bluuebunny/crossref_metadata_2025 huggingface dataset:
The Association Between Mode of Delivery and Later Educational Outcomes
Authors: Katz Alan , Kinew Kathi Avery , Star Leona , Taylor Carole , Koseva Ina
Published: December 2020

IntroductionA 2002 report described the gap in health status between First Nations (FN) and all other Manitobans (AOM). That report was widely quoted in the context of other initiatives recognizing the inequities in Canadian society.

Objectives and ApproachWe analyzed linked administrative data held in the Manitoba Population Research Data Repository to determine the health status and health care use of First Nations people. To provide context to the findings we compared First Nations to all other Manitobans, disaggregated by on-reserve off-reserve status, and presented our findings by Region and Tribal Council area. The 35 indicators were chosen to address First Nations priorities and providecomparisons with the previous study. Results were age and sex adjusted.

ResultsThe gap between FN and AOM has grown. Premature mortality rates are 3x higher for FN compared to AOM. Rates of death by suicides and suicide attempts are 5x higher for FN compared to AOM. Rates of opioid prescribing are 2.5x higher for single prescription, and 4.5x higher for multiple prescriptions for FN compared to AOM. Colorectal cancer screening rates are 2x higher among all other Manitobans compared to FN. Continuity of care is much lower in FN than in AOM. For FN, primary care is less likely to be provided close to home than for AOM

Conclusion / ImplicationsDespite initiatives like the Truth and Reconciliation Commission, and Indian Residential School survivors pursuing healing, the gap in health outcomes has increased. Underlying causes such as ongoing systemic racism and colonialism within health governance should be addressed.
Creating Additional Census Income Topics from Linked Administrative Data
Authors: Mowle James
Published: December 2020

IntroductionThe Census is the largest statistical collection undertaken by the Australian Bureau of Statistics (ABS), with its data critical to informing the planning and delivery of Government and community services. While the Census measure of income supports a wide range of analysis, demand exists for additional income topics to complement and extend the range of socio economic analysis that can be undertaken. The ABS has recently developed three experimental income topics for the 2016 Census using linked administrative data: main source of income; main source of government payments; and previous financial year income.

Objectives and ApproachThis research utilised administrative data integrated by the ABS for the Multi-Agency Data Integration Project (MADIP). Taxation data from the Australian Taxation Office (ATO) and social security data from the Department of Social Services (DSS) were used in conjunction with the 2016 Census data to derive the additional topics.

ResultsOverall, the three measures compare relatively closely to similar measures from the ABS Survey of Income and Housing (SIH). The ‘Main source of income’ and ‘Main source of government payments’ measures exhibit similar distributions to those from the SIH. The ‘Previous financial year income’ measures compare more closely with Census and SIH at the higher end of the income distribution, with some differences apparent at the lower end of the income distribution.

Conclusion / ImplicationsThis work demonstrates the potential to supplement and enhance existing Census topics with linked administrative data. Further research, development and consultation with data users and the Australian community is needed.
Cooperation and Innovation in Data Linkage Creates A Linked, Multi-Sectoral Data Repository for Western Australia – The SIDR Project
Authors: Ferrante Anna , Eitelhuber Tom , Maller Max , Randall Sean , Brown Adrian , Pedrotti David , Boyd James , Sibma Kurt
Published: December 2020

IntroductionDuring 2019, the Western Australian (WA) government and Curtin University’s Centre for Data Linkage (CDL) created a large, de-identified researchable database – the Social Investment Data Resource (SIDR) – to support government in delivering targeted early interventions to young offenders and their families to reduce the likelihood of re-offending (the Target 120 program).

Objectives and ApproachSIDR brings together administrative data from health, education, justice, child protection, disability and housing sectors. The linked, de-identified data provides an invaluable resource for actuarial assessment and social investment analytics to assess long-term costs and benefits of the Target 120 program. SIDR also provides an invaluable tool for academic research. SIDR adopted a distributed linkage model where linkage workload was shared between the Department of Health Data Linkage Branch who create and maintain the WA Data Linkage System (WADLS) and the CDL. Design elements of the model included a common spine (embedded into the infrastructure of both groups), methods for leveraging quality from WADLS, and inclusion of family relationships data from the WA Family Connections database. The linkage model within SIDR uses a combination of traditional and privacy-preserving record linkage (PPRL) methods. PPRL does not require release of personal identifiers; instead, data is irreversibly hashed prior to release for probabilistic linkage.

ResultsThrough cooperation (distributed linkage) and innovation (a mix of traditional and PPRL linkage), the project has delivered a large, linked, cross-sectoral data resource for policymakers and researchers. Sharing of the linkage workload maximised the capacity and unique capabilities of each linkage unit. PPRL enabled ‘hard to get’ datasets from justice to be included. SIDR is being updated in 2020.

Conclusion / ImplicationsSIDR provides a resource for whole-of-government policy development, service evaluation, academic research and social investment analytics for T120 and beyond. The SIDR linkage model has potential for adaptation and use elsewhere.
Twenty Years of Data Linkage in The Australian Longitudinal Study on Women’s Health
Authors: Loos Colleen , Mishra Gita , Dobson Annette , Tooth Leigh
Published: December 2020

IntroductionLinked health record collections, when combined with large longitudinal surveys, are a rich research resource to inform policy development and clinical practice across multiple sectors.

