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[Memory, awareness and learning in general anesthesia].

Enough information concerning memory and other cognitive functions in total anesthesia is available in the literature. Some basic theories about neuronal mechanisms of memory and consciousness are known. An attempt trying to bridge the gap between psychological and biologic levels is the usage of anesthetics in pharmacologic tests enabling the study of their influence on awareness and memory in humans. With the help of this approach it is possible to inquire into the psychological mechanisms and to demonstrate the influence of anesthetics on them. 44 patients were included in the study, operated on in inhalation anesthesia. The effects of anesthesia on awareness, consciousness, learning and memory in our study sample were following: 1. No episode of awareness was observed during the study; 2. There was an improvement of the memory quotient (MQ) following total inhalation anesthesia (p < 0.05); 3. The pain threshold significantly decreased after anesthesia (p < 0.001); 4. There exists a learning mechanism in total anesthesia more efficient in the group of patients auditively learning pain related words (p < 0.05) comparing to the control group of patients auditively learning pain nonrelated words; 5. Statistical analysis of the number of remembered pain related words and pain nonrelated words revealed significantly higher number of words in the first group of pain related words (p < 0.001). (Tab. 3, fig. 6, Ref. 22.)

Anesthesia, Inhalation↗

Modelling nutrition knowledge, attitudes, and diet-disease awareness: the case of dietary fibre.

Understanding how nutrition knowledge and attitudes vary across different population groups is critical for designing and evaluating nutrition education programmes and monitoring the nation's progress toward dietary goals. In this paper we use the Diet and Health Knowledge component of the USDA Continuing Survey of Food Intakes by Individuals to examine consumer knowledge of dietary fibre, fibre consumption attitudes and the awareness of fibre-related health problems. We use a latent variable probit model to estimate the relationships between an individuals's socio-demographic characteristics and his or her fibre knowledge, attitude and disease-awareness. The results suggest that the demographic profile of persons least knowledgeable about the fibre content of foods is low income, male, Black, Hispanic, smoker and low education levels. Add to this list younger individuals and one has a good description of those who lack information on the importance of eating plenty of grain products as well as those who lack awareness of fibre/disease links. The research suggests that messages about increasing fibre intake may have greatest success when targeted to individuals with some or all of these characteristics.

Adult↗

Asian Tobacco Education and Cancer Awareness Research Special Population Network. A model for reducing Asian American cancer health disparities.

Asian Americans are the fastest growing and the second largest foreign-born ethnic group in the United States. Cancer is a leading cause of death among Asian Americans. The Asian Tobacco Education and Cancer Awareness Research (ATECAR) Special Population Network, Center for Asian Health, aimed to reduce or eliminate cancer health disparities in these diverse, underserved populations in Pennsylvania, New Jersey, Delaware, and New York. The ATECAR logic model was adapted from a variety of conceptual frameworks to develop and implement the network's multifaceted cancer health disparities research, training, awareness, and outreach programs. The model was the basis for the developmental phases of the network that included (1) needs assessment, infrastructure, and partnership building; (2) intervention research, training, and mentorship; and (3) evaluation, dissemination, and diffusion. Community involvement occurred at every operational level to ensure program and network sustainability. Between 2000 and 2005, the ATECAR network consisted of 88 partners, representing a cross-section of Asian communities, academia, cancer centers, and health service agencies, ensuring a viable infrastructure for the network's multidimensional cancer health disparities programs. ATECAR's research covered tobacco control, cancer prevention and intervention, and clinical trials. More than 22 research projects were conducted and their results disseminated in peer-reviewed journals. ATECAR also trained 76 junior researchers and special population investigators and 1014 community professionals in disparity issues. ATECAR's multimedia cancer awareness education program reached over 116,000 Asians. The ATECAR network's achievements have had a profound impact on Asian Americans and established a trend toward reducing cancer health disparities, especially among underserved Asian Americans. Cancer 2006. (c) 2006 American Cancer Society.

