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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]

Information on several papers discussed at the panel meeting hosted by the European Commission in Brussels, Belgium in April 2009 is presented. Topics include the issue on the huge differences in the research output of U.S. and European universities, the inactiveness in the reforms and re-election procedures which resulted from a lack of political capital in confronting vocal interest groups. Other papers discussed include the employment protection legislation and the harmful effect of cannabis.

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]

The article presents the editorial report from the editorial office of the journal. In 2008, the total number of submissions to the journal was 2949 while the journal "NDT Plus" received 623 manuscripts At the Ghent, Belgium editorial office of the journal, the turnover rate for manuscripts submitted to the journal now averages less than two working days The average time from definitive acceptance of a paper in the journal to online publication was approximately five weeks in 2008.

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]

This paper presents estimates based on individual data of downward nominal and real wage rigidities for 13 sectors in Belgium, Denmark, Spain, and Portugal. Our methodology follows the approach recently developed for the International Wage Flexibility Project, whereby resistance to nominal and real wage cuts is measured through departures of observed individual wage change histograms from an estimated counterfactual wage change distribution that would have prevailed in the absence of rigidity. Our estimates of wage rigidities are set against structural features of the labour markets studied, including the wage bargaining level and the degree of product market competition. [ABSTRACT FROM AUTHOR]

This paper suggests a conceptual shift in the way we approach information sharing by foregrounding the role of categorization. We argue that the establishment of professional categories, while being central to institutional intervention, is contingent on the complexities of everyday inter-professional encounters. It is important therefore to analyse situations in professionals report on the negotiation of categories as well as how professionals account for a failure to align sender and receiver frames. The data analysed in this paper consists two excerpts each from a public inquiry in the UK (the Victoria Climbié Inquiry) and one in Belgium (the Parliamentary Commission Dutroux). In conclusion, we address a number of themes in contemporary debates about improving interagency and within-agency communication. In particular, we advocate the promotion of language awareness rooted in interactional analysis and the need to understand the on-the-ground dynamics of evolving everyday practice as important prerequisites for bringing about and responding to change. [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]

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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]

There is a growing interest in cross-cultural comparative research of attitudes. In many studies it is assumed that attitudes are comparable across cultures. Often this assumption is not tested. In this paper we argue that before comparing attitudes among different cultural groups two methodological issues need to be investigated. First, any measurement of latent attitudes should exclude the possibility that response style biases measurement. Secondly, cross-cultural comparisons are only valid if construct equivalence is tested. In this article we demonstrate the flexibility of a multigroup latent class factor approach in detecting extreme response bias and in investigating construct equivalence. Using data from the MHSM surveys among Turkish and Moroccan minorities in Belgium we detected a tendency toward extreme response style behavior in answering Likert type attitudes toward gender roles and perceived discrimination. Furthermore, a model with several covariates proved to be partially homogeneous. The results indicated that the partially homogeneous model with direct effects of ethnic group and correcting for response style behavior allowed for `fine-tuning' the estimated effects of the covariates on the latent content factors. [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]

Mumps is a potentially severe viral infection. The incidence of mumps has declined dramatically in high-income countries since the introduction of mumps antigen-containing vaccines. However, recent large outbreaks of mumps in highly vaccinated populations suggest waning of vaccine-induced immunity and primary vaccine failure. In this paper we present a simple method for identifying geographic regions with high outbreak potential, demonstrated using 2006 mumps seroprevalence data from Belgium and Belgian vaccination coverage data. Predictions of the outbreak potential in terms of the effective reproduction number in future years signal an increased risk of new mumps outbreaks. Literature reviews on serological information for both primary vaccine failure and waning immunity provide essential information for our predictions. Tailor-made additional vaccination campaigns would be valuable for decreasing local pockets of susceptibility, thereby reducing the risk of future large-scale mumps outbreaks. [ABSTRACT FROM PUBLISHER]

