Trends in health expectancy indicators in the older adult population in Belgium between 1997 and 2004

The objective is to assess if longer life in Belgium is associated with more healthy years through the evaluation of trends (1997–2004) in health expectancy indicators at ages 65 and 80 covering different health domains: self-perceived health, chronic morbidity, disease clusters, and disability. Information was obtained from Belgian Health Interview Surveys. Health expectancies were calculated using the Sullivan method. Among males at age 65, the increase in years expected to live without chronic morbidity, without a disease cluster or without disability exceeded the increase of the life expectancy (LE). The rise in LE in good self-perceived health was equal to the gain in LE. Among women at age 65 and among men and women at age 80, none of the changes in the expected years of life in good health in any health domain were statistically significant. At age 65 among women, the increase in LE was smaller than the increase in years without chronic disease or without disability. The increase in years without disease clusters was less that the LE increase. At age 80 among men, the years without disability increased as the LE, with a shift toward years with moderate limitations. In any other health domains for men (except co-morbidity) and in all domains for women the years in good health either decreased or increased less than the LE. The recent rise in life expectancy in Belgium is, among the youngest old and especially among males, accompanied by an improved health status. At age 80 and particularly among women expansion of unhealthy years prevails.

Voice outcome indicators for unilateral vocal fold paralysis surgery: A survey among surgeons

IntroductionStandardization of voice outcomes indicators (VOIs) is an important issue when it comes to evaluating and comparing surgical treatments for Unilateral Vocal Fold Paralysis (UVFP). In a recent review, 11 VOIs were found to represent 80% of the VOIs cited in the literature. A survey was launched among the European laryngologists to acquire surgeons’ opinions on the above mentioned preselected VOIs.Material and methodThe electronic survey took place between November and December 2016. Three general questions were asked about surgeon's practice setting(s) and experience. The eleven next questions concerned (a) surgeon's VOIs preference and (b) their estimates of post-operative target values, they would consider being satisfactory.ResultsThe response rate was 16% (50 surveys). The majority of responders worked in tertiary hospitals (50%), had 15 years of experience with UVFP and performed on average 20 UVFP related procedures a year. The VOIs that were favored by the responding surgeons were, in decreasing order of importance, Voice handicap Index (VHI-30), Maximum Phonation Time (MPT), GRBAS-I, Mean Airflow Rate (MeAF), Jitter and Shimmer. There was an excellent consensus on post-operative VOI target values between survey's results and the literature data, except for three VOIs that showed somewhat divergent tendencies (absolute VHI-30, Jitter and Shimmer).ConclusionsThree VOIs are favored by surgeons: VHI-30, MPT and GRBAS-I. Jitter and Shimmer, although very frequently reported and statistically valid in the literature, come last concerning surgeon's choice as VOI for UVFP treatment assessment.     

Optimization and Application of a Multiplex Digital PCR Assay for the Detection of SARS-CoV-2 Variants of Concern in Belgian Influent Wastewater

Since the beginning of the COVID-19 pandemic, the wastewater-based epidemiology (WBE) of SARS-CoV-2 has been used as a complementary indicator to follow up on the trends in the COVID-19 spread in Belgium and in many other countries. To further develop the use of WBE, a multiplex digital polymerase chain reaction (dPCR) assay was optimized, validated and applied for the measurement of emerging SARS-CoV-2 variants of concern (VOC) in influent wastewater (IWW) samples. Key mutations were targeted in the different VOC strains, including SΔ69/70 deletion, N501Y, SΔ241 and SΔ157. The presented bioanalytical method was able to distinguish between SARS-CoV-2 RNA originating from the wild-type and B.1.1.7, B.1.351 and B.1.617.2 variants. The dPCR assay proved to be sensitive enough to detect low concentrations of SARS-CoV-2 RNA in IWW since the limit of detection of the different targets ranged between 0.3 and 2.9 copies/µL. This developed WBE approach was applied to IWW samples originating from different Belgian locations and was able to monitor spatio-temporal changes in the presence of targeted VOC strains in the investigated communities. The present dPCR assay developments were realized to bring added-value to the current national WBE of COVID-19 by also having the spatio-temporal proportions of the VoC in presence in the wastewaters.     

