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The need to ensure the economic wellbeing and quality of life of those who reach the official retirement age is a matter of concern in the world of social services and in social policy making. Since some working older adults may be forced to retire when they reach the official retirement age while others retire voluntarily, the study is based on a dedicated survey among 508 persons who retired both willingly and unwillingly for good after reaching the official retirement age and 437 persons who continued working uninterruptedly. The findings show that the odds of staying on the job after retirement age are contingent on the socio-demographic and health-related characteristics of the older adult. Furthermore, the economic predictors of remaining in the labour force after retirement age depend on how strongly the older adult wishes to retire. Those who continue working after retirement age and those who retire willingly are undifferentiated in the level of financial support that they give others. Comparing older adults who continue working uninterruptedly with those who retire unwillingly, the chances of being among the former are higher among those who are better off before reaching retirement age. These results emphasise the need to extend welfare and financial-support policies to older adults who are forced to retire, in order to minimise the economic blow that this path to retirement causes.

It is frequently assumed that the inheritance of wealth undermines economic activity. If such an assumption is valid, the expected wave of bequests may have a negative impact on labour market activity of heirs, what might further weaken the financing of state pension systems. This paper provides a detailed review of the empirical findings on the associations of inheritances with labour market activity, that is labour force participation status and working hours, and presents own analyses based on the survey of health, ageing, and retirement in Europe. We find that the receipt of an inheritance is not related to labour force participation in general. Inheritance expectations even have a small, but statistically significant positive effect on remaining in the labour force for men. Women who expect an inheritance tend to reduce working hours, but the effect of having received an inheritance is not significant, neither for men nor for women. We conclude that the receipt of an inheritance will not affect labour market decisions, so that the expected wave of bequests will not undermine active ageing policies.The online version contains supplementary material available at 10.1007/s10433-022-00706-1.

Purpose The purpose of this study is to determine which element of advance care planning (ACP) - an advance directives (AD) document or an end-of-life discussion between patient and family (DwF), if any—improves the likelihood of cancer patients’ attaining their preferences regarding treatments in the last month of life and dying in the place they prefer. Methods First-degree relatives of deceased cancer patients, interviewed by telephone, were asked if the treatments the patients received in their last month of life and their place of death corresponded to the patients’ preferences. Nominal logistic regression analyses were conducted in search of significant association between having an AD document and/or conducting a DwF and patients’ treatment and place of death in accordance with their preferences. Results 491 deceased patients were included in the study. Their average age was 68; 52% were women. According to 32% of the relatives, the patients’ treatment in the last month of life was aligned with their preferences and 55% said the patients had died in their preferred place. Only 16.5% had an AD document, 58.5% only discussed their treatment preferences with relatives, and 25% did neither. DwF and ability to speak until last week of life were significantly related to receiving treatment consistent with patients’ preferences. Dying where the patient prefers is significantly associated with having an AD and a DwF, with an AD yielding higher odds. Conclusion A multifaceted interconnection exists between the two elements of ACP in attaining cancer patients’ wishes and abetting better end of life care.

To promote long-term care policies for older adults, accurate mapping of the often invisible and insufficiently recognized role of their informal caregivers is needed. This paper measures the prevalence of informal caregivers in the European population, illustrates current difficulties in gathering unequivocal information on this topic and deals with the scientific and policy implications of the problem. Using the European Health Interview Survey (EHIS), the European Quality of Life Survey (EQLS) and the Study on Health and Ageing in Europe (SHARE), the current difficulties in gathering unequivocal information on this topic are illustrated. In most countries, the share of informal caregivers varies, sometimes markedly, among the three surveys. As for the sex of caregivers, while confirming the well-known higher prevalence of caregivers among women than among men, large variations emerge across the three surveys in most countries in respect of the two sexes. The takeaway message of the paper is that it is urgent to promote international concerted action in gathering comprehensive informal caregiving information and/or exploring in greater depth the different intercultural understandings of informal care itself.

Researchers engaged in text and data mining (TDM) research collect vast amounts of digitized material and use software to analyze and extract information from it. TDM is a crucial first step to many machine learning, digital humanities, and social science applications, addressing some of the world’s greatest scientific and societal challenges, from predicting and tracking COVID-19 to battling hate speech and disinformation. Although applications of TDM often occur across borders, with researchers, subjects, and materials in more than one country, a patchwork of copyright laws across jurisdictions limits where and how TDM research can occur. With the World Intellectual Property Organization (WIPO) Standing Committee on Copyright and Related Rights, and legislatures around the world, deliberating the harmonization of copyright exceptions for various research uses, we discuss policy measures that can ensure that TDM research is unambiguously authorized under copyright law.

