Objectives: Examine the extent to which financial assistance, in the form of subsidies for life-extending treatments (LETs) or cash pay-outs, distorts the demand for end-of-life treatments. Methods: A discrete choice experiment was administered to 290 cancer patients in Singapore to elicit preferences for LETs and palliative care (PC) only. Responses were fitted to a latent class conditional logistic regression model. We also quantified patients' willingness to pay to avoid and willingness to accept a less effective LETor PC only. We then simulated the effects of various LET subsidy and cash pay-out policies on treatment choices. Results: We identified 3 classes of patients according to their preferences. The first class (26.1% of sample) has a strong preference for PC and are willing to give up life expectancy gains and even pay for receiving only PC. The second class (29.8% of sample) has a strong preference for LETs and prefers to extend life regardless of cost or quality of life. The final class (44.1% of sample) prefers LETs to PC, but actively trades off costs, length and quality of life when making end-of-life treatment choices. Policy simulations show that LETsubsidies increase demand for LETs at the expense of demand for PC, but an equivalent cash payout was not shown to distort demand. Conclusions: Cancer patients have heterogeneous end-of-life preferences. LET subsidies and cash payouts have differing effects on the utilization of LETs. Policymakers should be mindful of these differences when designing healthcare financing schemes for patients with life-limiting illnesses.

Purpose: To prescribe different physical activity (PA) intensities using activity trackers to increase PA, reduce sedentary time, and improve health outcomes among breast cancer survivors. The maintenance effect of the interventions on study outcomes was also assessed. Methods: The Breast Cancer and Physical Activity Level pilot trial randomized 45 breast cancer survivors to a home-based, 12-wk lower (300 min•wk−1 at 40%-59% of HR reserve) or higherintensity PA (150 min•wk−1 at 60%-80% of HR reserve), or no PA intervention/control. Both intervention groups received Polar A360® activity trackers. Study outcomes assessed at baseline, 12 and 24 wk included PA and sedentary time (ActiGraph GT3X+), health-related fitness (e.g., body composition, cardiopulmonary fitness/VO2max), and patient-reported outcomes (e.g., quality of life). Intention-to-treat analyses were conducted using linear mixed models and adjusted for baseline outcomes. Results: Increases in moderate-vigorous intensity PA (least squares adjusted group difference [LSAGD], 0.6; 95% confidence interval [CI], 0.1-1.0) and decreases in sedentary time (LSAGD, −1.2; 95% CI, −2.2 to −0.2) were significantly greater in the lowerintensity PA group versus control at 12 wk. Increases in VO2max at 12 wk in both interventions groups were significantly greater than changes in the control group (lower-intensity PA group LSAGD, 4.2; 95% CI, 0.5-8.0 mL•kg−1•min−1; higher-intensity PA group LSAGD, 5.4; 95% CI, 1.7-9.1mL•kg−1•min−1). Changes in PA and VO2max remained at 24wk, but differences between the intervention and control groups were no longer statistically significant. Conclusions: Increases in PA time and cardiopulmonary fitness/VO2max can be achieved with both lower-and higher-intensity PA interventions in breast cancer survivors. Reductions in sedentary time were also noted in the lower-intensity PA group.

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The two fields of continuing professional development (CPD) and knowledge translation (KT) within the health care sector, and their related research have developed as somewhat parallel paths with limited points of overlap or intersection. This is slowly beginning to change. The purpose of this paper is to describe and compare the dominant conceptual models informing each field with the view of increasing understanding and appreciation of the two fields, how they are similar and where they differ, and the current and potential points of intersection. The models include the "knowledge-to-action'' (KTA) cycle informing KT, models informing CPD curriculum design and individual self-directed learning, and the Kirkpatrick model for evaluating educational outcomes. When compared through the perspectives of conceptual designs, processes, and outcomes, the models overlap. We also identify shared gaps in both fields (eg, the need to explore the influence of the context in which CPD and KT interventions take place) and suggest opportunities for synergies and for moving forward.