STUDY QUESTION What is the effect of a legal limitation of the number of embryos that can be transferred in an assisted reproductive technology (ART) cycle on the multiple delivery rate? SUMMARY ANSWER The Belgian national register shows that the introduction of reimbursement of ART laboratory costs in July 2003, and the imposition of a legal limitation of the number of embryos transferred in the same year, were associated with a >50% reduction of the multiple pregnancy rate from 27 to 11% between 2003 and the last assessment in 2010, without any reduction of the pregnancy rate per cycle. WHAT IS KNOWN ALREADY Individual Belgian IVF centres have published their results since the implementation of the law, and these show a decrease in the multiple pregnancy rate on a centre by centre basis. However, the overall national picture remains unpublished. STUDY DESIGN, SIZE, DURATION Cohort study from 1990 to 2010 of all ART cycles in Belgium (2685 cycles in 1990 evolving to 19 110 cycles in 2010), with a retrospective analysis from 1990 to 2000 and prospective online data collection since 2001. PARTICIPANTS/MATERIALS, SETTING, METHODS Registration evolved from paper written reports per centre to a compulsory online registration of all ART cycles. From 2001 up to mid-2009, data were collected from Excel spread sheets or MS Access files into an MS Access database. Since mid-2009, data collection is done via a remote and secured web-based system (www.belrap.be) where centres can upload their data and get immediate feedback about missing data, errors and inconsistencies. MAIN RESULTS AND THE ROLE OF CHANCE National Belgian registration data show that reimbursement of IVF laboratory costs in July 2003, coupled to a legal limitation in the number of embryos transferred in utero, were associated with a 50% reduction of the multiple pregnancy rate from 27 to 11% without reduction of the pregnancy rate per cycle, and with an increase in the number of fresh and frozen ART cycles due to improved access to treatment. LIMITATIONS, REASONS FOR CAUTION There is potential underreporting of complications of ART treatment, pregnancy outcome and neonatal health. WIDER IMPLICATIONS OF THE FINDINGS Over the 20 years of registration, the pregnancy rate has remained constant, despite the reduction in the number of embryos transferred, optimization of laboratory procedures and stimulation protocols, introduction of quality systems and implementation of the EU Tissue Directive over the period 2004–2010. STUDY FUNDING/COMPETING INTEREST(S) No external funding was sought for this study. None of the authors has any conflict of interest to declare. [ABSTRACT FROM AUTHOR]

This paper evaluates the farm-level supply and income effects from removing milk quotas and reducing producer prices with increasing direct compensatory payments. Using a panel of Belgian dairy farms, we first estimate a multi-output multi-input flexible cost function that generates a U-shaped marginal cost curve for each farm of the sample. We then embed each farm cost function in a profit-maximisation programming model that is built and calibrated for each farm in the sample. Accounting for farm heterogeneity, the simulations show how dairy farms without quotas may respond differently to changes in prices and structural changes that may take place within the dairy sector. A quota removal with a 20 per cent reduction in milk prices keeps aggregate milk supply and farm income at about the same level of the 2006 reference year. [ABSTRACT FROM AUTHOR]

This paper analyses the Belgian contribution to the design reform movement in the second half of the nineteenth century. Hitherto, few studies have been dedicated to the history of design practices in Belgium in the decades that preceded the birth of Art Nouveau. In particular, the extremely laborious acknowledgement of an official status for the design discipline, legitimized through the reform of education in the attempt to improve teaching methods in the academies and in the art schools and to raise the quality of the industrial product, has only been partially explored. The support and the intersection of a series of various documentary sources—archive funds, printed records, reports and essays concerning the domain of arts and their influence on industry—have helped in recreating the background of Belgian decorative arts reform. Documentary analysis has permitted the evaluation of diverse experiences within the theoretical and didactic framework, illustrating their possible contribution in the field of technical and practical literature, in artistic instruction and in the instruments of transmission and representation. Moreover, this reform process had led, at the end of the century, towards some of the most remarkable outcomes in Belgium, contributing to the advent of Art Nouveau. [ABSTRACT FROM PUBLISHER]

