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Summary: Purpose: This study aimed to adapt and validate the Korean version of the Caregiver Burden Questionnaire for Family Caregivers of Hemodialysis Patients, originally developed by Hejazi et al. in 2022, to ensure its applicability and validity in Korea. Methods: Using both online and offline approaches, this study included 230 family caregivers. Data analysis was performed with SPSS AMOS version 29.0 using the Korean version of the Caregiver Burden Questionnaire for Family Caregivers of Hemodialysis Patients and the Korean version of the Zarit Burden Interview as the primary instruments. Results: The findings confirmed the high content validity of the questionnaire (scale-level content validity index = .99), and confirmatory factor analysis established its construct validity. Convergent validity was confirmed with average variance extracted values ranging from .43 to .87, and composite reliability scores ranging from .80 to .91. A significant positive correlation with the Korean version of the Zarit Burden Interview (r = .81) demonstrated concurrent validity. The tool consists of 21 items across four factors on a 5-point Likert scale, exhibiting excellent internal consistency (Cronbach's α = .91) and good test-retest reliability (intraclass correlation coefficient = .79). Conclusion: This study validated a reliable instrument for assessing caregiver burden in families of hemodialysis patients in Korea. This tool accurately measures caregiver challenges and has the potential to enhance societal health and welfare.

Objectives: To investigate the associations between caregivers’ burden, family quality of life (QoL), and siblings’ QoL in Brazilian families of children with cerebral palsy, and to analyze siblings’ QoL using as a parameter the QoL of typically developed Brazilian children. Methods: It was a cross-sectional study. The 212 families, 212 caregivers and 131 siblings completed the Family Quality of Life Scale, Burden Interview, and KIDSCREEN-27 Child and Adolescent Version and Parents Version questionnaires at a neurorehabilitation center in southeast Brazil. Univariable and multivariable models were used. Results: Family QoL significantly worsened as caregivers’ burden increased (95 % CI -0.66 to -0.38). Caregivers’ burden was significantly lower with increasing family QoL scores (95 % CI -0.52 to -0.30). Self-reported siblings’ QoL was significantly worse than that of their typically developed peers (95 % CI -7.6 to -3.6). Self-reported siblings’ QoL was significantly lower as siblings’ age (95 % CI -2.52 to -0.59) and caregivers’ burden (95 % CI -0.35 to -0.05) increased. Parent-reported siblings’ QoL was significantly lower with increasing caregivers’ burden (95 % CI -0.45 to -0.16) and higher as family QoL increased (95 % CI 0.09 to 0.37). Conclusions: The cross-sectional nature of these data precludes any statement of causality. Family QoL worsened with higher caregivers’ burden levels. Lower caregivers’ burden scores were associated with a higher family QoL. Siblings’ QoL was impaired as compared to typically developed peers, worse among older siblings, and as caregivers’ burden increased and better with higher family QoL levels. Future multicenter studies may validate the generalizability of the present findings.

Background: The ability to understand and use language is impacted in people with aphasia, often requiring Speech and language therapy interventions to improve their ability to communicate. Currently, there is limited information concerning the experiences of people with aphasia who have undergone speech therapy in many countries such as Ghana where the practice of speech and language therapy is still in its infancy. Such knowledge is known to enhance the uptake of speech and language therapy services and improve both quality and reach. Objective: This study examines the perceived benefits of speech and language therapy interventions for people with aphasia in Ghana from the perspectives of those living with aphasia, their family members and Speech therapists. Additionally, this study sheds light on the interventions employed by Speech therapists in their pursuit of enhancing communicative competence among people with aphasia. Design: We employed a qualitative research design with a purposive sampling technique to recruit seven people with aphasia together with a family member and five Speech therapists. Participants: A total of 19 participants (7 people with aphasia, 7 family members and 5 Speech therapists) were recruited for this study. Methods: A semi-structured interview guide was used. Interviews were audio recorded, transcribed, and subjected to thematic analysis employing the Interpretative Phenomenological Analysis approach, to explore and comprehend the participants' lived experiences. Results: Our findings revealed that people with aphasia perceived speech and language therapy interventions to be beneficial as it enhanced their communication abilities as well as their quality of life. Family members of people with aphasia valued speech and language interventions as it gave them the opportunity to play a significant role in the recovery process of their family members with aphasia. Speech therapists described using a combination of impairment and functional/communication-based interventions to improve the communication skills and social participation of their clients with aphasia. Conclusions: Findings of the study indicate that people with aphasia and their caregivers experience significantly negative impact on their communication and quality of life, underscoring their profound appreciation for the relief provided by speech and language therapy interventions. Those who have undergone speech and language therapy interventions are inclined to recommend it to others due to its substantial benefits. This can be leveraged to increase the uptake of speech and language therapy and countries where the practise is still in its infancy.

Technology plays a growing role in allowing aging persons to live independently. However, it is often difficult to motivate aging persons to use these new technologies. Using 182 dyads of aging persons and their primary family caregiver, this study investigates how family members' beliefs about the capabilities of the aging person are associated with the aging person's engagement in using healthcare technology—a phenomenon known as the Pygmalion effect. A quantitative statistical method response-surface analysis (RSA) was performed. RSA is often employed to understand complex, nonlinear interactions within a data set. It was investigated how the level of fit (when both the aging person and his or her family caregiver hold similar beliefs about the technological capabilities of the aging person) and the direction of misfit (whether the abilities of the aging person are greater or worse than the family caregiver thinks) shape the aging person's intention to use healthcare technologies. The individual perception of capabilities is an important driver of the intention to use technology. In line with the Pygmalion effect, the effects of family members on aging persons drives their adoption of healthcare technology. The greatest intentions to use technology are observed when there is a fit in beliefs. In contrast, misfit leads to lower usage intentions. The direction of misfit further reveals that aging person's beliefs about their capabilities are more decisive than their family caregiver's beliefs in promoting their technology usage intentions. In addition, age, experience with technology, attitudes, social norms, and technological savviness in the family also have an impact on aging persons' intentions to use technology. This study extends the theoretical basis of the Pygmalion effect by including fit, misfit, and direction of (mis)fit.

Objective: End-of-life experiences can have important implications for the meaning-making and communication of bereaved family members, particularly due to (in)access to formal healthcare services (i.e., palliative care and hospice). Grounded in Communicated Narrative Sense-Making theory, this study extends knowledge about how the stories told about end-of-life by bereaved family members affect and reflect their sense-making, well-being and importantly, potential disparities in end-of-life care. Methods: Semi-structured interviews with 25 bereaved individuals were conducted regarding their experiences with the terminal illness and death of an immediate family member. Using a framework of family bereavement narratives, a cross-case data analysis demonstrated qualitative patterns between (in)access to end-of-life care and how participants framed bereavement stories. Results: Four themes illustrated the continuum of communication that families engaged in when making sense of end-of-life experiences, including reflections on silence, tempered frustrations, comfort with care, and support from beyond. Innovation: This innovative qualitative connection between family members' bereavement stories and end-of-life care emphasizes the importance of employing a health equity lens within hospice and palliative care, especially in addressing the important aim of comprehensively supporting families even when illness ends. This study demonstrates that access to, quality of, and imagining beyond current structures for EOL may be vital factors for facilitating effective sense-making for the dying and their family systems. Conclusion: These findings illustrate the potential interconnections between (in)access to end-of-life care, sense-making, and communication for individuals and families experiencing terminal illness and bereavement.

