bluuebunny/crossref_metadata_2025 huggingface dataset:
Research Progress of Drilling and Completion Fluid Loss Model in Fractured Reservoir
Authors: Wang Jinchang
Published: October 2023

Well loss and its accompanying reservoir damage is a common and serious problem, which not only greatly restricts the economic benefit, but also seriously affects the correct evaluation of reservoir oil and gas resources in the early stage of exploration. With the exploration and development of deep Marine carbonate oil and gas resources, fracture leakage has gradually become a frontier and hot issue to be studied urgently. Foreign scholars began to study the leakage model of fractured reservoir in the 1990s, but at present, domestic scholars mainly focus on the clastic rock model, focusing on the plugging technology and plugging materials, while ignoring the importance of the dynamic development of the leakage indirectly reflecting the leakage type and the size of the leakage channel. This paper comprehensively analyses the effects of drilling completion fluid rheology, fracture opening variation, fracture wall filtration and other factors on well loss from the time sequence of the establishment of the leakage model, summarizes the research progress of the mathematical model of leakage in fractured reservoirs, and proposes to pay attention to and strengthen the monitoring of the leakage mechanism and the dynamic process of leakage, so as to provide a theoretical basis for the rapid diagnosis of leakage types and the optimization of leakage control.
Spatial multiplexing encryption with cascaded metasurfaces
Authors: Fan Zhixiang , Jia Yuetian , Chen Hongsheng , Qian Chao
Published: October 2023

Recent years have witnessed rapid progresses in information encryption by harnessing different dimensions of light, yet, pushing the capacity of encrypted information is an endless goal. Meta-holographic encryption introduces an efficient method in optical information encryption. Here, we propose a spatial multiplexing encryption technique using cascaded metasurfaces, allowing multiple users to simultaneously access independent encryption information. By employing cascaded metasurfaces, cipher images and corresponding decryption keys can be transferred to unique spatial hologram coordinates for each user, ensuring secure identification of encrypted information. We demonstrate the feasibility of six encrypted channels and analyze the sensitivity to holography spatial location, revealing a low correlation among different channels. Our findings highlight the potential of cascaded metasurfaces in spatial multiplexing encryption, paving the way for high-volume optical information encryption.
The effect of distance on risk perception towards waste incineration plants: a comparison between local residents living within 0–3 km versus 3–8 km in Dongguan, Southern China
Authors: Zhang Lizhou , Liabsuetrakul Tippawan
Published: October 2023

Waste incineration is becoming the dominant method of waste disposal globally, including in China. Local residents are concerned about the potential negative impacts of waste incineration plants (WIPs) on their environment and health. This study aimed to measure the differences of risk perception of local residents living within 0–3 km versus those living 3–8 km distant from a WIP and explore other factors associated with risk perception. A cross-sectional study was conducted in communities surrounding three municipal WIPs in Dongguan, China. Of 881 residents randomly selected, 454 lived within 0–3 km and 427 lived 3–8 km from their local WIP. Differences in risk perception between the two groups and factors associated with risk perception were analyzed using multivariable logistic regression. Seventy percent of the residents reported a high overall risk perception towards the WIPs. Overall risk perceptions, perceived health effects, and psychological stress domains were not significantly different between those living within 0–3 km and 3–8 km groups after adjusting for other variables. The effect of distance on risk perception was modified by social trust, as the study found that those in the 0–3 km group having low social trust had significantly higher risk perception. Gender, marital status, housing type, and duration of residence were independently associated with risk perception. Social trust is an important factor in alleviating the residents’ risk perceptions towards a WIP, and is further affected by the distance from the WIP. It is essential for WIP governors to provide accurate information about WIPs to their residents along with good quality control.
Ortho-isomorphisms of Grassmann spaces in semifinite factors
Authors: Shi Weijuan , Shen Junhao , Ma Minghui
Published: October 2023

Let

M

\mathcal M

be a semifinite factor with a faithful normal semifinite tracial weight

τ
\tau

, and

P

\mathscr P

the set of all projections in

M

\mathcal M

. Denote by

P

c

\mathscr P_{c}

the Grassmann space of all projections in

P

\mathscr P

with trace

c
c

, where

c
c

is a positive real number. A map

ψ
:

P

c

→

P

c

\psi : \mathscr P_c\rightarrow \mathscr P_c

is called an ortho-isomorphism if

ψ
\psi

is a bijection of

P

c

\mathscr P_c

onto

P

c

\mathscr P_c

satisfying, for all

P
,
Q
∈

P

c

P,Q\in \mathscr P_c

,

P
⊥
Q

P\perp Q

if and only if

ψ
(
P
)
⊥
ψ
(
Q
)

\psi (P)\perp \psi (Q)

. The aim of this paper is to establish a version of Uhlhorn’s theorem in the setting of semifinite factors. We give a complete characterization of ortho-isomorphisms on Grassmann space

P

c

\mathscr P_c

in a semifinite factor. And we show that an ortho-isomorphism

ψ
:

