Search Results (386)

Background: Social and financial services are essential for the inclusion and well-being of people with disabilities (PWDs), who often rely on family caregivers to access these systems. In Saudi Arabia, where disability inclusion is a strategic goal under Vision 2030, understanding caregiver experiences is crucial to identifying service gaps and improving accessibility. Objectives: This study aimed to explore caregivers’ perspectives on awareness, perceived barriers, and accessibility of social and financial services for PWDs in Saudi Arabia. The analysis is grounded in Andersen’s Behavioural Model of Health Service Use and the WHO’s International Classification of Functioning, Disability and Health (ICF) framework. Methods: A cross-sectional survey was conducted with 3353 caregivers of PWDs attending specialised day schools. The survey collected data on demographic characteristics, service awareness, utilisation, and perceived obstacles. Exploratory Factor Analysis (EFA) identified latent constructs, and Structural Equation Modelling (SEM) was used to test relationships between awareness, barriers, and accessibility. Results: Findings reveal that over 70% of caregivers lacked awareness of available services, and only about 3% had accessed them. Key challenges included technological barriers, complex procedures, and non-functional or unclear service provider platforms. Both User Barriers and Service Barriers were negatively associated with Awareness and Accessibility. Awareness, in turn, significantly predicted perceived Accessibility. Caregiver demographics, such as age, education, gender, and geographic location, also influenced awareness and service use. Conclusions: There is a pressing need for targeted awareness campaigns, accessible digital service platforms, and simplified service processes tailored to diverse caregiver profiles. Inclusive communication, decentralised outreach, and policy reforms are necessary to enhance service access and promote the societal inclusion of PWDs in alignment with Saudi Arabia’s Vision 2030. Full article

Survivors of pediatric cancer are at risk for late effects and require risk-adapted long-term follow-up (LTFU) care. Yet less than 50% of survivors attend LTFU care. This study aimed to identify barriers and enablers of engaging with LTFU care as perceived by Canadian survivors of pediatric cancer and healthcare providers (HCPs). Survivors (n = 108) and HCPs (n = 20) completed surveys assessing barriers and enablers to attending LTFU care, summarized using descriptive statistics. Participants were invited to participate in survivor focus groups (n = 22) or HCP semi-structured interviews (n = 7). These were analyzed using reflexive thematic analysis and the Capability, Opportunity, and Motivation for Behaviour Change (COM-B) model, which explores how an individual’s capability, opportunity, and motivation influence a target behaviour. Structural barriers, transitioning from pediatric to adult care, and time constraints were highlighted as barriers that affect survivors’ physical opportunity to engage in LTFU care. Accessibility, financial support, HCPs and family support, and community resources were highlighted as enablers that better survivors’ physical and social opportunity to engage in LTFU care. In conclusion, Canadian survivors of pediatric cancer highlighted barriers that limited their physical opportunity to attend LTFU care, while factors that enhanced their physical and social opportunities facilitated greater engagement with LTFU care. Full article

Since the end of the Civil War, Cambodia has pursued economic development to enhance livelihoods, particularly in rural areas, where land is a critical resource. Previous studies have indicated that the country has changed land use and land cover. However, they have not explained how these changes can improve the livelihoods of local communities, thereby mitigating their negative impacts through an asset-based approach. Battambang Province, in the northwestern region, was the battleground until political integration in 1996. Since then, the province has been home to immigrants exploring the lands for livelihood. Thus, this study aims to examine agricultural livelihoods in the villages of Dei Kraham and Ou Toek Thla, located west of Battambang Town. These were selected because of their common characteristics. Adopting a quantitative approach and a sustainable livelihood framework, this study employed stratified random sampling to select 123 families for interviews across three population subgroups: old settlers, new settlers, and young settlers. In situ information was collected using structured questionnaires and analyzed using Kruskal–Wallis tests to assess the livelihood assets underlying the physical, natural, human, financial, and social capital. The statistical analysis results reveal no significant differences (p-value = 0.079) in livelihood assets between the strata at the village level. Meanwhile, significant differences were observed in physical, human, and financial capital between old and young settlers when examining the subgroups (p-value 0.000). The extent of the land resources held by old settlers was associated with household income and livelihoods related to agriculture. Based on livelihood asset scores, nearly half of the new settlers (0.49–0.5) and a quarter of the young settlers (0.47) are vulnerable groups requiring support. The youth will soon face an uncertain future if they do not prioritize education. Full article