Background. Comprehensive geriatric assessment has been advocated as an effective way to first identify multidimensional needs and second to establish priorities for organizing an individual health care plan for community-dwelling elderly. This paper reports on the perception of an internationally evaluated assessment system for use in community care programmes, the Minimal Data Set-Home Care (MDS-HC©), by a group of experienced GP trainers.Objective. The primary study aim was to determine the perception of a standardized home care assessment system (MDS-HC©) by GP trainers in terms of acceptability, perceived clinical relevance, care planning empowerment and valorization of the GP.Methods. Sixty-five first-year GP trainees were educated about the MDS-HC© and the use of a first version of an electronic interface. Each trainee included two elderly patients, based on strict inclusion criteria. Prior to the assessment, GP trainers and trainees were invited to complete together a basic medical record on the basis of their knowledge of the included patients. Next, the collected data, covering the multiple domains by MDS-HC©, were introduced in the electronic interface by the trainee. Based on the collected data for each patient, a series of clinical assessment protocols (CAP's) were generated. Afterwards, these CAP's were critically discussed with the trainer. To investigate how the application of the MDS-HC© was perceived, a 21 Likert-type item scale was drawn up based on four dimensions regarding the tool.Results. The perception questionnaire had a good internal consistency (Cronbach's alpha 0.93). The first version of the electronic interface was considered not ‘user-friendly’ enough and the introduction of data time-consuming. The perception of the GP's about the overall clinical relevance of the MDS-HC© was found to have little added value for the GP in the establishment of a personal management plan.Conclusions. Many developments in health care result in an increasing demand for a standardized home care assessment system. In Belgium, the federal public health service advised to promote the MDS-HC© for use in the community setting. In this study, it appears that its added value was not perceived by this sample of 37 experienced GP trainers as an empowering tool in term of management of the patient and valorization of the role of GP. [ABSTRACT FROM AUTHOR]

This paper presents a novel technique for the determination of the material damping ratio in shallow soil layers. It is based on the spectral analysis of surface waves (SASW) test. The technique is an alternative to existing methods, where the damping ratio is determined from the spatial decay of the Rayleigh wave. These methods rely on the knowledge of the geometric damping, and may lead to incorrect results if the geometric damping is calculated based on an inaccurate shear wave velocity profile. The existing methods may also lead to incorrect results when higher modes contribute to the wavefield in the soil. In the proposed technique, the wavefield is transformed to the frequency–wavenumber domain. The resulting frequency–wavenumber spectrum exhibits a peak that corresponds to the fundamental Rayleigh wave. The dispersion curve is derived from the peak's position, whereas the attenuation curve is derived from its width, using the half-power bandwidth method. Due to the use of the appropriate wavenumber transformation, this method does not require the calculation of the geometric damping. In addition, the occurrence of higher Rayleigh modes does not affect the attenuation curve associated with the fundamental Rayleigh wave, as higher modes appear as separate peaks in the frequency–wavenumber spectrum that do not interfere with the peak corresponding to the fundamental Rayleigh wave (except at the osculation points). Three benchmark problems are considered to validate the outlined technique; the results are compared with those obtained using existing methods. All methods perform well when applied to a regular soil profile, where the stiffness of the soil increases with depth. For soil profiles with a soft layer trapped between two stiffer layers, or where the soil properties vary smoothly with depth, the proposed technique yields more accurate results than the existing methods. The practical applicability of the new method is finally illustrated using experimental data collected from a test site in Belgium. [ABSTRACT FROM AUTHOR]

The 'entrepreneurial university' has become commonplace in debates about new ways of knowledge production and the changing relationships between university, industry and government. A rich literature has developed exploring outputs of such activity, most notably 'patenting', 'licensing', and 'spin-outs'. There is also an 'organisational' literature exploring the entrepreneurial transformation of universities. All too often these two streams of literature ignore each other. This paper aims to make a bridging contribution by exploring the case of Université Libre de Bruxelles (ULB). Is it necessary for universities to transform themselves into fully entrepreneurial organisations to contribute substantially in terms of economic development? The ULB case illustrates the potential for nurturing entrepreneurial activities locally as well as the possibilities and limitations of top-down actions instilling entrepreneurial culture among academic rank and file. [ABSTRACT FROM AUTHOR]

The article presents a speech by Erika Feller, assistant United Nations High Commissioner, at the public hearing on the Future Common European Asylum System on November 7, 2007, in Brussels, Belgium.