Objectives and ApproachThe Australian Longitudinal Study on Women’s Health (ALSWH) is a national study of over 57,000 women in four cohorts. Survey data collection commenced in 1996. Over the past 20 years, ALSWH has also established an extensive data linkage program.

The aim of this poster is to provide an overview of ALSWH’s program of regularly up-dated linked data collections for use in parallel with on-going surveys, and to demonstrate how data are made widely available to research collaborators.

ResultsALSWH surveys collect information on health conditions, ageing, reproductive characteristics, access to health services, lifestyle, and socio-demographic factors. Regularly updated linked national and state administrative data collections add information on health events, health outcomes, diagnoses, treatments, and patterns of service use.

ALSWH’s national linked data collections, include Medicare Benefits Schedule, Pharmaceutical Benefits Scheme, the National Death Index, the Australian Cancer Database, and the National Aged Care Data Collection. State and Territory hospital collections include Admitted Patients, Emergency Department and Perinatal Data. There are also substudies, such as the Mothers and their Children’s Health Study (MatCH), which involves linkage to children’s educational records.

ALSWH has an internal Data Access Committee along with systems and protocols to facilitate collaborative multi-sectoral research using de-identified linked data.

Conclusion / ImplicationsAs a large scale Australian longitudinal multi-jurisdictional data linkage and sharing program, ALSWH is a useful model for anyone planning similar research.
Innovative Use of Administrative Data in Legal Research and Practice
Authors: Jay Matthew A , Byrom Natalie , Jay Matthew A , Forell Suzie
Published: December 2020

IntroductionThere is widespread recognition of the need to use administrative data from justice, crime, prisons and legal services to improve the evidence base on determinants and outcomes of involvement with justice systems and to improve services. There is great opportunity to use data from justice to improve health and other outcomes for clients and service users but this is a relatively unexplored area and these datasets have been neglected partly due to access concerns. This 90 minute symposium presents research and learning from data initiatives in justice settings and will explore challenges from the perspectives of researchers and the legal profession.

Objectives and ApproachTalks will cover:

Development of legal epidemiology and use of administrative data in this nascent field (Matthew A Jay). Examples from the presenter’s family justice research using linked data will also be presented.

The UK Ministry of Justice’s (MoJ’s) Data First programme (Prof Betsy Stanko). Data First aims to unlock the potential of data already created by MoJ, by linking datasets from the justice system and beyond, and enabling accredited researchers to access the data ethically and responsibly.

UK court reform and data collection: using data to monitor equality and access to justice in the move to on-line dispute resolution (Dr Natalie Byrom).

Health Justice Partnerships (HJPs) in Australia (Prof Suzie Forell). HJPs bring legal help into health settings to address social issues affecting the health of patients. This will be a discussion of HJPs as an opportunity to explore the impact of legal assistance on health and the challenges and opportunities of relevant data generation.

Conclusion / ImplicationsBetter use of data in justice spheres will be a difficult process requiring cross-disciplinary collaboration. But it is one that promises to bring the study and practice of law into the 21 st Century.
Centering Equity Across the Administrative Data Life Cycle
Authors: Nelson Amy Hawn
Published: December 2020

Data integration by local and state governments is undertaken for the public good to support the interconnected needs of families and communities. And though data infrastructure is a powerful tool to support equity-oriented reforms, equity is rarely centered as a core goal for data integration. This raises fundamental concerns, as integrated data increasingly provide the raw materials for evaluation, research, and risk modeling. This session presents findings from a toolkit collaboratively generated by a workgroup convened by Actionable Intelligence for Social Policy at the University of Pennsylvania.

IntroductionWhile data sharing occurs within a legal framework, an emphasis on equity is often peripheral. Generally, institutions have not adequately examined and acknowledged structural bias in their history, or the ways in which data reflects systemic inequities in the development and administration of policies and programs. Meanwhile, the public are rarely consulted in the development and use of data systems.

Objectives and ApproachThis toolkit was collaboratively generated by a workgroup of civic data stakeholders from across the US.

ResultsThe toolkit aims to support agencies seeking to acknowledge and compensate for the harms and bias baked into data and practice. It is organized across six stages of the administrative data life cycle—planning, data collection, data access, use of algorithms and statistical tools, analysis, and reporting and dissemination. For each stage, the toolkit includes promising and problematic practices for centering equity in administrative data reuse, with site-based examples of work in action from across the US.

Conclusion / ImplicationsThe workgroup concluded that centering equity within data integration efforts is not a binary outcome, but rather a series of small steps towards more equitable practice. There are countless ways to center equity across the administrative data reuse life cycle, and this report provides concrete strategies for agencies, organizations and collaboratives to begin and grow that work in practice.
Community Attitudes Towards Sharing Government Health Data with Private Companies: A Scoping Review
Authors: Street Jackie , Fabrianesi Belinda , Bosward Rebecca , Carter Stacy , Braunack-Mayer Annette
Published: December 2020

IntroductionLarge volumes of health data are generated through the interaction of individuals with hospitals, government agencies and health care providers. There is potential in the linkage and sharing of administrative data with private industry to support improved drug and device provision but data sharing is highly contentious.

