bluuebunny/crossref_metadata_2025 huggingface dataset:
What happened to my patient after I dropped them off at the ED? Linking Welsh ambulance to secondary care and mortality data
Authors: John Gareth
Published: September 2018

IntroductionThe Welsh ambulance service hold very detailed information about emergency calls received, incidents and associated ambulance journeys, but very little about what happens to patients after they have been conveyed to hospital.

Linkage of ambulance data to secondary care and mortality data can allow new outcome measures to be developed.

Objectives and ApproachA proof of concept was jointly initiated by the Welsh Ambulance Service, Welsh Government and the NHS Wales Informatics in order to explore how ambulance conveyance data could be linked to other routinely collected secondary care and mortality data, with the aim of developing new outcome-based measures for the evaluation of the effectiveness of the ambulance service and the unscheduled care system as a whole.

As there were very few patient demographic data items common to both the ambulance and secondary care datasets, the resulting probabilistic linkage relied largely on the use of time and location-based distributions.

ResultsThe linkage methodology proved to be highly successful for those patients conveyed by ambulance to an ED, with the various location and time-based fields from the ambulance dataset combining well with similar fields in the ED dataset. Out of all ED attendance records which had "Ambulance" as the stated mode of arrival, an associated ambulance record was found in over 90\% of cases.

Additional exact and rules-based deterministic methods were used to link the ED attendances to associated admissions, critical care and mortality records, with new ED, in-hospital and longer term outcome variables developed.

Finally, the project team analysed the impact of ambulance response times and ED handover delays on these outcome measures.

Conclusion/ImplicationsThe work demonstrated how the linked data could provide managers, commisioners and policy-makers with a more holistic view of the unscheduled care system. Work to-date has focussed mainly on conveyances to ED, however the next stage will be to develop outcome measures relating to those patients treated at the scene or advised by phone.
Attending Nurse Practitioners in Long-Term Care Homes Evaluation
Authors: Fearon Danielle , Saskin Refik , Ishiguro Lisa , Graves Erin
Published: September 2018

IntroductionIn 2014, the Ontario Ministry of Health and Long-Term Care (MOHLTC) announced funding for 75 nurse practitioners (NPs) over three years in long-term care (LTC) homes. This evaluation was approved by ICES’ Applied Health Research Question (AHRQ) team, a portfolio which answers questions from stakeholders having impact on healthcare policy.

Objectives and ApproachThe purpose of this project is to evaluate the impact of the first thirty NPs hired. Changes will be evaluated using key outcome measures of resident care (e.g., early hospital discharge, emergency room bed days) identified through a literature review conducted by the MOHLTC. LTC home residents were identified using all individuals with claims in OHIP during the 2016-17 fiscal year with a location of a LTC home. LTC homes with a hired NP were considered to be cases and all other LTC homes were considered to be controls.

ResultsFor part one of this evaluation, case and control LTC homes were stratified by bed size, Case Mix Index, rurality and Local Health Integration Network. Hospitalization records and emergency visits (from Discharge Abstract Database and National Ambulatory Care Reporting System) were determined for LTCH residents 6 months before and after the NP hire date of October 1, 2016. Overall, the rate of hospital admissions (per 100 residents) increased by 3.44% (8.51% to 11.94%) following the NP hire date; whereas, the rate of hospital admissions increased by 2.29% (6.55% to 8.83%) among controls. Following the NP hire date, the rate of emergency department visits also increased by 3.15% among cases (16.62% to 19.77%) in comparison to a 2.31% increase among controls (12.55% to 14.86%).

Conclusion/ImplicationsThe findings from this evaluation will inform further implementation strategies of the NP program and guide decision-making of future funding opportunities. In summary, the results will inform policies to strengthen care of LTC homes and improve the quality of care of residents.
Using data to explore vulnerable women's utilization of maternity health care
Authors: Rostami Mahnoush , Charland Paola , Memon Ameera
Published: September 2018

IntroductionInequitable access to appropriate maternity health care is an issue for vulnerable women that negatively impacts health outcomes. As part of a feasibility study on midwifery services for vulnerable women, we used administrative data to further our understanding of socially disadvantaged women’s use of the primary care system during pregnancy.

Objectives and ApproachTo better understand maternity health service utilization and social vulnerability of women in Calgary Alberta, a research partnership was formed between Alberta Health Services and a social service agency that serves clients experiencing, poverty, and food insecurity and were at risk for homelessness. This multi-phase study linked postal code data to data from provincial databases. Variables included socioeconomic characteristics, prenatal health care utilization and maternal and birth outcomes for the years 2013 to 2015.

ResultsDatabases accessed included the Alberta Perinatal Health Program (APHP), Alberta Health Practitioner Claims Database, AHS Admission Discharge Transfer Database, Discharge Abstracts Database, National Ambulatory Care Reporting, and Provincial Registry Database.

Data linkages yielded a total sample size of 7493 women, with 15.5% of women qualifying as ‘socially vulnerable’. Women receiving social assistance are relatively younger, experience more pregnancies, have higher antenatal risk scores and accessed maternal and emergency care more often and later in their pregnancy than those women who are not accessing social services. Our results suggest women living in vulnerable circumstances experience higher risk pregnancies that those not living in vulnerable circumstances. Therefore a maternity care model such as midwifery, which uses a holistic approach to care may be beneficial for vulnerable women.

