Search Results (581)

Background/Objectives: Childhood-onset systemic lupus erythematosus (cSLE) is a chronic, multisystem autoimmune disease that is associated with more severe organ involvement, more intensive drug therapy, and increased long-term organ damage compared with adult-onset disease. The objectives of this study were to evaluate the performance of widely used small area-level multidimensional indicators of neighborhood disadvantage in a mixed urban–rural cSLE cohort against disease outcomes. Methods: This retrospective cohort study utilized electronic health records to identify and evaluate pediatric patients with cSLE across a single center in South Carolina between 1 January 2020 and 31 December 2024. Primary outcomes included disease activity at diagnosis, measured by Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K); the achievement of a low lupus disease activity state (LLDAS) by the last visit; the development of major organ involvement; and the rates of unplanned hospitalizations and emergency department visits. The associations of the census tract-level Area Deprivation Index (ADI), Social Vulnerability Index (SVI), and Childhood Opportunity Index (COI) with clinical presentation and outcomes were estimated using generalized linear models and logistic regression. Results: A total of 85 patients with cSLE were included, of which 76% reported being of Black race, and 28% lived in rural areas. Lupus disease severity was inconsistent across the metrics of area-level social vulnerability, neighborhood deprivation, child opportunity, and rurality. Patients who lived in more socially vulnerable communities were more likely to attain LLDAS during follow-up, while those who lived in lower-opportunity areas were more likely to develop CNS lupus. Baseline disease activity, renal involvement, and healthcare use were not significantly associated with area-level social disadvantages or rurality. Conclusions: In this single-center, mixed urban–rural cohort of children with cSLE, indicators of neighborhood-level disadvantage and rurality alone explained little variation in disease severity and disease control overall. The utility of available small area-level metrics is likely context-dependent and influenced by regional features, population characteristics, and the outcomes being studied. Future work should integrate individual- and area-level factors across diverse settings to better understand the drivers of health disparities. Full article

This paper examines how exclusionary epistemic practices embedded in science as a discipline are reproduced in classroom settings and how these practices can be disrupted when teachers adapt existing materials toward goals of epistemic inclusion. The inequities in access, participation, and representation in science that are reproduced at a societal level are developed in the classroom. Students learn how to do science—they develop the epistemic and social practices of the scientific discipline—in science education classes. When exclusion of some students from classroom knowledge building is normalized, marginalization becomes part of how students learn to engage in science and engineering practices. Drawing on a curricular redesign project conducted during the COVID-19 transition to virtual learning, the study highlights how the repositioning of teachers as active agents and experts in curriculum adaptation was central to the work. Using qualitative data-driven coding with productive disciplinary engagement and epistemic inclusion to guide the analysis, critical cases of curricular adaptations were developed with 10 elementary science teachers during a year-long project-based learning online science curriculum enactment project. Five themes associated with disruption of entrenched exclusionary practices emerged that can be codified as adaptation principles: 1. adapt features of project-based learning to: (1) bring in and leverage students’ identities and intellectual resources from home; (2) provide student-centered choice; (3) elicit diverse knowledge, expertise and ideas; (4) support students to make use of many different modalities; (5) dismantle the usual (traditional) structures between the teacher and students. Full article

Alcohol consumption is associated with significant social and economic challenges for nations worldwide, including alcohol-related healthcare costs and alcohol-related crime. According to the U.S. Center for Disease Control (CDC), even moderate drinking correlates with greater health risks compared with not drinking at all. These health risks include physical harm to a person’s heart, brain, liver, and other organs; impaired social functioning; reduced work performance; and increased incidence of alcohol-related violence and injury (e.g., physical and sexual assault and drunk driving-related injuries and death). Although personal health and social problems are correlated with alcohol consumption across genders, women experience disproportionately worse problems associated with alcohol-related crime and family disruption. At the societal level, alcohol use coincides with substantial negative economic problems, including increased healthcare costs, often covered by the government; reduced worker productivity; and higher criminal justice system costs. This paper applies an econometric analysis to evaluate the association between alcohol consumption and key social and economic factors and suggests actions that business firms, government entities, universities, and other organizations can take to reduce alcohol-related harm, such as encouraging sobriety in the workplace, offering alcohol-related counseling services, and not establishing associations with nor accepting payments of any kind from alcohol beverage companies. The findings have implications for business managers, government leaders, policy-makers, and others. Full article

