bluuebunny/crossref_metadata_2025 huggingface dataset:
A influência da criação de jogos no ensino fundamental: contribuições para os processos de aprendizagem e desenvolvimento interpessoal
Authors:   , Zamparoni Samuel Caliani
Published: September 2024

Esta dissertação trata de uma pesquisa cujo tema é o ensino de elementos da geometria plana por meio de jogos criados pelos estudantes, em uma turma de 9º Ano do Ensino Fundamental, através da Aprendizagem Baseada em Projetos, uma Metodologia Ativa de Ensino. A pergunta norteadora do trabalho é: como a criação dos jogos educativos e temáticos por parte dos alunos pode contribuir para a sua aprendizagem em aulas de matemática? O objetivo geral parte de duas investigações: “se” e “de que maneira” a criação de jogos temáticos e educativos pode contribuir para a aprendizagem em geral; e os específicos são: interpretar os resultados das avaliações pré-jogo e pós-jogo; observar a participação individual dos alunos envolvidos e intervenções necessárias durante o processo; explicitar os relacionamentos entre os participantes de um determinado grupo e como os grupos se relacionam entre si durante o desenvolvimento da pesquisa; identificar o grau de interesse demonstrado pelos alunos por esse tipo de abordagem, para que outros trabalhos com a mesma temática possam vir a ser realizados. Para fundamentar esta pesquisa foi abordado o conceito de Zona de Desenvolvimento Proximal pois, na perspectiva de Vigotski, as atividades realizadas em colaboração podem criar possibilidades para o desenvolvimento, assim como a afetividade, sob a perspectiva de Wallon, no sentido de contribuir com desenvolvimento do indivíduo. Os dados analisados foram coletados por meio de diários de bordo, desenvolvidos pelos grupos e pelo professor, por um questionário aplicado ao início e ao término da criação dos jogos e por meio da aplicação de um teste pré e pós-jogo. Os dados foram sistematizados de acordo com o nível de satisfação dos grupos na realização do trabalho, assim como a contribuição dele nas relações interpessoais. A relevância desta pesquisa está no fato de verificar se é possível que os processos de aprendizagem ocorram através da criação de jogos educativos e temáticos, averiguando de que maneira isso ocorre, assim como identificar de que forma essa abordagem pode contribuir nas relações interpessoais dos envolvidos.
ASPECTOS A SEREM CONSIDERADOS EM AUDIODESCRIÇÃO DE IMAGENS EM FÍSICA COM VISTAS AO SEU ENTENDIMENTO POR PESSOAS COM DEFICIÊNCIA VISUAL
Authors: Chaves da Silva Alexandre , Souza Divanizia do Nascimento
Published: September 2024

Este trabalho discute sobre aspectos textuais da audiodescrição como uma ferramenta do letramento visual para promoção da acessibilidade de pessoas com deficiência visual (PcDV) no ensino e avaliação de Física. Essa ferramenta pode assegurar às PcDV o direito a informações contidas em imagens de livros didáticos, avaliações escritas e desenhadas na lousa, antes dispostas apenas visualmente. Na discussão, são elencados aspectos inerentes às informações essenciais para a resolução de um item do ENEM relativo à Física. A imagem apresentada no item foi audiodescrita por cinco professores de Física, atuantes em um ou mais níveis de ensino. Nas descrições foi identificado excesso de informações e de pessoalidade, sendo esses fatores apontados como negativos em uma descrição. Os padrões adotados para a avaliação dos aspectos considerados são os descritos na plataforma MECDAISY e em outros trabalhos. A partir do que foi identificado nas transcrições, um conjunto de aspectos textuais foi compilado em um questionário, com a finalidade de facilitar o trabalho do professor ao avaliar itens de Física e outras Ciências da Natureza, de modo a produzir audiodescrições e/ou descrições literais no ensino de Física que contribuam para a interpretação de imagens em contextos variados por parte das PcDV e videntes.
Developing a Predictive Model of Crowd Behavior at Music Concerts and Festivals (MCF): A Proposal for a Research Framework
Authors: Mohamad Halim Cempaka Nur Huda , Khir Masrur Mohd , Roslan Azreen
Published: September 2024

Music Concerts and Festivals (MCF) have experienced steady growth each year, transforming these events into large-scale international gatherings from their humble beginnings in the 1980s. The trend of increasing attendance by festival-goers and concert-goers at MCF has prominently emerged in the 21st century. The attendance of MCF contributes to the formation of crowds, which are indirectly influenced by risky behavior. Consequently, this trend has led to numerous incidents related to risky behavior at MCF. However, there is insufficient research on such behavior, and few existing studies address any predictive models specific to MCF. As a result, there has been a slight increase in aggressive behavioral incidents among festival-goers and concert-goers. This issue has demonstrated the importance of studying crowd behavior among those attending musical concerts and festivals. Therefore, this paper will focus on the important variables related to risky behavior that can cause crowd behavior and bridge the gap by identifying risky behavior among crowds. Additionally, this study will propose a research framework for the development of a crowd behavioral predictive model to anticipate future risk behavior among attendees. This research will employ a mixed-methods approach comprising both qualitative and quantitative methodologies as its method of investigation. The research framework will then be used to develop a predictive model of crowd behavior among attendees of MCF that will help to provide significant information for event and concert organizers to understand potential risky behavior among the crowd, hence, help in mitigating or preventing unwanted crowd safety incidents at MCF.
Synergies of Success: Unveiling the Transformative Influence of Sponsorship on Event Excellence
Authors: Zamri Muhammad Hafizi , Mohd Kodri Aida Nur , Abdul Halim Abdul Hamid , Zainal Abidin Mohamad Imaduddin , Mohamed Kamil Liyana Shamimi
Published: September 2024

