Perceptions Of Adults Research Articles

Personal Gains and Challenges of Virtual Intergenerational Service-Learning in Health Promotion

ABSTRACT The Coronavirus Disease 2019 (COVID-19) pandemic has disrupted the conventional face-to-face learning since 2020. Face-to-face intergenerational service-learning was switched to online learning. Fifty-six undergraduate students in the health studies program taking the compulsory subject of Practices in Health Promotion were involved in this study which aimed to evaluate the personal gains and challenges of virtual intergenerational service-learning by applying a deductive content analysis on reflective essays submitted by the students. Results indicated that students had gained leadership skills, developed sense of empathy, built a reciprocal relationship with the community, had positive impact on future development and changed in perception of older adults after the virtual intergenerational service-learning. Challenges of the experience consisted of technical issues and support, interruptions during online presentation and effectiveness of services. Recommendations are provided for academic and community settings to achieve successful virtual intergenerational service-learning.

Exploring women's bladder self-care practices: A qualitative secondary analysis.

To describe women's experiences with a range of bladder self-care practices. We conducted a secondary, directed content analysis of qualitative data from the Study of Habits, Attitudes, Realities and Experiences, a multisite focus group study designed to explore adolescent and adult women's experiences, perceptions, beliefs, knowledge and behaviours related to bladder health. This study was conducted by the National Institute of Diabetes and Digestive and Kidney Diseases' Prevention of Lower Urinary Tract Symptoms Research Consortium. Study methods were informed by the Consortium's conceptual framework, based on a social ecological model adapted from Glass and McAtee's Society-Behavior-Biology Nexus. Participants were recruited at seven geographically diverse United States research centres between July 2017 and April 2018. Data for the current analysis were collected using a semi-structured discussion group with 36 focus groups involving 316 community-dwelling adult women aged 18-93 years. Coded text was re-examined according to eight self-care behavioural domains identified through literature review and expert opinion as potentially influencing bladder health. Participants described many self-care practices they had adopted to prevent bladder problems or manage existing symptoms and conditions. Eight themes were identified: 'Choosing fluids, foods and medications'; 'Dressing for bladder health'; 'Promoting bodily cleanliness'; 'Managing toileting environments'; 'Timing when to void'; 'Exercising pelvic floor muscles for bladder control'; 'Limiting physical activities that challenge the bladder' and 'Staying home and navigating when away'. Thirteen subthemes were derived from five of the eight themes. Women use a broad array of self-care practices related to their bladder health. Research is needed to examine the efficacy of self-care behaviours for preventing or managing bladder symptoms and conditions, and to discern potential risks. Results have important implications for development of bladder health promotion interventions and public health messaging around women's bladder health. This study provides a comprehensive framework for understanding women's bladder self-care practices, which can be used by clinicians and public health professionals in designing interventions to promote bladder health and function. Women with and without lower urinary tract symptoms use a broad range of self-care practices that may affect their bladder health, including some that may be harmful. Because of the high prevalence of bladder symptoms in women, this study may help patient assessment and counselling regarding self-care practices. This study was reported according to the Standards for Reporting Qualitative Research (SRQR). No patient or public contribution.

The association between socioeconomic status perception and mental health among Chinese older adults: the mediating roles of social trust and justice

BackgroundMental health is a matter of quality of life among older adults. This study aimed to explore the association between the socioeconomic status (SES) perception and mental health of older adults using data from 2017 Chinese General Social Survey (CGSS).MethodsOrdinary least squares (OLS) regression was used to analyse the association between SES perception and mental health, and the substitution model and variable methods were used to check the robustness of the results. Moreover, we adopted the Sobel model to analyse the mediating roles of social trust and justice.ResultsSES perception was positively associated with mental health, and this association was mediated by social trust and justice. This kind of positive association was mainly embodied in those groups with the highest or lowest objective SES. In other words, this study confirmed the phenomenon of “a contented mind is a perpetual feast” in Chinese society.ConclusionsHigher SES perception is associated with improved mental health for Chinese older adults. It is imperative to prioritize efforts to enhance the perceptual abilities of older adults, particularly those with the highest or lowest objective SES, to promote their overall subjective well-being.

