Adjusting for under-identification of Aboriginal and/or Torres Strait Islander births in time series produced from birth records: Using record linkage of survey data and administrative data sources

Background: Statistical time series derived from administrative data sets form key indicators in measuring progress in addressing disadvantage in Aboriginal and Torres Strait Islander populations in Australia. However, inconsistencies in the reporting of Indigenous status can cause difficulties in producing reliable indicators. External data sources, such as survey data, provide a means of assessing the consistency of administrative data and may be used to adjust statistics based on administrative data sources. Methods. We used record linkage between a large-scale survey (the Western Australian Aboriginal Child Health Survey), and two administrative data sources (the Western Australia (WA) Register of Births and the WA Midwives Notification System) to compare the degree of consistency in determining Indigenous status of children between the two sources. We then used a logistic regression model predicting probability of consistency between the two sources to estimate the probability of each record on the two administrative data sources being identified as being of Aboriginal and/or Torres Strait Islander origin in a survey. By summing these probabilities we produced model-adjusted time series of neonatal outcomes for Aboriginal and/or Torres Strait Islander births. Results: Compared to survey data, information based only on the two administrative data sources identified substantially fewer Aboriginal and/or Torres Strait Islander births. However, these births were not randomly distributed. Births of children identified as being of Aboriginal and/or Torres Strait Islander origin in the survey only were more likely to be living in urban areas, in less disadvantaged areas, and to have only one parent who identifies as being of Aboriginal and/or Torres Strait Islander origin, particularly the father. They were also more likely to have better health and wellbeing outcomes. Applying an adjustment model based on the linked survey data increased the estimated number of Aboriginal and/or Torres Strait Islander births in WA by around 25%, however this increase was accompanied by lower overall proportions of low birth weight and low gestational age babies. Conclusions: Record linkage of survey data to administrative data sets is useful to validate the quality of recording of demographic information in administrative data sources, and such information can be used to adjust for differential identification in administrative data

Negotiating the EU data protection reform: reflections on the household exemption

The re-drafting of the household exemption comprises one of the main areas of dispute in the ongoing negotiations for the EU data protection reform. The aim of this paper is twofold: First, we present and critically assess the wording proposals that have been put forward mainly at EU institutional level and identify the particular areas which cause tension. Second, we concomitantly ask which is the most appropriate wording for the exemption in question and in particular, whether the household exemption should comprise a set of decisive criteria or whether it should provide a more general framework. We eventually argue for a broad wording of the Article 2(2)(d) coupled with the addition of further non-determinative criteria at Recital 15, i.e. the non-operative part of the proposed Regulation

The Structure of Stellar Coronae in Active Binary Systems

A survey of 28 stars using EUV spectra has been conducted to establish the structure of stellar coronae in active binary systems from the EMD, electron densities, and scale sizes. Observations obtained by the EUVE during 9 years of operation are included for the stars in the sample. EUVE data allow a continuous EMD to be constructed in the range log T~5.6-7.4, using iron emission lines. These data are complemented with IUE observations to model the lower temperature range. Inspection of the EMD shows an outstanding narrow enhancement, or ``bump'' peaking around log T~6.9 in 25 of the stars, defining a fundamental coronal structure. The emission measure per unit stellar area decreases with increasing orbital (or photometric) periods of the target stars; stars in binaries generally have more material at coronal temperatures than slowly rotating single stars. High electron densities (Ne>10^12 cm^-3) are derived at ~10 MK for some targets, implying small emitting volumes. The observations suggest the magnetic stellar coronae of these stars are consistent with two basic classes of magnetic loops: solar-like loops with maximum temperature around log T~6.3 and lower electron densities (Ne>10^9-10.5), and hotter loops peaking around log T~6.9 with higher electron densities (Ne>10^12). For the most active stars, material exists at much higher temperatures (log T>6.9) as well. However, current ab initio stellar loop models cannot reproduce such a configuration. Analysis of the light curves of these systems reveals signatures of rotation of coronal material, as well as apparent seasonal changes in the activity levels.Comment: 45 pages, 9 figures (with 20 eps files). Accepted for its publication in ApJ