P

c

→

P

c

\psi : \mathscr P_c\rightarrow \mathscr P_c

can be extended to a Jordan

∗
*

-isomorphism

ρ
\rho

of

M

\mathcal M

onto

M

\mathcal M

. As an application, we obtain the structure of surjective isometries on

P

c

\mathscr P_c

with respect to strictly increasing unitarily invariant norms.
Microbial manipulation of memories and minds
Authors: Gubert Carolina , Hannan Anthony J
Published: October 2023

This scientific commentary refers to ‘Microbiota from Alzheimer’s patients induce deficits in cognition and hippocampal neurogenesis’ by Grabrucker et al. (https://doi.org/10.1093/brain/awad303).
Impact of different kinds of biomass mixtures on combustion performance, interaction and synergistic effects in cofiring of coal and biomass in steam power plants
Authors: Soleh Mochamad , Ahmad Azaria Haykal , Juangsa Firman Bagja , Darmanto Prihadi Setyo , Pasek Ari Darmawan
Published: October 2023

The cofiring of biomass and coal may be one of the most effective methods to improve energy utilization efficiency and reduce greenhouse gas emissions. This study aims to investigate combustion performance, interaction and synergistic effects in the cofiring of coal and three types of biomass. Blended fuel consisting of coal and three types of biomass such as sawdust, rice husk and solid recovery fuel was selected as the research object. Ultimate and proximate analysis and differential thermogravimetric analysis with heating rates of between 10°C and 40°C/minute are used to analyse combustion characteristics. Simulation of combustion in a 600-MWe steam power plant with a Carolina-type boiler is also carried out with the help of computational fluid dynamic (CFD) analysis to see the effect of the interaction and synergy of the mixed fuel on the performance of the steam generator. The effect on the combustion process in the combustion chamber of a steam power plant is also simulated. Based on the analysis of several test results of parameters such as ignition temperature, burnout temperature, calorific value of the fuel mixtures as well as CFD simulation, the results of the study show a strong indication of a positive synergy in mixing some of these biomasses as compared with a fuel mixture consisting only of coal and one type of biomass. Practically no power derating of the boiler occurs until the biomass content in the fuel mixture is ~30% on a mass basis. The reduction in greenhouse gas emissions also appears significant from the results of the CFD simulation of this study, which is characterized by a decrease in the fraction of CO2 in flue gas from 21.5% for coal alone as fuel to 15.9% in the case of cofiring excluding the CO2 attributed to the biomass.
Myocardial infarction and haemorrhagic stroke as a rare presentation of acute aortic dissection: a fatal case report
Authors: Lasa-Berasain Pablo , Salas Pablo Raposo , Azparren Edurne Erice , Sanz Eva Regidor
Published: October 2023

Background

Type A acute aortic dissection (AAD) is an extremely severe condition, having a high risk of mortality. Initial diagnosis can be deceptive, especially in patients with other confounding presentations.

Case summary

We present the case of a 60-year-old male with a history of endovascular aortic repair for abdominal aortic dissection, in whom a diagnosis of AAD was made, but almost missed, after he presented with stroke signs and left coronary myocardial infarction. Thorough clinical evaluation and point-of-care ultrasound (POCUS) were fundamental to the diagnosis of the underlying condition, which showed the intimal flap in the ascending aorta, aortic insufficiency, and a dissected left common carotid artery. The diagnosis was confirmed with a head and thoracic computed tomography scan, which also showed bilateral haemorrhagic strokes. Treatment options can be limited in patients with AAD with associated complications. After a careful multidisciplinary evaluation, life-sustaining therapy was withdrawn and the patient passed away.

Discussion

Our case depicts the diagnosis challenge presented by patients with AAD. We emphasize the importance of clinical suspicion and POCUS examination for the diagnosis of the underlying condition, as it is frequently missed during first evaluation. We discuss the available literature regarding the prevalence and described mechanisms by which AAD can associate occlusion myocardial infarction, which more commonly involves the right coronary artery, as well as haemorrhagic stroke. We briefly mention management options, which are limited and controversial.
Delving into vaccine hesitancy through multicentre studies: VAX-TRUST and INF-ACT projects’ insights
Authors: Lo Moro G , Bert F , Odone A , De Vito C , Carta M , Langiano E , Ferrara M , Vuolanto P , De Vito E , Siliquini R
Published: October 2023

Vaccine hesitancy is a wide and varied phenomenon and represents a challenge for healthcare professionals (HCPs), who may encounter obstacles in building trusting relationships with parents and patients. Depicting the multifaceted aspects of hesitancy and finding effective tools that could help HCPs in addressing this issue are major public health priorities. This presentation will provide insights about two multicentre research initiatives that aim to respond to these needs. The “VAX-TRUST - Addressing Vaccine Hesitancy in Europe” project (funding from European Union's Horizon 2020 research and innovation program under Grant Agreement No. 965280) involves several institutions across Finland, Belgium, Poland, the Czech Republic, Italy, Portugal, and the UK. One of the goals of VAX-TRUST is to assist HCPs in dealing with hesitancy by implementing tailored interventions, specific for each target region. The process of development of interventions, starting from data supporting the planning up to the final intervention framework, will be discussed. The INF-ACT project (Next Generation EU funding within the MUR PNRR Extended Partnership initiative on Emerging Infectious Diseases, Project no. PE00000007) is a multicentre collaboration including universities and institutions throughout Italy. Within this project, the EPI-MOD node will contribute to realize novel monitoring methods to gather information on human behaviours during outbreaks and evaluate vaccine hesitancy levels and determinants. Among the main objectives, EPI-MOD will examine features and applications of immunization registries and will delve into vaccine hesitancy through a broad Italian nationwide survey, profiling subgroups of population at high risk for vaccine hesitancy.

