Negative Self-perception Research Articles

Association between sleep problems and self-perception of health among community-dwelling older adults: Data from the 2019 national health survey

BackgroundSleep problems in the older adults are often linked to their self-perceived health status, significantly affecting their overall well-being. Investigating this relationship is essential to understand how sleep impacts health perception in older adults and to develop targeted strategies to improve their quality of life and health outcomes. The objective was to verifying the association between sleep problems and negative self-perception of health in community-dwelling older adults. MethodsCross-sectional study, with data from 43,554 older adults participants of the National Health Survey (PNS-2019). The exposure variable was self-report of sleep problems in the last 15 days (difficulty in falling asleep, waking up frequently at night, or sleeping more than usual) and the study endpoints were self-perception of health (positive/negative). Associations were checked using multivariable logistic regression. ResultsOlder adults with sleep problems were 1.92 (95 %CI 1.77; 2.08) more likely to have a negative self-perception of health when compared to older adults without sleep problems. ConclusionsThese findings reinforce the need for programs aimed at reducing sleep problems in older adults, since these are associated with negative self-perceptions of health. A better understanding of these associations may help health care professionals to better control sleep disturbances as well as their outcomes.

Integrating Subjective Recovery and Stigma Resistance in Individuals with Schizophrenia: A Narrative Review and Theoretical Integration

Stigmatised attitudes are known to be associated with negative outcomes in schizophrenia, yet there is little focus on the role of stigma in the recovery process. Attempts to develop interventions to reduce self-stigma in schizophrenia have not been found effective. This paper presents a theoretical integration based on a narrative review of the literature. PsycINFO, Medline and Embase databases were searched up to the 11th December 2023. Studies were included if they were: i) empirical studies using qualitative, quantitative or mixed methods studies investigating mental health stigma; ii) included participants based in the United Kingdom, fluent in English, between the ages of 16 and 70, meeting criteria for a schizophrenia spectrum diagnosis. Fourteen studies were included. In Part 1, we propose a novel theoretical model derived from a synthesis of service-user perspectives on the relationship between stigma and schizophrenia. Stigmatised attitudes were commonly perceived to be caused by a lack of education and further exacerbated by disinformation primarily through the media and cultural communities. Stigma led to negative self-perceptions, negative emotional responses, social isolation and increased symptom severity, ultimately acting as a barrier to recovery. In Part 2, we identify several factors that ameliorate the impact of stigma and promote clinical and subjective recovery among service-users: education, empowerment, self-efficacy, self-acceptance, hope and social support. We argue that the notion of stigma resistance may be helpful in developing new interventions aimed at promoting recovery in individuals with schizophrenia. Wider implications are discussed and recommendations for future research and practice are explored.

RELATIONSHIPS BETWEEN SOCIAL MEDIA ADDICTION AND SELF-ESTEEM AMONG UNIVERSITY STUDENTS IN MALAYSIA

Self-esteem can greatly influence one's emotional well-being, behavior, and interactions with others. It can range from high self-esteem, where individuals have a positive and healthy view of themselves, to low self-esteem, where individuals may have feelings of inadequacy, self-doubt, and a negative self-perception. Social media usage can have a negative impact on one's self-esteem, however, it can also potentially have a positive effect. This research is conducted to identify the level of social media addiction among university students and the relationship between social media addiction and self-esteem among university students. There are 384 respondents who were selected using simple random sampling techniques among university students in Malaysia. The findings show that the level of social media addiction among university students in Malaysia is high and it shows that there is a significant relationship between social media addiction and self-esteem among university students.

Self-stigma, career development and employment in young adults with ASD in Chile.

