Search Results (9,136)

Background: The present study aimed to assess the caregiving burden among family caregivers of adult patients with various cancer types and stages in the Kingdom of Saudi Arabia (KSA), and to examine the associations with caregiver and patient characteristics. Materials and Methods: A cross-sectional study involving 212 family caregivers of cancer patients was conducted between March and April 2024 at King Abdullah Medical City in Makkah, KSA. The Arabic version of the Zarit Burden Interview (ZBI) scale was used to assess overall and specific burdens. Associations between overall burden and sociodemographic variables were analyzed using significance tests. Results: Over half (55%) of participants experienced burden, with a mean ZBI score of 26.33 ± 16.86, indicating a mild to moderate level. Low levels of psychological (7.34 ± 5.41), social (2.27 ± 2.93), physical (1.96 ± 2.22), and financial (1.22 ± 1.41) burdens were found. Financial difficulties and patient immobility significantly contributed to higher burden scores. Caregivers with financial hardships scored higher (31 ± 14.8 vs. 24 ± 17.3, p = 0.01), and those caring for bedridden patients experienced greater burdens (38 ± 21.8 vs. 18 ± 12.5, p = 0.001). Conclusions: Although financial difficulties and patient immobility significantly contribute to caregiver burden, the overall burden in the Makkah region remains relatively moderate. Strong cultural and familial support systems in KSA may alleviate challenges, yet coping strategies targeting financial and physical burdens are necessary. Full article

Permanency planning, an approach to the placement of children in out-of-home care, is central to child and family system practice, policy and law. Using the example of legislative reforms in New South Wales (NSW), Australia, this article explores how privileging legal permanence leads to ongoing failures to account for Aboriginal worldviews and child-rearing practices. Drawing on qualitative research, including Yarning Circles and semi-structured interviews that I conducted with Aboriginal community members in NSW, the findings contribute to limited evidence on permanence from Indigenous perspectives, revealing how familial and cultural connectedness shape belonging and social and emotional wellbeing and highlighting the importance of children’s ongoing connections with extended Aboriginal family, community and culture. Aboriginal understandings of permanence align more closely with cultural, relational and physical domains than with the construct of legal permanence that predominates in permanency planning approaches. Prioritizing legally permanent care arrangements above other domains poses long-term risks to Aboriginal children’s social and emotional wellbeing, demonstrating the need for “deep-level” cultural adaptation in child welfare law, policy and practice. The findings have implications for decolonizing child protection and repositioning Aboriginal conceptualizations of permanence as the foundation for legislation, policy and practice—reforms that must be Indigenous-led, culturally grounded from the outset, and anchored in full implementation of principles embedding self-determination and Indigenous children’s fundamental rights. Full article

Dementia caregiving represents a major public health challenge, with spousal caregivers assuming the greatest burden. Spouses, themselves typically older adults, provide high intensity, long-term, and largely unpaid care across all stages of cognitive decline. Despite their central role in dementia care, the health consequences experienced by spousal caregivers remain insufficiently characterized in the literature and inadequately addressed in clinical and public health practice. This structured narrative review synthesizes current evidence on the multidimensional impact of dementia caregiving on the physical, psychological, cognitive, social, and financial health of spousal caregivers. It further contextualizes these consequences within the trajectory of dementia progression, and identifies interventions, support systems, and policy considerations necessary to mitigate caregiver burden. Spousal caregivers experience disproportionate burden due to continuous, escalating responsibilities that often mirror the progressive deterioration of their partners. Emotional burdens, including uncertainty during pre-diagnostic stages, role strain, conflict, loss of intimacy, and anticipatory grief. Physically, spouses endure musculoskeletal strain, sleep disruption, poor nutrition, and heightened frailty risk. Psychologically, spousal caregivers exhibit elevated rates of depression, anxiety, loneliness, and stress-related disorders. Socially, caregivers experience substantial isolation, stigma, and erosion of social networks. Financial hardship, including early retirement, reduced employment, and uncompensated care hours, further exacerbate stress. Evidence suggests that chronic caregiving stress contributes to biological changes such as immune dysregulation, inflammation, acceleration, aging, and potential cognitive decline in caregivers themselves. Caregiver burden influences patient outcomes as evidenced by increased emergency department use, falls, and earlier institutionalization in persons with dementia whose caregiver is subjected to a high burden. Current care models rarely include routine, caregiver assessment or structured guidance following diagnosis, resulting in substantial unmet needs. Effective mitigation requires integrated, stage-sensitive interventions, including psychosocial support, caregiver education, respite services, culturally tailored programs, and digital health tools, alongside broader policy reforms to reduce financial and structural barriers. Full article

