Finola Ferry, Ronald McDowell, Jamie Murphy
et al.
Objectives
Trajectories of social mobility may be a more informative predictor of health than point-in time analyses. We sought to identify area-level deprivation trajectories within the Northern Ireland (NI) population and their associations with mortality; receipt of psychotropic medication; and Accident and Emergency (A&E) attendance.
Methods
The spine of the study was the NI population registered with a General Practitioner (GP) in 2010. The study period was split into two parts. In the first part (2010-2016), Latent Class Growth Analysis (LGCA) was used to identify distinct trajectories (classes) in area-level deprivation as measured by the NI Multiple Deprivation Measure. In the second part (2017-2021), the relationship between the latent classes and adverse health outcomes (all-cause mortality; receipt of psychotropic medication; presentations to A&E departments) was modelled using discrete time series analysis and hurdle models, adjusting for confounding variables.
Results
Using data of 1.7 million individuals, we identified seven social mobility classes: three stable, two upwardly mobile and two downwardly mobile. Upward mobility was associated with reduced risk of all outcomes compared to the consistently deprived; while downward mobility was associated with higher risk compared to the consistently non-deprived. For example, the least deprived were less likely to attend A&E and attended less frequently compared to the consistently deprived (OR 0.72: 0.72,0.73; IRR 0.71: 0.70,0.72). An approximate dose-response relationship was observed across classes, with lower ‘endpoint’ deprivation associated with lower risk of adverse outcomes. The exception was the ‘substantial upward mobility’ class, with risk of poor outcomes second highest despite improved deprivation rank (e.g. any A&E attendance (OR 1.01: 0.99,0.94); yearly rate (IRR: 0.94 (0.93,0.96)).
Conclusion
Although social mobility influences health, the effects are more nuanced than generally recognised. While continuous residence in deprived neighbourhoods is associated with poor health, upward mobility may not ameliorate this phenomenon. The residual effects of residence in deprived areas underline the importance of ‘front-loading’ of resources early in the life-course.
Richard Silverwood, Gergo Baranyi, Lisa Calderwood
et al.
Objectives
Analyses of population administrative data can often only be minimally adjusted due to the unavailability of a full set of control variables, potentially leading to bias due to residual confounding. We aimed to use linked cohort data to help address residual confounding in analyses of population administrative data.
Methods
We propose a multiple imputation-based approach, introduced through application to simulated data in three different scenarios related to the structure of the datasets. We then apply this approach to a real-world example – examining the association between pupil mobility (changing schools at non-standard times) and Key Stage 2 (age 11) attainment using data from the UK National Pupil Database (NPD). The limited control variables available in the NPD are supplemented by multiple measures of socioeconomic deprivation captured in linked Millennium Cohort Study (MCS) data.
Results
The proposed approach is observed to perform well when using simulated data across the different scenarios. The association between pupil mobility and Key Stage 2 attainment was attenuated after supplementing the NPD analysis with information from linked MCS data, though with a decrease in precision.
Conclusion
We have demonstrated the potential of the proposed approach. More work is required to understand how it can be applied more broadly. The principles underlying this innovative approach are widely applicable: any analysis of administrative data could potentially be strengthened by linking a subset of individuals into richer cohort data.
Nowadays, the topic of CO2 emissions has been a subject of intensive debate. There is a significant policy push toward reducing emissions that cause air pollution and other environmental concerns. The aim of this paper is to analyze the CO2 emissions as well as economic growth along with renewable energy use and the level of urbanization in the selected World countries in the period of 1995-2018. In general, almost all of the Northern part of the World was characterized by a high level of CO2 emissions, while the majority of African territory was the least polluted. The empirical result shows that the growth rate of air pollution is much higher in countries that initially had a low level of CO2 emissions, so the convergence process occurred. Conditioning convergence with the renewable energy use and the urbanization level indicates that its speed is higher. Club convergence analysis has proved that well-developed regions in terms of GDP per capita are able to improve the ecological situation despite further economic growth.
After obtaining the German upper secondary school-leaving certificate (Abitur), school-leavers are free in their choice of career path. Obtaining a double qualification by first completing an apprenticeship and then graduate from university is thereby popular. Using the BIBB/BAuA Employment Survey of the Working Population on Qualification and Working Conditions 2018, this paper analyses the individual effects of these double qualifications by exploiting the rich information on education in the data. In relation to earlier studies, we find that the proportion of men gaining a double qualification decreased by 8 percentage points but is almost constant for women. Furthermore, we detect a significantly negative effect of double qualification on wages for women, but no significant effect on wages for men. We presume that these changes may be related to the rising inequality due to the rising number of academics and the increase of earnings inequality.
