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Objective: Ethnic minorities in the Netherlands experience worse (mental) health than Dutch natives. So far, socioeconomic factors, discrimination, and the migration process have been identified as underlying factors, neglecting the potential role of health-related behaviours. This study investigates the mediating effect of lack of physical activity, smoking and alcohol consumption on ethnic inequalities in (mental) health in the Netherlands.Design: Data from a municipal health survey (2012) in the four largest cities in the Netherlands, including 15,633 Dutch natives, 1,297 Surinamese, 850 Turks and 779 Moroccans were analysed. Mediation analyses were performed on the associations between ethnicity and psychological distress (range 10–50) and self-rated health (range 1–5).Results: Being from an ethnic minority was associated with higher distress and poorer self-rated health, especially for Turks (higher distress 4.69, 95%CI 4.22–5.16; poorer health 0.35, 95%CI 0.30–0.40). Moroccans and Turks were the least physically active, Turks smoked the most, and Dutch natives drank the most. Lack of physical activity partially mediated the association between Turks (6% respectively 11%) and Moroccans (13% respectively 9%) for psychological distress and self-rated health. Smoking played a mediating role (3%) in Turks.Conclusion: Lower physical activity and smoking more cigarettes partly explained ethnic health inequalities in the Netherlands. The current findings suggest that intervening and facilitating certain ethnic groups in engaging in health behaviours could contribute to improving their health and reduce ethnic health inequalities.

BackgroundDiagnostic errors have been attributed to cognitive biases (reasoning shortcuts), which are thought to result from fast reasoning. Suggested solutions include slowing down the reasoning process. However, slower reasoning is not necessarily more accurate than faster reasoning. In this study, we studied the relationship between time to diagnose and diagnostic accuracy.MethodsWe conducted a multi-center within-subjects experiment where we prospectively induced availability bias (using Mamede et al.’s methodology) in 117 internal medicine residents. Subsequently, residents diagnosed cases that resembled those bias cases but had another correct diagnosis. We determined whether residents were correct, incorrect due to bias (i.e. they provided the diagnosis induced by availability bias) or due to other causes (i.e. they provided another incorrect diagnosis) and compared time to diagnose.ResultsWe did not successfully induce bias: no significant effect of availability bias was found. Therefore, we compared correct diagnoses to all incorrect diagnoses. Residents reached correct diagnoses faster than incorrect diagnoses (115 s vs. 129 s,p p = .971) than to other errors (115 s vs 136 s,p = .082).ConclusionsWe showed that correct diagnoses were made faster than incorrect diagnoses, even within subjects. Errors due to availability bias may be different: exploratory analyses suggest a trend that biased cases were diagnosed faster than incorrect diagnoses. The hypothesis that fast reasoning leads to diagnostic errors should be revisited, but more research into the characteristics of cognitive biases is important because they may be different from other causes of diagnostic errors.

Additional file 2: Survey questions.

Additional file 1: Example of a clinical case.

Achtergrond: Veel ouderen willen zo lang mogelijk zelfstandig blijven wonen. Een woonomgeving die lichaamsbeweging stimuleert kan hierbij van groot belang zijn. Hoe een ‘beweegvriendelijke’ omgeving voor oudere mensen er precies uit moet zien is nog minder duidelijk. In een onderzoek in Spijkenisse zijn kenmerken van de woonomgeving en het beweeggedrag van oudere mensen gedetailleerd gemeten. Met deze gegevens zijn verschillende onderzoeken uitgevoerd, die in dit artikel worden samengevat. Methoden: De onderzoeken werden uitgevoerd onder mensen van 65 jaar en ouder. Met behulp van vragenlijsten, versnellingsmeters, geografische informatiesystemen en GPS-apparatuur werd onderzocht hoeveel en hoever ouderen bewogen, en of er een verband was met omgevingskenmerken. Voor de vertaling naar beleid zijn de resultaten vervolgens besproken met de deelnemers en beleidsmakers. Resultaten: De deelnemers brachten het merendeel van de dag zittend door. De totale hoeveelheid lichamelijke activiteit bestond vooral uit licht intensieve vormen van bewegen, zoals wandelen en fietsen. Hoewel veel getoetste verbanden niet statistisch significant waren, bleek dat in een woonomgeving met meer voorzieningen en een betere esthetiek meer werd gewandeld voor transportdoeleinden. Conclusie: Gedetailleerde meting toonde enkele verbanden aan tussen bepaalde fysieke omgevingskenmerken en lichamelijk activiteit. Beleid dat de beweegvriendelijkheid van de woonomgeving van oudere mensen moet bevorderen, dient zich te richten op het voorzieningenniveau en de esthetiek in de woonomgeving. De evaluatie van veranderingen in deze kenmerken kan antwoord geven op de vraag in hoeverre de fysieke woonomgeving een onderdeel moet zijn van een aanpak om de groeiende groep van oudere mensen langer zelfstandig te laten wonen.

Physical activity is important for healthy ageing, and daily walking is seen as a feasible way to be active at older ages. Yet, many older persons, particularly in lower socioeconomic groups and residing in deprived neighbourhoods, are insufficiently active. Creating a physical and social neighbourhood environment that is more supportive for walking has the potential to improve walking behaviour. Current evidence of the impact of changes to the physical and/or social environmental on walking behaviour is scarce. The aim of the NEW.ROADS study is to design, implement and evaluate changes to the physical and social environment for the purpose of increasing walking behaviour among older residents of deprived neighbourhoods. Physical and social environmental interventions were developed by matching scientific evidence on environmental determinants of walking, with input from the target population and stakeholders, and ongoing neighbourhood activities. Specifically, a neighbourhood walking route was designed and marked, and neighbourhood walking groups were organised. These environmental interventions were evaluated in a four-armed experimental study. In addition, the design of the study to evaluate the effect of these environmental changes on walking behaviour is described. Designing and implementing environmental interventions is a complex endeavour, challenged by limited available theory and evidence. Input from the target population and professional stakeholders is essential, but may also put constraints on the evaluation. NTR3800 (registered 9/1/2013)

The Daily Mile (TDM) is a school-based physical activity intervention encompassing a 15-minute run at least three times per week. This study aimed to determine (1) the effects of performing TDM for 12 weeks on Dutch primary school children&rsquo, s aerobic fitness levels and (2) if additional personal support for teachers impacted the effectiveness of TDM. Nine Dutch primary schools (n = 659 children, grades 5&ndash, 8) were allocated to a control (no TDM), intervention (12 weeks TDM) or intervention-plus (12 weeks TDM, additional personal support) group. The Shuttle Run Test (SRT) was used to assess aerobic fitness at baseline and follow-up. Data were analyzed using a multiple-imputed dataset and multilevel linear regression models to account for the clustering of students within classes and classes within schools. The regression analyses were adjusted for sex and age. Compared with the control group, significant intervention effects of TDM on SRT score were observed for the intervention group (&beta, = 1.1, 95% CI: 0.8, 1.5) and the intervention-plus group (&beta, = 0.6, 95% CI 0.3, 0.9). Additional personal support had no impact on the effectiveness of TDM. These results suggest that performing TDM at least three times per week for approximately 12 weeks increases primary school children&rsquo, s aerobic fitness. Additional personal support did not improve the effectiveness of TDM on aerobic fitness within this period. These results contribute to the body of evidence surrounding TDM, but further research is needed regarding long-term implementation of TDM.

