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Segal R.,The Ottawa Hospital | Zwaal C.,McMaster University | Green E.,Canadian Partnership Against Cancer | Tomasone J.R.,Kingston University | And 2 more authors.
Current Oncology | Year: 2017

Background Development of this guideline was undertaken by the Exercise for People with Cancer Guideline Development Group, a group organized by Cancer Care Ontario’s Program in Evidence-Based Care (PEBC). The purpose of the guideline was to provide guidance for clinicians with respect to exercise for patients living with cancer, focusing on the benefits of specific types of exercise, recommendations about screening requirements for new referrals, and safety concerns. Methods Consistent with the pebc’s standardized approach, a systematic search was conducted for existing guidelines, and systematic literature searches were performed in medline and embase for both systematic reviews and primary literature. Content and methodology experts performed an internal review, which was followed by an external review by targeted experts and intended users. Results The search identified three guidelines, eighteen systematic reviews, and twenty-nine randomized controlled trials with relevance to the topic. The present guideline provides recommendations for the duration, frequency, and intensity of exercise appropriate for people living with cancer. It also provides recommendations for pre-exercise assessment, safety concerns, and delivery models. Conclusions There is sufficient evidence to show that exercise provides benefits in quality of life and muscular and aerobic fitness for people with cancer both during and after treatment, and that it does not cause harm. The present guideline is intended to support the Canadian Society for Exercise Physiology’s Canadian physical activity guidelines. The recommendations are intended for clinicians and institutions treating cancer patients in Ontario, and for policymakers and program planners involved in the delivery of exercise programs for cancer patients. © 2017 Multimed Inc.


Bryant H.,Canadian Partnership Against Cancer
Cancer Forum | Year: 2014

There are few topics in medical science that arouse as much controversy - and as much passion - as the role of mammography in breast cancer screening. Part of the reason for continued debate lies within the complexity of the audiences for any recommendations made. The recent emphasis has been upon the individual weighing personal benefit and risk. Public health recommendations however, are based upon the overall population-based estimates of risk and benefit. In particular, population-based screening programs and public messaging must, by definition, come to conclusions about the best course of action based on a weighting of the risks and benefits for 'average' women in a specific population. This overview provides a window into the current analyses of the risk and benefits of mammography screening, and of the impact of these debates on considerations of programmatic screening. It examines current information on the perceived benefits and risks, the recent move towards individualised decisions of risks and benefits, and the role of public health messaging and population-based programs within this context. © 2014, Cancer Council Australia. All rights reserved.


Sutcliffe S.B.,Canadian Partnership Against Cancer | Sutcliffe S.B.,Terry Fox Research Institute
Cancer | Year: 2011

Canada is a westernized, market-economy nation with a publicly funded health care and cancer control system and has health indices reflective of a high-resource economy. Provision of health services is in accord with the Canada Health Act and is implemented through federal, provincial, and territorial relations wherein federal funding partly provides support for the provincial/territorial delivery of health services. Cancer services are provided within the acute health care system with dedicated entities existing in parallel in most provinces to provide services specific to the diagnosis, treatment, and support of cancer patients. Interprovincial and territorial collaboration to enhance and facilitate optimal cancer system performance is enabled through the Canadian Partnership Against Cancer (the Canadian national cancer control initiative). Adolescent and young adult (AYA) cancer patients use both the pediatric and adult cancer systems. There is recognition, however, that although AYA patients are numerically a small portion of all cancer patients, the negative personal, societal, and socioeconomic impacts of potential years of life lost are substantial and can be lessened through attention to awareness, education, redesign of care and care pathways, quality of life, developmental aspects related to adolescent-teen-adult transitions, continuity of care, and surveillance across pediatric and adult settings. Appropriate solutions need to be established within the framework of the Canadian Health Service by innovative rethinking and realignment of system capacity and performance to the special needs of AYA cancer patients. Copyright © 2011 American Cancer Society.


