Awareness: The act of "taking account" of an object or state of affairs. It does not imply assessment of, nor attention to the qualities or nature of the object.Intraoperative Awareness: Occurence of a patient becoming conscious during a procedure performed under GENERAL ANESTHESIA and subsequently having recall of these events. (From Anesthesiology 2006, 104(4): 847-64.)Health Knowledge, Attitudes, Practice: Knowledge, attitudes, and associated behaviors which pertain to health-related topics such as PATHOLOGIC PROCESSES or diseases, their prevention, and treatment. This term refers to non-health workers and health workers (HEALTH PERSONNEL).Questionnaires: Predetermined sets of questions used to collect data - clinical data, social status, occupational group, etc. The term is often applied to a self-completed survey instrument.Health Education: Education that increases the awareness and favorably influences the attitudes and knowledge relating to the improvement of health on a personal or community basis.Consciousness: Sense of awareness of self and of the environment.Cross-Sectional Studies: Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time.Unconscious (Psychology): Those forces and content of the mind which are not ordinarily available to conscious awareness or to immediate recall.Subliminal Stimulation: Stimulation at an intensity below that where a differentiated response can be elicited.IndiaPerception: The process by which the nature and meaning of sensory stimuli are recognized and interpreted.Attitude to Health: Public attitudes toward health, disease, and the medical care system.Health Promotion: Encouraging consumer behaviors most likely to optimize health potentials (physical and psychosocial) through health information, preventive programs, and access to medical care.United StatesRisk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Prevalence: The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.Data Collection: Systematic gathering of data for a particular purpose from various sources, including questionnaires, interviews, observation, existing records, and electronic devices. The process is usually preliminary to statistical analysis of the data.Malaysia: A parliamentary democracy with a constitutional monarch in southeast Asia, consisting of 11 states (West Malaysia) on the Malay Peninsula and two states (East Malaysia) on the island of BORNEO. It is also called the Federation of Malaysia. Its capital is Kuala Lumpur. Before 1963 it was the Union of Malaya. It reorganized in 1948 as the Federation of Malaya, becoming independent from British Malaya in 1957 and becoming Malaysia in 1963 as a federation of Malaya, Sabah, Sarawak, and Singapore (which seceded in 1965). The form Malay- probably derives from the Tamil malay, mountain, with reference to its geography. (From Webster's New Geographical Dictionary, 1988, p715 & Room, Brewer's Dictionary of Names, 1992, p329)Phonetics: The science or study of speech sounds and their production, transmission, and reception, and their analysis, classification, and transcription. (Random House Unabridged Dictionary, 2d ed)Mass Media: Instruments or technological means of communication that reach large numbers of people with a common message: press, radio, television, etc.ReadingAttitude of Health Personnel: Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc.Patient Education as Topic: The teaching or training of patients concerning their own health needs.Visual Perception: The selecting and organizing of visual stimuli based on the individual's past experience.Educational Status: Educational attainment or level of education of individuals.Rural Population: The inhabitants of rural areas or of small towns classified as rural.Interviews as Topic: Conversations with an individual or individuals held in order to obtain information about their background and other personal biographical data, their attitudes and opinions, etc. It includes school admission or job interviews.Patient Acceptance of Health Care: The seeking and acceptance by patients of health service.Knowledge: The body of truths or facts accumulated in the course of time, the cumulated sum of information, its volume and nature, in any civilization, period, or country.Persistent Vegetative State: Vegetative state refers to the neurocognitive status of individuals with severe brain damage, in whom physiologic functions (sleep-wake cycles, autonomic control, and breathing) persist, but awareness (including all cognitive function and emotion) is abolished.Nigeria: A republic in western Africa, south of NIGER between BENIN and CAMEROON. Its capital is Abuja.Consciousness Monitors: Devices used to assess the level of consciousness especially during anesthesia. They measure brain activity level based on the EEG.Public Opinion: The attitude of a significant portion of a population toward any given proposition, based upon a measurable amount of factual evidence, and involving some degree of reflection, analysis, and reasoning.Breast Self-Examination: The inspection of one's breasts, usually for signs of disease, especially neoplastic disease.Socioeconomic Factors: Social and economic factors that characterize the individual or group within the social structure.Mass Screening: Organized periodic procedures performed on large groups of people for the purpose of detecting disease.Repetition Priming: A type of procedural memory manifested as a change in the ability to identify an item as a result of a previous encounter with the item or stimuli.Clinical Competence: The capability to perform acceptably those duties directly related to patient care.Agnosia: Loss of the ability to comprehend the meaning or recognize the importance of various forms of stimulation that cannot be attributed to impairment of a primary sensory modality. Tactile agnosia is characterized by an inability to perceive the shape and nature of an object by touch alone, despite unimpaired sensation to light touch, position, and other primary sensory modalities.Photic Stimulation: Investigative technique commonly used during ELECTROENCEPHALOGRAPHY in which a series of bright light flashes or visual patterns are used to elicit brain activity.Attention: Focusing on certain aspects of current experience to the exclusion of others. It is the act of heeding or taking notice or concentrating.Program Evaluation: Studies designed to assess the efficacy of programs. They may include the evaluation of cost-effectiveness, the extent to which objectives are met, or impact.Focus Groups: A method of data collection and a QUALITATIVE RESEARCH tool in which a small group of individuals are brought together and allowed to interact in a discussion of their opinions about topics, issues, or questions.Students: Individuals enrolled in a school or formal educational program.Anesthesia, General: Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery.Advertising as Topic: The act or practice of calling public attention to a product, service, need, etc., especially by paid announcements in newspapers, magazines, on radio, or on television. (Random House Unabridged Dictionary, 2d ed)Health Surveys: A systematic collection of factual data pertaining to health and disease in a human population within a given geographic area.Physicians: Individuals licensed to practice medicine.Great BritainContraception, Postcoital: Means of postcoital intervention to avoid pregnancy, such as the administration of POSTCOITAL CONTRACEPTIVES to prevent FERTILIZATION of an egg or implantation of a fertilized egg (OVUM IMPLANTATION).Self Concept: A person's view of himself.Health Personnel: Men and women working in the provision of health services, whether as individual practitioners or employees of health institutions and programs, whether or not professionally trained, and whether or not subject to public regulation. (From A Discursive Dictionary of Health Care, 1976)Delayed Diagnosis: Non-optimal interval of time between onset of symptoms, identification, and initiation of treatment.Early Detection of Cancer: Methods to identify and characterize cancer in the early stages of disease and predict tumor behavior.Age Factors: Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.Health Care Surveys: Statistical measures of utilization and other aspects of the provision of health care services including hospitalization and ambulatory care.Consumer Health Information: Information intended for potential users of medical and healthcare