http://hdl.handle.net/2268/120 Chercher dans ce canal chercher http://orbi.ulg.ac.be/simple-search http://hdl.handle.net/2268/148660 Titre: Health related guidelines for wind farms in Belgiu m <br/> <br/>Auteur, co-auteur: van den Berg, Frits; Passchier, Wim; Botteldooren, Dick; Deggoui, Naïma; Fallon, Catherine; Hens, Luc; Nemerlin, Jean; Pauluis, Jean; Pepermans, Yves <br/> <br/>Résumé: In 2011 the Belgian authorities have asked the Supe rior Health Council (SHC) to advise on the health e ffects of wind farms. A working group of experts with diff erent backgrounds was put together to assess all th e available literature. This group considered the req uest in the context of sustainable development and drafted an advice that was reviewed by two international ex perts. It is expected that the advice will be publi shed in the spring of 2013. The advice mentions direct effects of operational w ind turbines that may have negative consequences fo r the health and well-being of neighbouring people. It st resses the importance of factors such as the change in landscape, the possible intrusion on people’s attac hment to their environment and the effect of local economic benefits and costs associated with a wind energy project. Also, the perception of the future quality of life will determine the social acceptance of a w ind project by a local community. The advice gives a number of recommendations to better deal with all t hese aspects. The paper will give an overview and explanation of these recommendations. http://hdl.handle.net/2268/148423 Titre: Le vécu de l'entourage des patients en soins palliatifs <br/> <br/>Auteur, co-auteur: Duchesnes, Christiane; Ketterer, Frédéric; Giet, Didier <br/> <br/>Résumé: Contexte : En Belgique, comme ailleurs, la famille est fort sollicitée dans la prise en charge des proches en soins palliatifs. Ce soutien familial, bien qu’indispensable, est perçu comme allant de soi. Cependant, la vie sociale et professionnelle moderne rend cette prise en charge plus difficile qu’il n’y paraît. Le souci des aidants professionnels est de mettre en place des moyens matériels et humains susceptibles d’aider l’entourage. Cela nécessite de connaître le vécu et les besoins de la famille pour apporter une aide pertinente. Méthode : 50 proches de patients ayant bénéficié de soins palliatifs ont été interviewés. Les entretiens ont été intégralement retranscrits et analysés, de manière thématique, par deux chercheurs indépendants. Résultats : L’entourage exprime les difficultés traversées au cours de la maladie. Le patient, à domicile, souhaite souvent conserver autonomie et intimité. Néanmoins, il perd ses fonctions motrices, ses capacités à gérer la vie quotidienne et parfois ses repères spatio-temporels. La famille prend en charge ces aspects dans un premier temps, mais la défaillance physique, le sentiment d’impuissance et l’épuisement de l’aidant principal, ainsi que l’augmentation de la complexité des soins, nécessitent le recours à des aides professionnelles de plus en plus diversifiées. Les charges administratives et financières sont mises en avant, associées à un manque d’informations pour le malade et son entourage, dans une situation où ils se sentent pourtant désemparés. Mais, les personnes interrogées mentionnent aussi des aspects positifs concernant ces événements de la vie : le renforcement des liens affectifs, le partage de moments importants pour chacun, la sensation d’utilité personnelle ainsi que le soulagement de recevoir une aide ciblée et compétente. Les liens tissés avec le patient et avec le personnel soignant constituent souvent un élément tempérant, a posteriori, les difficultés rencontrées. Discussion : L’étude se base sur la narration d’événements anciens. Une atténuation de la pénibilité des situations et une sélection des souvenirs s’est probablement opérée lors du travail de deuil. Néanmoins, l’ambivalence des sentiments de chacun est bien mise en évidence : le souhait du patient de garder son autonomie et de ne pas représenter un fardeau pour les autres est contrebalancé par le sentiment de solitude et d’incapacité. De même, chez l’aidant principal, le souhait de répondre à la volonté du patient, de se dévouer pour prendre en charge les aspects défaillants du patient cohabitent avec les sentiments d’impuissance, d’épuisement et donc de besoin d’aide pour lui-même. Les charges administratives et financières, de même que la difficulté d’obtenir les informations souhaitées, sont souvent présentées comme des éléments perturbateurs dans une vie quotidienne déjà fort complexe. Perspectives : Au-delà des aspects matériels et thérapeutiques, la famille devrait être plus soutenue dans le vécu de ces situations. Une connaissance des difficultés traversées permettrait au personnel qui les côtoie de prévenir des situations d’épuisement et de faciliter certains aspects de la prise en charge pour que le travail psychologique puisse s’effectuer de manière plus sereine. http://hdl.handle.net/2268/148302 Titre: Y a-t-il une filiation entre la structure des fiches de malades dans les