Conclusion/ImplicationsFindings from our study confirm that women experiencing poor social circumstances are at increased risk for complications during pregnancy and birth. Therefore, we need to further investigate utilizing maternity models of care that serve both the maternal health needs and the social needs of this population.
In-Utero SSRI and SNRI Exposure and the Risk of Neurodevelopmental Disorders in Children: A Population-Based Retrospective Cohort Study Utilizing Linked Administrative Data
Authors: Singal Deepa , Chateau Dan , Dahl Matthew , Derksen Shelley , Ruth Chelsea , Katz Laurence , Wall-Wieler Elizabeth , Hanlon-Dearman Ana , Brownell Marni
Published: September 2018

IntroductionMany studies demonstrating an association between in utero exposure to serotonergic antidepressants and higher risk of neurodevelopmental disorders in children are confounded by history of maternal depression and disease severity. We conducted a population-based analysis of women diagnosed with mood/anxiety disorder, a patient population for whom pharmacotherapy is clearly indicated.

Objectives and ApproachUsing linked population-based administrative data, we identified all mother-newborn pairs in Manitoba (born 1996 to 2009, with follow-up through 2014). High dimensional propensity scores and inverse probability treatment weighting were used to address confounding by indication and disease severity. The final trimmed cohort consisted of mothers who were diagnosed with a mood/anxiety disorder from 90 days prior to conception until delivery (n=4995). Cox Proportional Hazard Regression models were used to estimate risk of Autism Spectrum Disorder, epilepsy and attention deficit hyperactivity disorder (ADHD) in offspring. In addition to clinical data, we used novel education data to define outcomes in children.

ResultsAmong the cohort of mothers diagnosed with a mood/anxiety disorder during pregnancy or up to 90 days before, 16.8% received at least two dispensations of an SSRI or SNRI during pregnancy. We did not observe an association between use of SSRIs/SNRIs during pregnancy and increased risk of Autism Spectrum Disorder (hazard ratio 0.92; 95% CI 0.42 to 2.03), epilepsy (hazard ratio 1.21; 95% CI 0.48 to 3.05), or ADHD (hazard ratio 1.13, 95% CI 0.78 to 1.64) among offspring.

Conclusion/ImplicationsIn the absence of randomized control trials, large observation studies using sophisticated data analysis are the gold standard of evidence to help patients and clinicians making the decision to continue antidepressant use during pregnancy. Results of this study reassure women for whom the medication is clinically indicated.
Measuring Trends in Health Inequalities across Urban Cities in Canada: A Focus on Health System Outcomes
Authors: Nichols Meredith , Chuang Junior , Grimwood Sara , Hynes Geoff , Harvey Jean , Plante Charles , Neudorf Cory , Allin Sara
Published: September 2018

IntroductionThe majority of Canadians live in cities, which have experienced rising income inequality. This study examines how socio-economic inequalities in health system outcomes vary across and within Canada’s major cities over time to better understand these differences and to support informed decision-making and public policy planning to reduce inequalities.

Objectives and ApproachThis study links a range of hospitalization indicators with neighbourhood income quintile and city geography data using patient postal codes and Statistics Canada’s Postal Code Conversion File Plus (PCCF+). Age-standardized indicator rates were calculated and income-related health inequalities were summarized using disparity rate ratio (DRR), disparity rate difference (DRD) and relative concentration index (RCI). Data were pooled across five-year intervals and linked to Census data years (2006, 2011, and 2016). City (Census Metropolitan Areas (CMAs)) and sub-city (Census Subdivisions (CSDs)) results enabled comparisons within and across cities and provided local level information to strengthen measuring and monitoring of health inequalities.

ResultsAnalysis of the age-standardized rates for the hospitalization indicators (Hospitalizations for COPD (less than 75 years), Heart Attacks, Injury, Stroke, Self-Injury, Opioid Poisoning, Ambulatory Care Sensitive Conditions, and Hospitalizations Entirely Caused by Alcohol), overall and by neighborhood income quintile revealed an income gradient and significant variations within and across the CMAs and over time. Variations in DRR, DRD and RCI results were also observed across the CMAs over time, and between the CSDs within a CMA. Income-related inequalities in some hospitalization indicators persisted in Canada’s major cities with trends showing that people from lower income neighbourhoods experienced increased rates of hospitalization compared to people from higher income neighbourhoods.

Conclusion/ImplicationsThis is the first study examining socio-economic health inequalities at city and sub-city levels across Canada. The methods used are relevant to others interested in local health inequality measurement. Our analysis provides evidence for developing and targeting public policy and health interventions to improve outcomes for vulnerable populations within cities.
From the back room to the front room: Combining clinical and financial information to support evidence-based decision making
Authors: Robertson Nathalie , Loreti Marcus
Published: September 2018

IntroductionDecisions in healthcare are not based on a single piece of evidence. Decision-makers consider a broad range of information, including patient, system and financial information. Canadian healthcare decision-makers now have access to linked clinical and financial data – at the patient level - via an online, private tool.

Objectives and ApproachThe objectives of this presentation are to showcase the power of having linked inpatient and ambulatory care clinical and financial data, as presented in an online tool. More specifically, two separate scenarios will be worked through, demonstrating how key decisions can be impacted by having record-level clinical and financial information. For example, a hospital may make a different decision when looking at the price differential of performing some surgeries and keeping patients overnight, versus performing these same surgeries in day surgery context and sending patients home. Supporting drill-down detail and visualizations will also be showcased.

ResultsThe presentation will focus on the importance of leveraging and integrating available information to better support decision-making. The presentation will emphasize how this tool, which uses linked clinical and financial data, is an example of the integration of new information sources into traditional decision-making practices. For example, with the availability of detailed cost estimates tied to clinical information, decision-makers have the ability to provide budgeting and costing estimates, by area, for different patient types. This is particularly important for health organizations that do not have a patient costing system in place.

