Adult Members Research Articles

Beta-testing the feasibility of a family-based financial incentives smoking cessation intervention with Alaska Native families: Phase 2 of the Aniqsaaq (to breathe) Study.

Beta-testing the feasibility of a family-based financial incentives smoking cessation intervention with Alaska Native families: Phase 2 of the Aniqsaaq (to breathe) Study.

History of COVID-19 infection is associated with disrupted cardiovascular stress response habituation in physically active people.

History of COVID-19 infection is associated with disrupted cardiovascular stress response habituation in physically active people.

Does caregiving make a difference? Health penalty and family caregivers during the pandemic in China

AbstractObjectiveThis study aimed to examine the health penalty of primary family caregivers during the COVID‐19 pandemic in China.BackgroundFamily caregivers often experience social disadvantages and structural marginalization. In the growing literature on the multidimensional system of the family caregiver penalty, insufficient research efforts have been made to understand the health dimension.MethodWe conducted a national online survey with 2,819 Chinese citizens aged 18 years and older. They completed the questionnaire on their personal and family experiences of the COVID‐19 pandemic. We adopted logit models and generalized ordered logit models to discuss the health penalty of primary family caregivers.ResultsWe found that, compared with individuals who did not serve as primary family caregivers, primary family caregivers were more likely to become infected by the virus when China adopted the zero‐COVID policy approach, suffered from more severe symptoms during infection when China lifted all the control measures, and took a longer period to recover. Primary family caregivers of different gender and different care duties experienced the health penalty in different patterns, and female primary family caregivers, those living with underage children, and those living with other adult family members were identified as the more disadvantaged groups.ConclusionThis study confirms the health penalty for primary family caregivers and social disparities during the pandemic in China.ImplicationsThe findings called for policy to address family and caregiver well‐being in public health crises.

Liver Fibrosis Marker FIB-4 Is Associated With Hepatic and Extrahepatic Malignancy Risk in a Population-Based Cohort Study.

An association between Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and the development of extrahepatic malignancies has been demonstrated. However, the association of fibrosis with extrahepatic cancer is unclear. Our study aimed to test the long-term association between liver fibrosis marker and the incidence of hepatic and extrahepatic malignancies. A retrospective cohort study of a nationally representative sample, following 763 752 adult Clalit health services members without pre-existing liver-related diagnoses or malignancies for 14.67 years. The adjusted association between baseline liver Fibrosis-4 score (FIB-4; FIB-4 ≥ 2.67 indicated presumed advanced fibrosis), assessed from routine laboratory measurements, and incident cancer was assessed through multivariable Cox regression models. The study included 763 752 people (mean age 54.3 ± 8.2 years, 43.9% males). Presumed advanced fibrosis was associated with a 16% greater risk for malignancy compared to the risk of those with no fibrosis (hazard ratio (HR) = 1.16; 95% CI, 1.10-1.22), adjusting for age, sex, ethnicity, socioeconomic status, peripherality index, baseline smoking, and obesity. The association of advanced fibrosis with malignancy was stronger when the age-specific FIB-4 cutoff was applied (HR = 1.40; 1.34-1.46) and in a subsample of subjects with MASLD diagnosis at baseline (HR = 1.43; 1.12-1.83). The association remained robust across sex, age, and ethnic groups. Both inconclusive fibrosis and fibrosis were strongly associated with malignancy of the liver or bile ducts [(HR = 1.41; 1.21-1.66) and (HR = 5.66; 4.19-7.64), respectively]. Liver fibrosis score is independently associated with malignancy occurrence and certain types of malignancies, and may serve as an indicator of high-risk cancer in the general population.