IntroductionStigma describes prejudicial attitudes, negative stereotypes, and discrimination targeting a subgroup. Various forms of stigma have been identified in the literature, including self-stigma. Self-stigma or internalized stigma occurs when stigmatized individuals become aware of the negative stereotypes and apply these to themselves. Self-stigma may be a barrier to career development and employment in individuals with Autism Spectrum Disorder (ASD). However, there are few data available on the presence of self-stigma among young adults with ASD in Chile to inform local interventions and policies.ObjectivesTo analyze self-stigma and its relation with career development and employment in young adults with ASD in Chile.MethodsA mixed-method observational study was conducted to analyze self-stigma and its association with career development and employment among young adults with ASD in two regions of Chile. For the quantitative analysis, self-stigma was assessed using the Internalized Stigma of Mental Illness (ISMI) scale, and employment information was collected. For the qualitative analysis, in-depth interviews were conducted. Data from the interviews were digitalized and transcribed, and the analysis was conducted using ATLAs.ti following the principles of Glaser and Strauss’s Grounded Theory. All participants provided written informed consent, and the study was approved by the local Institutional Review Board.ResultsOverall, 356 participants were included in the quantitative analysis (mean age: 27.8 [SD 6.2] years, 44.7% women, 14.8% with regular employment). The mean ISMI for the total sample was 2.34 (SD = 0.62). By triangulating this information with the qualitative analysis (n=27), it was observed that young adults with ASD frequently experience self-stigma attitudes. Through the in-depth interviews, we identified barriers and facilitators for the development of self-stigma. Also, we identified that negative self-perceptions among young adults with ASD may be a barrier to seeking career development opportunities and employment in this population.ConclusionsThe current study shows self-stigma is present in young adults with ASD in Chile, and this may impact negatively their career development and employment.Disclosure of InterestNone Declared

“Externalizing the Internalized:” Exploring Externalizing Conversations in Narrative Therapy with Adolescents and Young Adults in the Indian Context

People who seek therapy often view the problems they are experiencing as reflections of something internal, which could lead to a sense of helplessness over the problem, ideas of blame, and negative self-worth. Narrative therapy is a respectful, non-blaming approach to therapy that centers people as the experts in their own lives and views problems as separate from people. Externalizing conversations are a facet of narrative therapy that seek to separate individuals from these “internalized” understandings or ideas of a problem, place the problem in the social context, and construct preferred stories that align with their values and skills to re-author problem stories. The problem stories people bring into therapy may often focus on perceived failures, weaknesses, or feeling overwhelmed with the problem. Externalizing conversations can play a role in deconstructing these narratives and therefore challenge the negative perceptions of self and identity associated with the problem. The stories presented in this article by three narrative practitioners working in the Indian context revolve around their therapeutic work with three young people, with a focus on the use of externalizing conversations to de-pathologize LGBTQIA+ identities, work with experiences of violence and abuse without retraumatization, and deconstruct the diagnosis of ADHD. Here, externalizing conversations serve as a framework to deconstruct ideas of internalized blame, shame, and guilt for young people with different problems, ages, and socio-cultural contexts. Weaving these distinct stories together and reflecting on the use of externalizing conversations in the therapeutic context, this article seeks to explore and discuss dominant ideas about problem stories and therapeutic intervention and create paths to reauthored stories with a focus on individual agency and social justice.

The impact of social media on women's physical appearance and self-esteem: A feminist perspective

This research paper investigates the impact of social media on women's physical appearance and self-esteem from a feminist perspective. Social media platforms have become pervasive in modern society, shaping beauty standards and influencing women's perceptions of themselves. Through a feminist lens, this paper examines how social media perpetuates unrealistic beauty ideals, fosters body dissatisfaction, and contributes to negative self-perception among women. Additionally, it explores the ways in which feminist movements and digital activism on social media challenge these harmful narratives and promote body positivity, self-acceptance, and inclusivity. By analysing the interplay between social media, feminism, and women's physical appearance, this paper aims to contribute to a deeper understanding of the complex relationship between technology, gender, and self-esteem.

Adults diagnosed with gynecologic cancer and their relationship with their body: A study on the supportive role of yoga using interpretative phenomenological analysis

The purpose of this qualitative study was to explore the thoughts, feelings, attitudes, and perceptions of adults diagnosed with gynecologic cancer on their body, and the role of yoga in shaping these aspects. A phenomenological research design was used. Fifteen women (Mage=50.1 ± 13.5 years, range=28–66) who practice yoga at least once/week completed a sociodemographic survey online, two semi-structured interviews, and a 30-day journal online. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using interpretative phenomenological analysis. Participants’ responses and the authors’ interpretations were summarized into four main superordinate themes: (1) internal monologue of the changed body, (2) balancing act between acceptance and improvement, (3) value of taking time to prioritize oneself by practicing yoga, and (4) transformative catalysts of expectation and mindset on body-related self-perceptions after yoga. Body functionality and appearance, and their sexual health were often deeply interconnected, and impacted participants’ self-perceptions and behaviours. Yoga was a vehicle for growth and acceptance; however, participants’ expectations and mindsets before and during yoga could lead to negative self-perceptions after yoga. The findings underscore the importance of integrating yoga – a holistic practice – into survivorship care programs, while emphasizing the need to address expectations and attitudes that could hinder positive outcomes.

