[Unconditional self-acceptance and self-compassion: another clinic for anorexia nervosa?] / L'acceptation inconditionnelle de soi et l'autocompassion : une autre clinique de l'anorexie mentale ?

People suffering from anorexia have a particular emotional and cognitive profile (altered body and self-perception, emotional dysregulation, perfectionism, obsessive traits), which the disorder can compensate for through emotional distancing strategies. Self-compassion and unconditional self-acceptance have been shown to have therapeutic effects on the barriers to recovery associated with this profile.

[Acceptability of innovative male contraceptive methods among major of age heterosexual adult men in France in 2021]. / Acceptabilité des méthodes de contraception masculine innovantes chez les hommes majeurs hétérosexuels en France en 2021.

INTRODUCTION: New methods of male contraception are being studied: male hormonal contraception, reversible occlusion of the vas deferens and thermal contraception. This study aimed to evaluate the acceptability of these methods among men. MATERIAL AND METHODS: We carried out an opinion survey from July to November 2021, through an anonymous questionnaire distributed in France on the internet. The subjects were adult, heterosexual men. RESULTS: Of the 1545 connections to the questionnaire, we analyzed the 905 complete questionnaires. Seventy three percent of men say they are in favor of adopting an innovative male contraceptive method as their primary contraception: 64% in favor of reversible occlusion of the vas deferens, 22% in favor of male hormonal contraception and 13% in favor of thermal contraception. CONCLUSION: Despite its limitations, this study shows that a significant part of the male population is interested in innovative methods of contraception that concern them. This should encourage continued research in this area.

[Tobacco and surgery: A survey of health professionals' practices and knowledge. A role for the community pharmacist]. / Tabac et chirurgie : enquête sur les pratiques et les connaissances des professionnels de santé. Un rôle pour le pharmacien d'officine.

OBJECTIVE: To evaluate the knowledge and management of preoperative smoking patients by different health professionals. METHOD: We conducted a survey among surgeons, anesthesiologists, and pharmacists using questionnaires. The study included 115 pharmacists and 7 physicians. RESULTS: Only 28% of pharmacists felt they had the necessary knowledge about smoking cessation before surgery and its consequences. Moreover, pharmacists were informed of the surgery less than one month before in 61% of cases, whereas physicians claimed to inform patients at least 3 months before in 57% of cases. The main reasons mentioned by the pharmacist for not informing the patient about presurgical smoking cessation were a lack of knowledge of the information to be relayed and a late knowledge of the scheduling of a surgery. Additionally, 57% of physicians stated that they never prescribed nicotine replacement products, while 42% of pharmacists felt that they never dispensed them. CONCLUSION: The study provides a clear picture of the smoking pathway before surgery and highlights areas for improvement in the management of preoperative smoking patients by different health professionals.

Patients présentant une pathologie chronique et soins palliatifs en oncologie: Une mise en relation trop tardive. Télémédecine pour les soins palliatifs en oncologie / Pacients amb patologia crònica i cures pal·liatives en oncologia: una connexió feta massa tard. Telemedicina per a cures pal·liatives en oncologia / Pacientes con patología crónicay cuidados paliativos en oncología: una conexión hecha demasiado tarde. Telemedicina para cuidados paliativos en oncología / Patients with chronic conditions and palliative care in oncology: A connection made too late. Telemedicine for palliative care in oncology

La population française comprendra 23,4 % de personnes de plus de 65 ans en 2030. La plupart d’entre elles présentera des pathologies chroniques (cancers) nécessitant une prise en charge globale par les équipes de soins palliatifs. Toutefois le nombre restreint de lits d’hospitalisation et de médecins suggère que l’on aura rapidement besoin de developper la télémédecine pour le suivi des patients en soins palliatifs Nous avons proposé à 30 patients un suivi mensuel par téléconsultation après une première évaluation en Hospitalisation De Jour de soins palliatifs afin d’évaluer la faisabilité matérielle des consultations par télémédecine (patients altérés dans le cadre de leur parcours avancé dans la maladie cancéreuse, souvent âgés) et l’adhésion des patients dans cette pratique. Nous avons recueilli le vécu et ressenti des patients par rapport à ces téléconsultations 3 mois post inclusion. Nous avons montré la faisabilité de la téléconsultation pour les patients suivis en soins palliatifs. Les patients sontfavorables à ce type de suivi. Ils n’ont aucune difficulté à se connecter indépendamment de leur âge. Tous en tirent bénéfice. Une relation de confiance s’établit facilement avec leur médecin, malgré leur méconnaissance antérieure à la téléconsultation.(AU)

