“Up To Date 2” Vervolgproject

Prévalence de l'abus de substances dans la population belge au travail. Formation des médecins à la thématique des abus de substances.Up to Date 2 (Use of psychoactive substances in adults: Prevention and Treatment by general practitioners and Occupational physicians - DATa retriEval

A mechanism for brief glacial episodes in the Mesozoic greenhouse

International audienceThe Mesozoic, perhaps the longest period of warmth during the Phanerozoic Earth history, has been repeatedly affected by short-lived cold interludes lasting about one million years. While the origin of these cold snaps has been classically attributed to a temporary atmospheric CO(2) drawdown, quantified mechanisms explaining these instabilities of the carbon cycle are still lacking. Based on a climate carbon cycle model, we show that the general demise of carbonate platforms accompanying these short-lived cold interludes is a powerful mechanism capable of generating a fast atmospheric CO2 decrease and a moderate sea level drop associated with ice sheet buildup. The temporary nature of the carbonate production decline explains the relative short time of these cold events but makes it possible to account for ice sheet waxing and waning

Obstacles in measles elimination: an in-depth description of a measles outbreak in Ghent, Belgium, spring 2011

BACKGROUND: From Mid-February to April 2011 one of the largest measles-outbreak in Flanders, since the start of the 2-dose vaccination scheme in 1995, took place in Ghent, Belgium. The outbreak started in a day care center, infecting children too young to be vaccinated, after which it spread to anthroposophic schools with a low measles, mumps and rubella vaccination coverage. This report describes the outbreak and evaluates the control measures and interventions. METHODS: Data collection was done through the system of mandatory notification of the public health authority. Vaccination coverage in the schools was assessed by a questionnaire and the electronic immunization database ‘Vaccinnet’. A case was defined as anyone with laboratory confirmed measles or with clinical symptoms and an epidemiological link to a laboratory confirmed case. Towards the end of the outbreak we only sought laboratory confirmation for persons with an atypical clinical presentation or without an epidemiological link. In search for an index patient we determined the measles IgG level of infants from the day care center. RESULTS: A total of 65 cases were reported of which 31 were laboratory confirmed. Twenty-five were confirmed by PCR and/or IgM. In 6 infants, too young to be vaccinated, only elevated measles IgG levels were found. Most cases (72%) were young children (0–9 years old). All but two cases were completely unimmunized. In the day care center all the infants who were too young to be vaccinated (N=14) were included as cases. Thirteen of them were laboratory confirmed. Eight of these infants were hospitalized with symptoms suspicious for measles. Vaccination coverage in the affected anthroposophic schools was low, 45-49% of the pupils were unvaccinated. We organized vaccination campaigns in the schools and vaccinated 79 persons (25% of those unvaccinated or incompletely vaccinated). CONCLUSIONS: Clustering of unvaccinated persons, in a day care center and in anthroposophic schools, allows for measles outbreaks and is an important obstacle for the elimination of measles. Isolation measures, a vacation period and an immunization campaign limited the spread of measles within the schools but could not prevent further spread among unvaccinated family members. It was necessary to raise clinicians' awareness of measles since it had become a rare, less known disease and went undiagnosed

Les facteurs qui favorisent l’implication des médecins généralistes belges dans la gestion des abus de substances. Une étude qualitative basée sur le I-Change Model

Objectifs Les médecins généralistes (MG) jouent un rôle majeur dans la détection et la gestion des abus de substances. L’étude présentée ici investiguait les facteurs qui influencent leur implication concernant la gestion des abus d’alcool, des drogues illégales, des hypnotiques et des anxiolytiques dans la population belge des 18-65 ans. Méthodes 20 MG ont été interrogés par entretiens semi-directifs dans les régions de Liège et d’Anvers. Le I-Change Model de de Vries a été utilisé pour construire le guide d’entretien et analyser les données récoltées. Résultats Parmi les principaux résultats de l’étude, il ressortait que les MG étaient fortement influencés dans leur approche par leurs propres représentations de l’abus, qui oscillait leurs responsabilités professionnelles envers ces patients et la responsabilité de ces derniers quant à la gestion de leur santé, avec l’idée de faute morale en substrat. En ce sens, l’abus de substance était perçu sur un continuum entre l’abus comme forme de maladie chronique d’une part, et la faute morale d’autre part. L’alcool et le cannabis étaient néanmoins mieux acceptés socialement que les autres substances. Les propres expériences personnelles des MG concernant les abus avaient aussi une incidence sur leur volonté de s’investir avec ces patients. Pour autant, les pratiques multidisciplinaires (notamment au forfait) et l’expérience étaient évoqués comme des facteurs importants quant à l’engagement dans la gestion. Les contraintes temporelles et l’investissement demandé étaient, en revanche, considérés comme des barrières. Conclusion Les facteurs motivationnels apparaissaient centraux dans la décision de s’investir dans la gestion des abus de substances, bien davantage que les connaissances théoriques et les formations qui semblaient plus secondaires. La peur du burn-out s’exprimait donc en substrat. La formation des MG devrait tenir compte de ce souhait de se protéger, afin de favoriser simultanément une approche centrée sur le patient

