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Abstract Background Although most countries in the European Union are richer and healthier than ever, health inequalities remain an important public health challenge. Health-related problems and premature death have disproportionately been reported in disadvantaged neighbourhoods. Neighbourhood social capital is believed to influence the association between neighbourhood deprivation and health in children and adolescents, making it a potentially interesting concept for policymakers. Methods This study aims to review the role of social capital in health inequalities and the social gradient in health and well-being of children and adolescents. A systematic review of published quantitative literature was conducted, focussing on (1) the mediating role of neighbourhood social capital in the relationship between socio-economic status (SES) and health-related outcomes in children and adolescents and (2) the interaction between neighbourhood social capital and socio-economic characteristics in relation to health-related outcomes in children and adolescents. Three electronic databases were searched. Studies executed between 1 January 1990 and 1 September 2011 in Western countries (USA, New Zealand, Australia and Europe) that included a health-related outcome in children or adolescents and a variable that measured neighbourhood social capital were included. Results Eight studies met the inclusion criteria for the review. The findings are mixed. Only two of five studies confirmed that neighbourhood social capital mediates the association between neighbourhood deprivation and health and well-being in adolescents. Furthermore, two studies found a significant interaction between neighbourhood socio-economic factors and neighbourhood social capital, which indicates that neighbourhood social capital is especially beneficial for children who reside in deprived neighbourhoods. However, two other studies did not find a significant interaction between SES and neighbourhood social capital. Due to the broad range of studied health-related outcomes, the different operationalisations of neighbourhood social capital and the conceptual overlap between measures of SES and social capital in some studies, the factors that explain these differences in findings remain unclear. Conclusions Although the findings of this study should be interpreted with caution, the results suggest that neighbourhood social capital might play a role in the health gradient among children and adolescents. However, only two of the included studies were conducted in Europe. Furthermore, some studies focussed on specific populations and minority groups. To formulate relevant European policy recommendations, further European-focussed research on this issue is needed.

Abstract Background In order to address the challenges of an ageing population the Belgian government decided to allocate resources to the creation of geriatric day hospitals (GDHs). Although GDHs are meant to be a strategy to support general practitioners (GPs) caring for the frail elderly, few Belgian GPs seem to refer to a GDH. This study aims to explore the barriers and facilitating factors of GPs' referral to GDHs. Methods A qualitative study using focus group discussions (FGDs) was conducted. Fifteen FGDs were organized in the different Belgian regions (Flanders, Wallonia, Brussels). Results Contextual factors such as the unsatisfactory cooperation between hospital and GPs and organizational barriers such as the lack of communication on referral procedures between hospital and primary health care (PHC) were identified. Lack of basic knowledge about the concept or the local organization of GDH seemed to be a problem. Unclear task descriptions, responsibilities and activities of a GDH formed prominent points of discussion in all FGDs. Nevertheless a lot of possible advantages and disadvantages of GDHs for the patient and for the GP were mentioned. Conclusions In the case of poor referral to GDHs, focusing on improving overall collaboration between primary and secondary health care is essential. This can be achieved by actively delivering adequate information, permanent communication and more involvement of PHC in the organization and functioning of GDHs. The absence of a transparent health care system with delineated role definitions, seems to hinder the integration of new initiatives like GDHs in the care process. Strategies to enhance referral to GDHs should use a comprehensive approach.

The principal aim of this multilevel study was to assess the impact of collective efficacy and disorder, as neighborhood characteristics, and individual social capital on an individual's avoidance behavior, independent of the neighborhood composition. The theoretical backdrop to the present study integrates insights from social capital theory, collective efficacy theory, and broken windows theory. The multilevel model is based on an individual-level questionnaire of inhabitants (N = 2,730) and a neighborhood-level questionnaire of key informants in neighborhoods in Ghent, Belgium (N = 142). The results suggest small but significant neighborhood effects on an individual's avoidance behavior. Individuals with lower levels of individual social capital and who live in neighborhoods with higher levels of disorder report more avoidance behavior. [ABSTRACT FROM AUTHOR]