Objectives and ApproachWe conducted a scoping review of quantitative and qualitative studies examining public attitudes towards the sharing of health data, held by government, with private industry for research and development. We searched four data bases, PubMed, Scopus, Cinahl and Web of Science as well as Google Scholar and Google Advanced. The search was confined to English-only publications since January 2014 but was not geographically limited. We thematically coded included papers.

ResultsWe screened 6788 articles. Thirty-six studies were included primarily from UK and North America. No Australian studies were identified. Across studies, willingness to share non-identified data was generally high with the participant’s own health provider (84-91%) and academic researchers (64-93%) but fell if the data was to be shared with private industry (14-53%). There was widespread misunderstanding of the benefits of sharing data for health research. Publics expressed concern about a range of issues including data security, misuse of data and use of data to generate profit. Conditions which would increase public confidence in sharing of data included: strict safeguards on data collection and use including secure storage, opt-in or opt-out consent mechanisms, and good communication through trusted agents.

Conclusion / ImplicationsWe identified a research gap: Australian views on sharing government health data with private industry. The international experience suggests that public scepticism about data sharing with private industry will need to be addressed by good communication about public benefit of data sharing, a strong program of public engagement and information sharing conducted through trusted entities.
Characterizing Potential Medication Related Harm in the 30-Days Following Hospitalization Using Linked Provincial Administrative Health Data
Authors: Weir Daniala L , Pearson Douglas , Tang Terence , Mills Allan
Published: December 2020

IntroductionPatients transitioning between hospital and home are at risk of experiencing adverse drug events. Hospital-based care teams require a better understanding of how therapeutic decisions and patient risk factors impact adverse health outcomes following discharge.

Objectives and ApproachThe objective was to describe medications prescribed at discharge and quantify the association between these medication classes and risk of emergency department (ED) visits within 30 days. A retrospective, population-based cohort study was conducted using linked health administrative databases of adults discharged from hospital to the community between April 2016-March 2017, in Ontario, Canada. To distinguish medications prescribed at discharge from those by community providers, we examined medications dispensed in the 30-days following hospitalization but prior to another healthcare encounter (physician visit, ED visit, or rehospitalization). Adjusted logistic regression was used to determine the association between medication classes at discharge and ED visits in 30 days post discharge.

ResultsOur study cohort included 214, 011 patients. Median age was 76 (IQR:66-82), 52% were females, 92% were discharged home and 8% were discharged to long term care. Patients were dispensed a median of 3 medications (IQR: 2-6). The most common medications included hydromorphone (16% of all patients, 71% of which represented new use), pantoprazole (15% of patients, 40% new use), furosemide (13% of patients, 34% new use), amlodipine (10% of patients, 35% new use) and oxycodone (9% of patients, 70% new use). To account for confounding by indication, we adjusted for age, sex, discharge service, discharge disposition, in hospital diagnoses and length of stay. Medications which were most highly associated with an increased risk of ED visits included antipsychotics, antiepileptics, anti-infectives, systemic corticosteroids, antihypertensives and cardiac stimulants.

Conclusion / ImplicationsCharacterizing potential medication related harm in the 30-days following hospitalization is an important first step in understanding which patients may benefit most from hospital-based medication related interventions.
Occupational Exposures and Ischaemic Heart Disease: Results from The Entire New Zealand Population
Authors: Eng Amanda , Corbin Marine , Denison Hayley , Barnes Lucy , Mannetje Andrea 't , McLean Dave , Laird Ian , Douwes Jeroen
Published: December 2020

IntroductionIschaemic Heart Disease (IHD) is a leading cause of death in Western countries. Common occupational exposures such as loud noise, long working hours, and sedentary work have been associated with increased IHD risks, but inconsistently.

Objectives and ApproachThis study examines associations between incident IHD and exposure to long working hours, sedentary work, and loud noise. Individual-level microdata from Statistics New Zealand Integrated Data Infrastructure (IDI) were extracted for adults (age 20-64 years) with occupation recorded on the 2013 Census. The number of working hours was extracted from the Census, and exposure to sedentary work and loud noise was assessed through job exposure matrices (JEMs). IHD events (from 2013 to end of 2018) were identified using hospitalisations, prescriptions and deaths. Hazard ratios (HRs) were calculated using cox regression adjusted for age, socioeconomic status, and smoking. Results were stratified by sex and ethnicity.