Asian↗

Why worry about awareness in choice problems? Econometric analysis of screening for cervical cancer.

The decision to undertake a screening test is conditional upon awareness of screening. From an econometric perspective there is a potential selection problem, if no distinction is made between aware and unaware non-screeners. This paper explores this problem through analysis of the determinants of cervical screening in Australia. Cervical cancer is one of the most preventable and curable forms of cancer. Since 1991 there has been a concerted effort in Australia to recommend and encourage women to have Pap smears every two years. The success of this program can be partly gauged by exploring the determinants of screening for cervical cancer. Using unit record data from the 1995 National Health Survey, an econometric model is developed for whether women have ever screened or not. A proportion of women in the sample contend that they have never heard of a Pap test. The analysis characterizes this group of women and accounts for their presence in the modelling. The paper demonstrates failing to model awareness can result in inconsistent parameter estimates even when the degree of censoring in the sample is relatively small.

Adolescent↗

Metacognition and awareness.

It is tempting to assume that metacognitive processes necessarily evoke awareness. We review a number of experiments in which cognitive schema have been shown to develop without awareness. Implicit learning of a novel schema may not involve metacognitive regulation per se. Substitution of one automatic process by another as a result of the inadequacy of the former as circumstances change does, however, clearly involve metacognitive and executive processes of error correction and schema selection. We describe a recently published study in which we serendipitously discovered that a blindsight subject could change the schema with which he processed cue information in orienting spatial attention task without reporting any awareness of this change, or of the cues and targets which respectively directed and were the object his attention.

Attention↗

Increased clinic awareness and attitudes of independence through client advisory board membership.

In order to determine the effect of client advisory board membership on clients' awareness of a clinic, and on client attitudes of independence, the responses of 13 board members were compared with those of 13 matched controls on two self-report measures (Clinic Recognition Test, Client Independence Questionnaire) before and after 3-month periods. Analysis of the results indicated that, whereas the responses of controls did not significantly change on the Client Independence Questionnaire, the responses of board members indicated a significant increase in attitudes of independence. And, even though both board members and control clients significantly increased their awareness of clinic and staff over 3 months, the awareness of the broad members was significantly greater than that of the control clients.

Adult↗

The impact of shared medical records on smoking awareness and behavior in ambulatory care.

In a randomized controlled trial of sharing medical records with ambulatory adults as part of periodic health examinations, 193 patients (experimental group; 37 smokers) received copies of their medical records while 208 patients (control group; 50 smokers) did not. Awareness of smoking as a health problem and smoking behavior were assessed two weeks and six months later. At two weeks, 46% of experimental group smokers indicated that smoking was a major health problem, compared with 21% of the control group (p less than 0.02), and 43% of the experimental group had quit or reduced smoking, compared with 20% of the control group (p less than 0.02). At six months smoking problem awareness was not significantly different (33% experimental group vs. 14% control group, p = NS), but 65% of the experimental group had quit or reduced compared with 29% of the control group (p less than 0.04). Sharing medical records with smokers after periodic health examinations is effective in enhancing patient awareness of smoking as a health problem and beginning the process of changing smoking behavior.

Female↗

Parental awareness regarding childhood injuries.

OBJECTIVE: To assess parental awareness regarding common childhood injuries and to focus on preventive issues. METHODS: Two hundred parents of children each grouped into 2 attending OPD of government hospital and private clinic respectively were enrolled, interviewed and responses analyzed. RESULTS: The commonest potential mode of injuries identified in both groups was falls (53% vs 84%). None of the households in group 1 and less than 2/3rd in group 2 had provision of restraints at stairs. Awareness was found to be greater in the group with higher educational background and socioeconomic status. CONCLUSION: Awareness regarding common childhood injuries and their prevention was lacking. There was a felt need that the pediatricians must counsel the parents on this aspect during visits. Since the sample size is small, a larger community based study is needed.