Neurological, Metabolic, and Psychopathological Correlates of Lifetime Suicidal Behaviour in Major Depressive Disorder without Current Suicide Ideation

Plain Language SummaryAlthough thinking of suicide for some period of time (suicide ideation) is traditionally viewed as necessary to attempt suicide in the future, many people who engage in suicide behaviour do not report specific suicidal thoughts during clinical interviews. We wanted to know how to predict suicide in these subjects; therefore, we investigated a number of promising characteristics in two different age groups of depressed patients (sample 1: n = 230; age: 18–65 years; sample 2: n = 258; age >60 years) who were negatively tested for the presence of suicide ideation. As expected, SB was not rare in these groups. Among younger patients, suicide attempts were a little more frequent than in the other group (15 vs. 9%); they more often involved men, those who had been victims of sexual abuse in childhood, those who had negative thoughts about themselves or were predisposed to bipolar disorder. On the other hand, in old age, suicide risk was correlated with neurological problems, foremost alterations in language and movement disorders, and cholesterol levels. Thanks to this information, to determine suicide risk is still possible even when intent to die is not reported.

Negative self-perceptions and severity of NSSI: Testing the benefits and barriers model.

Nonsuicidal self-injury (NSSI) is theorized to be caused by negative associations with the self, including low self-esteem, but the mechanisms explaining why low self-esteem is related to more severe NSSI are unclear. The current study aimed to address this limitation by evaluating a mediation model, proposing that low self-esteem would relate to more severe NSSI through increasing self-punishment motivations. Data came from 468 undergraduate students with a history of NSSI who completed an online survey measuring NSSI characteristics and functions, self-esteem, and self-punishment motivations for NSSI. Mediation was tested using a structural equation model using bootstrapped 95% percentile-corrected confidence intervals in which NSSI severity was modeled as a latent variable composed of NSSI frequency, recency, and versatility of methods. The total model was significant and the indirect effect of self-esteem on NSSI severity through self-punishment motives was significant. Self-esteem also retained significant direct effects on NSSI severity, indicating partial mediation. These results provide support for the benefits and barriers model of NSSI, suggesting that negative self-views increase risk for more severe NSSI through self-punishment motivations. Clinical interventions that emphasize self-compassion and focus on modifying self-punishment motivations may help reduce NSSI behavior.

Young women's leisure time physical activity determinants: a mixed methods approach.

The aim of the study was to analyze the habits, motives and barriers related to Leisure Time Physical Activity (LTPA) among young women of Gipuzkoa, from a mixed approach. A total of 526 women aged 18-29 (24.60 ± 3.30 years) responded to the Gipuzkoa Women's Physical Activity Questionnaire (GWPAQ), seven of which were later interviewed. The main motives for LTPA were intrapersonal - related to health and enjoyment - and to interpersonal networks. However, the main barriers facing LTPA were mostly intrapersonal, such as lack of time, tiredness, and laziness. Contextual factors such as the availability of safe spaces, previous negative experiences, or negative self-perception of motor competence also emerged as conditioning factors in young women's LTPA habits. This study may help to promote policies aimed at incentivizing LTPA for young women based on their needs and interests, by addressing the diversity of factors.

Effects of workplace ageism on negative perception of aging and subjective well-being of older adults according to gender and employment status.

According to stereotype embodiment theory, workplace ageism can worsen older adults' self-perceptions of aging and subjective well-being. However, there has been little research on gender differences in this regard. This study examined the effects of workplace ageism on attitudes toward aging and subjective well-being according to gender and employment status. We carried out an online survey of 600 participants aged 60-74 years in October 2021. Participants were equally divided into women who had worked full-time, women who had worked part-time and men who had worked full-time, and further divided by current employment status, forming a total of six groups for comparison. A total of 75% of the participants perceived some form of workplace ageism. Structural equation modeling showed that, for men and women in full-time employment, workplace ageism was associated with a negative self-perception of aging and poor subjective well-being, the effect of which was strong among those currently employed and weak among those who had retired. For women working part-time, the impact of workplace ageism on subjective well-being was stronger among those who were currently unemployed. Workplace ageism exacerbates older adults' self-perception of aging and decreases their subjective well-being. Women working part-time might quit their jobs when their subjective well-being worsens due to workplace ageism. Therefore, it is necessary to create a workplace environment that is comfortable for older workers and free of ageism. Geriatr Gerontol Int 2024; 24: 259-265.

