Search Results (43)

Informal waste picking and scrap collection constitute critical yet highly precarious livelihood strategies among economically marginalised women in rural South Africa. This article presents a cross-sectional mixed-methods study, guided by Sen’s Capability Approach as its analytical framework, examining the lived experiences, motivations, and livelihood outcomes of 126 Black African women engaged in scrap collection along the N2 Highway in the Eastern Cape, specifically in Mthatha, Xhora, and Qumbu. The study integrates quantitative descriptive statistics with qualitative thematic analysis derived from structured interviewer-administered questionnaires. The findings indicate that participation in scrap collection is overwhelmingly driven by structural economic constraints, including chronic unemployment, household poverty, and extensive caregiving responsibilities, rather than autonomous occupational choice. The sample is characterised by limited educational attainment, frequently disrupted by poverty, bereavement, early marriage, and early caregiving roles, which collectively constrain access to formal employment opportunities. Participants consistently described scrap collection as physically hazardous, economically insecure, and detrimental to both physical health and psychosocial wellbeing, while remaining indispensable for household survival. Through the lens of the Capability Approach, these conditions reflect severe restrictions in substantive freedoms, particularly in relation to economic security, bodily health and human dignity. Expressions of acceptance are interpreted as manifestations of adaptive preferences formed under conditions of prolonged structural deprivation rather than indicators of genuine agency. The study contributes to informal economy scholarship by demonstrating how intersecting structural inequalities constrain capability sets and limit livelihood trajectories and calls for targeted policy interventions to enhance occupational safety, income security and access to sustainable livelihood alternatives. Full article

Background/Objectives: Work stress (WS), occupational fatigue (OF), and Burnout syndrome (BS) among administrative workers are associated with negative psychosocial and metabolic effects. Although antioxidant-rich nutritional strategies have been proposed to help manage stress, evidence from real-world occupational settings is still limited. This study evaluated the total antioxidant capacity (TAC) of a multi-antioxidant dietary supplement 2.0 (DS2.0; apple polyphenols, [APP], astaxanthin [AXT], and fucoxanthin [FXT]; 387:12:1 ratio) and explored its association with metabolic parameters, OF, psychosocial outcomes, and hair cortisol concentration (HCC) in administrative workers with and without obesity. Methods: A quasi-experimental pilot study was conducted among 22 workers, who received DS2.0 (52.13 mg/day, n = 17) or a placebo (n = 5) for 30 days. TAC was analytically assessed using standardized assays. Metabolic outcomes (lipid profile, fasting plasma glucose), psychosocial variables (SOFI-SM, CESQT/SBI, and IMSS tests), and HCC (competitive immunoassay) were evaluated before and after supplementation. Statistical analyses included within-group pre–post comparisons, independent-sample tests, and effect size estimation. Results: DS2.0 demonstrated high TAC. Supplementation was associated with reductions in total lipids, total cholesterol, and non-HDL cholesterol, as well as decreases in OF, BS, and WS scores. HCC decreased in the overall sample (217.19 vs. 31.64 pg/mg; p = 0.000) and among workers with obesity (276.80 vs. 34.13 pg/mg; p = 0.002). Stress-related symptoms, including sleep deprivation, exhaustion, appetite changes, difficulty waking, and palpitations, also improved (p ≤ 0.05). Conclusions: An antioxidant-rich DS2.0 supplement may be associated with psychosocial and stress-related biomarkers; however, these exploratory findings require confirmation in larger randomized controlled trials. Trial registration: ISRCTN 12762846. Full article

This study examines the impact of family multidimensional poverty on cognitive function among older adults in China using the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Filling a critical gap in the existing literature, we construct a multidimensional poverty index (MPI) based on the Alkire-Foster methodology to evaluate cognitive decline within the context of China’s post-poverty-eradication landscape. Utilizing quantile regression analysis, our findings demonstrate that multidimensional poverty exerts a significant, negative effect on cognitive function, which is more pronounced among individuals at lower cognitive quantiles, consistent with the cumulative disadvantage theory. Furthermore, we identify substantial urban–rural and regional disparities, revealing unique socio-economic inequalities. By linking multidimensional poverty to elderly cognitive health through psychosocial pathways, this study provides empirical evidence that reducing multidimensional deprivation among older adults is integral to achieving both SDG1 and SDG3 in China’s post-eradication context, demonstrating that income-based metrics alone are insufficient to capture the full burden of poverty on elderly cognitive health. Full article

