bluuebunny/crossref_metadata_2025_split huggingface dataset:
346 A RETROSPECTIVE REVIEW OF THE PREVALENCE, MANAGEMENT AND SPECIALIST REVIEW OF TIA DIAGNOSIS
Authors: Geraghty T , Fernandez C 
Published: October 2022

Abstract

Background
Transient Ischaemic Attach (TIA) and suspected TIA are common presentations to emergency departments and stroke services, often heralding a subsequent stroke in up to 25% of patients. The first week after TIA symptom onset carries a significant risk of impending stroke, reported risk at 2 days of between 2.0 and 4.1%, and at 7 days of between 3.9 and 6.5%. As such, a TIA presentation may offer an opportunity to reduce the significant risk of chronic morbidity and mortality.

Methods
We conducted a retrospective review of all patient records with a diagnosis of TIA on their clinical discharge summary using the HIPE system from June 2020 to June 2021.

Results
Two-hundred and Sixty-nine patients were recruited into the study. 77 patients without discharge letters or incomplete medical information were excluded. The remaining 192 were analysed. Mean age was 75 (+/-10), 45.8% (n=88) patients were male and average length of stay 3.9 days. 52.6% (n=101) were followed up in designated TIA or Neurology OPD, 42.2% (n=81) were confirmed TIA. 10.4%(n=20) were diagnosed with another pathology. 47.4% (n=91) did not have any OPD follow up care. 100% of OPD confirmed TIA cases (n=81) were on anti-platelet or anticoagulation therapy. 4 out of 9 confirmed TIA cases with high HbA1c levels had no prior history of diabetes. 4.2% (n=8) were actively smoking and not on nicotine replacement therapy. 27.2% (n=22) had a history of previous TIA.

Conclusion
Accurate TIA recognition and management remains crucial to stroke prevention. Outpatient follow up in TIA and Neurology clinics can improve TIA diagnosis and guide appropriate management. Despite guidelines recommending an early referral to a stroke team, almost half (47%) of those patients diagnosed with TIA during admission did not have OPD follow up. TIA mimics represent a considerable pitfall in TIA diagnosis for NCHDs.
350 INTEGRATION OF VISION AND HEARING IS ASSOCIATED WITH GAIT VELOCITY IN A LARGE SAMPLE OF MIDDLE-AGED AND OLDER ADULTS
Authors: Setti A , Hernandez B , Hirst R , Donoghue O , Kenny RA , Newell FN 
Published: October 2022

Abstract

Background
Multisensory integration is the ability to appropriately merge information from several senses for the purpose of perceiving and acting in the environment. Its importance for higher level cognition and function has emerged in recent years. Walking requires to combine information from multiple senses to coordinate effective movements. In this study, we tested the association between a well characterised multisensory task, the Sound-Induced Flash Illusion (SIFI), and gait velocity in 3,255 participants from The Irish Longitudinal Study on Ageing. The SIFI is the illusory perception of two flashes when one flash is presented with two beeps. We hypothesised that high SIFI susceptibility would be associated with slower gait velocity

Methods
Gait was measured under three conditions; usual pace, cognitive dual tasking, and maximal walking speed. A separate logistic mixed effects regression was run for: (1) gait at usual pace, (2) change in gait speed for the cognitive dual-task relative to usual pace, and (3) change in maximal walking speed relative to usual pace. The model controlled for covariates including age, sex, education, vision and hearing abilities, Body Mass Index, and cognitive function.

Results
Slower gait was associated with more illusions, indicating that those who integrated incongruent sensory inputs over longer intervals, also walked slower. Relative change for cognitive dual tasking and maximal walking speed were also significantly associated with SIFI at longer SOAs.

