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PubMed2006

The influence of awareness of terminal condition on spiritual well-being in terminal cancer patients.

We developed a Spirituality Transcendence Measure (STM) and studied whether awareness of terminal illness affects spiritual well-being in terminal cancer patients. Three sources of spiritual transcendence--the situational, the moral and biographical, and the religious aspect--were assessed in the STM. Cronbach's alpha of the STM was 0.95, and the principle axis factor analysis extracted only one factor. Thirty-seven terminal cancer patients with male predominance (59.5%) were studied. Awareness of terminal illness was associated with a higher total STM score (Z = -2.21, P = 0.027), along with the individual scores for each of the three transcendences (Z = -2.39, P = 0.017; Z = -2.71, P = 0.007; and Z = -1.96, P = 0.050). Acceptance of death was associated with a higher situational score (Z = 2.01, P = 0.046) and a higher religious score (Z = -2.27, P = 0.023). Announcement of testament was associated with a higher situational score (Z = -2.30, P = 0.021). We conclude that awareness of terminal illness is associated with spiritual well-being. Telling the complete truth is necessary even when dealing with terminal conditions.

Adult↗
PubMed2006

Awareness of mother-to-child transmission of human T-cell lymphotropic virus (HTLV) type I through breastfeeding in a small group of HTLV-positive women in Maripasoula and Papaïchton, French Guiana.

The aim of this study was to assess the awareness of human T-cell lymphotropic virus (HTLV) transmission, especially through breastfeeding, in a small group of 40 HTLV-seropositive women in French Guiana and to examine the public health policies in place to reduce transmission. The results show that the majority of HTLV-positive women were aware of having a blood virus, diagnosed antenatally, and were advised to avoid breastfeeding. This advice was followed in the majority of cases despite financial difficulty. Participants were largely unaware of other modes of transmission. Public awareness was low, leading to increased stigmatising of people with HTLV, more so than HIV. Health policies in place to reduce transmission of HTLV are focused on vertical transmission, with women being routinely tested antenatally and advised to avoid breastfeeding. There was no further advice routinely given on other modes of transmission. There was no routine follow-up of HTLV-positive women. Suggestions include public education programmes such as those that are in place for HIV, education of healthcare workers, and setting up a network for systematic follow-up and support of HTLV patients.

Adult↗
PubMed2006

Health professional's knowledge and awareness of perinatal depression: results of a national survey.

INTRODUCTION: Postnatal depression affects 14% of women, occurring also antenatally, with potential long-term consequences, making it an important disorder to detect and manage early. In this study we sought to examine knowledge and awareness of perinatal depression in health professionals involved in perinatal care throughout Australia prior to the implementation of a comprehensive screening program, aimed at improving detection and access to appropriate management. METHODS: A random sample of General Practitioners (GPs) and Maternal Child Health Nurses (MCHNs) and Midwives, in regions throughout Australia to be subsequently targeted by a screening and education program, were invited to participate. Responses to a hypothetical vignette and a knowledge questionnaire, as well as details of experience were completed. FINDINGS: Questionnaires were completed by 246 GPs, 338 MCHNs and 569 midwives, with overall response rates; GP's 23%; MCHN's 55% and midwives 57%. Although knowledge level was similar among professional groups, MCHNs had higher levels of awareness of perinatal depression. Both GPs and MCHNs were more likely than midwives to recognize the need for providing help to women with emotional distress. Depression was more likely to be considered postnatally than antenatally in all groups, with GPs most likely to provide this diagnosis. GPs had a significant propensity to recommend antidepressants, and midwives to select non-specific medications. CONCLUSIONS: Health professionals responding to this survey had a high awareness and similar knowledge base. Further education on antenatal depression and the safety risks and alternatives to medication is important for all groups, but particularly important for midwives and GPs. The latter is especially relevant given the preference for women with perinatal depression not to use pharmacological interventions to treat their emotional distress.

