bluuebunny/crossref_metadata_2025 huggingface dataset:
Who Moves the Malaysian Stock Market— the U.S. or Japan?: Empirical Evidence from the Pre-, During, and Post-1997 Asian Financial Crisis
Authors: Mohd. Yusof Rosylin , Abd. Majid M. Shabri
Published: September 2018

This paper examines long run co-movements between Malaysian stock market and the two largest stock markets in the world: the U.S. and Japan. By employing time-series analysis, i.e., cointegration, variance decompositions, and impulse response functions, the paper seeks to investigate which market actually leads the Malaysian stock market before, during, and after the 1997 Asian financial crisis periods. The results indicate that there is a co-movement of these markets only in the post crisis period. The Japanese stock market is found to significantly move the Malaysian stock market compared to U.S. stock market for the post-crisis period. At the same time, there seems to be a growing proportion of bilateral trade between Malaysia and Japan during the mentioned period. This finding seems to be consistent with the view that the stronger the bilateral trade ties between two countries, the higher the degree of co-movements (Masih and Masih 1999; Bracker et al. 1999; Pretorius 2002; Ibrahim 2003; Kearney and Lucey 2004). Our finding implies that the opportunities of gaining abnormal profits through investment diversification during the post-crisis period in the Malaysian and Japanese stock markets are diminishing as the markets move towards a greater integration. This further implies that any development in the Japanese economy has to be taken into consideration by the Malaysian government in designing policies pertaining to Malaysian stock market.
A Structural Model of Business Performance: An Empirical Study on Tobacco Farmers
Authors: Priyanto Sony Heru
Published: September 2018

Few studies have been conducted on how farmers’ entrepreneurship affects their farm performance. However, factors of entrepreneurship have not been adequately explored by researchers. Textbooks and articles on farm management usually stress the importance of farmers’ management capability with respect to their farm output. Unfortunately, they have failed to relate management capability to entrepreneurship. This study was conducted using a multilevel analysis with Structural Equation Model (SEM) to know the causal relationships among environment factors such as the country’s economy, natural resources, institutions and organizations, individual backgrounds, entrepreneurship, management capacity, and farm performance. The cross-sectional data was obtained in 2003 from four dominant tobacco-producing districts in Central Java. The multilevel model –that relates external environment, entrepreneurship, and management capacity– can adequately represent the data to estimate farm performance.The results of the analysis indicate that factors like personal aspects, together with physical, economic and institutional environments, affect farmers’ entrepreneurship. Personal aspects turn out to be the dominant factor that determines entrepreneurship and farm performance. This study also shows that farmers’ entrepreneurship is affected by their management capacity, which, in turn, affects the farmers’ farm performance. While there is no doubt in the adequacy of the model to estimate farm performance, this finding invites further investigation to validate it in other fields and scale of business, such as in small and medium enterprises and other companies. Furthermore, in order to evaluate the goodness of fit of the model in various contexts, further research both in a cross-cultural context and cross-national contexts using this model should be conducted.
Predicting TUrnover Intentions of Hotel Employees: The Influence of Employee Development Human Resource Management Practices and Trust in Organization
Authors: Hemdi Mohamad Abdullah , Nasurdin Aizzat Mohd.
Published: September 2018

This study investigates the variables that may be predictive of hotel employees’ turnover intentions. The influence of trust in organization as a mediator in the proposed relationship is also examined. A total of 380 operational employees from 5-star rated hotels completed the questionnaires. Hierarchical regression analysis was used to test the relationships hypothesized in the model. Most of the hypotheses were supported. It is suggested that to enhance employees’ trust in organization and subsequently to reduce turnover intentions, hotels need to continue to provide training and development programs to their employees, conduct fair and formal appraisal system, and provide ample and clear career advancement to their employees. Limitations and suggestions for future studies are forwarded.
THE PREDICTIVE CONTENT OF DISAGGREGATED NORMAL INCOME: An Empirical Study in the JSX
Authors: Sugiri Slamet
Published: September 2018

The main objective of this study is to examine a hypothesis that the predictive content of normal income disaggregated into operating income and nonoperating income outperforms that of aggregated normal income in predicting future cash flow. To test the hypothesis, linear regression models are developed. The model parameters are estimated based on fifty-five manufacturing firms listed in the Jakarta Stock Exchange (JSX) up to the end of 1997.This study finds that empirical evidence supports the hypothesis. This evidence supports arguments that, in reporting income from continuing operations, multiple-step approach is preferred to single-step one.
The Bank Lending Channel of Monetary Policy? The Panel Evidence from Egypt
Authors: Shokr Mohamed Aseel , Karim Zulkefly Abdul , Jusoh Mansor , Zaidi Mohd. Azlan Shah Shah
Published: September 2018