Introduction: Migrants are overrepresented in the European HIV epidemic. We aimed to understand the barriers and facilitators to HIV testing and current treatment and healthcare needs of migrants living with HIV in Europe. Methods: A cross-sectional study was conducted in 57 HIV clinics in nine countries (Belgium, Germany, Greece, Italy, The Netherlands, Portugal, Spain, Switzerland and United Kingdom), July 2013 to July 2015. HIV-positive patients were eligible for inclusion if they were as follows: 18 years or older; foreign-born residents and diagnosed within five years of recruitment. Questionnaires were completed electronically in one of 15 languages and linked to clinical records. Primary outcomes were access to primary care and previous negative HIV test. Data were analysed using random effects logistic regression. Outcomes of interest are presented for women, heterosexual men and gay/bisexual men. Results: A total of 2093 respondents (658 women, 446 heterosexual men and 989 gay/bisexual men) were included. The prevalence of a previous negative HIV test was 46.7%, 43.4% and 82.0% for women, heterosexual and gay/bisexual men respectively. In multivariable analysis previous testing was positively associated with: receipt of post-migration antenatal care among women, permanent residency among heterosexual men and identifying as gay rather than bisexual among gay/bisexual men. Access to primary care was found to be high (>83%) in all groups and was strongly associated with country of residence. Late diagnosis was common for women and heterosexual men (60.8% and 67.1%, respectively) despite utilization of health services prior to diagnosis. Across all groups almost three-quarters of people on antiretrovirals had an HIV viral load

__Background:__ Neighbourhood inequalities in psychological distress are well reported, but underlying mechanisms remain poorly understood. The main purposes of this study were to investigate associations between structural neighbourhood conditions and psychological distress, and to explore the potential mediating role of neighbourhood social cohesion. __Methods:__ Cross-sectional questionnaire study on a random sample of 18 173 residents aged ≥16 years (response 49%) from the four largest cities in the Netherlands. Psychological distress was measured with the Kessler Psychological Distress Scale (K10). Structural environmental factors under study were neighbourhood socio-economic status (SES), neighbourhood green, urbanity and home maintenance. Neighbourhood social cohesion was measured by five statements and aggregated to the neighbourhood level by using ecometrics methodology. Multilevel linear regression analysis was used to investigate associations of neighbourhoods characteristics with psychological distress, adjusted for individual level characteristics. __Results:__ High neighbourhood SES and neighbourhood social cohesion were associated with decreased psychological distress. Adjusted for individual level characteristics and neighbourhood SES, only neighbourhood social cohesion remained significantly associated with psychological distress. Neighbourhood social cohesion accounted for 38% of the differences in the association between neighbourhood SES and psychological distress. __Conclusions:__ High neighbourhood social cohesion is significantly associated with decreased psychological distress among residents of the four largest cities in the Netherlands. Reducing neighbourhood inequalities in psychological distress may require increasing social interactions among neighbourhood residents.

BACKGROUND physical activity (PA) is an important factor to promote healthy ageing. However, older adults are not physically active enough. Socio-ecological models suggest that weather conditions are determinants of PA and may bias relations between other environmental factors and PA. This may especially be the case for the most vulnerable and inactive older persons. Understanding the role of weather conditions is based on daily or seasonal variation in weather, but it can be improved by using hour-to-hour measured weather conditions. PURPOSE to study the hour-to-hour relationships between weather factors and objectively measured walking and cycling in a sample of Dutch older adults. METHODS baseline data (2013) of a sub-sample of older adults (3,248 observations clustered in 43 adults) participating in The Neighborhood Walking in Rotterdam Older ADultS (NEW.ROADS) trial were used. Participants wore a GPS logger for 7 consecutive days. Hour-to-hour weather data (temperature, wind speed, rain and sun time) for the city of Rotterdam were retrieved from the Royal Netherlands Meteorological Institute. Multilevel linear regression models were fitted with minutes walked and minutes cycled as dependent variables and the weather variables as independent variables. RESULTS the time older adults walked increased with higher temperature, higher wind speed and the absence of rain. The time cycled increased with higher temperature. CONCLUSIONS this study improves the evidence of weather factors as a determinant for walking and cycling in older adults. Studies on the relation between environmental factors and PA should consider adjustment for weather factors.

Background Changing the physical environment is one way to promote physical activity and improve health, but evidence on intervention effectiveness is mixed. The theoretical perspectives and conceptual issues discussed or used in evaluative studies and related literature may contribute to these inconsistencies. We aimed to advance the intervention research agenda by systematically searching for and synthesising the literature pertaining to these wider conceptual issues. Methods We searched for editorials, commentaries, reviews, or primary qualitative or quantitative studies in multiple disciplines by electronic searches of key databases (MEDLINE and MEDLINE In-Process, Web of Science, Cochrane Reviews, ProQuest for dissertations, Health Evidence, EPPI-Centre, TRID and NICE) and snowballing. We extracted theoretical and conceptual material and used thematic analysis in an in-depth, configurative narrative approach to synthesis. Results Our initial searches identified 2760 potential sources from fields including public health, sociology, behavioural science and transport, of which 104 were included. By first separating out and then drawing together this material, we produced a synthesis that identified five high-level conceptual themes: one concerning outcomes (physical activity as a behaviour and a socially embedded practice), one concerning exposures (environmental interventions as structural changes) and three concerning how interventions bring about their effects (the importance of social and physical context; (un) observable mechanisms linking interventions and changes in physical activity; and interventions as events in complex systems). These themes are inter-related but have rarely been considered together in the disparate literatures. Drawing on these insights, we present a more generalisable way of thinking about how environmental interventions work which could be used in future evaluation studies. Conclusions Environmental and policy interventions are socially embedded and operate within a system. Evaluators should acknowledge this, and the philosophical perspective taken in their evaluation. Across disciplinary fields, future studies should seek to understand how interventions work through considering these systems, the context in which interventions take place, and the (un) observable mechanisms that may operate. This will help ensure that findings can be more easily interpreted and widely applied by policymakers. We hope that highlighting these conceptual issues will help others to interpret and improve upon a somewhat contested evidence base. Electronic supplementary material The online version of this article (doi: 10.1186/s12966-017-0610-z) contains supplementary material, which is available to authorized users.

Background There is little evidence on how changing the physical environment changes health-related behaviours. We studied the effects of the new M74 motorway (freeway) — opened in 2011 — and the existing M8 motorway in Glasgow, Scotland, on physical activity and sedentary behaviour among local residents. Methods This natural experimental study used baseline (T1; 2005) and follow-up data (T2; 2013) from a longitudinal cohort (N = 365) and two cross-sectional samples (T1 N = 980; T2 N = 978). Adult participants were recruited from three study areas: one surrounding the new motorway, one surrounding the existing motorway, and a third, control, area without a motorway. The outcomes were self-reported time spent sitting, walking, and in moderate-to-vigorous physical activity (MVPA). Motorway exposure was defined in terms of (1) study area and (2) distance from home to the nearest motorway junction. Outcomes were regressed on exposures in two-part (walking and MVPA) or linear (sedentary behaviour) cohort and repeat cross-sectional models, adjusted for baseline behaviour and sociodemographic covariates. Results Cohort participants living in the M8 area were less likely to participate in MVPA at follow-up than those living in the area without a motorway (OR 0.37; 95%CI 0.15, 0.91). Within the M8 area, those living closer to the motorway were also less likely to do so (OR 0.30; 95%CI 0.09, 0.97). No other statistically significant results were found. Conclusions We found some evidence of a negative association between exposure to an existing urban motorway and MVPA. However, the behavioural impacts of motorways are likely to be complex and evolve over time. Electronic supplementary material The online version of this article (doi:10.1186/s12966-017-0557-0) contains supplementary material, which is available to authorized users.