En 2030, el 23,4% de la població francesa tindrà més de 65 anys. La majoria d'ells tindran patologies cròniques (càncers) que requeriran una gestió integral per part dels equips de cures pal·liatives. No obstant això, el limitat nombre de llits hospitalaris i de metges suggereix que aviatserà necessari desenvolupar la telemedicina per al seguiment dels pacients en cures pal·liatives. Vam oferir a 30 pacients un seguiment mensual per teleconsulta després d'una avaluació inicial en un hospital de dia de cures pal·liatives amb la finalitat d'avaluar la viabilitat material de les consultes de telemedicina (pacients amb càncer avançat, sovint ancians) i l'acceptació d'aquesta pràctica per part dels pacients. Vam recollir l'experiència i els sentiments dels pacients respecte a aquestes teleconsultas 3 mesos després de la inclusió. Vam demostrar la viabilitat de la teleconsulta per a pacients seguits en cures pal·liatives. Els pacients estan a favor de este tipus de seguiment. No tenen cap dificultat per a connectar-se, independentment de la seva edat. Tots es beneficien d'això. S'estableix fàcilment una relació de confiança amb el seu metge, malgrat el seu desconeixement previ a la teleconsulta. (AU)

En 2030, el 23,4% de la población francesa tendrá más de 65 años. La mayoría de ellos tendrán patologías crónicas (cánceres) que requerirán una gestión integral por parte de los equipos de cuidados paliativos. Sin embargo, el limitado número de camas hospitalarias y de médicos sugiere que pronto será necesario desarrollar la telemedicina para el seguimiento de los pacientes en cuidados paliativos. Ofrecimos a 30 pacientes un seguimiento mensual por teleconsulta tras una evaluación inicial en un hospital de día de cuidados paliativos con el fin de evaluar la viabilidad material de las consultas de telemedicina (pacientes con cáncer avanzado, a menudo ancianos) y la aceptación de esta práctica por parte de los pacientes. Recogimos la experiencia y los sentimientos de los pacientes con respecto a estas teleconsultas 3 meses después de la inclusión. Demostramos la viabilidad de la teleconsulta para pacientes seguidos en cuidados paliativos. Los pacientes están a favor deeste tipo de seguimiento. No tienen ninguna dificultad para conectarse, independientemente de su edad. Todos se benefician de ello. Se establece fácilmente una relación de confianza con su médico, a pesar de su desconocimiento previo a la teleconsulta.(AU)

In 2030, 23.4% of the French population will be over 65 years old. Most of them will have chronic pathologies (cancers) requiring comprehensive management by palliative care teams. However, the limited number of hospital beds and physicians suggests that there will be a rapid need to develop telemedicine for the follow-up of palliative care patients. We proposed to 30 patients a monthly follow-up by teleconsultation after an initial evaluation in a palliative care day hospital in order to evaluate the material feasibility of consultations by telemedicine (patients altered in the context of their advanced course of cancer, often elderly) and the adherence of the patients to this practice. We collected the patients' experience and feelings regarding these teleconsultations 3 months after inclusion. We have shown the feasibility of teleconsultation for patients followed in palliative care. Patients are in favour of this type of follow-up. They have no difficulty connecting regardless of their age. They all benefit from it. A relationship of trust is easily established with their doctor, despite their lack of knowledge prior to teleconsultation.(AU)

[Resilience, a Buzzword?] / Resilienz, ein Modewort?

Resilience, a Buzzword? Abstract. There is a growing awareness of the importance of resilience in many areas of our society. Current research largely assumes that resilience can be trained and used to avoid suffering or to better overcome crises. This article deals with the question of what is meant by resilience and how t can be trained.

