bluuebunny/crossref_metadata_2025_split huggingface dataset:
351 PRIDE IN AGEING - DEVELOPING LGBTQ+ EDUCATION TO DRIVE INCLUSION IN OLDER PERSONS CARE
Authors: Dillon A , Fitzgerald K 
Published: October 2022

Abstract

Background
Older LGBTQ+ people are more likely to have diminished support networks and increased health risk factors, creating a greater reliance on healthcare. Within the literature concerns are voiced that fear of discrimination leads to mistrust and therefore underutilisation of health and social services among older LGBTQ+ people, leading to a lack of understanding of the specific needs and experiences of this cohort of patients. This mistrust of healthcare professionals and systems can negatively impact upon quality of life as older LGBTQ+ people do not avail of the health and social services they need to age well.

Methods
The author attended an international workshop to hear first-hand the lived experiences of older LGBTQ+ people from five European countries. A systematic literature review was completed to gain greater understanding of the challenges and discrimination faced by older LGBTQ+ people while accessing health and social care services. The author then received training with a leading LGBTQ+ organisation in order to gain insights into the experiences and concerns of older LGBTQ+ people in Ireland. Practical learning was gained on how to foster inclusion, provide education and create change within older persons services. Staff and patient engagement, feedback and evaluation was used to establish requirements for education, training and service development.

Results
LGBTQ+ education and training was developed for all disciplines working across acute, rehabilitation and residential older persons services in a large academic teaching hospital. This education is now delivered monthly to drive inclusion in older persons care. Staff feel more equipped and confident to provide inclusive care. There has been improved staff well-being and pride as the hospital moves towards being an inclusive and safe space for all.

Conclusion
There is a need for sustained education and training to equip staff with the skills and confidence to provide inclusive care to older LGBTQ+ patients accessing health and social care services.
353 FACTORS ASSOCIATED WITH ADVERSE OUTCOMES IN OLDER ADULTS DIRECTLY DISCHARGED FROM THE EMERGENCY DEPARTMENT
Authors: Mohamed A , Leahy A , Gabr A , Mannion M , Cassarino M , Carrol I , Hayes C , Peters C , Shanahan E , O'Connor M , Galvin R 
Published: October 2022

Abstract

Background
Older adults attend the Emergency Department (ED) frequently. Over 40% are directly discharged from the ED. The risk of adverse outcomes is high following discharge including unplanned ED return, institutionalisation, and mortality. The purpose of this study was to highlight factors that predict these adverse outcomes.

Methods
A secondary analysis was completed of SOAED (a prospective cohort study examining screening instruments to predict adverse outcomes for undifferentiated older adults attending the ED) and OPTIMEND (randomised control trial examining the effectiveness of an intervention by a team of Health and Social Care Professionals along with usual care and compared this to standard ED care alone). Inclusion criteria were adults aged 65 years and over presenting to ED at a University Teaching Hospital with medical complaints and a Manchester Triage System category 2–5.

Results
Three-hundred and nine patients were discharged directly from ED (mean age 80 years; 58% female). 96 patients re-attended ED within 6 months. 66 patients were re-hospitalised within 6 months. 16 patients died within six months of discharge. 63% of the discharged patients screened positive for frailty measured by PRISMA-7 (3 or more). Relative risk ratio analysis confirmed that the risk of revisiting a hospital was 1.241 times for patients that scored frail compared to those who scored not frail. The risk of mortality was 1.075 times for patients that scored frail compared to those who scored not frail. The risk of being admitted to a nursing home was 1.146 times for patients that scored frail compared to those who scored not frail.