Embracing virtual reality in rehabilitation of post-stroke aphasia.

About one-third of stroke survivors experience aphasia, i.e., language dysfunction caused by brain damage. Aphasia affects not only a person's ability to communicate, but it often leads to the inability to return to work, loss of close relationships, diminished quality of life, negative self-perception, and depression. Yet persons with aphasia are globally underserved due to limited access to resources, which limits their chance for recovery. Immersive virtual reality (VR) has the potential to solve this problem and deliver efficient, personalized treatments to millions of people worldwide who need access to rehabilitation services or more flexibility in treatment delivery. To reduce the global burden of stroke experts recommend taking bold, pragmatic actions across all four pillars of stroke quadrangle-surveillance, prevention, acute care, and rehabilitation. Embracing immersive VR-based rehabilitation of poststroke aphasia would be one step in that direction.

ВОССТАНОВЛЕНИЕ ПОСЛЕ ПСИХОЭМОЦИОНАЛЬНЫХ НАРУШЕНИЙ ДЕТЕЙ И ПОДРОСТКОВ В СВЯЗИ С ОНКОПРОЦЕССОМ С ПОМОЩЬЮ ЭЛЕМЕНТОВ АРТ-ТЕРАПИИ

The need to study the influence of art therapy techniques, in particular fairy tale therapy, game therapy, drawing and creativity therapy on the psycho-emotional state of children and adolescents with cancer is obvious due to the prevalence of mental disorders at the stage of hospitalization. Purpose: to analyze the literature to study the impact of art therapy elements on the psycho-emotional state of children and adolescents with cancer during treatment. General information. Children undergoing treatment for cancer often have psycho-emotional disorders such as depression, anxiety and report concerns about hair loss, nausea and fatigue, lower ability to perform physical activities, and expectations of dissatisfaction with life in the future. Negative self-perception of body image leads to low self-esteem and affects the ability to form healthy relationships with peers. Neurocognitive dysfunction (decreased speed of information processing, attention, memory) leads to low academic and professional success, poor self-esteem and behavioral or emotional disorders. Art therapy techniques such as fairy tale therapy, game therapy, drawing and creativity therapy effectively influence the psycho-emotional status of patients, help children get rid of painful feelings and cope with their anxiety, help improve well-being, relieve pain, etc. Psychotherapy provided to cancer patients in childhood in a timely manner will help improve the psycho-emotional state associated with the disease and treatment. The techniques are universal and complement each other if necessary; they can be successfully used in the treatment of many psychological disorders, as well as integrated and combined with other therapeutic approaches (body-oriented approach, music therapy, dance-movement method, etc.).

Self-assessment of dental health status, behaviours and oral health risk factors among adolescents from public schools in Maputo City-Mozambique

Self-assessment of dental health status may have an impact on the oral health behaviour of adolescents which could impact their oral health. Oral health has been linked to various medical health conditions, thus eliminating oral health diseases can improve general health. The present study aimed to assess the association between behaviours and risk factors (oral hygiene habits, sugar intake, urban/rural status) and negative self-perception of dental health status among adolescents attending public schools in Maputo City.Method An analytic cross-sectional study, conducted in three Primary public schools from urban and peri-urban areas in Maputo City selected by convenience due to their geographic location was included. The size of the sample was 236 12-year-olds. Data was collected using a self-completion questionnaire designed by the World Health Organization (WHO). Chi-square tests or Fishers’ Exact tests were used for associations. A simple and multiple logistic regression was used to determine the strength of these associations using backward elimination (p < 0.05). Results: The sample consisted of 221 adolescents, with 114 (51.6%) residing in urban areas and 107 (48.4%) in peri-urban areas. More than half of the participants (111 individuals) reported having a negative perception of their dental health. In the urban location, a higher percentage of participants had a “negative” perception of dental health (57.9%, n = 66), while in the peri-urban location, more participants perceived their dental health as “positive” (57.9%, n = 62). Participants residing in an urban setting were 82% more likely to have a negative perception of dental health (AOR = 1.82 [95% C.I.: 1.05 to 3.14]). Those who had experienced dental pain tended to report a higher proportion of negative dental perception (57.2%, n = 91), with 2.7 times more likely to report a negative perception of dental health (AOR = 2.72 [95% C.I.: 1.46 to 5.08]). The majority (n = 139; 63.2%) claimed to clean their teeth twice a day.Conclusion There was a higher negative perception of dental health in urban areas. The need to strengthen oral health promotion in urban schools is high since schools play such a significant role in oral health promotion.

