SEARCH · Search PubMed

Results for “Awareness”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 973 records · Page 54Linked to original sources

PubMed2003

The role of parietal cortex in awareness of self-generated movements: a transcranial magnetic stimulation study.

Awareness of self-generated movements arises from comparing motor plans, and the accompanying (hypothetical) efference copy, with the visual and proprioceptive consequences of movement. Here we used repetitive transcranial magnetic stimulation (rTMS) to investigate the role of a posterior region in the superior parietal lobule (SPL) in this process. Nine healthy volunteers performed a finger extension actively and passively while wearing a CyberGlove; the glove recorded these (actual) finger movements and used this information in real time to move a virtual hand displayed on a computer screen. To assess the participant's awareness of movement onset, we introduced a delay between the onset of the actual and virtual movement (60-270 ms, 30 ms increments); the task was to judge whether the virtual hand movements were delayed relative to the actual hand movements. Low-frequency rTMS (15 min, 0.6 Hz) was applied either over the left SPL or the left temporal cortex (control site) to decrease excitability of these regions and, in turn, test their role in the awareness of self-generated movement. Following the SPL stimulation, participants' assessments of asynchrony were impaired for active but not passive movements. No significant changes were observed after rTMS applied over the control site. We suggest that these findings are consistent with the role of the SPL in evaluating the temporal congruency of peripheral (visual) and central (efference copy) signals associated with self-generated movements. As such, this region may contribute to the sense of 'agency' and its disturbances in disorders such as apraxia and schizophrenia.

Adult↗

PubMed2005

Target visibility and visual awareness modulate amygdala responses to fearful faces.

The goals of the present study were twofold. First, we wished to investigate the neural correlates of aware and unaware emotional face perception after characterizing each subject's behavioral performance via signal detection theory methods. Second, we wished to investigate the extent to which amygdala responses to fearful faces depend on the physical characteristics of the stimulus independently of the percept. We show that amygdala responses depend on visual awareness. Under conditions in which subjects were not aware of fearful faces flashed for 33 ms, no differential activation was observed in the amygdala. On the other hand, differential activation was observed for 67 ms fearful targets that the subjects could reliably detect. When trials were divided into hits, misses, correct rejects, and false alarms, we show that target visibility is an important factor in determining amygdala responses to fearful faces. Taken together, our results further challenge the view that amygdala responses occur automatically.

Adaptation, Physiological↗

PubMed2003

Cancer patients' awareness about their diagnosis: a population-based study.

BACKGROUND: The aim of the study was to evaluate Norwegian cancer patients' awareness of their prior cancer diagnosis in a general population-based study. METHODS: A cross-sectional population-based study of cancer patients' responses to the index question: 'Do you have or have you had cancer?' was carried out. We assessed correctness of the response in relation to cancer site, date of diagnosis, marital status, age and education. Smoking was chosen as a marker of health awareness. A total of 65,330 persons participated in the Nord-Trøndelag Health Survey (HUNT-II), performed in 1995-1997. The database of HUNT-II was merged with the Cancer Registry of Norway (CRN), thus identifying each of the 2983 (4 percent) participants with an invasive cancer diagnosis. RESULTS: Excluding basal cell epithelioma, a total of 20 percent of the patients denied their prior cancer diagnosis. This group consisted mainly of men (54 percent) and those who were diagnosed as very young or as elderly. More smokers than non-smokers were unaware of their prior malignancy (24 percent versus 20 percent). CONCLUSIONS: A 20 percent rate of patients who denied their former malignancy is surprisingly and unacceptably high. Disclosure of a cancer diagnosis should help the patient to develop increased health awareness. It should enable a person to report his or her former cancer diagnosis when necessary.

Adult↗

PubMed2006

Radon awareness survey in Pakistan.

Significant progress has been made in reducing the risk from exposure to radon and its progeny all over the world as a result of efforts made by different organisations which are working together to educate public about the harmful effects of radon. During the past several surveys, it was found that uneducated people were totally ignorant of radon in Pakistan. Even a large number of science graduates knew very little about radon and its hazards. Therefore, a nationwide survey was conducted to measure general awareness and factual knowledge about radon and its health hazards. In this regard, a questionnaire was prepared and distributed among different classes of the society including students, government employees and general public throughout the country. A total of 7000 people with different educational backgrounds participated in this survey, which includes uneducated people (1000), science and humanities graduates (2000 each) and under graduate (2000). Statistical analysis, excluding uneducated people, revealed that 30.4% of the total respondents were aware of radon and 69.6% had even not heard of radon. Only approximately 8.4% of the total respondents were knowledgeably aware of radon.