Épidémies hippocratiques et celle des rapports médicaux grecs d’Égypte (Ier-IVe siècles) conservés sur papyrus ? <br/> <br/>Auteur, co-auteur: Ricciardetto, Antonio http://hdl.handle.net/2268/146441 Titre: le test de concordance de script en 20 questions <br/> <br/>Auteur, co-auteur: Giet, Didier; MASSART, Valérie; Gagnon, Robert; Charlin, Bernard <br/> <br/>Résumé: Le présent article se donne comme objectif de répondre, en 20 questionsréponses, aux principales préoccupations que les équipes d’enseignants potentiellement intéressées par le test de concordance de script (TCS) peuvent se poser. Les questions et objections souvent rapportées par les étudiants sont également prises en compte. Exégèse : Les principes qui sous-tendent le TCS sont rappelés. Ses atouts et ses limites sont évoqués. Les étapes de construction, de validation, de passation, de calcul de la note sont développées. Les auteurs illustrent le propos en s’appuyant sur une expérience concrète menée au Département de médecine générale de l’Université de Liège Most teacher concerns about Script Concordance Tests (SCT) are the object of some 20 questions and answers. The questions and objections most commonly reported by students are also taken into account. Analysis: The principles of SCT are described. Their strengths and limitations are discussed. The steps in designing, validating, testing and calculating scores are developed. The authors depict the concepts based an experiment led in the Department of Family Practice at the University of Liège. http://hdl.handle.net/2268/146441 Titre: le test de concordance de script en 20 questions <br/> <br/>Auteur, co-auteur: Giet, Didier; MASSART, Valérie; Gagnon, Robert; Charlin, Bernard <br/> <br/>Résumé: Le présent article se donne comme objectif de répondre, en 20 questionsréponses, aux principales préoccupations que les équipes d’enseignants potentiellement intéressées par le test de concordance de script (TCS) peuvent se poser. Les questions et objections souvent rapportées par les étudiants sont également prises en compte. Exégèse : Les principes qui sous-tendent le TCS sont rappelés. Ses atouts et ses limites sont évoqués. Les étapes de construction, de validation, de passation, de calcul de la note sont développées. Les auteurs illustrent le propos en s’appuyant sur une expérience concrète menée au Département de médecine générale de l’Université de Liège Most teacher concerns about Script Concordance Tests (SCT) are the object of some 20 questions and answers. The questions and objections most commonly reported by students are also taken into account. Analysis: The principles of SCT are described. Their strengths and limitations are discussed. The steps in designing, validating, testing and calculating scores are developed. The authors depict the concepts based an experiment led in the Department of Family Practice at the University of Liège. http://hdl.handle.net/2268/145989 Titre: Crises financiere, economique, sociale, societale, morale, des reactions en chaine. <br/> <br/>Auteur, co-auteur: SCHEEN, André http://hdl.handle.net/2268/145945 Titre: Paléotératologie ou le diagnostic anténatal 2000 ans plus tard <br/> <br/>Auteur, co-auteur: Ricciardetto, Antonio; Charlier, Philippe http://hdl.handle.net/2268/142840 Titre: Using merged kinematic and anatomical data to evaluate humeral motion estimation: a pilot study <br/> <br/>Auteur, co-auteur: Schwartz, Cédric; Leboeuf, Fabien; Rémy-Néris, Olivier; Brochard, Sylvain; Lempereur, Mathieu; Burdin, Valérie <br/> <br/>Résumé: Optoelectronic systems are widely used in 3D motion capture. However, the reliability of the motion estimation depends on soft tissue artifacts and should therefore be validated. Two different sets of humeral markers were studied on four subjects. Anatomical and kinematic measurements were combined and the plausibility of the relative position of the bones in the glenohumeral joint during motion was evaluated using a new coherence index. Our findings show that an identical protocol leads to a large variability of the articular coherence for the subjects. However the use of an extra marker on the distal part of the humerus improves the humeral kinematics for three of the four subjects. Scientists and clinicians using 3D systems should remain aware of the influence of subject-specific morphology on the accuracy of the measure. Differences with a reference group may come from clinical reasons but also from measurement errors due to the inter-individual morphological differences. http://hdl.handle.net/2268/142254 Titre: Prise en charge de la douleur chronique non cancéreuse en Belgique : un état des lieux <br/> <br/>Auteur, co-auteur: BERQUIN, Anne; FAYMONVILLE, Marie-Elisabeth; DESEURE, Kristof; VAN-LIEFFERINGE, Anne-Sophie; CELENTANO, Jessica; CROMBEZ, Geert; VLAEYEN, Johannes; HANS, Guy <br/> <br/>Résumé: Depuis 2005, une politique d'amélioration de la prise en charge de la douleur chronique se met progressivement en place en Belgique. Trois types de structures existent actuellement : 73 fonctions algologiques, 36 équipes