The lived experiences and perceptions of middle-aged adults in Dominica who have survived severe storms-a qualitative exploration.

The Eastern Caribbean island of Dominica has experienced diverse negative effects from the North Atlantic hurricane season, including deadly storms like Hurricane Maria in 2017. Vulnerability is increased by geographic location, small island developing state (SIDS) status, and ecosystem characteristics. A variety of negative health effects including stress and anxiety are caused by powerful storms. The perspectives of middle-aged (the "sandwich generation") survivors in this post-storm milieu are understudied. This phenomenological qualitative study describes the perceptions of middle-aged (35-55 years) Dominicans, purposively recruited with gatekeeper assistance from communities stratified according to four natural hazard vulnerability categories designated by the Climate Resilience Execution Agency for Dominica (CREAD), regarding their lived experiences in the context of severe storms. Data was collected between June and August 2022, using primarily Zoom-based semi-structured, individual interviews (12 of 13), guided by the principles of saturation and maximum variation. Verbatim interview transcripts were thematically analyzed with constant comparison using an ATLAS.ti-supported hybrid deductive-inductive coding frame. Reflexivity and contact summary sheets were used to minimize bias. Ten women and three men from diverse CREAD vulnerability and sociodemographic backgrounds were recruited. Data condensation yielded three organizing themes: (i) "The diverse health effects of severe storms", (ii) "Response to and recovery from severe storms", and (iii) "Preparedness and precaution for severe storms". These themes encapsulated the health impacts of severe storms on Dominicans and elucidated the role of facilitating and barricading resilience factors. Severe storms produced direct and indirect mental, social, and physical health impacts on middle-aged Dominicans, including anxiety and burnout. Participants used faith-based, tangible community-based support, and emotional mechanisms to cope with and demonstrate resilience. Better risk communication and early warning systems would improve population readiness. Persistent dispirited attitudes toward storm preparedness among some participants suggest the need for targeted methods to enhance community involvement in disaster planning, including traditional approaches like "coup-de-main" (self-help).

Life Chances, Subjective Perceptions, and Healthy Lifestyles in Older Adults: Longitudinal Evidence From China.

Previous studies and theories show that healthy lifestyles are affected by life chances and subjective perceptions. However, it remains unclear how older adults change between different lifestyle profiles as they age. We proposed the healthy lifestyle duality framework and tested it among older Chinese adults using a longitudinal design. Data were obtained from 4 Chinese Longitudinal Healthy Longevity Surveys conducted between 2008 and 2018 (N = 31,445). Latent transition analysis and hierarchical multinomial growth curve models were performed to investigate healthy lifestyle profiles and their associations with life chances and subjective perceptions over time. Four distinct healthy lifestyle profiles were identified: healthy, risky, low-standard, and mixed groups, and their changes show path dependency. Across 10 years, the proportion of the healthy group ranged from 11.16% to 16.97%. Both life chances and subjective perceptions were longitudinally associated with healthy lifestyles, with age and cohort effects observed. Our findings support the healthy lifestyle duality framework and reveal that life chances and subjective perceptions influence lifestyle changes over time. Public health policies and health intervention programs should adapt to the specific needs of different age groups and generations.

Cortical neurite microstructural correlates of time perception in healthy older adults

The human experience is significantly impacted by timing as it structures how information is processed. Nevertheless, the neurological foundation of time perception remains largely unresolved. Understanding cortical microstructure related to timing is crucial for gaining insight into healthy aging and recognizing structural alterations that are typical of neurodegenerative diseases associated with age. Given the importance, this study aimed to determine the brain regions that are accountable for predicting time perception in older adults using microstructural measures of the brain. In this study, elderly healthy adults performed the Time-Wall Estimation task to measure time perception through average error time. We used support vector regression (SVR) analyses to predict the average error time using cortical neurite microstructures derived from orientation dispersion and density imaging based on multi-shell diffusion magnetic resonance imaging (dMRI). We found significant correlations between observed and predicted average error times for neurite arborization (ODI) and free water (FISO). Neurite arborization and free water properties in specific regions in the medial and lateral prefrontal, superior parietal, and medial and lateral temporal lobes were among the most significant predictors of timing ability in older adults. Further, our results revealed that greater branching along with lower free water in cortical structures result in shorter average error times. Future studies should assess whether these same networks are contributing to time perception in older adults with mild cognitive impairment (MCI) and whether degeneration of these networks contribute to early diagnosis or detection of dementia.

