Transforming perspectives : aging, anger, and the environment in Margaret Laurence's The Stone Angel

We know that HIV treatment outcome depends on antiretroviral treatment (ART) adherence. Young adults with perinatal HIV (YPHIV) who survived have endured various adherence challenges in their adolescent years. While some of them could maintain perfect adherence with sustainable virologic suppression, many experienced one or more episodes of virologic failure. We explored factors affecting ART adherence from real-life experiences of YPHIV. A qualitative study was conducted between June and November 2022. Twenty YPHIV aged 21-29 years with a history of virologic failure and resumed virologic suppression during adolescent years were invited to share their experiences through individual in-depth interviews. Audio records were transcribed verbatim and analyzed using deductive thematic analysis. We divided excerpts into two themes: barriers and facilitators to ART adherence. The socio-ecological model was used to frame subthemes at personal, societal, and healthcare system levels. Most barriers to adherence were concentrated at the personal level, including work/study-related conditions, personal entertainment, medication issues, mental health problems, thought, and belief. At the societal level, social activities and fear of HIV disclosure were frequently mentioned as barriers. Medical care cost was the only identified barrier at the healthcare system level. The facilitators to adherence at the personal level included perceiving health deterioration, being afraid of hospitalization and medical procedures, and wishing to be healthy and move on. At the same time, perceived family support and determination to complete family without HIV transmission were identified as facilitators at the societal level. Service behaviors of healthcare providers were mentioned as facilitators to adherence at the healthcare system level. From this study, most factors associated with non-adherence in adolescents were at the personal level, and the fear of HIV disclosure was critical at the societal level. The key facilitator to adherence was the determination to be healthy and have a promising future. Our findings reinforce the importance of establishing youth-friendly services in the existing HIV care setting. More time allocation for tailored individual counseling, using other novel approaches like mHealth, online media, and involvement of social support from different sectors might be beneficial to maximize adherence self-efficacy during the transitional period of YPHIV.

Yagya holds great significance in Indian culture as a powerful form of communication deeply rooted in Vedic philosophy. Unlike Western views on communication, the Indian perspective emphasizes introspection, leading to self-awareness, freedom, and truth. Yagya is not just a ritualistic practice but symbolizes the pursuit of inner clarity and comprehension, aiming to connect with one’s inner self and ultimate truth. Both Yagya and communication share the core essence of building connections and fostering understanding. Throughout history, Yagya has been a profound means of communication in India, imparting knowledge, promoting unity, and conveying timeless life lessons for positive transformation. It serves as a conduit to transmit wisdom and guidance to rulers and the public, fostering open dialogue and mutual understanding, even in contemporary times with Yagya-based movements continuing to spread positive values and promote personal and societal growth.

Some risk perception studies suggest that personal and societal level risk judgements are distinct and largely separate, and people do not necessarily draw personal implications from their general views about society. This study explores the role of community involvement in people's risk judgements at personal and societal levels. Using risk judgements about four health issueswater contaminants, radon, AIDS and heart diseasewe examined if community involvement decreases the discrepancy between personal and societal level risk perceptions. The data were collected through a mail survey of a random sample of 750 upstate New York residents. Across the four issues people tend to have significantly more concern at the societal level than at the personal level. Multiple regression analysis shows that community involvement decreases the difference people have between the personal and societal level risk judgements and that it has a direct impact on people's personal level of concern about AIDS. Compared with men, women tend to have higher levels of societal concern across all four health issues. Interpersonal communication primarily influences personal judgements. These findings have important implications for health education campaigns and deserve more attention from researchers.

Self-ageism remains largely overlooked in the global campaign against ageism. While educational and learning interventions against ageism are considered promising, their effectiveness is not fully understood, and tailored approaches addressing specific manifestations of ageism like sexual (self-)ageism are lacking. In this study, we explore how a tailored Participatory Action Research (PAR) approach can foster transformative learning among older people to combat sexual self-ageism as part of the broader structural movement against ageism. We engaged 53 older adults in a 15-month PAR process involving dialogue groups on sexuality in later life. We analyzed the transformative impacts of the process through the lens of Transformative Learning (TL) theory. PAR fostered change across multiple levels. On the personal level, open dialogue helped older adults overcome social isolation. Interpersonally, group engagement facilitated critical self-reflection through exposure to diverse perspectives. Collaborative learning enabled shifts in discourse, relationships, and practices around later-life sexuality, extending the impact to the community level. The co-creation of a public video series marked a collective effort to challenge sexual ageism at the societal level. PAR can catalyze transformative learning processes that address sexual (self-)ageism at personal, interpersonal and community levels, with potential for broader societal impact. These findings underscore the value of participatory, tailored learning approaches in confronting self-ageism as an integral part of the global campaign against ageism, tackling ageism from within and from the bottom-up.