Air Pollutants, Radioactive↗

PubMed1989

Effects of dream reflection on waking affect: awareness of feelings, rorschach movement, and facial EMG.

The clinical and research literature suggests that waking dream reflection increases awareness of feelings. To examine this possibility, 16 male and 16 female participants spent a single night in the sleep laboratory while rapid eye movement (REM) sleep physiology and facial electromyogram (EMG) were monitored. Participants in the dream imagery condition were awakened from REM sleep and asked to reflect on their dreams. Participants in the fantasy imagery condition were awakened from REM sleep and asked to reflect on guided fantasies modeled on dream narratives. Participants were asked to reflect either on the affective connotations of their imagery or on the cognitive aspects of their imagery. Unexpectedly, self-reported awareness of feelings was less common during either affective or cognitive reflection on dreams than during such reflection on fantasies, especially for females. Also, kinesthetic sensitivity, as indicated by Rorschach movement responses, was less after dream reflection than after reflection on fantasy imagery, again especially for females. In contrast, facial EMG activity was greater during dream reflection than during fantasy reflection. Since facial EMG during REM sleep and during dream reflection was correlated with self-reported orienting within dream imagery, these results are understandable as evidence for the "carry-over" of REM orienting activity during dream reflection, resulting in reduced affective/kinesthetic sensitivity and reduced awareness of feelings.

Adolescent↗

PubMed2002

Imitation without awareness.

Imitation is a characteristic but little-understood function of the human brain and of some higher animals. The direct matching hypothesis suggests that a specialised brain circuit is able to extract and directly copy the motor commands of another person's observed actions. Here we investigate how conscious people are of this kind of imitation. We first showed that imitation reactions are faster than simple visual reaction times, consistent with a direct matching circuit in the CNS. We next compared the perceived time of imitation reactions in 17 healthy subjects with other kinds of actions. We found a significant delay in subjects' awareness of their own imitation reactions. Thus, while imitation reactions are unusually fast, subjects are not aware of this. The brain's direct-matching circuit for imitation partly bypasses conscious awareness.

Adult↗

PubMed2005

Visuomotor links in awareness: evidence from extinction.

In patients with extinction, ipsilesional stimuli may abolish awareness of contralesional stimuli. Explanations of extinction often assume a serial model of processing in which sensory competition and identification precedes the selection of responses. We tested the adequacy of this assumption by examining the effects of response variables on visual awareness in six patients using signal detection analysis. Ipsilesional stimuli modulated patients' response criteria in deciding whether a contralesional stimulus was a target, and response modality (verbal or motor) modulated patients' abilities to discriminate between contralesional targets and distractors. This pattern of input variables modulating response criteria and output variables modulating discriminability indicates the extent to which attentional and intentional systems are tightly intertwined, with bi-directional effects in producing visual awareness.

Aged↗

PubMedDate not supplied

Psychometric testing of the heart failure somatic awareness scale.

BACKGROUND: Self-management of heart failure relies on patients to assess their symptoms, but their ability to do so is often difficult to determine. The 12-item self-report Heart Failure Somatic Awareness Scale (HFSAS) was developed to measure awareness of and distress secondary to heart failure symptoms. The purpose of this study was to test the psychometric properties of the HFSAS. METHODS AND RESULTS: Feasibility and discriminant validity of the HFSAS were tested in 49 patients admitted for an exacerbation of heart failure. The HFSAS was acceptable to patients and discriminated between heart failure symptoms and anxiety (r = 0.25, P = .08). When reliability and validity were tested in 201 patients with acute heart failure, theta reliability was adequate (0.71). The HFSAS was low to moderately correlated with general bodily awareness (r = 0.48). No difference was found based on gender, but younger patients had higher mean and median HFSAS scores (more distress). The HFSAS was a significant predictor of symptom duration prior to seeking care for heart failure; higher scores were associated with longer delay before seeking care. CONCLUSION: The HFSAS is reliable with content, discriminant, and construct validity. Evaluation of its usefulness in teaching patients to monitor daily symptoms is needed.

