Automated Telephone Follow-up for Smoking Cessation in Smokers With Coronary Heart Disease: A Randomized Controlled Trial.

INTRODUCTION: Smokers with coronary heart disease (CHD) benefit from in-hospital cessation treatment, but relapse is common without ongoing support postdischarge. The purpose of this study was to determine if smoking abstinence would be higher after hospital discharge in smokers who received automated telephone follow-up (ATF) and nurse-counseling, compared with a standard care (SC) control group. METHODS: A total of 440 smokers hospitalized with CHD were randomly assigned to the ATF group (n = 216) or to the SC group (n = 224). Participants in the ATF group received automated phone calls 3, 14, 30, 60, 90, 120, 150, and 180 days after hospital discharge. The ATF system posed questions concerning smoking status, confidence in staying smoke-free, and need for assistance. If flagged by the ATF system, a nurse-counselor provided additional counseling by phone. Self-reported continuous smoking abstinence was assessed 26 and 52 weeks postdischarge using intention-to-treat analysis. The main outcome measure was continuous abstinence for weeks 1-26 postdischarge. RESULTS: Participants in the ATF group achieved higher abstinence rates for weeks 1-26 than those in the SC group (odds ratio [OR] = 1.53, 95% confidence interval [CI] = 1.01 to 2.33). There was no significant difference between groups in abstinence rates for weeks 27-52 (OR = 1.37; 95% CI = 0.89 to 2.09). CONCLUSIONS: ATF-mediated follow-up helped smokers with CHD achieve abstinence during the intervention period. There was a trend toward clinically important improvements for weeks 27-52; but between-group differences for this time point did not achieve statistical significance. CLINICAL TRIAL NUMBER: NCT00449852. IMPLICATIONS: Automated telephone follow-up exerts its effect by reinforcing participants' efforts to be smoke-free and by proactively linking people requiring assistance to individualized support (eg, telephone counseling). This study shows that automated telephone follow-up can assist smokers with CHD in remaining smoke-free; however, the success of automated telephone follow-up is limited to the treatment period and abstinence rates after the treatment period were not statistically different from among those receiving standard care. Extended treatment via automated telephone follow-up may provide a solution to extend cessation assistance beyond hospital discharge.

Recent trends in prostate cancer in Canada.

BACKGROUND: Prostate cancer is the most common type of cancer in Canadian men. Screening recommendations have changed substantially over the last 25 years. Since 2011 (United States) and 2014 (Canada), taskforce guidelines have recommended against screening using the prostate-specific antigen (PSA) test in low-risk men of all ages. This work reports on trends in prostate cancer incidence, mortality, and stage at diagnosis in Canada from 1992 to 2015. DATA AND METHODS: Prostate cancer incidence, mortality, and stage at diagnosis were retrieved from Statistics Canada's Canadian Cancer Registry and Canadian Vital Statistics - Death Database. Joinpoint analysis was used to examine trends over time. RESULTS: The age-standardized incidence rate (ASIR) of prostate cancer peaked in 1993 and 2001, and declined thereafter. From 2011 to 2015, the ASIR declined by 9.3% per year. The age-standardized mortality rate (ASMR) decreased continuously from 1992 to 2015, but fell most rapidly (2.9% per year) after 2001. Data from two provinces show that, from 2005 to 2015, the rate of Stage I and Stage II cancers decreased by 3.2% per year, while the rate of Stage III and Stage IV cancers remained relatively stable. DISCUSSION: Incidence of prostate cancer has declined substantially in recent years. Most of the decline seems to be in localized cases (Stage I and Stage II). Changes in incidence have mirrored changes to PSA screening recommendations. Future work should continue to monitor trends over time at the national level, especially as they relate to screening recommendations.

Outdoor time and dietary patterns in children around the world.