services. There is an emphasis on self-care and preventive approaches as well as information for community-wide dissemination and use.Perceptual Masking: The interference of one perceptual stimulus with another causing a decrease or lessening in perceptual effectiveness.Qualitative Research: Any type of research that employs nonnumeric information to explore individual or group characteristics, producing findings not arrived at by statistical procedures or other quantitative means. (Qualitative Inquiry: A Dictionary of Terms Thousand Oaks, CA: Sage Publications, 1997)Social Marketing: Use of marketing principles also used to sell products to consumers to promote ideas, attitudes and behaviors. Design and use of programs seeking to increase the acceptance of a social idea or practice by target groups, not for the benefit of the marketer, but to benefit the target audience and the general society.Dyslexia: A cognitive disorder characterized by an impaired ability to comprehend written and printed words or phrases despite intact vision. This condition may be developmental or acquired. Developmental dyslexia is marked by reading achievement that falls substantially below that expected given the individual's chronological age, measured intelligence, and age-appropriate education. The disturbance in reading significantly interferes with academic achievement or with activities of daily living that require reading skills. (From DSM-IV)Physician's Practice Patterns: Patterns of practice related to diagnosis and treatment as especially influenced by cost of the service requested and provided.Attitude: An enduring, learned predisposition to behave in a consistent way toward a given class of objects, or a persistent mental and/or neural state of readiness to react to a certain class of objects, not as they are but as they are conceived to be.PakistanHealth Behavior: Behaviors expressed by individuals to protect, maintain or promote their health status. For example, proper diet, and appropriate exercise are activities perceived to influence health status. Life style is closely associated with health behavior and factors influencing life style are socioeconomic, educational, and cultural.Health Services Accessibility: The degree to which individuals are inhibited or facilitated in their ability to gain entry to and to receive care and services from the health care system. Factors influencing this ability include geographic, architectural, transportational, and financial considerations, among others.Universities: Educational institutions providing facilities for teaching and research and authorized to grant academic degrees.Information Dissemination: The circulation or wide dispersal of information.China: A country spanning from central Asia to the Pacific Ocean.Communication: The exchange or transmission of ideas, attitudes, or beliefs between individuals or groups.Urban Population: The inhabitants of a city or town, including metropolitan areas and suburban areas.Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.Articulation Disorders: Disorders of the quality of speech characterized by the substitution, omission, distortion, and addition of phonemes.Public Health: Branch of medicine concerned with the prevention and control of disease and disability, and the promotion of physical and mental health of the population on the international, national, state, or municipal level.Hypertension: Persistently high systemic arterial BLOOD PRESSURE. Based on multiple readings (BLOOD PRESSURE DETERMINATION), hypertension is currently defined as when SYSTOLIC PRESSURE is consistently greater than 140 mm Hg or when DIASTOLIC PRESSURE is consistently 90 mm Hg or more.Smoking: Inhaling and exhaling the smoke of burning TOBACCO.Sex Factors: Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances.Pilot Projects: Small-scale tests of methods and procedures to be used on a larger scale if the pilot study demonstrates that these methods and procedures can work.Emotions: Those affective states which can be experienced and have arousing and motivational properties.Magnetic Resonance Imaging: Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques.Culture: A collective expression for all behavior patterns acquired and socially transmitted through symbols. Culture includes customs, traditions, and language.Communications Media: The means of interchanging or transmitting and receiving information. Historically the media were written: books, journals, newspapers, and other publications; in the modern age the media include, in addition, radio, television, computers, and information networks.Writing: The act or practice of literary composition, the occupation of writer, or producing or engaging in literary work as a profession.Anniversaries and Special Events: Occasions to commemorate an event or occasions designated for a specific purpose.Mental Recall: The process whereby a representation of past experience is elicited.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Reaction Time: The time from the onset of a stimulus until a response is observed.Australia: The smallest continent and an independent country, comprising six states and two territories. Its capital is Canberra.Intention: What a person has in mind to do or bring about.Minority Groups: A subgroup having special characteristics within a larger group, often bound together by special ties which distinguish it from the larger group.Linguistics: The science of language, including phonetics, phonology, morphology, syntax, semantics, pragmatics, and historical linguistics. (Random House Unabridged Dictionary, 2d ed)Consumer Participation: Community or individual involvement in the decision-making process.Neoplasms: New abnormal growth of tissue. Malignant neoplasms show a greater degree of anaplasia and have the properties of invasion and metastasis, compared to benign neoplasms.Community Networks: Organizations and individuals cooperating together toward a common goal at the local or grassroots level.Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory.Decision Making: The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea.Papillomavirus Vaccines: Vaccines or candidate vaccines used to prevent PAPILLOMAVIRUS INFECTIONS. Human vaccines are intended to reduce the incidence of UTERINE CERVICAL NEOPLASMS, so they are sometimes considered a type of CANCER VACCINES. They are often composed of CAPSID PROTEINS, especially L1 protein, from various types of ALPHAPAPILLOMAVIRUS.Hemianopsia: Partial or complete loss of vision in one half of the visual field(s) of one or both eyes. Subtypes include altitudinal hemianopsia, characterized by a visual defect above or below the horizontal meridian of the visual field. Homonymous hemianopsia refers to a visual defect that affects both eyes equally, and occurs either to the left or right of the midline of the visual field. Binasal hemianopsia consists of loss of vision in the nasal hemifields of both eyes. Bitemporal hemianopsia is the bilateral loss of vision in the temporal fields. Quadrantanopsia refers to loss of vision in one quarter of the visual field in one or both eyes.Community Health Services: Diagnostic, therapeutic and preventive health services provided for individuals in the community.Emergency Medical Service Communication Systems: The use of communication systems, such as telecommunication, to transmit emergency information to appropriate providers of health services.Language Tests: Tests designed to assess language behavior and abilities. They include tests of vocabulary, comprehension, grammar and functional use of language, e.g., Development Sentence Scoring, Receptive-Expressive Emergent Language Scale, Parsons Language Sample, Utah Test of Language Development, Michigan Language Inventory and Verbal Language Development Scale, Illinois Test of Psycholinguistic Abilities, Northwestern Syntax Screening Test, Peabody Picture Vocabulary Test, Ammons Full-Range Picture Vocabulary Test, and Assessment of Children's Language Comprehension.Practice Guidelines as Topic: Directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.Referral and Consultation: The practice of sending a patient to another program or practitioner for services or advice which the referring source is not prepared to provide.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Cognition: Intellectual or mental process whereby an organism obtains knowledge.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.