This paper examines the relevance of the bank lending channel of monetary policy in Egypt using bank-level data. Previous empirical studies in Egypt that used macro-level data have not supported the relevance of the bank lending channel. However, using a sample of 32 commercial banks for the period from 1998 until 2011 and a dynamic panel GMM technique, the empirical findings revealed the relevance of the bank lending channel of monetary policy in Egypt. Moreover, there is a heterogeneity effect of monetary policy on bank loans according to bank size, in which the small banks are more affected during a monetary contraction than larger banks. This finding signals that the monetary authorities in Egypt should take cognizance of the stability of interest rates in order to stabilize the bank loan supply.
Cooperation and Competition among Clustered MSEs in East Java
Authors: Hoetoro Arif
Published: September 2018

There has been a common picture in economic development that micro and small enterprises (MSEs) tend to conglomerate in various clusters for the sake of gaining location advantages. These MSEs then create inter-firm linkages and business strategies as the two play an important role in their performance. By taking selected manufacturing MSEs that operate in various small industrial clusters in East Java, Indonesia, this research examined the relationships between the inter-firm linkages and business strategies applied simultaneously by MSEs and their impacts on the firm’s performance. Viewed from the perspective of a co-opetition strategy, the results of this study revealed that some types of inter-firm linkages and business strategies matter for the MSEs’ performance. However, within small industrial clusters, inter-firm linkages seem to be less effective compared to business strategies in affecting a firm’s performance.
Aknowledgement
Authors: In Chief Editor
Published: September 2018

Aknowledgement
Hard Cover
Authors: In Chief Editor
Published: September 2018

Hard Cover
Do Private Firms Outperform SOE Firms after Going Public in China Given their Different Governance Characteristics?
Authors: Tong Shenghui , Junarsin Eddy
Published: September 2018

This study examines the characteristics of board structure that affect Chinese public firm’s financial performance. Using a sample of 871 firms with 699 observations of previously private firms and 1,914 observations of previously state-owned enterprise (SOE) firms, we investigate the differences in corporate governance between publicly listed firms that used to be pure private firms before going public and listed firms that used to be SOEs before their initial public offerings (IPOs). Our main finding is that previously private firms outperform previously SOE firms in China after IPOs. In the wake of becoming listed firms, previously SOE firms might be faced with difficulties adjusting to professional business practices to build and extend competitive advantages. In addition, favorable policies and assistance from the government to the SOE firms might have triggered complacency, especially in early years after getting listed. On the other hand, professional savvy and acumen, combined with efficiency and favorable business climate created by the government have probably led the previously private firms to improve their values stronger and faster.
Examining the Effects of Presentation Patterns, Orders, and Information Types in Investment Decision Making
Authors: Almilia Luciana Spica , Hartono Jogiyanto , Supriyadi . , Nahartyo Ertambang
Published: September 2018

This study aims to investigate the existence of Belief Model (BAM) developed by Hogarth and Einhorn (1992) in investment decision making. Particulary, this study examined: the effects of presentation patterns, presentation orders, and information types (accounting or non-accounting information) in investment decision making. This study used laboratory experiment to test the hypotheses. Hypotheses were tested using t-test. This study showed a “judgement bias” that is a recency which the effect of presentation pattern is consecutive is higher than unconsecutively.
MANAGEMENT STYLES IN A GLOBAL MARKET ECONOMY
Authors: Karsten Luchien
Published: September 2018

Globalization is the intensification of the spatial organization ofsocial relations and transactions, which put distant localities and local activities at a level of worldwide range, consequence and significance. These activities cluster into new reality like a globally operating market system and a globally developing technoscience. The question is to what extent a global civil society will come about too. At the level of internationally operating firms management styles will have to be developed to enhance the understanding of cultural heterogeneity within this global civil society. Cultural complexity will increase due to the intensification of interactions and transactions. Within and between internationally operating firms. Communicative rationality in terms of dialogue and conversations should be reinforced to deal adequately with this complexity. Communicative rationality perceives language not only as a mere representation of an objective reality but also as a human practice in a social context. Firms operating as communities of practice will enhance through proper management styles the reciprocal understanding we need in a world economy.
Grammatical Forms and Functions in Selected Political Interviews of Nigerian Presidential Aspirants in 2015 General Elections
Authors: Balogun (Ph.D.) Temitope Abiodun
Published: September 2018

