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5.X.1. Co-designing for policy impact: Belgium’s monitoring & evaluation framework for cancer care & control
No full textCancer is one of the main public health challenges, and the second leading cause of mortality in the EU. It is Belgium’s second leading cause of adult death after circulatory diseases and has been an increasing burden of disease in recent years. Recognizing the urgency of tackling the entire disease pathway, the European Commission (EC) has launched Europe’s Beating Cancer Plan (EBCP), a policydriven strategy, and the Mission on Cancer, a research-focused undertaking. In Belgium, Sciensano’s Cancer Centre has been charged with the coordination and implementation of these programs, pioneering the setup of a dedicated structure to coordinate them. While Belgian public, academic, private and non-for-profit entities have been highly involved in these EU initiatives since their launch, there is currently no mechanism to monitor the impact of EBCP’s uptake and implementation in Belgium. Moreover, in contrast to the investment and momentum at the European level, the last Belgian Cancer Plan dates from 2008, with its most recent evaluation being published in 2013, highlighting an important gap. To address this gap, the Cancer Centre was asked by the Federal Cabinet to develop a new monitoring and evaluation (M&E) framework for cancer care and control in Belgium. With a view to avoiding traditional top-down approaches, it was decided that the framework would be designed co-creatively, by engaging patients and experts in the field. The aim was to enable the iterative and flexible monitoring of Belgian policies related to the EBCP’s implementation, while generating buy-in from stakeholders. To achieve this goal, a modified Delphi process was used, with complementary qualitative data collection in the form of focus group discussions with experts across the cancer continuum. A Steering and Patient Committee were put in place to provide stewardship over the process, and based on their feedback, additional patient workshops were run to ensure M&E priorities for patients were taken into account. The framework will cover the entire spectrum of cancer prevention and control, as well as transversal themes such as inequalities and patient-centeredness. It will also anticipate future evolutions and undergo adjustments when needed. This workshop will use a Pecha Kucha approach, with panelists sharing insights from the Belgian case study. The session will guide the audience through a story of the strengths and pitfalls of co-creating an M&E framework in the field of public health monitoring. Topics covered will include challenges of monitoring cancer care and control policies, approaches taken in Belgium to overcome these challenges, and the importance of involving diverse stakeholders in the process. A moderated discussion will allow participants to share their perspectives and ask questions. Attendees will walk away with a real-world example on how to challenge top-down paradigms of populationlevel M&E frameworks and identify transferable elements for adaptation in their own settings.
Key messages:
Europe’s Beating Cancer Plan (EBCP) provides opportunities to tackle the second leading cause of disease in the EU but will require innovative approaches to monitor uptake and impact.
Development of Belgium policy-actionable monitoring & evaluation framework shows how co-creation can challenge top-down paradigms in public health monitoring and assess the uptake and impact of EBCP.
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VERMEER FCM: A tool integrating exposure and hazard modelling for chemicals migrating from food contact materials.
No full textA new tool, VERMEER FCM, was developed to support the risk assessment of single organic chemicals migrating from plastic food contact materials (FCM). The freely available tool is integrated into MERLIN-Expo and has been designed in line with Regulation (EU) No 10/2011 for plastic FCM. Overall, the tool consists of three modules that allow (i) to model the migration of chemicals into food, (ii) to predict toxicological endpoints relevant to risk assessment of FCM chemicals, and (iii) to automatically check whether the chemical of interest is included in Regulation (EU) No 10/2011. To apply the VERMEER FCM tool, users need to provide information regarding the chemical(s) of interest, the FCM, the food and other parameters (e.g. contact time and temperature). The three modules can be run either separately or in combination. Migration is predicted by a recently developed migration model, whereas hazard predictions for genotoxicity, subchronic toxicity, reproductive and developmental toxicity and carcinogenicity are provided by QSAR models selected from the publicly available VEGA HUB. The major novelty of the tool is that it combines information on hazard and exposure (i.e. migration) with regulatory information. Several case studies were performed to demonstrate the application of the tool.</p
Silicone wristbands as passive samplers to monitor pesticide exposure during farming practices
No full textActivity-based detection of synthetic cannabinoid receptor agonists in plant materials
No full textAbstract
Background: Since late 2019, fortification of ‘regular’ cannabis plant material with synthetic cannabinoid receptor agonists (SCRAs) has become a notable phenomenon on the drug market. As many SCRAs pose a higher health risk than genuine cannabis, recognizing SCRA-adulterated cannabis is important from a harm reduction perspective. However, this is not always an easy task as adulterated cannabis may only be distinguished from genuine cannabis by dedicated, often expensive and time-consuming analytical techniques. In addition, the dynamic nature of the SCRA market renders identification of fortified samples a challenging task. Therefore, we established and applied an in vitro cannabinoid receptor 1 (CB1) activity-based procedure to screen plant material for the presence of SCRAs.
