Search Results (390)

Background: Loneliness and social isolation among older people are currently widespread and recognized as the foremost public health problems globally and locally. Hong Kong, which exhibits a rapid aging trend and an expanding elderly population, is inevitably facing these issues. This study explored the lived experiences of loneliness among older adults in Hong Kong. Methods: Qualitative interviews were conducted among older adults in the community aged 60 or above who were cared for by migrant domestic workers and presented varying levels of loneliness. Purposive sampling was used to select subjects for face-to-face, semi-structured individual interviews, with consent for audio recording, which led to the inclusion of 19 older adults, among whom five were male, nine lived with a spouse, and three lived with their children. Interpretative phenomenological analysis was adopted. Results: We identified a core theme, “Should I stay at home alone?”, and the following four interrelated themes: (1) experience of inadequate social support and networks, (2) altered family dynamics and support, (3) deterioration in physical functions and mobility limitations, and (4) experience of negative and complex emotions. Conclusions: Based on our investigation into the lived experience of loneliness among older adults locally, we recommend that the government, non-governmental organizations, and healthcare institutions establish appropriate strategies and integrated services to address the social, physical, familial, and emotional issues in this population to foster healthy aging, improve their quality of life, and encourage support from families and communities. Full article

Background: Postpartum depression (PPD) is a major public health issue affecting maternal well-being and infant development. This systematic review and meta-analysis aimed to determine the prevalence and risk factors of PPD among Saudi women. Methods: A systematic search of PubMed, Web of Science, ProQuest, and EBSCOHost was conducted for studies published up to 31 March 2025. Statistical analysis was performed using R software (v4.4.2) with a random effects model. Study quality was assessed using the Joanna Briggs Institute (JBI) tool. Results: A total of 32 studies published between 2014 and 2024, including 10,975 women with a mean age of 30.38 ± 6.22 years, were analyzed. Prevalence of PPD varied based on the cutoff scores of the Edinburgh Postnatal Depression Scale (EPDS): 18% (95% CI: 10–27%) at EPDS ≥ 14, 30% (95% CI: 21–38%) at EPDS ≥ 13, 59% (95% CI: 33–85%) at EPDS ≥ 12, and 45% (95% CI: 28–62%) at EPDS ≥ 10. Across studies, 32 significant risk factors for PPD were identified. The most frequently reported included lack of social support, delivery method, young maternal age, and personal or family history of depression. In the meta-analysis, three factors showed statistically significant associations with postpartum depression: limited family support (p < 0.00001), poor spouse support (p < 0.00001), and unplanned pregnancy (p = 0.04). Conclusions: PPD is highly prevalent among Saudi women, with marked regional disparities. These findings highlight the need for tailored mental health strategies and region-specific interventions. Full article

Background/Objectives: Patients with heart failure (HF) experience increased morbidity, limited daily activities, and diminished quality of life (QoL), thus relying on a family member, widely known as informal caregiver, for support. The objective of this study was to explore (a) QoL, anxiety, and depression; (b) factors associated with QoL; and (c) the impact of associated factors on QoL among HF caregivers. Materials and methods: Data collection was performed using the 36-Item Short Form Survey (SF-36), the Hospital Anxiety and Depression Scale (HADs), and the European Heart Failure Self-care Behavior Scale (EHFScBS). Also recorded were characteristics of caregivers and patients. Results: In the present study, 110 HF caregivers and the family members they provided care to were enrolled. The majority of caregivers were patients’ spouses (60%) and were female (71.8%). Within a QoL score range of 0–100, caregivers showed moderate to high levels in role-physical, role-emotional, emotional well-being, and pain (median: 75, 66.7, 64, and 67.5, respectively); moderate QoL levels in energy/fatigue, social functioning, and general health (median: 55, 56.3, and 62, respectively); and poor QoL levels in physical functioning (median: 18). Moreover, 64.5% of caregivers had anxiety and 41.8% had depression. Caregivers with HADs scores that indicate anxiety and depression had worse QoL (p = 0.001). No association was detected between caregivers’ QoL and patients’ HADs and self-care. Conclusions: QoL and anxiety/depression merit further research by clinicians, health systems, and policymakers so that evidence-based policies and interventional programs tailored to their needs can be implemented. Full article