Political interviews are one of the ways by which political office-seekers in Nigeria sell themselves to the electorates. Extant studies have examined the discourse of political interviews from conversational, philosophical, rhetorical, stylistic and pragmatic perspectives with insufficient attention paid to grammatical forms and communicative intentions of the interviews granted by the two presidential aspirants in 2015 Nigerian General election. This study therefore fills this scholarly gap with the aim of unmasking their grammatical forms and communicative styles, intention and credibility. The paper adopts Halliday’s Systemic Functional Grammar specifically interpersonal function coupled with Searle’s model of Speech Acts Theory as theoretical framework. A total of six interviews granted by the two presidential aspirants in media serve as the source of our data. It is discovered that, in most cases, politicians’ communicative intention is to “pull down” their political opponents. While declaratives and interrogatives are simple, direct and straightforward, the intention is to condemn, lambast and castigate their opponents. This communicative style does not allow the general populace to decipher the political manifestoes of the political aspirants and the party they represent. The paper recommends that before Nigeria can boast of any sustainable growth and development, there is the need for her political office-seekers to adopt effective communication strategies and styles to unveil their intention and manifestoes so that electorates can evaluate their performance after their tenure of office.
A THERMAL ANALYSIS OF THE THREADED SPINDLE BEARING ASSEMBLY IN NUMERICALLY CONTROLLED MACHINE TOOLS
Authors: Krstić Vladislav , Milčić Dragan , Milčić Miodrag
Published: September 2018

A threaded gear in machine tools is a mechanical actuator that converts rotary motion into linear one of the machine axis using a recirculating ball-nut. It provides positioning accuracy, uniform motion, silent operation, reduced wear and an increased service life. The bearing assembly of the threaded spindles should provide load transfer (cutting forces and friction forces) while maintaining high guiding accuracy. Due to a high number of the threaded spindle revolutions and the presence of tension in the bearing and a high axial force originating from the cutting and friction forces, the increased heat load due to friction in the bearings is normally expected. For this reason, this paper presents a thermal analysis of the bearing assembly of the threaded spindle which is realized via an axial ball bearing with angular contact of the ZKLN type, produced by the German manufacturer Schaeffler (INA); in other words, a numerical thermal analysis has been performed.
THE STUDY AND THE MECHANISM OF NITROGEN OXIDES’ FORMATION IN COMBUSTION OF FOSSIL FUELS
Authors: Ongar Bulbul , Iliev Iliya K. , Nikolić Vlastimir , Milašinović Aleksandar
Published: September 2018

The burning of all fossil fuels is accompanied by the production of large quantities of nitrogen oxides. Nitrogen oxide from coal combustion is formed from the molecular nitrogen in the air and the nitrogen contained in the fuel. In accordance with the mechanism of formation of nitric oxide from fuel, it is desirable to increase the concentration of coal dust in the flame. The thermal regime of combustion accelerates the release of volatiles, with flames spreading out and the coke residue contributes to the chemical reduction of NOx. In this work we consider the specific issues of the formation mechanism of NOx fuel and ways to reduce their atmospheric emissions. Presented are results from the calculation of the influence of the following on the level of nitric oxides during coal combustion: temperature, oxygen concentration and time of release of fuel nitrogen. It has been established that the influence of nitric oxide fuel on the total nitric oxide emissions is more noticeable at low temperatures of the combustion process.
METHOD OF DIMENSIONALITY REDUCTION IN CONTACT MECHANICS AND FRICTION: A USER’S HANDBOOK. III. VISCOELASTIC CONTACTS
Authors: Popov Valentin L. , Willert Emanuel , Heß Markus
Published: September 2018

Until recently the analysis of contacts in tribological systems usually required the solution of complicated boundary value problems of three-dimensional elasticity and was thus mathematically and numerically costly. With the development of the so-called Method of Dimensionality Reduction (MDR) large groups of contact problems have been, by sets of specific rules, exactly led back to the elementary systems whose study requires only simple algebraic operations and elementary calculus. The mapping rules for axisymmetric contact problems of elastic bodies have been presented and illustrated in the previously published parts of The User's Manual, I and II, in Facta Universitatis series Mechanical Engineering [5, 9]. The present paper is dedicated to axisymmetric contacts of viscoelastic materials. All the mapping rules of the method are given and illustrated by examples.
INVESTIGATION OF THE ENERGY RECOVERY POTENTIALS IN VENTILATION SYSTEMS IN DIFFERENT CLIMATES
Authors: Kassai Miklos , Poleczky Laszlo , Al-Hyari Laith , Kajtar Laszlo , Nyers Jozsef
Published: September 2018

