搜索结果：Social & legal studies

With prison populations expanding and aging, palliative care (PC) is an urgent concern. People in prison (PIP) face chronic illness, mental health conditions, and social vulnerabilities, creating ethical and psychosocial challenges to dignified end-of-life (EOL) care. This scoping review mapped key ethical and psychosocial domains in the provision of PC in prisons. PubMed, Web of Science, and ScienceDirect were searched using the strategy: Population-individuals in prison; Concept-ethical and/or psychosocial issues in PC; Context-PC provision in prisons across regions and healthcare models. Data were coded inductively, organized into ethical and psychosocial domains, and synthesized narratively. Sixteen studies were included, mainly conceptual analyses (n=10), most from North America (n=11). Ethical domains included structural neglect of PIP with life-limiting illness, barriers to compassionate release, compromised autonomy, denial of death in prison culture, and inadequacies in care quality and access. Psychosocial domains encompassed stigma, mistrust, isolation, existential suffering, and fractured social bonds. PIP-led hospice models offered companionship but raised tensions around labour, confidentiality, and the normalization of death in custody. Prison-based PC requires systemic reforms, staff training, family and advocacy involvement, and legal safeguards to ensure equitable, compassionate, and dignified EOL care.

The health of undocumented migrants (UMs) in France is poorly understood, especially outside of health care settings. This study aimed to (1) describe the health status of UMs in France, (2) to analyse the influence of the social determinants of health (SDoH) on four main reported conditions and self-perceived health and (3) to compare UMs with documented migrants (DMs) for those five outcomes. The Premiers Pas study (PPS) is a cross-sectional survey that is representative of UMs aged 18&#xa0;years or older living in France. The study was performed between February and April 2019 at sixty-three sites. The 2019 European Health Interview Survey (EHIS), representative of the French population, was subsequently used to compare UMs with DMs. Five outcomes were compared: diabetes, high blood pressure (HBP), asthma, depression (using the PHQ-9) and self-perceived health (SPH, using the Minimum European Health Module). Logistic regression models were used to explore associations between the five outcomes and (i) SDoH among UMs and (ii) administrative status (UMs vs DMs). Among UMs, 68.1% reported having a current health condition (n&#x2009;=&#x2009;1188), and 33.5% reported having a chronic condition (n&#x2009;=&#x2009;1189). Musculoskeletal (30.3%), mental (27.4%) and digestive (12.0%) conditions were among the most reported conditions. Several SDoH were risk factors for poor outcomes. For example, food insecurity was associated with a greater risk of depression ('often' aOR&#x2009;=&#x2009;3.05 95% CI [1.58-5.89]). The prevalence of depression and poor SPH was significantly greater for UMs than for DMs for the same gender and age groups. After adjusting for age, gender, region of origin and job status, depression was higher (aOR&#x2009;=&#x2009;2.35 95% CI [1.85-2.99], p&#x2009;<&#x2009;0.001), and poor SPH was worse (aOR&#x2009;=&#x2009;2.49 95% CI [1.89-3.29] p&#x2009;<&#x2009;0.001) among UMs. This study showed that living conditions play an important role in the health of UMs. UMs had higher risks of poor SPH and depression than DMs. These inequalities persisted when stratifying by duration of residence and gender. Living conditions could be improved through targeted public policies that promote migrants' rights, social inclusion and legalization.