Overall, the results of these two large projects will allow to integrate novel data into information for action by identifying interventions that could be used to support HCPs and vulnerable groups that may require additional attention.
Mhealth tools for community-based infectious disease surveillance in Africa: a scoping review
Authors: Aku F , Amuasi J H , Debrah L B , Opoku D , Gmanyami J M , Debrah A Y , Hoerauf A , Quentin W
Published: October 2023

Background

Community-based surveillance may encourage early detection of outbreaks and other health threats. Mobile digital tools for health (mHealth) can potentially support the role of community health workers (CHW) in disease surveillance. However, limited information is available on mhealth use by CHW for infectious disease surveillance in Africa. The purpose of this review was to provide an overview of available mhealth tools used by CHW for community-based infectious disease surveillance in Africa.

Methods

The scoping review protocol was registered in OSF registries (doi: 10.17605/OSF.IO/W7MTY). We followed a mixed-methods approach in line with the framework of Arksey and O'Malley amended by Levac et al. and the Joanna Briggs Institute. We searched PubMed, Scopus, Web of Science, CINAHL, Google Scholar, Google and websites of relevant organizations for peer-reviewed and grey literature. Search terms included a range of synonyms for the three concepts of (1) mhealth, (2) CHW and (3) Africa. Reports were included if they reported on mHealth tools used by CHW for infectious disease surveillance in Africa.

Results

We identified 2,496 titles during our search but only 7 met our inclusion criteria. Studies were conducted in Tanzania, Zambia, Nigeria, Malawi, Kenya and Ghana, and focused on one or more diseases or symptoms: Acute Flaccid Paralysis, Lymphatic Filariasis (LF), COVID-19 and cough with fast respiratory rate. All interventions relied on CHW sending text messages to supervisors via the mhealth tool. Users’ perspective of mhealth tools included: improved surveillance, better linkage with the community and greater efficiency.

Conclusions

We found a small number of mhealth tools used by CHW for infectious disease surveillance in Africa. Tools focused on epidemic-prone and neglected tropical diseases, and linked CHW with their supervisors. Results indicate that mhealth holds potential for strengthening community-based surveillance in Africa.
1.D. Workshop: Long COVID: A Myth or a reality?
Authors:   Organised by: EUPHA-CHR, EUPHA-PHMR,   Chair persons: Sarah Cuschieri (Malta), Nienke Schutte (Belgium)
Published: October 2023

COVID-19 has been a pandemic since 2020 and to date has resulted in a substantial global burden through both morbidity and mortality. Long term symptoms impacting the mental, social, and physical well-being among COVID-19 survivors started to be noted from early pandemic. This phenomenon was reported as Long COVID, and the World Health Organization (WHO) has now defined it as “a condition that occurs in those with probable or confirmed COVID-19 infection where symptoms last for at least two months from the onset of the infection”. Yet, the paucity of longitudinal cohort studies and clinical trials on Long COVID presents the scientific, clinical, and public health ecosystems with limited understanding pertaining to this new condition as well as presents uncertainty on whether “Long COVID is a myth or a reality?” Additionally, on a country level, the level of preparedness to deal with Long COVID at a population level and through healthcare services are not established. With over 60% of Europeans reported to suffer from Long COVID, this timely workshop is set to bring forward a pan-European expert consensus on the existence and the deterrent effects attributed to Long COVID, with recommendations for the way forward. The workshop will start off by presenting the overall impact of COVID on the well-being of middle-aged and older adults residing in 27 European countries as well as explores whether having Long COVID further deteriorate their well-being. The symptoms of Long COVID will be explored along with their effect on the health-related quality of life (HRQoL), fatigue, mental well-being, while investigating the determinants that diminish HRQoL. This will provide an all-rounded approach to the direct effects of Long COVID. It is known that Long COVID individuals will seek their first medical care contact at primary healthcare. Therefore, the workshop will explore the general practitioner's knowledge, perceptions, and experience on Long COVID's diagnosis and management across two European countries. This will provide an insight whether primary healthcare practitioners are equipped with dealing with this emerging syndrome. The workshop then focuses on Italy's perspective, at a country level, in managing Long COVID through Good Clinical Practice and access to national services. Finally, a European overview of the Long-COVID-19 situation from a population health perspective will be provided and it will offer unique insights on the development of different tools, strategies and structures in national healthcare systems and their fight against long-COVID.