Desire for information about drugs: a survey of the need for information in psychiatric in-patients

Background Promoting therapy adherence requires understanding various psychosocial parameters, including patients need for information. Drug information adapted to patients needs may empower them and increase their confidence in drug therapy. Objectives: To explore psychiatric in-patients information preferences and to test the reliability of a Dutch version of the Intrinsic Desire for Information (IDI) scale in psychiatric institutions in Flanders.Methods Standardised interviews were conducted with psychiatric patients in 11 hospitals. The interview consisted of the IDI-scale and five open questions. Patient demographics collected were sex, age, number of medicines taken, diagnosis, number of admissions during the past year, marital status, education level and occupation.Results 279 patient interviews were completed. A factor analysis on the original 12-item scale yielded 3 factors. An abbreviated scale was derived from the first factor (F1). This 6-item scale measured extent of information desired: (EID) and consisted of six items (Cronbachs = 0,73). A second factor (F2) measured information provider preference (IPP) ( = 0,56) and a third factor (F3) measured inhibited information desire (IID) ( = 0,69). EID was associated with number of medicines taken, duration of hospitalisation and marital status.Conclusion The internal reliability of the EID-factor appears to be reproducible in the specific setting of psychiatric hospitals. It may be useful to help healthcare professionals develop pharmaceutical care towards psychiatric patients. Validation of the scale remains to be completed. Information need in psychiatric in-patients measured by the EID-score was comparable to the need measured in general hospitals during earlier research in England. Targeted information services seem to be desirable to enhance therapy adherence and quality of life in psychiatric patients.     

Root canal treatment performed by Flemish dentists. Part 1. Cleaning and shaping

AIM: To gather information on root canal treatment carried out by dentists working in Flanders (Belgium). METHODOLOGY: A questionnaire was handed to 312 dentists attending peer review sessions organized by the Flemish Universities. Basic information (age, gender, year of graduation, practice profile) and information on various issues relating to the cleaning and shaping of root canals was collected. RESULTS: A total of 310 questionnaires were returned. The majority (85.7%) of respondents categorized themselves as general practitioners; 25.7% mentioned a clinical interest or speciality in practice. Most practitioners (64.5%) did not use rubber dam routinely during root canal treatment and performed treatment over two visits irrespective of the number of root canals. The majority of respondents (82.4%) used sodium hypochlorite as an irrigant, but 10.6% did not know the concentration they used; EDTA was used by 61.6%. The vast majority exposed a radiograph with an instrument of known length in situ to gauge the working length; only 3.6% relied on tactile sense; electronic root canal length determination was seldom used. Amongst the root canal instruments, K-files were used solely or in combination with other instruments by 60.3% of the respondents, reamers were used solely or in combination with other instruments by 55.4%. The stepback technique was used by 31.2% of the participants, a combination of stepdown and stepback by 26.4%, a reaming technique by 26.1% and the step-down technique by 14.7%. The majority were familiar with mechanical root canal Instruments. Almost half of the practitioners believed their preparation technique could be improved: only 1.3% felt that their procedures were poor. CONCLUSIONS: The results of this study indicate that the theoretical knowledge of dentists working in Flanders is good. However, the use of rubber dam remained low, half believed their preparation technique could be improved.     

Nation's compensation for war wounds and work incapacities. The creation of a new welfare system for physically disabled veterans and civilians of the First World War in Interwar Belgium, 1918–1928

This article explores the creation of a new social welfare system for physically disabled veterans and civilians of the Great War in Belgium during the early interwar period. Through an analysis of debates among ministers and legislators, doctor's opinions and the member's periodicals of the two largest national associations for war-wounded veterans and civilians it examines how these actors shaped a new set of benefits that caused significant socio-economic inequalities inside and between both groups of victims and in relation to physically disabled citizens without war injuries. Consequently, this article reveals how the welfare system characterised a reimagining of war compensation, the physically disabled worker and disability equality in Belgium.