Storytelling: A Teaching Technique to Infuse Indigenous Knowledge in Physical Science Pre-service Teacher Training

The infusion of indigenous knowledge in academic subjects is often problematic due to personal perceptions or little experience with indigenous knowledge in a teaching and learning environment. The aim of the research was to indicate the experiences of pre-service teachers when infusing indigenous knowledge via storytelling in Physical Science. This article reports on the personal experience(s) of pre-service teachers in training at a higher education institution where indigenous knowledge was infused into the teaching and learning of Physical Sciences. The implementation of Ethnophysics as a teaching strategy, storytelling as a teaching technique, contextualised - and project-based learning as teaching methods and approaches and reflection on experiences when implementing participatory action learning and action research indicated a transformative way to embrace indigenous knowledge in the teaching and learning of Physical Science. Stories, related to the concept of heat in physical science were collected by the pre-service teachers from trusted adult members in their local communities. The pre-service teachers analysed the stories and reported their interpretation of scientific and indigenous knowledge in the stories. Inductive, thematic analysis was used to interpret pre-service teacher reflection on the experience and the Cultural Historical Activity Theory was used to indicate an overview and the connection between different elements of the research. The participating pre-service teachers indicated that storytelling, as a teaching technique, adds value to how they interpret concepts in Physical Science related to their unique culture. The pre-service teachers gained research skills regarding qualitative research and showed the ability to identify the contribution of both scientific and indigenous knowledge.

Multicultural Intensive Care: A Cross-sectional Study on Family-centered Care in the United Arab Emirates

Introduction Implementing Family-Centered Care (FCC) is widely recognized in healthcare settings for its quality and safety benefits. However, FCC in intensive care units (ICUs), particularly in highly diverse contexts such as the United Arab Emirates (UAE), poses additional challenges due to differing languages, religions, and cultural backgrounds. This cross-sectional study explores the dynamics of family and visitor interactions in UAE ICUs, aiming to provide insights that inform FCC implementation. Objective Understanding the core needs of families with relatives in ICUs is essential for the successful adoption of FCC, highlighting key factors required for effectively navigating the ICU environment. Methods From May to July 2024, a comprehensive study was conducted in selected critical care facilities across the UAE, involving approximately 240 adult family members closely associated with patients undergoing life-saving interventions. Data were gathered using the Critical Care Family Needs Inventory (CCFNI) Support Questionnaire. The data analysis was also conducted at the descriptive and inferential statistics level using SPSS version 16 software. Results and Discussion Among the five domains of the CCFNI, the highest mean score was for Information (38.8 ± 5.1), followed by Comfort (37.0 ± 5.6) and Support (28.0 ± 4.0). Proximity (18.6 ± 3.0) and Assurance (18.9 ± 2.8) recorded the lowest scores. Although families valued being near the patient and receiving assurance about care, their emotional support, timely information, and comfort needs remained insufficiently met in the UAE context. Conclusion & Recommendations Emotional support, timely information, and comfort should be prioritized to advance FCC in UAE ICUs. These findings can guide future research and foster the development of tailored support initiatives addressing the diverse needs of families. Also recommended to adapt visitation guidelines to allow increased family presence, particularly for critically ill patients, while maintaining infection control measures.

National Action to Reduce Barriers to and Bias against Women’s Leadership: A Comparative Analysis of Laws and Policies in 193 Countries

Women remain underrepresented in leadership roles worldwide. This article provides the first globally comparative analysis of laws and policies that reduce barriers to women’s career advancement. It finds that 86 per cent of countries failed to prohibit gender discrimination in performance evaluations and 73 per cent failed to prohibit discriminatory demotions. Caregiving responsibilities faced by women in leadership positions more than men went largely unsupported; 58 per cent of countries lack paid leave to address adult family members’ health. In spite of women leaders facing high rates of harassment, 90 per cent of countries lack laws prohibiting sexual harassment. Addressing these gaps is critical for progress.

Effectiveness of interventions to prevent or treat prolonged grief symptoms among families of patients who die in intensive care units: a systematic review protocol.