Commercialization of BRCA1/2 testing: practitioner awareness and use of a new genetic test. (1/1787)

It was our purpose to determine the characteristics of practitioners in the United States who were among the first to inquire about and use the BRCA1 and BRCA2 (BRCA1/2) genetic tests outside of a research protocol. Questionnaires were mailed to all practitioners who requested information on or ordered a BRCA1/2 test from the University of Pennsylvania (UPenn) Genetic Diagnostics Laboratory (GDL) between October 1, 1995 and January 1, 1997 (the first 15 months the test was available for clinical use). The response rate was 67% of practitioners; 54% (121/225) were genetic counselors, 39% (87/225) were physicians or lab directors. Most physicians were oncologists, pathologists, or obstetrician/gynecologists, but 20% practiced surgery or internal or general medicine. Fifty-six percent (125/225) had ordered a BRCA1/2 test for a patient; most of the rest had offered or were willing to offer testing. Of those who had offered testing, 70% had a patient decline BRCA1/2 testing when offered. Practitioners perceived that patients' fear of loss of confidentiality was a major reason for declining. Nearly 60% of practitioners reported that their patients had access to a genetic counselor, but 28% of physicians who ordered a BRCA1/2 test reported having no such access, despite the GDL's counseling requirement. The proportion of physicians reporting no access to genetic counselors for their patients increased from 22.4% in the first half of the study to 50% in the last half. Many practitioners have an interest in BRCA1/2 testing, despite policy statements that discourage its use outside of research protocols. Practitioner responses suggest that patient interest in testing seems to be tempered by knowledge of potential risks. An apparent increase in patient concern about confidentiality and inability to pay for testing could indicate growing barriers to testing. Although most practitioners reported having access to counseling facilities, perceived lack of such access among an increasing proportion of practitioners indicates that lab requirements for counseling are difficult to enforce and suggests that an increasing proportion of patients may not be getting access to counseling.  (+info)