Background: Torture, as a fundamental violation of human rights, is unequivocally condemned by all international organizations. Sexual torture is one of the most severe forms of torture, encompassing forced nudity, various forms of humiliation, and physical abuse, including rape. Despite testimonial evidence indicating the incidental use of sexual torture by Israeli authorities, there is a lack of epidemiological research providing a comprehensive understanding of this issue. This study aims to analyze the prevalence and characteristics of ill treatment and sexual torture among Palestinian male detainees and the subsequent impacts. Methods: This cross-sectional study analyzed a database of 517 former male detainees. The interview protocol included items related to psychological and physical methods of sexual torture, medical impacts, subjective psychological impacts, clinical medical and psychological measures, and psychosocial and community impacts. Results: The findings indicate that the majority of detainees experienced some form of sexual torture, with humiliation being the most common type. The impact of sexual torture are severe, affecting both clinical and social domains. The impacts of sexual torture persist over time and, in some cases, worsen, particularly regarding physical health outcomes. Socially, the consequences extend to the detainees’ families and communities. Conclusions: The prevalence of such torture tactics calls for urgent responses from both the authorities and civil society. These findings highlight the need for proactive measures to address and mitigate the impacts of sexual torture, including independent investigations, robust monitoring, secure reporting mechanisms, the prosecution of perpetrators and comprehensive reparation for victims. Full article

While the quantum emergence of spacetime is becoming a major research topic in physics, the quantum emergence of intelligence has not been widely researched in quantum information science (QIS). Following causal-logical quantum gravity theory, bipolar entropy vs. entropy and negative entropy (or negentropy) are reviewed and distinguished for quantum emergence/submergence of quantum agent (QA) and quantum intelligence (QI) in algebraic terms. This work refers to QA as an entangled bipolar string/superstring in bipolar dynamic equilibrium (BDE) and QI being centered on logically definable causality in regularity, mind-light-matter unity, and brain-universe similarity. ER = EPR is extended to ER ≥≥ EPR for the mathematical scalability of bipolar strings and their collective entanglement. The extension leads to a number of conjectures, testable predictions, and theorems. The term “equilibraton” is proposed as a type of EPR or bipolar generic string to serve as an entropic stitch to collectively hold the universe together as a quantum entanglement in BDE with ubiquitous, regulated local emergence and submergence of QA&QI. Equilibraton leads to the concept of bipolar entropy square—a complete entropic solution to the background issue in quantum gravity. With complete background independence, energy/information conservational bipolar entropy, energy/information invariance, bipolar entropy non-additivity, and equilibrium-based plateau concavity are introduced. The nature of the one-dimensional arrow of time is conjectured. As a unification of order and disorder for equilibrium-based regulation, bipolar entropy bridges QA&QI to agentic AI, where quantum-bio-economics can be viewed as a topological intervention of a natural dynamic equilibrium in a social or natural world. Use cases are reviewed to illustrate the practical and theoretical aspects of bipolar entropy in business management, quantum-bio-economics, quantum cryptography, physics, and biology. Eddington–Einstein’s comments on entropy are revisited. It is expected that bipolar entropy will bring quantum emergence/submergence to agentic AI&QI for entangled machine thinking and imagination as a naturally scalable and testable foundation of real-world quantum gravity, quantum information science (QIS), quantum cognition, and quantum biology (QCQB) to enhance Large Language AI Models (LLMs) and machine intelligence. Full article

Background/Objectives: This qualitative study investigated the perspectives and lived experiences of individuals with obesity, with a specific focus on psychological needs, beliefs, attitudes, and experiences related to psychological support. The study aimed to identify perceived barriers and facilitators to adherence in weight management and to examine participants’ views on digital psychological interventions designed to promote mental health and well-being. These findings represent the preliminary phase of a broader research project aimed at developing and implementing personalized digital psychological interventions to enhance engagement, treatment effectiveness, and equity of care in obesity management. Methods: Five focus groups were conducted with a purposive sample of 35 patients (48.6% female) diagnosed with obesity and enrolled in a four-week multidisciplinary weight-reduction program at the IRCCS Istituto Auxologico Italiano, San Giuseppe Hospital, Piancavallo (VB), Italy. Sessions were audio-recorded, supplemented with field notes, transcribed verbatim, and analyzed using reflexive thematic analysis to identify recurrent patterns of meaning across participants’ narratives. Results: Six overarching themes were identified: (1) obesity as an embodied and pervasive experience; (2) the interplay between emotions, weight stigma, and identity construction; (3) family and social relationships as both supportive and ambivalent; (4) personal agency and self-regulation processes in weight management; (5) access to healthcare services and experiences with healthcare professionals; and (6) the perceived role of psychological support within multidisciplinary care. Participants described obesity as a complex, multidimensional condition encompassing physical, emotional, relational, and contextual challenges that directly influence treatment engagement and adherence. Conclusions: Psychological support emerged as a central component of comprehensive obesity care. Findings underscore the need for personalized, flexible, and digitally supported psychological interventions to enhance long-term adherence, acceptability, and overall well-being. Full article