Background: The biopsychosocial model positions fibromyalgia (FM) as the result of altered pain modulation shaped by trauma, psychological vulnerability, and structural stressors. The Sense of Coherence (SOC) may be a key resilience factor explaining differences in symptom severity after similar hardships. Objectives: To evaluate whether SOC mediates and/or moderates associations between trauma-related adversity and symptom burden in FM and whether comorbidities, medication use, healthcare factors, or treatment engagement modify these relationships. Methods: In this cross-sectional study, 2099 women with FM completed an online survey assessing adversity, psychosocial factors, core symptoms, healthcare support, treatment engagement, and medication use. A theory-driven SOC composite followed Antonovsky’s model (comprehensibility, manageability, meaningfulness) using the proxy SOC composite derived from a theory-driven framework that underwent internal construct validation, including discriminant validity analyses and latent structure evaluation, but it was not benchmarked against a gold-standard SOC questionnaire. Linear regression evaluated adversity–symptom associations, SOC mediation, and moderation by SOC and medication classes. Results: Higher adversity predicted lower SOC (e.g., cumulative abuse: B = −0.25), and lower SOC predicted higher symptom burden (e.g., Fibromyalgia Impact Questionnaire (FIQ): B = −6.77), producing significant indirect effects (cognitive symptoms: 0.22; FIQ: 1.69). SOC also moderated the effects of adversity on fatigue and global impact, weakening associations at higher SOC. Comorbidities showed modest influence: hypertension had minor indirect effects (ab = 0.27), scheduled consultation produced small interactions (cognition β = −0.38 to −0.46; fatigue β = ~0.05–0.06), and stroke showed the only clinically meaningful moderation (β ≈ 4.9–5.2), all far smaller than SOC effects. Conclusions: SOC functions as a central psychosocial pathway and resilience-related factor in the association between trauma and FM symptoms. Targeting SOC-related processes may help reduce symptom burden and improve outcomes. Full article

Background/Objectives: People with mobility limitations face disproportionately high rates of chronic health conditions and demonstrate lower adherence to wellness interventions. Digital programs such as MENTOR offer accessible alternatives but often face high rates of attrition. This study applied machine learning (ML) methods to predict adherence to the eight-week MENTOR telewellness program and identify key predictors of participant attendance. Methods: Data were drawn from 1218 adults enrolled in MENTOR (2023–2024). Adherence was defined as the percentage of 40 sessions attended. Baseline demographic, socioeconomic, psychosocial, mindfulness, resilience, health status, and physical activity variables were included as predictors. Following preprocessing and imputation, 13 ML regression models were trained using an 80/20 train–test split. The best-performing model was identified using mean absolute error (MAE), followed by feature selection and SHAP interpretability analyses. Pairwise synergy analysis quantified interactions between top predictors. Results: Model performance was modest overall. Bayesian ridge regression achieved the best performance (MAE 20.98; RMSE 25.26; R² = 0.12). SHAP analyses revealed that education, race, emotional support, Area Deprivation Index, household size, mindfulness, life satisfaction, and disability onset were the strongest predictors of adherence. Higher emotional support, mindfulness, and life satisfaction were associated with greater adherence, while socioeconomic disadvantage predicted lower adherence. Synergy analyses showed the strongest predictive interactions between low education and psychosocial resources (emotional support and life satisfaction). Conclusions: Baseline characteristics alone modestly predicted adherence to a digital wellness program. However, psychosocial and socioeconomic factors emerged as meaningful predictors, underscoring the need for personalized support strategies to reduce dropout among participants with mobility limitations. Full article

Background: Hearing loss is one of the most common yet often overlooked sensory deficits worldwide, with consequences extending well beyond auditory function. Mounting evidence highlights the complex interrelationships among hearing loss, cognitive decline, and psychosocial well-being. Neural mechanisms underlying this association include increased cognitive load, cortical reorganisation, and social isolation, which mediate the impact of auditory deprivation on the brain and mental health. Furthermore, hearing impairment is consistently associated with a higher risk of depression and anxiety, particularly when the duration of untreated deafness is prolonged. Methods: This narrative review summarises recent longitudinal and neuroimaging studies investigating the effects of hearing loss and the timing of intervention with hearing aids. The review focuses on evidence addressing cognitive, psychological, and neural outcomes in relation to early versus delayed amplification. Results: Across multiple studies, early adoption of hearing aids within a limited timeframe after diagnosis is linked to better cognitive performance, lower depressive symptom scores, and more preserved neural network integrity. Experimental evidence supports the existence of sensitive periods for auditory intervention, during which brain plasticity allows for optimal reorganisation and recovery of function. Conversely, delayed amplification may lead to irreversible cortical changes and persistent psychosocial distress. Despite this, several barriers—healthcare accessibility, patient attitudes, and economic constraints—continue to delay timely intervention. Conclusions: Early identification and management of hearing loss are critical to preserve cognitive and emotional health. An integrated approach addressing both hearing and cognitive well-being, supported by patient education and personalised care strategies, may maximise the benefits of amplification and improve overall quality of life. Full article

