Search PubMed⌕ Search

Biomedical subjects

Joshua Fogel

Publications and source records attributed to Joshua Fogel.

At least 19 recordsLinked to original sources

Gastrointestinal cancer web sites: how do they address patients' concerns?

BACKGROUND: We studied the quality of web sites containing information on gastrointestinal cancer, focusing on the way these web sites dealt with the special concerns of these patients. MATERIALS AND METHODS: Searching the Internet for German-language gastroenterological cancer web sites, we collected 9,947 web pages from 14 search engines. Evaluation was done with a 36-item questionnaire. Information quality, availability of the web sites, and web site attributes considering patients' concerns and potential embarrassment were analyzed using a scoring system. RESULTS: Belonging to 165 web sites, 1,763 of 9,947 (17.7%) web pages found by search engines provided relevant information. Five hundred forty-seven (5.5%) hits were partly relevant, and 7,637 (76.8%) were irrelevant or not available. Most web sites reported about surgery (92.1%), chemotherapy (88.5%), and radiotherapy (73.9%). Of the web sites, 46.7% (n=77), 34.6% (n=57), and 21.8% (n=36) gave information about the author(s) itself, their qualifications, and references of their information, respectively. Search engines ranked web sites giving no information on evidence-based medicine higher than other web sites, whereas web sites providing this information accurately showed higher link popularities. Patients' concerns and potential embarrassment were best addressed by gastrointestinal web sites initiated by private individuals or web sites directed to both a patient and physician audience. CONCLUSIONS: With regard to gastrointestinal cancer web sites, many search engines may be ineffective, and patient emotional needs and concerns are often disregarded. Also, physicians should guide their patients through the Internet to find high-quality information and use link-popularity-based search strategies.

Gastrointestinal Neoplasms↗

Soap operas and talk shows on television are associated with poorer cognition in older women.

BACKGROUND: No information exists regarding whether a favorite television category choice affects attention, memory, or cognition among older women. METHODS: Cross-sectional data from a population-based community sample of 289 older cognitively and physically intact women who were surveyed about television use. The cognitive battery included measures of psychomotor speed, executive attention, immediate and delayed verbal memory, and global cognition. RESULTS: Talk shows (P < 0.05) or soap operas (P < 0.05) as a favorite television category were consistently associated with poorer scores on all cognitive outcomes in both unadjusted and adjusted analyses. Clinically significant cognitive impairment across domains were associated with watching talk shows (OR = 7.3; 95% CI = 1.9, 28.4) and soap operas (OR = 13.5; 95% CI = 3.7, 49.5). CONCLUSIONS: Clinical interviews can incorporate questions about television viewing habits. Endorsements of talk shows or soap operas as frequent and favored television programming may identify those at risk for cognitive impairment and targets for further cognitive screening.

Age Factors↗

African American couples merging strengths to successfully cope with breast cancer.

PURPOSE/OBJECTIVES: To explore the process of coping with breast cancer among African American women and their spouses. DESIGN: Exploratory, qualitative study using grounded theory methods. SETTING: Large metropolitan area in the mid-Atlantic United States. SAMPLE: 12 African American couples (N = 24). METHODS: African American women and their spouses were asked to complete a background data sheet and participate in a face-to-face semistructured interview. Qualitative data were audiotaped and transcribed verbatim. Themes were identified using the constant comparative method. Quantitative data were analyzed with descriptive statistics. MAIN RESEARCH VARIABLES: The process of coping with breast cancer among African American couples. FINDINGS: The basic social concern was living through and beyond a breast cancer diagnosis. The core variable was merging strengths to cope with and survive a breast cancer diagnosis. Six main categories emerged to describe how African American couples actively worked together to cope with a breast cancer diagnosis: walking together, praying together, seeking together, trusting together, adjusting together, and being together. CONCLUSIONS: African American couples described the importance of combining their strengths and working together as a couple to cope with a breast cancer diagnosis. IMPLICATIONS FOR NURSING: Nurses must understand the importance of developing culturally sensitive and culturally relevant interventions to assist African American couples with effectively coping with a breast cancer diagnosis. When providing care to African American couples, nurses should incorporate the six categories of walking, praying, seeking, trusting, adjusting, and being together to help couples cope with the various phases of the breast cancer experience.

Adaptation, Psychological↗

Stigma beliefs of Asian Americans with depression in an internet sample.