Objectives: Through the reflection of young breast cancer women on their selves and identities, we explored expectations of the wife role that they need to fulfill to return to their families, aimed to provide a reference basis for medical professionals to develop interventions related to cancer family rehabilitation. Methods: Descriptive phenomenological methods and purposive sampling were used. Young breast cancer patients and their spouses were selected for semi-structured face-to-face interviews in the study from March to April 2023 at the department of breast surgery and oncology center of a Class A tertiary hospital in Xuzhou City, China. The interviews were transcribed verbatim and analyzed using Colaizzi’s phenomenological approach. Results: Twenty patients and six spouses were interviewed. The mean patient age was (35.95 ± 3.36) years, and the mean spouse was (37.67 ± 5.28) years. Young breast cancer patients were concerned about three main wife expectations during their treatment and rehabilitation: preserving self-love and self-esteem (paying attention to physical health, embracing the disease, and regaining confidence in female characters); adjustment of conjugal relationships (harmonious and effective couple communication, providing support for marriage and love, and creating a beautiful married life together); assisting in family recovery (relieving stress on spouses from caregiving and finances, and management of daily household chores). Conclusions: The wife role expectations of young breast cancer women and their spouses encompass three core aspects: self, couple, and family. Self-esteem and self-love are the most fundamental expectations of the wife role, while adjusting the couple’s relationship and assistance in family rehabilitation represent higher expectations. This study can help healthcare professionals and cancer families gain a more comprehensive understanding of the wife role expectations for young cancer women, thereby enabling the development of couple-centered interventions to promote patient recovery and enhance the resilience of marriages and families.

Background: Compared to other occupational groups, first responders (FR) experience worse mental health outcomes due to duty-related trauma and occupational stressors. Despite their best efforts, they bring this stress home to friends and family. Consequently, FR and their supporters suffer from increased psychosocial difficulties and experience stigma and other barriers to help-seeking. Prior work offers little opportunity for open dialogue and shared understanding of the repercussions of this occupation for all members of the first responder community.In this qualitative study, we aimed to: (i) explore the lived experience of Irish FR and their family members (FM) related to occupational stressors, and (ii) identify opportunities to engage FM with existing organizational supports available for FR. Methods: Using a community based participatory research (CBPR) approach, we conducted six focus groups involving a total of fourteen participants comprising FR, organizational representatives, and FM. All focus groups were audio recorded, transcribed, and analyzed using reflexive thematic analysis. Findings: FR and FM shared their experiences of both joining and learning to live as members of the FR community in Ireland. Through our analysis, we identified a main theme of ‘crossing thresholds’, characterizing their transformative learning experiences. This learning experience includes recognizing the consequences of this new role for them as individuals and for their relationships. Participants also shared how they have learned to cope with the consequences of their roles and what they need to better support each other. Conclusions: FM are often unheard, hidden members of the first responder community in Ireland, highlighting an unmet need for FR organizations to acknowledge FM role in supporting FR and to provide them with the appropriate training and resources required. Training for new recruits needs to move beyond the tokenistic involvement of FM and encourage knowledge sharing among experienced and novice members. Cultural change is required to support help-seeking among FR and foster a sense of peer support and community among families.

Children with disabilities and their families have the right to access Early Childhood Intervention (ECI). Family members should act as active agents of the intervention. In this sense, service professionals should offer support and intervention to improve family well-being and child development. We analyzed the experiences of parents of children with disabilities users of ECI services and the professional coordinators in the Balearic Islands (Spain) from a phenomenological-hermeneutic approach. Data collection was through semi-structured interviews and focus groups. A total of 5 coordinators and 30 family members participated in the study. The results indicate five categories: making ECI visible, reception phase, family well-being, intervention, and current barriers. The findings project the need to make ECI visible in policies and administrations, as well as plans to raise social awareness of child disability. Protocols must be found to facilitate access to services for children and families. Implications for the improvement of ECI are proposed.

Background: Given the protective effect of nurturing caregivers and families for child and adolescent mental health, there is a need to review and synthesize research evidence regarding the effectiveness of parenting and family interventions in low and middle-income countries, including humanitarian settings. To advance practice, further understanding of the active ingredients of such interventions and implementation factors that lead to effectiveness are essential. Method: This systematic review, an update from a previous review, included studies on any parenting or family intervention for children and adolescents aged 0–24, living in a low- or middle-income country, that quantitatively measured child or adolescent mental health outcomes. We searched Global Health, PubMed, PsychINFO, PILOTS and the Cochrane Library databases on the 9th July 2020, and updated on the 12th August 2022. Risk of bias was assessed using an adapted version of the NIH Quality Assessment Tool. We extracted data on: effectiveness outcomes, practice elements included in effective interventions, and implementation challenges and successes. Main findings: We found a total of 80 studies (n = 18,193 participants) representing 64 different family or parenting interventions, 43 of which had evidence of effect for a child or adolescent mental health outcome. Only 3 studies found no effect on child, adolescent or caregiver outcomes. The most common practice elements delivered in effective interventions included caregiver psychoeducation, communication skills, and differential reinforcement. Key implementation strategies and lessons learned included non-specialist delivery, the engagement of fathers, and integrated or multi-sector care to holistically address family needs. Preliminary conclusions: Despite a high level of heterogeneity, preliminary findings from the review are promising and support the use of parenting and family interventions to address the wider social ecology of children in low resource and humanitarian contexts. There are remaining gaps in understanding mechanisms of change and the empirical testing of different implementation models. Our findings have implications for better informing task sharing from specialist to non-specialist delivery, and from individual-focused to wider systemic interventions.

Rising rates of youth anxiety, depression, and suicide mean that pediatricians are increasingly likely to encounter children struggling with their mental health in their clinical practices. Despite pediatric professional organizations encouraging pediatricians to contribute more to mental healthcare and suicide prevention, research on the role of pediatricians and whether families consider them a resource is limited. Drawing on original survey (N = 1230) and interview data (N = 102), we investigate how families conceptualize and involve pediatricians in their children’s mental healthcare, including during suicidal crises. Our survey data show that while families considered mental health professionals the ideal point of contact, pediatricians were a close second, confirming that families view pediatricians as a mental health resource. Parent interviews clarify that parents most often turn to pediatricians for medication and referrals to other mental health professionals or because mental health professionals were inaccessible. We also examine how pediatricians helped (by connecting families promptly to appropriate care) or hurt (by stigmatizing suicide or by providing interventions associated with harm) during a child’s suicidal crisis. We conclude by emphasizing the importance of proper suicide prevention training for pediatricians, as well as suggesting directions for future research.

Objective: To examine the effectiveness of a family-based program for post-stroke patients and their families. Methods: A cluster randomized controlled trial design was used. Participants were randomly selected in the experimental group (3 districts) and the comparison group (3 districts), with 62 families recruited. Sixty-two persons with new stroke and families (family caregivers and family members) who met the inclusion criteria were assigned to two groups, 31 in each group. Using the Neuman System Model as a framework, we implemented the stressors assessment and family-based intervention into the program. Participants in the comparison group received usual care, and those in the experimental group underwent a stressors assessment and received the family-based program. Measurement of functional status, depression, and complications in post-stroke patients and family function in family caregivers and family members, as well as caregiver burden and caregiver stress in family caregivers, were assessed at baseline, 4 weeks, and 12 weeks after enrollment. Data analysis included descriptive statistics, the chi-square test, Bonferroni test, and repeated measures analysis of variance. Results: After participating in a 12-week family-based program, post-stroke patients in the experimental group showed statistically significant improvements in their functional status and decreased depression compared to the comparison group (P

Objectives: This study investigated the relationship between health checkups, cervical cancer screenings, and breast cancer screenings (collectively referred to as wellness examinations) of wives and health checkups of their husbands. We aimed to develop strategies to encourage wellness examinations among married individuals in Japan. Methods: This study used the 2019 Comprehensive Survey of Living Conditions, focusing on married couples aged 40–64. We analyzed the percentage of wives undergoing wellness examinations, grouped based on whether their husbands had undergone health checkups. Subsequently, multivariable modified Poisson regression analysis was performed considering sociodemographic and health-related factors. All analyses considered medical insurance of wives because wellness examination methods varied depending on medical insurance type. Results: The sample comprised 40,560 couples undergoing health checkups, 39,870 undergoing cervical cancer screening, and 39,895 undergoing breast cancer screening. Regardless of the medical insurance type of the wife, a significant positive association was observed between the wellness examination of wives and the health checkup of husbands across all age groups. After adjusting for covariates, prevalence ratios (95% confidence intervals) for wives whose husbands underwent health checkups were 2.24 (2.09–2.40) for national health insurance, 1.18 (1.16–1.21) for employee insurance (employee), and 1.53 (1.44–1.63) for employee insurance (family) for health checkups. Similar trends were observed in cervical and breast cancer screening. Conclusions: Wellness examinations of wives were associated with those of their husbands, suggesting that couples often share similar health-seeking behaviors. Hence, targeted interventions are important for couples who do not undergo wellness examinations.