Artificial intelligence (AI), machine learning, natural language processing and related decision-support methods are increasingly studied in intimate partner violence (IPV), domestic-violence and gender-based violence contexts. The key question is not whether AI can predict femicide as an individual lethal event, but whether AI-related methods may help institutions recognise, document, communicate and act on distributed signs of escalation across clinical, legal, police, social-service and digital settings. This PRISMA-ScR scoping review, informed by Joanna Briggs Institute guidance and structured using the Population-Concept-Context framework, mapped English-language AI-related literature in IPV, domestic violence, coercive-control and femicide-related risk pathways. Sexual violence was included only when embedded in IPV, domestic-abuse, coercive-control, family-violence, lethality-risk or femicide-related pathways. Searches identified 4,099 records; after deduplication, 2,906 were screened, 166 reports were assessed at full text and 125 were included in the core evidence map. The evidence was heterogeneous, spanning clinical and electronic health records, police narratives, legal documents, social media or online posts, survey data, linked administrative data and survivor-facing digital tools. AI-related methods were used mainly for detection, classification, record linkage, risk stratification, text mining, triage or decision support rather than for direct evaluation of femicide-prevention interventions. Femicide, lethality and severe escalation were addressed in only part of the corpus, and few studies examined implementation, human oversight, false reassurance, fairness, privacy or downstream institutional action in depth. The findings do not support individual femicide prediction or demonstrate that AI prevents lethal violence. Instead, they support a more defensible role for AI as a bounded component in human-led risk-recognition pathways. The review develops a six-layer conceptual synthesis linking distributed risk signals, AI-assisted signal processing, human contextual review, multi-agency response, legal-ethical governance and medico-legal accountability. AI may support institutional recognition and coordination, but it cannot substitute for professional judgment, survivor-centred practice, due process or adequately resourced prevention systems.

Aim: The present cross-sectional study aimed to investigate the psychosocial and financial burden, as well as the perceived social support experienced by parents of hospitalized children in Greece. Materials and Methods: The sample consisted of 100 parents or legal guardians of children hospitalized in various departments of the General Hospital of Corinth, using a convenience sampling method. The Bakas Care Outcomes Scale (BCOS), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Index of Personal Economic Distress (IPED) were used as measurement tools (pp. 4-6). Data analysis was performed using descriptive statistics and Spearman's rho correlation coefficient. Results: The mean score on the BCOS was 51.34 (SD=5.79), indicating a moderate to negative perception of the caregiving experience. On the IPED scale, the mean score was 17.67 (SD=2.17), with 82% of participants experiencing severe financial hardship (score >15). The mean MSPSS score was 4.24 (SD=0.39), indicating moderate to high perceived social support =1. A significant positive correlation was observed between perceived social support and financial hardship (p=0.324, p=0.001), suggesting that those experiencing greater financial hardship received more support. Conclusions: The findings highlight the need for comprehensive, family-centered interventions within the hospital setting. Provision of psychosocial support, financial assistance, and accommodation facilities is imperative to alleviate the significant burden faced by caregivers and improve the overall hospital experience for families.

Abortions are one of the most common gynecological treatments worldwide. Although many studies investigate risk factors (RF) for a negative abortion-related psychosocial outcome (APO), less is known about protective factors (PF) and the interplay of RFs and PFs. From May to August 2022, we conducted a semi-structured interview study in Germany and interviewed 23 women (21-43 years) who had undergone an elective abortion within the last 12 months, asking them about their experiences, perceived RF, PF and APO. The data was analyzed using qualitative content analysis. We found three different patterns: The first group of women found the process, especially the legal requirements, stressful but reported a mostly positive outcome with sufficient social support as PF. Women who reported neuroticism-related personality factors as RF sought less social support and more frequently used emotion-focused coping strategies such as self-care and distraction and often showed a mixed outcome. A third group of women experienced intimate partner violence (IPV) and also reported distraction as PF. Regardless, all women who survived IPV reported a negative APO. The majority of women find the legal requirements (e.g., mandatory counseling, waiting periods) burdensome. At the same time, they offer no benefit to women who find themselves in critical situations such as coercion and domestic violence, which was a major RF. The protection of women who survived IPV should therefore be improved and the access to abortion improved. Further research is needed to include effects on more vulnerable groups such as migrants or queer individuals.