Background: In order to address the challenges of an ageing population the Belgian government decided to allocate resources to the creation of geriatric day hospitals (GDHs). Although GDHs are meant to be a strategy to support general practitioners (GPs) caring for the frail elderly, few Belgian GPs seem to refer to a GDH. This study aims to explore the barriers and facilitating factors of GPs' referral to GDHs. Methods: A qualitative study using focus group discussions (FGDs) was conducted. Fifteen FGDs were organized in the different Belgian regions (Flanders, Wallonia, Brussels). Results: Contextual factors such as the unsatisfactory cooperation between hospital and GPs and organizational barriers such as the lack of communication on referral procedures between hospital and primary health care (PHC) were identified. Lack of basic knowledge about the concept or the local organization of GDH seemed to be a problem. Unclear task descriptions, responsibilities and activities of a GDH formed prominent points of discussion in all FGDs. Nevertheless a lot of possible advantages and disadvantages of GDHs for the patient and for the GP were mentioned. Conclusions: In the case of poor referral to GDHs, focusing on improving overall collaboration between primary and secondary health care is essential. This can be achieved by actively delivering adequate information, permanent communication and more involvement of PHC in the organization and functioning of GDHs. The absence of a transparent health care system with delineated role definitions, seems to hinder the integration of new initiatives like GDHs in the care process. Strategies to enhance referral to GDHs should use a comprehensive approach. [ABSTRACT FROM AUTHOR]

Objective: To assess the quality of the Primary Health Care services provided to children and the feasibility of using the Brazilian version of Primary Care Assessment Tool (PCAT-Brazil) as a routine quality assessment tool. Methods: A cross-sectional study was carried out in Joanópolis, a small rural town in the State of São Paulo (SP), Brazil. Seven health professionals and 502 caretakers of children using the public health center were interviewed using the PCAT-Brazil, collecting data on the core and related attributes of Primary Health Care provided to children. The score of each attribute was calculated. Results: Caretakers rated as good the following attributes; "degree of affiliation", "first contact care - use of services", "coordinated care", and "comprehensive care - available services". The attributes of "first contact accessibility", "long term person care", "comprehensive care - offered services" and "family- and community-oriented care" were scored as poor. The health professionals only rated the attribute of "first contact accessibility" as satisfactory, and considered that all other Primary Health Care attributes needed improvement. To conduct this study, at least 1,241 working hours were invested, and the estimated budget was R$12.900,00 (or U$3,953.00). Conclusion: The use of the PCAT-Brazil as a routine assessment and planning tool seemed to be not feasible in the given setting due to high costs, lack of trained personnel and the huge workload. To overcome the encountered obstacles, advices are given based on field experience. [ABSTRACT FROM AUTHOR]

Background: Social capital has been related to various aspects of health. While literature suggests that men and women differently access and mobilize social capital, gender has received little attention within social capital research. This study examines whether the association between individual social capital and psychological distress is different for men and women., Methods: We made use of data from a representative sample of 1025 adults within 50 neighbourhoods of Ghent (Belgium), collected in the context of the cross-sectional Social capital and Well-being In Neighbourhoods in Ghent (SWING) Survey 2011. Six components of social capital were discerned: generalized trust, social support, social influence, social engagement and attachment, the volume of social capital and the mean occupational prestige in one's network. Multilevel linear regression models were fitted to explore interactions between gender and these components of social capital., Results: In accordance with previous research, men report lower levels of psychological distress than women (t = 4.40, p < 0.001). Regarding the gender gap in social capital, the findings are mixed. Only for half of the social capital variables (social support, social influence and volume of social capital), a significant gender difference is found, favouring men (t = 4.03, p < 0.001; t = 1.99, p < 0.001 and t = 4.50, p < 0.001 respectively). None of the analysed interaction terms between gender and social capital is significantly related to psychological distress., Conclusion: The analyses indicate that the association between individual social capital and psychological distress is similar for men and women. The relatively low level of gender stratification in Belgium might have influenced this finding. Furthermore, it is possible that social capital is not of greater importance for women in general, but mainly for women who are in an especially vulnerable social situation that deprives their access to alternative resources (e.g. unemployed women, single mothers). Future studies should seek to identify subgroups for whom social capital might be particularly influential, by transcending 'simple' dyads such as 'men versus women'.