Lower Income Levels Research Articles

The impact of fintech development on the entrepreneurial behavior of farmers: evidence from the China Household Finance Survey

Fintech is disrupting the traditional financial models with the power of technology. Will it solve the problems faced by farmers in starting their own businesses and stimulate the vitality of rural entrepreneurship? In this paper, we focus on the impact of fintech development on the entrepreneurial behavior of farmers in China. First, we theoretically analyze the effects of fintech development on the entrepreneurial behavior of farmers and put forward the corresponding theoretical hypotheses. Second, using data from Baidu search index and the China Household Finance Survey (CHFS), we employ a Probit model to verify our theoretical hypotheses. Our findings suggest that (1) fintech development encourages farmer entrepreneurial behavior, (2) it achieves this by alleviating credit constraints, information constraints, and risk aversion effects, (3) in terms of the type of entrepreneurship, the development of fintech mainly promotes survival entrepreneurship among farmers, while the entrepreneurial effect of fintech is more significant among farmers with low education level, low income level and in the central and western regions. Overall, our study provides timely insights into boosting farmer entrepreneurship in emerging countries such as China by leveraging the potential of fintech.

The investigation of frailty level and factors affecting frailty in older adults with osteoarthritis; a cross-sectional study on Turkish population

Aims: This study aims to evaluate the fragility level, fall risks and factors affecting both conditions of individuals with OA aged 60 and over living in an underdeveloped province. Methods: The research sample consists of 260 individuals over the age of 60 who were diagnosed with osteoarthritis. The frailty of the participants was measured. Their functional mobility and risk of falling were measured. Results: The prevalence of frailty and pre-frailty was found to be 82%. It was revealed that frailty is not always affected by the severity of osteoarthritis and the progression of age. In addition, it was found that factors such as stage IV osteoarthritis and being frail or pre-frail increase the risk of falling. The stage of osteoartritis, education level, lifestyle, and risk of falling explained 24% of the variance in the frailty variable. Having an unhealthy lifestyle increases frailty 20 times; lowincome level increases frailty eight times; and each increase in education level affects frailty at most four times negatively. Conclusion: Psychological rehabilitation and social support may negatively affect the development of frailty in individuals aged 60 years and older. Frail older women with severe OA are more vulnerable to falls.

Unaffordable, untrustworthy, or unnecessary? Reasons for foregoing building, home contents, and comprehensive car insurance in disaster‐prone Australia

AbstractIn Australia, building, home contents, and comprehensive car insurance facilitate the accumulation of assets associated with rational, responsible citizenship while promising protection in case of events such as fire, flooding, car accident, or theft. Yet many Australians lack these insurance products, risking exposure to devastating financial losses when disaster strikes. This article compares the findings of online surveys of insured and uninsured Australians and explores the factors driving some to forego insurance coverage. Our findings show that inability to afford premiums is a major driver of noninsurance in Australia, particularly for people with low levels of disposable income and assets, or those living in areas affected by rising disaster risk. Yet the decision to forego insurance is also influenced by attitudes to financial matters. Australians who forego insurance have lower levels of trust in insurance and are less likely to consider themselves under a social obligation to be insured. However, contrary to portrayals of the uninsured as risk‐takers, the decision to forego coverage does not appear to be driven by lesser risk aversion among uninsured Australians relative to those who do purchase building, home contents, and comprehensive car insurance policies.

The Relationship Between Religious Attitudes and Xenophobia: Evidence from Türkiye

In this study, we examined whether religious attitudes have an effect on xenophobia, which we have witnessed to increase in recent years in Türkiye as well as in the world due to economic, socio-political and other factors, in terms of socio-demographic variables. In this context, our research was conducted to better understand the relationship between xenophobia and religious attitudes. Our sample group consists of 419 people aged between 18 and 56, residing in different provinces of Türkiye. These diverse demographic participants come from different socio-economic and cultural backgrounds. Data were collected online through Google Forms using the Personal Information Form, Religious Attitudes Scale and the Xenophobia Scale. These scales were used to assess participants' demographic information, religious attitudes and attitudes towards xenophobia. The findings of our study reveal that religious attitudes do not directly affect xenophobia in terms of variables such as age, gender, marital status and occupational status. That is, individuals' religious beliefs and the degree of these beliefs do not seem to be an important factor in determining their negative attitudes towards foreigners. Instead, other important factors behind xenophobia were analyzed. In the context of economic threat, remarkable results were obtained. Our research has documented that xenophobic attitudes are higher among individuals with low education and income levels compared to individuals with high income and education levels. This shows how important the impact of economic situation on xenophobia is. Especially in times of increased economic uncertainty and threats, individuals tend to develop negative attitudes towards foreigners. This suggests that economic insecurity may play a fundamental role in increasing xenophobia.