Conclusion
These findings extend growing evidence showing that mobility is associated with multisensory processing in ageing; in particular, the mechanisms appear related to the temporal dynamics of sensory integration.
352 THE IMPACT OF ETHNICITY ON ACUTE STROKE ADMISSIONS IN AN IRISH HOSPITAL
Authors: Roche A , Duane C , Murchan A , Donaghy L , Guilfoyle P , Dolan E , Sheehan O 
Published: October 2022

Abstract

Background
Recent studies have demonstrated the variability of aetiology, clinical presentation and overall mortality between different ethnic groups presenting with acute stroke. The non-native Irish population accounts for almost 13% of the total population and is predicted to grow over the next decade. Recording and analysis of acute stroke patients based on their ethnicity and population demographics is an important step in planning for the future of stroke care in Ireland. In this study, we aimed to evaluate key differences between the Irish and non-Irish population presenting with acute stroke to an Irish hospital.

Methods
We reviewed our hospital stroke registry over a 12-month period (January-December 2021). Key parameters including country of birth, ethnicity, other patient demographics, clinical presentation, aetiology and subtype of stroke, stroke management and clinical outcomes.

Results
Of the 245 acute strokes admitted to our hospital in 2021, non-ethically Irish patients made up 12.2% (n = 30). The average age of non-ethnically Irish stroke presentations was younger than Irish stroke presentations (59 versus 71 years). Haemorrhagic strokes were more common in the non-Irish population (13.3% in non-Irish cohort vs 9.8% in Irish cohort). Median time of symptom onset to presentation to hospital was 3 hours and 58 minutes in the Irish patients and 6 hours and 10 minutes in the non-Irish patients. The overall length of stay in hospital post stroke was similar between the two population groups at an average of 19 days duration.

Conclusion
This study identifies disparities in acute stroke presentation between the Irish and non-Irish population presenting to an Irish hospital. This study demonstrated the importance of further research on a national scale to record the variability of strokes in different ethnic groups in order to adequately plan primary and secondary stroke care and provide targeted public health campaigns to remain inclusive to Ireland’s growing and increasingly diverse population.
354 PROMOTING THE BENEFITS OF COGNITIVE STIMULATION AMONGST OLDER PATIENTS: A BRIEF SURVEY AND QUALITY IMPROVEMENT PROJECT
Authors: Higgins M , Brewer L 
Published: October 2022

Abstract

Background
Cognitive Stimulation (CS) enhances cognitive function in patients with Cognitive Impairment (CI), including those with mild/moderate dementia. It has positive effects on various cognitive and non-cognitive symptoms. Engaging in CS can reduce the risk developing dementia and allows proactive improvement in wellbeing. Physical exercise and promotion of independence are also beneficial. Patients and staff are often poorly informed regarding such benefits.

Methods
We developed a 9-question survey, administered to a sample of representative doctors involved in the care of patients with CI to gauge their understanding of CS and its benefits. We envisaged this data may support the development of a patient-friendly information leaflet to educate about CS.

Results
Of 45 respondents, 68.89% could readily provide three examples of CS. 55.56% reported that CS “definitely” benefits patients with CI, 44.44% reported it “probably” does. All reported it was the joint responsibility of the doctor, memory nurse and occupational therapist to provide advice on CS. 44.44% regularly or sometimes discuss CS with patients/families, compared with 55.55% who rarely or never do. 55.56% were “not confident” giving advice on CS, only 8.89% were “quite confident”. 80% reported that exercise reduces the risk of CI. 37.78% could give an appropriate example of a compensatory strategy. All reported an information leaflet available for patients and their families, would be beneficial. We designed a patient information leaflet explaining cognitive domains, examples of impairments and measures patients can embrace to promote and maintain cognitive function. We highlighted physical and cognitive activities, social engagement and compensatory techniques to promote independence. We provided everyday examples of each including local clubs/classes to ensure accessibility and relatability.

