bluuebunny/crossref_metadata_2025 huggingface dataset:
Using family relationships to improve consistency of identification of Aboriginal people in linked administrative data
Authors: Gibberd Alison , Simpson Judy , Eades Sandra
Published: April 2017

ABSTRACTObjectivesWith the life expectancy of Aboriginal Australians 10 years less than non-Aboriginal Australians, administrative health datasets are essential tools to identify disparities and track changes over time. However, the Aboriginal status of individuals is often inconsistently recorded within, and across, datasets and Aboriginal people are frequently undercounted. Therefore, information from multiple linked records is often used resolve inconsistencies and undercount. However, very different algorithms are used and their performance is poorly understood.

We aimed to (i) assess the relative accuracy of three common algorithms by comparing how consistently family members were categorised; (ii) develop a new algorithm that incorporates information about the Aboriginal status of family members; and (iii) investigate the impact of these algorithms on estimates of health outcomes.

ApproachOur sample was people born from 1980 onwards recorded as Aboriginal at least once in 6 Western Australian datasets, as well as their Aboriginal and non-Aboriginal family members.

We applied the most inclusive algorithm, ‘ever-Aboriginal’ (EA, any record of being Aboriginal), and two more specific algorithms, ‘multi-stage median’ (MSM) and ‘last record’ (LR), to linked birth, birth registration, birth defects and hospital inpatient records. We also supplemented these algorithms with information from any children’s birth records (EA+, MSM+ and LR+). Finally, we used records from all family members to derive a final Aboriginal status (MSM+ with family), using a range of decision rules, such as classifying someone as Aboriginal if they had two full siblings categorised as Aboriginal.

ResultsEA+ classified 61% of our sample of 156,426 people as Aboriginal, compared with only 51% for LR.

MSM+ resulted in the most consistent classification of full siblings; only 8% of pairs had one sibling identified as non-Aboriginal and the other as Aboriginal, compared with 14% using EA+. MSM+ also performed best with parent-child triads; the classifications of the child and parents were inconsistent in only 8% of cases, compared with 27% using EA.

The proportions of low birthweight babies were similar for EA+, MSM+ and MSM+ with family, (10.6%, 10.8% and 10.8%, respectively). Stillbirth rates were also similar. However, an estimated 46% of mothers smoked during pregnancy for EA+, compared with 50% for both MSM+ and MSM+ with family.

ConclusionOf the 6 algorithms examined, MSM+ assigned Aboriginal status most consistently and EA was the least reliable. Estimates of health outcomes were worse for Aboriginal people when the more consistent algorithms were used. However, the differences were generally small.
A UKSeRP for SAIL: striking a balance
Authors: Jones Kerina , Ford David , Brooks Caroline
Published: April 2017

ABSTRACT

ObjectivesWhilst the current expansion of health-related big data and data linkage research are exciting developments with great potential, they bring a major challenge. This is how to strike an appropriate balance between making the data accessible for beneficial uses, whilst respecting the rights of individuals, the duty of confidentiality and protecting the privacy of person-level data, without undue burden to research.

ApproachUsing a case study approach, we describe how the UK Secure Research Platform (UKSeRP) for the Secure Anonymised Information Linkage (SAIL) databank addresses this challenge. We outline the principles, features and operating model of the SAIL UKSeRP, and how we are addressing the challenges of making health-related data safely accessible to increasing numbers of research users within a secure environment.

ResultsThe SAIL UKSeRP has four basic principles to ensure that it is able to meet the needs of the growing data user community, and these are to: A) operate a remote access system that provides secure data access to approved data users; B) host an environment that provides a powerful platform for data analysis activities; (C) have a robust mechanism for the safe transfer of approved files in and out of the system; and (D) ensure that the system is efficient and scalable to accommodate a growing data user base. Subject to independent Information Governance approval and within a robust, proportionate Governance framework, the SAIL UKSeRP provides data users with a familiar Windows interface and their usual toolsets to access anonymously-linked datasets for research and evaluation.

ConclusionThe SAIL UKSeRP represents a powerful analytical environment within a privacy-protecting safe haven and secure remote access system which has been designed to be scalable and adaptable to meet the needs of the rapidly growing data linkage community. Further challenges lie ahead as the landscape develops and emerging data types become more available. UKSeRP technology is available and customisable for other use cases within the UK and international jurisdictions, to operate within their respective governance frameworks.
Data Integration for Assessing Census Coverage
Authors: Diniz Da Silva Andrea
Published: April 2017