Background: Connubial melanoma, the occurrence of melanoma in non-consanguineous spouses, is rarely described in the literature. This study aimed to evaluate the prevalence of shared risk factors, preventive behaviors, and the influence of couple dynamics on the early diagnosis of cutaneous melanoma (CM). Methods: We conducted a retrospective observational study at the San Gallicano Dermatological Institute IRCCS, Rome, enrolling 52 heterosexual couples diagnosed with CM between 2010 and 2023. Clinical and anamnestic data, including phototype, history of sun exposure, use of tanning devices, and reason for dermatological evaluation, were collected. Dermatological assessments included dermoscopy, total body photography, and histological examination of excised lesions. Statistical analyses were performed using chi-square and Student’s t-tests. Results: Women reported significantly higher use of artificial ultraviolet sources (51.9% vs. 19.2%, p < 0.001) and more frequent histories of sunburn. Phototype II was associated with higher use of tanning devices and a greater prevalence of sunburns. Although the CM stage did not significantly differ between sexes, husbands exhibited a greater Breslow thickness. Melanoma localization differed by sex, with lower limbs more often affected in women and the trunk in men (p < 0.001). In 86.5% of cases, wives initiated their husband’s dermatological evaluation, leading to earlier diagnosis. Conclusions: Despite shared environmental exposures, men and women differ in preventive behaviors and risk profiles. Women play a crucial role in promoting early detection among couples. Couple-based preventive strategies may be instrumental in improving early melanoma diagnosis and outcomes. Full article

Immigrant households frequently face liquidity constraints upon arrival, which potentially hinders their long-term economic integration. The Family Investment Hypothesis (FIH) suggests that couples may respond to these constraints by coordinating their labor supply: one spouse works to finance the other’s investment in local human capital. Previous studies have tested the FIH by comparing married immigrants to married natives, attributing differences in outcomes to financial constraints. However, this approach may conflate such constraints with other inherent differences between immigrants and natives. This paper introduces a novel identification strategy that compares the differences in labor market outcomes of married and single immigrants to those of their native-born counterparts, allowing for better isolation of the effects of liquidity. Applying this strategy to repeated cross-sectional data on immigrants from the Former Soviet Union who arrived in Israel during the 1990s, the analysis finds no supporting evidence for the FIH. One possible explanation for this finding is the substantial government support extended to these immigrants, which may have mitigated their financial constraints. Alternatively, the results may indicate that immigrant households do not systematically adjust their labor supply in accordance with the FIH framework. These findings highlight the importance of the institutional context in shaping household labor supply decisions. Full article

Objective: Marital infidelity significantly impacts both the community and the institution of marriage. This study aims to develop a theoretical framework for analyzing marital infidelity through a game-theoretic lens. Methodology/Design/Approach: This research employs a game-theoretic model to predict the decision-making processes of unfaithful partners. Static game models are utilized to explore the interactions between spouses, focusing on identifying Nash equilibria that encapsulate the complexities and uncertainties inherent in infidelity-related decisions, whether through pure or mixed strategies. Results: The analysis reveals strategic dynamics in marital infidelity, where Nash equilibria indicate scenarios where one or both partners may engage in extramarital affairs. A Nash equilibrium is established when both partners perceive the benefits of infidelity as outweighing the costs, leading to diminished trust and communication. The Mixed-Strategy Nash Equilibrium (MSNE) hypothesis suggests that spouses may oscillate between fidelity and infidelity based on probabilistic strategies. Research Implications: This study provides a game-theoretic perspective on marital infidelity, whose findings may be used to inform legal frameworks and social policies addressing the consequences of infidelity, potentially impacting family counseling and legal services. Value/Originality: This research introduces a game-theoretic approach to understanding trust and transgression in marriages, identifying two primary categories of Nash equilibria. It fills a theoretical gap while providing practical insights into marital behavior. Full article