multidisciplinaires de la douleur chronique et neuf centres de référence multidisciplinaires de la douleur chronique. A la demande du Ministère de la Santé Publique, une équipe interuniversitaire a réalisé en 2010-2011 un travail d'évaluation de ces structures et formulé des recommandations pour le futur. Leurs observations et conclusions sont résumées dans cet article.; From 2005, a global policy aiming to improve chronic pain management is progressively installed in Belgium. Three types of structures presently exist : 73 algological functions, 36 multidisciplinary pain teams, and 9 multidisciplinary reference centers. On request of the Belgiun Ministry of Public Health, an interuniversity research team conducted an evaluation (in 2010-2011) of these structures and recommendations for the future. Their observations and conclusions are summarized in this paper. http://hdl.handle.net/2268/142114 Titre: Tables 1, 2, 3 and 4 (1-199) <br/> <br/>Auteur, co-auteur: independent Belgian/Luxembourg Working Party on Antimicrobial Therapy,; MELIN, Pierrette; Arendt, Vic; Cartuyvels, Reinoud; Delforge, Marie-Luce; De Waele, Jan; Delaere, Bénédicte; FRIPPIAT, Frédéric; Hites, Maya; Ieven, Greet; Malfroot, Anne; Konopnicki, Deborah; Pierard, Denis; Reynders, Marijke; Rossi, Camelia; Tuerlinckx, David; Van Eldere, Johan; Verhaegen, Jan; Vogelaers, Dirk http://hdl.handle.net/2268/141133 Titre: La restriction de croissance au sein des unités de soins intensifs néonatals peut être réduite chez les enfants prématurés de très faible poids à la naissance <br/> <br/>Auteur, co-auteur: Senterre, Thibault http://hdl.handle.net/2268/141075 Titre: La restriction de croissance au sein des unités de soins intensifs néonatals peut être réduite chez les enfants prématurés de très faible poids à la naissance <br/> <br/>Auteur, co-auteur: Senterre, Thibault http://hdl.handle.net/2268/141001 Titre: Pattern Recognition in NeuroImaging: What can machine learning classifiers bring to the analysis of functional brain imaging? <br/> <br/>Auteur, co-auteur: Schrouff, Jessica <br/> <br/>Résumé: The study of the brain development and functioning raises many question that are tracked using neuroimaging techniques such as positron emission tomography or (functional) magnetic resonance imaging. During the last decades, various techniques have been developed to analyse neuroimaging data. These techniques brought valuable insight on neuroscientific questions, but encounter limitations which make them unsuitable to tackle more complex problems. More recently, machine learning based models, coming from the field of pattern recognition, have been promisingly applied to neuroimaging data. In this work, the assets and limitations of machine learning based models were investigated and compared to previously developed techniques. To this end, two applications involving challenging datasets were defined and the results from widespread methods were compared to the results obtained using machine learning based modelling. More specifically, the first application addressed a research question: Is it possible to detect and characterize mnemonic traces? The fMRI experiment comprised a learning and a control tasks, both flanked by rest sessions. From previous studies, patterns of brain activity generated during the learning task should be spontaneously repeated during the following rest session, while no difference should be observed between the pre- and post-task rest session in the control condition. Using univariate and multivariate feature selection steps before a Gaussian Processes classification, mnemonic traces could be detected and their spatio-temporal evolution characterized. On the contrary, an analysis of the rest sessions based on the detection of independent networks did not provide any results supporting the theory of memory consolidation. The second application tackled a clinical issue: Can a pattern of brain activation characteristic to idiopathic Parkinson’s disease be detected and localized? The dataset considered to address this question comprised the fMRI images of aged healthy subjects and Parkinsonian patients while they were performing a task of mental imagery of gait at three different paces. The signal comprised in a priori selected regions of interest allowed for the support vector machines classification of healthy and diseased volunteers with an accuracy of 86%. To localize the discriminating pattern, a methodology based on the weight in labelled regions (e.g. from the anatomical automatic labelling or Brodmann atlases) was developed, which enabled the comparison between univariate and multivariate results and showed a nice overlap between them. Furthermore, models could then be compared quantitatively in terms of pattern localization, using a specifically defined measure of distance. This measure could then be used to compare the patterns generated from different folds of a same model, from different feature sets, or from different modelling techniques. The present study concluded that machine learning models can clearly and fruitfully complement