bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comunicação e consumo nas dinâmicas culturais do mundo globalizado
Authors: Castro Gisela G S 
Published: September 2018

No conjunto dos estudos multidisciplinares que caracterizam o campo da Comunicação, o consumo tornou-se um tema de destaque que tem merecido análises a partir de diferentes perspectivas teórico-metodológicas. Como denominador comum, entende-se que se trata de um vetor central na constituição da experiência contemporânea num mundo crescentemente regido por processos de globalização econômica e cultural. A principal motivação deste artigo é oferecer uma cartografia comentada das principais vertentes dos estudos do consumo nas ciências sociais. Pretende-se desse modo chamar a atenção para essa temática de investigação e dar a conhecer algumas das reflexões no campo ao dialogar com o oportuno tema selecionado pelos editores para este dossiê de Pragmatizes, a saber: cultura e práticas de consumo.
Control of Postprandial Hyperglycemia in Type 1 Diabetes by 24-Hour Fixed-Dose Coadministration of Pramlintide and Regular Human Insulin: A Randomized, Two-Way Crossover Study
Authors: Riddle Matthew C. , Nahra Rajaa , Han Jenny , Castle Jessica , Hanavan Kathryn , Hompesch Marcus , Huffman David , Strange Poul , Öhman Peter 
Published: September 2018

OBJECTIVE
Healthy pancreatic β-cells secrete the hormones insulin and amylin in a fixed ratio. Both hormones are lacking in type 1 diabetes, and postprandial glucose control using insulin therapy alone is difficult. This study tested the pharmacodynamic effects of the amylin analog pramlintide and insulin delivered in a fixed ratio over a 24-h period.

RESEARCH DESIGN AND METHODS
Patients with type 1 diabetes were stabilized on insulin pump therapy with insulin lispro before a randomized, single-masked, two-way crossover, 24-h inpatient study in which regular human insulin was administered with pramlintide or placebo using separate infusion pumps in a fixed ratio (9 μg/unit). Meal content and timing and patient-specific insulin doses were the same with each treatment. The primary outcome measure was change in mean glucose by continuous glucose monitoring (CGM). Profiles of laboratory-measured glucose, insulin, glucagon, and triglycerides were also compared.

RESULTS
Mean 24-h glucose measured by CGM was lower with pramlintide versus placebo (8.5 vs. 9.7 mmol/L, respectively; P = 0.012) due to a marked reduction of postprandial increments. Glycemic variability was reduced, and postprandial glucagon and triglycerides were also lower with pramlintide versus placebo. Gastrointestinal side effects were more frequent during use of pramlintide; no major hypoglycemic events occurred with pramlintide or placebo.

CONCLUSIONS
Coadministration of fixed-ratio pramlintide and regular human insulin for 24 h improved postprandial hyperglycemia and glycemic variability in patients with type 1 diabetes. Longer studies including dose titration under daily conditions are needed to determine whether this regimen could provide long-term improvement of glycemic control.
Data Quality Automation: a Generic Approach for Large Linked Research Datasets
Authors: Elmessary Muhammad A , Thayer Daniel , Rees Sarah , ReesKemp Leticia , Rees Arfon 
Published: September 2018

IntroductionWhen datasets are collected mainly for administrative rather than research purposes, data quality checks are necessary to ensure robust findings and to avoid biased results due to incomplete or inaccurate data.
When done manually, data quality checks are time-consuming. We introduced automation to speed up the process and save effort.
Objectives and ApproachWe have devised a set of automated generic quality checks and reporting, which can be run on any dataset in a relational database without any dataset-specific knowledge or configuration.
The code is written in Python. Checks include: linkage quality, agreement with a population data source, comparison with previous data version, duplication checks, null count, value distribution and range, etc.
Where dataset metadata is available, checks for validity against lookup tables are included, and the output report includes documentation on data contents. An HTML report with dynamic datatables and interactive graphs, allowing easy exploration of the results, is produced using RMarkdown.
ResultsThe automation of the generic data quality check provides an easy and quick tool to report on data issues with minimal effort. It allows comparison with reference tables, lookups and previous versions of the same table to highlight differences. Moreover, this tool can be provided for researchers as a means to get more detailed understanding about their data.
While other research data quality tools exist, this tool is distinguished by its features specific to linked data research, as well as implementation in a relational database environment. It has been successfully tested on datasets of over two billion rows.
The tool was designed for use within the SAIL Databank, but could easily be adapted and used in other settings.
Conclusion/ImplicationsThe effort spent on automating generic testing and reporting on data quality of research datasets is more than compensated by its outputs. Benefits include quick detection and scrutiny of many sources of invalid and incomplete data. This process can easily be expanded to accommodate more standard tests.
Design and operation of a distributed health data network
Authors: Brown Jeffrey 
Published: September 2018