Background: Whether outdoor time is linked to dietary patterns of children has yet to be empirically tested. The objective of this study was to examine the association between outdoor time and dietary patterns of children from 12 countries around the world. Methods: This multinational, cross-sectional study included 6229 children 9-11 years of age. Children self-reported the time that they spent outside before school, after school and on weekends. A composite score was calculated to reflect overall daily outdoor time. Dietary patterns were assessed using a food frequency questionnaire, and two components were used for analysis: healthy and unhealthy dietary pattern scores. Results: On average, children spent 2.5 h outside per day. After adjusting for age, sex, parental education, moderate-to-vigorous physical activity, screen time and body mass index z-score, greater time spent outdoors was associated with healthier dietary pattern scores. No association was found between outdoor time and unhealthy dietary pattern scores. Similar associations between outdoor time and dietary patterns were observed for boys and girls and across study sites. Conclusions: Greater time spent outside was associated with a healthier dietary pattern in this international sample of children. Future research should aim to elucidate the mechanisms behind this association.

Watching television or listening to music while exercising failed to affect post-exercise food intake or energy expenditure in male adolescents.

Watching television or listening to music while exercising can serve as motivating factors, making it more pleasant to exercise for some people. However, it is unknown whether these stimuli influence food intake and/or physical activity energy expenditure (PAEE) for the remainder of the day, potentially impacting energy balance and weight control. We examined the effects of watching television or listening to music while exercising on post-exercise energy intake and expenditure. Our study was a randomized crossover design, in which 24 male adolescents (mean age: 14.9 ±â€¯1.1 years) completed three 30-min experimental conditions consisting of walking/jogging on a treadmill at 60% of heart rate reserve while (1) watching television; (2) listening to music; or (3) exercising with no other stimulus (control). An ad libitum lunch was offered immediately after the experimental conditions, and a dietary record was used to assess food intake for the remainder of the day. An Actical accelerometer was used to estimate PAEE until bedtime. The primary outcome measure was post-exercise energy intake and expenditure (kJ). We found that exercising while watching television or listening to music did not significantly affect post-exercise energy intake or energy expenditure. Exercising on a treadmill was found to be significantly more enjoyable while watching television than with no stimulus present. Ratings of perceived exertion were not significantly different between conditions. Overall, our results suggest that watching television or listening to music while exercising does not impact post-exercise energy intake or expenditure in male adolescents, which may have positive implications for adolescents who may need additional motivation to participate in physical activity.

Pokémon Go: A game changer for the physical inactivity crisis?

There is an urgent need to find novel strategies aimed at motivating people to go outside and move more. Pokémon Go blends a fun smartphone game with real-life, outdoor physical activity. Initial reports suggest it is a successful population level strategy to increase physical activity levels. Further research is needed to understand the long-term risks and benefits of this new game. Free-to-play location-based augmented reality mobile games are likely to be a new model for promoting healthy active living in the future.

International normative 20†m shuttle run values from 1†142†026 children and youth representing 50 countries.

OBJECTIVE: To develop sex-specific and age-specific international norms for the 20 m shuttle run test (20mSRT) in children and youth (aged 9-17 years), and to estimate the prevalence meeting the FITNESSGRAM criterion-referenced standards for healthy cardiorespiratory endurance (CRE). METHODS: A systematic review was undertaken to identify papers explicitly reporting descriptive 20mSRT (with 1 min stages) data on children and youth since 1981. Data were included on apparently healthy (free from known disease/injury) 9-17 years old. Following standardisation to a common metric and for protocol differences, pseudo data were generated using Monte Carlo simulation, with population-weighted sex-specific and age-specific normative centiles generated using the Lambda Mu and Sigma (LMS) method. Sex-related and age-related differences were expressed as per cent and standardised differences in means. The prevalence with healthy CRE was estimated using the sex-specific and age-specific FITNESSGRAM criterion-referenced standards for [Formula: see text]. RESULTS: Norms were displayed as tabulated centiles and as smoothed centile curves for the 20mSRT using 4 common metrics (speed at the last completed stage, completed stages/minutes, laps and relative [Formula: see text]). The final data set included 1 142 026 children and youth from 50 countries, extracted from 177 studies. Boys consistently outperformed girls at each age group (mean difference±95% CI: 0.86±0.28 km/h or 0.79±0.20 standardised units), with the magnitude of age-related increase larger for boys than for girls. A higher proportion of boys (mean±95% CI: 67±14%) had healthy CRE than girls (mean±95% CI: 54±17%), with the prevalence of healthy CRE decreasing systematically with age. CONCLUSIONS: This study provides the most comprehensive and up-to-date set of international sex-specific and age-specific 20mSRT norms for children and youth, which have utility for health and fitness screening, profiling, monitoring and surveillance.