Does vestibular stimulation activate thalamocortical mechanisms that reintegrate impaired cortical regions? (2/1787)

Caloric stimulation induced a transient reversal of multimodal hemispatial cognitive deficits in an 81-year-old woman with an acute left cerebral hemisphere stroke. The patient had unawareness of her right hand (asomatognosia), right-sided visual unawareness (hemineglect), aphasia and right-sided weakness (hemiplegia) prior to the stimulation. Transient improvements in impaired sensory, motor, linguistic and cognitive function developed within 30 s following application of the caloric stimulus and onset of horizontal nystagmus. The effect persisted for 3 min and ceased completely after 5 min. While several recent reports have described the capacity of caloric stimulation to transiently improve or reverse a wide range of attentional, cognitive and motor impairments, most examples are in right-hemisphere-damaged patients with long-standing brain injury. Typically, patients have been tested several months or years after the onset of the deficit. A possible mechanism for the temporary reintegration of multiple cognitive functions in this patient is discussed.  (+info)

Audit of patients' awareness of ophthalmic diagnoses. (3/1787)

Providing information to patients about their medical condition and treatment options is important in medical management. To assess patients' knowledge of their ocular disease, prognosis, and treatment a questionnaire based survey was performed. 219 patients selected by random systematic sampling during six months from patients attending general ophthalmic clinics in Selly Oak Hospital, Birmingham, were questioned and 217 questionnaires were analysed. The findings showed that patients' knowledge of their diagnosis depended on their condition: patients with common conditions such as glaucoma and cataract had a better understanding of their condition, its treatment, and prognosis compared with patients with rarer conditions such as retinal detachment or patients with multiple diagnoses. In all, 152 patients (70%) wanted more information about their condition; 49 (23%) did not (although 12 (25%) had attempted to obtain information); and 16 (7%) were undecided. In view of the few patients with a precise understanding of their ophthalmic diagnosis and prognosis and the majority's wish for access to further information, that access needs improvement and different modes of disseminating the information should be implemented.  (+info)

Prevalence of insomnia: a survey of the enrollees at five managed care organizations. (4/1787)

The purpose of the study was to assess the prevalence of and factors associated with insomnia among enrollees of managed care organizations (MCOs). A survey was distributed either by mail or during a clinic visit to 7,500 enrollees of five MCOs in the United States. The survey included a sleep questionnaire, demographic questions, and questions about medical encounters and prescription drug use. Three levels of insomnia (none; level I--difficulty initiating or maintaining sleep; level II--insomnia with daytime dysfunction) were defined from the responses. Comorbidities were determined by proxy from prescription drug use reported by respondents. A total of 3,447 survey responses were received, yielding a response rate of 46%. Level I and level II insomnia was reported by 13.5% and 32.5% of the respondents, respectively. Level II insomnia increased with decreasing education, income, and age and was more prevalent in women and non-Caucasians. Insomnia was significantly correlated with all daytime sleepiness and most nighttime disturbances factors. Fifty-two percent of all respondents reported at least one comorbid condition. Respondents with multiple comorbidities reported level II insomnia more frequently than those with no comorbidities. Only 0.9% of clinic visitors were seeing a physician specifically for sleep problems. Of those with level I and level II insomnia, only 5.5% and 11.6%, respectively, were taking prescription medications specifically for sleep problems; 11.2% and 21.4%, respectively, were taking over-the-counter medications for sleep. Insomnia occurs in MCO enrollees at rates comparable to those found in the general population. However, few patients with insomnia are actually being treated for their condition. Proper evaluation, diagnosis, and treatment of insomnia are warranted.  (+info)