ABSTRACTObjectiveSince the 70’s census, the Brazilian Institute of Geography and Statistics –IBGE has been conducting a post enumeration survey – PES to assess census coverage. In 2010 the survey was conducted in a sample of enumeration areas in each of the 27 states and matching was performed for data from Census and PES. One of the biggest improvements of the 2010 Brazilian Census was the incorporation of new methodologies and technologies. Use of handheld devices in the 2010 Census and PES facilitated automatic matching of PES to the Census. MethodA matching system was designed aiming to find as much as possible the enumerated units by both Census and PES – the true matches. An accurate matching process was essential as the number of matches/unmatches had an effect on the coverage rates so that the levels of false positive (false matches) was strongly controlled during matching operation and the number of false negative (missed true matches) was minimised by successive steps in the matching system. The matching system comprised three stages: automatic, assisted and reconciliation. The automatic matching step was based on the probabilistic linkage theory and a probabilistic model was developed to identify true matches of persons and housing units from census and post enumeration survey data files. Scores were computed according to agreement and disagreement probabilities of selected variables in the pairs of records. The assisted step was held for all housing units and persons classified as unmatch or possible match at the end of automatic step. The procedures included revision of possible matches and matching “unmatched” pairs. This step was run through an application developed in house. The last step was the field reconciliation. Field team double checked the data collected on the unmatched housing units and persons from both Census and PES and searched for new matches. ResultsNew true matches were found while carrying out field checks, especially in rural areas where the addressing system is not standardized. The matching system has been fully implemented immediately after the completion of data collection in each enumeration area. The performance of automatic step was impressive as Brazil is eight million squares kilometers country with huge regional differences and the automatic step was based in a single model for the whole country. Automatic matching resulted in 76% of the total of pairs, with regional differences under 10%, while assisted allowed for 20% and reconciliation 3% of the final pairs.
The ELAStiC (Electronic Longitudinal Alcohol Study in Communities) project
Authors: Akbari Ashley , Lyons Ronan , Berridge Damon , Gallacher John , MacLeod John , Heron Jon , Hickman Matthew , Mahedy Liam , Bellis Mark , Fone David , Paranjothy Shantini , Trefan Laszlo , Evans Annette , Dunstan Frank , Tingay Karen , Bandyopadhyay Amrita , Gross Vanessa , Wang Yu-Chiao , Moore Simon
Published: April 2017

ABSTRACT

ObjectivesThe ELAStiC (Electronic Longitudinal Alcohol Study in Communities) project was established to determine factors that predict pathways into alcohol misuse and the life-course effects of alcohol use and misuse on health and well-being. This is achieved through accessing existing longitudinal data that are key sources of evidence for social and health policy, developing statistical methods and modelling techniques from a diverse range of disciplines, working with stakeholders in both policy, practice and the third sector to bring relevance to the work, and to bring together a diverse team of experts to collaborate and facilitate learning across diverse fields.

ApproachThe project will link data that include cohort studies such as; UK Biobank, ALSPAC (Avon Longitudinal Study of Parents and Children), Millennium Cohort Study, British Household Panel Survey, Understanding Society, E_CATALyST (Caerphilly Health and Social Needs Electronic Cohort Study) and WECC (Wales Electronic Cohort for Children). These data will be linked with routine data from primary and secondary healthcare in England, Scotland and Wales. Additional data from education and police data source will also be linked as part of the project.

The main work packages for the project are:

Methodological InnovationsMethodological developments in mechanisms for correcting bias in reporting alcohol consumption and for combining routine data with cohort data; the application of Markov models for examining the extent to which past behaviour influences future behaviour, and econometric hedonic pricing methods for providing insights into the costs of alcohol-related harm.

Pathways into HarmDo family structure, household composition, youngsters’ previous ill-health and educational attainment predict their use of alcohol and what socio-economic factors and household transitions contribute to hazardous alcohol consumption in adults?

Secondary HarmsWhat is the effect on children’s health and educational achievement of living in households in which one or more adults has experienced alcohol-related harm?

Mental Health & Well-BeingWhat is the relationship between alcohol consumption, hospital admission and mental health in adults and children?

ResultsThe results of the data linkage between the multiple cohorts and health, education and police data will be reported. The challenges of linking cohort and other data types from different nations will be discussed.

ConclusionsOur project will aim to provide evidence that informs the UK Government’s commitment to “radically reshape the approach to alcohol and reduce the number of people drinking to excess”, by working with existing longitudinal data collected in the UK to inform policy and practice.
Privacy protected text analysis in DataSHIELD
Authors: Wilson Rebecca , Butters Oliver , Avraam Demetris , Turner Andrew , Burton Paul
Published: April 2017

ABSTRACT

ObjectivesDataSHIELD (www.datashield.ac.uk) was born of the requirement in the biomedical and social sciences to co-analyse individual patient data (microdata) from different sources, without disclosing identity or sensitive information. Under DataSHIELD, raw data never leaves the data provider and no microdata or disclosive information can be seen by the researcher. The analysis is taken to the data - not the data to the analysis.

Text data can be very disclosive in the biomedical domain (patient records, GP letters etc). Similar, but different, issues are present in other domains - text could be copyrighted, or have a large IP value, making sharing impractical.

ApproachBy treating text in an analogous way to individual patient data we assessed if DataSHIELD could be adapted and implemented for text analysis, and circumvent the key obstacles that currently prevent it.

ResultsUsing open digitised text data held by the British Library, a DataSHIELD proof-of-concept infrastructure and prototype DataSHIELD functions for free text analysis were developed.

