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The aim of this study was to explore the note-taking experiences of university students using paper-based (non-electronic) and paperless (electronic) resources. By means of a hermeneutic phenomenological approach, the note-taking experiences of 18 students from an international program at a university in Belgium were examined throughout a semester. In order to document these students' practices with paper-based and paperless resources, four data collection methods were used: (a) in-depth interviews (b) observations (c) focus group discussions and (d) document analysis of students' lecture notes. The results showed that students experience note-taking as a complex phenomenon in which lived body, lived human relations, lived space and lived time come into play, and in which they try to find a balance between multiple engagements, between autonomy and authority, between attention and distraction, and between being original and mirroring others. This struggle for balance occurs irrespective of which medium (paper-based or paperless) they choose to use. These results provide an in-depth view of the phenomenon, and also highlight the complexity of the note-taking experience. [ABSTRACT FROM AUTHOR]

Landslides are among the major environmental hazards with large-scale socio-economic and environmental impacts that jeopardize socio-economic wellbeing in mountainous regions. Landslides are due to the interaction of several complex factors such as local or regional geology, geomorphology, topography, and seismic motions. The goal of this study is to review published articles on causes and effects of landslides in Central Asia throughout 2000–2020. In line with this goal, we have collected (using Scopus database), reviewed, and analyzed 79 papers published during 2000–2020. Our results revealed an increasing number of landslide studies in Central Asia during the period under investigation, with authors from Belgium dominating in the published outcomes (28% of total), followed by authors from Central-Asian countries. After then, the paper analyses the mostly applied models and frequently identified driving conditions and triggers of landsliding, such as aspect, altitude, soil types, precipitation, earthquakes and human interventions. Geographic information system (GIS) and remote sensing (RS) had not commonly been used in the papers between 2000 and 2010, and they have progressively been applied in landslide studies in Central Asia in the last decade. According to our analysis, geotechnical, geophysical and statistical methods were preferably used for the landslide studies in Central Asia. [ABSTRACT FROM AUTHOR]

Bedside handover is the delivery of the nurse-to-nurse handover at the patient's bedside. Although increasingly used in nursing, nurses report many barriers for delivering the bedside handover. Among these barriers is the possibility of breaching the patient's privacy. By referring to this concept, nurses add a legal and ethical dimension to the delivery of the bedside handover, making implementation of the method difficult or even impossible. In this discussion article, the concept of privacy during handovers is being discussed by use of observations, interviews with nurses, and interviews with patients. These findings are combined with international literature from a narrative review on the topic. We provide a practice-oriented answer in which two mutually exclusive possibilities are discussed. If bedside handover does pose problems concerning privacy, this situation is not unique in healthcare and measures can be taken during the bedside handover to safeguard the patient. If bedside handover does not pose problems concerning privacy, privacy is misused by nurses to hide professional uncertainties and/or a reluctance toward patient participation. Therefore, a possible breach of privacy—whether a justified argument or not—is not a reason for not delivering the bedside handover. [ABSTRACT FROM AUTHOR]

Through historical and anthropological inquiry, this paper addresses the issue of memory antagonisms involving cultural landscapes in the context of a former mining region: the Belgian Black Country. This region, which became increasingly industrialized in the 19th century through the massive development of coal mining and steel industry, subsequently experienced deindustrialization, and now finds itself mobilized in a process of 'post-industrial' mutation. The paper is divided into two parts. In the first part, it examines how the landscapes inherited from industry, and in particular the slag heaps of the coalfield, have over time become repositories of a working-class memory, through the living and working practices of the communities surrounding the mines. It also documents the various representations attached to these landscape objects, whose contradictions echo the oppositions between capital and labor that have marked the development of industrial capitalism. The second part of the paper, which focuses on the present situation, examines how these representations are remobilized in the valorization processes that are initiated by different actors, in the context of a 'post-industrial' urban transition strategy that seeks to produce a unified and pacified historical narrative. We'll be looking at how historical conflicts still permeate the representations of these landscapes, the question of their conservation, and their possible future. [ABSTRACT FROM AUTHOR]

Paperwork has always been a central part of bureaucratic work. Over the last few years, bureaucratic procedures have become increasingly standardised and digitalised. Based on interviews and ethnographic fieldwork within welfare offices in Switzerland and Belgium, we reflect on the way evidence is constructed within social policy and cases built for or against noncitizen welfare recipients in order to show how paper truths are established and challenged. The focus on digital practices within public policy implementation highlights how it contributes to enhanced control mechanisms on the implementation level and how migration law continues to guide welfare governance for noncitizens. This allows targeting of the most marginalised groups, whose rights to access state support are institutionally impeded. Through database information flows, official forms, paper reports and face-to-face meetings, we further show how a hybrid form of bureaucratic work emerges, where direct contact with the client is still key, yet highly influenced by standardisation processes. [ABSTRACT FROM AUTHOR]

Human geographers have analyzed the co-constitutive relationship between race, gender and sexualities across different spaces and social contexts and have called for intersectional approaches in discussions of identities, power and space. This article applies an intersectional framework to the processes of sexualization, racialization and exoticization that shape the daily lives and erotic/romantic encounters experienced and narrated by participants to two different projects: gay and bisexual men from a North African background living in Belgium; Italian gay men living in England; non-White gay men living in Italy. By discussing qualitative data collected during interviews with these men, and through a continued dialogue about this data between the authors, the paper explores both the effects of these processes on the lives of participants, and the strategies they enact to navigate their social worlds. The focus is on two elements, central to participants' narratives: the specificity of the intersectional experience of encountering men who expect a specifically gendered and racialized performance based on 'roughness' and 'wildness', and the capitalization on these exoticizing and racializing images to increase one's desirability on the dating/hook-up scene and everyday social and work life. By highlighting these elements, this paper shows the importance of applying an intersectional approach to analyses of the entanglements of racialization and sexualization in order to complicate linear accounts of these processes. [ABSTRACT FROM AUTHOR]

Background: Augmented reality (AR) is receiving increasing interest as a tool to create an interactive and motivating learning environment. Yet, it is unclear how instructional support affects performance in AR. Objectives: This study sought to explore how varying the instructional support in AR can affect performance‐related behaviours of students with low cognitive abilities during assembly work. Methods: A total of 90 Belgian secondary school students repeatedly executed four different realistic assembly tasks. Three levels of instructional support (low, medium, and high) in AR as well as a control condition with paper instructions with a high level of detail were systematically varied across tasks and participants. Results and Conclusions: Multilevel regression analyses showed that AR instructions yielded lower assembly times and a lower perceived physical effort than paper instructions. Additionally, participants perceived tasks as less complex when given AR instructions with a high or a medium level of detail than when given a low level of detail. No effects of instructional support were established for other performance‐related behaviours, namely necessary assistance, error‐making, cognitive load, competence frustration, and stress. Effect sizes were small, at least among the instructional support conditions studied, yielding a limited base for adaptivity. Presumably, tailoring the instructional support in AR is only beneficial for highly complex tasks. The results might be useful for the design and implementation of AR in educational settings. Lay Description: What is currently known about the subject matter: Augmented reality is knowing increased use in education.Little is known about how to design effective instructional support in augmented reality. What this paper adds: This study represents an initial insight into how to personalize instructional support.The impact of instructional support on augmented reality performance of students with low cognitive abilities was investigated.The study suggests that varying instructional support may lead to differences in performance outcomes. Implications for practitioners: How instructional support is constructed may affect augmented reality learning.The results may inform the design of effective augmented reality learning environments for students with special needs.How individual, contextual, and task‐specific characteristics moderate the effectiveness of instructional support should be further investigated. [ABSTRACT FROM AUTHOR]

