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In intensive farmland habitats, pollination of wild flowers and crops may be threatened by the widespread decline of pollinators. The honey bee decline, in particular, appears to result from the combination of multiple stresses, including diseases, pathogens, and pesticides. The reduction of semi-natural habitats is also suspected to entail floral resource scarcity for bees. Yet, the seasonal dynamics and composition of the honey bee diet remains poorly documented to date. In this study, we studied the seasonal contribution of mass-flowering crops (rapeseed and sunflower) vs. other floral resources, as well as the influence of nutritional quality and landscape composition on pollen diet composition over five consecutive years. From April to October, the mass of pollen and nectar collected by honey bees followed a bimodal seasonal trend, marked by a two-month period of low food supply between the two oilseed crop mass-flowerings (ending in May for rapeseed and July for sunflower). Bees collected nectar mainly from crops while pollen came from a wide diversity of herbaceous and woody plant species in semi-natural habitats or from weeds in crops. Weed species constituted the bulk of the honey bee diet between the mass flowering crop periods (up to 40%) and are therefore suspected to play a critical role at this time period. The pollen diet composition was related to the nutritional value of the collected pollen and by the local landscape composition. Our study highlights (1) a food supply depletion period of both pollen and nectar resources during late spring, contemporaneously with the demographic peak of honey bee populations, (2) a high botanical richness of pollen diet, mostly proceeding from trees and weeds, and (3) a pollen diet composition influenced by the local landscape composition. Our results therefore support the Agri-Environmental Schemes intended to promote honey bees and beekeeping sustainability through the enhancement of flower availability in agricultural landscapes.

Background In Belgium, as in many other countries, the juvenile practice of physical activity is insufficient. A growing attention has been paid to environmental factors that may influence physical activity but with inconsistent findings. This study aims to estimate the association between daily life environment characteristics and physical activity among children 10 to 13 years old in Wallonia (Belgium). Methods Data were collected using a self-administered questionnaire among 1940 children (HBSC survey). Associations between factors related to the children’s living environment and physical activity (vigorous physical activity (VPA) ≥ twice a week; global physical activity (GPA) defined as VPA ≥ twice a week and moderate-to-vigorous physical activity ≥1 h/day) were estimated using logistic regressions adjusted for potential confounders. Results Nearly three-quarters of the children practiced VPA ≥ twice a week, but only one in five practiced GPA consistent with recommendations. After adjustment, children living in a neighborhood with playgrounds or parks were more likely to achieve a recommended level of GPA (OR: 1.34 [1.04–1.73]), as were children who reported that other youngsters were present in their neighborhood with whom they could play outside (OR: 1.50 [1.12–1.99]). The presence of neighborhood children was also positively associated with VPA (OR: 1.80 [1.42–2.29]); in stratified analyses, the association was significant only among boys (OR: 1.95 [1.34–2.82]). Moreover, and only in girls (OR: 1.66 [1.10–2.49]), a feeling of safety in one’s neighborhood was positively associated with VPA. No association was found between VPA and the existence of a yard or a garden at home to go playing outside. Conclusion Our results argue for developing actions aimed at creating living environments more favorable to children’s daily physical activity. More specifically, they help better understand the environment of Belgian children and thus contribute to better identify their needs.

Background Early sexual intercourse (SI) may have long-lasting negative impacts on health-related quality of life (HRQoL). So far, these impacts have been studied using age for defining early SI instead of feelings about its timing. The present study examined the association between feelings about the timing of first SI and current HRQoL. Methods Data came from the 2014 cross-sectional Health Behaviour in School-aged Children (HBSC) study in French-speaking Belgium. Among participants aged 16–20 years who already had SI, 1778 were included in analyses. Univariate and multivariate logistic regressions were performed, including potential confounders. Results One quarter of adolescents (26.4%) had poor HRQoL, 19.8% expressed a negative feeling about the timing of first SI and 19.6% did not think about it. Compared with adolescents who thought first SI happened at the right time or wished it had happened sooner, adolescents who had a negative feeling about the timing and those who did not think about it were more likely to have a poor HRQoL (cOR = 1.67 (1.28–2.17) and cOR = 1.37 (1.05–1.80), respectively). After adjustment, associations were no more significant (aOR = 1.22 (0.91–1.63) and aOR = 1.22 (0.91–1.64)). Sex disparity in expressing a negative feeling mostly explained the difference between crude and adjusted analyses. Conclusion Further research is needed to better understand such a complex relationship. The high proportion of adolescents having poor HRQoL and negative feeling about the timing of first SI shows how important it is to find out effective prevention for both domains.