Fiil-Flynn, Sean M, Butler, Brandon, Carroll, Michael, Cohen-Sasson, Or, Craig, Carys, Guibault, Lucie, Jaszi, Peter, Jütte, Bernd Justin, Katz, Ariel, Quintais, João Pedro, Margoni, Thomas, de Souza, Allan Rocha, Sag, Matthew, Samberg, Rachael, Schirru, Luca, Senftleben, Martin, Tur-Sinai, Ofer, Contreras, Jorge L. (2022): Legal reform to enhance global text and data mining research. Science (New York, N.Y.) 378 (6623): 951-953, DOI: 10.1126/science.add6124, URL: http://dx.doi.org/10.1126/science.add6124

Background:Patient centeredness is a core element in healthcare. However, there is a gap between the understanding of this term by health care professionals, and patients’ capability, self-efficacy and willingness to take part in medical decisions. We aimed to expose standpoints toward "patient centeredness" among junior medical managers (JMM), as they bridge between policy strategies and patients. We tried to reveal cultural differences by comparing the views of the majority and the minority subpopulations of Israel (Arabic and Hebrew speakers).Methods:A cross-sectional survey among JMM studying for an advanced degree in health systems management at three academic training colleges in Israel was conducted in February-March 2022. The respondents completed a structured questionnaire, comprising four sections: a) perceptions towards trust, accountability, insurance coverage and economic status; b) perception regarding decision-making mechanisms; c) preferences toward achieving equity and d) demographic details.Results:A total of 192 respondents were included in the study, 50% were Hebrew speakers and 50% were Arabic speakers. No differences were found between Arabic and Hebrew speakers regarding perception towards trust, accountability, insurance coverage and economic status. JMM from both subpopulations perceived that patients' gender and age do not influence the attitude of physicians, but Arabic speaking respondents perceived that healthcare professionals prefer educated patients, or those with supportive families. All respondents perceived that patients would like to be more involved in medical decisions; yet, Arabic-speakers believe that patients tend to rely on physicians’ recommendations, while Hebrew speakers believe patients wish to lead the medical decision by themselves.Conclusions:Patient centeredness strategy needs to be implemented bottom-up as well as top-down, in a transparent nationwide manner. JMM are key actors to accomplish this strategy, as they realize policy guidelines in the context of social disparities, thus they can achieve a friendly personalized dialogue with their patients. We believe that empowerment of these JMM may create a ripple effect yielding a bottom- up perception of equity and initiating change.

In recent years, several studies have examined the effect of parents and friends on cyberbullying victims. Less is known about their combined effect on cyber perpetrators, especially among Jewish and Arab teens in Israel. We collected data from a representative sample of 350 Jewish and Arab adolescents (aged 15-16) and their parents. We repeated the interviews twice within a year. The survey included measurements of three parental practices: support, monitoring, and protectiveness, as reported by parents at the first time of data collection. We measured the adolescents' engagement in sensation-seeking and cyberbullying as perpetrators and perceptions about peers' involvement in these behaviors. Path-analysis models revealed that the perception of peers' involvement in cyberbullying perpetration was positively linked with involvement in such behavior among Jewish and Arab teens. Contrary to our expectations, no parental practice had a direct effect on cyberbullying perpetration among teens in either ethnic group. The study presents important and unique findings. The results indicate that youngsters involved in cyberbullying are strongly influenced by their peers. The prevalence of this pattern in both the Jewish and the Arab populations indicates its universal nature. On a practical level, it may be suggested that bullying behaviors may be mitigated by taking measures in formal and informal education. Another aspect of the results is the decline in parental influence on adolescents' cyberbullying behaviors, especially among Arab teens. This may be an indicator of cultural changes taking place in the Arab population in Israel alongside widening of the generation gap.

Background Concern about the cost and affordability of cancer drugs is widespread and well known. Even in countries with universal healthcare systems or health insurance for all, additional patient out-of-pocket (OOP) expenses are prevalent. Studies showed that honest communication between oncologists and patients is an important component in alleviating financial burden of cancer care. The study explores patient-caregiver-oncologist communication regarding the affordability of OOP medication and the extent to which this communication is related to families’ financial burden after their loved ones’ death. Methods A cross-sectional survey is conducted in Israel among 491 primary caregivers of deceased cancer patients, Jewish and Arab, in three oncology centers. Results About 43% caregivers said that they and/or the patients had paid OOP for medications during the last half-year of the patient's life. Most (73%) oncologists who suggested an OOP medication hardly asked or did not ask about financial ability and took little or no interest in ability to afford it, 43% hardly explained or did not explain the advantages of an OOP medication, and 52% hardly explained or did not explain any treatment alternatives. A linear regression analysis reveals that older age and female gender are related to less communication about an OOP medication and that better education, greater affluence, and having private health insurance are related to more communication. About 56% of caregivers say that OOP payment for medications inflicted a very heavy or heavy financial burden on patients and their households. A regression analysis revealed that physicians’ interest in their financial ability and in the explanation they gave decreased their burden. Conclusions Discussing and explaining the meaning of OOP payment alleviates the financial burden that families experience. It is crucial to develop and invest in improving oncologists’ education and skills to communicate costs more openly. Key messages

