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Jean-Luc Mommaerts,1 Gerlinde Beerens,1 Lieve Van den Block,1 Eric Soetens,2 Sandrina Schol,1 Erwin Van De Vijver,1 Dirk Devroey1 1Department of Family Medicine, 2Department of Cognitive and Biological Psychology, Vrije Universiteit Brussel, Belgium Background: Increasing numbers of students use stimulants such as methylphenidate (MPH) to improve their study capacity, making them prone to subsequent prolonged drug abuse. This study explored the cognitive effects of MPH in students who either assumed they received MPH or assumed they received a placebo. Methods: In a double-blind, randomized, placebo-controlled trial with a between-subjects design, 21 students were subjected to partial sleep deprivation, receiving no more than 4 hours sleep the night before they were tested. In the morning, they were given either a placebo or 20 mg of MPH. They then performed free recall verbal tests and Go/No-Go tasks repeatedly, their moods were evaluated using Profile of Mood States and their tiredness was assessed using a visual analog scale, with evaluation of vigilance. Results: No significant differences were found between those subjects who received MPH and those who received a placebo. However, significant differences were found between subjects who assumed they had received MPH or had no opinion, and those who assumed they had received a placebo. At three minutes, one hour, and one day after memorizing ten lists of 20 words, those who assumed they had received MPH recalled 54%, 58%, and 54% of the words, respectively, whereas those who assumed they had received placebo only recalled 35%, 37%, and 34%. Conclusion: Healthy, partially sleep-deprived young students who assume they have received 20 mg of MPH experience a substantial placebo effect that improves consolidation of information into long-term memory. This is independent of any pharmacologic effects of MPH, which had no significant effects on verbal memory in this study. This information may be used to dissuade students from taking stimulants such as MPH during examination periods, thus avoiding subsequent abuse and addiction. Keywords: methylphenidate, treatment assumption, placebo, cognitive functioning

Erwin Van De Vijver, Dirk Devroey Vrije Universiteit Brussels, Department of Family Medicine, Brussels, Belgium Background: Practical knowledge of emergency medical care among physicians seems to be insufficient worldwide. Research specifically aimed at family physicians is rather scarce. Additionally, in Belgium there are no data on this subject. Purposes: Our aim was to ascertain how confident Belgian family physicians feel about their ability to give adequate emergency care and to examine their assessment of their knowledge of relevant medical conditions. Methods: We used a web-based questionnaire for which a convenience sample of 974 Dutch-speaking family practitioners was invited through email. The survey assessed how these physicians perceived their own emergency skills and their knowledge of relevant medical conditions. Results: The survey had a recruitment rate of 22% (n = 210), with a 75% completion rate. The minimum criteria formulated pertaining to skills and knowledge were met by 64% and 55% of the participants, respectively. The mean cumulative scores on skills and knowledge were 2.5 and 3.2, respectively (on a scale from 0 to 4). Physicians with additional training in emergency care (3.07 versus 2.72), or with a spirometry certificate (2.94 versus 2.72) scored better than those without. Practitioners from rural areas felt more confident than those from urbanized regions (3.25 versus 3.15). Physicians felt more competent in aspects of emergency care where they had experience. Conclusion: Almost half of the Dutch-speaking family physicians in Belgium felt insufficiently competent to offer emergency medical care. Keywords: emergency medical care, family physician, Dutch, Belgium, medical training