OBJECTIVE: To study the beliefs of Asian Americans with depression about stigma associated with depression treatment among friends, employers, and family. METHOD: Participants completed the Center for Epidemiologic Studies-Depression Scale (CES-D) anonymously on the Internet. In this cross-sectional design, those who screened positive for depression were asked questions regarding stigma (n = 68 656). We used analysis of variance (ANOVA) and analysis of covariance (ANCOVA) to compare Asian Americans with whites and also to make comparisons by age and sex. Further, we stratified for Asian Americans and used ANOVA and ANCOVA to compare age and sex. We used linear regression to assess how stigma beliefs were associated with self-reported need for depression treatment. RESULTS: Asian Americans overall had greater stigma beliefs than did whites for all 3 stigma outcomes (P < 0.001), especially those related to family. Although this same pattern existed for subjects aged between 16 and 29 years and between 30 and 45 years (P < 0.001), among those aged under 16 years, this existed for family stigma (P < 0.001) but not for friends or employer stigma. In our stratified analyses among Asian Americans, male participants had greater stigma beliefs than did female participants for friends (P < 0.001) and employer (P < 0.05) but not for family. CONCLUSIONS: The pattern of Asian Americans having greater stigma levels than whites may be changing among younger Asian Americans because of acculturation. Also, among Asian Americans, unlike previous research showing no sex differences for stigma, we show that male participants had greater stigma levels than did female participants. Future directions should include measuring stigma after culture-specific interventions.

Acculturation↗

Quality of life in physical health domains predicts adherence among myocardial infarction patients even after adjusting for depressive symptoms.

OBJECTIVE: To prospectively study the relationship of quality of life (QOL) to adherence among myocardial infarction (MI) patients and also to determine if either QOL or depressive symptoms (DEP) has a primary role in predicting adherence. METHODS: Acute-MI patients (N=285) were administered questionnaires on QOL, DEP, and adherence in-hospital and 4 months post-MI. The seven adherence behaviors measured included (1). following a low-salt diet, (2). following a low-fat or weight loss diet, (3). taking prescribed medication, (4). exercising regularly, (5). decreasing stress, (6). carrying medical supplies for self-care, and (7). trying to socialize more with others. Hierarchical regression analyses examined cross-sectional and prospective relations between adherence and both physical and mental health QOL domains. Each QOL domain was modeled as "adherence=QOL domain+DEP." RESULTS: Physical health QOL was related to adherence using cross-sectional and prospective approaches even with DEP independently still related to adherence. Conversely, in separate models using cross-sectional and prospective approaches, mental health QOL was not related to adherence while DEP was related to adherence. CONCLUSION: Focused attention on those with low scores in physical health QOL or greater DEP may be an efficient approach to improve adherence in patients recovering from an MI.

Adult↗

Internet breast health information use and coping among women with breast cancer.

The objective of this work was to study, among breast cancer patients, if Internet health information use is associated with coping. Questionnaires were completed (n = 178) regarding Internet use and also coping as measured by the Brief Cope. MANOVA analyses were conducted for the 14 coping subscales. Following a significant MANOVA omnibus test, univariate ANOVA and multivariate ANCOVA analyses adjusting for covariates were performed. Univariate ANOVA showed acceptance, active coping, self-blame, and denial coping associated with Internet use but these results were not maintained in the multivariate ANCOVA models. Internet health information use is not associated with psychological coping in breast cancer patients.

Adaptation, Psychological↗

Health psychology: a new form of psychotherapy?

Psychotherapy in its traditional form is being challenged due to managed care pressures. Psychotherapy using the model of health psychology can adapt well in a managed care environment. Differences between traditional psychotherapy and the psychotherapeutic approach of health psychology are discussed in this article, with a focus on an overview of health psychology and its applications to primary care, and the concept of single-session therapy. A case example of a sample treatment emphasizing the model of brief health psychology treatment is illustrated.

Aged↗

Racial/ethnic differences and potential psychological benefits in use of the internet by women with breast cancer.

Many websites on the Internet offer information to breast cancer patients and are increasingly being used. The authors investigated the potential psychological benefits of Internet use and how it varied as a function of race/ethnicity among 180 white, African American, and Hispanic American breast cancer patients who used the Internet for medical information. Using standardized psychological measures, as measured by the Interpersonal Support Evaluation List (ISEL), Internet use among minorities was associated with greater overall, appraisal, and tangible social support (p's<0.05) but not belonging and self-esteem social support than among whites. No differences were observed for stress, depressive symptoms, loneliness, and coping. Since numerous studies suggest that social support may be related to survival, Internet use for breast health issues may have special clinical relevance to racial/ethnic minority groups.

Black or African American↗

Internet use and social support in women with breast cancer.