Analysis of Variance↗
PubMed2005

Survey of public awareness, attitudes, and understanding toward epilepsy in Nhan Chinh, Hanoi, Vietnam, in 2003.

PURPOSE: Many studies have shown that cultural and social awareness of, attitudes toward, and knowledge about epilepsy can have an impact on the acceptance of treatment. The aim of this study is to characterize public awareness of attitudes toward and understanding of epilepsy in a Vietnamese community and to compare results with those obtained in other cultures. METHODS: A survey concerning the knowledge, attitudes, and practices of Vietnamese people with respect to epilepsy was carried out in the Nhan Chinh precinct of Hanoi. One thousand people were randomly selected for face-to-face interviews regarding epilepsy. RESULTS: Of the subjects surveyed, 54.6% had heard of epilepsy; 45.5% knew someone with epilepsy; 49.2% had witnessed an epileptic seizure; 56% would not allow their son or daughter to marry someone with epilepsy; 42.1% did not believe that epileptic patients could hold down a normal job; 77.8% believed that epilepsy is an organic disorder of the brain; 23.8% thought that epilepsy is a form of dementia; and 91% thought that epileptic patients require medical care. CONCLUSION: As compared with surveys conducted in other countries, our survey showed that the awareness of epilepsy in this Vietnamese community is limited, and gives rise to alternative attitudes and practices.

Adolescent↗
PubMed1997

Factors associated with awareness of vocational rehabilitation services after traumatic brain injury.

OBJECTIVES: To determine the characteristics of persons with traumatic brain injury (TBI) who were aware of vocational rehabilitation (VR) services 1 year after hospital discharge. DESIGN: Medical record and longitudinal survey data on persons with TBI were analyzed using logistic regression and bivariate analyses. SETTING: The study sample was drawn from a population-based sample of persons hospitalized in 1 of 8 hospitals in north-central Alabama. PARTICIPANTS: Criteria for inclusion were: (1) being at least 18 years of age or older when injured; (2) having sustained a TBI; (3) being discharged alive after a hospital stay of at least 3 days; (4) residing and having been injured in the state of Alabama; (5) participation in a 12-month follow-up interview. MAIN OUTCOME MEASURE: Patients' awareness of VR service programs and benefits. RESULTS: Awareness of VR service programs was associated with: (1) being Caucasian; (2) being more often employed at the time of injury; (3) being more often severely injured; and (4) more frequently receiving outpatient rehabilitation. CONCLUSION: Interventions should target non-Caucasians, those who were unemployed when injured, those less severely injured, and those not receiving outpatient rehabilitation services after hospital discharge. Periodic review of VR benefits with patients and their families should be undertaken by health care and VR professionals.

Adult↗
PubMed2001

The relationship between involuntary pelvic floor muscle activity, muscle awareness and experienced threat in women with and without vaginismus.

This study assessed the relationship between involuntary pelvic floor muscle activity, muscle awareness and experienced threat in women with and without vaginismus. Information about this relationship may help understand the mechanism of vaginismus. Twenty-two women with vaginismus and seven control women participated in the study. Women were exposed to four emotion-inducing film excerpts. Vaginal electromyography was recorded. Experienced threat was continuously monitored with the use of a lever. Women responded with increased pelvic floor muscle activity to the threatening and sexually-threatening film excerpt. No changes occurred during the neutral and erotic excerpt. The subjective experienced threat as indicated with the lever showed the same response pattern. However, awareness of changes in muscle activity showed a slightly different pattern. Individual data were inspected. In general, agreement was found between recorded changes in muscle activity and experienced threat. The results of the erotic excerpt showed that awareness of changes in muscle activity is not only determined by information from the pelvic floor muscles, but also by other factors like situational information and the expectations of the women. The data support the idea of a general defense reaction as a mechanism of involuntary pelvic floor muscle activity.

