bluuebunny/crossref_metadata_2025 huggingface dataset:
Cohort Builder: Simplifying Cohort Creation
Authors: Toby Roshan , Thayer Daniel , Scanlon Ieuan , Stuart Amy
Published: September 2024

ObjectiveThe Cohort Builder package aims to streamline the cohort building process using R, with simplicity and efficiency as the primary focus. Researchers can generate cohorts from TRE (Trusted Research Environment) datasets by specifying simple cohort definitions as YAML (YAML Ain't a Markup Language) parameters using this package, eliminating the need to write complex queries.
ApproachCohort Builder offers researchers a user-friendly interface for defining cohort criteria by abstracting away the complexities of database queries using YAML configuration files. The package enables researchers to focus on defining the desired cohort characteristics rather than navigating the database and tables. Users can easily specify inclusion and exclusion criteria, demographic constraints, temporal constraints, and other dataset parameters to create cohorts tailored to their research goals and reproduce the results using the same configuration file.
ResultUsing the Cohort Builder, users may quickly create cohorts from TRE datasets with minimum code. The package facilitates reproducibility, transparency, and increased productivity. Researchers gain from having to rely less on specialised database expertise and having more flexibility when defining and exploring cohorts.
ConclusionCohort Builder offers a straightforward yet effective method for defining cohorts. The package frees researchers from having to worry about intricate technological details in favour of their analytical objectives.
ImplicationsMoving forward, Cohort Builder will support creative research projects across a range of disciplines and promote collaboration among researchers by allowing them to share configuration files for their cohorts.
Involving the public in transforming the data landscape in Scotland
Authors: Oldfield Katie , Baird Harriet
Published: September 2024

ObjectiveIn 2023 a public panel around public sector data use in Scotland was refreshed. The aim was to have a panel not only feedback on individual research projects but also the broader systems and processes of the data landscape in Scotland – from data sourcing and data storage, to data sharing and communicating research findings.
Approach  The public panel is a group of c. twenty members of the public and has, to date, focused on:

Recruiting a representative sample of people
Developing training materials to cover all aspects of the data system
Building mechanisms to incorporate feedback into system change
Increasing transparency of the panel discussions to support wider sector (including enhancing our website content and working to develop an annual report)
Embedding findings from discussions with the public panel across the system in Scotland

ResultsFeedback from panel members on recruitment and our approach has been positive. Panel discussions have already influenced ongoing work including synthetic data, website content and research projects. The panel have also begun advising on a system wide change from ‘just in time’ to ‘research ready’ data sets. This work followed a review of current data approvals processes across Scottish Safe Havens and the UK after COVID-19. 
Conclusions and ImplicationsThe current panel membership will run for two years after which a review of approach and impact will be carried out. Increasing transparency of the findings from the panels will enable organisations across the sector to benefit from this work.
Associations between long-term exposures to environmental factors and the development of amyotrophic lateral sclerosis: A matched case-control study
Authors: Saucier Daniel , Bélanger Mathieu , Liu Zikuan , O'Connell Colleen
Published: September 2024

ObjectiveAmyotrophic lateral sclerosis (ALS) is a motor neuron disease in which the causes remain unclear, particularly the contribution of environmental factors. Thus, we created a multifactorial database to investigate the association between long-term exposure to urbanization, air pollution, water pollution, and the development of ALS.
ApproachA matched case-control study was conducted in New Brunswick, Canada from January 2003 to February 2021. Study population included 304 ALS patients and 1207 controls with their historical postal codes from the New Brunswick Citizen Database linked to medical records and spatial environmental datasets from the Canadian Urban Environmental Heath Research Consortium. We compared their environmental exposures at place of residence prior to disease onset via conditional logistic regression models.
ResultsOf the common air pollutants investigated, odds of ALS was significantly higher with increased SO2 exposure (OR = 4.369, 1.190-16.044 [95% CI], per 1 ppb increase of SO2) in adjusted models. No significant associations were observed for the investigated urbanization and water pollution-related exposures.
ConclusionsThis is the first study to rigorously identify a potential environmental cause of ALS. Our findings suggest an association between long-term exposure to air pollutants, particularly SO2, and the development of ALS. Revision of SO2 emission regulations may be required.
ImplicationsThe identification of SO2 exposure as an ALS environmental risk factor opens new prospects for identifying ALS therapeutic targets. Utilizing a similar data linking workflow to pre-existing disease registries found within data centres should be conducted to further investigate environmental influences on complex diseases.
Risk of death after type of intimate partner violence (IPV) involvement
Authors: Urquia Marcelo , Trask Brandon , Scatliff Noah , Au Wendy , Hnatiuk Jill
Published: September 2024