Green E.,Canadian Partnership Against Cancer | Moody L.,Cancer Care Ontario
Healthcare Papers | Year: 2015

The authors of the paper, "The Patient Experience in Ontario 2020: What is Possible?", framed both the current state as well as the future of what patient experience might look like in five years. To ensure intention is catalyzed into meaningful change to improve experience and outcomes, we suggest four winning conditions. The first is to change the language; patients are people too, irrespective of their disease or illness; person-centred is inclusive language and ought to be the focus. The second condition is focused on leaders who play a critical role to establish, build and embed person-centred within the organization. The third and fourth winning conditions are building the evidence base and using effective and meaningful engagement, moving beyond advice, to partnership, respectively. Person-centred care is not the flavour of the month, it is here to stay. Ontarians are important actors in the system not only as users of the system but owners as well. To those who might argue that it is costly to do this work, what are the costs to not engage? Are we satisfied not only as administrators, and clinicians, but as patients at some point, to maintain the status quo?.


Rabin B.A.,Kaiser Permanente | Glasgow R.E.,Kaiser Permanente | Kerner J.F.,Canadian Partnership Against Cancer | Klump M.P.,Washington University in St. Louis | Brownson R.C.,Prevention Research Center In St Louis
American Journal of Preventive Medicine | Year: 2010

Context: An extensive array of effective interventions for the prevention of cancer exists, suggesting that evidence is ready for widespread use. However, few of these approaches have been extensively utilized in real-world settings. Further, little is known on how to best disseminate and implement evidence-based interventions for the primary prevention of cancer in community settings. Evidence acquisition: A systematic review of the dissemination and implementation literature was conducted between 2006 and 2008 in the topic areas of smoking, healthy diet, physical activity, and sun protection. English-language peer-reviewed articles published between 1980 and 2008 that met the inclusion criteria were classified by suitability of study design (i.e., greatest, moderate, least); quality of execution (i.e., good, fair, limited); and effectiveness (i.e., substantial, some, or little/no evidence of effectiveness) and were abstracted for dissemination- and implementation-related content. Evidence synthesis: Twenty-five unique dissemination and implementation studies were identified. The majority of included studies were conducted in the U.S., in schools, and with children as the ultimate target population, had the least suitability of study design, had fair or limited execution, and used a theoretic framework, active dissemination and implementation approaches, and multimodal strategies. There was considerable heterogeneity across studies in reported mediators, moderators, and outcomes. Conclusions: Key implications from this review include the need for uniform language, studies targeting various populations and settings, valid and reliable measures, triangulation of and more practice-based evidence, standardized reporting criteria, and active and multimodal strategies. © 2010 American Journal of Preventive Medicine.


Ellison L.F.,Health Statistics Division at Statistics Canada | Bryant H.,Canadian Partnership Against Cancer | Lockwood G.,Canadian Partnership Against Cancer | Shack L.,University of Calgary
Health Reports | Year: 2011

Survival estimates measured from the time of a cancer diagnosis become less informative after one or two years' survival. Using records from the Canadian Cancer Registry linked to the Canadian Vital Statistics Death Database, five-year conditional relative survival ratio (RSR) estimates were derived for a large number of cancers. For each cancer with an initial five-year RSR of at least 80% (except breast cancer), a conditional five-year RSR of 95% or more was achieved after five years' survival. Among cancers with initial five-year RSRs of 50% to 79%, a five-year conditional RSR of 95% or more was observed for cancers of the cervix uteri and colon after five years. There was no apparent improvement in survival prospects during the first five years after diagnosis for chronic lymphocytic leukemia (CLL). Despite initial prognoses of less than 50%, a conditional five-year RSR of at least 90% five years after diagnosis was achieved for stomach cancer and leukemia (excluding CLL).


