bluuebunny/crossref_metadata_2025 huggingface dataset:
A construção da agenda pública brasileira de enfrentamento da violência sexual infanto-juvenil
Authors: Nascimento Alexandre Ferreira do , Deslandes Suely Ferreira
Published: April 2017

Resumo O presente artigo analisa a emergência da questão social da violência sexual infanto-juvenil como problema público, sua inclusão e permanência na agenda formal das políticas nacionais nas décadas de 1990 e 2000. À luz de estudos sobre construção de agendas de políticas públicas e a partir da análise documental, o artigo contextualiza o amplo movimento de articulação e mobilização social da década de 1990, o Plano Nacional de Enfrentamento da Violência Sexual Infanto-juvenil como política pública intersetorial e a década de 2000 pautada pela sua implementação.
Avaliação da educação superior: um comparativo dos instrumentos de regulação entre Brasil e Portugal
Authors: Felix Glades Tereza , Bertolin Julio Godoy , Polidori Marlis Morosini
Published: April 2017

Resumo: O artigo procura estabelecer a relação entre os instrumentos utilizados no SINAES e a experiência empregada em nível internacional por meio do diálogo com o sistema europeu de avaliação da educação superior tendo como foco o caso de Portugal. Objetiva-se revisar, identificar e comparar a equivalência dos instrumentos de regulação implementados nos processos de avaliação e acreditação dos dois países. A investigação faz parte de uma pesquisa interinstitucional (UPF, UFSM, IPA e UCS) no âmbito do projeto “Meta avaliação do SINAES”, financiado pelo CNPq. Com base na pesquisa bibliográfica e na análise documental procurou-se demonstrar que são sistemas diferenciados, porém, relacionais que buscam a mesma finalidade: assegurar a forte capacidade reguladora do Estado. Conclui-se que no Brasil e em Portugal as avaliações são do tipo Top-down com perda de autonomia e liberdade acadêmica.
Electrical stimulation attenuates morphological alterations and prevents atrophy of the denervated cranial tibial muscle
Authors: Bueno Cleuber Rodrigo de Souza , Pereira Mizael , Favaretto Junior Idvaldo Aparecido , Bortoluci Carlos Henrique Fachin , Santos Thais Caroline Pereira dos , Dias Daniel Ventura , Daré Letícia Rossi , Rosa Junior Geraldo Marco
Published: April 2017

ABSTRACT Objective To investigate if electrical stimulation through Russian current is able to maintain morphology of the cranial tibial muscle of experimentally denervated rats. Methods Thirty-six Wistar rats were divided into four groups: the Initial Control Group, Final Control Group, Experimental Denervated and Treated Group, Experimental Denervated Group. The electrostimulation was performed with a protocol of Russian current applied three times per week, for 45 days. At the end, the animals were euthanized and histological and morphometric analyses were performed. Data were submitted to statistical analysis with a significance level of p<0.05. Results The Experimental Denervated Group and the Experimental Denervated and Treated Group had cross-sectional area of smaller fiber compared to the Final Control Group. However, there was significant difference between the Experimental Denervated Group and Experimental Denervated and Treated Group, showing that electrical stimulation minimized muscle atrophy. The Experimental Denervated and Treated Group and Initial Control Group showed similar results. Conclusion Electrical stimulation through Russian current acted favorably in maintaining morphology of the cranial tibial muscle that was experimentally denervated, minimizing muscle atrophy.
Risk factors for mortality in ventilator-associated tracheobronchitis: a case-control study
Authors: Pontes Leonilda Giani , Menezes Fernando Gatti de , Gonçalves Priscila , Toniolo Alexandra do Rosário , Silva Claudia Vallone , Kawagoe Julia Yaeko , Santos Camila Marques dos , Castagna Helena Maria Fernandes , Martino Marinês Dalla Valle , Corrêa Luci
Published: April 2017

ABSTRACT Objective To describe the microbiological characteristics and to assess the risk factors for mortality of ventilator-associated tracheobronchitis in a case-control study of intensive care patients. Methods This case-control study was conducted over a 6-year period in a 40-bed medical-surgical intensive care unit in a tertiary care, private hospital in São Paulo, Brazil. Case patients were identified using the Nosocomial Infection Control Committee database. For the analysis of risk factors, matched control subjects were selected from the same institution at a 1:8.8 ratio, between January 2006 and December 2011. Results A total of 40 episodes of ventilator-associated tracheobronchitis were evaluated in 40 patients in the intensive care unit, and 354 intensive care patients who did not experience tracheobronchitis were included as the Control Group. During the 6-year study period, a total of 42 organisms were identified (polymicrobial infections were 5%) and 88.2% of all the microorganisms identified were Gram-negative. Using a logistic regression model, we found the following independent risk factors for mortality in ventilator-associated tracheobronchitis patients: Acute Physiology and Chronic Health Evaluation I score (odds ratio 1.18 per unit of score; 95%CI: 1.05-1.38; p=0.01), and duration of mechanical ventilation (odds ratio 1.09 per day of mechanical ventilation; 95%CI: 1.03-1.17; p=0.004). Conclusion Our study provided insight into the risk factors for mortality and microbiological characteristics of ventilator-associated tracheobronchitis.
PENGEMBANGAN MODEL KOMUNIKASI EDUKATIF REINVENTING SUBSCONCIOUS MIND (RESMI) UNTUK MADRASAH IBTIDAIYAH
Authors: Prastowo Andi
Published: April 2017