Dyspnea, Care Dependency, and Frailty in Older Adults with Chronic Obstructive Pulmonary Disease: A Correlational Study

Objective: As chronic obstructive pulmonary disease (COPD) progresses, older adults have an increased symptom burden, including severe dyspnea. The present study aimed to investigate the relationship between dyspnea, care dependency, and frailty in older adults with COPD. Methods: The current study was a descriptive-correlational study. One hundred and five participants were included. Data were collected face-to-face using the Dyspnea-12 Scale, Care Dependency Scale, and Edmonton Frailty Scale. Correlation and regression analysis were performed. Results: The median score for dyspnea was 24 (moderate to high), 61 (low) for care dependency, and 10 (moderate) for frailty. Age (β=0.171, p=.013), COPD stage (β=0.465, p<.001), and income status (β=0.907, p=.049) were the predictors of dyspnea and explained 67.1% of the variance. Age (β=-0.43, p<.001), COPD stage (β = 0.506, p<0.001), and income status (β=- 0.147, p<.001) were also identified as the predictors of care dependency. Besides age and COPD stage, educational status (β=0.172, p<.049) were the predictors of frailty. Conclusions: This study implied that older adults who had advanced stage COPD, were lower educated, had low-income levels, and comorbidities perceived higher care dependency and frailty. Nurses should assess both dyspnea and care dependency to identify older adults with COPD at risk for increased frailty. Studies considering COPD stage, education level, income status, and comorbidities on dyspnea management, and alleviating care dependency and frailty are warranted.

Exploring the complex interplay of green finance, business cycles, and energy development

Green finance has emerged as a contemporary mechanism to support investments in renewable energy, energy efficiency, and sustainable infrastructure projects. This study aims to provide empirical insights into the asymmetric influence of green finance and business cycle fluctuations on energy development in 60 developing countries from 2000 to 2021. Four aspects of energy development, including energy access, stability, efficiency, and production gap, are examined using panel quantile regression with additive fixed effects. The research findings demonstrate that green finance plays a significant role in fostering energy development, with varying effects across different quantiles of the distribution. Specifically, the results indicate that green finance supports energy access and stability, particularly during economic recession, low-income levels, and limited technological advancement. However, the impact of green finance on energy efficiency exhibits notable heterogeneity, contingent upon technological and periods of economic expansion. Achieving tangible improvements in energy efficiency necessitates a certain level of technological and economic development. Moreover, green finance shows a capacity to maintain an optimal level of energy production, particularly evident during economic expansion and for highly technologically developed countries. The impact of business cycle fluctuations varies across different quantile distributions of energy development indicators, predominantly exerting an inhibitory effect of economic recession. In light of these results, it is recommended that policies in developing countries be revised to enhance energy access, optimize energy production levels, and promote the cost-effectiveness of renewable energy in conjunction with green finance initiatives.

Unveiling a Comprehensive Multi-epitope Subunit Vaccine Strategy Against Salmonella subsp. enterica: Bridging Core, Subtractive Proteomics, and Immunoinformatics.