Objectively-measured sleep and its association with adiposity and physical activity in a sample of Canadian children.

Cross-sectional associations between objectively-measured sleep duration, sleep efficiency and sleep timing with adiposity and physical activity were examined in a cohort of 567 children from Ottawa, Canada. Five-hundred and fifteen children (58.8% female; age: 10.0 ± 0.4 years) had valid sleep measurements and were included in the present analyses. Physical activity, sedentary time and sleep parameters were assessed over 7 days (actigraphy). Height, weight and waist circumference were measured according to standardized procedures. Percentage body fat was assessed using bioelectric impedance analysis. Light physical activity and sedentary time were greater in children with the shortest sleep durations (P < 0.0001), whereas children with the highest sleep efficiencies had lower light physical activity and more sedentary time across tertiles (P < 0.0001). In multivariable linear regression analyses, and after adjusting for a number of covariates, sleep efficiency was inversely related to all adiposity indices (P < 0.05). However, sleep duration and sleep timing were not associated with adiposity indices after controlling for covariates. Inverse associations were noted between sleep duration and light physical activity and sedentary time (P < 0.0001). Sleep efficiency (P < 0.0001), wake time and sleep timing midpoint (P < 0.05) were negatively associated with light physical activity, but positively associated with sedentary time. In conclusion, only sleep efficiency was independently correlated with adiposity in this sample of children. Participants with the shortest sleep durations or highest sleep efficiencies had greater sedentary time. More research is needed to develop better sleep recommendations in children that are based on objective measures of sleep duration, sleep efficiency and sleep timing alike.

Correlates of objectively measured sedentary time and self-reported screen time in Canadian children.

BACKGROUND: Demographic, family, and home characteristics play an important role in determining childhood sedentary behaviour. The objective of this paper was to identify correlates of total sedentary time (SED) and correlates of self-reported screen time (ST) in Canadian children. METHODS: Child- and parent-reported household, socio-demographic, behavioural, and diet related data were collected; directly measured anthropometric and accelerometer data were also collected for each child. Participants with complete demographic, anthropometric, and either SED (n=524, 41% boys) or ST (n=567, 42% boys) data from the Canadian site of the International Study of Childhood Obesity Lifestyle and the Environment (ISCOLE) were included in analysis. Sixteen potential correlates of SED and ST were examined using multilevel general linear models, adjusting for sex, ethnicity, number of siblings, and socio-economic status. All explanatory variables moderately associated (p<0.10) with SED and/or ST in univariate analyses were included in the final, fully-adjusted models. Variables that remained significant in the final models (p<0.05) were considered correlates of SED and/or ST. RESULTS: Children averaged 8.5 hours of daily SED; no differences in total SED, or total ST were seen between girls and boys, but boys reported significantly more video game/computer usage than girls. Boys also had higher waist circumference and BMI z-scores than girls. In the final models, waist circumference and number of TVs in the home were the only common correlates of both SED and ST. SED was also negatively associated with sleep duration. ST was also positively associated with mother's weight status, father's education, and unhealthy eating pattern score and negatively associated with healthy eating pattern score, and weekend breakfast consumption. Few common correlates existed between boys and girls. CONCLUSION: Several factors were identified as correlates of SED and/or of ST in Canadian children; however, few correlates were common for both SED and ST, and for both boys and girls. This suggests that a single strategy to reduce SED and ST is unlikely to be effective. Future work should examine a variety of other, non-screen based sedentary behaviours and their potential correlates in the hopes of creating tailored public health messages to reduce SED and ST in both boys, and girls.

Mediating role of television time, diet patterns, physical activity and sleep duration in the association between television in the bedroom and adiposity in 10 year-old children.