Tramadol or morphine administered during operation: a study of immediate postoperative effects after abdominal hysterectomy. (5/1787)

Tramadol may cause awareness and EEG activation during anaesthesia. We compared tramadol with morphine, administered during wound-closure, surmising that tramadol may cause earlier awakening, more rapid recovery, less respiratory depression and equivalent pain relief. Forty patients received nitrous oxide-enflurane for abdominal surgery. At wound closure, patients received tramadol 3 mg kg-1 or morphine 0.2 mg kg-1 and end-tidal enflurane concentrations were maintained at 0.5 kPa until skin closure, whereupon anaesthesia was discontinued. Times to spontaneous respiration, awakening and orientation were similar in the two groups, as were blood-gas tensions, ventilatory frequency, pain scores and incidence of nausea. Half of each group required supplementary analgesia during their 90-min stay in the recovery room. P-deletion counts improved more rapidly in the tramadol group. This study confirms previous reports that tramadol did not antagonize the hypnotic effects of volatile anaesthetics. Tramadol, administered during operation, was as effective as morphine in providing postoperative analgesia while permitting more rapid psychomotor recovery.  (+info)

Impact of network activity on the integrative properties of neocortical pyramidal neurons in vivo. (6/1787)

During wakefulness, neocortical neurons are subjected to an intense synaptic bombardment. To assess the consequences of this background activity for the integrative properties of pyramidal neurons, we constrained biophysical models with in vivo intracellular data obtained in anesthetized cats during periods of intense network activity similar to that observed in the waking state. In pyramidal cells of the parietal cortex (area 5-7), synaptic activity was responsible for an approximately fivefold decrease in input resistance (Rin), a more depolarized membrane potential (Vm), and a marked increase in the amplitude of Vm fluctuations, as determined by comparing the same cells before and after microperfusion of tetrodotoxin (TTX). The model was constrained by measurements of Rin, by the average value and standard deviation of the Vm measured from epochs of intense synaptic activity recorded with KAc or KCl-filled pipettes as well as the values measured in the same cells after TTX. To reproduce all experimental results, the simulated synaptic activity had to be of relatively high frequency (1-5 Hz) at excitatory and inhibitory synapses. In addition, synaptic inputs had to be significantly correlated (correlation coefficient approximately 0.1) to reproduce the amplitude of Vm fluctuations recorded experimentally. The presence of voltage-dependent K+ currents, estimated from current-voltage relations after TTX, affected these parameters by <10%. The model predicts that the conductance due to synaptic activity is 7-30 times larger than the somatic leak conductance to be consistent with the approximately fivefold change in Rin. The impact of this massive increase in conductance on dendritic attenuation was investigated for passive neurons and neurons with voltage-dependent Na+/K+ currents in soma and dendrites. In passive neurons, correlated synaptic bombardment had a major influence on dendritic attenuation. The electrotonic attenuation of simulated synaptic inputs was enhanced greatly in the presence of synaptic bombardment, with distal synapses having minimal effects at the soma. Similarly, in the presence of dendritic voltage-dependent currents, the convergence of hundreds of synaptic inputs was required to evoke action potentials reliably. In this case, however, dendritic voltage-dependent currents minimized the variability due to input location, with distal apical synapses being as effective as synapses on basal dendrites. In conclusion, this combination of intracellular and computational data suggests that, during low-amplitude fast electroencephalographic activity, neocortical neurons are bombarded continuously by correlated synaptic inputs at high frequency, which significantly affect their integrative properties. A series of predictions are suggested to test this model.  (+info)

Discharge profiles of abducens, accessory abducens, and orbicularis oculi motoneurons during reflex and conditioned blinks in alert cats. (7/1787)

