Perspectives Of Adults Research Articles

The Impact of Factional Discourse On the Palestinian National Cause

AbstractWith the Israeli war on Gaza raging, the Palestinian national movement must overcome divides that have weakened the cause. This study delves into the ramifications of divisive discourse on factionalism in Palestine, focusing on the dynamic between Hamas and Fatah. To do so, it investigates the effects of polarization on the sense of collective consciousness among university students in the occupied territories. Through a questionnaire designed to elicit the perspectives of these young adults, this research sheds light on the extent to which rhetoric employed to provoke or incite aggressive behavior has affected cohesion in Palestinian politics and society, as well as individuals’ beliefs in the possibility of a national movement. The article finds that in all of these facets, young adults have a high degree of cynicism and see divisive discourse reducing faith in institutions and leaders, causing rifts among friends and neighbors, and even leading them to think about emigrating. While the study was conducted before the Israel‐Hamas war that began in October 2023, which may force some compromise between factions, the survey results indicate the immense amount of work required to unify the movement.

Perceptions of Consumer Fraud and Aging Among Older People and the Judiciary in China.

Systematic research has been conducted on the relationship between aging and consumer fraud victimization. But few empirical studies examine the reality of judicial dispute resolution in consumer fraud against older people from the perspective of older adults and judges in China. Based on 161 court rulings, this qualitative study explores the perceptions of older adults in litigation about their experiences of being defrauded in China, alongside judges' responses. Results reveal that common fraud patterns used by business perpetrators render older individuals more susceptible to fraud. Older plaintiffs strategically frame "old age" in litigation, potentially as a tactical maneuver, while also readily emphasizing the importance of procedural justice. Results further show that judges expressed either negative ageism or age-neutral discourse in response to fraud targeting older individuals. Findings highlight the need to enhance consumer education to prevent fraud and address ageist stereotypes among older people. Findings also highlight the need to encourage Chinese courts to consider individual case specifics, leading to fair judgments and the protection of older individuals from fraud while upholding their rights.

Where Does Hope Lie? The Dialectical Tensions Between Hopes and Expectations of Vocational Transition Planning from the Perspectives of Autistic Young Adults, Parents, and Practitioners.

The post-secondary transition for autistic youth is a complex process, with hopes and expectations serving as malleable mediators often overlooked in research and practice. Career awareness, exploration, and counseling services play a critical role in facilitating vocational transition, but the vocational hopes and expectations of autistic youth and their parents are often disregarded. This study aims to explore these aspirations and their impact on the vocational transition process, seeking to harmonize elements to better align with the needs of autistic youth and their families. This study used a focus group design involving group interviews with three participant groups: autistic transition-aged youth, parents, and practitioners. The findings reveal five key themes: 1) Accepting Disability or Constrained by Ableism: Resisting Marginalization, 2) Finding the Sweet Spot: Are Parents and Youth's Expectations Too High or Too Low, 3) Market Forces at Work-Finding a Meaningful Vocational Path in a Capitalist Society, 4) Despite Meticulous Planning, there is a Disconnect Between Needs and Resources, and 5) The Hills and Valleys of Finding Resilience. Navigating the multifaceted landscape of vocational transition planning for autistic youth necessitates a collaborative and flexible approach. Identified tensions serve as opportunities for growth and transformation. Recognizing and addressing system shortcomings is crucial for informed decision-making. Challenges extend beyond individual circumstances, reflecting broader systemic issues, and identifying these gaps allows for a comprehensive understanding of available resources, cultivating a basis of hope as uncertainties are addressed.