Tania Moerenhout, Liesbeth Borgermans, Sandrina Schol, Johan Vansintejan, Erwin Van De Vijver, Dirk Devroey Vrije Universiteit Brussel, Department of Family Practice, Brussels, Belgium Background: Patient health information materials (PHIMs), such as leaflets and posters are widely used by family physicians to reinforce or illustrate information, and to remind people of information received previously. This facilitates improved health-related knowledge and self-management by patients. Objective: This study assesses the use of PHIMs by patient. It also addresses their perception of the quality and the impact of PHIMs on the interaction with their physician, along with changes in health-related knowledge and self-management. Methods: Questionnaire survey among patients of family practices of one town in Belgium, assessing: (1) the extent to which patients read PHIMs in waiting rooms (leaflets and posters) and take them home, (2) the patients’ perception of the impact of PHIMs on interaction with their physician, their change in health-related knowledge and self-management, and (3) the patients judgment of the quality of PHIMs. Results: We included 903 questionnaires taken from ten practices. Ninety-four percent of respondents stated they read PHIMs (leaflets), 45% took the leaflets home, and 78% indicated they understood the content of the leaflets. Nineteen percent of respondents reportedly discussed the content of the leaflets with their physician and 26% indicated that leaflets allowed them to ask fewer questions of their physician. Thirty-four percent indicated that leaflets had previously helped them to improve their health-related knowledge and self-management. Forty-two percent reportedly discussed the content of the leaflets with others. Patient characteristics are of significant influence on the perceived impact of PHIMS in physician interaction, health-related knowledge, and self-management. Conclusion: This study suggests that patients value health information materials in the waiting rooms of family physicians and that they perceive such materials as being helpful in improving patient–physician interaction, health-related knowledge, and self-management. Keywords: Patient health information materials, interaction, patients, physician, Belgium

Johan Vansintejan, Joris Janssen, Erwin Van De Vijver, Jan Vandevoorde, Dirk Devroey Department of Family Medicine, Vrije Universiteit Brussel (VUB), Brussels, Belgium Abstract: The aim of this Internet-based survey was to investigate the prevalence and associated predictors of sexual dysfunctions in Belgian self-reported HIV-positive men who have sex with other men. Of the 72 participants, 56% had a mild-to-severe erectile dysfunction, and 15% reported a hypoactive sexual desire disorder. The prevalence of premature ejaculation and anodyspareunia was 18% for both. Independent predictors for erectile dysfunction were frequency of masturbation, frequency of sex with partner, use of erectile enhancement drugs, having a passive sex role, and not having a steady relationship. Independent predictors for hypoactive sexual desire disorder were frequency of masturbation and having a lower lifetime number of sexual partners. Independent predictors for premature ejaculation were not having a steady relationship, having a lower lifetime number of sexual partners, and a lower level of education. The only independent predictor for anodyspareunia was having an active sex role. Keywords: homosexuality/male, sexual dysfunction, HIV, epidemiology

Ellie Senesael, Liesbeth Borgermans, Erwin Van De Vijver, Dirk DevroeyDepartment of Family Medicine, Vrije Universiteit Brussel, Brussels, BelgiumIntroduction: There is important evidence on the beneficial effects of treatment of cardiovascular risk factors in terms of morbidity and mortality, but important challenges remain in motivating patients to adhere to their treatment regimen. This study aimed to describe the effectiveness of a quality improvement intervention that included information and regular encouragement by email or letter on cardiovascular risk factors for patients at high risk for cardiovascular disease.Methods: This randomized single-blind study included patients of both sexes aged between 45 and 80 years old who had increased cardiovascular risk. Patients were randomly allocated to either a usual care group (UCG) or advanced care group (ACG). Patients in the UCG received regular care while patients in the ACG received usual care plus regular information and encouragement on cardiovascular risk factors by email or letter. Visits for both groups were planned at 0, 3, and 6 months. The outcome measures were blood pressure, weight, body mass index (BMI), waist circumference (WC), and smoking status.Results: Out of 178 eligible patients from one single primary care practice, 55 participated in the study, three of whom dropped out. After 6 months, there was a significant decrease in mean systolic and diastolic blood pressure in the UCG and ACG (P < 0.05). The decreases were already significant after 3 months, except for systolic blood pressure in the UCG. There was also a significant increase in the proportion of patients who met the target values for blood pressure in the UCG and ACG. There was a nonsignificant decrease of the average weight in the ACG, but significantly more patients lost weight in the UCG (P = 0.02). BMI, WC, and smoking status did not change in either group.Conclusion: This study found that there was a significant decrease of systolic and diastolic blood pressure in both study groups. Weight, BMI, WC, and smoking did not improve in either group. Information on cardiovascular risk factors and encouragement by means of letters or email did not provide additional benefits. Thus, effective patient empowerment probably requires more behaviorally sophisticated support to increase self-management, self-efficacy, and self-esteem in patients.Keywords: cardiovascular risk, tele-health, lifestyle, family medicine