The aim of this research study was to investigate the energy recovery potentials in ventilation systems under different climatic conditions. The well-known heating degree day from the literature was updated using the weather data of cities with different climates from the past 40 years. As the novelty of this research with the developed procedure drawn up in this study, the energetic possibilities of heat recovery under various climate and operating conditions may be examined in more detail and more realistically than with the methods and available information of current engineering practices. To achieve this long-term and high definition the weather data of several cities are processed in order to evaluate the possibilities of heat recovery on a daily and annual basis.
DYNAMICAL BEHAVIOR OF A HEAT PUMP COAXIAL EVAPORATOR CONSIDERING THE PHASE BORDER’S IMPACT ON CONVERGENCE
Authors: Nyers Arpad , Pek Zoltan , Nyers Jozsef
Published: September 2018

Using a dynamical mathematical model, we investigated transient behavior of a water-water heat pump’s evaporator. The model consists of time and space dependent partial differential equations of water, pipe wall and refrigerant. Mathematically the thermal expansion valve (TEV) and compressor are described with lumped parameters and represent the boundary conditions. During the numerical solution of this system of equations the problem emerged of divergence of solutions. It was determined that the cause of the divergence solution was in the location of phase change of the refrigerant. The aim of this paper is, firstly, to display and propose a new approach to the elimination of divergence. In addition, it examines dynamic behavior of the heat pumps’ coaxial evaporator.
FAST NUMERICAL IMPLEMENTATION OF THE MDR TRANSFORMATIONS
Authors: Benad Justus
Published: September 2018

In the present paper a numerical implementation technique for the transformations of the Method of Dimensionality Reduction (MDR) is described. The MDR has become, in the past few years, a standard tool in contact mechanics for solving axially-symmetric contacts. The numerical implementation of the integral transformations of the MDR can be performed in several different ways. In this study, the focus is on a simple and robust algorithm on the uniform grid using integration by parts, a central difference scheme to obtain the derivatives, and a trapezoidal rule to perform the summation. The results are compared to the analytical solutions for the contact of a cone and the Hertzian contact. For the tested examples, the proposed method gives more accurate results with the same number of discretization points than other tested numerical techniques. The implementation method is further tested in a wear simulation of a heterogeneous cylinder composed of rings of different material having the same elastic properties but different wear coefficients. These discontinuous transitions in the material properties are handled well with the proposed method.
Investigating disparities in cancer by linking the Canadian Cancer Registry to survey and administrative databases: a collaboration between the Canadian Partnership Against Cancer and Statistics Canada
Authors: Bryan Shirley , Tung Jasmine , Chadder Jennifer , Louzado Cheryl , Decady Yves , Sung Yubin , Rahal Rami
Published: September 2018

IntroductionThe Canadian Partnership Against Cancer reports on pan-Canadian system performance across the cancer control continuum, including how sociodemographic disparities create barriers in access and utilization of cancer control services. This has been done using mostly ecological data, which does not contain the individual level information required to identify the extent of disparities.

Objectives and ApproachThe Partnership collaborated with Statistics Canada (STC) to build individual level datasets that will allow researchers to investigate the relationship between sociodemographic factors, cancer outcomes and treatment patterns in Canada.The record linkage was conducted at STC within the Social Data Linkage Environment. Data from the Canadian Cancer Registry were linked to the Discharge Abstract Database, the National Ambulatory Care Reporting System and the Canadian Vital Statistics Death Database to obtain treatment information and deathand death outcomes. To obtain sociodemographic information the following datasets are also being linked: T1 Personal Master File (income), Immigrant Landing File and the Census Long Form (education and geography).

ResultsLinkage of all datasets is expected to complete by the end of January 2019. For the first time in Canada, record-level linkage of national cancer registry data with key datasets containing sociodemographic information will be available for exploratory analysis. The challenges with linkage and data limitations will be discussed, as well as the application of these linked databases to answer current disparities-related research questions.

Conclusion/ImplicationsThis initiative illustrates the value of collaboration between data custodians and health researchers as well as how linkage of existing datasets can leverage the full potential of available data, and broaden cancer research in supporting efforts to create a more equitable cancer control system.
If You Link It They Will Come, If They Like It They Will Stay: The Utah Population Database as a Model for Creating a Confidential Linked Population Health Research Registry
Authors: Smith Ken , Fraser Alison
Published: September 2018

IntroductionThere is increasing demand for so-called big data for a range of uses. One of the challenges is the method by which these data are obtained, the identiers used for record linking, how they are linked, and the secure manner by which researchers may use these data ethically.

Objectives and ApproachThe Utah Population Database (UPDB) has a long history of linking records derived from genealogies, death/birth certificates, medical diagnoses, and census records. This infrastructure offers a unique resource for genetic, public health, geographic and demographic investigations. The UPDB now holds information on 11 million individuals linked into multigenerational pedigrees. New data opportunities have arisen that provide value added to UPDB but that raise important infrastructure and privacy issues. This presentation will provide details and strategies for dealing with new challenges of adding new and complex sources of data.

