Allotment gardening and health: a comparative survey among allotment gardeners and their neighbors without an allotment

<p>Abstract</p> <p>Background</p> <p>The potential contribution of allotment gardens to a healthy and active life-style is increasingly recognized, especially for elderly populations. However, few studies have empirically examined beneficial effects of allotment gardening. In the present study the health, well-being and physical activity of older and younger allotment gardeners was compared to that of controls without an allotment.</p> <p>Methods</p> <p>A survey was conducted among 121 members of 12 allotment sites in the Netherlands and a control group of 63 respondents without an allotment garden living next to the home addresses of allotment gardeners. The survey included five self-reported health measures (perceived general health, acute health complaints, physical constraints, chronic illnesses, and consultations with GP), four self-reported well-being measures (stress, life satisfaction, loneliness, and social contacts with friends) and one measure assessing self-reported levels of physical activity in summer. Respondents were divided into a younger and older group at the median of 62 years which equals the average retirement age in the Netherlands.</p> <p>Results</p> <p>After adjusting for income, education level, gender, stressful life events, physical activity in winter, and access to a garden at home as covariates, both younger and older allotment gardeners reported higher levels of physical activity during the summer than neighbors in corresponding age categories. The impacts of allotment gardening on health and well-being were moderated by age. Allotment gardeners of 62 years and older scored significantly or marginally better on all measures of health and well-being than neighbors in the same age category. Health and well-being of younger allotment gardeners did not differ from younger neighbors. The greater health and well-being benefits of allotment gardening for older gardeners may be related to the finding that older allotment gardeners were more oriented towards gardening and being active, and less towards passive relaxation.</p> <p>Conclusions</p> <p>These findings are consistent with the notion that having an allotment garden may promote an active life-style and contribute to healthy aging. However, the findings may be limited by self selection and additional research is needed to confirm and extend the current findings.</p

Explaining variation in Down's syndrome screening uptake: comparing the Netherlands with England and Denmark using documentary analysis and expert stakeholder interviews.

Background: The offer of prenatal Down’s syndrome screening is part of routine antenatal care in most of Europe; however screening uptake varies significantly across countries. Although a decision to accept or reject screening is a personal choice, it is unlikely that the widely differing uptake rates across countries can be explained by variation in individual values alone. The aim of this study was to compare Down’s syndrome screening policies and programmes in the Netherlands, where uptake is relatively low ( 90% respectively), in an attempt to explain the observed variation in national uptake rates. Methods: We used a mixed methods approach with an embedded design: a) documentary analysis and b) expert stakeholder analysis. National central statistical offices and legal documents were studied first to gain insight in demographic characteristics, cultural background, organization and structure of healthcare followed by documentary analysis of primary and secondary sources on relevant documents on DSS policies and programme. To enhance interpretation of these findings we performed in-depth interviews with relevant expert stakeholders. Results: There were many similarities in the demographics, healthcare systems, government abortion legislation and Down’s syndrome screening policy across the studied countries. However, the additional cost for Down’s syndrome screening over and above standard antenatal care in the Netherlands and an emphasis on the ‘right not to know’ about screening in this country were identified as potential explanations for the ‘low’ uptake rates of Down’s syndrome screening in the Netherlands. The social context and positive framing of the offer at the service delivery level may play a role in the relatively high uptake rates in Denmark. Conclusions: This paper makes an important contribution to understanding how macro-level demographic, social and healthcare delivery factors may have an impact on national uptake rates for Down’s syndrome screening. It has suggested a number of policy level and system characteristics that may go some way to explaining the relatively low uptake rates of Down’s syndrome screening in the Netherlands when compared to England and Denmark

Are Dutch patients willing to be seen by a physician assistant instead of a medical doctor?

Background: The employment of physician assistants (PAs) is a strategy to improve access to care. Since the new millennium, a handful of countries have turned to PAs as a means to bridge the growing gap between the supply and demand of medical services. However, little is known about this new workforce entity from the patient's perspective. The objective of this study was to assess the willingness of Dutch patients to be treated by a PA or a medical doctor (MD) under various time constraints and semi-urgent medical scenarios. Methods: A total of 450 Dutch adults were recruited to act as surrogate patients. A convenience sample was drawn from patients in a medical office waiting room in a general hospital awaiting their appointments. Each participant was screened to be naive as to what a PA and a nurse practitioner are and then read a definition of a PA and an MD. One of three medical scenarios was assigned to the participants in a patterned 1-2-3 strategy. Patients were required to make a trade-off decision of being seen after 1 hour by a PA or after 4 hours by a doctor. This forced-choice method continued with the same patient two more times with 30 minutes and 4 hours and another one of 2 hours versus 4 hours for the PA and MD, respectively. Results: Surrogate patients chose the PA over the MD 96% to 98% of the time (depending on the scenario). No differences emerged when analysed by gender, age, or parenthood status. Conclusion: Willingness to be seen by a PA was tested a priori to determine whether surrogate Dutch patients would welcome this new health-care provider. The findings suggest that employing PAs, at least in concept, may be an acceptable strategy for improving access to care with this population