Background: The assessment of primary care organizations is considered to be essential for improving care. However, the assessments' acceptability to professionals poses a challenge. Developing assessment programmes in collaboration with the end-users is a strategy that is widely encouraged to make interventions better targeted. By doing so, it can help to prevent resistance and encourage adherence to the assessment. This process, however, is rarely reported. This paper aims to fill this gap by describing the process of the co-production of an assessment programme for community health centres (CHCs) affiliated to the Federation of Community Health Centres (FCHC) in French-speaking Belgium. Methods: We conducted a documentary study on the co-production of the assessment programme before carrying out semi-structured interviews with the stakeholders involved in its development. Results: CHCs in French-speaking Belgium are increasing in number and are becoming more diverse. For the FCHC, this growth and diversification pose challenges for the meaning of CHC (an identity challenge) and what beneficiaries can expect in terms of the quality of organizations declaring themselves CHC (a quality challenge). Faced with this double challenge, the FCHC decided to develop an assessment programme, initially called Label, using participatory action research. During the co-production process, this initial programme version was abandoned in favour of a new name "DEQuaP". This new name embodies new objectives and new design regarding the assessment programme. When studying the co-production process, we attributed these changes to two controversies. The first concerns how much and which type of variety is desired among CHCs part of the FCHC. The second concerns the organization of the FCHC in its capacity as a federation. It shed light on tensions between two professional segments that, in this paper, we called "political professionalism" and "pragmatic professionalism". Conclusions: These controversies show the importance of underlying challenges behind the development of an assessment programme for CHCs. This provided information about the evolution of the identity of multidisciplinary organizations in primary care. Issues raised in the development of this assessment programme also show the importance of considering assessment methods that reflect and embody the current realities of these organizations and the way of developing these assessment methods. [ABSTRACT FROM AUTHOR]

The exact role of biochemical markers of bone turnover in the management of metabolic bone diseases remains a topic of controversy. In this consensus paper, the Belgian Bone Club aimed to provide a state of the art on the use of these biomarkers in different clinical or physiological situations like in postmenopausal women, osteoporosis in men, in elderly patients, in patients suffering from bone metastasis, in patients with chronic renal failure, in pregnant or lactating women, in intensive care patients, and in diabetics. We also gave our considerations on the analytical issues linked to the use of these biomarkers, on potential new emerging biomarkers, and on the use of bone turnover biomarkers in the follow-up of patients treated with new drugs for osteoporosis. [ABSTRACT FROM AUTHOR]

The REpowerEU plan prioritizes combining electrification with low-carbon hydrogen for a green energy shift. However, uncertainties surrounding the future hydrogen market and its supply costs impede the establishment of its value chain. Without definite plans for hydrogen production and infrastructure, investing in low-carbon hydrogen industrial processes is risky. Simultaneously, the absence of solid market interest poses challenges in deploying a hydrogen backbone. In recent years, European gas Transmission System Operators (TSOs) in Belgium, Netherlands, and Germany, have introduced various roadmaps for their prospective national hydrogen network. Despite the infrastructure proposals, detailed quantitative scenario analysis for the future hydrogen supply chain is still missing. This paper presents a hydrogen infrastructure model that employs Mixed Integer Linear Programming (MILP) for investment and operational cost optimization at detailed spatiotemporal resolution. A regionalization method is proposed to allocate the potential hydrogen consumption in different industrial sectors across various clusters within a country, represented as the prospective hydrogen demand nodes. The model assesses extreme supply scenarios to examine the robustness of the resulting network infrastructure and compare the system-levelized cost of hydrogen. A real-life case study focusing on the potential Belgian hydrogen supply chain showcases the model's capabilities and outputs. • Regionalization of the industrial hydrogen consumption derived from a national-scale energy system model. • MILP cost optimization model for hydrogen infrastructure design. • Comparative analysis of diverse extreme low-carbon hydrogen supply scenarios. • In-depth case study focusing on the prospective Belgian hydrogen backbone. [ABSTRACT FROM AUTHOR]

In phosphorites, the content and distribution of rare earth elements are linked to the environment of phosphogenesis. This paper focuses on the question of sources and processes controlling the rare earth element content of apatite from Belgian phosphorites formed during three major phosphogenic events in the Lower Palaeozoic, Late Cretaceous and Cenozoic. To constrain sources and processes, new data include petrological, mineralogical (including cathodoluminescence and Raman spectroscopy) and in situ trace element and Sr and O isotope analyses of apatite. Fluorapatite from Lower Palaeozoic P‐rich conglomerates has the greatest rare earth element enrichment. It is affected by metamorphism that led to deformation of apatite nodules and formation of garnet porphyroblast inclusions. The role of Fe‐oxyhydroxides in element scavenging is highlighted by some apatite nodules that maintain their primary middle rare earth element enrichment, while others are characterized by altered rare earth element patterns resulting from competition for these elements between co‐crystallizing minerals during deformation. A systematic shift towards lower δ18O and radiogenic Sr isotopic composition compared to contemporaneous seawater indicate interaction with 18O‐depleted meteoric fluids and a crustal component. By contrast, carbonate‐rich fluorapatite from the Late Cretaceous phosphatic chalk mostly keeps its primary trace element and isotopic signatures (close to seawater), although an external rare earth element addition is noted, as well as rare earth element redistribution induced by diagenetic alteration. Cenozoic carbonate fluorapatite nodules mostly present flat rare earth element patterns that are indicative of a detrital influence. Slight changes in rare earth element distribution are assigned to post‐depositional alteration, which also led to an increase in radiogenic Sr, with unchanged δ18O compared to seawater. The methodology followed here efficiently helps in deciphering the processes that modified the chemistry of apatite in the frame of major phosphogenic events. [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]

Abstract: Bisphenol-A (BPA) is a commonly used color developer in thermal paper. In this application, BPA is present in its free, unbound form and can be readily released, making thermal paper a potential source for human exposure. In this study, BPA was determined in 44 thermal paper samples collected in Belgium. BPA was detected in all the samples; 73% of the samples had concentrations between 0.9% and 2.1% (between 9 and 21mg BPA/g paper), while the remaining 27% of the samples had concentrations below 0.01% (0.1mg BPA/g paper). The BPA concentrations measured in thermal paper were comparable with those reported in other international studies. Since thermal paper is a feedstock for paper recycling processes, contamination of other “BPA-free” papers can occur. An estimation of human exposure through thermal paper results in a median intake of 445ng BPA/day for the general population, which corresponds to an exposure of 6.4ng/kg bw/day for a person of 70kg. The exposure of those people who come occupationally in contact with thermal paper can be much higher. [Copyright &y& Elsevier]

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]

This paper describes the process of developing classroom culture that promotes reciprocal intercultural encountering in the primary school. Storycrafting, an oral storytelling method used for democratic encounters between participants, was used to connect classes in Scotland, Finland and Belgium over three cycles of design-based research. Abductive analysis produced a theoretical framework of seven key dimensions that influence the learning space for reciprocal encounters: power, knowledge, relatedness, purpose, structure, continuity and meaningfulness. These dimensions were used to identify four kinds of learning spaces that occurred during the implementation of the story exchange: the ambivalent space, the space of information, the transitional space and the space of reciprocal encountering. The intervention created a platform for children's encounters that reinforced mutuality and reciprocal interactions rather than Othering the exchange partners. [ABSTRACT FROM AUTHOR]