Conclusion/ImplicationsTools that integrate information in an easy to use format allow decision-makers to access important information quickly, thus facilitating more time to gather supplemental information and consider the information at hand, ultimately supporting evidence-based decision-making.
Use of the CANHEART ‘big data’ registry to conduct a large randomized registry clinical trial to improve lipid management in Ontario, Canada
Authors: Khan Anam , Jia Jing , Chu Anna , Udell Jacob , Farkouh Michael , Tully Jack
Published: September 2018

IntroductionCreation of registries using linked population-based databases could potentially be used to conduct large registry-based clinical trials. As part of the CANHEART-Strategy for Patient-Oriented Research (SPOR) innovative clinical trials initiative, we explored the practicality of using the linked CANHEART registry to conduct a cluster-randomized trial aimed at improving lipid management.

Objectives and ApproachThe CANHEART registry (www.canheart.ca) was created through the linkage of 19 population-based health databases in Ontario, Canada, providing individual-level socio-demographic, geographic, hospitalization, disease testing/screening, mortality, prescription medication, and behavior/lifestyle information. Using CANHEART defined eligibility criterion, small and medium-sized, high cardiovascular-risk health regions (defined as having acute myocardial infarction, stroke or cardiovascular death rates greater than the Ontario average) are being randomly allocated to receive either the intervention (availability of a lipid management ‘toolbox’) or standard care. Cohort linkages to additional years of data will occur regularly over the 3-year trial to ascertain the primary outcome of appropriate statin prescribing rates.

 

\section*{Results}

Record linkage enabled us to determine baseline characteristics of 835,345 patients aged 40-75 as of January 2016, being treated in the 28 study-eligible regions by 2,012 family physicians. Preceding the study, the baseline statin use rate was 35.7\% (in 66-75 year olds) across these regions and the cardiovascular event rate ranged from 3.78-5.64 events/1000 person-years. A randomization procedure yielded 14 regions in both the intervention and control arms which did not differ significantly in socio-demographic characteristics, traditional cardiovascular risk factors, disease history, prevalence of statin use, or access to healthcare indicators. Working groups have been established to operationalize the lipid management tools that will be made available in the intervention regions. Analysis of newly linked participant data will permit outcome ascertainment at trial completion.

 

\section*{Conclusion/Implications}

Our work demonstrates the feasibility of using the CANHEART ‘big data’ registry to conduct a large, cluster-randomized clinical trial aimed at improving lipid management, without requiring any primary data collection. Broader use of this methodology has the potential to change the existing paradigm for conducting pragmatic clinical trial research.
Implementing a script to improve the quality of the Brazilian Disease Surveillance Data System using record linkage
Authors: Sobrino Rejane , Souza Marli , Oliveira Gisele , Guillen Luis Carlos , Coeli Claudia , Saraceni Valeria
Published: September 2018

IntroductionThe National Disease Surveillance Data System (SINAN) is the main tool used by tuberculosis control programs to measure control actions and disease incidence rates in Brazil. Therefore, data quality is essential to support health surveillance and management.

Objectives and ApproachThe aim of this study was to propose an algorithm for the qualification of the variables type of entry, treatment outcome, HIV test, HIV/AIDS co-infection and diabetes comorbidity.

We conduct a probabilistic record linkage between three databases of the city of Rio de Janeiro: SINAN-Tuberculosis, 2004-2012; the Mortality Information System (SIM), 2009-2013; and AIDS unified database, until 2012 (SINAN-AIDS, SIM registries that AIDS was the basic cause of death, drug distribution and laboratory databases). The criteria for qualifying the variables were based on technical guidelines, published by the Brazilian Ministry of Health. We implemented a script using Structured Query Language.

ResultsThe script had 103 rules. There was an 115% increase in the treatment output classified as "dropout" due to a decrease in: i) the number of records with patient transference but that they were not followed by another health care unit; output treatment classified as "ignored"/missing values; records with treatment output classified as "cure" before the end of the treatment. There was a 28% decrease in the number of records with treatment output classified as "death due to tuberculosis" and a 64% increase in those classified as "death due to other causes". There was a 2.4% increase in the number of records with diabetes as a comorbidity, a 5.3% increase in the number of registries with HIV-positive test and a 8.7% increase in TB-HIV/AIDS co-infection.

Conclusion/ImplicationsLinking databases is an important strategy for retrieving information from other systems to improve the quality of information to support decision making for TB control.
Bias, accuracy and sample size in the systematic linking of historical records
Authors: Antonie Luiza , Inwood Kris , Minns Chris , Summerfield Fraser
Published: September 2018

IntroductionLinking distinct historical sources on an automated basis directs attention to the quality and representativeness of the linked data created by these systems. Linking with time-invariant personal characteristics arguably minimizes bias or departures from representativeness even though a wider set of features might generate more links.

Objectives and ApproachThe objective of this research is to compare, evaluate and understand bias when two linking methodologies are employed on the same data sources. Our approach to studying this problem is by comparing linked records from Canadian censuses (linking 1871 to 1881) generated by two different linking strategies. The first method is a support vector machine based classification model on time-invariant individual characteristics. Using this method a large number of multiple matches is generated, as records look similar on a small number of time-invariant individual characteristics. The second method adds a second stage of disambiguating multiple matches using family information.

ResultsWe compare the links produced by the two methods used in the study and we discuss the results. The comparison is in terms of number of links produced, their quality (false positive rate) and the bias of the linked data produced. A complication is that there are many dimensions of bias. Even time-invariant criteria typically generate some bias.

As expected, the two-step process produces a larger linked sample. Interestingly, it also produces a lower error rate and different patterns of bias. Both methods understate the Quebec-born, French-ethnicity, the unmarried and adolescents. Unexpectedly, the bias in favour of married people is larger using individual (first method) than family information (second method). However, family-based linking does over-represent young children.

