bluuebunny/crossref_metadata_2025_split huggingface dataset:
La iglesia en el siglo xxi: viejos y nuevos desafíos para el cristiano de hoy
Authors: Girardi  Stellin Victorino 
Published: November 2019

En la presente conferencia se reflexiona sobre los siguientes preguntas: 1. Una introducción de carácter metodológico que responda a la pregunta ¿cómo acercarnos a la Iglesia? ¿Cuál es la mejor actitud que debemos asumir cuando queremos conocerla? 2. ¿Cuáles son las características del Hoy en que la Iglesia está llamada a su misión? 3. ¿A qué hombre esta la Iglesia llamada a servir? ¿Cuáles son los rasgos principales de nuestros contemporáneos? 4. ¿Qué le puede ofrecer la Iglesia al hombre de hoy?
Estimates of mortality rates in people with diabetes and cardiovascular disease using administrative pharmaceutical data
Authors: Purkiss Shaun , Keegel Tessa , Vally Hassan , Wollersheim Dennis 
Published: November 2019

BackgroundQuantifying the mortality risk for people with diabetes is challenging because of associated comorbidities. The recording of cause specific mortality from accompanying cardiovascular disease in death certificate notifications has been considered to underestimate the overall mortality risk in persons with diabetes.
Main AimDevelop a technique to quantify mortality risk from pharmaceutical administrative data and apply it to persons diagnosed with diabetes, and associated cardiovascular disease and dyslipidaemia before death.
MethodsPersons with diabetes, cardiovascular disease and dyslipidaemia were identified in a publicly available Australian Pharmaceutical data set using World Health Organization anatomic therapeutic codes assigned to medications received. Diabetes associated multi-morbidity cohorts were constructed and a proxy mortality (PM) event determined from medication and service discontinuation. Estimates of mortality rates were calculated from 2004 for 10 years and compared persons with diabetes alone and associated cardiovascular disease and dyslipidemia.
ResultsThis study identified 346,201 individuals within the 2004 calendar year as having received treatments for diabetes (n=51,422), dyslipidaemia (n=169,323) and cardiovascular disease including hypertension (n=280,105). Follow up was 3.3 x 106 person-years. Overall crude PM was 26.1 per 1000 person-years. PM rates were highest in persons with cardiovascular disease and diabetes in combination (47.5 per 100 person years). Statin treatments significantly improved the mortality rates in all persons with diabetes and cardiovascular disease alone and in combination over age groups >44 years (p<.001). Age specific diabetes PM rates using pharmaceutical data correlated well with Australian data from the National Diabetes Service Scheme (r=0.82)
ConclusionProxy mortality events calculated from medication discontinuation in persons with chronic conditions can provide an alternative method to estimate disease mortality rates. The technique also allows the assessment of mortality risk in persons with chronic disease multi-morbidity.
Challenges and Principles to guide the linkage of government administrative data: Experiences from the Tassie Kids project
Authors: Stafford Joel 
Published: November 2019

Background with rationale An overarching concern influencing models of data linkage for public good is the maintenance of personal privacy. This concern is at times so strong that it prevents or slows the progress of achieving worthwhile linked administrative datasets across allied government departments, and even between distinct units within a single department. Where linkage has succeeded it has generally produced data sets that, by design, are difficult or impossible to re-identify, therefore meeting the requirement to guard privacy at the costs of the resulting data’s value to government decision makers.
Main Aim The main aim of this paper is to convey criteria to inform data linkage policy and practice in government that maintains a central role for privacy, but which can better deliver on the promise of high value data for policy.
Methods/Approach This paper is informed by the Tassie Kids project, a longitudinal linked administrative data study using an embedded researcher model underway in Tasmania, Australia. Among other outcomes, the project was designed to assist allied government agencies to identify key policy leverage points across multiple services. Using the Tassie Kids project as a case study this paper asks why allied departments don’t routinely link administrative data. Several important linked administrative data design principles are drawn from discussion of this question.
Results The paper explains the practice implications of these design principles relevant to policy analysis and information management units in government.
Conclusion The paper concludes with the suggestion that high value linked administrative data is data that maximises its representation of the dynamic mechanisms that affect the outcomes desired by government, while simultaneously minimising the data’s distance from its point of origin.
Evaluating needs-based home visiting support: Can administrative data help?
Authors: Warner Nell 
Published: November 2019