Objective and ApproachMost studies have focused on women’s IPV victimization but perpetration and bi-directional violence remain understudied. Using linked criminal justice and population registers in Manitoba, Canada, we assessed the risk of death according to the role in IPV incidents (accused-only, victim-only, bidirectional, none). In this retrospective matched cohort study, we assembled a cohort of 212,068 adults who were followed from April 2004 to March 2023 to assess IPV incidents and subsequent death. Those involved in an IPV incident were 1:3 matched to persons with no history of IPV based on birth year, sex and marital status at the time of the incident.
ResultsMen comprised 85% of accused-only, 21% of victim-only, and 50-51% in the other two groups. Overall, compared to those without IPV involvement, the adjusted Hazard Ratios for all-cause mortality were 1.38 [95% Confidence Intervals (CI): 1.28, 1.49] for accused-only, 1.39 (1.29, 1.50) for victim-only and 1.45 (1.19, 1.77) for bidirectional IPV. The associations were stronger among women, particularly that of bidirectional violence [1.24 (0.97, 1.60) among men and 1.92 (1.39, 2.66) among women]. Similar patterns were found for intentional mortality [0.96 (0.56, 1.64) among men and 2.43 (1.27, 4.65) among women].  
ConclusionsThere are clear sex inequities in IPV involvement. Any type IPV involvement is associated with higher risk of death, particularly among women, who comprise most of the victims.
ImplicationsUse of linked criminal justice data allows studying the consequences of IPV victimization, perpetration and bidirectional violence and monitor gender inequities over time.
Inequalities in Ambulatory Care Sensitive Conditions: An International Comparison of High-Income Countries
Authors: Spiro Grace , Bai Yu Qing , ICCONIC Research Collaborative  , Wodchis Walter
Published: September 2024

ObjectiveTo examine the differences in inequalities in Ambulatory Care Sensitive Conditions (ACSC) hospitalizations relative to socioeconomic status across nine countries, namely Australia, Canada, England, Finland, France, New Zealand, Spain, Switzerland, and the United States (US). 
ApproachThe International Collaborative on Costs, Outcomes, and Needs in Care (ICCONIC) research collaborative developed national data sets with hospitalization and sociodemographic data aggregated to small-area levels and pooled across countries using a common data model. Inequalities were assessed using both the slope index of inequality and the relative index of inequality.
ResultsThis study developed a common definition and set of codes for ACSC hospitalizations that proved to be comparable across countries and regions. Consistent socioeconomic gradients were observed in all countries with higher ACSC hospitalization rates for individuals in most disadvantaged areas. The greatest difference in hospitalizations between the highest and lowest income quintiles were observed in New Zealand (1603 per 100,000), Finland (1802 per 100,000) and England (1955 per 100,000).
ConclusionsThe high-income countries included in this study displayed many commonalities in inequalities in ACSC hospitalizations. As a proxy measure of primary care access and quality, the observed inequalities may implicate disparities in health care quality and access for the lowest socioeconomic status groups.
ImplicationsBarriers to health care access in low socioeconomic groups remain a complex and multifaceted issue. Future research should investigate the underlying contributing factors to the observed ACSC hospitalization equity gradients, including primary care delivery model, remuneration approach, and population structure.
All-cause and cause-specific mortality amongst individuals with substance misuse: A population-based linked data study in Wales
Authors: Bailey Grace , Farr Ian , Evans Hywel , Ahmed Saira , Ohaeri Columbus , O'Gorman Lauren , Phillips Ryan , Oluwasuji Olabambo , Dixon Josh , Maimaris JoshJoanne , Smith Josie
Published: September 2024

ObjectiveSubstance misuse has a detrimental impact on an individual’s health and the wider society, as well as elevated mortality. Here, we analysed the association between substance misuse events across several healthcare service providers and risk of mortality.
ApproachIn this retrospective population-based cohort study, we identified substance misuse amongst a cohort in Wales, aged ≥10 years old between 2010 and 2019 using the Secure Anonymised Linkage (SAIL) Databank. Cox regression and Kaplan-Meier survival curves were used to calculate risk for all-cause and cause-specific mortality.
ResultsDuring the study period 16,229 (9.7%) individuals with a substance misuse event died. A high proportion of these individuals died prematurely (<75 years, 66.7%), and nearly half were from the most deprived areas at time of death (46.8%). Alongside alcoholic liver disease and alcohol hepatic failure, cardiovascular and respiratory diseases were the most common underlying causes of death. Those in receipt of specialist substance misuse treatment for alcohol-use were at greatest risk of suicide (hazard ratio: 1.83) and drug-related deaths (hazard ratio: 1.98). Risk of suicide was also higher for those with a drug-use health event recorded during a hospital admission (hazard ratio: 1.89).
ConclusionsSubstance misuse was associated with elevated mortality risk, in particular, amongst those with substance misuse recorded during inpatient hospital admissions. These findings highlight the need for early interventions such as increased screening and monitoring of substance use to prevent premature mortality.
ImplicationsOur results provide a clear indication of service needs to support planning and provisioning of health services.
Cycling and Pedestrian Injuries in the Region of Peel, Ontario; An application of linked administrative health data to enhance local road safety and health service delivery, through an Applied Health Research Question (AHRQ)
Authors: Troke Natalie , Plumptre Lesley , Saskin Refik , An Diana , Fortin Natasha
Published: September 2024

