The online Personal Health Check: How do Dutch citizens and professionals feel about it?

Four Dutch cities implemented the Personal Health Check (PHC) among their citizens last year. The PHC includes an online questionnaire and diagnostic measures, generating a personal health profile with referral to a general practitioner (GP) if needed. The PHC aims at earlier identification of defined medical risk and at encouraging people to adopt healthier lifestyles. This study focused on acceptance of the PHC among citizens and professionals. Questions on acceptance were based on the UTAUT model by Venkatesh et al (2012) and sent online to participants. Focus group, face to face and telephone interviews were held with participants, professionals and non-responders. Preliminary results showed response rates varying between 11 and 23%. Differences were related to the variation in manners of invitation. Invitation by the GP doubled the response rate. About 2,500 people filled in the online PHC. On average, 50% of the respondents had additional diagnostics measured. Overall, participants were positive about the PHC. It made them more conscious about their lifestyle. Some though found the PHC not easy in use. Professionals too were positive as to the awareness raised on healthy lifestyle. Contrary to their expectations, not too many ‘extra patient visits’ came up due to the PHC outcome. In addition, they wondered whether the PHC reached lower socioeconomic groups sufficiently. Main reasons for non-responding were privacy issues (directed towards municipalities mostly) and being already familiar with chronic diseases. The online PHC seems promising in reaching large groups of people and raising awareness of health risks among them. Approach through primary care as compared to approach directly through municipalities increases acceptance and may solve privacy issues. Extra attention should be paid to simplifying PHC use and reaching lower socio economic groups at risk

Adjuvants Enhancing Cross-Presentation by Dendritic Cells: The Key to More Effective Vaccines?

Contains fulltext : 200565.pdf (publisher's version ) (Open Access)Over the last decades, vaccine development has advanced significantly in pursuing higher safety with less side effects. However, this is often accompanied by a reduction in vaccine immunogenicity and an increased dependency on adjuvants to enhance vaccine potency. Especially for diseases like cancer, it is important that therapeutic vaccines contain adjuvants that promote strong T cell responses. An important mode of action for such adjuvants is to prolong antigen exposure to dendritic cells (DCs) and to induce their maturation. These mature DCs are extremely effective in the activation of antigen-specific T cells, which is a pre-requisite for induction of potent and long-lasting cellular immunity. For the activation of CD8(+) cytotoxic T cell responses, however, the exogenous vaccine antigens need to gain access to the endogenous MHCI presentation pathway of DCs, a process referred to as antigen cross-presentation. In this review, we will focus on recent insights in clinically relevant vaccine adjuvants that impact DC cross-presentation efficiency, including aluminum-based nanoparticles, saponin-based adjuvants, and Toll-like receptor ligands. Furthermore, we will discuss the importance of adjuvant combinations and highlight new developments in cancer vaccines. Understanding the mode of action of adjuvants in general and on antigen cross-presentation in DCs in particular will be important for the design of novel adjuvants as part of vaccines able to induce strong cellular immunity

Emotional and instrumental feeding practices of Dutch mothers regarding foods eaten between main meals

BACKGROUND: To assess how much of a public health problem emotional and instrumental feeding practices are, we explored the use of these feeding practices in a sample of Dutch mothers regarding their child's food between main meals. METHODS: A cross-sectional questionnaire study was among 359 mothers of primary school children aged 4-12 years. The were completed online at home. RESULTS: Of the mothers, 29.5% reported foods to reward, 18.1% to punish and 18.9% to comfort their child. frequently offered energy-dense and nutrient-poor products such as candy context of emotional and instrumental feeding practices. The use of practices was associated with a lower age of both mother and child and a educational level of the mother. Mothers living in neighborhoods with intermediate socioeconomic position used the practices less often than from low and high socioeconomic position neighborhoods. CONCLUSIONS: Our show that mothers in our sample mainly used unhealthy products in the instrumental and emotional feeding practices. Research into the between these practices and children's dietary intake is warranted, of unhealthy products in the context of these practices may not to an increased consumption of these products. Findings regarding the of use of these practices among specific subgroups can be used to determine the target population for interventions and tailor the content interventions to specific target group characteristics. Besides associations between personal and family characteristics and the use of and instrumental feeding practices, attempts should be made to parents' reasons for using them

Gecombineerde leefstijl interventies in Nederland: ervaringen uit de Beweegkuur

Combined lifestyle interventions in the netherlands: experiences gained with the beweegkuur intervention this paper gives a reflection on the development, implementation and dissemination processes of the beweegkuur in primary care. The implementation of the programme took a lot of time and energy on the part of the health care providers. During the implementation process, multidisciplinary networks were formed and the contacts with local exercise facilities improved. Although it is plausible that without beweegkuur, some of these processes would also have come about, they would probably have taken more time and effort and would have remained more local

Restrictive rules of Dutch mothers regarding their children's dietary intake between meals

The use of restrictive food rules by parents has been found to be associated with dietary intake in their children. The aim of this study was to explore the use of restrictive rules of Dutch mothers regarding their child's food intake between main meals in detail, to generate necessary input for setting priorities for further research and intervention development. A cross-sectional questionnaire study on nine restrictive rules was completed by 359 mothers of primary school children aged 4-12years. Mothers reported to use an average of 4.1 (SD 2.1) out of nine restrictive food rules and all rules measured in this study were used. The rules mother's reported to use most were not eating shortly before meals, not eating certain foods too often and not eating too much of certain foods. The rules varied according to different foods, but particularly applied to the intake of potato chips, nuts and savory snacks, candy and chocolate. Mothers of a younger age, lower educated mothers and mothers with a higher BMI were less likely to use (certain) restrictive rules. This study showed that mothers use a large variety of rules, particularly to restrict the intake of unhealthy foods and reported on several subgroups that were less likely to use (certain) rules. Our results direct further research and inform the development of interventions

Mastery and perceived autonomy support are correlates of Dutch diabetes patients' self-management and quality of life

Objective: The aim of this study was to assess the associations between type 2 diabetes patients' mastery and perceived autonomy support and their self-management skills and health-related quality of life (HRQOL). Methods: A cross-sectional questionnaire survey was conducted among 3352 patients with type 2 diabetes. Key variables were assessed with validated questionnaires. Results: Patients' mastery and perceived autonomy support correlated positively with their self-management skills (r = 0.34, p < 0.001; r = 0.37, p < 0.001) and HRQOL (r = 0.37, p < 0.001; r = 0.15, p < 0.001). In the linear regression analysis, mastery and perceived autonomy support were positive correlates of self-management (beta = 0.23; p < 0.001; beta = 0.25; p < 0.001). Patients with more physical or psychological complications had significantly lower scores on mastery, perceived autonomy support, self-management and HRQOL. Conclusion: Our results indicate the importance of mastery in relation to diabetes patients' perceived autonomy support, self-management skills and HRQOL. Practice implications: Since a greater sense of mastery is likely to increase patients' autonomous motivation to cope with their disease, interventions can aim to influence patients' motivational regulation. In addition, we confirmed the need for autonomy support to improve patients' self-management skills. Professionals can be trained to be autonomy-supportive, which relates to person-centered approaches such as motivational interviewing (MI). (C) 2014 Elsevier Ireland Ltd. All rights reserved