The objective of this review is to evaluate the effectiveness of interventions to prevent or treat prolonged grief symptoms among families of patients who die in the intensive care unit (ICU). Up to 52% of families of patients who die in an ICU may be at risk of experiencing prolonged grief symptoms. This psychological morbidity should be addressed as early as possible through effective interventions. Studies of adult family members (≥18 years) of adult patients (≥18 years) who died in the ICU after a treatment withdrawal or withholding decision will be considered for inclusion. Family members must be exposed to tailored interventions to prevent or treat prolonged grief symptoms before, during, and/or after the patient's death. Randomized and non-randomized controlled trials; before and after studies; and interrupted time-series, cohort, and case-control studies will be considered. The JBI methodology for systematic reviews of effectiveness will be followed. Databases to be searched include CINAHL, Academic Search Complete, Psychology and Behavioral Sciences Collection, Cochrane Central Register of Controlled Trials, and APA PsycINFO (all via EBSCOhost), as well as PubMed, Web of Science Core Collection, and Scopus. Two independent reviewers will perform the study selection, critical appraisal, and data extraction. Studies will be pooled in meta-analysis, if possible. Heterogeneity will be assessed using the standard χ 2 and I 2 tests. Statistical analyses will be performed using the random-effects model. The fixed-effects model will be used if fewer than 5 studies are included. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach will be used to grade the certainty of evidence, and a Summary of Findings will be presented. PROSPERO CRD42024528308.

Everyone Deserves College

Intellectual and developmental disabilities (IDD) are defined by the National Institute of Child Health and Human Development as, “disorders that are usually present at birth and that negatively affect the trajectory of the individual’s physical, intellectual, and/or emotional development.”1 Individuals with IDD face difficulties such as social exclusion, physical limitations, and lack of opportunities because of their disorders and because the systems currently in place are unprepared to respond to individual needs. One of the largest disparities for those with IDD is accessing the workplace, as “85% of families reported that their adult family members with IDD were not employed.”2 Of those who are employed, there is current legislation that allows individuals with IDD to be paid subminimum wages if their work is not to the standard of an employee without a disability.3 With these indicators present, the obtainability of competitive employment for individuals with IDD appears to be near impossible.

Examining Child Labour Activities in South Africa

Abstract Background South Africa is a developing country characterised by high unemployment, poverty and inequality. Thus, it is possible child members of households are exploited to help the households survive financially. Objective This study investigated child labour activities in South Africa, and examined the impact of various personal- and household-level factors (including labour market status of adult members) on child labour incidence. Methods Data from the Survey of Activities of Young People (SAYP) released by Statistics South Africa was analysed to derive descriptive statistics relating to child labour activities. Probit regressions were also conducted to investigate the impact of various factors on child labour probability. Results Children involved in child labour were predominantly African rural residents who did not attend schools at the time of the survey, and came from households with only one employed adult member on average. These children spent four to five hours per week on economic activities in unskilled elementary occupations, and the key reasons for involving in these activities were to earn pocket money for themselves and assist their families. Regarding the results of probit regressions, children coming from households with a greater number of employed adult members were less likely to be in child labour, but the result was only statistically significant in 2015. Conclusions Child labour does exist in South Africa, particularly amongst households with a low number of employed adult members. Numerous socio-economic problems (such as poverty and adult unemployment) would need to be addressed to fully eradicate child labour incidence.

Право ребенка на выражение мнения в спорах об ограничении и лишении родительских прав его родителей, отмене ограничения и восстановлении родительских прав: проблемы реализации

<p><strong>Context and relevance.</strong> An important aspect of the modern familysaving model for regulating family relations should be the finding of a balance between the realization of the child's right to express his or her opinion on all matters affecting them, including procedural opportunity in administrative and judicial processes (Article 12 of the UN Convention on the Rights of the Child), on the one hand, and the family situation, including the voice of adult family members, on the other hand. <strong>Objective.</strong> The work is aimed at identifying the peculiarities of the child's expression of opinion in disputes about his upbringing, concerning the restriction and deprivation of parental rights of his parents, as well as the abolition of restrictions and restoration of parental rights. <strong>Hypothesis.</strong> The expression of a child's opinion is important in situations involving the realization, loss and protection of their birth parents' rights. Identifying the views of the child of different ages and degrees of maturity requires a professional and independent approach, special techniques and procedures that take into account the mutual nature of children's and parents' rights and the possibility of preserving or restoring the child-parent relationship. <strong>Methods and materials.</strong> The analysis of legislation in regulating the institute of restriction and deprivation of parental rights, cancellation of restrictions and restoration of parental rights has shown that the norms of the Family Code of the Russian Federation and the Code of Civil Procedure of the Russian Federation are not coordinated with each other in terms of material and legal value and procedural realization of the child's opinion (consent) in significant disputes concerning his upbringing. Law enforcement practice deals with this problem in different ways, but the explanations of the Supreme Court of the Russian Federation and summaries of practice are insufficient to fully ensure the fulfillment of the child's conventional right to express his or her opinion in cases of parental custody loss. <strong>Results.</strong> The results of the study showed that there is a significant gap in the issue of identifying the child's opinion in the process of restricting and depriving the children's relatives of parental rights, as well as in the parents' defense of their own rights, including the cancellation of the restriction and restoration of parental rights and the return of the child to the family. <strong>Conclusions. </strong>It is shown that the identification of the child's opinion in disputes about his upbringing has both material and procedural significance and specificity, and requires the development of a methodology for working with child-parent relations and an independent expert approach. It is proposed to develop special procedures for identifying and taking into account the child's opinion in order to develop formats for preserving and restoring child-parent relations.</p>