Adult↗
PubMed2001

[Trends in prevalence, awareness, treatment and control of arterial hypertension between 1986 and 1996: the MONICA-Catalonia study].

BACKGROUND: To describe temporal trends in blood pressure (BP) and in the prevalence, awareness, treatment and control of arterial hypertension(AH) between 1986-1996 in the MONICA-Catalonia study. SUBJECTS AND METHOD: Three cross-sectional health surveys in independent random samples of the general population aged 25-64, carried out in 1986-88,1990-92 and 1994-96 according to the WHO-MONICA study protocol.BP was measured twice with a random zero mercury sphygmomanometer. RESULTS: 2,571, 2,934 and 3,485 subjects were examined in each survey with response rates of 74, 67 and 72%, respectively. Age-adjusted mean of systolic BP (SBP) decreased 2 and 4 mmHg (p < 0.001)reaching 120 and 114 mmHg in 1994-96 in men and women, respectively. Diastolic BP (DBP) did not change in men (73-74 mmHg) nor in women(70-71 mmHg). Age-adjusted prevalence of AH (>= 160/95 and/or under pharmacological treatment) was 8% (men) and 10% (women)in 1994-96 and of AH (>= 140/90 and/or under pharmacological treatment) was 15% in both sexes. Awareness of hypertension (AH >= 140/90) increased from 67 to 76%. Treated hypertensives increased from 22 to 40% (men) and from 44 to 54% (women). The use of diuretics and betablockers decreased and ACE inhibitors increased. At the end of the period, 52% of hypertensives were controlled. SBP also decreased in normotensives but not DBP. CONCLUSIONS: Between 1986 and 1996, the prevalence of AH in Catalonia remained stable although awareness, treatment and control had substantially improved.SBP decreased but DBP remained stable.

Adult↗
PubMed2002

Neural response to emotional faces with and without awareness: event-related fMRI in a parietal patient with visual extinction and spatial neglect.

This study examined whether differential neural responses are evoked by emotional stimuli with and without conscious perception, in a patient with visual neglect and extinction. Stimuli were briefly shown in either right, left, or both fields during event-related fMRI. On bilateral trials, either a fearful or neutral left face appeared with a right house, and it could either be extinguished from awareness or perceived. Seen faces in left visual field (LVF) activated primary visual cortex in the damaged right-hemisphere and bilateral fusiform gyri. Extinguished left faces increased activity in striate and extrastriate cortex, compared with right houses only. Critically, fearful faces activated the left amygdala and extrastriate cortex both when seen and when extinguished; as well as bilateral orbitofrontal and intact right superior parietal areas. Comparison of perceived versus extinguished faces revealed no difference in amygdala for fearful faces. Conscious perception increased activity in fusiform, parietal and prefrontal areas of the left-hemisphere, irrespective of emotional expression; while a differential emotional response to fearful faces occurring specifically with awareness was found in bilateral parietal, temporal, and frontal areas. These results demonstrate that amygdala and orbitofrontal cortex can be activated by emotional stimuli even without awareness after parietal damage; and that substantial unconscious residual processing can occur within spared brain areas well beyond visual cortex, despite neglect and extinction.

Aged↗
PubMed1976

Bladder cancer in rubber workers. Do screening and doctors' awareness distort the statistics?

The use of recognised carcinogens in the rubber industry before 1950 led to the introduction of screening progammes offering urinary cytology to workers who had been exposed. Publicity given to the introduction of these programmes and to individual claims for compensation have increased medical practitioners' awareness of a relationship between work and the industry and the subsequent development of bladder cancer. In this study 27 rubber workers and 88 controls registered in 1966 and 1967 with bladder cancer have been followed. A comparison of their death-rates and of the relative frequency of bladder cancer recorded on the death certificates should indicate whether cytological screening or doctors' awareness might explain a recent rise in the bladder-cancer death-rate in this industry. Since the proportions of rubber workers and controls who died before 1976 were similar (74% and 73% respectively) and bladder cancer was mentioned with similar frequence on their death certificates (80% and 83% respectively) neither screening nor doctor's awareness would appear to have an important influence.