Key messages

• Long COVID is causing deterrent effects and impact the physical, mental, social and economic status of the populations.

• We need better tools (e.g., registries or targeted Health Examination Surveys) to assess the situation and to customise health care provision for the current patients and avoid the further spread.
Insights from the PHIRI Network: How different Countries deal with Long-COVID related issues and developments
Authors: Habl C , Weiss J , Gottlob A
Published: October 2023

Long COVID research shows that on average, 10-20% of COVID-19 patients experience a variety of mid- to long-term effects after recovery from initial illness. This represents a serious issue for the healthcare sector and decision-makers and experts in the field. Against this backdrop the Population Health Information Research Infrastructure collaboration (PHIRI) established a Rapid Exchange Forum (REF). REF is a series of bi-weekly meetings addressing urgent questions in population health during the COVID-19 pandemic and beyond. Participants are national representatives from over 30EU countries, ranging from European public health institutes, Ministries of Health to research institutions, universities, and EU-level stakeholders. In preparation, questions on a given topic are sent in a systematic manner, allowing rapid exchange of information across countries and provides comparative learnings on different challenges, best practices, and tools used to overcome population health issues (e.g., communication strategies, mortality indicators, long-term pandemic monitoring and surveillance, and pandemic impacts). REF on Long-COVID focused on 5 key aspects of Management of long-COVID Patients. Across 19 different EU/EEA countries information shows, for example, that by March 2023.

1) none of the 19 countries have stated to have a specific working registry for Long-COVID patients 2) few countries so far have developed specialised clinics or medical institutions for the treatment of Long-COVID but at least 3) most countries have adopted a wide range of different tools, strategies, and activities to create national guidelines and models for better management of Long-COVID Patients.

This discusses these findings and will take stock of the Long-COVID-19 situation from a population health perspective. It will offer unique insights on the development of different tools, strategies and structures in national healthcare systems and their fight against long-COVID.
Lung cancer cases attributable to PM2.5 in northeastern Italy
Authors: Serraino D , Valdi G , Toffolutti F , Driutti M , Parpinel M , Bidoli E , Dal Maso L
Published: October 2023

Background

According to the International Agency for Cancer Research (IARC), outdoor pollution is a well established cause of lung cancer, with a prominent carcinogenic role attributed to particulate matter (PM) pollution. 2001 WHO guidelines on outdoor pollution includes a recommendation to reach a PM2.5 annual average of 5ug/m3. The WHO recommendation is in sharp contrast with EU limits: thus, in the present study we estimated the number of incident lung cancer cases due to PM2.5 according to three different scenarios.

Methods

The number of newly incident lung cancer cases diagnosed in northeastern Italy from 2015 to 2020 was from the population-based cancer registry of the Friuli Venezia Giulia region. We considered three scenarios of average annual concentration of PM2.5: 25ug/m3 according to EU legislation; 10ug/m3 or 5ug/m3 according to 2005 and 2021 WHO guidelines. An 8% increase in the risk of lung cancer for every 10ug/m3 increase in PM2.5 was assumed. Data from outdoor average annual concentration of PM2.5 in northeastern Italy were from local air monitoring systems.

Results

5131 lung cancer cases were registered in 2015-2020 in Friuli Venezia Giulia, (i.e., 855 cases/year). In the same period, an average annual concentration of PM2.5 of 18ug/m3 was documented. According to EU legislation, there will not be an excess of future lung cancer cases attributable to PM2.5. Conversely, the projection of the excess cases ranged from 6.4%/year (WHO 2005) or 10.4% (WHO 2021). In absolute terms, we estimated that there will be an excess of future yearly lung cancer cases ranging from 55 cases to 89 cases due to PM2.5.air pollution exceeding WHO recommendations.

Conclusions

According to WHO recommendations, PM2.5 air pollution will cause an excess of up to 89 yearly cases of lung cancer in Friuli Venezia Giulia, northeastern Italy, a projection in sharp contrast with EU limits.

Key messages

• An excess of up to 89 yearly cases of lung cancer are projected for the future years due to PM2.5 concentration exceeding WHO guidelines.

• EU limits of PM2.5 average yearly concentration underestimate the risk of lung cancer in humans.
Telemedicine in management of heart failure: experience of the south-east Tuscany in COVID-19 period
Authors: Bosco R , Miserendino A , Cartocci A , Tina F , Messina G , Nante N
Published: October 2023

Background

The lockdown imposed by the COVID-19 pandemic has prompted the implementation of the use of Telemedicine (TL), overcoming the assumption of a service: the simultaneous on-site presence of the producer and user of that service. We aimed to evaluate the impact of TL on the management of the out-patient (MOP) with heart failure in both clinical and economic terms.

Methods

A prospective randomized trial of heart failure patients was performed at the Medical Area Cardiology of Cortona Hospital, Tuscany. From May to September 2020, 300 patients were enrolled and followed for 9 months. They were equally and randomly assigned to the MOP group with the possibility of ordinary hospitalization or to the TL group and followed through home care. The groups were homogeneous in terms of gender, age, comorbidities, presence or absence of caregivers, ability to connect to internet, and provision of the necessary tools to monitor their condition.