This study delves into the intricate dynamics of sponsorship strategies, media exposures, and event organizer practices within the Malaysian events industry. Employing a quantitative research approach, the research sampled 110 corporate sponsor representatives, utilizing a structured questionnaire to collect data. Analysis, carried out using Statistical Packages for Social Science Version 26.0 (SPSS Version 26.0), incorporated both descriptive and inferential methods. The findings illuminate a significant positive relationship between sponsorship strategies and media exposure with event success, accompanied by a noteworthy negative relationship between event organizer practices and event success. These results underscore the pivotal role of sponsorship and media exposure in influencing successful events, providing valuable insights for corporate sponsors and event organizers alike. Importantly, the study emphasizes the need for organizations to reassess their sponsorship approaches, fostering successful events by fortifying policies and aligning mutual objectives. As the events landscape continues to evolve, this research contributes to the broader discourse, guiding industry practitioners in optimizing strategies for sustainable success in the dynamic Malaysian events industry.
Common good in the urban context – insights from theoretical frameworks
Authors: Koszewska Joanna
Published: September 2024

The objective of the study is to analyse the role of the concept of common good in the contemporary field of urban studies. Through an interdisciplinary literature review, the basic explanation of the concept or common good is presented with a focus on common good in the urban environment. This work examines how urban commons became significant in scientific and public debates, translatable into tangible projects. The research results prove the academic and policy discussions focus on urban commons both in theoretical and engaged implementation of experiments in local urban governance. The notion of common good in the urban context, applied in territorial governance practices as commons, has an expanded international geographical reach, popularised within theoretical and more empirical approaches. The findings reveal a correlation between the discourse on urban commons and the proliferation of thematic debates and models; grassroot projects, demonstrating varied impacts by local social, cultural and policy contexts. In conclusion to the study of consecutive contemporary theories, the need to provide accurate elaboration on an urban commoning framework can be stated. This is a gap to bridge for enabling practical sustainable applications.
An analysis of the suppression of a pair of odd and even temperature fluctuation in an area occupied by a two-phase one-directional periodically layered composite
Authors: Wodzyński Łukasz , Dorota Kula  , Wierzbicki Ewaryst
Published: September 2024

The study concerns a heat conduction problem in a two-phase, one-directional periodically layered composite (commonly referred to as a laminate). The model is strictly related to considerations regarding continuous media and was introduced by Professor Czesław Woźniak. The basis for the study is a re-formulation of the heat conduction model for composites, referred to in the literature as “the extended tolerance heat conduction model”. The model equations consider coefficients responsible for the intensity of exponential and rotational suppression of boundary fluctuations of a temperature field in a limited area or in a half-space occupied by the composite. The study investigated the dependence of the suppression intensity of boundary fluctuations on the geometrical and material properties of the composite. Three special cases of pairs of interacting boundary fluctuations were analysed.
How Auditors’ Client Service Affects Managers’ Cooperation with Auditor Evidence Requests
Authors: Hatfield Richard C. , Hoang Kris , Ricci Michael A. , Thomas Edward
Published: September 2024

Audit quality is threatened when client managers are uncooperative (i.e., slow to provide evidence or not forthcoming with evidence). We examine whether auditors can increase client manager cooperation by providing better client service in their day-to-day interactions with client managers. For example, auditors can provide better client service by minimizing disruptions and communicating effectively. Across two experiments, we find that managers experiencing better client service respond timelier to auditor requests and are more forthcoming with evidence, including evidence that contradicts their preferred accounting position. Our findings suggest that auditors can use client service strategically to increase access to information, but anecdotal interviews with experienced auditors suggest that these strategic benefits are not at the forefront of auditors’ minds. Together, our study informs practice by illuminating strategic benefits of better client service and complements prior research which focuses on how service-related constructs can benefit auditors commercially and when negotiating with clients.
Caracterización biométrica de larvas de Cordulegaster boltonii (Donovan, 1807) en Sierra Nevada (sureste de la Península Ibérica)
Authors: Romero Martín Ángel , Márquez Francisco J. , López Montoya Antonio Jesús , Gilbert Rus Juan Diego
Published: September 2024

