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At least 19 recordsLinked to original sources
PubMed1986

Aware or non-aware. On the significance of awareness for the localization of the lesion responsible for homonymous hemianopia.

Some of the patients with homonymous hemianopia are unaware of any visual defect, whereas others perceive this defect more of less consciously. Analysis of the CT scans of 41 cases showed that patients who are partially or fully aware of the hemianopia have purely occipital lesions. The patients who were not aware of the visual defect were found to have larger and more anteriorly situated lesions. Parietal lesions or lesions interrupting the associative pathways to the primary or secondary visual association cortex are considered to be responsible for the lack of awareness of the defect.

Awareness↗
PubMed2004

Bispectral index monitoring to prevent awareness during anaesthesia: the B-Aware randomised controlled trial.

BACKGROUND: Awareness is an uncommon complication of anaesthesia, affecting 0.1-0.2% of all surgical patients. Bispectral index (BIS) monitoring measures the depth of anaesthesia and facilitates anaesthetic titration. In this trial we determined whether BIS-guided anaesthesia reduced the incidence of awareness during surgery in adults. METHODS: We did a prospective, randomised, double-blind, multicentre trial. Adult patients at high risk of awareness were randomly allocated to BIS-guided anaesthesia or routine care. Patients were assessed by a blinded observer for awareness at 2-6 h, 24-36 h, and 30 days after surgery. An independent committee, blinded to group identity, assessed every report of awareness. The primary outcome measure was confirmed awareness under anaesthesia at any time. FINDINGS: Of 2463 eligible and consenting patients, 1225 were assigned to the BIS group and 1238 to the routine care group. There were two reports of awareness in the BIS-guided group and 11 reports in the routine care group (p=0.022). BIS-guided anaesthesia reduced the risk of awareness by 82% (95% CI 17-98%). INTERPRETATION: BIS-guided anaesthesia reduces the risk of awareness in at-risk adult surgical patients undergoing relaxant general anaesthesia. With a cost of routine BIS monitoring at US16 dollars per use in Australia and a number needed to treat of 138, the cost of preventing one case of awareness in high-risk patients is about 2200 dollars.

Anesthesia Recovery Period↗
PubMed2007

Awareness of deficits in traumatic brain injury: a multidimensional approach to assessing metacognitive knowledge and online-awareness.

Recent models of impaired awareness in brain injury draw a distinction between metacognitive knowledge of difficulties and online awareness of errors (emergent and anticipatory). We examined performance of 31 Traumatic Brain Injury (TBI) participants and 31 healthy controls using a three-strand approach to assessing awareness. Metacognitive knowledge was assessed with an awareness interview and discrepancy scores on three questionnaires--Patient Competency Rating Scale, Frontal Systems Behavioral Scale and the Cognitive Failures Questionnaire. Online Emergent Awareness was assessed using an online error-monitoring task while participants performed tasks of sustained attention. Online anticipatory awareness was examined using prediction performance on two cognitive tasks. Results indicated that the TBI Low Self-Awareness (SA) group and High SA group did not differ in terms of severity, chronicity or standard neuropsychological tasks but those with Low SA were more likely to exhibit disinhibition, interpersonal problems and more difficulties in total competency. Sustained attention abilities were associated with both types of online awareness (emergent and anticipatory). There was a strong relationship between online emergent and online anticipatory awareness. Metacognitive knowledge did not correlate with the other two measures. This study highlights the necessity in adopting a multidimensional approach to assessing the multifaceted phenomenon of awareness of deficits.

Adult↗
PubMed2005

The relationship between phonological awareness and reading: implications for the assessment of phonological awareness.

PURPOSE: Speech-language pathologists (SLPs) use phonological awareness assessments in many ways. This study examines the usefulness of these assessments in kindergarten and 2nd grade. METHOD: Measures of phonological awareness and letter identification were administered in kindergarten, and measures of phonological awareness, phonetic decoding (i.e., nonword reading), and word reading were administered in 2nd and 4th grades to a sample of 570 children participating in a longitudinal study of reading and language impairments. RESULTS: A path analysis indicated that kindergarten measures of phonological awareness and letter identification provided information to the prediction of 2nd-grade reading. In 2nd grade, measures of reading offered information to the prediction of 4th-grade reading. Additionally, a reciprocal relationship was found between phonological awareness and word reading, with kindergarten phonological awareness predicting 2nd-grade word reading and, conversely, 2nd-grade word reading predicting 4th-grade phonological awareness. CLINICAL IMPLICATIONS: Phonological awareness assessment provides information about reading in kindergarten but loses its predictive power at 2nd grade. At that time, phonological awareness and word reading become so highly correlated that phonological awareness does not add information to the prediction of 4th-grade reading.