This paper describes a multi‐family therapy (MFT) group for adult outpatients with obsessive‐compulsive disorder and their family members. Since family accommodation (FA) is known to maintain OCD symptoms by preventing exposure and response prevention (ERP), reduction of FA is a major focus of the treatment. Furthermore, psychoeducation, conjoint ERP and (re)discovering resources and strengths of families are also important therapeutic foci of the family group. The organisation of MFT is explained and involvement of family is illustrated with clinical vignettes. Finally, some reflections about MFT are provided. On the basis of initial clinical impressions, MFT seems a promising approach. A clinical trial is currently underway. [ABSTRACT FROM AUTHOR]

Background: The Bethesda System for Reporting Thyroid Cytopathology is a commonly used classification for fine needle aspiration (FNA) cytology of suspicious thyroid nodules. The risk of malignancy (ROM) for each category has recently been analyzed in three international databases. This paper compares the diagnostic performance of the Bethesda classification in a high‐volume referral center in Belgium. Methods: All consecutive thyroid procedures were registered in a prospective database from January 2010 till August 2022. Patient and surgical characteristics, preoperative Bethesda categories, and postoperative pathology results were analyzed. Results: Out of 2219 consecutive thyroid procedures, 1226 patients underwent preoperative FNA. Papillary thyroid cancer was the most prevalent malignancy (N = 119, 70.4%), followed by follicular (N = 17, 10.1%) and medullary thyroid cancer (N = 15, 8.9%). Micropapillary thyroid cancer was incidentally found in 46 (3.8%) patients. Bethesda categories I, II, III, IV, V, and VI, respectively, represented 250 (20.4%; ROM 4.4%), 546 (44.5%; ROM 3.8%), 96 (7.8%; ROM 20.8%), 231 (18.8%; ROM 15.2%), 62 (5.1%; ROM 72.6%), and 41 (3.3%; ROM 90.2%) patients. Overall ROM was 13.8%. An negative predictive value (NPV) of 96.2% was found. Overall specificity was 64.2% with a positive predictive value (PPV) of 31.9%. Diagnostic accuracy was 67.8%. Compared to international databases (CESQIP, EUROCRINE, and UKRETS), ROM in this study appeared lower for Bethesda category IV (15.2 vs. 26.7% and p = 0.612). Conclusion: Despite being validated in numerous studies, ROM based on preoperative FNA cytology classified according to the Bethesda classification may vary among surgical centers and countries as this study reveals a higher NPV and lower PPV. [ABSTRACT FROM AUTHOR]

There has been a growing policy interest in establishing connections between heritage and education. Nevertheless, there seems to be very little evaluation or critical reflection on what actually happens in practice, and it remains unclear how heritage education is employed in countries throughout Europe. The aim of this paper is to assess the current status of heritage education in Flanders (the Dutch-speaking northern part of Belgium) via a literature review and an exploratory case study. The perceptions and opinions of pre-service teachers (n = 17) were investigated using three instruments: a questionnaire, document analysis, and the think aloud method. The results show that the pre-service teachers had a traditional interpretation of heritage, mainly relying on well-known and monumental examples and following a rather historical–artistic conception. However, it was found that their opinions were positive towards the use of heritage as an educational resource, and their evaluations of educational materials from the heritage and museum sector provided detailed information concerning teachers' desires and needs in this regard. The implications of this study should encourage initial teacher training in Flanders to further consider the epistemological and methodological challenges in the emerging field of heritage education. [ABSTRACT FROM AUTHOR]

This paper introduces a Techno-Economic Assessment (TEA) on present and future scenarios of different energy storage technologies comprising hydrogen and batteries: Battery Energy Storage System (BESS), Hydrogen Energy Storage System (H 2 ESS), and Hybrid Energy Storage System (HESS). These three configurations were assessed for different time horizons: 2019, 2022 and 2030, under both on-grid and off-grid conditions. For 2030, a sensitivity analysis under different energy scenarios was performed, covering other trends in on-grid electric consumption and prices, CO 2 taxation and the evolution of hydrogen technology prices from 2019 until 2030. The selected case study is the Research Park Zellik (RPZ), a CO 2 -neutral sustainable Local Energy Community (LEC) in Zellik, Belgium. The software HOMER (Hybrid Optimisation Model for Electric Renewable) has been selected to design, model and optimise the defined case study. The results showed that BESS was the most competitive when the electric grid was available among the three possible storage options. Additionally, HESS was overall more competitive than H 2 ESS-only, regardless of the grid connection mode. Finally, as per HESS, hydrogen was proved to play a complementary role when combined with batteries, enhancing the flexibility of the microgrid and enabling deeper decarbonisation by reducing the electricity bought from the grid, increasing renewable energy production and balancing toward an island operating mode. • Assessment of hybrid energy storage systems for future energy scenarios. • Sensitivity analysis with different technical, economic, and environmental KPIs. • Analysis of the effects of the connection and capacity access to the electric grid. • Application to a real case study: a CO2-neutral Local Energy Community. [ABSTRACT FROM AUTHOR]

Thermal processes represent a significant fraction of industrial energy consumptions, and they rely mainly on fossil fuels. Thanks to technological innovation, highly efficient devices such as high-temperature heat pumps are becoming a promising solution for the electrification of industrial heat. These technologies allow for recovering waste heat sources and upgrading them at temperatures up to 200 °C. Moreover, the coupling of these devices with thermal storage units can unlock the flexibility potential deriving from the industrial sector electrification by means of Demand-Side Management strategies. The aim of this paper is to quantify the impact on the energy system due to the integration of industrial high-temperature heat pumps and thermal storage units by means of a detailed demand–supply model. To do that, the industrial heat demand is investigated through a set of thermal process archetypes. High-temperature heat pumps and thermal storage units for industrial use are included in the open-source unit commitment and optimal dispatch model Dispa-SET used for the representation of the energy system. The case study analyzed is Belgium, and the analysis is performed for different renewable penetration scenarios in 2040 and 2050. The results demonstrate the importance of a proper sizing of the heat pump and thermal storage capacity. Furthermore, it is obtained that the electrification of the thermal demand of industrial processes improves the environmental impact (84% reduction in CO2 emissions), but the positive effect of the energy flexibility provided by the heat pumps is appreciated only in the presence of a very high penetration of renewable energy sources. [ABSTRACT FROM AUTHOR]

Research on the electoral personalization of politics has stressed a trend towards a greater role of top prominent political figures (party leaders and ministers). This trend was described as centralized electoral personalization. Yet, this trend is merely one side of a more complex story. No leader attracts all voters' support, and other candidates manage to stand out despite lower resources and visibility. Using a unique dataset of 47,239 actual ballot papers cast for the 2018 Belgian local elections, we show that candidate-level, list-level and district-level factors result in distinct preference voting behaviour. While these factors lead to unmistakable forms of (de-)centralized personalized forms of elections, we furthermore, show that intermediary situations distinctively emerge. A significant number of 'subtop' candidates stand out among candidates, by attracting support from voters who do not support the mere leader of the list. This 'oligarchized personalization' would deserve greater attention in the literature. [ABSTRACT FROM AUTHOR]