Cordulegaster boltonii es una libélula de amplia distribución en Europa y el norte de África, con poblaciones registradas en más de 25 países. Sin embargo, los estudios biométricos realizados en larvas de esta especie son muy escasos. Basándonos en las investigaciones previas y en la finalidad de este estudio, se han seleccionado cuatro parámetros morfológicos muy representativos y utilizados para caracterizar larvas de esta especie: longitud total del cuerpo (LT), longitud abdominal (LA), ancho de la cabeza (AC) y longitud de la pteroteca metatorácica derecha (LP). Se presenta el primer estudio biométrico realizado con larvas de C. boltonii provenientes de cinco ríos de Sierra Nevada, en el sureste de la Península Ibérica. Al comparar los valores de estas variables entre larvas de diferentes sexos y estadios larvarios, no se detectaron diferencias significativas entre las poblaciones estudiadas. Los resultados revelan valores muy homogéneos y singulares para la especie en Sierra Nevada, estableciendo un patrón biométrico para los cuatro últimos estadios larvarios (F-3 a F-0), teniendo en cuenta además el sexo de los ejemplares.
Contributions of Equine Therapy after Stroke
Authors: HM* Sanchez , GR dos Santos , EG de Morais Sanchez , LG Maia , LA da Silva
Published: September 2024

Introduction: Cerebral Vascular Accident (CVA) is an injury to the central nervous system that occurs due to a lack of tissue oxygenation due to congestion (ischemic) or vascular disruption (hemorrhagic) in a certain location of the brain. Stroke has been a considerable factor in disability, functional limitations or even death throughout the world. Objective: To investigate and describe the contributions of hippotherapy in patients undergoing this intervention after suffering a stroke. Methods: This study is designed as an integrative literature review. The electronic search was carried out through scientific databases: Scientific Electronic Library Online (Sicelo), US National Library of Medicine National Institutes of Health (PubMed), Latin American and Caribbean Literature (Lilacs) and Cochrane Library, accessed by Capes Periodicals (CAFe), from September to November 2023. Results: This research consisted of 110 articles, of which 6 articles valid for this review were maintained after selection, remaining as they met the determined inclusion and exclusion criteria. Conclusion: The hippotherapy method provides several benefits to practitioners, such as improving static and dynamic functional balance, gait performance, mobility, body posture, motor coordination, autonomy of movement, breathing, spatial and temporal orientation, verbal communication, relationships, improves sleep, attention, emotional control, self-esteem, communication and participation.
Embracing Sensitivity, Enhancing Impact: Developing A Co-Production Model of Public Engagement for Administrative Data Research
Authors: Nelson Elizabeth , Burns Frances
Published: September 2024

IntroductionPublic engagement and impact are important to research funders. But how these are done successfully in administrative data research is less established than in research where engagement mechanisms are more embedded. As admin data research is a relatively new field in public understanding, questions arise around how to utilise potentially sensitive datasets, or to utilise ‘ordinary’ data sets to illuminate issues around vulnerable or marginalised communities.
Objectives and ApproachOur objective was to develop an approach to maximise engagement with NGOs, data owners and policymakers; and research impact. We will use a series of case studies to demonstrate how we employed principles of public engagement in a model of co-production with stakeholders using project Steering Committees, targeted events and involvement workshops. Steering Committees comprised of governmental policymakers, data owners, and NGO representatives have a key role in shaping the research questions, responding to results, and incorporating findings into their work.
ResultsEngagement on several of our projects have been key to accessing data previously unavailable for researchers, shepherding findings towards government initiatives in need of evidence, helping to interpret findings, and directing future research. This has been particularly true of research on potentially sensitive topics.
Conclusion / ImplicationsGovernments have traditionally been cautious about data-sharing. Their default position is inertia, fearing public backlash. However, proactive and robust engagement is possible with complex and sensitive datasets. It enhances research and is demonstrates to data owners the potential for generating new evidence from datasets that have previously been unused for research. Engagement and impact strategies have to work with, rather than around, the sensitivities in data research to deepen and maintain the social license and impact on policy and practice.
Predictors of high hospital admission and criminal reoffending in adults experiencing homelessness: a retrospective cohort study
Authors: Mitchell Rebecca , Burns Nicholas , Glozier Nicholas , Nielssen Olav
Published: September 2024

ObjectivesTo examine the costs and predictors of high hospital use and criminal reoffending in adults experiencing homelessness.
ApproachRetrospective cohort study of 2,140 adults who attended homeless hostel clinics in New South Wales, Australia using linked clinic, health, criminal offence, and mortality data from 1 July 2008 to 30 June 2021. Multivariable logistic regression examined predictors of high all-cause hospital use (≥4 emergency department presentations in 12 months) and predictors of recidivism.
ResultsThere were 27,466 hospitalisations at a total cost of AUD$548.2 million. Twenty-seven percent of the cohort had high hospital use. Factors associated with high use were age ≥45 years, female (AOR: 1.52; 95%CI 1.05-2.22), presence of a mental disorder, substance use disorder (AOR: 1.36; 95%CI: 1.03-1.82), or being homeless for >1 year (AOR: 1.31; 95%CI: 1.06-1.62). There were 1,646 (76.9%) adults who had contact with the criminal justice system. Most (75.3%) reoffended within 24 months after index offence, and reoffenders were more likely to be younger, have a personality disorder (AOR: 1.31; 95% CI: 1.04-1.67), substance use disorder (AOR: 1.60; 95%CI 1.14-2.23), and had a previous charge dismissed on mental health grounds (AOR: 1.79; 95% CI: 1.31-2.46). Reoffenders more likely to have a principal theft-related offence (AOR: 1.85; 95%CI: 1.29-2.66). Total court finalisation costs were AUD$11.3 million.
ConclusionsThe high use of hospital and criminal justice services lends support to strategies to develop models of supported housing with a focus on integrated care, mental health support, improved referral pathways, and better coordination with community-based support agencies.
Leveraging Administrative Records and Record Linkages to Enhance Health Data at the U.S. Census Bureau
Authors: Udalova Victoria
Published: September 2024