ResultsThe record linking and data security measures developed for the construction of the UPDB, we suggest, is a model for other states and provinces. The ability for UPDB to obtain, store, link and dispense a diverse set of data at the individual and genealogical level for the research community for over forty years suggests that it has elements that are potentially replicable for other locations. The development of a unique and independent regulatory body, the Resource for Genetic and Epidemiologic Research (RGE), which oversees access to UPDB data, speaks to this as a model for protecting the confidentiality of the data while enhancing secure to researchers. We show the technical, statistical, legal and regulatory methods that have provided data for nearly 300 distinct health-related studies.

Conclusion/ImplicationsThis study demonstrates how the careful and consistent application of secure data management and regulatory oversight allows for the development of the UPDB and its ability to link diverse data sources for the research community. The legal and administrative strategies used serve as a model for other states and provinces.
Meta Matters - Enriching & Exploiting Your Metadata
Authors: Hacker Alex
Published: September 2018

IntroductionData is nothing without context: if you don't know how, when or why a variable was gathered, it's nigh impossible to draw conclusions from it. This presentation discusses different sorts of metadata and how they can be gathered, stored, and used to enrich data; drawing examples from our biobank.

Objectives and ApproachEach data item has two types of metadata: variable-level and value-level. For example, consider a questionnaire. The variable-level metadata covers each question: exact wording, validation rules for the answers, etc. The value-level metadata covers each individual answer: details of the questioner, date and time of response, and so on. We also have database-level metadata: datasets which list every dataset or every field in the database. While some of this information needs to be gathered alongside the data itself, much can be extracted or imputed from results or documentation. We present some generalizable examples.

ResultsLike any other data, metadata is only worth having if you’re using it. We will present principles and examples of applications that we have developed for it:

Data management – Deriving useful variables and tables, and helping to make your data easier to parse, extract, and validate.

Presentation – Making your data more human-readable by labelling variables and decoding values.

Documentation – Metadata tables make ideal repositories for granular institutional knowledge about your data: known issues, potential pitfalls, or explanations for missing values.

Analysis – Identifying which metadata variables are most valuable for analysts, and how best to provide them.

Automation – Using the metadata to generate code that can automatically produce summary statistics, tables, graphs… and more metadata!

Conclusion/ImplicationsEvery dataset comes with some metadata. When examined and built upon, it can deepen understanding of the data within, as well as becoming a powerful resource in its own right.
Housing and Health: Linking Population Health Survey Data to Housing Assistance Data
Authors: Golden Cordell , Mirel Lisa
Published: September 2018

IntroductionThe linkage of survey data with administrative data enhances the scientific value and analytic potential of both sources of information. Combining multiple data sources facilitates richer analyses and allows data users to answer research questions that cannot be addressed easily using a single data source.

Objectives and ApproachRecently, the United States National Center for Health Statistics (NCHS) and Department of Housing and Urban Development (HUD) collaborated to link two population health surveys conducted by NCHS with housing assistance program data maintained by HUD. The resulting linked data files enable researchers to examine relationships between the receipt of federal housing assistance and health. In this talk, we will describe some of the challenges faced when initiating a data sharing agreement between two federal agencies governed by distinct legislative authorities, particularly issues related to legal requirements and data access.

ResultsWe will describe each of the data sources used in the linkage as well as the methodology used to combine the data. Lastly, the discussion will focus on the inter-agency collaboration that led to the production of the supporting technical documentation developed to assist researchers using the linked data files. The linkage of NCHS survey data and HUD administrative data serves as an example of how two agencies were able to overcome challenges to successfully form a data sharing partnership as a cost-effective means to develop a robust data source that benefits the collaborating agencies as well as policy makers and outside researchers.

Conclusion/ImplicationsBoth agencies anticipate that this partnership will continue as additional survey and administrative data are collected.
Validation & Vindication – Comparing Electronic Health Records with Hospital Notes
Authors: Hacker Alex
Published: September 2018

IntroductionNo doubt your Electronic Health Records have been meticulously gathered, imported, validated and standardised. However, if you want to be certain that they are an accurate representation of reality, you can’t beat physically going to hospitals and cross-checking their records against yours. Our biobank did exactly this.

Objectives and ApproachOur validation exercise encompassed all reported cases in our follow-up data of three key conditions: stroke, heart disease, and cancer. Key data about each hospitalisation was extracted and exported to tablet computers running custom software. Our staff then visited each hospital in this dataset seeking the corresponding medical notes, and collected additional data from those that they found including photographs of key documents. These results were then adjudicated by specialist physicians to determine the accuracy of the diagnosis, and identify disease phenotypes of interest. Finally, all these results were merged back into our follow-up data.

