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Biomedical subjects

E B Fisher

Publications and source records attributed to E B Fisher.

At least 19 recordsLinked to original sources
PubMed1995

I get by with a little help from my family and friends: adolescents' support for diabetes care.

Evaluated and compared the support provided by family members and friends for adolescents' diabetes care. Family and friend support also were examined in relation to other measures of social support, to demographic variables (age, gender, duration of diabetes) and to adherence. Using a structured interview, 74 adolescents with diabetes described the ways that family members and friends provided support for diabetes management (insulin shots, blood glucose monitoring, eating proper meals, exercise), and for helping them to "feel good about their diabetes." Families provided more support than friends for three management tasks (insulin injections, blood glucose monitoring, meals); this support was largely instrumental. In contrast, friends provided more emotional support for diabetes than families. Greater family support was related to younger age, shorter disease duration, and better treatment adherence. Implications of the findings include encouraging parents to remain involved in adolescents' treatment management, and involving peers as supportive companions for meals and exercise.

Adolescent↗
PubMed1994

Depressive symptomatology and smoking among persons with diabetes.

The purpose of this study was to determine whether (a) symptoms of depression are more prevalent and severe among diabetic smokers than diabetic nonsmokers, (b) smoking is related to depressive symptomatology among diabetic patients, and (c) there is a positive relationship between number of cigarettes smoked and severity of depressive symptoms. Diabetic non-smokers (n = 103) and diabetic smokers (n = 83) were surveyed regarding symptoms of depression as measured by the Beck Depression Inventory (BDI). Depressive symptomatology was more prevalent and severe among smokers than nonsmokers. Smoking was significantly associated with depressive symptomatology. Among smokers, the number of cigarettes smoked per day was independently associated with cognitive symptoms of depression.

Adult↗
PubMed1992

The Type A belief system: relationships to hostility, social support, and life stress.

Certain core beliefs may underlie the Type A behavior pattern, predisposing individuals to health problems and impaired interpersonal relationships. Previous studies have revealed that the Type A Cognitive Questionnaire (TACQ), a self-report measure reflecting these beliefs, is indeed related to emotional distress. The current study assessed the TACQ's relationship to aspects of the interpersonal environment, including perceived social support and stressful events. It also investigated the TACQ's relationship to subtypes of hostility (ie, cynicism and paranoid alienation). Subjects were 111 college undergraduate volunteers. As hypothesized, the TACQ was significantly related to poor quality of social support and to greater perceived life stress. The TACQ appeared more strongly related to cynicism than to paranoid alienation. Findings were generally more pronounced for males. The discussion suggests that Type A beliefs may predispose individuals to health problems through impaired interactions with their interpersonal environment.

Achievement↗
PubMed1992

Demographic and socioeconomic differences in beliefs about the health effects of smoking.

To assess sociodemographic differences in beliefs about the health effects of cigarette smoking and passive smoke exposure, we recently surveyed 2092 adults in St. Louis and Kansas City, Mo. The percentages of respondents who knew that smoking causes lung cancer, emphysema, and heart disease were 76.7, 74.1, and 67.2, respectively. After multivariate adjustment, knowledge about smoking's health effects was generally lower among women, older respondents, those of lower education level, and current smokers. Blacks were generally less likely to appreciate the health effects of active smoking, but were more likely to acknowledge the health effects of passive smoking.

Adolescent↗
PubMed1992

Adolescent smoking.

This article reviewed the major personal, interpersonal, environmental, attitudinal, and physiological variables that contribute to adolescent smoking. As stated at the outset, multiple factors interact in complex ways to determine the cause and development of smoking among adolescents. No single factor or influence is either sufficient or necessary in and of itself. Given the substantial continuity of smoking status across the period from adolescence to adulthood and the fact that most adults began their smoking careers as teenagers, antismoking campaigns and other preventive strategies for reducing adolescent smoking are critical areas for future health promotion efforts. Efforts to prevent adolescent smoking have shown appreciable success in reducing the rate of "uptake." A frequent intervention strategy has focused on protecting adolescents against peer influence through teaching them skills for refusing or counteracting such influence and posing counterinfluence by recruiting high-status peers as leaders of prevention programs. Although these interventions have shown success, their scope appears limited in light of this article's emphasis on the multiple influences on adolescent smoking. For instance, further prevention research might address factors such as family influences and group and self-identity. It might also address the complex set of risk behaviors of which smoking may often be a member.

Adolescent↗
PubMed1992

Community organization to reduce the risk of non-insulin-dependent diabetes among low-income African-American women.