Sexual minority youth are at higher risk of substance use than heterosexual youth. However, most evidence in this area is from North America, and it is unclear whether the findings can be generalized to other cultures and countries. In this investigation, we used data from the 2014 Health Behaviour in School-aged Children (HBSC) study to compare substance use in same- and both-gender attracted 15-year-old adolescents from eight European countries (n = 14,545) to that of their peers who reported opposite-gender attraction or have not been romantically attracted to anyone. Both-gender attracted, and to a lesser extent, same-gender attracted adolescents were significantly more likely to smoke cigarettes, consume alcohol, get drunk and use cannabis, or be involved in multiple substance use in the last 30 days compared to their opposite-gender attracted peers. Those adolescents who have not been in love had significantly lower odds for substance use than all other youth. The pattern of results remained the same after adjusting for country, gender and family affluence. These findings are compatible with the minority stress and romantic stress theories. They suggest that sexual minority stigma (and love on its own) may contribute to higher substance use among adolescents in European countries.

Background This paper describes the methodological developments of the sexual health items included in the Health Behaviour in School-aged Children (HBSC) study since their mandatory inclusion in the study in 2002. The current methodological, ethical and pedagogical challenges in measuring young people’s sexual health behaviours are discussed along with the issues associated with the sexual health items introduced to the HBSC study in 2002. The development and piloting of new cross-national items for use in the 2013/14 HBSC data collection are presented and discussed. Methods An international pilot study was undertaken to determine the impact of these proposed changes. Questionnaires and classroom discussion groups were conducted in five pilot countries in 2012/2013 (France, Hungary, Ireland, Portugal and Romania) with a total of 612 school-aged children (age M = 15.55 years, SD = 0.95). Results The majority of participants in each country provided positive feedback about the appropriateness of the questions. Some small cross-national differences were found in the self-reported quantitative data relating to the appropriateness of the questions (χ 2  = 22.831, df = 9, p  = .007, V = .117). Qualitative feedback suggests that for the vast majority of students the phrasing and age-targeting of the questions were considered appropriate. With the exception of a small number of respondents who commented on the clarity and/or personal nature of the content, no specific issues with the questions were identified. Conclusions These findings provide guidance on the answerability (including the extent of missing and inconsistent data), understandability, acceptability (including in different cultures) and relevance of questions to potential participants. The findings from the pilot study suggest that in general, the questions are understandable, acceptable, and of a high priority to the target population, and that the simplification has significantly reduced the proportion of missing data. The new developments thus enhance the capacity of the questions to measure cross-nationally, sensitive aspects of young people’s sexual behaviour. These questions were included in the 2013/2014 round of the HBSC survey and will continue to be used to monitor trends in adolescent sexual health and behaviours, and to inform and influence health services and health education policy and practice at local, national and international levels.

