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Governments and public health authorities use seroprevalence studies to guide responses to the COVID-19 pandemic. Seroprevalence surveys estimate the proportion of individuals who have detectable SARS-CoV-2 antibodies. However, serologic assays are prone to misclassification error, and non-probability sampling may induce selection bias. In this paper, non-parametric and parametric seroprevalence estimators are considered that address both challenges by leveraging validation data and assuming equal probabilities of sample inclusion within covariate-defined strata. Both estimators are shown to be consistent and asymptotically normal, and consistent variance estimators are derived. Simulation studies are presented comparing the estimators over a range of scenarios. The methods are used to estimate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence in New York City, Belgium, and North Carolina. [ABSTRACT FROM AUTHOR]

Even though recognised to be of increasing importance, robust estimations of European farmers' risk preferences are still scarce. Using an incentivised lab-in-the-field experiment with farmers, free of learning bias, this paper analyses the structurally derived parameters of risk preferences based on the cumulative prospect theory. The sector studied is the apple and pear sector in Flanders, Belgium. Farmers are found to be highly risk-averse and to distort probabilities by overweighting a small probability of desirable outcomes. However, there is no evidence of loss aversion on average, unlike previous studies. Moreover, investigating the heterogeneous effects shows that some farmers significantly differ from the representative agent by still being extremely loss-averse. The results of this piece of research prove the need to consider heterogeneity within and across sectors when assessing farmers' risk preferences. [ABSTRACT FROM AUTHOR]

The Feel4Diabetes project conducted a 2-year intervention aiming to encourage healthy behaviours in families in six European countries. Within this paper, the intervention effect was evaluated after the first intervention year on 24-hour physical behaviour composition in Belgian families at risk for type 2 diabetes. Parents' and children's levels of physical activity (PA) and sedentary behaviour (SB) were objectively measured and sleep duration was self-reported. Valid data were obtained in 82 children (mean age: 8.2 ± 0.84; 50.0% boys) and 72 parents (mean age: 40.1 ± 5.5; 27.8% fathers). Data were analysed using a compositional data approach, and mixed models were used to take clustering into account. Results showed that for children, the mean baseline composition of the 24-hour day in sleep, SB, light and moderate-to-vigorous PA for the intervention group was (11 hours 18 minutes; 6 hours 33 minutes; 5 hours 02 minutes, 1 hour 08 minutes) and for the control group (11 hours 18 minutes; 6 hours 35 minutes; 5 hours 04 minutes; 1 hour 06 minutes), respectively. For parents, the mean baseline composition was for the intervention group (8 hours 12 minutes; 9 hours 36 minutes; 5 hours 43 minutes; 27 minutes) and for the control group (8 hours 00 minute; 9 hours 00 minute; 6 hours 27 minutes; 33 minutes). No significant intervention effects were found on 24-hour physical behaviour composition of either parents or children (p = 0.19 and p = 0.21, respectively). A relatively small study population and a poor attendance rate among parents could maybe explain the lack of effectiveness. More effective strategies are needed to retain vulnerable families in interventions. Furthermore, future approaches to improve the 24-hour physical behaviour composition should maybe focus more specifically on PA, SB and sleep, and involve teachers, children and parents in the design of the intervention. Trial registration: NCT02393872 in ClinicalTrials.gov. [ABSTRACT FROM AUTHOR]

Research on wood phenology has mainly focused on reactivation of the cambium in spring. In this study we investigated if summer drought advances cessation of wood formation and if it has any influence on wood structure in late successional forest trees of the temperate zone. The end of xylogenesis was monitored between August and November in stands of European beech and pedunculate oak in Belgium for two consecutive years, 2017 and 2018, with the latter year having experienced an exceptional summer drought. Wood formation in oak was affected by the drought, with oak trees ceasing cambial activity and wood maturation about 3 weeks earlier in 2018 compared with 2017. Beech ceased wood formation before oak, but its wood phenology did not differ between years. Furthermore, between the 2 years, no significant difference was found in ring width, percentage of mature fibers in the late season, vessel size and density. In 2018, beech did show thinner fiber walls, whereas oak showed thicker walls. In this paper, we showed that summer drought can have an important impact on late season wood phenology xylem development. This will help to better understand forest ecosystems and improve forest models. [ABSTRACT FROM AUTHOR]

Collecting sensitive data using surveys is one of the most challenging tasks facing survey methodologists as people may choose to answer questions untruthfully to present themselves in a positive light. In 2014, Mneimneh et al. proposed mixed Rasch models to detect socially desirable answering behaviors. This approach combines item response theory models with latent class analysis to differentiate substantive and biased answering patterns. Their results identified two latent classes, one of which was consistent with socially desirable answering. Our aim is to expand their approach to detecting social desirability by using a mixture confirmatory factor analysis (CFA) in round 7 of the European Social Survey. First, we attempt to estimate social desirability in three constructs separately (RQ1): effect of immigration on the country, allowing people to come in the country and social connection, using a mixture CFA. We then extend the analysis by (RQ2) introducing constraints between the latent classes, (RQ3) combining different constructs in one model, and (RQ4) comparing results in Belgium and the United Kingdom. In contrast with the paper published by Mneimneh et al. in 2014, the models with two latent classes do not have the best model fit. In addition, validation with the presence of a third person, the respondent's reluctance to give answers and personality traits are not systematically in line with our expectations. A small simulation shows that the method would work if the data would behave as we expect, with social desirability being the main factor influencing answering patterns. We conclude that a mixture CFA might not be able to identify social desirability in different survey contexts, especially in complex data as originating in cross-national social surveys. [ABSTRACT FROM AUTHOR]

Aims: The European Society of Cardiology (ESC) guidelines state that heart failure nurse specialists (heart-failure nurses) with specific competences are essential for a successful heart-failure-management programme. Thus, the Heart Failure Association (HFA) of the ESC developed the heart failure nurse curriculum (HFA curriculum). Several ESC member states developed cardiovascular education programmes to enable nurses to deliver high specialist care, but little is known of whether these curricula are in line with the HFA curriculum. Therefore, this paper describes the extent to which cardiovascular education programmes in Belgium, The Netherlands and Germany correspond to the HFA curriculum. Methods and results: A case study approach was adopted to obtain an in-depth understanding of the programme contents in relation to the HFA curriculum. For this purpose, representatives of the educational programmes and/or delegates of the national cardiovascular nursing organization shared their educational curricula. All of the studied cardiovascular education programmes aim to provide heart failure and/or cardiovascular nurses with essential competences for implementation of evidence based and guideline derived care. However, every cardiovascular education programme has a different focus/area of attention. Cardiovascular education in Belgium discusses aspects of all core-learning objectives of the HFA curriculum and emphasizes mostly knowledge aspects of these. Learning objectives in cardiovascular education in The Netherlands focus on chronic diseases in general and on learning objectives concerning patient education, support in self-care and management of device and pharmacological therapy. Cardiovascular education in Germany discusses most learning objectives; however, not all learning objectives receive equal attention. Conclusions: Although local cardiovascular education programmes adopt certain aspects of the HF curriculum, the curriculum as a whole is not adopted. [ABSTRACT FROM AUTHOR]