ResultsA total of 20,610 IHD cases were identified from 1,594,680 individuals employed at time of Census. Both short (<35) and long (55+) working hours were associated with an increased IHD risk in crude analyses, but effects disappeared after adjustment for age and socioeconomic status. For females, sedentary work (>90% of the time compared to <50%) was associated with a reduced risk (HR(Non-Māori)=0.86, 95%CI=0.75-0.99; HR(Māori)=0.71, 95%CI=0.44-1.14). For males, exposure to the highest noise category (>90dBA) compared to no exposure (<80dBA) was associated with elevated HRs without reaching statistical significance (HR(Non-Māori)=1.12, 95%CI=0.96-1.29; HR(Māori)=1.25, 95%CI=0.89-1.75). For females exposure to the 80-85dBA category compared to no exposure also showed elevated HRs (HR(Non-Māori)=1.14; 95%CI=1.04-1.26; HR(Māori)=1.16; 95%CI=0.93-1.46), but too few females were employed in jobs with the highest noise exposure.

ConclusionThese preliminary analyses do not support sedentary work or long working hours as IHD risk factors, but do suggest a modest increase in IHD risk associated with occupational exposure to noise.
Holistic Approach to Data Linkage at Monash University
Authors: Andrew Nadine , Mac Manus Chris , Padmanabhan Komathy , Lucas Mark , Kannan Anitha
Published: December 2020

IntroductionMonash University’s health researchers are at the forefront of Health, Epidemiological and Translational research. Powered by research funding of over $69 million per year, Monash encompasses 13+ registries, 44+ clinical trials and 47+ cohort studies underpinned by complex multimodal, large and often sensitive datasets. Many of these research activities are occurring in isolation. Opportunities exist to better deliver higher impact research at scale through capacity building in data sharing.

Objectives and ApproachWe have designed this session to demonstrate how significant investment in health data platform infrastructure by a University, can support best practice in data linkage and health research.

ResultsContent will include:

An overview of Helix – people as a platform, research stakeholders, and key capabilities.

Institutional data governance and sharing capabilities – linking two or more researcher held datasets exampled by a use-case of linking biobank data to a clinical registry dataset.

Monash Helix data linkage working group – established to develop a community of practice to advance data linkage capabilities across Monash with a focus on: knowledge sharing; ethics, governance and data security; analytic training; and improved access to external administrative datasets.

Secure eResearch Platform (SeRP) – developed by Swansea University who have partnered with Monash University to bring their best practice framework and technologies in managing sensitive health data to Monash researchers and their national and international collaborators.

Future directions - participation in defining the strategic priorities of the Health Studies National Data Asset Program by creating distributed data infrastructure capability to develop, share and link FAIR data collections from the government, research and health care sectors.

Conclusion/ImplicationsThe session will facilitate discussions on how we can build on these activities, both nationally and internationally, to develop a community of practice around knowledge sharing and best practice in data linkage.
Antibiotic Dispensing Before and After Primary and Revision Total Hip Replacement: An Australian Orthopaedic Association National Joint Replacement Registry Linkage Study
Authors: Gulyani Aarti , De Steiger Richard , Smith Paul , Pratt Nicole , Duszynski Katherine , Graves Stephen E , Inacio Maria , Harris Ian , Ackerman Ilana , Jorm Louisa , Lorimer Michelle
Published: December 2020

IntroductionInfection is a major complication following joint replacement (JR) surgery. However, little data exist on baseline use of antibiotics following primary JR and how use changes with subsequent revision surgery.

Objectives & ApproachOur study objectives were to describe community use of antibiotics before and after primary total hip replacement (THR) and change in use pre and post revision procedure.

Registry data were linked with national medication dispensing data using probabilistic record linkage. Patients with THR for osteoarthritis in a private hospital between 1999 and 2017 were included. Three groups were analysed: patients with primary procedures revised for infection, revised for non-infection reasons and those not revised. Rate of antibiotic dispensing/month was calculated as number of patients dispensed at least one antibiotic in a given month divided by number of patients at-risk.

ResultsThere were 102,577 patients included in the non-revised group, 3,156 revised for non-infection and 520 revised for infection. Prior to primary THR, baseline antibiotic dispensing rate was 9-11%/month in all groups. Post-primary rates were similar (10-11%) for non-revised and revised non-infection patients but higher (16-17%) for revised-infection patients. In 1, 6 and 12 months preceding revision for infection, antibiotic use was 55%, 27% and 22%, respectively. For patients revised for non-infection, antibiotic use was 21%, 14%, 13%, respectively. One-month following revision for infection, 82% of patients were dispensed antibiotics, remaining high (38%) at 6-months and 28% at 12-months. In the revision non-infection group, antibiotic use was 48% first month post-surgery, reducing rapidly to 15% at 6-months.

Conclusion / ImplicationsNon-revision and revision non-infection patients had similar antibiotic dispensing before and after surgery. Revision infection patients however, maintained higher antibiotic dispensing post-primary, pre and post revision. This may reflect either ongoing infection, need for long-term suppressive therapy or reluctance of treating physicians to terminate treatment.
Outcomes of Indigenous Twin and Singleton Pregnancies: Complications, Medical Care, Birth Experience and Infant Health
Authors: Gibberd Alison , Tyler Jessica , Preen David , Falster Kathleen , Hanly Mark , Clarke Marilyn , McNamara Bridgette , Eades Sandra , Scurrah Katrina
Published: December 2020

IntroductionMultifetal pregnancies and births tend to be more complicated and have poorer outcomes than singleton pregnancies. Singleton pregnancies and perinatal outcomes are worse, on average, for Indigenous people than non-Indigenous people, but little is known about Indigenous multifetal pregnancies.