ResultsNot only was gathering the data a huge logistical and technical challenge, integrating it back into the database presented its own difficulties. Our initial plan was to assign each sought event a status of ‘validated’, ‘corrected’ or ‘unfound’. However, this proved inadequate for addressing the complexities of the data, as we will discuss, with examples.

Our solution was to initially treat the retrieved hospital notes as simply another source of follow-up data. We were thus able to use our existing systems for validating, standardising and aggregating events; and thus produce validated endpoints that were meaningfully comparable to our reported endpoints. We could then implement and test definitions of the required validation statuses at a participant level for each disease of interest.

Conclusion/ImplicationsThis validation project was a huge and daunting undertaking, but repaid our investment with proof that our Electronic Health Records were generally very reliable, and also with much richer data about disease diagnosis and phenotyping. Other projects using Electronic Health Records may wish to adopt this approach.
The Economic Impacts of ICD-9 to ICD-10 Health Indicator Coding System Transition in the Calgary Region
Authors: Khair Shahreen , Lu Mingshan , Quan Hude , Doktorchik Chelsea , Eastwood Catherine
Published: September 2018

IntroductionCoded data serves a critical part in the process of identifying the resource allocation required for each department in a hospital and for research purposes. This paper attempts a cost-benefit analysis of the transition from ICD-9 health indicator coding system to ICD-10 coding system and quantify the economic impacts.

Objectives and ApproachThe hypothesis adopted by this paper is that the transition from ICD-9 to ICD-10 has been beneficial for the health system due better disease management, resulting in cost savings and facilitation of high quality health research. Analyzing the inflation-adjusted costs compared with the benefits accrued from implementing the new coding system would enable informed decision making for the stakeholders at government and other levels of health provision.

The methodology involves constructing ‘benefit scenarios’ via analysis of existing literature and interviewing coding managers; costs are evaluated using data collected on re-training coders and productivity losses during the transition phase.

ResultsAn example of a benefit scenario would take the form of cost savings associated with correctly identifying people with diabetes (due to coded charts), hence resulting in a decline in blood sugar (HbA1c) levels via better disease management. This in turn may cause reductions in other high blood-sugar related diseases and thus increase efficiency for government funding in the health care sector. Improved data quality in ICD-10 is expected to have resulted in gains from specificity due to increased sensitivity of data classification and grouping. Actual cost of re-training of coders and ICD-10 software provider fees are expected to be higher than the costs anticipated before ICD-10 implementation. Productivity losses in the transition phase are expected to have declined as coders became more adept at coding.

Conclusion/ImplicationsAn economic evaluation proves to be a vital part of eliciting whether the transition to the newer method of coding, ICD-10, has been beneficial to the end users of the data. It is important to understand the efficiency of resource allocation to healthcare and the financial implications such investments entail.
A big data analytics platform to support simulation modeling for osteoarthritis care pathways
Authors: Vik Shelly , Sharif Behnam , Seidel Judy , Marshall Deborah A
Published: September 2018

IntroductionTechnical solutions have been used in industry settings for many years to facilitate efficient management and analyses of big data sources. An initiative to apply a business solution to support development of simulation models for health systems research using nearly two decades of provincial administrative health data is described.

Objectives and ApproachAdministrative data including practitioner claims, hospitalizations and ambulatory care visits for patients with a diagnosis of osteoarthritis were obtained from Alberta Health for the period 1994/95 to 2012/13. These data were incorporated into a multidimensional data cube using Microsoft SQL Server Analysis Services. Initial steps required dimensional modeling to restructure the data into a star schema format. This involved appending several data sets and defining additional reference tables to contain stratification variables and denominator data for rate calculations. The modeling expert worked closely with the information technology team throughout the process and assessed validity of the output.

ResultsDevelopment and validation of the multidimensional cube occurred in iterations over approximately 12 months. The final solution resulted in an analytics platform that compiled data from approximately 400 million records obtained from four different administrative data sources. Ten dimension tables containing 102 variables provided enhanced flexibility to conduct ad hoc stratified analyses in a fraction of the time that would be required using conventional methods. For example, some analyses that previously required a day of analyst time could be performed in less than 15 minutes. The efficiencies in analytic time were achieved by the pre-aggregated measures and slice and dice capability of the data cube, which negated many intermediary steps for data extraction and time consuming iterative analyses required for development of the simulation models.

