Restricted Self-Transition: A Journey of Divorcees Through Lasting Marital Dissolution in Eastern European Society.

Although most empirical research has focused on divorcing individuals' experiences before or after marriage dissolution, how people understand and evaluate themselves during their lasting divorce processes has been largely understudied. We aimed to close this gap by learning how individuals regard their longer-lasting divorce process and how those experiences could relate to changes of self. Data were collected via semi-structured interviews and then analyzed by applying a grounded theory approach. Twenty-one research participants residing in Lithuania who were 6 months or more into their divorce processes (not living together or in a litigation process) participated in the study. By allowing participants to reflect on their ongoing divorce, data indicated three main categories illuminating the changes in self: temporal self-disruption, restricted self-transition, and transition-supporting strategies. These interconnected categories point toward complex paths of the divorcees from experienced losses toward a more stable and clear yet not finalized self-redefinition. Individuals' increased vulnerability, especially during the first years of the divorce, requires particular attention from child protection officers, lawyers, mediators, and other involved professionals. Unfortunately, support is often unavailable or refuted due to the perceived low effectiveness and lack of professionalism.

Do birds of a feather leave the nest together? The role of sibling personality similarity in the transition to adulthood.

Empirical evidences on intragenerational transmission of life course have been demonstrated and that interpersonal similarity may moderate the effect. In particular, siblings who are more similar in their demographic characteristics are more likely to follow each other's life course transitions. Focusing on parental home-leaving and building upon the social influence processes and similarity-attraction effects, this study investigates whether the association between siblings' departures from the parental home increases when they are similar in the Big Five personality traits, like similarity in demographic traits. We use 28 waves of a longitudinal sample from "Understanding Society: The U.K. Household Longitudinal Study". The results of the multilevel discrete-time event-history analysis (N = 3,717 children) indicate that the association between leaving of a sibling and oneself was strengthened when they had a similar level of extraversion, particularly when they were both introverts. This implies that although introverted adolescents and emerging adults might take less initiative regarding social relationships and be more hesitant in their transition to adulthood, when a similarly introverted sibling makes such a transition, they are more inclined to do so. To conclude, the study uncovers the relationship between siblings' personality similarity and their resemblance in nest-leaving, which helps explain young adults' home-leaving decision in an era when delayed leaving is observed.

Marital-history differences in increased loneliness during the COVID-19 pandemic: A European study among older adults living alone.

The COVID-19 pandemic and related physical distancing measures have disproportionally affected older adults living alone due to their greater social isolation. Unlike previous studies on the subject, the current research recognizes the diversity amongst older adults living alone by considering the impact of marital history. Combining information from Wave 8 of the Survey of Health Ageing and Retirement (SHARE), with data of SHARELIFE and the SHARE Corona survey, we investigated the differential impact of the COVID-19 pandemic on loneliness in older men (N = 1504) and women (N = 4822) living alone. Logistic multilevel analyses were performed on data from 26 European countries and Israel. For men, we found that the short-term widowed were more likely to report increased loneliness than the medium- and long-term widowed and those living apart together (LAT). For women, the results indicated that the short- and medium-term widowed and the divorced were at greater risk for increased loneliness than those in a LAT relationship. Also, medium-term widowed women were more likely to report increased loneliness than their long-term widowed counterparts. The three hypothesized underlying mechanisms - i.e., (i) the opportunity mechanism, (ii) the expectation mechanism, and (iii) the vulnerability mechanism - only played a small role in explaining the observed differences. In sum, our study highlights the importance of recognizing the diversity within the group of older adults living alone when investigating the effects of the pandemic on loneliness, yet the mechanisms behind the stratifying role of marital history are not fully understood.

Prevalence and incidence of chemotherapy-induced taste alterations in adult cancer patients: a systematic review protocol.

