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Background: The COVID-19 pandemic immensely impacted care provision, including quality of care in general practice. This paper aimed: (1) to assess how Belgian general practices acted upon the six dimensions of quality of care during COVID-19; (2) to study differences between the three Belgian regions; and (3) to benchmark the performance of the Belgian practices against the performance in other European countries. Methods: The data collected from 479 Belgian practices during 2020–2021 using an online survey as part of the international cross-sectional PRICOV-19 study were analyzed. Hereby, descriptive statistics, chi-squared tests, and binary logistic regression analyses were performed. Thirty-four survey questions related to the six dimensions of quality of care were selected as outcome variables. The adjusted regression models included four practice characteristics as covariates: practice type, being a teaching practice for GP trainees, multidisciplinarity of the team, and payment system. Results: Belgian practices made important organizational changes to deliver high-quality care during COVID-19. Most practices (n = 259; 56.1%) actively reached out to vulnerable patients. Limitations to the practice building or infrastructure threatened high-quality care in 266 practices (55.5%). Infection prevention measures could not always be implemented during COVID-19, such as using a cleaning protocol (n = 265; 57.2%) and providing a separate doctor bag for infection-related home visits (n = 130; 27.9%). Three hundred and sixty practices (82.0%) reported at least one safety incident related to a delayed care process in patients with an urgent condition. The adjusted regression analysis showed limited significant differences between the Belgian regions regarding the quality of care delivered. Belgian practices demonstrated varied performance compared to other European countries. For example, they excelled in always checking the feasibility of isolation at home but reported more patient safety incidents related to timely care than at least three-quarters of the other European countries. Conclusions: Future studies using different design methods are crucial to investigate which country and practice characteristics are associated with delivering high-quality care. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has disrupted societies globally. Public health institutions were tasked with responding to the pandemic in a dynamic and uncertain context. This paper sheds light on the experiences of COVID-19 response actors as they navigated multi-dimensional crises associated with the pandemic in general and vaccine hesitancy in particular. This research was conducted during the initial phase of the COVID-19 vaccine rollout in Flanders, Belgium. Participants included informants across all levels of the COVID-19 vaccination strategy including but not limited to those producing scientific knowledge, providing policy input, or implementing public health directives locally. 'Crisis' was identified as a recurring theme in interviews with informants. The paper highlights multi-dimensional crises experienced by informants such as the: (i) crisis of prioritization, (ii) crisis of communication, (iii) crisis of the changing image of science, (iv) crisis of epistemic agency and autonomy, and (v) crisis of trust. [ABSTRACT FROM AUTHOR]

In clinical practice, many drug therapies are associated with prolongation of the QT interval. In literature, estimation of the risk of prescribing drug-induced QT prolongation is mainly executed by means of logistic regression; only one paper reported the use of machine learning techniques. In this paper, we compare the performance of both techniques on the same dataset. High risk for QT prolongation was defined as having a corrected QT interval (QTc) ≥ 450 ms or ≥ 470 ms for respectively male and female patients. Both conventional statistical methods (CSM) and machine learning techniques (MLT) were used. All algorithms were validated internally and with a hold-out dataset of respectively 512 and 102 drug-drug interactions with possible drug-induced QTc prolongation. MLT outperformed the best CSM in both internal and hold-out validation. Random forest and Adaboost classification performed best in the hold-out set with an equal harmonic mean of sensitivity and specificity (HMSS) of 81.2% and an equal accuracy of 82.4% in a hold-out dataset. Sensitivity and specificity were both high (respectively 75.6% and 87.7%). The most important features were baseline QTc value, C-reactive protein level, heart rate at baseline, age, calcium level, renal function, serum potassium level and the atrial fibrillation status. All CSM performed similarly with HMSS varying between 60.3% and 66.3%. The overall performance of logistic regression was 62.0%. MLT (bagging and boosting) outperform CSM in predicting drug-induced QTc prolongation. Additionally, 19.2% was gained in terms of performance by random forest and Adaboost classification compared to logistic regression (the most used technique in literature in estimating the risk for QTc prolongation). Future research should focus on testing the classification on fully external data, further exploring potential of other (new) machine and deep learning models and on generating data pipelines to automatically feed the data to the classifier used. [ABSTRACT FROM AUTHOR]

The forced expiratory volume in one second (FEV1) is regularly used for the follow-up of patients with non-cystic fibrosis bronchiectasis (nCF-BE). The lung clearance index (LCI), measured by the multiple breath washout test, has been recently proposed as a lung function measure and a potential tool more sensitive than the FEV1 measured by spirometry in assessing airway changes seen on imaging. While several data have been endorsed as a useful endpoint in clinical trials of patients with early or mild CF lung disease and as the main outcome measure in clinical trials with CFTR modulators in children and adolescents with CF, few data are available in the context of non-CF bronchiectasis. The aim of this pilot study was to compare the LCI with the FEV1 as well as the forced vital capacity (FVC), the forced expiratory flow at 25–75% of the FVC (FEF 25–75%), and chest imaging based on the modified Reiff score in patients with primary ciliary dyskinesia (PCD) and non-CF, non-PCD bronchiectasis (PCD-BE and nCFnPCD-BE). Additionally, we compared each test's duration and the preferred technique. Twenty children were included; nine had PCD-BE and eleven had nCFnPCD-BE. The median age was twelve years (ages ranging between five and eighteen years). The median LCI was seven while the median z-scores of the FEV1, FVC, and FEF 25–75% were −0.6, 0, and −0.9, respectively. No significant associations or correlations were observed between LCI, spirometric parameters, or the modified Reiff score. However, nearly half of the population (n = 9) had an abnormal LCI, while only 10% had an abnormal FEV1. A total of 75% of children preferred MBW, despite it lasting five times longer than spirometry. In this paper, the authors suggest that LCI might be useful in a cohort of pediatric patients with PCD-BE and nCFnPCD-BE for detecting early lung function changes during their follow-up. Additionally, MBW seems to be preferred by patients. These data may encourage further studies on this topic. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Big data research requires public support. It has been argued that this can be achieved by public involvement and engagement to ensure that public views are at the centre of research projects. Researchers should aim to include diverse communities, including seldom‐heard voices, to ensure that a range of voices are heard and that research is meaningful to them. Objective: We explored how researchers involve and engage seldom‐heard communities around big data research. Methods: This is a qualitative study. Researchers who had experience of involving or engaging seldom‐heard communities in big data research were recruited. They were based in England (n = 5), Scotland (n = 4), Belgium (n = 2) and Canada (n = 1). Twelve semistructured interviews were conducted on Zoom. All interviews were audio‐recorded and transcribed, and we used reflexive thematic analysis to analyse participants' experiences. Results: The analysis highlighted the complexity of involving and engaging seldom‐heard communities around big data research. Four themes were developed to represent participants' experiences: (1) abstraction and complexity of big data, (2) one size does not fit all, (3) working in partnership and (4) empowering the public contribution. Conclusion: The study offers researchers a better understanding of how to involve and engage seldom‐heard communities in a meaningful way around big data research. There is no one right approach, with involvement and engagement activities required to be project‐specific and dependent on the public contributors, researchers' needs, resources and time available. Patient and Public Involvement: Two public contributors are authors of the paper and they were involved in the study design, analysis and writing. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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 circumplex version of the Impact Message Inventory (IMI-C) is one of the few existing diagnostic devices for the assessment of 'objective' (inter-subjective) countertransference. The IMI-C purports to assess eight categories of countertransference reactions along the circumference of the interpersonal circle, conceptualized as blends of the two basic dimensions of affiliation (AFF) and control (CON): dominant (D), hostile-dominant (HD), hostile (H), hostile-submissive (HS), submissive (H), friendly-submissive (FS), friendly (F) and friendly-dominant (FD). As a measure of objective (or 'inter-subjective') countertransference, a crucial test for the IMI-C is its ability to produce scores that are generalizable across different therapists involved with the same patients. In four previous psychometric studies, the 'objectivity' of countertransference reactions was examined with a Dutch paper-and-pencil IMI-C version. In the present study, the generalizability of countertransference reactions across therapists was tested with a computer-delivered IMI-C. Results obtained with the electronic IMI-C format were compared with the findings of the paper-and-pencil version. Similar to the four prior studies, D and HD were the comparatively most generalizable classes of countertransference reactions among the eight categories. Both the AFF and CON main dimensions scores were substantially generalizable across therapists. From different perspectives of analysis, more favorable results were obtained with the computer-delivered IMI-C in comparison to the paper-and-pencil-version for (a) five of the eight countertransference classes (D, HD, F, FS, FD) and also for (b) the AFF main dimension. The computer-based IMI-C appears to be a promising tool for assessing objective countertransference reactions. Copyright © 2010 John Wiley & Sons, Ltd. Key Practitioner Message: • Your countertransference reactions are likely to be partly patient-induced ('objective'). • Countertransference reactions can conveniently be classified in terms of the interpersonal circle. • The computer-based IMI-C is a user-friendly clinical instrument for the assessment of patient-induced countertransference reactions. [ABSTRACT FROM AUTHOR]