Although people with a migration background (MB) have more unmet mental health needs than the general population, patients with a MB are still underrepresented in mental health care services. Provider bias towards these patients has been evidenced repeatedly but its driving factors remain elusive. We assessed the moderating effect of the individual (e.g. age and ethnicity), interpersonal (e.g. healthcare provider trust), and organisational (e.g. perceived workload) factors on general practitioners (GPs) differential decision-making regarding diagnosis, treatment, and referral for a depressed patient with or without a MB. An experimental study was carried out in which GPs were shown one of two video vignettes featuring adult male depressed patients, one with a MB and the other without. Belgian GPs (n = 797, response rate was 13%) had to decide on their diagnosis, treatment, and referral. Analysis of variance and logistic regression were used to analyse the effect of a MB, adding interaction terms for the explanatory variables. Overall, we found that there were ethnic differences in GPs' decisions regarding diagnosis and treatment recommendations. GPs perceived the symptoms of the patient with a MB as less severe (F = 7.68, p < 0.01) and demonstrated a reduced likelihood to prescribe a combination of medical and non-medical treatments (F = 11.55, p < 0.001). Those differences increased in accordance with the GP's age and perceived workload; at an interpersonal level, we found that differences increased when the GP thought the patient was exaggerating his distress. This paper showed that lower levels of trust among GPs' towards their migrant patients and high GP workloads contribute to an increased ethnic bias in medical decision-making. This may perpetuate ethnic inequalities in mental health care. Future researchers should develop an intervention to decrease the ethnic inequities in mental health care by addressing GPs' trust in their migrant and ethnic minority patients. [ABSTRACT FROM AUTHOR]

Recent climate activism has played a key role in denouncing the unsustainability of representative democracy. Previous research has investigated the attitudes of climate activists towards representative institutions along the conceptual distinction between 'environmental' and 'ecological' democracy. Yet, little attention has been paid to climate activists' critique of capitalism and how it relates to demands for democratic reform. Our paper addresses this gap by conducting a mixed-method analysis of protest survey data collected in Belgium in 2019. Our findings show that activists display low levels of trust towards representative institutions, but still abide by the ideals of environmental democracy within the boundaries of existing institutions. At the same time, we observe a widespread critique of capitalism, signaling attraction towards the ideals of ecological democracy. Overall, our findings challenge the binary distinction between environmental versus ecological democracy, and raises normative questions about the role of environmental social movements in economic and democratic reform. [ABSTRACT FROM AUTHOR]

Introduction: Non-communicable diseases, such as arterial hypertension (HTN) and type-2 diabetes (T2D), pose a global public health problem. Integrated care with focus on person-centred principles aims to enhance healthcare quality and access. Previous qualitative research has identified facilitators and barriers for scaling-up integrated care, however the lack of standardized terms and measures hinder cross-country comparisons. This paper addresses these gaps by presenting a generic codebook for qualitative research on integrated care implementation for HTN and T2D. Description: The codebook serves as a tool for deductive or deductive-inductive qualitative analysis, organizing concepts and themes from qualitative data. It consists of nine first level and 39 second level themes. First level codes cover core issues; and second level codes provide detailed insights into facilitators and barriers. Discussion: This codebook is more widely applicable than previously developed tools because it includes a broader scope of stakeholders across micro, meso, and macro levels, and the themes being derived from highly diverse health systems across highand low-income countries. Conclusion: The codebook is a useful tool for implementation research on integrated care for HTN and T2D at global scale. It facilitates cross-country learning, contributing to improved implementation, scale-up and outcomes. [ABSTRACT FROM AUTHOR]

Background: Acute and late toxicities in patients treated with (chemo)radiotherapy for head and neck cancer (HNC) is common and can negatively impact quality of life and performance. Performance status instruments measure the functional ability to perform daily life activities and are important tools in the oncologic population. Aims: Since Dutch performance status scales for the HNC population are lacking, we conducted this study to translate the Performance Status Scale for Head and Neck Cancer Patients (PSS‐HN) into Dutch (D‐PSS‐HN) and to validate this version. Methods & Procedures: The D‐PSS‐HN was translated into Dutch according to the internationally described cross‐cultural adaptation process. It was administered to HNC patients and together with the Functional Oral Intake Scale completed by a speech and language pathologist at five different time points during the first 5 weeks of (chemo)radiotherapy. Patients were asked each time to complete the Functional Assessment of Cancer Therapy and the Swallowing Quality of Life Questionnaire. Pearson correlation coefficients were used to calculate convergent and discriminant validity and the evolution of D‐PSS‐HN scores was assessed by means of linear mixed models. Outcomes & Results: A total of 35 patients were recruited and > 98% of the clinician‐rated scales were completed. Convergent and discriminant validity were demonstrated, with all correlations rs between 0.467 and 0.819, and between 0.132 and 0.256, respectively. The subscales of the D‐PSS‐HN are sensitive to detect changes through time. Conclusion & Implications: The D‐PSS‐HN is a valid and reliable instrument to assess performance status in patients with HNC treated with (chemo)radiotherapy. It is a useful tool to measure HNC patients' current diet level and functional abilities to perform daily life activities. WHAT THIS PAPER ADDS: What is already known on the subject: Acute and late toxicities in patients treated with (chemo)radiotherapy for HNC are common and can negatively impact quality of life and performance. Performance status instruments measure the functional ability to perform daily life activities and are important tools in the oncologic population. However, Dutch performance status scales for the HNC population are lacking. Therefore, we translated the Performance Status Scale for Head and Neck Cancer Patients (PSS‐HN) into Dutch (D‐PSS‐HN) and validated this version. What this paper adds to existing knowledge: We translated the PSS‐HN and demonstrated its convergent and discriminant validity. The subscales of the D‐PSS‐HN are sensitive to detect changes through time. What are the potential or actual clinical implications of this work?: The D‐PSS‐HN is a useful tool to measure HNC patients' functional abilities to perform daily life activities. The tool can easily be used in clinical settings: since data collection duration is very short, this facilitates clinical (and research‐related) implementation of the scale. Patients' individual needs could be identified by using the D‐PSS‐HN, resulting in more appropriate approaches and (early) referrals if needed. Interdisciplinary communication could be facilitated. [ABSTRACT FROM AUTHOR]