ConclusionsWhilst it is possible to analyse free text within a DataSHIELD infrastructure, the challenge is creating generalised and resilient anti-disclosure methods for free text analysis. There are a range of biomedical and health sciences applications for DataSHIELD methods of privacy protected analysis of free text including analysis of electronic health records and analysis of qualitative data e.g. from social media.
Linking child travel routes and routine health data
Authors: Mizen Amy , Rodgers Sarah , Fry Richard , Lyons Ronan
Published: April 2017

ABSTRACTObjectivesLinking routinely collected health and environment data can allow for large scale evaluations of how our environment impacts our health. Our data linkage approach advances previous research where residence-based environmental exposures were anonymously linked in the SAIL databank using Residential Anonymous Linking Fields (RALFs). The dose-response relationship between exposure to food and dietary intake has not been widely investigated. Previous research found conflicting views on whether increased environmental exposure to unhealthy food contributes to higher BMIs. This may have been due to different methodological approaches, including imprecise exposures, small numbers, and the use of self-reported BMIs.

ApproachThis investigation calculated food exposure environments for routes from all homes to and from school. A Geographic Information System was used to calculate the environmental exposures along all potential routes up to a maximum age-appropriate walking distance from each school. Once within the SAIL databank we selected relevant routes using linked demographic and pupil datasets. To maintain privacy, the primary (doctoral) researcher generating the environmental exposures, did not have access to the final household-level exposure data in their identifiable form. The researcher automated their method so a second researcher could run the GIS analysis. Accuracy of modelled exposures will be compared with actual routes collected from GPS traces of children walking to school.

ResultsRemoving access to the final identifiable household-level route exposures enabled the primary researcher to complete analysis on the combined household and individual-level data within the secure environment. The environmental exposures were linked with routine health data from the SAIL databank; including BMI as an indicator of obesity. BMI data for 4-5 year olds, and a sample of 1300 13-14 year olds were linked to associated environmental exposures.

ConclusionDepending on modelled accuracy, a GIS and data linkage approach may allow the investigation of natural experiments and intervention evaluation at the scale of the total population. This is the first step towards anonymously modelling part of the daily exposure environment using routine data. A limitation is the lack of routinely collected BMI data for older children and teenagers an age when they are more likely to have the option to choose to buy food on the school route. This work will have many potential applications, including the delivery and evaluation of multiple school and workplace commuting interventions.
An automated tool for a uniform decentralized quality control and data analysis in multicenter studies with health care registry data
Authors: Endel Florian , Strassmayr Christa , Katschnig Heinz
Published: April 2017

ABSTRACTObjectivesThe EU FP7 funded project CEPHOS-LINK investigates hospital re-admissions of patients with a psychiatric disorder in 6 European countries by using linked health care registry data. In addition to the problems of different healthcare, payment and data collection systems, coordinating quality control, data analysis, and statistical modeling of sensitive data with six partners is challenging. For this purpose we have designed a secure online data analysis tool to diminish the time necessary to get results and incremental adaptions of reports as well as decreasing the chance and effects of misunderstandings between national and linguistic boundaries.

ApproachA comprehensive study protocol clearly defining variables to be obtained and methods to be applied has been put together. The protocol is based on a thorough investigation of the different healthcare systems and related registries. It became clear that nonetheless misconceptions occur and the incremental improvements consumed vast amounts of available resources. Therefore a system which automatically creates the required reports including all tables, graphics and statistical models including data preparation based on a defined data structure has been developed. The report system is based on the statistical environment R and the document markup language LaTeX, tightly integrated with R's package “knitr”.As this highly flexible solution is not straight forward to apply and implies various technical dependencies, a secure online platform hiding all technical details from the users has been developed. Utilizing state of the art software containers based on Linux and docker, a customized VPN solution, authentication and SSL encryption were put together. The web application itself is developed with R's “shiny” package and allows users to simply upload a dataset in the predefined format, interactively explore the contents, apply filters and generate the customizable, standardized report. Additionally, an offline version of the application is available for all major (desktop) operating systems.

ResultsThe new platform advances data analysis and reporting in a situation where several partners are involved in analyzing local datasets, as is the case of the CEPHOS-LINK project. Integrating new features, graphics and research topics can be managed centrally while users can update their results and reports in nearly no time.

ConclusionThe additional effort spent on developing a customized platform for quality control, data analysis and reporting has been worth the effort. Benefits include quick detection of implausible results, unifying the layout and graphics often depending on the software utilized and an established common data structure.
Cancer recording in patients with type 2 diabetes in primary care and hospital admission data
Authors: Williams Rachael , Gallagher Arlene , Van Staa Tjeerd , Hammad Tarek , Leufkens Bert , De Vries Frank
Published: April 2017

ABSTRACTObjectiveElectronic health records are increasingly used to investigate associations between antidiabetic therapy and cancer. Misclassification can impact results, especially if differential between comparators. The objective of this study was to estimate cancer misclassification when using primary care or hospital data alone.