Continuity is seen as an important aim for the quality of youth-care services. However, views on continuity are predominantly guided by experts, without much attention to user perspectives. This paper focuses on youngsters' experienced continuity in relation to youth-care services. Twenty-five youngsters, who were in residential care or reached by low-threshold youth services, were interviewed about their experiences in and out of care. In thematically exploring the biographical narratives for important experiences of continuity, three major themes emerged: (i) the need for footholds in moments of existential chaos, (ii) the importance of timing of interventions to match the youngsters' perspectives and (iii) the importance of the youngsters' impact on their own care pathways. This study shows the need for support that is imbedded in a relational network within the context of youngsters in vulnerable situations. Rethinking youth services towards a better connection with these contexts is essential. Furthermore, the amount of control youngsters experience in their care interventions seems to be beneficial to the experience of continuity. It is argued that continuity should be seen as a process, in order to leave more space for negotiation and flexibility throughout the youngsters' experiences in youth-care services. [ABSTRACT FROM AUTHOR]

Persuasive on-pack marketing strategies, such as colourful images and games, affect children's preferences and requests. The purpose of this study was to describe the prevalence of these child-directed (i.e. aimed at children) strategies on food packages at a Belgian retailer. Although previous research already demonstrated the frequency of most of these techniques directed at children, this paper extends to food pricing and facing strategies (i.e. the number of items from the same product aligned next to each other in the supermarket shelves) which were unstudied till now. Moreover, the association between the use of these strategies, the products' (un)healthiness and their type of brand (national vs. private) is investigated. The content analysis found that 372 food products contained one or more child-directed marketing strategies on-pack, all these communications were coded; the products could be classified in 15 food categories. On average, 3.9 (Min = 1; Max = 8) food promotion techniques were used per package. Unhealthiness of products was rated according to Food Standards Agency (FSA) Nutrient Profile UK. We found that 89.2% of all products with child-directed strategies were considered to be unhealthy. The presence of marketing strategies was associated with higher product unhealthiness, but did not differ much between types of brand. Overall, these findings suggest that (unhealthy) foods aimed at children typically feature many on-pack persuasive communications, which implies that policy makers should (continue to) monitor this. These findings highlight the need for further research to investigate the impact of on-pack communications on children's consumption. [ABSTRACT FROM AUTHOR]

Background Precision medicine represents a paradigm shift in health systems, moving from a one-size-fits-all approach to a more individualized form of care, spanning multiple scientific disciplines including drug discovery, genomics, and health communication. This study aims to explore the contextual factors influencing the equitable implementation of precision medicine in Belgium for incorporating precision medicine into routine cancer care within the Belgian health system. Methods As part of a foresight study, our approach evaluates critical factors affecting the implementation of precision oncology. The study scrutinizes contextual, i.e. demographic, economic, societal, technological, environmental, and political/policy-related (DESTEP) factors, identified through a comprehensive literature review and validated by a multidisciplinary group at the Belgian Cancer Center, Sciensano. An expert survey further assesses the importance and likelihood of these factors, illuminating potential barriers and facilitators to implementation. Results Based on the expert survey, five key elements (rising cancer rates, dedicated healthcare reimbursement budgets, increasing healthcare expenditures, advanced information technology solutions for data transfer, and demand for high-quality data) are expected to influence the equitable implementation of precision medicine in routine cancer care in Belgium in the future. Conclusions This work contributes to the knowledge base on precision medicine in Belgium and public health foresight, exploring the implementation challenges and suggesting solutions with an emphasis on the importance of comparative analyses of health systems, evaluation of health technology assessment methods, and the exploration of ethical issues in data privacy and equity. [ABSTRACT FROM AUTHOR]

Objective. Specific neck exercises are recommended in the rehabilitation of chronic nonspecific neck pain (CNNP). They are unfortunately often accompanied by acute pain flare-ups. Global exercises might be a beneficial addition, as they activate endogenous analgesia without overloading painful structures. However, it is still unclear which type of exercise is most effective. This randomized controlled trial was done to evaluate the effect of an online blended program of global and specific neck exercises, compared to programs including only 1 of both types of exercise. Methods. Forty-eight patients with CNNP were randomized into 3 groups. Online questionnaires were collected at baseline, at midtreatment, immediately after treatment, and at the 3-month follow-up. Quantitative sensory testing and actigraphy were assessed at baseline and after treatment. Linear mixed-model analyses were performed to evaluate treatment effects within and between groups. Neck pain-related disability after treatment was considered the primary outcome. Results. No time x treatment interaction effects were found. All groups improved in neck pain-related disability, pain intensity, self-reported symptoms of central sensitization, local pain sensitivity, physical activity, and pain medication use. No effects were found on quality of life, sleep quality, depression, anxiety, stress, widespread pain sensitivity, health economics, or actigraphy measurements. A higher global perceived effect was reported after performing the blended program, compared to the other groups. Conclusion. A blended exercise program was not superior to the stand-alone programs in reducing disability. Nevertheless, the global perceived effect of this type of exercise was higher. Future research necessitates larger sample sizes to adequately explore the optimal type of exercise for patients with CNNP. Impact. Exercise therapy should be an important part of the rehabilitation of patients with CNNP, regardless of the type of exercise. [ABSTRACT FROM AUTHOR]

This article presents the first rigorous, multi-country analysis of settlement rates. Data on settlement were collected for twenty-three of the twenty-five largest economies. Settlement rates vary greatly, from below 15% in France, Belgium, and Russia, to over two-thirds in Australia. Settlement rates also vary by subject matter, with settlement rates generally highest in tort, especially in the U.S. There are also dramatic differences in settlement rates by legal origin, with common law countries generally having the highest settlement rates. Because settlement rates in civil law countries are so low, selection effects may not be a significant problem for empirical work involving them. Higher settlement rates are correlated with early disclosure and shorter court delays, but more research is needed to explain the large differences in settlement rates. [ABSTRACT FROM AUTHOR]

Human consumption of insects has previously been examined in cross-cultural studies. However, such studies rarely include African countries and willingness-to-pay for insect-based food has never been assessed in cross-cultural studies. The current study presents a cross-cultural study conducted with 409 urban dwellers from Belgium (191 males; 218 females) and 412 urban dwellers from Gabon (219 males; 193 females). Each respondent was surveyed with a questionnaire following the Knowledge, Attitude, and Practices model and included questions relative to willingness-to-pay for 2 insect-based foods (insect baguette and insect burger). More than 90% of respondents from both countries were familiar with edible insects. However, acceptance of entomophagy was lower in respondents from Gabon than in respondents from Belgium. Intercultural differences were also recorded between Gabonese ethnic groups. Most respondents who accepted entomophagy were willing to eat the insect baguette and/or the insect burger. These findings confirm that entomophagy could further develop in Belgium and Gabon. Willingness-to-pay varied between countries and between insect-based foods. In Belgium, the average prices of comparable conventional foods (i.e. same foods but without insects) were lower than the average willingness-to-pay for insect-based foods. In Gabon, respondents were not willing to pay extra for insect-based foods. Setting the right price for insect-based foods is a necessary step to promote more frequent insect consumption. [ABSTRACT FROM AUTHOR]