IntroductionSeveral large health data networks such as FDA Sentinel, PCORnet, and the Canadian Network of Observational Drug Effect Studies (CNODES) facilitate multi-site research using real-world electronic health data such administrative claims data, electronic health record data and registries. Experience in operation of mutliple health data networks will described.
Objectives and ApproachOver the past 15 years substantial progress has been made in developing the optimal network operational design, governance, and technical architecture to facilitate the creation and operation of large-scale distributed health data networks. The design, architecture, and operation of a sustainable health data network requires balancing the needs of the network stakeholders such as funders, data sources, investigators, and regulatory bodies while enabling rapid and efficient use of data to support evidence generation and decision making. Important topics include protection of patient privacy, security, data autonomy, distributed analytics, data quality, and protection of confidential information.
ResultsThe design and architecture of existing distributed health data networks provides guidance regarding the potential operational model for new networks and identifies areas of research to improve network functionality and capabilities. Most health data network adopt a common data model approach to facilitate multi-site querying and data quality assessment. This approach is coupled with distributed querying in which data partners maintain physical and operational control of their data. This design maximizes protection of confidential and proprietary information and minimizes the need to share patient-level data. Privacy-preserving distributed regression approaches and methods that obviate the need to share person-level data while generating robust results help to ensure network participation. Strong security and governance structures are also necessary for effective operation of a distributed network.
Conclusion/ImplicationsDistributed health data networks offer the opportunity to use real-world data for public health surveillance and comparative safety and effectiveness research across large populations. The operational design, technical and analytic architecture, and governance models of networks drive their acceptance and success.
Coding Agreement on Identification of Main Resource Use Using ICD-10 and ICD-11
Authors: Doktorchik Chelsea , Southern Danielle , Quan Hude , Eastwood Catherine 
Published: September 2018

IntroductionMain condition coding definitions in the International Classification of Disease (ICD) 10th and 11th versions are broadly defined in the current and upcoming versions of ICD, and coding health data can involve subjective coding specialist interpretation. Inconsistent coding can lead to inaccurate reporting, and lower quality data for research use.
Objectives and ApproachMain condition coding agreement was compared between ICD-10 and ICD-11. 730 hospital charts were randomly selected from Foothills Medical Centre in Calgary, Alberta. These charts were previously coded using ICD-10, and six professional coding specialists recoded them using ICD-11. To compare frequencies of ICD-10 to ICD-11, we used current WHO crosswalk tables to match codes. For any missing codes, manual comparison by done by a qualified reviewer. In Canada, the “main condition” is the clinically significant reason for the hospital visit. If multiple problems were present, the diagnosis using the greatest amount of resources is coded, “main resource use”.
ResultsOverall, 730 ICD-10 coded charts were analyzed. Of these charts, 79% (577) had matching resource coding between ICD-10 and ICD-11, and 21% (153) had mismatching coding. Matching coding was either considered an exact match between definitions (23.2%, 134), or similar but not identical (often one code has greater detail, 76.8%, 443). Mismatching codes were either due to different codes for similar conditions (13.1%, 20), different codes for not similar but related conditions (43.8%, 67), or completely different codes for unrelated conditions (43.1%, 66).
Conclusion/ImplicationsICD-10 and ICD-11 main resource codes had a high match frequency indicating consistency between coding practices and ICD definitions (577/730, 79%). Future research will aim to understand underlying causes of mismatched main resource use codes. This research will help us understand issues in coding and contribute to future ICD-11 revisions.
Understanding Patterns of Emergency Department (ED) Use over time in Ontario to plan new EDs for the future
Authors: Dvorani Erind , Graves Erin , Ishiguro Lisa , Schull Michael , Sivilotti Marco 
Published: September 2018