Congenital adrenal hyperplasia (CAH) is a chronic endocrine disorder requiring lifelong management that may significantly impact health-related quality of life (HRQoL) in pediatric patients. Despite growing recognition of psychosocial outcomes in CAH, data from diverse populations remain limited. This cross-sectional study evaluated HRQoL in 40 children and adolescents with CAH (aged 2-18&#xa0;years) followed at our pediatric endocrinology clinic, compared with 82 healthy controls. The Pediatric Quality of Life Inventory (PedsQL) was administered to assess physical, emotional, social, and school functioning domains. Clinical data including 17-hydroxyprogesterone (17-OHP), adrenocorticotropic hormone (ACTH), androstenedione levels, bone age, treatment regimens, and surgical history were collected. Statistical analyses included Mann-Whitney U test, chi-square test, and Spearman correlation. The mean age of patients with CAH was 11.85&#x2009;&#xb1;&#x2009;4.3&#xa0;years. Based on child self-reports, total HRQoL scores were significantly lower in the CAH group compared with controls (81.69&#x2009;&#xb1;&#x2009;11.6 vs. 87.95&#x2009;&#xb1;&#x2009;6.0, p&#x2009;=&#x2009;0.007). Emotional functioning (p&#x2009;=&#x2009;0.001), social functioning (p&#x2009;=&#x2009;0.039), school functioning (p&#x2009;=&#x2009;0.048), and psychosocial health scores (p&#x2009;=&#x2009;0.002) were also significantly lower in patients, whereas physical functioning scores were comparable between groups (p&#x2009;=&#x2009;0.117). Parent proxy-reports similarly demonstrated significantly lower total HRQoL (p&#x2009;=&#x2009;0.001), social functioning (p&#x2009;<&#x2009;0.001), school functioning (p&#x2009;=&#x2009;0.010), and psychosocial health scores (p&#x2009;=&#x2009;0.001) in the CAH group. No significant differences were observed between child and parent assessments. Disease duration showed positive correlations with child-reported physical functioning (r&#x2009;=&#x2009;0.402, p&#x2009;=&#x2009;0.012), emotional functioning (r&#x2009;=&#x2009;0.595, p&#x2009;<&#x2009;0.001), psychosocial health (r&#x2009;=&#x2009;0.394, p&#x2009;=&#x2009;0.014), and total HRQoL scores (r&#x2009;=&#x2009;0.393, p&#x2009;=&#x2009;0.015). No consistent associations were identified between HRQoL scores and glucocorticoid dose, BMI SDS, height SDS, biochemical control, or history of surgery. Children and adolescents with CAH experience substantial impairments in HRQoL across all functional domains, particularly in psychosocial functioning.These findings should be interpreted with caution given the relatively small sample size of this study. Nevertheless, they suggest.Nevertheless, they suggest the need for comprehensive, multidisciplinary care approaches that address not only biochemical control but also psychological and social well-being in pediatric CAH management. &#x2022; Congenital adrenal hyperplasia requires lifelong glucocorticoid therapy. Its potential to impair health-related quality of life in affected children is increasingly recognized. &#xa0; &#x2022; Children and adolescents with CAH had significantly lower HRQoL than healthy controls on both self- and parent proxy-reports, with impairment concentrated in the psychosocial (emotional, social, and school) domains rather than physical functioning. &#x2022; HRQoL scores were unrelated to glucocorticoid dose, biochemical control, anthropometry, or surgical history.

The effectiveness of presumed consent policies in increasing donation and transplantation rates remains a matter of debate within the transplant community. The rationale for their implementation was derived from a limited body of experimental evidence and has largely relied on cross-country panel analyses reporting higher donation rates in opt-out systems. However, no previous study has systematically examined the risk of bias inherent in these analyses using a structured methodological framework. To address this gap, an operative framework of the deceased donation process was developed through the systematization of its phases and conditioning factors. This framework was subsequently used to perform a systematic review of cross-country panel data studies, applying the Risk Of Bias In Nonrandomized Studies of Interventions tool to assess risk of bias. Eighteen studies were identified. Although most (n&#x2005;=&#x2005;12) reported higher donation and/or transplantation rates in countries with presumed consent, risk of bias assessment identified serious limitations in 16 studies and critical limitations in 2. The principal concerns were inadequate control of confounding factors and misclassification bias resulting from imprecise definitions of how consent policies are implemented in practice, beyond the legal distinction between opt-in and opt-out systems. These findings suggest that, despite their apparent consistency, cross-country panel studies do not provide sufficiently robust evidence to support presumed consent as an effective strategy for increasing donation and transplantation rates. Greater emphasis should therefore be placed on the development of evidence-based donation policies that incorporate all validated determinants of effective deceased donation systems worldwide. Recommendations for improving research design in this field are also proposed.

