bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Change in Event Tourism: Developing Business Model for Sulayau Fabric as Community-Based Tourism Event Attraction
Authors: Zamzuri Norol Hamiza , Othman Abdul Kadir , Salleh Sharmila Mohamed , Hashim Hema Zulaikha , Rosman Rahman , Ghazali Rusmawati , Siew Len Jacqueline Koh , Syed Annuar Sharifah Norafizah 
Published: September 2024

This study explores the best model for community-based tourism events (CBTE) model with the inclusion of social innovation as part of the process. Producing Sulayau fabric is seen as a factor that contributes to the development of social innovation activities among the community in Sabah. Two workshops were conducted to empower communities to understand the use of the new social innovation tool known as Memating and gave support to those communities to improve the quality of their participation in tourism. Semi-structured interviews and observation were used as data collection techniques. The results revealed two interesting findings the need for using the social innovation tool of Memating in increasing efficiency among craft traders and the need for marketing strategies in creating visibility of Sulayau fabric in Sabah. Future studies are required for an empirical discussion in understanding how the role of social innovation shapes community-based tourism events.
Prevalence of dementia among people experiencing homelessness in Ontario, Canada: a population-based comparative analysis
Authors: Booth Richard , Forchuk Cheryl , Dasgupta Monidipa , Shariff Salimah 
Published: September 2024

BackgroundCognitive decline in people experiencing homelessness (PEH) is an increasingly recognized issue. We compared the prevalence of dementia among PEH to housed individuals in the general population and those living in low-income neighborhoods.
ApproachA population-based cross-sectional comparative analysis using linked healthcare administrative data from Ontario, Canada. We included individuals ≥45 years on January 1, 2019 who visited hospital-based ambulatory care (eg, emergency department), were hospitalized, or visited a Community Health Centre in 2019; and identified PEH if they had one or more healthcare records with an indication of homelessness or unstable housing. Prevalence of dementia was ascertained using a validated case definition for Alzheimer’s disease and related dementia. Poisson models were used to generate estimates of prevalence.
Findings12,863 PEH, 475,544 low-income comparators, and 2,273,068 general population comparators were assembled. Among these groups, dementia prevalence was 68.7, 62.6, and 51.0 per 1,000, respectively. Descriptively, prevalence ratios between PEH and the comparator groups were highest within the ages of 55-64 and 65-74 in both sexes, ranging from 2.98 to 5.00. After adjusting for age, sex, geographical location of residence, and health conditions associated with dementia, prevalence of dementia among PEH was found to be 1.71 (95% CI: 1.60–1.82) and 1.90 (1.79–2.03) times greater than the low-income and general population comparators, respectively.
InterpretationPEH experience high burden of dementia compared to housed populations in Ontario. Findings suggest that PEH may experience dementia at younger ages and may benefit from the development of proactive screening and housing interventions.
Factors influencing young people’s transitions from child to adult mental health services in Wales
Authors: Roberts Louisa , Wood Sophie , Wilkins David , Shelton Katherine 
Published: September 2024

ObjectivesThis presentation provides an overview of young peoples’ transitions from child to adult mental health services in Wales. Transitions are unstable times where need for support can be greatest, yet many young adults fail to qualify for ongoing specialist support. Young people with social care needs and/or living in poverty face an increased likelihood of mental ill health. These underlying factors of disadvantage are modifiable and can be considered ‘solution linked variables’ (O’Campo and Dunn, 2011) of particular relevance in public health policy development.
ApproachThis study positions intersectionality theory within a quantitative, secondary data methodology. Descriptive statistics and logistic regression models were used to elicit how social care need, deprivation, mental health diagnoses, gender and ethnicity might interact to influence likelihood of transition from child to adult mental health services. Sequence analyses developed pathway typologies from varying patterns of mental health service access.
ResultsNovel findings reflecting the interactional influences of differing social care need and area levels of deprivation on child to adult mental health service transitions will be presented alongside results controlling for gender, ethnicity and mental health diagnoses. The value of mapping typologies of mental health service use will be discussed in relation to the findings.
ConclusionsInterim findings suggest greatly increased mental health service use and differing patterns of access for young people with social care needs and/or living in the most deprived areas as they transition to adulthood. The implications for service development and delivery in times of unprecedented demand are explored.
Healthcare contact days for people with stage IV non-small cell lung cancer (NSCLC) in Ontario: A population-based study
Authors: Nguyen Paul , Gupta Arjun , Booth Christopher , Hanna Timothy 
Published: September 2024