This paper describes the method for ex-post peer-review evaluation per research discipline used at the Vrije Universiteit Brussel, and the outcomes obtained. Pertinent advice and responses at different levels benefit research quality, competitivity and visibility. Imposed reflection and contacts modify the researcher's attitude and improve team strategies. Deeper insights and data sets on research disciplines and extracted general recommendations support the university management's policy decisions, instruments and guidelines. Comparisons with other assessments lead to a better understanding of possibilities and limitations of different evaluation processes. The described peer-review method can be applied systematically, yielding a complete overview, or on an ad hoc basis for a particular discipline, based on demands from research teams or on strategic or policy arguments. [ABSTRACT FROM AUTHOR]

In this paper, a large-scale multicentre patient dose study performed in eight Belgian interventional cardiology departments is presented. Effective dose (E) was calculated based on a detailed dose--area product (DAP)-registration during each procedure and by using conversion coefficients generated by the Monte Carlo-based computer program PCXMC. Conversion coefficients were found to be 0.177 mSv Gycm-2 for systems that do not use any additional copper filtration in cineradiography and 0.207 mSv Gycm-2 for systems that use additional copper filtration in cineradiography. Mean E values of 9.6 and 15.3 mSv for diagnostic and therapeutic procedures, respectively, were obtained. DAP distributions were investigated in order to derive dose reference levels: 71 and 106 Gycm² for diagnostic and therapeutic procedures, respectively, are proposed. Significant differences were observed in DAP distributions taking into account whether additional copper filtration was used in the cineradiography mode. Apart from the skin, the organs most at risk are lungs and heart. The probability of fatal cancer for the studied population amounted to 1.1 x 10-4 and 2.1 x 10-4 for diagnostic and therapeutic procedures, respectively, for the age distribution of the patients considered in this multicentre study. [ABSTRACT FROM AUTHOR]

A diagnostic reference level (DRL) is a dose level for a typical X-ray examination of a group of patients with standard body sizes and for broadly defined types of equipment. These levels are expected not to be exceeded for standard procedures when good and normal practice regarding diagnostic and technical performance is applied. In this paper, we have calculated DRLs for screening mammography in Belgium. The 95th percentile of the mean average glandular dose is 2.46 mGy. The DRL based on polymethyl methacrylate (PMMA) measurements was 2.08 mGy. Correlation coefficient (R) between doses from patient studies and phantom studies was 0.90, with an average underestimation of the phantom measure-recants of 15% for systems that use only Mo/Mo anode/filter. For the centres that use other anode/filters, there is not enough scientific evidence that a single phantom measurement of a standard PMMA block is representative for the patient dose. [ABSTRACT FROM AUTHOR]

The past decade has seen intense legislative and judicial activity in Belgium regarding the prosecution of international crimes: a large number of complaints were filed with Belgian courts, which had been granted broad extraterritorial jurisdiction. Insofar as Belgium constituted a sort of laboratory for the implementation of a quasi-absolute universal jurisdiction, the analysis of the ‘Belgian case’ may prove very useful. The evolution of Belgian law over the past decade has been tumultuous. This paper is intended to offer an overview of the different cases brought to court in Belgium, to assess their significance and implications, and to draw a number of conclusions. [ABSTRACT FROM PUBLISHER]

This paper discusses governmental policies and measures that regulate the use of animal manure in the European Union (EU-15). Systematic intervention by governments with European agriculture in general started at the end of the 19th century. Major changes in governmental policies on agriculture followed after the establishment of the EU and its Common Agricultural Policy (CAP) in 1957. Environmental side effects of the large-scale intensification of agricultural production were addressed following the reform of the CAP and the implementation of various environmental regulations and directives from the beginning of the 1990s. The Nitrate Directive approved in 1991 has exerted, as yet, the strongest influence on intensive livestock production systems. This directive regulates the use of N in agriculture, especially through its mandatory measures to designate areas vulnerable to nitrate leaching and to establish action programs and codes of good agricultural practice for these areas. These measures have to ensure that for each farm the amount of N applied via livestock manure shall not exceed 170 kg•ha−1•yr−1. These measures have large consequences, especially for countries with intensive animal agriculture, including The Netherlands, Belgium, Denmark, and Ireland. The mean livestock density in these countries is between 1.5 and 4 livestock units/ha, and the average amounts of N in animal manure range from 100 to 300 kg/ha of agricultural land. More than 10 yr after approval of the Nitrate Directive, there appears to be a delay in the implementation and enforcement in many member states, which reflects in part the major complications that arise from this directive for intensive livestock farming. It also reflects the fact that environmental policies in agriculture have economic consequences. The slow progress in the enforcement of environmental legislations in agriculture combined with the increasing public awareness of food safety, animal welfare, and landscape maintenance call for a more fundamental change in EU agriculture. [ABSTRACT FROM AUTHOR]