IntroductionThe Applied Health Research Question (AHRQ) portfolio is an initiative funded by the Ontario Ministry of Health and Long-Term Care, leveraging the linked data and scientific expertise at ICES to answer questions that directly impact healthcare policy, planning or practice.
Objectives and ApproachThe objective of this project was to evaluate historical patterns of emergency department (ED) use to better plan for a new emergency Department in Kingston and to better understand the factors contributing to increasing ED utilization.
Emergency departments across Ontario continue to see consistent increases in volume at rates exceeding expected volume growth due to population growth alone. Some hospitals across the province observe significantly higher volume increases compared to the provincial average.
ResultsFrom 2006/07 to 2016/17, rate and volume of emergency department visits in Ontario increased 8.82% and 19.87% respectively. Throughout the same period, emergency department visit rate and volume at Kingston General Hospital increased 20.70%, and 27.2%. Using historical data and projected population growth by age and sex, we were able to estimate that emergency department volume would increase at least 11.94% by 2025 due to estimated shifts in population size and distribution (by age and sex) alone. From 2006/07 to 2016/17, the greatest rate of increase in reason for ED visits was mental/behavioral problems. Throughout this period the increase in volume and rate of ED visits due to mental/behavioural problems was 274.46% and 259.59% respectively.
Conclusion/ImplicationsPopulation-specific volume projections and historical trends in ED use can be utilized for planning ED operations to improve efficiency and patient care quality. This has been used to inform the redesign of the ED at the Kingston Health Sciences Centre to ensure it will meet the needs of the community.
Identifying Knowledge Gaps with Administrative Health Data: A Cohort Study of Traumatic and Non-Traumatic Spinal Cord Injury in Alberta
Authors: Bakal Jeff , Ho Chester , McKenzie Nicole , Yeung Jack Man Shun 
Published: September 2018

IntroductionThe Spinal Cord Injury (SCI) population consists of two main sub-groups: traumatic (TSCI) and non-traumatic (NTSCI). TSCI has been studied; however less attention has been given to NTSCI. It is important to understand both SCI sub-groups for identification of knowledge gaps and subsequent health service planning.
Objectives and ApproachThe goal is to study the SCI population (both TSCI and NTSCI) in Alberta, Canada, leveraging recent administrative health data. It is difficult to identify NTSCI patients for their heterogeneous conditions, and relatively low prevalence. Consequently, we followed a validated algorithm using particular ICD-10-CA codes, to identify (and index) adult SCI patients from Ambulatory and Inpatient records between April 1, 2006 and March 31, 2016.
Indexed patients were linked to various databases (inpatient, ambulatory, physician claims, provincial insurance registry), and analyzed in multiple perspectives such as demographics patterns, deaths, resource and cost utilization, geographic distribution, and care equity between groups.
ResultsThrough 10 years of data we have identified 5217 SCI patients (3309 TSCI; 1908 NTSCI). 68.7% TSCI and 58.6% NTSCI are male. NTSCI patients are approximately 10 years older (46.3 TSCI; 54.5 NTSCI), and have a 3-point higher Charlson score. 1-year mortality in NTSCI is approximately 2.4 times the TSCI group.
Hospitalizations, ER visits, critical care time have also been examined. Patients with NTSCI had a higher median index LOS (14 days IQR (4-51)) compared to the traumatic group who had much higher variability (11 days IQR (11-65.5)). Noted 13.7% NTSCI patients and 19.5% TSCI do not have hospitalizations after index (a diverse characteristic of SCI). Resource Intensity Weights, physician billing, rural-urban area utilization have also been compared between the sub-groups.
Conclusion/ImplicationsWith the use of administrative databases and a validated algorithm, we described a diverse patient cohort with two main sub-groups (TSCI/NTSCI). Both groups were analyzed upon multiple topics and showed variations. Our results have provided updated knowledge of a comprehensive SCI population in Alberta, Canada, and may lead to improvements on care-giving model.
Integrating Local Government, Non-Profit and Social Service Agency Data to Understand Systems and Outcomes in a Large, Southeasten U.S. City
Authors: Lane Justin , Hill David 
Published: September 2018