Conclusion/ImplicationsThis project demonstrated how a technical solution applied in industry can be utilized to address challenges encountered by researchers related to managing and analyzing large administrative health data sets. The methods could be applied in many other research settings to facilitate access to and analyses of information using big data.
Mining Twitter data to #educate the public about #sepsis
Authors: Guienguere Simon Olivier , Fiest Kirsten Marie , Williamson Tyler , Doig Christopher
Published: September 2018

IntroductionSepsis is not well known. Only 58% of Americans know the word sepsis, less than 1% can identify its symptoms and one-third wrongly believe the disease is contagious (1). What if social media educated users about sepsis? There are at least 500 million tweets worldwide per day on Twitter.

Objectives and ApproachEarly detection of sepsis with early treatment is associated with a decrease in mortality (2). The current study aims to use Twitter to share sepsis patients’ experiences. The approach consisted of using text data mining techniques by randomly extracting tweets (N =150) with the hashtag #sepsissurvivor (3) using R software (4). The study retrieved and quantified sepsis patients’ tweets into word frequency distributions using documentation summarization and word cloud techniques (5) for visual representation of Twitter data. Sepsis patients used images symptoms cards (6) to raise awareness. The study used the R package "tesseract" to extract text from images (6).

ResultsPatients sharing their experiences frequently used the word “sepsis.” Cardiorespiratory compromise (septic shock—the highest mortality risk) was illustrated in the words "my heart stops” or elevated "heart" rate or “low blood pressure.” Several studies have reported increased mortality associated with delays in antibiotic administration (7). Many sepsis survivors had antibiotics exposure, both in a timely manner or delayed in use. Sepsis patients experienced long stays in the hospital. Tweets mentioned "infection" 39 times (8), which supports patients’ diagnoses in addition to high rates of "fever." The clustering technique using word association indicated infection was highly correlated with sepsis (9). Sepsis survivors shared the "pain" they went through.

Conclusion/ImplicationsTwitter presents an opportunity for patients to disseminate information about sepsis raising awareness about important symptoms. The information tweeted explores the impact of this diagnosis, and the need for early treatment. The current study demonstrates the opportunity to raise awareness through the learned experiences of patients in a novel medium.
Study on construction of comprehensive community health databases through linkage between Community Health Survey data and other community contextual indicators in Korea
Authors: Kim Dong-Hyun
Published: September 2018

IntroductionSince 2008, Korea Centers for Disease Control and Prevention have performed nationwide survey, Korea Community Health Survey(K-CHS) annually, to collect information on pervalences of smoking, drinking, physical activity, obesity, diet, oral health, and other health-related activities among randomly selected community-dwelling residents aged 19 years or over in ~250 administrative districts(Si-gun-gu).

Objectives and ApproachThis study aims to build comprehensive data library through leakage of area-based data collected from K-CHS and other community contextual health indicators from various government databases. For this purpose, we reviewed other databanks on community status health indicators comprehensively and tried to search linkage information from the related national public database.

ResultsWe reviewed the community health model, which is theoretically and empirically proven in other studies and tried to propose health determinants of community health through population health perspectives. We collected information on health outcomes of each community, measured by overall mortality and self-rated health. We also assessed health determinants, measured in five domains including social network, health behaviors, clinical care, social and economic factors, and physical environment. Childhood environment was dealt briefly. Geo-coded data on selected core indicators were collected for each domain and the validity, reliability, sensitivity, and robustness of these measures was evaluated. We constructed comprehensive databases through linkage of health outcomes and health determinants. We also suggested summary sheet template, comprizing comprehensive community health status indicators.

Conclusion/ImplicationsIn conclusion, we anticipate evidence-based community health intervention and evaluation of its performance through utilizing comprehensive databases on community health.
Linking Clinical and Administrative Data to Inform Performance Measures Regarding Access to Specialist Care for Patients with Rheumatoid Arthritis
Authors: Marshall Deborah A , Barber Claire , Zhang Sharon , Patel Jatin , Chen Guanmin , Faris Peter
Published: September 2018

IntroductionRheumatoid arthritis (RA) is the most prevalent type of chronic adult inflammatory arthritis and requires timely diagnosis and subsequent access to specialist care and treatment from a rheumatologist. We developed a set of key performance indicators (KPIs) to evaluate access, effectiveness, acceptability, appropriateness and efficiency of care.

Objectives and ApproachThe overall objective was to measure performance of a central intake system for referral to rheumatology against the KPIs. We report on one accessibility KPIs: the percentage of patients with new onset RA with at least one visit to a rheumatologist in the first 365 days since diagnosis.  We identified a cohort of RA patients using a validated case definition: >16 years, at least 1 RA related hospitalization (ICD-10-CA:M05.x-M06.x) or two RA related physician visits ≥ eight weeks apart within two years (ICD-9: 714.x).  The incident case date was date of hospitalization or second physician visit (whichever came first).