Aged↗

PubMedDate not supplied

Overt and covert verbal problem-solving strategies: developmental trends in use, awareness, and relations with task performance in children aged 5 to 17.

Age-related changes in children's use, self report, and awareness of verbal problem-solving strategies (private speech) and strategy effectiveness were explored with a large (N = 2,156) cross-sectional sample of children aged 5 to 17. Children's verbal strategies moved from overt, to partially covert, to fully covert forms with age. Self-reports of verbal strategy use were accurate yet incomplete. Awareness of children's use of verbal strategies was low and increased with age. Although verbal strategies were associated with competence among the youngest children, self-talk was unrelated to task performance for older children, suggesting considerable persistence over time of a relatively ineffective strategy. Awareness was not a prerequisite for children's verbal strategy use but was positively associated with strategy effectiveness among those who talked.

Adolescent↗

PubMed2005

Awareness of the role of folic acid, dietary folate intake and plasma folate concentration in Japan.

AIM: To investigate awareness of the role of folic acid in the prevention of neural tube defects, dietary intake of folate, and plasma folate concentration. METHODS: Postal questionnaires were collected from 1190 lay female subjects in three different groups and from seven groups of 3067 health-care providers. Dietary folate was investigated by assessing food frequency charts that were kept for 3 days by 245 women, and plasma folate was assessed by analyzing the blood serum of 194 women. RESULTS: Less than 15% of citizens and mothers who had live births knew that there was a link between folic acid and neural tube defects. The exception was with myelodysplastic families, in which awareness was 92%. Awareness among health-care professionals was generally low. The highest level was found in obstetricians-gynecologists (76%) and the lowest in nurses (12%). Dietary folate intake and plasma concentration were highest in pregnant women (356 microg/day and 11.9 ng/mL) and the lowest in student nurses (217 microg/day and 6.8 ng/mL). When the recommended dietary allowance of folate in Japan is taken into consideration, 22% of the non-pregnant women and 71% of the pregnant women did not fulfill the recommended dietary allowance. CONCLUSIONS: Information on the role of periconceptional intake of folic acid is not sufficiently disseminated to young women and health-care professionals alike. Pregnant women should be repeatedly recommended to take folic acid supplements of 400 microg/day.

Adult↗

PubMed2006

Communication skills and cultural awareness courses for healthcare professionals who care for patients with sickle cell disease.

AIMS: This paper reports a project evaluating the efficacy and impact of a pilot communication skills and cultural awareness course for healthcare professionals who care for patients with sickle cell disease. BACKGROUND: Poor communication between patients with sickle cell disease and healthcare professionals causes suspicion and mistrust. Many patients feel that they are negatively labelled by the healthcare system and are sceptical of opening themselves to an unsympathetic system. They may therefore appear hostile and aggressive when interacting with healthcare professionals, which in turn leads to distortions and misunderstandings between both groups. The use of good communication skills by healthcare professionals is therefore vital for good healthcare practice. METHODS: Forty-seven healthcare professionals took part in a series of three pilot courses each lasting 3 days. Healthcare professionals were taught a repertoire of communication skills and cultural awareness strategies to use in challenging situations that arise in their care of sickle cell patients. Expert facilitators used a variety of teaching techniques, such as professionally-made videos, role-play, and group exercises. Participants' confidence in dealing with challenging situations was assessed at baseline, immediately after the intervention, and at 3- and 6-month postintervention. FINDINGS: A repeated measures anova revealed a statistically significant increase in confidence from pre- to postcourse scores. Confidence scores further increased from immediately postcourse and 3 months postcourse follow-up. These were then maintained at 6 months postcourse. CONCLUSION: The overall findings of this local study demonstrated that this type of communication skills and cultural awareness training had a positive and enduring impact on professionals' perceived ability and confidence in communicating with patients with sickle cell disease. Participants attributed this to the learner-centred approach of the course that provided them with the opportunity to transfer and apply the taught skills in their daily practice. This type of training might be helpful in reducing mistrust and increasing empathetic responses in healthcare professional.