Substance use is a critical public health issue in the U.S., with Black communities, particularly those with criminal justice contact, disproportionately affected. Chronic exposure to stressors can lead to substance use as a coping strategy. This study used data from 1476 Black adults with criminal justice involvement from the National Survey of American Life to examine how psychosocial stress and sleep disturbances relate to lifetime substance use and to determine if there are any sex differences. Sex-separate generalized linear models for a Poisson distribution with a log-link function estimated prevalence ratios and adjusted prevalence ratios (APRs) for lifetime alcohol abuse, lifetime cigarette, and marijuana use. Independent variables include stressors (family, person, neighborhood, financial, and work-related) and sleep problems, with covariates such as age, SES, and marital status. Lifetime alcohol abuse was associated with family stressors (APR = 2.72) and sleep problems (APR = 3.36) for males, and financial stressors (APR = 2.75) and sleep problems (APR = 2.24) for females. Cigarette use was linked to family stressors (APR = 1.73) for males and work stressors (APR = 1.78) for females. Marijuana use was associated with family stressors (APR = 2.31) and sleep problems (APR = 2.07) for males, and neighborhood stressors (APR = 1.72) for females. Lifetime alcohol abuse, as well as lifetime cigarette and marijuana use, was uniquely associated with various psychosocial stressors among Black adult males and females with criminal justice contact. These findings highlight the role of structural inequities in shaping substance use and support using a Social Determinants of Health framework to address addiction in this population. Full article

This research explores the concept of open building (OB) in the context of low-cost housing, focusing on its historical applications in Egypt during the 1980s. By evaluating past experiences, the study aims to extract key lessons that can inform the design and implementation of contemporary social housing projects. The goal is to foster resilience and diversity in housing typologies to ensure they align with the evolving needs of residents. To achieve these objectives, the research employed a multi-dimensional strategy, beginning with a comprehensive literature review of the open building movement (OB); then, the study traced the evolution of the OB movement in Egypt using a qualitative analysis approach, which involved analyzing its implementation in low-cost housing projects over the past four decades. Through this historical lens, the study identifies design principles and strategies that can enhance social housing projects by applying OB. Considering the life cycle cost, OB enables an incremental process that would align with users’ financial capacities. The research revealed the substantial capacity of open building (OB) to address Egypt’s social housing challenges, primarily by fostering user-driven flexibility in housing unit design and area selection. This empowers occupants to choose spaces perfectly suited to their family’s evolving needs. Moreover, the findings provide a roadmap for revitalizing the OB movement by analyzing and overcoming past implementation difficulties, consequently balancing the initial cost and long-term economics for citizens and significantly reducing the governmental sector’s expenditure. Full article

This study examines how U.S. immigration policies enact legal violence and multigenerational punishment through the spousal reunification process, particularly in mixed-status, transnational families. Building on the concept of “deportability,” we introduce “importability” to describe a beneficiary’s potential to secure permanent residency, which varies according to social markers such as race, gender, and region of origin. Drawing from a content analysis of threads on the Immigration Pathways (IP) web forum, we analyze discussions among U.S. citizen petitioners navigating marriage-based green card applications, with a focus on experiences involving administrative processing (AP) (i.e., marriage fraud investigations). Our findings show that couples who do not align with the state’s conception of “proper” family—particularly U.S. citizen women petitioning for Black African partners—face intensified scrutiny, long delays, and burdensome requirements, including DNA tests and surveillance. These bureaucratic obstacles produce prolonged family separation, financial strain, and diminished sense of belonging, especially for children in single-parent households. Through the lens of “importability,” we reveal how legal violence and multigenerational punishment of immigration policies on mixed-status families beyond deportation threats, functioning as a gatekeeping mechanism that disproportionately affects marginalized families. This research highlights the understudied consequences of immigration policies on citizen petitioners and contributes to a broader understanding of inequality in U.S. immigration enforcement. Full article

Background/Objectives: Against the backdrop of increasing global aging and the trans-formation of family structures, grandparental caregiving has become commonplace, and its impact on the mental health of older persons is of great concern. Methods: Based on data from the 2023 Xi’an Jiaotong University Urban and Rural Elderly Family Support and Psychological Condition Survey, this study analyzed the impact of grandparental care-giving behaviors on the mental health of the elderly through the Psychological Condition Measurement Scale (PCMS), and comprehensively assessed the presence, intensity, and heterogeneous impact of grandparental caregiving behaviors by gender by applying linear regression modeling, the Propensity Score Matching (PSM) method, and the Instrumental Variables Method (IVM). Results: Grandparental care has a significant positive effect on the mental health of older people, but this positive effect diminishes as the intensity of care increases. The results of the sub-sample estimation show that grandparental caregiving has a positive effect on men’s and low-intensity caregiving on women’s mental health, but high-intensity caregiving has a negative effect on women’s mental health. In addition, in-tergenerational financial support and intergenerational emotional comfort play an im-portant mediating role between grandparental caregiving and the mental health of older persons, in line with the explanatory framework of intergenerational exchange theory. Conclusions: It is recommended that the Government support grandparental care for the elderly at the financial, social security, and policy levels; that society build a diversified system of elderly care services and strengthen public childcare services; and that families establish a value identity of two-way support. Full article