Improving Social Interactions Among Adult Carers of Children with Disabilities Through Dialogic Literary Gatherings: A Case Study from Pakistan

The scientific literature has evidenced that certain educational and dialogic actions have been successful at increasing the quality of social interactions and improving mental health, among other beneficial aspects. One of these dialogic actions is the dialogic literary gathering (DLG). The impacts of DLGs have been demonstrated in Europe and South America but have yet to be explored in Eastern culture. The goal of the current study was to analyze the transferability of DLGs within South Asian culture in Pakistan. Specifically, the aim was to identify how the DLGs impacted the social interactions of middle-aged to older adults who were caregivers for children with disabilities. This research used a qualitative case study design with a communicative methodology to study a group of adult family members at a special education school who participated in the DLGs. Data collection included interviews, focus groups, and observations, and a thematic analysis was carried out. Based on the analysis, four broad categories emerged: cognitive engagement, mental well-being, self-development, and social–emotional experiences. Overall, the results demonstrate that the DLGs facilitated positive self-changes among participants, enabling them to experience and express a wide range of emotions through social interactions.

Sexual and Reproductive Health Needs of People Living with Disabilities: Family Planning Practice and Need in Gusau, Zamfara State, NW Nigeria

Background In Northwestern Nigeria, Persons Living With Disabilities (PLWD) often occupy marginalized low socioeconomic spaces, often considered as an afterthought for policy decisions and regularly face discrimination and barriers to accessing basic health needs, including access to Sexual and Reproductive Health (SRH) services, as compared to their able-bodied counterparts. Objective The study aims to understand the contraceptive and family planning needs and practices of PLWD, male and female, married and unmarried, living in Gusau, Zamfara State, Northwest Nigeria. Methods This cross-sectional study utilized primary data collected from 8 focus group discussions (FGD) with adult PLWD members of local disability community support organizations in Gusau, Zamfara State and their key informants. Participants were male and female, married and unmarried. Interviews were transcribed, translated and analyzed using descriptive thematic analysis. Results Most participants in all 8 FGD groups were aware of modern contraceptive methods and preferred them due to perceived safety and effectiveness in preventing pregnancy. Motivations for contraception use were to limit the number of children to avoid the financial burden of parenting. Reasons for not using contraceptives were paradoxically attributed to needing more children for assistance in activities of daily living (particularly by visually impaired PLWD), and for perceived fear of adverse effects of the contraceptives. Other barriers to use signaled access issues, included communication challenges, stigmatization by healthcare workers, and lack of disability-friendly services at the health facilities. Conclusion We recommend policies to improve SRH access for PLWD such as prioritizing respectful and disability-friendly healthcare environment, improved access to disability-type-specific health information, enhanced communication like braille and sign language interpretation, and free family planning services.

The humanistic burden of atopic dermatitis in Greece: a cross-sectional study.