Adult↗

Congenital spinal dermal sinuses: poor awareness leads to delayed treatment.

OBJECTIVE: Congenital spinal dermal sinuses are relatively uncommon congenital abnormalities that result from abnormal neurulation. Lack of awareness about this problem, especially at the primary care level, results in these patients not being managed appropriately. This issue is highlighted in this case series of nine patients. MATERIALS AND METHODS: The nine patients--six males and three females--were treated over a 3-year period in two centres in the UK and India. The age varied from 212 months to 19 years. Clinical presentations included meningitis or neurological deficits. One was asymptomatic. MRI was done in all cases and showed the sinus tracts in all cases. In five cases, there were intramedullary dermoids and in the others the sinus tract ended either on the dura or blindly. All cases were treated surgically by excision of the sinus and tumour if any. In terms of the neurological status, one became normal, four improved and four remained the same. Of the four who remained the same, two had had normal neurological examination preoperatively. The mean duration from first assessment by a medical practitioner to correct diagnosis and referral to a neurosurgeon was 5 years (range 2 months to 18 years). Proper diagnosis and appropriate management was delayed in these cases because professionals were not aware of this condition. CONCLUSIONS: Primary care physicians should be made more aware about congenital spinal dermal sinuses. This will facilitate early diagnosis and referral to specialist services.

Adolescent↗

A survey of consultant practice: intravenous salbutamol or aminophylline for acute severe childhood asthma and awareness of potential hypokalaemia.

British Thoracic Society guidelines recommend intravenous salbutamol or aminophylline for acute severe asthma in children. In the survey reported here, 133 consultant paediatricians completed a questionnaire aimed at evaluating their choice of intravenous bronchodilator for acute severe asthma and their awareness of subsequent hypokalaemia. Of the non-Paediatric Intensive Care Unit (PICU) consultants who responded, 82%, including respiratory paediatricians, reported using aminophylline; in contrast, PICU consultants were significantly more likely to use salbutamol (p=<0.001). There was a lack of awareness that hypokalaemia occurs with aminophylline: 50% of the consultants suggested that hypokalaemia was rare or did not occur. Consultants using intravenous aminophylline were significantly less likely to recheck serum potassium levels than those using intravenous salbutamol (p=0.03). Based on the completed questionnaires, salbutamol infusions are rarely used outside the PICU, and the awareness of potential hypokalaemia following intravenous bronchodilator treatment is variable. It would appear, therefore, that standardised clinical practice is required in order to recognise and treat potential hypokalaemia.

Albuterol↗

Awareness of diagnosis, and information-seeking behavior of hospitalized cancer patients in Greece.

PURPOSE: The goal of our study was to evaluate the extent of disease-related knowledge and the need for further information of cancer patients in Greece. MATERIALS AND METHODS: We evaluated 203 mentally competent adult cancer patients hospitalized in general and oncological hospitals in the city of Athens and its suburbs. Data were collected by means of semistructured interviews. Patients were evaluated as to whether they had awareness of their diagnosis. Those who did so (n = 83) were further questioned about additional disease-related information. RESULTS: The majority of patients (59%) claimed to have no knowledge of their diagnosis. Women (p = 0.004) as well as high school and university graduates (p = 0.024) showed significantly superior levels of information when compared to men and graduates of elementary schools, respectively. Age was also a factor that influenced the level of the awareness of the diagnosis and the request for additional information: patients who were informed about the diagnosis and patients who asked for more information were significantly younger than their counterparts who ignored the diagnosis (p < 0.001) and those who didn't ask for further information, respectively (p = 0.03). Hospital specialization (oncological versus general, p < 0.001) and department specialization (medical versus surgical, p = 0.004) were associated with significantly increased levels of information. The patient's educational level was associated with increased request for additional information (p = 0.006). Most patients with knowledge of their diagnosis requested detailed information about severity of their disease and prognosis. Only 13% of those in the informed group claimed they would have benefited psychologically by having been unaware of their diagnosis. CONCLUSIONS: Although Greek patients with diagnoses of malignancies want and need to be adequately informed, the amount of information they receive is inadequate. Over half of those patients evaluated were not aware of their diagnosis. Attitudes of health care professionals, preestablished family beliefs, "mind-set" difficulties, and organizational issues should not become barriers to the patients' right to be fully informed of their diagnoses and choices of potential therapies.

