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This study aims to understand how gender diversity and gender attitudes are linked to the sexual well-being of young adolescents. Data was collected among 561 adolescents in secondary schools in Flanders and binary logistic regressions were performed. Gender diversity was conceptualized as gender identity, gender expression, sex assigned at birth, sexual orientation and personal gender attitudes. Whereas "like to become a wo/man" and body image were used as measures for sexual well-being. Age and migration were added as covariates. The data illustrates that gender diversity is present among young adolescents and that it can be linked to young adolescent's body image and liking to become a wo/man. In addition, it shows how diverse sets of gender attitudes are differently associated with sexual well-being outcomes. The findings also suggest the internalization of patriarchal and heterosexual societal norms by the respondents. The results indicate an association between on the one hand gender diversity and gender attitudes and on the other hand adolescent sexual well-being. Furthermore, it suggests that gender transformative research and programs that aim to improve adolescent sexual health and well-being should carefully choose their gender focus and invest in improving gender equity beyond the individual level. Additional research is needed to investigate the association between gender diversity and adolescent sexual wellbeing among diverse sexual well-being conceptualizations and specific groups (gender, ethnic, and others) of young adolescents.

When the biocultural landscape differs from the country of origin, migrants develop strategies to maintain ethnobotanical habits and/or adapt them to the new environment. We conducted 30 semistructured interviews with people of Congolese descent to investigate medicinal plant use among the Congolese community (Democratic Republic of Congo) in Belgium. Participants were selected through snowball sampling and purposive sampling. We collected data on the plants used, administration methods, origins of used plants, and methods of obtaining plant material and recorded the use through free-listing. Our analysis focused on plant use, medicinal use values, geographic distributions, and plant obtention strategies. We recorded 86 plant species from 41 plant families used to treat 112 conditions. The species with the highest medicinal use value were Zingiber officinale Roscoe., Citrus limon (L.) Burm. f., and Lippia multiflora Moldenke. Plant species with the highest use values were brought from Congo to Belgium by the participants or their acquaintances. The used plants were mainly obtained through formal and informal trade.. The effects of urbanization and globalization were visible in the high diversity of plants from a wide range of geographical origins. However, the large proportion of plant species with a global or pantropic species distribution revealed that the set of used plant species is subject to biotic homogenization. [ABSTRACT FROM AUTHOR]

Background: The use of medicinal plants is integral to global healthcare systems, with Sub-Saharan Africa maintaining a robust tradition of herbal medicine alongside Western-oriented healthcare. As migrant communities tend to continue traditional herbal practices after migration, documenting this use is vital to develop culturally sensitive healthcare. This study investigates plant usage and perspectives in the context of sexual and reproductive health among the Congolese community in Belgium, particularly in the Matongé quarter of Brussels. Our research questions were: (1) What is the current knowledge of medicinal plants among the Congolese community in Belgium in the context of sexual health, and what are the applications and commonly employed administration methods of these plants? (2) What role does herbal medicine play in the context of sexual health for people of Congolese descent in Belgium and how this is influenced by perceptions of sexuality? and (3) Is there a gender bias in the use of medicinal plants, and if so, can this be related to perceived gender norms? Methods: We conducted 22 semi-structured interviews with people of Congolese descent currently living in Belgium. Participants were selected using both snowball sampling and purposive sampling. Plant use in the context of sexual health was recorded through freelisting. Data on narratives, ideas, and perceptions of this plant use in the context of sexual health were collected. Interview transcripts were analyzed using thematic analysis. Results: We identified 17 plant species used for sexual health. Three overarching themes emerged from our data. Plants were used with a notable gender bias favoring male sexual potency enhancement. Men used these plants for both remedying potency issues and enhancing sexual prowess. In contrast, knowledge about plants for female sexual health was limited. Gender norms reinforced the importance of male sexual potency, while stigmatizing open discussions of female sexuality. Conclusions: The use of medicinal plants for sexual health raises health, social, and conservation concerns, underscoring the need for further research in this area. This study contributes to understanding medicinal plant use within the Congolese community in Belgium and highlights the necessity for future research on herbal practices for female sexual health in this context. [ABSTRACT FROM AUTHOR]

Background: In Self-Determination Theory (SDT), a well-validated macro-theory on human motivation, a distinction is made between internally controlling teaching practices (e.g. guilt-induction and shaming) and externally controlling practices (e.g. threats and punishments, commands). While both practices are said to undermine students' motivation, they would do so through somewhat differential motivational processes. Unfortunately, the relevance of the conceptual distinction between internally and externally controlling strategies has not been examined systematically. In the context of sport and physical education (PE), most studies on controlling teaching have either measured controlling teaching in an undifferentiated way or have focused on one particular feature of controlling teaching. Purpose: The purpose of this study was to provide a more fine-grained picture on the differential de-motivational effects of internally and externally controlling teaching strategies in the domain of PE. Participants: A total of 925 students with an average age of 15.80 years (±1.99) coming out of 92 classes taught by 22 different PE teachers participated in the present study. Data analysis: Data on perceived controlling teaching style and students' motivation were analyzed within a multilevel framework from both a variable-centered (regression analyses) and person-centered approach (cluster analyses). Results: We found evidence for a distinction between perceived internally and externally controlling teaching. Both teaching styles were strongly related to each other (r = 0.54). At the level of zero-order correlations, both internally and externally controlling teaching related negatively to students' intrinsic motivation and identified regulation and related positively to introjected regulation, external regulation, and amotivation. However, when both teaching styles were included simultaneously as predictors of motivation in the regression analyses, only internally controlling teaching predicted poor quality and low quantity of motivation. A cluster analysis revealed different profiles of perceived controlling teaching style, with two profiles being characterized by either high or low levels of the two types of controlling teaching and other profiles displaying elevated or reduced levels of one of the types of controlling teaching. This person-centered analysis confirmed that particularly students who perceive their PE teacher as internally controlling are likely to report poor-quality motivation. Conclusion: Controlling teaching (and internally controlling teaching in particular) is related to maladaptive motivational outcomes. As such, it can be advised to PE-practitioners to refrain from using controlling strategies when teaching students. More research is needed to identify the conditions under which teachers' behavior is perceived as externally and/or internally controlling.