Background: Articulatory excursion and vocal intensity are reduced in many children with dysarthria due to cerebral palsy (CP), contributing to the children's intelligibility deficits and negatively affecting their social participation. However, the effects of speech‐treatment strategies for improving intelligibility in this population are understudied, especially for children who speak languages other than English. In a cueing study on English‐speaking children with dysarthria, acoustic variables and intelligibility improved when the children were provided with cues aimed to increase articulatory excursion and vocal intensity. While French is among the top 20 most spoken languages in the world, dysarthria and its management in French‐speaking children are virtually unexplored areas of research. Information gleaned from such research is critical for providing an evidence base on which to provide treatment. Aims: To examine acoustic and perceptual changes in the speech of French‐speaking children with dysarthria, who are provided with speech cues targeting greater articulatory excursion (French translation of 'speak with your big mouth') and vocal intensity (French translation of 'speak with your strong voice'). This study investigated whether, in response to the cues, the children would make acoustic changes and listeners would perceive the children's speech as more intelligible. Methods & Procedures: Eleven children with dysarthria due to CP (six girls, five boys; ages 4;11–17;0 years; eight with spastic CP, three with dyskinetic CP) repeated pre‐recorded speech stimuli across three speaking conditions (habitual, 'big mouth' and 'strong voice'). Stimuli were sentences and contrastive words in phrases. Acoustic analyses were conducted. A total of 66 Belgian‐French listeners transcribed the children's utterances orthographically and rated their ease of understanding on a visual analogue scale at sentence and word levels. Outcomes & Results: Acoustic analyses revealed significantly longer duration in response to the big mouth cue at sentence level and in response to both the big mouth and strong voice cues at word level. Significantly higher vocal sound‐pressure levels were found following both cues at sentence and word levels. Both cues elicited significantly higher first‐formant vowel frequencies and listeners' greater ease‐of‐understanding ratings at word level. Increases in the percentage of words transcribed correctly and in sentence ease‐of‐understanding ratings, however, did not reach statistical significance. Considerable variability between children was observed. Conclusions & Implications: Speech cues targeting greater articulatory excursion and vocal intensity yield significant acoustic changes in French‐speaking children with dysarthria. However, the changes may only aid listeners' ease of understanding at word level. The significant findings and great inter‐speaker variability are generally consistent with studies on English‐speaking children with dysarthria, although changes appear more constrained in these French‐speaking children. What this paper addsWhat is already known on the subjectAccording to the only study comparing effects of speech‐cueing strategies on English‐speaking children with dysarthria, intelligibility increases when the children are provided with cues aimed to increase articulatory excursion and vocal intensity. Little is known about speech characteristics in French‐speaking children with dysarthria and no published research has explored effects of cueing strategies in this population.What this paper adds to existing knowledgeThis paper is the first study to examine the effects of speech cues on the acoustics and intelligibility of French‐speaking children with CP. It provides evidence that the children can make use of cues to modify their speech, although the changes may only aid listeners' ease of understanding at word level.What are the potential or actual clinical implications of this work?For clinicians, the findings suggest that speech cues emphasizing increasing articulatory excursion and vocal intensity show promise for improving the ease of understanding of words produced by francophone children with dysarthria, although improvements may be modest. The variability in the responses also suggests that this population may benefit from a combination of such cues to produce words that are easier to understand. [ABSTRACT FROM AUTHOR]

Background: Assessing the speech production of multilingual children is challenging for speech‐language therapists (SLTs) around the world. Scientific recommendations to improve clinical practice are available, but their implementation has mostly been described in studies from English‐speaking countries. Aims: This survey aimed to describe the perspectives and practices of SLTs in assessing the speech production of multilingual children in French‐speaking Belgium. Methods & Procedures: An online survey was completed by 134 SLTs in French‐speaking Belgium. Outcomes & Results: SLTs predominantly used norm‐referenced assessment approaches, which are not recommended for use with multilingual children, and lacked necessary training and resources to implement recommended practices in the assessment of speech production of multilingual children. The shift towards more appropriate practices with multilingual children seems to be in its infancy among SLTs in French‐speaking Belgium. Some challenges identified by the SLTs were common to those in other countries and languages, such as the difficulty to distinguish between speech differences and speech disorders. Other challenges were specific to the French language and/or the Belgian context, such as the lack of appropriate tools in French. Conclusions & Implications: Action is required to improve clinical practice in assessing the speech production of multilingual children in French‐speaking contexts: better training for SLTs regarding linguistic diversity, more implementation research in the field of SLT, and advocacy for linguistic diversity with decision makers. What this paper adds: What is already known on this subject: Existing research indicates that assessing the speech production of multilingual children is challenging for speech‐language therapists (SLTs). Scientific recommendations for best practices have been published, and the shift to more appropriate assessment practices may be progressing differently across countries. SLTs' practices have been described in surveys, mostly conducted in English‐speaking countries. Although French is the fifth most spoken language in the world, data about SLTs' perspectives and practices in French‐speaking regions are scarce. What this study adds: The implementation of recommended practices in assessing multilingual children's speech production was limited among SLTs in French‐speaking Belgium. The norm‐referenced approach to assessment was predominant and few SLTs used recommended practices (e.g., criterion‐referenced measures, dynamic assessment, assessment of the child's speech production in the home language). Some challenges were identified that related specifically to practices in French‐speaking contexts (e.g., lack of French tools) and Belgian context (e.g., health policies unfavourable to multilingualism). These findings confirm that specific understanding of a situation is needed to develop context‐ and/or language‐specific solutions—and ultimately improve clinical practice. What are the clinical implications of this work?: SLTs in French‐speaking Belgium require specific training and support to provide appropriate assessment of speech production in multilingual children. Efforts to improve practices in French‐speaking contexts should focus on increasing understanding and consideration of cultural and linguistic diversity at all levels of the child's environment. Evidence‐based knowledge, assessment tools and multilingual resources are available to SLTs on websites in French and in English. [ABSTRACT FROM AUTHOR]

In this paper, we revisit this well‐established linear relationship of person‐organisation, demands‐abilities, and needs‐supply fit with job satisfaction, commitment, and OCBs, and propose that this relationship may be linear for affective work outcomes but curvilinear for behavioural ones. We test this idea in a two‐wave sample of 212 employees, with measures taken 4 weeks apart. The results support the idea that the relationship between fit and behavioural outcomes can, indeed, be curvilinear. Overall, this study contributes to a better understanding of the nature of the relationship between fit and work outcomes by challenging the long‐held 'more fit is better' logic that pervades much of the PE fit research to date. [ABSTRACT FROM AUTHOR]

