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Séverine Vermeire,1 François D’heygere,2 Antoine Nakad,3 Denis Franchimont,4 Fernand Fontaine,5 Edouard Louis,6 Philippe Van Hootegem,7 Olivier Dewit,8 Guy Lambrecht,9 Beatrijs Strubbe,10 Filip Baert11 1Department of Gastroenterology, University Hospital Gasthuisberg, Leuven, Belgium; 2Department of Gastroenterology, AZ Groeninge, Kortrijk, Belgium; 3Department of Gastroenterology, CHWAPI, Tournai, Belgium; 4Department of Gastroenterology, Erasme Hospital, Brussels, Belgium; 5Department of Gastroenterology, CHC St Joseph, Liège, Belgium; 6Department of Gastroenterology, University Hospital CHU Sart Tilman, Liège, Belgium; 7Department of Gastroenterology, AZ St Lucas, Brugge, Belgium; 8Department of Gastroenterology, UCL St Luc, Brussels, Belgium; 9Department of Gastroenterology, AZ Damiaan, Oostende, Belgium; 10Department of Gastroenterology, OLV Hospital, Aalst, Belgium; 11Department of Gastroenterology, AZ Delta, Roeselare-Menen, Belgium Purpose: Simponi® (golimumab, MSD) is a fully human monoclonal antibody against tumor necrosis factor alpha administered subcutaneously using an autoinjector or a prefilled syringe. This study examined preference for administration of golimumab by autoinjector or prefilled syringe in patients with moderate-to-severe ulcerative colitis (UC). Patients and methods: This was a multicenter, open-label, randomized crossover trial (EudraCT no 2014-000656-29). Patients with moderate-to-severe UC were randomized 1:1 to receive 2 subcutaneous injections of 50 mg golimumab with the autoinjector followed by 2 injections of 50 mg with the prefilled syringe or the same 4 injections administered in the opposite order. Patients assessed preference, ease of use, and discomfort immediately after the injections and 2 weeks later. Results: Ninety-one patients were included (median age=42.7 years [range, 19.7–93.7]; 58% male). The autoinjector was preferred by 76.9% of patients immediately after injections and by 71.4% 2 weeks later. The autoinjector was more often considered extremely easy or easy to use (94.5%) than the prefilled syringe (73.6%). Moderate discomfort or worse was reported by more patients when using the prefilled syringe (20.9%) than when using the autoinjector (5.5%), and severe discomfort or discomfort preventing injection of future doses was reported by 8.8% for the prefilled syringe but not at all when using the autoinjector. A favorable or extremely favorable overall impression was reported by 89.0% for the autoinjector and 72.5% for the prefilled syringe. Conclusion: Most patients with moderate-to-severe UC preferred to self-administer golimumab with the autoinjector over a prefilled syringe. Keywords: autoinjector, adherence, anti-TNF, subcutaneous injection, treatment, self-injection

Abstract Educational attainment is a key indicator of status and opportunity in meritocratic societies. However, it is unclear how educational expansion has affected the link between cognitive abilities and educational attainment. As a result, this study examines the correlation between cognitive ability and educational attainment across male birth cohorts in Norway. Utilizing administrative register data covering more than four decades, we investigate multiple measures of educational attainment and their connection to cognitive abilities. Our findings reveal a consistent decline in the correlation over time. These findings question the assumed shift towards meritocracy in educational systems and highlight a more complex relationship between cognitive ability and educational attainment.

This study investigates the relationship between job insecurity and the willingness to undertake training, accounting for perceived employability. Drawing on conservation of resources theory, we hypothesize that job insecurity negatively relates to the willingness to participate in training to strengthen the internal and external labor market position and that perceived employability has a buffering effect on this relationship. The hypotheses were tested among 560 Belgian employees using structural equation modeling. The results did not provide support for the relationship between job insecurity and the willingness to undertake training to strengthen the position inside the organization. We did, contrary to expectations, find a significant positive relationship with the willingness to undertake training to strengthen the position outside the organization. Furthermore, the relationship between job insecurity and the willingness to undertake training to strengthen the external labor market position was weaker with increasing levels of perceived employability.