Methods: The assay principle relies on the functional complementation of a split-nanoluciferase following recruitment of β-arrestin 2 to activated CB1. A straightforward sample preparation, encompassing methanolic extraction and dilution, was optimized for plant matrices, including cannabis, spiked with 5 µg/mg of the SCRA CP55,940.
Results: The bioassay successfully detected all samples of a set (n = 24) of analytically confirmed authentic Spice products, additionally providing relevant information on the ‘strength’ of a preparation and whether different samples may have originated from separate batches or possibly the same production batch. Finally, the methodology was applied to assess the occurrence of SCRA adulteration in a large set (n = 252) of herbal materials collected at an international dance festival. This did not reveal any positives, i.e. there were no samples that yielded a relevant CB1 activation.
Conclusion: In summary, we established SCRA screening of herbal materials as a new application for the activity-based CB1 bioassay. The simplicity of the sample preparation, the rapid results and the universal character of the bioassay render it an effective and future-proof tool for evaluating herbal materials for the presence of SCRAs, which is relevant in the context of harm reduction.
Keywords: Adulterated cannabis; CB1 cannabinoid receptor bioassay; Harm reduction; New psychoactive substances (NPS); Synthetic cannabinoid receptor agonists (SCRAs); Untargeted screening.
© 2024. The Author(s).</p
Registry Day
No full textThis is a presentation of the 3 diabetes registries during the registry day organized at Sciensano on 17/05/2024.
Improvement of the quality of care in specialized diabetes centers (IQED, IQED-Foot & IQECAD)</p
The use of nitrous oxide whippets as a recreational drug: Hidden health risks.
No full textWhipped cream canisters, also known as nitrous oxide whippets, are traditionally used in the culinary arts to prepare food foams. In recent years, however, these gas canisters have been cracked open and inhaled to produce a “legal” high. Users of these whippets have reported the presence of an oily residue containing metallic particles. This contamination was investigated using liquid chromatography-, gas chromatography- and inductively coupled plasma-mass spectrometry (ICP-MS) and optical emission spectrometry (ICP-OES). The particulate matter was also analyzed by scanning transmission electron microscopy (STEM) combined with energy-dispersive X-ray spectroscopy (EDX). The presence of cyclohexyl isothiocyanate was confirmed at a maximum concentration of 67 μg per whippet. ICP-MS and ICP-OES analysis revealed the presence of mainly iron and zinc, but also, traces of aluminum, chromium, cobalt, nickel, and lead were found. STEM-EDX analysis confirmed the presence of nano-sized particles containing iron and zinc. When simulating inhalation, using the multiple path particle dosimetry model, it was confirmed that these nano-sized particles can reach the deeper parts of the lungs. Most users assume that inhaling a food-grade nitrous oxide whippet for a “legal” high poses no risks. However, this research shows that users are exposed to cyclohexyl isothiocyanate, a substance classified as a respiratory sensitizer. The presence of zinc in the particulate matter could potentially be linked to lung lesions.</p
How to Deal with Uninformed and Poorly Informed Opinions of Citizens? A Critical Approach to Online Public Engagement
No full textPublic engagement is increasingly recognized as a mutual learning of perspectives between lay and expert stakeholders. Still, the intention to educate citizens sometimes prevails over an open and honest exchange. Because of this overemphasis on education, researchers may more easily label lay opinions invalid if uninformed or based on distorted beliefs. Our experience with uninformed and poorly informed (UPI) opinions in an online public engagement initiative (the DNA Debate) has taught us to think differently. First, UPI opinions might be ethically instructive, provided that one searches for the implicit message participants try to convey related to their values, fears, or needs. Since there will always be less informed or uninformed citizens, that would avoid rejecting their voices. Second, UPI opinions may highlight misconceptions in the general population for which more targeted education is necessary. This article is an invitation to reflect ethically on why and how researchers should deal with UPI opinions, illustrated by quotes from the DNA Debate.</p