Background: Methadone maintenance treatment programs implemented in Aboriginal communities have proven to be beneficial for the control of opioid addiction and its associated consequences, but the perceptions and opinions of different community members about these programs remain elusive. The goal of this study was to determine the perceptions of members of a First Nation community in New Brunswick, Canada, on the implementation of a methadone maintenance treatment program and its effects on the community. Methods:We conducted a qualitative study using semistructured focus group discussions with 3 distinct groups composed of health care professionals and influential community members, patients in the methadone maintenance treatment program and community members at large. Thematic analysis of discussion transcripts was performed.Results: A total of 22 partipants were included in the 3 focus groups. All groups of participants expressed that patients in the program are stigmatized and marginalized. Discussions also revealed widespread misconceptions about the program. Participants associated the program with improvements in community-level outcomes and in parenting abilities of patients, but also with difficulties preserving family unity.Interpretation: Despite being culturally adapted to the community, elements surrounding the methadone maintenance treatment program in this First Nation community appear to be misunderstood and stigmatized. It may be beneficial to provide community education on these programs to assure community buy-in for the successful implementation of harm reduction programs in Aboriginal communities. Abstract Research Research CMAJ OPEN E432CMAJ OPEN, 4(3)non-Aboriginal participants. [17][18][19] A report from the Health Council of Canada highlighted the importance of considering and respecting culture in Aboriginal health care to offer "culturally competent care" in "culturally safe environments." 20Although this applied to harm reduction strategies, it was suggested that the implementation of methadone maintenance treatment programs within Aboriginal communities can be accompanied by apprehension and distrust.21 Thus, although individual-level benefits of methadone programs have been established, knowledge on the perceptions and opinions of Aboriginal communities on these programs remains elusive.The First Nation reserve of Elsipogtog (population 3272) is located in southeastern New Brunswick, Canada. The Elsipogtog methadone maintenance treatment program was started at the Elsipogtog Health & Wellness Centre in 2007 to help counter the community's high rates of substance abuse and its related consequences. The program's mission is true to First Nation cultural beliefs and provides care according to the native medicine wheel. Most of the program's staff are from the Elsipogtog community and provide services in Mi'kmaq. They include a family physician, a nurse practitioner, a registered nurse, an alcohol-drug counsellor and a psychologist, as well as a traditional elder and a medical receptio...

These age differences clearly warn against consolidating the QOL or QOH scores of younger and older adults, and instead suggest that age at diagnosis is essential when considering patient perspective, and when establishing tailored support programs.

340Clinical studies in neuro-oncology typically express results using traditional outcome measures such as tumor size, toxicity effects, and of course, survival rates. Although paramount, these measures fail to fully capture the residual capacity, psychosocial health, and overall quality of life (QOL) of surviving patients. In recent years, a new emphasis has been placed on evaluating quality of life in patients, thus acknowledging the impact produced not only by the disease process, but also by different ABSTRACT: Background: The purpose of this study was to develop and validate a self-administered questionnaire to measure the health-related quality of life (QOL) of patients with brain cancer. We wanted to assess both core and disease-specific concerns in a single, easy-to-use instrument, thus promoting concision and clinical utility. The questionnaire departs from its predecessors in that it was designed for-and validated among French speaking Canadians. Methods: A focus group of health professionals was used to develop items for the questionnaire, which was later validated with 105 patients suffering from brain cancer. The underlying structure of the questionnaire was investigated using principal component analysis and confirmed using a principal factor analysis. Results: The final version of the questionnaire contains 30 items. Seven multi-item scales, tapping into distinct dimensions of QOL, were uncovered (i.e., functional well-being, symptom severity/fear of death, social support/acceptance of disease, autonomy in personal care, digestive symptomatology, neurocognitive function, and pain). Assessment of reliability revealed elevated internal consistency for each of the seven scales (Cronbach coefficient alpha ≥.65), whereas known-groups validity (anchor-based approach) revealed that the different dimensions uniquely discriminated between patients with different functional levels (Karnofsky Performance Scores) and clinical status (exposure to neurosurgery, radiotherapy, and use of chemotherapy and anticonvulsants). Conclusion: Our QOL questionnaire, the Sherbrooke Neuro-Oncology Assessment Scale, or SNAS, taps into both core and disease-specific issues relevant to neuro-oncology patients. It has good validity and reliability, and clearly reflects the multidimensional nature of QOL. Depending on the research focus, it may be used in clinical trials to track the impact of disease and/or treatment on satisfaction, functional status, and general well-being. RÉSUMÉ: Élaboration et validation d'un questionnaire sur la QDV pour les patients atteints de tumeurs cérébrales.Contexte : Le but de cette étude était d'élaborer et de valider un questionnaire autoadministré destiné à mesurer la qualité de vie reliée à la santé (QDV) de patients atteints de cancers du cerveau. Nous voulions évaluer les questions fondamentales et spécifiques de la maladie par un seul outil facile à utiliser, mettant l'emphase sur la concision et l'utilité clinique. Le questionnaire est différent de ses prédécesseurs du fait qu'il a été plan...