Search Results (48)

Objectives: Depressive symptoms are highly prevalent among individuals with chronic kidney disease (CKD). This study explores their associated factors and gender differences among middle-aged and older CKD patients in China. Methods: Based on the health ecology model (HEM), this study utilized the 2018 cross-sectional data from the China Health and Retirement Longitudinal Study (CHARLS) to examine gender differences in CKD patients across demographic groups. A multivariate logistic regression identified factors associated with depressive symptoms and gender differences among middle-aged and older patients with CKD in China. Additionally, a random forest model was constructed to rank the importance of key predictors based on the Gini index. Results: Among 1422 CKD patients, 50.35% reported depressive symptoms (42.97% of males and 59.56% of females). Factors significantly associated with higher depressive symptoms included female gender, rural residence, poor self-reported health, sleep duration < 7 h, and limitations in Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). The association of smoking and ADLs on depressive symptoms in CKD patients varied considerably between genders. Self-reported health and life satisfaction were the two variables most strongly associated with depressive symptoms among CKD patients. Conclusions: The study shows that female CKD patients have a higher prevalence of depressive symptoms than males. Several factors are significantly associated with depressive symptoms in patients with CKD. These findings provide valuable insights that potentially inform the development of targeted prevention and management strategies for depressive symptoms in middle-aged and older CKD patients in China. Full article

This study assessed whether COVID-19 pandemic experiences were associated with excessive alcohol use during the first year of the pandemic in Iowa, a heavy-drinking midwestern US state. We analyzed survey data from 4047 adult residents of Iowa collected in August 2020, focusing on three pandemic-related stressors (e.g., emotional reactions to the pandemic; disruption of daily activities; and financial hardship) and salient social support. Using multiple logistic regression, we tested correlates of increased drinking, heavy drinking, and binge drinking, controlling for demographic characteristics and health status. We found that nearly half (47.6%) of respondents did not change their drinking compared to before the pandemic; however, 12.4% of respondents reported increasing their drinking and 5.3% reported decreasing their drinking. Emotional reactions to the pandemic and disruption of daily activities were associated with higher odds of increased drinking, and rurality was associated with lower odds of increased drinking. No pandemic-related stressor was associated with heavy or binge drinking, but social support was associated with lower odds of binge drinking. Thus, we concluded that some pandemic-related stressors may explain increased drinking but not heavy or binge drinking. Understanding the nuances of alcohol use can inform preventive interventions, policy decisions, and preparations for future catastrophic events. Full article

Background: Physical inactivity among adolescents, particularly females in conservative societies like Saudi Arabia, poses significant risks to both physical and psychological health. Cultural norms, environmental constraints, and limited access to gender-appropriate sports facilities further exacerbate the problem. Understanding these factors is essential for developing effective, context-sensitive interventions. Aim: This study aimed to examine the relationship between daily physical activity behaviours and health outcomes, both physical and psychological, among adolescent females in Saudi Arabia. This paper also explores the impact of socio-environmental variables such as income, household size, and urban/rural residence on activity levels and wellbeing. Methods: A cross-sectional survey of 636 adolescent females aged 13–21 was conducted using validated instruments. The Physical Activity Questionnaire for Adolescents (PAQ-A) measured physical activity levels, and the Self-Rated Health (SRH) assessed psychological wellbeing and health-related quality of life. The analysis employed an Ordinal Logistic Model (OLM) guided by the Social Ecological Model (SEM) to assess predictors of physical activity participation. Results: The OLM results indicated that higher income levels, smaller household size, urban residence, and older age categories were significantly associated with higher levels of physical activity (p < 0.05). Participants with higher PAQ-A scores reported better psychological health and quality of life. The model showed a good fit, with a pseudo-R² of 0.36. Cultural and environmental barriers, particularly in rural areas, were identified as significant deterrents to participation. Conclusions: The findings highlight the urgent need for culturally adapted, gender-sensitive health promotion programs that target both individual and structural barriers to physical activity among adolescent girls in Saudi Arabia. Enhanced societal support and accessible sports infrastructure could significantly improve health outcomes and quality of life. Full article