Background/Objectives: Digital media play an important role in the lives of contemporary adolescents. While associated with many benefits, they also pose risks to physical health related to prolonged screen time and non-ergonomic body posture. This study analyzed the frequency of self-reported physical complaints among Polish adolescents in relation to time spent on different screen-based activities. Methods: The study included 9083 students aged 13–17 who completed an online survey in March and April 2024 in schools located in western Poland (approximately 30% of the region’s student population). Physical symptoms selected from the HBSC-SCL instrument were analyzed and supplemented with neck or shoulder pain and eye strain. Results: Longer screen time was associated with more frequent occurrence of all analyzed complaints. A 5-item index ranging from 0 to 20 points was proposed, including headache, neck or shoulder pain, eye strain, dizziness, and problems falling asleep (mean 6.56 ± 5.15). The index showed reliability at the level of α = 0.744 and good model fit according to CFA (RMSEA = 0.025). In a multivariate linear regression model (R² = 0.153), after adjusting for age, gender, place of residence, and family affluence, the variability of this index was most strongly associated with time spent on social media (β = 0.40) and browsing websites (β = 0.30). Gender-specific models were also compared. Conclusions: The results confirm the co-occurrence of physical complaints during adolescence and a significant association between their severity and screen-based activities, particularly engagement in social media. Full article

Extended Reality (XR) and Artificial Intelligence (AI) are increasingly converging within cyber–physical infrastructures, including digital twins, the Spatial Web, and smart-city systems. These environments require new frameworks for understanding how human performance emerges through sustained interaction with immersive interfaces and adaptive computational agents. This paper introduces the TAXI–XI-CAP framework, a two-layer model that links psychobiological mechanisms of XR–AI interaction to higher-level, experimentally testable capability constructs. The TAXI layer defines 42 mechanisms spanning perception, cognition, physiology, sensorimotor control, and social coordination, while XI-CAP organizes these into capability patterns such as remote dexterity, distributed cognition, and adaptive workload regulation. Derived through a theory-guided synthesis across XR, neuroscience, and human–automation interaction, the framework models performance as emerging from interacting mechanisms under real-world constraints. A validation-oriented research agenda is proposed, emphasizing mechanism-level measurement, capability-level evaluation, and longitudinal testing. The TAXI–XI-CAP framework provides a structured basis for hypothesis generation, comparative analysis, and empirical validation of XR–AI systems, supporting the development of reliable, scalable, and human-centered Extended Intelligence infrastructures. Full article

Background/Objectives: Type 2 diabetes mellitus (T2DM) is a major public health challenge, and several lifestyle-related factors associated with later T2DM may already emerge during the secondary school years. Socioeconomic status (SES), nutrition-related behaviors, physical activity, and basic diabetes-related knowledge may shape these early risk-related patterns. This study examined the relationships between SES, adapted FINDRISC-based T2DM-related risk patterns, and diabetes-related knowledge among Hungarian secondary school students aged 16–20 years. Methods: A nationwide, cross-sectional questionnaire survey was conducted among students attending Hungarian Baptist secondary schools (N = 1585). SES was classified by Two-Step cluster analysis based on parental education, parental occupation, number of books in the household, and frequency of travel abroad. Relative T2DM-related risk patterns were described using an age-adapted FINDRISC-based screening approach, and basic diabetes-related knowledge was assessed using a 12-item questionnaire. Associations were examined using cross-tabulation and regression analyses in SPSS version 27.0. Results: Most respondents fell into the lower categories of the adapted FINDRISC-based screening framework, whereas 7.4% were classified into the moderate or high adapted FINDRISC-based screening categories. SES was significantly associated with adapted FINDRISC-based screening categories (p < 0.001). Compared with the medium-SES group, students in the low-SES group had higher odds of belonging to a higher adapted FINDRISC-based screening category (OR = 1.81; 95% CI: 1.27–2.57; p = 0.001). SES was also significantly associated with basic diabetes-related knowledge profiles (p = 0.015); students with high SES were less likely to be in the low-knowledge group than in the high-knowledge group (OR = 0.62; p = 0.039). Conclusions: Social inequalities in T2DM-related risk patterns and diabetes-related knowledge are already visible among secondary school students aged 16–20 years. The adapted FINDRISC-based approach may be useful as a school-based, non-invasive descriptive screening framework for characterizing relative T2DM-related risk patterns, but it is not a validated risk prediction instrument for this age group. Full article

