Karolien van Nunen

Employment loss during economic crisis and suicidal thoughts in Belgium: a survey in general practice

BACKGROUND The economic crisis of 2009 led to a wave of corporate reorganisations and bankruptcies, with many dismissals of employees. GPs were confronted with subsequent health consequences. AIM To assess the possible relationship between losing ones job and having suicidal thoughts. DESIGN AND SETTING A survey of patients aged 18-49 years recruited from GP practices in Belgium in Deurne (Flemish region) and La Louvière (Walloon region) from September to December 2010. Method Anonymous self-administered questionnaire. RESULTS Of all eligible patients (n = 1818), 831 were offered the questionnaire and 377 completed it (45.4%). More than one in five had been confronted with employment loss in the past year (the responder or someone close losing their job). Almost one in ten had lost their job themselves in the past year. More than one in four had experienced suicidal thoughts and 11.7% had seriously considered ending their life in the past year. In the logistic regression analysis, the following characteristics showed a statistically significant relationship with having suicidal thoughts: being single (odds ratio [OR] = 4.8, 95% confidence interval [CI] = 1.7 to 13.8), not having satisfying social contacts (OR = 5.1, 95% CI = 1.6 to 16.2), having depressive complaints (OR = 18.4, 95% CI = 5.8 to 58.4), and having lost ones employment in the past year (OR = 8.8, 95% CI = 2.0 to 39.3). CONCLUSION This study points to a statistically significant relationship between losing ones employment in the past year and having suicidal thoughts. It emphasises the important role of the GP in the continuous and reinforced assessment of suicidal risk in times of recession.

Parents’ views on toilet training (TT) A quantitative study to identify the beliefs and attitudes of parents concerning TT

Background: In recent years, the age at which parents start and finish toilet training (TT) their children has increased. To cope with the problems caused by this later completion, it is essential to identify the beliefs and attitudes of the parents. Methods: Two thousand questionnaires were distributed to parents of children aged 30 to 36 months, attending 50 randomly selected schools in Antwerp, Belgium. Results: Too many children are toilet trained after the minimum school age of 30 months. Most parents are not aware of the possible negative consequences this can entail. Mothers with a paid occupation think more often that children should be toilet trained before the age of 30 months, and the higher the mother’s educational level, the more likely she will send her child to school toilet trained. More of single parents think that children who are not yet toilet trained should be allowed to go to school and more often send their not fully toilet-trained children to school. Conclusion: Parents should be better informed about the possible negative consequences of a later completion of TT. Single parents, more than other parents, should be assisted in the TT process and offered more support.

Measuring and improving safety culture in organisations: an exploration of tools developed and used in Belgium

To support organisations in addressing their safety culture, practical tools have been developed worldwide. Based on such practical tools, it is possible to measure where an organisation is situated regarding its safety culture in order to identify priority areas, formulate appropriate improvement strategies and determine changes over time. In this paper, it is examined which practical tools to measure and improve safety culture are provided on the Belgian market. In total, 15 Belgian tools were identified, of which 8 agreed to cooperate. Amongst the included tools, there is a lot of variation regarding the methods to diagnose the safety culture and the overall procedure to improve the safety culture. The importance to adapt the tool to the specific needs and context of organisations is acknowledged in most of the tools, as well as the importance to use a multi-method approach to measure the safety culture. Also, it is recognised that all hierarchic levels should participate during the process of diagnosing the safety culture. A point of attention is this overall participation during the validation of the results of the diagnosis, and the priority setting of the recommendations, which is mainly done by the higher management. The development of the Belgian tools is based on experience with a focus on direct practical application, which leads to the fact that none of the tools are validated through scientific evidence. Another point of attention is that organisations pay too little attention at the continuity of safety culture research. And finally, the question can be raised if the safety culture tools actually address the concept ‘safety culture’, or if they address only a subset of the concept. When safety culture is addressed, a comprehensive approach should be used, where technological, organisational, human and external aspects are taken into account as interacting and interrelating elements.

Een leven lang inzetbaar? Duurzame inzetbaarheid op het werk, interventies, best practices en integrale benaderingen.

SamenvattingIn dit boek wordt het zeer actuele thema van duurzame inzetbaarheid aangesneden. Duurzame inzetbaarheid betekent dat mensen, zowel jong als oud, nu en in de toekomst gemotiveerd, capabel en gezond kunnen functioneren in organisaties.