This cross-sectional study explored patients with suicidal ideation history's preferences regarding health system collection and utilization of social needs data. Surveys asked about willingness to report and request assistance for social needs, comfort reporting across methods, and inclusion of needs in health outcome prediction. Differences by demographics and suicidal ideation severity were examined. Willingness to report needs differed by domain (legal concerns 66% to healthcare affordability 95%). Most patients who were willing to report needs wanted assistance. Patients were most comfortable reporting needs in an office with a physician (86%), although comfort did not differ drastically across healthcare settings or practitioner. Most (77%) were somewhat/very comfortable with needs use in prediction. There were no significant differences across subgroups. Patients with suicidal ideation history are willing to report and request assistance from health systems for social needs, which could be incorporated into suicide prevention.

We evaluated the impact of the COVID-19 pandemic on adolescents born preterm versus at term. This prospective cohort study included participants aged 13-21&#xa0;years in the Environmental influences on Child Health Outcomes (ECHO) Cohort. Participants completed questionnaires from April 2020 to June 2022 about their behaviors during the pandemic and the impact of the pandemic on their social connectedness and overall well-being. Analyses compared adolescents born extremely preterm (before 28&#xa0;weeks of gestation; n&#x2009;=&#x2009;419) and those born moderate or late preterm (&#x2265;&#x2009;28&#xa0;weeks and&#x2009;<&#x2009;37&#xa0;week; n&#x2009;=&#x2009;118) with those born at term (n&#x2009;=&#x2009;1,598). Associations were expressed as adjusted prevalence ratios (PRadj) and 95% confidence intervals (CIs). Adolescents in both preterm groups were less likely than those born at term to participate in unhealthy behaviors, such as drinking alcohol and using marijuana (moderate preterm: PRadj 0.78 [95% CI 0.61, 0.99]; extremely preterm: PRadj 0.74 [95% CI 0.58, 0.94]). Girls born extremely preterm were more likely to report health-promoting/prosocial behaviors (PRadj 1.15 [95% CI 1.06, 1.25]). Participants born moderate or late preterm reported feeling more socially connected during the pandemic compared with pre-pandemic (PRadj 1.29 [95% CI 1.09, 1.52]); nonetheless, this group was more likely to report a negative overall impact of the pandemic on their lives (PRadj 0.84 [95% CI 0.76, 0.92]). During the COVID-19 pandemic, adolescent behaviors and self-reported impact differed for participants born preterm compared with those born at term. These findings can inform counseling for parents and adolescents during future national crises.

Mental health is an urgent public health issue with social and economic relevance. Business families play a key economic role, yet their specific mental health challenges remain underexplored. High performance expectations, succession pressures and the wish for discretion may obscure psychological stress. The WIFU-GESUND study addresses this gap by conducting the first representative mental health survey among adult members of business families in Germany. This cross-sectional study targets adults with legal ownership in German family businesses. A representative sample will be drawn from the MARKUS database of Creditreform, supplemented by a voluntary sample via the WIFU Foundation. Data will be collected via computer-assisted web interviewing/computer-assisted telephone interviewing using validated brief self-report screening measures, including depression (Patient Health Questionnaire), anxiety (Generalised Anxiety Disorder), somatic complaints and selected single-item symptom indicators from the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) Symptom Rating and alcohol use (Alcohol Use Disorders Identification Test) and drug use (Drug Use Disorders Identification Test). Predictors include chronic stress (Trier Inventory for Chronic Stress-Short Screening Scale for Chronic Stress), family functioning (Experience in Social Systems), self-efficacy (ASKU), impostor feelings (Impostor Phenomenon Short Scale), physical activity and business-related contextual factors. As the study does not include diagnostic assessments, it estimates positive screening results for probable mental health problems and related self-reported mental health indicators rather than diagnostic prevalence. Analyses will include descriptive statistics, comparisons with population-based reference values, regression models and exploratory analyses. Missing data will be handled using multiple imputation. Ethics approval was granted by the Ethics Committee of Witten/Herdecke University (Application No. 26/2023). Independent data collection is ensured by USUMA GmbH. Findings will be shared via peer-reviewed publications, conferences and practice-oriented formats. OPEN SCIENCE FRAMEWORK PREREGISTRATION: https://osf.io/7pcdr.