Results

48% of the services provided were TL (Televisit and Teleconsultation) while the remaining 52% were MOP services. There is no significant difference in terms of care delivered. In TL, per service, 0.09h were spent while in MOP 0.26h (also considering the application of anti-COVID procedures). In addition to savings in space, staffing and technology used, there was also a significant reduction in costs with TL (e.g., € 1600.00 per day of ICU admission, € 850.00 per day of ordinary hospitalization, € 150.00 per Emergency Department access).

Conclusions

TL has achieved economic savings, appropriateness of care with increased equity, effectiveness, and efficiency (due to continuous patient monitoring) resulting in reduced hospitalization. However, this requires an initial investment in resources as well as good integration between Hospital and Territory.

Key messages

• Telemedicine has reduced costs, time per visit, and resources in general. It constitutes an advantage for monitoring chronic patients.

• To make the best use of telemedicine, a good network between hospital and territory is needed.
Building Community Health Literacy with a Social Network Perspective
Authors: Sentell T , Saiki K , Abrams M A , Jones A , Melendez K , Chevrolet J , Roman M , Barnes J , Patterson E
Published: October 2023

Background

The COVID-19 pandemic underscored the vital importance of health literacy to combat misinformation, increase trust, and ensure health equity. Health literacy is a collective responsibility, including for organizations to “equitably enable individuals to find, understand, and use information and services.” This presentation will share key insights concerning health literacy in a social context. from a 2-year regional effort to build a sustainable, health literate community by growing trusted, multi-sectorial partnerships, relationships, and networks.

Methods

Advancing Health Literacy Franklin County is a 2-year project initiated in June 2021 with a goal of building a sustainable, health literate community in Franklin County, Ohio, USA. The project is a collaboration among public health departments, health care organizations, an academic institution, and community organizations. Evaluations include social network analysis of organizational relationships over time, training outcomes, validated organizational health literacy (OHL) measures, and key informant interviews.

Results

Social network analysis show growth in the number of engaged organizations and stronger ties in these relationships. Training outcomes reveal increased knowledge, skills, and recognition of the importance of health literacy. OHL measures show engagement and improved capacity. Key informant interviews highlight the importance of the social perspective for health literacy.

Conclusions

Considering health literacy in a social context is important to building community-level health literacy in a sustainable way, including networks of organizations working together and the engagement of community leaders to share trusted, community relevant health information in their professional and personal social networks. Insights from this real-world implementation can inform future practice, policy, and research.
Exploring job and workplace factors associated with nurse retention in the Irish Healthcare System
Authors: O'Donoghue C
Published: October 2023

Background

The COVID-19 crisis put unprecedented pressures on nurses both globally and in Ireland. This has led to concerns that a ‘great resignation’ could take place. Prior to the Covid-19 pandemic, significant numbers of Irish nurses migrated for better pay and working conditions. Understanding the factors involved in retaining nurse professionals and supporting them to remain in the Irish health system is thus critical to creating a fully functioning health system and maintaining and improving population health.

Methods

A secondary data analysis was carried out with two HSE ‘Your Opinion Counts’ surveys from 2016 and 2018. The surveys examined staff opinions and experiences on a range of issues, including job satisfaction and workplace culture. Descriptive statistics and association tests were run to examine which factors were the most associated with intention to stay within the HSE. The study also assessed the changes over time (2016 versus 2018) on intention to stay and by nurse subcategory. These data were then compared with actual turnover data for nurses over the COVID-19 era.

Results

Preliminary results indicate that public health nurses and nurse specialists were the nurse cadres most likely to intend to remain working within the HSE. Furthermore, staff nurses and midwives had greater intention to stay in 2018 compared with 2016. Feeling valued and recognised at work was among the most associated factors related to intention to stay.

Conclusions

Changing workplace cultures to more supportive environments where staff feel valued and recognised may increase staff retention. Policy makers should invest in understanding mechanisms and interventions that can change workplace cultures to increase staff retention.
Are differences in caesarean section rates between countries in Europe decreasing or increasing?
Authors: Velebil P , Tica V , Durox M , Nijhuis J , Alexander S , Zeitlin J , Gissler M
Published: October 2023

Objective

Caesarean section (CS) rates differ greatly between European countries, but whether these variations in practices between countries are increasing or decreasing has not been investigated. Improved scientific evidence to underpin CS indications as well as common trends in maternal characteristics could lead to convergence of rates. This study aimed to analyse trends in CS rates between 2004 and 2020 for all births and for specific risk sub-groups.

Methods

The study uses data from the Euro-Peristat network which collected national-level routine data on CS overall and by sub-group using a standardised protocol on births in 2004, 2010 and 2015-2020. Sub-groups were: parity (nulliparous, multiparous), multiplicity (singleton, multiple), previous CS (yes/no), breech (yes/no) and preterm/term. 25 countries had data at all time points. We divided countries into terciles based on 2004 rates and analysed trajectories in these three groups.