Conclusion
Older people have a high ED re-attendance rate of 31% after an index visit. Frailty (scored on PRISMA-7) is a significant predictor of adverse outcomes. Focused screening and intervention for frail patients who attend the ED should be a priority.
Comment ça va? The Status of French Laws in Vanuatu
Authors: Corrin Jennifer 
Published: October 2022

Abstract
Prior to Vanuatu’s independence in 1980, in the absence of applicable joint regulations, French law applied to French citizens and English law applied to British citizens. Members of the indigenous population were governed by a different regime. Subjects of other countries were required to “opt” for either the French or the English legal system within one month of arrival. At independence, French and English laws continued in force, unless revoked by the Vanuatu Parliament or incompatible with the independent status of Vanuatu. However, the opting provisions were repealed and it was not made clear when and to whom each system of law was to apply. In practice, French law is rarely applied. Commencing with a brief explanation of the sources of law in Vanuatu, this Article seeks to identify the rules for the application of French law in Vanuatu today through an analysis of relevant case law. It then goes on to explore divergence between English and French law, which might be of significance for parties to civil cases. The Article also discusses the results of empirical work carried out in Vanuatu, which sheds some light on the reasons why French law has been marginalised.
Precision of Soft-Tissue Filler Injections: An Ultrasound-Based Verification Study
Authors: Calomeni Mariana , Bravo Bruna S F , Schelke Leonie W , Velthuis Peter J , Schalet Grant , Frank Konstantin , Guertler Anne , Alfertshofer Michael , Cotofana Sebastian , Moellhoff Nicholas 
Published: October 2022

Abstract

Background
Uncontrolled product spread is an important issue to consider in facial filler injections. Lack of precision can result in reduced effectiveness and surface projection, as well as irregularities and product visibility.

Objectives
The authors sought to assess the precision of soft-tissue filler injections in the face by employing a cannula.

Methods
This single-center observational study investigated soft-tissue filler distribution utilizing real-time non-invasive ultrasound imaging. Outcome parameters included (1) the tissue plane of product distribution, (2) the extent of horizontal as well as vertical product spread at the injection site, and (3) the product surface area taking into account the multifactorial influence of several independent variables. Participants were followed up to 30 days post-injection.

Results
A total 100 facial injections were performed in 8 patients (2 males, 6 females) with a mean age of 37.20 (±6.34) years and a mean BMI of 22.21 (±1.39) kg/m.2. The plane of product distribution remained constant in approximately 90% of cases at day 0 (d0), d14, and d30. Mean horizontal product spread was higher compared with vertical spread, and both significantly decreased over all time points (P &lt; .001). Mean product surface area was 22.51 ± 16.34 mm2 at d0, 15.97 ± 11.28 mm2 at d14, and 12.9 ± 9.15 mm2 at d30. Analysis employing generalized linear models revealed that injection volume and injection depth significantly influenced product surface area.

Conclusions
Injection of soft-tissue filler employing a cannula allows precise application of the product within the intended tissue plane. Precision can be improved by injecting less product into deeper tissue layers.

Level of Evidence: 5
Concept drift detection in toxicology datasets using discriminative subgraph-based drift detector
Authors: Bharti Vandana , Nair Shabari S , Jain Akshat , Kumar Shukla Kaushal , Biswas Bhaskar 
Published: October 2022

Abstract
Due to the increasing importance of graphs and graph streams in data representation in today’s era, concept drift detection in graph streaming scenarios is more important than ever. Contributions to concept drift detection in graph streams are minimal and practically non-existent in the field of toxicology. This paper applied the discriminative subgraph-based drift detector (DSDD) to graph streams generated from real-world toxicology datasets. We used four toxicology datasets, each of which yielded two graph streams – one with abrupt drift points and one with gradual drift points. We used DSDD both with the standard minimum description length (MDL) heuristic and after replacing MDL with a much simpler heuristic SIZE (number of vertices + number of edges), and applied it to all generated graph streams containing abrupt drift points and gradual drift points for varying window sizes. Following that, we compared and analyzed the results. Finally, we applied a long short-term memory based graph stream classification model to all the generated streams and compared the difference in the performances obtained with and without detecting drift using DSDD. We believe that the results and analysis presented in this paper will provide insight into the task of concept drift detection in the toxicology domain and aid in the application of DSDD in a variety of scenarios.
Plenary 2 Benefits and challenges of the European Health Data Space
Authors:   Organised by: EUPHA, European Commission,   Moderators: Iveta Nagyova (EUPHA), Isabel de la Mata (European Commission)
Published: October 2022