Alexandra Dalton, Emily Ennis, Melinda Green
et al.
Introduction & Background
Food production is a substantial contributor to greenhouse gas emissions and climate change. A more sustainable diet is often a healthier one, so making lower carbon food choices serves to benefit the planet and person. In order to understand the carbon footprint of food choices, linkage of recipe information to carbon footprint data and transaction records is required. To inform positive change insights from data linkage must be communicated to the target audience, in this case schoolchildren.
Objectives & Approach
School dinner recipe information and transaction records for school meals at five schools for a six week period were acquired. Carbon footprint estimates were calculated for each recipe, using published data. An automated dashboard was created in order that these calculations could be replicated by catering teams. Carbon footprints were appended to the school transaction records for meal choices. An interactive web game was created in ‘top trump’s' style using a selection of the recipes, with carbon footprint and popularity ranking, generated from the transaction records.
Relevance to Digital Footprints
Transactional meal sales data from schools are digital footprint data. In this work we link these digital footprint data to detailed recipe information with estimated carbon footprints from an open data source.
Results
The Consumer Data Research Centre Carbon Calculator and The Planet Plates game were created. The Carbon Calculator is being used in a number of settings to support food procurement and recipe development. The Planet Plates game has been used in Leeds Schools to empower schoolchildren to make positive changes to lower the carbon footprint of their meal choices. The children were engaged with all the activities and not only learned about sustainability of their food choices, but about how data they generate can be used anonymously for public good.
Conclusions & Implications
Data linkage of digital footprint data is a powerful tool for behaviour change to tackle some of the world’s most pressing challenges. Methods and insights should be shared widely and made accessible to a range of stakeholders wherever possible.
In the attempt to build theoretical frameworks that synthesize the explanations given for changes in epidemiological profiles throughout history, the theory of epidemiological transition arises. Many have been the questions made to this theory, among them those made by Frenk et al. (1991a) who point to the idea of an alternative transition model for Latin America, called polarized-prolonged. Through the verification of the hypotheses of this transition model, the structure of the causes of death in Venezuela is analyzed in the consideration of the urban bias, during the years 2000 to 2010. For this, correlations are used (bivariate and partial) and simple regressions of the standardized mortality rates of the population aged 5 and over. The results obtained indicate the approach to the proposed model in the structure and evolution of the epidemiological profile in Venezuela. Despite the variations between the sexes, the differentials introduced by urbanization explain much of the polarization and overlap of stages found in the profile.
Social Sciences, Demography. Population. Vital events
Babak Jahanshahi, Duncan McVicar, Neil Rowland
et al.
Objectives
This paper links prescriptions data for the Northern Ireland population with data from the Northern Ireland Longitudinal Study and localized ambient air pollution data from 2002 onwards to estimate the association between long-term exposure to ambient air pollutant from fine particulates (PM2.5) and Parkinson’s Disease (PD).
Approach
Cox Proportional Hazards models are used to examine the impact of air pollution on PD, first unconditionally, and then conditioning on a rich set of observable individual, family and contextual characteristics. Long-term exposure to PM2.5 is defined as exposure averaged over the previous 5 years. Onset of PD is proxied by first receipt of a prescription for PD medication. Estimates are presented in the form of hazard ratios for the effect of long-term PM2.5 exposure on the risk of PD onset.
Results
There is a non-trivial magnitude and statistically significant unconditional association between long-term exposure to ambient PM2.5 pollution and receiving a prescription for PD, with those exposed to higher levels of pollution more likely to receive a prescription for PD. This estimated association disappears (becomes insignificantly different from zero), however, when the model accounts for confounding variables at household, individual and geographical levels.
Conclusions
This study contributes to an emerging literature examining the association between ambient PM2.5 pollution and onset of PD. Despite finding an unconditional association, we find no evidence for an association once individual, family and contextual characteristics are controlled for, at least in the relatively low-pollution context of Northern Ireland.
Objectives
Scotland has an established Trusted Research Environment (TREs) through the Scottish Safe Haven Network. These Safe Havens traditionally service structured datasets, however, researchers increasingly require access to large multi-modal linked datasets that include medical imaging. We therefore introduced an equivalent to access anonymised NHS images and reports.
Approach
A pan-Scotland collaboration of 15 partners from industry, NHS, and academia, collaborated to design and deploy a Safe Haven equivalent for SMEs and researchers interested in accessing anonymised NHS imaging and reports to allow them to develop, test, and validate AI algorithms for greater patient benefit. Two Safe Haven sites, worked with a leading medical software research and development team, to deliver a secure analytical platform for the research and development of AI for medical applications.
