bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are population health surveys reliable for self-reporting conditions and relative well-being for those with asthma?
Authors: Whiffen Tony , Akbari Ashley , Lowe Sarah , Lyons Ronan 
Published: June 2018

BackgroundPerson reported population sample surveys have been used to record information on self-reported health for a number of years and provide a useful information source for studies of disease burdens. Developments since 2013 have led to integration of health-related quality of life and subjective well-being as topic areas in some UK-based health surveys. The relative impact of different morbidities on subjective well-being in the UK though is unclear and has not been extensively researched.
ObjectivesThis descriptive study of a combined sample of two years of population-based data from the Welsh Health Survey (n=11,323) aims to address research questions relating to chronic conditions, self-reported health and well-being. The main questions are whether population surveys under- or overreport chronic conditions, and whether the relative level of mental wellbeing is different for those with chronic conditions to those without. Following this initial analysis it seeks to identify potential risk factors to mental wellbeing for those not affected by selected chronic conditions.
MethodsSurvey data were linked with clinical data contained within the Secure Anonymised Information Linkage (SAIL) Databank using SQL (Structured Query Language). The association between selected chronic conditions and relative subjective well-being was then assessed using SF-36 Mental Component Scores as a measure of mental wellbeing. Analysis was based on contingency tables, graphs and logistic regression in SAS 9.4.
FindingsResults show that some self-reported chronic conditions can more easily be verified than others from clinical data. Aside from the selected chronic conditions, potential risk factors to mental well-being include type 2 diabetes, a history of circulatory diseases, psychoactive substance abuse and hypertension.
ConclusionsLinkage of survey data can provide useful insights into relative levels of self-reported illnesses and subjective well-being but can also be used effectively to explore the risks that other morbidities present to mental wellbeing.
Replication of Acute Kidney Injury e-Alerts
Authors: Davies Gareth , Scale Timothy , Akbari Ashley , Chess James , Lyons Ronan 
Published: June 2018

BackgroundAcute Kidney Injury (AKI) is a serious condition occurring in approximately 20% of emergency hospital admissions. A Welsh AKI e-Alert (electronic alerts) system was introduced from 2013 with the aim of improving patient outcomes through early recognition of AKI.
ObjectivesOur objective is to replicate the AKI e-Alert system which has been implemented throughout Wales and create a retrospective AKI cohort to facilitate data linkage.
MethodsThe e-alert algorithm was re-produced in SQL (Structured Query Language) and applied to serum creatinine (SCr) values 2011-2014 held in the Secure Anonymised Information Linkage (SAIL) Databank. The algorithm utilises ratios between current SCr value (C1) to lowest SCr value within the previous 7 days (RV1), SCr median values from the previous 8-365 days (RV2), and lowest SCr within 48hrs (D). >50% increase in RV1 or RV2 or >26µmol/L above D triggers an alert. We created a temporal AKI cohort by using a renal dataset to exclude patients undergoing chronic dialysis.
Findings2,407,590 SCr tests were performed on adult patients with 2,077,493 of these coming from people in Abertawe Bro Morgannwg University Health Board who were not on dialysis at the time of the test. The average population for 2011-2014 was 520,293. 85,272 (4.1%) of these tests triggered alerts for AKI. The average incidence of AKI per 100,000 population per year for 2011-2014 was 1,717. The average first AKI episodes per year for 2011-2014 respectively were stage 1 (least severe): 79.2%; stage 2: 13.5%; stage 3 (most severe): 7.3%.
ConclusionsThe e-alert can be effectively reproduced using SQL to identify AKI in this large dataset, enabling subsequent validation of these alerts and evaluation of their impact through multisource data linkage.
A population-based data-linkage study of prescribed pain medications dispensed to persons with cerebral palsy
Authors: Garcia Jalon Guiomar , Maguire Aideen , Perra Oliver , Gavin Anna , O'Reilly Dermot , Thurston Allen 
Published: June 2018