Background/Objectives: Excess body weight is a global public health problem. This study aimed to identify differences in food-related behaviors and physical activity among healthy weight, overweight, and obese adult individuals in Poland. Particular attention was paid to health inequalities among analyzed groups. Methods: This was a secondary data analysis of a dataset generated by the public institution in Poland, within a representative cross-sectional study among working adults (aged 18–64 years) in December 2024. A total of seven different questions on lifestyle-related behaviors were analyzed. Results: A total of 4714 adults were included in the analysis, of which 47.0% had a healthy weight (BMI 18.5–24.9), 34.2% were overweight (BMI 25–29.9), and 18.9% were obese (BMI 30–39.9). People aged 45–64 had almost 6 times higher odds of belonging to the overweight group compared to people aged 18–24 (OR = 5.7; 95% CI: 4.34–7.49). Men were more likely to be overweight (OR = 1.69; 95% CI: 1.47–1.95), as were rural residents (OR = 1.21; 95% CI: 1.05–1.39). The overweight group was more likely to monitor the number of steps taken during the day (OR = 1.42; 95% CI: 1.19–1.71) and limit carbohydrates in the diet (OR = 1.39; 95% CI: 1.1–1.75). The group with a healthy weight was distinguished by eliminating products containing preservatives/artificial colors (OR = 0.76; 95% CI: 0.63–0.91) and performing home exercises, such as yoga or Pilates (OR = 0.68; 0.55–0.84). The obese group relative to the overweight group was more likely to perform regular exercise at least three times a week (OR = 1.5; 95% CI: 1.09–2.06), taking care for the presence of dietary fiber in the daily diet (OR = 1.35; 95% CI: 1.04–1.75) but also not paying much attention to one’s diet (OR = 1.23; 95% CI: 1.01–1.5). Conclusions: This study pointed out differences in lifestyle, especially food-related behaviors and physical activity among different BMI groups. Full article

Facing severe depopulation and aging, rural Japanese communities—particularly marginal settlements (genkai shūraku)—increasingly require revitalization strategies that integrate local culture and elder well-being. This study examines the Ōsawa Engawa Café, a community-led initiative in a mountainous tea-growing village, as a site of ikigai-zukuri—the active creation of life purpose among elderly residents. With the use of a mixed-methods approach, including spatial analysis, household surveys, and interviews, Chi-square Automatic Interaction Detection (CHAID) decision tree analysis was applied to identify factors shaping distinct household café operational states: Operating, Discontinued, and Never Operated. Qualitative findings reveal that support from local leaders, experts, and the government enabled the Ōsawa Engawa café’s launch. Broad household participation, often guided by elderly women, sustained the initiative by sharing local culture—such as engawa (verandas), Zairai tea (native variety), and omotenashi (hospitality)—thereby nurturing residents’ ikigai through daily engagement. Complementing these insights, the CHAID analysis revealed a hierarchy of influential factors: high-frequency support from out-migrated family members was the strongest predictor of continued operation; in the absence of such support, co-resident family cooperation proved essential; where both were lacking, agricultural engagement distinguished households that discontinued from those that never operated. Practically, the Ōsawa model offers a replicable, bottom-up strategy that activates the Rural Cultural Landscape (landscapes shaped by traditional rural life and culture, RCL) through community engagement grounded in cultural practices and elderly ikigai-zukuri, contributing to sustainable rural livelihoods. Theoretically, this study reframes ikigai-zukuri as a key socio-cultural pillar of community resilience in aging rural areas. Fostering such culturally embedded, purpose-driven initiatives is essential for building vibrant, adaptive rural communities in the face of demographic decline. However, the study acknowledges that the Ōsawa model’s success is rooted in its specific socio-cultural context, and its replication in other cultural settings may be limited without contextual adaptation. Full article

Background/Objectives: Orthodontic treatment offers significant functional and aesthetic benefits, but it often causes discomfort, impacting patients’ daily activities, including diet and medication use. The primary aim of this observational study was to assess the influence of orthodontic patients’ age, gender, and living environment on pain duration, diet impairment, and analgesic use one week after their first adjustment visit to the orthodontist. Methods: This observational study included a sample of 194 orthodontic patients who completed a questionnaire consisting of six single-choice questions. The questions addressed the following variables: age, gender, living environment, pain duration, diet impairment, and analgesic use. The main inclusion criteria encompassed undergoing fixed orthodontic treatment on the upper arch for one week using a 0.0016-inch superelastic NiTi archwire (American Orthodontics, Sheboygan, WI, USA) and presenting moderate to severe crowding of the upper and lower anterior teeth. Results: Female patients were significantly more likely to experience diet impairment than males (51.9% vs. 33.3%, p = 0.013). Among female patients reporting pain lasting approximately one week, a higher proportion resided in rural areas (25% vs. 6.8%, p = 0.045), whereas male patients reporting the same pain duration predominantly lived in urban areas (12.5% vs. 0%, p = 0.028). Overall, 55.7% of participants used analgesics, with females in rural areas being the most frequent users. Additionally, patients who used analgesics were significantly more likely to experience diet impairment than those who did not (64.3% vs. 49.1%, p = 0.041). Conclusions: Female patients residing in rural areas reported a longer duration of pain, which led to a greater likelihood of experiencing diet impairment and increased consumption of analgesics compared to their counterparts. These findings highlight the need for personalized pain management strategies in orthodontic treatment, especially for patients with increased vulnerability to discomfort. Full article