Background/Objectives: This study examined differences in physical activity (PA) and sedentary behavior among Korean cancer survivors compared to cancer-free individuals from 2017 to 2021 and identified differences based on their cancer treatment status. Methods: We used data for 28,528 adults (1585 cancer survivors and 26,943 cancer-free individuals) from the 2017–2021 Korea National Health and Nutrition Examination Survey. PA and sedentary behavior were assessed using the Korean version of the Global Physical Activity Questionnaire. We examined adherence to aerobic and resistance training guidelines, domain-specific activity, and sedentary time. We also analyzed the descriptive statistics and conducted chi-square tests, the Mann–Whitney U test, and the non-parametric Kruskal–Wallis test, stratified by demographic and clinical subgroups. Results: Compared with cancer-free individuals, cancer survivors showed significantly lower adherence to aerobic PA guidelines in 2017 (p < 0.01), 2018 (p < 0.05), and 2021 (p < 0.01). Transportation-related activity accounted for the highest share of the total PA (mean: 59.1%). Sedentary time increased among survivors from 8.1 h/day (2017) to 9.0 h/day (2021). In 2021, resistance training adherence was higher among survivors (24.7%) than among non-cancer individuals (22.9%). In the subgroup analyses, male sex, younger age, recent diagnosis, higher income, and living with a spouse were associated with higher adherence. Conclusions: The findings underscore a clear need to address both PA and sedentary behavior in cancer survivors, irrespective of treatment phase. Full article

Objective: The aim of this study was to assess complementary feeding practices and dietary diversity in relation to the nutritional status of children under five attending health facilities in the Thabazimbi sub-district, Limpopo Province. Methods: A cross-sectional study was conducted among 409 mother–child pairs. Data on socio-demographics, feeding practices, and anthropometry were collected using validated tools. Nutritional status was assessed using WHO growth standards, and dietary diversity was evaluated using WHO infant and young child feeding (IYCF) indicators and a 24 h dietary recall. Associations were analyzed using prevalence ratios in STATA 18. Results: Among 409 children (median age: 18 months, IQR: 12–24), 38% were stunted, 13% were underweight, 5% were thin, and 17% were overweight/obese. Exclusive breastfeeding was reported in 27%, and only 24% met the minimum dietary diversity (DDS ≥ 4). Complementary feeding practices varied significantly by maternal age, with mixed feeding more common among older mothers and younger mothers more likely to receive feeding advice (p = 0.001). Stunting was associated with being a boy (PR = 1.27; 95% CI: 1.00–1.61), age > 24 months (PR = 0.33; 95% CI: 0.16–0.65), and DDS ≥ 4 (PR = 0.72; 95% CI: 0.52–0.99). Underweight was more prevalent among boys (PR = 2.40; 95% CI: 1.40–4.11), but less likely in children with DDS ≥ 4 (PR = 0.43; 95% CI: 0.20–0.92) and those from spouse-headed households (PR = 0.33; 95% CI: 0.13–0.87). Thinness was associated with DDS ≥ 4 (PR = 2.70; 95% CI: 1.13–6.45) and age 12–24 months (PR = 2.80; 95% CI: 1.02–7.64). Overweight/obesity was linked to age 12–24 months (PR = 1.94; 95% CI: 1.25–3.03) and household income > ZAR 15,000 (PR = 4.09; 95% CI: 2.33–7.17). Conclusions: Complementary feeding and dietary diversity deficits contribute significantly to the dual burden of malnutrition in rural Limpopo, highlighting the need for targeted, context-specific nutrition interventions. Full article

Marriage is a social contract that carries a number of qualities recognized as having fundamental values. These qualities include a spiritual bond between spouses, mutual love, affection, and responsibility, the continuation of the generation, and the existence of social order. The social definition of marriage implies that it is a phenomenon that occurs not only between two individuals in the context of cultural continuity but also in other social structures. It evolves into a structure that encompasses not only the initial two families but also the broader societal context. In Islamic marriage, a contract is formalized between a man and a woman who meet the religious requirements for marriage. The contract is executed with their consent and in the presence of witnesses. However, from a cultural perspective, marriage embodies a multifaceted structure, influenced by religion, ritual practices, symbols, and traditions. In this study, topics such as oral culture, wedding traditions, and rituals are discussed, and cultural practices are interpreted. This study sheds light on the manner in which marriage rites influence the discourse and actions within the social structure. Such studies are of paramount importance in demonstrating the continuity and vitality of culture, as well as the transformative nature of ritual meanings over time. They underscore the notion that culture is an ever-evolving process of interpretation, a characteristic that is intrinsic to its very essence. These actions, inextricably linked to societal structures, have the potential to give rise to novel symbolic meanings and values at any given juncture. However, it is imperative to recognize that the mere analysis of texts representing oral culture products is insufficient for comprehending their ritual functions, social messages, and emotional dimensions. Consequently, an interdisciplinary approach that incorporates the study of transitional rituals and oral culture is necessary to achieve a more comprehensive understanding. By examining cultural elements from diverse perspectives, we can develop a more comprehensive and nuanced understanding of cultural diversity in Anatolia. Full article