The discharge profiles of identified abducens, accessory abducens, and orbicularis oculi motoneurons have been recorded extra- and intracellularly in alert behaving cats during spontaneous, reflexively evoked, and classically conditioned eyelid responses. The movement of the upper lid and the electromyographic activity of the orbicularis oculi muscle also were recorded. Animals were conditioned by short, weak air puffs or 350-ms tones as conditioned stimuli (CS) and long, strong air puffs as unconditioned stimulus (US) using both trace and delayed conditioning paradigms. Motoneurons were identified by antidromic activation from their respective cranial nerves. Orbicularis oculi and accessory abducens motoneurons fired an early, double burst of action potentials (at 4-6 and 10-16 ms) in response to air puffs or to the electrical stimulation of the supraorbital nerve. Orbicularis oculi, but not accessory abducens, motoneurons fired in response to flash and tone presentations. Only 10-15% of recorded abducens motoneurons fired a late, weak burst after air puff, supraorbital nerve, and flash stimulations. Spontaneous fasciculations of the orbicularis oculi muscle and the activity of single orbicularis oculi motoneurons that generated them also were recorded. The activation of orbicularis oculi motoneurons during the acquisition of classically conditioned eyelid responses happened in a gradual, sequential manner. Initially, some putative excitatory synaptic potentials were observed in the time window corresponding to the CS-US interval; by the second to the fourth conditioning session, some isolated action potentials appeared that increased in number until some small movements were noticed in eyelid position traces. No accessory abducens motoneuron fired and no abducens motoneuron modified their discharge rate for conditioned eyelid responses. The firing of orbicularis oculi motoneurons was related linearly to lid velocity during reflex blinks but to lid position during conditioned responses, a fact indicating the different neural origin and coding of both types of motor commands. The power spectra of both reflex and conditioned lid responses showed a dominant peak at approximately 20 Hz. The wavy appearance of both reflex and conditioned eyelid responses was clearly the result of the high phasic activity of orbicularis oculi motor units. Orbicularis oculi motoneuron membrane potentials oscillated at approximately 20 Hz after supraorbital nerve stimulation and during other reflex and conditioned eyelid movements. The oscillation seemed to be the result of both intrinsic (spike afterhyperpolarization lasting approximately 50 ms, and late depolarizations) and extrinsic properties of the motoneuronal pool and of the circuits involved in eye blinks.  (+info)

Awareness during anesthesia: a closed claims analysis. (8/1787)

BACKGROUND: Awareness during general anesthesia is a frightening experience, which may result in serious emotional injury and post-traumatic stress disorder. We performed an in-depth analysis of cases from the database of the American Society of Anesthesiologists Closed Claims Project to explore the contribution of intraoperative awareness to professional liability in anesthesia. METHODS: The database of the Closed Claims Project is composed of closed US malpractice claims that have been collected in a standardized manner. All claims for intraoperative awareness were reviewed by the reviewers to identify patterns of causation and standard of care. Logistic regression analysis was used to identify independent patient and anesthetic factors associated with claims for recall during general anesthesia compared to other general anesthesia malpractice claims. RESULTS: Awareness claims accounted for 79 (1.9%) of 4,183 claims in the database, including 18 claims for awake paralysis, i.e., the inadvertent paralysis of an awake patient, and 61 claims for recall during general anesthesia, ie., recall of events while receiving general anesthesia. The majority of awareness claims involved women (77%), younger than 60 yr of age (89%), American Society of Anesthesiologists physical class I-II (68%), who underwent elective surgery (87%). Most (94%) claims for awake paralysis represented substandard care involving errors in labeling and administration, whereas care was substandard in only 43% of the claims for recall during general anesthesia (P < 0.001). Claims for recall during general anesthesia were more likely to involve women (odds ratio [OR] = 3.08, 95% confidence interval [CI] = 1.58, 6.06) and anesthetic techniques using intraoperative opioids (OR = 2.12, 95% CI = 1.20, 3.74), intraoperative muscle relaxants (OR = 2.28, 95% CI = 1.22, 4.25), and no volatile anesthetic (OR = 3.20, 95% CI = 1.88, 5.46). CONCLUSIONS: Deficiencies in labeling and vigilance were common causes for awake paralysis. Claims for recall during general anesthesia were more likely in women and with nitrous-narcotic-relaxant techniques.  (+info)