Conclusion/ImplicationsResults suggest that neither method will be universally preferable. Rather, the choice of research question may affect the preferred balance of biases and link rate. Fortunately, the advance of computational capacity allows a researcher to select a method that generate links most appropriate for the problem at hand.
Pan-Canadian Real-World Health Data Network: Building a National Data Platform
Authors: Smith Mark , McGrail Kim , Schull Michael , Katz Alan , McDonald Ted , Paprica P. Alison , Victor J. Charles , Lix Lisa , Chateau Dan , Diverty Brent
Published: September 2018

IntroductionResearchers and decision makers from across Canada use linked provincial administrative data for analysis and to address research and policy questions. Currently there are several impediments to working harmoniously across provincial boundaries. A group of academic and policy researchers are working to address these multi-jurisdictional obstacles.

Objectives and ApproachResearchers and data organizations from across Canada are working together as the Pan-Canadian Real-World Health Data Network PRHDN). PRHDN aims to: (1) create harmonized data, algorithms and analytic protocols, and (2) link administrative databases to other types of data, including electronic medical records, clinical trials records, “omics data” and records from pan-Canadian cohort studies. PRHDN’s vision is to construct a unified, documented infrastructure to advance pan-Canadian population-based research and analysis. This presentation incorporates material that is part of PRHDN’s response to a funding call to create national, collaborative infrastructure.

ResultsScientists and staff at PRHDN organizations will create three main categories of infrastructure: 1) Algorithms: Reusable processes, ideally in the form of documented code, which implement a common approach or definition, e.g. to define cases or to create derived variables; 2) Harmonized Common Data: Based on the Sentinel model, we will establish a standardized subset of harmonized common data that are analysis-ready; 3) Common Analytic Protocols: Complementing work of the Canadian Network for Observational Drug Effect Studies (CNODES), we will establish processes for distributed analysis with common analytic protocols and meta-analysis of results to provide pan-Canadian estimates. Source data would remain within jurisdictional boundaries and only aggregate results would be pooled across jurisdictions. Details of these approaches will be presented.

Conclusion/ImplicationsThis initiative will improve coordinated access to distributed data from across Canada that is built once then used by many stakeholders for a variety of purposes including: research, benchmarking, performance monitoring to identify gaps and opportunities for improvement, multi-jurisdictional evaluations of novel interventions and inter-jurisdictional comparisons.
Advancing data collection of hospital-related harms: Results from hospital discharges dually coded with ICD-10 and ICD-11
Authors: Eastwood Catherine , Southern Danielle , Boxill Alicia , Wiebe Natalie , Ghali William , Quan Hude
Published: September 2018

IntroductionHospital safety performance is difficult to monitor when under-coding of hospital harms is common. The beta version of ICD-11 includes a 3-part model for coding harms to enhance adverse event descriptions. This method includes code clusters to detail each condition/event (e.g. bleed), cause (e.g. anticoagulant drug), and mode (over-dose).

Objectives and ApproachThe study objective was to compare the proportion of adverse events captured using different classification systems. A large field trial of inpatient charts, previously coded in ICD-10 were coded with ICD-11. Coding training for the new ICD-11 focused on new codes, code clustering, and extension codes for cause and mode of the harm. Sensitivity, Specificity, NPV and PPV were reported for ICD-10 compared to ICD-11.

ResultsOf the 1,009 records reviewed and coded using ICD-11 to date, 128 cases were coded as a harm in ICD-10 using our previously published PSI work. Coders identified 88 cases with the new ICD-11. Sensitivity and specificity were as follows: 31.3% and 94.6%. ICD-11 had NPV and PPV of 45.5% and 90.5% respectively compared to ICD-10. Detailed clinical comparison of mismatched codes will be completed. Study case examples will demonstrate advanced features of ICD-11, the coding rules being collaboratively developed by our team, CIHI, and WHO representatives, and potential analytic challenges.

Conclusion/ImplicationsThe new ICD-11 found 8% of hospital admission were associated with a harm. Although the sensitivity was modest, specificity is quite high and correctly Identifies those cases without a harm. Clinical review of mismatched codes will provide further detailed code comparisons.
Evaluating the Family Nurse Partnership Programme in Scotland: a natural experiment approach
Authors: Cannings-John Rebecca , Lugg-Widger Fiona , Robling Mike , Paranjothy Shantini , White James , Pell Jill , Sanders Julia
Published: September 2018

IntroductionThe Family Nurse Partnership(FNP) is an intensive home-visiting service for teenage first-time mothers (and children), developed/trialled in the US and adapted/trialled across Europe.The Scottish Government(SG) aims to build on and supplement the existing national/international evidence base for FNP, to assess effectiveness and opportunities for optimisation of the programme, for future decision making in Scotland.

Objectives and ApproachThe evaluation commissioned is a natural experiment of FNP, taking advantage of the existing information infrastructure in Scotland. This natural experiment represents an important opportunity to determine programme impact upon many key programme outcomes using routinely collected data at a lower cost than a comparably sized effectiveness trial. Key objectives are: to identify clients in receipt of FNP-support and a control sample of matched families who would meet criteria for FNP but did not receive support, to obtain approval and through anonymised data linkage link to health and other data, and to determine the effect of FNP across a range of maternal and child outcomes.

ResultsThe succes of the natural experiment design in trying to replicate the gold standard design of the RCT will be presented and will cover the following topics: (how cases and a comparable group of first-time teenage women have been identified across 10 Health Boards (HBs) between 2009 and 2016 using data made available by the electronic Data Research and Innovation Service (eDRIS) from FNP, NHS Scotland and SG; the matching process of the cases and controls using propensity score methods to ensure an unbiased comparison; the linkage to health, social care and educational datasets and the approval processes involved, and the strengths and limitations of using routine data to evaluate relevant study outcomes that map to a logic model.