Cesarean section (CS) is a lifesaving obstetric intervention when medically indicated, yet global rates have risen sharply over recent decades, with substantial variation across and within countries. While underuse persists in many low-resource settings, overuse is increasingly documented in higher-income and private-sector facilities, raising concerns about inequitable access, unnecessary surgical intervention, and divergent quality of maternity care. Existing explanations have largely focused on clinical indications and biomedical risk profiles, often neglecting the social and gendered structures that shape decision-making, institutional practice, and access to care. This scoping review examines how gender norms, roles, and power relations influence CS utilization across diverse global contexts. We conducted a scoping review following PRISMA-ScR guidelines, searching PubMed, Scopus, and CINAHL for English- and French-language publications from 2000 to 2025. Studies were included if they explicitly examined gender-related drivers or constraints shaping CS access, decision-making, or delivery practices. A three-concept search strategy captured cesarean delivery, gendered constructs, and mechanisms through which gender operates in health systems and social contexts. Data were extracted using a structured matrix and synthesized thematically through a gender analysis framework spanning access to resources, roles and practices, norms and beliefs, decision-making power, and institutions, while distinguishing between gendered "push" and "pull" factors influencing CS use. 95 studies met inclusion criteria. The evidence demonstrates that CS utilization is shaped by interacting gendered forces operating across individual, household, community, and health system levels. Four interrelated domains emerged. First, political and economic structures-including financing models, privatization, and provider incentives-shape institutional preferences for surgical delivery and normalize medicalized childbirth. Second, clinical cultures marked by medical paternalism, risk aversion, and medico-legal pressures shift decision-making authority from women to providers. Third, household and community gender relations structure reproductive decision-making through spousal authority, familial pressure, and socially embedded norms of motherhood, sexuality, and bodily integrity. Fourth, women's preferences are shaped by both enabling and constraining conditions, including time poverty, fear of labor pain, concerns about sexual and reproductive health, and uneven access to respectful maternity care. Across contexts, CS emerges as both overused and underused depending on women's social position, access to resources, and exposure to institutional power. Wealth, urban residence, and private insurance often facilitate elective CS, while poverty, geographic isolation, and weak health systems restrict access even when clinically necessary. Gendered norms simultaneously construct vaginal birth as morally valued and CS as either a marker of modernity or medical failure, reinforcing contradictory pressures on women and providers alike. This review highlights that CS is not solely a clinical outcome, but a socially produced intervention embedded within gendered systems of power. Addressing inequities in CS requires interventions that extend beyond clinical guidelines to include health financing structures, institutional accountability, provider norms, and the broader social conditions that shape reproductive agency.

Antiretroviral therapy has increased life expectancy of people living with HIV, though estimates of quality of life remain consistently lower than that of the general population. Research on determinants of health-related quality of life among people living with HIV has predominantly focused on clinical factors, with limited attention to upstream structural determinants, or the economic, political, and social systems shaping resource distribution and health outcomes. Moreover, structural and social determinants are frequently conflated in the literature, challenging both conceptual clarity and intervention design. A comprehensive synthesis leveraging a conceptual framework can support improved characterization of which structural factors are most strongly associated with health-related quality of life, distinguish structural from social determinants, and inform policy and programmatic priorities for improving the health and wellbeing for people living with HIV. We systematically searched PubMed, Embase, CINAHL, PsycINFO, PAIS, Sociological Abstracts, and Scopus from database inception to February 2026. Eligible studies will quantitatively examine associations between structural determinants (including policy and legal environment, culture, social class, socioeconomic position, stigma and discrimination, built environment, and material living conditions) and health-related quality of life measured using validated instruments among people living with HIV. Two reviewers will independently screen studies, extract data, and assess risk of bias using Joanna Briggs Institute critical appraisal tools. Random-effects meta-analysis will pool effect estimates where sufficient homogeneity exists. Subgroup analyses will examine variation by geographic region, gender, race, and structural determinant category. This review will systematically synthesize evidence on structural determinants of health-related quality of life among people living with HIV. Findings will identify modifiable upstream factors associated with quality of life, informing prioritization of structural interventions alongside biomedical approaches to HIV care. The review will also map evidence gaps, highlighting under-explored structural determinants and populations to guide research. By contributing to conceptual clarity in a field where structural and social determinants are frequently conflated, this review will provide a framework for more precise measurement and intervention design in future studies. PROSPERO CRD420261373190.