Self-perception and perceived parental perception in adolescent girls with anorexia nervosa.

Negative self-perception is associated with poor outcomes in adults with anorexia nervosa (AN). Our study aimed to assess the association between the self-perception of female adolescents with AN and how these adolescents perceive the attitudes of their parents toward them on the severity and short-term outcome of their illness. For this purpose, we assessed 30 adolescent girls hospitalized with AN and 30 female controls. Self-perception and perceived parental attitudes were assessed using the Structural Analysis of Social Behavior (SASB), according to which self-perception is formed via close relations with significant others in early life. Patients with AN responded to the SASB and to questionnaires assessing eating disorder (ED) symptomatology and emotional distress at both admission and discharge. Controls were similarly assessed once. We found that patients with AN showed a more negative self-perception than controls. Negative self-perception was associated with negative perceptions of the mothers' attitudes toward the girls. There was no between-group difference in the perceived perception of the fathers' attitude to the girls. Self-perception and perceived parental attitudes were associated with the severity of ED symptoms and emotional distress. Finally, an improvement was found in self-perception and perceived maternal attitudes toward the girl from admission to discharge, alongside a decrease in the severity of ED symptoms and emotional distress. Self-perception at admission was associated with ED pathology and emotional distress at discharge. These findings suggest that self-perception and perceived parental attitudes toward the adolescent with AN may be associated with the severity of the illness and its short-term outcome.

Self-perceptions as mechanisms of achievement inequality: evidence across 70 countries

Children from lower socioeconomic status (SES) backgrounds tend to have more negative self-perceptions. More negative self-perceptions are often related to lower academic achievement. Linking these findings, we asked: Do children’s self-perceptions help explain socioeconomic disparities in academic achievement around the world? We addressed this question using data from the 2018 Programme for International Student Assessment (PISA) survey, including n = 520,729 records of 15-year-old students from 70 countries. We studied five self-perceptions (self-perceived competency, self-efficacy, growth mindset, sense of belonging, and fear of failure) and assessed academic achievement in terms of reading achievement. As predicted, across countries, children’s self-perceptions jointly and separately partially mediated the association between socioeconomic status and reading achievement, explaining additional 11% (ΔR2 = 0.105) of the variance in reading achievement. The positive mediation effect of self-perceived competency was more pronounced in countries with higher social mobility, indicating the importance of environments that “afford” the use of beneficial self-perceptions. While the results tentatively suggest self-perceptions, in general, to be an important lever to address inequality, interventions targeting self-perceived competency might be particularly effective in counteracting educational inequalities in countries with higher social mobility.

Breaking the cycle with trauma-focused mentalization-based treatment: theory and practice of a trauma-focused group intervention.

Trauma-Focused mentalization-based treatment (MBT-TF) is an adaptation of mentalization-based treatment (MBT) specifically developed for patients suffering from attachment or complex trauma, with the possibility of co-occurring borderline personality pathology. The creation of MBT-TF was driven by previous research and observations that interventions centered on mentalizing could be significantly improved by directly addressing the impact of trauma. MBT-TF aims to mitigate symptoms that arise post-trauma, such as hyperarousal, hypervigilance, intrusions, flashbacks, avoidance behaviors, dissociative experiences, negative perceptions of self and others, and ensuing relational difficulties. Implemented as a group intervention, MBT-TF typically spans 6-12 months. From a mentalizing perspective, trauma, particularly attachment trauma, leads to a failure in processing the effects of trauma through and with others. Stress and attachment behavioral systems are disrupted, which undermines the capacity for epistemic trust, and impairs mentalizing abilities. This paper offers a concise summary of the reasoning for MBT-TF's creation, its theoretical underpinnings, and its clinical strategy for addressing the adverse impacts of trauma. It further details the treatment phases, their main goals, and their interventions, supplemented by clinical case examples that underscore MBT-TF's distinctive attributes and frequent clinical hurdles.

