Belgium

This paper looks at the journey of eleven counsellors in marital counselling centres in French-speaking Belgium, from the creation of the centres in 1953, to the 1970s, when contraception became legal, and abortion became a public issue. At the time of Humanae Vitae, groups of volunteers, working within Catholic organisations where counselling took place, began to structure their activity around Carl Rogers’s ethics of client-centred therapy, placing their religious ideology in a secondary position to focus on the problems experienced by the couples and women they were receiving in the centres. These were often challenges they were experiencing themselves in their own lives. The reiteration of the Catholic orthodox view on contraception through Humanae Vitae marked a gap between the counsellors and the Church. This contribution questions the identity-related tension of Catholics working in conjugal counselling centres and the type of commitments they made to both the conjugal centre...

Objective.To report baseline and followup data on the first 438 patients with systemic sclerosis (SSc) included in the Belgian Systemic Sclerosis Cohort.Methods.According to LeRoy and Medsger’s classification, 73 patients with limited SSc (lSSc), 279 with limited cutaneous SSc (lcSSc), and 86 with diffuse cutaneous SSc (dcSSc) were included. History was collected and clinical examination, blood tests, and paraclinical investigations were repeated. The Disease Activity Score (DAS) and Disease Severity Score (DSS) of several organ systems were computed. An organ system was considered to demonstrate SSc if the corresponding DSS was ≥ 1.Results.At baseline, patients with dcSSc had more general, joint/tendon, muscle, gastrointestinal, and kidney involvement. Mean DLCO was below normal in patients with lSSc, indicating unsuspected lung involvement. Patients with anti-Scl-70 had more vascular, skin, joint/tendon, and lung involvement. Patients with anti-RNA polymerase III had more skin and...

Depuis quelques années, on peut noter une nouvelle focalisation des études littéraires sur les questions de spatialité. Cet intérêt s'inscrit dans la continuité d'un « spatial turn » qui a profondément bouleversé les sciences humaines -l'histoire au premier plan, l'histoire de l'art (ARTL@S: http://www.artlas.ens.fr) et l'histoire littéraire (Ein literarischer Atlas Europas : http://www.literaturatlas.eu) beaucoup plus récemment.

HAL is a multidisciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

Background: The objective of this study was to analyse the impact of acute surgery for native aortic valve endocarditis and its influence on the long-term prognosis after surgery. Methods: A total of 161 patients underwent aortic valve replacement for native active aortic valve endocarditis (NAAVE) during a 29-year period, from 1967 to 1995 (age range: 10 to 72 years; mean 48 ± 12). The main indication for surgery was progressive congestive heart failure (76%). Other indications were unbeatable sepsis (27%), peripheral or central emboli (12%) and, from 1978, echocardiographic evidence of friable, pedunculated vegetations (3%). Streptococcal and staphylococcal infections predominated. Concomitant procedures were performed in 27% of the patients, including mitral and tricuspid valve surgery and coronary bypass procedures. Results: Operative mortality was 8% in the majority of cases caused by heart failure or multiorgan failure. Multivariate logistic regression analysis identified NYHA class IV to be an independent predictor for postoperative death. Long-term survival for discharged patients was 75% at 10 years and 58% at 15 years, with a mortality rate of 3.6%/patient/year. Cox regression analysis identified the year of operation, trivalvular endocarditis and staphylococcal infection as independent predictors of survival. At 10 and 15 years after aortic valve replacement, 91% and 84% of the patients, respectively, were free of recurrent endocarditis. The presence of an abscess cavity at first operation was found to be predictive of recurrent endocarditis. Conclusions: Valve replacement for NAAVE offers a good chance for a cure and satisfactory long-term survival. Improvements in pre- and per-op-rative management of the very ill patient, and the use of allograft valves are likely to further improve long-term results. Finally, the presence of staphylococcal endocarditis requires long-term postoperative antibiotic therapy.