Objective Home visiting is a form of family support which can help families with different problems in different ways. Previous evaluations have utilised either experimental or qualitative designs. However, the needs-based nature of support presents a challenge for evaluation using experimental designs.
Main Aim This paper illustrates the unique contribution that administrative data can make to understanding these problems and how it can be used to explore what support works for families in different situations.
Methods The analysis of administrative data from one UK home visiting organisation, Home-Start, is presented. Exploratory analysis considers measures describing how well parents are coping with a range of issues and how this changes over the course of support. This highlights problems with evaluation because of the variety of issues Home-Start is supporting parents to cope with and the fact that the duration of support is needs-based. Methodological solutions are proposed for these problems using the administrative data. These include using subgroups to study families with different problems and considering the rate at which improvements occur as an outcome variable. Linear regression models are presented to demonstrate how these methods can identify aspects of support related to improvements in parental self-esteem.
Results The methods used are able to demonstrate that the frequency of support and who the support is provided by are related to faster improvements in parental self-esteem. The analysis of sub-groups in the data shows that the frequency of support is important for all parents, but there are differences between parents in different situations, depending on whether volunteers or paid staff provide support.
Conclusion The analysis of administrative data is able to make a unique contribution to the evaluation of needs-based home visiting support.
Suicide following presentation to emergency departments with suicidal ideation: a population-wide study
Authors: Ross Emma , Maguire Aideen , O'Hagan Denise , O'Reilly Dermot 
Published: November 2019

Background Little is known about the association between suicide ideation and completed suicide. As NI has the highest suicide rate in the UK and Ireland it is vital to understand who is most at risk in order to target prevention strategies effectively.
Aim To explore the risk factors for completed suicide following presentation with suicide ideation.
Methods The Northern Ireland Registry of Self-Harm and Suicide Ideation contains information on all presentations to all Emergency Departments in NI for self-harm and suicide ideation. Data from 2012-2015 were linked to centralised electronic data relating to primary care, prescribed medication and mortality records. Initial analyses were completed to explore the profile of those who present with suicide ideation, and logistic regression was utilised to examine the likelihood of mortality post presentation. Cox regression was utilised to examine the factors associated with completed suicide following presentation with ideation.
Results The cohort consisted of 1,483,435 individuals born or resident in NI from 1st January 1970 until 31st December 2015 (maximum age in 2015, 45 years). Between 2012-2015, 4,975 (0.3%) individuals presented with suicide ideation and 583 (0.04%) individuals died by suicide. Ideation is more likely in men compared to women (OR=1.87, 95%CI 1.76,1.98), in those aged 18-24 years, and in more deprived individuals. Of those who presented with ideation, 66 (1.3%) subsequently died by suicide. In fully-adjusted models, those who presented with suicide ideation were 25 times more likely to die by suicide compared to those who did not (HR=25.0, 95%CI 19.3,32.5). Amongst suicide ideators, male gender (HR=2.67, 95% CI 1.39,5.10) and multiple presentations (HR=1.95, 95% CI 1.09,3.50) were associated with the greatest risk of death by suicide.
Conclusion These findings could help emergency department staff identify individuals at greatest risk of suicide and could be utilised in the development of targeted intervention strategies.
Health conditions, disability and economic inactivity in Northern Ireland. An administrative data study.
Authors: Miller Ana Corina , O’Reilly Dermot , Wright David , Tseliou Foteini , Rosato Michael , Mcguire Aideen 
Published: November 2019

Background Northern Ireland consistently experiences a higher rate of economic inactivity compared to other regions of the UK, currently 27% of the working age population compared to 22% in the UK. Historically, the major variance in explaining higher NI economic inactivity rates has been larger proportions of long-term sick/disabled. Only 34.7% of the NI population with a disability are employed compared to 77.9% of the non-disabled population.
Aim The aims were to explore the relationship between chronic health status and the labour-market in NI, and how receipt of DLA is associated with economic inactivity.
Methods This study links the 2011-NI-Census records, DLA-dataset, death registrations for the Census population, settlement-band data, the Land and Property Service capital-valuation of property, and the NI-Multiple-Deprivation Measure. The economically active population was defined as all individuals that were either employed or unemployed but looking for a job at the time of the 2011-Census.
Results Men with mental-health conditions reporting a lot of limitation in day-to-day activities are almost 51 times more likely to be economically inactive compared to men with no health condition (ORadj=50.99, 95%CI:46.8,55.6). Learning/mental-health conditions are more likely to be associated with economic inactivity in both women and men compared to physical health conditions, such as long-term pain, mobility or breathing difficulties. Individuals in receipt of DLA are more than twice as likely to be economically inactive as their peers who are not in receipt of DLA.
Conclusion Individuals with mental-health conditions reporting a lot of limitation in day-to-day activities have the lowest rates of participation in the labour-market. A lot of limitation in the day-to-day activities appears to be strongly associated with economic inactivity regardless of the health condition. DLA uptake is associated with considerably reduced likelihood of being economically active overall while the health conditions underlying DLA uptake are strong barriers to access the labour-market in NI.
Poor mental health and uptake of disability benefits
Authors: O’Reilly Dermot , Rosato Michael , Wright David , Tseliou Foteini , Miller Ana Corina , Maguire Aideen 
Published: November 2019