Direct data collection via surveys of patients and health care providers continues to experience declining response rates and increased costs. Alternative data sources such as medical claims or electronic health records hold significant promise to complement direct data collection efforts but these records often suffer from a lack of important sociodemographic, economic, and other critical social determinants of health characteristics. On the heath care provider side, existing records often lack information needed to fully describe complex organizational relationships between providers and their places of work, employment, and service delivery. Through strategic partnerships with external data owners, the Enhancing Health Data (EHealth) program at the U.S. Census Bureau links multiple data sources of restricted administrative records covering patients, providers, and health care businesses and leverages data assets and record linkage capabilities available exclusively at the Census Bureau. This presentation will describe existing EHealth projects and share the vision to build a data infrastructure that empowers researchers, policy makers, and the public to uncover new insights on patients, providers, and population health.
Cumulative incidence of chronic health conditions recorded in hospital admissions from birth to age 16 in England: a cohort study using linked hospital and education administrative data
Authors: Jay Matthew , Herlitz Lauren , Deighton Jessica , Gilbert Ruth , Blackburn Ruth
Published: September 2024

ObjectiveMonitoring the incidence of chronic health conditions (CHCs) in childhood in England using administrative data to derive numerators and denominators is challenged by unmeasured migration. We used a birth cohort design and different criteria for contact with health or education services to estimate the cumulative incidence of CHCs to age 16 years.
ApproachWe identified all births in Hospital Episode Statistics (HES) from 2002/3 to 2011/12, with follow-up to 2018/19 (maximum age 8 to 16 years), censoring on death, first non-England residence record or 16th birthday. Children must have linked to later HES records and/or the National Pupil Database (NPD), which provides information on all state-school enrolments. The cumulative incidence of CHCs was estimated to age 16 using diagnostic codes in hospital admission records. We also explored temporal variation. Sensitivity analyses varied denominator criteria.
ResultsBetween 423,456 children (79.4%, of all HES-recorded births in 2002/3) and 618,054 (97.5% in 2011/12) linked to later HES or NPD records. The cumulative incidence of ever having a recorded CHC before age 16 among children born in 2002/3 or 2003/4 was 24.6%, ranging from 21% to 32% in sensitivity analyses. There was little temporal variation. At least 28% of children with any CHC had more than one body system affected by age 16. Multimorbidity rates rose with later cohorts.
ConclusionsApproximately one quarter of children are affected by CHCs, but varies depending on how the denominator is defined. More accurate estimation of the incidence of CHCs requires a dynamic population estimate.
A profile of the mental health needs of children in out-of-home care in Wales between 2019-2020
Authors: Cummings Aimee
Published: September 2024

Objective and approachYoung people who have experience of being in out-of-home care are more likely to have poorer mental health when compared to those in the general population. However, some of the most highly cited literature around prevalence rates of different mental health conditions are becoming outdated. Data held in the Secure Anonymised Information Linkage (SAIL) Databank was used to better understand the mental health needs of this group. Health data from General Practitioner records, emergency department, and inpatient admissions were linked to the 2019/20 data from children’s social services. 
ResultsMental health was considered in relation to two facets: indicators and conditions. Indicators included incidents of self-harm, drug or alcohol use, while conditions included symptoms or diagnoses of five different mental health conditions (anxiety, depression, eating disorder, conduct disorder, and severe mental illnesses). Prevalence was looked at across general demographic characteristics, as well as those specific to the care experience. Logistic regression models examined if a young person’s care experience could predict the likelihood of mental health need. 
Conclusions The findings from this piece of work will inform current understanding of the vulnerabilities of this group. Future work will compare the needs of this group to others, including Children Receiving Care and Support, as well as the general population.
ImplicationsThis work will provide an update to existing literature. The findings have the potential to contribute to discussions about how we best support this group and will inform approaches to meeting the health needs of care-experienced young people.
Pilot Federated Analysis Projects
Authors: Thompson Simon
Published: September 2024

