Blood pressure awareness in Austria. A 20-year evaluation, 1978-1998.
(25/1787)
AIM: To evaluate public awareness following a nationwide educational campaign on hypertension. METHODS AND RESULTS: In 1978 the Austrian Heart Foundation conducted a nationwide educational campaign to increase the awareness of the population regarding the importance of recognizing and treating high blood pressure. Following this campaign, five opinion polls of random and representative samples were conducted to measure the awareness and knowledge of the population relating to issues of high blood pressure. The poll results indicated that during the period immediately following the awareness campaign, knowledge and perception of the dangers of high blood pressure increased. However, this effect dissipated during subsequent years. In 1978, 14% of the population were reported to be hypertensive and 10% had no relevant information about their blood pressure status. In 1998, those who labelled themselves as hypertensive dropped to 12%, while those who did not know their blood pressure values, increased to 14%. The percentage of the population who recalled having their blood pressure measured during the last 3 months dropped from 49% in 1978, to 34% in 1993, and remained at 34% in 1998. CONCLUSION: We conclude that the intensive blood pressure education campaign had only a temporary effect on improving blood pressure awareness. Improved strategies are needed to achieve better community control of hypertension. (+info)
Contextual influence on orientation discrimination of humans and responses of neurons in V1 of alert monkeys.
(26/1787)
We studied the effects of various patterns as contextual stimuli on human orientation discrimination, and on responses of neurons in V1 of alert monkeys. When a target line is presented along with various contextual stimuli (masks), human orientation discrimination is impaired. For most V1 neurons, responses elicited by a line in the receptive field (RF) center are suppressed by these contextual patterns. Orientation discrimination thresholds of human observers are elevated slightly when the target line is surrounded by orthogonal lines. For randomly oriented lines, thresholds are elevated further and even more so for lines parallel to the target. Correspondingly, responses of most V1 neurons to a line are suppressed. Although contextual lines inhibit the amplitude of orientation tuning functions of most V1 neurons, they do not systematically alter the tuning width. Elevation of human orientation discrimination thresholds decreases with increasing curvature of masking lines, so does the inhibition of V1 neuronal responses. A mask made of straight lines yields the strongest interference with human orientation discrimination and produces the strongest suppression of neuronal responses. Elevation of human orientation discrimination thresholds is highest when a mask covers only the immediate vicinity of the target line. Increasing the masking area results in less interference. On the contrary, suppression of neuronal responses in V1 increases with increasing mask size. Our data imply that contextual interference observed in human orientation discrimination is in part directly related to contextual inhibition of neuronal activity in V1. However, the finding that interference with orientation discrimination is weaker for larger masks suggests a figure-ground segregation process that is not located in V1. (+info)
Do older hospital patients recognize adverse drug reactions?
(27/1787)
OBJECTIVE: To establish the relationship between subjective complaints of side effects of drugs and the objective presence of adverse drug reactions in older patients. DESIGN: Observational cross-sectional study. SETTING: Five medical wards at the University Hospital Rotterdam Dijkzigt. SUBJECTS: Patients aged 70 and over admitted to the general medical wards over a 3-month period. METHODS: Statistical comparison and Kramer's algorithm. RESULTS: Of 106 patients, 102 used medication, and 93 of these were able to report whether they believed they were experiencing drug side effects. Thirty-six [39% (95% confidence interval 28.8-48.6)] believed that they were experiencing side effects and the number of diagnoses per patient and the proportion of patients with chronic obstructive pulmonary disease was higher in these 36 'complainers' than in the group of the 'non-complainers'. We found a correct opinion (true positive and negative) about the objective presence or absence of mild or severe adverse drug reactions in 79% (95% confidence interval 70.2-86.8). Asking the patient about side effects of drugs had a sensitivity of 0.70 and a specificity of 0.85 patients. The severe adverse drug reactions in 21 patients were not recognized by 14 of them. CONCLUSION: At hospital admission, older patients should be asked about drug side effects because they are often correct in recognizing them. However, severe adverse drug reactions are not easily recognized. (+info)
Are surgeons aware of the dangers of diathermy?
(28/1787)
Surgical diathermy is an invaluable aid in modern surgery and most contemporary diathermy machines are considered safe. However, diathermy accidents still do occur and a diathermy unit can be potentially lethal if adequate care is not exercised in its use. (+info)
Poor insight in schizophrenia: neurocognitive basis.