Background Making travel easier can improve people’s access to opportunities, but motor transport also incurs substantial undesirable health and social impacts. Aims To assess how a new urban motorway affected travel and activity patterns, road accidents and well-being in local communities, and how these impacts were experienced and brought about. Design The Traffic and Health in Glasgow study, a mixed-method controlled before-and-after study. Setting Glasgow, UK. Participants Repeat cross-sectional survey samples of 1345 and 1343 adults, recruited in 2005 and 2013, respectively. Of these, 365 formed a longitudinal cohort, 196 took part in a quantitative substudy using accelerometers and global positioning system receivers and 30, living within 400 m of the new motorway, took part in a qualitative substudy along with 12 other informants. Complementary analyses used police STATS19 road traffic accident data (1997–2014) and Scottish Household Survey travel diaries (2009–13). Intervention A new 5-mile, six-lane section of the M74 motorway, opened in 2011 and running through predominantly deprived neighbourhoods in south-east Glasgow, with associated changes to the urban landscape. Main outcome measures Differences in self-reported travel behaviour (1-day travel record), physical activity (short International Physical Activity Questionnaire) and well-being [Short Form 8 Health Survey (SF-8) and a short version of the Warwick–Edinburgh Mental Well-being Scale], and in the incidence of road traffic accidents. Methods A combination of multivariable cohort, cross-sectional, repeat cross-sectional and interrupted time series regression analyses comparing residents of the ‘M74 corridor’ intervention area and two matched control areas, complemented by novel qualitative spatial methods. Graded measures of the proximity of the motorway to each participant’s home served as a further basis for controlled comparisons. Results Both benefits and harms were identified. Cohort participants living closer to the new motorway experienced significantly reduced mental well-being (mental component summary of the SF-8 scale) over time compared with those living further away [linear regression coefficient –3.6, 95% confidence interval (CI) –6.6 to –0.7]. In the area surrounding an existing motorway, this association was concentrated among those with chronic conditions. In repeat cross-sectional analyses, participants living closer to a new motorway junction were more likely to report using a car at follow-up than those living further away (odds ratio 3.4, 95% CI 1.1 to 10.7). We found weaker quantitative evidence of a decline in physical activity participation and no quantitative evidence of an overall change in either active travel or accidents associated with motorway exposure. Qualitative evidence suggested that, although the new motorway improved connectivity for those with dispersed social networks and access to motor vehicles, the impacts were more complex for others, some of whom found the motorway to be a cause of severance. Changes in community composition and cohesion, and perceptions of personal safety, were widely perceived as more important to local people. Limitations A key limitation of natural experimental studies is that the risk of residual confounding cannot be eliminated. Conclusions Overall, these findings highlight the potential for urban infrastructural projects of this kind to add further burdens to already disadvantaged communities, exacerbating inequalities and contributing to poorer health outcomes. The health and social impacts of such initiatives should be more fully taken into account in planning and research. Funding The National Institute for Health Research Public Health Research programme.

Background: \ud Health and wellbeing are partly shaped by the neighbourhood environment. In 2011, an\ud eight kilometre (five mile) extension to the M74 motorway was opened in Glasgow, Scotland,\ud constructed through a predominantly urban, deprived area. We evaluated the effects\ud of the new motorway on wellbeing in local residents.\ud Methods: \ud This natural experimental study involved a longitudinal cohort (n = 365) and two cross-sectional\ud samples (baseline n = 980; follow-up n = 978) recruited in 2005 and 2013. Adults from\ud one of three study areas—surrounding the new motorway, another existing motorway, or no\ud motorway—completed a postal survey. Within areas, individual measures of motorway\ud proximity were calculated. Wellbeing was assessed with the mental (MCS-8) and physical\ud (PCS-8) components of the SF-8 scale at both time points, and the short Warwick-Edinburgh\ud Mental Well-being Scale (SWEMWBS) at follow-up only.\ud Results\ud In multivariable linear regression analyses, cohort participants living nearer to the new M74\ud motorway experienced significantly reduced mental wellbeing over time (MCS-8: -3.6, 95%\ud CI -6.6 to -0.7) compared to those living further away. In cross-sectional and repeat crosssectional\ud analyses, an interaction was found whereby participants with a chronic condition\ud living nearer to the established M8 motorway experienced reduced (MCS-8: -3.7, 95% CI-8.3 to 0.9) or poorer (SWEMWBS: -1.1, 95% CI -2.0 to -0.3) mental wellbeing compared to\ud those living further away.\ud Conclusions\ud We found some evidence that living near to a new motorway worsened local residents’ wellbeing.\ud In an area with an existing motorway, negative impacts appeared to be concentrated\ud in those with chronic conditions, which may exacerbate existing health inequalities and contribute\ud to poorer health outcomes. Health impacts of this type of urban regeneration intervention\ud should be more fully taken into account in future policy and planning.

We evaluated the effects of a new motorway built through deprived neighbourhoods on travel behaviour in residents. This natural experiment comprised a longitudinal cohort (n=365) and two cross-sectional samples (baseline n=980; follow-up n=978) recruited in 2005 and 2013. Adults from one of three study areas - surrounding the new motorway (South), an existing motorway (East), or no motorway (North) - completed a previous day travel record. Adjusted two-part regression models examined associations between exposure and outcome. Compared to the North, cohort participants in the South were more likely to undertake travel by any mode (OR 2.1, 95% CI 1.0–4.2) at follow-up. Within the South study area, cohort participants living closer to a motorway junction were more likely to travel by any mode at follow-up (OR 4.7, 95% CI 1.1–19.7), and cross-sectional participants living closer were more likely to use a car at follow-up (OR 3.4, 95% CI 1.1–10.7), compared to those living further away. Overall, the new motorway appeared to promote travel and car use in those living nearby, but did not influence active travel. This may propagate socioeconomic inequalities in non-car owners.

__Background:__ Various studies have reported socioeconomic inequalities in mental health among urban residents. This study aimed at investigating whether neighborhood social cohesion influences the associations between socio-economic factors and psychological distress. __Methods:__ Cross-sectional questionnaire study on a random sample of 18,173 residents aged 16 years and older from 211 neighborhoods in the four largest cities in the Netherlands. Psychological distress was the dependent variable (scale range 10-50). Neighborhood social cohesion was measured by five statements and aggregated to the neighborhood level using ecometrics methodology. Multilevel linear regression analyses were used to investigate cross-level interactions, adjusted for neighborhood deprivation, between individual characteristics and social cohesion with psychological distress. __Results:__ The mean level of psychological distress among urban residents was 17.2. Recipients of disability, social assistance or unemployment benefits reported higher psychological distress (β = 5.6, 95%CI 5.2 to 5.9) than those in paid employment. Persons with some or great financial difficulties reported higher psychological distress (β = 3.4, 95%CI 3.2 to 3.6) than those with little or no financial problems. Socio-demographic factors were also associated with psychological distress, albeit with much lower influence. Living in a neighborhood with high social cohesion instead of low social cohesion was associated with a lower psychological distress of 22% among recipients of disability, social assistance or unemployment benefits and of 13% among citizens with financial difficulties. __Conclusions:__ Residing in socially cohesive neighborhoods may reduce the influence of lack of paid employment and financial difficulties on psychological distress among urban adults. Urban policies aimed at improving neighborhood social cohesion may contribute to decreasing socio-economic inequalities in mental health.

BACKGROUND AND PURPOSE Platelet-derived growth factor (PDGF) modulates the airway smooth muscle (ASM) 'contractile' phenotype to a more 'proliferative' phenotype, resulting in increased proliferation and reduced contractility. Such phenotypic modulation may contribute to airway remodelling in asthma. We have previously shown that the cAMP effector molecules, protein kinase A (PKA) and the exchange protein directly activated by cAMP (Epac) inhibited PDGF-induced phenotypic modulation in bovine ASM. Here, we investigated these mechanisms in human ASM strips and cells. EXPERIMENTAL APPROACH ASM strips were incubated with PDGF in the absence or presence of the activators of Epac (8-pCPT-2'-O-Me-cAMP) or of PKA (6-Bnz-cAMP) for 4 days. Strips were mounted for isometric contraction experiments or analysed for the expression of contractile markers. Cell proliferation was measured and proliferative markers were analysed under similar conditions. KEY RESULTS Activation of Epac and PKA prevented PDGF-induced ASM strip hypocontractility, and restored the expression of smooth muscle actin, myosin and calponin, which had been markedly diminished by PDGF. Epac and PKA activation inhibited the PDGF-induced ASM cell proliferation and G1/S phase transition and the expression and phosphorylation of cell cycle regulators. CONCLUSIONS AND IMPLICATIONS Epac and PKA maintain a normally contractile ASM phenotype in a mitogenic environment, suggesting that specific activators of Epac and PKA may be beneficial in the treatment of airway remodelling in asthma.