BackgroundPopulation-based surveys to investigate pain in cerebral palsy (CP) can be costly and results limited by recruitment bias, recall issues, and differences between self-reports and parental accounts. Secondary data analysis may provide a cost-effective alternative to study this issue and its impact in this population.
ObjectiveInvestigate factors associated with dispensing of prescribed pain medications for those with CP.
MethodsData from the Northern Ireland CP Register were linked with the Enhanced Prescribing Database, a database of prescriptions dispensed by community pharmacies, to investigate dispensing of prescribed pain medications (non-steroidal antiinflammatories, opioids, non-opioids) between 2010 and 2014. The sample comprised 1,430 individuals with CP and 699,645 with no diagnosis of CP, born 1981-2008.
FindingsPain medications were dispensed to 61% of the CP population and 51% of the general population (p < 0.05). Individuals with CP displayed increased odds of receiving opioid analgesics compared to the general population (OR 2.81, 95%CI 2.32 to 3.40). Among those with CP, likelihood of being dispensed prescribed pain medications was greater amongst females (OR 1.34, 95%CI 1.06 to 1.70), younger age individuals (OR 1.60, 95%CI 1.02 to 2.51), those with reduced motor function (GMFCS V: OR 2.60, 95%CI 1.52 to 4.47), having seizures (OR 2.55, 95%CI 1.68 to 3.87), and living in deprived areas (OR 2.06, 95%CI 1.41 to 3.24).
ConclusionDispensing of pain medications in CP is associated with clinical factors, though even after adjustment for these, living in deprived areas influences uptake of pain medication.
A tool to improve the efficiency and reproducibility of research using electronic health record databases
Authors: Al Sallakh Mohammad , Rodgers Sarah , Lyons Ronan , Sheikh Aziz , Davies Gwyneth 
Published: June 2018

BackgroundInterrogation of electronic health record databases often involves time-consuming, manual, repetitive work in developing database queries. We developed a tool to automate this process.
MethodsWe identified elementary approaches to query primary care data from the Secure Anonymised Information Linkage databank of Wales. We designed a web-based query builder that allows using combinations of these approaches as ‘building blocks’ to query complex variables. We created an R programme to automatically generate and execute the corresponding Structured Query Language queries.
ResultsThe tool allows data extraction using combinations of the following methods: event count (e.g., asthma prescriptions); code/date of earliest/latest event; code/date/value of the event of maximum/minimum value; and frequency of temporally constrained events. Query intervals could be fixed, dynamic, or individualised. The tool integrates with a codeset repository. Data extraction procedures and codesets are saved on a web server as versioned, shareable, and citable objects.
ConclusionThis versatile tool allows rapid and complex data extraction with minimal to no programming skills, reduces human errors, and improves research transparency and reproducibility.
Funding/SupportHealth and Care Research Wales, ABMU Health Board, AUKCAR (AUK-AC-2012-01), Farr Institute of Health Informatics Research (MR/K006525/1-MR/K007017/1).
The impact of welfare reform in London - using benefits data to track the effect of government policies on employment outcomes
Authors: Tonutti Giovanni 
Published: June 2018

BackgroundThe last three parliamentary terms have marked a period of unprecedented change for the UK welfare system. Alongside reducing public spending, boosting behavioural incentives has represented the overarching drive behind the majority of reforms introduced.
ObjectivesPolicy in Practice has pooled benefits data across nineteen of thirty-two London boroughs to track changes in living standards and the impact of welfare reforms on low-income Londoners over a period of two years. This paper models and assesses the impact of two flagship welfare reforms on households’ behavioural responses. The policies analysed are the benefit cap and the impact of Universal Credit on selfemployed households.
MethodsThe project has gathered a sample of over 570,000 real households. Housing Benefit and Council Tax Support data has been collected from participating local authorities on a monthly basis for two years. The study combines complex policy modelling to forecast the future impact of Universal Credit on the living standards of self-employed households, with a Difference-in-Difference regression to understand the impact of the benefit cap on the employment outcomes of households affected.
FindingsThe findings of the analysis indicate a positive impact of the benefit cap on employment outcomes, with a difference in employment rates of 3.5 percentage points in favour of households affected by the cap, compared to the control group. At the same time, the model forecasts significant income losses for self-employed households as the result of the application of a Minimum Income Floor under Universal Credit, with an average income reduction of £341 p/m.
ConclusionThe research highlights the potential of locally held administrative data in systematically tracking the impact of policies and the effectiveness of government interventions. This work fits within the broader mission of Policy in Practice to promote an outcome-based approach to the design and delivery of social policy.
The Northern Ireland Baby Hearts Study: A Case-Control study using a hybrid data linkage method
Authors: McCullough Nichola , Dolk Helen , Loane Maria , Lagan Briege M , Casey Frank , Craig Brian 
Published: June 2018