Salmonella subsp. enterica (SE) presents a significant global health challenge in both developed and developing countries. Current SE vaccines have limitations, targeting specific strains and demonstrating moderate efficacy in adults, while also being unsuitable for young children and often unaffordable in regions with lower income levels where the disease is prevalent. To address these challenges, this study employed a computational approach integrating core proteomics, subtractive proteomics, and immunoinformatics to develop a universal SE vaccine and identify potential drug targets. Analysis of the core proteome of 185 SE strains revealed 1964 conserved proteins. Subtractive proteomics identified 9 proteins as potential vaccine candidates and 41 as novel drug targets. Using reverse vaccinology-based immunoinformatics, four multi-epitope-based subunit vaccine constructs (MESVCs) were designed, aiming to stimulate cytotoxic T lymphocyte, helper T lymphocyte, and linear B lymphocyte responses. These constructs underwent comprehensive evaluations for antigenicity, immunogenicity, toxicity, hydropathicity, and physicochemical properties. Predictive modeling, refinement, and validation were conducted to determine the secondary and tertiary structures of the SE-MESVCs, followed by docking studies with MHC-I, MHC-II, and TLR4 receptors. Molecular docking assessments showed favorable binding with all three receptors, with SE-MESVC-4 exhibiting the most promising binding energy. Molecular dynamics simulations confirmed the binding affinity and stability of SE-MESVC-4 with the TLR4/MD2 complex. Additionally, codon optimization and in silico cloning verified the efficient translation and successful expression of SE-MESVC-4 in Escherichia coli (E. coli) str. K12. Subsequent in silico immune simulation evaluated the efficacy of SE-MESVC-4 in triggering an effective immune response. These results suggest that SE-MESVC-4 may induce both humoral and cellular immune responses, making it a potential candidate for an effective SE vaccine. However, further experimental investigations are necessary to validate the immunogenicity and efficacy of SE-MESVC-4, bringing us closer to effectively combating SE infections.

INVESTIGATION OF THE PREVALENCE OF EXPIRED AND UNUSED PHARMACEUTICALS IN THE ANKARA REGION

Objective: Due to the increase in the market share of pharmaceuticals and the unconscious use of medicines, unused or expired medicines are being discarded in a way that harms the environment. This study aims to examine which medicines are brought to collection points as household waste in order to reduce waste medicines from the source. Material and Method: The medicines collected in 12 spontaneously selected pharmacies operating in low and high income levels in the Ankara region were recorded at different periods during one year and the results were statistically evaluated. 4852 waste medicines were sorted and classified according to pharmaceutical dosage form and indication Result and Discussion: Unopened 521 medicines were discarded. In addition, it was seen which drug groups create waste in socio-economic terms. In addition to the damage to the environment, it has created a foresight to prevent drug waste that creates a deficit in the budget.

Meta-analyzing the effect of online learning on academic achievement in higher education during COVID-19 pandemic

ABSTRACT Investigating the influence of the emergency transition to online learning during the Covid-19 pandemic can significantly enhance our understanding of the benefits and limitations of technology in higher education. We aim to assess the effect of online learning on college students' academic achievement compared to face-to-face learning during the Covid-19 crisis. This study utilizes a meta-analysis approach, examining 35 research studies conducted in 17 different countries and regions from 2020 to 2023, through an extensive database search encompassing the Web of Science Core Collection, EBSCO Host, JSTOR, Springerlink, and SCOPUS. The sample size comprised 8079 students, with 4160 assigned to the experimental group (online) and 3919 to the control group (face-to-face). We found that online learning yields a modest and positive effect (g = 0.336, 95% CI [0.139–0.534]) on students' academic achievement. The effect was consistent across class years and exam types but varied by subject, benefiting students in medicine, engineering, and natural sciences, while negatively affecting social sciences. Additionally, the effect of online learning shows a stronger positive impact on the academic achievement of students from lower-income level nations. Our research indicates that online learning could be a viable and potentially equalizing force in higher education.

Farmers’ Knowledge in Improved Maize Production Practices in Katni District of Madhya Pradesh, India

The study was conducted in Katni district of Madhya Pradesh where maize as a main crop in kharif season. A total of 120 respondents were selected purposively from 10 villages under Bohariband block where production and productivity is high. Descriptive research design was followed for the present study and data were collected through interview method by using pre-structured interview schedule, appropriate statistical analysis was done to draw the logical conclusions. The study revealed that 48.33 per cent of farmers belonged to middle age group, majority (56.67%) of farmers belonged to low level of land holding i.e. less than 1 ha., majority (55.00%) of farmers belonged to middle family size. The finding also revealed that majority of farmers belongs to 27.50 per cent education i. e illiterate, majority (65.00%) of farmers have agriculture only as an occupation, 49.17 per cent of farmers belongs to low level of income i.e less than Rs. 50,000. The finding also revealed that 55.00 per cent of the farmers had medium level of knowledge towards improved maize production practice followed by 27.50 per cent and 17.50 per cent of the farmers with low and high level of knowledge respectively.

