Simulation modelling to validate the flow method for estimating completeness of case ascertainment by cancer registries

Abstract: Purpose: To determine the percentage of Canadian youth meeting screen-time guidelines and to identify characteristics associated with different screen-time behaviours. Methods: Using nationally representative data collected from the 2008/2009 Youth Smoking Survey (YSS), we analyzed three screen-time behaviours, cigarette smoking, weekly spending money, self esteem, region and grade by sex, and conducted four logistic regression models to examine factors associated with more than 2 hours a day of sedentary screen time. Results: Of 51 922 Canadian youth in grades 6 to 12, 50.9% spent more than 2 hours per day in screen-based behaviours. The average daily screen time was 7.8 (± 2.3) hours. Males and current smokers were more likely to report over 2 hours per day watching TV and videos or playing video games, whereas students in higher grades and those with weekly spending money were more likely to report playing or surfing on a computer. Youth with higher self-esteem were less likely to report spending over 2 hours per day in each of the three screen-time behaviours examined. Conclusion: Developing a better understanding of the factors associated with more hours of screen time is required to develop and target interventions that reduce screen-time behaviours. Abstract Introduction: Workers are potentially exposed to known and suspected carcinogens in the workplace, many of which have not been fully evaluated. Despite persistent need, research on occupational cancer appears to have declined in recent decades. The formation of the Occupational Cancer Research Centre (OCRC) is an effort to counter this downward trend in Ontario. The OCRC conducted a survey of the broad stakeholder community to learn about priority issues on occupational cancer research. Methods: The OCRC received 177 responses to its survey from academic, health care, policy, industry, and labour-affiliated stakeholders. Responses were analyzed based on workplace exposures, at-risk occupations and cancers by organ system, stratified by respondents’ occupational role. Discussion: Priority issues identified included workplace exposures such as chemicals, respirable dusts and fibres (e.g. asbestos), radiation (e.g. electromagnetic fields), pesticides, and shift work; and occupations such as miners, construction workers, and health care workers. Insufficient funding and a lack of exposure data were identified as the central barriers to conducting occupational cancer research. Conclusion: The results of this survey underscore the great need for occupational cancer research in Ontario and beyond. They will be very useful as the OCRC develops its research agenda. Abstract Introduction: Participation rate is an important indicator for a screening program’s effectiveness; however, the current approach to measuring participation rate in Canada is not comparable with other countries. The objective of this study is to review the measurement of screening mammography participation in Canada, make international comparisons, and propose alternative methods. Methods: Canadian breast cancer screening program data for women aged 50 to 69 years screened between 2004 and 2006 were extracted from the Canadian Breast Cancer Screening Database (CBCSD). The fee-for-services (FSS) mammography data (opportunistic screening mammography) were obtained from the provincial ministries of health. Both screening mammography program participation and utilization were examined over 24 and 30 months. Results: Canada’s screening participation rate increases from 39.4% for a 24-month cut-off to 43.6% for a 30-month cut-off. The 24-month mammography utilization rate is 63.1% in Canada, and the 30-month utilization rate is 70.4%. Conclusion: Due to the differences in health service delivery among Canadian provinces, both programmatic participation and overall utilization of mammography at 24 months and 30 months should be monitored. Abstract Introduction: Estimates of the prevalence of chronic pain worldwide and in Canada are inconsistent. Our primary objectives were to determine the prevalence of chronic pain by sex and age and to determine the prevalence of pain-related interference for Canadian men and women between 1994 and 2008. Methods: Using data from seven cross-sectional cycles in the National Population Health Survey and the Canadian Community Health Survey, we defined two categorical outcomes, chronic pain and pain-related interference with activities. Results: Prevalence of chronic pain ranged from 15.1% in 1996/97 to 18.9% in 1994/95. Chronic pain was most prevalent among women (range: 16.5% to 21.5%), and in the oldest (65 years plus) age group (range: 23.9% to 31.3%). Women aged 65 years plus consistently reported the highest prevalence of chronic pain (range: 26.0% to 34.2%). The majority of adult Canadians who reported chronic pain also reported at least a few activities prevented due to this pain (range: 