BACKGROUND: Having a TV in the bedroom is associated with adiposity in children. It is not known how lifestyle behaviours (television viewing time, diet patterns, physical activity, and sleep duration) mediate this association. The objective of this study was to examine the mediating role of these lifestyle behaviours in the association between TV in the bedroom and percent body fat (% BF). METHODS: Cross-sectional data from 1 201 children (57.3% female; mean age = 9.8 years) from Ottawa, Canada and Baton Rouge, USA were examined. % BF was directly measured. Accelerometers were used to determine physical activity and sleep duration (24-h, 7-day protocol). Questionnaires were used to assess TV viewing time and healthy/unhealthy diet patterns (derived using factor analysis from food frequency questionnaire data). RESULTS: Canadian boys and girls with a TV in their bedroom had a higher % BF, watched more TV and had unhealthier diets. American boys and girls with a TV in their bedroom watched more TV, while boys had a higher % BF and a more unhealthy diet, and girls had less MVPA. In Canadian girls, TV viewing time mediated the association between having a TV in the bedroom and adiposity, independent of diet patterns, MVPA, and sleep duration. Other lifestyle mediators were not significant in Canadian boys or in US children. CONCLUSION: TV viewing is a mediating lifestyle behaviour in the association between TV in the bedroom and adiposity in Canadian girls. Future research is needed to identify lifestyle behaviours as intermediate mediators.

A cross-sectional examination of socio-demographic and school-level correlates of children's school travel mode in Ottawa, Canada.

BACKGROUND: Active school transport (AST) is an important source of children's daily physical activity (PA). However, decreasing rates of AST have been reported in multiple countries during the last decades. The purpose of the present study was to examine the socio-demographic and school-level correlates of AST. METHODS: A stratified sample of children (N = 567, mean age = 10.0 years; 57.8% female) was recruited in the Ottawa area. Four sources of data were used for analyses: 1) child questionnaire including questions on school travel mode and time; 2) parent questionnaire providing information on household socio-demographic characteristics; 3) school administrator survey assessing school policies and practices pertaining to PA; and 4) school site audit performed by the study team. Generalized linear mixed models were used to identify socio-demographic and school-level correlates of AST while controlling for school clustering. RESULTS: Individual factors associated with higher odds of AST were male gender (OR = 1.99; 95% CI = 1.30-3.03), journey time <5 minutes vs. >15 minutes (OR = 2.26; 95% CI = 1.17-4.37), and 5-15 minutes vs. >15 minutes (OR = 2.27; 95% CI = 1.27-4.03). Children were more likely to engage in AST if school administrators reported that crossing guards were employed (OR = 2.29; 95% CI = 1.22-4.30), or if they expressed major or moderate concerns about crime in the school neighbourhood (OR = 3.34; 95% CI = 1.34-8.32). In schools that identified safe routes to school and where traffic calming measures were observed, children were much more likely to engage in AST compared to schools without these features (OR = 7.87; 95% CI = 2.85-21.76). Moreover, if only one of these features was present, this was not associated with an increased likelihood of AST. CONCLUSION: These findings suggest that providing crossing guards may facilitate AST. Additionally, there was a synergy between the identification of safe routes to school and the presence of traffic calming measures, suggesting that these strategies should be used in combination.

Active Healthy Kids Canada's Position on Active Video Games for Children and Youth.

The effect of active video games (AVGs) on acute energy expenditure has previously been reported; however, the influence of AVGs on other health-related lifestyle indicators remains unclear. To address this knowledge gap, Active Healthy Kids Canada (AHKC) convened an international group of researchers to conduct a systematic review to understand whether AVGs should be promoted to increase physical activity and improve health indicators in children and youth (zero to 17 years of age). The present article outlines the process and outcomes of the development of the AHKC's position on active video games for children and youth. In light of the available evidence, AHKC does not recommend AVGs as a strategy to help children be more physically active. However, AVGs may exchange some sedentary time for light- to moderate-intensity physical activity, and there may be specific situations in which AVGs provide benefit (eg, motor skill development in special populations and rehabilitation).

