How equitable is access to treatment for lung cancer patients? A population-based review of treatment practices in Ontario.

AIM: Guideline concordance is one of the metrics used by the Cancer Quality Council of Ontario and Cancer Care Ontario to assess the quality of cancer care and to drive quality improvement. MATERIALS & METHODS: The rates for lung cancer surgical resection and concordance with the Cancer Care Ontario postoperative adjuvant chemotherapy (AC) guideline were assessed by health region during two time periods (2010-2011 and 2012-2013) according to five equity measures (age, sex, neighborhood income, location of residence and size of immigrant population). RESULTS: Of the patients with stage I/II NSCLC, 52.2% to 63.0% underwent surgical resection in the province of Ontario, Canada; for patients with stage IIIA disease, the rate was 26.4%. The probability of a surgical resection decreased substantially with age; only 26.9% of those with potentially resectable (stage I-IIIA) disease over 80 years underwent surgery. The use of postoperative AC increased modestly over the time of the study but the rate of use varied widely by health region (34.6 to 84.6%). Patients in rural areas were as likely to receive AC as urban dwellers; however, older aged patients (≥65 years) and those from the lowest income neighborhoods were significantly less likely to receive AC. CONCLUSION: Surgical rates and the use of AC vary by health region in Ontario and by age and level of neighborhood income despite universal access in a publicly funded health care system. The reasons for this variance are unclear but warrant further study.Presented in part at the 15th World Conference on Lung Cancer, Sydney, Australia, 27-30 October 2013.

The physical activity preferences of gynecologic cancer survivors.

PURPOSE/OBJECTIVES: To identify physical activity (PA) preferences of gynecologic cancer survivors (GCSs) and to understand the reasons for them. DESIGN: Population-based, cross-sectional mailed survey and semistructured interviews with a subsample. SETTING: Nova Scotia, Canada. SAMPLE: 239 GCSs completed the survey, and 16 participated in an interview. METHODS: GCSs identified from a provincial cancer registry completed a questionnaire assessing PA preferences. Survey respondents were asked to participate in a substudy exploring PA preferences through a semistructured interview. MAIN RESEARCH VARIABLES: Self-reported PA and PA preferences. FINDINGS: Analyses indicated that participants were interested in a PA program. Interviews highlighted that PA counseling was highly desired and should include discussions about the benefits and appropriate amounts of PA, as well as available opportunities for PA. CONCLUSIONS: GCSs have preferences regarding characteristics of PA discussions and programs. IMPLICATIONS FOR NURSING: Oncology nurses are integral to the promotion of PA in GCSs. Providing oncology nurses with training opportunities to learn about PA for cancer survivors is an important consideration for cancer centers in ensuring a satisfactory experience for cancer survivors.

Exercise as stigma management for individuals with onset-controllable and onset-uncontrollable spinal cord injury.

UNLABELLED: Studies have suggested that individuals with physical disabilities are often stigmatized and are perceived to possess less favorable physical and psychological characteristics than individuals without disability. PURPOSE: To investigate whether able-bodied adults' perceptions of people with different causes of spinal cord injury (SCI) are influenced by physical activity status information. METHOD AND PARTICIPANTS: Each participant (N = 198) read all five vignettes describing individuals with SCI who had varying levels of physical activity participation and cause of injury information (e.g., onset-uncontrollable [hit by impaired driver] and onset-controllable [caused by impaired driving]). After reading each vignette, participants completed a 12-item Warmth and Competence Questionnaire to evaluate each target. One-way repeated measures multivariate analyses of variance were conducted to examine the within-subjects differences. RESULTS: Physically active individuals with onset-uncontrollable SCI were rated most favorably on warmth and competence. Physically active individuals with onset-controllable SCI also were rated more favorably on warmth and competence than physically inactive targets with onset-controllable SCI. CONCLUSION: A physically active lifestyle may be beneficial in managing the stigma experienced by individuals with both onset-controllable and onset-uncontrollable SCI.