Background/Objectives: In traditional Chinese culture, grandparents often help care for grandchildren, especially in urban areas where parents face high work and life pressures. However, the physical and psychological impacts of grandchild care on older adults remain debatable. This study explored the associations between grandchild care, disability, and depressive symptoms among urban older adults, and examined whether disability mediates this link. Methods: Data were from the 2018 CHARLS study, including 1872 urban participants aged ≥60 years with grandchildren. Disability and depressive symptoms were assessed using the Activities of Daily Living (ADL) scale and Center for Epidemiologic Studies Depression Scale (CES-D), respectively. Group comparisons, multivariable logistic regression, and mediation analysis were performed. Results: Among caregivers, the prevalence of depressive symptoms was 19.2% and the prevalence of disability was 20.4%, both lower than among non-caregivers in unadjusted comparisons, though grandchild care was not independently significant in multivariable models. Female, disability, and depressive symptoms were significant risk correlates, while higher education, greater physical activity, and social participation were protective. The mediation analysis suggested that functional status partially mediated the relationship between grandchild care and depressive symptoms (proportion mediated = 33.70%). Conclusions: Grandchild care was associated with better physical and mental health among urban older adults in descriptive comparisons, though this association was attenuated in adjusted models. While moderate intergenerational involvement may offer social and psychological benefits, excessive caregiving burden should be prevented. Full article

Countries face interconnected policy challenges: population aging, fertility change, migration, urbanization, labor transitions, food and water security, climate risk, health-system demand, school planning, housing pressure, consumption planning, and spatial inequality. Yet planning evidence is often fragmented across ministries, statistical offices, surveys, administrative systems, research projects, and dashboards. This paper proposes the Population-Based Systems Model, or PopSyM, as a country-owned analytical infrastructure that places population dynamics at the center of integrated policy planning. PopSyM begins with a demographic spine by age, sex, location, year, and scenario, then links that spine to modules for health, education, food, labor, housing, social protection, environment, and local infrastructure. Its purpose is not projection for its own sake, but the measurement and improvement of population well-being: longer and healthier lives, adequate material conditions, skills, meaningful work, security, dignity, and country-specific dimensions of a good life. Nepal is used as a motivating example, but the proposed architecture is general. The paper argues that the population should be treated not only as a denominator for indicators but also as the organizing framework through which countries understand future demand, vulnerability, consumption needs, policy trade-offs, and feedback between people and systems. Full article

This study turns to W.E.B. Du Bois’ late-career works of fiction for insights about the importance of Historically Black Colleges and Universities (HBCUs), especially Black public Land-Grant universities in promoting racial justice in the United States. Commentators often argue that Du Bois’ early career endorsement of the emancipatory power of liberal education and social science research was later abandoned in favor of political activism. The present study challenges this assumption by demonstrating that an important, but generally underappreciated, source of continuity in Du Bois’ thoughts on education was his belief that German-inspired social science research could be a means to combat racial injustice in America. In his major work of fiction, the historical novels The Black Flame Trilogy, Du Bois expounded the positive role Black public universities, and their Presidents have historically played in what he called the “racial uplift” of African American people. Du Bois focuses on the impact of the Second Morrill Act of 1890, which established the legal framework for the system of Black Land-Grant universities and colleges, and which he believed provided the institutional foundations for social science research led primarily but not exclusively by Black scholars in projects that center Black experiences. I conclude with reflections on how Du Bois’ literary representation of the importance of historically Black public universities sheds light on current concerns about state coercion and systematic underfunding of Black Land-Grant Universities. Full article

Background and Objectives: Advances in medical, surgical, and acute burn care have shifted burn care from survival alone to survivorship; such improvement can be accompanied by extensive morbidity and disability in chronicity not previously encountered. The epidemiological characteristics of patients treated at a burn rehabilitation center, in the context of evolving social and occupational environments, may provide insights into current trends and their clinical implications. Notably, updated epidemiological data reflecting these changes in burn injury patterns remain scarce worldwide. To date, no epidemiological data from a burn rehabilitation center have been reported in Taiwan. Therefore, this study aimed to bridge this gap by providing a recent epidemiological review from the perspective of a burn rehabilitation center. Materials and Methods: This is a single-center, retrospective cross-sectional study enrolling patients who sustained burn injuries between January 2016 and December 2023. Data were collected from medical records and analyzed using SPSS version 20.0. Results: A total of 143 patients were recruited, of whom 101 were male (70.6%). The mean age was 38.51 years (SD = 20.28), and the mean total body surface area (TBSA) burned was 20.83% (SD = 18.77). Flame burns were the most common etiology, accounting for 67 cases (46.9%). Among the 143 patients, 73 (51.0%) sustained work-related burns, which were associated with a higher incidence of eye involvement compared with non-work-related burns (28.8% vs. 14.3%, p = 0.036). The upper extremity was the most frequently involved anatomical site, affecting 98 patients (68.5%). Conclusions: The present findings highlight an underrecognized need for stronger safety measures that address both personal and environmental risk factors. Risk-reduction strategies should particularly account for the aging workforce and vulnerable anatomical sites to mitigate preventable human and economic losses. Full article