Recovery of Flavor Perception and Umami Taste Sensitivity in Young Chinese Adults Following SARS-CoV-2 Omicron Infection: A Case-Control Series

Recovery of Flavor Perception and Umami Taste Sensitivity in Young Chinese Adults Following SARS-CoV-2 Omicron Infection: A Case-Control Series

THE SOCIODEMOGRAPHICS INFLUENCE IN THE KNOWLEDGE, PERCEPTION, AND BEHAVIOR OF OSTEOPOROSIS IN MALANG: A COMMUNITY-BASED STUDY

Background: Osteoporosis is a major global health issue that results in disability and high medical expenses. It can significantly impact both individuals and their caregivers, leading to pain, limitations in daily activities, and emotional distress. Purpose: This study observed the association of sociodemographic factors in affecting knowledge, perception, and behavior related to osteoporosis in a rural area of Malang, Indonesia. Methods: A cross-sectional study was conducted in a rural area of Malang to assess the knowledge, perception, and behavior of adults (≥18 years old) toward osteoporosis. Participants were asked to fill in a validated questionnaire, which was selected randomly using a multistage stratified sampling technique. Collected data were analyzed on SPSS for Windows version 25.0. Results: The study included 376 randomly selected participants from various rural areas in Malang. The subjects mostly were within the 51-60 age group (34.0%), with female respondents accounting for 73.4% of the sample. On average, participants scored 1.8 (±2.5) for knowledge, 12.0 (±2.1) for perception, and 12.2 (±2.9) for behavior regarding osteoporosis. Both age and education levels showed associations with knowledge and perception, while only age was significantly linked to behavior concerning osteoporosis. Conclusions: Our study revealed a strong association between low educational levels, especially among the elderly, and the lack of knowledge, perceptions, and behavior toward osteoporosis.

CEO compensation: US college student and adult perceptions

Purpose This study aims to understand differences in perceptions of CEO compensation between working adults and business students in the USA before and after reading CEO pay information. Design/methodology/approach Participants completed a survey about their perceptions of chief executive officer (CEO) compensation before and after reading CEO compensation information that included the median CEO-to-employee ratio and salary in 2021. Findings Working adults and business students had similar levels of concern about CEO compensation. Participants were more concerned with CEO compensation after reading information about CEO pay but also believed CEO pay was more justified, contrary to equity theory (Adams, 1965). Among the student and adult samples, women and noninvestors were more likely to have concerns about CEO compensation than other participants. Practical implications Individuals may not understand the components of CEO compensation, and the size of CEO salaries may be difficult to comprehend. Educators and the media should consider presenting CEO compensation information in a different way, for example, how long it takes a CEO to earn as much as an average employee does annually, for the public to understand how much more CEOs are paid than their employees. Originality/value Little research exists on CEO compensation understanding and concerns. This research opens the opportunity for future studies on CEO compensation, for example, that consider variables other than CEO pay (e.g. equity and other forms of compensation) and what individuals believe CEOs do that justifies their high compensation.

Understanding Frailty: Perspectives and Experiences of Rural Older Adults in India.