The large inflow of asylum-seekers in recent years has heralded a diversification in adopted asylum policies across European societies. Although a growing body of research has addressed these versatile approaches and their implications for the European integration project, insight into the social basis of these restrictive or open asylum policies remains underdeveloped. Hence, the current study provides detailed insight into public preferences for asylum policies and offers a new understanding of how these attitudes are affected by diverging socio-economic realities across Europe. In addition, this paper considers the role of individual factors that coincide with publicly adopted frames in contemporary asylum debates. In particular, to explain how contextual differences reflect on opinion climates, the impacts of the policy, economic, and migratory context are studied. On the individual-level, we focus on threat perception and human values, which represent humanitarian, economic, and cultural frames. To explore these relations, data on 20 countries from the European Social Survey Round 8 (2016) are analyzed through a multilevel structural equation modeling approach. Results indicate that, on the contextual-level, only unemployment rates have a significant impact and, rather surprisingly, lower unemployment rates provoke a more negative opinion climate. Yet, this relationship seems to be largely driven by some specific countries that are characterized by large unemployment rates and relatively positive opinion climates simultaneously. The migratory and policy context, on the other hand, do not influence attitudes toward asylum policy. This indicates that it is not necessarily the countries facing the largest inflow of asylum-seekers or issuing the most positive decisions on asylum applications that have the most restrictive opinion climates. As shown by the important roles of human values and threat perceptions, which represent widely adopted frames, public discourses seem much more important in explaining attitudes toward asylum policy across Europe.

Innovation is considered to be of crucial importance for organisational survival and growth, and in this respect employees play a leading role, as they are the ones who develop innovative ideas. At the same time, the struggle for organisational survival and growth gives rise to perceptions of job insecurity. To date, few studies have explored how employees’ innovative work behaviour (IWB) is influenced by the perceived threat of job loss (i.e. job insecurity). As both job insecurity and IWB are increasingly salient in light of organisational change and competition, the present study examines the relationship between job insecurity and IWB, as well as the role of psychological contract breach in explaining this relationship. We hypothesized a negative relation between job insecurity and innovative work behaviour, with psychological contract breach as a mediator in this relationship. Participants were 190 employees from an industrial organisation that had faced restructuring and downsizing for several years. Contrary to our predictions, no direct association was found between job insecurity and the two sub-dimensions of innovative work behaviour (i.e., idea generation and idea implementation). Indirect relationships, however, were found between job insecurity and the two types of IWB through psychological contract breach. Surprisingly, psychological contract breach was positively related to idea generation and idea implementation. These findings shed new light on the relationship between job insecurity and IWB.

Introduction: Many care organisations claim to employ multidisciplinary teams, but the term is used to describe quite different forms of collaboration. A systemic view of the work organisation of care delivery is presented and applied in this article that allows to identify and understand often overlooked yet important differences regarding team composition, working relationships and therapeutic relationships. Theory and Methods: We used modern socio-technical systems theory to study care delivery for a particular patient population as a system of interrelated activities. The concept of work organisation refers to the way in which the composite task of care delivery is divided into distinct tasks and how these are grouped in either monodisciplinary or multidisciplinary organisational units. The systemic perspective was applied in a comparative case study of four Multiple Sclerosis hospitals. Results: Among the hospitals, one was characterised by a functional work organisation, with similar tasks grouped in monodisciplinary teams. Cross-disciplinary working and therapeutic relationships were established on an ad hoc basis. The three other hospitals adopted a more process-oriented work organisation (which groups all tasks related to a specific care process within a single, multidisciplinary team). The more process-oriented the work organisation, the more working relationships and therapeutic relationships appeared to be fixed and continuous. Conclusion and discussion: The systemic view adopted in this study yields a better understanding of multidisciplinary teams through the concept of work organisation. The actual composition of multidisciplinary teams, and the related working and therapeutic relationships will vary depending on the type of underlying work organisation. Further validation of this conclusion will be needed in other settings.