BackgroundSurvival is limited with advanced NSCLC, and frequent healthcare visits can become all-consuming. We investigated patterns of contact days—days with any in-person healthcare contact as a measure of potential time toxicity—in a population-based sample.
MethodsWe created a population-based, retrospective cohort with health administrative data from Ontario, Canada, of adults with stage IV NSCLC in 2014-2017, dying 2014-2019. The primary outcome was contact days assessed from diagnosis to death. We stratified analyses by receipt, type and lines of systemic therapy administered. We plotted and fitted with cubic splines the weekly percentage of contact days to obtain trajectories over the disease course.
ResultsWe identified 5,785 stage IV NSCLC patients. The median (interquartile range [IQR]) survival was 108 days (49-426), and median percentage of contact days was 33.3%. Patients receiving systemic treatment had longer median survival (261 [152-420] vs. 66 [34-130] days) and lower median percentage of contact days (22.2% vs. 40.9%). Overall and for subgroups (systemic therapy vs. not; type and lines of therapy), trajectories followed a U-shaped distribution, with highest rates immediately following diagnosis and prior to death. The difference between the maximal peak and trough was greater in patients who received systemic therapy (peak 34.8% vs. trough 15.9%, ""deeper U"") vs. not (39.5% vs. 27.6%, ""shallower U"").
ConclusionStage IV NSCLC patients spent a significant proportion of days alive with healthcare contact. These data serve as a call to recognize patient time burdens, improve care efficiency, and better support patients during periods of high burden.
Applying Newly Identified Financially Focused Home Care Quality and Performance Indicators In Alberta's $23.5B/annum Health System - Preliminary Findings
Authors: Jajszczok Max , Quan Hude , Eastwood Catherine A , Lu Mingshan , Cunningham Ceara 
Published: September 2024

Through a multi-phased mixed-method research program including an international scoping review and a modified-Delphi panel with expert policy/academic/operational representatives from across Canada, three health-system, financially focused quality and performance home care indicators were identified.
This presentation will provide preliminary results of the application of the three financial indicators on overall health-system measures, system utilization and population outcomes within the province of Alberta. The time-period covered is the last five years data leading up to the start of the deceleration of the covid-19 global pandemic.
Based on provincial annual financial reporting, baseline 2016/17 fiscal year home care expenditures were $585K, this rose to significantly to $716M for fiscal year 2019/20, with the most significant increase (13%) occurred between the 2017/18 and 2018/19 years. Prior to 2016/17 home care expenditures increased at a rate less than 3%. These significant home care investments increased the percent of the overall expenditures in Alberta from 3.94 to 4.6%. Furthermore, the average annual expenditures per home care client rose from $5,417 to $6,112.
During this same time-period, numerous health-system indicators shifted to more favorable positions, with notable decreases in acute care days prior to death, number of those waiting in hospital for LTC, and preventing/delaying the need for LTC overall.
Based on comparisons of home care investments on the overall health-system and key health-system performance indicators focused on measuring system efficiencies, preliminary examinations suggest that significant home care focused investments in Alberta significantly improved health-system performance, efficiencies, and overall outcomes for the population.
Pragmatic Clinical Trials, Linkages and Agreements: Interjurisdictional Collaboration on Pragmatic Clinical Trials
Authors: Bakal Jeff , Youngson Erik , Garrison Scott 
Published: September 2024

The randomized clinical trial framework has proven to be a robust way of evaluating and comparing medications and procedures for many years. The promise of measured and unmeasured balance and equipoise through randomization remains very appealing. Emerging challenges for trialists have been diminishing returns in terms of effect sizes as treatments become more effective and the ever-growing costs associated with the operation of clinical trials.
The costs and operational overhead limit the ability of publicly funded trials to operate at a sufficiently robust level. Recently we have been working to engage clinicians and patients in pragmatic clinical trials which in part leverage routinely collected health system data to both provide an unbiased and effective means of obtaining high quality data for recruiting, randomization and outcomes.
As these trials have expanded between provincial jurisdictions, we have had to look for creative solutions to assembling and sharing data in order to reach the trial goals. This presentation will examine some of the technical and logistical challenges that we have faced, how they have been addressed and the path forward for clinical trials.
Occupation exposure to coal dust and vulnerability to Influenza: Scottish miners and the 1918 Influenza Pandemic.
Authors: Dibben Chris , Williamson Lee , Reid Alice , Garrett Eilidh , Christen Peter , Nanayakkara Charini 
Published: September 2024