OBJECTIVE: This study will synthesize the available evidence on the prevalence and incidence of chemotherapy-induced taste alterations in adult cancer patients. INTRODUCTION: Taste and smell alterations in cancer patients due to chemotherapy affect patients' quality of life and can cause malnutrition. Recent knowledge about the incidence and prevalence of chemotherapy-induced taste alterations may enable tailored food interventions for this specific population. Describing variations in taste changes in subgroups of chemotherapy is important to inform taste steering interventions. INCLUSION CRITERIA: The review will consider studies that include adult cancer patients who are receiving or have received chemotherapy as a treatment for an oncologic issue. It will include studies that investigate the prevalence and incidence of chemotherapy-induced taste alterations that have been assessed objectively or subjectively by patient-reported outcomes. METHODS: A systematic search will be performed of the following databases: MEDLINE (PubMed), CINAHL (Ovid), Embase, and OpenSIGLE. Analytical, observational, and cross-sectional studies will be considered. All studies will undergo critical appraisal, data extraction, and synthesis. Data will be extracted using the JBI standardized data extraction tool for prevalence and incidence. Type and frequency of treatment and cytostatic agent will be extracted. The population will be described by age and gender. In addition, study methods and proportions of interest to the review question will be extracted. Pooled prevalence estimates will be calculated using a random effects model. SYSTEMATIC REVIEW: PROSPERO CRD42020136706.

A qualitative study about cancer outpatients' experiences with selective taste control of bread as a self-care intervention.

AIM: Alterations in taste are distressing side effects for cancer patients receiving chemotherapy. The Center for Gastrology (Belgium) developed a self-care intervention based on taste control. This intervention contains an assessment of the individual taste and food hedonics. It provides recipes based on the individual assessed hedonics profile, so patients can self-prepare personalized meals. This study aims to describe the experiences of oncologic patients with the home baking of personalized bread. DESIGN: A qualitative, descriptive design with individual semi-structured interviews was used. METHODS: In August 2018, eleven face-to-face interviews were conducted until data saturation. RESULTS: The analysis of the interviews revealed five major themes: "Stepping out of your role," "Having something positive to do," "gaining insight," "receiving recognition" and "practical limitations."

Nest leaver or home stayer? Sibling influence on parental home leaving in the United Kingdom.

Studies have suggested that the timing of leaving one's parental home can be influenced by a number of factors, such as gender, educational background, and parental characteristics. However, despite empirical evidence showing that siblings may influence one another's life course decisions, intragenerational effects on leaving home have not been adequately studied. In this study, we investigated the extent to which an event of a sibling leaving is associated with one's decision to leave the parental home and how demographic sibling characteristics may impact on the association. We also tested whether the number of siblings who left the parental home first is related to one's timing of leaving. Using data from "Understanding Society: The U.K. Household Longitudinal Study", we studied the process of leaving the parental home among 22,719 children and their siblings. The results indicated a positive relationship between leaving of a sibling and the own event of leaving. When siblings are brothers and have a small age gap, and when the nest-leaving sibling is older than the at-risk children, this relationship is even stronger. Finally, the more nest-leaving siblings one has, the less likely one is to stay at home. The findings provide evidence for cross-sibling effects on parental home leaving, underscoring the role of intragenerational associations with respect to life course events.

The female payer: Gender differences in characteristics among child support payers.

Nonresident mothers who formally pay child support are becoming increasingly prevalent. If the profile of female payers differs from that of men or if their payment is motivated differently, existing gender-based child support policies and enforcement strategies face significant challenges. This study uses the payment framework of male compliance to map the differences between male and female payers of child support. The analysis applies discriminant analysis to a combination of register and fiscal data of separated parents. Whereas the separate aspects of the payment framework did not reach the threshold for acceptable discrimination, the full model revealed considerable differences between male and female payers. The aspect of willingness to pay showed the greatest discriminating power, suggesting that paying mothers have a higher willingness to do so than fathers. We conclude that while the discrepancies between nonresident mothers and fathers who pay child support can be partly attributed to demographic differences and residency patterns of children, differing motivations are also of importance.

How do post-divorce paternal and maternal family trajectories relate to adolescents' subjective well-being?