Adenocarcinoma↗
PubMed1999

Effects of clozapine on awareness of illness and cognition in schizophrenia.

Awareness of illness is a crucial factor in schizophrenia, both for clinical management and psychopathological modeling. To date, there has been relatively little investigation of the influence of treatment with conventional versus atypical neuroleptics in relation to awareness and cognitive functions. The effect of clozapine treatment, compared with conventional neuroleptics, was studied in 22 schizophrenic patients in a crossover study. The P300 component of the event-related potential and scores on the Scale for Unawareness of Mental Disorder (SUMD), the Extrapyramidal Side Effects Scale (EPS), and Andreasen's Scales for the Assessment of Positive (SAPS) and Negative Symptoms (SANS) were studied at time 1 (conventional neuroleptic treatment) and time 2 (after 6 months of treatment with clozapine, in patients who interrupted the previous conventional regimen). Significantly increased P300 amplitudes were associated with clozapine treatment, together with heightened insight and reduced involuntary movements. The results confirm the effectiveness of clozapine not only in enhancing neurocognitive function, but also in increasing awareness of illness in schizophrenic patients.

Adolescent↗
PubMed1996

Melanoma awareness and self-examination practices: results of a United States survey.

BACKGROUND: Skin cancers are common and there has been a dramatic increase in their incidence, particularly melanoma. However, little is known about awareness of melanoma and early detection practices in the general U.S. population. OBJECTIVE: In 1995, the American Academy of Dermatology increased their efforts to promote awareness of melanoma. This study was conducted to document current knowledge of melanoma and self-examination practices. METHODS: In February 1995, a telephone survey was conducted in a nationally representative sample of 1001 persons at least 18 years of age (3% margin of error) that included questions on knowledge, attitudes, and practices regarding early detection of melanoma. RESULTS: Almost 42% of those surveyed were unaware of melanoma, and only 26% of those who were aware could identify its specific signs. Most recognized at least one common risk factor for melanoma (e.g., sun exposure, fair skin). However, many did not distinguish melanoma from other skin cancers in terms of risk factors, signs of early disease, and body site distribution. The lowest measures of melanoma knowledge and attitudes were found among those who are male, nonwhite, and parents, and those with the lowest level of education and income. More than half (54%) did not conduct a self-examination. This practice was most frequently reported by women, white persons, and the elderly, as well as those with a greater knowledge of melanoma. CONCLUSION: Our research documents deficiencies in knowledge and practices related to early detection of melanoma in the general U.S. population and supports the need for public education about melanoma.

Adult↗
PubMed1999

Public knowledge, awareness, and perceptions of the association between skin aging and smoking.

BACKGROUND: Although the tobacco industry promotes images of glamour, 2 decades of epidemiologic research have concluded the opposite: smokers have enhanced facial aging and skin wrinkling compared with nonsmokers. OBJECTIVE: The purpose of this study was to obtain information on the public's awareness of the association between cigarette smoking and skin aging. METHODS: In the spring of 1994, the Maine-wide Cooperative Telephone Survey conducted telephone interviews in 678 randomly selected, nonseasonal dwelling units in Maine. From each dwelling unit, one randomly selected adult resident was interviewed to assess awareness of the association of skin aging with smoking. RESULTS: Fifty-eight percent of those persons interviewed had smoked at least 100 cigarettes, and among them, 24% were current smokers (28% men, 21% women). After adjusting for sex, age, and education, current smokers remained less likely to be aware of this association compared with former (prevalence ratio, 0.78; 95% confidence interval, 0.64-0.95) and never smokers (prevalence ratio, 0.87; 95% confidence interval, 0.70-1.07). However, nearly one fourth of smokers in this study believed that most or some smokers would consider this information in their decision to quit, with slightly higher findings in young smokers. CONCLUSION: These findings are of public health importance. While strategies for framing messages about the association between smoking and facial aging await further study, this association deserves to be considered in all tobacco control and counter-advertising campaigns.