Kerner J.,Canadian Partnership Against Cancer
Asian Pacific journal of cancer prevention : APJCP | Year: 2012

Substantial differences in population-based cancer control outcomes exist within and between nations. Optimal outcomes derive from 'what we know', 'what we apply in practice', and 'how complete and compliant is the population uptake of public health and clinical practice change'. This continuum of research (scientific discovery) to practice (application and uptake) to policy impacts the speed and completeness of practice change and is greatly influenced by the ability, opportunity and readiness of countries to implement evidence informed practices and policies through innovative change. Session 4 of the 4th International Cancer Control Congress focused on knowledge exchange through three plenary presentations and five interactive workshop discussions: 1) the role of epidemiological data as a basis for policy formulation; 2) existing global frameworks for cancer control; 3) knowledge exchange as it relates to public health practice and policy; 4) knowledge exchange in relation to primary, community, and specialist cancer care; and 5) the role of public engagement and advocacy in influencing cancer control policy. Common themes emerging from workshop discussions included the recognition of the importance of knowledge exchange processes, constituents and forums as key aspects of preparedness, awareness and readiness to implement public health and clinical practice change. The importance of cultural and contextual differences between nations was identified as a challenge requiring development of tools for generating relevant population/societal data (e.g., projection methodologies applied to population demographics, outcomes and resources, both societal, human and fiscal) and capacity building for facilitating knowledge transfer and exchange between the constituencies engaged in population-based public health practice and clinically based primary care and disease specialty practice exchange (researchers, health practitioners, health administrators, politicians, patients and families, and the private and public sectors). Understanding patient and public engagement advocacy and its role in influencing health and public policy investment priorities emerged as a critical and fundamental aspect of successful implementation of evidence-informed cancer control change.


Bryant H.,Canadian Partnership Against Cancer
Asian Pacific journal of cancer prevention : APJCP | Year: 2012

The goals of cancer control strategies are generally uniform across all constituencies and are to reduce cancer incidence, reduce cancer mortality, and improve quality of life for those affected by cancer. A well-constructed strategy will ensure that all of its elements can ultimately be connected to one of these goals. When a cancer control strategy is being implemented, it is essential to map progress towards these goals; without mapping progress, it is impossible to assess which components of the strategy require more attention or resources and which are not having the desired effect and need to be re-evaluated. In order to monitor and evaluate these strategies, systems need to be put in place to collect data and the appropriate indicators of performance need to be identified. Session 2 of the 4th International Cancer Control Congress (ICCC-4) focused on how to manage population health to prevent and detect cancers and non-communicable diseases through two plenary presentations and four interactive workshop discussions: 1) registries, measurement, and management in cancer control; 2) use of information for planning and evaluating screening and early detection programs; 3) alternative models for promoting community health, integrated care and illness management; and 4) control of non-communicable diseases. Workshop discussions highlighted that population based cancer registries are fundamental to understanding the cancer burden within a country. However, many countries in Africa, Asia, and South/ Central America do not have them in place. A new global initiative is underway, which brings together several international agencies, and aims to establish six IARC regional registration resource centres over the next five years. These will provide training, support, infrastructure and advocacy to local networks of cancer registries, and, it is hoped, improve the host countries' ability to assess and act on cancer issues within their jurisdictions. Multiple methods of programme evaluation were presented across workshops, but all were attuned to both the resource base and the specific questions to be addressed. Where innovative strategies were being tested, customized evaluation strategies should be undertaken. Where programmes are well-developed and data is being collected for evaluation, there is the opportunity for sophisticated analytical methods to be used to pinpoint specific areas or delivery sites for future quality improvement. Finally, unique opportunities now exist to integrate the strategies developed in cancer control and evaluation with those under development for other non-communicable diseases. This area will likely be one for future development.