Results

The CS rate ranged from 14.4% to 37.8% in 2004 and from 16.2% to 44.8% in 2020. Cutoffs for the terciles in 2004 were 19% et 25%. Countries in the first tercile (low rates, 9 countries) continued to have low rates with flat or mildly increasing trajectories. In the second tercile, there were two trajectories - flat or mildly increasing (3 countries) or sharper increases over time (4 countries). Countries in the highest tercile had increasing rates (8 countries). These patterns were observed most clearly in singleton and nulliparous pregnancies. For sub-group analyses, patterns varied, with some low CS countries having high CS rates for breech or preterm births, but practices within sub-groups were relatively stable over time.

Conclusions

Differences in overall CS rates between European countries over time have widened with more marked clustering into high and low CS groups. These analyses suggest a lack of progress in developing an evidence-base that would lead to standardisation of practice.
Excess physical disease burden associated with selected mental health disorders in Europe
Authors: Wienand D , Wijnen L I , Heilig D , Wippel C , Arango C , Knudsen G M , Goodwin G M , Simon J
Published: October 2023

Introduction

People with mental health disorders (MHDs) have worse physical health compared to the general population. To date, no comprehensive epidemiological overview exists and the extent of the excess public health burden is unknown. Our aim was to estimate the prevalence of excess PHC diagnoses associated with MHDs in the European working-age population.

Methods

We estimated excess PHC diagnoses associated with depressive disorders (DD), bipolar disorder (BD), schizophrenia (SZ), and alcohol use disorders (AUD) for year 2019. Levels of excess risks for PHCs were identified by a structured literature review and synthesised per MHD and categories of PHCs using random-effects meta-analyses. Estimated relative risks (RRs) were combined with country-level disease prevalence and population data to calculate population attributable fractions (PAFs). Based on obtained PAFs we calculated excess PHC diagnoses due to underlying MHDs for all EU-27 member states, Iceland, Liechtenstein, Norway, Switzerland, and the United Kingdom.

Results

We identified 72 studies for estimating excess levels of risk for PHCs, focused on DD (n = 29, 40%), SZ (n = 26, 36%), BD (n = 9, 13%), AUD (n = 4, 6%), or multiple MHDs (n = 4, 6%). Estimated RRs ranged from 1.3 to 1.8 (DD), from 1.8 to 15.8 (BD), from 1.5 to 4.0 (SZ), and from 1.9 to 3.3 (AUD). Corresponding excess PHC diagnoses in the total European working-age population (312.5 million) were 24.6 million (AUD), 12.6 million (DD), 6.6 million (BD), and 0.9 million (SZ).

Discussion

This is the first comprehensive estimation of the public health burden of excess PHCs associated with DD, BD, SZ, and AUD in the European working-age population. Our results unequivocally demonstrate broader population health benefits of investments into integrated mental and physical healthcare. Targeted policies should consider prevention strategies as sustainable and equitable approaches to alleviate substantial physical health disparities in people with MHDs.

Key messages

• Working-age individuals with mental health disorders in Europe suffer from substantial physical health disparities in nearly all physical health areas.

• Integrated mental and physical healthcare, and prevention strategies are equitable and sustainable approaches to reduce these physical health disparities.
Irregular migrants and work in Belgium: a case study
Authors: Dauvrin M
Published: October 2023

Although not allowed to work legally in Belgium, irregular migrants benefit from a range of rights, including a minimum wage, a limit on the number of hours they can work per week and access to health care. Alongside “traditional” sectors of irregular work (building, domestic staff, hotel and catering, cleaning), there are a growing number of irregular migrants employed as bicycle delivery riders. In order to benefit from access to healthcare, migrants must undergo a social investigation by the public authorities: this investigation assesses, among other things, whether the person has an income. This is a paradox: the migrant is entitled to the minimum wage but having an income may prevent him or her from receiving care as an irregular resident. During this presentation, we will explore the current situation facing irregular migrants in Belgium and the role of professional unions and health care professionals.
Understanding food discourse
Authors: Sasamoto R
Published: October 2023

In recent years, consumers have been faced with an increasing number of food choices, and they must consider multiple factors such as health concerns, nutritional content, animal welfare, sustainability, and climate change. While the language of food has attracted scholarly attention in linguistics, there are few studies in cognitive pragmatics that explore how consumers process information to make informed decisions. Therefore, this presentation will discuss the potential of pragmatics research, using Sperber & Wilson's (1986/1995) relevance theory as a framework, to address the reception of food discourse as presented to consumers. By examining how consumers interpret and respond to food-related messages, we can gain a better understanding of how to communicate with them effectively and encourage healthier, more sustainable food choices.
The one health approach applied to surveillance and control of Legionnaires’ disease in Switzerland
Authors: Wymann M
Published: October 2023

Issue/problem

Legionnaires’ disease numbers have been increasing in Switzerland since 2001. With a reporting rate of 6.5 / 100'000 inhabitants in 2022, Switzerland has one of the highest incidences in Europe. The reported cases are mainly severe, about 87 % are diagnosed by hospitals, about 5 % have already died at the time of reporting. In the majority of cases the infection source is unknown.