ApproachAdults aged ≥40 years with an insulin or oral antidiabetic prescription in Clinical Practice Research Datalink (CPRD) primary care data at least a year after start of data collection, and no record of type 1 diabetes, were included. Patients were matched by year of birth (stepwise within 5 years), sex and GP practice to up to 1 non-diabetic patient. The cohort was restricted to those eligible for Hospital Episode Statistics (HES) linkage with follow-up during the study period (01/04/97-31/12/06). Follow-up started at the maximum of the registration date with the practice, practice up-to-standard date (a CPRD quality metric), and start of study period. Follow-up ended at the minimum of when the patient left the practice, the date CPRD last collected data from the practice, and end of study period. Cancer was identified in CPRD via Read codes and in HES via ICD10 codes. For each cancer case in CPRD, analysis evaluated whether there was a corresponding record in HES coded with same, different or unspecified site. Analysis was repeated for cancers identified in HES.

Results53,585 diabetic patients were matched to 47,435 non-diabetic patients. 83% of cancer cases in CPRD had a corresponding record in HES (78% with the same type). Misclassification varied by cancer site, ranging from 3% (stomach cancer) to 57% (nonmelanoma skin cancer). 83% of cancer cases in HES had a corresponding record in CPRD, with all misclassification rates <20%.

ConclusionA good level of concordance and low level of misclassification of cancer exist between CPRD primary care data and HES. The value of linking these data for establishing cancer outcomes lies more in the complimentary variables held than in reducing misclassification.
Using Linked Data to Explore the Relationship Between Walking-Friendliness of Neighbourhoods, Physical Activity and Body Mass
Authors: Ross Nancy , Dasgupta Kaberi , Sanmartin Claudia , Wasfi Rania , Hajna Samantha , Mah Sarah
Published: April 2017

ABSTRACTObjectivesTo demonstrate the methodology and results for linking measures of neighbourhood walking-friendliness or "walkability" to Canadian health surveys and Canadian health surveys linked to administrative health care records.

ApproachWe linked multiple measures of neighbourhood walkability to hundreds of thousands of 6-digit postal codes of respondents to three large Canadian surveys using geographic information systems and anonymized banks of postal codes.

ResultsLong term exposure to walkable neighbourhoods was associated with increased reporting of walking for utilitarian purposes. Moving to a high walkable neighbourhood from a low walkable neighbourhood was associated with a full unit decrease in the body mass index of Canadian men over a 12-year follow-up. In a linkage of walkability measures to respondents who wore biosensors for a one-week period in several Canadian cities, we found that neighbourhood walkability was associated with increased reporting of utilitarian walking but not overall physical activity and step counts as measured by biosensors.

ConclusionThere is potential for walkable neighbourhoods to influence physical activity and body weight of Canadians which is more evident when individuals are followed for long periods of time.
Using Twitter to mine sleep related information from people who declare a diagnosis of a psychotic disorder
Authors: Dinev Mladen , Belousov Maksim , Morris Rohan , Berry Natalie , Nenadic Goran
Published: April 2017

ABSTRACT

ObjectivesOur group has investigated the occurrence of psychotic(-like) experiences (PLEs) in Twitter posts, namely auditory hallucinations. Tweets classified as potentially related to auditory hallucinations were proportionately higher between 23:00 and 5:00 in comparison to tweets not classified. This may indicate a clinically significant relationship between sleep and PLEs in the general population, a notion supported by the literature. Based on our previous investigation, the current study aimed to explore whether this methodology could be amended to generate datasets regarding sleep experiences in people who self-report a diagnosis of a psychotic disorder.

ApproachThe current investigation seeks to establish if it is feasible to generate anonymised datasets regarding sleep by extracting information from the timelines of people who self-report a psychotic diagnosis. A text mining method was implemented that utilised rule-based semantic filters that aimed to identify self-reported diagnoses. This focused on occurrences of personal and possessive pronouns to detect the subjectivity of tweets, as well as potential diagnostic verb indicators and any mentions of other related factors. For each diagnostic tweet, we collected information from user timelines. A sleep-related classifier was then implemented, which used lexical features (e.g. bag-of-words, part-of-speech tags) to predict whether a given tweet refers to sleep-related experience.

ResultsAfter training the classifier on the bag-of-words model, the most informative words which contributed to the performance of the classifier were: ‘sleep’, ‘can’t awake’, ‘never’, ‘stress’. Part-of-speech tags (e.g. verbs, adverbs) were also important features. The classification accuracy of the ‘bag-of-words’ model was better than the ‘part-of-speech’ model.

Through the method outlined herein, we were able to improve the quality of the generated datasets in comparison to the previous investigation. This methodology also facilitated the mining of individual Twitter users timelines who stated a personal diagnosis. To this end, an additional filter was implemented to identify tweets regarding sleep experience. The potential relationship between sentiment and temporality expressed in diagnosis and sleep experiences are also discussed.

ConclusionsThe results from this study have implications for mental health research on Twitter. Specifically, the refinements in the methodology enabled retrieval of two high quality datasets regarding psychosis and sleep. Therefore it is feasible other psychosis-related phenomena (e.g. visual hallucinations, delusions, medication) could also be applied as separate filters to create one dataset of psychosis-related experiences within individuals diagnosed with psychosis.
Social Housing and Health in Manitoba
Authors: Smith Mark , Finlayson Greg , Martens Patricia , Dunn Jim , Prior Heather , Taylor Carole , Soodeen Ruth-Ann , Hinds Aynslie , Burchill Charles , Guenette Wendy
Published: April 2017

ABSTRACT

ObjectiveFourteen years of social housing data (1995-2008) were acquired from the provincial government. This allowed for an unprecedented opportunity to describe the population of individuals living in social housing and, through data linkage, to compare them to the rest of the province on a number of health and social indicators.