Background: The clinical and economic burden of type 2 diabetes mellitus on society is rising. Effective and efficient preventive measures may stop the increasing prevalence, given that type 2 diabetes mellitus is mainly a lifestyle-driven disease. The Feel4Diabetes-study aimed to tackle unhealthy lifestyle (unhealthy diet, lack of physical activity, sedentary behaviour, and excess weight) of families with a child in the first grades of elementary school. These schools were located in regions with a relatively low socio-economic status in Belgium, Bulgaria, Finland, Greece, Hungary and Spain. Special attention was paid to families with a high risk of developing type 2 diabetes mellitus. Methods: The aim of this paper is to describe the detailed methodology of the intervention's cost-effectiveness analysis. Based on the health economic evaluation of the Toybox-study, both a decision analytic part and a Markov model have been designed to assess the long-term (time horizon of 70 year with one-year cycles) intervention's value for money. Data sources used for the calculation of health state incidences, transition probabilities between health states, health state costs, and health state utilities are listed. Intervention-related costs were collected by questionnaires and diaries, and attributed to either all families or high risk families only. Conclusions: The optimal use of limited resources is pivotal. The future results of the health economic evaluation of the Feel4Diabetes-study will contribute to the efficient use of those resources. [ABSTRACT FROM AUTHOR]

Background: The objective of the current paper is to estimate the all-cause mortality rates for people who have been in treatment for substance use disorders (SUD) in Belgium. Methods: Data from the national register of people who were in treatment for SUD between 2011–2014 was linked to mortality data gathered through the seven Belgian health insurance agencies (N = 30,905). Four comparators were matched on age, sex, and place of residence to each subject in treatment for SUD (N = 123,497). A Cox proportional hazards model was utilized to test the risk of all-cause mortality for being in treatment for SUD or not. A second Cox proportional hazards model tested the risk of all-cause mortality for several drug-related covariates for people in treatment for SUD. Results: The overall mortality rate for people in treatment reached 15.59 per 1,000 person-years. Being in treatment for illicit substance use disorders was associated with a nearly 11-fold increase in all-cause mortality, whereas being in treatment for licit drugs raised the likelihood of a premature death sevenfold. Conclusions: The results have implications for interventions seeking to reduce the elevated SUD-related mortality, and they highlight the need to intensify harm reduction strategies for people with SUD to significantly reduce drug-related mortality. [ABSTRACT FROM AUTHOR]

Simple Summary: Lymphedema is a common complication following gynecological cancer treatment, particularly affecting the lower limbs. However, self-reported data on lymphedema detection remain scarce. To address this gap, Yost developed the Lower Extremity Lymphedema Screening Questionnaire (LELSQ) specifically for women. The LELSQ is a straightforward and user-friendly tool designed for the early identification of lower extremity lymphedema (LEL). The validation of the questionnaire in Dutch was crucial for a larger trial called "The Gynolymph", since there were no validated questionnaires in Dutch for the detection of early LEL. This trial aims to enroll four hundred patients who will utilize the screening tool as part of a patient-reported assessment. By doing so, the trial seeks to detect the early development of lymphedema after cancer treatment. To ensure unbiased results, the study team translated and adapted the lymphedema questionnaire to Dutch. The cross-sectional survey conducted during this process demonstrated high internal consistency, test–retest reliability, and validity. Additionally, face and content validity were confirmed, allowing for the implementation of the questionnaire in the early detection of LEL among Dutch-speaking women. Background: Validated questionnaires of self-reported LEL are important in the assessment and diagnosis of LEL. The aim of this study was to validate and translate a Dutch version of the screening questionnaire, the LELSQ developed and validated by Yost et al. Methods: We tested the questionnaire on a group of healthy women and a group of patients diagnosed with LEL. The translation was carried out using the forward and backward method from English to Dutch. Statistical analyses: SPSS (IBM corp, Armonk, New York, NY, USA) version 28.0.1.0 (001) was used for statistical analysis in the process of validation. The internal consistency was assessed by determining Cronbach's alpha. The reliability was tested by test–retest reliability. The validity was determined by ROC analysis, and content and face validity were evaluated. Results: The internal consistency score in both groups had a strong value (0.83 to 0.90). The test–retest reliability was also strong in both groups. Face and content validity showed the LELSQ is an easy, understandable questionnaire that is not too time-consuming in the early detection of LEL. The ROC analysis showed an AUC value of 0.93, indicating strong validity. Conclusions: The validated Dutch translation showed high values for internal consistency, test–retest reliability, and validity, which allows us to implement the questionnaire in the early detection of LEL after gynecological cancer treatment. [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]

Online and blended learning (OBL) is valued, but it also offers challenges. Literature indicates that OBL can enhance access to education and increase flexibility for students. However, the reported dropout rates indicate that student participation in OBL programmes is a concern. Scientifically valid knowledge about how factors that help students participate in OBL are related to student participation is necessary for quality improvement of OBL. This knowledge can help professionals determine what they need to improve in their institution and how to prioritize those improvements. In this study, we report on the validation of a quality instrument with indicators related to quality dimensions present in quality management frameworks and important success factors that aid student participation in OBL. These success factors are as follows: credibility, transparency, flexibility, accessibility, interactivity, personalization, and productivity. The partial least squares structural equation modelling (PLS‐SEM) method is suitable for validating complex models in studies where predictive accuracy is important. According to adult students, all success factors, except flexibility, are important for aiding OBL participation. Adult students perceive that the quality dimensions of learning activities and student support (related to interactivity) deserve priority in improving participation in OBL in adult education. Lay Description: What is currently known about the subject matter? Dropout rates indicate that student participation is a concern in online and blended learning.Existing institutional quality management frameworks report similar quality dimensions.Scholars investigated these dimensions and how they are related and student satisfaction.These studies do not address the question of how institutions can improve participation. What does this paper add to this? We validate a quality instrument with indicators related to factors that aid participation and quality dimensions.Knowledge about how these factors are related to participation is relevant for quality improvement.We assess the relations between the factors and the predictors for participation.The links of the indicators with quality dimensions informs quality improvement. What are the implications for practitioners? The quality instrument is sufficiently valid and reliable to use as a survey to assess quality.According to adult students most factors, except flexibility, are important for participation.The factor "interactivity" is the main predictor for participation.Improving the quality dimensions "design of learning activities" and "student support" need priority. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known about the subject?: Euthanasia because of unbearable mental suffering (UMS euthanasia) has been legal in Belgium since 2002 under strict conditions of careful practice. UMS euthanasia occurs fairly rarely in Belgium, but the frequency has increased substantially over the past few years. Although most mental health nurses play an important role and are supportive of euthanasia in general, their role, attitude and knowledge when it comes to UMS euthanasia were unknown until now. What this paper adds to existing knowledge?: Most mental health nurses in Belgium appear to be supportive towards UMS euthanasia and where UMS euthanasia is carried out, mental health nurses are often involved in the preceding decision‐making process. Mental health nurses critically reflect on the interpretation and application of the legal euthanasia criteria as experienced in their daily work with their patients, and identify several problems. After a rather quiet period in Belgium, the public ethical debate regarding UMS euthanasia has recently been reopened and intensified. What are the implications for practice?: Sufficient attention must be paid to how mental health nurses can be involved in the process of UMS euthanasia. This applies at several levels: legal, healthcare policy, bedside care and education. Specific attention must be paid within the UMS euthanasia process to ensure adequate cooperation between physicians, nurses and patients. There is a need for proper training in: knowledge of psychiatric pathologies and remaining treatment options; communication skills; the legal framework and all its difficulties; transdisciplinary and multicultural approaches; ethical reflection and how nurses handle their own emotions. Abstract: Introduction: Euthanasia because of unbearable mental suffering (UMS euthanasia) has been legal in Belgium since 2002, under certain circumstances that govern careful practice. Despite the legal framework, there are specific difficulties and concerns regarding UMS euthanasia. Mental health nurses are often involved in the process, but little is known about their attitudes towards UMS euthanasia, their role and their knowledge. Aim: To determine the attitudes, role and knowledge of mental health nurses regarding UMS euthanasia. Methods: A cross‐sectional survey was performed at a convenience sample of four psychiatric hospitals in Belgium (n = 133) as a pilot study. Self‐administered questionnaires were provided to mental health nurses. Results: Half the nurses in our sample had been involved at least once in the process of UMS euthanasia. A large majority of mental health nurses were supportive of UMS euthanasia. Nurses show differences in attitudes related to the different psychiatric pathologies of the patients, and in whether or not minors are involved. In some cases, they believed that the mental suffering of psychiatric patients can be unbearable and irreversible and that psychiatric patients can be competent to voluntarily request UMS euthanasia. Nurses stated that they have an important role in the UMS euthanasia process, but also demanded more knowledge and clear guidelines to implement the procedure. Discussion: Nurses have a key role regarding UMS euthanasia but face several challenges: the recent process, resistance to a multidisciplinary approach by psychiatrists and an unclear role defined by the legal framework. Nurses do not appear to have a common voice on the topic and the development of clear guidelines appears to be essential. Social recovery can offer a way out of an UMS euthanasia request, but it will not always offer a solution. Implications for Practice: Sufficient attention must be paid to how mental health nurses can be involved in the process of UMS euthanasia at various levels: bedside practice, healthcare management, education and policy. A form of systematic cooperation between nurses, physicians and patients can contribute to the utmost careful decision‐making process needed in these cases. There is a need for proper training in: knowledge of psychiatric pathologies and remaining treatment options; communication skills; the legal framework and all its difficulties; transdisciplinary and multicultural approaches; ethical reflection and how nurses handle their own emotions. [ABSTRACT FROM AUTHOR]