Background: In the governmental delineation of the speech‐language therapist (SLT) profession and in preservice SLT education, Flemish SLTs are considered as gatekeepers of the standard language in Flanders. Yet, most Flemish clients typically use a colloquial language style. Following earlier research on how teachers' language style affects teacher–student interactions, an SLT's strict adherence to standard Dutch may potentially evoke perceptions of inequality in their clients. As a result, Flemish SLTs may find themselves torn between on the one hand adhering to the standard language and on the other hand adapting to the sociolinguistic style of their client and establishing trust. In the present study, we explored SLTs' views on using standard/colloquial language varieties in their practice. Methods & Procedures: Individual semistructured interviews were conducted with 13 Flemish SLTs who worked with children, adolescents and adults in special schools, private practices and hospitals. Interview transcripts were analysed with reflexive thematic analysis. Outcomes & Results: Analyses yielded three themes. Switching between styles was (1) triggered by client characteristics (age, style, therapeutic needs), and it was shaped by (2) the need for establishing trust and (3) a balance between the SLT's professional and personal identity. Notably, most SLTs described partially converging with their clients' colloquial style, effectively reconciling their professional identity as expert speakers with their personal identity as a colloquial language user. Conclusions & Implications: Despite consensus on the role of the SLT as gatekeeper of standard language, many SLTs felt that colloquial language also plays an important role as it bolsters therapeutic alliance and rehabilitation of functional communication. By implementing reflective mixed methods and integrating the client perspective, future studies should further examine how authentic style‐switching occurs and how various styles used by the SLT are evaluated by clients in different contexts. These findings may guide the development of style‐switching as a communicative strategy that can be addressed in preservice education. What this paper adds: What is already known on the subject: In Flanders, the existence of various (non‐)standard varieties of Dutch may evoke some tension regarding the preferred variety in a given context. Flemish teachers switch between standard language and colloquial language (style‐shifting), depending on the foregrounding of the transactional or relational nature of the context. Moving towards students' colloquial speech builds trust and perceptions of equality. Despite the importance of alliance in speech‐language therapy, little is known about how speech‐language therapists (SLTs) feel about using colloquial speech given that they are considered expert speakers. What this paper adds to existing knowledge: While 'talking properly' is part of the SLT's professional identity, many Flemish SLTs felt that strict adherence to the standard language variety hinders therapeutic alliance. While standard language was strongly associated with professionalism, strict adherence to standard language was used only when SLTs felt they had to prove their clinical competency or when language scaffolding was in the foreground. Partially converging with the clients' language use allowed SLTs to reconcile their professional identity as expert speaker with personal identity and authenticity. What are the potential or actual clinical implications of this work?: Both colloquial speech and standard speech serve a function in SLT practice. Therefore, switching between standard and colloquial speech needs further consideration as a communicative strategy rather than instilling in therapists an ideological, normative stance towards language. [ABSTRACT FROM AUTHOR]

This paper studies the contradictory effects of pro-homeownership policies on inequalities through the case of Belgium. While the literature describes high homeownership rates as levellers of wealth inequalities, this paper finds, using national microdata from ECHP and EU-SILC, that different mechanisms underlying homeownership growth have had contradictory effects on economic inequalities, even in the absence of a housing crisis or increase in income inequalities. Inequalities in the weight of rental costs have risen for newly contracted rental agreements in the last decade, while wealth inequalities are rising because of an increasingly exclusive mortgage-credit market. Current measurements of wealth inequalities are based on the distribution of net wealth, thereby missing the evolution of the difference between mean wealth and no wealth and the dynamic nature of wealth accumulation. Therefore, inequalities are rising in Belgium as poorer renters are increasingly constrained by rental costs when they are increasingly excluded from accessing homeownership. [ABSTRACT FROM AUTHOR]

This study provides an in-depth analysis of the potential role of hydrogen (H 2) in the Belgian transport sector in the context of sustainable and environmentally friendly growth. This paper starts by examining the energy-climate roadmap and the emission mitigation programme defined by the Belgian federal government in the context of environmental sustainability. Then, the Belgian situation is critically evaluated in light of the needs for H 2 fuel in the transport sector, as well as issues about a roadmap on environmental considerations for a sustainable future, while preserving the country's economic stakes. There are several key advances in this direction, especially as H 2 is seen as one of the best viable options for sustained development, unlike other possibilities. This paper also highlights some limitations that make it difficult to accelerate the transition to a sustainable H 2 energy future. Although there are many interests in favour of an advanced and non-polluting transport system, there are differing views on the approach to be taken in political decision-making at national level. Therefore, this study will help public authorities to better integrate environmental and sustainability issues in the context of a transition to a comprehensive hydrogen economy in the current transport sector. • An in-depth analysis of hydrogen's role in the Belgian transport sector is presented. • Considerations of sustainable and environmentally friendly growth are addressed. • It highlights the constraints and barriers to the full development of H 2 in Belgium. • There is no unified national public policy for hydrogen development. • Policies should prioritise R&D, training and social empowerment of hydrogen energy. [ABSTRACT FROM AUTHOR]

BACKGROUND: Do-it-yourself technologies such as 3D printing offer interesting opportunities for creating custom-made assistive devices for people with disabilities. Although these opportunities are increasingly acknowledged, it remains unclear how 3D printing technology should be implemented in assistive devices delivery processes. OBJECTIVE: In three separate action research projects carried out in Belgium, Italy and The Netherlands, workflows were designed and evaluated that incorporate 3D printing as a standard option for providing clients with suitable assistive devices. METHODS: In this paper we describe and compare the three workflows that were conceived simultaneously, yet independently from each other. RESULTS: Based on the evaluations of these workflows, and the experiences of the researchers who developed the workflows, we provide recommendations for implementing 3D printing as a common approach in assistive device delivery processes in practice. Most importantly, designing and manufacturing should be done by means of a client-centered co-creation process by interdisciplinary teams of clinicians, clients, and 3D printing experts. We provide several recommendations for facilitating and supporting collaborations within such teams. CONCLUSIONS: The three workflows presented in this paper are strikingly similar and therefore provide a convincing starting point for interdisciplinary design teams who wish to embark on 3D printing custom-made assistive devices. [ABSTRACT FROM AUTHOR]

With the development in the field of energy and the growing demand for sustainable energy, gas–electric integrated energy systems are attracting attention as an emerging energy supply method. At the same time, with the deep application of information technology, the cyber–physical interactions of gas–electric integrated energy systems are increasingly enhanced. To this end, first, the reliability assessment indices of a gas–electric integrated energy system, which comprehensively considers the interactions between cyber–physical and different energy sources, are established in this paper to quantitatively assess the reliability level of the system under different fault and failure conditions. Second, to solve the reliability optimization problem, a comprehensive reliability enhancement optimization model is constructed in this paper, which targets the sum of the total penalties of the failure rate and average repair time modification. The impact of the cyber systems on the gas–electric integrated energy systems is transformed into a modification of the failure rate and the average repair time, and the model is solved by an adaptive Gaussian particle swarm optimization algorithm. Finally, the applicability and superiority of the adaptive Gaussian particle swarm optimization algorithm to the reliability optimization of the gas–electricity integrated energy system are verified by conducting simulation tests on the gas–electricity integrated energy system coupled with an 8-node distribution system and the 11-node natural gas system in Belgium. Furthermore, the effects of cyber systems and cyber-attacks on system reliability optimization are also analyzed to verify the effectiveness of the proposed method and the rationality of the newly defined reliability indices. [ABSTRACT FROM AUTHOR]

Abstract: Since heterozygous familial hypercholesterolemia (HeFH) is a disease that exposes the individual from birth onwards to severe hypercholesterolemia with the development of early cardiovascular disease, a clear consensus on the management of this disease in young patients is necessary. In Belgium, a panel of paediatricians, specialists in (adult) lipid management, general practitioners and representatives of the FH patient organization agreed on the following common recommendations. [1.] Screening for HeFH should be performed only in children older than 2 years when HeFH has been identified or is suspected (based on a genetic test or clinical criteria) in one parent. [2.] The diagnostic procedure includes, as a first step, the establishment of a clear diagnosis of HeFH in one of the parents. If this precondition is satisfied, a low-density-lipoprotein cholesterol (LDL-C) level above 3.5mmol/L (135mg/dL) in the suspected child is predictive for differentiating affected from non-affected children. [3.] A low saturated fat and low cholesterol diet should be started after 2 years, under the supervision of a dietician or nutritionist. [4.] The pharmacological treatment, using statins as first line drugs, should usually be started after 10 years if LDL-C levels remain above 5mmol/L (190mg/dL), or above 4mmol/L (160mg/dL) in the presence of a causative mutation, a family history of early cardiovascular disease or severe risk factors. The objective is to reduce LDL-C by at least 30% between 10 and 14 years and, thereafter, to reach LDL-C levels of less than 3.4mmol/L (130mg/dL). Conclusion: The aim of this consensus statement is to achieve more consistent management in the identification and treatment of children with HeFH in Belgium. [Copyright &y& Elsevier]