Compounds with dioxin-like toxicity are suspected to adversely affect human reproduction even at current background exposures. Endometriosis, a gynecological disorder often associated with infertility, has been hypothesized to be linked to dioxins and similar chemicals, a hypothesis supported by the outcome of experimental studies on animal models. Endometriosis severity and incidence in Belgium is one of the highest of the world: in this country, the general population exposure to dioxin-like compounds has been, on average, higher than in most industrialized countries. Here we show the results of a pilot case-control study carried out on 22 Italian and 18 Belgian women of reproductive age, with and without endometriosis. No significant differences were found in dioxin-like compound body burdens between cases and controls on a country basis, whereas the body burdens of the Italian women resulted to be significantly lower than that of the Belgian. In particular, total TEQs in Italian and Belgian women without endometriosis were respectively 18 and 45 pg WHO-TE/g lb.

di questo numero di Forma Urbis, è un'istituzione accademica dedita alla ricerca che nasce con l'obiettivo di promuovere la cooperazione culturale, scientifica e artistica fra il Belgio e l'Italia. Come leggeremo più approfonditamente nelle pagine che seguono, lo spirito di collaborazione instauratosi fra le due nazioni fiorì ai tempi del matrimonio tra la Principessa Maria-Josè del Belgio e colui che sarebbe divenuto l'ultimo re d'Italia, Umberto II di Savoia. Il prestigioso centro di ricerca interdisciplinare di cui ci accingiamo a parlare fu inaugurato l'8 maggio del 1939 e, da allora, non ha mai cessato di essere un importante punto di riferimento per quanti, belgi o italiani, avessero a cuore la crescita culturale dei due Paesi. L'Academia vanta annualmente un ricco programma culturale aperto al pubblico che mira a favorire iniziative legate agli studi umanistici e scientifici: concerti, pubblicazioni, mostre, convegni -organizzati in collaborazione con conservatori musicali, curatori d'arte, archeologi, università e istituzioni culturali belghe, fra le mura del prestigioso istituto all'interno del quale, oltre alla Biblioteca scientifica, spiccano un'aula per i seminari e una sala per i concertimostrano l'eclettico alternarsi delle realizzazioni culturali, scientifiche e artistiche del Belgio a Roma. Tra le iniziative più esemplificative in tal senso, l'interessante mostra, tuttora in corso presso l'Academia, dal titolo Wunderkammer. Camera delle meraviglie contemporanea, una singolare esposizione di opere di artisti contemporanei, belgi e italiani, presentata come in un cabinet de curiosités a simboleggiare, asserisce il curatore Antonio Nardone, "la relazione fra artificialia e naturalia". L'Academia fa, inoltre, parte dell'Unione Internazionale degli Istituti di Archeologia, Storia e Storia dell'Arte in Roma, il cui scopo è quello di favorire la collaborazione internazionale tra gli istituti di ricerca italiani e stranieri attivi nella Capitale e coinvolti in progetti scientifici intrapresi in quest'ambito.

Since 2002, Belgium has had a national law legalising euthanasia. The law prescribes several substantive due care requirements and two procedural due care requirements, i.e. consultation with an independent physician and reporting of euthanasia to a Federal Control Committee. A large discrepancy in reporting rates between the Dutch-speaking (Flanders) and the French-speaking (Wallonia) parts of Belgium has led to speculation about cultural differences affecting the practice of euthanasia in both regions. Using Belgian data from the European Values Study conducted in 2008 among a representative sample of the general public and data from a large-scale mail questionnaire survey on euthanasia of 480 physicians from Flanders and 305 from Wallonia (conducted in 2009), this study presents empirical evidence of differences between both regions in attitudes towards and practice of euthanasia. Acceptance of euthanasia by the general population was found to be slightly higher in Flanders than in Wallonia. Compared with their Flemish counterparts, Walloon physicians held more negative attitudes towards performing euthanasia and towards the reporting obligation, less often labelled hypothetical cases correctly as euthanasia, and less often defined a case of euthanasia having to be reported. A higher proportion of Flemish physicians had received a euthanasia request since the introduction of the law. In cases of a euthanasia request, Walloon physicians consulted less often with an independent physician. Requests were more often granted in Flanders than in Wallonia (51% vs 38%), and performed euthanasia cases were more often reported (73% vs 58%). The study points out some significant differences between Flanders and Wallonia in practice, knowledge and attitudes regarding euthanasia and its legal requirements which are likely to explain the discrepancy between Wallonia and Flanders in the number of euthanasia cases reported. Cultural factors seem to play an important role in the practice of (legal) euthanasia and the extent to which legal safeguards are followed.