Adult↗

The recognition potential and conscious awareness.

The idea that conscious awareness of a recognizable image is necessary for it to evoke the recognition potential (RP) was tested by asking bilingual subjects to selectively attend to superimposed English and Chinese word images. The subjects detected most of the words in the attended language, but were largely oblivious of words in the non-attended language. Attended word images evoked the RP. Non-attended words did not. RP latency was less for Chinese than for English words. This provided a basis for inferring which language a subject was trying to read when valid English and Chinese words were both present. A subject was looking for Chinese if the latency was short and for English if it was long. The results showed that selective attention had a powerful effect on the RP. They supported the idea that conscious awareness is necessary for evoking it, though they did not rule out the theoretical possibility that some method not yet tested could be found that would block conscious awareness without blocking the RP. The sensitivity of the RP to what a subject is trying to see and its low variance seem to provide advantages for studying visual perception. It provides a short latency indicator of image processing that merits further investigation. Use of it may lead to a better understanding of visual perceptual processes.

Adult↗

Prevention-oriented life styles and diffusion of cholesterol screening and awareness: Massachusetts behavioral risk factor survey, 1987-1991.

Universal screening of the adult population for detection of elevated serum cholesterol has been recommended. We examined the relation of eight risk factors for morbidity and mortality (hypertension, overweight, inactivity, tobacco use, safety belt nonuse, binge alcohol consumption, driving after alcohol consumption, and chronic alcohol consumption) to adoption of cholesterol screening and to awareness of cholesterol level. Data were collected through the Massachusetts Behavioral Risk Factor Surveillance System between 1987 and 1991 (mean number of respondents interviewed annually, 1240). We compared trends in prevalence of cholesterol screening and awareness within risk groups defined on the basis of the presence or absence of each risk factor. Cholesterol screening prevalence increased from 46.8% in 1987 to 67.9% in 1991. Overweight and hypertensive respondents were more likely to have been screened than nonoverweight or normotensive respondents; for the other six risk factors, individuals at increased risk were less likely to have been screened. The difference in cholesterol screening prevalence between increased-risk and lower-risk respondents increased between 1987-1988 and 1990-1991 for four risk factors. Prevalence of awareness of cholesterol level increased from 7.8% in 1987 to 35.4% in 19991. Trends by risk status were comparable to those observed for cholesterol screening. Individuals already motivated toward a preventive life style appear to be those most likely to avail themselves of a new prevention possibility.

Adult↗

Do children know their parent's HIV status? Parental reports of child awareness in a nationally representative sample.

OBJECTIVE: To determine the rates and predictors of child awareness of parental human immunodeficiency virus (HIV) status and the effect of that knowledge on children. METHODS: Interviews were conducted with 274 parents from a nationally representative sample of HIV-infected adults receiving health care for HIV. The outcome measures were parental report of child's awareness of parental HIV status, how others reacted to child's parent having HIV, and reasons for nondisclosure. RESULTS: HIV-infected parents reported that 44% of their children (5-17 years old) were aware of their parent's HIV status, and parents had discussed with 90% of those children the possibility that HIV or acquired immunodeficiency syndrome (AIDS) might lead to their parent's death. Multivariate analyses revealed that parents with higher income, with an HIV risk group of heterosexual intercourse, with higher CD4 counts, with greater social isolation, and with younger children were less likely than others to report that their child knew the parent was HIV positive. Parents reported that 11% of children worried they could catch HIV from their parent. Reasons children did not know their parent's HIV status included that the parent was worried about the emotional consequences of disclosure (67%), was worried the child would tell other people (36%), and did not know how to tell their child (28%). CONCLUSIONS: HIV-infected parents often worry about the emotional consequences of disclosure to their children and that their children may tell others. More than a quarter of parents reported not knowing how to tell their children. Clinicians may be able to support and guide HIV-infected parents in deciding whether, when, and how to disclose their infection to their children.

