bluuebunny/crossref_metadata_2025 huggingface dataset:
Educational interventions for knowledge on the disease, treatment adherence and control of diabetes mellitus
Authors: Figueira Ana Laura Galhardo , Boas Lilian Cristiane Gomes Villas , Coelho Anna Claudia Martins , Freitas Maria Cristina Foss de , Pace Ana Emilia
Published: April 2017

Abstract Objective: to assess the effect of educational interventions for knowledge on the disease, medication treatment adherence and glycemic control of diabetes mellitus patients. Method: evaluation research with "before and after" design, developed in a sample of 82 type 2 diabetes mellitus patients. To collect the data, the Brazilian version of the Diabetes Knowledge Scale (DKN-A), the Measure of Adherence to Treatments and the electronic system at the place of study were used. The data were collected before and after the end of the educational interventions. The educational activities were developed within 12 months, mediated by the Diabetes Conversation Maps, using the Cognitive Social Theory to conduct the interventions. Results: the knowledge on the disease (p<0.001), the medication treatment (oral antidiabetics) (p=0.0318) and the glycated hemoglobin rates (p=0.0321) improved significantly. Conclusion: the educational interventions seem to have positively contributed to the participants' knowledge about diabetes mellitus, the medication treatment adherence and the glycated hemoglobin rates.
Tangibilidade e Intangibilidade na Identificação do Desempenho Persistente: Evidências no Mercado Brasileiro
Authors: Medeiros Ayron Wanderley , Mol Anderson Luiz Rezende
Published: April 2017

Resumo Carvalho, Kayo e Martin (2010) apontam que o desempenho acima da média e persistente de uma organização pode ser explicado por sua capacidade de explorar adequadamente os recursos e competências tidos como raros e valiosos. Esta pesquisa investigou se a persistência do desempenho superior de companhias abertas brasileiras, por setor, pode ser atribuída à tangibilidade, à intangibilidade, aos níveis de governança corporativa e ao grau de responsabilidade social das companhias. A amostra se constituiu das empresas brasileiras listadas na BM&FBovespa e as informações foram coletadas na base de dados da consultoria Bloomberg. Utilizou-se uma abordagem de painel dinâmico, por meio do Método dos Momentos Generalizados de Sistema (GMM-SYS) de Arellano e Bover (1995) e Blundell e Bond (1998). Os resultados apontam para a evidência significativa de que a intangibilidade impõe reduções à persistência do desempenho das companhias, na grande maioria dos setores. A tangibilidade e níveis de governança corporativa apresentam efeito heterogêneo sobre o desempenho persistente. Os níveis de responsabilidade social impactam, positivamente e significativamente, a persistência do desempenho superior das companhias abertas no Brasil.
CHANGES IN CHEMICAL PROPERTIES BY USE AND MANAGEMENT OF AN OXISOL IN THE AMAZON BIOME
Authors: RODRIGUES MARCOS , RABÊLO FLÁVIO HENRIQUE SILVEIRA , CASTRO HEBER AUGUSTO DE , ROBOREDO DELMONTE , CARVALHO MARCO ANTONIO CAMILLO DE , ROQUE CASSIANO GARCIA
Published: April 2017

ABSTRACT The proper soil use and management are essential for a sustainable production, thus the pursuit for systems that minimize damages to the environment and improve soil fertility is continuous. The objective of this study was to evaluate changes in soil fertility by the use and management of an Oxisol (Latossolo Vermelho-amarelo, SiBCS) in the Amazon biome. The soil uses and management systems evaluated were native forest, native pasture, minimum tillage system and conventional tillage system. The chemical atributes of the soil layers 0.00-0.10, 0.10-0.20, 0.20-0.30 and 0.30-0.40 m were evaluated. The soil pH (CaCl2) and the contents of organic matter, available phosphorus and exchangeable potassium, calcium, magnesium and aluminum were evaluated and the saturation by Al, effective cation exchange capacity and soil potential were determined. The highest pH values were found in the native pasture area, and the highest exchangeable aluminum contents were found in the layers 0.00-0.10 and 0.10-0.20 m of the conventional tillage system. The highest phosphorus availability was found in the layer 0.00-0.10 m of the native forest area. The highest potassium availability was found in the minimum tillage system. The lowest calcium and magnesium values were found in the layers 0.00-0.10 and 0.10-0.20 m of the conventional tillage system. The highest soil organic matter content was found in the layer 0.00-0.10 m of the native forest area. The nutrient availability for plants decreases in soils managed using the conventional tillage system. Soil uses and management systems of little soil disturbance are recommended to minimize environmental degradation in the Amazon biome.
ORGANIC MATTER FRACTIONS OF AN IRRIGATED OXISOL UNDER NO-TILL AND CONVENTIONAL TILLAGE IN THE BRAZILIAN SEMI-ARID REGION
Authors: SALES RAFAEL PEREIRA , PEGORARO RODINEI FACCO , PORTUGAL ARLEY FIGUEIREDO , MOREIRA JOSÉ ALOÍSIO ALVES , KONDO MARCOS KOITI
Published: April 2017