Sexual violence in conflict settings is a major public health and social justice issue with long-lasting psychological consequences. In the Democratic Republic of Congo (DRC), the Panzi One-Stop Centre model provides integrated medical, psychosocial, legal, and socio-economic support to rape survivors. However, evidence on how different combinations of services are associated with psychosocial well-being and equity in health outcomes remains limited. We conducted a cross-sectional study in July 2025 among 314 rape survivors who had received care between 2022 and 2024 in Eastern DRC. Self-esteem and life satisfaction were assessed using validated scales. Sociodemographic data and care pathways were collected through structured interviews. Standardised scores were analyzed using correlation and regression analyses, while analysis of variance (ANOVA) was used to compare mean standardised scores between pillars. General linear models (GLMs) were used to examine associations between sociodemographic factors, care configuration, self-esteem, and life satisfaction. Standardized regression coefficients (&#x3b2;) are reported throughout. Average life satisfaction was low, whereas self-esteem was moderately low, with substantial variability across participants. Survivors who were classified in care configurations including a combination of three care pillars (medical, psychosocial and socio-economic support), trend to show the slightly higher observed psychosocial well-being scores, although confidence intervals (CI) overlapped across several subgroups. Medical-only care was associated with comparatively lower observed scores. Employment was positively associated with self-esteem, whereas perceived social support appeared to be more consistently associated with life satisfaction than with self-esteem. A positive association was observed between the number of care pillars utilised and both self-esteem and life satisfaction. Care configurations including the socio-economic pillar tended to display a more pronounced positive relationship between self-esteem and life satisfaction. However, subgroup comparisons should be interpreted cautiously because several groups had small sample sizes and overlapping confidence intervals. Integrated multidisciplinary care was positively associated with psychosocial well-being among survivors. Variations observed across different combinations of care pillars suggest that equitable access to holistic services may be related to differences in recovery indicators. These findings highlight the potential relevance of ensuring the continuity and availability of multidisciplinary services for survivors of sexual violence in conflict-affected settings. However, given the cross-sectional nature of the study, these findings should be interpreted as descriptive associations rather than evidence of causal effects and warrant confirmation in longitudinal studies.

This study examines the dietary supplement consumption behaviors and ethical attitudes aiming to contribute to a more conscientious and ethical consumption culture within the health industry. A descriptive cross-sectional study was conducted from October to December 2019 with a sample size of 384 individuals aged 20-65 in Turkey. Analysis was performed using the Statistical Package for the Social Sciences 22.0, including exploratory factor analysis and statistical tests. About 55.5% of participants used dietary supplements, with Vitamin D, Vitamin B, Omega-3, and multivitamin complexes being common. Ethical concerns included inadequate label information, price discrepancies, and legal oversight issues. Statistically significant differences were observed in gender regarding the dimensions of meeting needs and promotion, in age regarding the legal dimension, and in the reasons for visiting a dietitian in the other four dimensions, except for the legal dimension (p < 0.05). This study revealed that factors such as gender, age, and dietary preferences influence individuals' supplement choices. Men were found to be more inclined toward the meeting needs and promotion aspects of dietary supplement purchases than women. In addition, age group and dietary preferences were found to affect the sensitivity of individuals in their supplement choices. Examinar los comportamientos de consumo de suplementos diet&#xe9;ticos y las actitudes &#xe9;ticas con el objetivo de contribuir a una cultura de consumo m&#xe1;s consciente y &#xe9;tica dentro de la industria de la salud. Se realiz&#xf3; un estudio descriptivo transversal de octubre a diciembre de 2019 con un tama&#xf1;o de muestra de 384 individuos de entre 20 y 65 a&#xf1;os, en Turqu&#xed;a. El an&#xe1;lisis se realiz&#xf3; utilizando SPSS 22.0, incluido el an&#xe1;lisis factorial exploratorio y las pruebas estad&#xed;sticas. El 55.5% de los participantes utilizaron suplementos diet&#xe9;ticos, siendo comunes la vitamina D, la vitamina B, los &#xe1;cidos grasos omega-3 y los complejos multivitam&#xed;nicos. Las preocupaciones &#xe9;ticas inclu&#xed;an informaci&#xf3;n inadecuada en las etiquetas, discrepancias en los precios y problemas de supervisi&#xf3;n legal. Se observaron diferencias estad&#xed;sticamente significativas en el sexo en relaci&#xf3;n con las dimensiones de satisfacci&#xf3;n de las necesidades y promoci&#xf3;n, en la edad en relaci&#xf3;n con la dimensi&#xf3;n legal, y en los motivos para acudir al dietista en las otras cuatro dimensiones, excepto en la dimensi&#xf3;n legal (p < 0.05). Este estudio revel&#xf3; que factores como el sexo, la edad y las preferencias diet&#xe9;ticas influyen en la elecci&#xf3;n de suplementos por parte de los individuos. Se observ&#xf3; que los hombres se inclinaban m&#xe1;s que las mujeres por los aspectos de satisfacci&#xf3;n de las necesidades y promoci&#xf3;n de la compra de suplementos diet&#xe9;ticos. Adem&#xe1;s, se encontr&#xf3; que el grupo de edad y las preferencias diet&#xe9;ticas influ&#xed;an en la sensibilidad de los individuos en el momento de elegir suplementos.

