Strategies for reducing the environmental impact of healthcare – a systemic approach

David Grimaldi (1), François Roucoux (2), Anne Berquin (3) Published in the journal : January 2024 Category : Durabilité et Soins de Santé: Quels Défis pour le Futur

From a systemic perspective, the healthcare system can be seen as an open system, involving flows of energy and materials, and producing greenhouse gases and waste besides healthcare. It is estimated that healthcare consumes between 4% to 7% mineral resources, metals, and fossil fuels used on earth each year, and produces more than 5% of all greenhouse gas emissions. To reduce this impact, it is necessary to combine an “item-by-item” approach with a more global and systemic one, which will require far-reaching changes. A few examples are given, particularly concerning the use of information and communication technologies

Read more

Climate change, mental health, and eco-anxiety

Clara Della Libera (1), Camille Mouguiama Daouda (1), Gérald Deschietere (2), Alexandre Heeren (1,3,4) Published in the journal : January 2024 Category : Durabilité et Soins de Santé: Quels Défis pour le Futur

In 2022, the second section of the sixth report from the Intergovernmental Panel on Climate Change (IPCC) dedicated a full chapter to the impact of climate change on health, including physical, community, and mental health. In terms of mental health, the authors reported observations of various impacts related to direct and indirect exposure to extreme weather events (e.g., floods) and gradual chronic changes (e.g., air pollution). Adequately documented, such impacts require the rapid adoption of healthcare system action plans. Beyond these effects, anxiety linked to the anticipation of climate change impacts – also known as eco-anxiety – represents an underexplored field whose prevalence and consequences on mental health remain poorly investigated. Recent studies suggest that, when moderate in intensity, eco-anxiety may constitute an adaptive response that stimulates the adoption of environmentally friendly behaviors without harming mental health. Delimiting the existence and predictors of such a range represents a crucial challenge of scientific research in this field. Here, we present some potential clinical interventions derived from similar fields of psychotherapy.

Read more

Prevention and healthcare organization

Jean Macq (1), Anne Berquin (2) Published in the journal : January 2024 Category : Durabilité et Soins de Santé: Quels Défis pour le Futur

Preventive healthcare, which generally decreases the need for medical treatment, is one of the levers for reducing healthcare’s environmental impact. Implementing preventive measures requires a global approach. This goes beyond the “disease” model, and simultaneously considers individual health, population health, and global/planetary health, from a systemic perspective that takes into account uncertainty and long term considerations. To tackle this challenge, we need to encourage dialogue and cross-fertilization of viewpoints, particularly among the three healthcare organization levels (micro level and its “health referent” function, meso level of catchment areas at which primary healthcare provision and its coordination with hospitals are established, macro level at which a country’s healthcare policies are defined). Sustainable development, prevention, and healthcare share numerous observations: we need to change our mindset, and in particular make more room for dialogue, deliberation, and uncertainty.

Read more

Outdoor physical activity and the health of future generations: a link between the environment, physical activity, and pediatrics

Nicolas Peeters (1), Lucie Vancraeynest (2) Published in the journal : January 2024 Category : Durabilité et Soins de Santé: Quels Défis pour le Futur

The health benefits of physical activities for children and adolescents are numerous and widely documented. While the World Health Organization recommendations for physical activity are clear, only 27 to 33% of children and adolescents worldwide achieve them. Belgium is no exception, with a very low percentage of children and adolescents having adequate levels of physical activity. In addition to various mental and physical health benefits of nature, the outside environment can play a role in promoting physical activities. Children and adolescents in contact with green spaces reportedly have higher levels of physical activity and less sedentary habits. In the outdoor environment, children exercise more intensively and spontaneously. Outdoor physical activities are likely to have a positive impact on young people’s health and general physical activity levels. Getting children outside more often and reconnecting them to nature can play an interesting role in the health of future generations.

Read more

Primary prevention: co-benefits for health and the environment

Mathilde Lechat Published in the journal : January 2024 Category : Durabilité et Soins de Santé: Quels Défis pour le Futur

This seminar summary is partly based on the work of Prof. Senn from the University Center for General Medicine and the research team from the University Center for General Medicine, University of Lausanne. Its purpose is to develop the notion of co-benefit for health and the environment. The latter is defined as the simultaneous impact on health and the environment of everyday choices and changes that people can undertake in their own lives (e.g. dietary or mobility choices). Rather than being a theoretical, abstract notion, it can be integrated into our daily practice, as illustrated by the clinical vignette presented in this article.

