Migration and reproduction in transitional times: stopping behavior of immigrants and natives in the Belgian city of Antwerp (1810-1925)

"In the course of the nineteenth century, millions of migrants moved to and settled permanently in western European urban centers. This large influx of immigrants, originating from various regions with different demographic backgrounds, affected the level and pace of the local fertility transition. In this study the authors sampled and analyzed 747 couples consisting of natives and immigrants in the city of Antwerp during the early fertility transition. Stopping behavior of both native, immigrant and mixed couples is analyzed. The authors found that adult migrants display stopping behavior that resembles that at their origin while individuals that immigrated during childhood adapt more often to the dominant local fertility pattern. While the migratory status of the mother was more decisive than that of the father, couples consisting of both immigrants were the last to implement more efficient reproductive strategies. By focusing on individual behavioral patterns, new light is shed on the diffusion of reproductive behavior during the Western European fertility decline." (author's abstract

Family size and intergenerational social mobility during the fertility transition

It has been argued in sociology, economics, and evolutionary anthropology that family size limitation enhances the intergenerational upward mobility chances in modernized societies. If parents have a large flock, family resources get diluted and intergenerational mobility is bound to head downwards. Yet, the empirical record supporting this resource dilution hypothesis is limited. This article investigates the empirical association between family size limitation and intergenerational mobility in an urban, late nineteenth century population in Western Europe. It uses life course data from the Belgian city of Antwerp between 1846 and 1920. Findings are consistent with the resource dilution hypothesis: after controlling for confounding factors, people with many children were more likely to end up in the lower classes. Yet, family size limitation was effective as a defensive rather than an offensive strategy: it prevented the next generation from going down rather than helping them to climb up the social ladder. Also, family size appears to have been particularly relevant for the middle classes. Implications for demographic transition theory are discussed.Belgium, demographic transition, fertility, nineteenth century, parental investment, quantity-quality trade-off, resource dilution, social mobility

Combination therapy with charged particles and molecular targeting : a promising avenue to overcome radioresistance

Radiotherapy plays a central role in the treatment of cancer patients. Over the past decades, remarkable technological progress has been made in the field of conventional radiotherapy. In addition, the use of charged particles (e.g., protons and carbon ions) makes it possible to further improve dose deposition to the tumor, while sparing the surrounding healthy tissues. Despite these improvements, radioresistance and tumor recurrence are still observed. Although the mechanisms underlying resistance to conventional radiotherapy are well-studied, scientific evidence on the impact of charged particle therapy on cancer cell radioresistance is restricted. The purpose of this review is to discuss the potential role that charged particles could play to overcome radioresistance. This review will focus on hypoxia, cancer stem cells, and specific signaling pathways of EGFR, NF kappa B, and Hedgehog as well as DNA damage signaling involving PARP, as mechanisms of radioresistance for which pharmacological targets have been identified. Finally, new lines of future research will be proposed, with a focus on novel molecular inhibitors that could be used in combination with charged particle therapy as a novel treatment option for radioresistant tumors

Migration and reproduction in an urbanizing context

Résumé Dans cette contribution, nous étudions les parcours de vie familiale de femmes natives et immigrées à Anvers et à Genève au 19ème siècle, deux contextes caractérisés par l’immigration, une forte croissance démographique et un rythme d’ur­banisation soutenu. Exploitant la base de données COR pour Anvers et une reconstitution des familles pour Genève, nous analysons des parcours familiaux individuels dans une perspective séquentielle. Pour ce faire, nous considérons quatre états distincts : la phase entre le début de l’âge reproductif et le mariage (1), l’intervalle proto-génésique (2), la phase reproductive en tant que telle (3) et la phase de famille achevée (4). Dans le cas anversois, notre analyse montre une opposition entre les immigrées locales dont les parcours étaient caractérisés par une longue période reproductive et les immigrées de longue distance dont la phase de famille achevée était plus longue. Dans le cas genevois, les natives se caractérisaient par un bas âge au mariage, ce qui explique pourquoi leur phase de famille achevée était particulièrement longue. Summary This paper investigates the family life course of native and immigrant women in 19th century Antwerp and Geneva, two contexts characterized by rapid population growth, urbanization and immigration. Using data from the COR-sample of Antwerp and from a family reconstitution of Geneva, we analyze individual family life courses in a sequential data perspective. We conceptualize the family life course as a sequence of 4 states: the phase between the entry into reproductive age and marriage (1), the interval between marriage and first birth (2), the period of childbearing (3) and the phase of completed family size (4). The analysis shows an opposition between local immigrants (characterized by long childbearing periods) and long-distance immigrants (longer periods of completed family size) in Antwerp. In Geneva, natives married at a much younger age than immigrants, which explains why their life course was characterized by a longer period of completed family size