Exploring the Perspectives of Social VR-Aware Non-Parent Adults and Parents on Children's Use of Social Virtual Reality

Social Virtual Reality (VR), where people meet in virtual spaces via 3D avatars, is used by children and adults alike. Children experience new forms of harassment in social VR where it is often inaccessible to parental oversight. To date, there is limited understanding of how parents and non-parent adults within the child social VR ecosystem perceive the appropriateness of social VR for different age groups and the measures in place to safeguard children. We present results of a mixed-methods questionnaire (N=149 adults, including 79 parents) focusing on encounters with children in social VR and perspectives towards children's use of social VR. We draw novel insights on the frequency of social VR use by children under 13 and current use of, and future aspirations for, child protection interventions. Compared to non-parent adults, parents familiar with social VR propose lower minimum ages and are more likely to allow social VR without supervision. Adult users experience immaturity from children in social VR, while children face abuse, encounter age-inappropriate behaviours and self-disclose to adults. We present directions to enhance the safety of social VR through pre-planned controls, real-time oversight, post-event insight and the need for evidence-based guidelines to support parents and platforms around age-appropriate interventions.

Past School Discipline Experiences: Perspectives of Disabled Adults.

School discipline has potential life-long consequences for students. Disabled youth can be misunderstood and experience harsh discipline and are at increased risk for negative outcomes, yet little research includes their voices. The aim of this study was to explore past school discipline experiences among disabled adults. Disabled adult perspectives (N = 9) regarding past school discipline experiences were explored employing qualitative descriptive methodology framed by the Peace and Power Conceptual Model. Peace-Power versus Power-Over-Powers involve actions/behaviors reflecting critical emancipation or oppression of those in power. Eight peace-power versus power-over themes emerged: "humiliating," "threatening," "escaping," "observing," "avoiding," "diverging," "isolating," and "failing." Disabled students can experience oppressive power-over dynamics separating them from others because they are unable to meet rigid classroom expectations. Educators may lack awareness of structural biases shaping reactions warranting need for school policies and practices promoting restorative justice, social-emotional learning, and inclusion. Classroom discipline can represent emancipatory peace-power or oppressive power-over powers. Not all teacher interactions represent 1 power or the other. Future research should focus on including disabled student voices informing school discipline practices. Educators' perspectives of their role fostering inclusive classrooms should also be considered.

Male perspectives on intimate partner violence: A qualitative analysis from South Africa.

Intimate partner violence (IPV) affects one in four women globally and is more commonly enacted by men than women. Rates of IPV in South Africa exceed the global average. Exploring the background and context regarding why men use violence can help future efforts to prevent IPV. We explored adult men's perspectives of IPV, livelihoods, alcohol use, gender beliefs, and childhood exposure to abuse through a secondary analysis of qualitative interviews that were conducted in South Africa. The setting was a peri-urban township characterized by high unemployment, immigration from rural areas, and low service provision. We utilized thematic qualitative analysis that was guided by the social ecological framework. Of 30 participants, 20 were residents in the neighborhood, 7 were trained community members, and 3 were program staff. Men reported consumption of alcohol and lack of employment as being triggers for IPV and community violence in general. Multiple participants recounted childhood exposure to abuse. These themes, in addition to culturally prescribed gender norms and constructs of manhood, seemed to influence the use of violence. Interventions aimed at reducing IPV should consider the cultural and social impact on men's use of IPV in low-resource, high-IPV prevalence settings, such as peri-urban South Africa. This work highlights the persistent need for the implementation of effective primary prevention strategies that address contextual and economic factors in an effort to reduce IPV that is primarily utilized by men directed at women.

What Is the Economic Benefit of Annual COVID-19 Vaccination From the Adult Individual Perspective?

With coronavirus disease 2019 (COVID-19) vaccination no longer mandated by many businesses/organizations, it is now up to individuals to decide whether to get any new boosters/updated vaccines going forward. We developed a Markov model representing the potential clinical/economic outcomes from an individual perspective in the United States of getting versus not getting an annual COVID-19 vaccine. For an 18-49 year old, getting vaccinated at its current price ($60) can save the individual on average $30-$603 if the individual is uninsured and $4-$437 if the individual has private insurance, as long as the starting vaccine efficacy against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is ≥50% and the weekly risk of getting infected is ≥0.2%, corresponding to an individual interacting with 9 other people in a day under Winter 2023-2024 Omicron SARS-CoV-2 variant conditions with an average infection prevalence of 10%. For a 50-64 year old, these cost-savings increase to $111-$1278 and $119-$1706 for someone without and with insurance, respectively. The risk threshold increases to ≥0.4% (interacting with 19 people/day), when the individual has 13.4% preexisting protection against infection (eg, vaccinated 9 months earlier). There is both clinical and economic incentive for the individual to continue to get vaccinated against COVID-19 each year.

