Search Results (866)

Background: Super morbid obesity (SMO), defined as a body mass index (BMI) ≥ 50 kg/m², represents a distinct and increasingly prevalent subgroup of patients undergoing bariatric surgery. Compared to individuals with lower BMI, patients with BMI ≥ 50 kg/m² often exhibit unique clinical, psychological, and social characteristics that may influence treatment outcomes. Objective: This study aimed to compare demographic, metabolic, and psychiatric profiles of patients with BMI ≥ 50 kg/m² and non-super morbid obesity (NSMO; BMI < 50 kg/m²) who were evaluated prior to bariatric surgery. Methods: A total of 319 patients were recruited between December 2022 and December 2023 at a bariatric center in Gdansk, Poland. All participants underwent a comprehensive preoperative assessment, including laboratory testing, psychometric screening (BDI, PHQ-9), and psychiatric interviews. Patients were stratified into class IV obesity and NSMO groups for comparative analysis. Results: Patients with BMI ≥ 50 kg/m² were significantly older and more likely to report a history of lifelong obesity, family history of obesity, and childhood trauma. They had higher rates of obesity-related health problems such as hypertension, obstructive sleep apnea, and chronic venous insufficiency, as well as worse liver function and lipid profiles. Although the overall psychiatric burden was high in both groups, patients with BMI ≥ 50 kg/m² reported fewer prior diagnoses of depression and eating disorders, despite similar scores on screening tools. Conclusions: Patients with BMI ≥ 50 kg/m² represent a clinically distinct population with elevated metabolic risk, complex psychosocial backgrounds, and possibly underrecognized psychiatric burden. These findings underscore the need for multidisciplinary preoperative assessment and individualized treatment strategies in this group of patients. 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

The problem associated with the manifestation of burnout syndrome is the subject of ongoing interest. In recent years, occupational burnout has been actively studied among professionals in the helping professions (teachers, physicians, social workers, psychologists, prison officers, etc.). However, the phenomenon has been poorly studied among freelancers. Therefore, the aim of this study is to fill this gap by determining the level of burnout syndrome among Bulgarian freelancers and investigate the influence of some work environment factors on professional burnout in the sample. A survey of 1138 freelancers was carried out using the Burnout Self-Assessment Questionnaire developed by Maslach and a questionnaire developed in-house to explore the factors of the occupational environment and ask questions related to socio-demographic factors. Hypotheses are tested using correlation analysis and structural equation modelling. The study reveals high levels of emotional exhaustion (40.91%, n = 484). High values on the scale of depersonalization were reported for 26,3% of the respondents (n = 311). Only 3.1% of the respondents (n = 37) had high values on the reduced personal accomplishment scale. The high levels of burnout among freelancers could be influenced by the specific characteristics of their work environment and the nature of their tasks. Full article

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

Sport volunteering plays an important role in achieving the goals of sustainable development by supporting the social dimension of sustainability, fostering social integration, and promoting a healthy lifestyle. However, there is a lack of systematic research in Poland on the motivations of sport volunteers, particularly in the context of mass endurance events. This study employed a quantitative, cross-sectional design involving 148 sport volunteers engaged in mass endurance events in Poznan, Poland. To measure motivation, the Polish adaptation of the VMS-ISE scale was used. Data analysis was conducted using one-way analysis of variance (ANOVA). The results showed that volunteer motivations were relatively homogeneous regardless of gender and education level, with the exception of passion for sport, which was significantly stronger among men (p = 0.037). Significant differences were found based on place of residence: residents of medium-sized cities demonstrated the highest motivation for personal development (p < 0.001), whereas individuals from rural areas exhibited stronger patriotism, a greater need for interpersonal interaction, and a higher valuation of external rewards (p < 0.05). The motivations of sport volunteers in Poland are complex and sensitive to environmental factors. Understanding these differences allows for better alignment of recruitment and volunteer management strategies, which can enhance both the effectiveness and sustainability of volunteer engagement. It is recommended to develop volunteer programs that take into account the demographic and socio-cultural characteristics of participants. Full article