Health journalists are central gatekeepers who select, frame, and communicate health news to a broad audience, but the selection and content of health news are also influenced by the sources journalists, rely on (Hinnant, Len-Rios, & Oh, 2012). In this paper, we examine whether the traditional elitist sourcing practices (e.g., research institutions, government) are still important in a digitalized news environment where bottom-up non-elite actors (e.g., patients, civil society organizations) can act as producers (Bruns, 2003). Our main goal, therefore, is to detect whether sourcing practices in health journalism can be linked with strategies of empowerment. We use a multi-method approach combining quantitative and qualitative research methods. First, two content analyses are developed to examine health-related news in Belgian magazines (popular weeklies, health magazines, general interest magazines, and women's magazines). The analyses highlight sourcing practices as visible in the texts and give an overview of the different stakeholders represented as sources. In the first wave, the content analysis includes 1047 health-related news items in 19 different Belgian magazines (March-June 2013). In the second wave, a smaller sample of 202 health-related items in 10 magazines was studied for follow-up reasons (February 2015). Second, to contextualize the findings of the quantitative analysis, we interviewed 16 health journalists and editors-in-chief. The results illustrate that journalists consider patients and blogs as relevant sources for health news; nonetheless, elitist sourcing practices still prevail at the cost of bottom-up communication. However, the in-depth interviews demonstrate that journalists increasingly consult patients and civil society actors to give health issues a more "human" face. Importantly, the study reveals that this strategy is differently applied by the various types of magazines. While popular weeklies and women's magazines give a voice to ordinary citizens to translate complex issues and connect with their audiences, general interest magazines and health magazines prefer elite sources and use ordinary citizen stories as a way of "window dressing." [ABSTRACT FROM AUTHOR]

Background: Malnutrition, sedentary lifestyle, cognitive dysfunction and poor psychological well‐being are often reported in patients on haemodialysis (HD). Aims: We aimed to explore needs, barriers and facilitators—as perceived by patients, their carers, and healthcare professionals (HCPs) for increasing the adherence to the diet, to physical activity and cognition and psychological well‐being. Methods: This is an observational cross‐sectional study following the STROBE statement. This study is part of an ERASMUS+ project, GoodRENal—aiming to develop digital tools as an educational approach to patients on HD. For that, the GoodRENal comprises HD centers located in four Belgium, Greece, Spain and Sweden. Exploratory questionnaires were developed regarding the perceived needs, barriers and facilitators regarding the diet, physical activity, cognition and psychological well‐being from the perspective of patients, their carers and HCPs. Results: In total, 38 patients, 34 carers and 38 HCPs were included. Nutrition: For patients and carers, the main needs to adhere to the diet included learning more about nutrients and minerals. For patients, the main barrier was not being able to eat what they like. Physical activity: As needs it was reported information about type of appropriate physical activity, while fatigue was listed as the main barrier. For Cognitive and emotional state, it was perceived as positive for patients and carers perception but not for HCPs. The HCPs identified as needs working as a team, having access to specialised HCP and being able to talk to patients in private. Conclusions: Patients and their carers listed as needs guidance regarding nutrition and physical activity but were positive with their cognitive and emotional state. The HCPs corroborated these needs and emphasised the importance of teamwork and expert support. [ABSTRACT FROM AUTHOR]

The article presents a study which examined the methodology and results of the transition to computer-based tarification services in the intensive care unit (ICU) in terms of execution time, cost evaluation, and return on investment. The study was conducted at Ghent University Hospital in Belgium. Also cited are the components of the platform architecture of the tarification web services including the Timer Service (TS), the data retrieval service (DRS), and the billing form service (BFS).

Purpose:The patients diagnosed with Ehlers–Danlos Syndrome Hypermobility Type (EDS-HT) are characterized by pain, proprioceptive inacuity, muscle weakness, potentially leading to activity limitations. In EDS-HT, a direct relationship between muscle strength, proprioception and activity limitations has never been studied. The objective of the study was to establish the association between muscle strength and activity limitations and the impact of proprioception on this association in EDS-HT patients. Methods:Twenty-four EDS-HT patients were compared with 24 controls. Activity limitations were quantified by Health Assessment Questionnaire (HAQ), Six-Minute Walk test (6MWT) and 30-s chair-rise test (30CRT). Muscle strength was quantified by handheld dynamometry. Proprioception was quantified by movement detection paradigm. In analyses, the association between muscle strength and activity limitations was controlled for proprioception and confounders. Results:Muscle strength was associated with 30CRT (r = 0.67,p = <0.001), 6MWT (r = 0.58,p = <0.001) and HAQ (r = 0.63,p= <0.001). Proprioception was associated with 30CRT (r = 0.55,p < 0.001), 6MWT (r = 0.40,p = <0.05) and HAQ (r = 0.46,p < 0.05). Muscle strength was found to be associated with activity limitations, however, proprioceptive inacuity confounded this association. Conclusions:Muscle strength is associated with activity limitations in EDS-HT patients. Joint proprioception is of influence on this association and should be considered in the development of new treatment strategies for patients with EDS-HT.Implications for rehabilitationReducing activity limitations by enhancing muscle strength is frequently applied in the treatment of EDS-HT patients. Although evidence regarding treatment efficacy is scarce, the current paper confirms the rationality that muscle strength is an important factor in the occurrence of activity limitations in EDS-HT patients.Although muscle strength is the most dominant factor that is associated with activity limitations, this association is confounded by proprioception. In contrast to common belief proprioception was not directly associated with activity limitations but confounded this association. Controlling muscle strength on the bases of proprioceptive input may be more important for reducing activity limitations than just enhancing sheer muscle strength. [ABSTRACT FROM AUTHOR]