IntroductionA central undercurrent between policymakers not being able to make totally informed decsions and non-profit leaders lacking knowledge to most effectively craft their services is the lack of data integration among organizations and across sectors.
Objectives and ApproachWe have 40+ data sharing agreements with local governmental agencies (school district, sheriff's office, DSS, Veteran Services, homeless services) and many local non-profit agencies. On an individual project basis, we integrate historical and longitudinally deposited data across datasets in order to research the effects of community initiatives and non-profts to understand the population they are serving and the outcomes assoicated with their services.
Many agencies lack the capacity for data cleanliness and structure, so we scrub and deposit their data on relational database on a secure server for future integration and investigation.
ResultsWe highlight two projects:

We completed a project for a local non-governmental, non-profit housing organization integrating data from 20+ data sharing agreements to investigate familial, individual, and childhood outcomes pre- and post- obtaining homeownership through this organization. This allowed the organization an in-depth, historical view of the effects that stable housing had on the recipients and their families, as well as how to tailor services for new families.
We integrate data from the school system, homeless information management systems, and non-proft services providers to understand the effects that family homelessness has on educational outcomes. This endeavor provided the community a report of the scope of local family homelessness as well educational outcomes of the students.

Conclusion/ImplicationsThrough the integration of seemingly disparate local governmental and social service provider datasets, we equip researchers, non-profit leaders, and policymakers to understand the effects of initiatives and redesign systems and/or reallocate resources.
Trends in Socioeconomic Inequalities in Hypertension in Ontario, Canada, 2000-2012
Authors: Shokar Simran , Rosella Laura , Smith Peter , Chen Hong , ChenManson Heather , Tu Jack , Smith Brendan 
Published: September 2018

IntroductionHypertension is leading risk factor for cardiovascular disease and mortality. Low socioeconomic position (e.g., income or high material deprivation) is an important risk factor for hypertension. However, there is limited evidence monitoring the extent to which socioeconomic inequalities in hypertension exist and are changing over time in Ontario.
Objectives and ApproachThe study objective was to estimate socioeconomic trends in prevalent hypertension by household income and material deprivation in Ontario from 2000 to 2012. A pooled cross-sectional study was conducted using data from 6 Canadian Community Health Surveys linked to the Discharge Abstract Database and Ontario Health Insurance Plan data (n=121,390 over 35 years, 54\% female). Relative-weighted Poisson regression models were used to estimate hypertension rates (adjusted for age, sex, ethnicity and immigration) across quintiles of equivalized household income and area-level material deprivation. Socioeconomic inequalities were estimated using the slope index of inequality (SII) and relative index of inequality (RII).
ResultsSocioeconomic inequalities in hypertension were observed across income quintiles on both absolute (SII: 1428 per 10,000, 95\%CI:1126,1730) and relative (RII:1.74, 95\%CI:1.53,1.94) scales in 2000, decreasing by 2012 (SII:297 per 10,000, 95%CI: -82,676; RII:1.19, 95%CI:0.93,1.45). A similar pattern was observed across material deprivation quintiles, however with smaller inequalities in 2000 (SII:595 per 10,000, 95%CI:306,884; RII:1.25, 95%CI:1.11,1.39) and 2012 (SII:389 per 10,000, 95%CI:17,761; RII:1.24, 95%CI:0.99,1.49).
Conclusion/ImplicationsSocioeconomic inequalities in hypertension were observed in Ontario, with decreasing trends between 2000 and 2012. Area-level material deprivation underestimated individual-level socioeconomic inequalities in hypertension.
Alberta's Data Mobilization Strategy: Leveraging Linked Data for Innovation
Authors: Svenson Larry , Simmonds Kimberley , Perry Alexa , Riemer Justin 
Published: September 2018