BACKGROUND AND PURPOSE Changes in airway smooth muscle (ASM) phenotype may contribute to the pathogenesis of airway disease. Platelet-derived growth factor (PDGF) switches ASM from a contractile to a proliferative, hypo-contractile phenotype, a process requiring activation of extracellular signal-regulated kinase (ERK) and p70S6 Kinase (p70S6K). The effects of cAMP-elevating agents on these processes is unknown. Here, we investigated the effects of cAMP elevation by prostaglandin E2 (PGE2) and the activation of the cAMP effectors, protein kinase A (PKA) and exchange protein activated by cAMP (Epac) on PDGF-induced phenotype switching in bovine tracheal smooth muscle (BTSM). EXPERIMENTAL APPROACH Effects of long-term treatment with the PGE2 analogue 16,16-dimethyl-PGE2, the selective Epac activator, 8-pCPT-2′-O-Me-cAMP and the selective PKA activator, 6-Bnz-cAMP were assessed on the induction of a hypo-contractile, proliferative BTSM phenotype and on activation of ERK and p70S6K, both induced by PDGF. KEY RESULTS Treatment with 16,16-dimethyl-PGE2 inhibited PDGF-induced proliferation of BTSM cells and maintained BTSM strip contractility and contractile protein expression in the presence of PDGF. Activation of both Epac and PKA similarly prevented PDGF-induced phenotype switching and PDGF-induced activation of ERK. Interestingly, only PKA activation resulted in inhibition of PDGF-induced phosphorylation of p70S6K. CONCLUSIONS AND IMPLICATIONS Our data indicate for the first time that both Epac and PKA regulated switching of ASM phenotype via differential inhibition of ERK and p70S6K pathways. These findings suggest that cAMP elevation may be beneficial in the treatment of long-term changes in airway disease.

This longitudinal study aimed to identify individual and environmental predictors of adolescents' sports participation and to examine whether availability of sports facilities moderated the intention-behaviour relation. Data were obtained from the ENvironmental Determinants of Obesity in Rotterdam SchoolchildrEn study (2005/2006 to 2007/2008). A total of 247 adolescents (48% boys, mean age at follow-up 15 years) completed the surveys at baseline and follow-up. At baseline, adolescents completed a survey that assessed engagement in sports participation, attitude, subjective norm, perceived behavioural control and intention towards sports participation. Availability of sports facilities (availability) was assessed using a geographic information system. At follow-up, sports participation was again examined. Multiple logistic regression analyses were conducted to test associations between availability of sports facilities, theory of planned behaviour variables and the interaction of intention by availability of sports facilities, with sports participation at follow-up. Simple slopes analysis was conducted to decompose the interaction effect. A significant availability x intention interaction effect [odds ratio: 1.10; 95% confidence interval: 1.00-1.20] was found. Simple slopes analysis showed that intention was more strongly associated with sports participation when sports facilities were more readily available. The results of this study indicate that the intention-sports participation association appears to be stronger when more facilities are available.

We conducted fieldwork on Bonaire and Curaçao, Netherlands Antilles, to assess the distribution and abundance of resident diurnal raptors. In total, seventy-three 1 km 2 sample plots were selected following a stratified random method and three landscape types were distinguished, i.e. cultivated area, hills and terrace. The diurnal raptors observed were the Crested Caracara Caracara plancus (93 records), Whitetailed Hawk Buteo albicaudatus (37), and the American Kestrel Falco sparverius (44 on Curaçao only). In the hills and on the terraces, all species were more abundant on Curaçao than on Bonaire. Caracaras were found significantly more in hills compared to terraces or cultivated land on both islands, as did White-tailed Hawks on Curaçao. The American Kestrel made more use of cultivated area and least of hills. As detection of the raptors did not seem to differ between the landscapes and between the islands, we infer that the observed differences in distribution are a true reflection of their habitat use. Our results suggest that the ongoing urbanization on Curaçao and Bonaire may lead to a decline in the Caracara and the White-tailed Hawk. For the American Kestrel, cultivated areas - including urbanized parts - apparently provide the open area the birds need for hunting.

We present an updated checklist of the birds of the islands of Aruba, Curaçao and Bonaire, and the islets of Klein Curaçao and Klein Bonaire, southern Caribbean, and compare this with earlier checklists (K.H. Voous, Stud. Fauna Curaçao Carib. Isl. 7: 1-260, 1957; Ardea 53: 205-234, 1965; Birds of the Netherlands Antilles, 1983). The avifaunal composition of the three main islands is relatively similar (similarity coefficients of 74-78% for residents and 65-73% for migrants) whereas the two islets are, or were in the past, inhabited mainly by sea birds. The total number of recorded resident species for these islands has increased from 115 (1957) to 168 (2006), and of migrants from 117 (1957) to 236 (2006). This increase was most prominent for the island of Aruba (residents from 34 to 56, migrants from 28 to 166), and least for Curaçao (residents from 42 to 57, migrants from 55 to 168). Historically Klein Curaçao was an important nesting site for seabirds, i.e. boobies, gulls and terns, but mining of guano in the 19th century significantly lowered the ornithological value of the islet. Klein Bonaire suffered heavily from the presence of goats but is slowly recovering following the islet’s inclusion in the protected area network. Despite the presence of a large number of migrants, or non-breeding birds, the islands are of limited importance as a stop-over site for birds. Migrants arrive from both the north (boreal migrants from North and Middle America) and the south (austral migrants from South America). We illustrate the phenology of migration with the numbers of migrant warblers species and migrant gulls and terns, and the abundance of migrant raptors recorded on the three islands. While migrants can be observed in all months of the year, for the warblers and raptors there are clear peaks in boreal spring (Mar-Apr) and autumn (Oct-Nov), with few summering birds in the boreal summer. The gulls and terns appear to be present in more or less equal numbers during all months of the year. About two-thirds of the breeding residents are either deemed common or rather common, and this proportion is consistent for all three islands. Of the breeding residents few are common or very common on one island, and at the same time scarce or very scarce on other islands. Notable exceptions are Greater Flamingo Phoenicopterus ruber that is an abundant breeding resident on Bonaire, a regular non-breeding visitor (with several attempts of breeding) in the low hundreds on Curaçao, but is only an irregular non-breeding visitor on Aruba. Yellow Oriole Icterus nigrogularis is common as a breeding resident on Curaçao, rather common on Bonaire, but scarce on Aruba. The islands are home to six globally threatened or near-threatened species. Two species, the Caribbean Coot Fulica caribaea and the Yellow-shouldered Amazon Amazona barbadensis are represented by globally significant populations, whereas the other species (Piping Plover Charadrius melodus, Olive-sided Flycatcher Contopus cooperi, Cerulean Warbler Dendroica cerulea and Golden-winged Warbler Vermivora chrysoptera) use the islands as over-wintering or stop-over site during migration. The Yellow-shouldered Amazon is found mainly on Bonaire, where there is a resident population of some 400 birds; small numbers are occasionally observed on Aruba and these may comprise migrant birds from Venezuela’s Paraguaná Peninsula or may represent released birds. The Caribbean Coot is present on all three islands and its status on the islands has improved, with more breeding sites occupied and more birds present than in Voous’s time. From a conservation perspective, a significant breeding population of Greater Flamingo on Bonaire and a smaller population on Curaçao are noteworthy as well as a breeding colony of Least Tern Sterna antillarum on Klein Bonaire. On the basis of the presence of these threatened and conservation-dependent species we identify fifteen Important Bird Areas, i.e. four on Aruba, five on Curaçao and six (including Klein Bonaire) on Bonaire.

Objective. Report frequencies of adolescents' active commuting to school in an inner city environment in the Netherlands, and to explore potential socio-demographic correlates of active commuting to school. Methods. Cross-sectional data were obtained from the ENDORSE study (2005-2006) including 1361 adolescents (response=82%), aged 12-15 from 16 schools in Rotterdam. Socio-demographic variables were assessed by questionnaire. height and weight were measured and distance to school was calculated based on route planner information. Multilevel logistic regressions were performed to analyze the data. Results. The proportions of participants categorized as walkers, cyclists, non-active commuters were 12%, 35% and 34% respectively. With cyclists as the reference category, adolescents of non-Western ethnic background were more likely to be walkers (OR=4.1; 95% CI=2.1-8.2) and non-active commuters (OR=5.1; 95% CI=3.3-7.9), compared to native Dutch adolescents. A further distance from home to school was inversely associated with being a walker (OR=0.22; 95% CI=0.17-0.29) and being a cyclist (OR=0.83; 95% CI=0.79-0.86) and positively associated with being a non-active commuter (OR=1.2; 95% CI=1.16-1.23). Conclusion. Almost 50% of the adolescents reported to actively commute to school on most school days, and mode of commuting was associated with ethnicity and distance. Further research is needed to examine main barriers to active commuting among adolescents from non-Western ethnic background. (C) 2008 Elsevier Inc. All rights reserved.