Patient Perspectives on the Use of Artificial Intelligence in Health Care: A Scoping Review.

Artificial intelligence (AI) technology is being rapidly adopted into many different branches of medicine. Although research has started to highlight the impact of AI on health care, the focus on patient perspectives of AI is scarce. This scoping review aimed to explore the literature on adult patients' perspectives on the use of an array of AI technologies in the health care setting for design and deployment. This scoping review followed Arksey and O'Malley's framework and Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews (PRISMA-ScR). To evaluate patient perspectives, we conducted a comprehensive literature search using eight interdisciplinary electronic databases, including grey literature. Articles published from 2015 to 2022 that focused on patient views regarding AI technology in health care were included. Thematic analysis was performed on the extracted articles. Of the 10,571 imported studies, 37 articles were included and extracted. From the 33 peer-reviewed and 4 grey literature articles, the following themes on AI emerged: (i) Patient attitudes, (ii) Influences on patient attitudes, (iii) Considerations for design, and (iv) Considerations for use. Patients are key stakeholders essential to the uptake of AI in health care. The findings indicate that patients' needs and expectations are not fully considered in the application of AI in health care. Therefore, there is a need for patient voices in the development of AI in health care.

Working with social isolation and loneliness in older people’s mental health services

Isolation and loneliness are common problems in both older people and individuals with mental health problems. However, little research has focused on how these issues might be addressed in clinical practice with older adults with complex mental health problems. Here we set out to understand how social isolation and loneliness present and how they could be better addressed from the perspective of older adults with complex mental health problems and the clinicians working with them. Semi-structured interviews were conducted with nine healthcare professionals and 11 service-users from an older people’s mental health team and analysed using reflexive-thematic analysis. Results showed that professionals found social isolation easier to understand and work with than loneliness and tended to address both issues by targeting behaviours (i.e. what service-users could do differently). The psychological dimensions of loneliness (i.e. service users’ thoughts and feelings) received less attention, although service-users emphasised these aspects. Other themes included the challenges faced by professionals in fostering social connections because of limited resources. We conclude that a greater awareness of the psychological dimensions of loneliness in older people with complex mental health problems is needed, as well as the resource challenges faced in creating social connections beyond mental health services.

Perspectives of older adults, adult children and caregivers on internet of things home care technologies in China: a qualitative study

ABSTRACT Internet of Things (IoT) home care technologies have great potential to support older adults’ everyday activities and compensate for age-related changes. This study aims to explore older adults’ preferences for IoT home care technologies and factors influencing their acceptance from different perspectives. A total of 19 participants were purposively recruited, including 12 community-dwelling and nursing home older adults (74.8 ± 8.7 years), three adult children (48.3 ± 11.9 years), and four caregivers (43.8 ± 9.4 years). Their experiences and attitudes were explored through semi-structured interviews, assessing their general opinions toward IoT home care technologies and exploring what factors may hinder or facilitate their use. Twenty-two IoT home care services were included and the interview data were analyzed using thematic analysis. The results revealed that community-dwelling older participants preferred entertainment services, while the nursing home group preferred safety services. Eight factors affecting older adults’ acceptance of IoT home care technologies were extracted: personality traits, self-health assessment, adult children support, roommate influence, affordability, credibility, compatibility, and substitutability. The impact of generational thrifty personality, adult children’s support, and service credibility are highlighted in the Chinese cultural context. Promotion of and education on using IoT services among older adults’ and their children is recommended.