On a déjà rendu compte de l'effet des jeux vidéo actifs (JVA) sur la dépense énergétique aiguë, mais on ne connaît pas leur influence sur d'autres indicateurs du mode de vie liés à la santé. Pour corriger cette lacune, Jeunes en forme Canada (JEFC) a réuni un groupe international de chercheurs afin qu'ils effectuent une analyse systématique pour établir s'il faut promouvoir les JVA pour accroître l'activité physique et améliorer les indicateurs de la santé chez les enfants et les adolescents (de zéro à 17 ans). Le présent article expose le processus et les résultats de l'élaboration de la position des JEFC sur les JVA pour les enfants et les adolescents. À la lumière des données disponibles, JEFC ne recommande pas les JVA comme stratégie pour aider les enfants à faire plus d'activité physique. Cependant, les JVA peuvent transformer un comportement sédentaire en une activité physique d'intensité légère à modérée, et dans certaines situations, les JVA peuvent se révéler bénéfiques (p. ex., développement de la motricité dans des populations ayant des besoins particuliers et dans un cadre de réadaptation).

Scientific sinkhole: estimating the cost of peer review based on survey data with snowball sampling.

BACKGROUND: There are a variety of costs associated with publication of scientific findings. The purpose of this work was to estimate the cost of peer review in scientific publishing per reviewer, per year and for the entire scientific community. METHODS: Internet-based self-report, cross-sectional survey, live between June 28, 2021 and August 2, 2021 was used. Participants were recruited via snowball sampling. No restrictions were placed on geographic location or field of study. Respondents who were asked to act as a peer-reviewer for at least one manuscript submitted to a scientific journal in 2020 were eligible. The primary outcome measure was the cost of peer review per person, per year (calculated as wage-cost x number of initial reviews and number of re-reviews per year). The secondary outcome was the cost of peer review globally (calculated as the number of peer-reviewed papers in Scopus x median wage-cost of initial review and re-review). RESULTS: A total of 354 participants completed at least one question of the survey, and information necessary to calculate the cost of peer-review was available for 308 participants from 33 countries (44% from Canada). The cost of peer review was estimated at $US1,272 per person, per year ($US1,015 for initial review and $US256 for re-review), or US$1.1-1.7 billion for the scientific community per year. The global cost of peer-review was estimated at US$6 billion in 2020 when relying on the Dimensions database and taking into account reviewed-but-rejected manuscripts. CONCLUSIONS: Peer review represents an important financial piece of scientific publishing. Our results may not represent all countries or fields of study, but are consistent with previous estimates and provide additional context from peer reviewers themselves. Researchers and scientists have long provided peer review as a contribution to the scientific community. Recognizing the importance of peer-review, institutions should acknowledge these costs in job descriptions, performance measurement, promotion packages, and funding applications. Journals should develop methods to compensate reviewers for their time and improve transparency while maintaining the integrity of the peer-review process.

Systematic review of sedentary behaviour and health indicators in school-aged children and youth.

Accumulating evidence suggests that, independent of physical activity levels, sedentary behaviours are associated with increased risk of cardio-metabolic disease, all-cause mortality, and a variety of physiological and psychological problems. Therefore, the purpose of this systematic review is to determine the relationship between sedentary behaviour and health indicators in school-aged children and youth aged 5-17 years. Online databases (MEDLINE, EMBASE and PsycINFO), personal libraries and government documents were searched for relevant studies examining time spent engaging in sedentary behaviours and six specific health indicators (body composition, fitness, metabolic syndrome and cardiovascular disease, self-esteem, pro-social behaviour and academic achievement). 232 studies including 983,840 participants met inclusion criteria and were included in the review. Television (TV) watching was the most common measure of sedentary behaviour and body composition was the most common outcome measure. Qualitative analysis of all studies revealed a dose-response relation between increased sedentary behaviour and unfavourable health outcomes. Watching TV for more than 2 hours per day was associated with unfavourable body composition, decreased fitness, lowered scores for self-esteem and pro-social behaviour and decreased academic achievement. Meta-analysis was completed for randomized controlled studies that aimed to reduce sedentary time and reported change in body mass index (BMI) as their primary outcome. In this regard, a meta-analysis revealed an overall significant effect of -0.81 (95% CI of -1.44 to -0.17, p = 0.01) indicating an overall decrease in mean BMI associated with the interventions. There is a large body of evidence from all study designs which suggests that decreasing any type of sedentary time is associated with lower health risk in youth aged 5-17 years. In particular, the evidence suggests that daily TV viewing in excess of 2 hours is associated with reduced physical and psychosocial health, and that lowering sedentary time leads to reductions in BMI.