Since then, further reports have supported these fi ndings [5-7]. Some studies have demonstrated, using molecular biology techniques, evidence of water-borne transmission of Aspergillus spp. and Fusarium spp., matching the genotypic identity of isolates recovered from patients and those isolated from the water in the patients' rooms [5,8,9]. Since similar data is not available from studies in Belgium, we conducted studies in Liège in order to fi nd out whether the water distribution system of a Belgian university hospital containing high-risk units could be a potential reservoir for fi lamentous fungi. Methods

Objective Patient use of over-the-counter (OTC) medicines contributes to improving public health and reducing public pharmaceutical expenditure. However, little is known of patient experiences of pharmacy distribution and services related to OTC medicines. The aim of this study is to explore patient experiences of purchasing OTC medicines in Flemish community pharmacies. Method Data were gathered from an anonymous postal questionnaire survey of patients purchasing OTC medicines in a random sample of Flemish community pharmacies in April 2008. The self-administered questionnaire related to the most recent purchase of OTC medicines by a patient in a community pharmacy. The questionnaire included questions about: (a) sources of information about OTC medicines; (b) the patient relationship with pharmacist and physician; (c) organization and layout of the pharmacy; (d) distribution channels; and (e) patient satisfaction. Questions were generally measured using Likert scales. The questionnaire was piloted among patients. Results One hundred and fifty-five pharmacies consented to distribute questionnaires to five patients each, yielding a total of 358 useable questionnaires (response rate of 46%). The first point of contact about OTC medicines was the pharmacist (61% of patients), followed by the physician (29%). Newspapers and the internet were not viewed as primary sources of advice on OTC medicines. Patients tended to purchase OTC medicines for the acute treatment of pain, gastro-intestinal conditions, common cold, cough or musculo-skeletal pain. More than 75% of patients felt that pharmacists provided sufficient information about the health condition and OTC medicine use. About one-third of patients did not wish the physician to be informed of their OTC medicine use. Patients did not seem to agree with distribution channels for OTC medicines other than the community pharmacy. Conclusions Flemish patients were satisfied with pharmacy distribution and services related to OTC medicines. They see an important role for pharmacists and physicians to accompany them in their OTC medicine use. Our results highlighted the need to strengthen communication between patients, pharmacists and physicians. It is also recommended that pharmacists keep an individual record detailing patient use of OTC and prescription medicines. Keywords Belgium Á Community pharmacy Á Distribution channels Á Flanders Á Information sources Á Over-the-counter medicines Á Patient experiences Á Patient relationship Impact of findings on Practice • There is a need to strengthen pharmacist-physician communication as well as patient-physician communication about OTC medicine use.

Objective: To assess different aspects of physical fitness and physical activity in obese and nonobese Flemish youth. Research Methods and Procedures: A random sample of 3214 Flemish schoolchildren was selected and divided into an "obese" and "nonobese" group based on body mass index and sum of skinfolds. Physical fitness was assessed by the European physical fitness test battery. Physical activity was estimated by a modified version of the Baecke Questionnaire. Results: Obese subjects had inferior performances on all tests requiring propulsion or lifting of the body mass (standing-broad jump, sit-ups, bent-arm hang, speed shuttle run, and endurance shuttle run) compared with their nonobese counterparts (p Ͻ 0.001). In contrast, the obese subjects showed greater strength on handgrip (p Ͻ 0.001). Both groups had similar levels of leisure-time physical activity; however, nonobese boys had a higher sport index than their obese counterparts (p Ͻ 0.05). Discussion: Results of this study show that obese subjects had poorer performances on weight-bearing tasks, but did not have lower scores on all fitness components. To encourage adherence to physical activity in obese youth, it is important that activities are tailored to their capabilities. Results suggest that weight-bearing activities should be limited at the start of an intervention with obese participants and alternative activities that rely more on static strength used.