Background: Chronic pain affects one in five youth globally and is frequently accompanied by mental health challenges that extend into adulthood. Caregivers play a vital role in supporting youth with chronic pain, yet their own mental and physical health needs are often overlooked. While caregiver well-being is linked to child outcomes, few interventions directly address caregivers’ health, especially among those facing systemic barriers. This study explored the lived experiences of caregivers to better understand their unmet needs and inform the co-design of a supportive digital health solution. Methods: We conducted a qualitative exploratory study involving 32 caregivers of youth with chronic pain across Canada and Australia. Semi-structured interviews were co-facilitated by caregiver partners. Thematic analysis was applied to interview data. Results: Two overarching themes were identified: (1) bearing the weight and sacrifice of caregiving and (2) deep interrelatedness and blurred boundaries. Caregivers reported profound emotional, physical, and financial burdens; strained relationships; and social isolation. Many struggled with self-neglect, prioritizing their child’s needs over their own. Fathers’ evolving caregiving roles challenged traditional gender norms, though mothers continued to bear a disproportionate load. Despite challenges, caregivers demonstrated resilience and recognized their well-being as interconnected with their child’s health. Conclusions: Findings underscore the need for systemic investment in caregiver well-being. Digital health solutions, including virtual peer networks, mental health resources, and tailored education, offer scalable, accessible pathways for support. These insights will inform the development of Power over Pain for Primary Caregivers, a digital solution and knowledge hub aimed at improving caregiver well-being and family outcomes, aligning with global efforts to enhance family-centred pediatric pain care. Full article

The COVID-19 pandemic significantly disrupted higher education worldwide, imposing strict isolation measures, transitioning learning online, and exacerbating existing social and economic inequalities. This literature review examines the pandemic’s impact on the mental health of college students, with a focus on those belonging to minority groups, including racial, ethnic, migrant, gender, sexuality-based, and low-income populations. While elevated levels of anxiety, depression, and loneliness were observed across all students, findings indicate that LGBTQ+ and low-income students faced the highest levels of psychological distress, due to compounded stressors such as family rejection, unsafe home environments, and financial insecurity. Racial and ethnic minority students reported increased experiences of discrimination and reduced access to culturally competent mental healthcare. International and migrant students were disproportionately affected by travel restrictions, legal uncertainties, and social disconnection. These disparities underscore the need for higher education institutions to implement targeted, inclusive mental health policies that account for the unique needs of at-risk student populations during health crises. Full article

Background—Against childhood lead poisoning, removing lead exposure is the main measure, but how to do it effectively has not been fully established. Our objective was to determine the impact of several interventions (education, housing remediation, and relocation) on children’s blood lead levels. Methods—A historical cohort of childhood lead poisoning was drawn in Marseille, France, from 2011 to 2018. A generalized mixed model was developed to study the kinetics of blood lead levels. Results—We included 151 children, with 56% living in legal substandard housing and others living in slums. Medical follow-up (median: 612 days) included 492 blood samples. In legal substandard housing, blood lead level decrease was significantly associated with every intervention. In slums, blood lead level decrease was significantly associated with housing relocation and education, although to a lesser extent. Conclusions—Every intervention contributed to reducing blood lead levels in substandard housing. Educational intervention is rapidly implemented. Housing remediation follows a long-lasting but effective legal procedure. Some families get housing relocation, depending on their financial resources or whether they are eligible for social housing. In slums, access to legal housing is the most effective against environmental exposure and education has a wider impact on health literacy. Full article

In Latin America, over 50% of the population has relied on loans from family members or friends, reflecting the importance of trust-based networks in response to financial exclusion. This study examines how distrust in the formal financial system influences the use of informal borrowing. Using data from 17 countries for the years 2014, 2017, and 2021, and applying a fixed-effects logistic regression model by country and time, we confirm that rising distrust significantly increases the likelihood of turning to loans from personal networks. This relationship intensifies in times of crisis. Beyond this, we find that macroeconomic variables such as GDP per capita and unemployment also significantly affect informal borrowing behavior. This research contributes to the literature by integrating institutional, economic, and social variables, highlighting the role of interpersonal trust as a form of social capital. It also advances the field of personal finance by revealing an everyday strategy of financial resilience. Finally, this study offers relevant implications for public policy, advocating for a more realistic and context-sensitive approach to financial inclusion, especially in regions where credit constraints in the formal sector have pushed households to seek more accessible and flexible alternatives. Full article