ABSTRACT The replacement of natural vegetation by crop systems directly impacts the soil organic matter fractions. The objective of this study was to evaluate the total organic carbon (TOC) and nitrogen (TN) contents in different fractions of the soil organic matter (SOM) of an Oxisol of the Brazilian semiarid region under different irrigated crops and different soil management systems. Seven treatments were evaluated, which consisted of two soil management systems (no-till and conventional tillage) and three crops (maize, sunflower and sorghum), using as reference the soil under a native forest (NF). The summer crops preceded common bean crops in the autumn-winter. The total organic carbon content, total nitrogen, carbon content in humic substances and their constituents (fulvic acids, humic acids and humin) and labile, non-labile and water-soluble carbon contents were evaluated two years and three months after the experiment implementation to determine the carbon lability (L) lability index (LI), partitioning index (CPI) and management index (CMI). The greatest carbon, nitrogen and organic matter contents in the soil surface layer (0.00-0.05 m) were found in crops under no-till system (NTS), especially maize. The crops under NTS presented greater carbon content in humic substances than the conventional tillage system (CTS) ones in the layer 0.05-0.10 m. The crops under NTS presented greater sustainability in the Brazilian semiarid region compared with those under CTS, as shown by their higher CMI in the soil surface layer.
AGRONOMIC PERFORMANCE OF COWPEA CULTIVARS DEPENDING ON SOWING SEASONS IN THE CERRADO BIOME
Authors: ALMEIDA FERNANDO DA SILVA , MINGOTTE FÁBIO LUIZ CHECCHIO , LEMOS LEANDRO BORGES , SANTANA MÁRCIO JOSÉ DE
Published: April 2017

ABSTRACT The objective of this work was to assess the agronomic performance of cowpea cultivars depending on sowing seasons in the Cerrado biome. Thus, an experiment was conducted in Uberaba, State of Minas Gerais, Brazil, in a complete randomized block design, in a 6x3 factorial arrangement, using six cowpea cultivars (BRS-Itaim, BRS-Guariba, BRS-Potengi, BRS-Cauamé, BRS-Novaera and BRS-Tumucumaque) and three sowing seasons (Dec 14, 2012; Jan 14, 2013; and Feb 14, 2013), with four replications. The interaction between the cultivars and sowing seasons was assessed regarding the number of days for full flowering, number of days for pod maturation, number of trifoliate leaves, height of the first pod -bearing node, pod length, number of pods per plant, final plant population, 100-grain weight and grain yield. The cowpea cultivars sown in December produced the lowest numbers of pods per plant and grains per pod, resulting in the lowest grain yields. The cultivar BRS-Tumucumaque had the highest grain yield in the January sowing. The highest grain yields were found in the February sowing, especially when the cultivars BRS-Itaim (3,439 kg ha-1), BRS-Novaera (3,435 kg ha-1), BRS-Guariba (3,168 kg ha-1) and BRS-Potengi (3,107 kg ha-1) was used.
BUFFEL GRASS MORPHOAGRONOMIC CHARACTERIZATION FROM Cenchrus GERMPLASM ACTIVE BANK
Authors: BRUNO LEILA REGINA GOMES PASSOS , ANTONIO RAFAELA PRISCILA , ASSIS JOSÉ GERALDO DE AQUINO , MOREIRA JOSÉ NILTON , LIRA IRLANE CRISTINE DE SOUZA ANDRADE
Published: April 2017

ABSTRACT This study aimed to characterize buffel grass accessions of the Cenchrus Germplasm Active Bank (CGAB) from Embrapa Semi-Arid in a morphoagronomic way, checking the descriptors variability and efficiency in accessions on two consecutive cuts. Twenty-five accessions and five buffel grass cultivars were used in randomized complete block design with three replications. Evaluations were conducted after two consecutive cuts, each evaluation performed 90 days after each cut. Characterization was based on 15 quantitative and qualitative morphoagronomic descriptors. Quantitative descriptors were subjected to individual and joint univariate analysis of variance, followed by the Scott-Knott’s test at 5% significance. Yet qualitative descriptors were submitted to descriptive analysis. Both quantitative and qualitative descriptors were grouped based on the Gower algorithm for divergence analysis. A dendrogram and calculations of the characters relative importance for divergence were established. Genotype and cutting effects were significant for almost all descriptors in the joint analysis. This result indicates a genetic variability between genotypes and, regarding the cut, it indicates mainly differences in growth rate of each genotype in each cutting season. Genotypes were separated into three groups, which showed good genotype variation. The number of tillers per clump, followed by number of inflorescence and color of seeds, were the most relevant characters in genotype separation.
FORMAÇÃO, CAMPO E OCASO: REGISTROS DA CRÍTICA CINEMATOGRÁFICA NA AMÉRICA LATINA
Authors: Altmann Eliska
Published: April 2017

Resumo No contexto dos estudos da recepção, o artigo traz resultados de uma pesquisa sobre crítica cinematográfica na América Latina por intermédio de pressupostos sociológicos. Formação, campo e um suposto ocaso da função da crítica são elementos-chave para a discussão dos personagens em questão. Assim, com base em entrevistas com críticos da Argentina, de Cuba e do México, são discutidas questões do tipo: qual o papel específico da crítica nesses países? E qual o seu estado nos dias de hoje em comparação a sua institucionalização nos anos de 1950/1960? Apesar da dificuldade de se chegar a uma definição estrita sobre a instituição "crítica", busca-se 1) valorizar o debate sobre recepção de bens culturais, e 2) compreender certo circuito latino-americano nele inscrito.
Motivos para atuação e formação profissional: percepção de doulas
Authors: Ferreira Junior Antonio Rodrigues , Barros Nelson Filice de
Published: April 2017