The Cambrian explosion of Trusted Research Environments (TREs) will inevitably lead to increased data siloing and potentially decrease achievable data science.  Federated access to data is a mitigation against this risk.  The presentation will cover two major infrastructure demonstrator projects to address this need and start the UK journey towards interconnected TRE’s.
TELEPORT was an infrastructure to connect TREs and allow all the data assets to be seen through a single pane of glass while leaving them in situ; the analysis can be performed on each data asset, as well as combining data from multiple TREs to derive knowledge.   The analysis is performed within the construct of a pop-up TRE, which is a temporary project-specific TRE.  The data governance model is operated in an as-is state, with all egress controls being applied upon extraction of research output.  This method has been termed Federated Data.
TREFX is a set of infrastructure based around international GA4GH standards and the RO-CRATE concept to provide a platform to send complex workflows to the TRE’s to be performed upon the data assets, with the output post egress checking to be re-packed into the inbound RO-CRATE prior to being returned to the researcher.  This method addresses both federated analysis and method reproducibility.   This project was extended to cover ADDI workloads for dementia.
Both solutions were jointly developed by Swansea University / SeRP and share common elements.  Future work will see both these products being combined into a hybrid approach as well as spin-out products and services.
Leveraging Linked Ontario’s Health-administrative Data to Evaluate Internet-delivered Cognitive Behavioural Therapy (iCBT) in routine care
Authors: Gatov Evgenia (Jenny) , Wiljer David , Strudwick Gillian , Bhattacharyya Onil , Kurdyak Paul
Published: September 2024

ObjectiveVirtual interventions show promise for meeting growing mental health (MH) service demands. In 2020, Ontario launched Internet-delivered Cognitive Behavioural Therapy (iCBT), an evidence-based, self-led, asynchronous intervention for anxiety and depression. While its efficacy has been demonstrated in randomized controlled trials, we examine its real-world reach and treatment completion in routine care.  
ApproachLinking iCBT records with health-administrative databases, we examined the characteristics (clinical, sociodemographic, health service use) of individuals receiving iCBT (via a pilot program), compared to fully-synchronous CBT (standard of care), ascertained who is more likely to receive either modality, and determined factors associated with treatment completion using Logistic regressions adjusted for sociodemographics, baseline depression (PHQ-9) and anxiety (GAD-7), and outpatient and acute MH-related service use one year prior to enrollment.
ResultsAmong N=167 individuals receiving iCBT at the Centre for Addiction and Mental Health (Jan 2020-Aug 2021) and N=300 controls receiving fully-synchronous CBT via Ontario’s Structured Psychotherapy Program, we found that older individuals, those with lower baseline anxiety, and those with greater prior MH service use were more likely to receive iCBT. Intervention modality was the only significant predictor for treatment completion, with 51% lesser odds among iCBT clients (ORadjusted=0.49, 95%CI 0.31-0.76).  
ConclusionsWhile certain demographic characteristics differentiate iCBT recipients from those receiving standard CBT, treatment adherence is lower in self-led, asynchronous therapy.
ImplicationsThis study examines iCBT in routine care and informs its wider implementation so it can reach the target population, ease access burdens, and improve MH service delivery. Future work will examine treatment effectiveness.
Navigating Indigenous Data Sovereignty: A Decolonizing Approach to Understanding Opioid Use Amongst First Nations in Manitoba
Authors: Phillips-Beck Wanda , Star Leona , Leggett Sidney
Published: September 2024

First Nations (FN) and Indigenous Peoples around the world face significant challenges in navigating the complexities of Western research systems, particularly in the context of data sovereignty and research about their people and communities; the same can be said for Western researchers navigating Indigenous research space.  We examine the intersection of Western research and FN data to explore opioid use amongst FN in Manitoba and highlight the ethical imperative of utilizing decolonizing frameworks when working with Indigenous data. 
Indigenous researchers led a retrospective cohort study linking the Manitoba FN research file to population-level data held at the Manitoba Centre for Health Policy. We centred Indigenous voices, knowledge, protocols, and contextually informed interpretation and fostered meaningful partnerships with academic researchers to ensure we utilized robust statistical methods while prioritizing community-driven questions, needs, and aspirations. 
Study period from 2015 to 2019 and included all Manitobans eligible for Manitoba Health Services. We found downward trends in opioid-related use, dispensation, hospitalization, and mortality rates for both FN and all other Manitobans (AOM), but a significant gap was found between FN and AOM for most indicators. Indigenous governance, ownership, engagement, collaboration, reciprocity, and respect for cultural and intellectual property rights are key concepts in ethical research practices that prioritize Indigenous self-determination and data sovereignty. 
We underscore the transformative potential of Indigenous-led research and use of decolonizing frameworks in fostering community empowerment to address opioid use in First Nation communities. We upheld the rights of Indigenous peoples to govern their data and undertake their own research.
Multiple imputation Procedure for Record Linkage and Causal Inference to Estimate the Effects of home-delivered meals
Authors: Gutman Roee , Thomas Kali , Shan Mingyang
Published: September 2024