Purpose: Cancer survivors in rural and underserved areas face barriers such as limited access to oncology exercise programs and limited facilities, contributing to health inequities in cancer survivorship. This study explored cancer survivors’ thoughts on exercise and mobile technology for exercising with a mobile application (app) during and after treatment in rural and remote areas. Methods: Three online focus groups were conducted in February 2024 using semi-structured interviews with 12 open-ended questions. Eligible participants were adult cancer survivors or caregivers living in medically underserved areas, English-speaking, consented to being audiotaped, and attended one 60-min group interview. The discussions were transcribed verbatim and analyzed via a content analysis approach with consensus. Results: Fifteen participants attended from four States. None of the participants were advised to exercise; availability of exercise resources depended on geographic location and a cancer-specific exercise app was desired. They understood the benefits of exercise after diagnosis but expressed a need for more guidance during treatment. Geographic location shaped their activities, with most engaging in daily physical tasks rather than structured exercise. Most participants were receptive to using an exercise app to manage fatigue. Suggested key features to exercise with an app included live trainers, exercise checklists, visual benchmarks, and programs tailored to different fitness levels. Conclusions: These results emphasize the need for personalized resources, guidance, and on-demand accessibility to an exercise oncology app. A cancer-specific exercise mobile app will mitigate health inequities for cancer survivors residing in rural and remote areas. Full article

Chronic kidney disease (CKD) can impair activities of daily living (ADL), reducing quality of life. The influence of biopsychosocial factors on ADL limitations among CKD patients remains unclear. This study aims to investigate associations between these factors and ADL limitations among CKD patients in the Brazilian population. We analyzed data from 839 individuals diagnosed with CKD obtained from the National Health Survey. The outcome was the presence or absence of limitations in ADL caused by CKD. Biopsychosocial factors included clinical and health status, self-perceived behavior, contextual social support, lifestyle, and household characteristics. Cox regression was employed to adjust interactions between these factors, with the prevalence ratio used as a measure of effect (α ≤ 5%). From the analyzed sample, 373 CKD patients (40.7%; 95% CI: 35.4–46.1%) reported experiencing limitations in ADL. These limitations were associated with individual and contextual factors, including lack of private health insurance, residing in a rural area, poorer self-perceived health, presence of depressive symptoms, physical/mental disabilities, use of medications, and undergoing hemodialysis. Limitations in ADL among individuals with CKD are associated with biopsychosocial factors in the Brazilian population, emphasizing the necessity for public policies that support enhanced therapeutic management and address behavioral health. Full article

Groundwater is essential for water resources, serving as a key drinking source in China. It supports daily needs for urban and rural residents, aids development, and maintains ecological balance. This study conducted a sampling survey of groundwater in the Wen River basin (WRB), assessing hydrochemical features, genesis mechanisms, water quality, and health risks. The findings reveal that groundwater in the WRB is weakly alkaline, with an average total dissolved solids (TDS) concentration of 755.24 mg/L. Freshwater constitutes approximately 81.48% of the groundwater, with the following order of concentration for cations: Ca²⁺ > Na⁺ > Mg²⁺ > K⁺, and for anions: HCO₃⁻ > SO₄²⁻ > NO₃⁻ > Cl⁻. The predominant hydrochemical types are SO₄·Cl-Ca·Mg and HCO₃-Ca·Mg. The chemical composition of the groundwater is primarily influenced by silicate rock weathering, dissolution processes, cation exchange, and human activities. The average Environmental Water Quality Index (EWQI) value of 74.65 for the WRB signifies that the overall quality of the groundwater is quite good, indicating that the majority of the groundwater is suitable for drinking purposes. Notably, the inferior quality water is predominantly found downstream of the Wen River. Calculations of the sodium adsorption ratio (SAR), residual sodium carbonate (RSC), and percentage of sodium (%Na) indicate that groundwater at most sampling points is suitable for irrigation. Furthermore, the human health risk assessment (HRA) reveals that oral intake presents a greater health risk to individuals than dermal contact. The mean Hazard Index (HI) for children is 3.24, with a staggering 79.89% of non-carcinogenic health risk (NHR) values surpassing the acceptable standards. For adults, the mean HI is 1.39, with 53.44% of NHR values exceeding the standards. These data indicate that children are more susceptible to health risks than adults and that the midstream and downstream of the river exhibit higher health risks compared to the upper reaches. These findings can provide critical data for groundwater quality assessment and risk management in the WRB and offer guidance for future groundwater resource management and pollution control efforts. Full article