Abstract

The creation of a European Health Data Space (EHDS) is one of the key components of a strong European Health Union. The objectives of the EHDS are: i) Empower individuals through better digital access to their personal health data; support free movement by ensuring that health data follow people; ii) Unleash the data economy by fostering a genuine single market for digital health services and products; and iii) Set up strict rules for the use of individual’s non-identifiable health data for research, innovation, policy-making and regulatory activities. As such, the EHDS aims to improve and support healthcare delivery within Europe by allowing public health data to be accessible throughout Europe. The EHDS also aims to promote better access and exchange of different types of health data for research and policy purposes. The aim is to have the EHDS up and running in 2025.
The EHDS is expected to bring great benefit, but it also brings challenges related to technology, governance and privacy. The exchange of data at European level means that health data from different sources need to be able to talk to each other. Making the data Findable, Accessible, Interoperable, and Re-usable is key to the success of the EHDS. Moreover, the diversity of Europe’s health information systems need to be taken in account. The EHDS will also have to be transparent to ensure privacy of personal information included in the EHDS.

Speakers:
Fulvia Raffaelli
European Commission, Brussels, Belgium
Petronille Bogaert
Sciensano, Brussels, Belgium
Irene Schlünder
TMF, Germany
Emmanuel Bacry
Health Data Hub, France
1.B. Workshop: Adaptations in a time of crisis – public health practice in Sweden during the COVID-19 pandemic
Authors:   Organised by: The Public Health Agency of Sweden,   Chair persons: Anna Månsdotter (Sweden), Karin Guldbrandsson (Sweden)
Published: October 2022

Abstract

Background
The Public Health Agency of Sweden has assessed the consequences of the COVID-19-pandemic in relation to the Swedish public health goals, aiming at good and equitable health. This assessment indicated 1) that preconditions for good and equitable health have changed during the pandemic, 2) that groups with higher risk of ill-health before the pandemic were more severely affected, 3) that the general health of the population remains good although some groups appear to have suffered from increased minor mental health problems, 4) that physical activity has decreased and sedentary behaviour has increased, and 5) that many activities of relevance for public health, such as prevention of alcohol, drugs, and tobacco (ADT) at the local and regional levels were paused or were replaced with other, often digital, alternatives.

Objectives
The objective of this workshop is to present and discuss the results of four projects studying the consequences of the COVID-19-pandemic for public health practice in Sweden. Special attention is paid to ADT-prevention at the local and regional levels, focusing on how such work has developed digitally during the pandemic. Potential implications will be discussed with the audience. The added value of organizing this workshop: This workshop will contribute to an improved understanding of how public health practice, particularly ADT prevention, has navigated through a time of a crisis (i.e. a pandemic) in order to provide important lessons for the future. The presentations in this workshop will lay the foundation for discussing with the audience what might happen within the arena of health promotion and disease prevention as a result of a pandemic as well as ways to cope with the consequences of such a pandemic at the local and regional levels. The coherence between the presentations and the topic of the workshop: There is an obvious logic between the main topic of the workshop and the four presentations. In different ways, they all discuss consequences of the COVID-19-pandemic on public health practice in Sweden.

The format of the workshop
The workshop will start with a brief introduction, aiming to give a short background and set the scene. Four presentations will then follow, with time allocated for questions after each presentation. The presentations will contain descriptions of each subproject, including the background, methods, results, and conclusions. Finally, the moderator will lead a discussion with the audience and the presenters.

Key messages
• The pandemic forced public health practice to adapt its ways of working.
• When challenged, public health practice can operate in new ways, although with some regional differences.
Public health in Sweden during the COVID-19 pandemic
Authors: Månsdotter A , Fochsen G 
Published: October 2022

Abstract

Background and objectives
The COVID 19 pandemic has highlighted how public health is dependent on many areas of society, and several aspects of public health can be affected. We have evaluated how the COVID-19 pandemic and the measures taken to reduce its spread have impacted public health in Sweden during 2020.