The effort to develop communicative competence of Madrasah Ibtidaiyah teachers in Indonesia is still low. It is shown from various upgrading programs for teacher’s professionalism and quality which rarely touch communicative competence aspect. However, government regulation on academic qualification standard and teacher competence stated that communicative competence becomes the bases of pedagogic, social, and professional competences, except personality competence. In addition, in teacher training institute the course on learning communication is not always given. While communication play an important role for effective learning process. This article presents the research of development of Fikih learning communications model in Madrasah Ibtidaiyah namely reinventing subconscious mind (RESMI). The result shows that its implementation improves the familiarity between teachers and pupils, learning enthusiasm, ability to memorize materials, and improve learning achievement.
DAMPAK KONFLIK DAN RESOLUSI KONFLIK TERHADAP SISTEM PENDIDIKAN AGAMA ISLAM DI SEKOLAH SONGSERM ISLAM SEKSA PATANI, THAILAND SELATAN
Authors: Sulong Miss. Komareeyah , Machali Imam
Published: April 2017

This study describes the conflict and its resolution as well as the impact on the system of Islamic Education in Schools Songserm Seksa Islam Patani (SSIS) South Thailand. The discussion focused on three issues. First, how the conflict and its resolution is. Second, how the impacts of the conflict on the education system of the Islamic religion. And third, how the impacts of conflict resolution on the Islamic education system. The results showed that the conflict in Pattani is due to several factors: injustice, discrimination, mistrust each other, the differences of culture, media propaganda, political conflicts and interests. The impact of conflict on the education system in SSIS is the reduction of school hours, the decline of student achievement and teacher performance, the uncertainty caused by the changes of government’s policy on conflict resolution, and the school should be off abruptly during the conflict. While the impact of the conflict resolution toward Islamic Education System in SSIS is the increased quality of teacher performance, the growth of the spirit of educators in the learning process, and a culture of effective and conducive learning in SSIS.
PEMAHAMAN HADITS TARBAWI BURHAN AL ISLAM AL ZARNUJI DALAM KITAB TA’LIM AL MUTA’ALLIM
Authors: Afwadzi Benny , Fattah Abdul
Published: April 2017

This paper explores the understanding of tarbawi (education) hadith from one of the major influential clerics in the Islamic educational system, especially in pesantren. He is Burhan al Islam al Zarnuji with his landmark book Ta’lim al Muta’allim. The conclusion that can be drawn is that al Zarnuji has shades of sufistical view in understanding tarbawi hadith. This can be seen in his understanding of hadith on obligation to seek knowledge (thalab al ilmi faridhatun ‘ala kulli muslimin wa muslimatin), which is interpreted as ilm al hal, the science concerning the condition of the human religious or simplistically said as the religious sciences; and the hadith of intention of studying (innama al a’malu bi al niyyat) with the intention for the sake of the hereafter and religion, not mundane. Such an understanding is not something taken for granted, but it can be reinterpreted and perfected in accordance with the spirit of the times of context.
Fine Mapping of qFIS1‐2, a Major QTL for Kernel Fissure Resistance in Rice
Authors: Sater Haley M. , Pinson Shannon R. M. , Moldenhauer Karen A. K. , Siebenmorgen Terry J. , Mason Richard E. , Boyett Virginia A. , Edwards Jeremy D.
Published: April 2017

Rice (Oryza sativa L.) kernel fissuring causes breakage during milling and thereby decreases the value of rice. This study employed molecular gene‐tagging methods to fine map a fissure resistance (FR) locus in ‘Cybonnet’, a semidwarf tropical japonica cultivar, as well as to transfer this trait to rice genotypes of non‐semidwarf stature that are better adapted to some rice production systems. Three quantitative trait loci (QTLs) for FR were previously reported, with the FR locus linked with the semidwarf sd‐1 locus on chromosome 1 having the strongest effect. For fine mapping, F2 progeny were produced from a cross between US breeding line RU1201108, having non‐semidwarf height (Sd‐1/Sd‐1) and poor milling quality, and Cybonnet (sd‐1/sd‐1), having semidwarf height and containing multiple FR loci. Simple sequence repeat (SSR) markers were used to select F2 plants that both retained at least one copy of the Sd‐1 allele and showed evidence of genetic recombination in the region of chromosome 1 known to contain Sd‐1 and qFIS1‐2, a QTL for FR. Progeny from three F2 individuals with desirable recombination at the qFIS1‐2 were phenotyped for kernel FR. Marker‐trait linkages observed in the three populations indicated that the qFIS1‐2 locus resides on chromosome 1 distal to RM1068 at 38.44 Mb, but anterior to RM3482 at 39.72 Mb, placing it ∼6 to 10 cM distal to sd‐1 on chromosome 1. The recombination documented in this study verifies that the previously identified qFIS1‐2 is not pleiotropic with nor reliant on sd‐1 and can be recombined with Sd‐1 to increase the FR of non‐semidwarf rice cultivars.
STRATEGI PENERAPAN MANAJEMEN BERBASIS SEKOLAH (Studi Kasus di MI Nurul Islam Ngaliyan Semarang)
Authors: Sulistiyoningrum Munif Kholifah
Published: April 2017