Description of the problem

Because the causative agent, Legionella spp., is ubiquitous in humid environments, including building plumbing systems, a collaborative, multisectoral and transdisciplinary approach is key for an efficient response to this public health threat.

Results

At the national level, a close collaboration between the federal offices for public health, food safety (public shower and bath water) and energy (buildings and energy) was established in 2019 with the creation of a dedicated legionellosis expert group. Goals were to strengthen the coordination and to improve measures to combat the observed increase.

Lessons

Stakeholders from authorities responsible for implementing measures but also building and sanitary experts, specialists in cooling technology, laboratory experts and scientists have been involved in multiple activities coordinated by the national legionellosis expert group. Together they revise recommendations for prevention and control of legionellosis, and develop factsheets for building technology engineers and an outbreak investigation toolbox. A coordinated communication to the public is ensured, for example in view of possible energy shortage measures. Knowledge gaps have been identified and scientific research to fill them is coordinated, mutually funded and the results will be transferred into practice in the coming years.

Key messages

• The One Health approach has proven to be very effective in coordination of activities and communication.

• The future will reveal if the joint efforts will have an impact on the high incidence.
Santé publique France's cross-sectoral response to the climate and environmental changes
Authors: Pascal M , Denys S
Published: October 2023

Heat is one of the most rapidly changing climate-related health issues. The Intergovernmental Panel on Climate Change (IPCC) considered that current existing and planned adaptation measures will not be sufficient to limit the health impacts of heat in Europe. The French heat wave alert system, set up in 2004, was one of the first and most innovative in the world thanks to a close collaboration between the French weather service Météo-France, the national public health agency and the ministry of health. It also benefits from a reactive syndromic surveillance based on emergency room visits and general practitioners emergency consultations. Yet, it is now challenged by the increase in frequency and intensity of heat waves due to climate change. The impacts of recent years show that short-term responses based on timely behavioural changes during heat waves are now insufficient. Structural adaptation measures are an asset, and should not only consider adaptation to heat, but also wider opportunities for mitigation and reduction of inequities, in order to promote robust healthy environments that protect against climate disruption. This presentation will share how Santé publique France is developing a set of interdisciplinary studies and an advocacy strategy to encourage stakeholders involved in urban planning and housing to better take into account the impact of heat in their projects.
How RIVM engages in cross-sectoral collaboration to ensure health is at the centre of climate action
Authors: Hall L , Hagens W , Limaheluw J
Published: October 2023

RIVM's mission on climate change and health is to give insight into the health impacts of a changing climate, climate measures, co-benefits and trade-offs, and to provide information, data and tools to support climate action from local to international level. To achieve this, we work closely across all RIVM's knowledge domains and with other knowledge institutes, authorities and stakeholders. The information and tools we provide are used in cross-sectoral policy and planning discussions. This ensures health is a major and timely consideration when developing climate measures, co-benefits are maximised and unintended negative effects avoided. This collaborative, cross-sectoral and interdisciplinary work enables us to tackle inherent complexities and ensures our outputs are fit for purpose. We will highlight some examples on:

Plugging knowledge gaps

• A database of extracted quantitative outcomes from the literature;

• Research on effectiveness of heat measures for the elderly;

• A survey to assess mental health impacts of flooding;

• Developing the knowledge base for municipalities and water boards to limit impacts of climate change and adaptation measures on urban water quality;

• An Expertise hub on wind energy and health with up-to-date, accessible information on wind turbines and health for municipalities and the public.

Supporting climate action

• Guidance for municipal public health services on heat and health, and an updated heat-health action plan;

• A frailty index, enabling mapping of vulnerable elderly at neighbourhood level so local actors take targeted actions regarding heat exposures;

• A sun-safety action plan with NGOs, leading to a nationwide communication campaign to promote healthy sun behaviour;

• A tool for municipalities to limit microbial risks of urban water features;

• Information on potentially negative health impacts of climate mitigation measures and examples of actions and advice public health services can put forward to minimize these effects.
The indirect impact of COVID-19 on hospitalization and mortality for ischemic stroke
Authors: Leucci A C , Berti E , Romoli M , Ferro S , Rolli M , Tedesco D
Published: October 2023

Background

Fear of contracting COVID infection may cause delay or reduction in hospital admissions for acute cerebrovascular events. The main objective of this study was to measure the indirect impact of the pandemic on the volume of hospitalizations for ischemic stroke (IS), in-hospital and 30-day mortality, 30-day readmissions and out-of-hospital IS mortality.

Methods

Study design was a quasi-experimental population-based interrupted time-series. Data were drawn from the Health Information System of the Emilia-Romagna region (Italy). To evaluate volume of hospitalizations and inpatient mortality, we included all inpatient care hospitalizations with a principal diagnosis of IS (ICD-9-CM: 433.x1, 434.x1, 436) between 2015-2021. To evaluate out-of-hospital mortality, we included all patients who died at home for IS (ICD-10 cause of death: H34.1, I63.x, I64.x).