Given the weak intrinsic reading motivation of many adolescents on the one hand and the importance of this type of motivation for reading competence on the other hand, the aim of the present study is to identify the related role of teacher behavior. To pursue this aim, a secondary analysis was carried out on PISA 2009 data. More particularly, data of a subsample of 4,269 Flemish 15-year olds were examined by means of multilevel modeling. In line with self-determination theory, the results provide evidence for the significance of perceived autonomy-supportive, structured, and involved teacher behavior. Teacher involvement was most strongly associated with adolescents' intrinsic reading motivation. Further, students' perception of teachers' autonomy support was particularly related to girls' intrinsic reading motivation.

Purpose: The purpose of this study was to investigate the influence of sign characteristics in a key word signing (KWS) system on the functional use of those signs by adults with intellectual disability (ID). Method: All 507 signs from a Flemish KWS system were characterized in terms of phonological, iconic, and referential characteristics. Phonological and referential characteristics were assigned to the signs by speech-language pathologists. The iconicity (i.e., transparency, guessing the meaning of the sign; and translucency, rating on a 6-point scale) of the signs were tested in 467 students. Sign functionality was studied in 119 adults with ID (mean mental age of 50.54 months) by means of a questionnaire, filled out by a support worker. Results: A generalized linear model with a negative binomial distribution (with log-link) showed that semantic category was the factor with the strongest influence on sign functionality, with grammatical class, referential concreteness, and translucency also playing a part. No sign phonological characteristics were found to be of significant influence on sign use. Conclusion: The meaning of a sign is the most important factor regarding its functionality (i.e., whether a sign is used in everyday communication). Phonological characteristics seem only of minor importance.

Self-determination theory (SDT) has served as a theoretical framework for considerable research on teaching behavior and student motivation. The majority of studies have focused on need-supportive teaching behavior at the expense of need-thwarting teaching behavior (i.e., the "dark side" of teaching). The goal of the present study was to examine motivational dynamics involved in controlling teaching behavior in the context of physical education (PE). The majority of studies on observed teaching behavior were conducted in the laboratory. To augment the ecological validity in the present study, the behavior of PE teachers was videotaped to rate their controlling teaching behavior in a real-life setting. In a sample of 56 teachers and 702 secondary school students, controlling teaching behavior during a specific PE class, as observed by external raters, was related positively to students' perceived controlling teaching behavior and, through these perceptions, to controlled motivation and amotivation. These associations were obtained in spite of the low incidence of controlling teaching behaviors, suggesting that students may be quite sensitive to controlling teaching behaviors. No associations were found between observed controlling behavior and student autonomous motivation and students' perceptions of autonomy-supportive teaching. Practical implications and recommendations for PE teachers' professional development training are included.

Background: Medication reviews are a structured critical evaluation of a patient's pharmacotherapy, carried out by a healthcare professional, but are not yet a routine pharmaceutical service in Belgium. A pilot project to initiate an advanced medication review (= type 3 medication review) in community pharmacies was set up by the Royal Pharmacists' Association of Antwerp. Aim: To investigate the experiences and opinions of patients who participated in this pilot project. Method: Qualitative study through semi-structured interviews with participating patients. Results: Seventeen patients from six different pharmacies were interviewed. The medication review process with the pharmacist was perceived as positive and instructive by fifteen interviewees. The extra attention that the patient received was highly appreciated. However, the interviews revealed that patients did not fully understand the purpose and structure of this new service or were aware of the subsequent contact and feedback with the general practitioner. Medication reviews in the home setting put patients more at ease, were highly appreciated, and enabled also to address practical problems such as drug dosing or storage requirements. Conclusion: This qualitative study analysed patients' experiences during a pilot project on the implementation of type 3 medication review. Although most patients were enthusiastic about this new service, a lack of patients' understanding of the whole process was also observed. Therefore, better communication to patients by pharmacists and general practitioners about the goals and components of this type of medication review is needed, with the added benefit of increased efficiency. [ABSTRACT FROM AUTHOR]

Despite recognition that sexual well-being is an important part of adolescent sexual and reproductive health, a clear description of adolescent sexual well-being does not yet exist. Through six in-depth interviews and four focus group discussions with 56 young people in two distinct contexts (Belgium and Ecuador), we used the social-ecological framework to identify factors influencing adolescent sexual well-being. According to respondents, the main factors that influence adolescent sexual well-being are not only situated at the individual (having knowledge and skills and being physically, sexually and mental mature and healthy) and interpersonal levels (positive attraction towards others and communication about sexuality), but at a broader societal level, including social acceptance of sex, gender and sexual diversity and its (legal) translation into comprehensive sexuality education and the ready availability of contraceptives. Our results go well beyond two existing definitions of (adolescent) sexual well-being to contribute to understanding and measurement from the perspective of young people themselves, adding substantively to ongoing discussion about the definition of the concept. [ABSTRACT FROM AUTHOR]