ApproachUsing data from the entire population of the province of Manitoba, Canada, cross-sectional comparison were made between those living in social housing and those not on 19 indicators of morbidity, mortality, health care utilization and social development. Regression models were developed to control for age, sex, region of residence, comorbidities, income and neighborhood level SES.

Results50% of the population in social housing are under the age 20, 75% are female and 50% of applicants receive some form of income assistance. As expected there are significant differences on most health status measures when compared to individuals not in social housing. However, after controlling for confounding factors most differences between the two groups disappear indicating that there is no independent effect of living in social housing. A few exceptions were noted on measures of total respiratory morbidity, mammography and high school completion rates, the later showing a very significant interaction with neighborhood level SES.

ConclusionDespite overall poor health status, after controlling for income and other confounding factors individuals in social housing score no worse on many measures of health care utilization and prevention. High school completion rates, in particular, showed a very strong interaction with neighborhood level SES. Policy implications of this research are discussed.
Policies to Optimize Physician Billing Data in Academic Alternative Relationship Payment Plans: Practices and Perspectives
Authors: Cunningham Ceara Tess , Quan Hude , Jette Nathalie , Noseworthy Tom , Decoster Carolyn
Published: April 2017

ABSTRACT

ObjectivesChanges in physician reimbursement policies may hinder the collection of billing claims in administrative databases. Various provincial academic alternative payment programs (APPs) use incentive- or punitive-based tools to motivate physicians to submit billing claims called shadow billings; however, these incentives are not well documented in the literature. We conducted a nation-wide survey and semi-structured face-to-face interviews in Alberta, Canada to determine existing policies and guidelines for incentivizing and promoting physician billing practices.

ApproachMail and online surveys were sent out to academic department head physicians in the following provinces: British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, New Brunswick, Prince Edward Island and Newfoundland and Labrador. Face-to-face interviews were conducted in the province of Alberta with managers, government stakeholders, and physicians/administrators from academic APPs and Fee-for-Service plans. Face-to-face interviews and responses by mail and email submission were summarized using content analysis grouped by question type.

ResultsIn total, there were 46 respondents (15 interviews, 26 mail/online). Content analysis revealed three primary perspectives, grouped at the level of individual physician, academic, and government. Across all of these unique perspectives, three primary themes emerged: 1) governance; 2) accountability; and 3) funding. Within these themes, findings were categorized as either (a) instruments or tools to promote physician billing in AAPPs; (b) enabling factors to support physician billing in AAPPs; and, (c) constraining factors impeding physician billing in AAPPs.

ConclusionAccording to the majority of our respondents, financial disincentives (i.e. income at risk, financial clawbacks) appear to be most effective as a mechanism to motivate physicians within an academic APP to submit their billings. However, key barriers to successful implementation and delivery of academic APPs include a lack of alignment between government stakeholders, academic leadership and APP physician members and differences in the organizational and accountability structures of APP plans between academic facilities. It is necessary in moving forward to achieve commonly defined standards and frameworks between the various APP models across provinces and academic institutions.
Effect of sampling period on the numbers of children and young people with a life limiting condition in stable, unstable, deteriorating and dying stages
Authors: Jarvis Stuart , Fraser Lorna
Published: April 2017

ABSTRACTObjectivesTo determine stage of condition (stable, unstable, deteriorating or dying) for children and young people (CYP) aged 0-25 years in Scotland with a life limiting condition (LLC) and to analyse the effects of different sampling periods on estimates of CYP in each group.

ApproachA national cohort of 20436 CYP with a LLC, resident in Scotland between 1 April 2009 and 30 March 2014, was identified from linked routinely collected healthcare data. Stage of condition was determined using the Scottish Morbidity Record (inpatient dataset), Scottish death register and Paediatric Intensive Care Audit Network (PICANet) database. Transitions were defined as: unstable stage – an emergency inpatient admission that lasted 48 hours or more; unstable phase – any emergency PICU admission; dying – last 28 days before death. CYP were stable if alive and not in one of the other stages. Transitions between stages of condition were determined for each cohort member and most severe stage determined on a 1, 3, 6 and 12-month basis. Numbers in each stage were determined overall and by age group. A monthly mean of the daily numbers in each stage of condition was also determined.

ResultsOver 2200 CYP were unstable, deteriorating or dying in each year. In 2010/11, most severe stage of condition was stable for 10678 (83%); unstable for 1816 (14%); deteriorating for 253 (2%) and dying for 183 (1%). Over shorter periods the stable fraction increased: using a one month sampling period (April 2010) the most severe stages of condition were: 1990 (97%) of CYP stable, 367 (3%) unstable, 33 (0.3%) deteriorating and 17 (0.1%) dying. However, the yearly figures for instability were lower (e.g. 1816 were unstable as most severe stage in 2010/11) than the sum of monthly totals (summing monthly figures for 2010/2011, 4367 were unstable). On an average day (mean for April 2010) 12222 (99%) were stable; 135 (1%) unstable; 14 (0.1%) deteriorating and ≤5 (<0.1%) dying. The effects of changing sampling period were greatest for under 1 year olds.