On Bonaire we assessed Bam Owl Tyto alba diets at four discrete sites. The 233 fresh pellets contained 755 identifiable prey items from four taxonomic orders. Average prey diversity differed two- to threefold between sites. Dietary composition showed large spatial variations between sites, from predominantly insectivorous to avian. Between-island variation was assessed by comparing the dietary composition of populations of Barn Owls on nine islands throughout the Caribbean region as reported in the literature. On 8/9 islands mammals (mainly rodents and bats) formed the main diet. On half of the islands about a fifth or more of the prey comprised birds. Reptiles and/or insects were eaten on 5/9 islands, but rarely dominated the diet. These large within-island dietary differences reflect differential prey availabilities in the Caribbean, possibly enhanced locally by specialisation.

Background Mechanisms linking changes to the environment with changes in physical activity are poorly understood. Insights into mechanisms of interventions can help strengthen causal attribution and improve understanding of divergent response patterns. We examined the causal pathways linking exposure to new transport infrastructure with changes in cycling to work. Methods We used baseline (2009) and follow-up (2012) data (N = 469) from the Commuting and Health in Cambridge natural experimental study (Cambridge, UK). Exposure to new infrastructure in the form of the Cambridgeshire Guided Busway was defined using residential proximity. Mediators studied were changes in perceptions of the route to work, theory of planned behaviour constructs and self-reported use of the new infrastructure. Outcomes were modelled as an increase, decrease or no change in weekly cycle commuting time. We used regression analyses to identify combinations of mediators forming potential pathways between exposure and outcome. We then tested these pathways in a path model and stratified analyses by baseline level of active commuting. Results We identified changes in perceptions of the route to work, and use of the cycle path, as potential mediators. Of these potential mediators, only use of the path significantly explained (85%) the effect of the infrastructure in increasing cycling. Path use also explained a decrease in cycling among more active commuters. Conclusion The findings strengthen the causal argument that changing the environment led to changes in health-related behaviour via use of the new infrastructure, but also show how some commuters may have spent less time cycling as a result., Highlights • Environmental perceptions did not explain effects of new infrastructure on cycling. • Motivational factors did not explain effects of new infrastructure on cycling. • Eighty-five percent of the effect on increasing cycling was explained by use of the infrastructure. • These results strengthen quasi-experimental causal attribution and understanding.

The incidence of hybridisation in birds differs greatly between orders and is expected to be low in or- ders comprising few species. The divers or loons (Gavi- iformes) are a species-poor group in which apparent hybridisation has been reported infrequently. Here we report on a hybrid diver stored in the collections of the Zoological Museum Amsterdam. The bird shows a heterogeneous set of characters, some shared with the putative parent species White-billed Diver Gavia adamsii and Great Northern Diver G. immer, others being intermediate between the two. A Canonical Discrimi- nant Function analysis positions the bird between these two putative parent species, making a hybrid status quite likely. We evaluate the evidence for hybridisation in the order Gaviiformes and conclude that hybridisa- tion has been suspected in four of the five species, though documentation is limited. If this high incidence could be confirmed, it would rank among the highest of any avian order, contradicting the assumption that incidence of hybridisation in small orders is relatively low.

The Caribbean Coot (Fulica caribaea) is endemic to the Caribbean region where it is uncommon to rare. Little is known about its breeding biology. From museum specimens, archives and correspondence, we document 134 records for Aruba, Curacao and Bonaire, Netherlands Antilles, from the years 1955-2004, and map their distribution. The islands are arid and rainfall can be unpredictable but with the establishment of permanent freshwater ponds since the 1970s, the Caribbean Coot appears to have become more common. We recorded 68 cases of breeding for the three islands. Although breeding can occur in almost any month, there is a clear preponderance for birds to breed in the first few calendar months of the year, approximately three months after the annual peak in rainfall.

This study aimed to explore whether individual cognitions and neighbourhood social capital strengthen each other in their relation with engaging in sports at least three times per week. Cross-sectional analyses on data from the last wave of the YouRAction trial (2009-2010, Rotterdam, the Netherlands; baseline response: 98%) were conducted. In total 1129 had data on the last wave questionnaire (93%) and 832 of them had complete data on a self-administered questionnaire on frequency of sports participation, perceived neighbourhood social capital, cognitions (attitude, subjective norm, perceived behavioural control and intention toward sport participation) and demographics. Ecometric methods were used to aggregate perceived neighbourhood social capital to the neighbourhood level. Multilevel logistic regression analyses (neighbourhood and individual as levels) were conducted to examine associations of cognitions, neighbourhood social capital and the social capital by individual cognition interaction with fit norm compliance. If the interaction was significant, simple slopes analyses were conducted to decompose interaction effects. It was found that neighbourhood social capital was significantly associated with fit norm compliance (OR: 5.40; 95% CI: 1.13-25.74). Moreover, neighbourhood social capital moderated the association of attitude, perceived behavioural control and intention with fit norm compliance. The simple slope analyses visualized that the associations of cognitions with fit norm compliance were stronger in case of more neighbourhood social capital. Hence, higher levels of neighbourhood social capital strengthen the associations of attitude, perceived behavioural control and intention in their association with fit norm compliance. (C) 2014 Elsevier Ltd. All rights reserved.

The persuasive game, Travelling Rose, aims to enhance walking activities of elderly residents living in neighbourhoods characterized by a low socioeconomic status. The game consists of a wooden pass-on box containing user-reports and instructions on how to find a companion, how to generate a surprise together, how to give this surprise a fellow neighbourhood member, and how to pass on the Travelling Rose box. The persuasive catch of the Travelling Rose is present when the companions are generating the surprise and are instructed to take a walk in the neighbourhood for easing social communication and flourishing creative ideas. In this chapter, the design process leading to the final version of the Travelling Rose is described, involving user studies, concept testing, and iterative prototyping. Secondly, the final prototype is presented and framed using the theoretical Persuasive Game Design model.

BackgroundStudies suggest that neighborhood ethnic diversity may be important when it comes to understanding ethnic inequalities in mental health. The primary aim of this study was to investigate whether neighborhood ethnic diversity moderated the association between the ethnic minority status and child behavioral and emotional problems.MethodsWe included 3076 preschoolers participating in the Generation R Study, a birth cohort study in Rotterdam, the Netherlands. At child age 3-years, parents completed the Child Behavior Checklist (CBCL/1,5-5). Individual-level data, assessed with questionnaires, was combined with neighborhood-level data. Multi-level logistic regression models predicted the Odds Ratios for the CBCL total problems score as a function of maternal ethnic background and neighborhood ethnic diversity, computed with the Racial Diversity Index and categorized into tertiles. Interaction on the additive scale was assessed using Relative Access Risk due to Interaction.ResultsBeing from an ethnic minority was associated with child behavioral and emotional problems in unadjusted (OR 2.76, 95% CI 1.88-4.04) and adjusted models (OR 2.64, 95% CI 1.79-3.92). Residing in a high diversity neighborhood was associated with child behavioral and emotional problems in unadjusted (OR 2.03, 95% CI 1.13-3.64) but not in adjusted models (OR 0.89, 95% CI 0.51-1.57). When stratifying by the three levels of neighborhood ethnic diversity, ethnic inequalities in behavioral and emotional problems were greatest in low diversity neighborhoods (OR 5.24, 95%CI 2.47-11.14), smaller in high diversity neighborhoods (OR 3.15, 95% CI 1.66-5.99) and smallest in medium diversity neighborhoods (OR 1.59, 95% CI 0.90-2.82). Tests for interaction (when comparing medium to low diversity neighborhoods) trended towards negative on both the additive and multiplicative scale for the maternal-report (RERI: -3.22, 95% CI -0.70-0.59; Ratio of ORs: 0.30, 95% CI 0.12-0.76).ConclusionThis study suggests that ethnic inequalities in child behavioral and emotional problems may be greatest in ethnically homogeneous neighborhoods.