In this study, we examined the factors that contribute to successful aging in place in the town of Shimogo, a depopulated mountainous area in Japan, focusing on the interplay between household support types, the performance of daily activities, and the involvement of geographically dispersed family members. A mixed-methods approach was used, combining survey data with multiple correspondence analysis and cluster analysis. The resident household findings reveal significant differences in community engagement and reliance on community support across three household support types: self-help, mutual aid, and combined support. The self-help households demonstrated high self-sufficiency and community participation, while the mutual-aid and combined-support households exhibited greater reliance on family and community resources. An analysis of the activities of out-migrated relatives uncovered diverse engagement profiles, motivated by both providing practical support and strengthening family bonds. The visit frequencies and activity types of the relatives were significantly influenced by both their own characteristics and the levels of self-reliance and community support needs of the resident households. Four distinct relative engagement clusters emerged, reflecting varying levels of support, community involvement, and visit frequency. Our findings underscore the crucial role of both informal (family) and formal (community) support networks in facilitating successful aging in place in rural depopulated areas. Policy implications include strategies supporting both self-reliance and the diverse mechanisms of family- and community-based support to ensure the sustainability of life in these challenging environments. Full article

Background: Loneliness in older people, especially those living in rural areas, is a phenomenon that has received little attention in research and can have detrimental effects on quality of life. The aim of this study was to evaluate loneliness and the psychosocial factors associated with loneliness in rural Spain, which have been minimally studied. Methods: A cross-sectional study was carried out in a sample of permanently resident older people in the Rincón de Ademuz region (Valencia, Spain), a geographic area with very low population density. Emotional and social loneliness were assessed using the de Jong Gierveld Loneliness Scale. We also assessed whether loneliness is associated with sleep quality, depressive symptoms, and autonomy in basic and instrumental activities of daily living. Results: A total of 108 community-dwelling individuals aged 65 years and older participated in the study out of a total sample of 181. Of them, 30.6% experienced feelings of moderate loneliness, while 2.8% presented severe loneliness. A significant correlation was found between loneliness and age (Rho = 0.28, p = 0.003). Significant differences were also observed between emotional loneliness and gender (p = 0.03) but not between social loneliness and the total score on the de Jong Gierveld Scale. Men experienced more emotional loneliness than women. In the multivariate analyses, significant associations were found between the degree of loneliness and having sons/daughters (p = 0.03; odds ratio [OR] = 0.24; 95% CI 0.06–0.89) and the role of caring for a dependent person (p = 0.002; odds ratio [OR] = 0.05; 95% CI 0.009–0.36) but not living with sons/daughters or the presence of grandchildren. Conclusions: There is a high prevalence of loneliness among older people living in rural areas, which is associated with some social factors. Therefore, nursing care plans should include assessments and interventions to prevent or detect and address loneliness in older people. This study was retrospectively registered in ClinicalTrials on 24 April 2024 with registration number NCT06382181. Full article