Objective Knee osteoarthritis (KOA) is a common musculoskeletal problem worldwide and its key symptom is pain. Guidelines recommend incorporating comorbidity-specific therapies into patient-centered care. Patients diagnosed with KOA frequently have insomnia, which is associated with higher-pain severity. For this reason, this study protocol outlines the methodology of a randomized controlled trial (RCT) investigating the effectiveness of cognitive behavioral therapy for insomnia (CBTi) combined with best-practice KOA care (BPC) compared to best-practice KOA care and lifestyle education. Methods A 2-arm RCT in patients with KOA and insomnia is conducted, in which a total of 128 patients are randomly allocated to an intervention or control group. The experimental intervention consists of 12 sessions of physical therapist–led BPC with an additional 6 sessions of CBTi. The control intervention also receives BPC, which is supplemented with 6 general lifestyle information sessions. The primary outcome is the between-group difference in change in pain severity at 6 months after intervention. Secondary outcomes are pain-related outcomes, sleep-related outcomes, symptoms of anxiety and depression, level of physical activity and function, perceived global improvement, biomarkers of inflammation, and health-related quality of life. Assessments are conducted at baseline, immediately after intervention, and 3, 6, and 12 months after intervention. Furthermore, a cost-utility analysis for the proposed intervention will be performed alongside the RCT. Impact This is the first RCT investigating the clinical and cost-effectiveness of a physical therapist–led intervention integrating CBTi into BPC in patients with KOA and insomnia. The results of this trial will add to the growing body of evidence on the effectiveness of individualized and comorbidity-specific KOA care, which can inform clinical decision-making and assist policymakers and other relevant stakeholders in optimizing the care pathway for patients with KOA. [ABSTRACT FROM AUTHOR]

Explicit criteria, such as the STOPP/START criteria, are increasingly used both in clinical practice and in research to identify potentially inappropriate prescribing in older people. In an article on the STOPP/START criteria version 2, O'Mahony et al. have pointed out the advantages of developing computerised criteria. Both clinical decision support systems to support healthcare professionals and software applications to automatically detect inappropriate prescribing in research studies can be developed. In the process of developing such tools, difficulties may occur. In the context of a research study, we have developed an algorithm to automatically apply STOPP/START criteria version 2 to our research database. We comment in this paper on different kinds of difficulties encountered and make suggestions that could be taken into account when developing the next version of the criteria. [ABSTRACT FROM AUTHOR]

The use of information and communication technology (ICT) in child welfare services has increased significantly during the last decades, and so have the possibilities to process health data. Parton (2009) states that this evolution has led to a shift in the nature of social work itself: from 'the social' to 'the informational'. It is claimed that social workers primarily are becoming information processors concerned with the gathering, sharing and monitoring of information, instead of being focused on the relational dimensions of their work. However, social workers have considerable discretion concerning the way they use ICT. In this paper, we investigate (i) the street-level strategies social workers develop regarding ICTand (ii) howthese relate to a narrative social work approach. To illustrate this, an evaluation of Charlotte was conducted, a client registration system that is used by social workers in child welfare services in Flanders, Belgium. Based on fifteen interviews, we find that social workers develop various strategies regarding Charlotte to preserve a relational and narrative work approach. These strategies not only result in a gap between ICT policy and the execution of that policy in practice, but also decrease the extent to which accountability can be realised via registration data. [ABSTRACT FROM AUTHOR]

Background The European Union has used Healthy Life Years (HLY) as an indicator to monitor the health of its aging populations. Scholarly and popular interest in HLY across countries has grown, particularly regarding the ranking of countries. It is important to note that HLY is based on self-assessments of activity limitations, raising the possibility that it might be influenced by differences in health reporting behaviours between populations, a phenomenon known as differential item functioning (DIF). Methods We estimated DIF-adjusted HLY at age 50 for Belgium, France, Germany, Greece, Italy, the Netherlands, Spain, and Sweden to determine the extent to which differences in HLY might be influenced by reporting heterogeneity across countries. We used anchoring vignettes, taken from the 2004 Survey of Health, Ageing and Retirement in Europe, to estimate DIF-adjusted prevalence rates of activity limitations measured by the Global Activity Limitations Indicator (GALI). The Sullivan method was used to calculate DIF-adjusted HLY. Results Changes in HLY before and after adjustment ranged from a 1.20-year decrease for men in Italy to a 1.61-year increase for women in Spain. Adjustment for DIF produced changes in the rankings of the countries by HLY, with upward and downward movements of up to three positions. Conclusion Our results show that DIF is likely to affect HLY estimates, thereby posing a challenge to the validity of comparisons of HLY across European countries. The findings suggest that HLY should be used to monitor population health status within a country, rather than to make comparisons across countries. [ABSTRACT FROM AUTHOR]

Background During extended (nocturnal) hemodialysis (ENHD), the dose of low-molecular-weight heparin (LMWH) can be administered as a single injection or as a divided dose over different time points. Our hypothesis was that a single injection might be sufficient to maintain dialyzer fiber patency. In addition, we investigated whether the biochemical clotting parameter anti-Xa accurately predicts fiber blocking. Methods Our hypothesis was tested in 20 stable patients on ENHD in a random cross-over setting during two consecutive midweek sessions. The regular total dose of LMWH (i.e. enoxaparin, Clexane® 40–100  mg, Sanofi, Belgium) was either given (i) in a single injection at the dialysis start or (ii) divided over two injections, at the start and halfway the dialysis session. Blood samples were taken from the arterial blood line at different time points to determine plasma anti-Xa activity levels. Post-dialysis, the rinsed and dried hemodialyzers were scanned with a reference micro-computed tomography (µCT) scanning technique, and non-blocked fibers were counted in a central cross-section of the dialyzer outlet potting (ImageJ, NIH, USA). Results The percentage of open fibers in the dialyzers after a single injection of LMWH [91 (61–96)%] versus divided administration [94 (79–98)%] was not different. Time averaged anti-Xa activity levels were clinically not significantly different between both sessions. Anti-Xa activity levels correlated with the administered anticoagulation doses normalized for body weight, but not with the percentages open fibers in the dialyzers. Conclusion Our results indicate that there is no need to administer enoxaparin over two injections for ENHD up to 8 h. The usefulness of monitoring anti-Xa levels to predict fiber patency, assessed by µCT, can be questioned, but further clinical trials are needed. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES There are several treatment options for non-elderly adults (18–60 years) in need of aortic valve replacement (AVR): a mechanical or biological substitute, a homograft, the Ross procedure or nowadays even transcatheter aortic valve replacement. This study evaluated the current opinions and practices of cardiac surgeons and cardiologists concerning AVR strategies in this patient group. METHODS A 43-item online survey was sent out to several scientific organizations, individual cardiac surgeons, cardiologists and residents/fellows worldwide. RESULTS Two hundred twenty-two physicians from 33 different countries answered the survey. The UK (24%), Belgium (23%) and North America (22%) are best represented. A mechanical valve is the most frequently used substitute in non-elderly. With increasing patient age, the popularity of a biological valve increases. Transcatheter aortic valve replacement and the Ross procedure are each used in <10% of this cohort. Only 12% of the cardiac surgeons has experience with the Ross surgery. In 23%, the patient seems not to be involved in the decision on the type of valve substitute. CONCLUSIONS The preferred surgical treatment for non-elderly patients in need of AVR differs widely. To enable a shared decision-making process including patient preferences, there is more need for collaboration between cardiac departments, as well as education and scientific research about patient-centred outcomes of the different AVR techniques. [ABSTRACT FROM AUTHOR]