Objectives and ApproachWe comprehensively describe and compare Indigenous twin and singleton pregnancies and births in Western Australia (WA) and New South Wales (NSW) and compare to NSW non-Indigenous pregnancies and births. Birth records and infant and maternal hospital records were linked for births during 2000-2013 (WA) and 2002-2008 (NSW). Time travelled for the birth was based on the distance from the hospital to the centroid of the mother’s geographical residential area.

ResultsIn the Indigenous populations, mothers of twins had poorer health than mothers of singletons (e.g. in WA, 19% of mothers of twins had hypertension/pre-eclampsia/eclampsia vs 9% of mothers of singletons). They were more likely to have antenatal care during the first trimester (e.g. 69% vs 64% in NSW), though less likely than non-Indigenous mothers of both twins (80%) and singletons (75%).The majority of Indigenous twins were born in a hospital with a neonatal intensive care unit (NICU) (e.g. 66% vs 26% in WA) and many mothers of twins travelled further for the birth (e.g. 8% of mothers of Indigenous twins in NSW travelled 3 hours or more vs 4% of mothers of singletons). In both jurisdictions, outcomes were worse for twins than singletons (e.g. 67% of twins in WA were preterm vs 13% of singletons and 30% of twins were admitted to a NICU vs 6% of singletons).

Conclusion / ImplicationsMothers of Indigenous twins faced significant challenges during the pregnancy, birth and the postnatal period in hospital and, in addition to accessible specialist medical care, these mothers may need practical and psychosocial support throughout their journey.
Using Coronial Records to Provide Novel In-Depth Insights into Work-Related Fatal Injury
Authors: Lilley Rebbecca , Davie Gabrielle , McNoe Bronwen , Driscoll Tim
Published: December 2020

IntroductionNew Zealand’s (NZ) workplace fatality record is very poor compared to similar OECD countries. The reasons for NZ’s poor performance are highly debated yet inadequately informed due to a lack of high quality fatality data. Due to incomplete official data on work fatalities in NZ, it is not currently possible to use routine official data collections to reliably report: i) who is fatally injured due to work activities, and ii) what groups should be prioritised for action.

Objectives and ApproachThis study uses coronial records to overcome the limitations of existing official data collections to provide the most complete and detailed evidence platform for occupational safety policy and action in NZ. A work-related fatal injury dataset spanning the period 2005-2014 was created by: 1) identifying possible cases aged 0-84 years from the Mortality Collection using selected external cause of injury codes, 2) linking these to Coronial records and 3) identifying and coding work-related cases.

ResultsOf 7,730 injury fatalities with corresponding Coronial records retrieved and reviewed, 1,924 (24%) were work-related, of which 955 were workers. Fifty-nine per cent more worker deaths were identified compared to available official NZ Government estimates from notification and compensation data. Workers killed on public roads were the main additional group identified. Official data do not provide occupation-based fatality rates; our study found ‘Miners and drillers’, ‘deckhands and fishermen’ and ‘loggers’ had the highest rates of fatal injury.

Conclusion / ImplicationsCoronial records offer a rich source of population data on work-related fatal injury deaths, providing better estimates of work-traffic fatalities and high risk occupations than are otherwise available as well as evidence for establishing prevention strategies in NZ.
Consolidated Person Level Health Data Improve Tuberculosis Surveillance and Patient Care
Authors: Smith Mariette , Heekes Alexa , Von Delft Arne , Mutemaringa Themba , Tiffin Nicki , Boulle Andrew
Published: December 2020

IntroductionElectronic tuberculosis (TB) register systems influence policy decisions, resource allocation and patient care in many ways, but their limitations have been demonstrated in many high-burden settings like South Africa. While digital health systems in the Western Cape, South Africa have improved over time and benefited from implementation of a unique patient identifier, questions about quality and completeness of register data remain. A Health Information Exchange (HIE), established in 2015, daily integrates routinely-collected person level health data from electronic sources in the Province, including laboratory, dispensing, clinical and encounter data, as well as disease register data for HIV and TB.

Objectives and ApproachUsing TB-related datapoints from various electronic platforms and resources, an algorithm was developed to infer cases, visit and treatment information, comorbidities and mortality - defined as a “cascade”. The cascade is recompiled daily incorporating new information added to the HIE, and presented to health care workers and managers as filterable, downloadable reports on an electronic platform. TB Register and inferred cascade data were compared for 2018.

ResultsThere were 40,227 cases in the register after 3,010 duplicate entries were eliminated by consolidating personal identifiers and duplicate entries across facilities into single TB episodes. 13,729 additional cases were identified in the HIE cascade. Of these, 6,984 had evidence of treatment; 4,143 were diagnosed and treated only in hospitals - thus less likely to be recorded in the registers. Updated patient contact details and allocation of a primary care facility based on patient visit history, aided in patient care.