Abstract

School based management determines e? ectiveness, e? ciency and productivity of school organization. It constitutes a new paradigm on educational system that gives wide autonomy to manage human and ? nance resources depending on priority. Its implementation is based on UU No.20 in 2003 regarding national education system article 51. MI Nurul Islam is one of the basic educational institutions that have successfully implemented school-based management. Th is is proved by academic and non-academic outcomes, supported by competitive quality, especially on religious discipline; good implementation stage of school based management (MBS); decentralization of educational implementation and successful character of headmaster of MI Nurul Islam. By using descriptive-qualitative approach, this study tries to explore the implementation strategy of school based management (MBS) in MI Nurul Islam Ngaliyan Semarang.

Keywords: School Based Management, Implementation Strategy, MI Nurul Islam, autonomy, decentralization.
The Relationship of Myometrial Invasion Between Other Prognostic Parameters in Endometrial Cancer
Authors: Bakır Mehmet Sait , Tahaoğlu Ali Emre , Erdoğdu Emre , Dane Cem
Published: April 2017

Objective: The aim of this study is to investigate the relationship between deep myometrial invasion and other prognostic factors in endometrial cancer. Recurrence rates, disease free survival and overall survival rates were evaluated in endometrial cancer patients with MI>50%.Sudy Design: A total of 132 patients with endometrial cancer who underwent surgical treatment between 2001 and 2011 were identified. Demographic, clinicopathological, surgical/adjuvant treatment and follow-up data were extracted.Results: Pelvic lymph node invasion ratio was 28,9% and para-aortic lymph node invasion ratio was 15,5% in patients with myometrial invasion is greater than 50%. Other prognostic factors especially lympho-vascular space invasion and pelvic/para-aortic lymph node metastasis were significantly higher when myometrial invasion is above 50% and also there was significant difference in recurrence rates, overall survival and disease free survival rates between patients with superficial and deep myometrial invasion (p<0.05).Conclusion: Myometrial invasion is an important prognostic parameter and can be determined intraoperatively to decide whether to perform pelvic and para-aortic lymph node dissection.
O conceito de saúde na ótica dos estudantes: contribuições para a formação de profissionais para o Sistema Único de saúde
Authors: MASAGÃO Simone Leite , BOTTEGA Carla Garcia
Published: April 2017

Este trabalho analisa a percepção a respeito do conceito de saúde de estudantes do curso de Administração: Sistemas e Serviços de Saúde da Universidade Estadual do Rio Grande do Sul (UERGS). A pesquisa, de cunho qualitativo, leva em conta os aspectos da realidade que não podem ser quantificados, buscando compreender e explicar a dinâmica das relações sociais. Também foram trabalhados dados sociodemográficos que permitiram analisar o perfil dos discentes, a partir de questionário autorrespondido. Além do conceito de saúde, também foram abordados o conhecimento sobre o Sistema Único de Saúde (SUS) e a experiência como estudante no Curso. Com a análise e discussão dos resultados, evidenciamos certo desconhecimento, por parte dos ingressantes, do sistema de saúde brasileiro em sua totalidade e complexidade; mas para os concluintes percebe-se um acúmulo de conhecimento construído ao longo da formação. É possível verificar que a concepção de saúde sofreu diversas mudanças ao longo da história e essa transformação também foi demonstrada pelas respostas dadas, pois, à medida que os discentes avançam no curso, nas oportunidades de conhecerem ações práticas em saúde, em seu trabalho, estágios e atividades complementares, também aprofundam a construção do conhecimento nesta área.
Um estudo sobre evasão e permanência em instituições de ensino superior no Rio Grande do Sul: um estudo com características do tipo do estado do conhecimento
Authors: HENGLES Aaron Concha Vasquez , PEREIRA Marcos Marcos Villela
Published: April 2017