Background: Incarcerated men experience disproportionately high levels of health inequities shaped by social determinants, including poverty, violence, family adversity, trauma, and limited access to healthcare. These long-standing disadvantages, added to the adverse conditions experienced in prisons, may be associated with elevated rates of suicidality in this population. This study examined the prevalence of suicidal ideation and lifetime suicide attempts among men deprived of liberty in Southern Brazil and investigated the role of cumulative adversities and current protective factors in these outcomes. Methods: A cross-sectional study was conducted with 496 incarcerated men. Participants completed a sociodemographic and background questionnaire assessing lifetime adversity (e.g., hunger, homelessness, sexual abuse, domestic violence, family substance dependence) and current protective factors in prison (e.g., family visits, education, leisure, physical activity, religion, positive self-perception). Cumulative adversity and protective factors were operationalized as composite indices. Logistic regression models tested whether cumulative adversities and protective factors were independently associated with suicidal ideation and suicide attempts. Results: Lifetime prevalence was 9.6% for suicidal ideation and 10.8% for suicide attempts. Cumulative adversities were associated with higher odds of both suicidal ideation (OR = 1.43; 95% CI = 1.11–1.84; p = 0.006) and suicide attempts (OR = 1.94; 95% CI = 1.50–2.52; p < 0.001). Protective factors were associated with lower likelihood of suicidal ideation (OR = 0.74; 95% CI = 0.58–0.96; p = 0.020) but were not significantly associated with suicide attempts. No significant interaction effects were observed, indicating that protective factors did not moderate the impact of adversity. Conclusions: Suicidal tendencies among incarcerated men were associated with cumulative structural and psychosocial adversities. Protective factors in prison were associated with lower odds of ideation but not attempts. These associations may inform person-centered and equity-oriented approaches and are consistent with the relevance of social determinants to mental health, although causal inferences are not supported by this project. Full article

This study examines the multidimensional human security challenges faced by internally displaced persons (IDPs) in Adigrat City, Tigray, Ethiopia, in the context of conflict-induced displacement. Guided by the Human Security Framework, the analysis addresses threats across economic, food, health, environmental, personal, community, and political domains. Data were collected through a cross-sectional survey using structured questionnaires administered to a stratified sample of 349 IDPs, and analysed through descriptive statistics. Content analysis was conducted on interviews from 17 respondents who were selected purposefully, and secondary data was collected to understand IDPs’ experiences and institutional responses. The findings reveal severe and overlapping forms of deprivation: IDPs reside in overcrowded and inadequate shelters, face chronic food insecurity, and lack access to clean water, healthcare, and education. These conditions are compounded by psychosocial distress, including trauma, anxiety, and the erosion of social cohesion. The study finds that governmental and international responses remain limited, poorly coordinated, and insufficiently responsive to the complex needs of displaced people. While the voluntary, safe, and dignified return of displaced populations to their areas of origin should remain the ultimate objective, this outcome could be realized by fully implementing the Pretoria Cessation of Hostilities Agreement. Responses including improved shelter, essential services access, livelihood recovery, and mental health support systems are essential to address urgent needs. Full article