With the continuous advancement of urbanization, rural areas are facing increasingly severe environmental pollution, excessive energy consumption, and high carbonization resulting from both daily living and production activities. This study, which is aligned with the low-carbon objectives of “carbon sequestration increase and emissions reduction”, explores the optimization strategies for ecological benefits through the combined application of rooftop photovoltaics and rooftop greening in rural residences. Three design approaches are proposed for integrating rooftop photovoltaics with green roofing: singular arrangement, distributed arrangement, and combined arrangement. Using PVsyst (7.4.7) software, this study simulates the effects of roof inclination, system output, and installation formats on the performance of photovoltaic systems, providing a comprehensive analysis of carbon reduction benefits in ecological rooftop construction. A rural area in East China was selected as a sample for adaptive exploration of ecological roof applications. The results of our research indicate that the optimal tilt angle for rooftop photovoltaic (PV) installations in the sample rural area is 17°. Based on simulations combining the region’s annual solar path and the solar parameters on the winter solstice, the minimum spacing for PV arrays is calculated to be 1.925 m. The carbon reduction benefits of the three arrangement methods are ranked, from highest to lowest, as follows: combined arrangement $14530.470{\mathrm{t}\mathrm{C}\mathrm{O}}_{2\mathrm{e}}$ > singular arrangement $11950.761{\mathrm{t}\mathrm{C}\mathrm{O}}_{2\mathrm{e}}$ > distributed arrangement $7444.819{\mathrm{t}\mathrm{C}\mathrm{O}}_{2\mathrm{e}}$. The integrated design of rooftop PV systems and green roofing not only meets the energy demands of buildings but also significantly reduces their carbon footprint, achieving the dual objectives of energy conservation and sustainable development. Therefore, the combined application of rooftop PV systems and green roofing in rural spaces can provide data support and strategic guidance for advancing green transformation and ecological civilization in East China, offering significant practical value for promoting low-carbon rural development. Full article

Traditional Chinese villages, recognized as national heritage sites, are invaluable cultural assets. Since 2012, efforts have focused on their preservation, though issues remain such as prioritizing authenticity over usability and material over cultural elements. This paper adopts the Historic Urban Landscape (HUL) approach, emphasizing the integration of physical heritage with daily life to shift value assessment. The fundamental argument of this paper is that the HUL method can serve as a new tool for preserving the historical heritage and landscape of rural areas, particularly in the context of assessing and formulating preservation frameworks for traditional Chinese villages. Through the case study of Tangfang village’s new conservation plan, the research demonstrates that the value of traditional villages lies in the continuous interaction between daily activities and physical space, including landscape, functional, and spiritual dimensions. The study concludes that a preservation framework based on local residents’ daily lives ensures more effective heritage conservation and landscape preservation by addressing both material and human values. Full article

Mental health disparities exist between rural and metro areas of the United States. Differences in dietary intake may contribute to these disparities. We examined differences in dietary intake and mental health between those 50 years and older (n = 637) living in rural counties to those living in metro counties in North Dakota and the relationship between dietary intake to days with depression or anxiety. A survey was conducted throughout North Dakota. Items were modified from other surveys, such as the Behavioral Risk Factor Surveillance System questionnaires and the National Health Interview Survey Cancer Control Supplement Dietary Screener Questionnaire. Comparing medians, individuals more likely to be unable to perform normal daily activities due to mental health (p = 0.009) resided in rural areas instead of metro areas. Those living rurally also ate more processed meats (p = 0.005), while trending toward less lean protein intake (p = 0.056). Multinomial regression analyses controlling for covariates revealed that lean protein intake and fruit intake were inversely associated with days with depression and anxiety (all p < 0.05), whereas processed meat intake was positively associated with anxiety (p = 0.005). Clinicians working with older adults residing in rural areas should emphasize substituting lean proteins for processed meats. Full article

In recent years, awareness has grown of the vital importance of ecological systems, provoking increased research into how to improve their resilience. Here, one popular new technical/management solution is the creation of greenways along riversides. In practice, however, the practical outcomes of such greenways have sometimes been disappointing due to an excessive focus on technical solutions at the expense of a sufficient consideration of the social impact. This study intends to reflect on the problem by looking at the dynamics of land use for ecosystem functions at the macro scale as well as the relationship between the implementation of greenways and the local demand for diverse everyday activities, in particular, recreation opportunities, at the micro scale. Based on this, it aims to reveal practical solutions to bridge ecological usages and everyday needs that achieve better preservation and services of ecosystems. Taking the greenways along the Yongning River (YRG), which runs through the urban–rural areas and the urban–rural interface of Huangyan-Taizhou, as a case study, GIS analysis and anthropology approaches were applied. The results show that the YRG has systematically improved the riparian ecosystems by better connecting the eco-land use and preserving the waterfront. At the same time, its ability to fulfil the large potential for leisure and recreation services needs to improve. Residents living in different parts of the city had disparate requirements depending on their patterns of daily behaviour. We conclude that the successful implementation of greenways in cities should not only consider technological and nature-based solutions but also consider the socio-cultural background. The diversity of local needs regarding everyday activities and recreation will lead to an equivalent diversity in riparian landscape design. Full article