Non-insulin-dependent diabetes mellitus is epidemic among African-American women in the United States; reports of its prevalence among African Americans range from 50% to 60% higher than among whites. African Americans also incur higher rates of diabetes-related complications such as blindness, end-stage renal disease, and amputations. Data indicate that non-insulin-dependent diabetes among African Americans is associated with lower socioeconomic status and with obesity. Because obesity has been hypothesized as contributing to the growing numbers of non-insulin-dependent diabetics among African-American women, new strategies are urgently needed to promote weight loss in this population. Community organization can broaden health education and facilitate behavior change toward development of life- and self-mastery skills. Specific strategies of this approach include (1) integrating community values into health messages, (2) facilitating neighborhood "ownership" and decision-making, (3) utilizing existing formal and informal networks, and (4) empowering individuals and community. Community organization may be a promising strategy among low-income minority communities to reduce the risk of non-insulin-dependent diabetes by promoting changes in dietary patterns, because it ensures that the health messages and programs that emerge will be consistent with existing sociocultural norms and beliefs.

Adult↗
PubMed1992

The role of cutaneous lymphoscintigraphy in determining regional lymph node drainage of truncal melanomas.

In the absence of clinically positive regional nodes, any value of prophylactic dissection in malignant melanomas depends on accurate preoperative determination of the pathway of lymphatic drainage. We report on the use of noninvasive radionuclide lymphoscintigraphy in the determination of regional patterns of lymph node drainage in patients with melanomas. Ten patients were studied; treatment was altered by test results in 2. Eleven node groups were excised in 7 patients. There have been no metastatic melanomas found in any nodal basins not detected by lymphoscintigraphy 23 to 42 months after operation.

Adult↗
PubMed1991

Psychosocial and physiological correlates of male gender role stress among employed adults.

Previous research has identified male gender role stress (MGRS) as a construct that leads men, as a function of traditional socialization processes, to appraise certain situations in ways that produce psychosocial and physiological distress. Because the initial research was based on college undergraduates, the current study explored the relationship of MGRS to psychosocial and physiological risk factors for cardiovascular disease among employed adults. As predicted, men obtained significantly higher scores than women on a measure, the MGRS Scale, developed to assess this construct. Women with elevated MGRS Scale scores, however, experienced undesirable outcomes much the same as their male counterparts. Specifically, MGRS Scale scores were significantly associated with Type A behavior, hostility, personal loss, life dissatisfaction, and elevated systolic and diastolic blood pressure. The authors discuss possible environmental contributors to the development and maintenance of MGRS, including organizational factors associated with male-dominated work environments.

Adolescent↗
PubMed1991

Measuring physical activity with a single question.

Using 1,004 subjects enrolled in a worksite health promotion program, this report evaluated the validity of a single question about participation in regular exercise. Measured at baseline, this one question had a significant age-adjusted association with body mass index (p less than 0.0001 in women and p = 0.001 in men), HDL cholesterol (p less than 0.0001 in women), and oxygen capacity (p = 0.0007 in women and p = 0.002 in men). Thus, one self-reported question can provide useful information about who is and who is not participating in regular exercise. The potential validity of a single exercise question is particularly relevant in complex epidemiologic studies where lengthy questionnaires highlight the importance of brief instruments.

Adult↗
PubMed1991

Determinants of cigarette smoking.

Smoking is a complex process influenced by social, environmental, psychologic, and biologic factors. This article explores the multiple determinants of smoking and how these variables interact to promote the persistence of smoking. Further examination of how smoking persistence varies in relation to several specific diseases is discussed.

Conditioning, Psychological↗
PubMed1990

Predictors of employee involvement in a worksite health promotion program.

Although worksite health promotion programs have proliferated, little is known about the population they reach. This study of employees of a large utility company compared whether the same characteristics which predict recruitment also predict extended participation. The study also prospectively assessed how risk factors are related to employees' on-going extended participation. The findings demonstrate that sociodemographic predictors of recruitment are almost mirror images of the predictors of extended participation. Over time employees who are at higher risk for cardiovascular disease participated in on-going sessions less frequently. Data suggest that referral to targeted sessions does not result in higher rates of attendance by employees with a particular risk factor, although there is no evidence of selective avoidance. Organizational influences on participation evident from the beginning are sustained through four sessions. Programs targeting higher risk employees nested within worksite-wide programs may be useful to increase the extended participation of individuals at elevated risk for heart disease.

Adult↗
PubMed1989

Implications of prosthetic valve implantation: an 8-year follow-up of patients with porcine bioprostheses.

Nurses in cardiovascular critical care settings routinely care for patients with implanted valvular prostheses. The presence of an artificial valve substitutes a new disease state for the preexisting valvular disease. Five hundred nine patients who underwent cardiac valve replacement with porcine bioprostheses and who were followed for a total of 1633 patient-years provide the data base for discussion of long-term survival, functional capacity, and morbidity associated with valvular prostheses. Seventy-two percent of patients survived 5 years after operation. New York Heart Association functional class was improved in 84%. Three major types of morbidity were documented: thromboembolism, endocarditis, and valve failure. Cardiovascular nurses should be familiar with the implications of valvular prostheses to provide appropriate patient education and to facilitate the prompt detection and treatment of valve-related complications.

Actuarial Analysis↗