“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

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

Evaluation of the Finnish Diabetes Risk Score (FINDRISC) for diabetes screening in occupational health care

Objectives: The objective of the study was to investigate the prevalence of undiagnosed dysglycaemia and the risk for type 2 diabetes using the Finnish Diabetes Risk Score (FINDRISC) in the working population of Belgium. Moreover, it was to evaluate performance and applicability of FINDRISC as a screening tool during occupational health surveillance. Material and Methods: A cross-sectional analysis was carried out over the years 2010–2011 among 275 healthy employees who underwent a health check including fasting plasma glucose and the FINDRISC questionnaire. The sensitivity, specificity and predictive value of different FINDRISC cut-off values to detect dysglycaemia was revised in the literature and then calculated. Results: The prevalence of unknown dysglycaemia was 1.8%. Twelve percent of the employees had a FINDRISC score of 12 to 14 corresponding to a moderate risk of 17% to develop diabetes within the next 10 years, and 5.5% had a score of 15 or more corresponding to a high – very high risk of 33% to 50%. All dysglycaemic individuals had a FINDRISC score of 12 or higher. The sensitivity and specificity for detecting dysglycaemia was respectively 100% and 84.1% for a FINDRISC cut-off value ≥ 12; and 80% and 95.9% for a cut-off value ≥ 15. Conclusions: A considerable number of workers had dysglycaemia or was at risk for developing type 2 diabetes. The questionnaire is a reliable, valuable and easy to use screening tool in occupational health surveillance

Burnout profiles among young researchers:A latent profile analysis

INTRODUCTION: Burnout is a growing problem among young researchers, affecting individuals, organizations and society. Our study aims to identify burnout profiles and highlight the corresponding job demands and resources, resulting in recommendations to reduce burnout risk in the academic context. METHODS: This cross-sectional study collected data from young researchers (n = 1,123) at five Flemish universities through an online survey measuring burnout risk, work engagement, sleeping behavior, and the most prominent job demands (e.g., publication pressure) and resources (e.g., social support). We conducted Latent Profile Analysis (LPA) to identify burnout profiles in young researchers and subsequently compared these groups on job demands and resources patterns. RESULTS: Five burnout profiles were identified: (1) High Burnout Risk (9.3%), (2) Cynical (30.1%), (3) Overextended (2.3%), (4) Low Burnout Risk (34.8%), and (5) No Burnout Risk (23.6%). Each burnout profile was associated with a different pattern of job demands and resources. For instance, high levels of meaningfulness (OR = −1.96) decreased the odds to being classified in the Cynical profile. CONCLUSION: Our findings show that the Cynical profile corresponds to a relatively high number of young researchers, which may imply that they are particularly vulnerable to the cynicism dimension of burnout. Additionally, work-life interference and perceived publication pressure seemed the most significant predictors of burnout risk, while meaningfulness, social support from supervisor and learning opportunities played an important protective role

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

Игровые модели формирования сетевого взаимодействия

В последнее время сетевые игры активно применяются для построения моделей социального взаимодействия. Однако общая теоретико-игровая модель страдает от большого количества равновесий по Нэшу. В данной работе представлена программная реализация модели, гарантирующей существование и единственность равновесия по Нэшу. Для кооперативной модели игры приведено доказательство непустоты с-ядра для полной сети.Network games in recent years are actively used to build models of social interaction. However, the general game-theoretic model suffers from multiple Nash equilibria. In this paper, I present a software implementation of the framework, which guarantees the existence and uniqueness of Nash equilibrium. For the co-operative model of the game shows the core nonemptiness proof for the complete network

Air pollution and endocrine disruptors induce human microbiome imbalances: A systematic review of recent evidence and possible biological mechanisms