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Text-to-speech technology can act as an important support tool in computer-based learning environments (CBLEs) as it provides auditory input, next to on-screen text. Particularly for students who use a language at home other than the language of instruction (LOI) applied at school, text-to-speech can be useful. The CBLE E-Validiv offers content in the LOI and one of six other languages. All content can be read aloud via text-to-speech. For students having a home language other than the LOI, the other language is set to their home language; students who use the LOI at home mostly have English or French available. This study aimed to determine fifth-grade students' use of bilingual text-to-speech and examine student characteristics related to this use ( n = 360). Multilevel hierarchical regression analyses show that particularly students having their home language available apply text-to-speech in their home language. However, their main focus remains on text-to-speech in the LOI. Students with a low self-assessed proficiency in their home language and those who often watch television and read books in the LOI use text-to-speech more in the LOI. Considerations for practice, the design of CBLEs with text-to-speech and future directions for research are discussed. Lay Description What is currently known about the subject? Text-to-speech (TTS) technology converts digital text to spoken language., Combining visual and auditory information extends working memory's capacity., TTS has potential to offer bilingual auditory support to language minority students., Learner characteristics may play a considerable role in the use of TTS., What does this paper add? Language minority students use TTS in the language of instruction and their home language., TTS in the home language is mainly applied as a support to strengthen understanding., Not being confident about the proficiency in the home language indicates a stronger focus on TTS in the language of instruction., Reading books and watching television in the language of instruction points to a stronger use of TTS in that language., What does this mean for practitioners? The computer-based learning environment can support students in meaning construction., TTS can assist language minority students both in the language of instruction and the home language., Students who are not confident in their home language need special attention. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? To stimulate reminiscence of older adults with dementia performed individually or through group sessions is a well-known practice in nursing homes resulting in effects on behaviour and well-being as an alternative for medication., Robust scientific proof of the effectiveness of individual reminiscence therapy performed in nursing homes is sparse., What this paper adds to existing knowledge? We have provided individual standardized reminiscence therapy to residents with dementia. The therapy was developed and tested in a previous study and performed in this study by trained nursing home volunteers., In comparison with a control group who received usual care, residents who received the reminiscence therapy showed significant less depressive symptoms. Moreover, residents were, in general, attentive, open and collaborative during the sessions and volunteers experienced the sessions as useful and pleasant., What are the implications for practice? Individual reminiscence therapy can be learned and used by nursing home volunteers to improve care in nursing homes., Abstract Aim To investigate the effect of a standardized individualized intervention based on the SolCos transformational reminiscence model on depressive symptoms (primary outcome), cognition and behaviour (secondary outcomes) for older people with mild to moderate dementia, performed by trained nursing home volunteers as facilitators. Background Because of limited pharmacological treatment options for older adults with dementia relevant physical, sensory, psychological or social interventions offer alternative opportunities. Method Randomized controlled trial (ISRCTN74355073) was set up in two nursing homes with 29 and 31 residents in the intervention and the control groups respectively. Eighteen nursing home volunteers were trained to perform the reminiscence therapy. Various assessment scales were measured pre- and post-sessions. Results Linear regression analysis showed an impact on depressive symptoms. However, no impact was identified on cognition and behaviour. Facilitators experienced the sessions as useful and pleasant, and study participants were, in general, attentive, open and collaborative. Discussion Study results showed that organizing standardized individual reminiscence therapy with nursing home volunteers was feasible and study participants' attention and participation were overall good. Further study initiatives to explore the potential of individual reminiscence therapy within a person-centred framework are recommended in order to improve care in nursing homes. [ABSTRACT FROM AUTHOR]

Introduction: Inspired by examples in low- and middle-income countries, 50 community health workers (CHWs) were introduced in Belgium to improve access to primary care for people living in socio-economically vulnerable circumstances. This article aims to explore the ways in which CHWs support people living in socio-economically vulnerable circumstances in their access to primary care. Methods: The qualitative research focuses on the first year of implementation of this pioneer nationwide CHW programme in Belgium. To respond to the research aim, thirteen semi-structured in-depth interviews were held with people living in socio-economically vulnerable circumstances. In addition, a photovoice study was conducted with fifteen CHWs comprising four phases: (1) photovoice training; (2) participatory observation with each CHW individually; (3) an individual semi-structured in-depth interview; and (4) three focus group discussions. The transcripts and the observation notes were analysed in accordance with the abductive analysis procedures described by Timmermans and Tavory. Results: The qualitative results show that the CHWs' outreaching way of working allows them to reach people living at the crossroads of different vulnerabilities that are intertwined and reinforce each other. They experience complex care needs, while at the same time they face several barriers that interrupt the continuum of access to primary care – as conceptualised in the theoretical access-to-care framework of (Levesque et al. Int J Equity Health. 12:18, 2013). Building on the theoretical access-to-care framework described by (Levesque et al. Int J Equity Health. 12:18, 2013), the conceptual model outlines first the underlying mechanisms of CHW-facilitated access to primary care: (I) outreaching and pro-active way of working; (II) building trust; (III) providing unbiased support and guidance in a culturally sensitive manner; and (IV) tailoring the CHWs' approach to the unique interplay of barriers at the individual and health system level along the access-to-care continuum as experienced by the individual. Further disentangling how CHWs provide support to the barriers in access to care across the continuum and at each step is outlined further in the process characteristics of this conceptual model. Furthermore, the qualitative results show that the way in which CHWs support people is also impacted by the broader health system, such as long waiting times and unwelcoming healthcare professionals after referral from a CHW. Discussion: The conceptual model of CHW-facilitated access to primary care developed in this article explores the way in which CHWs support people living in socio-economically vulnerable circumstances in their access to primary care in Belgium. Through their outreaching method, they play a valuable bridging role between the Belgian healthcare system and people living in socio-economically vulnerable circumstances. Highlights: - Community health workers (CHWs) reach people who live at the crossroads of different vulnerabilities. - CHWs adjust their support to the unique interplay of barriers at the individual and health system level across the access-to-care continuum. - Through their outreaching method, they play a valuable bridging role between the Belgian healthcare system and people living in socio-economically vulnerable circumstances. - The conceptual model of CHW-facilitated access to primary care explores the ways in which CHWs support people living in socio-economically vulnerable circumstances in their access to primary care in Belgium. [ABSTRACT FROM AUTHOR]

As we approach the deadline for achieving the United Nations’ 17 Sustainable Development Goals (SDGs), which is less than a decade away, it is crucial for researchers and research institutions at both national and international levels to conduct rigorous scientific assessments of the progress made towards these goals. The assessment is of utmost importance as it will provide valuable insights and information to political leaders and other stakeholders, guiding their actions and efforts towards successfully attaining the SDGs by the year 2030. This study aimed at providing vivid descriptions of the SDG 2 – zero hunger-related research endeavour. It employed bibliometric analysis and geographical patterns of SDG 2-related publications extracted from Scopus database from 2015 to 2023. A total of 397 documents were extracted where Sustainability journal ranked 1st among the journal outlets of zero hunger-related publications. The publication of zero hunger-related documents grew from 1.5% in 2016 to 29.7% in 2022. Food and Agriculture Organisation (FAO) and Chinese Academy of Sciences were the top 2 institutions publishing zero hunger-related documents while the lead article was published by Journal of Cleaner Production with 128 citations. The funding sponsors of SDG 2-related publications were dominated by sponsors from developed countries (such as China, Belgium, United States, and United Kingdom) while no funding sponsors from developing countries were among the top 10. The United States and United Kingdom were the two most productive countries while only one African country (South Africa) made the list of top 10 countries publishing zero hunger-related documents. This study provided political leaders and key stakeholders with in-depth understanding of the SDG 2-related research activities and highlighted research funding and collaboration gaps facing the developing nations. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to investigate the effect of pain neuroscience education compared to biomedical pain education after breast cancer surgery on (1) work status, (2) time until work resumption, and (3) change in return-to-work expectations up to 18 months post-surgery. Methods: Participants were randomly assigned to either pain neuroscience education (intervention group) or biomedical pain education (control group) in addition to a standard physical therapy program after surgery for breast cancer. The first four months following surgery, one to two physiotherapy sessions and three educational sessions were scheduled. After, two educational sessions and two physiotherapy sessions were held at six and eight months postoperatively. All outcomes were assessed at four, six, eight, 12 and 18 months postoperatively. Results: At 12 months, in the intervention group, 71% of the women returned to work compared to 53% in the control group (18% points difference, 95%CI:-0.1 to 35;p = 0.07). At 18 months, the differences decreased to 9% points, 95%CI:-26 to 7;p = 0.35). Neither time until work resumption (p = 0.46) nor change in estimation of own ability to return to work up to 18 months postoperatively (p = 0.21) significantly differed between both groups. Conclusion: No significant differences were found regarding return to work outcomes between women receiving pain neuroscience education versus biomedical pain education after breast cancer surgery. Further research is warranted to explore the potential role of pain neuroscience education in return-to-work interventions following breast cancer surgery. [ABSTRACT FROM AUTHOR]

Despite the growing consensus on the benefits of initiating palliative care early in the disease trajectory, it remains unclear at what point palliative care needs emerge. This study investigates quality of life and unmet palliative care needs at three phases in the cancer trajectory, curative, life-prolonging and most advanced (prognosis <6 months/no further disease-modifying treatment). We collected self-reported data from 620 patients with cancer in the University Hospital of Ghent, Belgium. They completed a questionnaire on quality of life (using the EORTC QLQ-C30) and unmet care needs within the domains of palliative care. We used European reference values of the EORTC QLQ-C30 to compare the mean scores with a norm group. The groups further on in the cancer trajectory reported statistically and clinically poorer functioning compared with earlier phases, also when controlled for the effects of sex, age or type of cancer. Higher symptom burdens for fatigue, pain, dyspnoea and appetite loss were found in groups further into the trajectory, p < .001. Patients in the curative phase experienced physical symptoms and had clinically worse functioning than a European reference group. This paper demonstrates the ongoing need for oncologists to address the broader palliative care needs of patients from diagnosis onwards. [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]

