Purpose To explain and predict racial or ethnic disparities in advance care planning (ACP) behaviors among American adults by using the Integrated Behavioral Model (IBM) and the Precaution Adoption Process Model. Methods A randomized, observational, nonexperimental, cross-sectional study design was used to survey American adults between 40 and 80 years of age ( n = 386). Results The majority of respondents (75%) had not completed ACP. Significant differences were found by race or ethnicity: 33% of Whites had completed ACP versus Hispanics (18%) and Blacks (8%). Whites had statistically significantly higher levels of most IBM constructs compared with Blacks and Hispanics. The IBM predicted 28% of the variance in behavioral intention. After controlling for sociodemographic variables, direct attitudes, indirect attitudes, and indirect perceived norms were significant predictors of behavioral intention. Conclusion The IBM and the Precaution Adoption Process Model are useful frameworks for interventions designed to increase ACP among racial or ethnic minorities in the United States.

Temozolomide (TMZ) during and after radiotherapy (RT) is recommended for patients with newly diagnosed glioblastoma (GBM). We analyzed the adoption of this new standard of care for GBM in an academic cancer centre in Canada and assessed its impact on survival. GBM patients registered with Cancer Care Ontario between 2004 and 2008 were identified. Those ≥ 16 years age, newly diagnosed, treated at our institution, had confirmed pathology and complete records were included. Demographics, treatments, toxicity and outcome were captured. For survival analysis patients were stratified by age, ECOG, and treatment modalities including total cycles of TMZ. Descriptive statistics were used for early progressors and long term survivors. Kaplan-Meier curves, log-rank test and Cox proportional hazards model were used for survival analyses. At a median follow-up of 28 months, we compared our outcome to updated EORTC-NCIC CE 3 results. Of 517 patients 433 were included for analysis. Majority were male (63 %), ECOG 0-1 (66 %), and ≤ 65 years (55 %). 44 % received CRT followed by TMZ, 13 % had CRT only, 30 % had RT only and 13 % had best supportive care. 10 % were early progressors and 9 % survived beyond 2 years. Comparison of our results to NCIC CTG CE.3 study data showed median survival was 15.8 versus 14.6 months, 2 year survival rate for CRT plus TMZ was 35 versus 26 %, and for RT alone 0 versus 10 %, respectively. <50 % of GBM patients complete CRT with TMZ in the real-world setting. Prognosis for most patients with GBM remains dismal particularly if they are not suitable for RT and CRT.

The treatment produced significant long-term changes in children's speech, even when administered by SLPs newly trained in the Lidcombe Program. Treatment results appear to be influenced by pretreatment stuttering severity.

Decoration of graphene oxide (GO) sheets with Ag nanoparticles has been demonstrated using a simple sonication technique. By changing the ratio between Ag-decorated-GO and GO, a series of Ag-decorated-GO samples with different Ag loadings were synthesized. These Ag-decorated-GO samples were characterized using transmission electron microscopy (TEM), X-ray diffraction (XRD) spectroscopy, thermal gravimetric analysis (TGA), and differential scanning calorimetric (DSC) techniques. TEM analysis showed that Ag nanoparticles were evenly distributed on GO sheets, and the size analysis of the particles using multiple TEM images indicated that Ag nanoparticles have an average size of 6-7 nm. TEM analysis also showed that Ag nanoparticles migrated from Ag-decorated-GO to later-added GO sheets. In XRD, all the Ag-decorated GO samples showed the characteristic peaks related to GO and face-centered-cubic (fcc) Ag. Thermal analysis showed peaks related to the combustion of graphitic carbon shifted to lower temperatures after GO sheets were decorated with Ag nanoparticles. In addition, further experiments performed using Ag-decorated-GO and multiwalled carbon nanotubes (MWNTs) confirmed that Ag nanoparticles migrated from Ag-decorated-GO to later-added carbon nanotubes without a noticeable coalescence of Ag nanoparticles.

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