Avoiding disclosure of individually identifiable health information: a literature review

Achieving data and information dissemination without arming anyone is a central task of any entity in charge of collecting data. In this article, the authors examine the literature on data and statistical confidentiality. Rather than comparing the theoretical properties of specific methods, they emphasize the main themes that emerge from the ongoing discussion among scientists regarding how best to achieve the appropriate balance between data protection, data utility, and data dissemination. They cover the literature on de-identification and reidentification methods with emphasis on health care data. The authors also discuss the benefits and limitations for the most common access methods. Although there is abundant theoretical and empirical research, their review reveals lack of consensus on fundamental questions for empirical practice: How to assess disclosure risk, how to choose among disclosure methods, how to assess reidentification risk, and how to measure utility loss.public use files, disclosure avoidance, reidentification, de-identification, data utility

Avoiding disclosure of individually identifiable health information: a literature review

Achieving data and information dissemination without arming anyone is a central task of any entity in charge of collecting data. In this article, the authors examine the literature on data and statistical confidentiality. Rather than comparing the theoretical properties of specific methods, they emphasize the main themes that emerge from the ongoing discussion among scientists regarding how best to achieve the appropriate balance between data protection, data utility, and data dissemination. They cover the literature on de-identification and reidentification methods with emphasis on health care data. The authors also discuss the benefits and limitations for the most common access methods. Although there is abundant theoretical and empirical research, their review reveals lack of consensus on fundamental questions for empirical practice: How to assess disclosure risk, how to choose among disclosure methods, how to assess reidentification risk, and how to measure utility loss

Conceptualising a model to guide nursing and midwifery in the community guided by an evidence review

Background: Successful models of nursing and midwifery in the community delivering healthcare throughout the lifespan and across a health and illness continuum are limited, yet necessary to guide global health services. Primary and community health services are the typical points of access for most people and the location where most care is delivered. The scope of primary healthcare is complex and multifaceted and therefore requires a practice framework with sound conceptual and theoretical underpinnings. The aim of this paper is to present a conceptual model informed by a scoping evidence review of the literature. Methods: A scoping evidence review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Databases included CINAHL, MEDLINE, PsycINFO and SocINDEX using the EBSCO platform and the Cochrane Library using the keywords: model, nursing, midwifery, community, primary care. Grey literature for selected countries was searched using the Google ‘advanced’ search interface. Data extraction and quality appraisal for both empirical and grey literature were conducted independently by two reviewers. From 127 empirical and 24 non-empirical papers, data extraction parameters, in addition to the usual methodological features, included: the nature of nursing and midwifery; the population group; interventions and main outcomes; components of effective nursing and midwifery outcomes. Results: The evidence was categorised into six broad areas and subsequently synthesised into four themes. These were not mutually exclusive: (1) Integrated and Collaborative Care; (2) Organisation and Delivery of Nursing and Midwifery Care in the Community; (3) Adjuncts to Nursing Care and (4) Overarching Conceptual Model. It is the latter theme that is the focus of this paper. In essence, the model depicts a person/client on a lifespan and preventative-curative trajectory. The health related needs of the client, commensurate with their point position, relative to both trajectories, determines the nurse or midwife intervention. Consequently, it is this need, that determines the discipline or speciality of the nurse or midwife with the most appropriate competencies. Conclusion: Use of a conceptual model of nursing and midwifery to inform decision-making in primary/community based care ensures clinical outcomes are meaningful and more sustainable. Operationalising this model for nursing and midwifery in the community demands strong leadership and effective clinical governance

The low-resolution version of HadGEM3 GC3.1: development and evaluation for global climate

A new climate model, HadGEM3 N96ORCA1, is presented that is part of the GC3.1 configuration of HadGEM3. N96ORCA1 has a horizontal resolution of ~135 km in the atmosphere and 1° in the ocean and requires an order of magnitude less computing power than its medium-resolution counterpart, N216ORCA025, while retaining a high degree of performance traceability. Scientific performance is compared both to observations and the N216ORCA025 model. N96ORCA1 reproduces observed climate mean and variability almost as well as N216ORCA025. Patterns of biases are similar across the two models. In the north-west Atlantic, N96ORCA1 shows a cold surface bias of up to 6K, typical of ocean models of this resolution. The strength of the Atlantic meridional overturning circulation (16 to 17 Sv) matches observations. In the Southern Ocean, a warm surface bias (up to 2K) is smaller than in N216ORCA025 and linked to improved ocean circulation. Model El Niño/Southern Oscillation and Atlantic Multidecadal Variability are close to observations. Both the cold bias in the Northern hemisphere (N96ORCA1) and the warm bias in the Southern hemisphere (N216ORCA025) develop in the first few decades of the simulations. As in many comparable climate models, simulated interhemispheric gradients of top-of-atmosphere radiation are larger than observations suggest, with contributions from both hemispheres. HadGEM3 GC3.1 N96ORCA1 constitutes the physical core of the UK Earth System Model (UKESM1) and will be used extensively in the Coupled Model Intercomparison Project 6 (CMIP6), both as part of UKESM1 and as a stand-alone coupled climate model

Common, low-frequency, rare, and ultra-rare coding variants contribute to COVID-19 severity