In the COVID‐19 pandemic, workplace transmission plays an important role. For this type of transmission, the longitudinal 14‐day incidence curve of SARS‐CoV‐2 infections per economic sector is a proxy. In Belgium, a census of confirmed 14‐day incidences per NACE‐BEL sector level three is available from September 2020 until June 2021, encompassing two waves of infections. However, these high‐dimensional data, with a relatively small number of NACE‐BEL sectors, are challenging to analyze. We propose a nonlinear Gaussian–Gaussian model that combines parametric and semi‐parametric elements to describe the incidence curves with a small set of meaningful parameters. These parameters are further analyzed with conventional statistical methods, such as CCA and linear models, to provide insight into predictive characteristics of the first wave for the second wave. Those nonlinear models classify economic sectors into three groups: sectors with two regular waves of infections, sectors with only a first wave and sectors with a more irregular profile, which may indicate a clear effect of COVID‐19 vaccination. The Gaussian–Gaussian model thus allows for analyzing and comparing incidence curves and to bring out key characteristics of such curves. Finally, we consider in which other settings the proposed approach could be applied, together with possible pitfalls. [ABSTRACT FROM AUTHOR]

Background: Mental health, particularly among young adults, has been severely affected during the COVID-19 pandemic, partially because of both forced social isolation measures and loneliness. Numerous papers on the short-term consequences of lockdown measures reported high psychological distress, as well as an increase of depressive and anxiety symptoms and psychotropic drug use. This study evaluated potential risk and protective factors, such as resilience, loneliness, social and family context, in order to detect vulnerable individuals. Methods: This prospective longitudinal study was carried out in a two phase survey: the first one, during lockdown in Spring 2020 (T1), and, the second one, in Summer 2020 (T2), when restrictive measures were slackened. The main outcomes included the Resilience Scale for Adults (RSA) and the University of California Los Angeles (UCLA) Loneliness Scale. The secondary outcomes included mental health care needs (MHCN), use of psychotropic drugs and family and social contacts. Results: This study evaluated risks and protective factors in mental health in 825 emerging adults aged from 18 to 25 years old in Belgium and in Italy. Participants were divided into three groups according to their MHCN before and after lockdown measures. 5% of the participants experienced an increase in MHCN at T1, including the start of a psychotropic treatment. At T1, statistically significant differences were found in mean RSA total scores and RSA Perception of Self scores between groups. At T2, the group who experienced an increase in MHCN displayed a significant decrease of mean loneliness scores compared with the other groups. This decrease is linearly correlated with resilience competencies. Conclusions: The COVID-19 pandemic and its associated restrictive measures cause a negative impact on youth’s mental health, particularly among vulnerable individuals. Resilience and social contacts are protective factors that need to be taken into account. [ABSTRACT FROM AUTHOR]

This article explores the role of geographical distance and regional co-location as a determinant of the size of contract research from firms to domestic universities. The analysis relies on a panel of three consecutive R&D surveys for Belgium, and controls for firm, university, and network characteristics. The findings reveal that firms tend to enter into larger-sized contract research with universities that are either located nearby or farther away. Regional co-location is also positively associated with the size of contract research from firms to universities. [ABSTRACT FROM AUTHOR]

Given that modern democracies face generation-transcending policy challenges, this study asks whether the interests of future generations are sufficiently taken into account in present-day parliamentary politics. Through analysis of parliamentary documents in Belgium (2010–2019), we examine whether present-day MPs make representative claims on behalf of future generations, how such claims are made and by whom. We find that MPs do formulate claims, but only to a limited extent and with little or no justification. Moreover, claims-making is driven by electoral-strategic considerations. Only those who hold prominent positions make claims for future generations and fewer claims are made in election years. [ABSTRACT FROM AUTHOR]

Tobacco smoking uptake is still a major public health concern, especially among youngsters living in vulnerable situations. Finding optimal ways to engage youngsters in smoking prevention is important. Compared to traditional settings such as schools, social work settings providing sports-based and recreational activities (SR-settings) tend to reach and engage youngsters more. This study aimed to gain insight into the reasons for smoking uptake among youngsters living in vulnerable situations and the conditions through which SR-settings are potentially beneficial for smoking prevention initiatives. Data were collected in two SR-settings in Flanders, Belgium, by means of five focus group discussions and six individual interviews with youngsters (n  = 38, mean age = 12.9 ± 2.61 years, 69.7% boys) and eight individual interviews with youth workers (n  = 8, mean age = 27.5 ± 7.95 years, 87.5% men). A thematic analysis (TA) approach was applied to analyse the data. Besides individual factors, such as attitudes towards smoking, the desire to be part of a group and conformity to group norms seem to be important drivers of smoking uptake among youngsters in vulnerable situations. The presence of powerful role models in SR-settings with whom youngsters identify may counteract group norms by encouraging healthy behaviour. SR-settings seem suitable for questioning perceptions of vulnerable youngsters, unlike other settings where they may struggle to be heard. The conditional characteristics of SR-settings, such as authentic group processes, having meaningful roles, and being heard, make these contexts promising venues for smoking prevention efforts among vulnerable youngsters. Youth workers who have established trusting relationships with youngsters seem well-suited to communicate smoking prevention messages. A participatory approach, in which youngsters are involved in developing smoking prevention programs, is desirable. [ABSTRACT FROM AUTHOR]

We investigate in which countries fiscal externalities provide a justification for increasing subsidies to higher education. First, we show that the marginal fiscal recovery rate, i.e. the ratio of the change in total net fiscal revenues and the change in total subsidy costs caused by a small change in tuition subsidies, is the key statistic: if larger than a well-specified threshold value, then a small increase in subsidies is desirable from a welfare point of view. We also show that the marginal fiscal recovery rate depends on three statistics: the elasticity of participation with respect to subsidies, the success probability of the marginal student, and the ratio of the net fiscal revenue gain and the subsidy level of a degree in higher education. Second, we use this formula to approximate the marginal fiscal recovery rate in twenty OECD countries. The average marginal fiscal recovery rate is equal to 0.94, meaning that, on average, 0.94 euro is recovered of an increase in subsidies by one euro. This average hides substantial heterogeneity between countries. In six countries, the marginal fiscal recovery rate is larger than one, implying that an increase in subsidies to higher education is unambiguously desirable (i.e. a Pareto improvement) in these countries. In the other 14 countries, the marginal fiscal recovery rate is below one. Yet, if the degree of inequality aversion is not extreme, then increasing subsidies is also desirable in 12 additional countries. Third, to check the quality of our approximation of the marginal fiscal recovery rate, we simulate it for Belgium (region of Flanders) on the basis of a more detailed model. This simulation provides a somewhat lower, yet fairly similar result compared to the approximation. [ABSTRACT FROM AUTHOR]

The Corona Virus Disease (COVID‐19) pandemic has increased mortality in countries worldwide. To evaluate the impact of the pandemic on mortality, the use of excess mortality rather than reported COVID‐19 deaths has been suggested. Excess mortality, however, requires estimation of mortality under nonpandemic conditions. Although many methods exist to forecast mortality, they are either complex to apply, require many sources of information, ignore serial correlation, and/or are influenced by historical excess mortality. We propose a linear mixed model that is easy to apply, requires only historical mortality data, allows for serial correlation, and down‐weighs the influence of historical excess mortality. Appropriateness of the linear mixed model is evaluated with fit statistics and forecasting accuracy measures for Belgium and the Netherlands. Unlike the commonly used 5‐year weekly average, the linear mixed model is forecasting the year‐specific mortality, and as a result improves the estimation of excess mortality for Belgium and the Netherlands. [ABSTRACT FROM AUTHOR]