Objective. This paper describes the characteristics of Belgian people who declare that they have a personal GP (PGP) compared with those who do not. Furthermore, patterns of cardiovascular prevention and care are described for these two groups. Methods. The data are derived from the 1997 Belgian Health Interview Survey (HIS) in which a representative sample (n = 10 221) of the Belgian population was questioned. The HIS data about physical activity, food, blood pressure, cholesterol, cardiovascular diseases, diabetes and stroke are analysed. Results. After standardization for age and gender, 7.0% of the subjects declared that they did not have a PGP. The mean age of patients without a PGP (33.2 ± 20.4 years) is significantly lower than for those with a PGP (40.4 ± 22.7 years) (P < 0.001). More smokers (38.5% compared with 28.5%) were reported among the subjects without a PGP (P < 0.001). For 14.8% of the subjects without a PGP, their blood pressure had never been measured, and for 51.1% their cholesterol had never been measured (6.7% and 35.7%, respectively in subjects with a PGP). Among the subjects without a PGP, 3.8% had high blood pressure and 1.5% had a coronary heart disease. Among the hypertensive patients without a PGP, 43.6% are not treated by any physician. Conclusion. Subjects without a PGP were less likely to have a healthy way of life. Having a PGP seemed to have a beneficial influence on the screening for and the follow-up of cardiovascular risk factors. However, it has never been confirmed that providing people who do not have a PGP with one would result in health improvements. In particular, cardiac patients without a PGP sought their medical treatment directly from specialists. [ABSTRACT FROM AUTHOR]

Background: Invasive meningococcal disease, due to Neisseria meningitidis, is an important cause of morbidity and mortality in young children and adolescents. Nasopharyngeal carriage of meningococci (MC), is most prevalent in young adults whereas carriage of Neisseria lactamica (LC), a related non-pathogenic organism, is most prevalent in young children. The objective of this study was to use modelling techniques to test hypotheses on the processes that govern the incidence of meningococcal disease (MD).Methods: Deterministic compartmental models were fitted to age structured data sets of MC, LC and MD.Results: The model most consistent with the available data sets is one where LC inhibits MC, an inhibition that lasts for a mean of 4.7 years. The hypothesis that LC also acts as a natural immunogen against MD was consistent with this model. The second peak of MD observed among adolescents could be due to the peak in the acquisition of MC in this age group.Conclusions: The role of LC as a natural immunogen against asymptomatic and symptomatic meningococcal infection was consistent with available field data. If the introduction of novel meningococcal vaccines into a population changes the prevalence of MC or LC, this could have a substantial impact on the effectiveness of immunization programmes. This paper demonstrates the potential utility of modelling to estimate these effects. [ABSTRACT FROM AUTHOR]

The article discusses the highlights of the 77th Congress of the European Orthodontic Society held in Ghent, Belgium from June 19 to 23, 2001. The keynote address was delivered by Luc Dermaut, president of the organization. A lecture on problems associated with tooth eruption was given by professor Jüri Kurol. Among the topics of papers presented at the event were orthodontic treatment in elderly patients and biomechanics in orthodontics.

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]

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]

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]

The article offers information on several events including Royal Institute of Philosophy Conference to be held at University of Wales College at Cardiff, Wales, during July 20-22, 1993, European Society for Philosophy and Psychology's Inaugural Conference to be held at Philosophy Institute, University of Louvain, Belgium during July 17-19, 1992 and Joint Session of the Aristotelian Society and the Mind Association to be held at the University of Reading in England during July 14-17, 1992.

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]