Law M.,McMaster University | Hanna S.,McMaster University | Anaby D.,McGill University | Kertoy M.,University of Western Ontario | And 3 more authors.
BMC Pediatrics | Year: 2014

Background: Outcomes of health and rehabilitation services for children and youth with disabilities increasingly include assessments of health-related quality of life (HRQoL). The purpose of this research was to 1) describe overall patterns of HRQoL, 2) examine changes in parent's perceptions of child's HRQoL across 18 months and 3) explore factors that predict these changes.Methods: Participants in this study included 427 parents of children (229 boys and 198 girls) with a physically-based disability between the ages of 6 to 14 years. The Child Health Questionnaire (CHQ) was administered three times, at nine month intervals. Comparisons to the CHQ normative data were analyzed at Time 1 using t-tests, and change over time was examined using linear mixed-effects models. Possible predictors were modeled: 1) child's factors measured by the Activities Scale for Kids, Strengths and Difficulties Questionnaire, and general health measured by SF-36, 2) family characteristics measured by the Impact on Family Scale and 3) environmental barriers measured by the Craig Hospital Inventory of Environmental Factors.Results: CHQ scores of the study's participants demonstrated significantly lower summary scores from the normative sample for both CHQ Physical and Psychosocial summary scores. On average, children did not change significantly over time for physical summary scores. There was an average increase in psychosocial health that was statistically significant, but small. However, there was evidence of heterogeneity among children. Environmental barriers, behavioral difficulties, family functioning/impact, general health and child physical functioning had negative and significant associations with physical QoL at baseline. Change in physical QoL scores over time was dependent on children's behavioral difficulties, family functioning and environmental barriers. Environmental barriers, behavioral difficulties, family functioning/impact and general health had significant associations with psychosocial scores at baseline, but none served as predictors of change over time.Conclusions: Children with physical disabilities differ from the normative group on parent ratings of their physical and psychosocial health. While there was little average change in CHQ scores over 18 months, there is evidence of heterogeneity among children. Factors such as environmental barriers, family functioning/impact, child physical functioning and behavioral difficulties and general health significantly influence QoL scores as measured by the CHQ. © 2014 Law et al.; licensee BioMed Central Ltd.