In India, frailty has been predominantly studied as a physiological aspect, overlooking the subjective perceptions of community-dwelling older adults, which holds global significance. This study aims to explore frailty perceptions among community-dwelling older adults, comparing those enrolled in a geriatric welfare program facility to those not-enrolled. A cross-sectional design with a qualitative descriptive framework was employed, using focus group methodology. The study took place in rural West Bengal, located in eastern India, with a sample of 27 participants aged 60-87 years. Data collection occurred between October 2018 and January 2020, conducted through a face-to-face, semistructured discussion guide. Thematic analysis was performed to ensure data saturation and reliability. Three key themes emerged from the analysis: (a) Perceptions of frailty were associated with aging, functional dependence, and psychosocial health, (b) Exposure to a scientific definition led to an ideological dilemma influenced by personal experiences, (c) Walking speed and grip strength were prominent components of frailty. The findings revealed that there was no difference in perception between program-enrolled and nonenrolled older adults, likely due to the concept of frailty being new to all participants. However, it was noteworthy that participants enrolled in the welfare program exhibited a resilient mindset toward the definition and demonstrated a proactive interest in preserving their overall health. This novel study underscores the necessity of enhancing community awareness and integrating frailty management into the Indian health care system, which is yet to be fully integrated, aiming to promote the well-being of older adults.

Perception of middle-aged and older adults towards mHealth apps: A comparative factor analysis between Australia and Germany

ObjectiveAlthough evidence of the global effectiveness and usability of mobile health (mHealth) apps as non-drug interventions is growing, older adults often demonstrate low adoption rates of these apps. This study aims to identify the perspectives of older adults on introducing and adopting mHealth apps in Australia and Germany. Materials and MethodsWe conducted two online cross-sectional surveys to examine factors from contextual, technological and personal perspectives that influence older adults in mHealth app adoption. Using descriptive statistics, chi-square tests and exploratory factor analysis, we identified the differences and similarities between respondents’ perspectives across two countries. ResultsA total of 290 respondents (149, Australia; 141, Germany) completed the survey. Older adults’ ability to use a mHealth app, the user-friendliness of the app, their positive self-efficacy regarding their health and resource availability for using mHealth apps were related to intended adoption. Differences between Germany and Australia were found in issues concerned with data sharing and empowerment by the doctor, while similarities were related to trust in the doctor and their treatment approaches. Discussion and ConclusionThis study highlights participants’ perspectives and attitudes towards mHealth app use, unmet needs and barriers, and the facilitating influences in the two countries. These insights can be used to inform the development and implementation of mHealth apps and to construct tailored strategies to increase the adoption rates of mHealth apps among older adults and to maximise their potential benefits.

Reimagine Aging: A Process-Based Intervention to Decrease Internalized Ageism

Objectives Exposure to ageism may be internalized in older adults, and this can have severe consequences. However, little research has addressed reducing internalized ageism. Thus, Reimagine Aging, a 6-week process-based intervention to reduce internalized ageism, was designed and implemented, using education, acceptance and commitment therapy, and attributional retraining to target theoretically based mechanisms of change. Methods Seventy-two older adults (M = 70.4 years, SD = 6.4 years) participated in Reimagine Aging, consented to participate in this robust single-sample pilot study, and provided valid data. Participants completed questionnaires prior to, immediately following, and 2 months after the intervention. Results Participants’ self-perceptions of aging ( η p 2 =0.37, p < .001) and perceptions of older adults ( η p 2 =0.27, p < .001) became significantly more positive, associated with large effect sizes. Furthermore, these positive gains were mediated by increases in psychological flexibility, mindfulness, and perceived control. Discussion This study provides initial support for this process-based intervention targeting a reduction of internalized ageism. Clinical Implications This program has the potential to reduce the negative impact internalized ageism has on the health of older adults. Furthermore, it provides novel insights into intervention targets and tools that may be useful in achieving this reduction.

Effects of Temporal Processing on Speech-in-Noise Perception in Middle-Aged Adults.