[Acceptance, mourning of delusions and recovery]. / Acceptation, deuil des idées délirantes et rétablissement.

Recovering from a mental disorder is a process by which the affected person will develop a new life project, based on the optimal use of personal and environmental resources. This involves adapting and managing certain symptoms better, in order to be able to rebuild oneself psychologically. This may be the case for delusions, which need to be distanced and accepted in order to develop this new life stage in. In this perspective, the notions of mourning for the self and mourning for delusional beliefs seem to be necessary steps in the reconstruction of a self that is favourable to recovery.

[Acceptance of voluntary termination of pregnancy in the French 18-to-24-year-old population in 2021]. / Acceptation du recours à l'interruption volontaire de grossesse chez les Français de 18­24 ans en 2021.

OBJECTIVES: report on acceptance of voluntary interruption of pregnancy in 2021 in the French 18-to-24-year-old population and to compare the results with the acceptance reported in 2014 in the Institut Français d'Opinion Publique survey. METHODS: A French cross-sectional study with questionnaires administered between February and April 2021. The target population was 18 to 24 years of age. For purposes of comparison, the question on acceptance of voluntary interruption of pregnancy was basically the same as that of the 2014 Institut Français d'Opinion Publique survey, as were the proposed response modalities. Data were described in terms of means ± standard deviation and number (percentage). Conditions for acceptance of voluntary interruption of pregnancy were compared with the results of the 2014 Institut Français d'Opinion Publique survey using the Chi-square test. Factors associated with acceptance of voluntary interruption of pregnancy without restrictive conditions were studied using univariate analysis (Student, Chi-square or Fisher exact tests) and multivariate analysis (logistic regression). RESULTS: Close to 2000 (1936) questionnaires were completed, including 1225 among 18-to-24-year-olds. Voluntary interruption of pregnancy was accepted without restrictive conditions by 92.1% of the study population (95%CI: 90.4-93.5) compared to 79.0% in 2014 (p < 0.0001). Female gender (93.4 % versus 85.8%; OR = 2.1 [1.4-3.4]; p = 0.0009) and residence outside of Paris (94.9% versus 86.6%; OR = 2.8 [1.9-4.3]; p < 0.0001) were significantly associated with acceptance of voluntary interruption of pregnancy without restrictive conditions. CONCLUSION: In 2021 in France, the 18-to-24-year-old population is massively favorable to voluntary interruption of pregnancy without restrictive conditions, in a significantly higher proportion than in 2014.

Efficacy of a Combined Acceptance and Commitment Intervention to Improve Psychological Flexibility and Associated Symptoms in Cancer Patients: Study Protocol for a Randomized Controlled Trial.

Psychological flexibility is a key concept of acceptation and commitment therapy (ACT). This factor has been linked with psychological wellbeing and associated factors, such as quality of life, in cancer patients. These and other positive results of acceptation and commitment therapy in cancer patients found in previous research could be enhanced by using mhealth tools. A three-arm randomized superiority clinical trial, with a pre-post-follow-up repeated measures intergroup design with a 1:1:1 allocation ratio is proposed. A hundred and twenty cancer patients will be randomly assigned to one of the following interventions: (1) face-to-face ACT + mobile application (app), (2) face-to-face ACT, and (3) Waitlist control group. The primary expected outcome is to observe significant improvements in psychological flexibility acceptance and action questionnaire- II (AAQ-II) in the face-to-face ACT + app group, after comparing baseline and post-treatment scores, and the scores will remain stable in the two assessment points, 3 and 6 months after the intervention. Secondary expected outcomes are significant increasing scores in quality of life (EORTC QLQ C-30) and post-traumatic-growth (PTGI-SF), and significant decreasing scores in anxiety and depression (HADS), insomnia (ISI) and fatigue (BFI) at the same assessment points. Also, it is expected that the scores of this group will be higher than the scores of the face-to-face ACT group and the waitlist control group. This study aims to assess the efficacy of a combined intervention (face-to face ACT + app) for psychological flexibility and associated symptoms in cancer patients. The results of this protocol may help to consider the use of acceptation and commitment therapy and mhealth applications in cancer settings as a valid therapeutic choice. Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT05126823].