Purpose: The purpose of this longitudinal study is to identify risk groups for disengagement from sports during adolescence. In addition, it will be explored whether cognitive and environmental factors can explain socio-demographic differences in disengagement from sports. Methods: Data were obtained from the Environmental Determinants of Obesity in Rotterdam Schoolchildren study, and 357 adolescents were eligible for analysis. Socio-demographics (gender, ethnicity, education), individual cognitions and neighbourhood perceptions were assessed at baseline (2005/2006), and sports participation at baseline and at follow-up (2007/2008). Two dichotomous outcome variables were constructed: (i) disengagement from sports (yes/no) and (ii) ceased compliance with the fitnorm (i.e. cease engaging in sports epsilon 3 times/wk) (yes/no). In logistic regression and mediation analyses, we identified socio-demographic differences in the two outcomes. Subsequently, we applied mediation analyses to identify the contribution of cognitive and environmental explanatory factors of the socio-demographic differences. Results: Girls [odds ratio (OR): 2.5, 95% confidence interval (CI): 1.5-4.5] were more likely than boys to disengage from sports. Girls (OR: 2.5, 95% CI: 1.4-4.2), adolescents of non-Western background (OR: 1.8, 95% CI: 1.0-3.0) and those in lower educational levels (OR: 1.7, 95% CI: 1.0-2.9) were more likely to cease compliance with the fitnorm. Perceived neighbourhood safety partly explained gender differences in disengagement from sports (8%). Intention partly explained ethnical (32%) and educational differences (37%) in ceasing compliance with the fitnorm. Conclusions: Girls, lower-educated adolescents and those with a non-Western background showed more pronounced reductions in sports participation and compliance with the fitnorm. Intention and perceived neighbourhood safety could partially explain these differences.

Background Interventions to change the built environment offer a promising approach for promoting physical activity and improving health. However, there has been little theoretical consideration of the underlying mechanisms. In a systematic review we aimed first, to map the potential causal pathways linking environmental changes with changes in physical activity, and second, to review the evidence for specific mechanisms. Here we focus on the first stage of the review. Methods We searched seven electronic databases (Cochrane, Medline, ProQuest, HealthEvidence, National Institute for Health and Care Excellence, Transport Research International Documentation, and Web of Science) representing a range of disciplines using a systematic, transparent, iterative process, which was completed in April, 2015. We did not assess study quality or apply date restrictions. Theoretical and conceptual material was extracted from review articles, theoretical papers, and intervention studies. We used thematic analysis in an in-depth, configurative, narrative approach to synthesis, aiming to derive a set of plausible generalisable pathways by which environmental changes could promote changes in physical activity. Findings Our initial searches identified 2760 potential sources from specialties that included public health, sociology, behavioural science, and transport. We included 79 papers. Broad overarching themes were related to physical activity as a behaviour and a practice, environmental interventions as structural changes, complexity and systems, contexts and observable or unobservable mechanisms. We devised a more generalisable set of hypothesised mechanisms linking environmental changes with changes in physical activity through combinations of changes in both attributes and judgments of both physical and social environments, as well as in individual reasoning. Mechanisms were either conscious or unconscious and operated at the individual and societal levels. Interpretation This conceptual and theoretical synthesis provides a new generalisable conceptual framework to contribute to the design and conduct of assessments of environmental interventions. Future research should seek to understand judgments and interpretations of the environment and how environmental and behavioural changes become embedded. Our thematic analysis highlights conceptual areas of dissonance and common ground for multidisciplinary research teams. In the second part of the review, we will search for evidence on specific mechanisms to assess what environmental interventions work, for whom, in what contexts, and how. Funding Medical Research Council (unit programme number MC_UU_12015/6). JP was also supported by a National Institute for Health Research postdoctoral research fellowship.

Background Increasing people's mobility can improve access to diverse opportunities, but new roads are associated with noise and community severance, and their effects on physical activity, injuries, and health inequalities are poorly understood. This study investigated how an urban motorway, opened in Glasgow in 2011, affected travel and activity patterns, injuries, and wellbeing in local communities, and how these impacts were experienced and brought about. Methods This was a mixed-method, controlled, before and after natural experimental study. We conducted multivariable cohort, cross-sectional, and repeat cross-sectional analyses of survey responses from adults resident in the M74 corridor (intervention area) and two matched control areas, one surrounding the existing M8 motorway and one with no motorway (numbers by area: baseline [in 2005] 449, 431, 465, respectively; follow-up [in 2013] 430, 446, 467; cohort participants 126, 112, 127). We also conducted interrupted time-series analyses of police casualty data (STATS19 forms, 1997–2014; n=78 919), and thematic analysis of ethnographic data from 42 participants using constant comparison. Graded exposure measures based on the log distance of the motorway from each participant's home served as a further basis for controlled comparisons. The study was approved by the University of Glasgow Faculty of Medicine (ref FM01304) and Social Sciences (refs 400120077, 400130156, and 400130157) ethics committees. Findings Living closer to the new motorway was associated with an estimated 3·6 unit (95% CI 0·7–6·6) reduction over time in mental wellbeing (mental component summary score [MCS-8] of SF-8) per unit of proximity in cohort analysis, and associated with a greater likelihood of car use at follow-up in repeat cross-sectional analysis (odds ratio 3·4, 95% CI 1·1–10·7). We found some evidence that participation in physical activity declined among cohort participants living closer to the existing M8 motorway (0·4, 0·2–0·9). We found no evidence of changes in active travel (survey data) or casualties (STATS19 data). Although the new motorway improved connectivity for individuals with more dispersed social networks and access to a motor vehicle, the impacts on those with neither of them were more complex and sometimes negative. Changes in community composition and cohesion, and perceptions of personal safety, were widely perceived as more important influences than was the opening of the motorway. Interpretation Although the study identified both benefits and harms, overall these findings highlight the potential for new major road infrastructure to add further burdens to already disadvantaged communities, exacerbating inequalities and contributing to poorer health outcomes. Funding National Institute for Health Research (NIHR) Public Health Research Programme. The funder had no role in the design of the study, the analysis or interpretation of the data, the writing of the abstract, or the decision to submit it for publication.

Background Individual and population wellbeing is partly shaped by neighbourhood physical environments, which have the potential to amplify social deprivation. In 2011, a five-mile extension to the M74 motorway was opened through predominantly urban, deprived areas of Glasgow. Proponents argued that the new motorway would improve mobility and contribute to wider regeneration and economic revival, which might improve wellbeing. Opponents countered that it would worsen wellbeing in local residents by increasing traffic noise, air pollution and severance (separation from amenities or social networks). We aimed to evaluate the effects of living near an urban motorway on wellbeing in local residents. Methods We conducted a natural experimental study, using data from a longitudinal cohort nested within two distinct cross-sectional samples of adults aged 16 years or over who responded to postal surveys at baseline (2005) or follow-up (2013). We sampled from three matched study areas: the first surrounding the new M74 motorway extension; the second surrounding the established M8 motorway, constructed in the 1960s; and a third control area with no motorway. Within each area, individual exposure (proximity) to the nearest motorway was represented by the negative natural logarithm of the straight-line distance from each participant’s home. Wellbeing was assessed using the mental (MCS-8) and physical (PCS-8) component summaries of the SF-8 scale at both time points, and the short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS) at follow-up only. Linear regression analyses were conducted in Stata13 to explore associations between motorway exposure and wellbeing, adjusted for potential confounders. Results 365 participants formed the cohort. The remaining 980 (baseline) and 978 (follow-up) participants together formed the repeat cross-sectional sample. Cohort participants living nearer to the new M74 motorway experienced significantly reduced mental wellbeing over time (MCS-8: −3.6, 95% CI −6.6 to −0.7) compared to those living further away. In cross-sectional and repeat cross-sectional analyses, an interaction was found whereby participants with a chronic condition living nearer to the established M8 motorway experienced reduced (MCS-8: −3.7, 95% CI −8.3 to 0.9) or poorer (SWEMWBS: −1.1, 95% CI −2.0 to −0.3) mental wellbeing compared to those living further away. Conclusion Using a repeat cross-sectional analysis to complement and corroborate a cohort analysis subject to inevitable attrition over time, we found some evidence that living near to a new motorway worsened local residents’ wellbeing. In an area with an existing motorway, negative impacts were concentrated in those with chronic conditions, which may exacerbate existing health inequalities.

