Thomas More Kempen

Research on the relation between childlessness and loneliness is limited and inconclusive. While some studies link childlessness to higher loneliness, others find no association. Few studies distinguish between distinct loneliness types (social, emotional, and existential) or life stages. This article explores how childlessness relates to various loneliness types across adult life stages, using cross-sectional data from the 2024 “A Lonely Planet” survey ( N = 3,756) in Flanders, Belgium. Results show that childless adults are lonelier (for all loneliness types) than parents, also when controlling for socio-demographic variables. However, this relationship depends on age and loneliness type: younger childless adults (18–34) face more social and existential loneliness than parents; middle-aged (35–64) childless adults experience all types more; older adults (65–74) experience more emotional and overall loneliness; no loneliness differences were found between childless adults and parents (75+). These findings underscore the need for a nuanced understanding of childlessness and loneliness.

IntroductionCardiovascular disease (CVD) represents a public health burden, with high prevalence and significant morbidity and mortality. Although evidence-based interventions exist, there is a need for more individualised care. The European project Individualised care from early risk of cardiovascular disease to established heart failure (iCARE4CVD) aims to personalise CVD prevention and treatment. Participatory health research, which actively involves patients in the planning, implementation and evaluation of projects, plays a crucial role here. However, patient participation is often unsuccessful due to the lack of a representative patient sample who is involved throughout the project’s duration, has knowledge of the project and can contribute their experience.Methods and analysisParticipative Research for Individualised Care in Cardiovascular Diseases is a non-interventional, non-randomised, multicentre mixed-methods study. The aim is to incorporate patients’ insights into several key activities within iCARE4CVD by establishing country-specific patient panels in Belgium, Germany, Ireland and the UK. The primary objective is to identify patients’ preferences, experiences, requirements and needs for better diagnosis, treatment and self-care of CVD. Therefore, 10–12 patients across the CVD spectrum, from early risk to established CVD and heart failure, will be included in each country (40–48 in total). Over 3.5 years, patient panel members are required to complete four tasks: (1) identification of meaningful Patient-Reported Outcome and Experiences Measures, (2) development of a motivational model to increase adherence, (3) feedback on CVD care processes and (4) usability testing of new digital tools developed within iCARE4CVD. These tasks comprise eight activities in the form of paper-based or digital exercises, telephone surveys, written surveys and in-person focus groups. The results will be continuously incorporated into iCARE4CVD.Ethics and disseminationThis study received ethical approval by the Ethics Committee at the Faculty of Medicine of RWTH Aachen University (EK 24-172) and St. Vincent’s University Hospital (RS24-027), Research Ethics Committee. In Geel and Belfast, positive ethics approval is pending. All participants will provide written informed consent prior to enrolment in the study and participation in the first patient panel task. Results will be published in peer-reviewed journals and presented at scientific conferences.Trial registration numberDRKS00034899.Protocol versionV2.1, 6 June 2024.

Land-use expansion is linked to major sustainability concerns including climate change, food security and biodiversity loss. This expansion is largely concentrated in so-called 'frontiers', defined here as places experiencing marked transformations owing to rapid resource exploitation. Understanding the mechanisms shaping these frontiers is crucial for sustainability. Previous work focused mainly on explaining how active frontiers advance, in particular, into tropical forests. Comparatively, our understanding of how frontiers emerge in territories considered marginal in terms of agricultural productivity and global market integration remains weak. We synthesize conceptual tools explaining resource and land-use frontiers, including theories of land rent and agglomeration economies, of frontiers as successive waves, spaces of territorialization, friction and opportunities, anticipation and expectation. We then propose a new theory of frontier emergence, which identifies exogenous pushes, legacies of past waves and actors' anticipations as key mechanisms by which frontiers emerge. Processes of differential rent creation and capture and the built-up of agglomeration economies then constitute key mechanisms sustaining active frontiers. Finally, we discuss five implications for the governance of frontiers for sustainability. Our theory focuses on agriculture and deforestation frontiers in the tropics but can be inspirational for other frontier processes including for extractive resources, such as minerals.