Previous research on adolescents' well-being has focused mainly on the differences between married and divorced families. Recently, interest has shifted towards the cumulative effects of the various family transitions experienced by children. To contribute to this literature, we investigate the relationship of maternal and paternal family trajectories following divorce with adolescents' well-being by analyzing two dyadic subsamples of the 'Divorce in Flanders' study: mothers-adolescents (n = 515) and fathers-adolescents (n = 365). Results from the sequence analyses and structural equation models show that adolescents' well-being was lower if their mothers were in less stable partnership situations, namely if they had never repartnered, were in a LAT (living apart together) relationship or had had several relationships since their divorce. For fathers, the opposite result was found: adolescents' well-being was lower when their fathers were in seemingly stable partnership situations, i.e. if they had remarried or begun living with a new partner since their divorce.

HIV/AIDS Competent Households: Interaction between a Health-Enabling Environment and Community-Based Treatment Adherence Support for People Living with HIV/AIDS in South Africa.

In the context of severe human resource shortages in HIV care, task-shifting and especially community-based support are increasingly being cited as potential means of providing durable care to chronic HIV patients. Socio-ecological theory clearly stipulates that-in all social interventions-the interrelatedness and interdependency between individuals and their immediate social contexts should be taken into account. People living with HIV/AIDS (PLWHA) seldom live in isolation, yet community-based interventions for supporting chronic HIV patients have largely ignored the social contexts in which they are implemented. Research is thus required to investigate such community-based support within its context. The aim of this study is to address this research gap by examining the way in which HIV/AIDS competence in the household hampers or facilitates community-based treatment adherence support. The data was analyzed carefully in accordance with the Grounded Theory procedures, using Nvivo 10. More specifically, we analyzed field notes from participatory observations conducted during 48 community-based treatment adherence support sessions in townships on the outskirts of Cape Town, transcripts of 32 audio-recorded in-depth interviews with PLWHA and transcripts of 4 focus group discussions with 36 community health workers (CHWs). Despite the fact that the CHWs try to present themselves as not being openly associated with HIV/AIDS services, results show that the presence of a CHW is often seen as a marker of the disease. Depending on the HIV/AIDS competence in the household, this association can challenge the patient's hybrid identity management and his/her attempt to regulate the interference of the household in the disease management. The results deepen our understanding of how the degree of HIV/AIDS competence present in a PLWHA's household affects the manner in which the CHW can perform his or her job and the associated benefits for the patient and his/her household members. In this respect, a household with a high level of HIV/AIDS competence will be more receptive to treatment adherence support, as the patient is more likely to allow interaction between the CHW and the household. In contrast, in a household which exhibits limited characteristics of HIV/AIDS competence, interaction with the treatment adherence supporter may be difficult in the beginning. In such a situation, visits from the CHW threaten the hybrid identity management. If the CHW handles this situation cautiously and the patient-acting as a gate keeper-allows interaction, the CHW may be able to help the household develop towards HIV/AIDS competence. This would have a more added value compared to a household which was more HIV/AIDS competent from the outset. This study indicates that pre-existing dynamics in a patient's social environment, such as the HIV/AIDS competence of the household, should be taken into account when designing community-based treatment adherence programs in order to provide long-term quality care, treatment and support in the context of human resource shortages.

Families in transition: A literature review.

Research on the transgender population is often limited to their medical care, and in particular to their mental well-being. The social and family environment in which a social gender role transition takes place is often overlooked. Although research is limited, this article reviews the existing literature on the family aspect of a gender transition. Articles regarding three different aspects were selected for this review: first, the issue of parenthood during transition and the experiences of children with a transgender parent, second, the experiences of partners and ex-partners of transgender individuals, and third, the experiences of parents with a gender variant child. Articles were restricted to those with a focus on family members and situations during transition. For all three contexts, several mediating factors, both individual and social, were distinguished. Various challenges for future research were identified.

On the road to HIV/AIDS competence in the household: building a health-enabling environment for people living with HIV/AIDS.