Legal and illegal drug use among female sex workers in bar and club prostitution in Belgium: A quantitative and qualitative study

Aims: This study describes the amounts and effects of drug use in bar and club sex work, and the use of healthcare for the drug-related needs of sex workers (SW). Methods: A cross-sectional study was carried out in Belgium. In a quantitative component, 120 bar and club SW were interviewed face-to-face by means of a semi-structured questionnaire. In a qualitative component, 25 SW were interviewed face-to-face and 5 focus group discussions with key actors professionally involved with the studys subject were conducted. Findings: Many bar and club SW drink frequently alcohol and engage in heavy drinking. Illegal drugs such as cannabis, cocaine and benzodiazepines are also frequently used. The drug use often involves poly or combined drug use. More than one-third experienced a certain degree of dependence on a product and many experienced effects from drug use on their sex work. The study shows that SW have difficulties accessing drug-related healthcare. Conclusions: SW use often legal and illegal drugs. The prevalence and influence of drug use among bar and club SW illustrates the need for drug and sex work related healthcare. Distribution of more information about the risks of drug use, the possible negative effects, and the available drug-related healthcare is needed.

Posttraumatische stress bij SEH-verpleegkundigen

Verpleegkundigen op de afdeling spoedeisende hulp (SEH) worden frequent blootgesteld aan traumatische gebeurtenissen op het werk. Twee soorten traumatische gebeurtenissen zijn te onderscheiden. Er zijn gebeurtenissen meegemaakt als getuige, zoals de dood van een kind, en gebeurtenissen meegemaakt als slachtoffer, zoals fysiek geweld veroorzaakt door een patiënt. Deze gebeurtenissen kunnen leiden tot symptomen van een posttraumatische stressstoornis (PTSS).SamenvattingVerpleegkundigen op de afdeling spoedeisende hulp (SEH) worden frequent blootgesteld aan traumatische gebeurtenissen op het werk. Twee soorten traumatische gebeurtenissen zijn te onderscheiden. Er zijn gebeurtenissen meegemaakt als getuige, zoals de dood van een kind, en gebeurtenissen meegemaakt als slachtoffer, zoals fysiek geweld veroorzaakt door een patiënt. Deze gebeurtenissen kunnen leiden tot symptomen van een posttraumatische stressstoornis (PTSS).

Transgender in Nederland

SamenvattingNederland is de wereldwijde koploper op vlak van transgenderzorg. Zo is het één van de weinige landen waar geslachtsoperaties onderdeel uitmaken van de reguliere gezondheidszorg. Deze positie ontstond echter niet zonder slag of stoot. Historicus Alex Bakker schetst in dit boek de veranderingen op vlak van medische behandelmogelijkheden, maatschappelijke opinies, juridische verwikkelingen en mediabeeldvorming.Nederland is de wereldwijde koploper op vlak van transgenderzorg. Zo is het één van de weinige landen waar geslachtsoperaties onderdeel uitmaken van de reguliere gezondheidszorg. Deze positie ontstond echter niet zonder slag of stoot. Historicus Alex Bakker schetst in dit boek de veranderingen op vlak van medische behandelmogelijkheden, maatschappelijke opinies, juridische verwikkelingen en mediabeeldvorming.

Interventies om onveilig werken op hoogte in de bouwsector aan te pakken

SamenvattingIn een Nederlands nationaal onderzoek werden interventies opgezet en geëvalueerd om onveilig werken op hoogte in de bouwsector aan te pakken.In een Nederlands nationaal onderzoek werden interventies opgezet en geëvalueerd om onveilig werken op hoogte in de bouwsector aan te pakken.

Actuele uitdagingen voor de veiligheid en de gezondheid op het werk

In dit boek van Belgische bodem komen verschillende actuele uitdagingen voor de veiligheid en gezondheid op het werk aan bod. Ondanks de Belgische focus van het boek worden verschillende vergelijkingen gemaakt met andere landen, waaronder Nederland, dat in vergelijking met België een meer rationele benadering van welzijn op het werk hanteert. De verschillende thema’s die aan bod komen worden gestaafd met wetenschappelijke inzichten en praktijkervaringen, maar zijn ook doorweven van treffende quotes en weinig bekende faits divers.

A practical example of the effects of overdiagnosis on hospital stay and sick leave costs

In 2009, a university hospital in Tenerife, Spain, implemented a guideline to reduce unnecessary hospital admissions for threatened preterm labour. According to the guideline, hospital admission for threatened preterm labour is justified if the cervical length is 25 mm or less.