This survey reports on the DNA identification and occurrence of Culex torrentium and Cx. pipiens s.s. in Belgium. These native disease-vector mosquito species are morphologically difficult to separate, and the biotypes of Cx. pipiens s.s. are morphologically indistinguishable. Culex torrentium and Cx. pipiens s.s. were identified using the COI and ACE2 loci. We recorded 1248 Cx. pipiens s.s. and 401 Cx. torrentium specimens from 24 locations in Belgium (collected between 2017 and 2019). Culex pipiens biotypes pipiens and molestus, and their hybrids, were differentiated using fragment-size analysis of the CQ11 locus (956 pipiens and 227 molestus biotype specimens, 29 hybrids). Hybrids were observed at 13 out of 16 sympatric sites. These results confirm that both species are widespread in Belgium, but while Cx. torrentium revealed many COI haplotypes, Cx. pipiens s.s. showed only one abundant haplotype. This latter observation may either reflect a recent population-wide demographic or range expansion, or a recent bottleneck, possibly linked to a Wolbachia infection. Finally, new evidence is provided for the asymmetric but limited introgression of the molestus biotype into the pipiens biotype. [ABSTRACT FROM AUTHOR]

To mitigate the massive COVID-19 burden caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), several vaccination campaigns were initiated. We performed a single-center observational trial to monitor the mid- (3 months) and long-term (10 months) adaptive immune response and to document breakthrough infections (BTI) in healthcare workers (n = 84) upon BNT162b2 vaccination in a real-world setting. Firstly, serology was determined through immunoassays. Secondly, antibody functionality was analyzed via in vitro binding inhibition and pseudovirus neutralization and circulating receptor-binding domain (RBD)-specific B cells were assessed. Moreover, the induction of SARS-CoV-2-specific T cells was investigated by an interferon-γ release assay combined with flowcytometric profiling of activated CD4+ and CD8+ T cells. Within individuals that did not experience BTI (n = 62), vaccine-induced humoral and cellular immune responses were not correlated. Interestingly, waning over time was more pronounced within humoral compared to cellular immunity. In particular, 45 of these 62 subjects no longer displayed functional neutralization against the delta variant of concern (VoC) at long-term follow-up. Noteworthily, we reported a high incidence of symptomatic BTI cases (17.11%) caused by alpha and delta VoCs, although vaccine-induced immunity was only slightly reduced compared to subjects without BTI at mid-term follow-up. [ABSTRACT FROM AUTHOR]

Background: As a hard-hit area during the COVID-19 pandemic, Belgium knew the highest mortality among people from sub-Saharan African descent, compared to any other group living in the country. After migration, people often maintain traditional perceptions and habits regarding health and healthcare, resulting in a high prevalence of traditional, complementary and alternative medicine use among different migrant communities in northern urban settings. Despite being the largest community of sub-Saharan African descent in Belgium, little is known on ethnobotanical practices of the Belgian Congolese community. We therefore conducted an exploratory study on the use of medicinal plants in the context of COVID-19 and perceptions on this new disease among members of the Congolese community in Belgium. Methods: We conducted 16 in-depth semi-structured interviews with people of Congolese descent currently living in Belgium. Participants were selected using purposive sampling. Medicinal plant use in the context of COVID-19 was recorded through free-listing. Data on narratives, ideas and perceptions on the origin, cause/aetiology and overall measures against COVID-19 (including vaccination) were collected. Interview transcripts were analysed using thematic analysis. Results: Four overarching themes emerged from our data. Firstly, participants perceived the representation of the severity of COVID-19 by the Belgian media and government—and by extend by all governmental agencies in the global north—as exaggerated. As a result, traditional and complementary treatments were seen as feasible options to treat symptoms of the disease. Fifteen forms of traditional, complementary and alternative medicine were documented, of which thirteen were plants. Participants seem to fold back on their Congolese identity and traditional knowledge in seeking coping strategies to deal with the COVID-19 pandemic. Finally, institutional postcolonial distrust did not only seem to lead to distrust in official messages on the COVID-19 pandemic but also to feelings of vaccination hesitancy. Conclusion: In the context of the COVID-19 pandemic, participants in our study retreated to, reshaped and adapted traditional and culture-bound knowledge. This study suggests that the fragile and sensitive relationship between sub-Saharan African migrant groups and other social/ethnic groups in Belgium might play a role in their sensitivity to health-threatening situations, such as the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Objective Examining the implementation barriers and facilitators of this service as provided by Belgian community pharmacists in collaboration with general practitioners. Setting Community pharmacies in Flanders. Method Qualitative study through interviews of pharmacists and general practitioners. Main outcome measure Opinions and experiences of pharmacists and general practitioners about type 3 medication review. Results Sixteen community pharmacists and thirteen general practitioners were interviewed and generally gave a positive assessment of the project. The general practitioners saw the pharmaceutical and pharmacotherapeutic recommendations of the pharmacists as an added value for the patients. The pharmacists indicated that performing an medication review was time-consuming, but that it improved their professional relationship with general practitioners and patients. They reported obstacles in obtaining information: cumbersome access to individual patient data (laboratory values) and difficulties in finding and choosing adequate medical information sources. Moreover, pharmacists indicated that there is a need for adequate reimbursement and additional training to make the implementation sustainable. Conclusion Both pharmacists and general practitioners were enthusiastic about medication reviews. The implementation improved the interprofessional collaboration. However, important barriers remain, such as the considerable investment of time and the difficulty in gathering all the necessary information. The sustainable implementation of type 3 medication review in Belgium requires adequate reimbursement and additional training. [ABSTRACT FROM AUTHOR]