To assess the impact of home-delivered meals programs offered by Meals on Wheels (MOW) a dataset that includes enrollment into MOW and healthcare utilization is required. Because of confidentiality restrictions this data is dispersed over MOW programs internal systems and Medicare claims. In the absence of unique identifying identifiers, MOW beneficiaries are linked to Medicare beneficiaries using probabilistic linking algorithm. However, this procedure may erroneously link individuals across the two datasets, which may result in biased treatment effect estimates and suboptimal interval estimates. We propose a two-stage multiple imputation framework to estimate causal effects when the covariates and outcome information are stored in Medicare claims and the treatment assignment is MOW program data. In the first stage, we create multiple datasets in which MOW beneficiaries are linked to Medicare beneficiaries using a Bayesian record linkage technique. In the second stage, we match Medicare beneficiaries that were not enrolled in MOW programs to those that did. Using these matches we multiply imputed for each MOW beneficiary their unobserved healthcare utilization if they did not receive MOW. This procedure propagates the errors in the linking process and the matching process, and can be used to estimate effects of interventions in other linked datasets when there are no unique identifiers.
The European Union Settlement Scheme Data Linkage Project in Wales: Findings relating to mental health and education
Authors: Lloyd-Williams Ffion , Curds Matthew , Drinkwater Stephen
Published: September 2024

Objective Following the UK’s exit from the European Union (EU) a settlement scheme was introduced for EU nationals currently living in the UK to apply to continue living in the UK. The European Union (EU) Settlement Scheme project compares the living experiences of EU and UK citizens in Wales.
ApproachWe conducted a retrospective population cohort study within the Secure Anonymised information Linkage (SAIL) Databank to explore the mental health, educational experiences and involvement in the Welsh labour market of EU citizens living in Wales in comparison to British citizens. UK Census data relating to country of birth, sex, week of birth, date of arrival in the UK and socio-economic status have been linked to variables of relevance in the Education for Wales and Welsh General Practice datasets respectively and analysed. 
ResultsFindings indicate statistically significant differences in secondary school attendance and attainment between Welsh born pupils and pupils born in EU countries. We will present findings on our exploration if differences exist between Welsh born and EU country born individuals in relation to diagnosis of depression and anxiety. Additional findings from this linking and analysis reveal other interesting differences between EU and UK born citizens.
ConclusionsLinking data in this way has gained a better understanding of the experiences and outcomes of EU citizens in Wales, generating better evidence to inform policies and services that address the needs of this population and a dataset of interest to academics. Reproduceable analytical pipelines have been created for other researchers to use.
Linking data across multiple sectors to reduce health inequities among justice-involved young people in Australia
Authors: Pearce Lindsay , Calais-Ferreira Lucas , Borschmann Rohan , Legge Matthew , Sawyer Susan , Kinner Stuart
Published: September 2024

BackgroundA scarcity of evidence on the health and social needs of justice-involved young people contributes to persistent health and social inequities. Linking data from multiple sectors provides an opportunity to improve the health, justice, and social systems that this group interacts with, with a view to reducing these inequities.
MethodsWe established two population-level cohorts of justice-involved young people using multi-sectoral data linkage: (1) we linked youth justice records in Queensland from 1993-2014 for 48,670 young people to adult correctional records, death records, and coronial records; (2) we linked all youth justice records in Australia from 2000-2019 for 88,110 young people with national emergency department, hospital, primary care, pharmaceutical, and death records. We calculated mortality rates among young people exposed to the youth justice system and compared them with the age- and sex-matched general population.
ResultsJustice-involved young people in Queensland died at a 4.1 times higher rate than their non-justice-involved peers. Approximately one-third (34.6%) of deaths were from suicide. There was a 67% increased rate of death due to non-communicable diseases compared to the general population.
ConclusionsThe national cohort will fill evidence gaps on health needs and health care use after justice system contact. These two cohorts provide the first comprehensive look into the health of justice-involved young people in Australia and internationally. They form the foundation for routine monitoring and reporting on health needs and trajectories. Multi-sectoral data linkage is essential for sustainable, timely, and evidence-informed decision-making to improve systems, health, and mortality outcomes.
Linking Maternal and Child Health Data to Enhance Public Health Surveillance in Indiana
Authors: Riggins Daniel P. , Inderstrodt Jill , Price John , Grannis Shaun J. , Schleyer Titus , Crago Jennifer , O'Brien Stephen , Dixon Brian E.
Published: September 2024

Indiana faces significant challenges in maternal and infant health, ranking 45th worst in infant mortality with a rate of 6.5 deaths per 1,000 live-births, and 21st in stillbirths. Indiana further has the 3rd highest rate of maternal mortality with 44 deaths per 100,000 live-births. Despite these alarming statistics, comprehensive surveillance of maternal and infant health is absent, and data often remains fragmented across disparate information systems.
In response, the Indiana University Fairbanks School of Public Health and Regenstrief Institute secured a cooperative agreement through the CDC's Pregnant People-Infant Linked Longitudinal Surveillance (PILLARS) program, collaborating with the Indiana Health Information Exchange, Indiana Department of Health, and Marion County Public Health Department. The initiative aims to enhance Indiana's infrastructure for surveillance of maternal and child health (MCH) using electronic health records (EHRs), public health, and administrative data. Key efforts have included development, validation, and application of linkage algorithms across records for mothers and children; integration of case data across data sources; design of routine surveillance reports; and design of longitudinal studies to examine determinants and outcomes in MCH populations. Using deterministic linkage algorithms, we have created over 800,000 mother-infant dyads; this number will expand with the implementation of probabilistic approaches. We also have developed a computational phenotype for identifying cases of pregnancy in the EHR even when not explicitly flagged in the EHR. Future efforts will build on this infrastructure to draw from additional public health data sources and/or expand surveillance efforts to include prioritized MCH outcomes.
Linking Community-based Substance Use Disorder Treatment to Health Administrative Data: understanding vulnerable populations.
Authors: Kurdyak Paul , Crocker Matthew , Huang Anjie , Saunders Natasha
Published: September 2024

