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The Canadian Organization of Medical Physicists (COMP), in close partnership with the Canadian Partnership for Quality Radiotherapy (CPQR) has developed a series of Technical Quality Control (TQC) guidelines for radiation treatment equipment. These guidelines outline the performance objectives that equipment should meet in order to ensure an acceptable level of radiation treatment quality. This particular TQC contains detailed performance objectives and safety criteria for CyberKnife® Technology. The quality control recommendations in this document are based upon previously published guidelines and the collective experience of all Canadian sites using this technology. This TQC guideline has been field tested at the newest Canadian CyberKnife installation site and includes recommendations for quality control of the Iris™ and InCise™ MLC collimation systems.

The aim of this study is to report outcomes and prognostic factors for early stage non-small cell lung cancer treated with patient-adapted Cyberknife stereotactic body radiotherapy. A retrospective analysis of 150 patients with T1-2N0 non-small cell lung cancer treated with stereotactic body radiotherapy was conducted. An algorithm based on tumor and patient's characteristics was used to orient patients towards soft tissue (Xsight Lung), fiducials or adjacent bone (Xsight Spine) tracking. Median biological effective dose without correction for tissue inhomogeneities was 180 Gy 10 for peripheral tumors and 113 Gy 10 for central tumors. Median follow-up was 22 months. Actuarial 2 years local control, overall survival and disease-specific survival were respectively 96%, 87% and 95%. Every 1 cm increase in tumor diameter was associated with a relative risk for regional or distant relapse of 2 (95%CI 5 1.2-3.6, p 5 0.009). With doses 132 Gy 10 and 132 Gy 10 , local control was 98% vs. 82% (p 5 0.07), disease-specific survival 97% vs. 78% (p 5 0.02) and overall survival 93% vs. 76% (p 5 0.01), respectively. Better disease-specific survival and a trend for better overall survival was observed for peripheral vs. central tumors (96% vs. 79%, p 5 0.05 and 92% vs. 74%, p 5 0.08, respectively). A higher Charlson comordibity score (4) predicted lower overall survival (79% vs. 98%, p 5 0.01). Toxicities included 3 patients with idiopathic pulmonary fibrosis who developed grade 5 pneumonitis and 2 patients with grade 3 pneumonitis.We therefore report excellent local control and disease-specific survival following patientadapted Cyberknife lung stereotactic body radiotherapy. Although toxicities were in general minimal, patients with pulmonary fibrosis might be at greater risk of severe complications.Small size, peripheral location, dose  132 Gy 10 and a low Charlson co-morbidity score seem to be associated with better outcomes.

Gambling habits of people aged 55 years and over without gambling problems are rarely being investigated. In order to document life events and to identify the impacts of gambling on quality of life, 19 participants aged 55 to 74 years without gambling problems, male and female, were assembled in three focus groups. Qualitative content analysis of the groups reveals changes in gambling habits associated with transition to retirement and occurrence of health problems. The content analysis further reveals a variety of positive and negative consequences of gambling habits on finances, hobbies, social relationships, and psychological health. Although the focus groups did not target the structural or environmental characteristics of gambling that influence participants' gambling habits, those themes were brought up spontaneously. Results highlight the necessity to study life events from a larger perspective including, for example, protective and risk factors, in order to better understand the life contexts and the individual characteristics that may lead to an alteration or not of gambling habits.

The development of pathological gambling (PG) among people with Parkinson’s disease (PD) is increasingly reported. The intake of dopamine agonists is most often associated with the emergence of this addiction. Although it is known that gambling habits contribute to the onset of gambling problems in the general population, these habits have not yet been studied in individuals with PD. Thus, this study aimed to explore gambling habits in people with PD. Twenty-five individuals with PD and 8 caregivers participated. Thirteen gamblers took part in a semi-structured interview regarding their gambling habits and the presence of a gambling problem and other impulse-control disorders. The results show that gamblers mainly play lotteries and slot machines. Most gamble for pleasure, but some reported wanting to win money to finance a cure for their PD. None of the gamblers involved a caregiver in their gambling activities and no gambler currently presented a gambling problem. However, 2 at-risk gamblers reported having developed a gambling problem in the past. This study sheds light on factors that may contribute to the development of PG among patients with PD, namely, the emergence of new reasons for gambling after a PD diagnosis, erroneous beliefs about gambling, and discretion about gambling habits. Prevention strategies are discussed in view of these results. However, given the small sample size, further studies examining the gambling habits of people with PD are required.RésuméDe plus en plus, on observe le développement du jeu pathologique (JP) chez les personnes atteintes de la maladie de Parkinson (MP). La prise d’agonistes de la dopamine est le plus souvent associée à l’émergence de cette dépendance. Bien qu’il soit connu que les habitudes de jeu contribuent à l’apparition de problèmes de jeu dans la population en général, ces habitudes n’ont pas encore été étudiées chez les personnes atteintes de la maladie de Parkinson (MP). Dans cette optique, cette étude explore les habitudes de jeu chez les personnes atteintes de la MP. Vingt-cinq personnes atteintes de la maladie de Parkinson et huit soignants y ont participé. Treize joueurs ont participé à une entrevue semi-structurée concernant leurs habitudes de jeu et la présence d’un problème de jeu et d’autres troubles liés au contrôle des impulsions. Les résultats montrent que les joueurs jouent principalement aux loteries et aux machines à sous. La plupart jouent par plaisir, mais certains ont déclaré vouloir gagner de l’argent pour financer une thérapie contre la maladie. Aucun des joueurs n’avait avec lui un fournisseur de soins dans ses activités de jeu et aucun joueur ne présentait actuellement de problème de jeu. Cependant, deux joueurs à risque ont déclaré en avoir développé un par le passé. Cette étude met en lumière les facteurs qui peuvent contribuer au développement du jeu pathologique chez les personnes atteintes de Parkinson, à savoir l’émergence de nouvelles raisons pour le jeu après un diagnostic de MP, les croyances erronées sur le jeu et la discrétion sur les habitudes de jeu. Compte tenu de ces résultats, des stratégies de prévention sont analysées. Cependant, étant donné la petite taille de l’échantillon, d’autres études examinant les habitudes de jeu des personnes atteintes de cette maladie sont nécessaires.