Adolescent↗

Ethnic differences in older americans: awareness, knowledge, and beliefs about hypertension.

BACKGROUND: Hypertension is often uncontrolled and contributes to health disparities, especially among individuals >or=50 years old. Ethnic differences in awareness, knowledge, and beliefs about hypertension may contribute to these disparities, but information is limited. METHODS: To address this gap, data from a national telephone survey on 1503 Americans 50 years and older were used to assess ethnic differences in awareness, knowledge, and beliefs about hypertension and the relationship of the responses to self-reported blood pressure (BP) control. RESULTS: Overall there were no ethnic differences in knowledge and beliefs about hypertension; however, there were differences in responses to specific questions. African Americans were more knowledgeable about the definition of hypertension and were more aware that hypertension can cause kidney failure than Hispanics and whites (64.2% v 54.8% and 46.3%, P<.0001). African American and Hispanics were more likely to perceive medications as the only way to control BP (50.5% and 55.5% v 23.3%, P<.0001), whereas whites reported lifestyle changes as more important than African Americans in BP control. Comparing self-reported BP control between ethnic groups, belief that medications are not the only way to treat BP (odds ratio [OR] 2.37, 95% confidence interval [CI] 1.43-3.95) and knowledge that moderation of alcohol use can lower BP (OR 2.34, 95% CI 1.20-4.57) were significantly associated with higher BP control rates. CONCLUSIONS: Ethnic differences in specific dimensions of knowledge and beliefs about hypertension exist and account for some of the disparities in BP control. Culturally appropriate educational programs that address these deficiencies may reduce disparities.

Black or African American↗

SeqQC-former: A sequence-quality fusion framework for QC-aware review prioritization of candidate somatic SNVs in cancer genomics.

The accurate prioritization of candidate somatic single-nucleotide variants (SNVs) remains a challenge due to the substantial variability in sequencing quality across genomic loci. SeqQC-Former is a sequence-quality fusion framework that integrates the local nucleotide context with read-level quality-control (QC) covariates derived from matched tumor-normal sequencing data. This integration generates QC-aware prioritization scores for the downstream review of candidate variants. Unlike conventional variant callers, SeqQC-Former is designed not to infer biological truth but to support post-calling review and prioritization under heterogeneous sequencing conditions. The framework was trained and evaluated on a SEQC2-derived dataset comprising 89,447 candidate loci, including 1378 positive and 88,069 negative loci. In chromosome-held-out validation, which aims to reduce potential genomic-position leakage, SeqQC-Former demonstrated strong discrimination (AUROC = 0.9479; AUPRC = 0.9448), indicating good generalization to previously unseen chromosomes. Given that the SEQC2-derived labels contain QC-associated information; these results should be interpreted as an evaluation of QC-aware prioritization capability rather than an independent validation of biological variant correctness. Ablation analyses revealed that structured QC covariates provided the dominant predictive signal under the current SEQC2-derived labeling regime. SeqQC-Former achieved a significantly higher AUROC than classical machine-learning baselines, as determined by DeLong's test (p&#x202f;<&#x202f;0.01). Application to 53,164 glioblastoma variants demonstrated that external predictions were sensitive to QC scaling and threshold selection, underscoring that model outputs should be interpreted as QC-dependent prioritization scores rather than calibrated probabilities or definitive biological classifications. Overall, SeqQC-Former offers a reproducible post-calling QC-aware prioritization framework for large-scale somatic SNV review and underscores the importance of explicitly modeling sequencing-quality information when interpreting structured cancer genomics datasets.