Conclusion/ImplicationsThe impact of this evaluation into the effectiveness of FNP in Scotland will establish a robustly matched study cohort, a more strealmined linkage and approval process, and identification of outcomes not only for a short-term follow-up but also for a longer-term follow-up of the teenage mothers and their children.
Teologia Pastoral e Teologia Prática, além da postura eclesial
Authors: Souza Alzirinha Rocha de
Published: September 2018

As questões suscitadas entre a TPas (Teologia Pastoral) e TPr (Teologia Prática) não são recentes e nem poucas no contexto latino-americano. De fato, o modelo de TPr como concebido no norte da Europa, ainda é recente em América Latina, que prima por denominar os trabalhos ligados à prática unicamente como TPas. Visando ampliar e trazer a luz os elementos de aproximação e divergências entre as duas linhas é que propomos e leitura desse artigo. Como afirmaremos ao largo do texto, não se trata de demonstrar a excelência de uma sobre a outra, antes de recuperar o sentido de teologias que complementando-se em suas especificidades, cumprem efetivamente o papel de “traduzir” o Mistério aproximando-o de seu destinatário.
Piedade popular e o culto a Maria: um olhar a partir do Diretório de Piedade Popular e Liturgia e da Exortação Apostólica Marialis Cultus
Authors: Von Zuben Newton Aquiles , Landgraf Robert Donizeti
Published: September 2018

O presente artigo apresenta uma pesquisa sobre o que a instituição católica entende por piedade popular, tendo como base o Diretório de Piedade Popular e Liturgia, para em seguida, abordar o tema piedade popular mariana, com suas características próprias, como sentimento via cordis, exuberância, expressividade, vitalidade e caráter maravilhoso, e analisar a postura do catolicismo oficial, diante dessa maneira de vivenciar a fé. Posto isso, pesquisou-se o culto mariano, tendo como horizonte a exortação apostólica Marialis Cultus, de Paulo VI, que contém orientações, como bíblica, litúrgica, sensibilidade ecumênica e antropológica, para promover uma genuína reforma da veneração a Maria.
Comunidades cristãs: eco da voz de Jesus
Authors: Ottaviani Edélcio , Ferreira Edi Gomes
Published: September 2018

Este artigo é um exercício de reflexão em Teologia Prática, a partir das interpelações da Exortação Apostólica Gaudete et Exsultate (GE) do Papa Francisco a respeito do chamado à santidade, e do trabalho de pesquisa sobre o chamado de Paulo a caminho de Damasco e sua experiência com as primeiras comunidades cristãs. Estabelece uma relação com relatos atuais de homossexuais ou transexuais que desejam viver os valores evangélicos, mas que se sentem perseguidos em sua condição. O objetivo deste artigo é suscitar uma reflexão sobre a experiência paulina que, ao perseguir as comunidades cristãs, em nome de um ideal de vida religioso, ouve a voz de Jesus que diz: “Saul, Saul por que me persegues?” (At 9, 4). Ele aplica a époché, própria ao método fenomenológico, para deixar vir à luz e chegar aos nossos ouvidos o grito muitas vezes abafado de pessoas que procuram viver os valores cristãos e um caminho de santidade sem negar sua própria condição. Estes se fazem reverberar na voz de Jesus e clamam: “por que nos perseguem?” Suspendendo estrategicamente as tábuas de valores pré-estabelecidas, este artigo deseja mostrar as razões teológico-pastorais que pressupõem, na aplicação do “princípio misericórdia” (Cf. GE, 46), a escuta dessas vozes.
A teologia, os teólogos e o pontificado de Francisco
Authors: De Souza Ney , Ferreira Reuberson
Published: September 2018

O presente artigo tem por objetivo apontar a relação entre o Papa Francisco e a Teologia. Por um lado, sua relação com a teologia latino-americano, mormente a Teologia do povo e o como ela transparece em alguns escritos pontifícios. De outro lado, pontuar o papel e os desafios do teólogo e da teologia no processo de recepção dos postulados de Francisco desenhados em seus gestos, pronunciamentos e documentos.
Randomised trial of HPV self-sampling among non-attenders in the Slovenian cervical screening programme ZORA: comparing three different screening approaches
Authors: Ivanus Urska , Jerman Tine , Fokter Alenka Repse , Takac Iztok , Prevodnik Veronika Kloboves , Marcec Mateja , Gajsek Ursula Salobir , Pakiz Maja , Koren Jakob , Celik Simona Hutter , Kramberger Kristina Gornik , Klopcic Ulrika , Kavalar Rajko , Zatler Simona Sramek , Kuzmanov Biljana Grcar , Florjancic Mojca , Nolde Natasa , Novakovic Srdjan , Poljak Mario , Zakelj Maja Primic
Published: September 2018

Background

To overcome obstacles within the Slovenian organised cervical cancer screening programme, a randomised pilot study of human papillomavirus (HPV) self-sampling among non-attenders was performed, aiming to assess three different screening approaches.

Participants and methods

Non-attenders aged 30–64 years from two Slovenian regions were randomised to two HPV self-sampling groups–the opt-in (I1, n = 14.400) and the opt-out (I2, n = 9.556), with a control group (P, n = 2.600). Self-collected samples were analysed using the Hybrid Capture 2 assay. HPV-positive women were invited to a colposcopy. The overall and type-specific intention-to-screen response rates and histological outcomes with a positive predictive value (PPV) according to the women’s age, the screening approach, the level of protection resulting from previous screening history, and the region of residence were assessed.