other analysis techniques to tackle challenging questions in neuroscience. On the other hand, more work is needed in order to render the methodology fully accessible to the neuroscientific community. http://hdl.handle.net/2268/140567 Titre: Comment j’explore …Une différence de risque de survenue d’un événement dans les études cliniques <br/> <br/>Auteur, co-auteur: SCHEEN, André; ERNEST, Philippe; JANDRAIN, Bernard <br/> <br/>Résumé: La médecine factuelle fait souvent appel à la comparaison de deux interventions thérapeutiques dans des essais cliniques contrôlés avec la démonstration d’une supériorité (par rapport à un placebo ou un comparateur actif) ou au moins d’une non-infériorité (par rapport à un comparateur actif) en ce qui concerne un critère de jugement primaire décidé a priori (survenue d’un événement clinique majeur, par exemple). La différence dans la survenue d’un événement entre les deux interventions thérapeutiques testées peut être analysée, sur le plan statistique, par la réduction du risque absolu, la réduction du risque relatif, le hasard ratio ou encore l’odds ratio (rapport de cotes). Cet article discute les nuances, parfois importantes, concernant la signification de ces diffé- rents indices et analyse les précautions à prendre et les pièges à éviter dans leur interprétation et leur utilisation. Le clinicien est, en effet, de plus en plus souvent confronté aux résultats d’études cliniques, mais est généralement peu informé quant aux subtilités des analyses présentées; Evidence-based medicine often requires the comparison of two therapeutic interventions in controlled clinical trials with the demonstration of a superiority (versus a placebo or an active comparator) or at least a non-inferiority (versus an active reference) concerning a primary endpoint that has been defined a priori (occurrence of a major clinical event, for instance). The difference in the occurrence of such an event between two treatments may be statistically analyzed by absolute risk reduction, relative risk reduction, hazard ratio or odds ratio. The present article discusses the nuances, sometimes of importance, concerning the significance of these various indices and analyses the cautions to be taken and the pitfalls to be avoided in their interpretation and use in practice. The clinician is, indeed, increasingly confronted to results of clinical trials, but is generally poorly informed regarding the nuances of these various statistical analyses. http://hdl.handle.net/2268/140263 Titre: Hypnosis for pain management <br/> <br/>Auteur, co-auteur: MALAISE, Nicole; SALAMUN, Irène; PALMARICCIOTTI, Valérie; FAYMONVILLE, Marie-Elisabeth <br/> <br/>Résumé: The purposes of this chapter are : - to provide a brief definition of hypnosis, hypnotic process and self-hypnosis. - to describe briefly the neurophysiological correlates of hypnosis and hypnotic analgesia. - to propose a short review of recent literature concerning the effectiveness of clinical hypnosis in chronic pain, emphasizing more specifically research on the effectiveness of hypnosis with migraine. - to address some questions about its daily clinical use. http://hdl.handle.net/2268/140242 Titre: PRoNTo: Pattern Recognition for Neuroimaging Toolbox <br/> <br/>Auteur, co-auteur: Schrouff, Jessica; Rosa, Maria Joao; Rondina, Jane; Marquand, Andre; Chu, Carlton; Ashburner, John; Phillips, Christophe; Richiardi, Jonas; Mourão-Miranda, Janaina <br/> <br/>Résumé: In the past years, mass univariate statistical analyses of neuroimaging data have been complemented by the use of multivariate pattern analyses, especially based on machine learning models. While these allow an increased sensitivity for the detection of spatially distributed effects compared to univariate techniques, they lack an established and accessible software framework. The goal of this work was to build a toolbox comprising all the necessary functionalities formultivariate analyses of neuroimaging data, based on machine learning models. The “Pattern Recognition for Neuroimaging Toolbox” (PRoNTo) is open-source, cross-platform, MATLAB-based and SPM compatible, therefore being suitable for both cognitive and clinical neuroscience research. In addition, it is designed to facilitate novel contributions from developers, aiming to improve the interaction between the neuroimaging and machine learning communities. Here, we introduce PRoNTo by presenting examples of possible research questions that can be addressed with the machine learning framework implemented in PRoNTo, and cannot be easily investigated with mass univariate statistical analysis. http://hdl.handle.net/2268/139287 Titre: Cognitive support for a better handoff: does it improve the quality of medical communication at shift change in an emergency department? <br/> <br/>Auteur, co-auteur: Gillet, Aline; GHUYSEN, Alexandre; Bonhomme, Suzanne; D'Orio, Vincent; Sophie Nyssen, Anne <br/> <br/>Résumé: AIM: To improve the communication during shift handover in an emergency department. METHODS: We observed the handover process and analysed the discourse