A rich body of literature indicates that environmental factors interact with the human microbiome and influence its composition and functions contributing to the pathogenesis of diseases in distal sites of the body. This systematic review examines the scientific evidence on the effect of environmental toxicants, air pollutants and endocrine disruptors (EDCs), on compositional and diversity of human microbiota. Articles from PubMed, Embase, WoS and Google Scholar where included if they focused on human populations or the SHIME® model, and assessed the effects of air pollutants and EDCs on human microbiome. Non-human studies, not written in English and not displaying original research were excluded. The Newcastle-Ottawa Scale was used to assess the quality of individual studies. Results were extracted and presented in tables. 31 studies were selected, including 24 related to air pollutants, 5 related to EDCs, and 2 related to EDC using the SHIME® model. 19 studies focussed on the respiratory system (19), gut (8), skin (2), vaginal (1) and mammary (1) microbiomes. No sufficient number of studies are available to observe a consistent trend for most of the microbiota, except for streptococcus and veillionellales for which 9 out of 10, and 3 out of 4 studies suggest an increase of abundance with exposure to air pollution. A limitation of the evidence reviewed is the scarcity of existing studies assessing microbiomes from individual systems. Growing evidence suggests that exposure to environmental contaminants could change the diversity and abundance of resident microbiota, e.g. in the upper and lower respiratory, gastrointestinal, and female reproductive system. Microbial dysbiosis might lead to colonization of pathogens and outgrowth of pathobionts facilitating infectious diseases. It also might prime metabolic dysfunctions disrupting the production of beneficial metabolites. Further studies should elucidate the role of environmental pollutants in the development of dysbiosis and dysregulation of microbiota-related immunological processes.Funding for open access charge: CRUE-Universitat Jaume

Multidimensional factors of burnout in general practice: a cross-sectional survey.

peer reviewed[en] BACKGROUND: General practitioners (GPs) are particularly vulnerable to job burnout. Tailored prevention and intervention strategies are needed. AIM: To investigate organisational, interpersonal and individual factors contributing to exhaustion and disengagement at work among GPs. DESIGN & SETTING: We conducted a cross-sectional study in a sample of Belgian GPs. METHOD: A total of 358 doctors (73% females, 301 with complete data) completed an online anonymous questionnaire assessing job burnout, psychosocial characteristics of the work environment, perceived social support in the private domain, emotional competence, and self-compassion. RESULTS: GPs reported moderate levels of exhaustion and disengagement. Regression models showed that included factors jointly explained 69% of the variance in exhaustion and 63% in disengagement. Exhaustion was significantly predicted by sex (being a woman) (β effect size =-.1), high perceived emotional demands (β=.19), as well as low self-compassion (β=-.14) and low emotional competence (β=.09). Disengagement was significantly predicted by low seniority (β=-.12) and limited opportunities for development (β=-.16). Both exhaustion and disengagement were predicted by low perceived quality of work (β=-.19 and -.14 respectively), meaning of work (β=-.17 and -.31 respectively) and role clarity (β=.09 and .12 respectively), as well as high perceived work-life conflict (β=.46 and .21 respectively). Moreover, GPs working in a multidisciplinary group reported lower levels of exhaustion and disengagement than those working in a monodisciplinary group or a solo practice, and this difference was associated with factors such as work-life conflict. CONCLUSION: Organisational, interpersonal and intrapersonal factors interact to predict a substantial part of burnout in general practice. The most significant risk factors were perceived work-life conflict and poor meaning of work. Policy-makers should work to support more sustainable practices based on the specific needs and constraints reported by GPs

The Race to Retain Healthcare Workers: A Systematic Review on Factors that Impact Retention of Nurses and Physicians in Hospitals

The shortage of healthcare workers is a growing problem across the globe. Nurses and physicians, in particular, are vulnerable as a result of the COVID-19 pandemic. Understanding why they might leave is imperative for improving retention. This systematic review explores both the prevalence of nurses and physicians who are intent on leaving their position at hospitals in European countries and the main determinants influencing job retention among nurses and physicians of their respective position in a hospital setting in both European and non-European countries. A comprehensive search was fulfilled within 3 electronic databases on June 3rd 2021. In total 345 articles met the inclusion criteria. The determinants were categorized into 6 themes: personal characteristics, job demands, employment services, working conditions, work relationships, and organizational culture. The main determinants for job retention were job satisfaction, career development and work-life balance. European and non-European countries showed similarities and differences in determinants influencing retention. Identifying these factors supports the development of multifactorial interventions, which can aid the formulation of medical strategies and help to maximize retention