ConclusionThe differences dependent on the sampling period show the degree of variability in the group of patients experiencing instability, with different individuals having periods of instability at different points in the year, but also some individuals having multiple episodes of instability. In informing healthcare provision and planning, it is important to understand these differences in numbers in each category across different time periods.
Trends in admissions for acute respiratory infections in children: an inter-country comparison between Western Australia and England
Authors: Moore Hannah , Abdalla Tasmin , Blyth Christopher , Gilbert Ruth , Hardelid Pia
Published: April 2017

ABSTRACTObjectiveAcute respiratory infections (ARI) including bronchiolitis, pneumonia and influenza are a major cause of hospital admissions in children worldwide. Linkage of administrative health datasets provides a platform to investigate temporal and seasonal trends in large populations over many years. We examined the similarities and differences in ARI admissions using linked datasets in Western Australia and England. ApproachThrough the availability of common data items in each jurisdiction, identical coding and data cleaning principles were applied to both datasets. Hospital admissions for ARI in children aged <5 years between 2000 and 2012 were identified using International Classification of Diseases diagnosis codes. Admission rates per 1000 child-years by age, gender and admission year were calculated in each jurisdiction. A total population birth cohort was available in Western Australia and the denominator was person time at risk whereas for England, all hospitalisations were used with the mid-year population as the denominator. ResultsThe overall incidence of ARI was 18.3/1000 child-years in Western Australia and 14.4/1000 in England. In both countries, the highest incidence of ARI was observed in infants (47.9/1000 child-years in Western Australia and 42.1/1000 child-years in England). Bronchiolitis was the most common primary diagnosis in infants in both countries, accounting for 79.7% of ARI admissions in Western Australia and 78.3% in England. The most common primary diagnosis in 1-4 year olds was unspecified lower respiratory tract infections in England (48.8% of ARI admissions in this age group) and pneumonia in Western Australia (43.9% of ARI admissions in 1-4-year-olds). The annual incidence rate for ARI hospitalisations declined in Western Australia from 2000 to 2006 and since remained steady. ARI admission rates increased in England throughout the study period. Admission rates across all age groups were 1.1-1.5 times higher in boys than girls in both countries. ConclusionThe availability of similar datasets in two economically similar countries in different hemispheres has afforded the opportunity to characterise and compare the epidemiology of paediatric respiratory infections over a 13 year period. Future analyses will allow us to assess differences in coding practices, seasonality and risk factors such as socio-economic deprivation and prematurity. Furthermore the availability of linked laboratory data for respiratory pathogens in each jurisdiction will allow for comparisons of pathogen-specific epidemiology and the impact of universal vaccination programs.
IMPLICAÇÕES ESTRATÉGICAS DA RESPONSABILIDADE SOCIAL CORPORATIVA
Authors: Barakat Simone Ruchdi , Polo Edison Fernandes
Published: April 2017

Apesar da crescente evidência da Responsabilidade Social Corporativa (RSC), ainda não é possível identificar uma definição comum ou um conjunto de princípios centrais sobre o assunto. Pesquisadores ainda discutem o significado de ser socialmente responsável e os impactos do desempenho social no desempenho financeiro. Diante dessa discussão, o presente estudo teve como objetivo analisar as implicações estratégicas da RSC. Foi proposto um modelo teórico em que a RSC leva à geração de valor para empresa, impactando positivamente tanto no desempenho social quanto no desempenho financeiro. Alguns desafios foram mostrados para evidenciar que utilizar a RSC para gerar vantagem competitiva exige considerações a respeito da natureza dos recursos que a empresa possui, da relação das atividades de RSC com a atividade principal da empresa, da disposição dos consumidores em pagar um preço prêmio por características e atributos de RSC e da capacidade da empresa em gerar valor reputacional e inovativo por meio da RSC.
ANÁLISE DA SUSTENTABILIDADE NO MEIO RURAL: ESTUDOS PUBLICADOS NO BRASIL DE 2005 A 2014
Authors: Sontag Anderson Giovane , Da Silva Elizandra , Hofer Elza
Published: April 2017

O objetivo deste estudo é analisar as publicações sobre a sustentabilidade e sua mensuração no meio rural como uma aplicação prática, verificando a preferência dos autores por indicadores ou índices e se estes estão inseridos em modelos. Metodologicamente, trata-se de uma pesquisa documental, com uso da técnica de meta-análise, com abordagem quantitativa das publicações científicas e qualitativa por meio de estudos comparativos de publicações ou citações. A base é composta por 36 artigos publicados nos periódicos científicos indexados nas bases de dados SciELO e Spell que envolveram a temática de sustentabilidade e sua avaliação no meio rural. Os resultados apresentam uma evolução histórica crescente do tema, com uma preferência pelo uso de indicadores de sustentabilidade, analisando tanto o sistema produtivo quanto comunidades rurais. Ainda cinco artigos utilizaram modelos como APOIA-NovoRural, Pressão-Estado-Resposta (PER) e Dashboard of Sustainability na análise da sustentabilidade.
RESPONSABILIDADE SOCIAL EM EMPREENDIMENTOS HIDRELÉTRICOS: UM ESTUDO DE CASO SOBRE A UHE FUNIL
Authors: Camero de Lima Andreina Del Carmen , Naves Mafra Flávia Luciana , Narciso Eliza Rezende Pinto
Published: April 2017