Telehomecare monitoring (TM) in patients with cancer is a complex intervention. Research shows variations in the benefits and challenges TM brings to equitable access to care, the therapeutic relationship, self-management, and practice transformation. Further investigation into these variations factors will improve implementation processes and produce effective outcomes. This study aims to concurrently analyze implementation and evaluate the effectiveness of TM for patients receiving anticancer oral therapy. The objectives are to (1) contextualize how and why TM is implemented according to (a) site characteristics, (b) team characteristics, and (c) characteristics of patients receiving anticancer oral therapy; (2) assess TM effectiveness for recording electronic patient-reported outcome measures (ePROMs) and patient-reported experience measures (ePREMs) according to the site, implementation process, and patient characteristics; (3) describe the acceptability and feasibility of TM from the perspectives of the people directly or indirectly involved and provide evidence-based actionable guidance in anticipation of provincewide implementation. This type II hybrid effectiveness-implementation study uses a concurrent mixed methods design. Evaluability assessment is integrated into an emerging practice in 3 participating sites to enable the evaluation of implementation strategies on TM clinical outcomes. Quantitative data for ePROMs and ePREMs will be collected using validated oncology questionnaire. Descriptive statistics and repeated measures using multiple linear mixed models and generalized estimating equations analyses will be undertaken alongside interpretive descriptive coding of qualitative data. Qualitative data will be gathered from key informants guided by the RE-AIM (reach, efficacy, adoption, implementation, maintenance) framework and its extension, PRISM (practical robust implementation and sustainability model). The concurrent approach allows results at multiple stages of this study to be integrated iteratively. The methodological choice aims to provide real-world data that are rigorous, rapidly usable in practice, and transferable to other settings. Questionnaires were pretested and the technological platform was codeveloped with members of the cancer care team and patients. Preparatory work was carried out to configure the TM platform and activate coordinating mechanisms between members of the cancer care team, patients, information technology experts, and the research team. A steering committee with 3 working groups was established to oversee the technological, clinical, and evaluation aspects of this study. Recruitment of patients for ePROMs started in February 2024, and data collection is expected to continue until March 2025. Interviews with members of the cancer care team began in November 2024. Full analysis should be completed by September 2025. This study will clarify how, why, for whom, and under what conditions TM can complement current care models. Our evaluability assessment will help to address implementation complexities and better understand intervention-to-practice operationalization so that implementation might be adapted to contextual factors without potentially harmful or inequitable impacts on patients. DERR1-10.2196/63099.

CONTEXT Although an association between gender equality and contraceptive use has been confirmed among adult samples, few studies have explored this relationship among adolescents. An examination of whether adolescents’ contraceptive use is more prevalent in countries with higher levels of gender equality is needed to fill this gap. METHODS Nationally representative data from 33 countries that participated in the 2013–2014 Health Behaviour in School‐Aged Children study and country‐level measures of gender equality—using the 2014 Global Gender Gap Index—were analyzed. Multilevel multinomial logistic regression analyses were employed to assess associations between gender equality and contraceptive use (condom only, pill only and dual methods) at last intercourse as reported by 4,071 females and 4,110 males aged 14–16. RESULTS Increasing gender equality was positively associated with contraceptive use among both males and females. For every 0.1‐point increase on the equality scale, the likelihood of condom use at last intercourse rose (odds ratio, 2.1 for females), as did the likelihood of pill use (6.5 and 9.6, respectively, for males and females) and dual method use (2.1 and 5.6, respectively). Associations with pill use and dual use remained significant after national wealth and income inequality were controlled for. Overall, associations were stronger for females than for males. CONCLUSIONS More research is needed to identify potential causal pathways and mechanisms through which gender equality and adolescents’ contraceptive use may influence one another.

Purpose The current study investigated the association between body mass index (BMI) and health-related quality of life (HRQoL) among a large and non-clinical sample of adolescents, and tested the possible moderating effect of perceived teacher and classmate support on this association. Methods French-speaking Belgian adolescents ( n  = 11,342) self-reported height and weight, HRQoL (KIDSCREEN-10), as well as their perception of teacher and classmate relationships. Adjusting for sociodemographics, linear regression analyses with HRQoL as the outcome variable were performed for boys and girls separately. Interactions between BMI and teacher support, and between BMI and classmate support were included to examine the effect of this support on the association between BMI and HRQoL. Results Obesity was associated with lower HRQoL for boys ( β  = − 2.14, p  = 0.002) and for girls ( β  = − 2.96, p  = 0.001), while only overweight girls showed a significant impaired HRQoL compared with normal-weight ones ( β  = − 0.94, p  = 0.01). In both sexes, lower perceived teacher and classmate support was associated with lower HRQoL. Interactions between BMI and perceived teacher relationships, and between BMI and perceived classmate relationships, were not significant for boys as for girls. Conclusions Perceived school-related social support constitutes an important dimension of adolescent well-being, suggesting the relevance of considering it for promoting greater HRQoL in overweight and obese youth. Future studies are needed to confirm the absence of moderating effect of this support and explore its effect on other weight-related factors, like body image, weight misperception and bullying, associated with decreased HRQoL in adolescents.