Adolescent↗
PubMed2001

[Is there awareness of pharmaceutical expenditure in the reformed primary care system?].

OBJECTIVE: To evaluate the effectiveness of feeding information on pharmacy back to primary care doctors in order to create awareness (knowledge) of pharmaceutical expenditure (PE). DESIGN: Retrospective cross-sectional study, through personal interview. SETTING: Reformed PC, Sabadell, Barcelona. PARTICIPANTS: The 80 PC doctors working with primary care teams. INTERVENTIONS: As the personal feed-back on PE, each doctor was asked for the PE generated during 1997 and the mean cost of prescriptions to active and pensioner patients. The statistical test used was the t test to compare means for paired data, with p < 0.05 the required level of significance. RESULTS: Out of the total doctors interviewed (80), 71 replies were obtained for the annual PE and 76 for the mean cost of prescriptions, for both active and pensioner patients. Significant differences were found between the annual PE in reality and doctors' estimates: around twelve million pesetas. The differences between the real mean costs of prescription and the estimates were also significant. CONCLUSIONS: In view of the results, it is concluded that there is no awareness of PE among the doctors in the reformed PC in our area. This poses a question over the efficacy of feed-back of pharmacy information in order to create this awareness. This information needs to be more frequent and richer in content, and to be complemented by other measures.

Cross-Sectional Studies↗
PubMed1990

Awareness among pregnant women of the effect on the fetus of commonly used drugs.

Epidemiological studies have shown that pregnant women continue to take substantial quantities of drugs, particularly those readily available to them without prescription. Little is known of the attitudes and knowledge among pregnant women of the effects of these substances on the fetus. Awareness of the effects on the fetus of commonly used drugs, cigarettes and alcohol among 514 women in the postnatal wards of two maternity units in Glasgow was assessed by self completion questionnaire between October 1987 and April 1988. Most of the women recognised that the fetus is most at risk of being harmed by drugs during the first 3 months of pregnancy. The majority felt it was safest not to smoke cigarettes and were aware of the adverse effects of smoking on fetal growth. Over half thought smoking was harmful while breastfeeding. Over half thought that alcohol should be avoided altogether in pregnancy and that drinking could harm the fetus. Most women considered alcohol harmful to the breast feeding baby. The majority of the women would opt for paracetamol containing analgesics only and only a small proportion would take one containing aspirin. Only half the study population would take a prescribed antibiotic. A generally high level of awareness of commonly used drugs was demonstrated although there are areas where further health education could be directed. The study has highlighted areas worthy of further research.

Adolescent↗
PubMed1998

Is imposing risk awareness cultural imperialism?

Epidemiology is the main supplier of "bases of action" for preventive medicine and health promotion. Epidemiology and epidemiologists therefore have a responsibility not only for the quality and soundness of the risk estimates they deliver and for the way they are interpreted and used, but also for their consequences. In the industrialised world, the value of, and fascination with health is greater than ever, and the revelation from epidemiological research of new hazards and risks, conveyed to the public by the media, has become almost an every-day phenomenon. This "risk epidemic" in the modern media is paralleled in professional medical journals. It is in general endorsed by health promoters as a necessary foundation for increased health awareness and a desirable impetus for people to take responsibility for their own health through behavioural changes. Epidemiologists and health promoters, however, have in general not taken the possible side effects of increased risk awareness seriously enough. By increasing anxiety regarding disease, accidents and other adverse events, the risk epidemic enhances both health care dependence and health care consumption. More profoundly, and perhaps even more seriously, it changes the way people think about health, disease and death--and ultimately and at least potentially, their perspective on life more generally. The message from the odds ratios from epidemiological research advocates a rationalistic, individualistic, prospective life perspective where maximising control and minimising uncertainty is seen as a superior goal. The inconsistency between applying an expanded health concept, comprising elements of coping, self-realisation and psycho-physical functioning, and imposing intolerance to risk and uncertainty, is regularly overlooked. Acceptance and tolerance of risk and uncertainty, which are inherent elements of human life, is a prerequisite for coping and self-realisation. A further shift away from traditional working-class values like sociability, sharing, conviviality and tolerance can not be imposed without unwanted side effects on culture and human interaction. The moral and coercive crusade for increased risk awareness and purity in life style can too readily take on the form of cultural imperialism towards conformity. Epidemiologists and the health care movement in general have a mandate to fight disease and premature death; they have no explicit mandate to change culture.