Background/Objectives: Psychosocial factors are not routinely screened for during the perioperative period, even though they significantly influence overall health. This study aimed to inventory the psychosocial vulnerabilities among patients undergoing cancer surgery. Methods: We conducted a cross-sectional analysis of a researcher-administered psychosocial screener implemented within a statewide health system between July 2023 and August 2025. A 45 min screener was offered to consecutive adult patients within two weeks before their major elective cancer surgery. Residential addresses were geocoded to assign neighborhood deprivation percentiles for the Area Deprivation Index (ADI) and the Social Vulnerability Index (SVI). Elevated psychosocial vulnerability was determined based on a model-based clustering approach, and a high deprivation index was defined as ≥75th percentile. Results: A total of 383 patients (37% response rate) completed the screener, including colorectal (40%), thoracic (36%), and surgical oncology (24%) patients, with a median age of 66 years (IQR, 57–73). Over half (52.0%, n = 199) reported ≥2 psychological and ≥2 social vulnerabilities. Younger patients (p = 0.021), non-white patients (p < 0.001), patients identifying as non-heterosexual (p = 0.014), without a partner (p < 0.001) or private insurance (p = 0.040), and those with lower household income (p < 0.001) were more likely to report elevated psychosocial vulnerability. Patients with elevated psychosocial vulnerability were more likely to reside in deprived neighborhoods (ADI: 34.0 vs. 29.0, p = 0.035; SVI: 0.35 vs. 0.27, p = 0.005). Conclusions: Patients undergoing major cancer surgery experience substantial psychosocial vulnerabilities, particularly those from socioeconomically disadvantaged neighborhoods. Future work should identify the psychosocial factors most predictive of poor surgical outcomes to guide targeted preoperative interventions. Full article

Prior research from Ghana suggests psychosocial stress is associated with lower body mass index (BMI) and waist circumference (WC), both markers of adiposity, contrasting with meta-analyses showing positive associations in other settings. This study aimed to explore how stress was associated with markers of adiposity in urban Ghanaian adults. Data included 854 adults from the Contextual Awareness, Response and Evaluation Diabetes in Ghana survey carried out in November–December 2022 in Ga Mashie, a deprived area of the capital Accra. Associations between self-perceived stress (Perceived Stress Scale 10, categorized into low and average–high stress) and BMI or WC-for-height ratio (WHR) were assessed using linear regression. Results were adjusted for survey design and confounders and stratified by sex. Greater stress was associated with higher BMI and WHR in females (adjusted coeff. [95% CI]: BMI: 2.3 [0.5, 4.0], WHR: 0.03 [0.00, 0.06]). No associations were found in males. These findings highlight the need to understand the complex interactions between gender, stress, and increasing burdens of obesity and other associated non-communicable diseases in urban African settings, with a view to designing context-specific interventions to reduce risk. Full article

Prostate cancer (PCa) is the second most frequently diagnosed malignancy in men worldwide. Although traditionally considered a disease of older men, the incidence of early-onset PCa (diagnosis < 55 years) is steadily rising. Advances in screening and therapy have significantly improved survival, creating a growing cohort of younger survivors for whom post-treatment quality of life—notably reproductive function—is paramount. Curative treatments such as radical prostatectomy, pelvic radiotherapy, androgen-deprivation therapy (ADT), and chemotherapy often cause irreversible infertility via multiple mechanisms, including surgical disruption of the ejaculatory tract, endocrine suppression of spermatogenesis, direct gonadotoxic injury to the testes, and oxidative sperm DNA damage. Despite these risks, fertility preservation is frequently overlooked in pre-treatment counseling, leaving many patients unaware of their options. This narrative review synthesizes current evidence on how PCa therapies impact male fertility, elucidates the molecular and physiological mechanisms of iatrogenic infertility, and evaluates both established and emerging strategies for fertility preservation and restoration. Key interventions covered include sperm cryopreservation, microsurgical testicular sperm extraction (TESE), and assisted reproductive technologies (ART). Psychosocial factors influencing decision-making, novel biomarkers predictive of post-treatment spermatogenic recovery, and long-term offspring outcomes are also examined. The review underscores the urgent need for timely, multidisciplinary fertility consultation as a routine component of PCa care. As PCa increasingly affects men in their reproductive years, proactively integrating preservation into standard oncologic practice should become a standard survivorship priority. Full article

Background: Sleep is a fundamental component of health, and deprivation has been linked to numerous adverse outcomes, including reduced academic and occupational performance, greater risk of accidents, and increased susceptibility to chronic diseases and premature mortality. Dietary and lifestyle behaviors are increasingly recognized as key determinants of sleep quality. Women are particularly susceptible to sleep disturbances due to hormonal fluctuations and psychosocial factors. However, women remain underrepresented in sleep research. This study aims to examine the associations between sleep quality, nutrition, and lifestyle in a large cohort of Spanish women. Methods: A cross-sectional study was conducted with 785 women aged 18–64. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and the NutSo-HH questionnaire on dietary and lifestyle behaviors. Descriptive analyses, correlation matrices, Gaussian Graphical Models, and Principal Component Analyses were used to assess relationships between variables. Results: More than half of the participants rated their sleep quality as good or very good, although over 30% experienced frequent nighttime awakenings. Poor sleep quality was significantly associated with higher alcohol consumption, lower vegetable and white fish intake, and lower levels of physical activity. Diets rich in ultra-processed foods correlated moderately with subjective poor sleep and daytime dysfunction. However, no strong associations were found between stimulant consumption, late meals, or dietary patterns (e.g., Mediterranean diet) and sleep. Self-perceived health emerged as a protective factor, while nocturnal lifestyles were linked to longer sleep latency and fragmented sleep. Conclusions: In adult women, better sleep quality is linked to healthy dietary choices, regular physical activity, and a positive perception of general health. In contrast, alcohol use and irregular lifestyles are associated with poor sleep. Individual variability and cultural adaptation may moderate the impact of some traditionally harmful behaviors. Personalized, multidimensional interventions are recommended for promoting sleep health in women. Full article