We study how countries' financial structure affects their transition to low-carbon growth. Using global industry-level data, we document that carbon-intensive industries reduce emissions faster in economies with deeper stock markets. The main channel underpinning this stylised fact is that stock markets facilitate green innovation in carbon-intensive sectors, resulting in lower carbon emissions per unit of output. More tentative evidence indicates that stock markets also help to reallocate investment towards more energy-efficient sectors. Cross-border spillovers are limited: less than 5% of these industry-level reductions in domestic emissions are offset by carbon embedded in imports. A firm-level analysis of an exogenous shock to the cost of equity in Belgium confirms our findings. [ABSTRACT FROM AUTHOR]

Why did the chairman of the "Jewish Council" in Belgium decide to resign from his position in late 1942 while his counterparts in the Netherlands, operating in a seemingly similar context, decided to remain in place until the council was dissolved? The choices and motivations of Jewish leaders during Nazi rule have been a persistent subject of discussion in Holocaust historiography for decades. To this day, research has overwhelmingly been conducted in national contexts, which has obscured a thorough understanding of the distinctive circumstances in which Jewish leaders operated. By exploring the different socio-historical premises on which the Jewish organizations in the Netherlands and Belgium were built, this article argues that the level of (dis)continuation with prewar communal structures played a significant role in the posture and choices of Jewish functionaries under Nazi occupation in these two countries. [ABSTRACT FROM AUTHOR]

Summary: Basal cell carcinomas (BCCs or "rodent ulcers") are the most common type of skin cancer and generally do not spread elsewhere on the body. They are not unusual in older people, but someone who develops lots of BCCs from an early age may have the rare genetic condition Basal Cell Naevus Syndrome (BCNS or "Gorlin syndrome"). Other clues to BCNS include an unusually shaped face, cysts in the jaw, and tiny irregularities on the palms and soles called palmar pits. The diagnosis is confirmed by testing DNA extracted from a blood sample. BCNS is caused by a mistake (mutation) in a gene called PTCH1 which is usually inherited from a parent, but occasionally develops for the first time in the embryo, in which case, the patient is described as mosaic because some body cells contain the mistake and some do not. Mosaic patients can be hard to diagnose because they tend to have a milder form of the condition (sometimes the only sign is a BCC developing in childhood) and the blood test may be negative for PTCH1 mutations. This paper, from Belgium and the Netherlands, describes two such patients: a 41 year old woman with BCCs on just one side of her body and no other features of BCNS and a 36 year old woman with BCCs, jaw cysts and palmar pits. In both patients the blood test was negative but PTCH1 mutations were found in all the BCCs tested. Confirming the diagnosis enabled the doctors to counsel these patients about possible complications of BCNS and the risk of passing it on to the next generation. Linked Article: Reinders et al. Br J Dermatol 2019; 181:587–591 [ABSTRACT FROM AUTHOR]

Aims Although life expectancy in adults with congenital heart diseases (CHD) has increased dramatically over the past five decades, still a substantial number of patients dies prematurely. To gain understanding in the trajectories of dying in adults with CHD, the last year of life warrants further investigation. Therefore, our study aimed to (i) define the causes of death and (ii) describe the patterns of healthcare utilization in the last year of life of adults with CHD. Methods and results This retrospective mortality follow-back study used healthcare claims and clinical data from BELCODAC, which includes patients with CHD from Belgium. Healthcare utilization comprises cardiovascular procedures, CHD physician contacts, general practitioner visits, hospitalizations, emergency department (ED) visits, intensive care unit (ICU) admissions, and specialist palliative care, and was identified using nomenclature codes. Of the 390 included patients, almost half of the study population (45%) died from a cardiovascular cause. In the last year of life, 87% of patients were hospitalized, 78% of patients had an ED visit, and 19% of patients had an ICU admission. Specialist palliative care was provided to 17% of patients, and to only 4% when looking at the patients with cardiovascular causes of death. Conclusions There is a high use of intensive and potentially avoidable care at the end of life. This may imply that end-of-life care provision can be improved. Future studies should further examine end-of-life care provision in the light of patient's needs and preferences, and how the healthcare system can adequately respond. [ABSTRACT FROM AUTHOR]

We herein report two cases of cathinone intoxication. The first case is about a drug addict who was admitted to the emergency room after the injection of an unknown compound. He presented with tachycardia, palpitations, mydriasis, dyspnea, dizziness, headache and nausea. After leaving the hospital against medical advice, he returned the next day with police escort, presenting aggressiveness and agitation signs. One month later, he returned one more time for sleeping disorders, hallucinations and anxiety. He was finally transferred for his 21st detoxification treatment. The second case concerns a man who was wandering the streets and tried to escape when police officers called him. He confessed to snorting of N -ethylpentedrone and was admitted with severe agitation including delusion of persecution, tachycardia, mydriasis and fever. Because of renal failure, rhabdomyolysis and metabolic acidosis, he was transferred to the intensive care unit where he manifested worsening of the symptoms, turning into coma. He was intubated for 3 days before a complete resolution of the symptoms. A screening was performed by high-resolution mass spectrometry followed by quantifications made by high-performance liquid chromatography coupled with a diode array detector. In the first case, alpha-pyrrolidinohexiophenone was identified only during the first two admissions. However, as plenty of other psychotropic substances were also found, the cathinone alone could not be held directly responsible for the symptoms. In the second case, more than 2,000 ng/mL of N -ethylpentedrone was found without any decrease in the next 17 h, underlining the long half-life of this compound. Unlike the first case, symptoms could be clearly attributed to the cathinone. In conclusion, cathinones can be found on the Belgian illicit drug market, with various routes of administration and clinical consequences. In these two case reports, some common points were observed initially. However, one patient was finally able to leave the hospital without any treatment, whereas the other would most likely have died without intensive care. [ABSTRACT FROM AUTHOR]

Social movement scholars have frequently pointed to individuals' personal networks to explain protest participation. While the recruitment function of micro networks has been explored in depth, the support effect of networks has received only scant attention. The study explores how and to what extent social support and social constraints in people's personal networks explain differential protest participation. Three dimensions of support are distinguished: the politicization of a person's network, the political agreement about the protest topic within a person's network, and the social approval of protest participation within a person's network. Drawing on panel survey data (N=1,684) of a large protest in Belgium including both participants and non-participants, we test whether the support effects of networks play a role on top of the recruitment effect. We find evidence that two functions of social networks (politicization and social approval) affect protest participation. Additionally, we find differences in support-effects across types of social ties. Co-members of an organization exert influence on protest participation across a variety of support functions. The most intimate ties prospective participants have (partners), in contrast, matter only in so far as they approve of participation. [ABSTRACT FROM AUTHOR]

Members of the Parisian financial elite, Meyer Joseph Cahen d'Anvers (1804–1881) and his descendants belonged to an Ashkenazi community rooted in Germany and Belgium. In the late nineteenth century, as targets of the anti-Semitic press, the Cahen d'Anvers family experienced the consequences of the Dreyfus Affair and the horrors of the racial laws. In an earlier generation, the family adopted what could be defined as a 'top-down' model of integration. This essay focuses on its mechanisms and development, in relation to the construction of the family's national and cultural identity. After tracing the patriarch's origins, the text analyses the properties and collections of Cahen d'Anvers and explores their influence upon the subsequent development of the family's place in society. As a showcase for their public identity, the Château de Nainville (Essonne) and the Petit Hôtel de Villars (Paris) distilled, in their architecture, furnishings and collections, Meyer Joseph's civil rights and ambitions. [ABSTRACT FROM AUTHOR]

