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During leisure-time activities, young people expose themselves regularly to sound levels that may hamper the auditory system. In Flanders (Belgium), there is a noise legislation for indoor and outdoor music venues whereby a distinction is made into three categories of maximum allowable sound levels and accompanying measures. The aim of the current study was to investigate the knowledge and personal opinion of organisers of music festivals regarding this noise legislation. An online questionnaire was answered by 36 music festival organisers. In general, the categories of (non-)classified facilities with maximum allowable sound levels and accompanying measures were not well known by the respondents. Most respondents were moderately prepared to apply the noise legislation at music festivals and most of them indicated the noise legislation is moderately financially feasible and very logistically feasible. The correctness of the answers to some knowledge questions was significantly different between the degree of being informed, the perception of intelligibility of the received information, and the financial and logistical feasibility of the noise legislation. Compliance with the noise legislation at music venues should be further investigated, along with a refreshing of the information that was made available to increase knowledge and awareness of the risks of noise exposure among organisers of music events. [ABSTRACT FROM AUTHOR]

The ongoing popularity in some second and third generation migrants in Western Europe of marrying a partner from the countries of origin of their (grand)parents is considered to be problematic for micro and macro level societal integration of some migrant populations. Partner choice and marriage practices in migrant communities are problematized in public, media and political discourses by discriminating them from marriage practices in the 'native' population on the basis of three related dichotomies: (1) agency versus structure, (2) us versus them and (3) romantic versus instrumental marriage intentions dichotomies. By means of in-depth qualitative research methodologies on the partner choice processes of women and men of Turkish, Moroccan, Algerian, Tunisian, Punjabi Sikh, Pakistani and Albanian descent in Belgium and an intersectional theoretical approach, this article aims to deconstruct popular and simplifying dichotomous representations of partner choice processes in these migrant populations. Our study reveals how religious, gender and social class boundaries are stretched to meet personal/individual desires and preferences. Individuals do experience social restrictions when it concerns social group boundaries and the potential partners that they can look for. At the same time individuals are never fully determined by their social environment, they creatively develop strategies to by-pass certain restrictions and to some extent are able to meet their personal needs while being sensitive to the desires of their social environment. [ABSTRACT FROM AUTHOR]

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Through in-depth qualitative research with Russian-speaking female migrants in Belgium, the present paper aims to deconstruct the category of 'Russian female marriage migrants'. By explicitly interrogating Russian-speaking women's own or co-ethnics' choice for a Belgian partner, their perceptions of Belgian men's preference for a Russian-speaking wife and their experienced (mixed couple) life in Belgium, we highlight the diversity within the group of Russian-speaking female marriage migrants in Belgium. The intersectional approach permits us to uncover social categories and power relations fundamentally shaping Russian-speaking females' senses of identity and (self-)representations, how these categories and power relations intersect, and what intersections are particularly salient in certain situations. Intersectionality is used as a theoretical approach and a methodology. [ABSTRACT FROM AUTHOR]

We report on quartz Optically Stimulated Luminescence (OSL) dating of the infill of 14 relict sand wedges and composite-wedge pseudomorphs at 5 different sites in Flanders, Belgium. A laboratory dose recovery test indicates that the single-aliquot regenerative-dose (SAR) procedure is suitable for our samples (measured to a given dose ratio 0.980 ± 0.005; n=139). Completeness of resetting of the wedge infill of two samples was confirmed by single-grain analyses. The suite of optical ages indicates that repeated thermal contraction cracking, degradation and infilling with wind-blown sediment appear to have been commonplace in Flanders during the Late Pleniglacial (Oxygen Isotope Stage 2; OIS2); more specifically, around the Last Glacial Maximum (LGM, ∼21 kyr ago) and the transition period between the LGM and the start of the Lateglacial (∼15 kyr ago). Optical dating at one site has revealed two significantly older wedge levels, the younger inset into the older; the younger wedge has an age of 36 ± 4 kyr (Middle Pleniglacial; OIS3), the older wedge 129 ± 11 kyr, which points to formation during the Late Saalian (OIS6). Our OSL ages of the wedges and host sediments bracket formation of the BGB (Beuningen Gravel Bed: a widespread deflation horizon in northwestern Europe) at between ∼15 and 18 kyr; this is in good agreement with previous OSL dating studies. We conclude that optical dating using quartz SAR OSL establishes an absolute chronology for these periglacial phenomena and allows secure palaeoenvironmental reconstructions to be made. [ABSTRACT FROM AUTHOR]