Cancer treatment-induced bone loss (CTIBL) is one of the most important side effects of adjuvant antineoplastic treatment in hormone-dependent neoplasms. Chemotherapy, GnRH analogs and tamoxifen can induce marked bone loss in premenopausal women with early breast cancer. Aromatase inhibitors (AIs) are replacing tamoxifen as the preferred treatment for postmenopausal women. As a class effect, steroidal (exemestane) and non-steroidal (anastrozole and letrozole) AIs increase bone turnover and cause bone loss (4%–5% over 2 years). When compared to tamoxifen, the risk of getting a clinical fracture under AI treatment is increased by 35%–50%. In patients with prostate cancer, androgen deprivation therapy (ADT) increases bone turnover, reduces bone mass (4%–5% per year) and increases the fracture rate depending on the duration of therapy. Zoledronic acid can prevent accelerated bone loss induced by goserelin in premenopausal women, by letrozole in postmenopausal women and by ADT in men. More limited data indicate that weekly alendronate or risedronate could also be effective for preventing CTIBL. Initiation of therapy early, prior to the occurrence of severe osteoporosis, rather than after, may be more effective. Bisphosphonate treatment should be considered in osteoporotic but also in osteopenic patients if other risk factor(s) for fractures are present. [ABSTRACT FROM AUTHOR]

The i-DREAMS project established a 'Safety Tolerance Zone (STZ)' to maintain operators within safe boundaries through real-time and post-trip interventions, based on the crucial role of the human element in driving behavior. This paper aims to model the inter-relationship among driving task complexity, operator and vehicle coping capacity, and crash risk. Towards that aim, data from 80 drivers, who participated in a naturalistic driving experiment carried out in three countries (i.e., Belgium, Germany, and Portugal), resulting in a dataset of approximately 19,000 trips were collected and analyzed. The exploratory analysis included the development of Generalized Linear Models (GLMs) and the choice of the most appropriate variables associated with the latent variables "task complexity" and "coping capacity" that are to be estimated from the various indicators. In addition, Structural Equation Models (SEMs) were used to explore how the model variables were interrelated, allowing for both direct and indirect relationships to be modeled. Comparisons on the performance of such models, as well as a discussion on behaviors and driving patterns across different countries and transport modes, were also provided. The findings revealed a positive relationship between task complexity and coping capacity, indicating that as the difficulty of the driving task increased, the driver's coping capacity increased accordingly, (i.e., higher ability to manage and adapt to the challenges posed by more complex tasks). The integrated treatment of task complexity, coping capacity, and risk can improve the behavior and safety of all travelers, through the unobtrusive and seamless monitoring of behavior. Thus, authorities should utilize a data system oriented towards collecting key driving insights on population level to plan mobility and safety interventions, develop incentives for road users, optimize enforcement, and enhance community building for safe traveling. [ABSTRACT FROM AUTHOR]

This paper proposes a critical analysis of the NEET category. We argue that it is both too focused on individual responsibility and too homogenizing to enable the development of public policies and measures capable of responding to the needs of the most excluded youth. We respond to these needs using a qualitative approach that has allowed us to account for the diversity of young people, especially the most marginalized, living in lower-class neighborhoods of the Brussels region. Our approach generates a NEET/non-NEET typology that helps deconstruct NEET as a statistical category by identifying social situations that are both diverse and temporary. This typology challenges the tendency to reify young people and to hold them responsible for their own circumstances. Furthermore, our typology shows how NEET situations result from trajectories shaped by structural dynamics as well as relations and processes of inequality. These may stem from social class, experiences of migration, or the intersection of the two, and inevitably exercise an effect on both school and job market environments. [ABSTRACT FROM AUTHOR]

Aims: Multilingual families are often challenged with the transmission of their heritage language (HL) to future generations. Departing from this observation, this study aims to investigate which factors correlate with multilingual families' HL maintenance efforts. The variables taken into account are the families' language policy (FLP), advice from both Early Childhood Care and Education (ECCE) professionals and other (informal) sources, the parents' linguistic and educational resources, as well as their migration generation. Methodology: Exclusively quantitative in nature, the data for this study involve 776 multilingual families in the Flemish community of Belgium. Analysis: These data have subsequentially been subjected to two inferential analyses: a bivariate correlational analysis followed by a logistic regression for a more detailed understanding of the relations at play. Findings: The results indicate a positive correlation between families' policies and their HL maintenance efforts, in addition to confirming the independence of FLP's three components (beliefs, practices, and management). Furthermore, contrary to advice from ECCE professionals, advice from other sources is positively and significantly associated with HL maintenance efforts. Finally, families comprised of parents with access to higher linguistic and educational resources are less likely to try and pass on the HL to their children, probably favouring the acquisition of the institutional language (IL). Originality: This paper quantitatively explores factors that correlate with parental HL maintenance efforts using a large and language-diverse sample. This quantitative approach facilitates generalizations for future (qualitative) research and advice-giving bodies to build on. Significance: Our findings bring about greater insights into the motivation of parents concerning HL maintenance and could contribute to the advice given to multilingual families. [ABSTRACT FROM AUTHOR]

Research shows that older people tend to not only be underrepresented on television (TV), but also to be represented within a number of fixed types. These correspond to cultural myths about ageing, which emphasise vulnerability and decline but also increasingly stress the individual's responsibility for successful ageing. This paper analyses the representation of older people on Flemish public TV, using qualitative content analysis to identify patterns of representation in a sample of 44 programmes broadcast in 2019 and 2020, including the first months of the COVID-19 pandemic. To complement our own analysis, we also interviewed eight experts on ageing. Our research shows that representations of older people on Flemish public TV tend to gravitate towards two types related to different age groups: vulnerable and passive old-old people (over 80 years old), particularly those in nursing homes who feature prominently in reporting on the COVID-19 pandemic; and dynamic and active young-old people (65–80 years old), connected to the ideals of successful ageing. The two predominant types correspond to cultural myths about ageing and are also connected to recurrent themes: sexual intimacy, loneliness and death. Our research highlights the need for a more diverse representation, reflecting the variety of individual life conditions and the functional age of older people. [ABSTRACT FROM AUTHOR]

This correction notice addresses errors in the original article titled "In-Season Potato Crop Nitrogen Status Assessment from Satellite and Meteorological Data." The errors pertain to the grouping of tuber samples and the calculation of biomass per hectare. While these errors do not compromise the overall findings of the paper, they require minor corrections in the results and discussion sections. The corrected figures and details of the corrections are provided in the notice. The article discusses the assessment of potato crop nitrogen status using remote sensing and meteorological data, highlighting the relevance of assessing shoots biomass and nitrogen content. The study focuses on potato fields in Belgium and emphasizes the need for efficient monitoring and advisory systems for potato fertilization. [Extracted from the article]