Methods
We systematically compiled international research on the pandemic's impact on public health, we examined living conditions of groups at a particularly increased risk of ill health, and we collected and analysed Swedish data on lifestyles, health, injury, and illness during the pandemic compared to previous years.

Results
Most people have, in one way or another, been affected by the pandemic and by societýs preventive measures. However, some groups have suffered more than others. Groups who were already at an increased risk of ill health before the pandemic have been most affected, e.g. in schools, on the labour market, and in society in general. There is a risk of increased health inequality, not only related to morbidity and mortality of COVID-19 during 2020, but also when it comes to the effects on living conditions.

Conclusions
The consequences of the COVID-19 pandemic pose major challenges for public health, and the measures taken to limit its spread inter-relate with social and economic conditions. In Sweden, health inequalities have remained the same or increased over the years. Our study suggests that the consequences of the pandemic will reinforce health inequalities. It is too early to determine what the pandemic's full impact on public health will be. Nevertheless, health promotion and preventive measures need to be strengthened and prioritized in order to maintain good public health and reduce inequalities.
The Transforming Health Care Systems Partnership – collaboration for improvement post-pandemic
Authors: Montante S 
Published: October 2022

Abstract
Building on the experience and results of important European initiatives like the TO-REACH Action, the new European Partnership on Transforming Health and Care Systems aims to accelerate the sustainable transformation of European health systems. By means of multidisciplinary research with a focus on improving the uptake of innovative solutions by health system actors, including organisational, service, and overarching policy innovations, the partnership plans to achieve access to high quality, sustainable and innovative health care for European populations. This presentation will explore current and upcoming plans for the Partnership, as well as discuss some of the lessons learnt from past initiatives and how these, combined with the experiences from the pandemic, have contributed to shaping the new Partnership's agenda. Inputs from stakeholders in the audience will be collected to inform the Partnership's ongoing learning process.
A country perspective from Slovenia
Vesna-Kestrin Petric
Slovenian Ministry of Health, Ljubljana, Slovenia
Health system strengthening and transformation – Current priorities of the European Commission
Isabel de La Mata
DG SANTE, European Commission, Brussels, Belgium
Air pollution and health – the importance of air monitoring and burden of disease for attaining SDGs
Authors: Martins C 
Published: October 2022

Abstract
Pollution is the worldwide largest environmental cause of disease and premature death, being also considered a risk for planetary health, a cause of ecosystems destruction and intimately linked to global climate change. Pollution is considered costly, with attributable diseases resulting in health-care costs that are responsible for 1.7% of annual health spending in high-income countries. Moreover, in utero and early childhood exposures are responsible for health effects in children. The importance of air pollution as a cause of disease is well reflected in the Sustainable Development Goals (SDG), mainly in the SDG 3, SDG 11, and SDG 15, but indirectly in all the SDGs. To tackle this issue, an integrative and holistic approach linking human and environmental health such as One Health is needed, to provide evidence-based data to support the establishment of reduced air pollutants’ maximum admissible levels. A case-study developed in Portugal in the scope of PMCardImpact project, regarding the exposure of population to particulate matter with a diameter of 2.5 μm or less (PM2.5) and the associated number of cases of cardiovascular diseases will be presented herewith. Four scenarios of exposure will be considered for presenting the results: current scenario of exposure, new WHO Air Quality guidelines, European Commission Air Quality Directive and lastly, a worst-case scenario. This assessment is the starting point for calculation of the burden of disease of CVD that exposure to PM2.5 represent in Portugal. With a view to promote the science to policy interface, PMCardImpact project will make available to policy makers the needed supporting information to act, including actionable knowledge on air pollution trends and related health effects, to implement reducing air pollution policies.
This work is funded by FCT/MCTES through national funds to PMCardImpact (EXPL/SAU-PUB/0944/2021) and CESAM (UIDP/50017/2020 + UIDB/50017/2020 + LA/P/0094/2020).
Increase in Mental Disorders During the COVID-19 Pandemic - Role of Occupational & Financial Strains
Authors: Dragano N , Reuter M , Peters A , Schmidt B , Bohn B , Berger K 
Published: October 2022

Abstract

Background
Numerous studies reported an increase in mental disorders during the COVID-19 pandemic, but the specific causes for this increase are unclear. We therefore investigate whether pandemic-related occupational and financial changes (e.g., reduced working hours, working from home, financial losses) were associated with increased symptoms of depression and anxiety compared with the situation before the pandemic.