Conclusion / ImplicationsLeveraging a consolidated environment for person-level health data can substantially enhance and verify disease registers. Appropriate tools can render these data accessible and actionable to improve patient care, minimise errors and missed opportunities to close treatment gaps, and increase accuracy of surveillance and reporting on a programmatic level.
Exploring the Effect of Nice Guidelines on Prescribing for Childhood Atopic Eczema in Primary Care with An Interrupted Time Series
Authors: Schreuders LIW , Ersser SJ , Thompson C
Published: December 2020

IntroductionAtopic eczema (AE) is a chronic inflammatory skin condition affecting 20-32% of UK children, typically diagnosed and treated in primary care. National Institute of Health and Clinical Excellence (NICE, 2007) guidelines recommend all children presenting with AE in primary care are prescribed emollient; topical corticosteroids (TCS) are co-prescribed if indicated by severity. The proportion of children receiving recommended treatment and NICE guideline impact on prescribing practices is unknown. This study was the first to access population-level UK-wide primary care dermatology data from SystmOne.

Objectives and ApproachWe explored treatment patterns for childhood AE documented in primary care data from SystmOne.

Secondary analysis of retrospective, longitudinal primary care data for childhood (<12yo) AE-related consultations from 2002 to 2013. Four treatment scenarios were compared: 1) emollient and TCS co-prescribed (NICE-recommended for moderate-high severity presentation), 2) emollient only (NICE-recommended for mild severity presentation), 3) TCS only (not recommended), or 4) no topical treatment prescribed (not recommended). ARIMA used to examine step and trend-change in prescribing following guideline release.

ResultsNICE-recommended treatments were more common following guideline release: emollient+TCS increased 8% (95%CI 7.7,8.7%); emollient alone increased 8% (95%CI 7.8,8.8%); TCS alone decreased 5% (95%CI -4.2,-5.1%); and no treatment decreased 11% (95%CI -11.3,-12.3%).

Longitudinal analysis indicated increased NICE-recommended prescribing was due to pre-existing trends not significantly altered by the guideline release. By December 2013, ~334 children per month were still not receiving recommended AE treatment (37% of ~900 first-time consultations/month).

Conclusion / ImplicationsAdherence to best practice guidelines for treatment and management of childhood atopic eczema is currently sub-optimal. Significant barriers to optimal use of this data could be achieved by improving design of data input interfaces with secondary use for research in mind. As well as study findings, this presentation will share challenges associated with utilising routinely collected SystmOne data for research purposes for the first time in the UK.
NGLMS-CR: A Web-Based Clerical Review Tool
Authors: Farrow James , Palfy Miro
Published: December 2020

Native applications often require special permissions to install and update which may not always be available in secure/controlled sensitive-data environments. Deploying new features can be time-consuming and introduce delays. The Next Generation Linkage System Clerical Review tool (NGLMS-CR) is a configurable web application which side-steps these issues. The NGLMS-CR allows rapid response to changing project requirements.

Objectives and ApproachWe wanted a lightweight platform-independent tool to run in any modern web-browser. This avoids a need for special administrative privileges and allows rapid deployment/update. The NGLMS-CR communicates via a simple RESTful protocol to a server managing user-permissions, workflows and review data. Data is stored in a relational or graph database. The NGLMS-CR does not require a graph database.

Users see various workpools (collections of records) and work through these at their own pace. Different workpools may be configured for different requirements, e.g. clusters requiring special expertise, clusters requiring higher data security, overly-large clusters &c. Custom workflows are built around workpools. Individual clusters can have customisable status indicators displayed to highlight integrity checks and other information, e.g. a cluster containing multiple birth records or containing records with inconsistent gender information.

The tool also promotes ergonomic and health objectives as well as collecting metrics about review activity. The review session tracks reviewer engagement and gives feedback on the situation so far: how long has been spent reviewing; how long activity has been undertaken without a break. The user is given visual warnings when sessions extend beyond a set time. Activity is logged and metrics regarding throughput/accuracy collated for analysis.ResultsIn real-time manual clerical review tasks the customisable nature of the NGLMS-CR has proven important. Changes are immediately visible to users and workflow and status icons changes available with no delay while software is ‘rolled out’.

Conclusion / ImplicationsUncoupling review from any particular linkage system enables flexibility in project administration. A web-based review application may run on any system and requires minimal administrative permissions. This facilitates deployment in sensitive environments. Customisable workflow allows quick creation of ad hoc projects/tasks, even mid-project as new situations are discovered. Customisable cluster integrity checks allows cluster- and project-sensitive feedback to be rapidly deployed to aid review. By being flexible and independent the NGLMS-CR can supplement and complement existing linkage and review processes.
Vaccine-Preventable Infections Among Solid Organ Transplant Recipients: A Data-Linked Cohort Study, Australia, 2000-2015
Authors: Waller Karen MJ , De La Mata Nicole L , Wyburn Kate R , Kelly Patrick J , Ramachandran Vidiya , Shah Karan , Morton Rachael , Rawlinson William D , Webster Angela C
Published: December 2020

IntroductionRecipients of solid organ transplants are at risk of serious infection due to immunosuppression. Some infections are preventable with vaccination; infection rates vary with immunosuppression, vaccination rates and baseline disease prevalence. Both adherence with and response to vaccination in this population are variable, and optimum vaccination strategies continue to be refined.

