Weight change and quality of life in a community-based population

*Objectives:* This study investigates the longitudinal association between 5-year weight change and quality of life (QoL) in Dutch men and women.

*Design:* A prospective cohort study (1998, 2000, 2003) in a population based sample. Subjects: 2,414 men and women from the Maastricht region of the Netherlands.

*Measurements:* QoL outcomes were measured by the RAND-36 (eight subscales and two overall composite scores, physical and mental health (PCS and MCS)). Weight was measured on a scale. Weight change was calculated as change in weight between 1998 and 2003. In addition, 5-year weight change was also categorized in three groups: weight losers, weight maintainers, and weight gainers. All analyses were stratified for gender.

*Results:* A total of 598 men (50%) and 646 women (54%) maintained their weight, 177 men (15%) and 163 women (14%) lost more than 2.5 kg, and 410 men (35%) and 379 women (32%) gained more than 2.5 kg. Associations between 5-year weight change and QoL were found for MCS ([beta] = 0.13, 95% CI: 0.02|0.24) in women, and PCS ([beta] = -0.09, 95% CI: -0.17|-0.00; [beta] = -0.10, 95% CI: -0.19|-0.01) in men and women respectively. Moreover, associations between weight change and QoL were most pronounced for women of normal weight and obese men. Furthermore, in both genders, weight gainers showed a greater reduction on all physical components of QoL compared with weight maintainers. However, after 5-years weight gainers and weight losers did not significantly differ from weight maintainers in the mean change of MCS and PCS.

*Conclusion:* Weight gain was inversely associated with the physical domains of QoL in women and obese men. Conversely, in women, weight gain was positively associated with the mental domains of QoL. No differences between weight losers and weight gainers were found in mean change of QoL compared with weight maintainers

Symptoms and functional status of patients with disseminated cancer visiting outpatient departments

Considerable research has focused on pain and other symptoms in terminal cancer patients referred to hospices and palliative care services. These patients differ from Dutch cancer patients in the palliative stage of their disease because the latter are cared for by general practitioners at home and medical specialists in outpatient departments. To clarify the experience of these Dutch patients, a study was started to investigate the prevalence and severity of pain and other symptoms as well as the functional status of consecutive patients visiting oncology outpatient departments for follow-up. After randomization, one group (I) of patients was interviewed at home by a general practitioner using structured questionnaires. The other group (II) received the questionnaires by mail, and scored the symptoms independently. The results of the symptom assessment show that patients in groups I and II suffered 2.4 (SD = 1.7) and 2.8 (SD = 2.0) symptoms, respectively. Between 30% and 40% of all patients reported constipation, nausea, loss of appetite, coughing, and dyspnea. These percentages were 50% lower when only moderate, severe, or extremely distressing symptoms were included. Sixty percent of all patients had pain, and 20% indicated a daytime pain score of 5 or greater on a scale of 0 to 10. Functional status was measured by the COOPWONCA charts; the mean score for the charts "physical fitness" and "daily activities" was 1.5 points lower for cancer patients than a random sample from the community of the same age and gender. The findings of this study should motivate doctors to put more energy in symptom assessment and interventions in palliative care. Record 29 of 32 - SilverPlatter MEDLINE(R)

Validity and repeatability of a simple index derived from the short physical activity questionnaire used in the European Prospective Investigation into Cancer and Nutrition (EPIC) study

Original article can be found at: http://journals.cambridge.org/action/displayJournal?jid=PHN Copyright The Authors. DOI: 10.1079/PHN2002439Peer reviewe

Involving children in creating a healthy environment in low Socioeconomic Position (SEP) neighborhoods in The Netherlands:A Participatory Action Research (PAR) project

To ensure that health behavior interventions for children living in low socioeconomic position (SEP) neighborhoods are in line with children’s wishes and needs, participation of the children in the development, implementation, and evaluation is crucial. In this paper, we show how children living in three low SEP neighborhoods in the Netherlands can be involved in Participatory Action Research (PAR) by using the photovoice method, and what influences this research process. Observations, informal chats, semi structured interviews, and focus group discussions with children and professionals were done to evaluate the research process. The photovoice method provided comprehensive information from the children’s perspectives. With the help of the community workers, the children identified feasible actions. We found that it is important to constantly discuss the research process with participants, start with a concrete question or problem, and adapt the project to the local context and skills of participants

Impact of provision of cardiovascular disease risk estimates to healthcare professionals and patients: a systematic review.

OBJECTIVE: To systematically review whether the provision of information on cardiovascular disease (CVD) risk to healthcare professionals and patients impacts their decision-making, behaviour and ultimately patient health. DESIGN: A systematic review. DATA SOURCES: An electronic literature search of MEDLINE and PubMed from 01/01/2004 to 01/06/2013 with no language restriction and manual screening of reference lists of systematic reviews on similar topics and all included papers. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: (1) Primary research published in a peer-reviewed journal; (2) inclusion of participants with no history of CVD; (3) intervention strategy consisted of provision of a CVD risk model estimate to either professionals or patients; and (4) the only difference between the intervention group and control group (or the only intervention in the case of before-after studies) was the provision of a CVD risk model estimate. RESULTS: After duplicates were removed, the initial electronic search identified 9671 papers. We screened 196 papers at title and abstract level and included 17 studies. The heterogeneity of the studies limited the analysis, but together they showed that provision of risk information to patients improved the accuracy of risk perception without decreasing quality of life or increasing anxiety, but had little effect on lifestyle. Providing risk information to physicians increased prescribing of lipid-lowering and blood pressure medication, with greatest effects in those with CVD risk >20% (relative risk for change in prescribing 2.13 (1.02 to 4.63) and 2.38 (1.11 to 5.10) respectively). Overall, there was a trend towards reductions in cholesterol and blood pressure and a statistically significant reduction in modelled CVD risk (-0.39% (-0.71 to -0.07)) after, on average, 12 months. CONCLUSIONS: There seems evidence that providing CVD risk model estimates to professionals and patients improves perceived CVD risk and medical prescribing, with little evidence of harm on psychological well-being.BS was supported by the European Commission Framework 7, EPIC-CVD: Individualised CVD risk assessment: tailoring targeted and cost-effective approaches to Europe's diverse populations, Grant agreement no: 279233. JUS was supported by a National Institute of Health Research (NIHR) Clinical Lectureship.This is the final version of the article. It first appeared from BMJ via http://dx.doi.org/10.1136/bmjopen-2015-00871