Socio-economic characteristics of small enterprises in the aspect of risky circumstances

The article considers the characteristics of small business entities in the context of risky circumstances. The socio-economic characteristics of small enterprises are analyzed taking into account the new crisis phenomena and their influence on the construction of management strategies. In the process of research the interrelation between these characteristics and risk factors is established, the necessity of actualization of existing approaches and methods of management of small enterprises is proved. Methods of search, analysis and generalization of information were used. The sociological interpretation of the concept of “risk” in historical retrospect and taking into account modern approaches is given, as well as the main provisions of risk concepts are given. Among the key ones are socio-economic characteristics of small enterprises interrelated with risky circumstances. Limited capital investments, small number of employees, the need to fulfill social obligations, relatively low level of income, simpler organizational structure, uniqueness of goods and services produced, localization of markets, significant social burden are highlighted. It is concluded that modern transformations in various spheres of society increase the probability of crisis processes. At the same time, the level of risk is interrelated with the socio-economic characteristics of small enterprises, which are more exposed to risk consequences. Small business shows significant adaptive capabilities and readiness to quickly change management tactics in terms of predicting and regulating risks.

Stepping Towards Economic Independence through Agricultural Tourism and Cultural Preservation in Pantai Labu District

Pantai Labu District in Deli Serdang Regency, North Sumatra, has high agricultural and cultural tourism potential. However, this potential has not been utilized optimally by the local community. This results in low levels of income and economic independence in the community. This community service activity aims to increase the economic independence of the community through the development of agricultural tourism and cultural preservation in Pantai Labu District. This activity is carried out using several methods, namely: (a) Socialization and training to the community regarding the development of agricultural tourism and cultural preservation. (b) Assistance in forming tourism awareness groups (pokdarwis). (c) Development of tourist infrastructure. (d) Promotion of tourism through various media.(e) This activity produced several results, namely: (a) Increasing community knowledge and skills regarding the development of agricultural tourism and cultural preservation. (b) Formation of pokdarwis in several villages in Pantai Labu District. (c) Improved tourist infrastructure in several locations. (d) The increasing number of tourists visiting Labu Beach District. This community service activity shows that the development of agricultural tourism and cultural preservation can increase the economic independence of the community in Pantai Labu District.

Association between Child Maltreatment and Intimate Partner Violence: Moderating Effects of Gender, Age, and Household Income Level

Purpose: This study examines the association between child maltreatment and the perpetration and victimization of intimate partner violence (IPV) in adulthood, exploring the moderating effects of gender, age, and household income level.Methods: This cross-sectional study analyzed secondary data from the 2016 Domestic Violence Survey in South Korea, including 1,765 married individuals aged 65 or younger who responded to key variables. Structural equation modeling was used to analyze associations among the variables.Results: The paths from child maltreatment to IPV perpetration (β=.22, p<.001) and victimization (β=.22, p<.001) were statistically significant. Gender, age, and household income level significantly moderated this relationship. Women under 40 were more likely to be IPV victims than perpetrators. Low-income level increased the likelihood of being both perpetrators and victims. Women under 40 who had experienced child maltreatment and had a low-income level showed different probabilities of being victims or perpetrators of IPV.Conclusion: Our findings highlight the need to mitigate the negative impact of child maltreatment in adulthood by designing specific interventions for vulnerable groups, such as women, younger individuals, and those with low-income levels. Ensuring lifelong prevention of child maltreatment and establishing tailored programs for IPV is crucial.

Exploring the Insights: Unraveling the Knowledge, Attitude, and Practice of Diabetics Regarding Diabetes and Diabetic Retinopathy in Hail, Saudi Arabia

Background: Diabetes Mellitus is a metabolic disorder causing high blood glucose levels and is a major health concern in Saudi Arabia (SA). Aims & objectives: This study aimed to assess the knowledge, attitude, and practices of diabetic patients towards diabetes and diabetic retinopathy (DR) in Hail, SA. Methods: A descriptive cross-sectional survey using an anonymous, structured, validated, and pilot-tested questionnaire was conducted between February and June 2023 from adult diabetic patients in Hail and analyzed using RStudio. Associations between variables were evaluated, with statistical significance set at p < 0.05. Results: 280 participants took part in the survey, with 57.0% females and 51.4% aged between 18 to 34 years. Poor knowledge was significantly higher among participants aged 35 to 50 years (92.8%). Negative attitudes were more prevalent in males (37.8% vs 24.7%, p = 0.019) and those with lower income levels (16.7%, 29.5%, and 62.5% among high-, middle-, and low-income groups, respectively, p = 0.008). Conclusions: The study revealed a lack of knowledge and negative attitudes towards diabetes, particularly among lower-income patients. There is a significant relationship between education and good disease control, highlighting the need for improved education and awareness of DM and DR in Hail.