Objectives and ApproachWe aimed to characterise the incidence and complications of vaccine-preventable infections in transplant recipients. Eligible participants received an organ transplant in New South Wales, Australia, in 2000-2015. Linkage was undertaken between transplant registries and the notifiable conditions information management system. Vaccine-preventable infections were diphtheria, Haemophilus influenzae type b, influenza, invasive pneumococcal disease, measles, mumps, pertussis, poliovirus, rubella and tetanus. Standardized incidence ratios (SIR) were calculated relative to Australian population notification rates, standardizing for gender, age and calendar year.

ResultsAmong 3,394 recipients, 399 vaccine-preventable infections affected 339 (10%) recipients. Influenza was the most common vaccine-preventable infection with 352 notifications among 305 recipients. Influenza cases were 8.9 times more common among transplant recipients than the general population (95%CI: 8.0-10.0). In 36 cases (10%), hospitalization was required, and 2 deaths due to influenza were reported.

There were 20 notifications of invasive pneumococcal disease (IPD) for 18 recipients. IPD occurred 10.2 times more often among transplant recipients than the general population (95%CI: 6.4-16.2). Most (n=13, 65%) cases were hospitalized, and one patient died from IPD.

Cases of pertussis occurred only slightly more often than in the general population (SIR 1.5, 95%CI: 1.0-2.3). Of 26 cases, there was one reported hospitalization and no deaths due to pertussis. Only one case of mumps, and no other vaccine-preventable infections, were reported.

ConclusionTransplant recipients have excess cases of influenza and IPD compared to the general population, although this has improved over time. The need for appropriate recipient vaccination is emphasized.
Spatial Linkage of Electronic Health Records and Census Data in A Children’s Hospital
Authors: Tan Jonathan M , Tam Vicky , Galvez Jorge A , Hsu Grace , Quarshie William , Wasey Jack O , Nelson Olivia , Simpao Allan F
Published: December 2020

IntroductionSocial determinants of health (SDOH) has a significant impact on access to health. Risk stratification of patients who have difficulty accessing care could allow for triaging of peri-operative resources. Unfortunately, there is a limited amount of SES factors available to study in electronic health records (EHR).

Objectives and ApproachOur objective was to understand the SES and location risk factors that are associated with paediatric patients arriving late to the hospital for elective surgery. We conducted a retrospective study of paediatric patients requiring elective surgery from 2015-2019. Spatial linkage of EHR data with US Census–ACS 2017 data was conducted. Analysis was at patient and neighbourhood block group levels. Statistical analysis was conducted utilizing SAS, Python and ArcGIS.

ResultsOur study had 40,943 patients with 7,453 patients (18.2%) who arrived ≥15 minutes late from their scheduled arrival. Patient level risk factors for arriving late included younger age, Black and Indian patients, non-English speaking, government insurance, increased co-morbidities and earlier appointments. The median time of arrival for patients arriving late was 23.0 minutes (18.0-33.0 minutes IQR), versus the on-time group of 7 min (4-22 minutes IQR) early. Median drive time and distance, using network analysis was not a significant factor. Statistically significant neighbourhood risk factors for arriving late included block groups with high unemployment, households receiving public assistance, low income households, higher number of high-school drop outs, female-headed households, more renter-occupied houses, and areas with high turnover. Logistic regression demonstrated neighbourhoods with the lowest quintile SES were 30% more likely to be late than the areas with the highest SES (p<0.001).

Conclusion / ImplicationsWe successfully identified patient and neighbourhood socioeconomic risk factors for arriving late to the hospital leveraging geospatial methods and EHR data. Leveraging EHR data with geospatial analytics can augment our understanding of the SDOH that may impact the delivery of care.
Fluxo digital na montagem simplificada de bráquetes linguais
Authors: Kairalla Silvana Allegrini , Kairalla Cláudia Allegrini , Loiola Angelo Vicentini , Shibuya Ronaldo Henrique
Published: December 2020

Introduction: In lingual orthodontics technique the brackets are positioned on the teeth lingual surface, and for this reason it is known as a difficult technique due to the complexity of brackets positioning. During the evolution of this technique many forms of lingual appliance assembly were developed. The most used technique recommended to make an orthodontic set-up model and later to transfer the appliance to the patient’s mouth using trays or jigs in order to perform the bonding itself. Subsequently, another and more simplified lingual appliance form emerged, in which the bonding would be performed directly, that is, on the lingual surface of the enamel, but it required greater skill from the professional. Also, it could be done on the cast model of malocclusion, without making the set-up model. Objectives: To facilitate the technique using technological resources with as a scanner and a software replacing some analogical steps in the assembly of the lingual device. Material and Method: Intraoral digitizing is performed by a scanner where the models are obtained in STL files, that inserted in the software together with the STL files of the lingual brackets will be positioned on the virtual surface of the digital models. A virtual transfer tray will be made of resin in a 3D printer where the metal brackets will be inserted for the actual bonding. Conclusion: The assembly of the simplified lingual device can be performed with excellence by digital means in almost all steps.
Comparação da resistência ao cisalhamento após colagem com dois cimentos ortodônticos – estudo in vitro
Authors: Pereira Kalena de Melo Maranhão , de Oliveira Fernanda Neves Borges , de Lima Clayton Pereira Silva , Gatti Joyce Figueira de Araújo , Reis Ana Cássia de Souza
Published: December 2020