Resumo A discussão sobre as práticas profissionais no modelo obstétrico brasileiro torna-se potente quando é possível destacar a atuação de cada ator neste cenário. Objetivou-se neste estudo analisar os fatores motivacionais para mulheres buscarem a formação de doula e desenvolverem suas atividades profissionais. Trata-se de pesquisa qualitativa exploratório-descritiva, realizada com 13 doulas, participantes de formação específica, através de entrevistas individuais por telefone. Após a análise dos depoimentos, emergiram duas categorias: O motivo para a formação no curso de doula; Os grupos de referência como perspectiva para o trabalho das doulas. Evidenciou-se que experiências individuais com o próprio parto motivaram mulheres na busca desta formação e que o fortalecimento da profissionalização por meio da constituição de grupos é uma forma buscada pelas doulas para qualificar sua atuação na obstetrícia.
Interictal abnormal fMRI activation of visual areas during a motor task cued by visual stimuli in migraine
Authors: Conforto Adriana Bastos , Chaim Khallil Taverna , Peres Mario Fernando Prieto , Gonçalves André Leite , Siqueira Inara Laurindo , Barreiros Maria Angela Maramaldo , Amaro Junior Edson
Published: April 2017

ABSTRACT Objective To assess changes in blood-oxygen-level-dependent activity after light deprivation compared to regular light exposure in subjects with migraine in the interictal state and in controls. Methods Ten subjects with migraine and ten controls participated in two sessions of functional magnetic resonance imaging. In each session, they performed a finger-tapping task with the right hand, cued by visual stimuli. They were scanned before and after 30 minutes of light deprivation or light exposure. In subjects with migraine, functional magnetic resonance imaging was performed interictally. Analysis of variance was made with the factors time (before or after), session (light deprivation or exposure), and group (migraine or control). Results There were significant “group” effects in a cluster in the bilateral cuneus encompassing the superior border of the calcarine sulcus and extrastriate cortex. There were no significant effects of “time”, “session”, or interactions between these factors. Conclusion The main result of this study is consistent with aberrant interictal processing of visual information in migraine. Light deprivation did not modulate functional magnetic resonance imaging activity in subjects with or without migraine.
Nommer les Choses: sur quelques inscriptions peintes dans la céramique attique archaïque
Authors: Lissarrague François
Published: April 2017

Résumé: Cet article étudie la façon dont les peintres de vases ont parfois associé aux objets représentés des inscriptions qui les nomment. Il ne s’agit pas, ce faisant, d’expliquer l’image mais d’attirer le regard sur des éléments de la représentation qui ont une importance narrative ou symbolique forte.
Management of patients with atrial fibrillation in general practice
Authors: Frolova Elena V
Published: April 2017

The lecture presents modern concepts of diagnosis and treatment of atrial fibrillation; principles of choosing the tactics of management of atrial fibrillation in general practice. The epidemiology of atrial fibrillation, risk factors, causes and mechanisms of its development are considered. The classification of atrial fibrillation is given. The tactic of diagnosis of atrial fibrillation is described. The principles of treatment of atrial fibrillation, including the anticoagulant therapy and pharmacological cardioversion, are presented.
A Robust Symmetric Nonnegative Matrix Factorization Framework for Clustering Multiple Heterogeneous Microbiome Data
Authors: Ma Yuanyuan , Hu Xiaohua , He Tingting , Jiang Xingpeng
Published: April 2017

Integration of multi-view datasets which are comprised of heterogeneous sources or different representations is challenging to understand the subtle and complex relationship in data. Such data integration methods attempt to combine efficiently the complementary information of multiple data types to construct a comprehensive view of underlying data. Nonnegative matrix factorization (NMF), an approach that can be used for signal compression and noise reduction, has aroused widespread attention in the last two decades. The Kullback–Leibler divergence (or relative entropy) information distance can be used to measure the loss function of NMF. In this article, we propose a fast and robust framework (RSNMF) based on symmetric nonnegative matrix factorization (SNMF) and similarity network fusion (SNF) for clustering human microbiome data including functional, metabolic and phylogenetic profiles. Many existing methods typically utilize all the information provided by each view to create a consensus representation, which often suffers a lot from noise in data and cannot provide a precise representation of the latent data structures. In contrast, RSNMF combines the strength of SNMF and the advantage of SNF to form a robust clustering indicator matrix thus can reduce the noise influence. We conduct experiments on one synthetic and two real dataset (microbiome data, text data) and the results show that the proposed RSNMF has better performance over the baseline and the state-of-art methods, which demonstrates the potential application of RSNMF for microbiome data analysis.
Molecular technologies for detection and typing of bluetongue virus
Authors: Niedbalski Wiesław
Published: April 2017