Problems with aphids in small grain cereals, either direct by feeding, or indirect by transmission of Barley Yellow Dwarf Virus, are expected to increase due to climate change and a recent ban on neonicotinoid seed treatments by the European Union. Moreover, insecticide resistance against pyrethroid insecticides is reported at multiple locations throughout the world. Therefore, a better understanding of cereal aphid population dynamics and increased attention towards an integrated pest management is needed. In this study, cereal aphids were monitored on 193 maize and small grain cereal fields throughout Flanders, Belgium. The population dynamics and species distribution were observed throughout the year and the effects of spatio-temporal variables were explored. A significant negative effect was found of grassland in a 1,000 m radius and a positive effect of grain maize in a 3,000 m radius around a small grain cereals field on the maximum infestation rate with aphids in autumn within this field. In a 3,000 m and 5,000 m radius, a significant positive effect of grain maize and a significant negative effect of other small grain cereals was found on the maximum infestation rate during the whole growing season within this field. The mean daily average temperature from 118 to 19 d before sowing had a significant positive effect on the maximum infestation rate in autumn. Mean precipitation, wind speed, and humidity from 52 to 26, 46 to 23, and 107 to 13 d before sowing respectively, had a significant negative effect on the maximum infestation rate in autumn. [ABSTRACT FROM AUTHOR]

It has been assumed that a trend toward devolution within a federal country would be associated with a growing apart of public opinion, and the federal kingdom of Belgium is routinely cited as an obvious example in this regard. Since the publication of the seminal Billiet et al. article, more competences have been devolved toward the autonomous regions, and in this research note we update the expectation that this has led to a further growing apart of public opinion in the country. Based on both electoral studies (2009/2014/2019), and the European Social Survey (2002–2018) we investigate whether these institutional differences are associated with a growing apart of public opinion in the regions of Belgium. Our results suggest that while there are clear attitudinal differences between the two major groups in the country, these differences are stable throughout the three-decade observation period. Differences are becoming more outspoken, however, with regard to the preferred extent of federalism. Interestingly, however, the dynamics in public opinion in this regard do not follow the same pattern as electoral results would suggest. [ABSTRACT FROM AUTHOR]

Increasing cultural and linguistic diversity among children and families brings new challenges for early intervention professionals. The purpose of this study was to identify the specific roles and needs of speech-language pathologists (SLPs) who practice in early intervention settings with culturally and linguistically diverse families of d/Deaf multilingual learners (DMLs). Thirteen SLPs completed an online survey about their practices and needs. Interviews were conducted with five parents of DMLs. Results showed that SLPs have lower self-satisfaction with families of DMLs compared to mainstream families. Parents were highly satisfied with the support they received. Both groups of participants reported a need for specific tools or adaptations, especially if there was no shared language. Thematic analysis identified three themes: communication and partnership, professional resources for responding to diversity, and diversity of parental profiles. This article provides an insight into the perspectives of both professionals and culturally and linguistically diverse parents, and identifies specific aspects of early intervention services with parents of DMLs: developing partnership in the context of cultural and/or linguistic differences, discussing topics related to multilingualism, and providing highly adaptable family-centered services. [ABSTRACT FROM AUTHOR]

Street-level police officers are regularly confronted with complex situations and often have to make split-second decisions. Despite the importance of these decisions for procedural justice and police legitimacy, we know little about the factors that impact Belgian police officers' decision-making. This article explores this topic by means of semi-structured interviews (n = 46) in the Belgian local police. We conclude that there is a variety of factors that play a role. These factors can be divided into four groups: characteristics of the police officer, characteristics of the civilian, organizational characteristics, and situational characteristics. The most influential factors are police officers' professional experience, laws and regulations, police officers' personality, one's colleagues and supervisors, and whether or not the civilian is aggressive and known by the police. [ABSTRACT FROM AUTHOR]

Aims The coronavirus disease-2019 (COVID-19) pandemic poses significant challenges to many groups within societies, and especially for people with chronic health conditions. It is, however, unknown whether and how the pandemic has thus far affected the physical and mental health of patient populations. Therefore, we investigated how the pandemic affected the lives of adults with congenital heart disease (CHD), compared pre- and peri-pandemic patient-reported outcome measures (PROMs) and a patient-reported experience measure (PREM), and investigated whether having had COVID-19 impacted pre-/peri-pandemic differences of the PROMs and PREM. Methods and results As part of the ongoing APPROACH-IS II project, we longitudinally surveyed 716 adults with CHD from Belgium, Norway, and South Korea. Pre-pandemic measures were administered from August 2019 to February 2020 and the peri-pandemic surveys were completed September 2020–April 2021. The majority of patients indicated that their social lives (80%), mental health (58%), and professional lives/education (51%) were negatively impacted by the pandemic. Patients felt worried (65%), were afraid (55%), reported the pandemic felt 'close' to them (53%), and were stressed (52%). However, differences between pre- and peri-pandemic scores on the PROMs and PREM were negligibly small (Cohen's d < 0.20). Across measures, 5.8–15.8% of patients demonstrated changes (improved or worsened scores) that exceeded the minimal clinically important difference. There were no difference-in-differences for PROMs and PREM between patients who did vs. did not have COVID-19. Conclusions Although the COVID-19 pandemic has been disruptive in many ways, pre- to peri-pandemic changes in PROMs and PREM of adults with CHD were negligibly small. [ABSTRACT FROM AUTHOR]

Introduction Maternal antibody interference of the infant's humoral immune responses raises some concern to the strategy of maternal Tdap (tetanus, diphtheria, acellular pertussis [aP]) vaccination. This study assessed the impact of maternal Tdap antibodies on the infant's pertussis-specific T lymphocyte responses following infant vaccination with an aP containing vaccine, in a term and preterm born cohort. Methods Heparin samples (±0.5 mL) were conveniently drawn from infants of a Belgian prospective cohort study (N = 79, NCT02511327), including Tdap vaccinated (Boostrix®) and nonvaccinated women (no Tdap vaccine in the last 5 years) that delivered at term or prematurely. Sampling was performed before and 1 month after primary (8-12-16 weeks) and booster vaccination (13 or 15 months) with DTaP-IPV-HB-PRP~T vaccine (Hexyon®). Pertussis toxin (PT)-specific CD3+, CD3+ CD4+ and CD3+ CD8+ lymphoblasts and their cytokine secretions were measured using a flow cytometric assay on whole blood (FASCIA) and multiplex technology (Meso Scale Discovery), respectively. Results In total, 57% of all infants were considered PT-specific CD3+ CD4+ lymphoblasts responders after primary and booster vaccination, whereas 17% were CD3+ CD8+ lymphoblast responders. Interferon (IFN)-γ, interleukin (IL)-13, IL-17A, and IL-5 cytokine secretions after primary and booster vaccination were indicative of a mixed T helper (Th) 1/Th2/Th17 cell profile. Lymphoblast and cytokine levels were comparable between term and preterm infants. Nonresponders for IL-13 after booster vaccination had higher maternal PT immunoglobulin G (IgG) levels at birth when compared to responders. Conclusions Term and preterm born infants are capable of inducing Th1, Th2, and Th17 responses after aP vaccination, yet maternal vaccination modulate these responses. Evaluation of this effect in larger trials is needed. [ABSTRACT FROM AUTHOR]

