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In the article the evolution of the image of the enemy in two cinemas is examined on the material of the Soviet and North American children’s and family films of 1936–1966 years in the following areas: representations of images of a political enemy in the movie, the critics of the axiological analysis of the discourse of a hostile culture, representation of the axiological discourse of their own culture. The analysis of publications on the topic is carried out and the concepts of “children’s cinema” and “family cinema” are clarified. The article reveals various types of construction in feature films for young audience of the “hidden threat” of the Cold War period. Based on the analysis of antagonist markers, archival materials and iconographic analysis of the films, the author identifies various modifications of the image of the enemy in children’s cinema. The article records the loss of interest in clichés by the mid-1960s. However, at the same time, the phenomenon of the spy film for the young audience in the USSR is of special interest, in particular, the militaristic aspect of the image of the internal and external enemy. In addition, the author focuses on the ways of constructing the space of childhood in two cinematographies, the social and cultural context, in particular, the role of social institutions and the family, the representation of social problems in different genres of children’s film. The author reveals that the evolution of the border violation motive in children’s films is associated with the peculiarities of the foreign policy of both countries, which also characterizes the interest in the cultural heritage of other peoples, cultural codes and formulas developed in literature and popular culture.

Background: The use of contraception is one of the benchmarks for the success of family planning programs. The COVID-19 pandemic has had an impact on people to limit activities outside the home. The appeal from the government also has an impact on the possibility of hampering access to family planning services. The delay in family planning services will lead to a decrease in the use of contraception will ultimately have an impact on the uncontrolled birth rate (Baby Boom). The purpose of this study was to see how the use of contraception in couples of childbearing age during the COVID-19 pandemic. Methods: This study is a literature review related to the use of EFA contraceptives during the COVID-19 pandemic through the Google Scholar database, PubMed, government publication data. Results: Contraceptive use among new family planning participants decreased in general as well as among MKJP participants in the NTB area. The prevalence of contraceptive use in Indonesia has increased but has not yet reached the national target of 61.8%. In the DIY region, there was a decrease in contraceptive use among active family planning participants, as well as a decrease in the use of pill and injectable contraception. The research conducted in the Kalimantan region found that most women of childbearing age used the contraceptive method with the highest dropout rate, namely the pill. The number of unmet need for family planning in the NTB area has decreased, but the drop out rate for family planning in the early days of the COVID-19 pandemi has increased. Conclusion: The use of contraception during the COVID-19 pandemi in several regions in Indonesia is still fluctuating, but has a tendency to decrease.

Introduction The estimate of people with clinical Alzheimer's disease (AD) and mild cognitive impairment provides an understanding of the disease burden. Methods We estimated people with cognitive impairment using a quasibinomial regression model in 10,342 participants with cognitive test scores. Results The 2020 US Census-adjusted prevalence of clinical AD was 11.3% (95% confidence interval [CI] = 10.7-11.9): 10.0% among non-Hispanic Whites, 14.0% among Hispanics, and 18.6% among non-Hispanic Blacks. We estimate that in 2020, 6.07 (95% CI = 5.75-6.38) million people were living with clinical AD, which increases to 13.85 (95% CI = 12.98-14.74) million in 2060, 423% higher among Hispanics, 192% higher among Blacks, and 63% higher among Whites. However, there are predicted to be more significant increases in later years among those over 85 and women compared to men. Discussion The number of people with clinical AD will increase as the "baby boom" generation reaches older ages, exerting a strong upward influence on disease burden.