  • The Ministry of Public Health (MoPH) and its partners will carry out a public awareness campaign on breast cancer during October as part of International Breast Cancer Awareness month to educate and raise awareness on the importance of early detection of breast cancer. (gulf-times.com)
  • FLORENCE, Ala. - The Zeta Tau Alpha sorority chapter of the University of North Alabama will host its annual "Pink Week" events Oct. 31 through Nov. 4 to raise awareness about breast cancer. (una.edu)
  • During the month-long campaign, Hamad Medical Corporation (HMC), Primary Health Care Corporation (PHCC), Qatar Cancer Society (QCS), Sidra Medicine and several other partners will organise awareness activities including community events, conferences, lectures, workshops and educational materials distribution. (gulf-times.com)
  • October is Breast Cancer Awareness Month, and groups across the nation are taking action to spread the word about the cancer that Susan B. Komen officials predict will produce more than 230,000 cases in women this year. (una.edu)
  • It is also breast cancer awareness month, National Down Syndrome Awareness Month, National Brain Injury Awareness Month, energy awareness month, Sudden Cardiac Awareness Month, domestic violence awareness month, National disability employment awareness month, national home indoor air quality Action & awareness month and I am sure a few more that I am not aware of. (wordpress.com)
  • For example, research has shown increased interoceptive awareness is linked to reductions in chronic pain, congestive heart failure, chronic renal failure, irritable bowel syndrome and reductions in anorexic eating behavior (Mehling et al. (scienceofbehaviorchange.org)
  • With January recognized as Cervical Health Awareness Month, it is important to make sure women understand the updated guidelines for annual exams as well as the latest information on a vaccine to prevent this cancer. (nevadaappeal.com)
  • October is Sensory Processing Disorder awareness month. (wordpress.com)
  • With all these "awareness month" things out there it is hard to believe that any of them actually get much focus and gain much awareness by the general population. (wordpress.com)
  • Okay, breast cancer awareness is huge on a national level this month and that is a really good thing. (wordpress.com)
  • We formed SCIPP to gather security awareness best practices in a single repository and incorporate them into educational and certificate services for end users and their organizations. (securitymagazine.com)
  • By investing in security awareness for end-users/consumers, organizations greatly improve their security posture by preventing security incidents as well as detecting and reacting to events more quickly, while reducing vulnerabilities and their associated costs in monetary and reputation damage," said Schmidt. (securitymagazine.com)
  • That pink is the official color for breast cancer awareness is a widely known fact. (nevadaappeal.com)
  • Do you have a guess on the color for cervical cancer awareness? (nevadaappeal.com)
  • Erin McCay, Pink Party chair with ZTA and UNA student, said the party will consist of entertainment by Moon Dance, a yogurt eating contest, a pink balloon arch with breast cancer awareness bows and more. (una.edu)
  • The "Pink Week" events leading up to the Nov. 4 party will include ZTA members handing out pink lemonade, encouraging fraternities to purchase individual paper links for a breast cancer awareness paper chain, and painting the UNA campus pink. (una.edu)
  • SCIPP certificate of security awareness programs include those customized for corporate employees (SCIPP-CE), corporate customers (SCIPP-CC), government employees (SCIPP-GE), government citizenry (SCIPP-GC), those who are self-employed (SCIPP-SE), and educators (SCIPP-ED). Based in Vienna, Va., with offices in Old Hickory, Tenn. (securitymagazine.com)
  • Examining what we have learned about risk awareness, or should have learned, in 2017, which we can resolve to put into action in 2018. (csoonline.com)
  • Sustainability Awareness Week took place for the 11th time in October 2018. (ualberta.ca)
  • In what seems to be an effort to outpace the "Light It Up Blue" bandwagon of Autism Speaks' puzzle-pieced "Autism Awareness Month," the tech giant has gone one step ahead, deliberately name-checking Autism Acceptance Month in two autistic-focused videos on YouTube. (forbes.com)
  • In 2020, World Tsunami Awareness Day encourages the development of national and community-level, local disaster risk reduction strategies to save more lives against disasters. (un.org)
  • CDC's Rx Awareness campaign tells the stories of people whose lives were impacted by prescription opioids. (cdc.gov)
  • Through the Get Covered America campaign, it's working with local organizations like Georgians for a Healthy Future to build awareness. (ajc.com)
  • The Blue Campaign has developed awareness and training materials to help increase awareness and educate on the indicators of human trafficking. (dhs.gov)
  • It's no joke, today is the first day of the second quarter of the SADS Foundation's awareness campaign, Keeping Hearts Beating . (constantcontact.com)
  • If you are interested in becoming an awareness campaign volunteer, e-mail Adrienne or call 1-800-STOP-SAD (786-7723). (constantcontact.com)
  • Live project set by the creative agency Purpose, to create an awareness campaign for Gynaecological cancer aimed at 18-25 year old women. (behance.net)
  • The campaign encourages business leaders and employees to take proactive steps to minimize the impact of fraud by promoting anti-fraud awareness and training. (shrm.org)
  • This can involved undertaking activity to raise awareness of the complications of diabetes and how they can be avoided e.g. a campaign about retinopathy screening will aim to reduce the number of people missing their screening appointments. (diabetes.org.uk)