Rapid and accurate diagnosis plays an important role in the implementation of effective measures to control the spread of disease. Historically, the laboratory diagnosis and typing of BTV were carried out by various serological and virological methods, including virus neutralization (VN) assay, ELISA, as well as virus isolation (VI) in cell cultures or in embryonated chicken eggs. At present, various molecular techniques to detect BTV genome are increasingly used as primary diagnostic tools for the serotyping and epidemiological investigations of BTV. Initially, the viral RNA was detected by simple nucleic acid hybridization technologies. Then, conventional RT-PCR assays were developed and evaluated for the detection of BTV serotypes based on nucleotide sequences of different genome segments. Although RT-PCR, with its increased sensitivity, has advantages over hybridization, it is almost impossible to quantify accurately by regular and multiplex PCR procedures, and regular PCR may produce false positive results. Over the recent years, a number of real-time RT-PCR (rRT-PCR) methods have been described. The rRT-PCR offers certain advantages over conventional RT-PCR assay, as it is more rapid, sensitive, and can provide quantitative as well as qualitative genetic information. It does not use agarose gel electrophoresis, decreases the risk of contamination because it is run within an enclosed tube, and is suitable for large-scale testing and automation. The target amplicon is usually smaller, reducing the potential for problems caused by target degradation. Loop-mediated isothermal amplification (LAMP), a novel rapid, accurate and cost effective gene amplification method, is an autocycling and strand displacement DNA synthesis method. LAMP assays have been applied as a method of detecting a variety of animal pathogens, including BTV. RT- LAMP assay can be a valuable tool complementing the routine laboratory diagnosis of BTV.
MANFAAT JEJARING SOSIAL BAGI KEGIATAN DAKWAH SISWA PRATEPSASANA ISMAIL MEMORIAL SCHOOL (PIMS) NAKHON SI THAMMARAT THAILAND SELATAN
Authors: Handayani Maya Rini
Published: April 2017

Abstract

This article discusses about the benefits of information technology for Islamic
da’wa activities of PIMS (Pratepsasana Ismail Memorial School) students. In this
article, the information technology focuses on social network, which is a facebook. PIMS is a school managed by Pondok Bantan in Nakhon Si Thammarat
(NST) province, Southern Thailand. Both PIMS school and pondok Bantan
have provided some modern facilities such as buildings, classrooms, and computer laboratories. Therefore, it is very interesting to know the PIMS student’s
Islamic da’wa activities using the information technology by utilizing computer
laboratories in PIMS and Pondok Bantan.

Keyword: dakwah Islamiyah, facebook, Pratepsasana Ismail Memorial
School
ISLAM DAN PERADABAN
Authors: Anieg Mukhamad
Published: April 2017

Abstract

! e word Civilization is often given the same meaning with culture. But there is a di$ erence in meaning between the two terms. The term Civilization to civilization and Culture for culture. Similarly differentiated between in Arabic word Tsaqafah (culture), said Hadharah (progress), and of the Tamaddun
(civilization). Al-kala’i argues that culture in the Arabic language means al-tsaqofah.Initially, i.e. from the time of Rosululloh until the 12th century ad this civilization has managed successfully so that it can give birth to world-class historians so that from here can also give birth to community organizations,
the economic centre of the region, language, education, religious belief and science, all of which were based on the religion of islam. Already quite a lot of Americans, Europeans and others converted to Islam. However, unfortunately the addition of Muslims is not coupled the readiness concept in Islamic
civilization progress. at this time the quantity of people the most is the religion of Islam which reached 1.4 billion people. But it is not the completion of the Muslims in the face of the progress of civilization.
Finally the triumph of Islam was down. ! erefore, we must build the Islamic Civilization.

Keyword: Civilization, religious, community.
EKSISTENSI TUHAN DALAM PANDANGAN ATEISME
Authors: Baharudin M.
Published: April 2017

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Implikasi Psiko-Sosio-Religius Tradisi Nyadran Warga Kedung Ombo Zaman Orde Baru
Authors: Hasanah Hasyim
Published: April 2017

Abstrak

Nyadran merupakan salah satu bentuk ritual sosial keagamaan masyarakat (khususnya) Jawa, biasa dilakukan menjelang bulan Ramadhan. Nyadran sebagai sebuah peristiwa sejarah yang menjadi tradisi, memiliki makna filosofis yang sangat beragam bagi masing-masing komunitas warga masyarakat. Variasi pemaknaan nyadran tergantung dari mana orang memahaminya. Makalah ini bertujuan untuk menganalisis implikasi psiko-sosio-religius tradisi nyadran warga Kedung Ombo zaman Orde Baru dalam tinjauan filsafat sejarah pragmatis. Penggunaan filsafat sejarah pragmatis berupaya menggali nilai-nilai moral sejarah yang meliputi perubahan, perkembangan, dan kemajuan nilai moral peristiwa sejarah. Untuk mendapatkan gambaran menyeluruh, maka penulis mempergunakan metode induktif. Data diperoleh melalui wawancara, dan dokumentasi. Analisis data menggunakan kerangka kerja filsafat sejarah pragmatis. Hasil penelitian menunjukkan bahwa, a) Praktik nyadran warga Kedung Ombo baru dilakukan pada masa orde baru tahun 1987, sebagai reaksi atas pembangunan Waduk Kedung Ombo; b) Nyadran bagi warga sekitar Waduk Kedung Ombo memiliki implikasi psikologis berupa respon emosional positif dalam bentuk penerimaan, kesadaran, dan semangat bertahan hidup menghadapi bencana kelaparan; c) Implikasi sosiologis tradisi nyadran memunculkan rasa solidaritas sosial sebagai wujud penghormatan kepada para leluhur; d) implikasi religius merupakan ungkapan rasa syukur atas karunia Tuhan.