Adaptation, Psychological↗
PubMed2002

Predictors of cervical Pap smear screening awareness, intention, and receipt among Vietnamese-American women.

BACKGROUND: Compared with white women, Vietnamese women in the United States have a higher rate of cervical cancer and lower Papanicolau (Pap) test utilization. We evaluated factors associated with awareness of the Pap test, intention to obtain it, and its receipt in Vietnamese-American women. METHODS: In 2000, we conducted a telephone survey of Vietnamese-American women aged >or=18 years living in Santa Clara County, California, and Harris County, Texas. We collected data on sociodemographics, healthcare system access and attitudes, as well as Pap test awareness, attitudes, intentions, and practices. RESULTS: Of 1566 subjects, 74% had heard of the Pap test, and 76% had had at least one. Only 42% of those who never had a Pap test had considered obtaining one. There were no significant differences between the two sites. Women aged >or=65 had the lowest rates for all three outcomes. For all women, younger age, being married, having requested a Pap test, physician recommendation, and preferring a female standby if the doctor was male were associated with Pap test intention. Being married, higher level of education, having a female doctor, having a respectful doctor, having requested the test, and physician recommendation were associated with Pap test receipt. CONCLUSION: Vietnamese-American women have low rates of Pap test awareness, intention, and receipt. The patient-doctor interaction is an important determinant. Efforts to increase Pap test utilization in this population need to be directed at encouraging physicians to offer the Pap test and empowering women to ask for the test.

Adult↗
PubMed1998

Contact with ticks and awareness of tick-borne diseases among the Czech population--a pilot study.

In the Czech Republic, the incidence of Lyme borreliosis (LB) has shown a rising trend since 1988. The goal of this study has been to find out to what extent a selected part of population is aware of ticks and of the relationship between ticks and LB. The study was based on a questionnaire survey. A total of 110 respondents were selected, including 19 secondary school students, 32 blood donors, 44 park-goers, 15 countryside people. As many as 99% of the respondents were aware of the presence of ticks, 91% knew that ticks are sucking blood of humans and animals, 1.8% thought they eat leaves. 74.5% of the respondents expect ticks to reach them from the vegetation while 22% believe that ticks fall from the trees. Furthermore, 87% and 75% of the respondents indicated to have had ticks attached to the skin or to have removed a tick from other persons' skin, respectively. Only 6.7% of them had never come into contact with ticks. 17% of the respondents use disinfectant when removing a tick, while 67% use oil for tick removal. Almost 30% remove ticks with naked hands. Over 14% destroy the ticks by squashing them with naked fingers. Finally, about 11% of the population studied had never heard about LB and 41% were not aware of the risk of tick-borne encephalitis.

Adolescent↗
PubMed1998

Lyme borreliosis awareness.

A Lyme borreliosis information leaflet has been produced to promote awareness amongst the general public. It was designed to provide a framework for similar material throughout Europe and complements a questionnaire produced to measure awareness of Lyme borreliosis. This questionnaire can be used to determine the impact of educational campaigns using material such as the leaflet. Feasibility studies showed that the questionnaire successfully highlighted predictable differences between sample groups and also that the leaflet performed well in increasing knowledge in low-awareness groups.

Blood Donors↗