Este estudo possui características de uma pesquisa do tipo do Estado do Conhecimento já que não temos a intenção de trabalhar com todos os tipos de publicações possíveis. Tem como objetivo evidenciar a temática da evasão e permanência nas Instituições Ensino Superior no Estado do Rio Grande do Sul, apresentando como maior propósito o de verificar o modo que esse assunto vem sendo anunciado nos programas de Pós-Graduação em Educação Stricto Senso no estado, fazendo um levantamento de dissertações e teses que versam sobre essa temática. O levantamento de dados deu-se através do portal de teses e dissertações da CAPES e também através dos repositórios digitais de todos os cursos de pós-graduação stricto sensu do Rio Grande do Sul, sendo utilizada posteriormente técnica de análise de conteúdo nas pesquisas encontradas. A análise indica uma preocupação recente com a evasão, pois é legítimo observar um aumento significativo no número de publicações nos últimos três anos. Foi possível verificar vários motivos relacionados ao abandono por parte dos estudantes e as estratégias para sua permanência, verificando a peculiaridade de cada caso.
Protocol for implementing the concept of citizen scientists for HealthWise Wales: a national population study
Authors: Townson Julia
Published: April 2017

ABSTRACT

ObjectivesHealthWise Wales is a national cohort study, aiming to recruit 260,000 people, over 16, living in, or accessing health services in Wales, within 5 years. The aims are; to create a cohort with longitudinal follow up data on behavioural and environmental exposures, using data linkage to healthcare datasets and outcomes; create a register of potential research participants; actively engage the public in research, inviting them to identify priorities. Research areas of importance include impact of social inequalities on health and well-being; effect of environment/neighbourhood on health; maintenance of health and well-being in the working age population and later life. Successful recruitment relies on public engagement strategies, engaging community members to engage others in their immediate community, and using local people to collect data and act as citizen scientists.

ApproachInvolving People Network members were invited to take part in an advisory group to discuss the possibility of members of the public acting as citizen scientists for HealthWise Wales. An advisory group was established in North and South Wales to inform this protocol. Researchers, through meetings and communication, directed members to other citizen scientist projects and 3rd sector groups that have utilised similar methods. The advisory group also considered online citizen scientist projects.

ResultsMembers of the group agreed that the term champion was more appropriate than citizen scientist. Levels of commitment and the role were discussed and members concluded that overall they thought it was a good idea. They stressed training would be necessary, as well as concise and clear messaging to allow HWW champions to talk confidently about the project. They felt it was important champions decide their own level of commitment and involvement. Two levels of champions were agreed: the first level where people will commit to finding out more about the project by either attending a training session or watching an online video; and the second where they pledge to engage members from their existing networks and communities through events, clubs and activities which they might already participate in.

ConclusionThe concept of HealthWise Champion is agreeable to members of the public but appropriate training and support will need to be provided. Materials will be developed in conjunction with the advisory group members to ensure that HealthWise Wales Champions are able to clearly and confidently disseminate the more difficult elements of the study to others e.g data linkage. An evaluation will be available by July.
Using Linked Administrative Data to Examine the Educational Outcomes of Children in Care in Manitoba
Authors: Brownell Marni , Chartier Mariette , Au Wendy , MacWilliam Leonard
Published: April 2017

ABSTRACT

ObjectivesManitoba has one of the highest rates of children in out-of-home care in the world. Our aims were to: 1) describe characteristics of children in care; 2) determine differences in educational outcomes for children in care, children receiving in-home protection services and children not involved with child welfare; and, 3) identify factors contributing to educational success for children in care.

ApproachPopulation-level administrative data from the Population Health Research Data Repository at the Manitoba Centre for Health Policy, were used. Several data sources were linked together at an individual level: child welfare services (e.g., in care, in-home services; hospital birth records (e.g., birth weight, gestational age); health status (e.g., from hospitalizations, physician visits); family risk factors (e.g., maternal prenatal smoking and/or drinking, maternal education); family characteristics (e.g., number of children in family, receipt of income assistance); education assessments at kindergarten, grades 3, 7, 8, 9 and 12. Children in care from 1998 onward were included. Number of children analyzed differed depending on the educational outcome examined: e.g., analyses at kindergarten include 1,893 children in care, 4,229 children receiving in-home services, and 32,280 children not involved with child welfare services; for high school completion these numbers were 11,234, 40,671, and 162,265 respectively. Multivariate regressions identified characteristics associated with educational outcomes for children in care.

ResultsOver one-third of children in care first entered care as infants, and of those, close to half were apprehended at birth. 5.5% of children in Manitoba spent some time in care before their 15th birthday, with an almost tenfold difference for Indigenous (16.6%) and non-Indigenous (1.7%) children. Across the range of educational outcomes, children in care did more poorly than children receiving in-home services, who in turn did more poorly than children with no child welfare involvement. For example, only 33.4% of children in care completed high school compared to 66.8% of children receiving in-home services and 89.3% of children with no child welfare involvement. Adjusting covariates reduced differences but all remained statistically significant. Factors associated with positive outcomes for children in care differed depending on the outcome and included measures like poverty (at Kindergarten, p<0.05; at high school, p<0.0001) and total number of care placements (at Kindergarten, p<0.05; at grade 9, p<0.01).

ConclusionsChildren in care are at risk of experiencing poor educational outcomes, from school entry onwards. Identifying factors associated with educational success for children in care can inform policy and program development.
A review of a standards-based set of information security practices applied in Data Linkage Centers
Authors: Marinho Da Silva Márcia Elizabeth , Camargo Kenneth , Pinheiro Rejane , Coeli Claudia
Published: April 2017

ABSTRACT

ObjectiveThis research aimed to study regulatory and operational aspects related to information security, especially confidentiality, in organizations that systematically carry out record linkage.