Keywords: Nyadran, filsafat sejarah pragmatis, implikasi psiko-sosio-religius
Manajemen Pendidikan Islam Dalam Keluarga
Authors: Murtopo Bahrun Ali
Published: April 2017

Abstrak

Individual’s relationship in a family environment very affects child’s psychological and the impact will be seen when she is a teenager. Loving atmosphere and conducive atmosphere in an intellectual development which have been built in a family will make a child able to adapt himself, with his family and the surrounding community. Many experts proved that children who grew up in a home without parental supervision more have problem than children who receive supervision from their parents.
Therefore, the formation of a family required an integrated education program and directed education program. Education programs in this family must be able to give a clear job description for each individual in the family, so that each individual can perform an ongoing role for the creation of a conducive family environment to educate children maximally.
In the first part of this book we will describe some of the significant factors in outlines family education according to the Islamic teaching, which is as follows.

Keywoard: konsep keluarga Islami, Hak dan kewajiban, Implikasiss
Discovery of Novel 2-Amino-5-(Substituted)-1,3,4-Thiadiazole Derivatives: New Utilities for Colon Cancer Treatment
Authors: Raj Vinit , Rai Amit , Singh Ashok K. , Keshari Amit K. , Trivedi Prakruti , Ghosh Balaram , Kumar Umesh , Kumar Dinesh , Saha Sudipta
Published: April 2017

Background:

Colon cancer is one of the most widespread disease, the mortality rate is high due to
cancer metastasis and the development of drug resistance. In this regards, new chemotherapeutic agents with
specific mechanisms of action and significant effect on patient’s survival are the new era for the colon cancer
drug development.

Objective:

The main objective of present study was to design, synthesize of a novel series of 1,3,4-thiadiazole
derivatives (VR1 to VR35) and screen them against HT-29 human colon cancer cell line.

Method:

Newly 1,3,4-thiadiazole scaffold were designed, synthesized and further, characterized by FTIR, NMR
(1H and 13C), MS and elemental analyses. Before the synthesis, molecular dynamic simulation and ADME studies
were performed to find out the most potent lead compounds. Later, SRB assay using HT-29 cells and ELISA
assays were performed to explore activity and molecular targets of VR24 and VR27 and find out whether in
silico data had a similar pattern in the molecular level.

Results:

The results of docking study revealed that both VR24 and VR27 had interaction energy >-5 kcal/mol
with various assigned molecular targets and the ligand-protein complexes were found to be stable with IL-6. The
computational analysis of molecules showed good ADMET profiling. Later, the in vitro anticancer study was
conducted where VR24 and VR27 were found to be active against HT-29 cells (GI50<10 µM). Finally, ELISA
assays revealed that both the compounds had higher inhibition properties to various biomarker of colon cancer
like IL-6 and COX-2.

Conclusion:

Collectively, these result suggested that VR24 and VR27 inhibited the assigned molecular targets,
imparting their ameliorative effects against colon cancer. Due to these encouraging results, we concluded that
both VR24 and VR27 may be effective against colon cancer therapy in future.
Using weighted hospital service area networks to explore variation in preventable hospitalisation.
Authors: Falster Michael , Jorm Louisa , Leyland Alastair
Published: April 2017

ABSTRACT

ObjectivesMarkets of health care are created in health services research to attribute variation in performance to characteristics of the health system. Defining patient catchments to capture hospital-level variation poses particular difficulties, because many factors other than geography drive choice of hospital. Several methods using linked data have been developed to create patient catchments or ‘hospital service areas’ (HSAs), including patterns of patient flow and networks of patient and physician referrals, yet these discrete catchments often have poor patient loyalty and are unable to attribute variation to specific hospitals. This study sought to demonstrate the use of multiple membership multilevel models, which cluster people in one or more higher-level units (such as multiple hospitals), in exploring between-hospital variation of preventable hospitalisations.

ApproachLinked hospital data from 267,014 participants in the 45 and Up Study, NSW Australia, with linkage by the NSW CHeReL, were used to create weighed hospital service area networks (HSANs) in which patterns of patient flow to large public hospitals within 593 postal areas were used to create a weighted probability of admission of participants to each hospital. Multiple membership multilevel Poisson models were used to explore variation in rates of preventable hospitalisation, clustering participants in hospitals using a weighted HSAN, and compared with models clustering participants in HSAs based on the most common hospital of admission.

ResultsThe most common hospital of admission accounted for an average of 67% of all admissions in each postal area. There was significant variation in rates of preventable hospitalisation between all 79 large public hospitals when clustering participants in a weighted HSAN, which was more than twice as large as the variation between the 72 hospitals forming the basis of HSAs. The ranking of hospitals differed between modelling approaches, and the hospital with the highest rate of preventable hospitalisation wasn’t identified when using HSAs. There was no association between hospital bed occupancy rate and preventable hospitalisations when using either modelling approach.