Grounded in Social Cognitive Theory, this study investigates how digital technologies shape employees’ work experiences and social life in digitally transforming hotel organizations. Specifically, it examines the role of digital empowering leadership in fostering digital work engagement through the mediating mechanisms of digital self-efficacy and digital thriving at work within five-star hotels in Egypt. As digital technologies increasingly redefine how employees interact, collaborate, and derive meaning from their work, understanding the human and social consequences of digital transformation has become a critical research priority. Data were collected from 394 full-time employees working in five-star hotels in Egypt and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) with WarpPLS software. The findings reveal that digital empowering leadership significantly enhances employees’ digital work engagement, digital self-efficacy, and digital thriving at work. Furthermore, digital self-efficacy and digital thriving at work positively influence digital work engagement and partially mediate the relationship between digital empowering leadership and digital work engagement. By highlighting how digitally enabled leadership shapes employees’ psychological capabilities and flourishing in technology-rich workplaces, this study contributes to the growing literature on the social implications of digital technologies in organizational settings. The findings underscore that successful digital transformation extends beyond technological adoption to encompass employees’ empowerment, well-being, and meaningful engagement in digital work environments. Practical implications are provided for hotel managers seeking to cultivate human-centered digital workplaces that support employees’ social and psychological flourishing amid ongoing technological change. Full article

Psychosocial job characteristics are important components of the work environment and are closely associated with occupational health, particularly among nurses working in demanding healthcare settings. However, evidence from primary healthcare settings in low- and middle-income countries remains limited. This study aimed to describe psychosocial job characteristics and job strain among nurses in urban primary healthcare centers in Vietnam and to examine factors associated with psychosocial job characteristics and job strain. A multicenter cross-sectional study was conducted among 768 nurses across four district-level healthcare centers in Ho Chi Minh City, Vietnam, using a structured questionnaire including the validated Vietnamese Job Content Questionnaire. Nurses reported moderate-to-high job demands, high social support, and limited decision latitude. Most participants reported low strain (45.6%) or active jobs (42.4%), while fewer were in the high-strain (6.3%) and passive (5.7%) categories. Sociodemographic and work-related factors were significantly associated with job strain (p < 0.001). Although the prevalence of high strain was relatively low, differences between perceived job demands and specific dimensions of decision latitude were observed. These findings highlight the importance of job control, workload, and workplace support as factors associated with psychosocial job characteristics and job strain and may help inform future workplace interventions and longitudinal research. Full article

Depopulation represents one of the most significant development challenges in the rural areas of the Pannonian Plain. This paper examines phenomena observed in the Vojvodina Region that may contribute to mitigating negative demographic trends. The research was initiated by information and narratives identified in the media and subsequently verified through fieldwork. The study is based on the analysis of semi-structured interviews conducted with residents of settlements where the presence of new inhabitants has been identified. Particular attention is paid to the settlement of foreign nationals and returning migrants, the arrival and return of well-known public figures to rural areas, and state support measures aimed at encouraging people to remain in or return to rural settlements. The paper also considers the role of the media in promoting rural areas, as well as the importance of new forms of work that enable greater spatial mobility and facilitate living outside urban centers. The collected data were analyzed using SWOT analysis, which enabled the identification of strengths, weaknesses, opportunities, and threats associated with the presence of new residents in rural areas. The aim of the paper is to examine the contributions of new residents to the sustainable development of rural areas in the Vojvodina Region and to highlight their alignment with the objectives of the 2030 Agenda for Sustainable Development. The significance of the study lies in drawing scholarly attention to these phenomena and emphasizing the need for their continuous monitoring, as they may influence future demographic, economic, social, and spatial transformations of the Vojvodina Region. Full article