© 2021 Elsevier Ltd. All rights reserved., Liver diseases have become a major health threat across Europe, and the face of European hepatology is changing due to the cure of viral hepatitis C and the control of chronic viral hepatitis B, the increasingly widespread unhealthy use of alcohol, the epidemic of obesity, and undiagnosed or untreated liver disease in migrant populations. Consequently, Europe is facing a looming syndemic, in which socioeconomic and health inequities combine to adversely affect liver disease prevalence, outcomes, and opportunities to receive care. In addition, the COVID-19 pandemic has magnified pre-existing challenges to uniform implementation of policies and equity of access to care in Europe, arising from national borders and the cultural and historical heterogeneity of European societies. In following up on work from the Lancet Commission on liver disease in the UK and epidemiological studies led by the European Association for the Study of the Liver (EASL), our multidisciplinary Commission, comprising a wide range of public health, medical, and nursing specialty groups, along with patient representatives, set out to provide a snapshot of the European landscape on liver diseases and to propose a framework for the principal actions required to improve liver health in Europe. We believe that a joint European process of thinking, and construction of uniform policies and action, implementation, and evaluation can serve as a powerful mechanism to improve liver care in Europe and set the way for similar changes globally., The SHARE data collection has been funded by the European Commission through FP5 (QLK6-CT-2001-00360), FP6 (SHARE-I3: RII-CT-2006-062193; COMPARE: CIT5-CT-2005-028857; SHARELIFE: CIT4-CT-2006-028812), FP7 (SHARE-PREP: GA N°211909; SHARE-LEAP: GA N°227822; SHARE M4: GA N°261982; DASISH: GA N°283646), and Horizon 2020 (SHARE-DEV3: GA N°676536; SHARE-COHESION: GA N°870628; SERISS: GA N°654221; SSHOC: GA N°823782) and by DG Employment, Social Affairs & Inclusion. Additional funding from the German Ministry of Education and Research, the Max Planck Society for the Advancement of Science, the US National Institute on Aging (U01_AG09740-13S2; P01_AG005842; P01_AG08291; P30_AG12815; R21_AG025169; Y1-AG-4553-01; IAG_BSR06-11; OGHA_04-064; HHSN271201300071C), and from various national funding sources is gratefully acknowledged. PC acknowledges support by the French National Agency for HIV, hepatitis and emerging infectious diseases research (ANRS / EMERGING INFECTIOUS DISEASES).

The lengthening of the amount of time adult children depend on their parents' support and rising longevity have pushed scholars to devote increasing attention to the phenomenon of older sandwich family generations. This brief report develops a descriptive portrait of the prevalence of being demographically and socially sandwiched in the population aged 50 or more years, in Europe. It is shown that the prevalence of social sandwiching is highly sensitive to the types of support utilized to operationalize the concept; also, differences between welfare and transfer regimes are significantly affected by different operationalizations. Next, the analyses highlight the dynamic nature of social sandwiching over the adult life cycle, and show that demographic events and the changing needs of older parents are the main drivers of moving in/out the status of socially sandwiched. Support to adult children is ubiquitous in all European societies. Among the pivot generation family solidarity prevails over competition, but children enjoy a strategic advantage when older parents are in good health.

During the first lockdown in Israel, citizens were instructed to visit community clinics only for urgent cases. However, they were not informed that emergency departments (EDs) were safe. Reports from the National Ambulance Services showed a 22% increase in at-home deaths during the lockdown. Perhaps, the reason is because some critically ill patients postponed referrals and came “at the last minute”. After the first lockdown, the Ministry of Health (MOH) declared that hospital EDs were safe. The objective of the study was to examine the rates of admission from EDs to hospital wards, and non-COVID-19 in-hospital deaths during the first lockdown in Israel, compared with the second and third lockdowns. From the business intelligence software of the Rambam Medical Center in Israel, we collected data about the rates of admission to the ED, the non-COVID-19 in-hospital deaths during the three lockdowns, during the same periods in the previous three years, and the main five causes of non-COVID-19 deaths. Data comparison was done using multiple chi-square tests. ED admission numbers were significantly higher during the first lockdown than during the second (χ2 (1, n = 36,245) = 24.774, p = 0.00001) and third lockdowns (χ2 (1, n = 36,547) = 8.7808, p = 0.0030). We found a significantly higher number of non-COVID-19 in-hospital deaths vs. discharges during the first lockdown than in the second and third lockdowns (χ2 (2, n = 26,268) = 7.794, p = 0.0203) The number of deaths due to respiratory diseases was significantly higher during the first lockdown than in the second lockdown (χ2 (1, n = 572) = 8.8185, p = 0.0029) and in the third lockdown (χ2 (1, n = 624) = 9.0381, p = 0.0026), and deaths from infectious diseases were higher during the first lockdown than during both the second and third lockdowns (χ2 (1, n = 566) = 5.9479, p = 0.0147, and χ2 (1, n = 624) = 9.5978, p = 0.0019), respectively. The onset of CVA and CVD are abrupt, while respiratory and infectious diseases may have an insidious pattern; this may have led patients to postpone referrals to hospitals to the “last minute” during the first lockdown, perhaps due to fears of contracting COVID-19, and as a result of vague instructions. Citizens and policymakers must be made aware of this point during future pandemics.