Results
The Safe Haven Artificial Platform (SHAIP) is designed to support development of sophisticated AI components and has been used by several SME’s to undertake exemplar projects in stroke, breast screening, and x-ray interpretation for limb fracture and chest. These researchers were supported by the Safe Haven’s governance processes. SHAIP became the first research environment to be directly linked to the Scottish National PACS archive. Access was provided to project specific deidentified images using ‘Hidden in plain sight’; a privacy and data-structure preserving technique. The researchers were able to upload virtual-machines, or ‘dockers’, to bring their toolsets to their research workspaces. An annotation capability was provided to support ground-truth development for machine learning.
Conclusion
The project has shown we can pull large scale medical images and reports into a TRE in such a way NHS Boards are reassured by our methods, creating a safe analytical platform for AI development that will benefit patient care by providing faster, cheaper and more accurate solutions.
Objectives
Research using unconsented healthcare data has the potential to have significant public benefit in terms of improved health outcomes. However, due to the sensitive nature of this data, appropriate governance, approvals, and mitigations are crucial to ensure that patient confidentiality and public trust are maintained.
Approach
As the permissions process can be a barrier to research, we established a local Governance Forum with the aim to streamline processes, increase transparency, and document approval requirements. Governance Forum membership includes representatives from the relevant health board and university departments (e.g., the regional Safe Haven, Information Governance, Ethics Committee, Data Protection, Research and Development). To achieve the Forum’s objectives, the regional Safe Haven raises current and potential project scenarios at quarterly meetings to confirm requirements and help develop a clear understanding of the approval pathway, with specific topics discussed with the relevant members out with these meetings as required.
Results
The Forum has strengthened communication and collaboration with Forum members which has enabled the Safe Haven to better support researchers. Outputs have included a permission pathway guidance document for researchers. This initial guidance document outlines approval requirements and provides relevant advice and support, with work currently ongoing to build on and improve this. In addition, as channels have been established for onboarding new project types and novel datasets, the diversity of datasets available for research is increasing and the route to approvals is now clearer for both researchers and internal teams. The Governance Forum activity has the potential to facilitate future research which may lead to academic publications and research funding, as well as improved health outcomes and policy change in the longer-term.
Conclusion
Although the progress so far has had significant impacts, the approval processes remain challenging for certain projects. Therefore, it will be imperative that sufficient resources are available in the future to ensure that further progress can be made via the Governance Forum as well as national initiatives.
Eduardo Jiménez López, Carlos Garrocho Rangel, Tania Chávez Soto
Combinamos geografía urbana, matemáticas de sistemas dinámicos, sistemas de información geográfica (SIG) y ciencias computacionales para diseñar una metodología de modelado de carácter general fundamentada en Autómatas Celulares en Cascada, que permite construir modelos específicos de la expansión de ciudades mexicanas. Sometemos nuestra metodología a una triple prueba empírica en ciudades con características contrastantes. Los modelos consideran restricciones a la expansión urbana (vialidades, parques, etc.). Utilizamos indicadores de bondad de ajuste global y local entre imágenes, articulados en un filtro en cascada, lo que reduce el procesamiento computacional. Los modelos mostraron ajustes alentadores.Ilustramos cómo nuestro método puede impulsar el codiseño de políticas urbanas.
Human settlements. Communities, Demography. Population. Vital events
Christian Haux, Frank` Gabel, Anna-Lena Trescher
et al.
ABSTRACT
Objectives
The multi-country-EU project ADVOCATE (Added Value for Oral Care) involves the analysis of routinely collected oral health care records from health insurance systems in six European countries, including NHS England and NHS Scotland. The data will be stored in a in a central repository using AnalytiXagility which adheres to strict privacy and security standards. Therefore, data usage agreements must be consented with all partners and being subjected to specific regulations in the respective nation. This will result in different aggregation levels for data integration, e. g. one of the partners does not allow the transfer of data that contain a personal identifier. To understand the variety of requirements and limitations in different countries, we performed a qualitative content analysis of the agreements.
Approach
A categorisation system for privacy and data protection aspects was developed. The aspects are based on privacy conditions mentioned in guidance documents, the agreements themselves and the project’s proposal. The agreements were examined for textual elements and systematically coded by three reviewers. Compliance between privacy conditions and the agreements was estimated using a nominal scale, whether the context was available in the agreement or not. The software MAXQDA was used for tagging relevant text passages.
Results
The initial coding scheme contains eight categories on top-level. They include, inter alia, aspects on data access, -preparation, -transmission, and -usage. The top-levels divide in up to four different levels of detail. The coding system was continuously adapted during full-text analysis. Initially, the agreements from the partners of Denmark and Germany were used. Characteristics in the agreements require a fine granularity of sub-categories. The German agreement, for example, names the whole institution as partner, whereas the Danish agreement differentiates in personal roles, each with own responsibilities.