Set against the backdrop of a competitive and demanding academic environment in China, this study reconceptualizes the small talk of early-career female academics through a sociocultural psychological lens. Moving beyond linguistic taxonomy, this study investigates how these informal interactions function as culturally situated tools for psychosocial adaptation. Using a thematic analysis informed by a conversation-analytic transcription approach, approximately 11.5&#xa0;h of naturalistic conversations within a close-knit friendship group were recorded and transcribed. The analysis identified eight recurrent interactional patterns: co-commiseration, collaborative exploration, identity affirmation, relationship-centric boundary management, protective deflection, humorous norm-policing, intellectual sparring, and co-constructing moral stances. The findings suggest that small talk serves as a critical, peer-mediated psychological resource, enabling participants to collectively navigate institutional pressures and gendered expectations while constructing a shared world of meaning and resilience. This research highlights the need for academic institutions to recognize and foster such organic, informal support systems.

Social determinants of health (SDoH) are the non-medical factors that influence an individual's health and well-being. This study aimed to examine the relationships between SDoH and post-concussion symptom severity in Canadian children. We conducted a secondary analysis of data collected through Advancing Concussion Assessment in Pediatrics (A-CAP), a prospective longitudinal cohort study. Children aged 8-16 years with concussion (n = 633) or orthopedic injury (OI; n = 334) were recruited from five Canadian pediatric emergency departments. Post-concussion symptoms were rated by children and parents using the Health and Behavior Inventory. Linear mixed-effects models assessed the associations of SDoH (i.e., race, household income, parental education, insurance status, neighborhood deprivation) and their interactions with time with post-concussion symptom severity. The cumulative impact of all SDoH was assessed with negative binomial generalized linear models at 3 months post-injury. In the linear mixed-effects models, race and education were significant predictors of both child-reported, race: F(5, 1390.37) = 2.27, p = 0.05; education: F(3, 1155.55) = 3.14, p = 0.03, and parent-reported somatic symptoms, race: F(5, 2562.35) = 2.93, p = 0.01; education: F(3, 787.22) = 3.28, p = 0.02. Joint tests of race, F(15, 804.38) = 2.12, p = 0.008, and neighborhood deprivation, F(3, 379.12) = 2.74, p = 0.04, and their interactions with time variables were statistically significant for parent-reported somatic symptoms. In the negative binomial generalized linear models, SDoH cumulatively contributed to the prediction of symptoms at 3 months post-injury over and above injury type (concussion vs. OI) and known prognostic factors (5P risk score) for child-reported cognitive, F(17, 1154.75) = 1.94, p = 0.012, and somatic, F(17, 322.81 = 2.11, p = 0.007, symptoms and parent-reported somatic symptoms, F(17, 327.15) = 1.93, p = 0.015. In summary, individual SDoH had small associations with symptoms after concussion in Canadian children, but the cumulative effects of multiple SDoH are likely an important factor in post-concussion symptom severity.