Auditory temporal processing is a vital component of auditory stream segregation, or the process in which complex sounds are separated and organized into perceptually meaningful objects. Temporal processing can degrade prior to hearing loss, and is suggested to be a contributing factor to difficulties with speech-in-noise perception in normal-hearing listeners. The current study tested this hypothesis in middle-aged adults-an under-investigated cohort, despite being the age group where speech-in-noise difficulties are first reported. In 76 participants, three mechanisms of temporal processing were measured: peripheral auditory nerve function using electrocochleography, subcortical encoding of periodic speech cues (i.e., fundamental frequency; F0) using the frequency following response, and binaural sensitivity to temporal fine structure (TFS) using a dichotic frequency modulation detection task. Two measures of speech-in-noise perception were administered to explore how contributions of temporal processing may be mediated by different sensory demands present in the speech perception task. This study supported the hypothesis that temporal coding deficits contribute to speech-in-noise difficulties in middle-aged listeners. Poorer speech-in-noise perception was associated with weaker subcortical F0 encoding and binaural TFS sensitivity, but in different contexts, highlighting that diverse aspects of temporal processing are differentially utilized based on speech-in-noise task characteristics.

Insights Into the Use of a Digital Healthy Aging Coach (AGATHA) for Older Adults From Malaysia: App Engagement, Usability, and Impact Study.

Digital inclusion is considered a pivotal social determinant of health, particularly for older adults who may face significant barriers to digital access due to physical, sensory, and social limitations. Avatar for Global Access to Technology for Healthy Aging (AGATHA) is a virtual healthy aging coach developed by the World Health Organization to address these challenges. Designed as a comprehensive virtual coach, AGATHA comprises a gamified platform that covers multiple health-related topics and modules aimed at fostering user engagement and promoting healthy aging. The aim of this study was to explore the perception and user experience of Malaysian older adults in their interactions with the AGATHA app and its avatar. The focus of this study was to examine the engagement, usability, and educational impact of the app on health literacy and digital skills. We performed a qualitative study among adults 60 years and older from suburban and rural communities across six states in Malaysia. Participants were purposefully recruited to ensure representation across various socioeconomic and cultural backgrounds. Each participant attended a 1-hour training session to familiarize themselves with the interface and functionalities of AGATHA. Subsequently, all participants were required to engage with the AGATHA app two to three times per week for up to 2 weeks. Upon completion of this trial phase, an in-depth interview session was conducted to gather detailed feedback on their experiences. Overall, the participants found AGATHA to be highly accessible and engaging. The content was reported to have a comprehensive structure and was delivered in an easily understandable and informative manner. Moreover, the participants found the app to be beneficial in enhancing their understanding pertaining to health-related issues in aging. Some key feedback gathered highlighted the need for increased interactive features that would allow for interaction with peers, better personalization of content tailored to the individual's health condition, and improvement in the user-experience design to accommodate older users' specific needs. Furthermore, enhancements in decision-support features within the app were suggested to better assist users in making health decisions. The prototype digital health coaching program AGATHA was well received as a user-friendly tool suitable for beginners, and was also perceived to be useful to enhance older adults' digital literacy and confidence. The findings of this study offer important insights for designing other digital health tools and interventions targeting older adults, highlighting the importance of a user-centered design and personalization to improve the adoption of digital health solutions among older adults. This study also serves as a useful starting point for further development and refinement of digital health programs aimed at fostering an inclusive, supportive digital environment for older adults.

“You get out of the house, you talk to each other, you laugh…And that’s fantastic” – a qualitative study about older people’s perceptions of social prescribing in mainland Portugal

BackgroundSocial prescribing (SP) is a non-clinical approach, most commonly based in healthcare units, that aims to address non-medical health-related social needs by connecting individuals with community-based services. This qualitative study explores the perception of Portuguese older adults regarding the benefits of SP and their willingness to participate in SP initiatives.MethodsThree face-to-face focus group sessions were conducted with 23 participants in different cities in Portugal. Open and semi-open questions were used to guide the discussions and thematic analysis was used to analyze the data.ResultsThe participants recognized the potential benefits of SP for older adults, including diversifying leisure activities, improving mental health, and complementing existing support systems. They highlighted the need for external support, usually in the form of link workers, to facilitate personalized referrals and consider individual characteristics and preferences. While some participants expressed reluctance to engage in SP due to their existing busy schedules and a perceived sense of imposition, others showed openness to having new experiences and recognized the potential value of SP in promoting activity. Barriers to participation, including resistance to change, mobility issues, and family responsibilities, were identified.ConclusionsThe study emphasizes the importance of a person-centered and co-designed approach to SP, involving older adults in the planning and implementation of interventions. The findings provide valuable insights for the development of SP programs tailored to the unique needs and aspirations of older adults in Portugal, ultimately promoting active and healthy aging. Future research should consider the perspectives of family doctors and include a broader representation of older adults from diverse geographic areas.

