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Emerging evidence suggests that living near major roads might adversely affect cognition. However, little is known about its relationship with the incidence of dementia, Parkinson's disease, and multiple sclerosis. We aimed to investigate the association between residential proximity to major roadways and the incidence of these three neurological diseases in Ontario, Canada. In this population-based cohort study, we assembled two population-based cohorts including all adults aged 20–50 years (about 4·4 million; multiple sclerosis cohort) and all adults aged 55–85 years (about 2·2 million; dementia or Parkinson's disease cohort) who resided in Ontario, Canada on April 1, 2001. Eligible patients were free of these neurological diseases, Ontario residents for 5 years or longer, and Canadian-born. We ascertained the individual's proximity to major roadways based on their residential postal-code address in 1996, 5 years before cohort inception. Incident diagnoses of dementia, Parkinson's disease, and multiple sclerosis were ascertained from provincial health administrative databases with validated algorithms. We assessed the associations between traffic proximity and incident dementia, Parkinson's disease, and multiple sclerosis using Cox proportional hazards models, adjusting for individual and contextual factors such as diabetes, brain injury, and neighbourhood income. We did various sensitivity analyses, such as adjusting for access to neurologists and exposure to selected air pollutants, and restricting to never movers and urban dwellers. Between 2001, and 2012, we identified 243 611 incident cases of dementia, 31 577 cases of Parkinson's disease, and 9247 cases of multiple sclerosis. The adjusted hazard ratio (HR) of incident dementia was 1·07 for people living less than 50 m from a major traffic road (95% CI 1·06–1·08), 1·04 (1·02–1·05) for 50–100 m, 1·02 (1·01–1·03) for 101–200 m, and 1·00 (0·99–1·01) for 201–300 m versus further than 300 m (p for trend=0·0349). The associations were robust to sensitivity analyses and seemed stronger among urban residents, especially those who lived in major cities (HR 1·12, 95% CI 1·10–1·14 for people living <50 m from a major traffic road), and who never moved (1·12, 1·10–1·14 for people living <50 m from a major traffic road). No association was found with Parkinson's disease or multiple sclerosis. In this large population-based cohort, living close to heavy traffic was associated with a higher incidence of dementia, but not with Parkinson's disease or multiple sclerosis. Health Canada (MOA-4500314182).

Food insecurity is the limited or uncertain availability of nutritionally adequate and safe foods or limited or uncertain ability to acquire foods in socially acceptable ways. The study presents a comparison of the principal determinants of individual food insecurity in Europe and other Continents, with particular regard to gender, since the literature clearly states the importance of women in the administration of food in the household. The study of gender related differences in food insecurity is particularly important in Europe, since women experience food insecurity at a larger extent than men, but with a variability related to the geographical distribution and with complex relationships with economic and social drivers. Using a large international sample of individual level data, that allows the analysis for developed Countries for the first time, and the first experiential measure of food insecurity comparable at the global level, the paper analyses the principal determinants of gender differences in food insecurity. In order to verify if women’s vulnerability in food insecurity is moderated by specific factors, the modelling approach allows gender to vary by education, poverty, place of residence. The results suggest that the driver that could most mitigate women disadvantage is education: people with a university degree present a lower probability of experiencing food insecurity, both for men and for women. On the contrary, familial characteristics, such as the number of children in the household, present a higher impact on women’s food insecurity than on men’s.

This study investigated the role of resilience as a mediator and the place of residence as a moderator of parenting stress and parental burnout. The Parenting Stress Index-Short Form, Parental Burnout Assessment, and Connor-Davidson Resilience Scale were administered to 249 Chinese parents of children with ASD (M = 33.95 years, SD = 7.6). Results show that resilience partially mediates the relation between parenting stress and parental burnout. Besides, both the effect of parenting stress on parental burnout and the mediating effect of resilience are moderated by rural/urban residence. This study highlights parenting stress is a risk factor for parental burnout and resilience is the potential mechanism underlying this relation. These findings provide implications for family services for parents of children with ASD.

The existing literature on neighbourhood effects suggests that a number of factors within local areas can have an impact on health, including environmental hazards, social networks and the socio-economic status of the area. However, there is minimal evidence regarding the role of housing organisations in shaping these effects. This article sets out the findings from a three-year longitudinal, mixed methods study of tenants of three housing organisations operating in the social and private rented sectors, examining different aspects of neighbourhood experience and their relationship to health and wellbeing outcomes. The findings demonstrate impacts of the immediate environment in terms of close neighbours, the wider neighbourhood environment, and social support networks, which are heavily influenced by tenant characteristics, previous experience and expectations. The services provided by housing organisations, themselves shaped by regulation and market factors, are also important. The findings will have relevance for tenants, housing providers, public health professionals and policy makers.