Read more

Health for life... it is possible and desirable! Or how the concept of positive health can open up new perspectives

Jean Hermesse Published in the journal : January 2024 Category : Durabilité et Soins de Santé: Quels Défis pour le Futur

Three great challenges are having a huge impact on health: major health inequalities, insufficient recognition of the socio-economic determinants of health, and an ageing population. Despite these well-known realities, our institutions remain focused on curative care based on a negative definition of health (absence of disease). The concept of positive health defines health as the ability to adapt and gain control when facing life’s social, physical, and emotional challenges. With its six dimensions (physical function, mental well-being, meaning of life, quality of life, social participation, and daily functioning), it offers an alternative, global vision of health. This unifying concept encourages the commitment of all players (schools, local authorities, town planners, social services, associations, healthcare professionals, etc.) in concrete projects, some of which have already proved their worth. A few examples are described here.

Read more

Ecological transition strategies: Which initiatives are on the front-line?

Ségolène de Rouffignac, Sarah De Munck Published in the journal : January 2024 Category : Durabilité et Soins de Santé: Quels Défis pour le Futur

The ecological transition is underway: This movement supporting the evolution towards a new model of society that embraces sustainability and solidarity calls into question our current healthcare system in particular. General medicine is also called upon to make this transition. This article highlights the concrete initiatives that have been put in place to educate, inform, and act in favor of planetary health at the front-line level. This article was presented during the “Teach the Teacher: Challenges and Perspectives” program on October 3, 2022, as part of the “University in Transition”.

Read more

Sustainable development in hospitals: at the roots of bioethics

Grégoire Wieërs, Laurent Ravez Published in the journal : January 2024 Category : Durabilité et Soins de Santé: Quels Défis pour le Futur

Global crises related to environmental changes are undermining healthcare structures. Yet, the medical practice itself contributes to this situation by responding to a logic of consumption and by indiscriminately generating pollution. To what extent are these behaviors counterproductive by contributing to a global evil? A medical ethic for the future, which would integrate environmental care into the prerogatives of medical practice, seems necessary.

This ethic already exists and is embodied in what for decades has been referred to as “bioethics”. Van Rensselaer Potter considered this discipline to be a necessary wisdom for the use of techniques and knowledge specific to the life sciences, and Fritz Jahr saw it as a moral obligation towards all living beings. However, it is the most pragmatic but also the most individualistic application proposed by André Helleghers and, following him, Beauchamp and Childress that has been retained and widely applicated.

Read more

Prevention of venous thromboembolism in medical patients: What role for fondaparinux (Arixtra®)?

Cédric Hermans Published in the journal : December 2023 Category : Actualité thérapeutique

Venous thrombotic events (deep vein thrombosis and pulmonary embolism) represent a major complication among hospitalized patients. For a long time, venous thromboembolism (VTE) was the focus of attention during surgical procedures. Today, however, it is among patients admitted for acute or chronic medical conditions that VTE is increasingly raising concerns and interest.

The incidence of VTE in medical patients, its lack of consideration, and insufficient prevention cannot be ignored. Systematic and rigorous assessment of the thrombotic risk in all admitted medical patients and consequent monitoring during their stay is a priority.

While low-molecular-weight heparins (LMWHs) have established themselves as the reference preventive antithrombotic agents, including in medical patients, the pentasaccharide fondaparinux (Arixtra®) represents an attractive alternative.

The properties of this synthetic molecule and its validation in clinical studies should make this anticoagulant a preferred alternative or a first-line agent for VTE prevention in medical patients.

Read more

Innovations in vaccinology

Julien De Greef Published in the journal : December 2023 Category : Maladies infectieuses

Several new vaccines have recently been developed, some of which are now available on the Belgian market. This article presents an overview of new vaccines against pneumococcus, respiratory syncitial virus, influenza, shingles and dengue fever.

Vaccine advances against malaria are also discussed.

Read more