BackgroundThe Northern Ireland (NI) Baby Hearts study aimed to investigate risk factors for congenital heart defects (CHD), and to investigate the health behaviours of a representative sample of NI pregnant women.
MethodsWe performed a case-control study with hybrid data collection methods, including self-administered iPad questionnaire or postal questionnaire, information held in maternity records and linkage to prescription records. Cases (n=286) were recruited following diagnosis prenatally or postnatally, controls (n=966) were recruited during recruitment months in each maternity unit at 18-20 weeks gestation.
FindingsRefusal rates for questionnaire completion were low (7-8%). Among those recruited, consent for access and linkage to medical records was high (98%). Recruitment of both cases and controls was closely representative of the NI population in terms of age, area of residence and deprivation. There was considerable discordance between self-report questionnaires, maternity records and prescription records regarding medications taken in the first trimester, and between self-report questionnaires and maternity records regarding behaviours such as preconceptional folic acid, pregnancy planning, and smoking. However, there were no differences between cases and controls that would indicate recall bias.
ConclusionsOur results suggest that hybrid data collection approaches are a useful way forward for aetiological studies.
Challenges of administrative data linkages: experiences of Administrative Data Research Centre for England (ADRC-E) researchers
Authors: Morris Hannah , Lanati Silvia , Gilbert Ruth 
Published: June 2018

BackgroundLinkage between administrative datasets routinely collected by government departments and other statutory bodies create rich resources for policy-relevant research. We describe how ADRC-E has achieved linkage between health and education data for England, and the challenges presented by this process.
MethodsA key task of ADRC-E is to progress exemplar studies of novel data linkages, and build relationships with data providers. While navigating untested data application and permission processes, ADRC-E researchers have maintained detailed timelines and developed a framework to improve the efficiency of future applications.
ResultsThe ADRC-E has approval to link four one-year birth cohorts of the National Pupil Database and Hospital Episode Statistics to facilitate research into outcomes for children with chronic conditions. The timeline of 3 years and 4 months represents 6 face-to-face meetings and 108 email and telephone correspondences. The technical challenges of data linkage have yet to be overcome before we receive data for research. Other examples of data timelines for cross-sectoral data linkage requests will be reported.
ConclusionsThe shifting legal landscape governing the use of personal data, and a lack of precedent mean that unlocking administrative data for research requires substantial time, diligence and expertise on the part of both researcher and data provider.
The efficacy of surgical parathyroidectomy assessed using Australian administrative pharmaceutical data and quasi-experimental design
Authors: Purkiss Shaun , Keegal Tessa , Wollersheim Dennis , Vally Hassan 
Published: June 2018