Systematic review of the health benefits of physical activity and fitness in school-aged children and youth.

BACKGROUND: The purpose was to: 1) perform a systematic review of studies examining the relation between physical activity, fitness, and health in school-aged children and youth, and 2) make recommendations based on the findings. METHODS: The systematic review was limited to 7 health indicators: high blood cholesterol, high blood pressure, the metabolic syndrome, obesity, low bone density, depression, and injuries. Literature searches were conducted using predefined keywords in 6 key databases. A total of 11,088 potential papers were identified. The abstracts and full-text articles of potentially relevant papers were screened to determine eligibility. Data was abstracted for 113 outcomes from the 86 eligible papers. The evidence was graded for each health outcome using established criteria based on the quantity and quality of studies and strength of effect. The volume, intensity, and type of physical activity were considered. RESULTS: Physical activity was associated with numerous health benefits. The dose-response relations observed in observational studies indicate that the more physical activity, the greater the health benefit. Results from experimental studies indicate that even modest amounts of physical activity can have health benefits in high-risk youngsters (e.g., obese). To achieve substantive health benefits, the physical activity should be of at least a moderate intensity. Vigorous intensity activities may provide even greater benefit. Aerobic-based activities had the greatest health benefit, other than for bone health, in which case high-impact weight bearing activities were required. CONCLUSION: The following recommendations were made: 1) Children and youth 5-17 years of age should accumulate an average of at least 60 minutes per day and up to several hours of at least moderate intensity physical activity. Some of the health benefits can be achieved through an average of 30 minutes per day. [Level 2, Grade A]. 2) More vigorous intensity activities should be incorporated or added when possible, including activities that strengthen muscle and bone [Level 3, Grade B]. 3) Aerobic activities should make up the majority of the physical activity. Muscle and bone strengthening activities should be incorporated on at least 3 days of the week [Level 2, Grade A].

Smoking behaviour among nurses in Ontario: cross-sectional results from the Champlain Nurses' Study.

OBJECTIVE: Nurses comprise the largest professional group within the Canadian health care workforce. We aimed to assess the prevalence and correlates of smoking among nurses. METHODS: The Champlain Nurses' Study was a multi-centre, observational study that evaluated the physical activity levels and health of hospital-based nurses. Participants completed a series of self-report questionnaires addressing a variety of health indicators including smoking status and smoking history. Multi-level modelling was used to examine variability in smoking status across hospital sites and to identify correlates of current smoking. RESULTS: A total of 406 nurses, from 14 urban and rural hospitals, were included in this analysis. On average, the nurses were 42.9 (standard deviation (SD), 11.9) years old, had a waist circumference of 78.7 (95% confidence interval (CI): 77.5, 80.2) cm and body mass index of 25.9 (95% CI: 25.3, 26.5) kg/m2, worked in urban hospitals (81.3%), and had either a university bachelor's (46.9%) or college (39.6%) education. Most participants (92.0%) reported that they are not current smokers, 4.0% reported that they currently smoke occasionally, and 4.0% reported that they are current daily smokers. Smokers were more likely to be working in rural hospitals than urban hospitals (34.4% versus 17.4% respectively, p = 0.018), associated with having a higher waist circumference (mean difference = 4.5 (SD, 2.1), p = 0.035), a college but not university education (71.9% versus 36.9%, respectively, p < 0.001), lower scores for the Barriers Specific Self-Efficacy Scale (mean difference = - 9.7 (SD, 4.6), p = 0.038), and higher scores for the Profile of Mood States scale (mean difference = 2.0 (SD, 3.3), p = 0.007). The only correlate that remained statistically significant in the final, multivariate model was marital status; however, this analysis may be underpowered. CONCLUSIONS: The prevalence of nurse smokers in our population is lower than previous estimates, and consistent with global declines in cigarette smoking. However, smoking was still prominent and associated with several other risk factors. Given the important relationship between smoking and health, and the critical role that nurses play in health care delivery, they should be an important focus for smoking cessation initiatives and other health education initiatives.