The combined impact of common and rare exonic variants in COVID-19 host genetics is currently insufficiently understood. Here, common and rare variants from whole-exome sequencing data of about 4000 SARS-CoV-2-positive individuals were used to define an interpretable machine-learning model for predicting COVID-19 severity. First, variants were converted into separate sets of Boolean features, depending on the absence or the presence of variants in each gene. An ensemble of LASSO logistic regression models was used to identify the most informative Boolean features with respect to the genetic bases of severity. The Boolean features selected by these logistic models were combined into an Integrated PolyGenic Score that offers a synthetic and interpretable index for describing the contribution of host genetics in COVID-19 severity, as demonstrated through testing in several independent cohorts. Selected features belong to ultra-rare, rare, low-frequency, and common variants, including those in linkage disequilibrium with known GWAS loci. Noteworthily, around one quarter of the selected genes are sex-specific. Pathway analysis of the selected genes associated with COVID-19 severity reflected the multi-organ nature of the disease. The proposed model might provide useful information for developing diagnostics and therapeutics, while also being able to guide bedside disease management. © 2021, The Author(s)

Genetic mechanisms of critical illness in COVID-19.

Host-mediated lung inflammation is present1, and drives mortality2, in the critical illness caused by coronavirus disease 2019 (COVID-19). Host genetic variants associated with critical illness may identify mechanistic targets for therapeutic development3. Here we report the results of the GenOMICC (Genetics Of Mortality In Critical Care) genome-wide association study in 2,244 critically ill patients with COVID-19 from 208 UK intensive care units. We have identified and replicated the following new genome-wide significant associations: on chromosome 12q24.13 (rs10735079, P = 1.65 × 10-8) in a gene cluster that encodes antiviral restriction enzyme activators (OAS1, OAS2 and OAS3); on chromosome 19p13.2 (rs74956615, P = 2.3 × 10-8) near the gene that encodes tyrosine kinase 2 (TYK2); on chromosome 19p13.3 (rs2109069, P = 3.98 ×  10-12) within the gene that encodes dipeptidyl peptidase 9 (DPP9); and on chromosome 21q22.1 (rs2236757, P = 4.99 × 10-8) in the interferon receptor gene IFNAR2. We identified potential targets for repurposing of licensed medications: using Mendelian randomization, we found evidence that low expression of IFNAR2, or high expression of TYK2, are associated with life-threatening disease; and transcriptome-wide association in lung tissue revealed that high expression of the monocyte-macrophage chemotactic receptor CCR2 is associated with severe COVID-19. Our results identify robust genetic signals relating to key host antiviral defence mechanisms and mediators of inflammatory organ damage in COVID-19. Both mechanisms may be amenable to targeted treatment with existing drugs. However, large-scale randomized clinical trials will be essential before any change to clinical practice

The psychological and economic factors that influence energy consumption habits of low income earners

Social marketers and governments have often targeted hard to reach or vulnerable groups (Gordon et al., 2006) such as young adults and low income earners. Past research has shown that low-income earners are often at risk of poor health outcomes and diminished lifestyle (Hampson et al., 2009; Scott et al., 2012). Young adults (aged 18 to 35) are in a transition phase of their life where lifestyle preferences are still being formed and are thus a useful target for long-term sustainable change. An area of focus for all levels of government is the use of energy with an aim to reduce consumption. There is little research to date that combines both of these groups and in particular in the context of household energy usage. Research into financially disadvantaged consumers is challenging the notion that that low income consumer purchasing and usage of products and services is based upon economic status (Sharma et al., 2012). Prior research shows higher income earners view items such as televisions and computers as necessities rather than non-essential (Karlsson et al., 2004). Consistent with this is growing evidence that low income earners purchase non-essential, energy intensive electronic appliances such as multiple big screen TV sets and additional refrigerators. With this in mind, there is a need for knowledge about how psychological and economic factors influence the energy consumption habits (e.g. appliances on standby power, leaving appliances turned on, running multiple devices at one time) of low income earners. Thus, our study sought to address the research question of: What are the factors that influence young adult low-income earners energy habits

NCRN Meeting Spring 2014: Metadata Standards & Technology Development for the NSF Survey of Earned Doctorates

Presentation from NCRN Spring 2014 meetingU.S. Censu

Money or mind? What matters most in influencing low-income earners to be energy efficient?

Purpose of the study: Designing a social marketing intervention for Australian young adult low-income earners requires an understanding of the key motivations. As part of the Low-Income Earner Energy Efficiency Program (LIEEP), this study investigates the key factors that influence energy behaviours amongst Australian young adult low-income earners as part of the PROGRAM X social marketing program. We also investigate the effect of gender. Method: An online survey of 753 low-income renters was conducted using validated measures. The data were analysed using structural equation modelling. Findings: The two factors that had the highest influence on intentions for energy saving behaviours were the ‘mind’ factor of self-efficacy and ‘money’ factor of price concern. There were gender differences in the effect of bill control and price concern on intentions for different energy efficiency behaviours. Practical implications: This study provides guidance on the key factors to emphasise when designing an energy efficiency program for Australian young adult low-income earners. Social implications: This study provides evidence for different motivations amongst Australian young adult low-income earners for energy efficiency programs and that a ‘one-size-fits-all’ approach may not be effective. Originality/Value: While there is high interest in the public sector for motivating Australian young adult low-income earners to change their energy behaviours little is known about the key factors that motivate intentions to engage in these behaviours

E: Rheumatoid forefoot deformity: a comparison study of 2 functional methods of reconstruction

The forefoot is an important area of morbidity in rheumatoid arthritis (RA). Initial manifestation of RA occurs in the foot in 16% of patients 1 ; 80-100% patients with a 10-year history have symptomatic forefoot problems 2-6 ; 25-40% of all surgical procedures are done on the foo