The rapidly changing dynamics of the digital age reshape the addiction relationship that high school students establish with technology. While smartphones remove boundaries in terms of communication and access to information, their usage triggers a source of anxiety and nomophobia. The increase in students’ anxiety levels because of their over-reliance on mobile phone use leads to significant behavioral changes in their mental health, academic performance, social interactions and financial dependency. This study examined the nomophobia levels of high school students according to selected socio-demographic indicators. Using the relational screening model, the multistage sampling technique was used to select a sample of 884 participants: 388 from Science High School and 496 from Anatolian High School (459 female, 425 male, Mage = 16.45 ± 1.14 year). Independent sample test and One-way ANOVA were applied. Depending on the homogeneity assumption of the data, Welch values were considered, and Tukey tests were applied as a second-level test from post hoc analyses. Comprehensive analyses of nomophobia levels revealed that young individuals’ attitudes towards digital technology differ significantly according to their demographic and behavioral characteristics. Variables such as gender, physical activity participation, grade level and duration of smartphone use are among the main factors affecting nomophobia levels. Female individuals and students who do not participate in physical activity exhibit higher nomophobia scores. Full article

Background: Lung cancer remains one of the leading causes of cancer-related mortality worldwide. While most diagnoses occur in outpatient settings, a subset of cases are incidentally identified during emergency department (ED) visits. The clinical characteristics and treatment decisions of these patients, particularly in relation to social background factors such as living situation and access to primary care, remain poorly understood. Methods: We conducted a retrospective study of patients diagnosed with malignancies in the ED of a single institution between April 2018 and December 2021. Patients diagnosed with lung cancer within 60 days of an ED visit were included. Data on demographics, disease status, treatment decisions, and background factors—including whether patients lived alone or had a primary care physician (PCP)—were extracted and analyzed. Results: Among 32,108 patients who visited the ED, 148 were diagnosed with malignancy within 60 days; 23 had lung cancer. Of these, 69.6% had metastatic disease at diagnosis, and 60.9% received active treatment (surgery or chemotherapy). No significant associations were observed between the extent of disease and either living arrangement or PCP status. However, the presence of a PCP was significantly associated with the selection of best supportive care (p = 0.023). No significant difference in treatment decisions was observed based on age (cutoff: 75 years). Conclusions: Although social background factors such as living alone were not significantly associated with cancer stage or treatment choice, the presence of a primary care physician was associated with a higher likelihood of best supportive care being selected. This may indicate that patients with an established PCP have more clearly defined care goals at the end of life. These findings suggest that primary care access may play a role in shaping end-of-life care preferences, highlighting the importance of personalized approaches in acute oncology care. Full article

Blue Zones (BZs) are regions across the world associated with exceptional human longevity, where individuals routinely live into their 90s and beyond. These areas share distinct lifestyle and environmental factors that promote healthy aging. The established BZs include Sardinia, Okinawa, Ikaria, and Nicoya, while several “emerging” BZs have been reported in various parts of the globe. This study investigates an area in Sicily for similar longevity patterns. Demographic data from the Italy National Institute of Statistics and local civil registries identify the municipality of Caltabellotta, home to approximately 3000 residents, and the nearby Sicani Mountains as a potential emerging BZ. The area exhibits a significantly higher prevalence of nonagenarians and centenarians compared to national and regional averages. Between 1900 and 1924, the proportion of newborns in Caltabellotta who reached age 90 and above rose from 3.6% to 14%, with 1 out of 166 individuals during this period reaching the age of 100. Historical, dietary, environmental, and sociocultural characteristics align with known BZ traits, including adherence to the Mediterranean diet, physical activity through agrarian routines, strong social cohesion, and minimal environmental pollution. A comparative analysis with the validated Sardinia BZ supports the hypothesis that this Sicilian area may represent an emerging longevity hotspot. Further multidisciplinary investigation is warranted to substantiate these findings. Full article

Background and Objectives: The association between female breast size and spinal back pain is widely suggested in clinical practice but remains insufficiently quantified in general, non-surgical populations in the scientific literature. Larger breasts may increase biomechanical strain on the spine, contributing to musculoskeletal pain and reduced quality of life. This study aimed to evaluate the association between breast size and back pain in a general orthopedic population of young women. Materials and Methods: A cross-sectional study was conducted among 200 women aged 18–36 who attended orthopedic clinics for non-spinal complaints. Data were collected via structured telephone questionnaires, including demographics, self-reported breast size (cup and band), pain characteristics, and SF-12 quality of life scores. Binary logistic regression, ANOVA, and chi-square analyses assessed associations between breast size, pain presence, severity, and functional outcomes. Results: Back pain prevalence increased with breast size: only 4.9% of B cup participants reported backache, compared to 85% of DD/E cup participants. VAS scores rose from 0.3 ± 1.6 (B cup) to 6.0 ± 2.9 (DD/E cup). Each 1 cm increase in band length raised the odds of back pain by 19.8% (OR = 1.198, p < 0.001), while large cup size was associated with up to 12-fold increased odds of pain. Larger breast size was also significantly associated with work limitations and social impairment. Conclusions: Breast size was strongly associated with the presence and severity of back pain, particularly in the thoracic and cervical regions. Clinicians should consider breast size in the assessment of backache, and reduction mammaplasty may have therapeutic value beyond aesthetics. Full article