Conclusion
Gaps in knowledge and confidence were identified amongst doctors rotating through the Geriatric Medicine Service. Recognising this, we designed an information leaflet ensuring we can readily impart accurate education and lifestyle advice to patients.
355 PREDICTORS OF HOME SUPPORT SERVICES AND THE CONSEQUENCES OF MISMATCH BETWEEN ALLOCATED AND RECEIVED SERVICES IN COGNITIVELY-IMPAIRED OLDER ADULTS
Authors: Whelan A , Murphy R , Shiel E , Griffith V , Mannion K , Neachtain M Ní , Mannion E , Conry M , Geoghegan J , Waters R , O'Donnell M , Robinson S , Canavan M 
Published: October 2022

Abstract

Background
Home support services aim to support older people to remain at home. Despite substantial investment in home support hours (€600 million), this has not translated into increased carers on the ground for older people. We aimed to report patterns of home support service utilisation in older patients with memory problems, and identify any mis-matches between allocated and received hours, and the impact on patients and caregivers.

Methods
Retrospective analysis of consecutive patients referred to community geriatric clinic from January 2021 to May 2022. 95/104 patients who were identified were suitable for inclusion.

Results
Participants had a median age of 82 (IQR 78-86) of whom 57% were female (n=54). 80% (n=76) were frail (CFS ≥4), with 82% dependent for IADLs (Lawton-Brody IADL Scale ≤6). Median MOCA score was 18, with 44% having moderate to severe cognitive impairment (MOCA ≤17). 40% of patients lived with alone (n=38). 52% (n=49) received formal home supports while 80% (n=76) had an informal carer. 37% (n=18) had a mismatch between hours allocated and hours received. There was a significant difference between median hours of care allocated (7) and median hours of care received (5), p &lt;0.001. Increasing age and frailty, worsening cognitive and functional impairment and living status (living alone) predicted allocation of home supports. Patients who lived with family members were 3 times more likely not to receive allocated hours (OR 3.84 (95% CI 1.2–13.7))

Conclusion
In this vulnerable population with cognitive and functional decline, just over half received formal home support hours. A large proportion experienced significant mismatch between allocated and received hours. Family and informal caregivers often have to fill gaps, adding to existing carer strain. Future models of home support should prioritise early intervention for people with IADL loss to remain independent at home and broaden of the scope of practice of carers to facilitate this.
356 OLDER PERSONS LIVING ALONE IN INTEGRATED CARE: DEPRESSION, LOW EDUCATION AND FUEL POVERTY
Authors: Dolphin H , Dyer A , Domsa M , McNally D , Doyle M , Keating J , Noonan C , McGuinn C , Ahern L , Murphy A , Malone N , Kennelly SP 
Published: October 2022

Abstract

Background
An important consequence of population ageing has been the increasing number of older adults who live alone. According to TILDA data, older adults with the lowest levels of education tend to experience most social isolation and there is a strong association between living alone and loneliness. We sought to compare the cohort of patients open to the Integrated Care for Older Persons (ICPOP) team in a University Teaching Hospital serving a community area of approx. 300,000 population, to this national dataset.

Methods
A convenience sample of 174 patients who underwent comprehensive geriatric assessment via domiciliary visit between July 2021-May 2022 by was analysed. Data was anonymised and analysis was performed using SPSS v.27.

Results
The average age was 81.5 (±8.1) with 63% women in the sample. Eighty-five older adults i.e. 49% of the sample either lived alone or spent more than 21 hours alone per 24-hour period. Compared to those who live with someone, those who lived alone had higher rates of likely depression as determined by Geriatric Depression Score (6.6 vs 4.8 p=0.007). They were also likely to have less educational attainment, as determined by years spent in full time education (11.81 vs 10.42 42 p= 0.0016) and those living alone had overall less central heating in their homes than those not living alone (64/85 vs 81/89 p=0.0109). There were no significant differences in the rates of polypharmacy, falls, dementia and home ownership between groups. There were higher levels of frailty in the group living with someone than those living alone as determined by Clinical Frailty Scale (6.14 vs 5.23 p&lt;0.001).