IntroductionMost substance use disorder (SUD) treatment occurs in community settings. Community-based SUD treatment information is rarely captured or utilized. The objective of this study was to examine the efficiency of a data linkage of community-based SUD treatment to health administrative data holdings in Ontario, Canada, and to describe sociodemographic and clinical characteristics of individuals accessing SUD services.
MethodsData from community-based SUD service providers (>180) from April 2015 to March 2022 were linked to administrative data holdings at ICES. Linkage rates were evaluated. Sociodemographic (age, sex, neighbourhood-level income) and clinical (substance use, physician visits, Emergency Department (ED) visits and hospitalizations) characteristics were evaluated.
ResultsThe linkage rate of DATIS ICES data holdings was >92% for all years (2015-2022). Of the 234,501 individuals admitted to a DATIS program, 36.1% were female, 46.2% were 25-44 years old, and 51.6% resided in the two lowest neighbourhood income quintiles. Alcohol (33.4%) was the most common substance identified. For outpatient care occurring within 1 year prior to admission, around 56.0% and 23.3% had Mental Health and Addictions (MHA) related primary care and psychiatrist visits, respectively. For acute health services, 29.8% and 14.2%  had a MHA- related ED visit or hospitalization, respectively. 
DiscussionSUD treatment data from community settings can be successfully linked to other health administrative data. Individuals with SUD have a high rate of acute health care use, and a relatively low access to psychiatrists. SUD treatment data linkage should be used to understand how to optimize access to care for vulnerable individuals.
Exploring the Experiences of Children in Kinship Care in Scotland: A Sequence Analysis of Care Journeys, Characteristics and Outcomes
Authors: Soraghan Joanna , Porter Robert
Published: September 2024

Objective and ApproachAn increasing proportion of children in care in Scotland are formally living with extended family or friends – known as kinship care. To gain an enhanced understanding of experiences within kinship care,  sequence analysis methods were applied to determine distinct patterns in care journeys throughout their first 5 years in care. Through linkage to education and health data, associations between these distinct types of care journey and children’s characteristics and outcomes were assessed.
ResultsUsing a sample of 2987 children born between 2008 and 2014 who had experienced kinship care, we identified four ‘typical’ care journeys which best describe their experiences in terms of the type, number and duration of care placements. Our analysis found that children who entered care as infants were more likely to experience short-term kinship care, while those with a disability were more likely to spend extended periods in foster care than kinship care. Those living mainly in kinship care had poorer educational outcomes than those living mainly in foster care.
ConclusionsSequence analysis can provide a more holistic view of children’s experiences over time than annual ‘snapshot’ data. The approach enabled us to identify different types of care journey, the characteristics of children who may be likely to have these experiences, and what their outcomes may be.
ImplicationsThese findings have implications for the commissioning and design of support services for families who experience kinship care, and highlight the importance of consistent, long-term data collection to facilitate longitudinal analysis.
Engagement and Communication Challenges for a Complex, Multi-nation Research Project: AD|ARC (Administrative Data | Agricultural Research Collection)
Authors: Pryce Freya , Lowe Sarah , Morrison-Rees Sian , Madden Laura , Caskie Paul , Loftus Racheal
Published: September 2024

The Administrative Data | Agricultural Research Collection (AD|ARC) is a complex research project involving four nations, a mixture of business-level, household-level and person-level data, and diverse partners, stakeholders and audiences. The project is creating independent but comparable Research Ready Datasets, using linked data for farm businesses, farmers and farm families in the four UK nations. The engagement and communications workstream is crucial to build trust, inform the programme of work, support and enhance scientific objectives, and deliver high-quality, relevant findings that meet stakeholder and funder expectations. 
The project deployed a bespoke engagement and communications framework to meet these objectives. This presentation shares key elements of AD|ARC project's engagement and communications framework and strategy:

Multi-region Approach: Balancing the need for a harmonised, federated resource with respecting regional differences in data, trusted research environments, and stakeholder perspectives.
Transparency and Trust: Engaging diverse stakeholders, including farmers, researchers, and policymakers, to build trust, support and legitimacy.
Collaborative Decision-Making: Interacting with diverse partners, (data owners, researchers, research subject representatives) to refine research questions.
Outreach and Dissemination: A multi-method, iterative approach to raise awareness, share and promote the project. 