As usinas hidrelétricas são atualmente a principal fonte de energia no Brasil. Para sua construção, é necessário, teoricamente, que empreendedores assumam a responsabilidade sobre as implicações decorrentes do empreendimento. A literatura aponta que os atingidos são atores que deveriam participar efetivamente das decisões concernentes à implantação desses empreendimentos, pois são os que sofrem diretamente os maiores impactos. Neste contexto, o objetivo do trabalho foi identificar e analisar as implicações decorrentes da implantação da usina UHE Funil, na perspectiva dos atingidos. Para tanto, foram realizadas entrevistas com os atingidos da Comunidade do Funil e os dados foram tratados através de Análise de Conteúdo (Bardin, 2010). Os resultados revelam a existência de diversas implicações, envolvendo aspectos sociais, ambientais e econômicos. Embora os empreendedores promovam ações sociais para minimizar essas implicações, percebe-se que as medidas mitigatórias são insuficientes, pois são pontuais e apenas cumprem com as obrigações legais, deixando de lado aspectos fundamentais sobre os impactos na vida dos atingidos.
DESAPROPRIAÇÃO, FUNÇÃO SOCIAL AMBIENTAL E EXPECTATIVAS SOCIAIS
Authors: Rovani Anatercia
Published: April 2017

A proteção ambiental, conforme a Constituição Federal Brasileira integra o conteúdo da função social da propriedade. A disposição, o uso e a fruição da propriedade somente se configuram enquanto poderes plenos do proprietário, se respeitada sua função social. Nesse sentido, a gestão socioambiental da propriedade apresenta-se como um conceito que extrapola os limites da gestão organizacional empreendedora e passa a constituir uma exigência aos proprietários de imóveis rurais e urbanos. Baseada na percepção de que o proprietário, atualmente, constitui-se também em gestor socioambiental de sua propriedade, apresenta-se, nesta análise, um estudo da relação entre a função do proprietário e a proteção do meio ambiente. Este estudo inclui uma leitura sobre a evolução da concepção da propriedade no sistema jurídico brasileiro, até a inclusão da função social em seu próprio conceito, ou seja, a propriedade vinculada ao bem estar coletivo. Propõe-se uma leitura na qual o proprietário apresenta-se como necessário gestor de seu domínio, atento tanto para a efetividade do uso da propriedade, quanto da efetividade socioambiental desse uso. A proteção ambiental, portanto, tende a causar expectativa de eficácia no campo social, a qual nem sempre é confirmada pelas decisões judiciais. Após a análise conceitual histórica da conceitualização de propriedade, parte-se para uma leitura da primeira decisão judicial brasileira na qual a procedeu-se a desapropriação pelo desrespeito a função social ambiental, ou seja, por má gestão ambiental.Palavras-chave:propriedade, função social, desapropriação, meio ambiente, gestão.ABSTRACTThe environmental protection is announced in the Brazilian Constitution as a fundamental guarantee. However, this guarantee depends on the accomplishment of the social function of property. In fact, the prerogatives regarding the use of the property by its owners are limited, preventing them to use the property as they want. What the Constitution intends is to guarantee that the property right could only be as a full right whether the owner accomplish to the social function of the property. The social function means to exert the property powers without damage neither the collectivities nor the environment. In this sense, the social and environmental function imposes to rural properties some rules for acting as: productivity index, environmental protection and labors protection. The focus of this article is to study the environmental protection as one of the requisites for the social function of the property. It is analyzed the evolution of the property concept into the Brazilian legal system and the first decision of the Brazilian Court concerning the property expropriation by bad environmental management.Keywords: expropriation, environmental and social function, social expectations
Inovação, Sustentabilidade e Responsabilidade Social: análise da experiência de uma empresa de equipamentos pesados
Authors: Corrêa Dalila Alves , Sacomano Neto Mário , Spers Valéria Rueda Elias , Giuliani Antonio Carlos
Published: April 2017