Adult↗

PubMed2006

Can we assess students' awareness of cultural diversity? A qualitative study of stakeholders' views.

CONTEXT: Personal attitudes of doctors towards cultural diversity may influence the delivery of clinical care. Yet whether medical schools should assess a student's cultural awareness and if so, how, has not been specifically debated. OBJECTIVE: To establish the views of key stakeholders in medical education on the assessment of awareness of cultural diversity within the undergraduate curriculum. METHODS: Semi-structured interviews were undertaken, using sampling and snowballing, with 61 stakeholders, including policymakers, teachers of diversity, students, service users and carers. The data were analysed qualitatively using quasi-statistical and template approaches and themes identified. RESULTS: Three main themes emerged. The first was ambivalence over the need to assess students. Most felt students should be assessed to ensure the subject was taken seriously. Some were concerned that assessment might encourage false attitudes. The second theme was uncertainty over the best methodology. Objective structured clinical examinations (OSCEs) were the most favoured method. Significant concern was expressed that this alone was sufficient. The third theme was concern that current assessment methods do not identify students with inappropriate attitudes that are potentially detrimental to patient care. CONCLUSIONS: Assessment of cultural awareness should be attempted but it needs to be multifaceted. The OSCE alone is inadequate. Other tools, such as reflective portfolios, need evaluation.

Attitude of Health Personnel↗

PubMed2006

Prevalence and awareness of melasma during pregnancy.

BACKGROUND: Melasma is an acquired hypermelanosis of the face. There is little information on its prevalence during pregnancy in Iran. Objective To determine the prevalence and awareness of melasma during pregnancy at the Shahed University Hospitals of Tehran, Iran. METHODS: A cross-sectional study was carried out by clinical examination and questionnaire on 400 pregnant women. RESULTS: The prevalence of melasma was 15.8%[95% confidence interval (CI) 12.3-19.4]. Malar pattern was seen in 65.9% of cases, whereas 33.8% of the patients had a centrofacial pattern. No case with a mandibular pattern was found. Positive family history of melasma was present in 54.7% of the cases. There was a statistically significant relation between melasma and ethnicity, phototype and grade of parity. However, no significant relation was observed between melasma and use of sunscreens, history of thyroid or liver disorders, trimester of pregnancy or phenotype (eye and hair color). 11.3% of the patients declared that they have developed melasma after using OCP Oral Contraception. Patients had little awareness of the etiology of melasma. In fact, 68.8% of the patients had no knowledge of its etiology. The effective factors or etiologies for melasma were stated as: 14.5% pregnancy, 9.8% sun exposure, 4.9% liver disorders, 4.9% nutrition and 1.6% sex of newborn. CONCLUSIONS: Our study confirms that melasma is common among pregnant women in Tehran, Iran. They had a low level of awareness of the etiology of melasma. There is a need for educational programs on the etiology and prevention of melasma in Iranian women.

Adolescent↗

PubMed2003

Transcranial magnetic stimulation of the human frontal eye field facilitates visual awareness.

What are the brain mechanisms allowing a stimulus to enter our awareness? Some theories suggest that this process engages resources overlapping with those required for action control, but experimental support for these ideas is still required. Here, we investigated whether the human frontal eye field (FEF), an area known to control eye movements, is involved in visual awareness. Volunteers participated in a backward masking task in which they were able to detect a target in a small proportion of trials. We observed that a single pulse of transcranial magnetic stimulation applied over the FEF shortly before the target's onset facilitated visual sensitivity; subjects were able to detect an otherwise subliminal object. These results show that modulating the neuronal activity of the FEF can enhance visual detection, thereby yielding new insights into the neural basis of visual awareness.

Adult↗

PubMed1992

Hormonal counterregulation, symptom awareness, and neurophysiological function in type 1 diabetes during insulin-induced hypoglycaemia.