Background Interventions to change the built environment offer a promising approach for promoting physical activity and improving health. However, there has been little theoretical consideration of the underlying mechanisms by which such interventions might operate. This systematic review aims first to map the potential causal pathways linking environmental changes with changes in physical activity, and second to review the evidence for specific mechanisms. This presentation will focus on the first, mapping, stage of the review. Methods We used a systematic, transparent and iterative approach, drawing on realist principles. As we were interested in scoping a diverse landscape of theories linking the environment, physical activity and health, we searched seven electronic literature databases representing a range of disciplines (Cochrane, Medline, ProQuest, HealthEvidence, NICE, TRID and Web of Science). Theoretical and conceptual material was extracted from a variety of source documents including review articles, theoretical papers and intervention studies. We used thematic analysis in an in-depth, configurative approach to synthesis, aiming to derive a set of plausible generalisable pathways by which environmental changes could promote changes in physical activity. Results Our initial searches identified 2760 potential sources from fields including public health, sociology, behavioural science, and transport. From these, 79 conceptual and review papers were included. A further 30 papers were found through reference lists, and 26 primary intervention studies were identified. Interventions included the creation or refurbishment of whole neighbourhoods (n = 2), greenspaces or parks (n = 9), trails or paths (n = 11), cycle infrastructure (n = 2), and public transport services (n = 2). The key themes elicited related to social practice, agency and structure, conscious and unconscious processes, and the interdependence of social and physical environments. A set of interlinked potential pathways was identified, linking environmental changes with changes in physical activity through combinations of changes in both attributes and judgements of both physical and social environments, as well as in individual reasoning. Conclusion Mapping these theoretical pathways provides greater understanding of the potential individual and social mechanisms of change. In the second part of the review, we will search for evidence to support or refute specific mechanisms. Assembling this evidence will shed light on why some environmental interventions do or do not ‘work’, how they operate, and in which contexts and population groups they are most effective. This will allow us to refine our understanding and identify promising intervention points and strategies.

BackgroundIn this study the one and six months effects of the computer-tailored YouRAction (targeting individual level determinants) and YouRAction+e (targeting in addition perceived environmental determinants) on compliance with the moderate-to-vigorous physical activity (MVPA) guideline and weight status are examined. In addition the use and appreciation of both interventions are studied.MethodsA three-armed cluster randomized trial was conducted in 2009-2010 with measurements at baseline, one and six months post intervention. School classes were assigned to one of the study arms (YouRaction, YouRAction+e and Generic Information (GI) control group). MVPA was derived from self-reports at baseline, one and six months post intervention. Body Mass Index and waist circumference were measured at baseline and six months post intervention in a random sub-sample of the population. Use of the interventions was measured by webserver logs and appreciation by self-reports. Multilevel regression analyses were conducted to study the effects of the intervention against the GI control group. ANOVA's and chi-square tests were used to describe differences in use and appreciation between study arms.ResultsThere were no statistically significant intervention effects on compliance with the MVPA guideline, overweight or WC. Access to the full intervention was significantly lower for YouRAction (24.0%) and YouRAction+e (21.7%) compared to the GI (54.4%).ConclusionThis study could not demonstrate that the YouRAction and YouRAction+e interventions were effective in promoting MVPA or improve anthropometric outcomes among adolescents, compared to generic information. Insufficient use and exposure to the intervention content may be an explanation for the lack of effects.Trial registrationTrialRegister.nl NTR1923.

Background The aim of this study is to explore whether availability of sports facilities, parks, and neighbourhood social capital (NSC) and their interaction are associated with leisure time sports participation among Dutch adolescents. Methods Cross-sectional analyses were conducted on complete data from the last wave of the YouRAction evaluation trial. Adolescents (n = 852) completed a questionnaire asking for sports participation, perceived NSC and demographics. Ecometric methods were used to aggregate perceived NSC to zip code level. Availability of sports facilities and parks was assessed by means of geographic information systems within the zip-code area and within a 1600 meter buffer. Multilevel logistic regression analyses, with neighborhood and individual as levels, were conducted to examine associations between physical and social environmental factors and leisure time sports participation. Simple slopes analysis was conducted to decompose interaction effects. Results NSC was significantly associated with sports participation (OR: 3.51 (95%CI: 1.18;10.41)) after adjustment for potential confounders. Availability of sports facilities and availability of parks were not associated with sports participation. A significant interaction between NSC and density of parks within the neighbourhood area (OR: 1.22 (90%CI: 1.01;1.34)) was found. Decomposition of the interaction term showed that adolescents were most likely to engage in leisure time sports when both availability of parks and NSC were highest. Conclusions The results of this study indicate that leisure time sports participation is associated with levels of NSC, but not with availability of parks or sports facilities. In addition, NSC and availability of parks in the zip code area interacted in such a way that leisure time sports participation is most likely among adolescents living in zip code areas with higher levels of NSC, and higher availability of parks. Hence, availability of parks appears only to be important for leisure time sports participation when NSC is high.

This study aims to explore whether objectively measured availability of parks and sports facilities within three different buffer sizes are associated with moderate-to-vigorous physical activity (MVPA) among adolescents, and to identify potential cognitive mediators of this association. Data were obtained from adolescents (N=209, mean age: 14.5 (SD: 0.6) years) at the follow-up measurement of the Children Living in Active Neighbourhoods study in 2004. MVPA was measured using accelerometers. Availability of parks and sport facilities were measured within 400, 800 and 2000 m buffers around participants' residential homes. Potential mediators (self-efficacy, attitude and the perceived availability of parks and sports grounds) were measured by self-administered questionnaires. No direct association was found between the objectively measured availability of facilities and objective assessments of MVPA and no evidence for mediation by cognitions was found in any of the buffer sizes. More specific and sensitive measures may be needed to understand environmental correlates of MVPA. (C) 2011 Elsevier Ltd. All rights reserved.

Objective. The objective of the present study was to assess the longitudinal association between cycling to school and weight status in two cities where cycling to school is common Kristiansand (Norway) and Rotterdam (The Netherlands). Methods. Data from two studies ENDORSE (Rotterdam) and YOUTH IN BALANCE (Kristiansand) were used. Both studies were longitudinal with two years between time (T) 1 and T2 measurements, and with mean age at T1 of 13.2 and 13.4 years, respectively. The sample was categorized into the following groups according to responses about main mode of commuting to school at the two time points: NO cycling, STARTED cycling, STOPPED cycling and CONTINUED cycling. Measured weight and height were obtained at both time points, and weight status (overweight vs. not overweight) was calculated using international classification criteria for BMI. The two datasets were analyzed separately and together. Results. In multilevel logistic regression models of the combined sample, adjusting for weight status at Time 1, those who stopped cycling had greater odds of being overweight at T2 (OR = 3.19; 95% CI = 1.41-7.24) while those continued cycling had lower odds of being overweight (OR = 0.44; 95% CI = 0.21-0.88), separately compared to the other three groups together. The same trend was observed in both study samples. Conclusions. This study shows that there are longitudinal associations between cycling to school and weight status in two cities where cycling to school is common, implying that interventions aiming at reducing overweight/obesity among adolescents might consider the promotion of sustained cycling behaviour.

Changes in airway smooth muscle (ASM) phenotype may contribute to the pathogenesis of airway disease. Platelet-derived growth factor (PDGF) switches ASM from a contractile to a proliferative, hypo-contractile phenotype, a process requiring activation of extracellular signal-regulated kinase (ERK) and p70(S6) Kinase (p70(S6K) ). The effects of cAMP-elevating agents on these processes is unknown. Here, we investigated the effects of cAMP elevation by prostaglandin E(2) (PGE(2) ) and the activation of the cAMP effectors, protein kinase A (PKA) and exchange protein activated by cAMP (Epac) on PDGF-induced phenotype switching in bovine tracheal smooth muscle (BTSM).Effects of long-term treatment with the PGE(2) analogue 16,16-dimethyl-PGE(2) , the selective Epac activator, 8-pCPT-2'-O-Me-cAMP and the selective PKA activator, 6-Bnz-cAMP were assessed on the induction of a hypo-contractile, proliferative BTSM phenotype and on activation of ERK and p70(S6K) , both induced by PDGF.Treatment with 16,16-dimethyl-PGE(2) inhibited PDGF-induced proliferation of BTSM cells and maintained BTSM strip contractility and contractile protein expression in the presence of PDGF. Activation of both Epac and PKA similarly prevented PDGF-induced phenotype switching and PDGF-induced activation of ERK. Interestingly, only PKA activation resulted in inhibition of PDGF-induced phosphorylation of p70(S6K) .Our data indicate for the first time that both Epac and PKA regulated switching of ASM phenotype via differential inhibition of ERK and p70(S6K) pathways. These findings suggest that cAMP elevation may be beneficial in the treatment of long-term changes in airway disease.

