Food intolerance is a growing concern in the UK given its frequency and cultural popularity. Current medical understanding is at odds with the use of this term by laypeople and in addition health professionals use the term in several ways. The present thesis focused on two main questions: 1. What are people like who report food intolerance? Study 1 showed that food intolerance is a condition that varies, its development, symptoms and the way people interact with and treat the condition is very individualistic. Study 2, showed that inflammatory symptoms were more frequent in the food intolerant population compared to non-inflammatory symptoms. It was also found that participants who reported being high in neuroticism and high in hypochondriasis were 20% more likely of having self reported food intolerance in the population sample. Study 3, replicated the findings found in study 2 in terms of inflammatory and gastrointestinal symptoms and greater anxiety and depression. In addition this study showed that the number of foods that disagree with you was also significantly associated with the number of GP visits in the past 12 months, major illness/chronic health, greater stressors as well as having poorer quality of life. 2. Is it possible to demonstrate that food disagreement is associated with stress? Study 4 showed that people were less stressed before eating foods that disagreed with them. Finally results from study 5 were inconclusive due to methodological problems. The current thesis used a multi method approach to explore the topic. It contributes to a better understanding about food intolerance and introduces new and previously unexplored dimensions about the condition. Most importantly the findings from this thesis provides the next steps for future research about a psychoneuroimmunological basis for food intolerance.

Since the introduction of combination therapy in 1996, Human Immunodeficiency Virus (HIV) treatment has changed substantially. Over twenty new antiretroviral drugs have been licensed for the treatment of HIV-infection and HIV has been transformed into a long-term chronic infection for many patients. Yet it remains unclear how improved efficacy of new antiretrovirals reported in clinical trials has translated to population-level effectiveness in general clinical care. Nor is it clear how the increasingly chronic nature of HIV-infection, characterised by an ageing HIV-population increasingly suffering from age-related non-infectious co-morbidities and drug-drug interactions, will affect HIV care. Such an evaluation is important not just to measure progress, but also to address future challenges for clinical care in order to develop evidence-based changes to clinical guidelines and ensure continued high-quality care. By analysing a dataset that collects data from all HIV-infected patients in clinical care in the Netherlands it was shown that the use of combination antiretroviral therapy (cART) regimens in the Netherlands closely follows changes in guidelines, to the benefit of patients. While there was no significant improvement in mortality, newer drugs with better tolerability and simpler dosing resulted in improved immunological and virological recovery and reduced incidence of switching due to toxicity and virological failure. An individual-based model of the ageing HIV-population in the Netherlands was constructed and used to quantify and evaluate the future challenges posed by an ageing HIV-population. The model showed that the age-structure of HIV-patients in the Netherlands is rapidly shifting to older age. By 2030, almost three quarters of patients will be aged 50 or over. This will result in an increased burden of co-morbidity, polypharmacy and an increasing proportion of patients who will experience potential complications with their HIV-treatment. Cardiovascular disease (CVD) in particular will become a major burden of co-morbid disease. Integrating a smoking cessation programme or changing HIV-treatment guidelines to recommend prescribing a polypill for CVD to all HIV-patients aged 45 or 55 years and over could improve the burden of CVD, improve patient outcome and be cost saving in the long-term.

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