Pleural Mesothelioma (PM) is a rare, incurable malignancy of the pleura. Lung-sparing surgery, considered investigational, aims to prolong survival and improve quality of life (QOL). Beyond the standard quantitative measures used to determine successful surgical outcomes, an understanding of an individual’s perception of the impact surgery has had on their symptom burden and QOL has not been reported in the literature. The primary aim of this study was to explore the lived experience of dyspnea and QOL before and after lung-sparing surgery. The philosophical approach to this study was grounded in hermeneutical phenomenology. Participants underwent in-depth semi-structured interviews before and 3–4 months post-surgery, analyzed through Interpretive Phenomenological analysis. The analysis identified Group Experiential Themes (GETs) before and after surgery: Psychological (mind supports body), Physiological (body fighting, enduring, and adapting), Social (others sharing and supporting), and Existential (facing an uncertain future). The emotional impact of PM is multidimensional, involving time, internal psychological struggles, and coping with the diagnosis. The physical impact disrupts normal routines and interactions, while social interactions influence the perception of the illness experience. Facing PM disrupts normal bodily routines and interactions with the world. This study provides qualitative evidence that perceptions of dyspnea and QOL significantly impact the patient experience before and after surgery. The enriched understanding of living with mesothelioma and enduring lung-sparing surgery comes from the patients’ voices, highlighting the continuum of dyspnea and QOL influenced by various factors. Healthcare teams must consider patients’ physical, emotional, social, and existential experiences beyond measurable outcomes. Full article

Background: Migraine in older adults represents an increasingly relevant yet underrecognized clinical challenge in aging societies, where multimorbidity, frailty, and polypharmacy complicate both diagnosis and management. Although traditionally considered a disorder of younger individuals, migraine frequently persists or presents after the age of 60 with atypical features, contributing to diagnostic uncertainty. Methods: This narrative review, conducted in accordance with the SANRA principles, aims to provide a comprehensive overview of the epidemiology, clinical presentation, pathophysiology, and management of migraine in older adults, with particular emphasis on age-related complexities, therapeutic challenges, and unmet clinical needs. Results: Migraine in this population often presents with atypical or misleading features, such as aura without headache, vestibular symptoms, or overlap with cerebrovascular conditions, leading to delayed or incorrect diagnoses. The burden of disease is substantial, affecting physical function, mobility, cognition, emotional well-being, and social participation, and is further amplified by comorbid conditions including cardiovascular and metabolic disorders, mood disturbances, and chronic pain syndromes. Aging-related neurobiological changes, such as impaired pain modulation, endothelial dysfunction, and neuroinflammation, may influence disease expression and treatment response. Therapeutic management is challenged by contraindications, increased susceptibility to adverse drug effects, and the complexity of polypharmacy, highlighting the importance of individualized and non-pharmacological approaches. Conclusions: Migraine in older adults is a significant but often overlooked contributor to disability and reduced quality of life. Improved recognition of its unique clinical features and age-specific vulnerabilities is essential to optimize patient-centered care. Future research should prioritize the inclusion of older populations and the development of tailored, safe, and effective management strategies. Full article