WHO CONSUMES MORE BROKEN RICE GRAIN? EVIDENCE FROM RURAL AND URBAN CONSUMERS

The present study, in response to rising food prices, was conceived to find quantitative differences, particularly in broken rice consumption concerning the consumers' geographic (urban/rural) location. Four districts, namely Faisalabad, Sheikhupura, Kasur, and Toba Tek Singh were selected as a case study from central Punjab. Cross- sectional data collected randomly from 250 consumers of broken rice (100 from Faisalabad and 50 from each of the remaining districts with equal proportion of rural and urban households) was used to run a descriptive and non-parametric test of Mann-Whitney U-Test, an alternative test to student t-test. Descriptive statistics show that the average monthly income of the households was Rs. 73251, with an average monthly income of Rs. 63911 and Rs. 82667 for rural and urban households, respectively. The overall total rice consumption per household (11.2 Kg/month) comprised almost half (51%) of broken rice (5.71 Kg/month). Total rice consumption was comparatively more in urban households despite a non-significant difference. The Mann-Whitney U-test finds a highly significant difference in the consumption of broken rice for rural and urban households. The test further clarifies that rural consumers consumed more broken rice (6.38 Kg/month) than urban households (5.04 Kg/month). Comparatively, more consumption of whole rice in urban settings and broken rice in rural areas seem in line with their respective higher and lower income levels. As these research findings have important policy implications for ensuring household food security, there is a need to further validate findings for appropriate national-level policy using large country level data sets. Keeping in view the role of rice similar to wheat flour in reducing food insecurity, studies finding the relationships between household income and consumption of rice, including locally called pona, adware, tota, or mix type categories of broken rice, are suggested to deeply understand the consumer preferences for broken rice market in the country.

SUBSISTENCE FARMER'S PRODUCTION DIVERSITY AND MARKET ACCESS: IMPACT ON RURAL WOMEN AND CHILDREN'S DIETARY DIVERSITY

Hunger and poverty are severe threats to developing nations like Pakistan. Rural people in developing countries are facing malnutrition and undernourishment due to low-income levels and limited access to nutritious food. Women's diets are the most crucial factor for their health and children. Increased dietary diversity is a significant approach to improving nutrition and health, and it can be enhanced by improving the production diversity among rural subsistence farming households. The study was conducted in four districts of the south Punjab region of Pakistan. Using the well-structured and pretested questionnaire, multistage stratified random sampling was employed to collect data from 600 rural households. The women's dietary diversity score, children's dietary diversity score, and production diversity score were calculated. The results indicate that women's dietary diversity is concerned with production diversity score; its interaction with market access, education, family size, and farming experience positively impacts dietary diversity. In contrast, the age of the respondent has a negative impact. The same association among factors was also observed for children's dietary diversity score. Based on the study results, it is recommended that there is a need to diversify the crops produced by small farmers, especially food crops so that they can get balanced food and not rely much on external purchases. Overall, the Government can play a crucial role by providing opportunities and facilities to grow non-conventional crops instead of conventional cash crops.

Labor market discrimination and suicidal ideation: A longitudinal study of Korean women

This study investigates the impact of gender discrimination in the labor market on suicidal ideation among Korean women, taking into consideration women's multiple social locations and their discriminatory experiences across various aspects of employment. Analysis using waves 4 to 8 data of the Korean Longitudinal Survey of Women and Family, with response rates ranging from 68.3% to 78.2%, indicates that gender discrimination in hiring, dismissal, promotion, job allocation, training, wage, and sexual harassment is strongly associated with suicidal thoughts among women. This relationship remains significant even after controlling for stress, depression, and other forms of discrimination. Subgroup analysis further highlights that women with lower income levels are particularly susceptible to the adverse effects of gender discrimination. The findings underscore the importance of policy intervention to mitigate labor market discrimination against women as a crucial step in preventing suicides among Korean women.