Results

Of the 26.556 women enrolled, 8.972 (33.8%) responded with self-sample for HPV testing and/or traditional cytology within one year of enrolment. Response rates were 37.7%, 34.0% and 18.4% (p < 0.050) for opt-out, opt-in and control groups. Cervical intraepithelial neoplasia (CIN)2+ was diagnosed in 3.9/1.000, 3.4/1.000, and 3.1/1.000 women (p > 0.050), respectively. PPV of the HPV self-sampling was 12.0% and 9.6% for CIN2+ and CIN3+. The highest PPV was obtained in non-attenders in screening programme for more than 10-years and concordant results of HPV testing with 40.8% for CIN2+ and 38.8% for CIN3+.

Conclusions

The results of our study show that a high response to HPV self-sampling can be achieved also in an opt-in approach, if women are encouraged to choose between self-sampling at home and screening with gynaecologist. In addition, clinically important risk difference for a high-grade cervical lesion exists in the case of a positive result of HPV testing on self-collected samples, depending on the length of the interval since last screening. Stratified management of these women should be strongly considered. Women who were not screened with cytology for at least 10 years should be referred to immediate colposcopy for histology verification instead to delayed re-testing.
Juventud, responsabilidad y comunidad. Abordaje cultural de la responsabilidad juvenil en Buenos Aires, Argentina
Authors: Fernández Mariana Cecilia
Published: September 2018

Una década, luego de la puesta en marcha de la ley N° 13.298 y su accesoria, ley Nº 13.634, que crea el Fuero de Responsabilidad Penal Juvenil en la Provincia de Buenos Aires, es un tiempo considerable que habilita el análisis de la configuración de la trama sociocultural que estructura el ejercicio de medidas no privativas de libertad en instituciones de la provincia de Buenos Aires entre 2015 y la actualidad. Este artículo indaga las matrices culturales que enmarcan los discursos de agentes socio-comunitarios en torno a la responsabilidad juvenil en el marco de la ejecución de tales medidas en la comunidad. Para ello, se emplean técnicas de entrevista en profundidad y se analiza el material desde una perspectiva cultural de la cuestión criminal.Palabras clave: Responsabilidad, Juventud, Comunidad, Cultura, Medidas no privativas de libertadYouth, responsibility and community. Cultural approach to youth responsibility in Buenos Aires, ArgentinaSummaryA decade after the implementation of Law No. 13.298 and its accessory, Law No. 13.634, which creates the Juvenile Criminal Responsibility Law in the Province of Buenos Aires, is a considerable time that enables the analysis of the configuration of the sociocultural plot that structures the exercise of non-custodial measures in institutions of the province of Buenos Aires between 2015 and today. This article explores the cultural matrices that frame the speeches of socio-community agents regarding youth responsibility in the framework of the execution of such measures in the community. To do this, in-depth interview techniques are used and the material is analyzed from a cultural perspective of the criminal issue.Keywords: Responsibility, Youth, Community, Culture, Non-custodial measuresJeunesse, responsabilité et communauté. Approche culturelle de la responsabilité juvénile à Buenos Aires, ArgentineRésuméUne décennie après l’application de la loi N° 13.298 - et son accessoire loi Nº 13.634 - qui créé la Juridiction de Responsabilité Pénale Juvénile dans la province de Buenos Aires, le temps passé permet l’analyse de la configuration de la trame socioculturelle qui structure l’exercice de mesures non privatives de liberté dans les institutions de la province entre 2015 et l’actualité. Cet article explore les matrices culturelles qui englobent les discours des agents sociocommunautaires autour de la responsabilité juvénile dans le cadre de l’exécution de ces mesures au sein de la communauté. A cette fin, nous employons des techniques d’entretien en profondeur et nous analysons le matériel réuni depuis une perspective culturelle sur la question criminelle.Mots-clés: Responsabilité, Jeunesse, Communauté, Culture, Mesures non privatives de liberté
PERUBAHAN TATA RUANG KOTA KERAJAAN TIDORE
Authors: Djamal Syuryani
Published: September 2018

Tata ruang kota kerajaan Tidore terbentuk (dibentuk) berdasarkan sembilan Soa yaitu Soa kolano,Soa sibumabelo, Soa mafu, Soa Jawa, Soa Yaba, Soa Kalaodi, Soa Failuku, Soa Rora, dan SoaCina. Soa dalam etimologi Tidore disebut kampung/desa/kabila/marga dan Sembilan disebut Sio,karena kota kerajaan terbentuk berdasarkan sembilan Soa maka kawasan kota kerajaan Tidore(K3T) kemudian disebut dengan sebutan Soasio yang berarti sembilankampung/desa/kabila/marga. Seiring perkembangannya, elemen kota sebagai identitas kotakerajaan Tidore seperti pola permukiman masyarakat yang dibentuk berdasarkan kelompok kabila(Soa) dan pola tata masa yang memiliki pagar pembatas, gerbang di depan rumah sebagai penandakeberadaan komunitas masyarakat menjadi hilang dan tak dapat dipertahankan. Oleh karena itu,penelitian ini dilakukan untuk menemukan, memahami, dan mengetahui faktor-faktor apa sajayang mempengaruhi perubahan tata ruang kota kerajaan Tidore, bagaimana proses terjadinyaperubahan tata ruang kota kerajaan Tidore, dan elemen-elemen kota apa saja yang tetap dan yangberubah pada tata ruang kota kerajaan Tidore.Kata kunci: Tata Ruang, Kota, Kerajaan, Tidore
STUDI PERUBAHAN FUNGSI RUANG PADA UNIT RUMAH TINGGAL DI CLUSTER ORLANDO DAN GEORGIA, KOTA WISATA CIBUBUR
Authors: Stevanus Danniel
Published: September 2018