A living lab to develop smart home services for the residential welfare of older adults

Owing to the decline in the physical and social functions of older adults, the residential environment substantially impacts the psychological and emotional stability and life satisfaction for older adults. Recently, there has been a growing interest in providing residential welfare services related to the health and independent living of the older adults. The primary objective of this research was to identify the needs and perceptions of older adults regarding smart home services and associated sensors and evaluate the indoor environment conditions of older adults through a living lab. Survey results indicate that older adults felt the burden of electricity bills in summer and winter and had relatively high safety-related smart home service needs. Focus group interviews with the participants in the living lab confirmed that older adults positively perceived the benefits and privacy of the living-lab sensors. In addition, the analysis of indoor environment data over one year from a case study household showed that approximately 66.4 % during the winter season and 13.1 % during the summer season have fallen within the neutral thermal comfort range according to the proposed approach (i.e., predicted mean vote (PMV) calculated using heart rate). This study adopted the proposed PMV method (hereafter PMV-P) that takes into account personal factors (e.g., metabolic rate of older adults that can be calculated using heart rate) and environmental factors (e.g., temperature, humidity) by using the real-time data collected from IoT (Internet of Things)-based sensors. Furthermore, this study proposed a new home energy management system (EMS) algorithm on the basis of model predictive control for reducing heating energy consumption while satisfying the thermal comfort. The new EMS was demonstrated to achieve 5–12 % heating energy savings depending on the thermal comfort preferences of occupants. Overall, the results of multidisciplinary research not only provided the preliminary evidence regarding the needs and perceptions of older adults toward IoT-based sensors but also showcased the development of IoT-based smart home service system through the living lab.

Negative perceptions of older adults and life satisfaction among community-dwelling older citizens in Japan

Background With the rapid aging of the population, increasing life satisfaction among older adults is essential. Negative perceptions of older adults are internalized, leading to poor mental health. This study hypothesized that participants with more negative perceptions of older adults would have lower life satisfaction. Methods A cross-sectional survey of older adults was conducted across five wards and four cities in Tokyo, Japan. Participants responded to questions regarding demographics, life satisfaction, and negative perceptions of older adults. Data from 285 participants (264 women, M = 71.97 years) were analyzed. Results The intraclass correlation coefficient for life satisfaction concerning residential areas was. 03 (95% confidence interval [CI] = [-.03, .10]). Instead of multilevel models, a multiple regression model with life satisfaction as the dependent variable and negative perceptions of older adults and demographics as the independent variables yielded the best fit. Results indicated that participants with more negative perceptions of older adults reported lower life satisfaction (β = -.16, 95% CI = [-.28, -.04], p = .008), supporting our hypothesis. Conclusions This study was constrained by limited variance in residential areas and a predominantly female participant pool. Previous studies have shown that higher life satisfaction is associated with increased social participation and extended life expectancy, and interventions aimed at enhancing life satisfaction in older adults are significant. Further exploration is warranted to ascertain whether a causal relationship exists, wherein more negative perceptions of older adults diminish life satisfaction.

Poor-Quality Daily Social Encounters, Daily Stress, and Subjective Cognitive Decline Among Older Adults.

Although prior research has shown that social relationships and daily stress are strongly associated with cognitive function, few studies have explored the link between the quality of daily social encounters and subjective cognitive decline (SCD). The present study explores whether the quality of older adults' daily social encounters is associated with SCD through daily stress. This study used data from 254 adults aged 70 or older (M age = 76.5 years, SD = 4.4; 67.7% women) who completed the Einstein Aging Study, a 2-week experience sampling study. Multilevel mediation analyses were conducted to account for daily measurements nested within individuals. We tested the indirect effect of the quality of daily social encounters on SCD through daily stress levels. There was a significant positive association between ambivalent and neutral social encounters and daily stress levels at both the within- and between-person levels. Between-person daily stress was, in turn, associated with greater SCD. Specifically, there was a significant indirect path from ambivalent social encounters to SCD through daily stress. This study contributes to a more detailed understanding of how the quality of daily social encounters can influence cognition via increased exposure to daily stress. The findings suggest that emotional support may be crucial to preserving perceptions of older adults' cognitive functioning.