BackgroundAs global populations age, understanding how older adults access and receive workplace accommodations is essential for promoting equity, productivity, and well-being.ObjectiveThis scoping review explores the intersection of aging, disability, and workplace accommodations among older workers.MethodsGuided by PRISMA-ScR standards, four databases-AgeLine, ScienceDirect, Scopus, and Social Science Premium Collection-were searched for empirical studies published from 1990 to 2023. Studies examining accommodations for employees aged 55 or older were included. Of 2293 records screened and 231 full texts reviewed, eight met the inclusion criteria.ResultsOlder workers most frequently requested accommodations included flexible scheduling, ergonomic adaptations, and job modifications (5 out of 8 studies); however, these supports were also the most frequently provided (4 out of 8 studies). Key influences on accommodation access included awareness of rights, stigma around disclosure, employer attitudes, and workplace culture. Most research was qualitative and focused on North America, underscoring the need for broader demographic, geographic, and methodological diversity. Thus, caution should be taken when interpreting the results.ConclusionsSignificant gaps persist between accommodation needs and implementation, driven by limited awareness, stigma, and uneven organizational support. To enhance outcomes, workplaces should foster inclusive cultures, train supervisors, and enforce accommodation policies. Future research should adopt mixed-methods and international perspectives to guide equitable employment practices for aging workforces under different cultures and legal frameworks.

Sex trafficking is a pervasive threat that disproportionately affects migrant populations. These groups are often targeted due to socioeconomic status, legal insecurity, and limited access to appropriate protections. The intersection between migration status and current structural inequalities further intensifies risks to migrant health and general well-being, making them highly susceptible to coercion and abuse. Despite growing research around these issues, evidence on sex trafficking among migrants remains an area for further exploration. To examine the scope, nature, and thematic trends in the literature on international migration and sex trafficking. This scoping review was guided by the population-Concept-Context (PCC) framework. Of the thirty-seven peer-reviewed studies screened, twenty-two studies published between 2003 and 2024 were analyzed across four databases (MEDLINE/Ovid, Embase, Scopus, Cochrane), and a content analysis was employed to synthesize data. We included 22 studies from 10 countries: 11 qualitative, seven mixed-methods, and four quantitative. This scoping review identified six major themes: (1) migrant vulnerabilities, (2) methods of coercion and control, (3) health consequences and barriers to care, (4) sexual violence across the migration journey, (5) systemic failures and institutional gaps, and (6) healing, recovery, and resilience. Economic, legal, and social vulnerabilities drive sex trafficking among migrants. Comprehensive, survivor-centered policies are urgently needed, including a shift away from punitive systems to preventative ones, expanded mental health support, and the reduction of stigma. Findings support the implementation of survivor-led screening in emergency departments, the decoupling of healthcare access from immigration status, and increased investment in pre-departure education.

In January 2023, British Columbia (BC) became the first Canadian province to implement a legally sanctioned drug decriminalization policy, removing criminal penalties for adults possessing 2.5 g or less of opioids, cocaine, methamphetamine, and MDMA. Introduced as a three-year pilot, it aimed to reframe substance use as a public health issue, reduce stigma, and improve health and social service engagement. Criminal penalties were reintroduced for drug possession in most public spaces in May 2024, and the pilot ended in January 2026. Its termination has been interpreted as policy failure; this review aimed to examine how the pilot was implemented in practice and to identify factors that shaped its operationalization and early implementation-relevant outcomes. We conducted a systematic review with narrative synthesis of peer-reviewed literature examining implementation-relevant aspects of BC's decriminalization pilot. Six databases were searched (January-February 2026) for studies published May 31, 2022-February 1, 2026. The protocol was registered in PROSPERO (CRD420251271694). Twenty-seven studies were included. Four cross-cutting implementation barriers were identified: pilot design features, public and cross-sector communication gaps, limited frontline training, and insufficient funding and infrastructure. Design features included the 2.5 g possession threshold, misalignment with real-world drug use patterns; the three-year timeframe, which constrained system-level effects; and the May 2024 amendment, which introduced additional instability. The pilot was implemented without commensurate investment in harm reduction, treatment, or housing infrastructure, within already constrained systems. BC's decriminalization pilot suggests the effects of legal reform are shaped by implementation context. Early outcomes may reflect design features, institutional readiness, and system capacity rather than legal change alone; longer-term impacts remain uncertain. Future reforms should align legal change with coordinated implementation, operational guidance, public communication, and adequate service infrastructure.