Methods
We analyzed data from the German National Cohort Study (NAKO). Between May and November 2020, 161,849 participants answered questions on their mental state and social circumstances. Responses were compared with data from the baseline survey before the pandemic (2014-2019). Linear fixed-effects models were used to determine whether individual changes in the symptoms of depression (PHQ-9) or anxiety (GAD-7) were associated with occupational/financial changes (controlling for covariates).

Results
A pronounced increase in symptoms was observed among those who became unemployed during the pandemic (+ 1.16 points on the depression scale, 95% confidence interval [0.91; 1.41], range 0-27). Increases were also seen for reduced working hours without short-term working allowance, increased working hours, working from home, insecurity regarding employment, and financial strain. The deterioration in mental health was largely statistically explained by the occupational and financial changes investigated in the model.

Conclusions
Depressive symptoms and anxiety disorders increased in the study population during the first year of the COVID-19 pandemic and occupational and financial difficulties were an essential contributory factor. These strains should be taken into account both in the care of individual patients and in the planning of targeted prevention measures. Results suggest that welfare state benefits such as short-time allowance in times of crises may reduce mental load in affected populations.
Risk factors for SARS-CoV-2 infection: a case-control study in college students after vaccination
Authors: Renzi E , Baccolini V , Covelli A , Migliara G , Massimi A , De Vito C , Marzuillo C , Villari P 
Published: October 2022

Abstract

Background
Within the SARS-CoV-2 screening campaign offered through RT-PCR test by Sapienza University of Rome, we conducted a case-control study to identify the risk factors for the acquisition of SARS-CoV-2 infection among university students.

Methods
Positive students identified through the SARS-CoV-2 screening campaign (September 2021 - February 2022) were enrolled as cases and matched to two randomly selected students who tested negative on the same day. The interview questionnaire consisted of 39 questions investigating exposure to modifiable and nonmodifiable risk factors for SARS-CoV-2 in the two weeks before testing. A multivariable conditional logistic regression model was constructed to identify predictors of SARS-CoV-2 infection. Adjusted odds ratio (aOR) and 95% CI were calculated.

Results
Out of 8.730 tests for SARS-CoV-2, 173 students tested positive (2.0%), of which 122 were included in the case-control study (response rate: 70.5%). Most students were female (73.2%), with a mean age of 23.3 years (SD ± 3.6), vaccinated for SARS-CoV-2 (97.8%) and enrolled in non-health faculty (56.8%). At the multivariable analysis, significant positive associations were found with having had contact with a person who tested positive for SARS-CoV-2 (aOR: 3.04, 95% CI: 1.59-5.82) or having been to a disco/nightclub (aOR: 5.37, 95% CI: 2.00-14.38). Instead, being vaccinated against SARS-CoV-2 (aOR: 0.13, 95% CI: 0.01-0.93), having a valid EU COVID digital certificate (aOR: 0.06, 95% CI: 0.01-0.30) and attending lectures in-person (aOR: 0.35, 95% CI: 0.17-0.70) were negatively predictors. No association was found for sex, age, health faculty students, use of public transportation, attendance at restaurants or gyms.

Conclusions
The results highlight how anti-COVID-19 vaccinations and the reasons for students to obtain an EU COVID digital certificate may prevent students from getting infected. In addition, university environment seems to be safe for students.

Key messages
• Promoting SARS-CoV-2 vaccination adherence in the college-age population is crucial to limiting the SARS-CoV-2 spread.
• Attending in-person educational activities in regulated settings (e.g., low occupancy, mask use) may not be a risk factor for COVID-19 infection.