Objectives: We used a social ecological model to examine vulnerability and resilience among older adults during the COVID-19 pandemic. Methods: We analyzed two open-ended questions included in a survey of 235 respondents, 51–95 years old (M = 71.35; SD = 7.39; 74% female), which asked about COVID-19-related difficulties and positive experiences during the past week. We identified three different levels for difficulties and positives at the personal, interpersonal, and/or societal levels. Results: Fewer than half of the respondents reported on difficulties (41%) and positives (40%) just at the personal level. In terms of crossing levels, people were most likely to report events spanning the personal and interpersonal levels (14% and 18%, respectively). A few individuals reported difficulties and positives at the societal level. Discussion: Older individuals were acutely aware of challenges and positives existing at all three levels, and contributed to resources at the interpersonal and community levels.

In this secondary analysis of interviews with people with chronic heart failure, we examine living with fatigue in terms of obstacles and opportunities on personal, systemic and societal levels. On a personal level, people report that their bodies force them to rest, and to give in to and make space in their lives for fatigue. The need for rest is strong, but resting and inactivity are also regarded as dangerous. The healthcare system provides assistance through home care and technical equipment. However, society imposes obstacles, such as a lack of services in the immediate surroundings that prevent living well. In conclusion, people with chronic heart failure can manage their lives on a personal level by means of selection, optimization and compensation, and the healthcare system can provide further support; however, on a societal level there is lack of resources for those suffering from fatigue due to chronic heart failure.

This article discusses the transformation of climate change science from scientific knowledge to Finnish upper secondary school geography curricula and textbooks from 1985 to 2023. Scientific knowledge transforms into teachable knowledge through the transformation process at the societal, institutional, and classroom levels. In our analysis, we apply the idea of powerful knowledge and use three levels of geographical powerful knowledge, including geographical knowledge, critical and conceptual knowledge, and propensity to imagine alternative futures. The research material consists of five framework curricula from 1985 to 2019 and a total of thirteen upper secondary school geography textbooks that are based on the curricula. Our findings suggest that climate science knowledge has transformed slowly into societal curricula. However, in textbooks, scientific knowledge has transformed more rapidly. According to our results, the transformation may not necessarily occur linearly, first at the societal level and finally in classrooms.

BackgroundPrevious research on health behavior and subjective well-being has mainly focused on interindividual differences or explored certain domains of health behavior. Good health behavior and subjective well-being at baseline can predict each other after a follow-up. In the present cohort study, we explored the outcomes of change for an individual i.e., how changed health behavior is reflected in subsequent subjective well-being and vice versa.MethodsData (n = 10,855) originates from a population-based Health and Social Support (HeSSup) study on working-age Finns in 2003 and 2012. A composite measure of health behavior included physical activity, dietary habits, alcohol consumption, and smoking status (range 0–4, worst–best) and a composite measure of subjective well-being (with reversed scoring) included three life assessments, i.e., interest, happiness, and ease in life, and perceived loneliness (range 4–20, best–worst). Different multiple linear regression models were used to study how changes in health behavior predict subjective well-being and the opposite, how changes in subjective well-being predict health behavior.ResultsA positive change in health behavior from 2003 to 2012 predicted better subjective well-being (i.e., on average 0.31 points lower subjective well-being sum score), whereas a negative change predicted poorer subjective well-being (i.e., 0.37 points higher subjective well-being sum score) (both: p < 0.001) compared to those study subjects who had no change in health behavior. Similarly, when a positive and negative change in subjective well-being was studied, these figures were 0.071 points better and 0.072 points worse (both: p < 0.001) health behavior sum score, respectively. When the magnitude of the effect of change was compared to the range of scale of the outcome the effect of health behavior change appeared stronger than that of subjective well-being.ConclusionChanges in health behavior and subjective well-being have long-term effects on the level of the other, the effect of the first being slightly stronger than vice versa. These mutual long-term benefits can be used as a motivator in health promotion on individual and societal levels.

Although theatrical activities are used in a variety of therapeutic settings, little attention has been paid to the ways that theater can enhance the recovery process and community integration for people living with psychiatric disabilities. Community-based theater involving people with psychiatric disabilities offers unique opportunities for personal growth, social connection, and advocacy efforts. This Open Forum posits that theater has the power to both facilitate individual recovery and improve the social conditions of people living with mental illness. Critical elements of theatrical activities that relate to processes of recovery and community integration are examined. Implications for future research and program development are discussed.