As innovative employees become imperative for an organizations’ success, research identified job design as a crucial variable in promoting innovative work behavior (IWB) (Hammond et al., 2011). Using the Job Demands-Resources (JD-R) model of Bakker & Demerouti (2007), this article contributes to the literature as it uses recent insights on the distinction between job challenges and job hindrances (Van den Broeck et al., 2010) and distinguishes between blue- and white-collar employees. Using survey data of 893 employees of various organizations the findings generally confirm the JD-R model, although important differences were found between blue-collar and white-collar employees regarding the relation of organizing and routine tasks with IWB. Job content insecurity further was found to be very detrimental for blue-collar IWB. These findings have important HR and political implications as they show that there is no ‘one size fits all’ HR solution for innovation.

This study investigates how quantitative and qualitative job insecurity relate to idea generation, a dimension of innovative work behaviour. We hypothesise that both types of job insecurity relate negatively to this type of innovative behaviour, and expect a stronger association between quantitative job insecurity and idea generation. Moreover, we argue that psychological contract breach mediates (‘explains’) these negative relationships. The hypotheses were tested in a sample of 1420 supervisors from a large Belgian organisation, using hierarchical regression analyses, bootstrapping analyses, and relative weight analysis. The results showed that both types of job insecurity are negatively associated with idea generation. Contrary to our expectations, the relationship between both forms of job insecurity and idea generation was equally strong. Psychological contract breach was found to mediate these relationships.

Crohn's disease (CD) patients included in the Tailored Treatment With Infliximab for Active Crohn's Disease (TAILORIX) trial started infliximab in combination with an immunosuppressant for 1 year. The aim of the present study was to determine the long-term disease course beyond the study period. We compared the outcomes of patients who did or did not reach the primary end point of the TAILORIX trial, defined as sustained corticosteroid-free clinical remission from weeks 22 through 54, with no ulcers on ileocolonoscopy at week 54. The primary outcome of this follow-up study was the progression-free survival of CD defined by anal or major abdominal surgery, CD-related hospitalization, or the need for a new systemic CD treatment. The 95 patients (median disease duration, 4.5 mo; interquartile range, 1.0–56.6 mo) analyzed, including 45 (47%) who achieved the primary end point, were followed up for a median duration of 64.2 months (interquartile range, 57.6–69.9 mo) after the end of the study period. There was no significant difference in CD progression-free survival at 1, 3, and 5 years between patients who achieved the TAILORIX primary end point and patients who did not (P =.64). No difference was observed between both groups for each component of CD progression: anal surgery, major abdominal surgery, CD-related hospitalization, or the need for a new systemic CD treatment. Achieving a sustained clinical remission off steroids with complete endoscopic remission in this cohort of 95 patients with early CD was not associated with less disease progression. Prospective trials to define the therapeutic goals that change the natural history of CD and prevent complications are needed. [ABSTRACT FROM AUTHOR]

In patients with hepatocellular carcinoma characterized by vascular invasion and/or extrahepatic disease, Sorafenib is considered treatment of choice. Although mild liver test abnormalities were reported in less than 1% of the patients in the two large randomized, controlled phase III trials, four cases of severe acute Sorafenib-induced hepatitis have been described. One of these four cases died from liver failure. In this paper, a patient with HCC with lung metastases developed high fever and a severe hepatitis that rapidly evolved into liver coma and death, two weeks after the initiation of Sorafenib. Biochemical parameters pointed to a hepatocellular type of injury. Clinical and biochemical presentations were compatible with a drug-induced hypersensitivity syndrome such as it has mainly been described for aromatic anticonvulsants, sulphonamides, and allopurinol. We hypothesize that an underlying cytochrome P450 dysfunction with the presence of reactive drug metabolites might lead to this potentially fatal Sorafenib-induced severe liver dysfunction.

Most individual-level outcomes of interest to sociologists are indirectly influenced by genetics, including socioeconomic outcomes like education, income, wealth, and occupational status. Despite this knowledge, an integration of sociological theories of class and status with the research literature on genetic heritability is largely lacking, and no previous studies have investigated the role of genetics specifically for class attainment – a central concept in sociology. To amend this, we estimate how much variation in such positions can be attributed to genetic and environmental factors in roughly 5000 Norwegian twin pairs. The results suggest that the variability in class and status attainment is influenced by genetics to a non-negligible degree, while shared environmental factors play a modest role as well. This is in line with previous findings using genetically informed designs to study other socioeconomic outcomes. Our study suggests that in addition to social environments, variation in class and status attainment can partly be explained by genetics. [ABSTRACT FROM AUTHOR]