IntroductionThe Province of Alberta maintains a mature data ecosystem with linkable data dating back over 30 years. The population-based nature of the data makes this a valuable asset for driving analytics to support health system innovation, with a focus on improving health outcomes and quality of life.
Objectives and ApproachAlberta Health has created the Secondary Use Data Access (SUDA) initiative to leverage its administrative health data. SUDA envisions strengthening partnerships between the public and private sectors with two main access approaches. The first is direct access to de-identified data held within the Alberta Health data warehouse by key health system stakeholders (e.g. academic instituions, Health Quality Council of Alberta, regulatory colleges). The second is indirect access to private and not-for-profit stakeholders, using a safe haven approach. Indirect access is achieved through private sector investments to a trusted third party that hires analysts to be placed within Alberta Health.
ResultsStaffing agreements and privacy impact assessments have been drafted to support the work. The indirect access route includes a multiple stakeholder steering committee to vette and prioritize projects. Private and not-for-profit stakeholders do not have access to the data, but rather receive access to aggregate data and statitstical models. All disclosures are done by Alberta Health staff to ensure compliance with Alberta's Health Information Act. Direct access has been established for the Alberta Medical Association as part of a long standing data sharing agreement, with access restricted to de-identified data only. To date, seven industry proposals for analytics have been received and are currently being actioned.
Conclusion/ImplicationsThe Secondary Use Data Access initiative uses a safe haven approach to leveraging data. It reduces the need to provision data outside of the data warehouse and allows for better monitoring of access and use of data. The approach provides assurances that people's health information is secure.
Linking Provincial and Prospective Cohort Study Data to Estimate the Incidence and Healthcare Burden of Viral Gastroenteritis
Authors: Tarr Gillian AM , Freedman Stephen 
Published: September 2018

IntroductionAcute gastroenteritis (AGE) is a major cause of morbidity in children. While viruses are known to cause the largest proportion of illnesses, slow adoption of new technology and recommendations against routine testing have blunted our ability to estimate the impact of viral AGE on the health system.
Objectives and ApproachOur objective was to quantify the incidence of medically-attended norovirus and other viral AGE etiologic agents as a baseline for future norovirus vaccination programs. AGE cases were identified through the Alberta Provincial Pediatric EnTeric Infection TEam (APPETITE) study, December 2014-December 2017, which tested participants for five viruses: rotavirus, norovirus, adenovirus, astrovirus, and sapovirus. Study data was linked to provincial health registry data to identify visits associated with the AGE episode. Comparable visits for children throughout the province were identified, and a comprehensive set of potential confounders was evaluated and used to standardize APPETITE rates to the Alberta population.
ResultsAPPETITE received and tested specimens from 2,358 children with AGE presenting to the emergency department (ED) for care and 513 children with AGE whose parent or guardian called the provincial health advice line Health Link (HL). Norovirus was the most commonly detected pathogen, associated with 579 (24%) ED cases and 177 (19%) HL cases. After norovirus, the most common viruses were, in descending order: adenovirus (441 ED, 97 HL), rotavirus (408 ED, 88 HL), sapovirus (211 ED, 68 HL), and astrovirus (75 ED, 21 HL). Results for the incidence of viral AGE by etiologic agent, with the associated number of hospitalizations, ED visits, and primary care visits, will be available by the date of the IPDLN conference.
Conclusion/ImplicationsBy linking data from APPETITE with the visit data available because of Alberta’s single-payer system, we are able to provide population-based estimates of disease incidence for viral AGE, as well as the burden on the health care system in terms of the number of visits associated with these viral illnesses.