Perceptional differences in the factors of local acceptance of waste incineration plant.

Existing research has documented that public attitudes towards waste incineration plants are determined by various factors, such as risk perception, economic impacts, and social trust. However, the diversity in perceptions within communities hosting waste incineration plants is understudied. Adds to existing knowledge, the present paper employed the Q methodology to examine the perceptions of residents living in the vicinity of a waste incineration plant in Xuzhou, China. The results revealed four perspectives on residents' perceptions towards waste incineration plants: I do not trust them and feel besieged by risks; I trust local governments but I am unfairly treated; I attach this place a lot but I am unfairly treated; I possess knowledge of waste incineration and feel besieged by risks. Our data show that risk perception, trust perception, and political efficacy perception are underlying reasons for local acceptance of waste incineration plants. The diversified subjectivities we obtained supplement existing literature that quantitatively documents the influencing factors. These findings demonstrate that it is necessary to explicitly consider the deep-seated values and perspectives among hosting residents' for the siting of the waste incineration plant.

Outcome expectation and risk tolerance in patients seeking bariatric surgery.

BACKGROUND: Average long-term outcome after laparoscopic Roux-en-Y gastric bypass is 25% total weight loss. The risk of short-term complications (leakage and bleeding), acute internal herniation, and mortality are 4.0%, 2.5%, and .2%, respectively. There is a paucity of evidence on what patients expect in terms of weight loss and to what extent surgical risks are tolerated. OBJECTIVE: To examine the patient's weight loss expectations and acceptance of the morbidity and mortality risk after primary laparoscopic Roux-en-Y gastric bypass. SETTING: Teaching hospital, Amsterdam, the Netherlands. METHODS: Two-hundred patients participated in a standardized survey after completion of an extensive multidisciplinary screening, before surgery. Weight loss expectations, naive assessment, and acceptation of risks of morbidity and mortality were addressed with standard gamble methods. RESULTS: The 200 participants (156 female, 78%) had a mean age of 45.1 years and a mean body mass index of 42.3 kg/m2. Weight loss was overestimated by 151 patients (75.5%), and 79 participants (39.5%) were disappointed with the predicted weight loss. Median accepted risks on short-term complications, acute internal herniation, and mortality were 35.8% (interquartile range, 21.0%-58.0%), 25.1% (interquartile range, 15.9%-50.8%), and 4.5% (interquartile range, 1.0%-10.0%), respectively. CONCLUSION: Patients seeking bariatric surgery seem to have unrealistic weight loss objectives and are willing to accept substantial risks to achieve these goals.

Colour thresholds of the gingival chromatic space.

OBJECTIVE: To establish the thresholds of chromatic perception and clinical acceptability of gingival colour according to professional category and in accordance with the perceptibility/acceptability threshold of 50:50 (colour differences that can be perceived/accepted by 50 % of the observers). METHODS: A total of 21 different coloured samples made of pink gingiva Heraceram porcelain were used. Dentists (n = 54), dental assistants (n = 56), dental students (n = 126) and participants unrelated to dentistry (n = 116) were asked to identify pairs of samples that appeared identical. In addition, they were asked to indicate the pairs of samples whose colour they considered to be acceptable for use in a dental rehabilitation. A least squares regression was adjusted using an S-shaped curve of the equation y = exp (B0 + B1/x). The adjusted model was used to predict a colour difference value for an acceptability percentage of 50 %. RESULTS: The threshold value for the perception of colour changes in human gingiva varies from ΔEab* 2.3 ±â€¯0.38 units and CIEDE2000 (ΔE00) 1.5 ±â€¯0.28units (dental students) to ΔEab* 2.7 ±â€¯0.43 units and ΔE00 1.8 ±â€¯0.30 units (participants unrelated to dentistry). The threshold of gingival acceptability varies from ΔEab* 2.9 ±â€¯0.43 units and ΔE00 2.0 ±â€¯0.31 units (dental assistants) to ΔEab* 3.6 ±â€¯0.54 units and ΔE00 2.5 ±â€¯0.41 units (dental students). CONCLUSION: From the total number of samples, the average threshold of perception for the gingival chromatic space is 3.1 units for ΔEab* and 2.1 units for ΔE00. Moreover, the mean gingival acceptance threshold is 4.1 units for ΔEab* and 2.9 units for ΔE00. These thresholds are similar for all professional categories studied. CLINICAL SIGNIFICANCE: The determination of the perception and acceptability thresholds in the gingival chromatic space are of special relevance for designing the physical shade tabs used in gingival colour guides. The results from this work will aid in selecting optimal gingival colour for patients.