Transition to self-management among emerging adults with type 1 diabetes: a mixed methods study.

Emerging adulthood is challenging for young people with type 1 diabetes (T1D). This study evaluated transition to diabetes self-management and perceptions of care transfer using mixed methods. An online survey queried demographics, management characteristics, diabetes knowledge, self-care readiness, adherence, and diabetes distress. T-tests compared survey scores between those with self-reported target A1c <7.0% versus ≥7.0%. Pearson correlations assessed associations between A1c and diabetes distress, stratified by A1c <7.0% versus ≥7.0%. Qualitative semi-structured interviews elicited perceptions of young adults; transcripts were analyzed using directed qualitative content analysis. Of 141 participants (30% male, 84% non-Hispanic white) completing the survey, 41% self-reported target A1c <7.0%. Diabetes knowledge and self-care readiness scores did not differ between those with A1c <7.0% versus ≥7.0%, while diabetes distress was lower (45 ± 20 vs 52 ± 20, p=0.01) and adherence higher (77 ± 12 vs 71 ± 14, p=0.02) in those with A1c <7.0% versus ≥7.0%. Diabetes distress was significantly associated with glycemic outcomes in those reporting A1c ≥7.0% (R=0.36, p<0.01). Qualitative analysis (24 participants) revealed five themes and two sub-themes, notable for need for more mental health support, support from others with T1D, benefits of technology for care autonomy, and challenges of obtaining diabetes supplies. Emerging adults with self-reported target A1c endorsed lower diabetes distress and higher adherence than those with elevated A1c. Mental health access, support from others with T1D, technology use, and guidance for supply acquisition may improve transition to self-management and care transfer for emerging adults with T1D.

The General Public and Young Adults' Knowledge and Perception of Palliative Care: A Systematic Review.

Background: As a result of demographic change, chronic and oncological diseases are gaining importance in the context of public health. Palliative care plays a crucial role in maintaining the quality of life of those affected. International guidelines demand access to palliative care not only for the elderly but also for younger people who face severe illnesses. It can be assumed that palliative care will become increasingly important for them. In order to develop public health strategies which are able to promote palliative care, it is important to assess the knowledge of, and attitude towards, palliative care as found among members of the general public and its specific target groups. In particular, little is known about young adults' knowledge and perceptions of palliative care. Objectives and design: This work aimed to assess the understanding and viewpoints regarding palliative care among the general population and among young adults aged 18 to 24. We therefore conducted a systematic review, which, for this target population, could be seen as a novel approach. Methods: Exclusion and inclusion criteria were developed using the PICOS process. Literature was researched within MEDLINE (via PubMed), Google Scholar and Web of Science. A search string was developed and refined for all three databases. Grey literature was included. Duplicates were excluded using Mendeley. The literature was independently screened by two researchers. Narrative synthesis was used to answer the main research question. Results: For the general public, palliative care is still associated with death and dying and comforting sick people towards the end of their lives. Multiple social determinants are linked to better knowledge of palliative care: higher education, higher income, female gender, having relatives that received palliative care, and permanent employment. The population's knowledge of palliative care structures increases, the longer such structures have been established within a country. Young adults are familiar with the term palliative care, yet their understanding lacks nuance. They associate palliative care with death and dying and perceive palliative care to be a medical discipline primarily for the elderly. Nevertheless, young adults demand participation within the planning of interventions to destigmatize palliative care. Conclusions: The general public still lacks a detailed understanding of palliative care. Palliative care faces stigma at multiple levels, which creates barriers for those who set out to implement it. However, addressing young adults as a crucial peer group can help break down barriers and promote access to palliative care.