Background and Objectives: Adolescence is a critical period of physical and mental development, yet allergic diseases are often poorly managed. Factors such as sleep deprivation, obesity, smoking, and mental stress can worsen allergic conditions and complicate treatment. This study examines the environmental, behavioral, and psychosocial factors influencing allergic diseases in Korean adolescents using data from the Korean National Health and Nutrition Examination Survey (KNHNES). Materials and Methods: From the 25,534 participants in the Fifth KNHNES, 1630 adolescents (aged 13–18 years) were selected. We analyzed demographic and lifestyle factors, including gender, age, housing type, family size, economic status, obesity, tobacco and alcohol use, sleep duration, and physical activity. Psychosocial factors such as stress perception, suicidal ideation, depressive symptoms, mental health counseling, and self-rated health were also examined. Results: The prevalence rates of allergic diseases were 23% for allergic rhinitis (AR), 11% for atopic dermatitis (AD), and 9.8% for asthma (AS), with 35.8% of adolescents having at least one allergic condition. Smoking was significantly associated with AS (odds ratio [OR] 1.753, p = 0.006), while shorter sleep durations increased AR risk (p = 0.000). Male adolescents had a lower risk of AD (OR 0.706, p = 0.046), and high economic status was inversely correlated with AD (OR 0.445, p = 0.006). Positive self-rated health was linked to lower AS risk (OR 0.447, p = 0.000). AR was significantly associated with male gender (OR 1.391, p = 0.045), high economic status (OR 1.784, p = 0.026), and high stress perception (OR 1.479, p = 0.013). Conclusions: Low self-rated health and high stress perception have been identified as risk factors for allergic diseases during adolescence. Integrating psychosocial counseling with medical treatment may improve management and outcomes. Full article

Aggressive behavior not only negatively affects an individual’s psycho-social adaptation but also undermines social harmony and stability. This study investigated the relationship between perceived crowdedness and aggression, examining the mediating role of relative deprivation and the moderating effects of upward social comparison and connectedness to nature based on the general strain theory and the I³ model. A cross-sectional design was employed, involving 848 participants (524 females, 61.8%) aged 20–75 (M = 33.15, SD = 6.83) in China. Structural equation modeling and bootstrapping procedures were used to test the hypothesized moderated mediation model. The results indicated that perceived crowdedness and upward social comparison positively predicted aggressive behavior, whereas connectedness to nature negatively predicted it. Relative deprivation mediated the relationship between perceived crowdedness and aggressive behavior. Only upward social comparison moderated the relationship between perceived crowdedness and relative deprivation, and connectedness to nature showed a marginally significant moderating effect on the relationship between perceived crowdedness and aggressive behavior. Unexpected trends are discussed, along with directions for future research. Full article

Aims: This research examined the incarceration experiences of adult women with histories of drug addiction, aiming to fill knowledge gaps regarding how these women subjectively interpret their incarceration experiences. Methodology: In-depth interviews were conducted with 22 formerly incarcerated women from the Northeast and Midwest United States. A phenomenological approach was used to explore the meaning of incarceration for the participants, with the deprivation model of imprisonment guiding the analysis. Findings: Women with drug addiction reported being treated differently while incarcerated because of their addiction. They experienced a lack of physical and psychosocial security, limited autonomy in health-related decisions, and diminished freedom to act and express themselves, often as a result of their mental health and drug addiction issues. Additionally, they experienced a loss of identity, stigma, and internalized stigma due to the way they were treated in prison. Conclusions: Incarceration is a critical life event that deprives women of many basic human needs, shaping their health, self-perception, and understanding of the criminal justice system. Further research is necessary to explore how the experience of incarceration impacts women’s mental health, drug addiction recovery, and overall well-being. Full article