between physicians at shift change first, and then we created two cognitive tools and tested their clinical impact on the field. We used different measures to evaluate this impact on the health care process including the frequency and type of information content communicated between physicians, duration of the handoff, physician self-evaluation of the quality of the handoff and a posthandover study of patient handling. RESULTS: Our results showed that the patient's medical history, significant test results, recommendations (treatment plan) and patient follow-up were communicated to a greater extent when the tools are used. We also found that physicians spent more time at the bedside and less time consulting medical records using these tools. CONCLUSION: The present study showed how in-depth observations and analyses of real work processes can be used to better support the quality of patient care. http://hdl.handle.net/2268/138684 Titre: Characterization of periodic upper limb movement disorder in a patient with restless arms syndrome. <br/> <br/>Auteur, co-auteur: Ruppert, Elisabeth; Cretin, Benjamin; Meyer, Christelle; Kilic-Huck, Ulker; Bourgin, Patrice <br/> <br/>Résumé: BACKGROUND: Restless legs syndrome (RLS) and the frequently associated periodic limb movements (PLM) are common neurological disorders whose pathophysiology remains elusive. We report on the case of a 40-year-old patient presenting with severe restlessness in the upper limbs, a poorly known variant of RLS. CASE REPORT: Video-polysomnography was performed because of the associated poor sleep quality and daytime sleepiness evocative of PLM. An electromyogram of the extensor carpi radialis muscle was added. Remarkably, our patient had movements of repeated extension of the small finger that contrasted with the extension of the hallux, characteristic for PLM. Pramipexol was an effective treatment relieving the patient's upper limbs of discomfort and ameliorating her restless sleep. CONCLUSIONS: Involvement of the upper limbs in RLS is relatively common, but restlessness may be located on the upper limbs solely. One should be aware of the upper limb variant, and that treatment by dopaminergic agonists proves to be very efficient. <br/> <br/>Commentaires: Copyright (c) 2012 Movement Disorder Society. http://hdl.handle.net/2268/138676 Titre: A national cohort of HIV-infected patients in Belgium: design and main characteristics. <br/> <br/>Auteur, co-auteur: Van Beckhoven, D.; Buve, A.; Ruelle, J.; Seyler, L.; Sasse, A.; MOUTSCHEN, Michel <br/> <br/>Résumé: In Belgium, individual laboratory and treatment data of all HIV-infected patients seen in the 9 AIDS Reference Centres and 7 AIDS Reference Laboratories are collected prospectively since 2006. We present here an analysis of patients recorded in the cohort database between 1st of January 2006 and 31st of December 2008. During that period, 11982 patients were under medical follow-up in Belgium. Sixty-one percent of the patients were male and the median age was 39.8 at the time of first recorded viral load. Among the patients whose nationality or probable mode of transmission was recorded, nearly half (48.0%) were Belgian and 38.3% originated from Sub-Saharan Africa; heterosexual contacts were reported in the majority of cases (56.0%) followed by homosexual contacts (35.3%). A total of 145 deaths were reported. Around three quarters of the patients were on ART. The median CD4 cell count rose from 470 cells/mm3 in 2006 to 501 cells/mm3 in 2008. This cohort enabled us to obtain comprehensive information on the numbers and characteristics of HIV-infected patients currently being followed up in Belgium, and on trends in antiretroviral therapy and biological results. This will serve for planning purposes, evaluation of access to care and as a source of information for further studies. http://hdl.handle.net/2268/138421 Titre: Automatic multiclass classification of 18FDG-PET scans for the distinction between Parkinson’s disease and atypical parkinsonian syndromes <br/> <br/>Auteur, co-auteur: Phillips, Christophe; Schrouff, Jessica; Luxen, André; Salmon, Eric; Garraux, Gaëtan <br/> <br/>Résumé: Part of the difficulty in the early diagnosis of Parkinson’s disease (PD) is in differentiating it from atypical parkinsonian disorders (APS) that have a poorer prognosis such as multiple system atrophy (MSA), progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS). 18flurodeoxyglucose (FDG) positron emission tomography (PET) has been recommended for the early differentiation between PD and APS [1]. Here, 120 FDG PET scans (42, 31, 26 and 21 for the PD, MSA, PSP and CBS resp.) were acquired on average 3.5 years after symptoms onset (because the initial clinical features were outside the prevailing perception for PD) to look, without any a priori assumption, for cerebral FDG uptake patterns that discriminate either between the PD and APS classes, or between the four PD, MSA, PSP and CBS classes. The diagnostic used to label the scans was defined by clinical criteria on average 4.5 years after PET assessment.