[Sustainability in Flemish and Dutch mental health care]. / Duurzaamheid in de Vlaamse en Nederlandse ggz.

BACKGROUND: The Flemish and Dutch (mental) health sectors cause greenhouse gas emissions and therefore will have to make an effort to reduce their climate impact. AIM: To assess whether differences can be found in the climate policies of Flemish and Dutch mental health institutions. METHOD: Descriptive research based on a sustainability questionnaire, in which concrete actions, objectives and ambitions in the field of sustainability were questioned at Flemish and Dutch mental health institutions. RESULTS: 59% and 38% of respectively the Flemish and Dutch institutions fully agreed that sustainability is a very important theme (with a main focus on sustainable energy transition and recycling in both regions). Statistically significant differences between both regions were only found with regard to fostering more sustainable commuting (stronger in Flanders; p < 0.0001). The climate impact of medicines and food, as well as investments in sustainable projects, received little attention. CONCLUSION: Although a substantial part of Flemish and Dutch mental health institutions consider sustainability (very) important, a systemic ‘transformation’ will be necessary to make them climate neutral.

[Tired of waiting: towards a joint approach of waiting times in Flemish mental health care]. / Genoeg gewacht: naar een gezamenlijke aanpak van wachttijden in de Vlaamse ggz.

BACKGROUND: Waiting times are an important barrier to timely obtaining appropriate mental health care in Flanders, but structural data is limited. AIM: To describe the waiting time problem in Flanders and propose some causal hypotheses and possible interventions. METHOD: An exploration of the available waiting time data, supplemented with literature and insights based on the results of some Flemish Centers for Mental Healthcare. RESULTS: Waiting times are especially problematic for subsidized outpatient care and care for children and youth, although the current data provide an incomplete picture. Besides capacity, important factors are the organization of the intake (e.g. assessment) and flow parameters (e.g. mean treatment duration - and intensity). CONCLUSION: Eliminating waiting lists is one of the greatest challenges for Flemish mental health care. There is a need to expand capacity as well as the smarter use of existing capacity and resources. A joint multi-level approach is required.

[Psychological care, stigma of mental problems and the sense of competence of doctors; a survey among Flemish future doctors]. / Psychische zorg, stigma van psychische problemen en competentiegevoel van artsen; een onderzoek onder Vlaamse toekomstige artsen.

BACKGROUND: Stigmatisation by health care providers of people suffering from mental health problems adds to the treatment gap of mental illnesses and discrimination of people with a mental illness in somatic care. Future physicians' effort may be key to reduce these inequalities.
AIM: To inventorise the attitudes towards (different) mental illnesses in future physicians, and to determine whether they affect one's feelings of being capable to treat people with mental illness.
METHOD: In April and May 2018, Flemish last-year medical students were presented with three psychiatric (and two other) cases online, each followed by statements on their attitude towards the described case.
RESULTS: When considering people suffering from mental illness, the ideas of our respondents most often corresponded with those included in the frames 'the journey', 'the mosaic' and 'the monster'. The latter may be most problematic in terms of stigma development, whereas the others may be helpful in reducing stigma. Importantly, respondents' attitudes strongly differed in function of the psychiatric problem the patient had. The extent to which respondents adopted 'the journey' and 'the mosaic' added to one's feelings of being capable to treat mental illness.
CONCLUSION: Flemish final year medical students often have a rather compassionate view on (people with) mental illness, but their ideas strongly differ between patients with different diagnoses. Mass media and educational institutions have a large responsibility in reducing stigma in future physicians and in learning them to think in the best possible way about mental illness. Moreover, attitudes helpful in reducing stigma add to a professional's feeling of being capable to treat patients with mental illness.

[Sézary syndrome with ascitis: case report and review of the literature]. / Ascite associée a un syndrome de Sézary: cas clinique et revue de la littérature.

This case report describes the evolution of a mycosis fungoides into a Sézary syndrome. The originality of the case consists in the appearance of ascitis with Sézary cells during the leukemic phase. It is the second report of a such case. Mycosis fungoides and its leukemic variant, the Sézary syndrome, are primary cutaneous T-cell lymphomas. Their incidence is low. The treatments are topical in the early stages and systemic during the advanced stages. New immunomodulating treatments are in development. The existing therapeutic agents unfortunately do not improve the prognosis of the disease today.

Characterisation and treatment of roads covered with zinc ashes, muffle furnace fragments and lead slags from former non-ferrous metal industries in Belgium.

Zinc ashes, muffle furnace fragments and lead slags from non-ferrous industries were applied to pave roads in the North of Belgium. From an inventory it appeared that there are at least 490 km of such roads. In our survey the materials on these roads were characterised. The total metal concentration, the availability and the leaching as a function of time were determined. It appeared that these materials contain high concentrations of heavy metals, some of which are readily available. The high leaching of some metals makes them as such unsuitable as secondary construction material. Methods for the application of these materials for road construction were examined where the materials replaced part of the sand and gravel fraction in lean concrete and in bituminous mixtures, or where they replaced the sand in sand-cement mixtures, all these to be used for road foundations, cycle tracks, etc. When lead slags were applied in lean concrete, a material was obtained complying with the standards for secondary construction materials and with sufficient compressive strength for road foundations. When zinc ashes or muffle fragments were used to replace sand in sand-cement mixtures, again a suitable construction material was obtained. The other combinations tried out were rather unsuccessful, because of high metal leaching and/or poor compressive strength.