11.4% to 13.3% of the overall population). Conclusion: Similar to international estimates, this Canadian population-based study confirms that chronic pain persists and impacts daily activities. Further study with more detailed definitions of pain and pain-related interference is warranted. associated with it. The specific research objectives were to (1) examine the prevalence of chronic pain in the Canadian population from 1994 to 2008; (2) describe the sex and age differences in prevalence of chronic pain; and (3) describe the sex differences in pain-related interference with activities of daily living. Abstract Introduction: Medical examiners’ records can contribute to our understanding of the extent of suicide in a population, as well as associated sociodemographic and other factors. Methods: Using a mixed methods approach, the key objective of this pilot study was to determine the sources and types of information found in the Nova Scotia Medical Examiner Service (NSMES) records that might inform suicide surveillance and targeted prevention efforts. A secondary objective was to describe the one-year cohort of 108 individuals who died by suicide in 2006 in terms of available sociodemographic information and health care use in the year prior to death. Results: Data extraction revealed inconsistencies both across and within files in terms of the types and amounts of sociodemographic and other data collected, preventing cor-relational analyses. However, linkage of the records to administrative databases revealed frequent health care use in the month prior to death. Conclusion: The introduction of systematic data collection to NSMES investigations may yield a comprehensive dataset useful for policy development and population level research. of overall suicide rates. 3 An Ontario study of the validity of death certification of unnatural adult deaths highlighted the difficulty in determining intent due to the subjectivity of interpretation. 4 Deaths due to hanging or inhalation of noxious gas were more likely to be attributed to suicide than those due to poisoning or drowning; death due to overdose of over-the-counter medication was certified more frequently as suicide than death as a result of heroin overdose. Increasing proof of intent resulted in increased odds of correct certification as suicide. In addition, some physicians may be reluctant to report suicide as the cause of death due to stigma or financial implications for family members. 5 When suicide is suspected, the manner of death is determined in a medico-legal process that can be informed by different types of evidence, including an investigation of the scene, post-mortem examination results, collection of medical histories and circum-stantial information. The systems for the investigation of suicides vary across Canadian provinces and territories; some jurisdictions possess a medical examiner system and others a coroner system. 6 Medical examiners are physicians, while coroners may have legal, Abstract An international roundtable on self-management support (SMS) for persons living with chronic conditions (CCs) was held in Vancouver, Canada, in June 2009. It brought together 23 leading researchers, policy makers, health care practitioners and consumers from Canada, Australia, New Zealand, the United Kingdom and the United States. It also provided a forum for critically reflecting on SMS approaches and for building consensus on how to move forward in the self-management field. The deliberations resulted in a draft international framework that identifies key definitions, principles and strategic directions and also outlines sample strategies to guide those working to develop SMS capacities at the local, regional or national level. The framework is a mechanism for knowledge exchange that will hopefully act as a catalyst to shift SMS-related policy, practice and research directions to better serve the needs of all CC populations. More than 400 multi-level stakeholders in the Canadian and international community have been invited to review the framework using an e-consultation process. The final framework is scheduled for release in the late fall of 2011. organizations and systems to support and increase people’s ability to self-manage their CCs. SMS includes infra-structures and policies, supportive services and programs, and skills, resources and social networks. A of governments, health authorities, health care facilities, professional associations and non-profit organizations are promoting initiatives in SMS-related research, policies and programs to help reduce the various impacts of illnesses such as arthritis, heart disease, multiple sclero-sis, depression and HIV/AIDS. Canada, SMS activities are developing at local, regional, provincial and national levels. These include an environmental scan of Canadian-based CC SMS activities funded by the Public Health Agency of Canada as well as efforts to improve primary health care delivery (i.e. family health teams) to better align SMS activities with the needs of the