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     people can help older people to improve their ability to utilize digital technologies and searching for health information online. This also can provide opportunities for older people to obtain needed health information and make better-informed health decisions for their CRC screening. Likewise, it Clozapine N oxide is also critical for health professionals to clearly communicate with their patients from underrepresented culture. As the preparation and process of CRC screening (e.g., sigmoidoscopy or colonoscopy) are relatively more complex (e.g., bowel preparation and sedation) than other screening tests, over the course of the screening, the maintenance of transparent communications is necessary for successful CRC screening outcomes. Health professionals can affect this commu-nication by answering health-related questions from patients in a timely manner, educating them to accurately evaluate health information obtained online, and establishing close relationships with them. In particular, it is worthwhile for health professionals to empower older underserved patients to use non-traditional communication tools (e.g., email and text messaging) which allow communication to occur even outside health care settings. Finally, as findings showed, health professionals’ cultural competence may positively influence the communications with older Korean American patients to demystify cultural misbeliefs regarding CRC screening or reduce negative attitudes toward the screening. This will contribute to eliminating the barriers to seeking online health information and assist Korean Americans in making their best health decisions around CRC screening.
    Conflict of interest
    No conflicts of interest to report.
    Funding details
    The first author for the project was supported by the National Institute on Minority Health and Health Disparities (NIMHD) under Grant Number U54MD008173, a component of the National Institutes of Health (NIH) and its contents are solely the responsibility of the authors and do not necessarily represent the official views of NIMHD or NIH.
    Ethical approval
    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/ or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
    [6] American Cancer Society, American Cancer Society Recommendations for Colorectal Cancer Early Detection, (2017) . colon-rectal-cancer/detection-diagnosis-staging/acs-recommendations. html.
    [34] U. Sarkar, A.J. Karter, J.Y. Liu, N.E. Adler, R. Nguyen, A. López, D. Schillinger, The literacy divide: health literacy and the use of an internet-based patient portal in an integrated health system—results from the diabetes study of Northern 
    Clinical-Prostate cancer
    Analyzing the current practice patterns and views among urologists regarding focal therapy for prostate cancer
    a Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
    b Center for Interventional Oncology, National Cancer Institute & Clinical Center, National Institutes of Health, Bethesda, MD Received 24 July 2018; received in revised form 11 November 2018; accepted 19 November 2018
    Introduction and objective: Focal therapy (FT) for localized prostate cancer (CaP) has been shown to have encouraging short-term oncological outcomes, excellent preservation of functional outcomes and is increasing in popularity in urologic community. We aim to eval-uate the preferences and practice trends among urologists regarding this treatment strategy.
    Methods: A 20 item online questionnaire was designed to collect information on urologists’ views and use of FT. The survey was sent to the members of the Endourological Society and the American Urological Association. Multivariate logistic regression analysis was done to determine predictors for utilization of FT.
    Results: A total of 425 responses were received [American Urological Association: 319, Endourological Society: 106]. Mean age of respondents was 53(SD: 11.3) years. Although half of the respondents (50.8%) believed FT to be moderate to extremely beneficial in the treatment of CaP, only 24.2% (103) of the respondents currently utilize FT in their practice. Respondents who were fellowship trained in urologic oncology were more likely to consider FT to be at least moderately beneficial (P < 0.001). Surgeon’s experience (greater than 15 years in urology practice) (P = 0.025) and seeing more than 10 patients with new CaP diagnosis per month (P = 0.002) were independent predictors of FT utilization for localized CaP. While the most common setting for utilization of FT was in patients with unilateral intermedi-ate-risk (72.8%) CaP, a small percentage of respondents also used FT for patients with unilateral high-risk CaP and bilateral intermediate risk (21.4% and 10.7%, respectively). Most common reasons for not using FT were the lack of belief in ’index lesion theory’ (63.2%), lack of experience (41.3%), lack of belief in FT’s efficacy (41.1%), lack of infrastructure (35.8%), difficult salvage treatment in cases of recur-rence (22.7%) and high cost (21.8%). About 57.6% would use FT more often in an office or outpatient setting if Bivalent had access to reliable and cost-effective options.