ConclusionQuantifying variation in health service use and outcomes is the cornerstone of creating accountable health care systems, yet much information is lost in creating discrete health catchments. Multiple membership multilevel models can help capture this uncertainty, and given they can be applied using extensions of current methodology, have potential to be used across a variety of methods for defining and analysing health care catchments.
Maternal age and child development outcomes at age five in Australian Aboriginal and non-Aboriginal children: a population data linkage study
Authors: Falster Kathleen , Hanly Mark , Banks Emily , Lynch John , Jorgensen Mikaela , Brownell Marni , Jorm Louisa
Published: April 2017

ABSTRACT

ObjectivesAlmost one-fifth of Australian Aboriginal mothers give birth before 20 years of age compared with 3% of non-Aboriginal mothers. We aim to quantify the effect of maternal age at birth on child development outcomes in Aboriginal compared with non-Aboriginal children.

ApproachThe ‘Seeding Success’ study cohort comprises an almost complete population of children who started school in Australia’s most populous state, New South Wales (NSW), in 2009 or 2012, and were born in NSW, identified by linking Australian Early Development Census (AEDC) data to perinatal and birth registration datasets. Of the 154,936 children in the cohort, 8001 (5%) were Aboriginal. We calculated the risk of developmental vulnerability on one or more AEDC domains by maternal age at birth and Aboriginality. Risk differences and risk ratios (RR) were estimated as measures of absolute and relative inequalities, respectively. Multilevel Poisson regression was used to test the effect of maternal age on child development by Aboriginality.

Results1383 (17%) Aboriginal children were born to a mother <20 years compared with 4310 (3%) non-Aboriginal children. Among Aboriginal and non-Aboriginal children, the risk of developmental vulnerability decreased with increasing maternal age up to 35 years; the risk increased for children born to mothers >35 years. Among Aboriginal children, the risk decreased from 46% (95%CI, 39-52) to 31% (95%CI, 24-38) in children born to mothers’ aged ≤16 years to age 35 years, respectively. In non-Aboriginal children, the risk decreased from 38% (95%CI, 33-43) to 16% (95%CI, 15-17) in those born to mothers’ aged ≤16 years to 35 years, respectively. Risk differences and risk ratios for developmental vulnerability between Aboriginal and non-Aboriginal children increased with increasing maternal age. Compared to non-Aboriginal children born to mothers aged ≥20 years (ref group, RR, 1.0), the RR for developmental vulnerability was 1.7 (95% CI, 1.6-1.9) for non-Aboriginal children born to mothers aged <20 years; 1.6 (95% CI, 1.6-1.7) for Aboriginal children born to mothers aged ≥20 years; and 2.2 (95% CI, 2.0-2.3) for Aboriginal children born to mothers aged <20 years.

ConclusionChildren born to very young mothers had a high risk of vulnerability regardless of Aboriginality, whereas Aboriginal children had a greater risk of developmental vulnerability across the rest of the maternal age range. Both absolute and relative inequalities in developmental vulnerability increased with increasing maternal age. Early intervention and support services targeted at Aboriginal mothers and their children, regardless of the mother’s age, may reduce this inequality.
Preschool attendance and early childhood development outcomes in the first year of school for Aboriginal and non-Aboriginal children in New South Wales, Australia
Authors: Jorgensen Mikaela , Falster Kathleen , Hanly Mark , Goldfeld Sharon , Jorm Louisa , Craven Rhonda
Published: April 2017

ABSTRACT

ObjectivesA key target to reduce the gap in early childhood outcomes between Australian Aboriginal and non-Aboriginal children has been to increase preschool enrolment rates, particularly in remote communities. However, there is little population-based information on preschool attendance and its impact on child development for Aboriginal children specifically. This study aims to examine: (i) the characteristics of children, families and areas associated with preschool attendance; and (ii) the association between preschool attendance and childhood development in the first year of school for Aboriginal and non-Aboriginal children in Australia’s most populous state, New South Wales (NSW).

ApproachRoutinely-collected birth registration, perinatal, health and education data were used to create a linked dataset consisting of an almost complete population of children known as the ‘Seeding Success’ cohort. These children were born in NSW and had an Australian Early Development Census (AEDC) checklist completed by their teacher in their first year of school in NSW in 2009 and 2012 (n=154,936). Multilevel Poisson regression modelling was used to determine child-, family- and area-level characteristics associated with preschool attendance in the year before starting school. The association between preschool attendance and childhood development in the first year of school, as measured across five AEDC developmental domains, was also examined.

Results71% of Aboriginal children attended preschool in the year before school (95% CI: 70% to 72%) compared with 76% of non-Aboriginal children (95% CI: 76% to 77%). The prevalence of preschool attendance was lower in major cities compared with regional and remote areas, with 65% of Aboriginal children attending preschool in major cities compared with 73% in outer regional and 79% in remote areas. Factors associated with preschool attendance in the year before starting school included being non-Aboriginal, speaking English as a first language, having a mother with a partner, having fewer older siblings, living in a more remote area and living in a less socioeconomically disadvantaged area. After adjusting for potentially confounding factors, Aboriginal children who attended preschool were more likely to be developmentally ‘on track’ compared with Aboriginal children who did not attend preschool, in four of the five AEDC domains.

