Quality of Life in Swiss Paediatric Inflammatory Bowel Disease Patients: Do Patients and Their Parents Experience Disease in the Same Way?

BACKGROUND AND AIMS Inflammatory bowel diseases (IBDs) may impair quality of life (QoL) in paediatric patients. We aimed to evaluate in a nationwide cohort whether patients experience QoL in a different way when compared with their parents. METHODS Sociodemographic and psychosocial characteristics were prospectively acquired from paediatric patients and their parents included in the Swiss IBD Cohort Study. Disease activity was evaluated by the Paediatric Crohn's Disease Activity Index (PCDAI) and the Paediatric Ulcerative Colitis Activity Index (PUCAI). We assessed QoL using the KIDSCREEN questionnaire. The QoL domains were analysed and compared between children and parents according to type of disease, parents' age, origin, education and marital status. RESULTS We included 110 children and parents (59 Crohn's disease [CD], 45 ulcerative colitis [UC], 6 IBD unclassified [IBDU]). There was no significant difference in QoL between CD and UC/IBDU, whether the disease was active or in remission. Parents perceived overall QoL, as well as 'mood', 'family' and 'friends' domains, lower than the children themselves, independently of their place of birth and education. However, better concordance was found on 'school performance' and 'physical activity' domains. Marital status and age of parents significantly influenced the evaluation of QoL. Mothers and fathers being married or cohabiting perceived significantly lower mood, family and friends domains than their children, whereas mothers living alone had a lower perception of the friends domain; fathers living alone had a lower perception of family and mood subscores. CONCLUSION Parents of Swiss paediatric IBD patients significantly underestimate overall QoL and domains of QoL of their children independently of origin and education.

Linking soil properties and pre-Columbian agricultural strategies in the Bolivian lowlands: The case of raised fields in Exaltación

This paper aims to further our understanding of pre-Columbian agricultural systems in the Llanos de Moxos, Bolivia. Three different types of raised fields co-existing in the same site near the community of Exaltación, in north-western Beni, were studied. The morphology, texture and geochemistry of the soils of these fields and the surrounding area were analysed. Differences in field design have often been associated with the diversity of cultural practices. Our results suggest that in the study area differences in field shape, height and layout are primarily the result of an adaptation to the local edaphology. By using the technology of raised fields, pre-Columbian people were able to drain and cultivate soils with very different characteristics, making the land suitable for agriculture and possibly different crops. This study also shows that some fields in the Llanos de Moxos were built to prolong the presence of water, allowing an additional cultivation period in the dry season and/or in times of drought. Nevertheless, the nature of the highly weathered soils suggests that raised fields were not able to support large populations and their management required long fallow periods.