Introduction: Delirium is a common acute brain dysfunction syndrome in patients admitted to intensive care units (ICUs). Family engagement strategies, based on the theory of multi-sensory stimulation to ameliorate sensory deprivation in patients, may be an effective and scalable method to reduce the burden of delirium. Methods: /design: This is a assessor-blinded, randomised controlled trial of the feasibility of multi-sensory stimulation (MS) in patients with delirium. A total of 72 mechanically ventilated patients (n = 24 in each group) admitted to the ICU will be randomised to routine non-pharmacological delirium care (control), family multi-sensory stimulation and nurse multi-sensory stimulation groups. All participants except the control group will receive multi-sensory stimulation, including visual, auditory, tactile and kinesthetic stimulation, for 5 days. Our primary aim is to determine the feasibility of the study procedure (recruitment, eligibility, retention and attrition rates, appropriateness of clinical outcome measures), feasibility, acceptability and safety of the intervention (adverse events, satisfaction and other). Our secondary objective is to assess the preliminary efficacy of the MS protocol in reducing the incidence, duration and severity of delirium. Sedation levels and delirium severity will be assessed twice daily. Enrolled participants will be followed in hospital until death, discharge or up to 28 days after treatment. Ethics and dissemination: The current study was approved by the Ethics Review Board of Huazhong University of Science and Technology Union Shenzhen Hospital, China (KY-2023-031-01). The results of this study will be presented at scientific conferences and submitted for publication in peer-reviewed journals. Trial registration number: ChiCTR2300071457.

Background: Family-Centered Care (FCC) is an approach to healthcare planning, delivery and evaluation, based on beneficial partnerships between health professionals, patients and families. FCC may be particularly relevant for families with children with intellectual disability (ID), given their needs of continuum care. Objective: To identify which components of the FCC are practiced and which health outcomes are considered effective in families with children with ID. Method: A systematic review guided by the PRISMA STATEMENT 2020 approach and the STROBE reporting guidelines was performed on specific databases through the EBSCOhost Web platform: MEDLINE with Full Text, CINAHL PLUS with Full Text, Academic Search Complete and Psychology and Behavioral Sciences Collection. Peer-reviewed articles published in English or Portuguese languages from 2018 to September 2023 were retrieved. Methodological quality was established using the Quality Assessment Tool for Observational, Cohort and Cross-Sectional Studies – NHLBI, NIH. Results: Ten studies met the eligibility criteria and were synthetized. The results revealed nine components, reflecting the way FCC was developed: shared decision-making; family education; respect for culture; family engagement; recognition of the family's needs, characteristics and interests; specialized care support; social and emotional support; family functionality; and family seen as a unit. The health outcomes demonstrate effective gains in improving children's health through family satisfaction with health services. Also achieved psychological and social benefits, with improved family well-being and quality of life, favoring family empowerment. Conclusions: The evidence suggests that FCC components involves an effective partnership between the family and health professionals as the main key in developing care plans, as well as the experience that the family unit brings to the delivery of care. FCC approach include all family members as decision-makers, providing emotional, physical and instrumental levels of support. Health outcomes emerged in three strands; for children with ID, families and health services.

Background: Due to the overlap of somatisation with other psychiatric symptomatology and the difficulty of making a clear diagnosis, few studies have focused on somatic symptoms after divorce. Moreover, their results are controversial and do not provide a conclusive differentiation according to gender. Objective: The present study is based on the hypothesis that psychological difficulties of adjustment to divorce and coparenting are linked to somatic symptomatology, in a sample of high-conflict divorcees, considering anxious and depressive symptoms as mediating factors. The role of some control variables was considered: marital status, level of education, time elapsed since separation, type of custody, frequency of contact with the children, and type of relationship with the ex-partner. In addition, the differential role of gender was studied. Method: A path analysis was carried out with the IBM SPSS AMOS 28 programme. Results: Its results supported the relationship between psychological difficulties of adjustment to divorce and somatisation, as well as the mediating role of anxiety. A direct relationship between coparenting and somatisation was also found. These results were invariant in men and women, although specific differences were identified in the impact of anxiety. Limitations: As a preliminary study, it is not without limitations. Firstly, it can be noted that it is a homogeneous sample with similar socio-demographic characteristics. Furthermore, the instruments used are general screening tests, and it could be interesting to incorporate more specific assessment tools. Conclusions: This study supported the link between the conflictive divorce and the somatic symptomatology, leading to further research.

This paper introduces a new three-parameter distribution called the modified Kies Gompertz (MKGO) distribution to identify an effective statistical distribution in a real-life modeling data set. The distribution’s probability density function may take numerous forms and graphs, and it could be negatively and positively skewed and uni-modal. We established several statistical properties of the MKGO distribution, such as moments, skewness, kurtosis, moment generating function, distribution of order statistic, quantile function, stress strength reliability and two cases of entropy measures. Further, we proposed six methods for estimating the unknown parameters of the suggested model. A brief Monter Carlo (MC) simulation study is illustrated in terms of average estimate (AE) and mean square error (MSE). to show the efficiency of these estimators. Finally, we analyzed four real data sets in the engineering sector to evaluate the potential of the proposed model with that of various existing distributions.

Despite the numerous concepts of caregiving discussed in the literature, there is still no agreed definition and concept of family caregiving from the perspective of Islam. This study aims to comprehensively define family caregiving from Islamic religious and Muslim cultural perspectives. Rodger's evolutionary model was used to generate content by analyzing and redefining concepts. A thorough examination of the relevant literature using Scopus, PubMed, Medline, and CINAHL databases also trusted sources offered a total of 52 articles and 8 books to be reviewed. Our study reveals that family caregiving is viewed as God's gift as important as an essential religious and cultural obligation in Islam, where humans are expected to deliver care for their families although they are unprepared. This can be motivated by aspirations for respect, love, responsibility, and a desire to recompense parents, as well as the belief that by doing so they will be rewarded in the hereafter. The provision of family caregiving leads to positive consequences such as living with hope, gaining rewards and achievement, but at the same time, it also causes devastated life. This research contributes to a new discourse on family caregiving based on Islamic literature which helps in the comprehension of the practices of Muslim communities worldwide.

The number of multicultural adolescents has been increasing globally, and their psychological well-being has received keen attention. The present study aimed to identify the factors affecting the positive orientations (i.e., self-esteem, optimism, and life satisfaction) of Korean adolescents from multicultural families based on the socio-ecological model.This study comprised a cross-sectional survey that used data from the Multicultural Adolescents Panel Study by the National Youth Policy Institute in South Korea. In total, 1260 adolescents from Korean multicultural families participated. To assess how the factors contributed to positive orientations, we performed a hierarchical linear regression analysis.Of the individual-level factors, gender, appearance satisfaction, social withdrawal, bicultural and multicultural attitudes, and academic achievement satisfaction affected the positive orientations of the adolescents. Among the relationship-level factors, their family support, relationships with their friends, and relationships with their teachers influenced their positive orientations; in particular, family support was the most influential factor.The study identified influential factors on the positive orientations among multicultural adolescents. These findings can help healthcare, educational, and social service professionals develop programs to enhance the positive orientations of adolescents from multicultural families.