The present study aimed at identifying the members of the Anopheles maculipennis complex (Diptera: Culicidae) occurring in Belgium. Therefore, the second internal transcribed spacer of nuclear ribosomal DNA (ITS2) and the mitochondrial cytochrome oxidase subunit I (COI) loci were sequenced in 175 and 111 specimens, respectively, collected between 2007 and 2019. In parallel, the suitability of two species‐diagnostic PCR‐RFLP assays was tested. The identified specimens included: An. maculipennis s.s. (N = 105), An. daciae (N = 62), An. atroparvus (N = 6) and An. messeae (N = 2). Each species was characterized by unique ITS2 haplotypes, whereas COI only supported the monophyly of An. atroparvus, a historical malaria vector in Belgium. Species identification results were further supported by unique PCR‐RFLP banding patterns. We report for the first time An. daciae in Belgium, where it was found to co‐occur with An. maculipennis s.s. The latter was the most prevalent in the collection studied (60%) and appears to have the widest distribution in Belgium. As in other studies, An. daciae and An. messeae appeared the most closely related species, up to the point that their species status remains debatable, while their ecological differences, including vector competences, need further study. [ABSTRACT FROM AUTHOR]

Background: Aedes japonicus japonicus has expanded beyond its native range and has established in multiple European countries, including Belgium. In addition to the population located at Natoye, Belgium, locally established since 2002, specimens were recently collected along the Belgian border. The first objective of this study was therefore to investigate the origin of these new introductions, which were assumed to be related to the expansion of the nearby population in western Germany. Also, an intensive elimination campaign was undertaken at Natoye between 2012 and 2015, after which the species was declared to be eradicated. This species was re-detected in 2017, and thus the second objective was to investigate if these specimens resulted from a new introduction event and/or from a few undetected specimens that escaped the elimination campaign. Methods: Population genetic variation at nad4 and seven microsatellite loci was surveyed in 224 and 68 specimens collected in Belgium and Germany, respectively. German samples were included as reference to investigate putative introduction source(s). At Natoye, 52 and 135 specimens were collected before and after the elimination campaign, respectively, to investigate temporal changes in the genetic composition and diversity. Results: At Natoye, the genotypic microsatellite make-up showed a clear difference before and after the elimination campaign. Also, the population after 2017 displayed an increased allelic richness and number of private alleles, indicative of new introduction(s). However, the Natoye population present before the elimination programme is believed to have survived at low density. At the Belgian border, clustering results suggest a relation with the western German population. Whether the introduction(s) occur via passive human-mediated ground transport or, alternatively, by natural spread cannot be determined yet from the dataset. Conclusion: Further introductions within Belgium are expected to occur in the near future, especially along the eastern Belgian border, which is at the front of the invasion of Ae. japonicus towards the west. Our results also point to the complexity of controlling invasive species, since 4 years of intense control measures were found to be not completely successful at eliminating this exotic at Natoye. [ABSTRACT FROM AUTHOR]

The European Union prohibits the import of meat (products) unless specifically authorised and certified as being eligible for import. Nevertheless, various scientific papers report that passengers from west and central African countries illegally import large quantities of meat, including bushmeat, into Europe via its international airports. They also suggest that African bushmeat is an organised luxury market in Europe. In the present study we explore several aspects of the African bushmeat market in Brussels, Belgium. We demonstrate the clandestine nature of this market where bushmeat is sold at prices at the top of the range of premium livestock and game meat. Inquiries among central and western African expatriates living in Belgium, who frequently travel to their home countries, indicate that the consumption of bushmeat is culturally driven by the desire to remain connected to their countries of origin. DNA-based identifications of 15 bushmeat pieces bought in Brussels, reveal that various mammal species, including CITES-listed species, are being sold. Moreover, we find that several of these bushmeat pieces were mislabelled. [ABSTRACT FROM AUTHOR]

Two European countries, Belgium and Ireland, have recently reformed their abortion laws. Through a comparative approach, this article analyses the 2018 Abortion Acts and pinpoints the common challenges encountered in the drafting process. Under both legal regimes, abortion is lawful up to 12 weeks with no requirement as to reason, and provisions on a mandatory reflection period and conscientious objection only differ in detail. While later abortion is permitted in Ireland and Belgium on similar medical grounds, access to abortion on the foetal abnormality ground remains substantially more limited in Ireland as compared to Belgium. To conclude, this article reflects upon the general direction in which abortion law in Europe is heading, as exemplified by the discussed reforms. As is true for most European countries, ongoing concern regarding the level of criminalisation and barriers to safe and equitable access to abortion may necessitate further reform. [ABSTRACT FROM AUTHOR]