O artigo aborda a prática da responsabilidade social em empresas que atuam de forma inovadora e sustentável. Responsabilidade social empresarial é um assunto que tem suscitado o interesse de autores da área de gestão, bem como vem estabelecendo relações com as abordagens inovação e sustentabilidade. Seu objetivo é mostrar, pelo estudo de caso desenvolvido numa empresa de grande porte, fabricante de equipamentos pesados, que as práticas de responsabilidade social, a inovação e a sustentabilidade são desdobramentos decorrentes da estratégia corporativa da empresa e que estão vinculadas aos seus objetivos econômicos, legais e sociais. Os dados da pesquisa foram coletados através de entrevistas realizadas com profissionais da empresa, observação e análises documentais sobre os projetos implantados e em desenvolvimento. Nesse sentido, a experiência construída pela empresa permite comentar que decisões sobre inovação tecnológica e sustentabilidade devem estar diretamente vinculadas às questões e ações sociais e ambientais, bem como emergir da base das concepções estratégicas do negócio. O estudo busca contribuir para as discussões que abordam estratégias de inovação e sustentabilidade aliadas aos propósitos de natureza socialmente responsáveis.Palavras-chave:Responsabilidade social, Inovação, Sustentabilidade, Projetos Sociais.ABSTRACTThe relation among Corporate Social Responsibility (CRS), Innovation and Sustainability is a subject that has interested many companies and authors of the management area. This article has a main objective to analyze this relation in a heavy equipment manufacturer. The research data have been collected through interviews with professionals of the company, observation and analyses of institutional documents. The results indicated that the company decisions about technological innovation and sustainability are directly linked with the social and environmental issues related to the business strategy.Keywords:Corporate Social Responsibility (CRS), Innovation, Sustainability, Heavy Equipment Manufacturer.
GESTÃO DE SERVIÇOS DE LIMPEZA URBANA EM CIDADES DE MÉDIO PORTE
Authors: Leite Valderi Duarte , Oliveira Susiene Almeida de , Prasad Shiva , Ribeiro Maria Denise
Published: April 2017

Este trabalho tem como principal objetivo, estudar a realidade do Sistema de Limpeza Urbana da cidade de Campina Grande-PB, analisando de maneira integrada os seus aspectos sociais, econômicos e ambientais. A metodologia fundamentou-se na aplicação de questionários aos técnicos da Secretaria de Obras e Serviços Urbanos do município e aos da empresa prestadora de serviço, responsável por 90% da coleta de resíduos sólidos domiciliares e comerciais da cidade e entrevistas à comunidade atendida pela serviço de limpeza pública, para obtenção de informações a respeito da problemática dos resíduos sólidos urbanos da cidade de Campina Grande-PB. O trabalho foi norteado também na identificação dos roteiros e prática de coleta realizada no município, na determinação da taxa de produção per capita e caracterização física e química dos resíduos sólidos domiciliares. Os resultados advindos da realização deste trabalho,apresentam substanciais contribuições na área da limpeza urbana. Além disso, com base no diagnóstico obtido delineou-se um novo modelo para o sistema de limpeza urbana tanto para a cidade de Campina Grande-PB, enquanto para as demais cidades com características equivalentes.Palavras-chave:Resíduos sólidos; limpeza urbana; coleta de resíduos; sistema de gestão.ABSTRACTThis work has as its main objective to study the reality of the System of Urban Cleaning in the city of Campina Grande (PB), analyzing in an integrated way its social, economic and environmental aspects. The methodology is based on the application of questionnaires to the technicians in the local Urban Services Department and to the employees of the waste collection company, responsible for 90% of the collection of solid waste. Interviews are also applied to members of the local community. The work was also guided towards the identification of the routes and procedures of collection carried out in the city, and also the determination of per capita production rating and physical and chemical characterization of the home solid waste. The results present substantial contribution to the area of the urban cleaning. Therefore, a new model for the system of urban cleaning is designed not only for Campina Grande but also for other cities alike.Keywords:Solid waste; urban cleaning; waste collection; management system.
AUDITORIA DE SISTEMA DE GESTÃO AMBIENTAL: APLICAÇÃO EM UMA INDÚSTRIA ALIMENTÍCIA EM NATAL/RN
Authors: Soares Daniel Carvalho , Pimenta Handson Claudio Dias
Published: April 2017

A conscientização ambiental vem crescendo globalmente; em consequencia as cobranças sociais aumentam sobre o meio empresarial a fim de que as organizações busquem um desempenho ambiental satisfatório, minimizando a sua potencialidade poluidora. O presente artigo tem como objetivo implementar um modelo de auditoria ambiental estruturado nas especificações e recomendações da ISO 19011 e ISO 14001, visando melhorias no Sistema de Gestão Ambiental de uma empresa do ramo alimentício, localizada na microrregião de Natal/RN. A realização de ações para promoção da melhoria contínua no desempenho ambiental e no processo de adequação ambiental organizacional favorece a sustentabilidade empresarial. Assim, a pesquisa foi classificada como exploratória e descritiva, tendo sido o modelo proposto dividido em três fases: planejamento da auditoria, aplicação do modelo e conclusão da auditoria. Foram consideradas como escopo do modelo a Política Ambiental e a fase de Planejamento do Sistema de Gestão Ambiental. Os resultados apontam que a necessidade da empresa voltar maior atenção para avaliação dos aspectos e impactos ambientais, pois, apesar de existir um procedimento de avaliação, não foram evidenciados registros contendo os aspectos e impactos significativos. Sendo assim, não há confiabilidade no levantamento dos requisitos legais e outros aplicáveis, bem como no estabelecimento dos objetivos, metas e programas. Contudo, a aplicação do modelo permitiu uma análise prática e crítica da situação real da empresa, possibilitando o levantamento de pontos fortes e oportunidades de melhoria na gestão.