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IntroductionMechanical ventilation (MV) is an important intervention used in critically ill patients. Accurately identifying MV use in Hospital Discharge Abstracts will be extremely useful in population-based research. Although Canadian Institute for Health Information collects information on MV for all hospitalization, its validity in intensive care unit (ICU) patients is unknown.
Objectives and ApproachWe validated MV use within ICU patients in Hospital Discharge Abstracts. Winnipeg Regional Health Authority (WRHA) ICU database prospectively collects use of MV by trained nurses. All patients admitted to a WRHA ICU (82 beds) between April 1, 2000 and March 31, 2012 were identified in Hospital Discharge Abstracts. MV was identified in Hospital Discharge Abstracts through International Classification of Diseases (ICD-9-CM), prior to 2004, while Canadian Classification of Health Interventions (CCI) were used 2004 onwards. Agreement between the WRHA database (gold standard) and Hospital Discharge Abstracts for invasive ventilation, non-invasive ventilation or neither was calculated at ICU encounter level.
ResultsThere were 54,680 WRHA ICU admission during the study period. The linking of these two sources was highly successful with accurate identification exceeding 99%. There were 26,083 mechanical ventilations (25,387 invasive; 696 non-invasive) from the Hospital Discharge Abstracts and 30,455 (28,315 invasive; 4,554 non-invasive) from the CIC data. Hospital Discharge Abstracts had a sensitivity of 82.8%, specificity of 96.4%, Positive Predictive Value (PPV) of 96.7%, and Negative Predictive Value (NPV) of 81.7% for identifying mechanical ventilation. For invasive ventilation, Sensitivity was 85.5%, Specificity was 95.6%, PPV was 95.4% and NPV was 86.0%. Validation of non-invasive ventilation was poor in sensitivity (9.38%) and PPV (61.35%): with specificity 99.5% and NPV 92.36%.
Conclusion/ImplicationsHospital Abstracts data are a good source to identity mechanically ventilated patients for ICU containing hospital stays especially invasive mechanical ventilations. Future research needs to explore the poor agreement with non-invasive mechanical ventilation.

IntroductionOut-of-school programs for grade K-12 students support healthy behaviours, boost academic achievement, and strengthen social networks. The Boys and Girls Clubs of Winnipeg (BGCW) have been active for 40+ years; however, little is known about how participating in their programs influences students' short- and long-term health, educational and social outcomes.
Objectives and ApproachWe are investigating the association between participation in BGCW out-of-school programs using the individual-level data held in the population-based Manitoba Population Research Data Repository at the Manitoba Centre for Health Policy (MCHP). Data on BGCW program participation for children born 1987-2010 was linked with administrative records from the healthcare system, education system, and social services. The comparison group of non-participants was matched on age, sex, 3-digit postal code and school division. Outcomes of interest include health services use, teen pregnancy, grade repetition, high school graduation, enrollment in post-secondary institutions, receipt of income assistance, and involvement with the justice system.
ResultsWe conducted analyses of children (K-8) attending the Community Schools Investigator (CSI) summer enrichment program, an academic and recreational program that aims to combat learning loss for children in low-income neighbourhoods. After one summer of CSI, participants (n=970) were significantly more likely to repeat a grade than the matched comparison group (n=783) (5.4% CSI students repeated a grade [95% CI 3.9, 6.8] vs 2.76% comparison students [95% CI 2.20, 3.32]). However, the likelihood of CSI students repeating a grade dropped to the level of the comparison group after two or more years of participation in CSI (2.91% CSI students repeated a grade [95% CI 1.26, 4.56]). Ongoing analyses are examining how participating in CSI and other BGCW programs is linked to health and social outcomes.
Conclusion/ImplicationsOur findings suggest that engagement in a BGCW out-of-school summer program contributes to better educational outcomes for low-income students. Using the information-rich Data Repository at MCHP, we can examine additional outcomes across multiple sectors to demonstrate how out-of-school programs help young people achieve their full developmental potential.