Analyzing the contributions of a government-commissioned research project: a case study

Background: It often remains unclear to investigators how their research contributes to the work of the commissioner. We initiated the 'Risk Model' case study to gain insight into how a Dutch National Institute for Public Health and the Environment (RIVM) project and its knowledge products contribute to the commissioner's work, the commissioner being the Health Care Inspectorate. We aimed to identify the alignment efforts that influenced the research project contributions. Based on the literature, we expected interaction between investigators and key users to be the most determining factor for the contributions of a research project.Methods: In this qualitative case study, we analyzed the alignment efforts and contributions in the Risk Model project by means of document analysis and interviews according to the evaluation method Contribution Mapping. Furthermore, a map of the research process was drafted and a feedback session was organized. After the feedback session with stakeholders discussing the findings, we completed the case study report.Results: Both organizations had divergent views on the ownership of the research product and the relationship between RIVM and the Inspectorate, which resulted in different expectations. The RIVM considered the use of the risk models to be problematic, but the inspectors had a positive opinion about its contributions. Investigators, inspectors, and managers were not aware of these remarkably different perceptions. In this research project, we identified six relevant categories of both horizontal alignment efforts (between investigators and key users) as well as vertical alignment efforts (within own organization) that influenced the contributions to the Inspectorate's work.Conclusions: Relevant alignment efforts influencing the contributions of the project became manifest at three levels: the first level directly relates to the project, the second to the organizational environment, and the third to the formal and historical relationship between the organizations. Both external and internal alignments influence the contributions of a research project. Based on the findings, we recommend that research institutes invest in a reflective attitude towards the social aspects of research projects at all levels of the organization and develop alignment strategies to enhance the contributions of research. © 2014 Hegger et al.; licensee BioMed Central Ltd

Reliability and validity of the Activity Questionnaire for Adults and Adolescents (AQuAA)

BACKGROUND: Accurate measures of physical activity are highly needed. We evaluated the test-retest reliability and construct validity of the self-report Activity Questionnaire for Adults and Adolescents (AQuAA). The AQuAA is a commonly used questionnaire in Dutch youth. METHODS: In the test-retest reliability study, 53 adolescents and 58 adults completed the AQuAA twice, with an interval of two weeks. In the validity study, 33 adolescents and 47 adults wore an accelerometer (Actigraph) during two weeks, and subsequently completed the AQuAA. RESULTS: In adolescents the test-retest reliability was fair to moderate (intraclass correlations (ICCs) ranging from 0.30 to 0.59). In adults the test-retest reliability was fair to moderate for the time spent on sedentary, light and moderate intensity activities (ICCs ranging from 0.49 to 0.60), but poor for time spent on vigorous activities (ICC = -0.005). The correlations between the AQuAA and Actigraph were low and nonsignificant. Compared with the Actigraph, time spent on all physical activities was significantly higher according to the questionnaire (except for light intensity activities in adolescents), while time spent on sedentary behaviours was significantly lower. CONCLUSION: Reliability of the AQuAA is fair to moderate. The validity of the AQuAA compared to an accelerometer is poor. Both adolescents and adults underestimate the time spent on sedentary behaviours and overestimate the time spent on physical activitie

Leergangevaluatie: de Curvo-strategie in de praktijk

Leergangevaluatie staat in de literatuur bekend als een moeilijke en tijdrovende aangelegenheid. Aan het nut hiervan wordt vaak getwijfeld. Hebben evaluatie-experts er al de grootste moeite mee, nog moeilijker wordt het wanneer de evaluatie wordt uigevoerd door schoolteams binnen de context van een school. Deze ‘tour de force’ is met behulp van de Curvo-strategie uitgevoerd in vier projecten. Het ging hierbij om schoolteams die, met steun van interne en/of externe begeleiders, zelf hun leergangen evalueerden. Deze projecten zijn uitgevoerd in een MAVO/LBO-scholengemeenschap, een Kleuterschool en een Nieuwe Leraren Opleiding. In dit artikel presenteren we de opzet en resultaten van het empirisch onderzoek naar het functioneren van de Curvo-strategie in deze projecten. Centraal staat hierbij de vraag: Is de Curvo-strategie uitvoerbaar, effectief en efficiënt bij het structureren van het proces van leergangevaluatie? De resultaten van dit onderzoek geven aan dat de Curvo-strategie deze krachtproef redelijk heeft doorstaan in drie van de vier projecten. De strategie bleek een belangrijk hulpmiddel bij het evalueren in de praktijk. Een grondige bezinning op enkele uitgangspunten en vooronderstellingen achter de deelstrategie is echter gewenst. De deelstrategie kan op verschillende punten worden verbeterd, waardoor de waardevolle elementen nog beter tot hun recht komen