The objective of this study was to evaluate the shear strength of orthodontic bands cemented with a new Orthobite composite, comparing them to the conventional glass ionomer cement in bovine enamel and to analyze the Adhesive Remnant Index (ARI). The sample consisted of 30 bovine teeth divided into 2 groups: Group I - Orthobite (FGM) and Group II - CIV MERON (VOCO). Prophylaxis has been made with pumice and water followed by cementation according to the manufacturer’s instructions. Afterwards, they were subjected to the shear test at a speed of 0.5 mm/minute speed. Data were submitted to the Student T and Kruskal- -Wallis tests. Significant statistical differences were found between the groups both in the shear strength values (p> 0.05) and in the ARI assessment (p> 0.05). The Orthobite cement proved to be statistically superior to MERON, that is, it presented a better margins seal and a greater resistance to displacement, so this stable union between the tooth and the band is fundamental for the success of the orthodontic treatment.
Avaliação da intensidade de dor em pacientes submetdos à anestesia tópica com tetracaína e lidocaína, previamente à injeção de toxina botulínica
Authors: Secaf Jorge Taylor Moraes , Tagliani Marcela
Published: December 2020

Aesthetic procedures are associated with improving of individual's self-esteem. The specialty of Orofacial Harmonization (HOF) in Dentistry makes it possible to treat patients' orofacial function and aesthetics. Through numerous procedures, the objective is to improve and correct individuals facial aspects. For this, it is necessary to use topical anesthetics prior to the procedures. The product must be potent, effective and safe. There are few options commercially available in Brazil, which leads to the fact that the professional has many times to manipulate the anesthetic for use. Thus, the present study aimed to clinically compare the performance of two topical anesthetics, one already commercialized in Brazil (lidocaine) and another manipulated (tetracaine). So, patients were asked to point out on a scale the intensity of pain felt after the injections. The data was tabulated and analyzed. Partial results show that 4% tetracaine topical anesthetic was more effective than lidocaine regarding pain control prior to botulinum toxin injections.
O uso de plasma rico em plaquetas e da fbrina rica em plaquetas injetável como terapias de rejuvenescimento facial
Authors: Borges Kely Pereira , Ziroldo Sidmarcio
Published: December 2020

The autologous concentrates of platelets and of growth factors have been used as a therapeutic option for facial rejuvenation, as they provide a biostimulation in the production of collagen. Platelet Rich-Plasma (PRP) and Injectable Platelet Rich-Fibrin (i-PRF) are safe options, without allergic reactions, and are autologous materials with reduced production costs, and with different protocols and presentations. The aim of this study was to highlight the benefits and specificities of the application of PRP and i-PRF in the treatment of interfacial rejuvenation, in the current clinical activities of aesthetic treatment in the Dentistry field based on clinical evidence. It was based on a systematic search of qualitative nature in databases, evaluating electronic scientific articles published between the years 2013 to 2020. Searches in English and Portuguese were included, with the terms ["platelet rich plasma" OR "Platelet Rich Fibrin Injectable "] AND ["Facial Rejuvenation" OR "rejuvenation"], investigating clinical applications in the studies. The results achieved after therapy with the autologous concentrates PRP and i-PRF report the improvement in the skin appearance and promote the reduction of wrinkles. More detailed studies are needed in order to clarify their quantification and qualification, and the standardization of the methods to obtain these concentrates, in order to expand their use in the aesthetic practice of facial rejuvenation.
Acquiring Interactional Competence in A Socially Constructed Environment Through the Use Of “Roll N’ Play”: An Interactional Board Game
Authors: Sabri Salina , Khairuddin Zulaikha , Amir Johan Syafiqah Johan , Mohd Daud Khairunnisa
Published: December 2020

This paper highlights the benefits of game-based learning for adults in acquiring interactional competence in English. Roll N’ Play is an interactional board game that is deemed to be an appropriate learning tool for acquiring interactional competence in English for adults because in acquiring a language, it has to be of use in any adult’s professional and personal lives. Roll N’ Play enables players to use English, the target language, in a socially constructed environment while having fun in a competitive environment and at the same time applying peer-learning strategies. Roll N’ Play allows a hands-on experience in language use and it also fosters creativity and problem-solving skills as players compete to reach the highest score in order to win the game. This board game has four bonus squares, eight challenge squares, two penalty squares and one first date square. The educational benefit of this innovation is that it will inevitably improve players’ interactional competence because players are required to interact with other players to complete situational-based tasks in a timely manner. Although there are many online language games and applications, those who are not Internet- savvy will not be able to enjoy such games applications and some users may even find them unappealing. This paper concludes that purposeful language use can be promoted through an engaging and enjoyable social activity such as a board game.