ApproachWe searched international experiences of data linkage units from the literature and from the catalog of International Population Data Linkage Network (IPDLN) members. In addition, we surveyed technical standards of the International Association for Standardization (ISO) on health informatics.

ResultsWe studied organizations in Australia, Canada, UK and the United States. Six standards were selected for deep analysis. In the end, we organized a set of 75 practices relating to information security in data linkage units, grouped by 5 dimensions: infrastructure and operations; record linkage model; relationship with managers; relationship with researchers and relationship with the society. The linkage process must be described in a sufficiently clear and didactic way, so that ordinary citizens are able to understand that the privacy of their health information is protected. In addition to a transparent work process, the data linkage center must also make their privacy policies available. The Australian and Canadian experiences with ethic review committees that include social participation and awareness of media and explanations to the public are a good source of inspiration. Regarding safety, the institutions responsible for health databases should apply security controls in their information systems to consider the rules on consent to perform record linkage. Ideally, all institutions should seek full compliance with the controls recommended in the technical safety standards. However, the scarcity of resources (human, financial and technical) lead to the prioritization of the implementation of these security controls. The criteria for this prioritization can be given by feasibility analysis (cost / time impact, benefits), providing an orderly road map for the adoption of these measures.

ConclusionThe practices systematized in this study can be used in order to check current information security conditions of data linkage centers and as guidelines for further improvements. This will certainly bring more confidence in the data linkage center process and, at least, help researchers, managers and society move forward toward the same objective of better public health.
Modelling Diagnostic Validity Estimates from Administrative Health Data
Authors: Kroeker Kristine , Lix Lisa M. , Jiang Depeng , Muthukumarana Saman
Published: April 2017

ABSTRACT

ObjectivesValidation studies compare diagnostic information in linked administrative and reference (i.e., gold standard) data; they are an essential tool to develop accurate case definitions, the rules used to identify individuals in administrative data with a specific health condition. Validation studies often estimate the accuracy of multiple case definitions, in order to identify the data features (e.g., diagnosis codes, type of data source) that influence accuracy estimates. Descriptive analyses are commonly used to select a case definition(s) with the greatest accuracy estimates, but fail to account for uncertainty in accuracy estimates. The objectives were to: (1) compare the performance of regression-based approaches to test for differences in diagnostic accuracy estimates, and (2) demonstrate how to apply and use these models.

ApproachComputer simulation was used to compare three regression models: (a) univariate fixed-effects models applied to estimates of sensitivity and specificity; (b) univariate fixed-effects model for Youden's index, the average of sensitivity and the complement of specificity; and (c) bivariate random-effects joint model of sensitivity and specificity. The simulations varied the means and variances of sensitivity and specificity, the correlation between these parameters, and the number of case definitions. Performance was compared using: (a) bias (i.e., difference between estimated and observed mean), (b) mean squared error (MSE), the sum of the estimated variance and bias squared, and (c) 95% confidence interval (CI) coverage, the proportion of times the population mean is contained in the 95% CI. For objective 2, we applied the models to estimates of diagnostic accuracy from a published rheumatoid arthritis (RA) validation study with 61 case definitions.

ResultsUnivariate models of sensitivity and specificity had lower bias than the bivariate model (e.g., univariate=1.8%, bivariate=2.2%). The bivariate model had a smaller MSE than the univariate models when sample size was large and there was a small correlation between sensitivity and specificity (e.g., univariate=3.4%, bivariate=2.6%). Across all scenarios, the univariate model for Youden’s index showed small bias (average=2.4%) and MSE (average=2.1%). For objective 2, the univariate models of sensitivity, specificity, and Youden’s index revealed multiple case definition features that were associated with estimates of RA diagnostic accuracy: 1+ diagnosis in hospital records, >1 diagnosis in physician claims, and 1+ diagnoses by a specialist physician.

ConclusionsWe recommend the bivariate model when a validation study contains a large number of case definitions. When the data contain a small number of case definitions, univariate models are recommended.
Clinical Text De-identification and Other Large Scale Processing Tasks in Resource Constrained Environments
Authors: Jackson Richard , Dobson Richard , Stewart Robert
Published: April 2017

ABSTRACT

ObjectivesClinical text de-identification is a common requirement of the ‘enclave’ governance model of ethical EHR research. However, there is often little consideration of the engineering task that is required to scale these approaches across the hundreds of millions of clinical documents containing personal identifiers that are resident in the data repositories of a typical NHS Trust. Similarly, natural language processing is an increasingly important field of clinical data science, yet it requires fault tolerant approaches to data processing. This work concerns the development of “turbo-laser” - a distributed document processing architecture based upon the popular ‘battle hardened’ Spring Batch framework - an industry standard for large scale processing tasks.