Despite evidence for the utility of self-determination theory in physical education, few studies used objective indicators of physical activity and mapped out between-class, relative to between-student, differences in physical activity. This study investigated whether moderate-to-vigorous physical activity (MVPA) and rated collective engagement in physical education were associated with autonomous motivation, controlled motivation, and amotivation at the between-class and between-student levels. Participants were 739 pupils (46.3% boys, Mage = 14.36 ± 1.94) from 46 secondary school classes in Flanders (Belgium). Multilevel analyses indicated that 37% and 63% of the variance in MVPA was explained by between-student and between-class differences, respectively. Students' personal autonomous motivation related positively to MVPA. Average autonomous class motivation was positively related to between-class variation in MVPA and collective engagement. Average controlled class motivation and average class amotivation were negatively associated with collective engagement. The findings are discussed in light of self-determination theory's emphasis on quality of motivation. [ABSTRACT FROM AUTHOR]

Termination of pregnancy when the foetus is considered viable remains a legal and ethical challenge for lawmakers and society. In Belgium, the lawfulness of late termination of pregnancy is contested by legal scholars up until today. Through statutory interpretation, this analysis demonstrates that this controversy is unwarranted and that termination of pregnancy for particularly severe and incurable foetal abnormality or for serious threats to the health of the pregnant person is also permitted after foetal viability. Nonetheless, by using open terms the Belgian Act on the Voluntary Termination of Pregnancy creates considerable legal uncertainty. Drawing on a comparison with the regulatory frameworks of the Netherlands and the United Kingdom, this article underlines the need for increased multidisciplinary debate, medical guidance, and scientific research on late termination of pregnancy in Belgium. [ABSTRACT FROM AUTHOR]

Objective: The accessibility of contraceptives varies greatly from country to country. Because unintended pregnancies have a considerable impact, programmes have been initiated in some countries to make certain contraceptives available without a prescription. We therefore investigated whether or not Flanders, the Dutch-speaking part of Belgium, is ready for such an initiative.Method: We used a mixed-methods approach with a mainly qualitative methodology. The opinions of pharmacists, general practitioners (GPs) and gynaecologists, the three types of health care provider most closely involved in the prescription and delivery of contraception, were examined.Results: A majority of pharmacists supported the idea. Moreover, a large majority occasionally dispensed hormonal contraception without a prescription. Pharmacists expected negative responses from physicians. Among GPs and gynaecologists, a small majority supported the idea conditionally. A minority either fully supported the idea or found it completely unacceptable.Conclusion: Economic aspects were clearly important in forming an opinion on the topic, although medical arguments were often used when they happened to point in the same direction. Flemish pharmacists were willing to train for and implement a new service that would provide contraceptives without a prescription. The majority of GPs and gynaecologists expressed reservations about such a service and doubted that it would reduce unintended pregnancies. If this service were to be implemented, caution would be needed to avoid giving contraceptive users conflicting information. [ABSTRACT FROM AUTHOR]

Aim The aims of this trial were as follows: (1) to compare the (cost-) effectiveness of a turning and repositioning system and an algorithm for a tailored repositioning vs. usual care to improve reposition frequency in patients at risk; and (2) to compare the (cost-) effectiveness of standardized incontinence care vs. usual care. Background Pressure ulcers are a serious and common problem for hospitalized patients. In many countries, pressure ulcers are recognized as a national health issue and governments designate pressure ulcers as one of the most important sentinel events for health care. International guidelines recommend the use of pressure redistributing support surfaces, systematic patient repositioning and preventive skin care to prevent pressure ulcers. Interventions should be patient-tailored and based on a thorough assessment of both the patient and contextual risk factors. There is a lack of rigorous research addressing the effectiveness of a turning and repositioning system and it is unclear how to tailor the frequency and posture to specific patient needs. Design Multicentre, cluster, three-arm, randomized, controlled pragmatic trial and a cost-effectiveness analysis. The ward is the unit of randomization. Methods Tailored repositioning, the use of a device to facilitate patient repositioning and an optimal procedure for incontinence care will be combined. Participating wards will be intensive care units, geriatric and rehabilitation wards. A sample size calculation was performed (80% power, α = 0·05). This study is approved by the Ethics Committee (February 2016). Discussion Data collection is currently ongoing. The results are expected to be obtained in March 2017. [ABSTRACT FROM AUTHOR]

On December 4th 2014, the International Centre for Reproductive Health (ICRH) at Ghent University organized an international conference on adolescent sexual and reproductive health (ASRH) and well-being. This viewpoint highlights two key messages of the conference - 1) ASRH promotion is broadening on different levels and 2) this broadening has important implications for research and interventions -- that can guide this research field into the next decade. Adolescent sexuality has long been equated with risk and danger. However, throughout the presentations, it became clear that ASRH and related promotion efforts are broadening on different levels: from risk to well-being, from targeted and individual to comprehensive and structural, from knowledge transfer to innovative tools. However, indicators to measure adolescent sexuality that should accompany this broadening trend, are lacking. While public health related indicators (HIV/STIs, pregnancies) and their behavioral proxies (e.g. condom use, number of partners) are well developed and documented, there is a lack of consensus on indicators for the broader construct of adolescent sexuality, including sexual well-being and aspects of positive sexuality. Furthermore, the debate during the conference clearly indicated that experimental designs may not be the only appropriate study design to measure effectiveness of comprehensive, context-specific and long-term ASRH programmes, and that alternatives need to be identified and applied. Presenters at the conference clearly expressed the need to develop validated tools to measure different sub-constructs of adolescent sexuality and environmental factors. There was a plea to combine (quasi-)experimental effectiveness studies with evaluations of the development and implementation of ASRH promotion initiatives. [ABSTRACT FROM AUTHOR]