Di samping peningkatan, terdapat fenomena perubahan pada unit rumah tinggal yang cukup banyak di dalam suatu kompleks perumahan. Pada kompleks perumahan Kota Wisata ini ditemukan banyak sekali bentuk rumah yang sudah tidak sesuai dengan bentuk rumah asli yang dirancang developer. Perubahan tersebut dapat mengindikasikan adanya kekurangan/ketidakpuasan penghuni terhadap rancangan rumah yang disediakan. Hal yang diteliti adalah faktor apa yang menjadi penyebab utama dalam perubahan rumah-rumah tersebut, terutama pada aspek fungsi ruangnya. Temuan penelitian ini diharapkan dapat menjadi bahan kritik dan evaluasi bagi pihak developer untuk merancang perumahan di masa mendatang. Disamping itu, diharapkan temuan ini juga dapat bermanfaat bagi pihak penghuni  yang ingin memenuhi kebutuhannya melalui desain rumah yang dimilikinya. Kata Kunci : Developer, Penghuni, Perubahan, Perumahan, Rumah.
PENGARUH KONDISI PERMUKIMAN TERHADAP PREFERENSI BERMUKIM BURUH INDUSTRI DI PERMUKIMAN TIBAN KAMPUNG
Authors: Armela Tiara
Published: September 2018

Tujuan dari penelitian ini yaitu untuk mengidentifikasi faktor-faktor kondisi permukiman saja yang berpengaruh dan pengaruh yang dihasilkan faktor-faktor tersebut terhadap preferensi bermukim buruh industri di kawasan permukiman Tiban Kampung. Metode yang digunakan dalam penelitian ini yaitu metode kuantitatif dengan metode analisis deskriptif dan metode analisis menggunakan statistic berupa regresi untuk melihat pengaruh antar variabel. Hasil dari penelitian ini menunjukkan bahwa faktor-faktor kondisi permukiman yang berpengaruh signifikan terhadap preferensi bermukim buruh industri di permukiman Tiban Kampung yaitu meliputi pendapatan, jumlah anggota keluarga, luasan ruang tamu, kemiringan lahan pada lingkungan rumah tinggal, ketersediaan sarana peribadatan, orientasi bangunan rumah, dan frekuensi penggunaan halte bus. Kata kunci: Permukiman, Preferensi Bermukim
pengaruh Karakteristik Ventilasi dan Lingkungan Terhadap Tingkat Kenyamanan Termal Ruang Kelas SMPN di Jakarta Selatan
Authors: Razak Humairoh
Published: September 2018

Tulisan ini membahas mengenai kenyamanan termal di dalam ruang kelas yang dipengaruhi oleh ventilasi dan lingkungan alami di sekitar ruangan. Tujuan penelitian ini adalah untuk menjadi panduan bagi perancang bangunan dalam merancang bangunan sekolah yang mana ruang kelasnya memenuhi aspek kenyamanan termal tanpa sistem penghawaan buatan. Penelitian ini dilakukan di sekolah-sekolah negeri tingkat menengah pertama (SMPN) di Daerah Jakarta Selatan. Penelitian dilakukan dengan mengukur suhu, kelembaban udara, dan kecepatan angin di dalam ruangan untuk mendapatkan nilai temperatur efektif yang menjadi parameter kenyamanan termal. Tidak ketinggalan adalah, bentuk dan ukuran ventilasi yang ada di ruangan tersebut. Hasil penelitian ini menunjukan aspek ventilasi yang paling mempengaruhi kenyamanan termal. Kata kunci : Kenyamanan Termal, Ventilasi, Temperatur Efektif
PENGARUH HETEROGENITAS SOSIAL, EKONOMI, BUDAYA PENGHUNI TERHADAP HETEROGENITAS DESAIN FASAD BANGUNAN SEBAGAI PEMBENTUK KUALITAS KAWASAN PERUMAHAN (Studi Kasus: Perumnas Klender, Jakarta)
Authors: Gultom Kariaman
Published: September 2018

Perumnas Klender mempunyai karakter fisik yang homogen pada saat dibangun. Perumahan ini mulai memiliki heterogenitas desain fasad bangunan. Penelitian ini bertujuan untuk mengetahui heterogenitas sosial, ekonomi, budaya penghuni yang mempengaruhi heterogenitas desain fasadbangunan menggunakan metode penelitian kuantitatif. Disimpulkan bahwa kenyamanan seseorang tidak secara keseluruhan harus seragam atau beragam dalam heterogenitas desain fasadnya. Hal ini menunjukkan kenyamanan orang tercapai pada skala 3 (Cukup Homogen) sampai skala 4 (Cukup Heterogen) dengan pembagian yang seimbang.Kata Kunci: Perubahan Visual Bangunan, Heterogenitas Penghuni, Heterogenitas DesainFasade Bangunan
EFEKTIVITAS VENTILASI BAWAH TERHADAP KENYAMANAN DAN PMV (PREDICTED MEAN VOTE) PADA GEREJA KATEDRAL, SEMARANG
Authors: Sekatia Augi
Published: September 2018