The continued professionalization of the humanitarian workforce requires sound underpinning by appropriate educational programs. The international disaster medicine and emergency health community requested the World Association for Disaster and Emergency Medicine (WADEM) develop international standards and guidelines for the education and training for disaster medicine. The Working Group of the WADEM Education Committee prepared and circulated an Issues Paper to structure input on this significant international task. Subsequently, the Working Group facilitated an Open International Meeting convened in Brussels, Belgium, 2004. The "Issues Paper" also was used as a framework to structure this International Meeting, which utilized case studies selected to represent the scope of disaster medicine, and prepared a meeting consensus on a framework for disaster health and for related educational programs. The two-day Brussels meeting attracted 51 participants from 19 countries, re...

s u m m a r y Despite ongoing targeted surveillance efforts, no overall in-hospital prevalence data for hospital-acquired infections (HAIs) have been published for Belgium. Sixty-three Belgian acute hospitals participated in a point-prevalence study among either all patients admitted in their institution or 50% of the patients in each ward. HAIs were registered bed-site at a single day per ward during the period October-November 2007. The diagnosis was made according to the Centers for Disease Control and Prevention (CDC) criteria implemented in a custom-made rulebased software expert system available on a portable computer. The total number of patients surveyed nationally was 17 343, from 543 distinct hospital wards. The overall prevalence of HAIs was 7.1% (95% confidence interval: 6.7-7.4%); 6.2% (5.9-6.5%) of the patients suffered from at least one HAI. Prevalence of HAIs on adult intensive care was 31.3%. The major proportion of HAIs was observed among patients admitted on non-intensive care unit (non-ICU) wards, mainly on the wards of internal medicine, surgery, geriatrics and rehabilitation. Urinary tract infections were the most common type of HAI at geriatric and rehabilitation wards. This study demonstrates that the use of a portable computer system with a designated expert system for diagnosing HAIs according to the CDC criteria in a large point prevalence study is feasible and may reduce the within-subject variation. In Belgium, the prevalence of HAIs in acute hospitals thus identified is similar to that of neighbouring countries. As more than 80% of all HAIs occur on non-ICU wards, preventive efforts need to extend beyond the ICU.

An oral, human-derived monovalent (G1P1A) rotavirus vaccine, strain RIX4414, has been developed by GlaxoSmithKline, Rixensart, Belgium. The safety, immunogenicity and efficacy of this vaccine were evaluated in a randomized, double-blind, placebo-controlled, phase IIb trial conducted in Brazil, Mexico and Venezuela. Healthy infants were given two doses of vaccine (104.7, 105.2 or 105.8 ffu) or placebo at age 2 and 4 months, with routine DTPw-HBV and Hib vaccines. OPV was given separately, at least 2 weeks before or after administration of the study vaccine. A total of 2155 infants were enrolled, of whom 1618 received one of the three vaccine viral concentrations and 537 were given placebo. Analysis of efficacy included diarrheal episodes occurring from 2 weeks after second dose until one year of age. Efficacy rates against any rotavirus gastroenteritis, severe rotavirus gastroenteritis and hospitalizations for rotavirus disease were as high as 70% (46-84%; 95%CI), 86% (63-96%; 95%CI), and 93% (54-100%; 95%CI), respectively. For non-G1 (mainly G9) serotypes, RIX4414 vaccine conferred protection as high as 83% (40-97%; 95%CI) against severe gastroenteritis. A decrease was noted in the incidence of severe rotavirus-related gastroenteritis after first dose. It is demonstrated that two doses of RIX4414 are highly efficacious against severe rotavirus gastroenteritis and hospitalization, including disease caused by non-G1 strains, namely G9 serotypes.

La COP21 donne lieu à des prises de conscience fortes dans le chef des partis politiques belges francophones. Tous soulignent aujourd'hui l'enjeu fondamental que représente le changement climatique pour la planète et les générations futures.

Belgium is often portrayed as a textbook example of gradual federalization. Today, however, a rather new debate among political elites has emerged: whether to refederalize some of the powers that have been devolved to the substate entities. Yet, little is known about how citizens see the issue. The objective of this article is therefore to explore and compare citizens' arguments for more or less regional autonomy. To this end, three citizen forums focusing on federalism were organized in 2017-2018: one in French, a second one in Dutch and a third one in German. They were transcribed and analysed using thematic analysis. Our results suggest that citizen opinions are justified based on two major argumentative themes: identity and efficiency. While one would expect the former to be of traditional importance, our analysis revealed that considerations about efficiency have taken the lead. This can above all be understood given the advanced stage of the Belgian federalization process, for which considerations of identity are still latently important but explicitly not sufficient enough anymore to justify further dynamics. Finally, our analysis also outlined the existence of additional argumentative frames related to path dependencies and the peculiar situation of Brussels.

