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Background & Aims: Parents of children with intestinal failure, dependent on Home Parenteral Nutrition (HPN), may experience psychosocial problems due to the illness and intensive treatment of their child. Literature concerning psychosocial problems is scarce. Therefore, we aimed to investigate Health-Related Quality of Life (HRQOL), levels of anxiety, depression, distress and everyday problems of these mothers and fathers., Methods: A multicenter study was conducted among 37 mothers and 25 fathers of 37 children on HPN (response-rate 37/49 = 76%, mean age children = 5.1 years, SD = 4.6). Parents completed three questionnaires to measure different outcomes on the KLIK website (www.hetklikt.nu): the TNO-AZL QOL Questionnaire (TAAQOL) to measure HRQOL, the Hospital Anxiety and Depression Scale (HADS) to measure anxiety and depression, and the Distress Thermometer for Parents (DT-P) to measure distress. Scores were compared to Dutch reference mothers and fathers using Mann-Whitney U-tests., Results: No differences were found in HRQOL, measured by the TAAQOL, between HPN parents compared to the reference groups, except for the subscale 'depressive emotions' for mothers (p = .01) and 'daily activities' for fathers (p = .04). HPN mothers reported higher levels of depression compared to reference mothers (p = .001). In addition, HPN mothers and fathers reported higher levels of distress than reference mothers (p = .001) and fathers (p = .03). HPN mothers reported significantly more problems in the practical, emotional, cognitive and parenting domains, fathers in the social, emotional and parenting domains., Conclusions: On HRQOL, anxiety and depression, HPN parents generally did not show much differences compared to reference parents. However, when asked about parental distress and everyday problems, HPN treatment of their child seems highly stressful for some parents and influences daily functioning. Therefore, structural screening for parental psychosocial problems in clinical practice, e.g. using the DT-P, is necessary in order to improve the well-being of both these parents and their children dependent on HPN., (Copyright © 2018 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

There is limited evidence on the causality of previously observed associations between neighborhood characteristics and physical activity (PA). We aimed to assess whether individual-level PA was associated with changes in fear of crime, social cohesion, green spaces, parking facilities, social disorder, and physical disorder that occurred over the past 3 years. In general, in neighborhoods where residents had more favorable perceptions of the environment in 2006, residents were more likely to be physically active in 2009. In addition, improvements between 2006 and 2009 with respect to perceived social cohesion, green spaces, social disorder, and physical disorder were associated with increased odds of being active in 2009. For both the levels in 2006 and trends in the period 2006-2009, the associations were somewhat stronger among women than among men, but associations did not vary by age or length of residence. For several environmental factors, we observed that not only the levels at a certain point in time, but also recent improvements over time were related to PA. These results provide new support for a causal relationship between these environmental factors and PA., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Objective: Obtaining insight into the geographic distribution of attendance and smear test results at the cervical cancer screening program in Rotterdam neighbourhoods, associated with socio-economic status, marital status and the percentage migrants., Design: Ecological analysis was carried out on data on cervical cancer screening outcome and population figures, provided by the Rotterdam Local Health Information System, in which health information is collected at neighbourhood level., Setting: The cervical cancer screening program in the city of Rotterdam., Participants: Fifty-three neighbourhoods, with overall 569,105 inhabitants, of whom 70,621 women between 1992 and 1994 were invited for the screening program., Main Results: Between neighbourhoods a large difference in attendance rate and the percentage positive smears exists. A high socio-economic level of a neighbourhood, and a low percentage migrants, single or divorced women correspond with high attendance. A high socio-economic status of a neighbourhood and a low percentage migrants correspond with a low percentage smear test Pap 3B or higher. Socio-economic status, percentage migrants and marital status are highly interrelated on neighbourhood level. Multivariate analysis showed a negative correlation between the attendance rate and the percentage of single and divorced women, and a positive correlation between the percentage migrants and the percentage of positive smears (Pap 3B or higher)., Conclusion: Various risk groups, showing low attendance or a high percentage of positive smears, are clustered in neighbourhoods and can be identified by socio-economic status, marital status and nationality. Activities to improve attendance can be focused towards these neighbourhoods.