Unlike in neurological patient populations, the effects of Extended Reality within the context of sports medicine have rarely been studied. This systematic review was conducted to investigate the value of Extended Realty-assisted rehabilitation and injury prevention strategies on injury rehabilitation and prevention outcomes. PubMed and Web of Science databases were consulted. The search strategy consisted of the terms Virtual Reality (Intervention), rehabilitation and injury prevention (Outcome) and healthy athletes or athletes with a musculoskeletal sports injury (Population). After eligibility and Risk of Bias screening, ten articles were included. Risk of Bias analysis resulted in a level of evidence varying between C (three articles), B (six articles) and A2 (one article) scores. Extended Reality was found to provide an added value for both sports injury prevention and rehabilitation outcomes. It particularly provides clinicians with the opportunity to address the underlying biomechanical risk profile for common sports injuries, allowing the athletes to train protective movement patterns more effectively. More large-scale high-quality prospective research is needed in order to determine whether Extended Reality-assisted therapy is superior to conventional therapy in sports rehabilitation and injury prevention circles with strong conclusive evidence. • Including XR in musculoskeletal rehabilitation improves clinical outcomes. • Including XR in screening procedures for injury risk detection might make the assessment more sensitive. • Including XR in Return To Sport screening might make RTS decisions more valid and accurate. • XR implementation should be considered in (secondary) injury prevention. [ABSTRACT FROM AUTHOR]

Diagnostic laparoscopy (DL) with peritoneal lavage has been adopted as a standard staging procedure for patients with gastric cancer (GC). Evaluation of the value of DL is important given ongoing improvements in diagnostic imaging and treatment. As contemporary data from European centres are sparse, this retrospective cohort study aimed to assess the yield of DL in patients with potentially curable gastric cancer, and to identify predictive factors for peritoneal metastases. Patients with adenocarcinoma of the stomach, treated between January 2016 and December 2018, were identified from institutional databases of two high volume European Upper-GI centres. Patients who underwent a DL with peritoneal lavage for potentially curable disease after clinical staging with imaging (cT1-4N0-3M0) were included. The primary outcome was the proportion of patients with a positive DL, defined as macroscopic metastatic disease, positive peritoneal cytology washings (PC+) or locally irresectable disease. Some 80 of 327 included patients (24.5%) had a positive DL, excluding these patients from neoadjuvant treatment (66 of 327; 20.2%) and/or surgical resection (76 of 327; 23.2%). In 34 of 327 patients (10.3%), macroscopic metastatic disease was seen, with peritoneal deposits in 30 of these patients. Only 16 of 30 patients with peritoneal disease had positive cytology. Some 41 of 327 patients (12.5%) that underwent DL had PC+ in the absence of macroscopic metastases and five patients (1.5%) had an irresectable primary tumour. Diffuse type carcinoma had the highest risk of peritoneal dissemination, irrespective of cT and cN categories. The diagnostic yield of staging laparoscopy is high, changing the management in approximately one quarter of patients. DL should be considered in patients with diffuse type carcinoma irrespective of cT and cN categories. [ABSTRACT FROM AUTHOR]

This contribution argues that neither the self-interest framework, nor theories about cultural dispositions are sufficient to fully explain why socioeconomically vulnerable groups express more criticism on the welfare state. We highlight the importance of social experiences as a source of this discontent with the functioning of the welfare state. First, this dissatisfaction is embedded in a broader welfare populism that pits the hard-working people against the deceitful elite and welfare abusers. Second, we argue that welfare populism arises as a result of experiences of resentment that are the result of the restructuring of relative group positions. We differentiate between four types of discontent: economic insecurity, relative deprivation, social distrust and powerlessness. Using structural equation modelling, we test whether these experiences mediate the relationship between the social structure and welfare state criticism. The results indicate that relative deprivation consistently leads to more economic and moral criticism, and lowers perceptions of the positive social consequences. Social distrust, moreover, stimulates a higher level of moral criticism. This study illustrates that resentment can partly explain the paradoxical findings on the relationship between social class and welfare state criticism. [ABSTRACT FROM AUTHOR]