Awareness↗
PubMed2005

Motor awareness without perceptual awareness.

The control of action has traditionally been described as "automatic". In particular, movement control may occur without conscious awareness, in contrast to normal visual perception. Studies on rapid visuomotor adjustment of reaching movements following a target shift have played a large part in introducing such distinctions. We suggest that previous studies of the relation between motor performance and perceptual awareness have confounded two separate dissociations. These are: (a) the distinction between motoric and perceptual representations, and (b) an orthogonal distinction between conscious and unconscious processes. To articulate these differences more clearly, we propose a new measure of motor awareness, based on subjects' ability to reproduce the spatial details of reaching movements they have just made. Here we focus on the dissociation between motor awareness and perceptual awareness that may occur when subjects make rapid visuomotor adjustments to reaching movements following a target shift. In experiment 1, motor awareness was dissociated from perceptual awareness of a target shift during reaching movement. Participants' reproduction of movement endpoints following visuomotor adjustment was independent of whether they saw the target shift or not. Experiment 2 replicated this result, and further showed that neither motor awareness nor motor performance were disrupted by TMS over the parietal cortex. The neural mechanisms underlying motor awareness, and the implications for theories of consciousness, are discussed.

Adult↗
PubMed2002

On the neural correlates of object recognition awareness: relationship to computational activities and activities mediating perceptual awareness.

Based on theoretical considerations of Aurell (1979) and Block (1995), we argue that object recognition awareness is distinct from purely sensory awareness and that the former is mediated by neuronal activities in areas that are separate and distinct from cortical sensory areas. We propose that two of the principal functions of neuronal activities in sensory cortex, which are to provide sensory awareness and to effect the computations that are necessary for object recognition, are dissociated. We provide examples of how this dissociation might be achieved and argue that the components of the neuronal activities which carry the computations do not directly enter the awareness of the subject. The results of these computations are sparse representations (i.e., vector or distributed codes) which are activated by the presentation of particular sensory objects and are essentially engrams for the recognition of objects. These final representations occur in the highest order areas of sensory cortex; in the visual analyzer, the areas include the anterior part of the inferior temporal cortex and the perirhinal cortex. We propose, based on lesion and connectional data, that the two areas in which activities provide recognition awareness are the temporopolar cortex and the medial orbitofrontal cortex. Activities in the temporopolar cortex provide the recognition awareness of objects learned in the remote past (consolidated object recognition), and those in the medial orbitofrontal cortex provide the recognition awareness of objects learned in the recent past. The activation of the sparse representation for a particular sensory object in turn activates neurons in one or both of these regions of cortex, and it is the activities of these neurons that provide the awareness of recognition of the object in question. The neural circuitry involved in the activation of these representations is discussed.

Awareness↗
PubMed2005

Changing models across cultures: associations of phonological awareness and morphological structure awareness with vocabulary and word recognition in second graders from Beijing, Hong Kong, Korea, and the United States.

Using data provided by approximately 100 second graders each from Beijing, Hong Kong, Korea, and the United States, we investigated relations among phonological awareness, morphological structure awareness, vocabulary, and word recognition. Our results indicate that across languages, phonological awareness and morphological structure awareness are similarly associated with one another and with vocabulary knowledge; however, phonological awareness and morphological structure awareness have different associations with word recognition in different scripts among second graders. Specifically, phonological awareness may be more important for reading in English and Korean than for reading in Chinese. In contrast, morphological structure awareness may be more important for reading in Chinese and Korean than for reading in English at this grade level.

Awareness↗
PubMed2006

Measuring awareness in people with mild to moderate Alzheimer's disease: development of the Memory Awareness Rating Scale--adjusted.

Variations in level of awareness among people with Alzheimer's disease (AD) may impact on well-being for the person with dementia and their carer, and may influence outcomes of cognitive rehabilitation interventions. Awareness has often been assessed using discrepancies between self and proxy rating or between self-rating and objective task performance, with the latter considered to be preferable. Measures are available that are suitable for people with mild AD, for example the Memory Awareness Rating Scale (MARS). However, these may be less appropriate for people whose impairments are more advanced and who consequently have more difficulty with the objective task component. In order to provide a measure suitable for people with moderate AD, an adjusted Memory Awareness Rating Scale (MARSA) was developed by altering the objective task component of the MARS. The MARSA was piloted with 41 participants with mild to moderate AD. It was found to be suitable for use with a broader group of participants than the MARS. The component ratings were found to have good internal consistency. The component ratings and the two indices of awareness had high test-retest reliability. The extension of the original measure offers the opportunity to consider awareness throughout the course of the disease and provides a basis for longitudinal investigations of awareness.