Sexual consent is essential, but in some instances an individual may consent to sexual behaviors that are unwanted. The likelihood of unwanted consensual sex may be influenced by multiple social and individual factors. The current study examined engagement in unwanted consensual sex based on demographics, relationship and/or hookup history, and sexual communication characteristics among college students. This cross-sectional study was conducted utilizing a random sample of college students at one midwestern university. Data was collected via an online survey, including questions about sexual behavior, communication, and sexual consent. Basic frequencies and bivariate and multivariate analyses were conducted. This random sample included 1263 undergraduate students. Level of comfort communicating about sex was negatively associated with unwanted consensual sex. Gender was significantly associated with the likelihood of unwanted consensual sex and was a significant predictor of unwanted consensual sex among this sample. Unwanted consensual sex may vary based on individual characteristics, like gender. The current findings may help guide future studies on unwanted consensual sex, as well as continued sex education programming on college campuses to increase comfort when communicating about sexual behaviors. Full article

Background and aims: Pneumococcal infections, primarily caused by Streptococcus pneumoniae, pose significant global public health challenges, particularly in vulnerable populations. In Saudi Arabia, the introduction of pneumococcal vaccination has been a crucial step towards its prevention. However, gaps in public knowledge and attitudes toward the vaccine may hinder its effectiveness. Recent studies indicate a lack of awareness about the benefits of pneumococcal vaccination, suggesting a need for further investigation. This study determined the knowledge, attitudes, and practices (KAP) of Saudi residents regarding pneumococcal infection and vaccination. Study design and Methods: This observational cross-sectional study was conducted across Saudi Arabia from November 2024 to March 2025. Data were collected through a self-administered online questionnaire designed to evaluate KAP towards pneumococcal infection and vaccination. The sample size was calculated to be 385 participants. The questionnaire underwent expert validation and a pilot study to ensure clarity and reliability. The questionnaire was distributed via social media platforms to collect the data. Data management was conducted using Microsoft Excel, and statistical analysis was performed using Statistical Package for Social Sciences (SPSS) software version 26. Results: This study included 1230 participants of whom 630 (51.2%) were females and 1075 (87.4%) were Saudi citizens. Almost half of the participants (50.2%) were aged 18–30 years, and 498 (40.5%) were married. The average knowledge score was 58.6%, indicating a moderate level of understanding among the participants regarding pneumococcal infection. Also, the average attitudes score was 70.6%, reflecting a generally positive outlook towards the importance of pneumococcal vaccination and its potential to limit infection spread. In addition, the average practices score was 68%, indicating a fairly good level of behaviors regarding vaccination practices. Statistical analyses showed that demographic factors and clinical characteristics significantly shape individuals’ KAP towards pneumococcal infection and vaccination. Conclusions: This study highlights the critical need to improve KAP regarding pneumococcal infections and vaccinations among Saudi residents and could help in developing more targeted and effective public health interventions to protect Saudi residents from pneumococcal infections. Full article

This article presents a new evaluation and analysis of the five censuses undertaken at the initiative of philanthropist Sir Moses Montefiore among the Jewish population of Palestine/the Land of Israel between 1839 and 1875. The main purpose of the censuses was to ascertain the composition and needs of a generally poor Jewish population in order to better provide to its welfare. The information collected concerned basic demographic characteristics, countries of origin—namely along the main divide of Ashkenazi and Sephardi/Mizrahi Jews—and periods of immigration, social composition, and religiosity. By combining the different censuses into an integrated database, the authors are able to show changes intervening over time not only regarding the aggregate population, but also concerning individual and household profiles. The data aggregation allows us to better understanding the material conditions of the Jewish population and to outline with greater accuracy the relationship between socio-cultural communities and socio-economic stratification. The analysis unveiled the patterns of Jewish immigration all along the surveyed period and its variations by size and by countries of origin. These data provide important evidence concerning the overall Jewish presence in the Land of Israel and demonstrate that immigration was a significant factor well before the formal beginning of Aliyah in the early 1880s. No such analysis of the whole set of Montefiore censuses had been performed previously. The findings will prove very useful to historians and social scientists in their further investigation of the area and its populations in the 19th century. Full article