Experiences and Impacts of the COVID-19 Pandemic: A Thematic Analysis

The COVID-19 pandemic prompted global public health restrictions that impacted Canadians in multiple ways. The effects of the pandemic are well examined in specific populations and in researcher-defined areas (e.g., mental health, physical activity, social connections, and financial impacts). Few studies explore the complex perspectives of adults who experienced and were impacted by the pandemic. The purpose of this study was to understand Canadian adults’ perspectives of pandemic impacts over time. Methods: A sample of 347 Canadian adults were recruited during the first six months of the COVID-19 pandemic to respond to open-ended questions about the pandemic’s impacts, administered every two weeks between April 2020 and January 2021. The responses were amalgamated into epochs, defined by dates that paralleled infection rates and public health responses in Canada. Qualitative thematic analysis identified major themes for each epoch and changes in themes over time. Results: The participants predominately reported adverse impacts of the pandemic during each epoch assessed, particularly with respect to mental health, future-oriented worry, activity restrictions, and social, and employment disruptions. Key concerns were potentially driven by changes in infection rates and public health policy changes. Conclusions: The COVID-19 pandemic impacted individuals in predominantly negative and complex ways that varied over time with public health responses. Findings from the present study may direct future pandemic responses to mitigate adverse effects to best prevent infection while preserving wellbeing.

“Just Get Up and Get on.” Purpose in Later Life

ABSTRACT Although the varied benefits of purpose are increasingly recognized, there is more to learn about the how and why of purpose in later life. Forty older adults (aged 68–96 years) living within the South Australian community participated in a face-to-face interview to further existing understanding of purpose in older age. Conversations with older adults suggest that the majority continues to value and pursue purpose in their lives. Amongst older adults interviewed there was no single perception, definition or experience of purpose. However, through thematic analysis four categories of purpose emerged. Purpose was fulfilled through a drive for life; roles and responsibilities; routine, activity and independence; and faith and spirituality. The outcomes of this study build upon the limited body of evidence defining “purpose” from the perspective of older adults themselves which may in turn help inform future conceptualizations and measurements of purpose, as well as enable the design of interventions intended to promote, sustain or re-introduce purpose across the life span.

Integrating perspectives of transgender and gender-diverse youth, family members, and professionals to support their health and wellbeing – a mixed-method study protocol

BackgroundThe current literature highlights a strong link between the poor health outcomes of transgender and gender diverse (TGD) individuals and their negative experiences in various areas of life. Most of these publications rely on adults’ memories, lacking a focus on the current experiences and needs of young transgender and gender-diverse individuals. Furthermore, previous studies on support for these young people often solely consider the perspectives of TGD adults or professionals and rarely involve parents’ viewpoints.MethodsThis study will use a mixed sequential method with a participatory approach. Firstly, the qualitative phase will explore the difficulties and needs of TGD (15–20 years old) and of the families and professionals who support them. Results from this part will be used to develop the questionnaire for the quantitative phase, with the help of a community board. Secondly, based on participatory epidemiological research, the quantitative phase will use an intersectional perspective to measure the impact of individual and structural factors on the quality of life and well-being of transgender and gender-diverse young people. Finally, a co-creation phase will be undertaken to formulate recommendations based on the results of the first two phases.DiscussionThis research aims at better understanding the influence of gender identity on the quality of life and health of TGD young people and their families and to identify protective and risk factors that affect their vulnerabilities.Ethics and disseminationThis study has been approved by the Ethics Committee of the Erasme Faculty Hospital (CCB B4062023000140). As this research is participatory and part of a PhD dissertation, we aim to disseminate the results through our partners’ networks and structures locally, and internationally through conferences and peer-reviewed journals.