  • We are honored to add NCI's expertise to our health campaign Mi Salud Primero that offers family friendly tools for health awareness and improvement. (prnewswire.com)
  • Americans for Prosperity, for example, is a special-interest group that opposes efforts to raise public awareness of the coverage options. (ajc.com)
  • The fact that more than 500,000 Americans have lupus, making it more common than muscular dystrophy, multiple sclerosis or leukemia, only emphasizes the tragedy of this lack of public awareness. (chicagotribune.com)
  • Since I lost my husband, NBC news correspondent David Bloom, six years ago due to DVT-related complications while covering the war in Iraq, I have been working with the Coalition to Prevent DVT as the National Patient Spokesperson for the Coalition to help raise public awareness and further health education measures surrounding this potentially fatal condition. (huffingtonpost.com)
  • The Awareness Page webmaster and ISP are not responsible for content on external websites. (archive.org)
  • Because it is a multi-faceted epidemic, we are working with communities, educators, and service providers to promote awareness of the dangers of opioids and prescription drugs, to share information, and to coordinate training. (justice.gov)
  • Download and share these awareness posters with your organization. (sans.org)
  • In December 2015, the UN General Assembly designated 5 November as World Tsunami Awareness Day, calling on countries, international bodies and civil society to raise tsunami awareness and share innovative approaches to risk reduction. (un.org)
  • Efforts to raise awareness and donations for our NGO, THARCE, which provides non-medical integrative therapies to these victims who are of the Acholi community in Gulu have been successful and awe-inspiring, as my social media following showed up for the last two years on my birthday for Tonic.com and Crowdrise campaigns. (huffingtonpost.com)
  • Efforts to describe consciousness in neurological terms have focused on describing networks in the brain that develop awareness of the qualia developed by other networks. (wikipedia.org)
  • For example, an advertiser that's introducing a new energy drink wants to create awareness and interest among as many sports enthusiasts as possible, and isn't necessarily concerned with selling actual bottles of the drink online. (google.com)
  • Statewide Severe Weather Preparedness/Awareness Weeks are an opportunity to increase awareness of and response to severe weather hazards. (weather.gov)
  • Statewide Winter Weather Preparedness activities provide a focused opportunity to increase awareness of and response to winter weather hazards. (weather.gov)
  • Flood Safety Awareness activities strive to increase awareness of and response to flooding. (weather.gov)
  • Unfortunately, many breaches result from a lack of employee awareness of the security risks inherent in their actions online, in social media, at work and at home. (symantec.com)
  • I think there needs to be a retitling or a merge: US style "awareness ribbons" are just a subset of symbolic ribbons in general, and I don't think awareness ribbons (perhaps with the notable exception of the red AIDS ribbon) merit their own article. (wikipedia.org)
  • Phonemic awareness relates only to speech sounds, not to alphabet letters or sound-spellings, so it is not necessary for students to have alphabet knowledge in order to develop a basic phonemic awareness of language. (wikipedia.org)
  • Through interactive discussion, participants will gain awareness and develop strategies for recognizing discrimination, harassment, and sexual misconduct. (nyu.edu)
  • Improving Self-Awareness will improve self-control, reduce procrastination, and develop mood management. (oreilly.com)
  • The researchers say that awareness distinguishes minimally conscious patients from those in a vegetative state and has important healthcare, ethical and legal implications. (www.nhs.uk)
  • This was an experimental study with cross-sectional analysis in 23 patients in a vegetative state (patients are 'awake' in the sense they have sleep-wake cycles, but without detectable awareness) and 31 patients in a minimally conscious state (where patients show inconsistent but reproducible signs of awareness, tested by behavioural responses to stimuli, including the ability to follow commands. (www.nhs.uk)
  • UN Disaster Risk Reduction (UNDRR) facilitates the observance of World Tsunami Awareness Day in collaboration with the rest of the United Nations system. (un.org)
  • Location awareness is supported by navigation systems, positioning systems and/or locating services. (wikipedia.org)
  • We need them to be aware of our product or service, but awareness isn't good enough. (lynda.com)
  • But the other reason is the set of forces that pushed for going beyond autism awareness--are you aware of autism yet? (forbes.com)
  • citation needed] Popular ideas about consciousness suggest the phenomenon describes a condition of being aware of oneself (self-awareness). (wikipedia.org)
  • Within an attenuated system of awareness, a mind might be aware of much more than is being contemplated in a focused extended consciousness. (wikipedia.org)
  • Self-awareness has proliferated the professional world, and its proficiency in leadership is emerging as highly indicative of positive business outcomes, with research even revealing a strong correlation to the bottom line. (forbes.com)
  • Awareness may be focused on an internal state, such as a visceral feeling, or on external events by way of sensory perception. (wikipedia.org)
  • These resources will enable you with the topics and techniques to improve your learner's awareness in security. (sans.org)
  • The Awareness API unifies 7 location and context signals in a single API, enabling you to create powerful context-based features with minimal impact on system resources. (google.com)