Unravelling the nature of HD 81032 - a new RS CVn Binary

BVR photometric and quasi-simultaneous optical spectroscopic observations of the star HD 81032 have been carried out during the years 2000 - 2004. A photometric period of $18.802 \pm 0.07$ d has been detected for this star. A large group of spots with a migration period of $7.43 \pm 0.07$ years is inferred from the first three years of the data. H$\alpha$ and Ca II H and K emissions from the star indicate high chromospheric activity. The available photometry in the BVRIJHK bands is consistent with spectral type of K0 IV previously found for this star. We have also examined the spectral energy distribution of HD 81032 for the presence of an infrared colour excess using the 2MASS JHK and IRAS photometry, but found no significant excess in any band abovethe normal values expected for a star with this spectral type. We have also analyzed the X-ray emission properties of this star using data obtained by the ROSAT X-ray observatory during its All-Sky Survey phase. An X-ray flare of about 12 hours duration was detected during the two days of X-ray coverage obtained for this star. Its X-ray spectrum, while only containing 345 counts, is inconsistent with a single-temperature component solar-abundance coronal plasma model, but implies either the presence of two or more plasma components, non-solar abundances, or a combination of both of these properties. All of the above properties of HD 81032 suggest that it is a newly identified, evolved RS CVn binary.Comment: 18 pages, 10 figures, 3 tables, Accepted for the publication in JAp

Effect of intravenous clarithromycin in patients with sepsis, respiratory and multiple organ dysfunction syndrome: a randomized clinical trial.

Clarithromycin may act as immune-regulating treatment in sepsis and acute respiratory dysfunction syndrome. However, clinical evidence remains inconclusive. We aimed to evaluate whether clarithromycin improves 28-day mortality among patients with sepsis, respiratory and multiple organ dysfunction syndrome. We conducted a multicenter, randomized, clinical trial in patients with sepsis. Participants with ratio of partial oxygen pressure to fraction of inspired oxygen less than 200 and more than 3 SOFA points from systems other than the respiratory function were enrolled between December 2017 and September 2019. Patients were randomized to receive 1 gr of clarithromycin or placebo intravenously once daily for 4 consecutive days. The primary endpoint was 28-day all-cause mortality. Secondary outcomes were 90-day mortality; sepsis response (defined as at least 25% decrease in SOFA score by day 7); sepsis recurrence; and differences in peripheral blood cell populations and leukocyte transcriptomics. Fifty-five patients were allocated to each arm. By day 28, 27 (49.1%) patients in the clarithromycin and 25 (45.5%) in the placebo group died (risk difference 3.6% [95% confidence interval (CI) - 15.7 to 22.7]; P = 0.703, adjusted OR 1.03 [95%CI 0.35-3.06]; P = 0.959). There were no statistical differences in 90-day mortality and sepsis response. Clarithromycin was associated with lower incidence of sepsis recurrence (OR 0.21 [95%CI 0.06-0.68]; P = 0.012); significant increase in monocyte HLA-DR expression; expansion of non-classical monocytes; and upregulation of genes involved in cholesterol homeostasis. Serious and non-serious adverse events were equally distributed. Clarithromycin did not reduce mortality among patients with sepsis with respiratory and multiple organ dysfunction. Clarithromycin was associated with lower sepsis recurrence, possibly through a mechanism of immune restoration. Clinical trial registration clinicaltrials.gov identifier NCT03345992 registered 17 November 2017; EudraCT 2017-001056-55

The contribution of geogenic particulate matter to lung disease in indigenous children

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. Indigenous children have much higher rates of ear and lung disease than non-Indigenous children, which may be related to exposure to high levels of geogenic (earth-derived) particulate matter (PM). The aim of this study was to assess the relationship between dust levels and health in Indigenous children in Western Australia (W.A.). Data were from a population-based sample of 1077 Indigenous children living in 66 remote communities of W.A. (>2,000,000 km2), with information on health outcomes derived from carer reports and hospitalisation records. Associations between dust levels and health outcomes were assessed by multivariate logistic regression in a multi-level framework. We assessed the effect of exposure to community sampled PM on epithelial cell (NuLi-1) responses to non-typeable Haemophilus influenzae (NTHi) in vitro. High dust levels were associated with increased odds of hospitalisation for upper (OR 1.77 95% CI [1.02–3.06]) and lower (OR 1.99 95% CI [1.08–3.68]) respiratory tract infections and ear disease (OR 3.06 95% CI [1.20–7.80]). Exposure to PM enhanced NTHi adhesion and invasion of epithelial cells and impaired IL-8 production. Exposure to geogenic PM may be contributing to the poor respiratory health of disadvantaged communities in arid environments where geogenic PM levels are high