Marital crises are common and can arise at any stage of marriage. When facing difficulties, many spouses seek support from religious communities, which provide spiritual and emotional guidance. These communities play a vital role in marriage preparation and helping couples navigate crises. In response to rising divorce rates, changing gender roles, and economic pressures, religious communities are adapting their pastoral methods. One innovative approach is storytelling, which allows couples to connect with others’ experiences, helping rebuild trust and understanding in their marriages. This article explores the role of storytelling as a tool for supporting couples in crisis, particularly in the context of religious pastoral care, focusing on its impact on communication, marital bonding, and spiritual growth. Full article

Objective: This study aimed to assess the prevalence of depression and anxiety among patients with acute leukemia in Vietnam and to identify associated sociodemographic and clinical factors. Methods: A cross-sectional study was conducted at the Hematology and Blood Transfusion Center of Bach Mai Hospital, a national tertiary care facility in Hanoi, Vietnam. A total of 82 patients diagnosed with acute leukemia were recruited using a convenience sampling method. Data on sociodemographic characteristics (e.g., age, gender, residence, education, occupation, marital status, and income) and clinical information (e.g., leukemia type, treatment stage, comorbidities, substance use) were collected. Depression and anxiety were assessed using the Beck Depression Inventory (BDI) and Zung’s Self-Rating Anxiety Scale (SAS). Multivariate logistic and Tobit regression analyses were applied to explore associated factors. Results: Participants had a mean age of 43.4 years (SD = 14.0), with 53.7% male and 69.5% residing in rural areas. Most were married (82.9%) and had completed high school (45.1%). Farmers constituted the largest occupational group (29.3%). The mean BDI score was 13.7 (SD = 9.8), and the mean SAS score was 39.2 (SD = 6.3). Overall, 50.0% of patients met criteria for depression, while 26.8% exhibited clinically significant anxiety symptoms. Among those with anxiety, 59.1% had mild symptoms, 22.7% moderate, and 18.2% severe or very severe. Patients with education above high school (OR = 7.32; 95% CI: 1.01–53.23), a spouse (OR = 25.10; 95% CI: 2.14–294.55), or comorbidities (OR = 8.05; 95% CI: 1.63–39.68) had significantly higher odds of depression. A higher income (>10 million VND/month) was associated with lower depression scores (Coef. = −6.05; 95% CI: −11.65 to −0.46). Regarding anxiety, the female gender was associated with higher odds (OR = 3.80; 95% CI: 1.21–11.93) and SAS scores (Coef. = 4.07; 95% CI: 1.64–6.51), while higher income predicted lower anxiety severity (Coef. = −3.74; 95% CI: −6.57 to −0.91). Conclusions: This Vietnamese hospital-based study highlights a high prevalence of depression and anxiety among patients with acute leukemia. Routine mental health screening and culturally appropriate psychosocial interventions are strongly recommended to improve patient well being. Full article

Background. Despite the high transmissibility of SARS-CoV-2, some individuals remain uninfected despite prolonged exposure to a high viral load, suggesting the involvement of an innate resistance mechanism, possibly underpinned by the host’s genetic factors. The angiotensin-converting enzyme-1 (ACE1), ACE2, and C-C Chemokine Receptor 5 (CCR5) polymorphisms have been shown to influence susceptibility to the infection. In this study, the role of ACE1, ACE2, and CCR5 gene polymorphisms in modulating susceptibility to SARS-CoV-2 infection within the context of intimate contact was evaluated. Methods. A cohort of heterosexual couples from Northern Sardinia, characterized by a homogenous genetic background, was recruited during the initial pandemic wave (March–June 2020). In each couple, one partner (index case) tested positive for SARS-CoV-2 by at least two consecutive independent molecular tests (real-time polymerase chain reaction: RT-PCR) on nasopharyngeal swabs. Bed-sharing partners of SARS-CoV-2 positive index cases, resistant and susceptible to the infection, were genotyped for ACE1 287 bp Alu repeat insertion/deletion (I/D) polymorphism, ACE2 G8790A (rs2285666) variant, and a 32-base pair deletion (Δ32) of CCR5. Resistant and susceptible partners to the infection were compared for polymorphisms. Results. Out of 63 couples, 30 partners acquired SARS-CoV-2 infection, while 33 remained uninfected despite intimate exposure. Clinical history was minimal for current or past illnesses. SARS-CoV-2-infected index spouses and partners who acquired the infection developed a mild disease, not requiring hospitalization. The observed distribution of ACE1 I/D and ACE2 G8790A genotypes was consistent with previously reported frequencies in Sardinia and across European populations. None of the study participants carried the CCR5-Δ32 variant. No statistically significant differences (p > 0.05) in the allelic or genotypic frequencies of these polymorphisms were observed between the infected and resistant partners. Conclusions. No differences in the distribution of ACE1, ACE2, and CCR5 polymorphisms between the two groups were detected. These findings suggest that resistance is likely multifactorial, involving a complex interplay of genetic, immunological, and environmental factors. Full article