[Acceptance of "voices" in people with or without psychiatric disorders: Francophone validation of the 9-item VAAS scale]. / Acceptation des « voix ¼ chez les personnes avec ou sans troubles psychiatriques : validation francophone de l'échelle VAAS à 9 items.

OBJECTIVES: Hearing voices is a common experience for people with schizophrenia. Perceived voices are in most cases a source of great distress for patients. This experience also exists in the general population and is considered as "non-clinical". Much research has focused on the psychological and neuropsychological mechanisms behind the emergence of voices. With regard to voice persistence factors, the acceptance of the voice-hearing phenomenon is still relatively unexplored. In addition, there are few standardized tools that specifically assess this dimension of voice experience. The Voices Acceptance and Actions Scale (VAAS) is the only validated tool to address voice acceptance in individuals with schizophrenia. However, to date, there is no French version. The objective of this research was to validate the VAAS in a French speaking population. METHOD: Our sample consisted of individuals with schizophrenia (N=65) and voice hearers from the general population (N=321). For the clinical population, individuals with schizophrenia and auditory hallucinations were assessed using the VAAS scale in its two abbreviated versions (9 and 12 items). In order to validate the measure in French, we administered psychopathology scales (BPRS) and voice belief scales (BAVQ-R) for convergent and divergent validity. For the non-clinical population, we administered the VAAS scale online (via LimeSurvey), accompanied by a brief sociodemographic questionnaire (age, sex, country of origin, existence of medical or psychological follow-up). RESULTS: The psychometric properties of the VAAS scale were satisfactory and similar to the original English-language tool for both versions, with a slight advantage for the one with 9-items. The convergent validity measured with the BAVQ-R scale, and the divergent one measured with the BPRS depression subscale, were found to be satisfactory. In addition, the re-test performed 6 weeks after the first test (N=30) was satisfactory for both scales, with a Pearson correlation index greater than 70 (r=0.70; P<0.001 for the VAAS 9 items) and (r=0.79; P<0.001 for the 12 item version). In individuals with schizophrenia (clinical population), the level of voice acceptance was low and strongly correlated with depression. This point seems to corroborate the current data in the field suggesting that voice hearing in this population is associated with significant distress and has a significant impact on their lives. Conversely, the level of acceptance obtained from the non-clinical population was much higher, reflecting a higher level of acceptance in this population. People from the non-clinical population seemed to accept and experience their voices with less distress than people from the clinical population in this study. CONCLUSION: To date, a paucity of studies have investigated the acceptance of auditory hallucinations. Our results support the psychometric validity of the French version of the VAAS, particularly the 9-item version. Furthermore, our study supports the need to continue studying voice acceptance, as it appears to be strongly linked to depression in people with psychiatric disorders such as schizophrenia. In addition, our study is novel in that it also explored, with a standardized tool, the level of voice acceptance in a non-clinical population and found people to be more accepting of the voices they hear and better at living with them. These data provide new evidence to better understand the links between the level of acceptance of voices, their experiences, and depression. Clinically, it seems essential to conduct more systematic and regular evaluations of the level of voice acceptance in those hearing voices. Finally, in terms of rehabilitation, voice acceptance can become a therapeutic target in order to improve the psychological and behavioral functioning of the person.

[Severe burns, a long journey of care and rehabilitation]. / Le brûlé grave, un long parcours de soins et de réhabilitation.