A pilot study to Assess Effectiveness of Nurse Lead Program for Implementation of In-Vitro fertilization treatment &amp; related coping strategies among Infertile women at selected hospital( Aum &amp; Priya IVF Clinic) Annand ,Gujarat

Infertility affects many families in terms of their social relationships, finances, and intramarital relationship. But most significantly, it affects the psychological health of the infertile woman or couple. Infertility is stigmatized in our society. According to Inhorn MC's study, social isolation and negative self-perception are two outcomes of infertility. The inability to carry out a pregnancy successfully, or the pregnancy being interrupted at some point, is referred to as infertility. One-fifth to one-sixth of couples who are old enough to procreate suffer from infertility. Although infertility does not endanger a person's life or compromise their physical integrity, it has a detrimental impact on their social and psychological well-being.

Prevalência e fatores associados à fragilidade em pessoas idosas hipertensas por meio da Escala de Fragilidade de Edmonton e Índice de Vulnerabilidade Clínico Funcional-20

Abstract Objective To assess the prevalence of frailty and compare the variables associated with frailty in Brazilian community-dwelling older adults with hypertension using the Edmonton Frail Scale (EFS) and the Clinical Functional Vulnerability Index-20 (IVCF-20). Methods This is a cross-sectional analytical study conducted with community-dwelling older adults with hypertension aged ≥60 years residing in the city of Montes Claros, Minas Gerais, Brazil. Sample selection followed a probabilistic cluster sampling model. Data were collected between November 2016 and February 2017 through in-home questionnaire administration. Demographic, socioeconomic, and clinical-care variables were analyzed. Poisson regression with robust variance was used to obtain crude and adjusted prevalence ratios. Results A total of 281 older adults with hypertension participated in the study. The overall prevalence of frailty as assessed by the EFS was 31.3%, and by the IVCF-20 was 22.1%. Variables that were statistically associated with frailty in older adults with hypertension, as determined by both the EFS and IVCF-20 simultaneously, were: advanced age (80 years or older), comorbidities such as rheumatoid arthritis/osteoarthritis, stroke, negative self-perception of health, falls, and hospitalizations in the last 12 months. Only by the EFS, variables associated with frailty included less than 4 years of education, absence of religious practice, and lack of personal income. Meanwhile, according to the IVCF-20, only monthly family income was associated with frailty. Conclusion It was found that frailty assessed by EFS and IVCF-20 exhibits similarity; however, EFS is more sensitive. These findings underscore the imperative for healthcare professionals to early identify frailty.

Influencing factors of self-perceived aging among empty nesters: a cross-sectional studyg empty-nesters

Introduction: The mental health issues faced by empty nesters deserve more attention. Studying self-perception of aging (SPA) and its influencing factors among empty nesters may help prevent negative SPA. Objective: To analyze situations and factors influencing SPA among elderly empty nesters, especially the mediating role of daily living ability and loneliness. Materials and Methods: A cross-sectional study was conducted in two communities in Binzhou City, Shandong Province of China. A total of 613 elderly empty nesters were studied using a self-designed general information questionnaire, the Brief Ageing Perception Questionnaire (B-APQ), the Activities of Daily Living (ADL) Scale, and the UCLA Loneliness Scale (ULS-6). Structural equation modeling (SEM) was used to analyze the relationships between variables. Results: Pathway analysis of SPA influencing factors shows that marital status, children’s visits, and self-reported health had an indirect effect on SPA through loneliness. Chronic disease status had an indirect effect on SPA through daily living ability. Time outdoors had an indirect effect on SPA through activities of daily living and loneliness. Discussion: Daily life ability, chronic disease status, time outdoors, loneliness, self-reported health, marital status, and children's visits affected SPA among empty nesters. Conclusion: Empty nesters' SPA is relatively negative, and there are many influencing factors. It is important to improve empty nesters' abilities to manage healthcare tasks, increase outdoor activities and family members’ care, and provide comprehensive interventions to help them navigate aging.