ObjectivesAn Applied Health Research Question request from Peel Public Health was investigated, to provide a comprehensive overview of injury patterns and healthcare utilization, among cyclists and pedestrians in the Peel Region of Ontario. 
ApproachEmergency department visits and hospitalizations across the Peel region were analyzed from 2018 to 2022, and categorized by collision type (pedestrian, cyclist motor vehicle collision (MVC), and cyclist non-MVC). Data was segmented quarterly and annually, and further stratified by residence status, sex, and age, by linking individuals to other administrative health databases. Additionally, 30-day mortality outcomes were evaluated. To contextualize incidence rates with population demographics, Public Health Data Zone and Census Subdivision data were also utilized. 
ResultsFor ambulatory visits, a substantial majority of Peel residents received treatment within the region, evidenced by 4,483 cyclist visits (55%) and 1,338 pedestrian visits (50%). However, a noteworthy portion of Peel residents — 188 cyclists (45%) and 182 pedestrians (46%) — received treatment outside the region. Hospitalization patterns echoed these visits. Overall, non-MVCs accounted for a large proportion of cycling incidents, particularly among females, stressing the need for targeted safety measures. Still, survival rates post-incident were notable, with a 100% survival rate for cyclists after ambulatory visits. Pedestrian survival rates were similarly high.
ConclusionThis study provided valuable insights into patterns of pedestrian and cyclist injuries among Peel residents, revealing considerable cross-regional healthcare utilization.
ImplicationsFindings will be utilized by the Region of Peel and partner organizations, to enhance local road safety initiatives and service delivery for vulnerable road users.
IDI Search: a metadata search app for exploring New Zealand’s administrative linked data
Authors: Elliott Tom , Milne Barry , Li Eileen , Sporle Andrew , Simpson Colin
Published: September 2024

How can we lower barriers to reuse of linked administrative data and improve quality at the same time? Linked data resources are expensive and complex, but accompanying readily-accessible metadata supports data reuse and quality control. However, metadata systems that are unsystematic or non-automated can lead to inconsistencies, making metadata use difficult even for experienced analysts.
Our national statistics office (NSO) maintains a research database (RD) of administrative datasets linkable at the individual level. With the NSO’s agreement, we extracted schema information (e.g. tables and variables) from the RD and obtained data dictionaries. R was used to extract information (e.g., descriptions, human-friendly names, codings) from the data dictionaries, which identified errors and inconsistencies that the NSO then fixed. A metadata database was collated using schema and data dictionary information about variables and datasets in the RD. Finally, a public web app was developed to enable exploration of the meta database by searching specific terms or navigating the hierarchical relationships.
We now work with the NSO data team to re-extract variables and add or update dictionaries ahead of the regular data updates. Metadata coverage is displayed on the app and used by our NSO to improve metadata quality and coverage. Our scripting workflow demonstrates the utility of automation in picking up errors and inconsistencies quickly, and before they can propagate by copy and paste. The web app, available to existing and new users, is now listed by the NSO as a “go-to” resource for using the linked administrative data resources.
The (dis)continuing of antithrombotic drugs and its implications for occurrence of adverse cardiovascular and bleeding events in cancer patients during end of life
Authors: Aldridge Sarah J , Akbari Ashley , Edwards Adrian , Lifford Kate , Abbel Denise , Cannegieter Suzanne , Goedegebuur Jamilla , Kempers Eva , Gulbech Ording Anne , Kruip Marieke , Portielje Johanneke , Søgaard Mette , Visser Chantal , Noble Simon
Published: September 2024

Background and ObjectivesFor patients receiving end-of-life care, adjusting polypharmacy and deprescription of potentially harmful medicines are important impactors on quality-of-life. Antithrombotic therapies (ATT) are used by 30-50% of patients with cancer, rising to 80% in older cancer patients, and are often continued until a quality-of-life-impacting bleeding event, or a patient is physically unable to take oral medication. We aimed to describe the use of ATT and occurrence of clinical outcomes in patients with cancer during end-of-life care.
ApproachLinked health and administrative data in SAIL were used to identify end-of-life cancer patients diagnosed in Wales, focusing on cancer types with an estimated 1-year survival time. Survival analysis was used to describe current ATT usage and to investigate the associations between ATT usage and major cardiovascular and bleeding events.
Results21,880 individuals were diagnosed with the pre-defined cancer types between January 2013 and December 2019, 5,660 (26%) of these were taking ATT at diagnosis. During the study period 1670 (30%) were discontinued. Median survival time of patients taking ATT at diagnosis was 169 (IQR 158-180) days, while median time to deprescription was 206 (IQR 190-224) days. Among ATT-users diagnosis, 460 (8%) and 900 (16%) experienced a major bleed or a cardiovascular event, respectively, within 1 year following diagnosis, compared to 1100 (7%) and 1930 (12%) among those who were not prescribed ATT at diagnosis.
Conclusions and ImplicationsOur research highlights the need for careful assessment and management of ATT in the interest of improving quality-of-life for patients with cancer during end-of-life care.
Investigation of the differences in characteristics of Welsh farming households with and without off-farm income
Authors: Thyer Jenny , Morrison-Rees Sian , Scully Sean , Caskie Paul
Published: September 2024

ObjectiveTo examine the characteristics of farming households that have no off-farm income, and how they compare to farming households containing at least one person employed in a non-farming occupation.
ApproachThis research uses the AD|ARC dataset for Wales held in the SAIL databank at Swansea University. This Research Ready Dataset, created by the research team, is comprised of population census data and existing agricultural datasets.
Individuals were split into two groups, those in households where all individuals were primarily employed in farming or unemployed, and those in households where at least one individual was in a non-farming occupation.
ResultsComparing these groups, our findings show:

There are 8135 farming households with at least one person in a non-farming occupation, and 5415 households with no off-farm income.
Households with off-farm income are on average 65% larger than households with no off-farm income.
33% of farming only households consist of a single person; 73% of these farmers are male, and the average age is 62.
The average age for farming-only households is 45, and the average age of households with non-farming occupations is 36.
We will present detailed findings on the socio-economic and farm business characteristics of these groups.