Patient access to electronic health records gives rise to ethical questions related to the patient-doctorcomputer relationship. Our study aims to examine patients’ moral attitudes toward a shared EHR, with a focus on autonomy, information access, and responsibility. A de novo self-administered questionnaire containing three vignettes and 15 statements was distributed among patients in four different settings. A total of 1688 valid questionnaires were collected. Patients’ mean age was 51 years, 61% was female, 50% had a higher degree (college or university), and almost 50% suffered from a chronic illness. Respondents were hesitant to hide sensitive information electronically from their care providers. They also strongly believed hiding information could negatively affect the quality of care provided. Participants preferred to be informed about negative test results in a face-to-face conversation, or would have every patient decide individually how they want to receive results. Patients generally had little experience using patient portal systems and expressed a need for more information on EHRs in this survey. They tended to be hesitant to take up control over their medical data in the EHR and deemed patients share a responsibility for the accuracy of information in their record. [ABSTRACT FROM AUTHOR]

The present study aims at explaining individual differences in self-reported political violence. We integrate key concepts from the field of criminology that are conceptually related to social identity theory (Flemish identity, feelings of group superiority, and ethnocentrism) and the dual process model on prejudice (perceived injustice, perception of threat, and right-wing authoritarianism). In our model, social identity concepts are hypothesized to play a mediating role between mechanisms derived from the dual process model and political violence. To test the integrated model, a model was run for testing the strength of direct and indirect effects of perceived injustice, authoritarianism thrill-seeking behavior, feelings of superiority, Flemish nationalism, ethnocentrism, right-wing extremist beliefs, and exposure to racist peers on political violence. The analyses are based on a web survey (N = 723) among adolescents and young adults in Flanders, Belgium. Results indicate that social identity variables play an important mediation role between perceptions and ideological attitudes related to injustice, and political violence. The main path revealed by our study is that perceived injustice may result in heightened perceptions of threat, which in turn positively influence levels of right-wing authoritarianism. Mediated by ethnocentrism, this variable has a significant and positive effect on right-wing beliefs, which in turn has a positive effect on political violence. [ABSTRACT FROM AUTHOR]

Autism spectrum disorders (ASD) have a high degree of heritability, but there is still much debate about specific causal genes and pathways. To gain insight into patterns of transmission, research has focused on the relatedness of quantitative autism traits (QAT) between family members, mostly using questionnaires. Yet, different kinds of bias may influence research results. In this paper, we focus on possible informant effects and, taking these into account, on possible intergenerational transmission of QAT. This study used multiple informant data retrieved via the Social Responsiveness Scale from 170 families with at least one member with ASD. Using intraclass correlations (ICCs) and mixed model analyses, we investigated inter-informant agreement and differences between parent and teacher reports on children and between self- and other-reports on adults. Using structural equation modelling (SEM), we investigated the relatedness of QAT between family members in ASD families. Parent-teacher agreement about social responsiveness was poor, especially for children with ASD, though agreement between parents was moderate to strong for affected and unaffected children. Agreement between self- and other-report in adult men was good, but only moderate in women. Agreement did not differ between adults with and without ASD. While accounting for informant effects, our SEM results corroborated the assortative mating theory and the intergenerational transmission of QAT from both fathers and mothers to their offspring. [ABSTRACT FROM AUTHOR]

This paper assesses whether gender plays a role when male and female participants discuss the quality of doctor-patient communication in gynaecological consultations. A European multi-centre study was conducted comprising 259 participants in 35 genderand country-specific focus groups. In all focus groups, a set of four videotaped Objective Structured Clinical Examination (OSCE) consultations was used as a prompt for discussion. The doctors' ability in communication was assessed by participants' ratings and by a quantified content analysis of their comments, using a mixed-method approach. Gender analysis was performed applying a set of generalized linear regression models. The findings indicated that gender differences were smaller than expected. The individual ratings of the overall quality of communication were similar for male and female participants, and there were hardly any differences in the content of the discussions. The only two exceptions were that female doctors were criticized more than male doctors when they made impersonal comments and that female participants were more outspoken than men, positively and negatively. The prevalence of gender similarities suggests that doctors' empathy, support, understanding and pleasantness are highly appreciated by both male and female participants and appear to transcend gender differences. [ABSTRACT FROM AUTHOR]

Given the importance of communication skills in the psychologist-patient relationship, several training programs have been proposed. Cumulative microtraining (CMT) has shown positive impacts on communication skills in previous studies. The aim of this naturalistic pre–post study was to test the feasibility of a hybrid CMT program and obtain preliminary data on its impact on communication skills in French-speaking third-year psychology students. The training included an e-learning curriculum and role plays. Pre–post measures included recorded peer-to-peer role plays and self-assessments by participants themselves using the Calgary Cambridge Grid (n = 38) and assessed by an independent rater (n = 29) with a checklist focused on objective behaviors and the CARE questionnaire measuring perceived empathy. The results showed increases in most communication skills at different levels. Summarizing, paraphrasing, and structuring skills were significantly increased after training (all P ≤ 0.001), as were self-reported measurements (all P < 0.001), and empathy and confidence assessed by an independent rater (all p < 0.05). This study provides new evidence on the impact of CMT, including e-learning and role plays, on both self-rated assessments and assessments by an independent rater who measured communication and empathy in a population of French-speaking students. These findings highlight the importance of implementing such instruction in initial training despite the cost involved. It demonstrates the feasibility of its inclusion in university curriculum, facilitated by the adaptation of theoretical aspects of teaching in e-learning. [ABSTRACT FROM AUTHOR]

This paper describes the risk factors for the development of posttraumatic stress reactions in children after a technological disaster in Ghislenghien, Belgium in 2004. Children were assessed at five months (T1, N = 128) and at fourteen months (T2; N = 69). At T1 and T2 respectively, 7 % and 4 % of the responding children showed severe posttraumatic stress reactions. Of those who showed posttraumatic stress reactions at T1, 60 % recovered from these symptoms at T2. One child developed severe posttraumatic stress reactions between T1 and T2. Risk factors related to posttraumatic stress reactions were: (a) type of exposure to the disaster; (b) peritraumatic dissociation during or immediately after the disaster; and (c) dissatisfaction with the received psychological help. [ABSTRACT FROM AUTHOR]

This study focused on the effects of family type, family relationships and socialization on alcohol consumption and delinquent behaviour among Flemish adolescents. Data came from the second round of the Leuven Adolescents and Families Study and were collected in 2010 by paper-and-pencil questionnaires in 10 different secondary schools (N = 1,688). The results show that children living in non-intact families are more likely to be delinquent and to drink alcohol at an age it is not legally allowed (below 16 years old). High delinquent behaviour is found among boys in single parent families and among girls in stepfamilies. For alcohol use the reverse is true. A good relationship with the same-sex parent is negatively associated with delinquency. High interparental conflict increases delinquency for boys and alcohol use for girls. Parental role models are highly important, since drinking behaviour of parents, and especially the same-sex parent, are positively associated with externalising problems of children. [ABSTRACT FROM AUTHOR]

Aim This paper reports a study testing the content and face validity and internal consistency of the Dutch version of the Aging Sexual Knowledge and Attitudes Scale. Background The ability of older residents to sexually express themselves is known to be influenced by the knowledge and attitudes of nursing home staff towards later-life sexuality. Although the Aging Sexual Knowledge and Attitudes Scale is a widely used instrument to measure this, there is no validated, Dutch translation available. Design Instrument development. Method Following a standard forward/backward translation into Dutch, the scale was further adapted for use in Flemish nursing home settings. Content and face validity and user-friendliness were assessed. The psychometric properties were determined by means of an exploratory study. Data were collected from March-April 2011 at eight Flemish nursing homes. Reliability was assessed using internal consistency and item-total correlations. Results Both subscales of the Flemish adaptation showed acceptable content validity. The face validity and user-friendliness were deemed favourable with hardly any remarks given by the expert panel. The Cronbach's α was 0·80 and 0·88 for the knowledge and attitude subscales, respectively. The item-total correlations ranged from 0·21-0·48 for the knowledge section and from 0·09-0·68 for the attitude subscale. Conclusion We conclude from our study that the Dutch version of the scale has acceptable to good psychometric properties. The Flemish adaptation therefore seems to be a valuable instrument for studying nursing staff's knowledge and attitudes towards aged sexuality in Flanders. [ABSTRACT FROM AUTHOR]