Background: Social-media-based risk screening is promising, yet deployment quality is constrained by noisy language, class imbalance, low explainability, and uncertainty handling. Objective: This work develops an application-specific BiLSTM-centered proxy risk screening framework that combines chaos-regularized learning, SMOTE balancing, SHAP explanation, and TF-IDF similarity fallback. Methods: Experiments used an annotated Twitter corpus (>31,000 English posts) with neutral, hate, and offensive labels, where hate/offensive content was treated only as a proxy risk indicator rather than as evidence of depression, self-harm, or clinical psychological distress. The workflow covered text normalization, tokenization, fixed-length sequence modeling, imbalance correction, and thresholded inference. The model stack used GloVe embeddings with recurrent layers and chaos-based dropout, trained with Adam plus adaptive stopping/scheduling. Operational safety was supported through lexicon checks and a balanced TF-IDF reference set for low-confidence cases. Results: Validation performance reached an F1-score of 0.86, accuracy 0.79, and AUC 0.93 under the reported pipeline. Component-level evidence further indicated that SHAP, thresholding, TF-IDF retrieval, and lexicon checks add explanation, uncertainty handling, reference context, and conservative escalation beyond the underlying classifier, although their marginal effects were not isolated through rerun ablation. Conclusion: The proposed system offers a practical tradeoff between predictive quality, interpretability, and safety-aware operation for proxy risk screening on noisy social media. The contribution is positioned as an integrated application pipeline rather than a new NLP algorithm, and future work should validate the framework with clinically grounded labels, leakage-safe resampling, ablation studies, and transformer baselines. Full article

On behalf of the Canadian Association of Psychosocial Oncology, we are pleased to present the abstracts from the 2026 Annual Conference, titled “A New Horizon: Expanding the Access and Impact of Psychosocial Oncology”. The 41st Annual CAPO Conference was held in St. John’s, Newfoundland from 8 June 2026 to 9 June 2026. As we stand at a new horizon in psychosocial oncology, we recognize the unprecedented opportunities to expand both the access to and the impact of comprehensive cancer care. This conference will explore innovative strategies for breaking down traditional barriers that have historically limited access to psychosocial support, including geographic isolation, resource constraints, cultural disparities, and systemic inequities in healthcare delivery. This expansion of reach and influence represents not merely growth in service numbers, but a fundamental transformation in how we conceptualize, design, and implement patient-centered psychosocial care across diverse communities and care settings. We will explore scalable solutions that amplify impact while maintaining the deeply personal, human-centered approach that defines excellence in psychosocial oncology. From telehealth innovations and peer support networks to community-based interventions and integrated care models, this conference will showcase evidence-based strategies that expand our collective ability to support individuals and families navigating the cancer journey, wherever they may be. This conference brought together key stakeholders including multidisciplinary professionals from nursing, psychology, psychiatry, social work, spiritual care, nutrition, medicine, rehabilitation medicine, occupational health and radiation therapy for both adult and pediatric populations. Participants included clinicians, researchers, educators in cancer care, community-based organizations and patient representatives. Patients, caregivers and family members presented abstracts that speak to their role in managing cancer experiences and care. Over one-hundred and fifty (150) abstracts were submitted for presentation as symposia, 20 min oral presentations, 10 min oral presentations, 90 min workshops and poster presentations. We congratulate all the presenters on their research work and contributions. Full article

Background/Objectives: Illness uncertainty is a pervasive psychosocial experience in chronic conditions that is particularly prominent in pediatric oncology. While existing research has explored its psychological impact, a gap remains in understanding how this uncertainty evolves throughout the disease trajectory and how families collectively negotiate and manage this experience over the long term. Methods: This qualitative study was conducted in the hematology ward at a pediatric hospital in Shanghai, China. Using purposive sampling, semi-structured interviews were performed with 32 participants from 12 families of children currently undergoing cancer treatment. Data were collected through in-depth interviews and analyzed using reflexive thematic analysis. The sample was dominated by leukemia cases, with a small number of lymphoma cases; therefore, the findings are most directly transferable to families of children with hematological malignancies. Results: Illness uncertainty is a dynamic and persistent experience permeating the entire pediatric cancer trajectory. Key sources of uncertainty include diagnostic ambiguity and delays, barriers in physician–patient communication, and profound disruptions to family daily life. In response, families proactively develop multidimensional coping strategies: reframing meaning to accept uncertainty, reorganizing family roles and responsibilities, strengthening internal communication, and mobilizing external support networks. These strategies demonstrate both family resilience and inherent vulnerability under sustained pressure. Conclusions: Illness uncertainty in pediatric cancer transcends medical boundaries and is deeply embedded in family life. Healthcare systems should recognize uncertainty as a core experience throughout the disease process and provide family-centered psychosocial and structural support. Strengthening hospital social work services and fostering synergy between peer networks and community resources are essential to enhancing families’ capacity to manage uncertainty and alleviating their long-term psychosocial burden. Full article