Background with rationale Disability related social security benefits were introduced to help off-set the additional costs incurred by people with disability and to help them better integrate into society. However, there are concerns that not everyone with a disability is receiving the benefits to which they are entitled.
Aim To undertake a record-linkage study to compare levels of benefit uptake Disability Living Allowance (DLA) according to disability type and severity as reported in the Northern Ireland 2011 Census.
Data/methods The linked data sources were the 2011 census records and all DLA records for calendar year 2011. The main comparison was of DLA receipt amongst those reporting chronic mobility difficulties (MD) and those with chronic poor mental health (PMH) (both yes/no) with the addition of limitation of daily activities (none, a little, a lot), which was used as a proxy for severity and DLA eligibility.
Results Most people with disability had multiple disabilities but here the analysis is primarily amongst people with solitary conditions to avoid potential confounding. Approximately 20,000 people in the population reported either only MD or only PMH, though 68% of MD had their daily activities limited a lot compared to 55% of those with PMH. Overall, 71.8% of people with MD and daily activities limited a lot were on DLA compared to only 57.5% of similarly affected people with PMH the relative odds ratio being (OR 0.53 95%CI 0.50, 0.56).
Conclusion It appears that people with poor mental health are less likely to receive disability benefits compared to those with mobility problems. This may be because they are less able to prove their eligibility for these benefits under the current assessment processes.
Does the risk of poor mental health rise before widowhood?
Authors: Feng Zhiqiang , Dibben Chris , Everington Dawn , Williamson Lee , Raab Gillian 
Published: November 2019

Background A large body of literature has shown that transition into widowhood has detrimental effects on the surviving spouse’s health leading to elevated risks of mortality, poor mental health and hospitalisation. However, few studies have examined health outcomes before widowhood. Anticipatory grief and long term care giving are likely to lead to poor mental health conditions.
Aim This paper examined whether the risk of depression and anxiety rose before the widowhood event using linked administrative data.
Methods The study population was drawn from the Scottish Longitudinal Study (SLS) linked to prescribing data, available from 2009. We included all cohort members who were married in 2001 and who were aged 50 and over by 2009. We then followed the cohort for 5 years from 2009 to 2013 (N=~58,000). Andersen-Gill models were used to explore the risk of prescription of antidepressant and antianxiety drugs before and after loss of spouse adjusting for a number of confounders. The analysis was carried out separately for men and women.
Results We found that the risk of depression and anxiety were higher 6 months before widowhood for women (0-3 months, HR=1.17, 95%CI 1.07-1.28; 3-6 months, HR=1.15, 95%CI 1.05-1.27) but not for men (0-3 months HR=1.07, 95% CI 0.90-1.26; 3-6 months HR=1.01, 95% CI 0.84-1.21). The risk after widowhood for men became significantly higher lasting for 2 years (0-3 months HR=1.40, 95% CI 1.21-1.61; 21-24 months HR=1.24, 95% CI 1.01-1.52). For women the elevated risk remained at a heightened level up to 2 years (0-3 months HR=1.50, 95% CI 1.29-1.75; 21-24 months HR=1.29, 95% CI 1.03-1.60).
Conclusion It has been previously shown that widowhood has negative effects on a surviving partners’ health. This research shows that this effect is also apparent in women before their partner’s deaths.
Long-term outcomes of urinary tract infection (UTI) in childhood: The LUCI study
Authors: Hughes Kathryn , Cannings-John Rebecca , Jones Hywel , Lugg-Widger Fiona , Lau Mandy , Paranjothy Shantini , Francis Nick , Hay Alastair , Butler Christopher , Van der Voort Judith , Hood Kerenza 
Published: November 2019