At-a-glance - Twenty years of diabetes surveillance using the Canadian Chronic Disease Surveillance System. / Aperçu - Vingt ans de surveillance du diabète grâce au Système canadien de surveillance des maladies chroniques.

In 1999, the Government of Canada, along with the provinces and territories, established the National Diabetes Surveillance System (NDSS) to track rates of diabetes in Canada. The NDSS used a novel method to systematically collect and report national diabetes data using linked administrative health databases. The NDSS has since evolved to become the Canadian Chronic Disease Surveillance System (CCDSS) and provides information on over 20 chronic conditions. This At-a-glance report provides the most up-to-date CCDSS information on diabetes rates in Canada. Currently, 8.8% of Canadians (9.4% male, 8.1% female, aged one year and older) live with diabetes, and approximately 549 new cases are diagnosed each day. Since 2000, the age-standardized prevalence rate has increased by an average of 3.3% per year. The age-standardized incidence rate has remained relatively stable, and all-cause mortality rates among those with diabetes have decreased by an average of 2.1% per year. This suggests that people are living longer with a diabetes diagnosis.

The Canadian Chronic Disease Surveillance System has provided important information on diabetes rates in Canada since 2000. Currently, 8.8% of Canadians (9.4% male, 8.1% female, aged one year and older) live with diabetes. The age-standardized prevalence rate of diabetes has increased over time, whereas the age-standardized incidence rate has remained stable. The all-cause mortality rate among those with diabetes has decreased, suggesting people are living longer with a diabetes diagnosis.

Le Système canadien de surveillance des maladies chroniques fournit des renseignements importants sur les taux de diabète au Canada depuis 2000. Actuellement, 8,8 % des Canadiens (9,4 % des hommes et 8,1 % des femmes d'un an et plus) sont atteints de diabète. Le taux de prévalence du diabète normalisé selon l'âge a augmenté avec le temps, tandis que le taux d'incidence normalisé selon l'âge est demeuré stable. Le taux de mortalité toutes causes confondues chez les personnes atteintes de diabète a diminué, ce qui donne à penser que l'on vit plus longtemps avec un diagnostic de diabète.

Scientific sinkhole: The pernicious price of formatting.

OBJECTIVE: To conduct a time-cost analysis of formatting in scientific publishing. DESIGN: International, cross-sectional study (one-time survey). SETTING: Internet-based self-report survey, live between September 2018 and January 2019. PARTICIPANTS: Anyone working in research, science, or academia and who submitted at least one peer-reviewed manuscript for consideration for publication in 2017. Completed surveys were available for 372 participants from 41 countries (60% of respondents were from Canada). MAIN OUTCOME MEASURE: Time (hours) and cost (wage per hour x time) associated with formatting a research paper for publication in a peer-reviewed academic journal. RESULTS: The median annual income category was US$61,000-80,999, and the median number of publications formatted per year was four. Manuscripts required a median of two attempts before they were accepted for publication. The median formatting time was 14 hours per manuscript, or 52 hours per person, per year. This resulted in a median calculated cost of US$477 per manuscript or US$1,908 per person, per year. CONCLUSIONS: To our knowledge, this is the first study to analyze the cost of manuscript formatting in scientific publishing. Our results suggest that scientific formatting represents a loss of 52 hours, costing the equivalent of US$1,908 per researcher per year. These results identify the hidden and pernicious price associated with scientific publishing and provide evidence to advocate for the elimination of strict formatting guidelines, at least prior to acceptance.

Cannabis use among middle and high school students in Ontario: a school-based cross-sectional study.

