Cultural factors associated with racial disparities in lung cancer care.

Rationale: Minority patients with lung cancer are less likely to receive stage-appropriate treatment. Along with access to care and provider-related factors, cultural factors such as patients' lung cancer beliefs, fatalism, and medical mistrust may help explain this disparity.

Objectives: To determine cultural factors associated with disparities in lung cancer treatment.

Metered dose inhaler technique among inner-city asthmatics and its association with asthma medication adherence.

Introduction: Inhaled medications, critical for asthma treatment, are self-administered through metered dose inhalers (MDI). Asthma self-management hinges on adherence to these medications and to proper MDI technique.

Objective: To assess predictors of proper MDI technique, and MDI technique as a tool to identify patients with low adherence to inhaled medications.

Effectiveness of radiation therapy alone for elderly patients with unresected stage III non-small cell lung cancer.

Purpose: Chemoradiotherapy is the standard of care for unresectable stage III non-small cell lung cancer (NSCLC). Elderly patients, who are often considered unfit for combined chemoradiotherapy, frequently receive radiation therapy (RT) alone. Using population-based data, we evaluated the effectiveness and tolerability of lone RT in unresected elderly stage III NSCLC patients.

Evaluating beliefs associated with late-stage lung cancer presentation in minorities.

Introduction: Minority patients in the United States present with later stages of lung cancer and have poorer outcomes. Cultural factors, such as beliefs regarding lung cancer and discrimination experiences, may underlie this disparity.

Methods: Patients with a new diagnosis of lung cancer were recruited from four medical centers in New York City.

Racial and ethnic differences in beliefs about lung cancer care.

Background: Disparities in lung cancer treatment and palliative care are well documented. However,the mechanisms underlying these disparities are not fully understood. In this study, we evaluated racial and ethnic differences in beliefs and attitudes about lung cancer treatment and palliative care among patients receiving a new diagnosis of lung cancer.

Beliefs and attitudes about lung cancer screening among smokers.

The National Lung Screening Trial (NLST) recently reported that annual computed tomography (CT) screening is associated with decreased lung cancer mortality in high-risk smokers. Beliefs about lung cancer and screening, particularly across race and ethnicity, and their influence on CT screening utilization are largely unexamined. Our study recruited asymptomatic, high-risk smokers, 55-74 years of age from primary care clinics in an academic urban hospital.

Radiotherapy and chemotherapy for elderly patients with stage I-II unresected lung cancer.

Radiotherapy (RT) is the standard therapy for unresected stage I-II nonsmall cell lung cancer (NSCLC). Using population-based data, we compared survival and toxicity among unresected elderly patients treated with combined chemoradiotherapy (CRT) or RT alone. Using the Surveillance, Epidemiology and End Results (SEER) registry (National Cancer Institute, Bethesda, MD, USA) we identified 3,006 cases of unresected stage I-II NSCLC.

Barriers to adherence to COPD guidelines among primary care providers.

Background: Despite efforts to disseminate guidelines for managing chronic obstructive pulmonary disease (COPD), adherence to COPD guidelines remains suboptimal. Barriers to adhering to guidelines remain poorly understood.

Methods: Clinicians from two general medicine practices in New York City were surveyed to identify barriers to implementing seven recommendations from the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines.

Survival and risk of adverse events in older patients receiving postoperative adjuvant chemotherapy for resected stages II-IIIA lung cancer: observational cohort study.

Objective: To compare the survival and risk of serious adverse events in older patients with stages II-IIIA non-small cell lung cancer treated with or without postoperative platinum based chemotherapy.

Design: Observational cohort study.

Setting: Cases of lung cancer in Surveillance Epidemiology and End Results registry linked to Medicare files, 1992-2005, and follow-up data to December 2007.

Inhaler device, administration technique, and adherence to inhaled corticosteroids in patients with asthma.

Aim: To compare inhaled corticosteroid (ICS) inhaler type with user technique and ICS medication adherence among adults with asthma.

Methods: We classified 270 adults into two groups by ICS device type: metered-dose inhaler (MDI) or dry powder inhaler (DPI). Inhaler technique was assessed using standardised checklists.

Perennial allergen-specific immunoglobulin E levels among inner-city elderly asthmatics.

Background: The role of allergen sensitization has been well established among children and young adults with asthma. Some studies have suggested that allergens play a less important role among older patients with asthma. However, whether older asthmatics have a lower prevalence of allergen sensitization than younger adults remains controversial.

Use of herbal remedies and adherence to inhaled corticosteroids among inner-city asthmatic patients.

Background: Complementary and alternative medicines (CAM), such as herbal remedies, are widely used by patients with chronic diseases, such as asthma. However, it is unclear whether use of the herbal remedies is associated with decreased adherence to inhaled corticosteroids (ICSs), a key component of asthma management.

Objective: To examine the association among use of herbal remedies, adherence to prescribed ICSs, and medication and disease beliefs.