Fly larvae living on dead corpses can be used to estimate post-mortem intervals. The identification of these flies is decisive in forensic casework and can be facilitated by using DNA barcodes provided that a representative and comprehensive reference library of DNA barcodes is available. We constructed a local (Belgium and France) reference library of 85 sequences of the COI DNA barcode fragment (mitochondrial cytochrome c oxidase subunit I gene), from 16 fly species of forensic interest (Calliphoridae, Muscidae, Fanniidae). This library was then used to evaluate the ability of two public libraries (GenBank and the Barcode of Life Data Systems - BOLD) to identify specimens from Belgian and French forensic cases. The public libraries indeed allow a correct identification of most specimens. Yet, some of the identifications remain ambiguous and some forensically important fly species are not, or insufficiently, represented in the reference libraries. Several search options offered by GenBank and BOLD can be used to further improve the identifications obtained from both libraries using DNA barcodes. [ABSTRACT FROM AUTHOR]

Abstract: In a context where several sectors of society compete for space, land use types must be carefully designed and spatially allocated to guarantee a sufficient level of relevant ecosystem services (ES) in a territory of interest. In this respect, contemporary land use planning involves multiple, often conflicting objectives and criteria. Consequently, major benefits can be expected from spatial decision support systems (sDSS) designed to deal with complex spatial allocation problems. This paper presents the generic conceptual framework ‘OSMOSE’ and its free and open source software implementation, for the generation of specific sDSSs for spatial land use planning. The specific sDSSs generated with OSMOSE are meant to (i) identify land units which meet multiple predefined ES-attribute values for a specific land use type (LUT) and (ii) rank land units for a given LUT according to these multiple ES-attributes. A complementary purpose is to (i) identify and (ii) rank LUTs for a given land unit. Whereas ‘identification’ is done by means of a threshold query, ‘ranking’ is based on the Iterative Ideal Point Thresholding (IIPT) method. The proposed framework is extremely flexible as it can accommodate differentially weighted, continuous and/or ordinal attributes with, for the latter, equal or unequal number of classes, alternative land unit definitions and land use types. Moreover, assessments cannot only be made using ES-levels for the land unit/LUT combinations but also in terms of changes in ES-levels after a particular change of LUT. The OSMOSE framework is illustrated by means of the specific sDSS BoLa which is generated to support land use planning in the region of Flanders (Belgium) with focus on soil protection. Four cases are presented in which the decision support varies between the available approaches (threshold – selection, threshold – ranking, IIPT – selection, IIPT – ranking). [Copyright &y& Elsevier]

Abstract: Gram-negative, rod-shaped bacteria were isolated from Robinia pseudoacacia root nodules. On the basis of the 16S rRNA gene phylogeny, they are closely related to Bradyrhizobium, Rhodopseudomonas and Nitrobacter species (97% sequence similarity), belonging to the class Alphaproteobacteria and family Bradyrhizobiaceae. The results of physiological and biochemical tests together with sequence analysis of housekeeping genes (atpD, dnaK, gyrB, recA and rpoB) allowed differentiation of this group from other validly published Bradyrhizobiaceae genera. NodA, nodC and nifH genes could not be amplified. On the basis of genotypic and phenotypic data, these organisms represent a novel genus and species for which the name Tardiphaga robiniae gen. nov., sp. nov. (LMG 26467T =CCUG 61473T), is proposed. [Copyright &y& Elsevier]

Abstract: We investigated the diversity of rhizobia isolated from different indigenous legumes in Flanders (Belgium). A total of 3810 bacterial strains were analysed originating from 43 plant species. Based on rep-PCR clustering, 16S rRNA gene and recA gene sequence analysis, these isolates belonged to Bradyrhizobium, Ensifer (Sinorhizobium), Mesorhizobium and Rhizobium. Of the genera encountered, Rhizobium was the most abundant (62%) and especially the species Rhizobium leguminosarum, followed by Ensifer (19%), Bradyrhizobium (14%) and finally Mesorhizobium (5%). For two rep-clusters only low similarity values with other genera were found for both the 16S rRNA and recA genes, suggesting that these may represent a new genus with close relationship to Rhodopseudomonas and Bradyrhizobium. Primers for the symbiotic genes nodC and nifH were optimized and a phylogenetic sequence analysis revealed the presence of different symbiovars including genistearum, glycinearum, loti, meliloti, officinalis, trifolii and viciae. Moreover, three new nodC types were assigned to strains originating from Ononis, Robinia and Wisteria, respectively. Discriminant and MANOVA analysis confirmed the correlation of symbiosis genes with certain bacterial genera and less with the host plant. Multiple symbiovars can be present within the same host plant, suggesting the promiscuity of these plants. Moreover, the ecoregion did not contribute to the separation of the bacterial endosymbionts. Our results reveal a large diversity of rhizobia associated with indigenous legumes in Flanders. Most of the legumes harboured more than one rhizobial endosymbiont in their root nodules indicating the importance of including sufficient isolates per plant in diversity studies. [Copyright &y& Elsevier]

Abstract: The objective of this study is to estimate the atmospheric emissions by international merchant shipping of carbon dioxide (CO2), sulphur dioxide (SO2) and nitrogen oxides (NO X ) during 1 year in the Belgian part of the North Sea, including the four Belgian seaports: Antwerp, Ghent, Ostend and Zeebrugge. The estimated emissions are based on a bottom-up, activity-based methodology (Group 1), covering more than 90% of shipping activity, complemented with a top-down fuel consumption methodology for the remaining activities. In total, an estimate of 1880kton CO2, 31kton SO2 and 39kton NO X is emitted over the period April 2003 until March 2004. Compared to national inventories (2003 data) this accounts to 1.5% for CO2, 30% for SO2 and 22% for NO X of total emissions of these gases in Belgium. When the CO2 figure is compared with the current estimate of CO2 emissions from international shipping, based on sold bunker fuels (22754kton CO2), the relevance of a detailed and precise emission inventory becomes clear. In the end, the Belgian estimates are validated by comparing them with Dutch, EU and international emission estimates. [Copyright &y& Elsevier]