BackgroundAdministrative data base research may have a role in surgical quality outcome evaluation. Such data provide independent and epidemiological perspectives of surgical performance that may differ from the results generated by the surgical units themselves. This may be of significance in decisions concerning health resource allocation, the appraisal of procedures and identification of specialised units. Primary hypoparathyroidism is recognised as associated with several chronic conditions and parathyroidectomy is an established surgical treatment.
ObjectivesThis study examines the scope of a linked Australian pharmaceutical database to assess patient outcomes following parathyroidectomy for primary hypoparathyroidism using therapeutic profiles and chronic conditions defined by proxy.
MethodsThe prevalence of a range of chronic conditions were identified within a surgical cohort (age>50, N=610) using allocated World Health Organization Anatomical-Therapeutic codes.
An observational study with quasi experimental design was employed to track the pre and post-operative prevalence trends of chronic diseases and treatment groupings. Treatment efficacy was assessed by regression discontinuity after surgery and mortality estimated by proxy using service discontinuation.
FindingsParathyroidectomy had significant beneficial effects upon the prevalence of bodily and bone pain, treatments for cardiovascular disorders and infective episodes. In contrast, dyslipidaemias, psychosis, depression, glaucoma and obstructive airways diseases showed no evidence of regression discontinuity. Four year survival was 89%.
ConclusionsThe Australian data employed can define chronic conditions and track pre and post-operative prevalence trends to provide an alternative perspective for assessment of surgical treatment. This method has the potential for the evaluation of infrequently performed procedures and may reduce reporting biases and provide new insights into surgical practice.
Chronic Disease Prevalence. A perspective using Administrative Data from Australia
Authors: Purkiss Shaun , Keegal Tessa , Wollersheim Dennis , Vally Hassan 
Published: June 2018

BackgroundPharmaceutical administrative data can provide an alternative method to assess chronic disease prevalence. The data within prescription exchanges includes the specific nature of the medication dispensed which can be utilised for case definition by proxy of certain chronic diseases.
ObjectivesThis study examines the potential of Australian administrative pharmaceutical data to define chronic disease and provide population prevalence estimates. The utility of allocated World Health Organization Anatomical Therapeutic Chemical (ATC) codes to the treatment supplied will be assessed and the validity of the results generated compared with other Australian sources of chronic disease prevalence.
Methods23 chronic conditions were defined by ATC codes within an Australian (administrative) Pharmaceutical Benefits Scheme (PBS) dataset. This enabled calculation of chronic disease prevalences for the period 2003 to 2014 using Australian census data as denominator values.
FindingsPrevalence estimates from PBS data when compared with questionnaire based studies demonstrated homogeneity overall (Mann-Whitney P>0.05). PBS prevalence estimates of diabetes, gout and asthma showed respective correlations of 0.999, 0.8385 and 0.58 to 0.82 with community surveys. In general, the prevalence of most chronic conditions rose. Cardiovascular disorders, iron deficiency treatment, HIV and prescription pain medication however demonstrated notable increases. Prevalence estimates were influenced by artefactual factors including new government regulation in 2012. For diabetes prevalence estimates this improved the correlation associated with community survey data.
ConclusionsAustralian pharmaceutical administrative data have potential utility for chronic disease prevalence estimates. Advantages include low costs, speed of analysis, high power and good representation. We consider the technique offers a complimentary perspective of chronic disease prevalence providing new insights into population health.
A case of pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome successfully treated with combination therapy of corticosteroids, cyclosporine, and colchicine
Authors: Hashizume Hideo , Kageyama Reiko , Umayahara Takatsune , Morio Tomohiro 
Published: June 2018

Pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome is an autoinflammatory disease characterized by destructive inflammation of the skin and joints in association with genetic mutation of the Pombe Cdc15 homology family member PSTPIP1. Because a therapeutic strategy specific to this disease has not been established, treatment is always challenging for clinicians. We herein describe a case of PAPA syndrome with typical clinical features successfully treated with combination therapy of traditional anti-inflammatory drugs. A 39-year-old man presented with painful plaques on his extremities that had been present for several years. Large brown plaques were observed on both arms and legs with numerous fistulae and ulcers. Cystic acne lesions subsequently appeared on his cheeks and upper back. We diagnosed the patient with PAPA syndrome based on the presence of typical clinical features; however, no genetic mutations of exon-1 to 15 of PSTPIP1were found. Although recent reports have emphasized the efficacy of biologics that target inflammatory cytokines such as antibodies to interleukin-1β and tumor necrosis factor-α, use of these agents remains uncovered by health insurance in Japan, showing unresolved discrepancy in practical use for clinicians. The present patient was successfully treated with combined therapy of a corticosteroid, colchicine, and cyclosporine A, encouraging the use of this combination therapy as a novel therapeutic option.
Tendencia de la incidencia, mortalidad y supervivencia por cáncer en Pasto, Colombia
Authors: Yepez Chamorro María Clara , Jurado Fajardo Daniel Marcelo , Bravo Goyes Luisa Mercedes , Bravo Ocaña Luis Eduardo 
Published: June 2018