Many Web sites offer information to breast cancer patients, who are increasingly using these sites. The authors investigated the potential psychological benefits of Internet use for medical information by breast cancer patients. Of the 251 women approached, 188 were successfully interviewed (74.9%). Forty-two percent used the Internet for medical information related to breast health issues and did so for an average of 0.80 hr per week. The Interpersonal Support Evaluation List and the UCLA Loneliness Scale, with results controlled for covariates, showed that Internet use for breast health issues was associated with greater social support and less loneliness than Internet use for other purposes or nonuse. Breast cancer patients may obtain these psychological benefits with only a minimal weekly time commitment.

Adaptation, Psychological↗

Metabolite changes resulting from treatment in children with ADHD: a 1H-MRS study.

Previously the authors noted an increase in glutamatergic tone in children with attention deficit hyperactivity disorder compared with age- and gender-matched control subjects. In this study they examine the effect of treatment on metabolite concentrations. Fourteen children with attention deficit hyperactivity disorder were investigated medication free and after treatment, using proton magnetic resonance spectroscopy. In the prefrontal cortex and striatum, metabolite peaks of N-acetyl-aspartate, glutamate/glutamine/gamma-aminobutyric acid, creatine/phosphocreatine, and choline compounds were measured, and ratios of the peaks were calculated and compared before and after treatment. The glutamate/glutamine/gamma-aminobutyric acid-to-creatine/phosphocreatine ratio decreased significantly in the striatum. No other metabolites demonstrated any change in response to medication. These findings suggest that glutamate may be involved in treatment response in attention deficit hyperactivity disorder, especially in the striatum.

Adolescent↗

Depression following acute myocardial infarction: a prospective relationship with ongoing health and function.

The relationship between baseline depression and health-related quality of life were examined in a cohort of patients after hospitalization due to acute myocardial infarction (N=196). Patients were assessed for presence of mood disturbance, anxiety, and quality of life at the time of hospitalization and again 4 months later. Baseline assessment was used to assign subjects to a depressed or a nondepressed group. Adjusting for preinfarction quality of life, in-hospital anxiety, and demographic variables, depression was prospectively and independently related to reduced global health at 4 months as well as reduced overall mental health-including vitality, psychological health, and social function-and increased role interference from psychological problems.

Aged↗

Internet use for cancer information among racial/ethnic populations and low literacy groups.

Many Web sites on the Internet offer health information related to cancer and are increasingly being used by patients, caregivers, and those interested in cancer prevention and treatment. To comprehensively review the cancer literature regarding Internet health information use among those of racial/ethnic populations and low literacy groups, a comprehensive review of the MEDLINE/Pre-MEDLINE, LISA, PsycInfo, CINAHL, Embase, and Web of Science databases was conducted. Eight relevant articles were retrieved: seven are classified as content research and one as outcomes research. Little empirical research exists on this topic of cancer Internet health information use among those of racial/ethnic populations and low literacy groups. This area of research is open for many unique contributions to the scientific literature.

Cultural Diversity↗

Beliefs and attitudes associated with the intention to not accept the diagnosis of depression among young adults.

PURPOSE: Negative attitudes and beliefs about depression treatment may prevent many young adults from accepting a diagnosis and treatment for depression. We undertook a study to determine the association between depressive symptom severity, beliefs about and attitudes toward treatment, subjective social norms, and past behavior on the intent not to accept a physician's diagnosis of depression. METHODS: We conducted a cross-sectional study of 10,962 persons aged 16 to 29 years who participated and had positive screening results on the Center for Epidemiologic Studies Depression (CES-D) score in an Internet-based public health depression screening program. Participants reported whether they would accept their physician's diagnosis of depression. Based on the theory of reasoned action, we developed a multivariate model of the factors that predict intent not to accept a diagnosis of depression. RESULTS: Twenty-six percent of the participants stated their intent not to accept their physician's diagnosis of depression. Disagreeing that medications are effective in treating depression (strongly disagree, odds ratio ( OR ) = 6.5, 95% confidence interval (CI), 4.6-9.3), that there is a biological cause for depression (strongly disagree, OR = 1.9, 95% CI, 1.3-2.7), and agreeing that you would be embarrassed if your friends knew you had depression were associated with the intent not to accept a diagnosis of depression (strongly agree, OR = 2.3, 95% CI, 1.8-2.9). Beliefs and attitudes, subjective social norms, and past behavior explained most of the variance in this model (84%). CONCLUSIONS: Negative beliefs and attitudes, subjective social norms, and lack of past helpful treatment experiences are associated with the intent to not accept the diagnosis of depression and may contribute to low rates of treatment among young adults.

Adolescent↗