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Enquête de santé 2023-2024 : Contacts avec des praticiens de médecine non conventionelle
No full textSurveillance épidémiologique des hépatites B et C en Belgique. Situation au 31 décembre 2023.
No full textThe OPTIMUS International Consensus Guidance for Monitoring User-Reported Outcomes of Opioid Maintenance Treatment: a Delphi Study
No full textOpioid use disorder is a major cause of drug-related harm and mortality. These can be reducedby expanded access to evidence-based and highly effective opioid agonist maintenance treatmentor therapy (OMT). There is a lack of consensus on how to assess opioid use disorder treatmentoutcomes, and key health outcomes are often omitted. We report the results of a Delphi studyto produce service user- and public health–centred international consensus guidance for OMToutcomes monitoring. An international group of 110 substance use specialists in 32 countries,including service providers, researchers and people with lived experience of OMT, produceddraft guidance over multiple meetings. The guidance includes a service user-reported OMT out-comes questionnaire, based on 26 core questions, plus optional questions, in six domains (treat-ment, physical health, mental health, social functioning, substance use, quality of life). A Delphipanel of 757 OMT professionals and service users (46%) from 29 countries, of which 40% werefemale, reviewed the questionnaire over two survey rounds, supporting and improving it (round 2mean agreement score on a 1-6 Likert scale: 5.2; 95%CI 5.1–5.3). By focusing on service user–reported and public health–centred outcomes of OMT, the OPTIMUS consensus guidance aims to facilitate the communication between service providers and service users and improve the qual-ity of care and the survival, health and quality of life of OMT service users.</p
Ketamine, a new (or old) kid on the block: A comprehensive three-year spatio-temporal study in Belgium through wastewater-based epidemiology
No full textBased on reports of ketamine seizures, self-reported consumption and harmful associated health effects, there are signs of increased ketamine use. However, monitoring population-level consumption patterns remains difficult. This study employed wastewater-based epidemiology (WBE) to address this challenge by analysing influent wastewater (IWW) from Belgium for biomarkers of ketamine consumption to evaluate spatio-temporal trends.
Daily 24-h composite IWW samples were collected from 26 locations across the northern part of Belgium (Flanders and Brussels region), every Monday and Wednesday in 2023 (n = 716). Additionally, a temporal dataset from daily IWW samples from Leuven (n = 399) and Brussels (n = 285) in 2021 and 2022 was evaluated using time series analysis. Measured concentrations of ketamine, norketamine and dehydronorketamine in IWW were transformed to population-normalised mass loads (PNML, expressed in mg/day/1000 inhabitants) to assess ketamine consumption patterns.
Ketamine, norketamine and dehydronorketamine were detected in respectively 98%, 96%, and 76% of all samples. Substantial consumption was observed in both urban and rural areas, with higher PNMLs in major cities and the east of Flanders. Temporal analysis showed no seasonal trends but an increase in weekend consumption, likely linked to recreational use. PNMLs increased 7- to 11-fold compared to available data in 2012. Actual consumption and direct disposal down the drain could be differentiated by the investigation of the ketamine to norketamine ratio.
Ketamine use is widespread across the north of Belgium, encompassing a relatively stable, year-round consumption. In future WBE studies, it is recommended to measure both norketamine and ketamine to assess ketamine consumption and to rule out any dumping events.</p
Molecular epidemiology of <i>Salmonella</i> Enteritidis in humans and animals in SpainABSTRACT
No full textA citizen-centred approach to public engagement on the ethical, legal and societal issues of health technologies
No full textPublic engagement in health technologies continuously expands thanks to increased recognition and financial support. Yet, the lack of a shared definition and standards enables practitioners to conduct initiatives in ways that prioritise their self-interests over the empowerment of citizens. Experts and policymakers generally design engagement initiatives following rigid protocols to fit their agenda, limiting the influence of citizens upstream. In reaction to this and as an attempt to disambiguate public engagement from an ethical perspective, we investigate its intrinsic value. Starting from the assumption that public engagement must primarily empower citizens and not those who already have enough power to make their voices heard, we argue that the more the engagement process puts citizens at the centre, the more the engagement practice becomes valuable regardless of the methods used. To make the citizen-centred approach a reality, we suggest ethical principles that practitioners could apply across the spectrum of engagement.</p
Residential tree canopy configuration and mortality in 6 million Swiss adults: a longitudinal study.
No full textBACKGROUND: Residential exposure to trees has been associated with reduced mortality risks. We hypothesise that in addition to tree canopy cover, tree canopy configuration also plays a role in exposure-mortality relationships. As there is limited evidence on this hypothesis, especially longitudinal evidence, we performed a nationwide study to investigate the residential tree canopy configuration-mortality associations in the Swiss population.
METHODS: In this longitudinal study, the tree canopy cover and configuration metrics within 500 m of individuals’ residences were quantified using high-resolution tree canopy data (1 × 1 m) from 2010 to 2019. We developed single-exposure and multi-exposure time-varying Cox regression models to estimate the associations between the different exposure metrics and natural-cause and cause-specific mortality in Swiss adults (aged from 20 years to 90 years). Mortality and census data were taken from the Swiss National Cohort (SNC). We estimated the hazard ratios (HRs) and corresponding 95% CIs per IQR increase in the metrics adjusting for personal sociodemographic and contextual covariates. We also explored the effect modification by tree canopy cover, PM, air temperature, urbanisation level, age, sex, and area-based local socioeconomic position.
FINDINGS: Our analyses included 6 215 073 individuals from the SNC between 2010 and 2019. In the fully adjusted single-exposure models, we observed protective associations between natural-cause mortality risk and tree canopy cover (IQR 12·4%, HR 0·979 [95% CI 0·975-0·983]) and configuration metrics describing the aggregation (6·3%, 0·831 [0·823-0·840]), and connectedness (2·9%, 0·946 [0·938-0·953]); and detrimental associations with two metrics describing the fragmentation (211 patches per 100 ha, 1·073 [1·066-1·080]) and shape complexity (1·9, 1·094 [1·089-1·100]) of patches. The associations were generally preserved with other common causes of death. According to the multi-exposure models, the HR (95% CI) for the combination of one IQR decrease in aggregation and one IQR increase in fragmentation and shape complexity was 1·366 (1·343-1·390). Analyses on modification effects suggested a stronger association in people living in areas with a higher level of tree canopy cover, PM concentration, air temperature, and urbanisation level.
INTERPRETATION: Aggregated, connected, and less fragmented forested greenspaces might offer stronger health benefits than isolated, fragmented ones, but are difficult to implement in cities. Our study provided valuable insights into optimising forested greenspaces and highlighted future directions for the planning and management of urban forests towards healthy and green cities.
FUNDING: National Research Foundation, Prime Minister’s Office, Singapore under its Campus for Research Excellence and Technological Enterprise programme and ETH Zurich.</p