ConclusionThe barriers to preschool attendance for Aboriginal children living in major cities should be further explored. Targeted support for families and areas where preschool attendance is lower is likely required to ensure children have access to the apparent benefits of preschool education.
Identification of falls subgroups through semantic similarity analysis
Authors: Almohaimeed Muhannad , Brass Andy , Ba-Dhfari Thamer
Published: April 2017

ABSTRACT

ObjectivesThe information contained within medical data is often used to make new medical discoveries. However, the most common way to use such data has been to query the data to answer very specific questions. For example, does having diabetes cause some patients to experience falls? If researchers have good questions, then the data can provide good answers. But are there any other equally important questions that could be asked of the data that people haven’t yet thought to ask?

We are exploring a new strategy that we have developed to look for unusual and interesting patterns about falls in the elderly at subgroups level to see the different risks associated with different groups. Some of these risks will be associated with questions that are already well-known, but some should point to new and important questions that have not yet been asked. This opens up a better opportunity to identify patients at risk of falls, helping guide policy so as to reduce falls.

ApproachWe mapped patient records into a low dimensional space using the notions of semantic similarity (Resnik node-based) and machine learning (principal component analysis) to provide a good representation of the data. This representation was used for clustering and visualisation through the DBSCAN algorithm. To look for enrichment in the resultant clusters, we analysed each cluster separately and look at the sets of patients defined in these clusters. Then, classic data mining techniques were used in order to generate hypotheses. The associations found were then be tested using more traditional comorbidity measures such as relative risk (RR) and its confidence intervals.

ResultsWe demonstrated the methodology on 589,169 older adults from clinical practice research datalink (CPRD). We successfully identified six distinct subgroups of falls from the elderly population who are identified with different risks. Some of the associations found are well defined in the literature; for example, depression and musculoskeletal conditions are significantly associated with falls. However, a number of associations are not reported in the clinical literature. Such hypotheses need further exploration by epidemiologists.

ConclusionFuture work will focus on incorporating temporal dimension which might provide useful insights into missed opportunities detection and risk modelling and understanding of a disease. Last, this methodology holds promises for the study of other complex diseases using any source of data which are described using terms from taxonomies or ontologies.
In adults with multimorbidity, does the provision of social care services have an effect on the use of primary care and secondary care health services?
Authors: Henderson David
Published: April 2017

ABSTRACT

ObjectivesHealth and social care is an area of high policy importance in the UK. Integration of health boards with local authority provided social care in Scotland in 2016 is a major structural change in delivery of care. Improvements in service and efficiency are expected and indeed required in an era of declining budgets. 

Intuitively, health and social care are closely linked, particularly for those with multiple morbidities. However, little is known about the relationship between health and social care services and how usage of one has an impact on the other in terms of outcomes and costs.

The study aims to describe the methods that have been used to analyse the relationship between social care, primary care and secondary care services.

Findings will inform the analysis of a large linked dataset of health care, social care and benefits data that will investigate the interactions between health and social care, multimorbidity and socioeconomic status.

ApproachA Scoping review of literature aiming to identify academic studies that have made an assessment of the relationship between health care and social care.

A search of academic databases will be augmented by a search of grey literature aiming to identify the extent, range and nature of studies. Data will be extracted on populations, study designs, results and recommendations. Results will be visualised in charts alongside a descriptive qualitative synthesis.

ResultsExpected June 2016
Comparison of child mortality by characteristics at birth in England and in Sweden using linked administrative data
Authors: Zylbersztejn Anna , Gilbert Ruth , Hjern Anders , Hardelid Pia
Published: April 2017

ABSTRACT

ObjectivesEngland has one of the highest child mortality rates in Western Europe, while Sweden has one of the lowest. These differences suggest that improvements in early life mortality should be achievable in England. However, policy makers need to know when in the life course to target interventions to prevent the largest number of deaths in early life, e.g. by addressing the prevalence of risk factors at birth (such as preterm birth or low birthweight), or improving the care of babies after birth. This study aims to compare child mortality in England and in Sweden using whole country birth cohorts based on linked administrative health databases in order to determine whether the disparities are driven by risk factors operating before or after birth.

ApproachWe created birth cohorts from a national birth register (Sweden) and a hospital admission database (England). These were linked to longitudinal hospital data and death registration data. All singleton live births for 2003-2012 were included and followed from birth up to five years. We compared mortality in England and in Sweden using Cox proportional hazard model with characteristics at birth (gestation, birthweight, gender, maternal age, congenital malformations), socio-economic status and country as covariates.

ResultsThe study cohort comprised 1,047,192 children in Sweden and 6,117,693 children in England. 2,820 of cohort children died in Sweden (0.3%) and 28,434 in England (0.5%).

Preliminary results showed that under-5 mortality was almost twice as high in England as in Sweden (5.1 deaths per 1000 live births, 95% confidence interval (CI): 5.0/1000-5.2/1000 vs 3.0/1000, 95% CI: 2.9/1000-3.2/1000). Mortality rates were 45% higher in England during infancy, but only 15% higher in early-childhood (1-4 years). Children with congenital malformations were at similar risk of death in England (33.9/1000, 95% CI: 32.9/1000-34.8/1000) as in Sweden (32.7/1000, 95% CI: 29.5/1000-35.8/1000). The prevalence of congenital malformations, however, was twice as high in England (5.1% vs 2.6%).