Background: Pediatric Crohn’s Disease (CD) affects more than physical health, influencing emotional well-being, social integration, and developmental milestones, with an impact on disease management. This study aimed to explore adolescents’ lived experiences with CD and identify factors influencing their motivation for self-management. Methods: A descriptive, cross-sectional qualitative study was conducted using a semi-structured, self-administered online questionnaire. Participants (n = 10) were adolescents with CD who had been diagnosed for over three years and were recruited from a tertiary pediatric gastroenterology center. Data included demographics, clinical characteristics, IMPACT-III (HRQOL), and PROMIS short forms. Open-ended responses underwent thematic analysis using the framework developed by Braun and Clarke. Results: Participants (80% female, median age 16.2 years, median disease duration 4.6 years) were all in clinical remission (median PCDAI = 2) and with good quality of life (median IMPACT-III = 80.7). Six themes emerged: (1) disease knowledge, (2) emotional responses, (3) coping and adaptation, (4) social support, (5) daily life and school impact, and (6) transition to adult care. Most participants demonstrated strong disease literacy and reported effective coping strategies. Emotional responses to diagnosis ranged from relief (60%) to distress (40%); relapses commonly triggered anxiety and fear. Therapeutic changes and disease monitoring were perceived as beneficial (100%) but with concern. Diagnostic procedures were viewed as burdensome by 70% of respondents. School performance and extracurricular participation were negatively affected in 40% during flares. Concerns regarding the future were reported by 40% of participants, with 30% believing that CD might limit life aspirations. While 60% managed their disease independently, 30% relied on parental support. All acknowledged the need for transition to adult care, though readiness varied. Conclusions: This study illustrates the overall impact of disease on pediatric CD patients. It reports significant emotional challenges and difficulties, as well as an impact on daily life, despite good disease knowledge. The findings underscore the importance of psychosocial well-being, ongoing mental health assessment, non-invasive monitoring, and holistic care, emphasizing the patient perspective, in managing pediatric CD. Full article

This study investigates how demographic characteristics, severity of intimate partner violence (IPV), social support, gender equality awareness, and demographic factors (e.g., living with children at home) influence help-seeking behaviors among 2527 IPV-experienced women in Beijing, Shanghai, Guangzhou, and Shenzhen. Drawing on the help-seeking model and conservation of resource theory, the study distinguishes between formal (e.g., police, legal aid) and informal (e.g., family, friends) help-seeking. Logistic regression results reveal that greater violence severity, stronger perceived social support, and higher gender equality awareness significantly increase both formal and informal help-seeking. Notably, living with children is associated with a higher likelihood of seeking formal help, possibly due to increased concerns for children’s safety and the desire to change the abusive environment. While help-seeking behavior is on the rise overall, particularly among women with strong support networks and progressive gender attitudes, structural and cultural barriers remain. The findings underscore the need to improve public education, reduce stigma, and enhance accessibility of support systems. This study contributes to the growing literature on IPV in China and provides evidence for refining policy interventions and service delivery. Full article

Using the behavioral model of engagement in health services, the current study assessed client characteristics that may contribute to treatment duration in trauma-focused psychotherapy in a community clinic setting. Participants (n = 893) were adults ages 18–78 years old (M = 36.36, SD 12.37). Demographic data (e.g., age, income) and health profile questionnaires assessing trauma and depression symptoms were collected at intake and every three sessions thereafter to track health outcome progress. Logistic regression models assessed factors associated with treatment duration at three time points: treatment initiation (0–2 sessions), treatment engagement (3–5 sessions), and treatment sustainment (6–8 sessions). For this sample, 38.6% ended treatment at the treatment initiation phase. Lower education level and higher quality of social relationships was predictive of ending treatment. In the engagement phase, 29.2% of the remaining participants (n = 548) ended treatment before six sessions, but there were no predictors of ending. During the sustainment phase, 31.7% ended treatment. African American race was associated with ending at this phase. In total, 70.3% of participants ended treatment before nine sessions. Participants who remained in treatment through the sustainment phase showed significant improvement in trauma and depression symptoms at each of the previous treatment phases, providing evidence of a dose response effect. Lower education, higher quality of social relationships, and African American race were associated with leaving treatment early. Many participants ended treatment before nine sessions, but those that completed treatment experienced improvement in symptoms to sub-clinical levels. Full article