BACKGROUND: Knowledge of first aid (FA), which constitutes lifesaving treatments for injuries or illnesses, is important for every individual. In this study, we have set up a group-randomized controlled trial to assess the effectiveness of a board game for learning FA. METHODS: Four class groups (120 students) were randomly assigned to 2 conditions, a board game or a traditional lecture method (control condition). The effect of the learning environment on students' achievement was examined through a paper-and-pencil test of FA knowledge. Two months after the intervention, the participants took a retention test and completed a questionnaire assessing enjoyment, interest, and motivation. RESULTS: An analysis of pre- and post-test knowledge scores showed that both conditions produced significant increases in knowledge. The lecture was significantly more effective in increasing knowledge, as compared to the board game. Participants indicated that they liked the game condition more than their fellow participants in the traditional lecture condition. CONCLUSION: These results suggest that traditional lectures are more effective in increasing student knowledge, whereas educational games are more effective for student enjoyment. From this case study we recommend alteration or a combination of these teaching methods to make learning both effective and enjoyable. [ABSTRACT FROM AUTHOR]

The present paper will use fat mass percentage (FM%) obtained via BOD POD® air-displacement plethysmography (FMADP%) to examine the relative validity of (1) anthropometric measurements/indices and (2) of FM% assessed with equations (FMeq%) based on skinfold thickness and bioelectrical impedance (BIA). In 480 Belgian children (aged 5–11 years) weight, height, skinfold thickness (triceps and subscapular), body circumferences (mid-upper arm, waist and hip), foot-to-foot BIA (Tanita®) and FMADP% were measured. Anthropometric measurements and calculated indices were compared with FMADP%. Next, published equations were used to calculate FMeq% using impedance (equations of Tanita®, Tyrrell, Shaefer and Deurenberg) or skinfold thickness (equations of Slaughter, Goran, Dezenberg and Deurenberg). Both indices and equations performed better in girls than in boys. For both sexes, the sum of skinfold thicknesses resulted in the highest correlation with FMADP%, followed by triceps skinfold, arm fat area and subscapular skinfold. In general, comparing FMeq% with FMADP% indicated mostly an age and sex effect, and an increasing underestimation but less dispersion with increasing FM%. The Tanita® impedance equation and the Deurenberg skinfold equation performed the best, although none of the used equations were interchangeable with FMADP%. In conclusion, the sum of triceps and subscapular skinfold thickness is recommended as marker of FM% in the absence of specialised technologies. Nevertheless, the higher workload, cost and survey management of an immobile device like the BOD POD® remains justified. [ABSTRACT FROM PUBLISHER]

International Journal of Paediatric Dentistry 2013; 23: 39-47 Background. Caries in preschool children remains an important public health issue. Aim. To determine (i) which teeth and tooth surfaces are most susceptible to dental caries by age 3, (ii) where do caries lesions develop during 2-year follow-up, and (iii) to evaluate the impact of caries onset on the distribution of new caries experience. Design. One thousand and fifty seven consecutively born children were recruited in Flanders (Belgium). Parents completed validated questionnaires on oral health-related behaviour and trained dentists examined the children at ages 3 and 5. Results. Children with visible caries experience at age 3 were significantly more vulnerable in developing additional caries during follow-up. In this group, new caries experience developed primarily in the occlusal and distal surfaces of the mandibular first molars and the occlusal surfaces of the maxillary second and first molars, whereas in the caries-free group, the occlusal surfaces of both mandibular and maxillary second molars ranked first. Conclusions. This paper confirms the higher vulnerability for further caries development in those children with caries experience at age 3. Visible caries develops most frequently in the occlusal surfaces of the second molars: in high-risk children already by age 3 and in children who were caries free at baseline by age 5. [ABSTRACT FROM AUTHOR]

Background: Although differences between paper-and-pencil questionnaires and accelerometers have been reported for overall physical activity and time spent in moderate and vigorous activity, few studies have looked at domain-specific behavior. This study compared estimates of domain-specific physical (in)activity obtained with the Flemish physical activity computerized questionnaire (FPACQ) with those obtained from a combination of the SenseWear Armband and an electronic diary. Furthermore, it was investigated whether the correspondence between the two methods varied with gender and age. Methods: Data were obtained from 442 Flemish adults (41.4±9.8 years). Physical activity was questioned with the FPACQ and measured for seven consecutive days using the SenseWear Armband together with an electronic activity diary (SWD). Analogous variables were calculated from the FPACQ and SWD. Mean differences and associations between FPACQ and SWD outcomes were examined with paired t-tests and Pearson correlations. The Bland-Altman method was used to assess the level of agreement between the two methods. Main effects and interaction of gender and age groups (20-34; 35-49; 50-64 years) on differences between FPACQ and SWD outcomes were analyzed using two-way ANOVAs. Results: All parameters of the FPACQ were significantly correlated with SWD assessments (r = 0.21 to 0.65). Reported activity was significantly different from SWD-obtained values for all parameters, except screen time. Physical activity level, total energy expenditure and time spent in vigorous activities were significantly higher (+0.14 MET, +25.09 METhours·week-1 and +1.66 hours·week-1, respectively), and moderate activities and sedentary behavior significantly lower (-5.20 and -25.01 hours·week-1, respectively) with the FPACQ compared to SWD. Time and energy expenditure of job activities and active transport were significantly higher, while household chores, motorized transport, eating and sleeping were significantly lower with the FPACQ. Time spent in sports was lower (-0.54 hours·week-1), but energy expenditure higher (+4.18 METhours·week-1) with the FPACQ. The correspondence between methods varied with gender and age, but results differed according to the intensity and domain of activity. Conclusions: Despite the moderate correlations, significant differences between the two methods were found. In general, physical activity was higher and sedentary behavior lower as calculated from the FPACQ compared to SWD. [ABSTRACT FROM AUTHOR]

Background and Objective: Psychotropic drug use is high in nursing homes in Belgium. A practice improvement initiative (including education, professional support and the transition towards person-centred care) achieved significant reductions in psychotropic drug use. The initiative outline was transcribed into a general intervention template, and consequently implemented in five nursing homes (in mixed locations and with a mixed character) in preparation for a future broader roll-out in Belgium. The impact of the intervention on the use of psychotropic drugs in these five nursing homes is reported in this paper. Methods: The general intervention template was fitted into the individual nursing home setting. Education for the nursing home personnel on psychotropic drugs and non-pharmacological alternatives, as well as details for a transition to person-centred care was provided. Psychotropic drug use was recorded using a dynamic cohort study design with cross-sectional observations (November 2016–November 2017). Results: At baseline, participants' (n = 677) mean age was 85.6 years (range 54–109 years), with 72.6% female. Mean medication intake was 8.5 (range 1–22), predominantly central nervous system drugs (Anatomic Therapeutic Chemical classification N, 88.8%). Long-term (> 3 months) psychotropic drug use (62.0%) and concomitant psychotropic drug use (31.5% taking two or more medications) were high. After 12 months, the prevalence of long-term psychotropic drug use decreased significantly (from 62.0 to 52.9%, p < 0.001), likewise the combined use of psychotropic drugs (from 31.5 to 24.0%, p = 0.001). The decrease in the prevalence of antidepressant and hypnosedative use was significant (respectively, from 32.2 to 23.4%, p < 0.001, and from 35.3 to 28.7%, p = 0.006) in contrast to antipsychotic use (from 17.1 to 15.9%, p = 0.522). Conclusions: The stand-alone adaptation of the previously reported initiative using a general template was possible. This intervention resulted in a significant decrease in psychotropic drug use (predominantly hypnosedatives and antidepressants) among nursing home residents after 12 months. [ABSTRACT FROM AUTHOR]