This study predicts how sociodemographic trends—smaller family sizes, increased longevity, and marital patterns—could affect family care for people with dementia through 2060. By coupling dementia information from the Health and Retirement Study with a well-established kinship microsimulation model, we analyze the impact of demographic changes on the future care landscape, focusing on changes in race and gender differences in two key areas: (1) the availability of family caregivers for people with dementia, and (2) the likelihood of having a family member with dementia, among those without dementia. Our model projections suggest that future dementia cohorts will be more likely to have a living spouse than the current ones, with diminishing gender disparities due to increased male longevity. However, racial disparities will persist, particularly for Black women. The likelihood of older adults lacking spouses, children, and siblings will increase, but remain low. For potential caregivers, we predict an increased likelihood and longer duration of exposure to family members with dementia in future birth cohorts, particularly for Black individuals, potentially placing more people at risk of the adverse health and well-being outcomes associated with caregiving. Full article

Total hip arthroplasty (THA) is the definitive treatment for end-stage hip osteoarthritis, reliably relieving pain and restoring joint function. However, patient-reported quality of life (QoL) after THA remains heterogeneous, with recovery trajectories influenced by a range of biological, psychological, and social factors. A comprehensive synthesis of these determinants is lacking, limiting our ability to optimize individualized perioperative care and long-term outcomes. This review examines the various factors impacting quality of life (QoL) before and after hip arthroplasty. An analysis of 67 studies reveals significant postoperative enhancements in physical function, pain alleviation, and overall patient satisfaction. Identified key factors encompass physical activity, mental health status (anxiety and depression), lifestyle choices (diet and weight management), and social support systems, particularly from spouses and family members. The review indicates that, although these elements positively influence recovery, it also recognizes limitations including dependence on subjective, self-reported QoL measures, possible selection biases, and inconsistencies in study design. The results indicate that a com-prehensive, patient-focused strategy—integrating organized rehabilitation, psychological assistance, and family engagement—can markedly improve recovery and long-term QoL for arthroplasty patients. Nonetheless, additional research employing standardized protocols and extended follow-up durations is essential to corroborate these findings and guide clinical practice. The early implementation of tailored, multidisciplinary perioperative pathways—including structured rehabilitation programs, routine psychological screening and intervention, nutritional counseling for weight management, and active family involvement—may optimize functional recovery, reduce complications, and maximize long-term QoL in patients undergoing THA. This review highlights the importance of a multidisciplinary approach to enhance post-surgical quality of life, thereby advancing the understanding of patient-centered recovery strategies in orthopedic care. Full article

Building on the work–home resources model, this study develops a mediated moderation model to examine how benevolent sexism within intimate relationships influences female employees’ thriving at work through job resources and self-efficacy. In this cross-sectional study, we surveyed 209 married female employees from six Chinese public hospitals and their spouses via online questionnaires between April and July 2023. To mitigate common method bias, we implemented a two-wave data collection approach with a one-month interval. We employed confirmatory factor analysis, Pearson’s correlation, and multiple regression to test the hypothesized relationships. The results support the proposed model, indicating that benevolent sexism within intimate relationships moderates the positive effect of job resources on thriving at work, such that this relationship weakens when benevolent sexism within intimate relationships is high. Furthermore, this moderating effect is mediated by self-efficacy, as benevolent sexism within intimate relationships undermines female employees’ self-efficacy, thereby limiting their ability to leverage job resources effectively. These findings highlight the need for human resource managers to consider the personal circumstances of female employees and implement targeted interventions to facilitate their optimal utilization of job resources, thereby enhancing their ability to thrive in both professional and domestic domains. Full article