Over the past decade, energy drinks (ED) have become increasingly popular among adolescents. Due to their high content in caffeine, sugar and other energy-promoting components, frequent ED consumption may have adverse health effects, like cardiovascular symptoms, sleep impairment, and nervousness. Previous studies have shown that ED consumption was more frequent among males. To extend this knowledge, our analysis examined how sociodemographic and lifestyle determinants of frequent ED consumption may differ by gender among Belgian adolescents. This study was based on data self-reported by 9,119 12–19 year-old French-speaking Belgian adolescents in secondary school, within the 2014 cross-sectional Health Behaviour in School-Aged Children survey. Pupils reporting they usually consumed ED once a day or more were considered as “high ED consumers”. Sociodemographic and lifestyle characteristics were described in relation to ED consumption, for boys and girls separately. We used multiple logistic regression models, stratified by gender, to assess the associations between the sociodemographic and lifestyle variables, with high ED consumption. Daily ED consumption was reported by 7.9% of boys and 4.6% of girls. In both genders, the proportion of high ED consumers was significantly higher among adolescents of grades 1–3, those of lower family affluence, in first- and second-generation immigrants, those watching TV more than 6 hours/day, those reporting later bedtimes, and those consuming soft drinks daily. In girls only, higher percentages were observed in girls from single- (7.6%) or blended-families (5.2%), than in girls from two-parent families (3.5%). In boys only, this percentage was higher among adolescents meeting physical activity recommendations (14.5% vs 6.5%). Multivariate analyses showed that high ED consumption was associated with lower grades, long screen time, later bedtimes, and daily soft drink consumption in both genders. In girls only, adolescents from single-parent families were more likely to consume ED daily (OR 1.70; 95% CI 1.23–2.37) (vs. two-parent families). In boys only, first-generation immigrants (OR 1.53; 95% CI 1.06–2.21) (vs. natives) and youth sufficiently physically active (OR 2.19; 95% CI 1.65–2.90) were more likely to consume ED daily. High ED consumption was more frequent among boys and showed gender-specific patterns, with associations with family structure in girls only, and with migration status and physical activity in boys only. Our findings provide evidence about patterns of high ED consumption among adolescents and should be used to inform the development of prevention strategies.

IntroductionDuring adolescence, while the body is still in development, alcohol consumption can cause irreversible damages. Well-being and family, social and school environment may influence alcohol consumption among adolescents. According to their gender, they may be more or less receptive to some of these influences. Our aim was to identify potential gender differences in the correlates of alcohol consumption in early adolescence.MethodsAnalyses were based on 4,714 10–14-year-old adolescents attending schools in Wallonia, and included in the 2014 Health Behaviour in School-aged Children (HBSC) cross-sectional survey. Information were collected through self-administered questionnaires. Alcohol consumption was defined as having drunk at least one day during the last 30 days before the survey. Gender-stratified associations were estimated using multivariable logistic regressions.ResultsTwenty percent of 10–14-year-old adolescents (boys: 21.6%; girls: 18.0%) reported having consumed alcohol during the past month. After adjustment, associations with age, frequency of contacts via social networks and frequency of outings with friends after class hours, were similar in both genders. Adolescents aged 13–14 years (vs. 10–12 years), those who communicated at least every week via social networks (vs. less than once a week) and those who met their friends at least once after class hours (vs. less than once a week) were more likely to consume alcohol.Boys’ and girls’ 2nd-generation migrants and boys’ 1st-generation migrants (vs. natives) were less likely to have consumed alcohol in the past month. Furthermore, boys and girls with “low” Family Affluence Scale (FAS) and boys from “medium” FAS (vs. “high”) were less likely to have consumed alcohol.In boys only, school satisfaction was significantly associated with alcohol consumption during the past month (vs. those who liked school a lot: those who liked school a bit (OR = 1.88 [1.13–0.84]) or did not like school very much (OR = 2.20 [1.32–3.66]) or did not like school at all (OR = 2.91 [1.69–5.02]).In girls, family status (vs. two-parent families: stepfamilies (OR = 1.43 [1.05–1.95])) and life satisfaction (vs. “high”: “low” (OR = 1.63 [1.19–2.26])) were significantly associated with alcohol consumption.ConclusionAlthough both genders share common risk factors (age, peer relationships, migration status and socioeconomic status), some differences have been highlighted. In boys only, school satisfaction was inversely associated with alcohol consumption. High life satisfaction and living in two-parent families seemed to play a protective role in girls only. These results should help better identify adolescents to be targeted in campaigns preventing early alcohol consumption.