Among the most important sociocultural phenomena of contemporary global societies, immigration brings significant changes to all areas of immigrants' life (family, profession, and quality of life), impacting their cultural identities, including identity associated with their language use. As migrants need to be understood in the languages they are proficient in, receive instruction in the destination language, and access essential services understandable to them, language becomes an indispensable agent of migration. In this context, our paper examines the impact of migration on the linguistic behaviour of immigrants, and recognising the pivotal role of language in facilitating the integration of immigrants into host societies. The study focuses on the circumstances Romanian immigrants within Belgium's multilingual milieu, illustrating the dimensions of the identity crisis they grapple with. Data analysis has shown that migration generates consistent changes regarding the immigrants' linguistic behaviour, driven, on the one hand, by their desire to be integrated in the host country and, on the other hand, by their attachment to the cultural heritage values of their country of origin. [ABSTRACT FROM AUTHOR]

The Member States of the European Union pledged to reduce greenhouse gas emissions by 80–95% by 2050. Shallow geothermal systems might substantially contribute by providing heating and cooling in a sustainable way through seasonally storing heat and cold in the shallow ground (<200 m). When the minimum yield associated with the installation of a cost-effective aquifer thermal energy storage (ATES) system cannot be met, borehole thermal energy storage, relying mostly on the thermal conductivity of the ground, is proposed. However, for large-scale applications, this requires the installation of hundreds of boreholes, which entails a large cost and high disturbance of the underground. In such cases, ATES systems can nevertheless become interesting. This paper presents a case study performed on a Ghent University campus (Belgium), where the feasibility of ATES in an area with a low transmissivity was determined. The maximum yield of the aquifer was estimated at 5 m3/h through pumping tests. Although this low yield was attributed to the fine grain size of the aquifer, membrane filtering index tests and long-term injection tests revealed that the clogging risk was limited. A groundwater model was used to optimize the well placement. It was shown that a well arrangement in a checkerboard pattern was most effective to optimize the hydraulic efficiency while maintaining the thermal recovery efficiency of the ATES system. Hence, for large-scale projects, efficient thermal energy storage can also be achieved using a (more cost-effective) ATES system even in low-permeability sediments. [ABSTRACT FROM AUTHOR]

Historical re-enactments have become an increasingly popular topic in academic debate, as some scholars argue that re-enactments allow participants to critically investigate history and its representations. As a pastime dominated by men, most literature on war re-enactment and gender, however, has emphasized the subordinate position of women and the reproduction of conventional gender roles. This paper focuses on two European women re-enactment groups that challenge this understanding: Die Flakhelferinnen in the Wehrmacht of Nazi Germany and the Army Nurse Corps of the United States. Based on a visual ethnography of their Instagram combined with fieldwork in the Czech Republic and Belgium, I analyse the strategies these reenactors use in the remediation of the 'invisible' histories of women in the armed forces during WWII. The analysis demonstrates a complex negotiation between historical notions of 'femininity', contemporary identities, and Instagram's affordances in the remediation of gendered pasts. [ABSTRACT FROM AUTHOR]

Does federalism fuel tensions in divided states? This paper addresses this question from a power-sharing angle. It provides a longitudinal analysis of the evolution of ethno-territorial conflict during five waves of federalization in a least-likely case: Belgium (1979–2018). Two original datasets on all cabinet conflicts (N = 1013; N = 328) provide an unprecedented picture of ethno-territorial conflict's intensity, nature, and frequency (absolute/relative). All indicators forcefully contradict the paradox thesis. Conflict did not increase. If anything, there is a tentative decline. Exposing intra-segmental and segmentally mixed conflicts, this study also challenges conventional views on factors like bipolarity and the repercussions of split party systems. [ABSTRACT FROM AUTHOR]

Background: Aphasia can affect the communication between the person with aphasia (PWA) and the communication partner (CP). It is therefore necessary to support both the PWA and their CPs. Communication partner training (CPT) focuses on training communication between dyads of whom one person has aphasia. Although there is increasing evidence supporting CPT as an effective intervention to improve communication and reduce the psychosocial consequences of stroke, implementation in clinical practice remains limited. Aim: To understand the mechanisms behind the practice–evidence gap currently hindering CPT implementation, this study investigated the role of (1) education, (2) concept knowledge, (3) work setting and (4) clinical experience in CPT. Methods & Procedures: Flemish speech and language therapists (SLTs) clinically involved in aphasia rehabilitation were surveyed online regarding CPT. Statistical analyses include descriptive statistics to report survey results and non‐parametric group comparisons to investigate the role of the four variables on CPT. Outcomes & Results: In this study 72 SLTs were included, of whom 73.61% indicated they deliver CPT but of whom only 43.10% indicated CP presence during therapy. The most frequently identified barriers to CPT delivery were lack of time and CPT‐specific knowledge. Other barriers were lack of resources, work setting dependent factors, PWA or CP dependent factors, individual therapy to the PWA being of higher priority, existing CPT methods and interventions being perceived as unclear and feeling uncertain about CPT delivery. Concerning the role of the four variables on CPT delivery, neither education nor concept knowledge had a significant effect on CPT delivery. Work setting and clinical experience did, however, influence CPT delivery. More specifically, CPT delivery and CP presence were higher in the private practice (chronic phase) compared to the other three settings and experienced SLTs deliver CPT more often compared with less experienced SLTs. Conclusions & Implications: To reduce the practice–evidence gap, we suggest prioritising the two most frequently identified barriers, that is, lack of time and CPT‐specific knowledge. To overcome the time barrier in CPT, we propose implementing automated natural speech analysis to reduce the workload. To enhance CPT‐specific knowledge, speech and language therapy curricula should provide more in‐depth theory and hands‐on practice for CPT. In addition, increased awareness about CPT‐specific methods is needed to further support clinical practice. WHAT THIS PAPER ADDS: What is already known on the subject: Communication partner training (CPT) is an effective intervention to improve communication and reduce the psychosocial consequences of stroke. Despite this evidence base, a current practice–evidence gap exists. What this study adds: This is the first study to characterise CPT delivery in a Flemish cohort of speech and language therapists (SLTs). In addition, on a more international perspective, few studies have investigated the role of education, concept knowledge, work setting and clinical experience in CPT. We found that neither education nor concept knowledge has a significant effect on CPT delivery. CPT delivery and communication partner presence are significantly higher in the private practice compared to the hospital, rehabilitation centre or nursing home settings. Experienced SLTs deliver CPT more often compared with less‐experienced SLTs. The two most prominent reported barriers include lack of time and CPT‐specific knowledge. What are the clinical implications of this work?: This study suggests reducing the practice–evidence gap by alleviating the main barriers identified, that is, lack of time and CPT‐specific knowledge. Time‐barriers can be addressed by implementing automated natural speech analyses. We additionally advocate for more in‐depth theory and hands‐on practice for CPT in speech and language therapy curricula. [ABSTRACT FROM AUTHOR]

In Belgium, an extensive corrosion program on a wide range of metals has been studied as candidate container material, which is considered in the geological disposal concept of high‐level radioactive waste or spent fuel. This paper presents an overview of the corrosion studies initiated by SCK CEN more than 40 years ago. The experiments conducted in these studies were conceived based on early disposal designs, that is, designs in which the radioactive waste was to be enclosed in a metallic overpack that would be directly emplaced in an argillaceous environment. A step‐wise approach was adopted consisting of laboratory screening studies, detailed studies, and demonstration tests. The screening studies included accelerated tests, conducted in a surface laboratory, and exposure tests carried out either in autoclaves or in the field in a surface clay quarry. The detailed studies involved both in situ and laboratory experiments. Gradually, the emphasis shifted from basic research to large‐scale integrated demonstration experiments enabling the simultaneous study of different parameters and/or processes and their coupling. [ABSTRACT FROM AUTHOR]