ApproachUsing Spring Batch, we developed a highly scalable unstructured data processing framework, using the concept of remote partitioning. Remote partitioning allows us to offload processing tasks to any and all computers in a network. With this approach, it is possible to harness the entire compute available of an organisation, whether it be an office of 15 desktop PCs that go unused overnight, or a compute cluster of a thousand processors. This method is especially valuable in the NHS, where the provision of sufficient compute to make large scale analytics possible are often hindered by the lack of available hardware, or difficulties in navigating technical governance policies ill equipped for the demands of modern data science.

ResultsTurbo-laser was developed in consideration of the processing challenges common in the NHS. Currently, four types of ‘job’ are available - De-identification, using the Cognition algorithm, generic GATE output, text extraction from binary files such as MS Office, PDF and scanned documents, and a document re-compiler to deal with EHR legacy issues. Examples of turbo-laser usage include processing 9 million binary documents on modest hardware, within 48 hours.

ConclusionTurbo-laser is an enterprise grade processing tool, in keeping with the software engineering pattern of ‘batch processing’ that has been at the forefront of the informatics movement. An open source project, it is hoped that others may contribute and extend its principles, lowering the barrier of large scale data processing throughout the NHS.
Using population data linkage to make the invisible, visible: patterns and trends in mortality for Victorian born Aboriginal compared with non-Indigenous Victorian infants
Authors: Ritte Rebecca , Freemantle Jane , Mensah Fiona , Sullivan Mary , Chang Sue , Read Anne
Published: April 2017

ABSTRACTObjectivesThe disparity between the infant mortality rates of Aboriginal and Torres Strait Islander (forthwith respectfully ‘Aboriginal’) and non-Aboriginal populations in Australia is well documented. However, major public health initiatives and campaigns aimed particularly at halving the Aboriginal infant mortality rate are hindered by the lack of comprehensive and accurate data. To date, infant and child mortality rates for Victorian born Aboriginal children have not been reported in national statistics. The aim of Victorian Aboriginal Child Mortality Study was to accurately measure the patterns and trends of Aboriginal infant mortality and to report the disparities between Aboriginal and non-Aboriginal infants born in Victoria, Australia between 1999 and 2008 inclusive. ApproachWe used best practice methodologies to link total population data and comprehensive mortality case review to classify and code the deaths to determine, for the first time, all-cause and cause-specific mortality for Aboriginal and non- Aboriginal infants born in Victoria from 1999 to 2008.ResultsBetween 1999 and 2009, Aboriginal infants were twice as likely to die in in the first year of life as non-Aboriginal infants. Infant cumulative mortality rates (CMR) were higher among Aboriginal births (9.1/1000 livebirths in 1999-2003 and 9.4/1000 livebirths in 2004-2008) than non- Aboriginal births (4.7/1000 livebirths in 1999-2003 and 4.5/1000 livebirths in 2004-2008). For Aboriginal infants there was an observed decrease in the rate of neonatal deaths, and conversely an increase in the postneonatal CMR (from 2.2/1000 livebirths in 1999-2003 and 3.8/1000 livebirths in 2004-2008). Among Aboriginal infants there was an increase in deaths attributed to prematurity (3.1/1000 livebirths in 1999-2003 and 4.3/1000 livebirths in 2004-2008) and sudden infant death syndrome (SIDS) (1.0/1000 livebirths in 1999-2003 and 1.7/1000 livebirths in 2004-2008). There were significantly more potentially preventable deaths among Aboriginal infants than in non-Aboriginal infants [infection (0.6/1000 Aboriginal livebirths vs 0.2/1000 non-Aboriginal livebirths, RR 2.5 95%CI 1.1-5.6) injury (0.6/1000 Aboriginal livebirths vs 0.1/ 1000 non-Aboriginal livebirths, RR 5.8 95%CI 2.5-13.5), and SIDS (1.4/1000 Aboriginal livebirths vs 0.28/1000 non-Aboriginal livebirths, RR 5.0 95%CI 2.9-8.6)]. ConclusionThis is the first time that all-cause and cause-specific mortality rates for Victorian born Aboriginal and non-Indigenous infants have been reported. The observed increasing disparities between Aboriginal and non- Indigenous infants, especially due to preventative causes, such as infection, injury and SIDS, in the post neonatal period, demand immediate action in partnership with Aboriginal communities. Collaborative action must focus on both access to primary health care and better living conditions.
High resolution data from everyday life: coproducing a technically robust and engaging sensing platform
Authors: Machin Matthew , Hassan Lamiece , Ainsworth John
Published: April 2017

ABSTRACTObjectives Researchers are increasingly recognising the potential for connected health devices – in particular, wearables and smartphones - to capture high-resolution, multi-dimensional data from everyday life. The Dementias Platform UK project aims to develop research capacity in this emerging area by providing a combination of hardware and software: a pool of devices capable of generating data supported by a ‘sensing platform’ designed to securely receive, store and link these data with sources, including clinical records and cohort data. We collected feedback from researchers and patients to (i) develop requirements for the sensing platform and (ii) inform procurement of a device pool.