ConclusionsOur preliminary results suggest that the disparities in early-childhood mortality were partly driven by increased prevalence of congenital malformations in England relative to Sweden, as mortality rates within this group were comparable.

Individual-level data from birth cohorts constructed using linked administrative health databases enable comparing mortality among children with the same combinations of risk factors at birth. Such analyses can inform policy makers whether resources to prevent early-life mortality are most effectively targeted at improving the health of pregnant women, neonatal care, or supporting families with young children.
Autism Spectrum Disorders and Assisted Reproductive Technology: Massachusetts 2004-2010 Population-based Results from Data Linkage Efforts
Authors: Kotelchuck Milton , Gopal Daksha , Kernan Gabriela , Diop Hafsatou
Published: April 2017

ABSTRACT

ObjectivesThe etiology of autism spectrum disorders (ASD) is unknown. The impact, if any, of assisted reproductive technology (ART) on ASD has not been established. The study compares the prevalence of children 0-3 years with ASD conceived by mothers with infertility through ART (ART), mothers with infertility but not using ART (SUBFERT), and mothers without infertility spontaneously conceiving (FERTILE) – separately among singletons and twins. The importance of linked population-based data systems to this analysis will be highlighted.

ApproachThis analysis requires linkage of three distinct data systems: the Society of Assisted Reproductive Technology Clinical Outcomes Reporting System (SART-CORS) clinical database; the Massachusetts Pregnancy to Early Life Longitudinal (PELL) public health data system (which includes birth certificate and hospital discharge data); and the Massachusetts’ children’s special needs Early Intervention (EI) program data. PELL data from 7/1/04-12/31/10 included 370,755 women with 474,784 deliveries resulting in 486,075 live births and fetal deaths. These were deterministically linked to 70,086 ART cycles among 28,490 women from SART-CORS; and then further linked to EI program participant data from 7/1/04-12/31/13. ASD was defined as a documented ASD diagnosis (ICD9 codes: 299) in the EI or hospital discharge records and/or claims documentation for autism-related EI specialty services. Chi-square and multivariate regression models estimated the association of ART, SUBFERT and FERTILE with ASD, controlling for maternal demographics, payer source, prenatal care, smoking, parity, delivery method, hypertension, obstetric or gynecologic health conditions, gender, paternal age and prematurity.

ResultsOur final study population consisted of 481,575 children (460,117 singletons and 21,458 twins). Among singletons, the ASD prevalence was 1.7% and 1.3% in the ART and SUBFERT groups, respectively, compared to 1.0% in the FERTILE group. Among twins, the ASD prevalence was 2.3% and 2.4% in the ART and SUBFERT groups, respectively, compared to 2.0% in the FERTILE group. Among singletons, the adjusted odd ratios (aORs) were 1.0 [95% CI: 0.9-1.3] and 1.1 (95% CI: 0.9-1.4) for ART and SUBFERT compared to the FERTILE group. Among multiples, aORs were 1.1 (95% CI: 0.8-1.4) and 1.2 (95% CI: 0.8-1.8) for ART and SUBFERT compared to the FERTILE group. There were no significant differences in ASD prevalence between ART and SUBFERT groups.

ConclusionsThe likelihood of an ASD diagnosis among singleton or twin children born to ART or SUBFERT mothers does not differ from FERTILE mothers. Population-based linkage of clinical and public health databases provides unique opportunities to examine longer-term outcomes of ART.
High quality linkage using Multibit Trees for privacy-preserving blocking
Authors: Brown Adrian , Borgs Christian , Randall Sean , Schnell Rainer
Published: April 2017

ABSTRACT

ObjectivesAs privacy-preserving record linkage (PPRL) emerges as a method for linking sensitive data, efficient blocking techniques that help maintain high levels of linkage quality are required. This research looks at the use of a Q-gram Fingerprinting blocking technique, with Multibit Trees, and applies this method to real-world datasets.

ApproachData comprised ten years of hospital and mortality records from several Australian states, totalling over 25 million records. Each record contained a linkage key, as defined by the jurisdiction, which was used to assess quality (i.e. used as a ‘gold standard’). Different parameter sets were defined for the linkage tests with a privacy-preserved file created for each parameter set. The files contained jurisdictional linkage key and a Cryptographic Long-term Key (the CLK is a Bloom filter comprising all fields in the parameter set).

Each file was run through an implementation of the Q-gram Fingerprinting blocking algorithm as a deduplication technique, using different similarity thresholds. The quality metrics of precision, recall and f-measure were calculated.

ResultsResultant quality varied for each parameter set. Adding suburb and postcode reduced the linkage quality. The best parameter set returned an F-measure of 0.951. In general, precision was high in all settings, but recall fell as more fields were added to the CLK. We will report details for all parameter settings and their corresponding results.

ConclusionThe Q-gram Fingerprinting blocking technique shows promise for maintaining high quality linkage in reasonable time. Determining which fields to include in the CLK for the linkage of specific datasets is important to maximise linkage quality, as well as selecting optimal similarity thresholds. Developing new technology is important for progressing the implementation of PPRL in real-world settings.