Objectives: This study aimed to develop a valid and reliable food service satisfaction questionnaire for use by family members of residents in nursing homes. Design: Questionnaire development and validation study conducted using COSMIN® benchmarks for excellence. Setting: Nursing homes. Participants: Family members of residents in nursing homes. Measurements: Content validity was established based on a review of the literature, qualitative interviews with family members (n = 9) and expert review (n = 10). Face validity was established in pilot testing with family members (n = 5). A 40-item questionnaire was developed for psychometric testing. Data from 414 family members was used to establish construct validity (Principal Components Analysis), with data from 101 of those family members used to evaluate reliability (internal consistency (Cronbach’s alpha [α]) and temporal stability [weighted Kappa]). Results: A two factor 24-item scale resulted, with excellent internal consistency (factor one: 11 items related to food and meals (α = 0.960); factor two: 13 items related to the mealtime experience (α = 0.907)). Temporal stability was moderate to near perfect (weighted Kappa: 0.461−0.875; p

Global Youth Tobacco Survey (GYTS), Indonesia showed that 60,9 % of students noticed cigarette advertisements or promotions in outdoor media. Our study aimed to understand the impact of outdoor tobacco advertising and peer and family association with Youth's smoking behavior.This study deployed a cross-sectional approach to explore factors related to youth smoking behavior, such as peers, family, and tobacco advertising. The GYTS questionnaire was adapted as the instrument and distributed to 400 students from 20 high schools to observe smoking behavior. The chosen schools based on the previous study whose classify school in hot-spot and non hot-spot area. This study applied a data mining approach with a decision tree to generate the models.This study generates a decision tree model that describes the peer factor as the key to introducing Youth to smoking. The model also reveals that youth in the non-hotspot advertising area are not likely to develop Youth to smoke. The model has a performance classification of 77.5 % This study found that youth with smoking fathers are more likely to start smoking earlier, youth whose both parents are smokers, and mothers who are smokers have a confidence level of 100 % to smoke. Further research is warranted to investigate rural districts to explore any regional and socioeconomic variations.

Background: Families experiencing the loss of their close other following advanced illness have varying degrees of needs that stretch into bereavement. Evidence-based recommendations for bereavement support are often not well implemented in palliative care services due to multiple system barriers and lack of contextual fit. To close this know-do gap, we undertook an implementation science research project. Objective: To adapt evidence-informed recommendations for supporting bereaved families to the local context, and to develop a tailored implementation strategy for their integration in specialised palliative care services. Settings and participants: Two specialised palliative care services located at urban teaching hospitals in German-speaking Switzerland. Participants were palliative care staff working in the service, including nurses, physicians, chaplains, psychologists, and two service users. Methods: Multi-method implementation research project combining community engagement strategies, qualitative contextual analysis, and theory-driven implementation design processes for integrating evidence-informed interventions in new contexts: First, evidence was identified and adapted through co-design staff workshops and service user consultations, following intervention adaptation guidelines. Next, focus group interviews were held to identify barriers and facilitators to implementation, informed by the Consolidated Framework for Implementation Research and analysed using qualitative content analysis. Drawing on implementation mapping methodology, a systematic and participatory process was used to develop an implementation plan that specified activities needed to address identified barriers and support integration into palliative care services. Results: The study resulted in an adapted bereavement support pathway with three core functions of evidence-informed practices delivered during dying, at death, three-to-six, and if necessary nine-to-twelve months post-loss: screening and assessing family needs and risks, intervention and support activities for families, and team collaboration and coordination within and across providers. Implementation was expected to be influenced by the features of the intervention itself, staff competencies, and organisational conditions, with resources required being a frequent barrier, whereas workplace culture and the project-related network acted as facilitators. A multifaceted implementation strategy with 16 distinct activities was developed to reach 70 % of bereaved families: designing a practical, implementable pathway, creating necessary team capacity and roles, optimizing workflow, offering education and clinician support, ensuring leadership and organisational commitment, and facilitating mutual exchange and learning. An implementation research logic model specified expected mechanisms of impact and outcomes. Conclusions: The project resulted in an adapted bereavement support intervention fitted to local palliative care contexts and a tailored implementation plan. Adapting evidence to specific contexts and understanding potential barriers and facilitators is necessary to prepare implementation. Registration: https://osf.io/qgr7y

This study contributes to existing research on gender inequities in living donor liver transplantation (LDLT) by employing a feminist and sociocultural theoretical perspective. Through participant observation and in-depth interviews with 36 participants from 13 families, including 13 donors, 10 recipients, and 13 caregivers, at the Chang Gung Memorial Hospital, this study provides a nuanced understanding of the complexities of family dynamics and gender relations throughout the decision-making and meaning-making processes for LDLT in Taiwan. The interviews were transcribed verbatim, translated from Mandarin to English, and analysed using grounded theory and thematic analysis. The findings reveal that LDLT is a gendered experience embodied through four aspects: 1) the impact of family dynamics and gender politics on decision-making, 2) societal and cultural perceptions of women's bodies and families, 3) the multiple roles and multifaceted care work of female caregivers, and 4) gender differences in the discourse on the meaning-making of LDLT. The study illuminates the complex interplay of family, gender, and care within the sociocultural landscape of Taiwan. It underscores the gendered and hierarchical division of care work within households and the vulnerability experienced by female caregivers and donors, as well as other disadvantaged family members. Furthermore, the study offers insights for healthcare professionals and policymakers to recognise the value of caregiving and the need for more support and resources for caregivers. Future research could adopt a multifaceted approach and inform interventions and policies aimed at reducing gender inequities in LDLT, moving beyond the narrow focus on numerical gender imbalance.

Objectives: Disclosure of bad news is distressing for patients and family members. Our aim was to assess patients' perceptions and preferences regarding bad news in the health setting. Methods: Cross-sectional, multi-centered study supported by an external grant in 15 Government and Private Hospitals across Pakistan. A sample size of 1673 patients and family members was used. Ethics permission/consent was taken from each participating hospital and participant. Responses were compared across provinces, gender, age, education and income. Results: >80% patients preferred their relatives to know the diagnosis first and they wanted the news to be disclosed to them by doctors. Significant association between education level, income and preference for wanting to know the diagnosis was found. Reasons for wanting to know the diagnosis included treatment, prognosis and prevention options whereas reasons for not wanting to know included fear of emotions and God's will. Conclusion: The majority of Pakistani patients want to be informed and want the family to know first. Preferences for disclosure vary across, age, education and income level. Innovation: First countrywide study on this topic. Identifies need for culturally sensitive guidelines that include the family's role in disclosure of bad news.

Objectives: This study aimed to investigate colorectal cancer-related knowledge, health beliefs, and screening behaviour in first-degree relatives (FDRs) of patients with Lynch syndrome-associated colorectal cancer (CRC) and explore the predictive factors of screening behaviour based on a health belief model. Methods: This cross-sectional study was conducted in the colorectal department of a Class A tertiary hospital in Guangzhou from December 2017 to December 2019. A total of 265 FDRs of 96 patients with Lynch syndrome-related CRC were selected. The study was conducted in the colorectal department of a tertiary cancer centre in Guangzhou. The demographic questionnaire, the simplified CRC knowledge questionnaire, and the Champion’s Health Belief Model Scale were used for evaluation. Data were analyzed using statistical description, between-group comparisons, and binary logistic regression. Results: A total of 160 (60.4%), 61 (23.0%), and 44 (16.6%) of the participants had high, medium, and low levels of knowledge about CRC, respectively; the average overall score of health belief was 121.36 ± 13.02. Sixty-one participants (23.0%) underwent Lynch syndrome-associated cancer screening. The predictive factors of screening behaviour included sex (male), age (older), married status (married), multiple primary cancers of the index patients, and high levels of knowledge and health beliefs (P

Objectives: This study aimed to identify the relationship between nurses’ perceived self-confidence in performing family-witnessed resuscitation and the implementation of the practice among nurses and to describe nurses’ preferences regarding family-witnessed resuscitation practice. Methods: This study was a cross-sectional survey. A stratified random sampling design was used to obtain study participants from various units within the medical-surgical departments of the hospital. Data was collected using the Family Presence Self-confidence Scale designed by Twibel et al. Chi-square test and binary logistic regression were used to analyze the association between levels of perceived self-confidence and the implementation of family-witnessed resuscitation practice. Results: There was a significant association between nurses’ perceived self-confidence (χ2 = 8.06, P = 0.01) and the implementation of family-witnessed resuscitation practice. The nurses who were quite/very confident were 4.9 times more likely to perform witnessed resuscitation than those who were somewhat confident (OR = 4.94, 95% CI 1.07–22.71) Conclusion: The perceived self-confidence in performing family-witnessed resuscitation varied widely among nurses. To achieve successful implementation of family-witnessed resuscitation practice, medical-surgical nurses should get higher levels of perceived self-confidence in the presence of patients’ families through advanced specialized training and practice on resuscitation.