The Power of Theater to Promote Individual Recovery and Social Change

The Impact Of Illness Perceptions On Post-Stroke Activity Engagement And The Moderating Role Of Gender

It is assumed in Western society that women want to become mothers. This desire is situated within the ideology of the ‘perfect mother’. However, feminists have highlighted contradictions between this ideology and the reality of mothering. A trend towards later motherhood has recently been identified. Delayed motherhood has been associated with a number of advantages such as a sense of psychological readiness, however this may mask some of its negative aspects. The aim of the study reported here was to explore the transition to, and lived experience of, delayed motherhood. Five women who were over 30 prior to the birth of their first child were interviewed. A narrative analysis at the personal, interpersonal and societal levels was conducted. At the personal level, diverse stories which contained both problems in adapting to motherhood and also progressive aspects of positive experiences and integration of maternal identities were told. At the interpersonal level, the prominence of the ‘double‐edged’ tone conveyed maternal ambivalence. At the societal level, dominant ideologies of the ‘good mother’ and normative development were identified. Though the women actively constructed their stories and attempted to resist dominant representations, this analysis emphasises the need for more realistic portrayals of delayed motherhood. Copyright © 2006 John Wiley &amp; Sons, Ltd.

Within the last decade, system and policy-level changes have driven substantial shifts in heart failure (HF) care from hospital to home, requiring greater support from informal care partners. What has not been examined is the state of the care partner science by person and system-level domains using qualitative studies to understand impact across multiple person and system levels. (1) Identify by person and system levels and domain what is known about informal care partners and (2) Identify gaps in the caregiving science and suggest ways to move forward. This secondary analysis of a large HF systematic review is guided by the National Institute on Minority Health and Health Disparities and MIRACLE frameworks and uses meta-synthesis techniques with critical realist approaches to synthesize and interpret the themes across papers. Using data from 46 papers and 1695 care partners, we identified patterns occurring across 6 domains (biological, behavioral, affective, physical/built environment, sociocultural environment, and healthcare system) and on 4 levels (individual, interpersonal, community, and societal). Existing research predominantly addressed affective and behavioral domains, followed by health system and sociocultural domains. Few studies focused on biological and physical/built environment domains, leaving large gaps in what is known about caregiving at the cellular (biological) and societal (community and societal) levels. HF caregiving continues to be studied at a very rudimentary level. This synthesis also reveals critical gaps in what is known about caregiving within the physical/built environment domain and at the community and societal levels.

The article defines the peculiarities of managing transformation processes in general secondary education institutions during the period of modernization, transformation, positive changes and their continuous, stable, sustainable development. Our reflections are based on the fact that the management of transformation processes in general secondary education institutions is strategic and should be built in the plane of "Study globally – determine the scientific basis – act locally" and is complex and innovative in content. The strategic problem of transformation processes is the management of the spiritual positive energy of transformation and peace. That is why the management of transformation processes at school in modern conditions is viewed through the prism of strategic management and is carried out taking into account the need to ensure the development of participants in the educational process, subject to overcoming the negative consequences of a pandemic, war, environmental disaster, climate "records", crisis and the presence of educational losses, educational gaps, poor performance, illiteracy, knowledge gaps in students and the need to quickly involve internally displaced children and students in the educational process. Determining the features of the management of transformational processes in the field of education and general secondary education institutions is the highest level of the art of management and is provided by strategic thinking, strategic management and covers the theory and practice of training teaching staff, children, students, and parents to the acquisition by schoolchildren of high-quality scientific knowledge, mastery of a scientific worldview on the basis of harmonious development and education, as well as planning, forecasting and organizing the educational process, researching its regularities, developing and applying methods, options, methods, and forms of learning, studying, and self-education of students. It provides for a rational, competent arrangement of available pedagogical staff, effective use of the material and technical base, information resources, determination of strategic priorities, goals and tasks for class leaders, class teachers, teachers, librarians, heads of circles, sections, creative teams, heads of offices, as well as the use of innovative forms and methods of education, forming the sphere of cooperation with state management bodies, scientific institutions, methodical services, educational institutions, public organizations and professing the ideology of pedagogy of cooperation and mutual understanding between the participants of the educational process. Strategic management of transformational processes in institutions of general secondary education, especially in conditions of war, is closely related to educational policy in the country and stems from the needs of a free creative gifted individual, a social human society, a democratic state, an innovative economy of knowledge and the needs of defense, protection, guardianship, compliance with social guarantees. Legislation, normative legal acts set tasks for educational institutions, and the strategy ensures their fulfillment. The strategy of managing transformational processes in institutions of general secondary education depends on the level, state and pace of economic development and on the actual provision of necessary and sufficient funding, security, including social security, of all participants in the educational process. The strategy of managing transformational processes is, as a rule, the same for all schools and its recommendations, the main provisions should be mandatory for all institutions of general secondary education, regardless of status, type, subordination, location and form of ownership. With regard to tactics, strategic management plays a certain role and at the same time takes into account the powers, status and capabilities of the institution of general secondary education and should serve to realize the basic rights and freedoms of participants in the educational process, and the basic right to a spiritual, happy, safe, protected, joyful life in the plane of observance and fulfillment of the main spiritual laws – Love, Forgiveness and worldview and value categories and principles of Peace, Faith, Hope, unity, solidarity, commonwealth.

Natural amenities-driven migration and tourism entrepreneurship: Within business social dynamics conducive to positive social change