Humans↗

Event-related brain correlates of associative learning without awareness.

Controversy exists about whether associative learning occurs without awareness. In an earlier study using subthreshold (subliminal) stimuli, we reported evidence that such learning could occur as measured by event-related brain potentials [ERP; Cons. Cognit. 6 (1997) 519]. In the present study, we extend these findings by changing several aspects of the methodology in order to provide a more stringent test of this effect and to examine its generality. We used two matched words (murder and cancer) as conditional stimuli (CS); a 100 dB white noise blast as unconditional stimulus (US); a CS-US interval of 3 s; and a full-factorial design with CSs counterbalanced. The conditioning-acquisition phase occurred when the CSs were perceptually unconscious, as confirmed by a subsequent behavioral task. The conditioning-acquisition and postconditioning-extinction phases were examined for ERP evidence of associative learning. The clearest and strongest evidence for associative learning without awareness was observed in the ERP component measures (up to 1 s, poststimulus) in the postconditioning-extinction phase. The CS+ was significantly more positive than the CS- in the P3b-LP component region, which is highly consistent with the results of our earlier study. Differences also were observed in the P1-P2 components. In an unexpected finding, we observed a significant positive slow potential shift for the CS+ in the region between 1 and 3 s poststimulus. We discuss these results and their implications for our understanding of associative learning and awareness.

Adult↗

Changes in young women's awareness, attitudes, and perceived barriers to using emergency contraception.

BACKGROUND: In a 1996 survey, most young women ages 13-20 years from an urban, hospital-based clinic and a drug treatment center had inadequate awareness of emergency contraception (EC), and perceived several barriers to its use. Since that time, the FDA has approved two products for EC, media coverage has increased, and physicians have provided more counseling about EC. PURPOSE: The purpose of this study is to compare the awareness, attitudes, and perceived barriers to using EC among a sample of young women from 1996 with a different sample of women from 2002. METHODS: We recruited 139 young women (mean age 16.7 +/- 1.8 yrs) from the same adolescent clinic and drug treatment center as the 1996 sample. They had similar demographic characteristics, with the majority (63%) being African-American or multi-ethnic; 85% had ever been sexually active. They were interviewed using a questionnaire about their sexual and contraceptive history as well as their knowledge of and experience with EC. They then watched a 4(1/2) minute video and received a 5-minute didactic review of EC. Following the educational intervention, participants' knowledge, attitudes, and perceived barriers to using EC were assessed. The questionnaire used to guide the interviews was nearly identical to that used in 1996. RESULTS: Between 1996 and 2002, the percentage of participants reporting that they had ever heard of EC grew (44% vs. 73%, P < 0.001), as well as the percentage reporting that they had ever used EC (4% vs. 13%, P = 0.02). Of those participants who had ever heard of EC, fewer 1996 participants knew where to obtain it compared to 2002 participants (78% vs. 95%, P = 0.002) and fewer 1996 participants knew the correct time limits for use (20% vs. 51%, P < 0.001). The above data were collected prior to a didactic review session about EC. After receiving information about EC, the percentage of participants reporting a positive attitude toward EC grew between 1996 and 2002 (72% vs. 96%, P < 0.001). Young women also had fewer concerns about safety and side effects in 2002. The 1996 participants were more likely to report barriers to using EC compared to the 2002 participants. In 1996, EC side effects and impact on fertility were the most commonly perceived barriers to EC use. However, in 2002 the frequency of all reported barriers decreased and cost had become the number one perceived barrier. CONCLUSION: Since 1996, young women at an urban hospital-based adolescent clinic and drug treatment center increased their awareness, use, and positive attitudes towards EC, as well as decreased their perceived barriers to using EC. Educational interventions that focus on improving knowledge among younger adolescents, specifically about correct time limits and identifying ways to find affordable EC, will address the most common knowledge deficits and perceived barriers to EC use among adolescents.

Adolescent↗