When aiming to provide chronic disease care within the context of human resource shortages, we should not only consider the responsibility of the individual person living with HIV/AIDS (PLWHA) but also the capacity of the social environment to actively encourage a lifestyle that fosters health. In this social environment, extensive efforts are thus required to increase HIV/AIDS knowledge, reduce stigma, stimulate HIV testing, improve health care-seeking behavior, and encourage safe sexual practices-described in the literature as the need for AIDS competence. In accordance with socio-ecological theory, one cannot restrict the research focus to communities, as AIDS competence studies should also incorporate the intermediate household level. In responding to this research need, the aim of this article is to conceptualize an "HIV/AIDS competent household" based on qualitative interviews and focus group discussions conducted in a township on the outskirts of Cape Town, South Africa. Our results show that a household's supportive response to disclosure allows a patient to live openly as HIV positive in the household concerned. This may mark the start of the road to HIV/AIDS competence in the household, meaning the PLWHA receives sustainable support throughout the care continuum and positive living becomes the norm for the PLWHA and his or her household. A feedback loop might also be created in which other household members are encouraged to be tested and to disclose their status, which is an important step towards a sustainable response to HIV/AIDS-related challenges. Despite the fact that this road to HIV/AIDS competence at the household level is fragile and prone to various barriers, this article shows that the household has the potential to be a health-enabling environment for PLWHA.

The impact of community support initiatives on the stigma experienced by people living with HIV/AIDS in South Africa.

In the current context of human resource shortages in South Africa, various community support interventions are being implemented to provide long-term psychosocial care to persons living with HIV/AIDS (PLWHA). However, it is important to analyze the unintended social side effects of such interventions in regards to the stigma felt by PLWHA, which might threaten the successful management of life-long treatment. Latent cross-lagged modeling was used to analyze longitudinal data on 294 PLWHA from a randomized controlled trial (1) to determine whether peer adherence support (PAS) and treatment buddying influence the stigma experienced by PLWHA; and (2) to analyze the interrelationships between each support form and stigma. Results indicate that having a treatment buddy decreases felt stigma scores, while receiving PAS increases levels of felt stigma at the second follow up. However, the PAS intervention was also found to have a positive influence on having a treatment buddy at this time. Furthermore, a treatment buddy mitigates the stigmatizing effect of PAS, resulting in a small negative indirect effect on stigma. The study indicates the importance of looking beyond the intended effects of an intervention, with the goal of minimizing any adverse consequences that might threaten the successful long-term management of HIV/AIDS and maximizing the opportunities created by such support.

Adult non-response bias from a child perspective. Using child reports to estimate father's non-response.

Most parenting research on paternal involvement uses data from a father perspective. Nevertheless, research on bias in father non-response is scarce. In this study, we examine the non-response bias of fathers, hypothesizing that fathers who engage in parenting studies might already be fathers who are more involved with their children than fathers who do not engage in these studies. Furthermore, we expect a double non-response bias by socio-demographic characteristics of the father, which impacts both paternal participation as well as paternal involvement. Using the multi-actor dataset from the "Divorce in Flanders"-project, which provides data from children whose fathers actually participated (N=461) as well as data from children whose fathers did not (N=137) with children reporting on paternal involvement, we are able to test our hypotheses. Results confirm our first hypothesis, indicating that non-participating fathers are significantly more uninvolved than participating fathers. Regarding our second hypothesis, an indirect effect of father's educational level and age on non-response was revealed for one out of three indicators of paternal involvement.

Families as catalysts for peer adherence support in enhancing hope for people living with HIV/AIDS in South Africa.

