The Association between Survivorship Care Plans and Patient-Reported Satisfaction and Confidence with Follow-Up Cancer Care Provided by Primary Care Providers.

Survivorship care plans aim to facilitate a smooth transition from tertiary to primary care settings after primary cancer treatment is completed. This study sought to identify the sociodemographic factors associated with receiving a survivorship care plan and examine the relationship between receiving a plan and confidence in follow-up care delivered by primary care providers. A cross-sectional analysis of the Canadian Partnership Against Cancer's Experiences of Cancer Patients in Transition Study was conducted (n = 9970). Separate adjusted multinomial logistic regression models assessed the relationship between survivorship care plans and follow-up care outcomes. Proportion of survivors more likely to receive a survivorship care plan varied by numerous sociodemographic and medical factors, such as cancer type (colorectal and prostate), gender (male), and education (high school or less). In unadjusted and adjusted models, individuals who received a Survivorship Care Plan had significantly higher odds of: having felt their primary care providers were involved; agreeing that their primary care providers understood their needs, knew where to find supports and services, and were able to refer them directly to services; and were confident that their primary care provider could meet their follow-up care needs.

Psychosocial Aspects of Living Long Term with Advanced Cancer and Ongoing Systemic Treatment: A Scoping Review.

(1) Background: Studies examining the psychosocial impact of living long term on systemic treatment in advanced cancer patients are scarce. This scoping review aimed to answer the research question "What has been reported about psychosocial factors among patients living with advanced cancer receiving life-long systemic treatment?", by synthesizing psychosocial data, and evaluating the terminology used to address these patients; (2) Methods: This scoping review was conducted following the five stages of the framework of Arksey and O'Malley (2005); (3) Results: 141 articles published between 2000 and 2021 (69% after 2015) were included. A large variety of terms referring to the patient group was observed. Synthesizing qualitative studies identified ongoing uncertainty, anxiety and fear of disease progression or death, hope in treatment results and new treatment options, loss in several aspects of life, and worries about the impact of disease on loved ones and changes in social life to be prominent psychosocial themes. Of 82 quantitative studies included in the review, 76% examined quality of life, 46% fear of disease progression or death, 26% distress or depression, and 4% hope, while few studies reported on adaptation or cognitive aspects. No quantitative studies focused on uncertainty, loss, or social impact; (4) Conclusion and clinical implications: Prominent psychosocial themes reported in qualitative studies were not included in quantitative research using specific validated questionnaires. More robust studies using quantitative research designs should be conducted to further understand these psychological constructs. Furthermore, the diversity of terminology found in the literature calls for a uniform definition to better address this specific patient group in research and in practice.

Material deprivation and rates of all-terrain vehicle- and snowmobile-related injuries in Ontario from 2003 to 2018: a population-based study.

OBJECTIVES: Socio-economic status (SES) is a well-established predictor of health outcomes; however, there is a dearth of evidence on the relationship between SES and off-road vehicle (ORV) injuries. In Ontario, all-terrain vehicles (ATVs) and snowmobiles present a serious risk for preventable injury. This study assessed the association between area-level material deprivation and the risk of ATV- and snowmobile-related injuries in Ontario, as well as the impact of sex and age. METHODS: A population-based, repeat cross-sectional study was conducted using administrative data of ATV- and snowmobile-related emergency room visits from 2003 to 2018. Material deprivation was measured using the Ontario Marginalization Index, which assigned a score and quintile of deprivation to each dissemination area in Ontario. Age-standardized incidence rates and relative index of inequality values were calculated, stratified by quintile of deprivation, sex, age group, vehicle type, and health region. RESULTS: We found a significant, positive relationship between ORV-related injuries and quintile of material deprivation (RII = 1.28, 95% CI: 1.01-1.63). Rates of ATV- and snowmobile-related injuries remained stable over time. Across all age groups, sex, and rural categories, we found an inverse u-shaped relationship between rates of injuries and quintile material deprivation. Males, individuals living in rural areas, and adolescents and young adults experienced the highest rates of injuries. CONCLUSION: Despite the positive relationship between ORV-related injuries and quintiles of deprivation, the inverse u-shaped relationship suggests that this increased risk of injury is likely related to exposure to ORVs. These results contribute to an understanding of the prevalence of the injury problem at a local level in Ontario. Stable rates of injury over time suggest that current public health programs are not sufficient in reducing these injuries, and further research should determine which factors amenable to intervention are contributing to increased risk of injury.