At the patient's bedside 24 hours a day, the nurse is at the heart of the rehabilitation management of the severely burnt patient: installation, technical dressings, supervision of postures and placement of compressors, to limit the functional consequences to the type of retractable and hypertrophic scars. The nurse takes care of the patient in this long journey leading to social reintegration; from accompaniment to autonomy and acceptance of self-image.

Effect of processing technology and sugarcane varieties on the quality properties of unrefined non-centrifugal sugar.

In this research, the unrefined non-centrifugal sugar (UNCS) quality obtained from two sugarcane varieties (RD 7511 and CC 8475) and using two types of technologies (traditional and Ward-Cimpa production facilities) were evaluated. The parameters monitored through the process were impurities, total soluble solids, acidity, pH, and temperature profile. Microbiological analyses were carried out on beating, molding, packing, and storage operations; and finally, an organoleptic analysis was carried out on the final UNCS product. Results showed that the UNCS obtained from variety CC 8475 had higher consumer acceptance; meanwhile, the technologies assessed did not show significant differences in final product quality. However, these technologies showed significant differences in the highest temperature, syrup, and juice properties. Microbiological analyses highlighted beating and molding as the critical points in UNCS production safety. Finally, it was evident that the implementation of new technologies or the improvement of the furnace, as in the Ward-Cimpa production facility, is not enough to achieve food safety requirements, as many other conditions affect the microbiological quality of the product. Although the temperatures reached on the Ward-Cimpa furnace are higher than those reached with the traditional furnace and thus, enough to kill all the harmful microorganisms, contamination in downstream operations still occurs.

Acceptance of pregnant women's vaccination against pertussis among French women and health professionals: PREVACOQ-1 and -2 studies.

OBJECTIVES: Protection of French young infants against pertussis only relies on their relatives' vaccination. The alternative is vaccination of pregnant women against pertussis (cocooning strategy), but this strategy is not yet recommended in France. We assessed the acceptance of this strategy among French postpartum women and health professionals. PATIENTS AND METHODS: We performed a multicenter survey in 2016 among postpartum women and health professionals (family physicians, obstetricians-gynecologists, midwives, and medical students) to determine the acceptance of anti-pertussis vaccination. We evaluated knowledge, perception, and attitude towards vaccination to identify factors associated with acceptance. RESULTS: Questionnaires were completed by 52% (1208/2337) of women and 40% (694/1754) of health professionals. Seventy-seven per cent of women (95% CI: 74-79) and 93% of health professionals (95% CI: 91-95) were favorable to anti-pertussis vaccination of pregnant women. Thirty-three per cent (227/687) of health professionals believed that pertussis induced life-long immunity and 20% (136/687) of them were not aware of the cocooning strategy. In multivariate analysis, factors associated with acceptance among women were younger age, higher knowledge, having received advice during pregnancy, being vaccinated against influenza, and having never refused any vaccine; among health professionals, factors associated with acceptance were belief that inactivated vaccines are obstetrically safe, regular practice of influenza vaccination in pregnant women, pertussis cocooning strategy, and never prescribing preventive homeopathy for influenza. CONCLUSION: Vaccination of pregnant women against pertussis should be well-accepted by informed mothers and health professionals. If this strategy were to be implemented in France, efforts should be made towards adequate information.

[Factors associated with poor acceptance of illness in patients with COPD]. / Facteurs associés à une mauvaise acceptation de la maladie chez les patients BPCO.

INTRODUCTION: In patients suffering from chronic obstructive pulmonary disease (COPD), the acceptance of the illness is probably a major factor in the improvement of quality of life. The aim of this study is to identify the criteria associated with a good or bad acceptance of the disease and to identify means of improving it. METHODS: We have undertaken a telephone enquiry among patients with COPD with the aid of a standardized questionnaire established by several health experts. RESULTS: Of the 1040 patients who have been contacted, 356 (34 %) replied to the questionnaire. Ninety-nine patients reported unacceptance of their disease (28 %). The patients who did not accept their disease were significantly more severe, with more difficulty in performing daily life activities, particularly exercising. These patients had significantly greater difficulty in understanding their disease and also reported more frequently a moralizing attitude among their family. CONCLUSION: The greater the handicap of the disease, the greater is the difficulty in accepting the disease by the patient. The doctor could have an impact in improving the therapeutic education and involving the family in the patient's care.

