Our study is the first to document that latent toxoplasmosis reduces GM in schizophrenia but not in controls.

Latent toxoplasmosis in schizophrenia may lead to more severe positive psychopathology and perhaps less favourable course of schizophrenia.

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25 Background: Advances in oncologic sciences have resulted in successful treatments for many cancers with improved event-free and overall survival for millions of patients. Efficient delivery of state of the art cancer care requires well-orchestrated performances of multiple oncology, primary care and social services providers. However, many rural oncology providers do not offer such multidisciplinary cancer services and rely on patients to coordinate their own care. This study assessed perspectives of rural cancer patients and caregivers on their confidence to make decisions and address their care needs. Methods: We conducted focus groups with the attendees of 3 rural Congregate Meals. The county-sponsored programs bring together seniors for nutritional meals, social connectedness and educational programs. We also developed and piloted a 5-question survey, asking respondents to rate their confidence in interacting with their clinicians about care needs, care coordination and barriers to care. Results: Overall, 85 individuals participated in the focus groups and 76 persons returned the survey (90% response rate). The vast majority of the participants were cancer survivors or caregivers to patients with cancer. Transportation to and from oncology appointments presents a major concern for the rural communities, as most patients had to travel long distance to see a doctor. Patients also reported having difficulty making decisions regarding their care due to a lack of knowledge about specific cancer services and limited availability of providers. Cancer support groups, behavioral health providers, exercise and nutrition therapies were reported to be particularly scarce in rural areas. We found that patients who had trusted relationships with their physicians tended to be more confident in their ability to obtain necessary help from their providers compared to patients who reported poor communication and lack of trust. Conclusions: There are numerous reasons that may lead to rural-urban disparities in cancer survivorship outcomes including limited availability of supportive services, limited patient resources, burden of patient decision making and care coordination, and lack of adequate patient-provider communication.