Results

We observed in 2020 a 13% decrease in IS hospitalizations and an increase in the proportion of in-hospital mortality (+20%), out-of-hospital mortality (2 more deaths per day on average), and 30-day mortality (+4%). Compared to 2020, 2021 showed a 16% lower in-hospital mortality and a 7% lower 30-day mortality. Change in out-of-hospital mortality was not statistically significant. Comparing 2021 to 2015-2019, almost all outcomes did not significantly differ (in-hospital mortality: +0.62%; 30-day mortality: -3.18%; 30-day readmissions: +2.34%). Wee found a significant 12% decrease in hospital admissions and an increase in out-of-hospital mortality by 1.37 deaths per day on average, in 2021 compared to 2015-2019.

Conclusions

COVID pandemic caused a reduction in hospital admissions, resulting in worse outcomes, mostly in 2020 and to a lesser extent in 2021. The improvement in 2021 for most outcomes may have benefitted by the vaccine indirect effect.

Key messages

• Reduction in IS admissions due to COVID had a negative impact on patient outcomes.

• This lesson needs to be acknowledged and considered in a preparedness framework for future pandemics.
Religious service attendance and mortality in southern Sweden
Authors: Lindström M , Pirouzifard M
Published: October 2023

Aims

This study aims to investigate associations between attendance in religious service at least once during the past year and all-cause and cause-specific mortality. Study design: Prospective cohort study design.

Methods

A public health survey conducted by Region Skåne in southern Sweden in the autumn of 2008 was sent to a stratified random sample of the adult 18-80 year population with a participation rate of 54.1%. A total of 24,855 participants were included in the present study. The baseline survey was connected to prospective mortality data with 8.3-year follow-up. Analyses were conducted in survival (Cox regression) models.

Results

A total 14% had attended religious service at least once during the past year, while 86% were non-attenders. The religious service attenders were women, high and medium position non-manual employees, born outside Sweden, never alcohol consumers and participants with high generalized trust to a higher extent than non-attenders. They also displayed lower proportions with daily smoking and low physical activity compared to non-attenders. The group of religious service attenders had significantly lower hazard rate ratios (HRRs) of all-cause mortality compared to non-attenders in all multiple models. Cardiovascular (CVD) mortality was significantly lower for religious service attenders in the multiple models until BMI, physical activity, daily smoking and alcohol consumption were entered in the survival model. No significant results for cancer and other cause mortality were found.

Conclusions

Religious service attendance in Sweden, a highly secularized and individualized high-income country, is significantly associated with lower all-cause mortality. This may to some extent be by explained lower CVD mortality partly mediated by protective health-related behaviors.

Key messages

• Religious service attendance and health has mostly been investigated in the USA, and much less in more secularized countries like Sweden.

• Religious service attendance was associated with lower all-cause and CVD mortality, partly mediated by protective health-behaviors.
Measuring the Burden of Climate-Related Asthma in Ireland via Microsimulation and Hybrid Costing
Authors: Di Capua G , Hynds P , O'Dwyer J , Priyadarshini A
Published: October 2023

Asthma affects approximately 5.7% of EU citizens, with over 7.7% of Irish residents suffering from the condition. Climate change will significantly affect both the prevalence and severity of asthma via exposure to temporal stressors including fluctuating air quality, changing local vegetation patterns, and increasingly intense precipitation. Resulting asthma cases will result in significant additional costs and pressures on the healthcare sector, the magnitude of which however remains, to date, unclear. The current project will provide an econometric analysis of the public healthcare burden generated by climate-related asthma via a national longitudinal survey (n = 1,695) of asthma sufferers and semi-structured interviews with healthcare professionals. Current and future likely healthcare expenditures will be quantified using time-driven activity-based costing and microsimulation as a function of future demographic shifts and climate change scenarios. The indirect burden of climate-related effects will be calculated utilizing a hybrid set of physical, psychological, and economic burden-of-disease measures. Preliminary results indicate that asthma-related limitations on daily activities significantly impair males more than females (t = 2.937, p =.005), with decreases in quality of life significantly differing across age groups (F = 4.234, p =.003). The asthma-related toll on quality of life is further associated with presentation of adverse mental health effects including depression (r = -.301, p<.001) and anxiety (r = -.340, p<.001), indicating compounded physical and psychological health and economic susceptibilities within households with younger, male asthma patients. Findings will increase the current evidence-base for specific demographic groups across Ireland, enabling future budget allocation, surveillance, and healthcare management and providing a replicable model for surveillance of the economic burden of climate-related asthma across Europe.

Key messages

• The study will increase the evidence-base for budgetary allocation based on simulated health vulnerabilities and develop a baseline for research on climate-associated health outcomes.

• The study will translate cross-sectoral health impacts into monetary “bottom lines” for elucidating health-related costs associated with specific climate change scenarios via hybrid costing.