The purpose of this study was to evaluate the quality of life (QoL) and psychosocial burden in adult Greek patients with atopic dermatitis (AD) using validated tools and to investigate factors that influence AD's humanistic burden. This observational, cross-sectional study was conducted in Greece (January-September 2023) with 150 adult members of the patient association "EPIDERMIA", all diagnosed with AD. Data was collected via a structured questionnaire, including socio-demographic details, clinical history, AD severity (using the Patient-Oriented Eczema Measure [POEM]), QoL, sleep disorders, and psychological health. Based on POEM scores, 11% of participants had clear/almost clear skin, 27% had mild eczema, 51% had moderate eczema, and 12% had severe/very severe eczema. AD had a moderate or very/extremely large impact on QoL for 29% and 42% of participants, respectively. Insomnia affected 55%, while 31% had mild anxiety, 23% had moderate/severe anxiety, 10% had moderate depression, and 8% had moderately severe/severe depression. AD severity was associated with reduced QoL and higher rates of insomnia, anxiety, and depression. Our study highlights significant associations between AD severity, QoL, and psychosocial factors, emphasizing the need for comprehensive management strategies.

Community perceptions about factors influencing access to care after sexual violence in North Kivu, Democratic Republic of the Congo: a qualitative study

BackgroundSexual violence is widespread in the eastern parts of the Democratic Republic of the Congo, including in the North Kivu province. Moreover, in this region survivors of sexual violence often have limited access to care and encounter a variety of barriers when seeking care and support. The aim of this study was to explore community perceptions about access to care, barriers, enablers and possible actions to improve access to care for survivors of sexual violence in North Kivu. A deeper understanding of community perceptions about access to care can guide ongoing efforts to overcome barriers and increase access to care for survivors of sexual violence.MethodsThe study utilised a qualitative design, based on focus group discussions with male and female adult community members in the study area. Previous experience of sexual violence was not a requirement. The transcripts from the discussions were analysed using manifest and latent qualitative content analysis.ResultsA total of 18 focus group discussions were carried out. The analysis resulted in three main themes; Knowledge and misconceptions around medical consequences crucial for care seeking, Community and family attitudes playing a dual role in care seeking behaviours and Care seeking dependent on optimised healthcare facilities and sensitive staff.ConclusionsLack of correct knowledge, harmful attitudes from community and healthcare staff, and poorly adapted healthcare services constitute barriers to accessing care. Improved awareness raising around sexual violence is needed to address both lack of knowledge and misconceptions. Efforts should be made to build upon the community support models and actively work to improve community attitudes towards survivors of sexual violence. In addition, there is a need for better adapted healthcare services with improved proximity, access for different groups of survivors and respectful and well-trained healthcare staff.

Ageing together and the paradox of negotiating care transitions for informal disability carers in migrant multicultural communities

ABSTRACT This paper examines care transition planning and the experiences of ageing carers who provide care for family members with disability from culturally and racially marginalised migrant (CaRM) backgrounds in Western Sydney. The study was designed as collaborative qualitative research involving family-based in-depth interviews and a validation workshop with nine families with a total of 16 participants: parents (n = 9); adult family members with disability (n = 7). The findings in this paper report only on informal carers (n = 9) and show that ageing informal carers are anxious about the future, stemming from their self-awareness of ageing, ongoing health concerns, and frustration with service systems. Long-term care transition plans include seeking independence for the family member with a disability, continuing living together until the end of life, and relying on normative disability services. The paper argues that ageing informal carers from CaRM backgrounds providing disability care face a growing challenge in negotiating social and healthcare service barriers affecting how they plan for future care. Ongoing advocacy and awareness of disability issues in CaRM communities are essential for prioritising care transition planning, disability rights, and service navigation. Carer support organisations should empower aging carers to address inconsistencies in aged and disability care, considering cultural norms.

Social evolution and absence of olfactory function in larval honey bees.

Social evolution made larval honey bees dependent on adult colony members for feeding. We therefore predicted they have diminished olfactory capabilities, and based on organismal resource conservation theory, also have downregulated olfactory receptor (OR) gene expression. Behavioral assays demonstrated that larvae cannot find food via olfaction and expressed very low levels of Orco , an essential gene for OR function. By contrast, larvae showed higher expression of Ir25a, an essential gene for multiple forms of sensory perception including gustation. These results suggest larvae rely on taste for feeding. In addition, considering that adult bees use OR-based olfaction extensively, they demonstrate strong developmental regulation of the OR system. Comparative transcriptomics of social and non-social insects further highlight the role of social evolution in shaping this sensory trait.