BackgroundInterpersonal Violence (IV) against children in sports is a prevalent problem and has a major impact on their well-being. However, the causal relationship and the costs for society remain unclear. ObjectiveThe aim of this study is to estimate the causal effect of severe IV in sports on Subjective Well-Being (SWB) and to monetize the collective loss for society. Participants and settingThe study used survey data from 4003 respondents in the Netherlands and Flanders (Belgium). The questionnaire included current SWB as well as 41 items to assess experiences with psychological, physical and sexual IV in sports before the age of 18. Severity was quantified by experts and reported frequency. MethodsBy using the number of sports that someone participated in during their youth as an instrumental variable to control for confounding, the study estimates the causal effect of severe IV on SWB. The Three-Stage Well-Being Valuation Approach was used to monetize the loss in SWB in terms of income compensation. ResultsThe results show that experiencing severe IV in sports results in significant lower SWB levels (b = −0.45, p < .01). The lower SWB is comparable to an annual loss of income of 9672 euro per person. ConclusionsWe have found evidence for a causal effect of severe IV in childhood on the SWB later in life. The results highlight the long-term, extensive impact of experiencing severe IV in sports that exceeds direct physical and psychological health outcomes.

ABSTRACT This study investigated whether multilinguals who stutter differ from multilinguals who do not stutter in terms of attention networks. Towards that end, it measured (a) performance differences in attention networks between multilinguals who stutter and those who do not stutter and (b) the correlation between stuttering characteristics and attention networks. Twenty-four multilingual Dutch-English speaking adults (20–46y), half of whom were diagnosed with stuttering, completed the Attentional Network Task (ANT) that evaluates the attention networks of alerting, orienting, and executive control. A language and social background questionnaire and a lexical decision task (LexTALE) assessed the participants’ language proficiency. The Stuttering Severity Instrument 4th Ed. and the Brief Version of the Unhelpful Thoughts and Beliefs About Stuttering Scale were used to evaluate stuttering characteristics. The two groups did not differ in the ANT in terms of reaction time and error rate scores. Furthermore, no differences were observed in the three attention networks between the groups. Lastly, no correlation was found between stuttering characteristics and attention networks. The results suggest that the attention abilities of multilinguals who stutter do not differ from multilinguals who do not stutter.

Introduction: Health and functional decline in older people greatly affects their need for care and support. Governments, when confronted with ageing populations, therefore use the policy perspective of ‘ageing in place’, which supports social and health care in the personal environment of people. Recent studies also accentuate the influence of the location in which people live on their health and social care needs. One possible way to implement social and health care in localities is by integrated community care (ICC) or caring neighbourhoods. In Flanders (Belgium), we see a couple of initiatives and policy using the concept of ICC. Although internationally there is progressively more attention towards this concept, there is virtually no agreement between scholars on what exactly it entails. This study aims to develop a framework for a better understanding of ICC by providing insight in its objectives and critical success factors. This framework can be used by initiators of ICC projects and policy makers to develop ICC projects and to formulate policy recommendations. Method: The study consisted of five focus groups with stakeholders of ICC to identify the objectives and critical success factors. Two main groups of stakeholders were defined in Flanders and Brussels: (1) stakeholders with experiences regarding ICC, and (2) academic experts or policy makers of the Flemish or Brussels’ Government. The first group was questioned using the Multi-actor multi-criteria analysis method (Macharis et al., 2012). The second group reflected on the results of the first focus groups, using a semi-structure interview scheme. The results of the descriptive thematic analysis were compared and combined with key elements of ICC, as found in a review of academic and grey literature. Results: The five focus groups with the stakeholders led to the identification of objectives and critical success factors. We identified two sets of objectives: (i) process goals; and (ii) operational objectives, or effective objectives. For every objective, accompanying and general critical success factors were formulated. All objectives can be connected to key elements of ICC found in literature, dealing with methods or strategies, goals or ambitions and stakeholders. The presence of involved stakeholders was mostly cited in the critical success factors. The effective objectives correspond with the goals formulated in literature, however, there are some differences. In literature they focus heavily on social and health care, while goals formulated by the stakeholders target mainly social and societal changes. Conclusion: Focus groups allowed to define a clear set of stakeholder objectives that determine the success of ICC. The use of the Multi-actor multi-criteria analysis method allowed to build a framework that enable both practitioners and scholars to understand which quantitative and qualitative factors contribute to the success of an ICC project. Future research is needed to understand the relative importance of each factor and objective and how it contributes to the success of ICC. Reference: Macharis, C., Turcksin, L., &amp; Lebeau, K. (2012). Multi actor multi criteria analysis (MAMCA) as a tool to support sustainable decisions: State of use. Decision Support Systems, 54(1), 610-620. https://doi.org/10.1016/j.dss.2012.08.008