Aged↗
PubMed2001

Awareness of genetic testing for breast cancer risk among women with a family history of breast cancer: effect of women's information sources on their awareness.

The purpose of this study was to relate women's awareness of breast cancer risk genetic testing to the sources of information used by women for obtaining information about breast health. A sample of 354 women with a family history of breast or ovarian cancer was interviewed. Study variables included women's information sources for breast health, personal risk perceptions, family history of breast cancer, personal experience (i.e., having had a biopsy), awareness of genetic testing, and demographic variables. Regression analyses were conducted to assess the relationships among the variables. Only approximately one-third of the study participants were moderately aware of genetic testing for breast cancer risk. The Internet Web was the only information source significantly related to awareness of genetic testing. Having had a biopsy, being more highly educated, and being married also were significant predictors of awareness of genetic testing. Study participants were not uniformly aware of genetic testing. If the diffusion of Web technology continues, the Web may be a promising source for increasing awareness on genetic testing for breast cancer risk.

Adolescent↗
PubMed1992

Reduced subjective awareness of bronchoconstriction provoked by methacholine in elderly asthmatic and normal subjects as measured on a simple awareness scale.

BACKGROUND: Asthma death rates are rising, with the greatest rise and highest death rates in old age. A reduced cardiovascular response in the elderly may lead to the underestimation by physicians of the severity of acute asthma attacks. This would be compounded if elderly patients had reduced awareness of bronchoconstriction. METHODS: Methacholine provoked bronchoconstriction was compared in 34 elderly (17 asthmatic, 17 normal; age 60-83, mean 68 years) and 33 young subjects (16 asthmatic, 17 normal; 20-46, mean 30 years). None were smokers. All underwent inhaled methacholine challenge by the Newcastle dosimeter method, monitored by maximal expiratory flow-volume loops (MEFVL). The endpoints were a 35% fall in forced expiratory flow at 50% vital capacity or cumulative inhalation of 6.4 mg methacholine. The one second forced expiratory volume (FEV1) was derived from MEFVL. After challenge and before bronchodilatation subjects graded awareness of respiratory discomfort from 1 (no symptoms) to 4 (pronounced symptoms needing immediate treatment). RESULTS: Despite a greater fall in FEV1 in elderly asthmatic patients (mean (SE) 27.4% (2.2%)) than in young asthmatic patients (21.5% (1.7%)) elderly patients were less aware of bronchoconstriction (awareness score 2.00 (SE 0.15) than young patients (3.06 (0.11)). Similar differences in awareness score were seen between elderly normal subjects (1.53 (0.17)) and young normal subjects (2.76 (0.22)), despite no difference in degree of bronchoconstriction. CONCLUSIONS: Reduced awareness of moderate acute bronchoconstriction in old age may delay self referral in acute asthma and contribute to higher asthma mortality in the elderly.

Adolescent↗
PubMed1996

[Awareness of health and welfare planning for elderly and methods to increase awareness: based on social marketing].

To clarify the socio-psychological factors affecting awareness of health and welfare planning for the elderly, a survey of community residents was performed in the Tokyo metropolitan area. The results obtained were as follows: 1. There were three factors which affected awareness concern about health and welfare services for the elderly as a social issue: concern about the local community; and concern about the local government. 2. Two other factors which did not affect the level of awareness were: anxiety about the health and welfare services for the elderly as a personal issue; and having personal experience of nursing care. From these results, a method to increase awareness was studied based on social marketing methods. Two primary target groups for increasing awareness were identified. One target was people who have the socio-psychological factors described above. Another target was people who have the potential need for health and welfare services but who were not aware of it. That is, they have relatively high anxiety about health and welfare services for the elderly as a personal issue and have personally experienced nursing care. The method of approach for these targets were studied. For the first group, the amount of the information available seemed to be important because these persons are ready to recognize the need for planning. Therefore, efficient information channels should be selected. For the second group, approaches that generate greater consumer participation by presenting this as an efficient method for solution of the problem should be adopted.

Adult↗
PubMed2006

High prevalence and low awareness of CKD in Taiwan: a study on the relationship between serum creatinine and awareness from a nationally representative survey.