Is the finer the better for municipal solid waste (MSW) classification in view of recyclable constituents? A comprehensive social, economic and environmental analysis.

With the accelerating pace of urbanization, the continuous increase of municipal solid waste (MSW) has become a major obstacle to China's economic development. Therefore, China recently regards MSW classification scenario as an important strategy for national ecological civilization. However, published references have not focused on MSW classification in view of environmental, economic and social acceptation simultaneously. This research proposes a new Decision Support System (DSS) model considering all three aspects to analyze the comprehensive benefit of the four MSW classification scenarios in Pudong (Shanghai, China) using cost benefit analysis (CBA), life cycle assessment (LCA) and analytical hierarchy process (AHP). Among them, there is an important boundary factor in the life cycle assessment. This work mainly focuses on the net energy consumption, namely the air and water emission of different substances. The results show that the classification scenario II, dividing MSW into toxic and hazardous waste, recyclable, kitchen waste and combustible waste, is the best option. Although scenario III (MSW is divided into toxic and hazardous waste, recyclable waste (paper, plastic, scrap metal, waste glass and other small class), kitchen waste and combustible wastes) and IV (recyclable waste in Scenario II is further classified, for example, paper is subdivided into newspapers, books, cardboard, etc.) further refine the MSW classification, the DSS model analysis results indicate that neither of these are the most feasible scenario. Therefore, finer classification is not always the better if we consider all three pillars of sustainability.

Male and female opinions about orthotic devices of the lower limb: A multicentre, observational study in patients with central neurological movement disorders.

BACKGROUND AND OBJECTIVE: Because user-satisfaction and acceptance may partly determine the grade of compliance to an orthotic device (OD), the aim of this multicentre observational study was to inquire the reasons for acceptance and the user-satisfaction of an OD of the lower limb in male and female central neurological movement disorders (CNMD) patients. METHODS: Persons with CNMD having at least one prescribed OD of the lower limb were included. Two questionnaires were used: the MIRAD-ACCORT-II (reasons for acceptance) and a modified version of the D-QUEST 2.0 (user-satisfaction). Descriptive analyses were performed and to analyse the differences between the males' and females' answers Chi2- and Mann-Whitney U tests were used. RESULTS: Twenty-six stroke and 23 multiple sclerosis patients participated (53% males). "Comfort", "safety", "effectiveness" and "ease of use" were reported as most important aspects. 86% of the patients were (very) satisfied about their OD. Only for the aspect safety, compared to males, significant more females reported that if the OD is not safe enough they will not use it. CONCLUSION: For both, males and females, aspects related to comfort and functionality were reported as much more important than the esthetical aspects, and in general they are quite satisfied with the OD and the process of providing the OD. Orthopaedic technicians and health care providers can take these aspects into account when developing, constructing and providing OD's.

What is the opinion of patients with multiple sclerosis and their healthcare professionals about lower limb orthoses? A qualitative study using focus group discussions.

OBJECTIVE: The aim of this study was to collect patients' and healthcare professionals' opinions about lower limb orthoses (LL-orthoses): 1) the positive and negative aspects; 2) the differences in wearing them according to location; and 3) their recommendations for future modifications. METHODS: Four focus group discussions were performed, with in total twenty patients with MS with a prescribed LL-orthosis and seven healthcare professionals. Audiotaped discussions were transcribed and qualitatively processed (NVivo11). RESULTS: Healthcare professionals and patients state that a LL-orthosis improves gait and reduces the risk of falling. Some negative aspects were indicated like stigmatization, difficulties to put on and off the LL-orthosis and the aesthetic aspects. Several patients mentioned that they did not get enough or no correct information about the adaptability and use of the orthoses. Opinions regarding differences in wearing according to location (e.g. in and outside the rehabilitation center) were diverse. Recommendations for future changes were e.g. more refined and firmer orthoses. CONCLUSIONS: The opinions collected are interesting for taking into account in the process of construction and delivering of LL-orthoses. Future research should focus on the opinions concerning different types of LL-orthosis in relation with the severity of the limitations of the patients.