ApproachSeparate workshops were held to involve (i) researchers (public and private sector) and (ii) over 30 patients from four potential user groups, including people with dementia. Both groups gave feedback on the suitability and acceptability of a range of wearable devices for capturing data for different study purposes. Additionally, researchers commented on the platform functionality. Patients were provided opportunities to handle multiple devices and test them at home. We captured feedback at workshops using notes, which were collated, shared and discussed among the team. An agile software development methodology was used to respond rapidly to changing requirements.

ResultsPatients supported plans for connected health dementia research and, in principle, were willing to wear devices, provided they consented voluntarily and data were stored securely and confidentially. Many patients were prepared to undergo some level of inconvenience, for example wearing devices for longer periods, particularly if given ongoing feedback about research progress, findings and benefits. Researchers and patients agreed the platform should be open to a wide range of devices, available currently and in future. Researchers envisaged using the platform for a range of projects and data types. As a result, we established a device pool (including wearables, smartphones and tablets) and developed a generic, ‘device-agnostic’ platform to receive and store data. Platform architecture was designed to be as flexible as possible to allow for future modifications.

ConclusionWe found it was feasible to integrate requirements from both researchers and patients when developing a sensing platform for dementia research. By seeking feedback from both user groups, we were better able to attend to device linkage requirements, platform functionality and acceptability, integrating these within development and procurement processes. Furthermore, we identified aspects of research setup and design that could support sustained engagement from participants, thereby improving data completeness and quality.
IMECCHI-DATANETWORK: empowering knowledge generation through international data network
Authors: Le Pogam Marie Annick , Metcalf Amy , Johnsen Søren Paaske , Hider Phil , Patel Alka , Kim Hongsoo , Carlini Emanuele , Perego Raffaele , Quan Hude , Gini Rosa
Published: April 2017

ABSTRACT

ObjectivesThe International Methodology Consortium for Coded Health Information (IMECCHI), an international collaboration of health services researchers, launched the IMECCHI-DATANETWORK initiative in October 2015. Its main objective is to enable replication of observational studies across countries through a distributed data infrastructure.

ApproachIn a distributed data infrastructure, individual raw data are not shared. Instead, data are converted locally using a common data model (CDM) and loaded into a common software for data processing and analysis. Whenever a study protocol is agreed upon and ethically approved, an ad hoc procedure is programmed - using that software - including the data processing steps needed to create the analytical dataset from the CDM: record linkage, case selection, sampling, matching, etc. The procedure is then shared and locally run by each partner to generate an analytical dataset of integrated data. Analytical datasets may then be shared and pooled for statistical analyses.

ResultsSix partners of the IMECCHI collaboration, located in countries across 4 continents (Canada, Denmark, Italy, New Zealand, South Korea, and Switzerland), currently participate in the initiative. They first conducted a survey to describe the origin, content, completeness and main attributes of each table in their original databases. Based on the results of the survey, a CDM was created, encompassing 4 tables of coded or structured data to be linked at the individual level using a common personal identifier: (1) characteristics of the subjects with dates of birth and death; (2) hospital discharge summaries with diagnosis and procedure codes, and admission, discharge and procedure dates; (3) drug dispensing information with date of dispensing, drug name, duration of the amount of active principle according to the Defined Daily Dose of the World Health Organization; (4) causes of death. In each table, additional attributes describe the coding systems in which the other attributes are coded. Using such specific attributes facilitates interoperability across multiple coding systems. The open source Java-based software, TheMatrix, which operates on flat csv files using a domain-specific programming language, was chosen to embed the ad hoc procedure.

ConclusionWithin the IMECCHI-DATANETWORK initiative, databases from various countries will be locally converted in a CDM which will facilitate study replication in a distributed fashion while granting interoperability across coding systems. Through such international data networks, data are empowered for creating results which are generalizable to multiple countries. Cross-border data sharing and international comparisons are also facilitated.
Gaps in Health and Wealth: The relationship between trends in income inequality and breastfeeding inequalities
Authors: Nickel Nathan , Brownell Marni , Chateau Dan , Katz Alan , Burland Elaine
Published: April 2017

ABSTRACT

ObjectivesThe objective of this study was to identify whether breastfeeding inequalities have increased between 1984 and 2014 and to examine whether trends in income inequality are related to breastfeeding inequalities.

MethodsWe used linkable administrative data from the Population Health Research Data Repository. Our sample included all infants born in Manitoba, 1984 to 2014. We used area-level income – derived from the Canadian Census – to stratify infants into income quintiles. Canadian Census income data were also used to quantify provincial level income inequality for each fiscal year in our study period. Data from the hospital discharge abstract database were used to classify infants according to whether or not they had initiated breastfeeding. We linked infant data to maternal data using the Manitoba health insurance registry to capture maternal characteristics – including the mother’s postal code of residence and her age at first birth. We used generalized linear models to calculate income quintile-specific breastfeeding rates for each fiscal year in our observation period for all of Manitoba. We also calculated age-adjusted breastfeeding rates to account for the changing age distribution in Manitoba mothers, over time. We measured breastfeeding inequities using the concentration index as well as the rate ratio and rate difference (comparing the breastfeeding rate between the highest and lowest income quintiles). We quantified income inequality using the Gini coefficient on income. Trend analyses and two-sided Z-tests tested for changes, over time. Time by income-quintile interactions tested whether breastfeeding rates were statistically significantly different, across socioeconomic groups.