Summary: Ebstein’s anomaly is a rare congenital heart disease characterized by tricuspid valve downward displacement and is associated with additional cardiac phenotypes such as left ventricle non-compaction. The genetic basis of Ebstein’s anomaly has yet to be fully elucidated, although several genes (e.g., NKX2-5, MYH7, TPM1, and FLNA) may contribute to Ebstein’s anomaly. Here, in two Ebstein’s anomaly families (a three-generation family and a trio), we identified independent heterozygous nonsense variants in laminin subunit 3 α (LAMA3), cosegregated with phenotypes in families with reduced penetrance. Furthermore, knocking out Lama3 in mice revealed that haploinsufficiency of Lama3 led to Ebstein’s malformation of the tricuspid valve and an abnormal basement membrane structure. In conclusion, we identified a novel gene-disease association of LAMA3 implicated in Ebstein’s anomaly, and the findings extended our understanding of the role of the extracellular matrix in Ebstein’s anomaly etiology.

Background: Data and interventions are lacking for family-centred perioperative care in adults. Perioperative information given to relatives by nurses or surgeons is associated with improved satisfaction and fewer symptoms of anxiety for relatives and the patient themselves. However, the frequency of the provision of information by anaesthesiologists to patients' relatives during surgery has never been reported. Methods: A cross-sectional survey was sent to French anaesthesiologists in October 2020 to inquire how often they provided information to patients' family members during surgery and what factors led to them providing information frequently (i.e. in more than half of cases). Results: Among 607 anaesthesiologists, 53% (319/607) were male, with median age 47 (36–60) yr and nearly half (43%, 260/607) reported more than 20 years of clinical experience; most responders (96%, 580/607) mainly treated adults. Forty-nine (8%) anaesthesiologists declared that they frequently provide information to relatives during surgery. After multivariate analysis, age >50 yr, female gender, and paediatric practice were associated with providing information more frequently. Reasons for not providing information included a lack of time and dedicated space to talk to relatives. Urgent surgery or surgery lasting >2 h were identified as factors associated with provision of information to relatives. Conclusions: Giving information to relatives during surgery is not a common practice among anaesthesiologists. It depends on individual anaesthesiologists' personal characteristics and practice. Information during surgery could be provided systematically in situations identified as being the most important by anaesthesiologists in our survey. By creating new pathways of information, we could reduce stress and anxiety of patients and relatives.

Older adults’ risk from COVID-19 led many, especially in the first year of pandemic, to travel less frequently and take shorter trips. Studies document declines in driving and walking, but fewer examine cycling and getting rides from others. Moreover, few explore how people felt about these changes. Using data from a survey of Floridians aged 50 or older (n = 4,145), we compare use of various transportation modes – driving, walking, cycling, and getting rides from family and friends – before the start of the pandemic and during its first year. Results revealed declines in driving but little overall change in walking and cycling. Results also indicated that rides from others declined, especially rides with friends compared with family. Analysis of responses to an open-ended item revealed positive and negative assessments of these changes.

Given the high fatality rate due to road traffic accidents in China, understanding the factors influencing aggressive driving behaviors among Chinese drivers is essential to alleviate the problem. The paper describes a dataset of 1039 Chinese drivers’ driving behaviors and the socio-cultural factors associated with the behaviors. The dataset was collected through an online survey. The dataset comprises five main categories: 1) driving information, 2) aggressive driving behaviors, 3) friend/peer influence, 4) family influence, and 5) socio-demographic information. The dataset is valuable for public health and transportation researchers to explore factors influencing drivers’ driving behaviors and public safety in China. The dataset's construct validity was confirmed by the Bayesian Mindsponge Framework (BMF) analytics. Specifically, the analysis shows that safe driving behaviors are affected by information promoting safe driving that is passively and actively absorbed from friends/peers (friends/peers being role models and friends’/peers’ support, respectively). The result is consistent with the Mindsponge Theory's information-processing mechanism in human minds.

Background: Mental disorders can significantly impact children's lives and affect their emotional, cognitive, and behavioral development. Family support and care is critical to the well-being of children, particularly children with mental disorders. However, given the “gap” between research and practice“,” there have been very few studies in the Arab region that focus on the role of the family in supporting children with mental disorders. The study also examines how families cope with caring for a person with mental disorders and what behaviors may influence the patient's distress. In addition, the study will examine the importance of family rehabilitation and integration of people with mental disorders into society. Methods: The study adopts the descriptive-analytical method and uses a questionnaire to gather data from the participants. The 350-parents sample (with 113 boys, 237 girls) was selected from the Shafallah Center for Integrating People with Disability. Morgan's law is used to determine the sample size. Results: The results show that there are statistically significant differences in the role of family members in supporting people with mental disorders due to two variables: Gender and Work. Age has no statistically significant effect on the role of family members in supporting people with mental disorders. Conclusion: This study is the first study conducted to investigate the role of family in supporting children with mental disorders in the Gulf Cooperation Council (GCC) in general and Qatar in particular. The results show that families should cope with the needs of a person with a mental disorder. Family rehabilitation is important in the care of people with mental disorders. There are certain behaviors of family members that can increase or decrease stress for the person. The results suggest that the family plays an essential role in supporting and promoting the lives of people with mental disorders and recommending effective ways to cope with them.

Children’s overweight is strongly associated with family socioeconomic position (SEP) and family characteristics (FC). There is limited research on the extent to which FC account for a socioeconomic gradient in childhood overweight. This study examined whether FC explain SEP differences in the prevalence of overweight. The study used baseline data of preschool-aged children from the German ‘PReschool INtervention Study’. The sample (n = 872, 48% girls) was recruited at kindergartens in Baden-Württemberg, Germany. Data included children’s measured weight status and parents’ reports on socioeconomic indicators (e.g., school education, vocational education, income) and FC. Variables represent main determinants of overweight (nutrition: sweets consumption in front of TV, soft drink consumption, regular breakfast, child sets table; physical activity: outdoor sports; parental role model). In single mediation analyses indirect effects of SEP on overweight were analysed (OR[95%CI]). Preschool girls and boys with low parental education had higher odds for overweight than children with high parental education. Among boys, low levels of parental education contributed to the odds of overweight via indirect effects by both factors ‘sweets consumption in front of TV’ (OR = 1.31[1.05–1.59]) and ‘no sports’ (OR = 1.14[1.01–1.38]). Among girls, FC measured did not explain SEP differences in overweight. Family nutrition and parental/family physical activity contribute to inequalities in overweight among preschool boys, but not girls. Research is needed to identify FC that explain inequalities in overweight for both.

