Flemish Community

Background summary: This workshop is linked to the plenary session on the innovative policy of Flanders and the WHO on Caring Neighborhoods. From the Department of Welfare, Public Health and Family and the Flemish association of cities and municipalities (VVSG) we zoom in on the concrete elaboration of our policy and vision, regionally and locally, based on international principles. Through this workshop we want to both inspire and exchange knowledge about the key aspects of caring neighborhoods. Policy: There are currently 133 caring neighborhood projects at work in Flanders and Brussels for two years, until the end of February 2024. These projects are supported by a consortium, coordinated by the King Baudouin Foundation, of more than 15 universities, colleges and civil society organizations that provide the projects not only with coaching, but also with training on key aspects concerning caring neighborhoods. There is also a complementary research by the Policy Research Centre for Welfare, Public Health and Family (SWVG) that will identify obstacles and incentives based on the ongoing projects, formulate policy recommendations and work on a toolbox for start-up caring neighborhoods. At the same time, we are working to scale up these projects through the dissemination of information, knowledge and inspiration to, first and foremost, all local governments and welfare and care organizations, but also to housing corporations, schools, etc. Policy vision: Our vision on caring neighborhoods is based on the WHO model on “people-centred integrated care”. We present the three pillars of a caring neighborhood (neighborhood participation and inclusion, connecting informal and formal care and intersectoral collaboration between wellbeing and care partners and partners from other domains in a network that focuses on prevention, health promotion and the provision of integrated care and support with a focus on quality of life). In addition, we explain the model with the eight building blocks of a caring neighborhood, based on the model of the VVSG and the seven effectiveness principles for integrated community care of the Transnational Forum on Integrated Care. Since our vision and policies are based on international principles, they are universally understandable and applicable. Workshop: It will be quite a challenge to turn the knowledge learned into a sustainable local and regional policy on caring neighborhoods. Through this workshop we want to both inspire other regions and countries and exchange knowledge around the key aspects of caring neighborhoods. We present several questions to the workshop members, in a World Café approach. (The concrete questions can be discussed further with the ICIC organization.) What is the added value of a caring neighborhood? What are key aspects of a caring neighborhood? What are preconditions for developing and sustaining a caring neighborhood? How can we ensure that local residents, volunteers remain committed to a caring neighborhood? Target audience: Policy makers, experts working in the field of caring neighborhoods and researchers familiar with (key aspects of) caring neighborhoods.

Implementation of evidence-based practice necessitates identification of barriers and facilitators as well as using effective implementation strategies tailored to these barriers and facilitators. Collaboration with stakeholders is an essential aspect of implementation, but there is limited guidance on how to combine input from stakeholders with other sources of information when designing implementation actions. In this study, we adapt and evaluate a novel stepwise procedure (based on Knapp et al, 2022) to combine multi-stakeholder input with best available evidence on matching barriers to implementation strategies. In the context of an implementation project for physiotherapist led Cognitive Behavior therapy for Insomnia (CBT-I) in patients with Knee Osteoarthritis (OA), stakeholders (physiotherapists (PTs), patients with OA and comorbid insomnia, general practitioners (GPs), orthopedic surgeons (OS), rheumatologists, and psychologists with expertise in CBT-I) participate in a rigorous, iterative process of identifying and prioritizing barriers, followed by a selection of implementation strategies to address identified barriers. In this process, stakeholder discussion or survey input is alternated with feedback from the research team, who are providing a summary of stakeholder perspectives and provide input based on findings from the implementation science literature. The process integrates aspects of user-centered design (Dopp et al., 2018; Dopp et al., 2020), a modified version of Delphi approach (Hasson et al., 2000), a participatory approach (Jagosh et al., 2012), and the Expert Recommendations for Implementing Change (ERIC) protocol (Powell et al., 2015; Waltz et al., 2015). Compared to Knapp et al. (2022) we have streamlined the development process into a six-step alternating procedure. Furthermore, we have broadened the categories of stakeholders participating in the stakeholder discussions, including patients and health care providers of different disciplines. In order to facilitate representation of patients and different disciplines of health care providers, we are conducting the first step stakeholder discussions in two parallel teams: (1) a team focusing on the determinants related to patient-PT interactions, the process of implementation, and the intervention itself; and (2) a team focusing on the determinants related to interactions between different health care providers, the referral patterns, and the structural aspects of healthcare. The first team consists of patients, psychologists, and physiotherapists. The second team involves various healthcare providers involved in the treatment of osteoarthritis, both first and second line. That is physiotherapists, GPs, orthopedic surgeons, and rheumatologists. The study is currently ongoing, and we will be discussing preliminary outcomes related to the methodology and design process, including evaluations at each stage of the project. The project can serve as a template for structured, multidisciplinary stakeholder engagement in the design of implementation actions. This work is integrated into a clinical trial that was funded by the Applied Biomedical Research Program, Research Foundation Flanders (Fonds voor Wetenschappelijk Onderzoek Vlaanderen), Belgium (FWO-TBM project no. TBM2021 - T000521N - 54252, “Towards PREcision MEdicine for Osteoarthritis: Added value of cognitive behavioural therapy for insomnia (the PREMEO trial).