Background: We conducted a nationwide survey to describe the in-and out-of-hospital flow (diagnosis, treatment and follow-up) of patients with heart failure with reduced ejection fraction (HFrEF)., Method: A survey was developed with five dedicated HF cardiologists. The data are all self-reported by cardiologists., Results: The response rate was 84%. Presence of a dedicated HF cardiologist or HF nurse was indicated by 49% and 46% of the hospitals respectively. Devices ( p  < .05), angiotensin receptor neprilysin inhibitors, and rehabilitation are considered more standard of care therapy by dedicated compared to non-dedicated HF cardiologists. Most cardiologists indicated that target dosages of HF drugs can be reached in 25‒75% of patients. Achieving >75% of the target dose seems easier for angiotensin converting enzyme inhibitor/angiotensin receptor blockers (ACEI/ARB) (22%) and mineralocorticoid receptor antagonists (25%), compared to β-blockers (10%) and angiotensin receptor neprilysin inhibitors (7%). 62%, 49% and 4% of the cardiologists indicated to use subtypes of angiotensin converting enzyme inhibitors, angiotensin receptor blockers and β-blockers respectively not validated in the HF population. In the acute setting, dedicated HF cardiologists (23%) are less influenced by blood parameters for decongestion compared to non-dedicated HF cardiologists (39%). They tend to change patients more to guideline-recommended drugs (60% vs 47%). Six minutes walk test and ergospirometry are significantly more used by dedicated compared to non-dedicated HF cardiologists for HF drug change (17% and 29% vs 2% and 4%)., Conclusion: This survey showed that a minority of hospitals have HF care. Those that do, report a higher implementation of guideline-recommended diagnosis, treatment and follow-up of HF patients. Competent authorities could use this survey as a tool to improve HF care.

Background: The uptake rate of non-vitamin K oral anticoagulants (NOAC) for the treatment of non-valvular atrial fibrillation (AF) was far lower in the Netherlands (NL) compared to Belgium (BE). Also, patients on VKA in NL were treated with a higher target international normalized ratio (INR) range of 2.5 to 3.5., Objectives: To explore the effect of these differences on thromboembolism (TE) and bleeding., Methods: Data from the GARFIELD-AF registry was used. Patients with new-onset AF and ≥1 investigator-determined risk factor for stroke were included between 2010 and 2016. Event rates from 2 years of follow-up were used., Results: In NL and BE, 1186 and 1705 patients were included, respectively. Female sex (42.3% vs 42.2%), mean age (70.7 vs 71.3 years), CHA 2 DS 2 -VASc (3.1 vs 3.1), and HAS-BLED score (1.4 vs 1.5) were comparable between NL and BE. At diagnosis in NL vs BE, 72.1% vs 14.6% received vitamin K antagonists (VKA) and 17.8% vs 65.5% NOACs, varying greatly across cohorts. Mean INR was 2.9 (±1.0) and 2.4 (±1.0) in NL and BE, respectively. Event rates per 100 patient-years in NL and BE, respectively, of all-cause mortality (3.38 vs 3.90; hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.65-1.15), ischemic stroke/TE (0.82 vs 0.72; HR 1.14, 95% CI 0.62-2.11), and major bleeding (2.06 vs 1.54; HR 1.33, 95% CI 0.89-1.99) did not differ significantly., Conclusions: In GARFIELD-AF, despite similar characteristics, patients on anticoagulants were treated differently in NL and BE. Although the rate of major bleeding was 33% higher in NL, variations in bleeding, mortality, and TE rates were not statistically significant., (© 2020 The Authors. Journal of Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis.)