Summary: Background: There is a strong societal belief that parents are role models for their child's dietary behaviours in early life that may persist throughout the life course. Evidence has shown inconclusive dietary resemblance in parent-child (PC) pairs. This systematic review and meta-analysis aimed to examine dietary resemblance between parent and children. Methods: We systematically searched for studies on PC dietary resemblance, via six electronic databases (PubMed, Ovid MEDLINE, Embase, APA PsycNet, CINAHL, and Web of Science) and other grey sources of literature between 1980 and 2020. We performed quality effect meta-analysis model on transformed correlation coefficients (z) to examine the resemblance in dietary intakes including nutrient intakes, food group intakes and whole diet. Finally, the Fisher's transformed coefficient (z) was used for meta-regression analysis to identify potential moderators. Heterogeneity and inconsistency were examined using the Q and I2 statistic. The study is registered on PROSPERO, CRD42019150741. Findings: A total of 61 studies met the inclusion criteria for systematic review, 45 were included in the meta-analysis. Pooled analyses showed weak to moderate PC dietary intake associations for energy: (r: 0.19; 95% CI: 0.16, 0.22), fat (% energy): (r: 0.23; 95% CI: 0.16, 0.29), protein (% energy): (r: 0.24; 95% CI: 0.20, 0.27), carbohydrate (% energy): (r: 0.24; 95% CI: 0.19, 0.29), fruits and vegetable (g/d): (r: 0.28; 95% CI: 0.25, 0.32), confectionary food (g/d): (r: 0.20; 95% CI: 0.17, 0.23), and whole diet (r: 0.35; 95% CI: 0.28, 0.42). Dietary intakes associations by study characteristics, including population, study year, dietary assessment method, person reporting dietary intake, quality of the study, and study design were highly variable, but associations were similar between PC pairs. Interpretation: The resemblance among parent-child pairs was weak to moderate for most aspects of dietary intakes. These findings challenge the social myth that parental dietary intake behaviour shapes their child's dietary intake. Funding: None.

Background: Alaska Native and American Indian (ANAI) communities in Alaska are disproportionately affected by commercial tobacco use. Financial incentive interventions promote cigarette smoking cessation, but family-level incentives have not been evaluated. We describe the study protocol to adapt and evaluate the effectiveness and implementation of a remotely delivered, family-based financial incentive intervention for cigarette smoking among Alaskan ANAI people. Methods: The study has 3 phases: 1) qualitative interviews with ANAI adults who smoke, family members, and stakeholders to inform the intervention, 2) beta-test of the intervention, and 3) randomized controlled trial (RCT) evaluating intervention reach and effectiveness on verified, prolonged smoking abstinence at 6- and 12-months post-treatment. In the RCT, adult dyads (ANAI person who smokes [index participant] and family member) recruited throughout Alaska will be randomized to a no-incentives control condition (n = 328 dyads) or a 6-month incentive intervention (n = 328 dyads). All dyads will receive cessation support and family wellness materials. Smoking status will be assessed weekly for four weeks and at three and six months. Intervention index participants will receive escalating incentives for verified smoking abstinence at each time point (maximum $750 total); the family member will receive rewards of equal value. Results: A community advisory committee contributed input on the study design and methods for relevance to ANAI people, particularly emphasizing the involvement of families. Conclusion: Our study aligns with the strength and value AIAN people place on family. Findings, processes, and resources will inform how Indigenous family members can support smoking cessation within incentive interventions. Clinical Trials Registry: NCT05209451

Social connectedness is essential for health and longevity, while isolation exacts a heavy toll on individuals and society. We present U.S. social connectedness magnitudes and trends as target phenomena to inform calls for policy-based approaches to promote social health. Using the 2003–2020 American Time Use Survey, this study finds that, nationally, social isolation increased, social engagement with family, friends, and ‘others’ (roommates, neighbors, acquaintances, coworkers, clients, etc.) decreased, and companionship (shared leisure and recreation) decreased. Joinpoint analysis showed that the pandemic exacerbated upward trends in social isolation and downward trends in non-household family, friends, and ‘others’ social engagement. However, household family social engagement and companionship showed signs of progressive decline years prior to the pandemic, at a pace not eclipsed by the pandemic. Work hours emerged as a structural constraint to social engagement. Sub-groups allocated social engagement differently across different relationship roles. Social engagement with friends, others, and in companionship plummeted for young Americans. Black Americans experienced more social isolation and less social engagement, overall, relative to other races. Hispanics experienced much less social isolation than non-Hispanics. Older adults spent more time in social isolation, but also relatively more time in companionship. Women spent more time with family while men spent more time with friends and in companionship. And, men's social connectedness decline was steeper than for women. Finally, low-income Americans are more socially engaged with ‘others’ than those with higher income. We discuss potential avenues of future research and policy initiatives that emerge from our findings.

Postoperative mortality in Africa is twice that of wealthier countries. The SMARTER trial underscores this critical issue and aims to address the high mortality rates by harnessing a readily available resource requiring minimal funding. Conducted in Mbale, Uganda, this innovative trial trained family members to monitor basic vital signs following surgery. This task is usually performed by healthcare workers who are often a limited resource in low- and middle-income settings. Although the results demonstrate a potential for increasing the capacity to rescue in the postoperative period, there is a need for further research to assess real-world effectiveness. Any improvement in patient monitoring would be limited by the system's capacity to respond effectively to escalations made by family members and the possible inaccuracy of their monitoring. Intervening earlier in the preoperative pathway can reduce the need to rescue postoperatively, but the SMARTER intervention has the potential to contribute to the larger effort needed to reduce surgical deaths globally in resource-limited settings., Competing Interests: Declaration of interest The authors declare no conflict of interest., (Copyright © 2024. Published by Elsevier Ltd.)

Objectives: Decision models for economic evaluation are increasingly including health-related quality of life (HRQoL) for informal/unpaid carers, but these estimates often come from poor quality data and typically rely on cross-sectional analysis. We aimed to identify within-person effects using longitudinal analysis of 13 waves of Understanding Society (the UK Household Longitudinal Survey)., Methods: We analyzed data for coresident carer and care-recipient dyads, where the carer reported "looking after or giving special help to" the care recipient in any of the 13 waves. We used fixed-effects models to study the effects of caring for the care recipient (the "caregiving" effect) using volume of care (hours per week) and continuous duration of caregiving (years) and caring about the care recipient (the "family" effect) using the care recipient's HRQoL on the carer's HRQoL. HRQoL was measured using the Short Form 6 Dimension, calculated from the Short Form 12., Results: We found consistent evidence for the family effect: improving care recipient's HRQoL by 0.1 would improve carer's HRQoL by approximately 0.012. We also consistently found evidence of a small but statistically significant decrement to carer's HRQoL for each additional year of caring. These findings were robust to scenario analyses. Evidence for the relationship between volume of care and carer's HRQoL was less clear., Conclusions: We propose that our estimates can be used to populate economic models to predict changes in carers' HRQoL over time and allow disutilities to be estimated separately for the family and caregiving effect., Competing Interests: Author Disclosures Author disclosure forms can be accessed below in the Supplemental Material section., (Copyright © 2025. Published by Elsevier Inc.)

Introduction: Social relationships offer the opportunity to provide support and resources to others. Feeling needed and useful to others has been understudied during adolescence, despite being shown to predict health and well-being during adulthood. The current study examined this underappreciated way in which family and peer relationships may shape psychological well-being during adolescence., Method: A cross-sectional sample of high school students across the United States completed an on-line questionnaire during school hours in the fall of 2020. The sample consisted of 1301 adolescents averaging 15.94 (SD = 1.24) years in age in the ninth through twelfth grades, with 48.4% identifying as female, 47.3% as male, and 3.2% reporting either other gender identities or preferring not to answer (1%). Participants identified as Hispanic or Latino (40.2%), European American (19.8%), African American (14.7%), Multiethnic (9.2%), Asian American (7%), Other Ethnicities (7.8%), and 1.3% did not report their ethnicity., Results: Feeling needed and useful was predicted by both helping and receiving support from others, strongly predicted better psychological well-being, and mediated associations of helping and receiving support with well-being. Males reported feeling more needed by their family as compared to females, and both reported higher levels of being useful to their family than those with other gender identifications., Conclusions: Like adults, adolescents have a need to contribute and feel needed in their social worlds. Studies of close relationships should incorporate the ways in which youth provide resources and support to others in their lives as well as the sense of feeling needed and useful derived from those activities., (© 2024 Foundation for Professionals in Services to Adolescents.)