Chronic exposure to simulated space conditions predominantly affects cytoskeleton remodeling and oxidative stress response in mouse fetal fibroblasts

Microgravity and cosmic rays as found in space are difficult to recreate on earth. However, ground-based models exist to simulate space flight experiments. In the present study, an experimental model was utilized to monitor gene expression changes in fetal skin fibroblasts of murine origin. Cells were continuously subjected for 65 h to a low dose. (55 mSv) of ionizing radiation (IR), comprising a mixture of high-linear energy transfer (LET) neutrons and low-LET gamma-rays, and/or simulated microgravity using the random positioning machine (RPM), after which microarrays were performed. The data were analyzed both by gene set enrichment analysis (GSEA) and single gene analysis (SGA). Simulated microgravity affected fetal murine fibroblasts by inducing oxidative stress responsive genes. Three of these genes are targets of the nuclear factor-erythroid 2 p45-related factor 2 (Nrf2), which may play a role in the cell response to simulated microgravity. In addition, simulated gravity decreased the expression of genes involved in cytoskeleton remodeling, which may have been caused by the downregulation of the serum response factor (SRF), possibly through the Rho signaling pathway. Similarly, chronic exposure to low-dose IR caused the downregulation of genes involved in cytoskeleton remodeling, as well as in cell cycle regulation and DNA damage response pathways. Many of the genes or gene sets that were altered in the individual treatments (RPM or IR) were not altered in the combined treatment (RPM and IR), indicating a complex interaction between RPM and IR

Modulation of gene expression in endothelial cells in response to high LET nickel ion irradiation

Ionizing radiation can elicit harmful effects on the cardiovascular system at high doses. Endothelial cells are critical targets in radiation-induced cardiovascular damage. Astronauts performing a long-term deep space mission are exposed to consistently higher fluences of ionizing radiation that may accumulate to reach high effective doses. In addition, cosmic radiation contains high linear energy transfer (LET) radiation that is known to produce high values of relative biological effectiveness (RBE). The aim of this study was to broaden the understanding of the molecular response to high LET radiation by investigating the changes in gene expression in endothelial cells. For this purpose, a human endothelial cell line (EA.hy926) was irradiated with accelerated nickel ions (Ni) (LET, 183 keV/mu m) at doses of 0.5, 2 and 5 Gy. DNA damage was measured 2 and 24 h following irradiation by gamma-H2AX foci detection by fluorescence microscopy and gene expression changes were measured by microarrays at 8 and 24 h following irradiation. We found that exposure to accelerated nickel particles induced a persistent DNA damage response up to 24 h after treatment. This was accompanied by a downregulation in the expression of a multitude of genes involved in the regulation of the cell cycle and an upregulation in the expression of genes involved in cell cycle checkpoints. In addition, genes involved in DNA damage response, oxidative stress, apoptosis and cell-cell signaling (cytokines) were found to be upregulated. An in silico analysis of the involved genes suggested that the transcription factors, E2F and nuclear factor (NF)-kappa B, may be involved in these cellular responses

General practice patients treated for substance use problems: a cross-national observational study in Belgium.

BACKGROUND: General Practitioners (GPs) are well placed to care for patients with (chronic) substance use problems. This pilot was carried out to study the feasibility and usefulness of a continuous surveillance of substance use problems among general practice patients. The objectives were (i) to describe variables with missing values exceeding 1% and whether patients were reported without substance-related problems; (ii) the profile and the magnitude of the patient population that is treated for substance use problems. METHODS: Observational study by the Belgian Network of Sentinel General Practices (SGP) in 2013. Baseline (at the first encounter) and 7-month follow-up data were reported of all patients treated for substance use problems. Two main measurements were type of substance use and patient status at follow-up. Multiple logistic regression analysis was used to examine patient status at follow-up. RESULTS: Of 479 patients, 47.2% had problems with alcohol alone, 20.3% with prescription drugs, 16.7% with illicit drugs other than heroin or methadone and 15.9% with heroin or methadone. Problems with alcohol alone were more prevalent in Flanders (53.0%; 95% confidence interval (CI) 46.8-59.1%) than in Wallonia-Brussels (39.8%; 95% CI 33.1-46.8%), while problems with heroin or methadone were more prevalent in Wallonia-Brussels (27.0%; 95% CI 21.1-33.5%) than in Flanders (7.1%; 95% CI 4.3-10.9%). At follow-up, 32.8% of the patients had dropped out, 29.0% had discontinued GP treatment and 38.2% had continued GP treatment. Overall, 32.4% of 479 patients had continued GP treatment for substance use problems during the study period. In Wallonia-Brussels, this proportion was higher (42.7%; 95% CI 35.9-49.6%) than in Flanders (24.3%; 95% CI 19.2-29.8%). CONCLUSIONS: A continuous surveillance of the general practice population treated for substance use problems seems to be feasible and useful. The latter is suggested by the specific profile and the relative magnitude of the population. Inter-regional health system differences should be taken into account to estimate the epidemiology of substance use problems among general practice patients.Peer reviewe