LIVESTOCK DEVELOPMENT IS AN INTEGRAL PART OF THE SUSTAINABLE DEVELOPMENT OF THE UKRAINIAN COUNTRYSIDE AND THE COUNTRY’S FOOD SECURITY

Agricultural production is one of the most important components of the economy of every country, as it guarantees their food security. The livestock products market occupies an important place in the general food market of Ukraine. Ensuring the needs of the population with food products produced from the products provided by the livestock industry depends on its development. However, the actual state of the industry during the last 30 years does not correspond to potential opportunities and is characterized by a reduction in the number of almost all types of farm animals. In the 90s of the last century, after a short-lived reform of the agro-industrial complex, livestock farming in Ukraine underwent negative changes. The population of agricultural animals in large agricultural enterprises (collective farms and state farms) began to decrease at a catastrophic pace, productivity decreased, production became unprofitable and product quality deteriorated, the country’s export potential decreased and the social living conditions of the rural population worsened. All this puts national food security at risk. The article analyzes the state of animal husbandry development in the period 1991–2021 and found that after 1990, the production of the main livestock products moved to private homesteads of peasants, to small areas of homestead plots. Most of the peasants in their households keep pigs (68.4%), sheep and goats (78%), poultry (79.5%), rabbits (99.5%) and bee colonies (88.3%). It was established that in 2021, the production of meat and meat products amounted to 70.1%, milk and dairy products — 44.6% of those produced in 1991, but the production of eggs increased by 8.3% compared to 1991. It was found that the low level of income does not allow Ukrainians to eat well. In 2021, the level of consumption of meat and meat products by the population of Ukraine amounted to 71% of the rational norm and exceeded the minimum necessary norm by only 9.2%. Ukrainians also do not consume enough milk and dairy products — 53.1% of the rational norm, and only eggs — an almost rational norm (95.9%). At the same time, it should be noted that 29% of the average daily diet of Ukrainians is provided by the consumption of products of animal origin. The influence of the enemy’s military actions on the livestock industry of Ukraine is given. Significant losses of farm animals and poultry and ecological damage to the natural environment for decades to come have been caused due to the destruction of animals and the inability to dispose of them in time and in accordance with the rules.

Air pollution and individual risk preference: Evidence from China

Individual risk preference is a crucial determinant of decision-making under conditions of uncertainty. Risk preference is associated with internal individual characteristics as well as external environmental factors, such as air pollution. Combining a nationally representative longitudinal survey with Air Quality Index(AQI) and thermal inversion data, we find that for each unit increase in the AQI reduces risk preference by 8.9% of one standard deviation. Furthermore, heterogeneous analysis shows that men, youth, unmarried, employed, low-income level, low-education level and people with lower attention to the environment are more likely to be affected by air pollution. Research on mechanisms shows that air polluton may affect the risk preferences of individuals by affecting emotions and cognition.

Body image and social appearance anxiety in patients with cancer undergoing radiotherapy: a cross-sectional study

BackgroundThe body image of patients with cancer can be negatively affected due to treatment toxicities. Changes in body image may cause patients to experience social appearance anxiety. This study aimed to evaluate the body image and social appearance anxiety of patients with cancer undergoing radiotherapy.MethodsThe cross-sectional study was conducted with 153 patients with cancer undergoing radiotherapy in a university hospital. The data were collected with a Patient Information Form, the Body Image Scale, and the Social Appearance Anxiety Scale and the Radiation Therapy Oncology Group Skin Toxicity Criteria.ResultsPatients’ mean body image score was 15.18 ± 8.26 (min = 0, max = 30), mean social appearance anxiety score was 45.29 ± 14.50 (min = 16, max = 80). Patients with low education levels and low-income levels had higher body image and social appearance anxiety scores (p < 0.01). Body image and social appearance anxiety scores were found to be higher in patients with advanced cancer, grade III-IV skin toxicity, pain, fatigue, and constipation (p < 0.05).ConclusionsRadiotherapy may negatively affect body image and social appearance anxiety. Assessments of body image and social appearance anxiety regularly before, during, and after treatment are essential. Psychosocial support should be provided to patients to reduce body image and social appearance anxiety and increase their well-being. Patients with cancer especially those who have low income and education levels, advanced cancer stage and skin toxicity, and suffer from pain, fatigue, constipation, etc. should be supported by methods such as counseling and social support groups.