BACKGROUND: Cannabis use can have serious detrimental effects in children and adolescents. It is therefore important to continually assess the use of cannabis among young people in order to inform prevention efforts. We assessed the prevalence of cannabis use among middle and high school students in Ontario and examined its association with demographic and behavioural factors. METHODS: Data were obtained from the 2015 Ontario Student Drug Use and Health Survey, a province-wide school-based survey of students in grades 7 through 12. Analyses included a representative sample of 9920 middle and high school students. Bivariate cross-tabulations and logistic regression analyses were used to investigate the factors associated with cannabis use. RESULTS: Overall, 21.5% and 13.9% of students reported using cannabis in the previous year and previous month, respectively. The conditional probability that an adolescent who reported cannabis use in the previous year would report daily use was 12.5%. There was a significant dose-response gradient with age, with older students being more likely to use cannabis than younger students. In multivariable analyses, being in grades 10 through 12 (odds ratios [ORs] ranged from 3.71 to 3.85), being black (OR 2.67 [95% confidence interval (CI) 1.76-4.05]), using tobacco cigarettes (OR 10.10 [95% CI 8.68-13.92]) and being an occasional (OR 5.35 [95% CI 4.01-7.13]) or regular (OR 14.6 [95% CI 10.8-19.89]) alcohol user were associated with greater odds of cannabis use. Being an immigrant was associated with lower odds of cannabis use (OR 0.55 [95% CI 0.39-0.78]). INTERPRETATION: The findings suggest that cannabis use is prevalent among middle and high school students in Ontario and is strongly associated with tobacco cigarette smoking and alcohol consumption. Future research should document trends in cannabis use over time, including its risks, especially when the legalization of recreational cannabis comes into effect.

Prospective, Cluster-Randomized Trial to Implement the Ottawa Model for Smoking Cessation in Diabetes Education Programs in Ontario, Canada.

OBJECTIVE: To test whether a practice-level intervention to promote the systematic identification, treatment, and follow-up of smokers (the Ottawa Model for Smoking Cessation [OMSC]) would improve long-term abstinence rates among smoker-patients with type 2 diabetes or prediabetes receiving care from diabetes education programs in Ontario, Canada. RESEARCH DESIGN AND METHODS: The Tobacco Intervention in Diabetes Education study was a matched-pair, cluster-randomized clinical trial. Within each pair, sites were randomly allocated to either an OMSC intervention (n = 7) or a wait-list control (WLC) condition (n = 7). Diabetes education programs in the OMSC group introduced standardized processes to identify smokers and routinely provided smoking cessation interventions and follow-up. Smokers in the OMSC group received counseling, a discount card to partially cover the cost of smoking cessation medication, and follow-up telephone calls over a 6-month period. Diabetes education programs in the WLC condition were offered the OMSC intervention after a 1-year waiting period. Smokers in the WLC group received usual care for smoking cessation from their diabetes educator. The primary end point was carbon monoxide (CO)-confirmed 7-day point prevalence abstinence from smoking at 6-month follow-up. RESULTS: A total of 313 smokers (OMSC group n = 199, WLC group n = 114) with diabetes or prediabetes were enrolled. The CO-confirmed abstinence rate at 6 months was 11.1% in the OMSC group versus 2.6% in the WLC group (odds ratio 3.73 [95% CI 1.20, 11.58]; P = 0.02). CONCLUSIONS: Implementation of the OMSC in diabetes education programs resulted in clinically and statistically significant improvements in long-term abstinence among smokers with diabetes or prediabetes.

Measurement of sedentary behaviour in population health surveys: a review and recommendations.

BACKGROUND: The purpose of this review was to determine the most valid and reliable questions for targeting key modes of sedentary behaviour (SB) in a broad range of national and international health surveillance surveys. This was done by reviewing the SB modules currently used in population health surveys, as well as examining SB questionnaires that have performed well in psychometric testing. METHODS: Health surveillance surveys were identified via scoping review and contact with experts in the field. Previous systematic reviews provided psychometric information on pediatric questionnaires. A comprehensive search of four bibliographic databases was used to identify studies reporting psychometric information for adult questionnaires. Only surveys/studies published/used in English or French were included. RESULTS: The review identified a total of 16 pediatric and 18 adult national/international surveys assessing SB, few of which have undergone psychometric testing. Fourteen pediatric and 35 adult questionnaires with psychometric information were included. While reliability was generally good to excellent for questions targeting key modes of SB, validity was poor to moderate, and reported much less frequently. The most valid and reliable questions targeting specific modes of SB were combined to create a single questionnaire targeting key modes of SB. DISCUSSION: Our results highlight the importance of including SB questions in survey modules that are adaptable, able to assess various modes of SB, and that exhibit adequate reliability and validity. Future research could investigate the psychometric properties of the module we have proposed in this paper, as well as other questionnaires currently used in national and international population health surveys.