Primary palliative care for older people in three European countries : a mortality follow-back quality study

Background Many older people with serious chronic illnesses experience complex health problems for which palliative care is indicated. We aimed to examine the quality of primary palliative care for people aged 65-84 years and those 85 years and older who died non-suddenly in three European countries. Methods This is a nationwide representative mortality follow-back study. General practitioners (GPs) belonging to epidemiological surveillance networks in Belgium (BE), Italy (IT) and Spain (ES) (2013-2015) registered weekly all deaths in their practices. We included deaths of people aged 65 and excluded sudden deaths judged by GPs. We applied a validated set of quality indicators. Results GPs registered 3496 deaths, of which 2329 were non-sudden (1126 aged 65-84, 1203 aged 85+). GPs in BE (reference category) reported higher scores than IT across almost all indicators. Differences with ES were not consistent. The score in BE particularly differed from IT on GP-patient communication (aged 65-84: 61% in BE vs 20% in IT (OR=0.12, 95% CI 0.07 to 0.20) aged 85+: 47% in BE vs 9% in IT (OR=0.09, 95% CI 0.05 to 0.16)). Between BE and ES, we identified a large difference in involvement of palliative care services (aged 65-84: 62% in BE vs 89% in ES (OR=4.81, 95% CI 2.41 to 9.61) aged 85+: 61% in BE vs 77% in ES (OR=3.1, 95% CI 1.71 to 5.53)). Conclusions Considerable country differences were identified in the quality of primary palliative care for older people. The data suggest room for improvement across all countries, particularly regarding pain measurement, GP-patient communication and multidisciplinary meetings

Caring for Long COVID patients in primary health care : a cross-sectional study among general practitioners in Belgium and Malta

Background and Objective: At least 10% of COVID-19 recovered individuals experience persistent symptoms (Long COVID), with primary health care and general practitioners (GPs) at forefront in their care. In this study, GPs’ knowledge, perception and experience on Long COVID, and the definition used across two countries are investigated to provide insight in their care at cross-country level. Methods: A cross-sectional study targeting GPs was conducted in Belgium and Malta during mid-2022. An online survey on Long COVID was disseminated. Country-specific practice and demographic characteristics were collected. Descriptive and logistic regression analyses were performed.peer-reviewe

Quality of primary palliative care for older people with mild and severe dementia : an international mortality follow-back study using quality indicators

Background: measuring the quality of primary palliative care for older people with dementia in different countries is important to identify areas where improvements can be made. Objective: using quality indicators (QIs), we systematically investigated the overall quality of primary palliative care for older people with dementia in three different countries. Design/setting: a mortality follow-back survey through nation-and region-wide representative Sentinel Networks of General Practitioners (GPs) in Belgium, Italy and Spain. GPs registered all patient deaths in their practice. We applied a set of nine QIs developed through literature review and expert consensus. Subjects: patients aged 65 or older, who died non-suddenly with mild or severe dementia as judged by GPs (n = 874). Results: findings showed significantly different QI scores between Belgium and Italy for regular pain measurement (mild dementia: BE = 44%, IT = 12%, SP = 50% | severe dementia: BE = 41%, IT = 9%, SP = 47%), acceptance of approaching death (mild: BE = 59%, IT = 48%, SP = 33% | severe: BE = 41%, IT = 21%, SP = 20%), patient-GP communication about illness (mild: BE = 42%, IT = 6%, SP = 20%) and involvement of specialised palliative services (mild: BE = 60%, IT = 20%, SP = 77%). The scores in Belgium differed from Italy and Spain for patient-GP communication about medical treatments (mild: BE = 34%, IT = 12%, SP = 4%) and repeated multidisciplinary consultations (mild: BE = 39%, IT = 5%, SP = 8% | severe: BE = 36%, IT = 10%, SP = 8%). The scores for relative-GP communication, patient death outside hospitals and bereavement counselling did not differ between countries. Conclusion: while the countries studied differed considerably in the overall quality of primary palliative care, they have similarities in room for improvement, in particular, pain measurement and prevention of avoidable hospitalisations