INTRODUCTION: Hope is an essential dimension of successful coping in the context of illnesses such as HIV/AIDS, because positive expectations for the future alleviate emotional distress, enhance quality of life and have been linked to the capacity for behavioural change. The social environment (e.g. family, peers) is a regulator of hope for people living with HIV/AIDS (PLWHA). In this regard, the dual aim of this article is (1) to analyze the influence of a peer adherence support (PAS) intervention and the family environment on the state of hope in PLWHA and (2) to investigate the interrelationship between the two determinants. METHODS: The Effective AIDS Treatment and Support in the Free State study is a prospective randomized controlled trial. Participants were recruited from 12 public antiretroviral treatment (ART) clinics across five districts in the Free State Province of South Africa. Each of these patients was assigned to one of the following groups: a control group receiving standard care, a group receiving additional biweekly PAS or a group receiving PAS and nutritional support. Latent cross-lagged modelling (Mplus) was used to analyse the impact of PAS and the family environment on the level of hope in PLWHA. RESULTS: The results of the study indicate that neither PAS nor the family environment has a direct effect on the level of hope in PLWHA. Subsequent analysis reveals a positive significant interaction between family functioning and PAS at the second follow-up, indicating that better family functioning increases the positive effect of PAS on the state of hope in PLWHA. CONCLUSIONS: The interplay between well-functioning families and external PAS generates higher levels of hope, which is an essential dimension in the success of lifelong treatment. This study provides additional insight into the important role played by family dynamics in HIV/AIDS care, and it underscores the need for PAS interventions that are sensitive to the contexts in which they are implemented.

Individual and institutional push and pull factors as predictors of retirement timing in Europe: A multilevel analysis.

The number of retired people in Europe has increased significantly in recent decades. It remains unclear, however, whether individuals are more likely to be pulled toward retirement by their expectations about life after retirement than they are to be pushed out of the labour market due to poor health or dislike of one's job. The fact that retirement timing differs rather considerably between European countries suggests that not only micro, but also macro push (i.e. labour market constraints) and pull (i.e. economic incentives) factors influence retirement decisions. This duality heightens the need to determine the influence of micro-level and macro-level push and pull indicators on the retirement timing of older workers (50+) in Europe. Results are obtained performing multilevel event history analysis using longitudinal micro data from the first (2004/05) and second (2006/07) waves of the Survey of Health, Ageing and Retirement in Europe and macro data derived from the Organisation for Economic Cooperation and Development (OECD) and Eurostat. The results indicate that at the individual level, older workers are pushed out due to health problems as well as being attracted towards retirement to spend time with their grandchildren. At the institutional level, financial incentives such as a high implicit tax on continued work and high expenditures on early exit schemes make retirement attractive, whereas the institutional push context is of lesser importance.

The influence of mothers' and fathers' parenting stress and depressive symptoms on own and partner's parent-child communication.

This study examines how parenting stress and depressive symptoms experienced by mothers and fathers influence their own (actor effects) and the partner's (partner effects) parent-child communication. Based on the Actor-Partner Interdependence Model, data from 196 families were analyzed, with both parents rating their parenting stress and depressive feelings, and parents as well as children rating the open parent-child communication. Actor effects were found between parenting stress and open parent-child communication, whereas partner effects were prominent between depressive symptoms and open parent-child communication. The results provide no evidence for gender differences in the strength of the pathways to open parent-child communication. Our findings demonstrate the need to include both parents in studies on parent-child communication to enhance our understanding of the mutual influence among family members.

'More shades of grey in my answers': an interview study revisiting attitude erosion during clerkships.

CONTEXT: Small declines in patient-centred attitudes during medical education have caused great concern. Although some of the self-report scales applied have solid psychometric foundations, validity evidence for the interpretation of attitude erosion during clerkships remains weak. OBJECTIVES: We sought to address this gap in a qualitative study of the relationships between scores on four commonly used attitude scales and participants' experiences and reflections. Our aim was to gain a better understanding of the score changes from the participants' perspectives. METHODS: We conducted semi-structured interviews with 15 junior doctors from a cohort (n = 37) that had previously shown a small decline in patient-centred attitudes during clerkships, measured on four self-report scales. In the interviews, we explored interviewees' experiences of their development of patient-centredness and subsequently discussed their scale scores, particularly for those items that contributed to a rise or decline in scores. We analysed the data using a process of constant comparison among personal experiences, scale scores and participants' explanations of score changes, applying the coding techniques of grounded theory. RESULTS: The analysis revealed important response distortions that might be responsible for small declines in scores during clerkships separately from changes in attitudes. The drastic alterations to the participants' frame of reference, attributable to the transition to clinical practice, represented the most prominent cause of distortion. More nuanced, context-specific, patient-centred reasoning resulted in more neutral responses after clerkships, paradoxically causing a decline in scores. In addition to response distortions, the interviews revealed shortcomings in content validity such as an 'extreme' construct of patient-centredness. CONCLUSIONS: This study calls into question the validity of the interpretation of attitude erosion during clerkships. The findings suggest that small declines in scores on self-report attitude scales are related to a recalibration of trainees' understandings of patient-centredness as they grow more clinically experienced. The evolved construct of patient-centredness and the way attitudes are measured require special attention in the development of future instruments.