ABSTRACT
ObjectivesRoots of Empathy is a school-based mental health program with demonstrated effectiveness in reducing bullying and aggression, and raising children's social/emotional competence and empathy. This study examines the program's impact on several longer-term health and social outcomes that are related to the program's goals, but not specifically targeted by the program's design or objectives.
ApproachThis study used linked, de-identified administrative records of health, education, social service use and justice system involvement for children and youth in Manitoba who participated in the ROE program, along with a carefully matched comparison group. Propensity scores were used along with hard matching on key variables to ensure comparability of groups. Outcome measures encompass a broad array of health, educational, and social indicators including hospitalization for injury, teen pregnancy, high school graduation, involvement with the criminal justice system, and suicide attempts. Analyses were performed at the Manitoba Centre for Health Policy (MCHP), using SAS 9.4.
ResultsFindings from analyses of data from the pilot study (N=688) reveal several 'collateral benefits' that may be related to the program, though most differences did not reach statistical significance in this initial sample. (Results from the full sample will be available May 2016; N ~ 8000.) Compared to matched counterparts who did not receive the program, ROE participants had lower rates of teen pregnancy (6.6% vs 9.6%; p=0.19), and school grade repetition (2.4% vs 3.8%, p=0.09), and higher rates of high school graduation (77.7% vs 73.5%, p=.36). However, they also had higher rates of injury-related hospitalization (6.4% vs 5.0%, p=0.14). Even in this small pilot, sub-group analyses for some outcomes showed significant differences for some strata but not others. Analyses of the full study group (underway) will provide more robust results.
ConclusionThese findings provide intriguing evidence suggesting beneficial impacts in several longer-term health and social outcomes that could feasibly be related to participation in the Roots of Empathy program. The multi-variable propensity scores and hard-matching algorithms used on this large group provide considerable confidence in attributing group differences to program participation. Results from the full sample will provide more conclusive results, and allow sub-group analyses. The linkage of databases from health, education, social service and justice systems provides a unique opportunity to examine the truly multi-dimensional long-term impacts of a program already proven to provide dramatic improvements in short and medium-term outcomes.

IntroductionThe relationship between childhood/adolescent mental disorders and adult outcomes has been studied using surveys and clinical samples. These studies are prone to selection, recall and self-reporting biases. No previous studies have used population-based administrative databases linking individual-level data that could address these biases and further elucidate this relationship.
Objectives and ApproachUsing de-identified administrative databases housed at the Manitoba Centre for Health Policy, we aimed to determine whether people diagnosed with mental disorders in childhood/adolescence, compared to those without, were at higher risk of early adverse adult outcomes. We created a birth cohort of 60,838 residents of Manitoba, Canada, born from fiscal years 1980/81 to 1984/85 and followed them to the end of study period in 2014/15. Through a scrambled health identifier, health, education, social services and justice system data were linked at an individual level. Survival analysis was used to test for differences controlling for key childhood covariates.
ResultsWe found that 16.5% of the cohort had a diagnosed mental disorder at some point in their childhood/adolescence. Having a diagnosed mental disorder in childhood/adolescence increased the risk of being diagnosed with the same disorder in early adulthood (at age 30 to 34 years old). It also increased the risk of suicidal death (hazard ratio (HR): 2.41), suicide attempts (HR: 3.05), public housing use (HR: 1.44), income assistance use (HR: 2.07), criminal accusation (HR:1.53), and criminal victimization (HR:1.54) in adulthood. Similarly, but to a greater extent, suicide attempts in adolescence increased the risk of suicidal death (HR: 3.65), suicide attempts (HR: 5.68), public housing use (HR: 1.64), income assistance use (HR: 1.68), criminal accusation (HR: 2.18), or criminal victimization (HR: 2.43) in adulthood.
Conclusion/ImplicationsYoung people's mental health has significant influence on their health and well-being trajectories into adulthood. This knowledge could directly inform policy and practice to provide better population-based mental health promotion, prevention and early interventions for children/adolescents with mental disorders and subsequently prevent adverse adult outcomes in the future.