We aimed to investigate whether social capital (obtaining support through indirect ties such as from neighbors) and social cohesion (interdependencies among neighbors) within neighborhoods positively affect the well being of older adults. This cross-sectional study included 945 of 1,440 (66% response rate) independently living older adults (aged ≥70 years) in Rotterdam. We fitted a hierarchical random effects model to account for the hierarchical structure of the study design: 945 older adults (Level 1) nested in 72 neighborhoods (Level 2). Univariate analyses showed that being born in the Netherlands, house ownership, education, income, social capital of individuals, neighborhood security, neighborhood services, neighborhood social capital, and neighborhood social cohesion were significantly related to the well being of older adults. Multilevel analyses showed that social capital of individuals, neighborhood services, neighborhood social capital, and neighborhood social cohesion predicted the well being of older adults. Single and poor older adults reported lower well being than did better off and married older adults. However, the effects of marital status and income were mediated by neighborhood services, social capital, and social cohesion. Neighborhood services, social capital, and social cohesion may act as buffer against the adverse effects of being single and poor on the well being of older adults. The results of this study support the importance of social capital of individuals, as well as social capital within the neighborhood and social cohesion within the neighborhood for well being of older adults. The well being of older adults may also be enhanced through the improvement of quality of neighborhood services.

Patients with multi-morbidity have complex care needs that often make healthcare delivery difficult and costly to manage. Current healthcare delivery is not tailored to the needs of patients with multi-morbidity, although multi-morbidity poses a heavy burden on patients and is related to adverse outcomes. Patient-centered care and co-creation of care are expected to improve outcomes, but the relationships among patient-centered care, co-creation of care, physical well-being, social well-being, and satisfaction with care among patients with multi-morbidity are not known. In 2017, a cross-sectional survey was conducted among 216 (of 394 eligible participants; 55% response rate) patients with multi-morbidity from eight primary care practices in Noord-Brabant, the Netherlands. Correlation and regression analyses were performed to identify relationships among patient-centered care, co-creation of care, physical well-being, social well-being, and satisfaction with care. The mean age of the patients was 74.46 ± 10.64 (range, 47–94) years. Less than half (40.8%) of the patients were male, 43.3% were single, and 39.3% were less educated. Patient-centered care and co-creation of care were correlated significantly with patients’ physical well-being, social well-being, and satisfaction with care (all p ≤ 0.001). Patient-centered care was associated with social well-being (B = 0.387, p ≤ 0.001), physical well-being (B = 0.368, p ≤ 0.001) and satisfaction with care (B = 0.425, p ≤ 0.001). Co-creation of care was associated with social well-being (B = 0.112, p = 0.006) and satisfaction with care (B = 0.119, p = 0.007). Patient-centered care and co-creation of care were associated positively with satisfaction with care and the physical and social well-being of patients with multi-morbidity in the primary care setting. Making care more tailored to the needs of patients with multi-morbidity by paying attention to patient-centered care and co-creation of care may contribute to better outcomes.

The neighborhood social environment has been identified as an important aspect of older people’s well-being. Poor neighborhood conditions can pose difficulties in obtaining support, especially for older people who live alone. Although social environments have been found to be related to well-being among older people, the longitudinal relationship between the social environment and well-being remains poorly undestood. Research on the effects of changes in neighborhood characteristics, such as social cohesion and social belonging, on well-being is lacking. Therefore, the study aims are (i) describe social cohesion, social belonging, and instrumental goals to achieve well-being among community-dwelling older people, (ii) determine whether these factors varied according to neighborhood social deprivation and compare these findings to those from chronically ill/previously hospitalized older people, and (iii) identify longitudinal relationships between social cohesion and belonging and well-being. Independently living Dutch older adults (aged ≥ 70 years) were asked to complete questionnaires in 2011 (T0) and 2013 (T1). Response rates at T0 and T1 were 66% (945/1440) and 62% (588/945), respectively. Descriptive statistics, paired sample t-tests, analysis of variance, univariate analyses and multilevel regression analyses controlling for background characteristics and baseline well-being were performed. Of 945 respondents [43% male; mean age, 77.5 ± 5.8 (range, 70–101) years], 34.7% were married and 83.3% were Dutch natives. Social cohesion remained constant over time, whereas social belonging improved (p ≤ 0.05). Older people living in socially deprived neighborhoods report poorer overall well-being and instrumental goals to achieve well-being. Baseline social cohesion, changes therein (both p ≤ .001), baseline social belonging, and changes therein (both p ≤ .05) predicted well-being at T1. This study showed that social cohesion, belonging, and changes therein predict the social as well as physical well-being of community-dwelling older people in the Netherlands over time. The creation of stronger ties among neighbors and a sense of belonging is needed.

Tuberculosis (TB) is a global health concern. Inadequate case finding and case holding has been cited as major barrier to the control of TB. The TB literature is written almost entirely from a biomedical perspective, while recent studies show that it is imperative to understand lay perception to determine why people seek treatment and may stop taking treatment. The Eastern Cape is known as a province with high TB incidence, prevalence and with one of the worst cure rates of South Africa. Its inhabitants can be considered lay experts when it comes to TB. Therefore, we investigated knowledge, perceptions of (access to) TB treatment and adherence to treatment among an Eastern Cape population.

Parental stress has been identified as a major affecter of caregivers’ psychological well-being and a risk increaser for unwillingly placing children with disabilities in the care of others. Recognition of effective means to ease caregiving burdens must guide policymaking and will help to provide better and tailored support and intervention for the children. This study aims to characterize caregivers of children with intellectual disabilities who are about to seek outside support and care and to identify the conditions under which psychological well-being and parental stress are affected using parental stress as a mediating factor. We found that parental stress and the child’s depressive feelings strongly affected psychological well-being. We also found an indirect relation of restricted caregiver social activities through parental stress. To protect psychological well-being of caregivers, support services should address depressive feelings among children with intellectual disabilities, facilitate caregivers’ social activity, and reduce stress.