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.
Continuous flash suppression: Continuous flash suppression (CFS) is an adapted version of the original flash suppression method. In CFS, the first eye is presented with a static stimulus, such as a schematic face, while the second eye is presented with a series of rapidly changing stimuli.Bispectral indexBehavior change (public health): Behavior change is a central objective in public health interventions,WHO 2002: World Health Report 2002 - Reducing Risks, Promoting Healthy Life Accessed Feb 2015 http://www.who.Closed-ended question: A closed-ended question is a question format that limits respondents with a list of answer choices from which they must choose to answer the question.Dillman D.School health education: School Health Education see also: Health Promotion is the process of transferring health knowledge during a student's school years (K-12). Its uses are in general classified as Public Health Education and School Health Education.Qualia: In philosophy, qualia ( or ; singular form: quale) are individual instances of subjective, conscious experience. The term "qualia" derives from the Latin neuter plural form (qualia) of the Latin adjective quālis () meaning "of what sort" or "of what kind").Unconscious cognition: Unconscious cognition is the processing of perception, memory, learning, thought, and language without being aware of it.Tamil Nadu Dr. M.G.R. Medical UniversityImmaculate perception: The expression immaculate perception has been used in various senses by various philosophers.Lifestyle management programme: A lifestyle management programme (also referred to as a health promotion programme, health behaviour change programme, lifestyle improvement programme or wellness programme) is an intervention designed to promote positive lifestyle and behaviour change and is widely used in the field of health promotion.List of Parliamentary constituencies in Kent: The ceremonial county of Kent,QRISK: QRISK2 (the most recent version of QRISK) is a prediction algorithm for cardiovascular disease (CVD) that uses traditional risk factors (age, systolic blood pressure, smoking status and ratio of total serum cholesterol to high-density lipoprotein cholesterol) together with body mass index, ethnicity, measures of deprivation, family history, chronic kidney disease, rheumatoid arthritis, atrial fibrillation, diabetes mellitus, and antihypertensive treatment.Yamtuan Besar: Yamtuan Besar, also known as Yang di-Pertuan Besar, is the royal title of the ruler of the Malaysian state of Negeri Sembilan. The ruler of Negeri Sembilan is selected by a council of ruling chiefs in the state, or the datuk-datuk undang.Non-native pronunciations of English: Non-native pronunciations of English result from the common linguistic phenomenon in which non-native users of any language tend to carry the intonation, phonological processes and pronunciation rules from their mother tongue into their English speech. They may also create innovative pronunciations for English sounds not found in the speaker's first language.Mass media impact on spatial perception: Mass media influences spatial perception through journalistic cartography and spatial bias in news coverage.Spalding MethodOnline patient education: Online Patient Education also known as Online Patient Engagement is a method of providing medical information and education to patients using Learning Management Systems delivered through the Internet.Evaluation of bariatric Centers of Excellence Web sites for functionality and efficacy.Psychiatric interview: The psychiatric interview refers to the set of tools that a mental health worker (most times a psychiatrist or a psychologist but at times social workers or nurses) uses to complete a psychiatric assessment.Disorders of consciousness: Disorders of consciousness are medical conditions that inhibit consciousness. Some define disorders of consciousness as any change from complete self-awareness to inhibited or absent self-awareness.Nigerian Ports Authority: The Nigerian Ports Authority (NPA) is a federal government agency that governs and operates the ports of Nigeria. The major ports controlled by the NPA include: the Lagos Port Complex and Tin Can Island Port in Lagos; Calabar Port, Delta Port, Rivers Port at Port Harcourt, and Onne Port.Public opinion on nuclear issues: Public opinion on nuclear issues is the aggregate of attitudes or beliefs held by the adult population concerning nuclear power, nuclear weapons and uranium mining.Breast self-examination: Breast self-examination (BSE) is a screening method used in an attempt to detect early breast cancer. The method involves the woman herself looking at and feeling each breast for possible lumps, distortions or swelling.Cancer screeningApperceptive agnosia: Apperceptive agnosia is failure in recognition that is due to a failure of perception. In contrast, associative agnosia is a type of agnosia where perception occurs but recognition still does not occur.Gary H. Posner: Gary H. Posner (born c.Standard evaluation frameworkCigarette smoking among college students: The rates of college students smoking in the United States have fluctuated for the past twenty years. Majority of lifelong smokers begin smoking habits before the age of 24, which makes the college years a crucial time in the study of cigarette consumption.General anaesthesia: General anaesthesia (or general anesthesia) is a medically induced coma and loss of protective reflexes resulting from the administration of one or more general anaesthetic agents. A variety of medications may be administered, with the overall aim of ensuring unconsciousness, amnesia, analgesia, relaxation of skeletal muscles, and loss of control of reflexes of the autonomic nervous system.Advertising Standards Canada: Advertising Standards Canada (ASC) is the advertising industry's non-profit self-regulating body created in 1957 to ensure the integrity and viability of advertising in Canada. The organization includes over 160 advertisers, advertising agencies, media organizations, and suppliers to the advertising sector.Samuel Bard (physician): Samuel Bard (April 1, 1742 – May 24, 1821) was an American physician. He founded the first medical school in New York.National Cancer Research Institute: The National Cancer Research Institute (NCRI) is a UK-wide partnership between cancer research funders, which promotes collaboration in cancer research. Its member organizations work together to maximize the value and benefit of cancer research for the benefit of patients and the public.Emergency contraceptive availability by country: The following is a list of countries that allow access to dedicated-purpose emergency contraceptive pills.Age