Background Increasing physical activity (PA) among adolescents is an important health promotion goal. PA has numerous positive health effects, but the majority of Dutch adolescents do not meet PA requirements. The present paper describes the systematic development of a theory-based computer-tailored intervention, YouRAction, which targets individual and environmental factors determining PA among adolescents. Design The intervention development was guided by the Intervention Mapping protocol, in order to define clear program objectives, theoretical methods and practical strategies, ensure systematic program planning and pilot-testing, and anticipate on implementation and evaluation. Two versions of YouRAction were developed: one that targets individual determinants and an extended version that also provides feedback on opportunities to be active in the neighbourhood. Key determinants that were targeted included: knowledge and awareness, attitudes, self-efficacy and subjective norms. The extended version also addressed perceived availability of neighbourhood PA facilities. Both versions aimed to increase levels of moderate-to-vigorous PA among adolescents. The intervention structure was based on self-regulation theory, comprising of five steps in the process of successful goal pursuit. Monitoring of PA behaviour and behavioural and normative feedback were used to increase awareness of PA behaviour; motivation was enhanced by targeting self-efficacy and attitudes, by means of various interactive strategies, such as web movies; the perceived environment was targeted by visualizing opportunities to be active in an interactive geographical map of the home environment; in the goal setting phase, the adolescents were guided in setting a goal and developing an action plan to achieve this goal; in the phase of active goal pursuit adolescents try to achieve their goal and in the evaluation phase the achievements are evaluated. Based on the results of the evaluation adolescents could revise their goal or choose another behaviour to focus on. The intervention is delivered in a classroom setting in three lessons. YouRAction will be evaluated in a cluster-randomized trial, with classes as unit of randomization. Evaluation will focus on PA outcomes, cognitive mediators/moderators and process measures. Discussion The planned development of YouRAction resulted in two computer-tailored interventions aimed at the promotion of PA in a Dutch secondary school setting. Trial registration NTR1923

Background This study examined the associations of the perceived and objective environment with adolescent engagement in sports activities and walking and cycling in leisure time. It also explored the degree of agreement between objective and perceived availability of physical activity (PA) facilities in neighborhoods. Methods Cross-sectional data on physical activity, the perceived availability of physical activity opportunities (perceived physical environment) was assessed through a questionnaire and the objective availability of PA opportunities (objective physical environment) was obtained through GIS data. The final sample included 654 adolescents with a mean age of 14.1 (SD = 1.2) years. Results Perceived availability of sports facilities and parks was significantly associated with engaging in sports (OR: 1.73; 95% CI: 1.16-2.56) and with walking and cycling in leisure time (OR: 1.66; 95% CI: 1.07-2.57) respectively. Agreement between objective and perceived environment was low to moderate with Kappa values ranging from -0.005 to 0.053. Conclusion The perceived environment was the stronger correlate of PA behavior among adolescents. There were substantial differences between assessments of objective and perceived physical environment., International Journal of Behavioral Nutrition and Physical Activity, 6, ISSN:1479-5868

Na+ [C6H2(NO2)3O]− H2O,Mr=269.11, monoclinic,C2/m (No. 12),a=13.065(1),b=20.065(2),c=3.6957(4) A,β=90.75(1)°,V=968.7(1) A3,Z=4,Dm=1.848 g cm−3 (by flotation),Dx=1.845 g cm−3, λ(CuKα)=1.54184 A,μ(CuKα)=17.5 cm−1,F(000)=540,T=295 K,R=0.055,wR=0.060 for 879 observed reflections withI≥2.5σ(I). p]In the structure the picrate anion has exact twofold symmetry, the water molecule has exact mirror symmetry and the two sodium cations occupy special positions on inversion centers at (0, 1/2, 0) and (1/2, 1/2, 1/2). The phenyl ring together with the four substituent N and O atoms is strictly planar, but the phenyl ring is severely distorted from hexagonal symmetry, as is commonly observed in structures containing the picrate fragment. Both sodium ions are eight-coordinated with Na(1) and Na(2) in a cubic and distorted cubic arrangement, respectively. Na(1) coordinates to four charged phenoxide O atoms and four O atoms of nitro groups, and Na(2) to four O atoms of nitro groups and four water molecules. The water molecule donates two hydrogen bonds to symmetry-related O(2) atoms ofortho nitro groups. Two symmetry-related O(3) atoms ofortho nitro groups serve as acceptors in a very unusual asymmetric bifurcated C-H⋯O hydrogen bond.

In 2005 to 2006 we assessed the status of the Caribbean coot Fulica caribaea in the Netherlands Antilles, largely semi-arid islands in the South Caribbean, with small numbers of permanently available fresh water bodies. The Caribbean coot is a freshwater bird which is dependent on the seasonal availability of freshwater ponds for breeding; it breeds on 4 of the 6 islands of the Netherlands Antilles, viz. Curaçao (first recorded in 1956), Bonaire (1974), Aruba (1977), and St. Maarten (1981). Compared to the period up to and including 1979, group sizes in 1980 to 2006 were larger on Curaçao, and it appears more abundant in the latter period on all islands. We report on 49 sites (>5 ha) in the Caribbean where the species has been recorded, or where we would expect it to occur on the basis of available habitat. Threats to the Caribbean coot include drainage or reclamation of habitat, hunting, and pollution. Few sites receive protection. The coot has a restricted range of occupancy of some 1000 km2, spread out over 13 islands, representing 10 countries. Based on its restricted range, coupled with high levels of threat and the limited amount of protection, we recommend that the species be included as 'Vulnerable' in the IUCN (International Union for the Conservation of Nature and Natural Resources, World Conservation Union) Red list. An increase in the level of (legal) protection, in addition to an increase in the amount of habitat included in the regional protected areas network and heightening the awareness of the needs of this Caribbean endemic are overdue. The establishment of permanent freshwater ponds, especially in the arid parts of its range, appears favourable for the species, and may aid conservation.

We documented the ontogeny of androgen receptor (AR) immunoreactivity for rat lumbar motoneurons of the sexually dimorphic motor pools, the spinal nucleus of the bulbocavernosus (SNB) and the dorsolateral nucleus (DLN), and for the sexually monomorphic retrodorsolateral nucleus (RDLN). We also assessed the ontogeny of AR immunoreactivity in the rat sexually dimorphic levator ani (LA), which is a target muscle for SNB motoneurons. Lumbar spinal cords and LA muscles from gonadally intact males at ages postnatal days (P)7, P10, and P14 and as adults were incubated with the rabbit antiserum PG-21. Half of the prepubertal males (P7-P14) received 200 micrograms of testosterone propionate (TP) 2 hours prior to death to enhance immunodetection of ARs. We found that SNB motoneurons developed AR immunoreactivity at first and achieved adult levels by P10. In contrast, the number of RDLN motoneurons with AR-immunopositive nuclei during development remained well below the adult number. Development of AR immunoreactivity in the DLN shared characteristics with both the SNB and the RDLN. AR immunoreactivity developed in some DLN motoneurons by P10, although the percentage of labelled motoneurons remained below that in adulthood. Acute TP treatment significantly increased the number of SNB motoneurons with AR-positive nuclei at P7. The LA showed a robust pattern of AR immunostaining from P7 to adulthood. Immunostaining was present only in nuclei and constituted only a subpopulation of the nuclei present in muscle. The present results confirm and extend previous results based on steroid autoradiography and steroid binding assays regarding regional and developmental differences in the expression of ARs.

Germ cells contain androgen receptor (AR). Germ cells do not contain androgen receptor. These diametrically opposed views are at the center of a long-running dispute regarding the cell site of androgen action within the testis (reviewed in 1, 2). In this chapter we examine AR distribution in the rat and mouse testis using an affinity-purified rabbit polyclonal antibody made to a 21 amino acid peptide of the amino terminus of the rat AR (3–5). Results reveal the presence of AR in testicular somatic cells, as well as in elongated spermatids.