Trademark
Canadian Partnership Against Cancer | Date: 2016-08-25

printed and electronic publications, namely, reports, bulletins, guides, statistical reports, online and print advertisements, promotional flyers, brochures and banners in the fields of disease of cancer, cancer prevention, cancer screening and detection, cancer diagnosis and clinical care, cancer research, cancer risk factors, cancer epidemiology, cancer health system resources, cancer health care policies, cancer control tools, cancer patient experience, cancer supportive care, cancer workforce, cancer guidelines, cancer control and treatment funding, cancer treatment and therapeutic options, cancer patient and family support. operation of a website featuring information in the fields of disease of cancer, cancer prevention, cancer screening and detection, cancer diagnosis and clinical care, cancer research, cancer risk factors, cancer epidemiology, cancer health system resources, cancer health care policies, cancer control tools, cancer patient experience, cancer supportive care, cancer workforce, cancer guidelines, cancer control and treatment funding, cancer treatment and therapeutic options, cancer patient and family support; providing access to a website featuring forums, blogs and other online collaborative spaces for exchanging information, experiences and ideas in the fields of disease of cancer, cancer prevention, cancer screening and detection, cancer diagnosis and clinical care, cancer research, cancer risk factors, cancer epidemiology, cancer health system resources, cancer health care policies, cancer control tools, cancer patient experience, cancer supportive care, cancer workforce, cancer guidelines, cancer control and treatment funding, cancer treatment and therapeutic options, cancer patient and family support; operating social media sites providing information in the fields of disease of cancer, cancer prevention, cancer screening and detection, cancer diagnosis and clinical care, cancer research, cancer risk factors, cancer epidemiology, cancer health system resources, cancer health care policies, cancer control tools, cancer patient experience, cancer supportive care, cancer workforce, cancer guidelines, cancer control and treatment funding, cancer treatment and therapeutic options, cancer patient and family support; creating, maintaining and providing access to a website to provide educational information and resources in the nature of online interactive tutorials, video recordings and information in the fields of disease of cancer, cancer prevention, cancer screening and detection, cancer diagnosis and clinical care, cancer research, cancer risk factors, cancer epidemiology, cancer health system resources, cancer health care policies, cancer control tools, cancer patient experience, cancer supportive care, cancer workforce, cancer guidelines, cancer control and treatment funding, cancer treatment and therapeutic options, cancer patient and family support; coordinating public and professional awareness and education through seminars, educational webinars, workshops, presentations, and the distribution of educational materials in the fields of disease of cancer, cancer prevention, cancer screening and detection, cancer diagnosis and clinical care, cancer research, cancer risk factors, cancer epidemiology, cancer health system resources, cancer health care policies, cancer control tools, cancer patient experience, cancer supportive care, cancer workforce, cancer guidelines, cancer control and treatment funding, cancer treatment and therapeutic options, cancer patient and family support; providing access to online video recordings and publications, namely, reports, bulletins, guides, whitepapers, newsletters, studies, commentaries, books, abstracts, journal articles, journals, magazine articles, presentations, interviews, editorials all in the fields of disease of cancer, cancer prevention, cancer screening and detection, cancer diagnosis and clinical care, cancer research, cancer risk factors, cancer epidemiology, cancer health system resources, cancer health care policies, cancer control tools, cancer patient experience, cancer supportive care, cancer workforce, cancer guidelines, cancer control and treatment funding, cancer treatment and therapeutic options, cancer patient and family support; summarizing and providing online access to thematic summary documents on publications in the fields of disease of cancer, cancer prevention, cancer screening and detection, cancer diagnosis and clinical care, cancer research, cancer risk factors, cancer epidemiology, cancer health system resources, cancer health care policies, cancer control tools, cancer patient experience, cancer supportive care, cancer workforce, cancer guidelines, cancer control and treatment funding, cancer treatment and therapeutic options, cancer patient and family support; providing education and training services, namely, organizing, managing and offering seminars and conferences in the fields of disease of cancer, cancer prevention, cancer screening and detection, cancer diagnosis and clinical care, cancer research, cancer risk factors, cancer epidemiology, cancer health system resources, cancer health care policies, cancer control tools, cancer patient experience, cancer supportive care, cancer workforce, cancer guidelines, cancer control and treatment funding, cancer treatment and therapeutic options, cancer patient and family support. providing consultation services in the fields of disease of cancer, cancer prevention, cancer screening and detection, cancer diagnosis and clinical care, cancer research, cancer risk factors, cancer epidemiology, cancer health system resources, cancer health care policies, cancer control tools, cancer patient experience, cancer supportive care, cancer workforce, cancer guidelines, cancer control and treatment funding, cancer treatment and therapeutic options, cancer patient and family support; providing access over the internet to computer software that collects and analyzes data relating to the fields of disease of cancer, cancer prevention, cancer screening and detection, cancer diagnosis and clinical care, cancer research, cancer risk factors, cancer epidemiology, cancer health system resources, cancer health care policies, cancer control tools, cancer patient experience, cancer supportive care, cancer workforce, cancer guidelines, cancer control and treatment funding, cancer treatment and therapeutic options, cancer patient and family support; providing temporary use of computer software for use in the fields of population based modeling, simulation, and optimization for assessing and analyzing the impact of environmental, healthcare, health and economic variables related to cancer control and prevention on population health and the healthcare system; providing temporary access and use of computer software for analysis, modeling, and simulation of environmental, healthcare, health and economic variables related to cancer control and prevention. conducting research in the fields of cancer and related health system services; conducting research in the field of population based modeling, simulation, and optimization for assessing and analyzing the impact of environmental, healthcare, health and economic variables related to cancer control and prevention on population health and the healthcare system; conducting studies in the field of cancer-related health and lifestyle; seeking trends, patterns and regional, national and international differences in relation to the causes and control of cancer; providing simulations and projections related to cancer control.

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