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This paper discusses the increasing severity of droughts due to climate change. It emphasises the complexity of defining drought and the diverse perspectives among stakeholders. Lots of stakeholders with unclear responsibilities are involved, which can lead to uncertainty and indecisiveness in addressing the issue. To tackle this, the present paper proposes a methodology to dissect drought systems and reveal the intricate relationships between their components. This approach combines a comprehensive definition of drought with the "Water Resilience Assessment Framework" and an "Actor-Relational Approach", visualised through network analysis. The methodology was applied to a case study situated in the Leie Basin of Flanders, Belgium. By employing this strategy, policymakers and mediators can gain a deeper understanding of drought, identify its root causes, and prioritise necessary changes for more effective drought and water management. [ABSTRACT FROM AUTHOR]

Background: Early distinction between mild and serious infections (SI) is challenging in children in ambulatory care. Clinical prediction models (CPMs), developed to aid physicians in clinical decision-making, require broad external validation before clinical use. We aimed to externally validate four CPMs, developed in emergency departments, in ambulatory care. Methods: We applied the CPMs in a prospective cohort of acutely ill children presenting to general practices, outpatient paediatric practices or emergency departments in Flanders, Belgium. For two multinomial regression models, Feverkidstool and Craig model, discriminative ability and calibration were assessed, and a model update was performed by re-estimation of coefficients with correction for overfitting. For two risk scores, the SBI score and PAWS, the diagnostic test accuracy was assessed. Results: A total of 8211 children were included, comprising 498 SI and 276 serious bacterial infections (SBI). Feverkidstool had a C-statistic of 0.80 (95% confidence interval 0.77–0.84) with good calibration for pneumonia and 0.74 (0.70–0.79) with poor calibration for other SBI. The Craig model had a C-statistic of 0.80 (0.77–0.83) for pneumonia, 0.75 (0.70–0.80) for complicated urinary tract infections and 0.63 (0.39–0.88) for bacteraemia, with poor calibration. The model update resulted in improved C-statistics for all outcomes and good overall calibration for Feverkidstool and the Craig model. SBI score and PAWS performed extremely weak with sensitivities of 0.12 (0.09–0.15) and 0.32 (0.28–0.37). Conclusions: Feverkidstool and the Craig model show good discriminative ability for predicting SBI and a potential for early recognition of SBI, confirming good external validity in a low prevalence setting of SBI. The SBI score and PAWS showed poor diagnostic performance. Trial registration: ClinicalTrials.gov, NCT02024282. Registered on 31 December 2013. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to assess implementation adherence (how well the patient's actual intake matches the prescribed dosing regimen) to non-vitamin K antagonist oral anticoagulants (NOACs) and to explore experiences with and beliefs about NOACs in a real-world sample of long-term NOAC users.Methods: A cross-sectional observational study was conducted in home-dwelling adults who started taking a NOAC at least 1 year prior to inclusion. Pharmacy dispensing data were used to calculate the Medication Possession Ratio (MPR). Patients were recruited in 158 community pharmacies in Flanders, Belgium. They completed a questionnaire collecting basic characteristics and exploring self-reported adherence to NOACs (using the Medication Adherence Report Scale, MARS) and experiences with and beliefs about NOACs (using the Beliefs about Medicines Questionnaire, BMQ).Results: A total of 766 patients (mean age 76.2±8.8 years, median CHA2DS2-VASc score 4 (IQR=3-4)) were included. The majority (93.5%) used NOAC for stroke prevention in atrial fibrillation. The median MPR was 95.2% (IQR=87.8-99.7) which corresponds with half of the study population not taking their NOAC on at least 17 cumulative days per year. Almost 21% of participants reported non-adherence on the MARS (score <25), with unintentional non-adherence (forgetfulness) most frequently reported (15.4%). Although two-thirds of NOAC users indicated to experience adverse drug reactions, the BMQ demonstrated a positive attitude towards NOAC therapy, where necessity beliefs outweigh the concerns.Conclusions: Our data indicate that long-term NOAC users have high implementation adherence and a positive attitude towards NOAC therapy. However, taking into account patients' thromboembolic risk and NOACs' short half-lives, further optimisation of NOAC use seems warranted in this population. [ABSTRACT FROM AUTHOR]

The acquisition of [PART+AUX] and [AUX+PART] word order in Flanders. A descriptive, methodological and theoretical addition toMeyer & Weerman (2016) This paper presents new data on the acquisition of verb clusters in Flemish children. The data were collected by means of a sentence repetition task and the results are in line with the development path for verb clusters in Dutch children as proposed by Meyer & Weerman (2016). While Flemish children also show a development from more 2-1 orders in the youngest group to more 1-2 orders in the older group, this development seems to happen more slowly in Flemish children than in Dutch children. In spite of the fact that the results of both the Flemish and the Dutch study refute an analysis that takes the input adult language as the main factor in verb cluster formation in children, the Flemish data suggest that the higher frequency of 2-1 orders in the Flemish context could help to explain why 1-2 orders are acquired more slowly in Flemish children than Dutch children. In addition, this paper also discusses the results of a production test in Flanders that shows a high preference for 2-1 orders until the age of 7, thus questioning the type of linguistic skills that are assessed in a sentence repetition task. [ABSTRACT FROM AUTHOR]

Background Although studies are available on patients' ideas, concerns, and expectations in primary care, there is a scarcity of studies that explore the triad of ideas, concerns, and expectations (ICE) in general practice consultations and the impact on medication prescribing. Aim To evaluate the presence of ICE and its relation to medication prescription. Design of study Cross-sectional study. Setting Thirty-six GP teaching practices affiliated with the University of Ghent, in Flanders, Belgium. Method Participants were all patients consulting on 30 May 2005, and their doctors. Reasons for an encounter (consultation or home visit) with new and follow-up contacts, the identification of ICE, and the prescription of medication were recorded by 36 trainee GPs undergoing observational training. The study included 613 consultations. Results One, two, or three of the ICE components were expressed in 38.5%, 24.4%, and 20.1% (n = 236, 150, 123) of contacts respectively. On the other hand, in 17.0% (104/613) of all contacts, and in 22% (77/350) of the new contact reasons, no ICE was voiced, and the GPs operated without knowing this information about the patients. Mean number of ICE components per doctor and per contact was 1.54 (standard deviation = 0.54). A logistic regression analysis of the 350 new contacts showed that the presence of concerns (P = 0.037, odds ratio [OR] 1.73, 95% confidence interval [CI] = 1.03 to 2.9), and expectations (P = 0.009, OR = 2.0, 95% CI = 1.2 to 3.4) was associated with not prescribing new medication (dichotomised into the categories present/absent); however, other patient, doctor, and student variables were not significantly associated with medication prescription. Conclusion An association was found between the presence of concerns and/or expectations, and less medication prescribing. The data suggest that exploring ICE components may lead to fewer new medication prescriptions. [ABSTRACT FROM AUTHOR]