Effectiveness of BNT162b2 and Ad26.COV2.S vaccines against COVID-19-related hospitalisation amongst adult members of a private health insurance plan in South Africa during the Delta and Omicron periods: A test-negative case-control study

Effectiveness of BNT162b2 and Ad26.COV2.S vaccines against COVID-19-related hospitalisation amongst adult members of a private health insurance plan in South Africa during the Delta and Omicron periods: A test-negative case-control study

Associations Between Social Support, Social Control, and Stage of Change With Self-Reported and Objectively Assessed Physical Activity in Adult Latino Dyads.

Health behaviors such as physical activity (PA) are socially influenced, such that individuals from shared social networks or living environments may exhibit similar habits. This cross-sectional study examined associations of social support, social control, and family member stage of change with moderate-to-vigorous self-reported and objective PA in dyads of adult Hispanic family members. We used the Godin Leisure-Time Physical Activity Questionnaire to assess self-reported PA and accelerometry for objective PA. Validated scales assessed social support, social control, and stage of change. We performed multivariable multilevel analysis using generalized estimating equations (GEE) to account for within-dyad correlations. We conducted multivariable negative binomial regression for Metabolic Equivalent Task minutes (MET-minutes) (self-reported; N = 429) and accelerometer data (N = 356) and logistic regression for meeting PA guidelines (self-reported; N = 429). Most dyads were spouses (41%) or parents and adult children (32%). Individuals with high family support had 81% higher odds of meeting PA guidelines (1.81 adjusted odds ratio (aOR); 95% confidence interval [CI] = [1.06, 3.09]; p = .030) and 58% higher leisure-time MET-minutes of PA per week (1.58 adjusted incidence rate ratio [aIRR], 95% CI = [1.30, 1.91]; p < .0001) than those with low levels of support. Participants reporting medium-to-high family punishment were 98% higher in odds of meeting PA guidelines (1.98 aOR; 95% CI = [1.09, 3.61]; p = .025) and had 70% higher leisure-time MET-minutes of PA (1.7 aIRR; 95% CI = [1.36, 2.13]; p<.0001) compared with those with low scores. Participants with study partners in action or maintenance stages had significantly higher leisure-time MET-minutes of PA per week (aIRR = 1.45, 95% CI = [1.10, 1.91], p = .009 and aIRR = 1.33, 95% CI = [1.01, 1.76], p = .041, respectively) compared with those with partners in other stages. No statistically significant associations were observed for social control with any measure of PA or between psychosocial measures and accelerometer-assessed PA. Our findings demonstrated that interventions should engage social networks and multimodal forms of PA assessment to optimize behavior change in similar populations.

Influenza-associated hospitalization rates by underlying conditions, 2016-17 to 2019-20: A retrospective cohort study.

Various underlying medical conditions (UMCs) elevate the risk of influenza-associated hospitalization. We evaluated how these rates changed by type and number of UMCs. Retrospective cohorts were constructed among adult members of two health systems aged ≥18 years with prior healthcare utilization. Across the 2016-17 to 2019-20 seasons, we estimated influenza-associated hospitalization rates by type and number of UMCs. Hospitalizations were defined using discharge diagnoses or laboratory confirmation. We calculated adjusted rate ratios (aRR) using Poisson regression controlling for site, season, and demographic characteristics. We used causal mediation to estimate the effect of UMCs on influenza-associated hospitalization accounting for influenza vaccination status. Among 870,888 cohort members, 1,403 were hospitalized with influenza at least once within a season across four seasons. Compared to those without, the aRR for influenza-associated hospitalization was highest for individuals with congestive heart failure (4.2, 95% CI: 3.6-4.9). The aRRs also increased with each additional UMCs compared to those with no UMCs. The effect of UMCs on influenza-associated hospitalizations was higher when not mediated by vaccination status; for those with ≥4 UMCs compared to no UMCs, rates were about 60% higher. The burden of baseline medical conditions is associated with higher rates of influenza-associated hospitalization. Among those with varying types and number of UMCs, if vaccination prevalence had been lower than observed, influenza-associated hospitalization rates would have been higher. These findings highlight the importance of preventive medical care and annual influenza vaccination in reducing influenza-associated hospitalizations, particularly for individuals at high-risk.