ConclusionUnderstanding differences between households with and without off-farm income provides insights on farm types and households most impacted by changes in agricultural policies and subsidies. This can inform policy design and help authorities deliver commitments on just transitions in a targeted and efficient manner.
Linkage and Demographic Indexing for Nursing Dynamics in the Integrated Data Service
Authors: O'Connor Nathan , Adedire Tolu , Stephenson Dilly , Quinn Leah
Published: September 2024

Objective and ApproachThis project links UK Nursing and Midwifery Council (NMC) Registrant data to the 2021 England and Wales Census (“Census 21”).
The Office for National Statistics (ONS) has composed a framework of index tables to facilitate linkage between prominent datasets in the UK. In linking person-level data to Census 21, ONS’ Demographic Index enables onward linkage to other administrative datasets that are indexed alike.
NMC Register and Census 21 records have been initially linked using bespoke deterministic and probabilistic methods, with resulting matches being joined to the Demographic Index. ONS’ Demographic Index Matching Service (DIMS) will also be used to link NMC data to the Demographic Index to enable comparisons between methods.
ResultsAnalysis of both approaches will compare quality metrics such as match rate, recall and precision and tools will be used to assess bias in matches made through each method. These metrics will provide an insight into how the index matching services have been designed and whether improvements can be made to account for any shortcomings in their performance.
ConclusionsHybrid approaches using both bespoke and indexing methods are proving valuable where sole use of the matching services is not suitable. This research will help ONS to refine which methods will yield the highest quality linkage and when.
ImplicationsAs ONS pursues an ‘indexing first’ approach to linkage, the outcomes of this and similar projects will influence the future of utilising indexes in varied capacities when creating or maximising the potential of linked data.
Implementation of a common data model in Health Data Research Network Canada: Lessons learned
Authors: Lix Lisa , Archbold Georgina , HDRN Canada CDM Working Group  , Azimzee Mahmoud
Published: September 2024

BackgroundThe Observational Medical Outcomes Partnership (OMOP) Common Data Model (CDM) is a standardized structure for observational data that enables collaborative health research. Health Data Research Network (HDRN Canada) is conducting a pilot study to implement this standard at partner data linkage centers.
ObjectiveOur objective is to describe the process used to implement the OMOP CDM, methodological and technical challenges, and the approach to evaluate CDM implementation at multiple sites.
ApproachCDM working group members include technical staff from data linkage centers in four provinces and a national data coordinating center, HDRN Canada operational and executive leads, and OMOP CDM consultants. The evaluation aims to collect quantitative and qualitative information on Extract, Transform, and Load (ETL) processes, performance of the CDM in a multi-site observational case study, and data quality.   
ResultsInitial steps have included collaborative learning about the CDM structure, importing open-source tools and licensed coding standards (i.e., Systematized Nomenclature of Medicine-Clinical Terms [SNOMED-CT], RxNorm) at data linkage centres, and exploring the technical requirements for developing ETL processes and hosting OMOP data. Creation of select OMOP tables has been accompanied by discussions about models for mapping clinical and prescription drug coding standards. A scoping review of evaluation strategies is underway.  
Conclusions and ImplicationsThe benefits of standardizing health data for multi-site research and supporting the production of findable, accessible, interoperable and reusable (FAIR) national data underscores the importance of HDRN Canada embarking on this OMOP CDM implementation project. The lessons learned will benefit other multi-site data standardization initiatives.
The Networked Data Lab: using linked data to understand intermediate care services in the United Kingdom
Authors: Fraser Caroline , Prendergast Tom , Kifetew Chamut , Ruziczka Zoe , Knight Hannah
Published: September 2024

Intermediate care (IC) is short-term care aimed at maximising patients’ independence. Across the UK, scaling up IC is included in post-pandemic recovery plans. This could reduce pressures on acute services through timely discharge or preventing admissions. The issues IC seeks to address are common across high-income countries. 
The Networked Data Lab is a network of analytical teams embedded in the UK health and care system. Each year, we support five local partners with acquisition, linkage and analysis of health and social care datasets. Our 2023-24 project is focused on IC. 
Patients and the public (PP) played an integral role in throughout our project. We established a panel of individuals with lived experience of IC to assist with the research questions, interpretation, and communication of results.  Our partners all consult PP in their areas to inform their analyses.  
Our partners’ analyses of linked patient-level data on IC will provide information about who is receiving IC, changes over time and outcomes for patients. We are also analysing national linked data for England on intermediate care following hospital discharge. 
Preliminary results include:

The age and health needs of people receiving bed-based intermediate care has increased over time (Grampian, Scotland)
Intermediate care following a hospital admission is more common for emergency admissions than elective admissions (Leeds, England)
Large variation in intermediate care delivery between neighbouring boroughs (North West London, England)