Introducción: En Colombia es necesario que se continúe produciendo información de calidad y actualizada sobre la magnitud del cáncer a partir de los datos de los registros para contribuir a la toma de decisiones y a la implementación de estrategias de promoción de la salud, prevención y tratamiento del cáncer con el objetivo de disminuir el impacto en la población.Objetivo: Describir la incidencia y mortalidad por cáncer en el Municipio de Pasto.Metodología: Estudio observacional descriptivo de la morbi-mortalidad causada por tumores malignos en Pasto durante 1998-2012. La recolección, procesamiento y sistematización de los datos se realizó de acuerdo a parámetros estandarizados internacionalmente para registros poblacionales de cáncer. Las tasas de incidencia y mortalidad se calcularon por periodo, sexo, edad y localización del tumor.Resultados: En el período 1998-2012 se registraron 8.010 casos nuevos de cáncer, de ellos, 57,7% se presentaron en mujeres. Se reportaron 4.214 muertes, 52% en mujeres. La incidencia y mortalidad no presentó cambios significativos durante 15 años de observación y los tumores que casusas mayor morbi-mortalidad afectan al estómago, cuello uterino, mama y próstata.Discusión: El cáncer en general constituye un importante problema de salud para la población de Pasto. El comportamiento global de la incidencia y el aumento de la mortalidad por cáncer en relación con otras causas de muerte, evidencian la necesidad de fomentar y fortalecer programas de promoción y prevención, enfocados especialmente hacia los tumores que producen mayor morbi mortalidad en la población.
PLANIFICACIÓN ESTRATÉGICA EN EMPRESAS DEL SECTOR PÚBLICO DE LA PROVINCIA DE SANTA ELENA, 2017
Authors: Bacilio Bejeguen Jacqueline Rocio , Reyes Tomalá Lorena , Alomoto Tomalá Mario , De la Cruz Pozo Luis , Salgado Suárez María , Sánchez Lino Jacinto 
Published: June 2018

El objetivo del presente artículo consiste en diagnosticar la función administrativa de las instituciones públicas de la provincia de Santa Elena, específicamente la etapa de la planificación estratégica, la contribución teórica se realiza con la finalidad de confrontar la parte teórica con la práctica, de reconocer que la planificación estratégica tiene su razón de ser, como es la satisfacción de las necesidades de la población y velar por la calidad del servicio prestado; y, que se ejecuta a través de un proceso participativo y continuo. Se exponen los resultados de las encuestas realizadas a los administradores de las instituciones públicas de la provincia de Santa Elena que formaron parte de una muestra simple pero que realzan la importancia de esta función y explica las debilidades, que como ciudadanos visualizamos al reclamar nuestro derecho como contribuyentes, dejando en el pensamiento si para ser un administrador público necesita conocimientos y habilidades más que los votos populares o una simple designación.
Palabras claves: administración, función, planificación estratégica, instituciones públicas.
ABSTRACT
The aim of this article is to diagnose the administrative function of the public institutions of the province of Santa Elena, specifically the stage of strategic planning, the theoretical contribution is made with the purpose of confronting the theory with practice, to recognize that the strategic planning has its reason to be, as is the satisfaction of the needs of the population and ensure the quality of the service rendered; and, that is executed through a participatory and continuous process. The results of the surveys directed to administrators of public institutions of the province of Santa Elena who formed part of a simple sample but that highlight the importance of this function and explains the weaknesses, that we as citizens visualize to claim our right as taxpayers, leaving in the thinking if a public administrator needs knowledge and skills more than the popular votes or a simple designation.