La conférence s’attache à préciser les rapports entre enseignement de la citoyenneté et enseignement de la religion. Elle constate le changement de contexte de cette problématique qui remonte au XIXe siècle, mais dont les coordonnées sont tout à fait nouvelles. Nous vivons le « second désenchantement du monde », qui porte non sur la religion mais sur les idéaux modernes. La religion s’est repositionnée dans les sociétés sécularisées, ce dont témoigne la réorientation du cours de religion en Belgique francophone depuis les années 1970-1980. D’un côté, la religion a progressivement effectué une critique interne, articulée à l’expérience de la citoyenneté démocratique. D’un autre côté, la citoyenneté moderne constitue un discours et une pratiques incomplètes et insuffisantes sur le plan moral. Elle n’est émancipatrice que si elle reconnaît cette limite.  Les rapports entre citoyenneté et religion sont donc de limitation et de complémentarité réciproques.

The 1-year clinical relapse rate after steroid withdrawal H, Jesdinsky H. European Cooperative Crohn's Disease Study was 64% { 9% in the placebo arm of the present study. (ECCDS): results of drug treatment. Gastroenterology 1984;86: 249-266.

The problem of poor compliance/adherence to prescribed treatments is very complex. Health professionals are rarely being asked how they handle the patient's (poor) therapy compliance/adherence. In this study, we examine explicitly the physicians' expectations of their diabetes patients' compliance/adherence. The objectives of our study were: (1) to elicit problems physicians encounter with type 2 diabetes patients' adherence to treatment recommendations; (2) to search for solutions and (3) to discover escape mechanisms in case of frustration. In a descriptive qualitative study, we explored the thoughts and feelings of general practitioners (GPs) on patients' compliance/adherence. Forty interested GPs could be recruited for focus group participation. Five open ended questions were derived on the one hand from a similar qualitative study on compliance/adherence in patients living with type 2 diabetes and on the other hand from the results of a comprehensive review ...

BACKGROUND: In longitudinal cohort studies, subjects may be lost to follow-up at any time during the study. This leads to attrition and thus to a risk of inaccurate and biased estimations. The purpose of this paper is to show how multiple imputation can take advantage of all the information collected during follow-up in order to estimate the cumulative probability P(E) of an event E, when the first occurrence of this event is observed at t successive time points of a longitudinal study with attrition.

METHODS: We compared the performance of multiple imputation with that of Kaplan-Meier estimation in several simulated attrition scenarios.

RESULTS: In missing-completely-at-random scenarios, the multiple imputation and Kaplan-Meier methods performed well in terms of bias (less than 1%) and coverage rate (range = [94.4%; 95.8%]). In missing-at-random scenarios, the Kaplan-Meier method was associated with a bias ranging from -5.1% to 7.0% and with a very poor coverage rate (as low as 0.2%). Multiple imputation performed much better in this situation (bias <2%, coverage rate >83.4%).

CONCLUSIONS: Multiple imputation shows promise for estimation of an occurrence rate in cohorts with attrition. This study is a first step towards defining appropriate use of multiple imputation in longitudinal studies.

Background: Patient safety can be increased by improving the organization of care. A tool that evaluates the actual organization of care, as perceived by multidisciplinary teams, is the Care Process Self-Evaluation Tool (CPSET). CPSET was developed in 2007 and includes 29 items in five subscales: (a) patient-focused organization, (b) coordination of the care process, (c) collaboration with primary care, (d) communication with patients and family, and (e) follow-up of the care process. The goal of the present study was to further evaluate the psychometric properties of the CPSET at the team and hospital levels and to compile a cutoff score table. Methods: The psychometric properties of the CPSET were assessed in a multicenter study in Belgium and the Netherlands. In total, 3139 team members from 114 hospitals participated. Psychometric properties were evaluated by using confirmatory factor analysis (CFA), Cronbach's alpha, interclass correlation coefficients (ICCs), Kruskall-Wallis test, and Mann-Whitney test. For the cutoff score table, percentiles were used. Demographic variables were also evaluated. Results: CFA showed a good model fit: a normed fit index of 0.93, a comparative fit index of 0.94, an adjusted goodness-of-fit index of 0.87, and a root mean square error of approximation of 0.06. Cronbach's alpha values were between 0.869 and 0.950. The team-level ICCs varied between 0.127 and 0.232 and were higher than those at the hospital level (0.071-0.151). Male team members scored significantly higher than females on 2 of the 5 subscales and on the overall CPSET. There were also significant differences among age groups. Medical doctors scored significantly higher on 4 of the 5 subscales and on the overall CPSET. Coordinators of care processes scored significantly lower on 2 of the 5 subscales and on the overall CPSET. Cutoff scores for all subscales and the overall CPSET were calculated.