Background: During fractional flow reserve (FFR) measurement, the simple presence of the guiding catheter (GC) within the coronary ostium might create artificial ostial stenosis, affecting the hyperemic flow. We aimed to investigate whether selective GC engagement of the coronary ostium might impede hyperemic flow, and therefore impact FFR measurements and related clinical decision-making., Methods: In the DISENGAGE (Determination of Fractional Flow Reserve in Intermediate Coronary Stenosis With Guiding Catheter Disengagement) registry, FFR was prospectively measured twice (with GC engaged [FFR eng ] and disengaged [FFR dis ]) in 202 intermediate stenoses of 173 patients. We assessed (1) whether ΔFFR eng -FFR dis was significantly different from the intrinsic variability of repeated FFR measurements (test-retest repeatability); (2) whether the extent of ΔFFR eng -FFR dis could be clinically significant and therefore able to impact clinical decision-making; and (3) whether ΔFFR eng -FFR dis related to the stenosis location, that is, proximal and middle versus distal coronary segments., Results: Overall, FFR significantly changed after GC disengagement: FFR eng 0.84±0.08 versus FFR dis 0.80±0.09, P <0.001. Particularly, in 38 stenoses (19%) with FFR values in the 0.81 to 0.85 range, GC disengagement was associated with a shift from above to below the 0.80 clinical cutoff, resulting into a change of the treatment strategy from medical therapy to percutaneous coronary intervention. The impact of GC disengagement was significantly more pronounced with stenoses located in proximal and middle as compared with distal coronary segments (ΔFFR eng -FFR dis , proximal and middle 0.04±0.03 versus distal segments 0.03±0.03; P =0.042)., Conclusions: GC disengagement results in a shift of FFR values from above to below the clinical cutoff FFR value of 0.80 in 1 out of 5 measurements. This occurs mostly when the stenosis is located in proximal and middle coronary segments and the FFR value is close to the cutoff value.

Background: AF, anticoagulation, NOACs, changing patterns of prescription. Methods: We describe baseline data and treatment patterns of patients recruited in Belgium in the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF). Recruitment began when novel oral anticoagulants (NOACs) were introduced and provides a unique picture of changing treatment patterns over time. 1713 patients with a new (≤6 weeks duration) diagnosis of non-valvular atrial fibrillation (NVAF) and at least one investigator-defined stroke risk factor were recruited between May 2012 and August 2016, and will be prospectively followed for at least 2 years. Results: Overall, anticoagulant use in Belgium was higher than in the rest of Europe: 80.1% of patients received an anticoagulant ± antiplatelet (AP) therapy (14.5% on vitamin K antagonists; 65.6% on NOAC), 10.7% AP therapy and 9.3% no antithrombotic therapy. Over time, we observed an increase in anticoagulant use and a decrease in AP use for stroke prevention. NOAC use in Belgium was the highest of Europe at the study start, with many countries catching up later. In high stroke risk patients (CHA 2 DS 2 -VASc ≥2), anticoagulants were used in 84.3%, leaving 15.7% unprotected. In low risk patients (CHA 2 DS 2 -VASc 0-1) anticoagulants were overused (58.7%). Factor Xa inhibitors were used more frequently than direct thrombin inhibitors. Conclusion: Guideline adherence on stroke prevention was higher in Belgium than in the rest of Europe, and increased over time. NOAC use in Belgium was the highest of Europe at the study start, with many countries catching up later. Possible reasons are discussed. Clinical Trial Registration: http://www.clinicaltrials.gov . Unique identifier: NCT01090362.