Full results are expected in April 2024.
Our work highlights the importance of linking data to answer important health and care questions.
Urban Trail Exposure in Winnipeg, Canada: Longitudinal Cohort Development for a 20-Year Difference-in-Differences Analysis of a Natural Experiment with Varied Duration of Exposure Times
Authors: Prior Heather , Burchill Charles , McGavock Jonathan
Published: September 2024

ObjectiveDevelop a cohort to evaluate a real-world experiment of the built environment on the incidence of disease, accounting for movement of people, postal codes, incidence of disease and changing demographics.
ApproachThe City of Winnipeg, Canada built multi-use trails in 2010-2012.  We used the administrative data housed at the Manitoba Centre for Health Policy to evaluate the effect of this change in the built environment on the incidence of cardiovascular disease events (CVDE) and risk factors (CVDRF) before (2000-2009) and after (2012-2019) the trails were built.  The Manitoba Health Insurance Registry contains postal code and demographic information on nearly all city residents and was utilized for cohort creation and person-time exposure.  Individuals’ residential postal codes were linked to geo-spatial data to determine proximity to built trails at 400m, 800m and 1200m.  Semi-annual postal code changes accounted for movement within/outside city limits or exclusion from the cohort.  Diagnoses from hospital abstract and physician visit data and outpatient prescription dispensations were used to access prevalence and incidence of a CVDE composite measure of congestive heart failure, ischemic heart disease and stroke and a CVDRF composite measure of diabetes, dyslipidemia and hypertension.
Conclusions and ImplicationsLeveraging a diverse set of administrative databases, we built a cohort evaluate the effect of building multi-use trails in Winnipeg on the reduction on CVDE and CVDRF.  This demonstrates how administrative data can be used to evaluate natural, real-world experiments with minimal direct data measurement or public intrusion, resulting in actionable results to inform public policy.
Centering The Voices of People Living with Multimorbity to Develop Visual Dashboards to Facilitate Structured Medication Reviews: The Role of Patient and Public Involvement and Engagement in the DynAIRx Study
Authors: McCloskey Erin
Published: September 2024

The use of Artificial Intelligence in healthcare has the potential to enhance the experiences of both patients and healthcare practitioners (Rajpurker et al., 2022). In an effort to streamline Structured Medication Reviews (SMRs) and to support medication optimization, The Artificial Intelligence (AI) for dynamic prescribing optimization and care integration in multimorbidity (DynAIRx) is a project which seeks to apply AI extracted from clinical records to improve the lives of people who are living with multimorbidity. SMRs were introduced at the primary care level to holistically support complex multimorbid patients’ health journeys and who are considered to be polypharmacy (at least five medications daily). However, there has been poor integration of health records across systems, and limited guidance on how to identify people who need yearly SMR. Without appropriate monitoring a patient’s medication, their polypharmacy may worsen (NICE, 2017); negatively impacting a patient’s overall health. Using AI and statistical approaches to predict the risk of poor outcomes, DynAIRx will produce visual dashboards for healthcare providers to use to facilitate reviews of medications for patients requiring SMRs.
A Public Advisory Steering Group, comprised of individuals with lived multimorbidity experiences or carers of people with multimorbid conditions sits at the heart of DynAIRx. The steering group is designed to ensure co-production is implemented throughout each work package. This presentation presents DynAIRx as a case study on how to develop and implement PPIE as user/partnership-centered approach to AI research in healthcare and potential implications of including the public’s perspectives on the larger product.
Co-Creating an Inclusion, Diversity, Equity, and Accessibility Strategy: Defining approach and outcomes in a health data research network
Authors: Freier Amy , Stirling Morgan , Nickel Nathan
Published: September 2024

BackgroundHealth Data Research Network Canada (HDRN) has committed to strengthening data use to improve health equity. Key this priority is has been an increased operationalization of Inclusion, Diversity, Equity, and Accessibility (IDEA) across the organization and within the data research processes HDRN Canada supports. Missing, however, was a unifying strategy for embedding IDEA within all HDRN Canada initiatives.
ApproachGuided by results from an internal environmental scan and network feedback, HDRN Canada began developing an IDEA strategy in 2023. With the end goal of embedding IDEA across all internal teams and across all HDRN Canada strategic goals, collaborative participation methods were chosen to involve all levels of the organization. A process was designed that included focus groups, interviews, and roundtables.
ResultsCo-creating the IDEA strategy required broad buy-in including detailing expectations of the planning process in advance. A flexible management approach that enabled the team to adhere to the defined process allowed the Project Team to manage unanticipated challenges. 4 key strategies emerged focusing on learning, data quality and research, leadership, and community engagement. Developing the strategy with co-creative methods helped to identify practical approaches for HDRN to prioritize IDEA within its complex data research initiatives.
ConclusionHDRN Canada has outlined its commitment to IDEA in the health data ecosystem. The co-created strategy supports efforts towards accomplishing its organizational objectives and priorities. It is also a valuable resource for those in the health data space working to ensure data research contributes to equitable health outcomes.
Utilization of Real-World Data in the Intervention to Reduce Early Peanut Allergy in Children (iREACH) Trial
Authors: Bilaver Lucy , Jiang Jialing , Gupta Ruchi
Published: September 2024