A key characteristic of flooded paddy fields is the plough pan. This is a sub-soil layer of greater compaction and bulk density, which restricts water losses through percolation. However, the thickness of this compacted layer can be inconsistent, with consequences such as variable percolation and leaching losses of nutrients, which therefore requires precision management of soil water. Our objective was to evaluate a methodology to model the thickness of the compacted soil layer using a non-invasive electromagnetic induction sensor ( EM38- MK2). A 2.7 ha alluvial non-saline paddy rice field was measured with a proximal soil sensing system using the EM38- MK2 and the apparent electrical conductivity ( ECa) of the wet paddy soil was recorded at a high-resolution (1.0 × 0.5 m). Soil bulk density ( n = 10) was measured using undisturbed soil cores, which covered locations with large and small ECa values. At the same locations (within 1 m2) the depth of the different soil layers was determined by penetrometer. Then a fitting procedure was used to model the ECa - depth response functions of the EM38- MK2, which involved solving a system of non-linear equations and a R2 value of 0.89 was found. These predictions were evaluated using independent observations ( n = 18) where a Pearson correlation coefficient of 0.87 with an RMSEE value of 0.03 m was found. The ECa measurements allowed the detail estimation of the compacted layer thickness. The link between water percolation losses and thickness of the compacted layer was confirmed by independent observations with an inverse relationship having a Pearson correlation coefficient of 0.89. This rapid, non-invasive and cost-effective technique offers new opportunities to measure differences in the thickness of compacted layers in water-saturated soils. This has potential for site-specific soil management in paddy rice fields. [ABSTRACT FROM AUTHOR]

INTRODUCTION: A randomized placebo controlled trial with methylphenidate (MPH) was set up to identify the effects of MPH on cognition in healthy young adults (ea. without attention deficit hyperactivity disorder, ADHD). Subjects repeatedly performed tests of the immediate and delayed memory and vigilance tasks after administration of placebo or 20 mg MPH. CASE PRESENTATION: We report the case of an 18 year old man who participated in the study. He suffered from stuttering since childhood. During the study phase he reported a remarkable relief of the stuttering after the intake of 20 mg MPH. CONCLUSIONS: For D-amphetamine the beneficial effect on stuttering has been demonstrated but it was never implemented in clinical practice because of important adverse events. MPH, an amphetamine analogue, doesn't present these side effects. For this reason, MPH seems to merit further investigation in a randomized-controlled trial as a possible agent in the treatment of stuttering. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the cardiovascular risk (CVR) factors and morbidity in a sample of the population that received a brief intervention on cardiovascular prevention seven years ago. All family physicians who participated in the Cardiovascular Prevention Campaign in five Belgian towns in 2002-2003 received a follow-up questionnaire for each participating patient. The questionnaire included questions about new cardiovascular diagnoses, parameters of the latest physical examination and blood tests. Analyses were based on the 318 questionnaires that included essential information such as the date of the latest contact and the new diagnosis or mortality. The proportion of patients with a low CVR decreased from 75% in 2002-2003 to 40% in 2010. Participants showed a significant increase of the abdominal circumference, triglycerides and fasting glycaemia. Only LDL-cholesterol levels decreased significantly (p = 0.002). Four percent of the patients died, more male (7 ) than female (2%) (p = 0.03). One in ten patients presented with a cardiovascular event. Most of the changes are probably attributable to age. It is clear that the long-term effect of a brief intervention only followed by usual care is not sufficient to attain optimal level of cardiovascular prevention. [ABSTRACT FROM AUTHOR]