Background Guidelines recommend the prompt diagnosis and treatment of UTI in young children to reduce the risk of renal scarring and possible long-term complications. However, the evidence for this association is weak and has been questioned. There is an urgent need to clarify this as the correct approach to urine sampling and diagnosis of UTI in children hinges on this association.
Main Aim Determine outcomes following UTI in childhood (<5years)
Approach We used the Secure Anonymised Information Linkage (SAIL) Databank to access demographic, hospital, GP and microbiology data from children in Wales. Children with >1 microbiologically confirmed UTI (mcUTI) aged <5, were compared to those with no mcUTI. The primary outcome was renal scarring and secondary outcomes included hypertension, chronic kidney disease and renal failure. The primary analysis used multinomial regression and time to event models.
Results A cohort of 159,201 children was defined. 11,099 (7.0%) had >1 mcUTI.
The overall prevalence of renal scarring in the cohort by age 7 was 0.16%; 1.26% in those with >1 mcUTI; 0.08% in those with no mcUTI. The unadjusted odds ratio (OR) was 16.62 (12.91-21.39) and adjusted 3.64 (2.57-5.14). Among the group with >1 mcUTI, predictors of renal scarring were VUR, younger age of first UTI, and greater number of UTIs <5
Conclusion UTI was associated with renal scarring even after adjusting for covariates.
The prevalence of renal scarring in children with >1 mcUTI was lower than expected. Possible explanations include poor coding in routine data, different patient populations or missed renal scarring diagnoses. We are currently validating our results using radiology data. If renal scarring diagnoses are being missed, a more proactive urine sampling and imaging strategy may be indicated. However, if renal scarring rates are low following UTI, this may not be necessary.
The association between mother’s alcohol consumption during pregnancy and their child’s educational attainment and risk of hospital admission by age 14
Authors: Bandyopadhyay Amrita , Brophy Sinead , Moore Simon , Akbari Ashley , Paranjothy Shantini , Lyons Ronan 
Published: November 2019

Background Heavy alcohol consumption by mothers during pregnancy is associated with developmental problems in their children. However, the impact of light to moderate consumption on the long-term health and educational attainment up to adolescence has not been established.
Main Aim To investigate the association between mother’s alcohol use during pregnancy and health and educational attainment of their children up to age 14 years.
Methods Millennium Cohort Study (MCS) children in Wales (1,838), with parental consent, were record-linked to emergency hospital admission data between birth and 14 years (1,795) and National Curriculum Key Stage-Three (KS3) (1,645) records within the Secure Anonymised Information Linkage (SAIL) Databank. Mother’s self-reported alcohol use during pregnancy was classified into a) abstain; b) light (1 - 2 units per week/occasion, 1 unit = 8g ethanol)); c) moderate (3 - 6 units per week/3-5 units per occasion) and d) heavy (> 6, dropped due to a paucity of data). Cox regression estimated the risk of emergency hospital admission and multivariate linear regression models estimated the difference in KS3 scores by exposure group.
Results 71% of mothers abstained, 24% were light drinkers and 5% moderate. Light drinking was associated with children’s lower risk of emergency hospital admission (HR = 0.85, 95% CI 0.75 - 0.97) and better KS3 scores (β = 0.14, 95% CI 0.05 - 0.23) by age 14 years, when compared to abstaining mothers. Children of mothers who drank moderately had a comparable risk of emergency hospital admission (HR = 1.07, 95% CI 0.79 - 1.46) and a better KS3 score (β = 0.30, 95% CI 0.11 - 0.49), compared to abstaining mothers.
Conclusion Consumption during pregnancy of 1-2 units of alcohol per week/occasion was neither associated with an increased risk of emergency hospital admission nor poor academic attainment in children up to 14 years of age.
Assessing the health impacts of adults’ participation in sports: investigating the role of accessibility to sport facilities
Authors: Pouliou Theodora , Lowe Sarah , Higgs Gary 
Published: November 2019

The health benefits of individual and group participation in sports are well-known. While a positive association between participation in sport and self-assessed health has been reported for England and Scotland, research has been limited in Wales. In addition, research examining the relationship between levels of physical activity and the accessibility of sport facilities give inconsistent findings.
This research project proposes to explore the potential association between the accessibility of sports facilities, sport participation and health. In particular, we will examine whether:

Accessibility to sport facilities contributes to participation in sporting activities.
Sports participation mediates the association between accessibility to sport facilities and health outcomes (as recorded in routine-health-records).
The association between participation in sports and health is independent of individual characteristics such as gender, socio-economic characteristics.

The data-sets used were: the Welsh Demographic Service Data (WDSD), the Patient Episode Database for Wales (PEDW), the Sport Wales Active Adults Survey (AAS) and Enhanced Recreational Database (ERD). Accessibility measures were derived from the SWERD, while the Charlson Comorbidity Index (CCI) was estimated as an indicator of general health based on PEDW data. The AAS was then linked to PEDW and the ERD. Appropriate regression analysis was applied based on the type of outcome explored.
Preliminary results showed that 72% of the adults participated in sports in the 4 weeks prior to interview and 39% of them participated 3 or more times. Accessibility to sport facilities was significantly associated with outdoor sport activities rather than indoor activities. Distance to a sports hall was significantly associated with sport participation. Adults with a chronic condition based on CCI were less likely to participate in sports. The study provided a unique opportunity to explore the benefits of analysing linked administrative and survey data, therefore contributing to current research on sport participation/accessibility and health.