The disruption caused by Covid-19 in the educational sector may last longer than originally predicted. To better understand the current situation, this article analyses the mental health status of university students during the pandemic and investigates the learning conditions needed to support students. The sample included 557 undergraduate students who took part in an online survey. Overall, the students reported coping well during lockdown but indicated that lecturers were challenged by distance teaching, which created some stress for the students.

ObjectiveBreaking bad news about life-threatening and possibly terminal conditions is a crucial part of paediatric care for children in this situation. Little is known about how the parents of children with life-threatening conditions experience communication of bad news. The objective of this study is to analyse parents’ experiences (barriers and facilitators) of communication of bad news.DesignA qualitative study consisting of a constant comparative analysis of in-depth interviews conducted with parents.SettingThe Netherlands.ParticipantsSixty-four parents—bereaved and non-bereaved—of 44 children (aged 1–12 years, 61% deceased) with a life-threatening condition.InterventionsNone.ResultsBased on parents’ experiences, the following 10 barriers to the communication of bad news were identified: (1) a lack of (timely) communication, (2) physicians’ failure to ask parents for input, (3) parents feel unprepared during and after the conversation, (4) a lack of clarity about future treatment, (5) physicians’ failure to voice uncertainties, (6) physicians’ failure to schedule follow-up conversations, (7) presence of too many or unknown healthcare professionals, (8) parental concerns in breaking bad news to children, (9) managing indications of bad news in non-conversational contexts, and (10) parents’ misunderstanding of medical terminology.ConclusionsThis study shows healthcare professionals how parents experience barriers in bad news conversations. This mainly concerns practical aspects of communication. The results provide practical pointers on how the communication of bad news can be improved to better suit the needs of parents. From the parents’ perspective, the timing of conversations in which they were informed that their child might not survive was far too late. Sometimes, no such conversations ever took place.

With the increasing prevalence of adults with autism spectrum disorder (ASD), research examining the service experiences of this population is greatly needed. The current study investigated service use, unmet needs, and obstacles to service access for a large sample of adults with ASD. After accounting for various demographic factors known to impact service usage and needs, living situation was a significant predictor of service use, needs, and obstacles to services. Adults with ASD living with family reported less service use, higher unmet need, and more obstacles to accessing services. With more than half of this adult sample living with family, results have clear public policy implications to support the increasing population of adults with ASD living with aging caregivers.

This article analyzes how Melayu people choose their place of living in a coastal community in Riau, focusing on people who do not own land. Based on field research conducted in A Community, I discuss the following: (1) characteristics of the community, (2) people’s choices of place of living, and (3) people’s migration to upstream areas of the community. The relevant characteristics of A Community are that it is a fishing community—it was formed in brackish water areas around the coast—and not very dependent on land. Family dwellings and family ties are the most fundamental determinants of people’s choice to live here. People’s livelihoods rely on a combination of various sources of income, and employment and schooling are often outside the community. Plantation companies starting their business in the upstream areas in the late 1990s brought employment to the people but reduced fish stocks and deposited so much waste into the river that dwellings built on the water could no longer be repaired. These changes led people to migrate to upstream areas of the community. Over time, upstream migration may lead to deep cultural changes that transform this and other coastal communities such that they come to resemble their terrestrial counterparts.

School choice expansion in recent decades has weakened the strong link between neighborhoods and schools created under a strict residence-based school assignment system, decoupling residential and school enrollment decisions for some families. Recent work suggests that the neighborhood-school link is weakening the most in neighborhoods experiencing gentrification. Using a novel combination of individual, school, and neighborhood data that link children to both assigned and enrolled schools, this study examines family, school, and neighborhood factors that shape whether parents enroll in the assigned local school. I find that parents are more likely to opt out of neighborhood schools in gentrifying neighborhoods compared with non-gentrifying neighborhoods when nearby choice options are available. Recent movers to gentrifying neighborhoods bypass local schools more compared with parents who have lived in the neighborhood longer. Results have implications for thinking about neighborhood-school linkages in an era of school choice and urban change.

During the first wave of COVID-19, three-quarters of Canadian deaths were among those age 80 and older. We examined whether age, chronic disease load, sex, or place was the strongest predictor of such deaths. A cross-sectional analysis of administrative data from 1 January 2020 to 30 October 2020 for the population of Ontario (n = 15,023,174) was performed. Using logistic regression analysis, we determined whether place of residence (community dwelling, community dwelling with formal home care, or long-term care facility), age group, sex, or chronic disease burden was most strongly associated with the outcome of death within 60 days of a positive SARS-CoV-2 PCR test. Overall, there were 2766 deaths attributed to COVID-19. The age-related odds of dying increased from 6.1 (age 65–74) to 13.4 (age 85 or older) relative to those aged <65 years. This age effect was dwarfed by an odds ratio of 117.1 for those living in long-term care versus independently in the community, adjusted for age, sex, and chronic disease burden. The risk of death from COVID-19 aligned much more with social realities than individual risks. The disproportionate mortality arising specifically from institutional residence demands action to identify sources and ameliorate the harms of living in such facilities.