Conclusion
Undertaking an overview of privacy conditions can be a valuable step in comparing privacy and security requirements in different national regulations. The qualitative content analysis was found a suitable approach for this purpose because it enables the detection of fine characteristics. By using an incremental design, it is possible to adapt the coding system to include additional partners. However, the current coding system has the limitation that heterogeneity between the agreements leads to a fine granularity of categories that hamper the comparability between partners. Despite these problems, the approach allows the comparison of data privacy and supports the development of a data integration process for international harmonisation.
Более половины умерших в России в 2011-2014 гг. были подвергнуты патологоанатомической или судебно-медицинской аутопсии, из них в 3,8% случаев причина смерти не была определена. Произведено более 147 тыс. безрезультативных вскрытий, оставивших причину смерти неустановленной. Большое число случаев не позволяет объяснить данный итог состоянием тел умерших в момент вскрытия. Еще 161 тыс. смертей (4,1% вскрытий) были классифицированы как повреждение с неустановленным намерением. В статье предпринята попытка найти рациональное объяснение высокой доли неопределенных заключений о причине смерти, полученных в результате аутопсии.
Анализ на макроуровне (субъекты Федерации) с привлечением факторного анализа и методов кластеризации сочетается в статье с анализом на микроуровне (анонимные индивидуальные записи) с использованием мультиноминальной логистической регрессии. Статья целиком основана на данных российской государственной статистики.
Обнаружены существенные межрегиональные различия в практике определения причины смерти на основе аутопсии. Практика диагностики внешних причин также сильно различается по регионам. При этом в регионах, где выше доля неустановленных причин, выше и доля повреждений с неустановленными намерениями. Эти различия не связанны с особенностями смертности населения региона.
Проделанный анализ позволил предположить, что частота случаев, когда по итогам вскрытия причина смерти остается неустановленной, связана с отсутствием стимулов к уточнению причины смерти после выдачи предварительного свидетельства о смерти.
Кроме того, существующая система взаимоотношений между бюро судебно-медицинской экспертизы и правоохранительными органами не предусматривает ознакомление судмедэксперта с окончательными выводами дознавателя о внешней причине смерти.
Число судебно-медицинских вскрытий умерших от болезней с 2011 по 2014 г. выросло на 20%, но возникают сомнения, что полученная по итогам вскрытий информация эффективно используется системой здравоохранения.
Contemporary transformations of rural areas involve changes in land uses, economic perspectives, connectivity, livelihoods, but also in lifestyles, whereupon a traditional view of 'the rural' and, consequently, of 'rural development' no longer holds. Accordingly, EU's 2007-2013 Rural Development policy (RDP) is one framework to incorporate aspects labelled as quality of life (QOL) alongside traditional rural tenets. With a new rendition of the RDP underway, this paper scopes the content and extent of the expired RDP regarding its incorporation of QOL, in order to better identify considerations for future policy making. Using novel methodology called topic modelling, a series of latent semantic structures within the RDP could be unravelled and re-interpreted via a dual categorization system based on RDP's own view on QOL, and on definitions provided by independent research. Corroborated by other audits, the findings indicate a thematic overemphasis on agriculture, with the focus on QOL being largely insignificant. Such results point to a rationale different than the assumed one, at the same time reinforcing an outdated view of rurality in the face of the ostensibly fundamental turn towards viewing rural areas in a wider, more humanistic, perspective. This unexpected issue of underrepresentation is next addressed through three possible drivers: conceptual (lingering productionist view of the rural), ideological (capitalist prerogative preventing non-pecuniary values from entering policy) and material (institutional lock-ins incapable of accommodating significant deviations from an agricultural focus). The paper ends with a critical discussion and some reflections on the broader concept of rurality.
Nadia Huitzilin Jiménez Torres, Sonia San Martín Gutiérrez
Pese a que el 80% de la población del mundo vive en mercados emergentes y países en desarrollo, como México, la investigación sobre el consumidor de estos países ha sido insuficiente. El objetivo de este estudio es determinar el perfil del consumidor mexicano en función de variables psicosociológicas como el etnocentrismo, la apertura cultural, el patriotismo, el colectivismo y las características demográficas. Con este propósito se recogió la información de una muestra de 274 consumidores, se realizaron un análisis factorial de sus principales componentes y un análisis cluster con el cual se aglomeró a los individuos en tres grupos con diferentes perfiles psicosociológicos y demográficos.
Human settlements. Communities, Demography. Population. Vital events