ObjectiveTo demonstrate the use of linked, real-world data in the context of a pediatric practice-based clinical trial.
ApproachThe Intervention to Reduce Early Peanut Allergy in Children (iREACH) is a two-arm, cluster randomized, controlled trial. The intervention included clinician education and clinical decision support to increase pediatric clinician adherence to the NIAID’s 2017 Prevention of Peanut Allergy guidelines during infants’ 4- and 6-month well child care visits. Electronic health record (EHR) data were shared with the data coordinating center under a Health Insurance Portability and Accountability Act (HIPAA) waiver. All caregivers of eligible infants were invited to complete two surveys via REDCap, an online survey platform. The consents included an optional HIPAA authorization to link EHR data with survey responses and authorization to collect and link administrative data from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program, if applicable.
ResultsOverall, 30 Illinois pediatric practices participated. EHR data was collected for 18,480 infants of whom 4,331 had any caregiver survey data (23.4% response rate). Permission to link survey responses to EHR data was obtained for 3,950 infants among those with any survey data (91.2%). Consent for linking WIC data with study data was obtained for 229 infants and 194 mothers.
ConclusionsAuthorization for data linkage in the consent forms allowed investigators to amass data to compare caregiver and clinician responses, generate hypotheses, and propose future research outside the scope of the main trial.
ImplicationsMultiple real-world data sources can be effectively combined to extend the findings of clinical trials.
Iowa’s Integrated Data System for Decision-Making (I2D2): a collaborative approach for responsible and relevant use of population data
Authors: Rouse Heather , Abraham W. Todd
Published: September 2024

Integrated data systems (IDS) bring together people, processes, and priorities in a disciplined approach to generate evidence about child and family needs and service system gaps. In response to pressure for more efficiently coordinated early childhood services, Iowa built an IDS as a collaborative effort between university researchers and government leaders. Iowa’s Integrated Data System for Decision-Making (I2D2) includes an engaged governance approach that has received national attention as a model for ensuring federal and state priorities direct the work, rigorous scientific standards are used, and community engaged users have access to the information they need when they need it. This presentation will describe I2D2’s governance and technology solutions and provide examples of cyclical, community-engaged projects that have informed program improvement. Multi-stage integration protocols ensure individual records from disparate systems in health, education, child welfare, and workforce are accurately matched within a process that attends to equity. Dissemination processes within communities of practitioners, executive leaders, and researchers ensure findings are relevant and used to drive strategic planning. Public facing dashboards and interactive applications display prioritized indicators and support improved data literacy and common language across partner groups. Examples of use will be discussed including the evolution of a statewide strategic planning process using integrated data indicators, evidence-based expansion of home visiting programming to meet the needs of underserved families, and support for sustainable childcare businesses through the availability of real-time vacancy, supply, and demand data and easy to access applications for families to find available care when they need it.
“Hiding in the Crowd”: defining conceptual models for privacy-preserving linkage of place-based and personal data for public benefit research.
Authors: Boyd Andy , Dibben Chris , Fry Rich , Hardelid Pia , Smith Cassie , McNamara Edel , Davies Bethan , Fecht Daniela , Blackburn Ruth , Gilbert Ruth
Published: September 2024

ObjectiveTo address the challenge of linking identifiable but low-sensitivity place-based data with high-sensitivity, de-identified, health and socio-economic records. While also minimising the financial and carbon costs of computationally intensive environmental modelling.
ApproachFor domain and legal experts, TRE leads and public contributors to co-develop a trusted system-wide governance model for linking these data.
ResultsWe identified the UK’s ‘Unique Property Reference Numbers’ (UPRNs) - a geo-coordinated national property ID number - as ideally suited for linking individuals to households and households to place-based data. Under Data Protection laws, UPRNs are considered inherently identifiable, yet public-domain research use is permitted as the data have low sensitivity and there is broad societal acceptance. Once linked with individuals’ records, additional controls are needed to preserve privacy. We developed a workflow for modelling place-based data at a national level by a single agency and then, using trusted third parties, de-identifying and sharing minimised derived extracts into TREs for linkage and analysis. To maintain confidentiality, the UPRNs of the population of interest are masked by matched ‘control’ UPRNs drawn from the wider population. We will discuss permutations of the model, proof-of-concept implementations in UK TREs and public views on the models proposed.
ConclusionsThe challenge can be addressed by minimising the data flowing between national generators of place-based data and TREs using trusted third parties and masking data to maintain confidentiality.
ImplicationsRelatively small adjustments to existing TRE workflows principles could enable new research possibilities without requiring re-evaluation of current governance norms or high-cost infrastructure changes.
“COMCIÊNCIA” AMBIENTAL: UMA PROPOSTA DE APLICATIVO PARA EDUCAÇÃO AMBIENTAL E SUSTENTABILIDADE
Authors: Sousa Rone Caetano , Oliveira Claudir , Góes Marciana Lima , Góes Josecley Fialho
Published: September 2024