Results are demonstrated by success in being selected as an ADR UK Flagship Dataset; integrating diverse perspectives into the creation of comparable Research Ready Datasets; consensus on a research programme; useful learning which is incorporated into strategy; and actionable evidence to inform policymaking. 
The presentation will reflect on lessons learned, drawing out implications for research and public engagement that could apply to any complex research project.
Utilization of Outpatient Mental Health Services During and After The COVID-19 Pandemic
Authors: Hayek Michelle , Park Sulki , Lawley Mark , Bovin Michelle , Kum Hye-Chung
Published: September 2024

Objective and ApproachThis study examines the impact of COVID-19 on outpatient mental health (OP-MH) service use and assesses the role of telehealth on OP-MH service patterns. Using the 5% national sample of Medicare beneficiaries, the intervention group was defined as those newly diagnosed with a MH condition in 2019 (no MH diagnosis 2 years prior) with a 2-year study period of 2020-2021. The comparison group included non-overlapping individuals newly diagnosed in 2017 with a study period of 2018-2019. The OP utilization patterns were examined over the 2 years post-diagnosis and compared across MH diagnostic categories, including schizophrenia, bipolar, depression, anxiety, trauma-related, and substance-use disorders. 
ResultsThe intervention group observed a significant reduction in MH utilization in March-April 2020 compared to the matched sample. While patients with schizophrenia and bipolar disorders saw a return to normal patterns by May 2020, those with depression, anxiety, trauma-related, and substance-use disorders continued to exhibit significant reductions in MH utilization post-COVID-19. The intervention group demonstrated a significant increase in telehealth usage, transitioning from 1% pre-COVID-19 to a peak of ~60% during the pandemic. This trend gradually decreased, reaching an average of 30% by the end of 2021 across all conditions. 
Conclusions and ImplicationsThis study underscores the impact of the pandemic on OP-MH utilization and emphasizes the potential of telehealth in improving access to care to meet OP-MH needs. Further, the results highlight the differences in OP-MH utilization across diagnostic categories and the relative benefit of telehealth options for these conditions.
Psychotropic medication profiles and future treatment risk among Northern Irish adults: a Latent Transition Analysis
Authors: McDowell Ron , Rosato Michael , Murphy Jamie , Leavey Gerry
Published: September 2024

ObjectiveTo identify within the Northern Irish adult population distinct psychotropic prescription profiles at initiation/discontinuation of a ‘treatment episode’ and associated risk of future psychotropic treatment. 
ApproachData linkage analysis of psychotropic prescriptions and household information. The ‘treatment episode’ was defined as the first identified period (>6 months) of psychotropic prescriptions preceded and followed by ≥ 12 months without psychotropics. Latent Transition Analysis was used to identify classes of psychotropic usage at initiation/discontinuation of treatment, with Cox regression used to estimate the likelihood of recommencing psychotropics.
ResultsWe identified 157,836 patients, median age forty-five years (IQR 32,62) , 58.7% female, median exposure 1.5 years (IQR 1,2.5). Five latent classes of patients were identified in relation to received prescriptions: hypnotics, anxiolytics, antipsychotics, antidepressants and multiple psychotropics. The percentage of patients in the antidepressant class increased between initiation and discontinuation (from 64.2% to 67.1%) while that in the multiple psychotropics class fell (from 7.2% to 5.4%). 43% of patients who started treatment with multiple psychotropics had switched to antidepressants at discontinuation. These patients were significantly less likely to restart treatment than those who continued to receive multiple psychotropics (Hazard Ratio 0.83, 95%CI 0.76, 0.89) after adjusting for age at discontinuation, year of entry, deprivation, sex and duration of previous treatment.
ConclusionsContinued receipt of multiple psychotropics is associated with an increased risk of future/ongoing treatment. This may reflect diagnostic uncertainly, complex disorder and discontinuation-associated side-effects.
ImplicationsResearchers and practitioners alike should consider the diagnostic, health and treatment implications of these findings.
General practitioners’ perspectives on data linkage in Australian general practice
Authors: Green Heidi , Beilby Justin , Flack Felicity , Adams Caroyln , Fabrianesi Belinda , Carolan Lucy , Brown Anthony , Nettel Aguirre Alberto , Braunack-Mayer Annette
Published: September 2024

ObjectiveIn the rapidly evolving landscape of digital health, data sharing using primary health care records has gained prominence. Linking primary care data with other administrative health datasets has the potential to provide a whole-of-life perspective on the patient journey and improve health outcomes. This study aimed to gain insight into Australian General Practitioners' (GPs) perspectives on the use of general practice health records for research and data linkage. 
ApproachThe study employed a mixed-methods approach. We conducted semi-structured interviews with GPs who had little experience of data sharing, focusing on understanding the challenges and opportunities that increased data sharing poses. We also conducted a three-round modified Delphi study with GPs with experience of and interest in research and data sharing to refine recommendations for data sharing using general practice data.
ResultsIn this paper we describe the findings from both arms of the study and compare their recommendations to contribute to a nuanced understanding of general practitioners’ views on data linkage and sharing in general practice.
Conclusions and ImplicationsBridging the knowledge gap between novices and expert practitioners, the findings will inform policies, practices, and initiatives to address the ethical, legal and social implications of data sharing in general practice settings in Australia.