorer phonemic awareness than children in the control group, and that developmental advance in perceptual weighting strategies and phonemic awareness would be correlated. Results indicated that children with histories of chronic OM performed more poorly on both kinds of tasks than did children in the control group, and low-SES children performed more poorly still. Children experiencing both low-SES and chronic OM performed no differently than the low-SES children. These results provide support for the claim that the development of mature perceptual weighting strategies for speech and of phonemic awareness are related. Support is also provided for the claim that both depend on receiving sufficient and appropriate experience with a native language during the preschool years.

Child, Preschool↗
PubMed2002

Consequences of surveying folate awareness.

OBJECTIVES: To assess women's concerns when interviewed about the association between folate and neural tube defects (NTDs) and to determine how this is affected by time, being folate aware, having seen folate promotional material or being pregnant. DESIGN: As part of a community randomized trial outcomes evaluation, independent cross-sectional follow-up surveys were carried out in 1997 and 2000. SETTING AND PARTICIPANTS: Six local government areas in the state of Victoria, Australia; 2431 women aged between 15 and 44 years. MAIN VARIABLES STUDIED: Whether or not women knew of the association between folate and NTDs (i.e. were folate aware), whether or not women had been concerned by seeing folate/NTD information and if an interview about folate and NTDs had raised any concerns for them. RESULTS: In the 1997 survey, 36% of women said that the interview had raised concerns and this decreased to 26% in 2000. Women who were folate aware were significantly less likely to have raised concerns than women who were not folate aware (OR(adj) = 0.38, 95% CI 0.24-0.60). In general, women who had seen promotional material were less likely to feel concern about the interview than those who had not, although this varied with whether or not the promotional material had raised concerns. These effects were greater in women who were pregnant. CONCLUSIONS: Women had increased concerns having seen folate promotional material and after being interviewed about it. These results are consistent with the proposition that an initial emotional response to sensitive health information is part of an adaptive response appropriate to the process of health-related behaviour change.

Adolescent↗
PubMed2003

Physician awareness and self-reported use of local and national guidelines for community-acquired pneumonia.

OBJECTIVES: To assess physician awareness and reported use of medical guidelines for community-acquired pneumonia (CAP), and to identify factors associated with variations in awareness and use of these guidelines. DESIGN: A questionnaire was administered during the preintervention phase of a randomized clinical trial of a pneumonia guideline implementation strategy. PARTICIPANTS: Three hundred and fifty-two physicians who managed CAP patients at 7 Pittsburgh, PA hospitals completed the questionnaire. Physician and practice setting characteristics, and physician awareness and reported use of national American Thoracic Society (ATS) and local (hospital-developed) guidelines for CAP were assessed. RESULTS: Overall, 48% reported being influenced by ATS guidelines and 20% reported using these guidelines; 48% were uncertain whether a local pneumonia guideline existed. Only 28% of physicians who knew a local guideline existed reported frequently using the guideline. Use of national ATS guidelines was independently associated with practice as an infectious disease or pulmonary medicine specialist, nonpatient care-related professional activities, and intellect personality score. Use of local guidelines was independently negatively associated with practice as an infectious disease or pulmonary medicine specialist, and positively associated with positive attitudes toward practice guidelines. CONCLUSIONS: Results indicate low levels of awareness and use of guidelines for the management of CAP. Key indicators (e.g., medical specialty, fewer clinical duties, and positive attitudes about guidelines) were associated with greater use of national and local guidelines. If replicated with data on actual physician management practices, more effective guideline implementation strategies will be necessary to encourage compliance with practice guidelines for the management of CAP.

Anti-Bacterial Agents↗
PubMed2005

Visibility, visual awareness, and visual masking of simple unattended targets are confined to areas in the occipital cortex beyond human V1/V2.

In visual masking, visible targets are rendered invisible by modifying the context in which they are presented, but not by modifying the targets themselves. Here, we localize the neuronal correlates of visual awareness in the human brain by using visual masking illusions. We compare monoptic visual masking activation, which we find within all retinotopic visual areas, with dichoptic masking activation, which we find only in those retinotopic areas downstream of V2. Because monoptic and dichoptic masking are equivalent in magnitude perceptually, the present results establish a lower bound for maintenance of visual awareness of simple unattended targets. Moreover, we find that awareness-correlated circuits for simple targets are restricted to the occipital lobe. This finding provides evidence of an upper boundary in the visual hierarchy for visual awareness of simple unattended targets, thus constraining the location of circuits that maintain the visibility of simple targets to occipital areas beyond V1/V2.