A gestão de resíduos sólidos urbanos é um desafio crítico nas agendas globais de sustentabilidade. Este estudo propõe o desenvolvimento do aplicativo 'Comciência Ambiental' como uma ferramenta educacional para abordar a coleta seletiva e a reciclagem. Utilizando a plataforma Fábrica de Aplicativos, foi desenvolvido um protótipo para promover a conscientização ambiental e facilitar o ensino de práticas sustentáveis. A metodologia incluiu uma análise comparativa de aplicativos existentes, a identificação de funcionalidades educativas essenciais e testes práticos com usuários. O aplicativo oferece mapas interativos de pontos de coleta, jogos educativos, podcasts, vídeos temáticos e atualizações sobre reciclagem. Para validar empiricamente o aplicativo, foi realizado um teste com um grupo heterogêneo de usuários, visando identificar evidências iniciais de eficácia e aplicabilidade, além de coletar feedback em fases piloto. Os participantes avaliaram a usabilidade, praticidade e design do aplicativo por meio de questionários digitais e impressos. Os resultados indicaram uma aceitação positiva, destacando a facilidade de uso e a utilidade das informações. Este estudo demonstra o potencial das Tecnologias da Informação e Comunicação na educação ambiental, servindo como modelo para futuras iniciativas que busquem integrar tecnologia e sustentabilidade.
Fluorescence of Atomic Hydrogen in Aqueous Media
Authors: Pivovarenko Yuri
Published: September 2024

It is shown that aqueous solutions of atomic hydrogen fluoresce under the action of UV irradiation. It is also shown that the spectra of this fluorescence have peaks whose maxima are close to the 5th and 6th lines of the Balmer series. All this made it possible to propose using this fluorescence to determine the concentration of atomic hydrogen in aqueous media, which seems relevant for both hydrogen energy and medicine. In addition, the possible involvement of this fluorescence in such phenomena as the blueness of the daytime sky, Cherenkov radiation and the Kirlian aura is analyzed here.
Renforcer les capacités des aînés et de la collectivité : résultats d’une évaluation de l’élaboration des programmes de prescription sociale conçus par Centraide Colombie-Britannique à l’intention des aînés
Authors: Kadowaki Laura , Symes Bobbi , Lalji Kahir , Park Grace , Giannasi Wynona , Hystad Jennifer , McIvor Elayne
Published: September 2024

Introduction

Les aînés ayant des besoins accrus sont des candidats idéaux pour les interventions de prescription sociale, compte tenu de la nature complexe et intersectorielle de leurs besoins. Cet article présente les résultats d’une évaluation de l’élaboration de 19 programmes de prescription sociale destinés aux aînés à risque de fragilité.

Méthodologie

Nous avons effectué une évaluation des programmes pour la période 2020-2023. Nous avons utilisé les données de trois composantes de l’évaluation : 1) les données de l’évaluation initiale, recueillies en 2020 et en 2021, 2) les profils des programmes élaborés en 2022 et 3) les séances de cocréation tenues en 2023.

Résultats

De leur lancement jusqu’au mois de mars 2023, les programmes ont servi 2 544 aînés. Les agents de liaison communautaire ont cerné les facteurs au niveau individuel, au niveau interpersonnel, au niveau des établissements, au niveau de la collectivité et au niveau des politiques qui ont contribué à la mise en oeuvre et à la prestation de leurs programmes (médecins champions, communautés de pratique, solides relations préexistantes avec le système de santé, etc.), de même que les difficultés qui ont été rencontrées (capacité limitée des médecins de famille, manque de ressources communautaires, etc.). Les agents de liaison communautaire ont convenu qu’un programme de prescription sociale efficace devrait comprendre les éléments essentiels suivants : 1) établir des liens avec les ressources communautaires nécessaires, 2) prévoir la cocréation d’un plan de mieux-être avec les clients ayant besoin d’un soutien de longue durée ou intensif, 3) assurer un suivi et des vérifications de façon continuelle dans le cas des clients ayant des plans de mieux-être et 4) prévoir un processus d’évaluation et de triage pour la priorisation des clients.

Conclusion

Pour tirer pleinement parti des possibilités offertes par les interventions de prescription sociale, il est essentiel que les programmes mobilisent un éventail de fournisseurs de soins de santé et de services sociaux, que les agents de liaison communautaire soient qualifiés et bien appuyés et que des investissements adéquats soient faits dans le secteur des organismes à but non lucratif et du bénévolat.
Utilizing the determinants of healthy aging to guide the choice of social prescriptions for older adults
Authors: Mansell Beth , Summach Anne , Molen Samantha , O’Rourke Tammy
Published: September 2024

Executive summary

The age of Canada’s population is increasing, necessitating innovative methods and tools for assessing the needs of older adults and identifying effective health and social prescriptions. In Alberta, a community-based, senior-serving organization undertook the development and piloting of the Healthy Aging Asset Index, an assessment tool and social prescribing guide for use by a variety of professionals within the community. Tool development was rooted in medical complexity assessment and social work practice, and adhered to the determinants of healthy aging established by Alberta’s Healthy Aging Framework, which is based on the determinants of healthy aging published by the World Health Organization. Results from the pilot showed improvement in the functionality of older adults within the determinants over time, as they were supported in addressing areas of personal vulnerability. Adopting tools such as the Healthy Aging Asset Index can bring cohesiveness to the support that older adults receive across the care continuum and has the potential to shift the balance of care away from the health system and towards the community, thus improving the capacity of health systems and government to meet the needs of Canada’s older adults.
DRIVERS OF PROFIT CONVERGENCE IN EURO AREA BANKS
Authors: Bruffaerts Hélène , Vander Vennet Rudi
Published: September 2024