RéSUMé: OBJECTIFS: Le statut socioéconomique (SSE) est un prédicteur bien établi des résultats pour la santé, mais il existe une pénurie de preuves sur la relation entre le SSE et les blessures des véhicules hors route. En Ontario, les véhicules tout-terrain (VTT) et les motoneiges présentent un risque sérieux de blessures évitables. Cette étude a évalué l'association entre la privation matérielle au niveau de la zone et le risque de blessures liées aux VTT et aux motoneiges en Ontario, ainsi que l'impact du sexe et de l'âge. MéTHODES: Une étude transversale répétée basée sur la population a été menée à l'aide des données administratives des visites aux urgences liées aux VTT et aux motoneiges de 2003 à 2018. La privation matérielle a été mesurée à l'aide de l'Ontario Marginalization Index, qui a attribué un score et un quintile de privation à chaque aire de diffusion en Ontario. Les taux d'incidence normalisés selon l'âge et l'indice relatif des valeurs d'inégalité ont été calculés, stratifiés par quintile de privation, sexe, groupe d'âge, type de véhicule et région sanitaire. RéSULTATS: Nous avons trouvé une relation positive significative entre les blessures liées aux VTT et le quintile de privation matérielle (RII = 1,28, IC à 95% : 1,01 ­ 1,63). Les taux de blessures liées aux VTT et aux motoneiges sont demeurés élevés au fil du temps. Dans tous les groupes d'âge, sexe et catégories rurales, nous avons trouvé une relation en forme de U inverse entre les taux de blessures et les quintiles de privation matérielle. Les hommes, les personnes vivant dans les zones rurales, les adolescents et les jeunes adultes ont connu les taux de blessures les plus élevés. CONCLUSION: Malgré la relation positive entre les blessures liées aux VTT et les quintiles de privation, la relation en forme de U suggère que ce risque accru de blessures est probablement lié à l'exposition aux VTT. Ces résultats contribuent à une compréhension de la prévalence du problème de blessures au niveau local en Ontario. Des taux stables de blessures au fil du temps suggèrent que les programmes de santé publique actuels ne sont pas suffisants pour réduire ces blessures, et des recherches plus poussées devraient déterminer quels facteurs susceptibles d'intervenir contribuent à augmenter le risque de blessures.

Prevalence of Involuntary Environmental Cannabis and Tobacco Smoke Exposure in Multi-Unit Housing.

No research has examined the prevalence of involuntary cannabis exposure in the home within the context of multi-unit housing (MUH). The 2017 cycle of the Centre for Addiction and Mental Health Monitor population RDD survey included measures of environmental cannabis smoke (ECS) and environmental tobacco smoke (ETS) for Ontario, Canada. These ECS measures were defined for those who did not live in a detached dwelling self-reporting noticing any tobacco or cannabis smoke enter the home from a neighboring unit or from outside the building at least once in the past 6 months. Overall, 6.6% (95% CI: 4.5-9.5%) and 7.5% (9% CI: 5.4-10.4%) of the population reported being exposed to ETS and ECS in MUH respectively. Individuals exposed to ECS were single, had used cannabis in the past 12 months, and had lower household incomes. The prevalence of involuntary exposure to cannabis smoke is similar to exposure to tobacco smoke. Exposure correlates were primarily associated with characteristics of those who lived in MUH who tend to be members of more vulnerable populations.