Vitality of older adults through internal and external connectedness

BackgroundVitality is a relatively unresearched concept and defined in existing literature either on the premise of one's functioning, or in terms of feeling alive. There is, however, little known about the significance of a sense of connectedness to life for vitality, especially from the perspective of older adults. This research aims to explore the association between the concept of connectedness and the perspective of vitality as a sense of aliveness, in order to formulate a theoretical understanding grounded in the subjective perceptions that older adults themselves hold of vitality. MethodsFollowing a constructivist grounded theory approach and theoretical sampling, constant comparative analysis was performed on the transcripts of 15 semi-structured interviews, conducted in the Netherlands with older adults (mean age 73 years, eight females and seven males), regarding their vitality. Concurrently, empirical and theoretical findings were translated into a theoretical conceptualisation. ResultsAccording to the older participants, connecting to life itself enhanced their sense of vitality. This connection was achieved through internal connectedness (connecting to one's own life, intrinsic stimuli and intrinsic goals in an independent manner) and external connectedness (social connectedness, environmental connectedness, engagement with the external world). Furthermore, our findings revealed distinct interactions between internal and external connectedness and facilitating tools, such as freedom from physical constraints, financial freedom and adaptation. ConclusionsOur findings provide a holistic concept of vitality and connectedness and consolidate existing perspectives on vitality into an overarching framework, which can contribute to the development of effective care policy, healthcare interventions and welfare services.

Plasma metabolomics identifies S-adenosylmethionine as a biomarker and potential therapeutic target for vascular aging in older adult males

Brachial-ankle pulse wave velocity (baPWV) is a noninvasive index of vascular aging. However, the metabolic profile underlying vascular aging has not yet been fully elucidated. The current study aimed to identify circulating markers of vascular aging as assessed by baPWV and to elucidate its mechanism from a metabolomic perspective in older adults. A total of 60 and 61 Chinese male participants aged ≥80 years were recruited to the metabolome and validation cohorts, respectively. The baPWV of participants was measured using an automatic waveform analyzer. Plasma metabolic profile was investigated using ultra-performance liquid chromatography coupled with triple quadrupole linear ion trap tandem mass spectrometry. Orthogonal partial least squares (OPLS) regression modeling established the association between metabolic profile and baPWV to determine important metabolites predictive of vascular aging. Additionally, an enzyme-linked immunosorbent assay was employed to validate the metabolites in plasma and culture media of vascular smooth muscle cells in vitro. OPLS modeling identified 14 and 22 metabolites inversely and positively associated with baPWV, respectively. These 36 biomarkers were significantly enriched in seven metabolite sets, especially in cysteine and methionine metabolism (p <0.05). Notably, among metabolites involved in cysteine and methionine metabolism, S-adenosylmethionine (SAM) level was inversely related to baPWV, with a significant correlation coefficient in the OPLS model (p <0.05). Furthermore, the relationship between SAM and vascular aging was reconfirmed in an independent cohort and at the cellular level in vitro. SAM was independently associated with baPWV after adjustments for clinical covariates (β = −0.448, p <0.001) in the validation cohort. In summary, plasma metabolomics identified an inverse correlation between SAM and baPWV in older males. SAM has the potential to be a novel biomarker and therapeutic target for vascular aging.

Older Adult and Primary Care Practitioner Perspectives on Using, Prescribing, and Deprescribing Opioids for Chronic Pain