To assess the occurrence and associations of verbal and non-verbal care-resistant behaviour (CRB) during oral examination by a dental hygienist in nursing home residents with dementia. CRB is a barrier to providing professional oral care and daily oral hygiene care. Understanding the predictors of CRB might help care professionals in learning to anticipate this behaviour. In this multicentre cross-sectional study signs of verbal and non-verbal CRB were reported during the oral examination. Data collection occurred in the psychogeriatrics wards of 14 different nursing homes in the Netherlands (N=367). A total of 367 residents were included. CRB was evident in 82 residents (22.3%), of whom 45 (55%) showed verbal and 37 (45%) non-verbal CRB. Associated with CRB were age >85 years, duration of residential stay longer than 2 years, and having Korsakov dementia. Other factors associated with CRB were duration of residential stay (categories ">2 and ≤4 years" or ">4 years") and having a natural dentition (P=.043-.005, OR=1.20-1.33, 95% CI=1.00-8.48). Significant associations for verbal and non-verbal CRB were age between 76 and 85 years, vascular dementia and Korsakov dementia (P=.031-.006, OR=.020-1.49, 95% CI=0.43-2.15). The occurrence of CRB was 22.3% and was associated with older age and longer duration of residential stay, Vascular and Korsakov dementia and natural dentition.

Data literacy is a hot topic, which is currently discussed in many different fields from open data initiatives, statistics, computer societies, coding initiatives, and beyond. The resulting literature is inspiring but not always satisfying from the perspective of the media literacy scholarly field. The goals behind data literacy are often instrumental and utilitarian in the function of job-related skills or open data initiatives. We hope that this special issue will contribute to a broader discussion about data literacy. In this introductory essay we provide an overarching introduction, highlighting some of the main themes, questions, issues, and insights addressed in the different articles. We weave in our own insights, reflections, and conclusions as well.

BackgroundLegionnaires’ disease (LD) is a severe bacterial infection causing pneumonia. Surveillance commonly underestimates the true incidence as not all cases are laboratory confirmed and reported to public health authorities. The aim of this study was to present indicators for the impact of LD in Belgium between 2013 and 2017 and to estimate its true burden in the Belgian population in 2017, the most recent year for which the necessary data were available.MethodsBelgian hospital discharge data, data from three infectious disease surveillance systems (mandatory notification, sentinel laboratories and the national reference center), information on reimbursed diagnostic tests from the Belgian National Institute for Health and Disability Insurance and mortality data from the Belgian statistical office were used. To arrive at an estimate of the total number of symptomatic cases in Belgium, we defined a surveillance pyramid and estimated a multiplication factor to account for LD cases not captured by surveillance. The multiplication factor was then applied to the pooled number of LD cases reported by the three surveillance systems. This estimate was the basis for our hazard- and incidence-based Disability-Adjusted Life Years (DALYs) calculation. To account for uncertainty in the estimations of the DALYs and the true incidence, we used Monte Carlo simulations with 10,000 iterations.ResultsWe found an average of 184 LD cases reported by Belgian hospitals annually (2013–2017), the majority of which were male (72%). The surveillance databases reported 215 LD cases per year on average, 11% of which were fatal within 90 days after diagnosis. The estimation of the true incidence in the community yielded 2674 (95% Uncertainty Interval [UI]: 2425–2965) cases in 2017. LD caused 3.05 DALYs per case (95%UI: 1.67–4.65) and 8147 (95%UI: 4453–12,426) total DALYs in Belgium in 2017, which corresponds to 71.96 (95%UI: 39.33–109.75) DALYs per 100,000 persons.ConclusionsThis analysis revealed a considerable burden of LD in Belgium that is vastly underestimated by surveillance data. Comparison with other European DALY estimates underlines the impact of the used data sources and methodological approaches on burden estimates, illustrating that national burden of disease studies remain essential.

<p>The aim of the Extensive Literature Search (ELS) carried out in response to the terms of reference set out in the EFSA mandate on the Qualified Presumption of safety (QPS), i.e. review of the recommendations for the QPS list and specific qualifications, was to identify any publicly available studies reporting on safety concerns for humans, animals or the environment caused by organisms that have QPS status, since the publication of the previous QPS review in 2016 (i.e. publications from June 2016 to June 2019). <strong>The details on the search strategy, search keys and approach are presented here.</strong></p>