Introduction: Compulsory drug rehabilitation continues to be a major governmental response to illicit drug use in East and Southeast Asia despite repeated calls for its discontinuation. Extensive evidence from individuals with substance use disorders and advocacy groups highlights the adverse health, social and economic outcomes associated with compulsory drug rehabilitation. However, the perspective of families on this issue remains relatively unexplored., Method: Between April 2020 and August 2022, we conducted in-depth interviews in three major cities in Vietnam with 20 family members of people who recently returned from or were about to leave compulsory drug rehabilitation centers. Interviews explored how compulsory rehabilitation met the needs of families, how effective families perceived compulsory rehabilitation was and what families' needs or concerns that remained unmet., Results: Compulsory drug rehabilitation centers, despite their recognized limitations, were perceived as the last resort for family members after multiple failed attempts to protect their loved ones from the consequences of drug use and to relieve themselves from constant drug-related stress. Family members considered the effectiveness of compulsory rehabilitation to be the short-term improvements in the health and mood that their loved ones exhibited while in the centers. However, families predominantly worried about the risk of relapse after release and employed three main strategies consisting of conditional support, employment and close monitoring to prevent it. The support available to families to support recovery at post-release was severely limited., Conclusion: The study underscores the urgent need to alleviate the burden of drug use on families affected by substance use disorders. It is imperative to develop community-based and evidence-based rehabilitation options for PWUD and supportive services for their families., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Involving families in the planning and delivery of care to relatives living with a mental health disorder is beneficial to achieve optimal recovery and medication adherence, and to reduce decompensation and hospital readmission rates. However, in the specific context of forensic mental health, the involvement of families in the planning and dispensation of care to relatives has been difficult. The purpose of our study, which was conducted in Ontario, Canada, was to better understand the interactions between families and the forensic mental health system. To meet this objective, we used a qualitative methodology, namely interpretive phenomenology. We collected data from 17 family members of persons in the forensic mental health system through semi-structured interviews. Interviews were analysed using a three-pronged approach with a particular attention paid to the spatial, temporal, and interpersonal dimensions of families' lived experiences. In this article, we present our findings related to families' experiences with the Review Board, a mental health tribunal responsible for the legal management of patients in the forensic mental health system. We regrouped the experiences of family members in four overarching, and occasionally overlapping, categories: (1) Preparation for Review Board hearings; (2) Review Board hearing processes; (3) Information Discussed during Review Board hearings; and (4) Format of Review Board hearings. Among other things, our findings highlight that Review Boards are experienced by families as rubber-stamping exercises, and that Review Board panels lack sociodemographic diversity. These findings have implications for healthcare professionals and mental health tribunals in Canada and abroad., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objective: The onset of childhood diabetes necessitates that the child and family quickly must learn numerous self-management tasks. Diabetes education is key to successful self-management, and established diabetes-related habits are known to be difficult to change. Hence, the initial hospital-based diabetes education and support is a distinct opportunity to optimize habits and disease management. The aim of this study is to investigate parents' experiences with the education and support provided at the hospital when a child has been newly diagnosed with type 1 diabetes., Methods: Twenty semi-structured interviews were conducted with parents of children (0-18 years) newly diagnosed with type 1 diabetes. Inductive thematic analysis was used for data analysis., Results: Four overarching themes, each with its own implications were identified: 1) From a feeling of uncertainty toward a sense of perceived security 2) Certainty induces calmness 3) A balanced approach to diabetes 4) Trying to learn all about diabetes in just one week. The four themes stress the families' need of immediate reassurance from the health professionals., Conclusions and Practical Implications: The study sheds light on families' challenges during initial hospital-based diabetes education, offering insights for healthcare professionals to tailor support strategies and improve diabetes management., Competing Interests: Declaration of Competing Interest Four authors are employed at Steno Diabetes Center Copenhagen, a public hospital and research institution under the Capital Region of Denmark, which is partly funded by a grant from the Novo Nordisk Foundation. No conflicts of interest exist., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objectives: To assess the association between schoolchildren's consumption of ultra-processed foods (UPFs) and various lifestyle factors of their parents in Brazil., Study Design: Cross-sectional population-based study with parent-child dyads aged 6-11., Methods: The sample was distributed proportionally across Brazilian macro-regions and type of school. Recruitment utilized the snowball technique, and participants filled in an online questionnaire. Initially, parents provided data on education, eating practices, food consumption markers, screen time, and physical activity. Subsequently, their children reported their UPF consumption using the Illustrated Questionnaire on Food Consumption for Brazilian Schoolchildren. The UPF consumption among children was assessed using the NOVA score. Poisson's regression log-linear analysis was performed (p < 0.05) with adjustments for macro-regions, type of school (as a proxy for socioeconomic status), gender, and age of the child., Results: This study included a total of 2021 child-parent dyads. On average, children consumed 3.5 UPFs on the previous day. We found a significant association between high consumption of UPFs by the child and parents with less healthy eating practices (p < 0.05), excessive screen time (p < 0.05), and high UPF consumption (p < 0.05)., Conclusions: These findings demonstrate a relationship between Brazilian schoolchildren's consumption of UPFs and various lifestyle factors of their parents, particularly regarding eating practices, food consumption markers, screen time, and physical activity. This underscores the importance of the home food environment in shaping children's health during this critical developmental stage of life, emphasizing the need to incorporate support for family lifestyle factors into public health policies., (Copyright © 2024 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

We investigate whether neural, cognitive, and psychopathology phenotypes that are more strongly related to genetic differences are less strongly associated with family- and state-level economic contexts (N = 5374 individuals with 1KG-EUR-like genotypes with 870 twins, from the Adolescent Behavior and Cognitive Development study). We estimated the twin- and SNP-based heritability of each phenotype, as well as its association with an educational attainment polygenic index (EA PGI). We further examined associations with family socioeconomic status (SES) and tested whether SES-related differences were moderated by state cost of living and social safety net programs (Medicaid expansion and cash assistance). SES was broadly associated with cognition, psychopathology, brain volumes, and cortical surface areas, even after controlling for the EA PGI. Brain phenotypes that were more heritable or more strongly associated with the EA PGI were not, overall, less related to SES, nor were SES-related differences in these phenotypes less moderated by macroeconomic context and policy. Informing a long-running theoretical debate, and contra to widespread lay beliefs, results suggest that aspects of child brain development that are more strongly related to genetic differences are not, in general, less associated with socioeconomic contexts and policies., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Existing literature highlights that posttraumatic stress disorder (PTSD) after military deployment not only affects the formerly deployed veteran, but when the veteran has a family, has detrimental effects on the entire family. While research suggests that social support can have a positive mediating effect on the impact of PTSD, we know little about how veteran families experience the impact of PTSD, and how this relates to their experiences of formal and informal social support. Drawing on a hermeneutic phenomenological framework, we addressed this gap by exploring perceptions and experiences of formal and informal social support in six Danish veteran families. We found veteran families to be closely involved with formal and informal social support structures. However, the social support available did not always match their needs or understandings of helpful social support. Some families experienced an overload of social support or perceived the provided social support as inappropriate or prescribed. We construe these three types of social support as misguided social support—support that did little to meet their actual needs—on the contrary. We discuss how families come to experience and understand social support as an overload, or as inappropriate or prescribed; and what it takes for social support not to be experienced as misguided. We suggest that in order to meet families’ social support needs, tailored social support and improved collaboration between (in)formal social support structures and veteran families may promote more meaningful social support of veteran families affected by PTSD.