ResultsThis KPI assessed the proportion of patients seen by a rheumatologist within one year of first RA visit by patients in the RA cohort. 13,914 cases of RA were diagnosed between April 1 2010 and March 31 2016. The percentage of patients with new onset RA with at least one visit to a rheumatologist in the first 365 days since diagnosis increased between fiscal years 2011 and 2015. Of the 2851 incident RA cases in fiscal year 2011, 1490 (53%) met the performance measure compared to 1710 of 2710 (63%) who met the definition in fiscal year 2015. Other KPIs, including wait times, are being evaluated using both clinical and administrative data.

Conclusion/ImplicationsBy linking multiple administrative datasets, we are able to measure system performance against a defined KPI and identify opportunities for system improvement. This is the first initiative in Alberta for patients with RA where data from different multi-custodial data repositories have been extracted, linked and analyzed for this purpose.
Factors associated with screen-detected breast cancer across five Canadian provinces: a CanIMPACT study
Authors: McBride Mary , Winget Marcy , Groome Patti , Decker Kathleen , Kendell Cynthia , Mahar Alyson , Grunfeld Eva
Published: September 2018

IntroductionBreast cancer screening is intended to identify cancer in early stages when prognosis is better and treatments less invasive.

Objectives and ApproachWe describe Canadian inter- and intra-provincial variation in the percentage of screen-detected cases and identify factors related to having a screen-detected versus a non-screen detected breast cancer.

Breast cancers diagnosed from 2004/7 to 2010/11/12 in 5 Canadian provinces were included. Standard provincial datasets were created using screening program and claims data. A common algorithm (Alberta, Ontario) or variable from the screening dataset (British Columbia, Manitoba, Nova Scotia) was used to identify the mode of diagnosis (screening versus not). Relationship between screen-detected cancer and several demographic, clinical and healthcare utilization factors were explored.

ResultsThe percentage of screen-detected breast cancers varied from 25 to 40 percent across provinces; it ranged 43 to 51 percent for those aged 50-69. Within provinces, the percentage of screen-detected cancers varied across regional health authorities by a low of 1\% to a high of 33\%. Urban residence was positively associated with screen-detection in some provinces and negatively in others. Women in the lowest neighborhood income quintile had the smallest proportion of screen-detected cancers; the absolute difference from those in the highest quintiles ranged from 3.3-11.5\% across provinces. High continuity of care with a usual primary care provider was positively associated with having a screen-detected cancer compared to those with no usual care provider.

Conclusion/ImplicationsThe proportion of screen-detected breast cancers varied significantly across and within provinces suggesting geographic variability in access to screening services. Variation across provinces in terms of factors associated with screen-detected breast cancer also likely reflect access issues. The positive association of high continuity of care with screen-detection in all provinces suggests that regular care with a primary care physician is an important factor in improving screening rates and detection.
Principles and operational model for governing Diabetes Action Canada's data repository for patient-oriented research
Authors: Willison Donald , Trowbridge Joslyn , Sullivan Frank , Keshavjee Karim , Greiver Michelle
Published: September 2018

Introduction Diabetes Action Canada is developing a data repository and registry of potential research participants to support research, QI, and service to improve diabetes care. Central to the repository are pseudonymised linkable electronic medical records (EMRs) from family practices that are participating in the Canadian Primary Care Sentinel Surveillance Network (CPCSSN).

Objectives and Approach We sought to develop an information governance process that would engender the trust of patients and the health care professionals (HCPs) that their EMR data were being managed responsibly in the best interests of patients living with diabetes. Following an extensive literature review, we developed a principles-based governance framework and operational model, with a strong focus on patient participation in the governance process. We recruited patients through our pre-existing patient advisory circles and physicians through our partners in CPCSSN. In January 2018, we held a training workshop for Research Governing Committee (RGC) members.

Results We identified eight values-based principles to guide our governance process: transparency; accountability; following the rule of law; integrity of purpose, science and ethics; participation and inclusiveness; impartiality and independence; effectiveness; efficiency and responsiveness; and reflexivity and continuous quality improvement of process. Patients represent 50% of RGC members and HCPs 20%. Patient members provide their perspectives on: goals and outcomes of the research; the benefits and burdens among people living with diabetes; and the communication preferences of patients around recruitment. HCPs provide a deep understanding of the settings and systems in which care is provided to ensure contextual integrity of the research. Two researchers and one person with bioethics expertise provide technical and ethics perspectives on data requests.

Conclusion/Implications Governance must go beyond legal compliance to ensure a ’social licence’ for the use of the data. In part, we address this through our guiding principles, our emphasis on patient and healthcare provider perspectives, and focus on research that is scientifically sound, ethically robust and in the public interest.