Conclusion
A high proportion of patients seen by our ICPOP team live alone and have complex care needs that require an innovative, multidisciplinary approach. Financial vulnerability in this group is likely to compound isolation and loneliness.
360 PROFILING FRAILTY IN A POPULATION OF OLDER FARMERS IN THE WEST OF IRELAND
Authors: Merrick C , French H 
Published: October 2022

Abstract

Background
Identification of different groups at risk of frailty is a key research focus. Farmers frequently have higher prevalence of some health problems; however, they undertake high levels of physical activity which may provide protection against the development of frailty in this cohort. To date, no published research has examined prevalence of frailty levels in older farmers in Ireland. This research aimed to profile frailty levels of older farmers in the west of Ireland, and, establish if there is an association between frailty levels in this group and different farming specific demographics/socioeconomic factors such as; type of farming undertaken, amount of time spent farming outdoors and amount of land owned by farmers

Methods
This cross-sectional study recruited older farmers via livestock marts in the west of Ireland. A questionnaire regarding participants characteristics and farming demographics was provided to participants. This questionnaire also included the Program on Research for Integrating Services for the Maintenance of Autonomy (PRISMA-7) questionnaire and the short 5-question assessment of Fatigue, Resistance, Aerobic capacity, Illnesses, and Loss of weight (FRAIL) questionnaire to assess frailty. Data were analysed using STATA statistical software.

Results
In total, 58 older farmers participated in the study. Results showed found that two participants (3.5%) were ‘frail’, with 27 participants (47%) classified as ‘prefrail’. An association existed between the type of farming undertaken and frailty levels based on the FRAIL scale (p=0.009). No association was found between frailty levels and the amount of land owned by farmers (p=0.34) or the amount of time spent farming outdoors (p=0.18).

Conclusion
A minority of participants in this study were classified as frail. The type of farming undertaken by farmers may have an association with frailty levels. Results should be interpreted with caution secondary to the small sample size and the small geographical scope of recruitment.
HAT-field: a cheap, robust and quantitative Point-of-care serological test for Covid-19
Authors: Joly Etienne , Maurel Ribes Agnès 
Published: October 2022

Abstract
The haemagglutination test (HAT)-field protocol described here is an optimization of the recently published HAT, for the detection of antibodies directed against the receptor binding domain (RBD) of the SARS-Cov-2 virus. HAT and HAT-field are both based on haemagglutination triggered by a single reagent, the IH4-RBD recombinant protein. A sample of IH4-RBD sufficient for several thousand tests or a plasmid encoding IH4-RBD can be obtained from the authors of our first paper. Using titration of IH4-RBD, HAT-field now allows a quantitative assessment of antibody levels in a single step, using a few microliters of whole blood, such as can be obtained by finger prick, and requires only very simple disposable equipment. Because it is based on a single soluble reagent, the test can be adapted very simply and rapidly to detect antibodies against variants of the SARS-CoV-2, or conceivably against different pathogens. HAT-field appears well suited to provide quantitative assessments of the serological protection of populations as well as individuals, and given its very low cost, the stability of the IH4-RBD reagent in the adapted buffer and the simplicity of the procedure, could be deployed pretty much anywhere, including in the poorest countries and the most remote corners of the globe.
The International Law Commission and Politics: Taking the Science Out of International Law’s Progressive Development
Authors: Voulgaris Nikolaos 
Published: October 2022

Abstract
The idea that jurists have a vocational duty to progressively develop the law finds its way in international law chiefly via the mission statement of the United Nations’ International Law Commission (ILC). Mandated by states to codify and progressively develop international law, the ILC’s modern practice has merged these two distinct exercises. The Commission utilizes a common working procedure for the elaboration of both and appears to perceive progressive development as an appurtenance of codification. What is more, progressive development has often been equated by the ILC with lex ferenda propositions and policy considerations. It is little wonder then that the ILC has never attempted to meaningfully analyse this aspect of its mandate. This article examines progressive development from a methodological standpoint and maintains that it is an exercise with self-standing importance. It argues that there are two ways to understand the ILC’s mandate to progressively develop the law: either as ‘progressive development stricto sensu’ or as ‘legislation’. The difference between the two is methodological; ‘progressive development stricto sensu’ is elaborated via an inductive methodology and principally justified by legal considerations. On the other side, in the case of ‘legislation’, provisions are principally justified by policy considerations and, hence, imbued with uncertainty regarding their methodological foundations. The article suggests that ‘progressive development stricto sensu’ falls squarely within the ILC’s legal mandate, while this will be the case with respect to ‘legislation’ only when the ILC is conscious of the question it sets out to answer and the requisite methodology that it employs to do so. To this end, the article lays down some basic methodological principles that the ILC should adhere to when engaging with topics of work where political considerations play a significant role in the development of the law. Finally, it calls for a revival of the forgotten discussion regarding the ILC’s capacity to develop international law.
Plenary 3 Health Systems Performance Assessment for Policy: Uses and Abuses
Authors:   Organised by: European Observatory on Health Systems and Policies, European Commission,   Moderators: Isabel de la Mata (European Commission), Dimitra Panteli (European Observatory on Health Systems and Policies)
Published: October 2022