Exploratory analysis of the human breast DNA methylation profile upon soymilk exposure

Upon soy consumption, isoflavone metabolites attain bioactive concentrations in breast tissue possibly affecting health. Though in vitro epigenetic activity of soy metabolites has been described, the in vivo impact on the epigenome is largely unknown. Therefore, in this case-control study, the breast glandular tissue DNA methylome was explored in women undergoing an aesthetic breast reduction. After a run-in phase, 10 generally healthy Belgian or Dutch women received soymilk for 5 days. MethylCap-seq methylation profiles were compared with those of 10 matched controls. Isoflavones and their microbial metabolites were quantified in urine, serum, and glandular breast tissue (liquid chromatography-mass spectrometry) and 17 beta-estradiol in glandular breast tissue (immunoassay). Global DNA methylation levels were obtained for 6 cases and 5 controls using liquid chromatography-mass spectrometry. Although lower MethylCap-seq coverages were observed, mass spectrometry results and computational LINE-1 methylation analysis did not provide evidence supporting global methylation alterations upon treatment. At a false discovery rate of 0.05, no differentially methylated loci were identified. Moreover, a set of previously identified loci was specifically tested, but earlier reported results could not be validated. In conclusion, after a 5-day soymilk treatment, no major general epigenetic reprogramming in breast tissue could be found in this exploratory study

The challenge of return to work in workers with cancer : employer priorities despite variation in social policies related to work and health

This study explored employer's perspectives on (1) their experience of good practice related to workers diagnosed with cancer and their return to work (RTW), and (2) their perceived needs necessary to achieve good practice as reported by employers from nine separate countries. Twenty-five semi-structured interviews were held in eight European countries and Israel with two to three employers typically including HR managers or line managers from both profit and non-profit organisations of different sizes and sectors. Interviews were recorded and transcribed verbatim. A grounded theory/thematic analysis approach was completed. Employers' experience with RTW assistance for workers with cancer appears to be a dynamic process. Results indicate that good practice includes six phases: (1) reacting to disclosure, (2) collecting information, (3) decision-making related to initial actions, (4) remaining in touch, (5) decision-making on RTW, and (6) follow-up. The exact details of the process are shaped by country, employer type, and worker characteristics; however, there was consistency related to the need for (1) structured procedures, (2) collaboration, (3) communication skills training, (4) information on cancer, and (5) financial resources for realizing RTW support measures. Notwithstanding variations at country, employer, and worker levels, the employers from all nine countries reported that good practice regarding RTW assistance in workers with a history of cancer consists of the six phases above. Employers indicate that they would benefit from shared collaboration and resources that support good practice for this human resource matter. Further research and development based on the six phases of employer support as a framework for a tool or strategy to support workers with a history of cancer across countries and organisations is warranted

Suivis gynécologiques de juments dans le cadre d'une clientèle vétérinaire‎ : analyse des performances de reproduction

L’objectif de cette étude était de décrire la gestion de la reproduction et d’étudier les facteurs pouvant influencer les performances de reproduction chez la jument dans le cadre de la saillie naturelle, l’insémination artificielle et la collecte d’embryons. Pour cela, 769 cycles (dont 35 consacrés à la collecte d’embryons) de 494 juments suivis au Haras du petit Hautier (Normandie) entre 2014 et 2018, ont été analysés. Pour la reproduction classique, le taux de gestation par cycle s’est élevé à 54,7%et l’exploitation de1,5 cycles en moyenne a permis d’obtenir une gestation. Le taux de poulain né par jument mise à la reproduction est de 67,5% et le taux d’avortement embryonnaire et fœtal de 20,5%. Dans notre étude, la gestion des endométrites post-insémination a représenté un enjeux majeur et l’administration d’utérokinétiques et/ou de lavages utérins à titre préventif avant l’insémination, ou curatif après l’insémination s’est avérée efficace pour préserver la fertilité des juments. Les collectes embryonnaires ont concerné un effectif réduit de juments et le taux d’embryons collectés par cycle a été de 0,39. Le taux d’embryons collectés a été augmenté lors d’ovulations multiples comparativement à une ovulation simple. Un lavage supplémentaire après une collecte infructueuse permet d’améliorer le taux de collecte