ResultsBreastfeeding rates increased from 1985 to 2014, from 72% to 81% (p<0.01). The Gini coefficient increased from 0.16 to 0.21; a linear trend test of the Gini coefficient showed income inequality increased over the study period (p<0.05). Rate differences, rate ratios, and the Concentration index showed that significant breastfeeding inequalities existed throughout the study period. Trend tests revealed that breastfeeding inequalities did not increase, over time.

ConclusionsAggregate analyses may suggest overall improvement when inequality persists. Although there was improvement in breastfeeding initiation rates, children from lower socioeconomic status continue to lag behind their counterparts. Policy-focused health equity research needs to measure outcomes, overall, and inequity across time.
Linking hospital and immigrant landing data to understand patterns of hospital use among refugees in Canada
Authors: Ng Edward , Sanmartin Claudia , Manuel Douglas
Published: April 2017

ABSTRACT

ObjectivesIn Canada, refugees represent between 10% and 15% of the total immigrant annual in-take of immigrants. Refugees are generally admitted with different selection criteria and have different settlement challenges which may lead to higher health risk, compared to other categories of immigrants. The purpose of this study is to use linked hospital and immigrant landing data to report hospitalization rates among refugees arriving to Canada between 1980 and 2006 with special focus on those from refugee-dominant source areas, namely Poland and Vietnam, and the Middle East.

ApproachData from the 2006/07-2008/09 Discharge Abstract Database (DAD) were linked to the 1980-2008 Immigrant Landing File (ILF) to identify hospitalizations among immigrants by category of admission. Age-standardized hospitalization rates (ASHR) for overall causes (excluding pregnancy), and for selected causes are derived for refugees overall and by specific source country. Rates are compared with those for the Canadian-born population and with economic class immigrants from the same source country.

ResultsOverall, refugees had substantially lower overall ASHR compared with the Canadian-born population (494 per 10,000, 95% CI, 487, 500 vs 891 per 10,000, 95% CI, 890, 892, retrospectively). Among refugees, those who landed in Canada (refugee claimants) had the highest ASHR (539, 95% CI 524,555), especially for circulatory disease. Among refugee-dominant areas, Government-assisted refugees from the Middle East tended to have higher ASHR at levels comparable with that of the Canadian born population (for circulatory disease). Refugees had higher rates of hospitalization compared with their economic class counterparts, except among those from Poland.

ConclusionRefugees, like other immigrants, generally had lower hospitalization rates compared with the Canadian born population, but the heterogeneity within groups reveals specific vulnerability for certain types of health care use.
Analysing the daily, weekly and yearly cycles of births and their implications for the NHS using linked data
Authors: Harper Gill , MacFarlane Alison , Dattani Nirupa , Dodwell Miranda , Gibson Rod , Cortina Mario , Martin Peter
Published: April 2017

ABSTRACT

ObjectivesThis project builds on previous work linking routinely collected data from birth registration, birth notification, death registration and hospital discharges, extending it to six million births in England and Wales from 2005 to 2014. This linkage is creating a new dataset to investigate previously unanswerable questions about variations in time of birth and its outcome which are highly contested in the health service in England and Wales:

1. How do numbers of births vary according to time of day, day of the week and time of year of birth and how does this relate to modes of onset of labour and delivery?2. How do patterns of birth vary between maternity services in relation to variations in medical and midwifery staffing, patterns of intervention and size of unit?3. How does the outcome of pregnancy, in terms of mortality and morbidity rates at birth and in the first year of life, vary according to time of birth in relation to gestational age, and intervention in the onset of labour and delivery?4. Have the patterns changed over the years 2005 to 2014?

ApproachRoutinely collected national datasets for 2005-14 have been linked using patient identifiable data items. They differ in the way data items are recorded. Methods of linkage, quality assurance and data cleaning have been improved, compared with those developed in the original project.

This unique approach links clinical data from hospital admissions with more reliable data on birthweight from birth registration and with gestational age and time of birth from birth notification. This enables investigation of the associations between day and time of birth with its outcome.

This is also the first study to link mothers’ and babies’ hospital discharge data for England and Wales and to draw on public and patient involvement to include outcome measures specifically designed to be women-centred. Overall, the linkage has created a fuller range of data.

ResultsResults will be available by the time of the conference. Initial results already clearly illustrate differences in timings of birth by time of day and day of the week by mothers’ age, gestational age and birth setting and for singleton and multiple births.

ConclusionThe study has created a valuable linked dataset that will uniquely enable analyses of associations between timing of birth and its outcome. These results will potentially be able to inform and impact NHS service provision.