Introduction: Haemorrhoidal Artery Ligation (HAL) +/- Recto-Anal Repair (RAR) is a minimally invasive surgical technique for all grades of hemorrhoidal disease. This paper reports on the results after ten years of follow-up. Methods: This retrospective study analyzed the outcomes of 274 consecutive HAL or HALRAR procedures between January 2004 and August 2014, at Sint-Lucas General Hospital in Ghent, Belgium. Data was collected through a questionnaire and the patient records. All data was analyzed with SPSS 24.0. Results: The initial symptomatology was discomfort in daily life, anal blood loss, anal pain and hemorrhoidal prolapse. Before seeking medical treatment, 61.1% were symptomatic for years. Patients were treated by HAL or HALRAR. During a HAL procedure, a mean of 5 sutures were placed. For RAR, a mean of 2 mucopexies were performed. The majority (74.8%) was treated on a day-clinic basis. Mean Visual Analog Scale (VAS) for postoperative pain is 5.28. The postoperative complication rate was 11.3%, most frequently anal pain (3.6%), hemorrhoidal thrombosis (3.3%) and urinary retention (2.6%). Symptoms of hemorrhoidal disease decreased significantly after HAL or HALRAR, but 44.4% of patients needed further treatment. Satisfaction after HAL or HALRAR was 84.4%. Conclusion: These long-term results after HALRAR show a significant decrease in symptomatology and a high patient satisfaction but confirmed concerns about high recurrence rates. More prospective randomized trials are needed to evaluate long term results compared to other surgical techniques. [ABSTRACT FROM AUTHOR]

This article examines how income poverty is affected by changes to the scale of tax-benefit policies and which are the most cost-effective policies in reducing poverty or limiting its increase in seven diverse EU countries. We do that by measuring the implications of increasing/reducing the scale of each policy instrument, using microsimulation methods while holding constant the policy design and national context. We consider commonly applied policy instruments with a direct effect on household income: child benefits, social assistance, income tax lower thresholds and a benchmark case of rescaling the whole tax-benefit system. We find that the assessment of the most cost-effective instrument may depend on the measure of poverty used and the direction and scale of the change. Nevertheless, our results indicate that the options that reduce poverty most cost-effectively in most countries are increasing child benefits and social assistance, while reducing the former is a particularly poverty-increasing way of making budgetary cuts. [ABSTRACT FROM AUTHOR]

Preventive interventions to reduce occupational injuries and diseases among farmers require an appraisal of the relative importance of the various risk factors. This paper describes the results of a cross-sectional study investigating determinants of occupational health and injuries among 510 Belgian farmers, looking at health-related behaviors (machinery use, animal handling, fall prevention, and pesticide use), as well as nonbehavioral risk factors (demographic characteristics, farm characteristics, and participation in safety training). Education level and number of employees on the farm were identified as nonbehavioral risk factors for injuries, with highly educated farmers and working with one employee associated with a higher injury risk. In contrast, none of the nonbehavioral factors were related to occupational disease. Unsafe machinery use, animal handling, fall prevention, and pesticide use were behavioral risk factors for injuries, with unsafe pesticide use representing the highest risk. Unsafe machinery and pesticide use were also risks for disease. Significant differences in self-reported behavior were found for gender, age, number of employees, and the interaction between age and education. The study highlights the importance of behavioral factors as determinants of occupational injuries and diseases among farmers, and suggests that tailored preventive interventions should be developed to accommodate for differences in these behaviors among subgroups of farmers. [ABSTRACT FROM AUTHOR]

This paper examines pain, illness and medicine metaphors as used in consultations between chronic pain patients and anaesthesiologists, physiotherapists and psychologists in a Belgian pain clinic. As metaphors frame and highlight aspects of understanding and experiences of life events, including illness, they can provide insight in how health professionals and patients construct illness, pain and medicine in interaction. 16 intake consultations (collected in Belgium in April–May 2019) between 6 patients and 4 health professionals were qualitatively coded twice ATLAS. TI by a team of 3 coders, using an adjusted form of the Metaphor Identification Procedure. Each metaphor was labelled for source domain, target domain and speaker. A number of metaphors that have been previously documented in past research were frequent in our data too, such as journey and machine metaphors, although sometimes also used differently, like war metaphors. Our data set also contained many few-used and sometimes more novel metaphors, such as ILLNESS IS A YO-YO. Many metaphors highlight particular aspects of living with and talking about chronic pain, such as its duration and persistent presence, a lack of agency and feelings of powerlessness, and a dualistic perspective on body and mind. The metaphors used by health professionals and patients give insight in the lived experience of having and treating chronic pain. In this way, they can contribute to our understanding of patients' experiences and challenges, how they recur in clinical communication, and how they are related to wider discourses on health, illness and pain. • Metaphors are key in framing illness experiences such as living with chronic pain. • In a Belgian pain clinic, conventional metaphors such as journey metaphors are used. • But also more novel metaphors like ILLNESS IS A YOYO are crucial in consultations. • Metaphors point to the pain's persistence, a lack of agency, and mind-body dualism. • They give insight in the lived experience of chronic pain in clinical settings. [ABSTRACT FROM AUTHOR]

Background: Medication self‐management (MSM) is considered an important aspect of pharmacotherapy and plays an essential role in the treatment of various illnesses. To date, research into the willingness and attitude of psychiatric healthcare providers toward MSM in patients diagnosed with schizophrenia or bipolar disorders during hospitalization is lacking. Aim: The aim of this study was to identify healthcare providers' willingness to MSM and assess their attitude, conditions, benefits, and ability toward it during hospitalization. Methods: A multicenter, quantitative cross‐sectional observational design was used to study psychiatric healthcare providers' attitude to MSM during hospitalization in patients diagnosed with schizophrenia or bipolar disorders. Results: In this study, 173 healthcare providers, of which 147 were nurses and 26 psychiatrists, participated. During hospitalization, 86% of the healthcare providers were willing to MSM. Regularly evaluating patients' ability regarding MSM during hospitalization was seen as an important condition (94%). Psychiatrists were significantly less convinced that MSM during hospitalization has a positive impact on adherence when compared to nurses (respectively 54% vs. 77%, p =.009). Discussion: Most healthcare providers indicated that they were willing to MSM in patients diagnosed with schizophrenia or bipolar disorders during hospitalization under specific conditions. [ABSTRACT FROM AUTHOR]

This study investigated Belgian and Dutch parental opinions on confidentiality and consent regarding medical decisions about adolescents. Through an online survey, we presented six cases (three on confidentiality, and three on consent) to 1,382 Belgian and Dutch parents. We studied patterns in parental confidentiality and consent preferences across and between cases through binomial logistic regressions and latent class analysis. Participants often grant the right to consent for a treatment to the adolescent, but the majority diverges from the adolescent's preferences regarding confidentiality. More educated participants would rather not be informed about cases regarding a sexually transmitted disease or depression than lower educated participants. Further analysis shows that participants' preferences correspond to authoritative (47%), permissive (30%) and authoritarian (17%) parenting styles. Belgian and Dutch parents are willing to grant some degree of autonomy, but they want to be informed about specific health issues. Parental views on confidentiality and granting consent appear to mirror existing parenting styles. [ABSTRACT FROM AUTHOR]

Abstract: In the margin of the ongoing experimental and quasi‐experimental research projects on family preservation, some research projects focus on the process through which families accomplish change and acknowledge the importance of the working alliance. There is, however, little information about barriers and facilitators in building this working alliance. To fill this gap, we performed a multiple case study with a triangulation of ethnographical methods such as observation, in‐depth interviews, case file analysis, and multistakeholder focus groups. We illustrate how, in a context of managerialism and transactional leadership, social workers find themselves in a continuous tension between complying with the expectations of their social organization and “tuning in” with the service users. This jeopardizes the working alliance between a social worker and a family. Consequences for research, practice, and policy regarding family preservation interventions are discussed. [ABSTRACT FROM AUTHOR]