Introduction The ageing of baby boomers is expected to confront addiction care with new challenges. This cohort had greater exposure to psychoactive substances in youth than earlier cohorts. In this study, we aimed to investigate whether Berlin addiction care is confronted with a sustained change in its clientele initiated by the baby boomers. Methods Using data from Berlin outpatient addiction care facilities, we contrasted type of primary substance use disorder and number of comorbid substance use disorders in baby boomers with an earlier and a later cohort. To isolate cohort effects, two‐level random intercept regression models were applied in the overlapping age groups of the baby boomer cohort with each of the other cohorts. Results Compared with the earlier cohort, alcohol use disorder lost importance whereas illicit substance use disorder gained importance in the baby boomers. Baby boomers presented a higher number of comorbid substance use disorders than the earlier cohort. Comparing baby boomers with the later cohort, these relationships pointed in the opposite direction. Discussion and Conclusions Outpatient addiction care faces a sustained change to more illicit and comorbid substance use disorders. With increasing life expectancy and the ageing of baby boomers marked by higher substance use than previous cohorts, older clients, who had been under‐represented in outpatient addiction care, will gain relevance. Hence, addiction care has to adapt its offers to appropriately meet the changing needs of its clientele.

Covid-19 has been declared a world pandemic by WHO. Large-scale social restrictions and community appeal to stay at home in an effort to oppose Covid-19 transmission will have an impact on the sustainability of public health services, including family planning services. 54,6% of the total family services planned by midwives are conducted at the private midwifery practice. The purpose of this study was to analyze family planning service visits at the private midwifery practice in Yogyakarta. This study used article quantitative descriptive research method. The population in this study is midwives who have private midwifery practice in the Special Region of Yogyakarta. The results showed that almost all methods of contraception experienced a decrease in service in the private midwifery practice, but the method of family planning through progestin injection did not decrease. As many as 44,7% of midwives provide family services planned through the post placenta Intrauterine Device (IUD) was a method of contraception that was added as a post partum contraception during the main Covid-19 pandemic. Family service protocols have been implemented in the pandemic era with 19% 78% of midwives, online, and using standard personal protective equipment. There was a decrease in family planning services by midwives in the practice of independent midwives in Yogyakarta during the Covid-19 pandemic by 13,8% (from February to April 2020). By the decline predicted to result in a high chance of a baby boom that gives various impacts on the condition of an area. Midwives are expected to improve family planning services after delivery, especially the IUD, and utilize online media. Other efforts can be made through the BKKBN, namely by encouraging not to become pregnant during the Covid-19 pandemic and the existence of free family planning services so that productive partners can routinely control the use of acceptors.

Members of Generation Y (or Millennials) now make up more than 50% of those in the workplace. They are expected to comprise greater than 75% by 2025. The Millennial generation has brought new idiosyncrasies to the workplace, and most literature has focused on ways to manage these differences. The Baby Boom generation is retiring at an increasing pace, leaving ongoing leadership needs in the care of Millennials. Conversations must now shift from how to lead the Millennials to preparing them to lead others. The SHAPE framework highlights some of the idiosyncrasies of this generation and ways they can be leveraged when approaching the challenges of health care today.

2018 was the year when the funding machine for privately held biotech companies went into overdrive, with mega-rounds and rapid flotations. John Hodgson brings us this deep dive.

The article shows that the modelling of products and processes has been around for decades, but it is only in very recent years that the digital twin has come into the mainstream, and it is in the industrial sector that it has its spiritual home.

Seismic international events, such as world wars and pandemics, have a global impact on healthcare that continues well beyond the duration of the event. Following the Spanish flu in 1918-1919 there was a baby boom, life expectancy increased, and socialized healthcare systems began to be established. In 1948, following the second world war, the NHS was established. The changes to healthcare that we will see following the Covid-19 pandemic will become apparent over the next few years but it is clear that models of care have already changed significantly and are unlikely to return to previous established pathways. In particular, remote care delivery has become established as a viable choice for people living with diabetes.