Cardiac surgery in Jehovah&#39;s Witnesses may be challenging during the operation and postoperative period given their refusal of blood products. The aim of this study was to document our center&#39;s experience with Jehovah&#39;s Witnesses undergoing major cardiac surgery and to compare surgical outcomes with a matched control group. We retrospectively reviewed the demographic, perioperative, and in-hospital postoperative data for 31 Jehovah&#39;s Witness patients undergoing surgery from 1991 to 2012 and compared findings with a control group of 62 patients of the same sex and age, who underwent the same type of operations in the same period. Early mortality, major in-hospital morbidity, laboratory findings, and hospital stays were compared between groups. Demographic data were similar between groups, except that more patients in the Jehovah&#39;s Witness group had extracardiac arteriopathy compared with controls (p = 0.04). There was no difference in predicted mortality, calculat...

In a working group of the Belgian Hospital Physicists Association (BHPA), a new protocol has been developed for comprehensive testing of computed tomography scanners. The tests were selected to verify if the scanner is technically adequate, if preprogrammed patient protocols are up-to-date, and if exposure values displayed at the console are sufficiently correct. In addition, they will ensure that the participating medical physics expert (MPE) gets a full understanding of the system to enable him/her to guide optimization processes and allow automated patient dosimetry. Several new test procedures had to be developed. The tests go beyond the criteria identified in the EC guidance document radiation protection (RP) 91 and its successor RP 162. The results of the tests of the BHPA protocol are discussed in the light of the acceptability criteria in RP 91 and RP 162. It is concluded that the ensemble of tests in the BHPA protocol and in RP 162 provide very useful information on the sca...

The addition of beringite along with iron grit into an As-contaminated soil decreases As transfer to and impacts on snails. a b s t r a c t An As-contaminated soil (Unt) was amended with either iron grit (Z), a coal fly ash (beringite, B) or B þ Z (BZ) and placed in lysimeters in 1997. An uncontaminated soil (R) was also studied. In summer and autumn 2003, lettuces were cultivated in the lysimeters and snails were caged for one month. Lettuce As concentrations were higher during the summer, while no differences occurred in snails between seasons. Snail As concentrations (mg g À1 DW) ranged from 2.5 to 7.0 in B, Z and BZ, and peaked at 17.5 in Unt. In summer, snail survival was affected in Unt and Z compared to R and B while no mortality was noticed in autumn. Snail growth decreased only in B, BZ and Unt in autumn. Snail As concentrations suggest a risk for their predators even on the remediated soils.

Rationale: To assess the success rate of smoking cessation with the ''minimal intervention strategy'' in general practice, and to determine the influence of spirometry on this success rate. Methods: Training in smoking cessation advice was given to 16 general practitioners (GPs). During 12 weeks, these GPs screened their practice population for smoking habits, the degree of dependence on nicotine, and the motivation to quit smoking. Patients willing to stop were randomised to a group that underwent a single office spirometry, or to a control group. The GPs were asked to support the attempts with the minimal intervention strategy. Success rates were compared after 6, 12 and 24 months. Results: On a population of 5590 patients, 1206 smokers were identified (22%). To the vulnerable group, identified following the Prochaska and Di Clemente scheme, the proposal was made to change smoking behaviour. Two hundred and twenty-one patients undertook an attempt of smoking cessation. Nicotine replacement therapy (NRT) or bupropion was prescribed in 51% of the attempts. Sixty-four sustained quitters were counted after 6 months (29%), 43 after 1 year (19%) and 33 after 2 years (15%). We found a small but statistically non-significant difference in success rate in favour of the group that underwent office spirometry. Conclusion: GPs can motivate almost 20% of their smoking population to quit smoking. The success rate with the minimal intervention strategy was 19% after 1 year and 15% after 2 years. We found no arguments in favour of confronting smokers with their lung function as a tool for enhancing smoking cessation.