Background/Objectives: Head and neck cancer (HNC) is associated with substantial morbidity, functional impairment, and represents a substantial socioeconomic burden worldwide. Although advances in surgery, radiotherapy (RT), and systemic therapies have improved oncologic outcomes, treatment-related toxicities frequently overlap with profound economic consequences for patients and caregivers. Financial toxicity (FT), defined as the objective financial burden and subjective financial distress associated with cancer care, has emerged as a clinically relevant determinant of treatment adherence, quality of life (QoL), and survival. In HNC, FT appears particularly critical during active treatment, when multimodal therapies, nutritional compromise, work interruption, transportation costs, and supportive care needs converge. Methods: This structured narrative review synthesizes current literature regarding FT during active treatment for HNC, focusing on conceptual definitions, measurement approaches, temporal dynamics, clinical and psychosocial consequences, and health system determinants. The review was conducted according to the Scale for the Assessment of Narrative Review Articles (SANRA) framework using searches of PubMed/MEDLINE, Scopus, Embase, and Google Scholar. Results: Available evidence suggests that FT may emerge early during treatment and evolve dynamically throughout the care trajectory. Lower socioeconomic status, treatment intensity, work interruption, and limited social support have been reported in association with increased FT. FT has also been linked to worse health-related QoL, higher symptom burden, treatment interruptions, hospitalization, and reduced survival, although the limited number of studies and methodological heterogeneity preclude definitive conclusions. Emerging evidence suggests that FT may be partially modifiable through interventions such as financial counseling and patient navigation. Conclusions: Future research should prioritize prospective and interventional designs using standardized multidimensional instruments capable of capturing both objective and subjective domains of FT. Integrating routine FT assessment into supportive oncology workflows may help identify vulnerable patients and support more equitable, patient-centered HNC care. Full article

Background and Aims: Home parenteral nutrition (HPN) is a life-sustaining therapy for patients with chronic intestinal failure who cannot meet their nutritional needs enterally. Portable infusion pumps allow HPN to be administered safely at home, improving mobility and independence. However, their effect on quality of life (QoL) remains insufficiently explored. This study evaluated QoL in adults receiving HPN with portable infusion pumps at home. Methods: A cross-sectional survey was conducted in 102 adults receiving HPN with portable infusion pumps. Data were collected between September 2020 and December 2025 through outpatient clinics and a patient support group. Instruments included the WHOQOL-BREF and an author-designed questionnaire. Descriptive statistics, Mann-Whitney U, Kruskal-Wallis tests, and Pearson correlations were applied. Results: Overall QoL was moderate. WHOQOL-BREF scores were higher in the physical and psychological domains and lower in the social relationships and environmental domains. Most patients reported that portable pumps improved mobility, independence, and the ability to perform daily and social activities, including travel. Pump-related factors were positively associated with self-reported health status and overall QoL (p < 0.05). The main burdens were nocturnal infusions, sleep disturbances, and prolonged infusion duration. Metabolic complications and unplanned hospitalizations were infrequent and were not associated with pump usability. Conclusions: Portable infusion pumps may improve QoL in most patients receiving HPN by enhancing daily functioning and independence. Further optimization of pump-related factors may improve patient well-being, although some patients may not benefit from pump use. Clinical Relevance Statement: In adults receiving home parenteral nutrition, portable infusion pumps may improve daily functioning, independence, mobility, and participation in social and work-related activities. However, overall quality of life remains affected by treatment burden, particularly nocturnal infusions and prolonged infusion duration. These findings suggest that, in addition to selecting an appropriate infusion device, optimizing pump-related treatment factors may help improve patient-centered outcomes in home parenteral nutrition. Full article