Guidelines recommend deprescribing opioids in older adults due to risk of adverse effects, yet little is known about patient-clinician opioid deprescribing conversations. To understand the experiences of older adults and primary care practitioners (PCPs) with using opioids for chronic pain and discussing opioid deprescribing. This qualitative study conducted semistructured individual qualitative interviews with 18 PCPs and 29 adults 65 years or older prescribed opioids between September 15, 2022, and April 26, 2023, at a Boston-based academic medical center. The PCPs were asked about their experiences prescribing and deprescribing opioids to older adults. Patients were asked about their experiences using and discussing opioid medications with PCPs. Shared and conflicting themes between patients and PCPs regarding perceptions of opioid prescribing and barriers to deprescribing. In total, 18 PCPs (12 [67%] younger that 50 years; 10 [56%] female; and 14 [78%] based at an academic practice) and 29 patients (mean [SD] age, 72 [5] years; 19 [66%] female) participated. Participants conveyed that conversations between PCPs and patients on opioid use for chronic pain were typically challenging and that conversations regarding opioid risks and deprescribing were uncommon. Three common themes related to experiences with opioids for chronic pain emerged in both patient and PCP interviews: opioids were used as a last resort, opioids were used to improve function and quality of life, and trust was vital in a clinician-patient relationship. Patients and PCPs expressed conflicting views on risks of opioids, with patients focusing on addiction and PCPs focusing on adverse drug events. Both groups felt deprescribing conversations were often unsuccessful but had conflicting views on barriers to successful conversations. Patients felt deprescribing was often unnecessary unless an adverse event occurred, and many patients had prior negative experiences tapering. The PCPs described gaps in knowledge on how to taper, a lack of clinical access to monitor patients during tapering, and concerns about patient resistance. In this qualitative study, PCPs and older adults receiving long-term opioid therapy viewed the use of opioids as a beneficial last resort for treating chronic pain but expressed dissonant views on the risks associated with opioids, which made deprescribing conversations challenging. Interventions, such as conversation aids, are needed to support collaborative discussion about deprescribing opioids.

Travel insurance: an adult CHD patient's perspective.

Many adult CHD patients encounter difficulties in obtaining affordable travel insurance. We aimed to assess their travel habits and perspectives through a questionnaire. Our results indicate that many adult CHD patients use travel insurance but incur a premium due to their condition. There is an urgent need to provide better guidance to these patients on travel insurance options available to them.

ONCOLOGY NURSES’ ATTITUDES CONCERNING DYING WITH DIGNITY PRINCIPLES AND RELATED FACTORS

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Virtual care during COVID-19: The perspectives of older adults and their healthcare providers in a cardiac rehabilitation setting.

The present study aimed to explore the perspectives of older adults and health providers on cardiac rehabilitation care provided virtually during COVID-19. A qualitative exploratory methodology was used. Semi-structured interviews were conducted with 15 older adults and 6 healthcare providers. Five themes emerged from the data: (1) Lack of emotional intimacy when receiving virtual care, (2) Inadequacy of virtual platforms, (3) Saving time with virtual care, (4) Virtual care facilitated accessibility, and (5) Loss of connections with patients and colleagues. Given that virtual care continues to be implemented, and in some instances touted as an optimal option for the delivery of cardiac rehabilitation, it is critical to address the needs of older adults living with cardiovascular disease and their healthcare providers. This is particularly crucial related to issues accessing and using technology, as well as older adults' need to build trust and emotional connection with their providers.

Centering Autistic Perspectives: Social Acceptability of Goals, Learning Contexts, and Procedures for Young Autistic Children.

Despite the importance of centering autistic perspectives in educational decision-making for autistic children, few studies have directly assessed autistic perspectives on the social acceptability of early childhood practices. We conducted an online survey to recruit perspectives of autistic adults on a current, comprehensive range of educational practices typically employed with autistic children. We also extended the survey to caregivers and early childhood practitioners, to identify commonalities and discrepancies between shareholder groups. We conducted a descriptive survey study to assess social acceptability of goals, learning contexts, and procedures typically implemented with young autistic children. We received responses from 660 individuals, 226 of whom identified as autistic. For Likert scale and ranked items, we reported median rating and ranking for each item, by shareholder group. For open-ended questions, we conducted open and axial coding, to determine consistent themes within and across shareholder groups. Respondents reported (a) high acceptability for goals promoting self-determination and low social validity for goals promoting masking; (b) high acceptability for antecedent interventions and low social validity for some forms of extinction; (c) that appropriate learning environments are highly context dependent, varying with individual needs; and (d) that the child is the most important shareholder in educational decision-making. We make recommendations to practitioners in response to survey results, including (a) respecting autistic culture and characteristics in selecting goals; (b) considering social, emotional, and psychological needs in selecting procedures; and (c) individualizing goals, learning contexts, and procedures based on the child's perspectives and unique needs.