Apres un rappel concernant l&#39;histoire des editions Marabout depuis l&#39;immediat apres-guerre, l&#39;article s&#39;interesse aux deux collections destinees a la jeunesse : &#39;Marabout Junior&#39; avec comme heros recurrent Bob Morane, et &#39;Marabout Mademoiselle&#39;, avec comme personnage principal Sylvie, hotesse de l&#39;air. C&#39;est ce personnage, cree en 1954 par l&#39;ecrivain Rene Philippe, qui retient ensuite toute l&#39;attention, en particulier parce que l&#39;etude s&#39;attache a la maniere dont cette serie destinee aux jeunes filles se fait l&#39;echo du monde colonial (le Congo belge), puis de la decolonisation et enfin du tiers-mondisme.

We show that the intuition underlying the supplier-induced demand (SID) hypothesis is reflected in the cheap-talk literature from game theory, and in the credence-good literature from the economics of information. Applying these theories, we conclude that a neoclassical version of the SID hypothesis is only relevant for treatment decisions involving an expensive treatment that is equally effective in curing several states, but efficient in curing only some of these states (in that a cheaper treatment is efficient otherwise). For a simple game involving such a treatment decision, we show that a Nash equilibrium exists where the patient is able to constrain the physician in inducing demand, without the market for the potentially induced treatment failing. This equilibrium allows us to derive comparative statistics and welfare results.

Aims: Carbohydrate deficient transferrin (CDT) is a common diagnostic marker for detecting chronic alcohol abuse. For over 2.5 years, it has been used in traffic medicine among subjects applying for driver's license renewal or regranting in Belgium. We report on data collected during the program and provide an estimation of an applicable cutoff point in forensic situations. Using this cutoff , the success of the driver's license regranting program is evaluated. Methods: CDT was assayed at Ghent University Hospital by capillary zone electrophoresis, measured on the Capillarys 2 ™ system, in 3977 subjects applying for driver's license regranting. Determination of a cutoff was done by using Bhattacharya statistics and by adding a measurement uncertainty interval. The outcome of the program was evaluated by monitoring CDT values for 163 subjects during one entire year. Results: In 3977 subjects (3481 males and 496 females), CDT values were significantly higher in men compared with women, but there is no need for a gender-specific cutoff value. Drunk drivers under the age of 30 have significantly lower CDT values than older subjects, and a separate cutoff could be calculated. A general cutoff of 2.3% CDT was calculated for the entire study population. Using this cutoff value for evaluating the outcome of the program for 163 subjects, the percentage offenders at the beginning (29%) decreased to 8% after 1 year. Conclusion: Applying a marker for chronic alcohol abuse such as CDT for driver's license renewal or regranting is a powerful tool. Analysis of data collected over 2.5 years reveals a favorable outcome of the program and a useful cutoff point could be determined.

Objectives: Continuous sedation until death (CSD), the removal of consciousness of an incurably ill patient until death, has become a controversial practice. Some consider CSD a palliative treatment, whereas others claim that CSD is frequently used with the intention to hasten death. In nursing homes in Flanders, the rate of CSD has tripled over the past decade, whereas legal euthanasia remains a rare practice. This study wants to investigate to what extent CSD is used to hasten death (CSDþ) and to identify possible associated factors. Design: Nationwide cross-sectional retrospective survey, conducted in 2012. Setting: Nursing homes in Flanders, Belgium. Participants: Coordinating and advisory physicians of all nursing homes in Flanders (n ¼ 660). Measurements: Physician reports of their most recent patient treated with CSD. Results: The response rate was 57.3%, and 159 of the 378 responding physicians reported a case of CSD (42.1%). According to the reported intentions involved, 62.2% of these cases were considered CSDÀ cases (no life-shortening pursued), whereas 37.8% were labeled CSDþ (life-shortening pursued). Physician factors such as experience in end-of-life care, palliative care training, training in sedation, or knowledge of sedation guidelines did not affect the outcome distribution (CSDÀ or CSDþ). In CSDþ, the patient has a longer life expectancy, is more competent, is clearly longing for death, and requests for euthanasia more frequently. Conclusions: In nursing homes in Flanders, CSD is frequently used to hasten the patient's death. In some cases, CSD can even be considered a substitute for legal euthanasia.