adjustment: In epidemiology and demography, age adjustment, also called age standardization, is a technique used to allow populations to be compared when the age profiles of the populations are quite different.Essex School of discourse analysis: The Essex School constitutes a variety of discourse analysis, one that combines theoretical sophistication – mainly due to its reliance on the post-structuralist and psychoanalytic traditions and, in particular, on the work of Lacan, Foucault, Barthes, Derrida, etc. – with analytical precision, since it focuses predominantly on an in-depth analysis of political discourses in late modernity.Social marketing: Social marketing seeks to develop and integrate marketing concepts with other approaches to influence behaviors that benefit individuals and communities for the greater social good. It seeks to integrate research, best practice, theory, audience and partnership insight, to inform the delivery of competition sensitive and segmented social change programs that are effective, efficient, equitable and sustainable.Dyslexia: (developmental),Aga Khan University Hospital, Karachi: The Aga Khan University Hospital (AKUH) in Karachi, established in 1985, is the primary teaching site of the Aga Khan University’s (AKU) Faculty of Health Sciences. Founded by His Highness the Aga Khan, the hospital provides a broad range of secondary and tertiary care, including diagnosis of disease and team management of patient care.Behavior: Behavior or behaviour (see spelling differences) is the range of actions and [made by individuals, organism]s, [[systems, or artificial entities in conjunction with themselves or their environment, which includes the other systems or organisms around as well as the (inanimate) physical environment. It is the response of the system or organism to various stimuli or inputs, whether [or external], [[conscious or subconscious, overt or covert, and voluntary or involuntary.Antenor Orrego Private UniversityLayout of the Port of Tianjin: The Port of Tianjin is divided into nine areas: the three core (“Tianjin Xingang”) areas of Beijiang, Nanjiang, and Dongjiang around the Xingang fairway; the Haihe area along the river; the Beitang port area around the Beitangkou estuary; the Dagukou port area in the estuary of the Haihe River; and three areas under construction (Hanggu, Gaoshaling, Nangang).History of communication studies: Various aspects of communication have been the subject of study since ancient times, and the approach eventually developed into the academic discipline known today as communication studies.Public Health Act: Public Health Act is a stock short title used in the United Kingdom for legislation relating to public health.HypertensionBio Base EuropeEmotion and memory: Emotion can have a powerful response on humans and animals. Numerous studies have shown that the most vivid autobiographical memories tend to be of emotional events, which are likely to be recalled more often and with more clarity and detail than neutral events.HyperintensityLife writing: Life writing is the recording of selves, memories, and experiences, whether one's own or another's. This applies to many genres and practices, under which can be found autobiography, biography, memoir, diaries, letters, testimonies, personal essays and, more recently, digital forms such as blogs and email.Wedding anniversary: A wedding anniversary is the anniversary of the date a wedding took place. Traditional names exist for some of them: for instance, 50 years of marriage is called a "golden wedding anniversary" or simply a "golden anniversary" or "golden.Spaced retrieval: Spaced retrieval, also known as expanded retrieval or uniform retrieval, is a learning technique, which requires users to rehearse information to be learned at different and increasing spaced intervals of time or a set uniform amount of time.Haslam, C.Temporal analysis of products: Temporal Analysis of Products (TAP), (TAP-2), (TAP-3) is an experimental technique for studyingAustralian National BL classEthnic groups in the United Kingdom: People from various ethnic groups reside in the United Kingdom. Migration from Northern Europe has been happening for millennia, with other groups such as British Jews also well established.JAPE (linguistics): In computational linguistics, JAPE is the Java Annotation Patterns Engine, a component of the open-source General Architecture for Text Engineering (GATE) platform. JAPE is a finite state transducer that operates over annotations based on regular expressions.Explicit memory: Explicit memory is the conscious, intentional recollection of previous experiences and information. People use explicit memory throughout the day, such as remembering the time of an appointment or recollecting an event from years ago.The Final Decision: The Final Decision is an episode from season 1 of the animated TV series X-Men Animated Series.CervarixHomonymous hemianopsiaComprehensive Rural Health Project: The Comprehensive Rural Health Project (CRHP) is a non profit, non-governmental organization located in Jamkhed, Ahmednagar District in the state of Maharashtra, India. The organization works with rural communities to provide community-based primary healthcare and improve the general standard of living through a variety of community-led development programs, including Women's Self-Help Groups, Farmers' Clubs, Adolescent Programs and Sanitation and Watershed Development Programs.Advanced Medical Priority Dispatch System
(1/1787) Commercialization of BRCA1/2 testing: practitioner awareness and use of a new genetic test.
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)
(2/1787) Does vestibular stimulation activate thalamocortical mechanisms that reintegrate impaired cortical regions?
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)
(3/1787) Audit of patients' awareness of ophthalmic diagnoses.
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)
(4/1787) Prevalence of insomnia: a survey of the enrollees at five managed care organizations.
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)
(5/1787) Tramadol or morphine administered during operation: a study of immediate postoperative effects after abdominal hysterectomy.
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)
(6/1787) Impact of network activity on the integrative properties of neocortical pyramidal neurons in vivo.
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)
(7/1787) Discharge profiles of abducens, accessory abducens, and orbicularis oculi motoneurons during reflex and conditioned blinks in alert cats.
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)
(8/1787) Awareness during anesthesia: a closed claims analysis.
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)