Adolescent↗
PubMed2002

Self-awareness following traumatic brain injury and implications for rehabilitation.

PRIMARY OBJECTIVE: Many studies investigating self-awareness following traumatic brain injury (TBI) have been conducted more than 2 years post-injury, thereby providing limited information regarding the implications of insight for rehabilitation. The present study aimed to investigate awareness of deficits in a group of patients who were less than 2 years post-injury and still involved in rehabilitation. RESEARCH DESIGN: Thirty patients with a history of moderate or severe TBI and their significant other (SO) were studied in a cross-sectional analysis. A sub-group also participated in an interdisciplinary Memory Group at the Bethesda Rehabilitation Centre. METHODS AND PROCEDURES: Level of insight was measured by the degree of agreement between self and significant other (SO) report on the Awareness of Deficit questionnaire (ADQ), assessing various domains of daily functioning. RESULTS: There was substantial agreement between patients and their SO, although the patients with TBI were less likely to acknowledge executive problems. Interestingly, both groups reported only low-to-moderate levels of difficulty. CONCLUSIONS: The data indicate that SO's awareness may also be limited in the early recovery stages. A sub-group of the patients obtained benefit from participation in the Memory Group in a rehabilitation setting.

Adolescent↗
PubMedDate not supplied

Inner body and outward appearance: the relationships between appearance orientation, eating disorder symptoms, and internal body awareness.

This study investigated the associations of appearance orientation and eating disorder symptoms with internal body awareness in an eating-disordered group of women and a general sample of women. In the eating-disordered group, appearance orientation was positively associated with internal body awareness. Eating disorders symptoms were negatively related to the awareness of bodily signals. No significant associations were found in the general sample of women. The results indicate that in eating-disordered individuals preoccupation with the body and eating-disordered behaviors are not only negatively associated with hunger, but with awareness of other bodily signals as well.

Journal Article↗
PubMed2006

Prism adaptation changes perceptual awareness for chimeric visual objects but not for chimeric faces in spatial neglect after right-hemisphere stroke.

Prism adaptation can ameliorate some symptoms of left spatial neglect after right-hemisphere stroke. The mechanisms behind this remain unclear. Prism therapy may increase exploration towards the contralesional side, yet without improving perceptual awareness, as apparently for the left side of chimeric face stimuli (Ferber et al. 2003). However, other prism studies suggest that perceptual awareness might be improved (e.g., Maravita et al., 2003). We tested the impact of prism therapy on visual awareness for the left side of chimeric objects as well as chimeric faces, in three neglect patients. Prism therapy dramatically improved awareness for the identity of the left side of chimeric non-face objects, but had no effect on judging expressions for chimeric faces. The latter may thus be unique in showing no prism benefit.

Adaptation, Physiological↗
PubMed1996

Hypertension awareness, treatment and control rates for an Asian population: results from a national survey in Korea.

OBJECTIVE: This observational study was performed in order to determine the hypertension awareness, treatment, and control rates for the country of Korea. METHODS: Rates were determined in conjunction with a national blood pressure survey in Korea in 1990. Through cluster sampling, individuals aged > 30 in 190/146,944 districts were selected for study. Among 25,567 eligible individuals, 21,242 had measurement of blood pressure (BP) and answered a standard questionnaire. BP was recorded as the mean of two measurements with a standard mercury manometer. Hypertension was defined either as BP > or = 160/95 mm Hg or on treatment (n = 2628), or as BP > or = 140/90 mm Hg or on treatment (n = 4219). Treatment was defined as any method of BP treatment, including dietary, traditional, or medication. RESULTS: Rates for BP > or = 160/95 mm Hg or on treatment: aware 1057 (40%), treated 696 (27%), controlled 367 (14%). Rates for BP > or = 140/90 mm Hg or on treatment: aware 1069 (25%), treated 696 (16%), controlled 221 (5%). CONCLUSIONS: Hypertension awareness, treatment, and control rates are relatively low in Korea. Blood-pressure control programs, including detection strategies, are needed here and worldwide.

Adult↗