Many approved oral paediatric medicines continue to have poor taste acceptance, suggesting that the ingredient blends employed in these medicines are not adequately effective in taste-masking drugs with strongly aversive tastes. To address this inadequacy, this narrative review provides a comparative evaluation of taste-masking ingredients used by the pharmaceutical industry with those employed in the food industry, as well as food items used by caregivers to mask the unpalatable taste of medicines for young children. Information was sourced from academic databases, industry publications, and caregiver forums on informal social platforms. Ingredients were classified into sweeteners, salts, acids, fats, peptides/amino acids, flavourants, cyclodextrins and polymers, with their taste-masking mechanisms delineated into receptor-level interactions and the creation of physical barriers and alternative dominant taste. Their applications are compared across the regulated medicinal and consumer food products, and in home remedies. Sweeteners show the highest cross-domain convergence as they are used in medicinal and food products and are recommended by caregivers. Peptides, amino acids, salt and texture modifiers applied in food and home remedies may have translational potential in medicines. Challenges, including drug–food interactions, regulatory constraints, and the need for combination approaches, are addressed. A decision framework is also designed to guide the development of simple, acceptable, and effective ingredient-based taste-masking systems for drugs with aversive tastes. Full article

Mobility is key to independent living, and life-space mobility (LSM) describes the extent to which a person moves within and beyond their home. Restricted LSM may limit participation in life. Parkinson’s disease (PD) can influence LSM through changes in physical function and social engagement. This study investigated LSM in people with mild-to-moderate PD using self-reported and objective measures, examining agreement between measures and relationships with physical activity and quality of life. The participants completed the Life-Space Assessment (LSA) and wore an accelerometer and GPS monitor for seven days. The accelerometer and GPS data were processed to derive GPS life-space and physical activity variables. The participants (n = 11) demonstrated variability in GPS-derived measures of LSM despite high levels of self-reported LSM (median 82). The participants spent approximately two thirds of wear time in close proximity to the home, where most activity time was sedentary. Higher levels of moderate-to-vigorous physical activity and step counts were observed beyond the home. Self-reported health-related quality of life showed weak associations with LSM. These findings suggest that while the LSA captures overall mobility, GPS data provides complementary insight into location-specific activity and individual movement patterns. Full article

Social media platforms have become critical infrastructures for customer relationship management (CRM), requiring scalable and intelligent solutions to handle high-volume interactions. In the luxury fragrance sector, digital promotion poses a unique challenge because olfactory attributes cannot be experienced online. As a result, physical fragrance samples remain essential, generating large volumes of sample requests or inquiries across social media. However, many requests remain unmanaged due to limitations in manual CRM (i.e., human-driven processes), revealing a design gap that may negatively affect perceived responsiveness and service quality. This study uses qualitative content analysis with NVivo 12 to examine large-scale sample request interactions on the Facebook pages of four luxury fragrance brands. Data was collected via NCapture and analyzed to identify recurring patterns, linguistic structures, and customer expressions related to sample requests. Findings confirm frequent repetitive requests, highlighting inefficiencies in traditional CRM systems under high demand. This research proposes an AI-driven CRM Sample Request Management Architecture (CRM–SRMA) that systematically captures and processes customer sample requests, collects the necessary mailing information, and seamlessly transfers validated data to the final dispatching stage. The proposed system also models individual fragrance preferences by analyzing customers’ interactions with samples, particularly in terms of top, middle, and base notes. By leveraging this information, the architecture enables the targeted promotion of new fragrance releases that closely align with customers’ demonstrated olfactory preferences. The insights of this research provide a scalable, intelligent mechanism that enables luxury social media managers and CRM systems to manage high-volume interactions while maintaining service quality. By automating sample request processing, the mechanism improves responsiveness and reduces operational burden. It also supports long-term relationship building through preference tracking and updating customers with any new relevant-fragrance releases. Although focused on fragrances, the mechanism is adaptable to other luxury cosmetic categories, thereby ideally enhancing overall social media-based customer service. Full article

The millisecond-level volatile fluctuations in workloads in large-scale intelligent computing clusters pose significant challenges to traditional electricity markets. Constrained by optical–electrical–optical conversion bottlenecks, these markets struggle to achieve real-time response and risk substantial social welfare loss. Leveraging existing fiber-optic infrastructure to build All-Optical Networks (AONs) presents a cost-effective evolutionary path. This paper develops a distributed energy trading strategy based on all-optical multicast. By utilizing the physical multicast properties of the underlying light-tree architecture instead of traditional protocols, the proposed strategy bypasses end-to-end latency constraints. This enables rapid transaction synchronization and dynamic tracking of social welfare optima within millisecond-level time-slots. Simulation results demonstrate that the proposed scheme elevates the transaction saturation threshold by two orders of magnitude compared with traditional strategies, effectively breaking the physical locking effect of latency on system throughput. Across various topologies, the social welfare gains exceed those of conventional schemes by more than 20 times. This study validates the engineering value of all-optical architectures for high-frequency trading and provides critical technical support for ultra-dynamic power trading algorithms. Full article