ObjectiveThere has been little work on the high level of mortality, noted that the time, in coal mining areas during the 1918 Influenza pandemic. Increased risk during viral infection from exposure to particulates (eg cigarette smoke, air pollution) has been studied.
ApproachWe use the historic administrative data for Scotland, 1900 to 1930, with standardised codes for occupation and cause of death, and a pseudo household design and Quasi Poisson models, where the spouses of miners are their controls, to test whether miners (aged 20 to 50) were more at risk of death during the main waves of the 1918 pandemic than a matched population. Secondly, we repeat the analysis for Labourers to test if [1] Sex or [2] hard labour and for clerks, if [3] Pulmonary Tuberculosis might explain the effect.
ResultsWe find that miners compared to their spouses were significantly more likely to die during all waves of the pandemic but considerably more so during the Autumn wave (RR 4.7). This difference was even greater for younger miners (20 to 35) (RR 7.6). In contrast labourers and clerks had a much lower and often non-significant comparative risk of death during all waves than their spouses. This was true even for those aged 20-35.
ConclusionsMale coal miners appear to have been at much higher risk of death compared to matched populations.
ImplicationsWorkers with exposure to airborne particulates should be a priority for public health planning during periods of high virus infections.
Trends in incidence of self-harm, neurodevelopmental and mental health conditions among university students compared to the general population: a nationwide electronic data linkage study in Wales.
Authors: Rouquette Olivier , Lee Sze Chim , Smith Jo , Del Pozo Banos Marcos , John Ann 
Published: September 2024

Objective and ApproachThey are growing concerns that self-harm and mental health conditions are increasing in university students. This may reflect widening access to higher education, existing population trends or stressors associated with this setting. We linked real-world data from the Higher Education Statistics Agency between 2012-2018 with primary and secondary healthcare records. Students were undergraduates aged 18 to 24 years at university entry. Non-students were pseudo-randomly selected based on an equivalent age distribution. We used regression approach to examine characteristics of students and non-students and their risks of self-harm and mental health conditions before and during university.
ResultsThis e-cohort study included 96,760 students and 151,795 non-students. Being male, self-harm and mental-health conditions recorded before university entry, and higher deprivation levels resulted in lower odds of entering university and higher odds of dropout. Risks of self-harm, Autistic Spectrum Disorder (ASD), depression, anxiety, drug misuse, and schizophrenia were lower for students. Risks of self-harm, ASD, ADHD, depression, alcohol misuse and schizophrenia were increasing more in students over time. Older students experienced higher risk of self-harm and mental-health conditions. Younger students were more at risk of alcohol misuse than non-students.
ConclusionsMental health conditions in students are common, diverse and they influence their academic outcomes. University students have mental health needs and trajectories that differ from those of the general population.
ImplicationsThe diversity and complexity of students’ needs require integrated person-centred stepped care approach within universities including triage, access to well-being support, counselling, and referral pathways to mental health services.
Improving transparency and quality assurance: Operationalising semi-automated data provenance tracking in a Trusted Research Environment
Authors: O'Sullivan Katherine , Markovic Milan , Dymiter Jaroslaw , Martin Adrian , Odo Chinasa , Rowlands Helen , Ciocarlan Ana , Wilde Katie , Casey Arlene 
Published: September 2024

We present a prototype solution for improving transparency and quality assurance of the data linkage process through a data provenance dashboard designed to assist data analysts, researchers and information governance teams in authenticating and auditing data workflows within a trusted research environment (TRE). Building on prior research (Scheliga, et al., 2022), this work describes our first operationalised prototype tested in a real-world setting.
The prototype development involved four stages: (1) Co-design of interfaces with end users for provenance data collection and visualisation, producing a low-fidelity design; (2) Extension and refinement of the Safe Haven Provenance (SHP) ontology (https://tre-provenance.github.io/SHP-ontology/releases/v0.2/index-en.html); (3) Design and implementation of mechanisms for semi-automated collection of data linkage provenance using the SHP ontology; (4) Implementation and user evaluation of the dashboard.
A participatory design process with data analysts, researchers and information governance teams resulted in a low-fidelity prototype and was validated via public consultations to ensure it met public trust. The resulting prototype dashboard (https://tre-provenance.github.io/) was built as an offline desktop app to match the deployment TRE requirements. The interactive dashboard displays the data linkage information extracted from a knowledge graph described using the SHP ontology (e.g., modifications of datasets, data release) and results of rule-based validation checks (e.g., checking extracted data against researchers' specification). User evaluations confirmed the dashboard would contribute to better quality of data linkage.
This project demonstrates the next stage in advancing transparency and quality assurance within TREs by semi-automating and systematising data tracking from ingress to egress in a single tool.
AD|ARC (Administrative Data Agri-Research Collection): Comparative analysis of highest educational qualification in Welsh households receiving a farming subsidy with rurality-matched control households, using 2011 UK Census data.
Authors: Addison Katy , Morrison-Rees Sian , Caskie Paul , Crowley Liam , Madden Laura , Scully Sean 
Published: September 2024