Since there are persistent concerns about the viability of euro area banks, we analyse their profit recovery in the post-crisis period, applying the concepts of β and σ convergence as well as the Phillips and Sul clustering algorithm. The results are consistent with ROE convergence, but to different levels across bank groups. The clustering analysis reveals the existence of banks with solid performance, but also a group of persistent underperformers. We find that non-interest income and operational efficiency emerge as crucial discriminating factors to explain the banks’ relative post-crisis ROE dynamics. Supervisors and bank managers are advised to monitor and reinforce bank business model viability.
Analisis Pendapatan Usahatani Bawang Merah di Dataran Tinggi Kota Batu
Authors: Hasbiy Khoirul Umam , Hardana Andrean Eka
Published: September 2024

Komoditas bawang merah merupakan salah satu komoditas unggulan untuk sayuran dan menjadi target pengembangan agribisnis bagi Pemerintah Kota Batu. Tujuan penelitian adalah untuk (1) menganalisis kelayakan finansial petani yang berusahatani bawang merah, dan (2) mendeskripsikan manajemen usahatani bawang merah di dataran tinggi Kota Batu. Penentuan lokasi penelitian dilakukan secara sengaja yakni di Desa Junrejo, Kecamatan Junrejo, Kota Batu. Metode pengambilan responden usahatani dilakukan dengan pendekatan probability sampling dengan metode rancangan sampel acak sederhana. Metode analisis data yang sesuai untuk penelitian analisis usahatani bawang merah adalah analisis data kuantitatif untuk analisis pendapatan usahatani dan kualitatif untuk deskrispi manajemen usahatani bawang merah. Rata – rata produksi komoditas bawang merah sebesar 14,6 ton/ha, dengan perhitungan total biaya rata – rata usahatani meliputi biaya tetap serta biaya variabel yang dikeluarkan sebesar Rp 54.010.236,2/ha dan penetapan harga jual rata - rata sebesar Rp 7.000. Maka didapatkan perhitungan pendapatan usahatani di daerah penelitian sebesar Rp 47.916.916,2/ha, sehingga data dikatakan usahatani bawang merah menguntungkan. Manajemen usahatani bawang merah di Desa Junrejo Kecamatan Junrejo Kota Batu telah berjalan sesuai dengan pelaksanaan di lapang, namun terdapat beberapa fungsi manajemen yang harus mendapatkan perhatian seperti fungsi controling yang lebih diperhatikan lagi dalam pelaksanaan di lapang terutama berkaitan dengan aplikasi input usahatani.
A Stochastic Model to Predict Road Accidents in Albania
Authors: Kacorri (Salillari) Denisa , Caushi Anita , Basholli Albina , Prifti Luela
Published: September 2024

The importance of predicting accident rates lies in the improvement of road infrastructure and the effective implementation of laws and traffic regulations. The statistical change of many phenomena over time is described by time series.  This paper aims to forecast the number of individuals involved in road accidents in Albania by applying SARIMA model approach. This study used monthly number of individuals involved in road traffic accidents in Albania from 2016 to 2023. Using forecasting techniques for the number of traffic accidents can serve as a valuable strategy for achieving various objectives including the implementation of traffic safety campaigns, strategies, and action plans outlined in traffic safety initiatives. The model was found to be effective in capturing the underlying patterns and trends in the data, providing valuable insights for understanding and forecasting traffic accident occurrences in Albania.
Bestias salvajes, bestias domesticadas
Authors: Padilla Mauricio
Published: September 2024

Mucho se ha escrito en torno a la complicada relación entre Friedrich Nietzsche y Platón. Sin embargo, más allá de lo irreconciliable de sus posturas e intereses, ambos llevan a cabo su empresa filosófica enfrentándose a los valores dominantes de su época para ponerlos en entredicho y proponer, a su vez, otro estilo de vivir y de sentir alterno. Así como Nietzsche detecta una primera transvaloración de todos los valores (Umwertung aller Werte) en la rebelión de los esclavos en la moral, Platón haría lo propio con las tesis socráticas del Gorgias. Nietzsche mismo apunta a una transvaloración de todos los valores, así como antes de él lo han hecho Platón y el judeocristianismo.
Las preposiciones SÍ importan en la investigación educativa
Authors: Vázquez Recio Rosa
Published: September 2024

Esta historia mínima es una invitación a pensar en las preposiciones, aun siendo palabras invariables. El empleo de una u otra demarca y determina no solo el sentido de lo que se dice, sino también, y, sobre todo, el lugar que se ocupa en la relación de dependencia que define entre dos o más partes. Se plantea que su uso y dominio es una cuestión política. Se analiza las construcciones "investigar a" e "investigar sobre", las cuales son propias de investigaciones extrativistas, antidemocráticas y deshumanizadoras. Se reivindican otras construcciones, como "investigar con", "investigar junto con" e "investigar para" para garantizar la justicia cognitiva que supone luchar por lo “inédito viable” (Freire, 1993).