Background: Adolescent substance use is a significant issue which occurs during a critical period of life of youth. Perceived stress is a risk factor for adolescent substance use, and life events such as low family support, and community and familial turmoil often lead to ongoing feelings of stress and uncertainty. Similarly, structural factors such as poverty, local neighborhood disinvestment and disrepair, and exposure to racism and discrimination are linked to feelings of stress. The US-Mexico border region is favorable for drug smuggling. Such a context exacerbates stressful life events during adolescence and increases the risk of adolescent substance use. This study aims to investigate the impact family support has on substance use in adolescents living on either side of the U.S./Mexico border who self-reported high perceptions of disordered neighborhood stress, border community and immigration stress, or normalization of drug trafficking. Methods: This study used data from the cross-sectional BASUS survey. Logistic regression was used to study the association between family support and past 30-day use of alcohol, tobacco, marijuana, and any substance in a sample restricted to students who self-reported high perceptions of disordered neighborhood stress, border community and immigration stress, or normalization of drug trafficking. Results: Participants with low family support were at higher risk of using any substance compared to participants with high family support (aOR= 1.58, 95% CI: 1.02; 2.45). Similar results were found for alcohol (aOR= 1.79, 95% CI: 1.13, 2.83). While the odds of using tobacco were higher for those with low social support as compared to participants with higher social support, this association was not statistically significant (aOR = 1.74, 95% CI: 0.93, 3.27) Conclusion: Prevention programs tailored to the U.S.-Mexico border region should emphasize strengthening family support as a preventive factor against adolescent substance use. Family support should be considered in school counseling assessments, healthcare screenings and other social services.

This study aims to examine the complex relationship between child abuse and divorce within the Malaysian context, utilizing the ARDL approach. With a focus on the period spanning from 1989 to 2020, the primary objective was to uncover the dynamics underpinning the impact of child abuse on marital stability. The findings reveal that while female employment can positively influence divorce in the short run, this effect diminishes over the long run. Conversely, unemployment and poverty consistently positively impact divorce in the short and long run. Intriguingly, inflation emerges as a factor that can increase divorce rates in the long run. This research enriches the understanding of divorce determinants in Malaysia through a rigorous methodology and comprehensive analysis. The study's findings unveil a web of intriguing and sometimes unexpected connections between child abuse and divorce. Notably, the results demonstrate that the influence of child abuse on divorce extends to both short-term and long-term dynamics. This revelation underscores the urgency of addressing child abuse as a critical social issue and a potent determinant of family dissolution. By exposing the enduring link between child abuse and divorce, this research emphasises the need for comprehensive strategies to safeguard family cohesion and protect the well-being of children.

Family members are some of the most common sources of weight stigma reported by youth and adults with higher body weight; however, little is known about the ways in which weight stigma manifests from different family members. To better understand the nature of weight stigma by family members, the current study qualitatively examined women's retrospective accounts of these experiences. Participants were 410 U.S. adult women engaged in a commercial weight management program who described an experience of weight stigma by a family member in response to an open-ended survey question. Using an inductive qualitative coding approach, we identified 11 forms of weight stigma experienced across 15 family sources. For childhood experiences of stigma from family members, weight teasing was most common. In adulthood, participants most commonly described critical weight comments from family members. Overall, mothers were the most common source of weight stigma, followed by spouses/romantic partners, and references to ‘family’ generally. Across diverse family sources, participants described these stigmatizing experiences as having lasting negative ramifications. Together, these findings can inform interventions to reduce weight stigma in familial relationships.

A vast and growing body of research has shown that crime tends to run in families. However, previous studies focused only on traditional crimes and research on familial risk factors for cyber offending is very scarce. To address this gap in the literature, the present study examines the criminal behavior of the family members of a sample of cyber offenders prosecuted in the Netherlands. The sample consists of 979 cyber offenders prosecuted for computer trespassing between 2001 and 2018, and two matched groups of 979 traditional offenders and 979 non-offenders. Judicial information and kinship data from Dutch Statistics were used to measure criminal behavior among family members. Both traditional offenders and cyber offenders were found to be more likely to have criminal fathers, mothers, and siblings than non-offenders. Additional analyses, however, showed different patterns between cyber offenders who were only prosecuted for cyber offenses and those who also committed traditional crimes. While the former group of cyber offenders were similar to non-offenders in terms of family offending, the latter group of cyber offenders were more similar to traditional offenders. Overall, these results suggest that the traditional mechanisms of intergenerational transmission of crime can only partially explain cybercrime involvement.

Post-deployment posttraumatic stress disorder (PTSD) does not merely affect veterans. A growing body of literature highlights the detrimental impact of veteran PTSD on entire families. One area less studied pertains to how PTSD affects veterans’ parenting skills and engagement with social support structures in response to family struggles. Through an interpretative phenomenological analysis, we addressed this gap by drawing on qualitative research with six Danish veteran families affected by PTSD. We applied a theoretical lens of epiphanies as turning points to explore the interface between experiences of the impact of PTSD on the family system and support-seeking practices within the families’ social networks. Aided by Denzin’s notion of epiphany, we locate and report on the occurrence of four types of epiphanies that instigate help-seeking. The epiphanies reveal details about parents’ experiences of the effect of PTSD on family life, as well as their needs and responses to struggles of parenting and children’s distress. The epiphanies also serve as critical enablers of PTSD-affected veterans and their families’ engagement in support-seeking practices. Social support services aiming to help veteran families should consider how parenting experiences and epiphanies can mobilize pathways to social support.

Knowledge of family health history can help to mitigate risk for chronic non-communicable diseases known to run in families. However, disclosure of disease or illness is not always a given. This paper explores the relationship between care and intrafamilial communication regarding chronic health conditions in Ghanaian families, drawing on concepts of generativity and reciprocity. Data were drawn from a qualitative description study on family histories and health. This paper analyzes four focus group discussions and two intergenerational family interviews conducted among 35 older adults and their adult children and grandchildren in the Greater Accra Region of Ghana. Data were analyzed thematically using an inductive approach and themes relating to care and intrafamilial communication were assessed for this analysis. Findings showed that intergenerational care can serve as a means to disclose and communicate family health histories while disclosure of illness serves as a means to receive and give care for oneself and one's family. Furthermore, care services can sometimes be a barrier to communication of family health histories while concealment of disease and of family health histories and identities may be a form of care. Finally, intergenerational family health history discussions may prompt encouragement of care-seeking behaviors and preventive care. The results of this pilot study suggest avenues through which care arrangements could be capitalized on to promote the sharing of health history information within families to better manage chronic disease risk. In addition, they illustrate the potential for family health history discussions to further encourage care-seeking for chronic disease prevention.

Prevention of skin cancer involves decreasing exposure to ultraviolet radiation (UVR) and avoiding sunburn, especially early in life. Individuals living in urban versus rural areas, as defined by the Rural Urban Commuting Area (RUCA) code classification, have different risks for skin cancer, likely due to differing patterns of outdoor activities and preventive behaviors employed when outdoors. However, few studies have examined differences in outdoor activities between rural and urban individuals and examined this among both adults and children. This study compared the outdoor activities, sun protection strategies, tanning behaviors, and sunburn occurrence of adults and children (n = 97 dyads) in rural versus urban settings in a Western region of the United States. The relationships between outdoor activities and sunburn occurrence were examined in both groups. Analyses employed Barnard’s Exact Test and logistic generalized estimating equations models. Individuals in rural and urban areas reported differences in sun protection strategies used, tanning behaviors, and outdoor activities. Individuals in urban areas more commonly reported use of certain forms of sun protection, such as sunscreen and shade, whereas long pants and skirt wearing were more common for children in rural areas. Individuals in rural areas were more likely than those in urban areas to engage in farm work, yard work, and youth sports. Gender differences in these outcomes were also identified. Skin cancer preventive interventions could be tailored for rural and urban families to target sun protection strategies to outdoor activities and to situations in which sunburns are likely to occur.