To evaluate a putative differential impact of human (HI) and porcine (PI) insulin on human brain function we examined 10 Type 1 (insulin-dependent) diabetic patients without any signs of sensory or autonomic neuropathy. The glucose clamp technique was applied to achieve stable glycaemic plateaus of 5.6, 3.3, 2.2, and 1.7 mmol l-1 on two occasions with randomized and blinded allocation of either HI or PI. At each of the plateaus, symptom awareness, hormonal counterregulation, and neurophysiological functions (primary sensory information processing of the auditory and somatosensory system) were recorded. The effect of both types of insulin on glucose metabolism and counterregulatory hormone response was almost identical. Catecholamines increased (adrenaline p less than 0.05; noradrenaline p less than 0.02) during hypoglycaemia, independent of the type of insulin being used. Symptom awareness increased significantly during the fall of blood glucose concentration. This effect was more pronounced (total symptom score 26 vs 2, p less than 0.05) with PI, but only during developing hypoglycaemia (3.3 mmol l-1-plateau). For brainstem auditory evoked potentials and somatosensory evoked potentials, all individual and averaged latencies and corresponding amplitudes were within the normal range. No effect of insulin type or blood glucose concentration on neurophysiological measures could be detected. Our results suggest a differential impact of HI and PI on human brain function with regard to symptom awareness, but not hormonal counterregulation. This direct effect of insulin on central nervous function does not involve the afferent transmission in the auditory and somatosensory system.

Adult↗

PubMed2006

Fear but not awareness predicts enhanced sensory processing in fear conditioning.

It is not clear whether enhanced cortical processing of reinforced stimuli as reported by neuroimaging studies is due to expectancy of an aversive event alone or to activation of the fear system. The present study investigated cortical and autonomic responses of aware participants using an instructed fear conditioning design. Steady-state visual evoked fields (ssVEF) and heart rate change were recorded to assess sensory processing and activation of the fear system by reinforced (CS+) and nonreinforced stimuli (CS-). Participants who showed heart rate acceleration demonstrated increased ssVEFs in visual and parietal cortex during CS+ in acquisition trials. Heart rate decelerators did not show enhanced cortical activation with respect to the CS+. Participants in both groups reported awareness of CS-US contingencies. Awareness of stimulus contingency in fear conditioning seems not to be sufficient to elicit enhanced visual cortical processing.

Adult↗

PubMed2005

Physician awareness of celiac disease: a need for further education.

BACKGROUND: Celiac disease is a common disorder (up to 0.7%); however, it is uncommonly diagnosed in the United States. OBJECTIVE: We sought to determine physician awareness of celiac disease. DESIGN: Surveys completed by 2,440 (47%) of 5,191 patients in a support group were analyzed for frequency of diagnosis by physician specialties. Questionnaires were then sent to primary care physicians (PCPs) (n=132) in a southern California county to assess knowledge of celiac disease. RESULTS: In patient surveys, only 11% were diagnosed by PCPs (internists and family physicians) versus 65% by gastroenterologists. Physician surveys (70% response) showed that only 35% of PCPs had ever diagnosed celiac disease. Almost all physicians (95%) knew of wheat intolerance, but few (32%) knew that onset of symptoms in adulthood is common. Physicians were well aware (90%) of diarrhea as a symptom, but fewer knew of common symptoms of irritable bowel syndrome (71%), chronic abdominal pain (67%), fatigue (54%), depression and irritability (24%) or of associations with diabetes (13%), anemia (45%) or osteoporosis (45%), or of diagnosis by endomysial antibody tests (44%). CONCLUSIONS: Lack of physician awareness of adult onset of symptoms, associated disorders, and use of serology testing may contribute to the underdiagnosis of celiac disease.

Awareness↗

PubMed2005

Teaching personal awareness.

Educators rarely consider the attitudes that determine whether a learner will use the clinical skills we teach. Nevertheless, many learners and practitioners exhibit negative attitudes that can impede the use of patient-centered skills, leading to an isolated focus upon disease and impairing the provider-patient relationship. The problem is compounded because these attitudes often are incompletely recognized by learners and therefore are difficult to change without help. We present a research-based method for teaching personal awareness of unrecognized and often harmful attitudes. We propose that primary care clinicians without mental health training can follow this method to teach students, residents, faculty, and practitioners. Such teachers/mentors need to possess an abiding interest in the personal dimension, patience with a slowly evolving process of awareness, and the ability to establish strong, ongoing relationships with learners. Personal awareness teaching may occur during instruction in basic interviewing skills but works best if systematically incorporated throughout training.

Attitude of Health Personnel↗