Kota Semarang masih memiliki bangunan yang menggunakan ventilasi bawah, salah satunya adalah Gereja Katedral Semarang. Pengukuran suhu udara, temperatur efektif, kelembaban udara, kecepatan angin, PMV (Predicted Mean Vote) dan PPD (Predicted Percentage of Dissatisfied)dilaksanakan pada 5 waktu ibadah dengan perlakuan yang berbeda untuk membuktikan bahwa ventilasi bawah dapat mempengaruhi kenyamanan termal. Disimpulkan bahwa titik dimana terdapat ventilasi bawah (titik A, C, G, dan I) memiliki temperatur efektif dan kelembaban udara yang lebih rendah dari titik lain, dan kecepatan udara lebih tinggi dari titik lain. Responden merasa nyaman pada keempat titik tersebut.Titik paling nyaman menurut responden adalah titik I dengan TE berkisar 24,95˚C, kelembaban udara berkisar 78,9%, kecepatan udara berkisar 0,28 m/s, PMV berkisar -0,09 dan PPD berkisar 16,8%. Dengan begitu keadaan ventilasi bawah terbuka terbukti mempengaruhi kenyamanan termal dan membuat kenyamanan termal dapat tercapai. Kata Kunci : Gereja, Ventilasi, PMV, PPD, Kenyamanan Termal
PENGARUH KEHIDUPAN BERTETANGGA TERHADAP PERUBAHAN RUANG TERBUKA DI PERUMAHAN DI YOGYAKARTA
Authors: Winandari M.I Ririk
Published: September 2018

Sebagian ruang terbuka publik di perumahan mengalami perubahan. Ada indikasi perbedaan perubahan ruang tersebut di perumahan menengah atas dan di perumahan menengah bawah. Muncul pertanyaan apakah perubahan tersebut terkait dengan kehidupan bertetangga penghuni di kedua kelompok perumahan. Penelitian ini bertujuan untuk mengeksplorasi kehidupan bertetangga terkait dengan perubahan ruang terbuka di perumahan. Metode studi kasus ganda digunakan untuk eksplorasi terhadap 4 kasus perumahan menengah atas dan 4 kasus perumahan menengah bawah. Hasil penelitian menunjukkan bahwa perubahan ruang terbuka publik di perumahan menengah atas dan perumahan menengah bawah di Yogyakarta dipengaruhi oleh perbedaan jejaring bertetangga, kuantitas kebutuhan ruang, dan kesepakatan penghuni, pedagang dan pengelola perumahan.Kata Kunci : Bertetangga, Ruang Terbuka Publik, Perumahan, Studi Kasus, Yogyakarta
O SISTEMA INTERAMERICANO DE PROTEÇÃO AOS DIREITOS HUMANOS E O DIREITO INTERNO BRASILEIRO: O CASO DA MEDIDA CAUTELAR N° 382/2010 – COMUNIDADES INDÍGENAS DA BACIA DO RIO XINGU, PARÁ, BRASIL
Authors: Lopes Marcelo Leandro Pereira , Pereira Natália Ila Veras
Published: September 2018

O presente artigo versa sobre Sistema Interamericano de Proteção aos Direitos Humanos e o cenário atual de insegurança gerado pelo descontentamento de alguns Países Membros em face de recentes decisões de órgãos do sistema. No caso específico do Brasil, analisou-se a Medida Cautelar nº 382/2010, proferida pela Comissão Interamericana de Direitos Humanos, referente às comunidades indígenas da Bacia do Rio Xingu atingidas pela construção da Usina Hidrelétrica de Belo Monte. Objetivou-se, portanto, analisar a atual situação e desafios enfrentados dentro do sistema na busca pela proteção dos Direitos Humanos, bem como, avaliar as possíveis atitudes por parte do governo brasileiro que levaram a reavaliação da referida medida e que deram forças para que propostas de mudanças no sistema fossem adiante. Para isso, foi desenvolvida uma pesquisa bibliográfica, pesquisa documental e estudo de caso do procedimento da Medida Cautelar n° 382/2010. Dentre os autores estudados encontram-se Flávia Piovesan (2012), Lingdren Alves (1997), Deyse Ventura (2012), entre outros. Por fim, chegando-se ao entendimento de que, nos moldes estudados, a Usina de Belo Monte deveria ter sido melhor avaliada, e que de igual forma, as propostas de mudanças para o Sistema Interamericano devem ser encaradas com toda cautela, para que o real motivo de sua existência não seja abalada, gerando um sério comprometimento aos Direitos Humanos em face de interesses econômicos ou políticos envolvidos.
O INTERCULTURALISMO CONSTITUCIONAL SOB A ÓTICA DA CRÍTICA POPPERIANA DO “MITO DO CONTEXTO”: SOBRE A POSSIBILIDADE DE DIÁLOGOS MULTICONSTITUCIONAIS
Authors: Oliveira Lizziane Souza Queiroz Franco de
Published: September 2018

Definir o que é verdade não é tarefa simples; mesmo assim, tem motivado em cientistas do mundo todo o interesse em investigar sobre a verdade e seus desdobramentos. Dentre as diversas discussões que tais estudos podem ensejar, o principal deles gira em torno de precisar se a verdade seria relativa ou absoluta. Em se tratando de teorias racionalistas, a verdade é tida como absoluta, não ensejando espaço para relativismos de qualquer ordem. No entanto, há as teorias relativistas que sustentam que a verdade pode varias a depender do contexto, afirmando que contextos distintos são incomensuráveis, sendo impossível o diálogo entre eles. Como crítica racional à esta teoria relativista, Karl Popper formula sua crítica designada “o mito do contexto” que sustenta que é possível o diálogo entre contextos diversos, ainda que se trate de uma difícil tarefa. À luz desta teoria crítica, tem-se a teoria do interculturalismo constitucional como sendo uma possibilidade de diálogo entre contextos constitucionais distintos. Entretanto, a teoria do interculturalismo deve ser revista quanto ao seu objetivo de propor uma teoria unívoca para contextos constitucionais distintos. Ainda que se pretenda promover o diálogo com respeito aos pontos divergentes, há que se conceber que nem sempre uma conciliação é possível ou necessária, bastando que o diálogo seja fomentado a fim de que as diferentes culturas possam relacionar-se de modo pacífico, evitando enfrentamentos que podem culminar em guerras.