Abstract

The COVID-19 pandemic constitutes a powerful reminder of the importance of health systems strengthening in protecting and improving the health of our populations. For policy makers ‘to build back better’ systems to face future shocks, they will need to be able to determine which areas work best (in terms of providing access, quality, population health, responsiveness or efficiency) to prioritize and direct resources towards. More than ever, we need now to count with strong health systems monitoring, appraisal and assessment to draw practical policy implications.
This plenary will look at the effective application of Health Systems Performance Assessment (HSPA) to health systems’ improvement as we face key challenges in the sustainability of our health systems. Too often the results of HSPA exercises, particularly when benchmarking is involved, are not well interpreted, and understood. When translating HSPA results into policy changes, we need to address a series of questions not only about the quality and validity of the indicators but, importantly, about the causal attribution and accountability implications and about the kinds of policy interventions required to address the performance failures.
Following an introductory keynote providing practical illustrations of those issues and drawing policy lessons, the panelists will focus on three key HSPA questions particularly relevant in the current policy context. First, how to interpret and attribute overall health system performance outcomes to individual health system functions and strategies in need of reform. Second, how best to benchmark and compare performance between European countries to identify and learn from best practices. Finally, how to measure resilience as core component of systems performance and draw lessons to prepare for future shocks.

Introductory keynote speaker:
Reinhard Busse
European Observatory on Health Systems and Policies and Technical University Berlin, Germany

Panellists:
Kenneth Grech
EU Expert Group Health Systems Performance Assessment & Ministry of Health Malta, Malta
Irini Papanicolas
Department of Health Policy, London School of Economics and Political Science, UK
Marina Karanikolos
Research Fellow, European Observatory on Health Systems and Policies; London School of Economics and Political Science, UK
Food labelling
Authors: Gokani N 
Published: October 2022

Abstract
The Commission has undertaken to regulate the information provided to consumers on food. In particular, it intends to propose mandatory front-of-pack nutrition labelling (FoPNL) for food by the end of 2022. Even though nutrition labelling has been regulated by the EU since 1990, the tactics of industry, with the support of a minority of Member States, have prevented, so far, the adoption of a single, EU-wide, mandatory FoPNL scheme. Questions therefore arise regarding the extent to which the EU may secure agreement for the adoption of an EU-wide scheme which could effectively contribute to a high level of public health protection.
Food marketing
Authors: Garde A 
Published: October 2022

Abstract

The Commission has established a joint action with Member States through the Best ReMaP joint action (2020-2023) to facilitate the effective implementation of the Audiovisual Media Services Directive which, in its revised version, calls on Member States to ensure that codes of conduct protect children from exposure to unhealthy food marketing. This provision itself highlights the tension between, on the one hand, the desire to limit the exposure of children to harmful food marketing and, on the other, the likelihood of achieving this objective through the implementation of codes of conduct.

Speakers/Panellists
Nikolai Pushkarev
Healthy Environments & EPHA Policy, European Public Health Alliance, Brussels, Belgium
Contact: nikolai.pushkarev@epha.org
EPHA will present the perspective of the public health advocacy community, and discuss some of the initiatives civil society are engaged in to help the EU move from rhetoric to practice.