The article discusses the influence of concrete construction techniques on modern architecture in Belgium. The author examines the girder knows as the Preflex beam and its application in contemporary architecture. The Preflex beam was developed by Belgian engineer Abraham Lipski in 1950-1. The author also examines the sculpture house in Angleur. The author explains that the house was designed as a synthesis of art, structure, and form. The use of shotcrete in the sculpture house is explored. The article also discusses design and construction of the office tower Zuidertoren.

Processing municipal and industrial wastes on land and particularly near inhabited centra has met with increased opposition. An apparent remedy to the problem is the establishment of such facilities offshore, hence various projects to build them on artificial islands. The paper examines a concrete proposal to locate such an island offshore from the Belgian Coast. Oceanographic and environmental aspects of the site are discussed, construction methods reviewed, erosion and corrosion effects looked at. The possibility of utilizing ocean power to provide the necessary operation energy is likewise considered. [ABSTRACT FROM AUTHOR]

A multifactorial approach using environmental, performance, health and welfare parameters was used to investigate the numerous associations of ventilation throughout three consecutive fattening batches (08/2015 to 12/2016) in a farrow-to-finish commercial pig farm in Belgium. Two fattening pig units were used, unit A (1256 pigs) with mechanical ventilation and unit B (1264 pigs) with natural ventilation. Animal genetics, nutrition, stocking density and health management were the same for both units. Key environmental indicators were monitored in real-time (temperature, humidity, CO2 and NH3) and the daily prevalence of respiratory disease cases was recorded to monitor the temporal expression of disease over time within a farm environment. The welfare status of the animals was assessed twice per production round (batch) with a simplified version of the Welfare quality® protocol. Serological tests for the most prevalent respiratory infectious agents (Mycoplasma hyopneumonniae, swine influenza virus (subtypes H1N1, H1N2 and H3N2), Actinobacillus pleuropneumoniae serotypes 1-2-9-11 and porcine circovirus type 2) were performed during the first, second and final third of each fattening period. Finally, key performance parameters were calculated (average daily growth, feed conversion ratio) and upon slaughter lungs from pigs from unit A (n: 782) and from unit B (n: 544) were assessed for the presence of lung lesions, pleurisy and fissures. To identify the associations of ventilation on the aforementioned parameters, statistical models were run that also included other factors (when applicable) namely production batch, season, age and sampling. Overall, the use of natural ventilation was associated with a less optimal environment with regards to thermal comfort (p < 0.001), CO 2 (p < 0.001) and NH 3 (p < 0.001). A higher daily prevalence of respiratory disease cases was seen in the naturally-ventilated unit (p < 0.001). Concerning the sero-prevalence of the infectious agents tested, the odds to have a positive H1N1 sample were 3.17 higher in the naturally-ventilated unit (p = 0.003). From the visual assessment of the lungs no statistically significant associations were seen between ventilation type and the presence of lesions, fissures or pleuritis. Yet, the lung lesion score was expected to be lower in the naturally-ventilated unit (p = 0.010). Regarding performance parameters, feed conversion ratio and average daily gain were overall better in the mechanically-ventilated unit (descriptive results). Finally, a better welfare score was seen in the mechanically-ventilated unit in all three production batches (descriptive results). In conclusion, the mechanically-ventilated farm was associated with better environmental conditions for the fattening pigs. Yet, further research is needed to reach definite causal claims. [ABSTRACT FROM AUTHOR]

The technology development in wireless sensor network (WSN) offers a sustainable solution towards precision agriculture (PA) in greenhouses. It helps to effectively use the agricultural resources and management tools and monitors different parameters to attain better quality yield and production. WSN makes use of Low-Power Wide-Area Networks (LPWANs), a wireless technology to transmit data over long distances with minimal power consumption. LoRaWAN is one of the most successful LPWAN technologies despite its low data rate and because of its low deployment and management costs. Greenhouses are susceptible to different types of interference and diversification, demanding an improved WSN design scheme. In this paper, we contemplate the viable challenges for PA in greenhouses and propose the successive steps essential for effectual WSN deployment and facilitation. We performed a real-time, end-to-end deployment of a LoRaWAN-based sensor network in a greenhouse of the 'Proefcentrum Hoogstraten' research center in Belgium. We have designed a dashboard for better visualization and analysis of the data, analyzed the power consumption for the LoRaWAN communication, and tried three different enclosure types (commercial, simple box and airflow box, respectively). We validated the implications of real-word challenges on the end-to-end deployment and air circulation for the correct sensor readings. We found that temperature and humidity have a larger impact on the sensor readings inside the greenhouse than we initially thought, which we successfully solved through the airflow box design. [ABSTRACT FROM AUTHOR]