(29/1787)
Poor insight in schizophrenia has been recently thought to be a reflection of prominent and enduring neurocognitive impairments. Reports supporting this theory have implicated prefrontal and parietal lobe functions, among other parameters. The results of other studies have negated the role of neuropsychological abnormalities in poor insight. The analogy between poor insight in schizophrenia and anosognosia in neurological illness as proposed by one set of workers has been elucidated in this review and it appears quite promising. However, the drawing of definite conclusions from all this work has been deferred by us, because of the need for more uniform and standardized methodologies for research on the subject. Nevertheless, attempts to improve the cognitive processes, which affect insight in schizophrenia, may be done to gain better treatment outcome in this disorder. (+info)
Insufficient adaptation of hypoglycaemic threshold for cognitive impairment in tightly controlled type 1 diabetes.
(30/1787)
It is well known that hypoglycaemic thresholds for hormones and symptoms occur at lower plasma glucose levels in patients with strict glycaemic control. However, whether the threshold for cognitive impairment also shifts is still an unresolved question. We studied 19 type 1 diabetic patients, including 8 with hypoglycaemia unawareness, aged 37.0 +/- 7.4 y.r., with diabetes duration 15.2 +/- 10.7 yr, and HbA1c 7.6 +/- 1.1%. Hypoglycaemic thresholds for hormones, symptoms, awareness and cognitive function using the 4-choice reaction time test (4RT), were measured every 30 min during a 150 min stepped 4.4 to 2.2 mM hypoglycaemic hyperinsulinemic clamp. We found that 4RT- accuracy deteriorated earlier than 4RT-time (3.2 and 2.7 mM, respectively, p<0.01), and that both correlated poorly with HbA1C before and after adjustment for age and diabetes duration (r=0.11, and 0.18, respectively). On the opposite, adrenaline, autonomic and neuroglycopenic symptoms, and awareness significantly correlated with HbA1c values (r=0.56, 0.70, 0.61, and 0.63, after adjustment, respectively). Furthermore, after allocating the patients into two subgroups according to HbA1c values (<8% n=12, and >=8% n=7), we found that, as opposed to other thresholds, accuracy and 4RT-time were minimally and not significantly influenced by glycaemic control, therefore exhibiting the smaller glucose thresholds shifts (- 0.2 and - 0.5 mM for accuracy and time, respectively, vs. 0.6 -0.8 for other thresholds). IN CONCLUSION: 1) the hypoglycaemic thresholds for cognitive dysfunction shift with strict glycaemic control, but not significantly and less than other thresholds, 2) as opposed to other reports, accuracy deteriorates earlier than speed during the 4RT test, and 3) these "maladapted" reactions may contribute to the higher risk for severe hypoglycaemia in subjects with tight glycaemic control. (+info)
Motion integration and postdiction in visual awareness.
(31/1787)
In the flash-lag illusion, a flash and a moving object in the same location appear to be offset. A series of psychophysical experiments yields data inconsistent with two previously proposed explanations: motion extrapolation (a predictive model) and latency difference (an online model). We propose an alternative in which visual awareness is neither predictive nor online but is postdictive, so that the percept attributed to the time of the flash is a function of events that happen in the approximately 80 milliseconds after the flash. The results here show how interpolation of the past is the only framework of the three models that provides a unified explanation for the flash-lag phenomenon. (+info)
What do parents of wheezy children understand by "wheeze"?
(32/1787)
BACKGROUND: Reported wheeze is the cornerstone of asthma diagnosis. AIMS: To determine what parents understand by wheeze. METHODS: Two studies were undertaken: (1) Parents of clinic attendees with reported wheeze (n=160) were asked by questionnaire what they understood by "wheeze" and how they knew their child was wheezy. Responses were compared to definitions of wheeze in 12 epidemiology studies and their response options. (2) The extent of agreement of parents' reports (n=139) of acute wheezing in their children and clinicians' findings of "wheeze" and "asthma" was examined. RESULTS: (1) "Sound" and "difficulty in breathing" were perceived central to "wheeze". "What you hear" was not selected by 23% (95% confidence interval (CI) 16-30%). "Whistling" was mentioned by 11% (CI 6-15%) but featured in 11 of 12 epidemiology questionnaires. (2) There was les than 50% agreement between parents' and clinicians' reports of wheeze and asthma. CONCLUSIONS: Conceptual understandings of "wheeze" for parents of children with reported wheeze are different from epidemiology definitions. Parents' reports of acute wheeze and clinicians' findings also differ. (+info)