Parents provide most of the support needed for children with cerebral palsy (CP) to increase the child’s participation and independence. Understanding the experiences of parents caring for children with CP is essential for developing effective family programs and services. The current knowledge about parents’ experiences in CP is based on studies in Western countries, with little known about this phenomenon in Arab countries like Saudi Arabia. This study aimed to understand the unique experiences and support needs of Saudi parents caring for children with CP from a social-ecological perspective. We conducted a qualitative, exploratory, descriptive study involving 12 semi-structured interviews with mothers and fathers of children with different types of CP. We analyzed the data using a reflexive thematic approach, following six distinct phases. Participants’ narratives revealed a complex caregiving journey marked by both challenges and rewards. Support from Saudi nuclear and extended family members was considered important; however, many parents expressed a need for additional physical and financial assistance from their families. Parents reported feeling stressed and experiencing challenges in accessing and navigating educational and healthcare services. Our findings highlight that Islamic values play a crucial role in the experiences of Saudi parents. These values foster a sense of collectivism, highlighting the importance of family support and community involvement, which can affect the Saudi caregiving environment. Parents remain an essential yet often invisible part of the Saudi caregiving system. Without adequate support, parents are at risk of experiencing social, financial, academic, physical, and mental health challenges, which may affect their overall family well-being. Future work may need to consider spiritual and gender roles when developing programs or services to support Saudi parents of children with CP. Full article

The increasingly observable financial vulnerability of households in emerging market countries makes it imperative to investigate the factors influencing it. Considering that China stands as a representative of emerging market economies, analyzing the factors influencing household financial vulnerability in China presents great reference significance for the sustainable development of households in emerging market countries. Using data from the China Household Finance Survey (CHFS) household samples, this paper presents the regional distribution of households with financial vulnerability in China. Utilizing machine learning (ML), this research examines the factors that influence household financial vulnerability in China and determines the most significant ones. The results reveal that households with financial vulnerability in China takes up a proportion of more than 63%, and household financial vulnerability is lower in economically developed coastal regions than in medium and small-sized cities in the central and western parts of China. The analysis results of the SHAP method show that the debt leverage ratio of a household is the most significant feature variable in predicting financial vulnerability. The ALE plots demonstrate that, in a household, the debt leverage ratio, the age of household head, health condition, economic development and literacy level are significantly nonlinearly related to financial vulnerability. Heterogeneity analysis reveals that, except for household debt leverage and insurance participation, the key characteristic variables exerting the most pronounced effect on financial fragility differ between urban and rural households: household head age for urban families and physical health status for rural families. Furthermore, digital financial inclusion and social security exert distinct impacts on financial vulnerability, showing significantly stronger effects in high per capita GDP regions and low per capita GDP regions, respectively. These findings offer valuable insights for policymakers in emerging economies to formulate targeted financial risk mitigation strategies—such as developing household debt relief and prevention mechanisms and strengthening rural health security systems—and optimize policies for household financial health. Full article

Divorce represents a significant life transition with implications for emotional well-being, social integration, and economic security. This study examines the post-divorce experiences of women in Abu Dhabi, focusing on four challenges: financial insecurity, emotional distress, co-parenting difficulties, and struggles in forming new relationships. Drawing on data from the 5th Cycle of the Abu Dhabi Quality of Life Survey (n = 4347), the study explores how these challenges affect indicators such as life satisfaction, mental health, social trust, and financial stability. The findings show financial insecurity is the most prevalent and detrimental issue, particularly among older and less-educated women. Co-parenting stress peaks among women aged 35–49, while non-Emirati women report heightened financial vulnerability. Emotional distress is associated with poor sleep, reduced trust, and digital coping behaviors. Older women face greater social reintegration challenges. Religious practice emerges as a frequent coping mechanism, especially among those experiencing stigma and isolation. Guided by the Stress Process Model, the study highlights the interplay of social and psychological stressors and offers practical insights for psychiatric and mental health practitioners supporting women through family disruption. Full article

Accurate gold price forecasting is essential for informed financial decision-making, as gold is sensitive to economic, political, and social factors. This study presents a hybrid framework for multivariate gold price prediction that integrates classical econometric modelling, traditional machine learning, modern deep learning methods, and their combinations. The framework incorporates financial, macroeconomic, and sentiment indicators, allowing it to capture complex temporal patterns and cross-variable relationships over time. Empirical validation on an eleven-year dataset (2014–2024) demonstrates the framework effectiveness across diverse market conditions. Results show that advanced supervised techniques outperform traditional econometric models under dynamic market environment. Key advantages of the framework include its ability to handle multiple data types, apply a structured variable selection process, employ diverse model families, and support model hybridisation and meta-modelling, providing practical guidance for investors, institutions, and policymakers. Full article