Over the last two decades, scholars have witnessed a remarkable wave of new commons. They have mostly been conceptualized either as pragmatic management of common-pool resources or as a radical political idea and praxis. We assert that enriching the literature with a Polanyian perspective allows to go beyond the binary conception and affords a better understanding of the societal relevance of commons. Conceptualizing commons as part of a countermovement aimed at the gradual decommodification and re-embedding of markets, results in a more dynamic view on how commons function in the interplay of the social force of capitalism and the forces that limit or reverse it. This also shows the relevance of commons as interstitial alternative practices. The framework is illustrated by a case study on commons established in Belgium in 2015–2016. It shows that instead of focussing primarily on contentious action, commoners concentrate on establishing alternatives that prefigure the desired future society. [ABSTRACT FROM AUTHOR]

We examine the impact of internship experience during secondary education on students' schooling and early labour market outcomes by analysing unique, longitudinal data from Belgium. To control for unobservable differences between students with and students without internship experience, we estimate a dynamic discrete choice model. In line with literature on vocational education, we find that internship experience has a positive effect on one's employment chances up to 5 years after graduation. This positive effect is mainly explained by a positive direct employment effect. Although we also find a positive indirect employment effect through a higher chance to obtain a secondary education qualification, this is largely compensated by negative indirect effects through lower tertiary education attainment. (JEL codes: I21, I26, J21, and J24) [ABSTRACT FROM AUTHOR]

We propose a realistic model for the evolution of the COVID-19 pandemic subject to the lockdown and quarantine measures, which takes into account the timedelay for recovery or death processes. The dynamic equations for the entire process are derived by adopting a kinetic-type reactions approach. More specifically, the lockdown and the quarantine measures are modelled by some kind of inhibitor reactions where susceptible and infected individuals can be trapped into inactive states. The dynamics for the recovered people is obtained by accounting people who are only traced back to hospitalized infected people. To get the evolution equation we take inspiration from the Michaelis Menten's enzyme-substrate reaction model (the so-called MM reaction) where the enzyme is associated to the available hospital beds , the substrate to the infected people , and the product to the recovered people , respectively. In other words, everything happens as if the hospitals beds act as a catalyzer in the hospital recovery process. Of course, in our case, the reverse MM reaction has no sense in our case and, consequently, the kinetic constant is equal to zero. Finally, the ordinary differential equations (ODEs) for people tested positive to COVID-19 is simply modelled by the following kinetic scheme |$S+I\Rightarrow 2I$| with |$I\Rightarrow R$| or |$I\Rightarrow D$|⁠ , with |$S$|⁠ , |$I$|⁠ , |$R$| and |$D$| denoting the compartments susceptible, infected, recovered and deceased people, respectively. The resulting kinetic-type equations provide the ODEs, for elementary reaction steps , describing the number of the infected people, the total number of the recovered people previously hospitalized, subject to the lockdown and the quarantine measure and the total number of deaths. The model foresees also the second wave of infection by coronavirus. The tests carried out on real data for Belgium, France and Germany confirmed the correctness of our model. [ABSTRACT FROM AUTHOR]

War commemoration either solidifies or undermines the nation. Studying the evolution of Belgian nationalism during and between the two World Wars, the authors argue that the impact of war commemoration on nationalism is conditional on the military networks in which warfare was embedded. The authors rely on commemorative books and archival records to create a unique database of World War I military networks and commemoration as well as nationalist resistance and anti-nationalist collaboration during World War II. Aligned with the main hypothesis, autoregressive network models reveal that if military networks crosscut the regional communities and fostered equal relationships, commemoration was likely to strengthen the defense of the nation. In the absence of these relationships, however, commemoration activated internal fault lines that undermined nationalism. These findings highlight how collective rituals, military organization, and social structure should be studied simultaneously to fully understand the relational dynamics of warfare and nation. This article also calls attention to a distinct set of mechanisms through which organizational and ideational effects produced by one war can carry on to the next. [ABSTRACT FROM AUTHOR]

Study Question: Which success rates do female and male IVF patients expect, what determines their expectations and do patients reconsider their expectations after receiving a personal IVF prognosis at the expense of anxious reactions?Summary Answer: Female and male IVF patients have unrealistic high expectations which are positively associated with their dispositional optimism, and which are only reconsidered by patients receiving a less than average IVF prognosis, which leads to more anxious reactions in females.What Is Known Already: Female patients undergoing IVF are known to have unrealistic expectations of the success of their own IVF cycle. The available evidence suggests women expect above average performance of their fertility clinic and (family) reproductive systems. The association of gender and personality trait dispositional optimism, with expectations of IVF success and the impact of providing couples with their IVF prognosis have not been studied previously.Study Design, Size, Duration: A total of 148 partnered individuals participated in this prospective survey at two separate points in treatment: following oocyte aspiration (T1) and embryo transfer (T2) (2019-2020, participation rate = 85%). At the time of embryo transfer, gynaecologists provided couples with their IVF prognosis, calculated with the Adapted van Loendersloot model. Women and their male partners completed questionnaires independently and immediately following oocyte aspiration and embryo transfer.Participants/materials, Setting, Methods: Dispositional optimism ('LOT-R' questionnaire) and expectations of IVF success (numerical rating scale) were assessed in eligible couples commencing a 2nd-6th IVF cycle on T1. Expectations of IVF success and anxiety ('Spielberger State-Anxiety Inventory') were (re)assessed on T2. The inter-partner correlation of expectations of IVF success was examined. Linear mixed models examined hypothesized determinants of expectations of IVF success (T1) and explored (determinants of) whether participants reconsidered their expectations after receiving their IVF prognosis (T1-T2) and whether couple's IVF prognosis was associated with anxious reactions (T2).Main Results and the Role Of Chance: The mean of the IVF success rates expected by patients immediately after oocyte aspiration was 59.1% (±20.0), irrespective of gender (P = 0.077). Partners expectations of IVF success were moderately correlated (r = 0.483; P < 0.001). Expectations of IVF success were positively associated with the participant's dispositional optimism (P < 0.001) but were not associated with their partner's dispositional optimism, women's age and their previous (un)successful IVF experiences. Gynaecologists gave couples their calculated IVF prognosis ranging from 4.8% to 69.2% (mean = 30.9%) at the time of embryo transfer. Gender did not influence whether participants reconsidered their expectations after receiving their prognosis. In contrast to the subgroup (n = 78), who received at least an average IVF prognosis and that did not reconsider their expectations of IVF success, the subgroup (n = 70) receiving a below average IVF prognosis lowered their expectations of IVF success (interaction effect: P < 0.001) from 55% to 46%. A below average IVF prognosis was associated with anxious reactions in women but not in men (interaction effect: P = 0.011).Limitations, Reasons For Caution: The study design and sample size were more optimal for examining hypothesized determinants of patient's expectations of IVF success than for studying the impact of sharing prognoses with patients. Whether (reconsidering) expectations influences IVF discontinuation rates and achieved live birth rates has yet to be followed-up.Wider Implications Of the Findings: Clinics are advised to offer patients the opportunity of receiving their IVF prognosis. Providing prognoses is in line with patient preferences and tempers the unrealistic high expectations of both partners in couples with a less than average prognosis. A sensitive communication style is indicated, as lower prognoses are associated with mild anxious reactions in women.Study Funding/competing Interest(s): E.A.F.D. holds a postdoctoral fellowship of the Research Foundation-Flanders (12H9819N) and this study was funded by the Research Council of the KU Leuven (C14/18/106; project of J.V., K.P. and E.A.F.D.) and as an investigator sponsored study of K.P. and E.A.F.D. by Merck nv/sa Belgium, an affiliate of Merck KGaA, Darmstadt, Germany. The authors declare no conflict of interest related to this study.Trial Registration Number: N/A. [ABSTRACT FROM AUTHOR]