While economic voting theory assumes that voters respond to economic conditions, critics have argued that most voters lack an adequate understanding of key national economic indicators. In this paper, we investigate the occurrence of a neighbourhood effect, where citizens can observe unemployment levels in their own local communities. Using both official statistics and survey data of three recent election studies in Belgium, we assess whether local unemployment levels are associated with the assessment of the national economy, and incumbent voting. While the results show that the local unemployment level is strongly associated with the assessment of the national economy, results regarding a direct association with supporting incumbent political parties are mixed. We argue that the neighbourhood effect is an important mechanism in economic voting, as citizens react to a neighbourhood effect in their assessment of the state of the national economy. [ABSTRACT FROM AUTHOR]

The prevalence of Attention-Deficit/Hyperactivity Disorder (ADHD) diagnoses and medication use has increased over time around the world, but significant regional differences remain. This paper aims to determine and explain disparities in ADHD prevalence and medication use among school-aged children in two distinct school systems, in Flanders (Belgium) and Québec (Canada). We present detailed descriptive and comparative analyses of data from 35 schools, 114 teachers, and 1046 parents (children) that were collected as part of a comparative international project. The data concern teacher and parent suspicions, teachers' ratings of ADHD-related behaviors in children, teachers' views of medication use, and teachers' beliefs about ADHD. The results show that, compared with Flanders, Québec had significantly more children diagnosed with ADHD and more frequent suspicions of ADHD in children by teachers and parents. We refer to the conceptual, institutional, and interactional levels of medicalization to interpret our findings and conclude that social and cultural readings of children's behaviors differ greatly between regions. Medicalization of children's behaviors is more common in Québec than in Flanders. [ABSTRACT FROM AUTHOR]

Introduction: Cancer causes a substantial burden to our society, both from a health and an economic perspective. To improve cancer patient outcomes and lower society expenses, early diagnosis and timely treatment are essential. The recent COVID-19 crisis has disrupted the care trajectory of cancer patients, which may affect their prognosis in a potentially negative way. The purpose of this paper is to present a flexible decision-analytic Markov model methodology allowing the evaluation of the impact of delayed cancer care caused by the COVID-19 pandemic in Belgium which can be used by researchers to respond to diverse research questions in a variety of disruptive events, contexts and settings. Methods: A decision-analytic Markov model was developed for 4 selected cancer types (i.e. breast, colorectal, lung, and head and neck), comparing the estimated costs and quality-adjusted life year losses between the pre-COVID-19 situation and the COVID-19 pandemic in Belgium. Input parameters were derived from published studies (transition probabilities, utilities and indirect costs) and administrative databases (epidemiological data and direct medical costs). One-way and probabilistic sensitivity analyses are proposed to consider uncertainty in the input parameters and to assess the robustness of the model's results. Scenario analyses are suggested to evaluate methodological and structural assumptions. Discussion: The results that such decision-analytic Markov model can provide are of interest to decision makers because they help them to effectively allocate resources to improve the health outcomes of cancer patients and to reduce the costs of care for both patients and healthcare systems. Our study provides insights into methodological aspects of conducting a health economic evaluation of cancer care and COVID-19 including insights on cancer type selection, the elaboration of a Markov model, data inputs and analysis. [ABSTRACT FROM AUTHOR]

Les goûts et les couleurs ne se discutent pas, la primauté et l'effet direct ne cessent de se discuter. While it is pointless to discuss matters of tastes and colours, the legal scholarship has not ceased to see the benefit of discussing the cornerstone principles of primacy and direct effect. This debate persisted due to the perceived inconsistencies in the case law of the Court of Justice of the EU on the matter, seemingly requiring provisions of Union law to have direct effect before allowing them to generate independent effects vis-à-vis conflicting national measures before national courts in some cases, while letting go of this requirement in others. After decades of lively discussion, clarity was finally provided by the Court in Popławski II and Thelen Technopark, where it stated that for such independent effects to be generated on the basis of Union law by itself, direct effect is indeed necessary. After exploring this debate, the paper veers west of Luxembourg in inquiring whether this clarification is likely to alter the future case law of Belgium's highest administrative court, the Conseil d'État. Analysis of selected cases shows that, despite legal scholarship questioning the consistency and necessity of such a requirement, the Conseil d'État can be considered to generally require provisions of Union law to have direct effect before allowing them to generate independent effects in the dispute at hand by virtue of their precedence over conflicting national measures. No change in the case law of the Conseil d'État is thus likely to follow the clarifications to the decade-old debate on the role of primacy and direct effect by the Court in Popławski II and Thelen Technopark. [ABSTRACT FROM AUTHOR]

When conducting a postal survey, a traditional recommendation is to use paper postage stamps instead of an automated postage system, to make sure that invitations have a more personal and attractive appearance. In this research note, we investigate whether this traditional recommendation is still valid. In the autumn of 2020, a postal survey was conducted among high-school teachers in Belgium strictly adhering to the Dillman protocol. The overall response rate was 43.4%. Invitations with a real paper postage stamp had a three-percentage points higher response rate (44.9% versus 41.8%), but this difference proved not to be significant. There are no significant gender or age differences between the groups. In addition, the presence or absence of a paper stamp did not influence the respondents' choice for answering the questionnaire online or on paper, as those who received a stamped envelope were equally likely to choose the online answering tool. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to measure the extent to which students possess the necessary competences of an employable graduate, the authors explored the development and validation of a questionnaire that measures employability competences of students in higher education through combining insights from higher education and workplace learning literature. Design/methodology/approach: The paper aims to develop and validate the questionnaire a systematic literature review and factor analyses were conducted. The authors applied the questionnaire to two different groups of students. First, to undergraduate students in an applied sciences program in Belgium (N = 935). The dataset was randomly divided into two subsets to conduct an exploratory and a confirmatory factor analysis. Next, another confirmatory factor analysis was done to cross-validate the factor structure found. For this, the questionnaire was offered to a group of undergraduate and graduate students at a university in The Netherlands (N = 995). Findings: The results support a model of employability based on combined insights from higher education and workplace learning literature. The model consists of the following seven factors: social competences, e-literacy, efficacy beliefs, flexibility, healthy work–life balance, lifelong learning and oral and written communication. Originality/value: The questionnaire can be utilized to screen students' employability profiles and examine the relationship between teaching practices and students' employability competences. [ABSTRACT FROM AUTHOR]

This paper examines the impact of the legal rhythms and temporalities of migration on the specific temporalities of family life, under conditions of enforced temporariness. It apprehends enforced temporariness as a mode of governance infused with chronopolitics, which – by producing specific experiences of time – deprives migrants of the right/capacity to lead their family lives according to their plans and aspirations. Through a focus on highly qualified third-country nationals holding temporary visas in Belgium, it shows that these experiences of time result from the friction between the institutional timescale of administrative procedures and policies, and migrants' everyday and biographic timescales. Starting from the administrative timescales of highly-skilled migrants, the paper describes the existing Belgian migration legislation, with a focus on administrative procedures. It then explores the specific experiences of time those procedures generate, by highlighting different kinds of friction migrants experience as well as their effects. It presents some of the ways these migrants cope with them, and concludes by highlighting the fruitfulness of applying a friction lens to the study of intersecting timescales. [ABSTRACT FROM AUTHOR]