The age-dependent influence of self-reported health and job characteristics on retirement.

OBJECTIVES: Social scientists and economists doubt the usefulness of self-reported health status as an indicator of overall health status. Self-reported health acts as a justification for retirement when this decision is in reality driven by other reasons. In this study, we looked at income, job satisfaction, and job status. METHODS: We introduce a survival model (Cox model) that simultaneously includes both health and job characteristics as independent variables. We also take the age-dependent character of these effects into account. RESULTS: An analysis of the European Community Household Panel data did not validate the justification bias with respect to these variables. The addition of job characteristics had no influence on the effect estimates of self-reported health. CONCLUSIONS: We found significant effects for self-reported health as well as for objective health measures. The addition of job characteristics did not contribute to the explanation of the effect of self-reported health falsifying the justification bias hypothesis.

Parenting of divorced fathers and the association with children's self-esteem.

Research suggests that high parental support and control improves children's well-being. However, a large part of these studies have focused on the parenting of married parents. Research on parenting after a divorce, mainly has focused on parenting of divorced mothers, with few exceptions concentrating primarily on non-residential fathers. Therefore, we compared both parenting dimensions support and control of fathers in different family structures (non-residential fathers, fathers in joint custody and married fathers). We also investigated the association between fathers' parenting dimensions and children's self-esteem, controlled for the parenting dimensions of the mother. Data from 587 children (50 % girls) between 10 and 18 years old and their parents were examined. Results revealed that non-residential fathers (n = 225) were less supportive and controlling than fathers in joint custody (n = 138) and married fathers (n = 224). Nevertheless, having a supportive father was beneficial to children's self-esteem in each family structure. We conclude that, even after a divorce, fathers have the capacity to enhance children's self-esteem and we suggest that future research should investigate this capacity.

Short-term physical and emotional health outcomes of public sector ART in the Free State province of South Africa.

INTRODUCTION: In order to assess the health outcomes of the South African public sector antiretroviral treatment (ART) programme, it is important to gain a better understanding of the complex relationship between ART and the multidimensional construct quality of life (QoL). Because of the gap between supply and demand, equity issues arise concerning the provisioning of ART. OBJECTIVE: The aim of this paper is to examine how and to what extent public sector ART is related to the physical and emotional health of people living with HIV/AIDS (PLWHA). METHODS: The stratified random sample consisted of 371 AIDS patients on ART or medically certified for ART, but still awaiting treatment. A model of the relationships between patient characteristics (age and gender) and socio-economic position (educational level, income, type of dwelling, number of rooms), ART duration, and physical and emotional QoL was tested using structural equation modelling. RESULTS: Patients with a higher personal income (beta = .19, P < .05) and a larger dwelling (beta = .45, P < .01) were significantly more likely to enter the programme at this early stage. The model showed that the initial months of ART have been associated with significant improvements in the physical QoL (beta = .21, P < .01). Furthermore, patients on ART reported significantly higher levels of emotional well-being than patients awaiting treatment (beta = .10, P < .01). Finally, the results indicate that ART is not only directly associated with emotional QoL, but is also indirectly associated with emotional QoL via the mediating variable physical QoL (beta = .30, P < .01). CONCLUSIONS: The study suggests that the poorest of the poor are not the first beneficiaries of the public programme. Most importantly, the present findings demonstrate the positive physical and emotional health outcomes of the first 6 months of ART in the Free State, South Africa.