This report describes the points of improvement to set up a high quality mental health care for t... more This report describes the points of improvement to set up a high quality mental health care for the elderly in Belgium.
Alternatively spliced GNAS1 and XL-GNAS1, encoding respectively the stimulatory G-protein alpha-s... more Alternatively spliced GNAS1 and XL-GNAS1, encoding respectively the stimulatory G-protein alpha-subunit (Gsalpha) and the extra-large stimulatory G-protein alpha-subunit (XLsalpha), are located on the imprinted chromosomal region 20q13.12-13. We presently report a functional polymorphism in the imprinted XL-GNAS1 gene. In three patients, a 36 bp insertion and two basepair substitutions flanking this insertion were found in the paternally inherited XL-GNAS1 exon 1. They clinically manifest an enhanced trauma-related bleeding tendency and a variable degree of mental retardation. A platelet aggregation inhibition test to evaluate Gs function was developed. Their platelets display Gs hyperfunction and an enhanced cAMP generation upon stimulation of Gs-coupled receptors. The prevalence of the XLsalpha insertion in a normal control group was 2.2%. Normal controls, inheriting the insertion maternally, had a normal platelet Gs activity, whereas controls inheriting the insertion paternally had increased inducible platelet Gs activity, defining the insertion as a functional polymorphism. This paternally inherited XLsalpha insertion represents a new genetic cause of an inherited bleeding tendency, although to a variable degree.
This study aims to investigate the clinical benefits of stroke units, the quality indicators prop... more This study aims to investigate the clinical benefits of stroke units, the quality indicators proposed in the international literature and the organization of stroke units in other European countries. What is the evidence about the impact of admission to acute stroke (systematic review and meta-analysis)? Which quality criteria for stroke units are proposed in the literature and what is their underlying scientific evidence (literature review)? How are stroke units organized in other countries? What is the quality including the quality criteria (literature review and questionnaire) In view of the previous questions, what are the suggestions for the organization of stroke units in Belgium and for the assessment of quality stroke care?
The prevalence of mental health problems among children and adolescents in Western countries is h... more The prevalence of mental health problems among children and adolescents in Western countries is high. Belgium, like many other Western countries, struggles with the set-up of a coherent and effective strategy for dealing with this complex societal problem. This paper describes the development of a policy scenario for the organization of child and adolescent mental health care services (CAMHS) in Belgium. The development process relied on Soft Systems Methodology including a participatory process with 66 stakeholders and a review of the existing (inter-)national evidence. A diagnostic analysis illustrated that the Belgian CAMHS is a system in serious trouble characterized by fragmentation and compartmentalization. A set of 10 strategic recommendations was formulated to lay down the contours of a future, more effective CAMHS system. They focus on mastering the demands made on scarce and expensive specialized mental health services; strengthening the range of services - in particular for those with serious, complex and multiple mental health problems - and strengthening the adaptive capacity of and the ethical guidance within the future CAMHS system.
This report describes the points of improvement to set up a high quality mental health care for t... more This report describes the points of improvement to set up a high quality mental health care for the elderly in Belgium.
Alternatively spliced GNAS1 and XL-GNAS1, encoding respectively the stimulatory G-protein alpha-s... more Alternatively spliced GNAS1 and XL-GNAS1, encoding respectively the stimulatory G-protein alpha-subunit (Gsalpha) and the extra-large stimulatory G-protein alpha-subunit (XLsalpha), are located on the imprinted chromosomal region 20q13.12-13. We presently report a functional polymorphism in the imprinted XL-GNAS1 gene. In three patients, a 36 bp insertion and two basepair substitutions flanking this insertion were found in the paternally inherited XL-GNAS1 exon 1. They clinically manifest an enhanced trauma-related bleeding tendency and a variable degree of mental retardation. A platelet aggregation inhibition test to evaluate Gs function was developed. Their platelets display Gs hyperfunction and an enhanced cAMP generation upon stimulation of Gs-coupled receptors. The prevalence of the XLsalpha insertion in a normal control group was 2.2%. Normal controls, inheriting the insertion maternally, had a normal platelet Gs activity, whereas controls inheriting the insertion paternally had increased inducible platelet Gs activity, defining the insertion as a functional polymorphism. This paternally inherited XLsalpha insertion represents a new genetic cause of an inherited bleeding tendency, although to a variable degree.
This study aims to investigate the clinical benefits of stroke units, the quality indicators prop... more This study aims to investigate the clinical benefits of stroke units, the quality indicators proposed in the international literature and the organization of stroke units in other European countries. What is the evidence about the impact of admission to acute stroke (systematic review and meta-analysis)? Which quality criteria for stroke units are proposed in the literature and what is their underlying scientific evidence (literature review)? How are stroke units organized in other countries? What is the quality including the quality criteria (literature review and questionnaire) In view of the previous questions, what are the suggestions for the organization of stroke units in Belgium and for the assessment of quality stroke care?
The prevalence of mental health problems among children and adolescents in Western countries is h... more The prevalence of mental health problems among children and adolescents in Western countries is high. Belgium, like many other Western countries, struggles with the set-up of a coherent and effective strategy for dealing with this complex societal problem. This paper describes the development of a policy scenario for the organization of child and adolescent mental health care services (CAMHS) in Belgium. The development process relied on Soft Systems Methodology including a participatory process with 66 stakeholders and a review of the existing (inter-)national evidence. A diagnostic analysis illustrated that the Belgian CAMHS is a system in serious trouble characterized by fragmentation and compartmentalization. A set of 10 strategic recommendations was formulated to lay down the contours of a future, more effective CAMHS system. They focus on mastering the demands made on scarce and expensive specialized mental health services; strengthening the range of services - in particular for those with serious, complex and multiple mental health problems - and strengthening the adaptive capacity of and the ethical guidance within the future CAMHS system.
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