Objective To investigate highest level of educational attainment in farming households compared to rural non-farming households in Wales.
Approach We used the AD|ARC dataset of households in Wales receiving farming subsidies in 2010.
We included farming households containing at least one member reporting an Agricultural Main Occupation (AMO) and households where all members reported Non-Agricultural Main Occupations (Non-AMO) but farming occurs.
Utilising Census 2011 variables relating to age, gender, education and occupation we conducted comparative analyses of educational attainment within AMO, Non-AMO and non-farming rural households at both an individual and household level.
ResultsFindings will be presented comparing the educational attainment for AMO individuals with matched individuals within Non-AMO and non-farming rural households. At the household level, we calculated the highest level of education attained within each household and will present results comparing the highest household level of education between each group. We will present detailed results regarding the structure and educational attainment within these households.
Full results and findings will be presented at the conference but are currently subject to information governance restrictions.
ConclusionOne indicator of resilience amongst farmers and farm households is ability to respond to economic and non-economic pressures by adopting new practices and techniques or reducing reliance on farming via diversification or off-farm employment. As educational attainment is closely correlated to acquisition of skills and is a gateway to employment, understanding relative and absolute levels of attainment is important in identifying need and devising policies which support agricultural and rural communities.
Mapping domains of early-life determinants of future multimorbidity across three UK longitudinal cohort studies.
Authors: Stannard Sebastian , Berrington Ann , Fraser Simon , Paranjothy Shantini , Hoyle Rebecca , Owen Rhiannon , Akbari Ashley , Shiranirad Mozhdeh , Chiovoloni Roberta , Alwan Nisreen 
Published: September 2024

ObjectivesMany studies use a reductionist approach to isolate the influence of one factor in childhood on multimorbidity rather than consider the combined effect of wider determinants. We aimed to explore how potential multiple early-life determinants of multimorbidity can be audited and characterised across three UK cohort studies.
ApproachWe used the 1958 National Child Development Study (NCDS), the 1970 British Cohort Study (BCS70), and the Aberdeen Children of the 1950s Study (ACONF) to identify and categorise early-life variables that fit into 12 previously conceptualised domains of early-life determinants of multimorbidity. A data audit manually assigned variables into the domain they best represented. Principal component analysis (PCA) reduced the dimensionality of the data and structured variables into subgroups. Important PCA components defined as the component that contributed the greatest proportion of the overall variance were identified.
ResultsSeven domains were characterised by 74 variables in ACONF, ten domains by 143 variables in the NCDS, and twelve domains by 289 variables in the BCS70. PCA analysis reduced the dimensionality of ACONF variables from 74 to 41, from 143 to 73 in the NCDS, and from 289 to 149 in the BCS70. Important PCA components included maternal fertility histories, long-term illnesses, educational ability, ethnicity, housing status and parental-child interactions.
Conclusions and ImplicationsConceptualising the risk of future multimorbidity as lifecourse domains composed of multiple factors can help challenge the existing understanding of disease aetiology and inform strategies for the prevention of multimorbidity.
Understanding the developmental well-being of children from refugee backgrounds in British Columbia, Canada: A population-level mixed methods approach
Authors: Gadermann Anne , Guhn Martin , Poon Brenda , Janus Magdalena , Edwards Benjamin 
Published: September 2024

Objectives and ApproachThis study utilized an explanatory sequential mixed methods approach to investigate the developmental well-being of children from refugee backgrounds in British Columbia (BC), Canada. Objective 1 (quantitative) leveraged population-level, government administrative data individually linked to a province-wide, routinely collected, teacher-reported measure of children’s development in kindergarten (the Early Development Instrument; EDI) to examine developmental outcomes across five domains for children identified as first-generation refugees (N=770), first-generation immigrants (N=7875), and non-migrants (N=199,186). In Objective 2 (qualitative), the population-level EDI results were brought to focus groups with BC educators and settlement workers (N=7) who work closely with children from refugee backgrounds to further corroborate, expand, and elaborate on the findings.
ResultsA series of multiple linear regression models; adjusted for age, sex, and English Language Learner status showed that first-generation refugee status was significantly predictive of lower EDI scores in the areas of language & cognitive development, communication & generation knowledge, social competence, emotional maturity, and physical health & well-being. Focus group results corroborated the quantitative findings, added critical complexity/context (e.g., impacts of trauma), and identified important policy-oriented levers (e.g., early, accessible assessments and supports).
ConclusionsThe study provided an understanding of the population-level developmental well-being of children from refugee backgrounds in BC, framed by rich, contextualized, and actionable knowledge from focus groups.
ImplicationsShowcasing the combined breadth and depth of using a mixed methods approach, how we can best support the developmental challenges and build upon the strengths of children from refugee backgrounds will be discussed.