BACKGROUND: The burden of chronic kidney disease (CKD) is a global challenge. Empirical evidence of low CKD awareness rates in developed countries speaks for an urgent need to strengthen strategies for CKD identification and prevention. The aim of this study is to estimate the awareness rate of CKD in Taiwan to promote early detection of CKD in this country. METHODS: Data from a nationally representative survey were used for analysis. The study included 6,001 subjects. The simplified Modification of Diet in Renal Disease equation was used to define glomerular filtration rate (GFR) and CKD stages according to criteria of the US National Kidney Foundation. Descriptive methods were used to analyze data. RESULTS: The prevalence of CKD stages 3 to 5 in Taiwan is 6.9% (95% confidence interval, 4.4 to 9.4). Awareness rates for CKD in Taiwan are low: 8.0% for individuals with stage 3, 25.0% for those with stage 4, and 71.4% for those with stage 5. Awareness rate is related closely to serum creatinine level: those with creatinine levels greater than 1.6 mg/dL (>141 micromol/L) are more likely to be informed of having a kidney disease. CONCLUSION: The high prevalence and low awareness of CKD in Taiwan explicitly show the need to advocate more strongly for CKD prevention and education for both physicians and the populace. Establishment of a mandated automatic GFR reporting system may be the first priority we need to accomplish in Taiwan to improve kidney well-being.

Adult↗
PubMed1997

Calibrating the physician. Personal awareness and effective patient care. Working Group on Promoting Physician Personal Awareness, American Academy on Physician and Patient.

Physicians' personal characteristics, their past experiences, values, attitudes, and biases can have important effects on communication with patients; being aware of these characteristics can enhance communication. Because medical training and continuing education programs rarely undertake an organized approach to promoting personal awareness, we propose a "curriculum" of 4 core topics for reflection and discussion. The topics are physicians' beliefs and attitudes, physicians' feelings and emotional responses in patient care, challenging clinical situations, and physician self-care. We present examples of organized activities that can promote physician personal awareness such as support groups, Balint groups, and discussions of meaningful experiences in medicine. Experience with these activities suggests that through enhancing personal awareness physicians can improve their clinical care and increase satisfaction with work, relationships, and themselves.

Attitude of Health Personnel↗
PubMedDate not supplied

Body/self awareness and interpersonal communications: fundamental components of reproductive health awareness.

To protect and advocate for their own reproductive health, people of all ages can greatly benefit from enhanced body/self awareness and strong interpersonal communication skills. Body/self awareness and interpersonal communications, along with gender awareness and the integration of sexuality, are the fundamental components of a new approach to obtaining high quality health called reproductive health awareness.

Awareness↗
PubMed2006

Evaluative conditioning and the awareness issue: assessing contingency awareness with the four-picture recognition test.

An experiment is described that tested the moderating influence of contingency awareness on evaluative conditioning. After participants were conditioned within the picture-picture paradigm, contingency awareness was assessed by means of a recognition test (i.e., the 4-picture recognition test). Results indicate an inverse relationship between the conditioned affective reaction and contingency awareness: Only participants classified as unaware in the recognition test showed significant effects of evaluative learning. A closer inspection indicates that aware individuals stored not only the valence but also the nominal stimulus in mind.

Adult↗
PubMed2007

Aware and (dis)liking: item-based analyses reveal that valence acquisition via evaluative conditioning emerges only when there is contingency awareness.

Evaluative conditioning (EC) refers to changes in the liking of an affectively neutral stimulus (the conditioned stimulus, or CS) following the pairing of that stimulus with another stimulus of affective value (the unconditioned stimulus, or US). In 3 experiments, the authors assessed contingency awareness, that is, awareness of the CS-US associations, by relying on participants' responses to individual items rather than using a global method of assessment. They found that EC emerged on contingency aware CSs only. Of note, whether the CSs were evaluated explicitly (Experiments 1 and 2) or implicitly (Experiment 3) did not make a difference. This pattern supports the idea that awareness of the CS-US associations may be required for valence acquisition via EC.

Advertising↗
PubMed2003

Measurement of impaired self-awareness after traumatic brain injury: a comparison of the patient competency rating scale and the awareness questionnaire.

PRIMARY OBJECTIVE: To compare the Patient Competency Rating Scale (PCRS) and the Awareness Questionnaire (AQ) in the measurement of impaired self-awareness (ISA) in persons with traumatic brain injury (TBI). RESEARCH DESIGN: Prospective cohort of patients seen for inpatient rehabilitation following TBI. PROCEDURES: Measures of self-awareness were collected at resolution of post-traumatic amnesia and outcomes (rated employability) were collected at discharge from inpatient rehabilitation. OUTCOMES AND RESULTS: Subjects were 129 persons with TBI. Measures from the PCRS and AQ showed moderate correlations. Models using as predictors patient/clinician discrepancies for the PCRS and the AQ performed comparably in predicting employability (Nagelkerke R(2) = 0.22 and 0.20, respectively). CONCLUSIONS: The PCRS and AQ showed only moderate correlations, but performed comparably as measures of ISA after TBI. Patient/clinician discrepancies appeared to be more valid measures of ISA early after TBI than patient/family discrepancies. Preliminary cutting points for severity of ISA were presented for the two scales.

Adult↗