Because European maximum guidance values of mycotoxins are only available for feed, mycotoxin exposure in animals is mainly monitored by feed analysis. However, proper sample collection is needed to ensure reliable results because of uneven distributions and disproportional spread of mycotoxins in feed which can hamper the evaluation of mycotoxin exposure in animals. A cross-sectional study was performed on 40 randomly selected broiler farms in Belgium. During a farm visit at the animal's age of 28 d, a pooled feed sample at the beginning and the end of the feed line was collected. Feed samples were analyzed by a validated multimycotoxin LC-MS/MS method. Moreover, serum samples were collected from 10 randomly selected chickens per farm. Serum concentrations of mycotoxins and major in vivo phase I metabolites were analyzed quantitatively, whereas the presence of phase II metabolites was determined in a qualitative approach by an UPLC-HRMS method. Deoxynivalenol (DON) was the most frequently occurring mycotoxin, being present in 74% of the feed samples, with an average concentration of 270 ± 171 μg/kg and a maximum concentration of 751 μg/kg in positive samples. Also the acetylated forms 3- and 15-acetyldeoxynivalenol (3 and 15ADON) were present in half of the samples, however, at lower concentrations (8 ± 3 μg 3ADON and 10 ± 7 μg 15ADON/kg). Only in 17.5% of the farms, DON was detected in serum samples at a mean serum concentration and standard deviation (SD) of 11 ± 19 ng/mL. The maximum serum concentration of 49 ng DON/mL was detected in broilers which were fed a diet that was contaminated with 191 μg DON/kg, whereas the maximum concentration of DON in feed was 751 μg/kg. Besides, 3 and 15ADON were only detected in 10% of the serum samples (max. 1.3 ng/mL). Sulfate conjugates of DON were only detected in a few serum samples. Qualitative screening for phase II metabolites of other mycotoxins showed similar results. Overall, correlations between feed and serum concentrations of all mycotoxins were lacking (R2 = 0.18 for DON). [ABSTRACT FROM AUTHOR]

Direct-acting antivirals (DAAs) have revolutionized the treatment of hepatitis C virus (HCV) infection. Although previous studies have reported positive results with DAAs after kidney transplantation (KT), their impact on the prevalence of HCV viremia (HCVv) in prevalent kidney transplant recipients (KTRs) remains ill defined. We retrospectively reviewed the HCV status of all patients followed at Cliniques Universitaires Saint-Luc, Brussels, Belgium, outpatient KT clinic between January 2014 and December 2018. We collected the clinical features of KTRs treated with DAAs during this period and calculated the annual prevalence of HCVv over this period. Out of 1451 KTRs, 22 (1.52%) had HCVv in 2014 to 2018. From 2014 to 2018, the annual prevalence of HCVv dropped from 1.97% to 0.43%, (P <.001). Fourteen KTRs were treated with DAAs a median of 197 months (range: 5-374) after KT, mostly (79%) in 2017 after reimbursement restrictions of DAAs for KTRs in Belgium were removed. DAA treatment was safe with a sustained virological response rate at 12 weeks after treatment (SVR12) of 93%. Two patients died 14 months (lymphoma, despite SVR12) and 7 months (hepatocarcinoma, no SVR12) after DAAs initiation, respectively. Among HCVv KTRs not treated with DAAs (n = 8), 2 lost their graft, 5 died, and 1 is initiating therapy. The current prevalence of HCVv in the cohort is 0.08%, with a single patient currently on treatment. Treatment with DAAs led to a dramatic decrease of HCVv prevalence in this KTR cohort. DAA use was safe and effective. Elimination of HCV is possible at KT clinics. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to estimate the prevalence of erectile dysfunction (ED) in the male population of Belgium, and to study its correlation with education, the international prostate symptom scale (IPSS), sexual activity, depression, body mass index, alcohol, smoking, easiness to discuss ED with a doctor, current health index, physical activity, hypertension, diabetes, cardiovascular disease, professional status, residence and whether or not the respondent lives alone.Methods: An age-stratified random sample of the male population aged 40–70 years of Ghent and Charleroi was interviewed in the home by a trained, experienced male nurse, using a structured interview that included the international index of erectile function (IIEF) and the IPSS. ED was classified by the subjects’ self-reported confidence to achieve and maintain an erection.Results: In total, 799 men were interviewed, with a participation rate of 38.0%. The overall age-adjusted prevalence of ED was 10.1% severe, 24.7% moderate, 26.6% mild, and 38.7% reported no ED. Age and the absence of sexual activity over the last 4 weeks were the strongest correlates of ED. Other strong correlates were four or more health complaints, depression, a high score for the IPSS and absence of physical activity.Discussion: The prevalence of ED in Belgium is comparable with the results of other population-based studies for severe and moderate ED. Sexual inactivity over the last four weeks is a strong correlate of ED, and should make the clinician think of a possible problem of ED. [ABSTRACT FROM AUTHOR]

The change in antimicrobial resistance of organisms isolated from blood cultures was studied in a university hospital that opened in July 1977 and had 550 beds by December 1982. Minimal inhibitory concentrations (MIC) were studied by an automatic microdilution technique. Analysis of MICs in the different groups of organisms in relation with time demonstrated no enhancement of resistance during these first 5 1/2 years, except for Pseudomonas aeruginosa that became significantly more resistant (p less than 0.05) to five of the seven antibiotics tested. However, comparison of the two periods July 1977-December 1980 and january 1981-December 1982 evidenced a trend towards a decrease in Enterobacteriaceae (p. less than 0.001) and increase in P. aeruginosa (p less than 0.01) and S. aureus (p less than 0.001). This suggests that the selective pressure from hospital use of antibiotics caused no increase in resistance of different organisms but rather a modification of their relative frequency.