Introduction Hospitalization is associated with acute changes in sarcopenia status in older people, but the influencing factors are not fully understood. Pre-admission care dependency level as a risk factor has not yet been investigated. Objective Evaluate if pre-admission care dependency level is an independent predictor of sarcopenia changes following hospitalization. Setting and subjects Data came from the Sarcopenia 9+ EAMA Project, a European prospective multi-centre study. For this study, 227 hospitalised older people were included from four different hospitals in Belgium, Spain and Poland, between 18 February 2019 and 5 September 2020. Methods Sarcopenia status at admission and discharge were calculated using a combined score (desirability value) based on muscle mass (calf circumference), strength (grip) and function (walking speed). Ratio of admission to discharge status was the outcome (desirability ratio; 1.00 meaning no difference). Predictor variable was the pre-admission care dependency level, classified into three groups: independent older people living at home, dependent older people living at home and older people living in a care home. Linear regression models were applied, considering potential confounders. Results Mean desirability ratio for dependent older people living at home ('middle dependent group') was lower (0.89) compared to independent older people (0.98; regression coefficient −0.09 [95% CI −0.16, −0.02]) and care home patients (1.05; −0.16 [95% CI −0.01, −0.31]). Adjusting for potential confounders or using another statistical approach did not affect the main results. Conclusion Dependent older people living at home were at higher risk of deterioration in sarcopenia status following hospitalization. In-depth studies investigating causes and potential interventions of these findings are needed. [ABSTRACT FROM AUTHOR]

Objectives: The criteria for the reimbursement of fluoroquinolones changed in Belgium on 1 May 2018. This study aims to quantify the difference in fluoroquinolone use after this change, and to assess the timing and persistence of this effect, both in terms of total reimbursed fluoroquinolone use and its relative proportion.Methods: Longitudinal reimbursement data on fluoroquinolone use in the Belgian community from January 2017 to November 2018 were analysed to identify a change in reimbursed fluoroquinolone use expressed in DDD per 1000 inhabitants per day (DID), using a set of non-linear mixed models including change-points. In addition, longitudinal data on the relative proportion of prescribed fluoroquinolones from January 2017 to December 2018 were analysed to identify a change in the relative proportion of prescribed fluoroquinolones using generalized estimation equations including change-points.Results: Fluoroquinolone use dropped significantly immediately after the change in reimbursement criteria, from 2.21 DID (95% CI: 2.03-2.38) to 0.52 DID (95% CI: 0.48-0.56) and from 9.14% (95% CI: 8.75%-9.56%) to 6.52% (95% CI: 6.04%-7.04%). The observed decrease in fluoroquinolone use persisted over time.Conclusions: While fluoroquinolone use was still above the target of 5% after the change in reimbursement criteria, its implementation helped to lower fluoroquinolone use in Belgium. [ABSTRACT FROM AUTHOR]

This article investigates the preferences of food delivery platform workers regarding their employment status and working hours. We focus on the relationship between flexibility and protection, both of which can be understood—from a worker's perspective—as a means towards increased autonomy and control. The analysis is based on a case study of Deliveroo in Belgium, which hired riders as employees through an intermediary, SMart. Despite their flexible working lives, most riders preferred employee status to self-employment. However, riders were divided in their preferences regarding working time flexibility, with many in favour of more regular working time patterns. To explain this divergence, we develop an embeddedness framework that relates worker preferences to the degree of their dependency as shaped by labour market and institutional factors. We thus link divergence in preferences concerning flexibility to workers' scope for exercising control, their labour market vulnerability and economic attachment to the platform. [ABSTRACT FROM AUTHOR]

When assessing interview response quality to identify potentially low-quality interviews, both numerical and categorical response quality indicators (mixed indicators) are usually available. However, research on how to use them simultaneously is very rare. In the current article, we extend the application of conventional multivariate control charts to include response quality indicators that are of a mixed type. We analyze data from the eighth round of the European Social Survey in Belgium, characterized by six numerical and two categorical response quality indicators. First, we employ a principal component analysis mix procedure (PCA Mix) to transform the mixed quality indicators into principal components. The principal component scores are subsequently used to construct a Hotelling T 2 statistic. To deal with the non-multivariate normal nature of the principal component scores obtained from the PCA Mix, a nonparametric bootstrap method is then applied to calculate the control limit for the T 2 statistic. Second, we suggest tools to interpret an identified outlier in terms of finding the responsible original indicator(s). Third, we present a cyclic procedure for determining the "in-control" data, by iteratively removing the outliers until the process is considered as being in control. Lastly, we identify the most important indicators that discriminate the outliers from the in-control data. Our results imply that multivariate control charts based on relevant projection tools such as PCA Mix in combination with the bootstrap technique have great potential for use in evaluating interview response quality and identifying outliers. [ABSTRACT FROM AUTHOR]

Based on multisited fieldwork in Kigali, Rwanda, Belgium, and the Netherlands following the political crisis in Burundi in 2015, we explore decisions and plans for the future among Burundians in exile. In this way, we contribute to research about future making and social reproduction in families in a transnational social field affected by crisis. Adding to the literature, we show the specific effects of crisis on transnational families' practices and aspirations, such as parental efforts to prevent traumatic world views and the constant need for families to readjust their plans to ongoing crisis dynamics. We argue that as the violence has disrupted the migrant parents' hopes for a better future for themselves, they redirect their efforts towards their children's futures. We thus argue that not only future making practices but also aspirations should be seen as social and relational, particularly in times of crisis. In particular, the Burundians living in Rwanda, Belgium and the Netherlands seek to provide their offspring with the skills to become educated, social and moral beings, even it entails sacrificing their own lives and aspirations. Moreover, adding to debates on migrants' efforts to reproduce their own cultural values and practices in host societies, we find that the Burundian parents attempt to change what they perceive as a 'culture of hatred and vengeance' with parenting practices. As such, we argue that many migrant parents explicitly pursue social transformation through their children. [ABSTRACT FROM AUTHOR]

The decentralization of political power towards subnational entities is one of the major contemporary processes of territorial transformation in European democracies. Traditionally, research has focused on arguments related to nationalism and identities. Later, the strategic agency of political parties has been integrated as they typically play a major role in negotiating constitutional reforms. We investigate two institutionalist factors to explain why political Parliamentarians (MPs) favour decentralization while others oppose it: their parliamentary institutional affiliation and their career pattern (as well as the interaction between both). The importance of these factors is studied based on a large-scale survey among Belgian MPs from all federal and regional parliaments. Our results indicate that MPs' preferences for decentralization significantly differ depending on their institutional affiliation (regional MPs being more decentralist than national MPs). This difference is moderated by MPs' career pattern, but only for national MPs (who are more decentralist when they have a regional career pattern). [ABSTRACT FROM AUTHOR]