Lyme disease is the most common vector-borne disease in the United States and is characterized by a bimodal age distribution and male predominance. We examined trends in reported cases during a 25-year period to describe changes in the populations most affected by Lyme disease in the United States. We examined demographic characteristics of people with confirmed cases of Lyme disease reported to the Centers for Disease Control and Prevention during 1992-2016 through the National Notifiable Diseases Surveillance System. We grouped cases into 5-year periods (1992-1996, 1997-2001, 2002-2006, 2007-2011, 2012-2016). We calculated the average annual incidence by age and sex and used incidence rate ratios (IRRs) to describe changes in Lyme disease incidence by age and sex over time. We converted patient age at time of illness into patient birth year to ascertain disease patterns according to birth cohorts. The incidence of Lyme disease in the United States doubled from 1992-1996 to 2012-2016 (IRR = 1.74; 95% CI, 1.70-1.78) and increased disproportionately among males; IRRs were 39%-89% higher among males than among females for most age groups. During the study period, children aged 5-9 years were most frequently and consistently affected. In contrast, the average age of adults with Lyme disease increased over time; of all adults, people born during 1950-1964 were the most affected by Lyme disease. Our findings suggest that age-related behaviors and susceptibilities may drive infections among children, and the shifting peak among adults likely reflects a probability proportional to the relative size of the baby boom population. These findings can inform targeted and efficient public health education and intervention efforts.

Spontaneous combustion of skies leading to forest fires, earth bursting, and sewage tank cleaners dying from toxic gas inhalation are increasingly reported; newer varieties of creeping, flying insects of larger size with stings have been observed in the last decade. As a result, an altruistic analysis based on observation and correlation with pathogenesis is carried out. For the past 15 years, an analysis of the above incidence has been conducted in correlation with global implementation of contraception abortion. Mortality by all causes was studied in 350 people classified as with and without contraception, who were randomly selected from the community and hospital and were separated into three age groups: 20-35 years, >35 years, and >50 years. Over the last decade, there has been a 4-9 fold increase in spontaneous combustion of the skies, resulting in forest fires, earth breaking with explosion, connected with tsunami, death of sewage tank cleaners, and the introduction of newer insects.4-7 fold increase in mortality [p value50 years. 863,000,000 reported surgical abortions till 2010 1; 1989,375,754 women of reproductive age group made to menstruate 200 months 2 more, by small family norms, forcibly declining fertility rates; global hypoxia 3 of air, water secondary to aborted blood, contraceptive menstrual blood pollution depleting oxygen, which cannot be replaced by plants, unlike mandatory live humans with their emissions, of God ordained self-sustaining ecology, leads to lakhs of fish, water living washed ashore dead, birds disappearance and resulting in robust growth of 4 anaerobic, aerobic microbes including corona virus with virulence, locusts. The concept is intentionally acquired aetiology of innumerable contraception, abortion as described above, destroys human lives, water living, birds, living organisms, and enable, massive putrefaction in the bodies of millions of aborted foetuses and millions of contracepted young parents with acquired early demise like flies, contracepted menstrual and aborted blood, releasing toxic gases in the environment of soil, water, air namely sewage tanks, earth`s hollow areas, including coastal ocean beds, which can be lethal, resulting in further increased death of water living, fish, humans; toxic gases are explosive with spontaneous combustion of the skies or combustion with associated thunder lightning resulting in increased thunder bolt struck mortality unexplained forest fire, oil tanker vessel fire and emergence of stinging newer larger, insects, mites, wasps; how much more will not the toxic gases of putrefaction swirl up the oceanic bed producing hiked up waves, split, rupture the earth producing tsunamis-entry of sea over the coastal regions?; how much more will not the toxic gases other than depleting oxygen of the environment including waters, be harmful to all life in the water supplies, including oceans, even if the stores of oxygen and sustenance for life as ordained by the creator were hugely sufficient prior to the era of contraception? Whereas God ordained Live humans with their excreta, waste food items existing in nature are degraded to make biogas, bio methane that may be used to fuel a car or supply energy, a reminder of God designed self-sustaining ecosystem that exists to maintain the living, creation, which is agonisingly disturbed by achieving contraception, abortion - i.e. acquired profound mortality [death, diseases] in the name of family welfare, specially fetuses, children and young parents.

The City of Toronto is undergoing a significant demographic shift as a result of the aging ‘Baby Boom’ generation, the first of whom turned 65 years old in 2011. By 2031, the seniors population in Toronto is expected to almost double, increasing to 22 percent of the total population (Hemson Consulting Ltd, 2012) from only 14 percent in 2011 (Statistics Canada, 2011). This will produce a number of housing related planning challenges for the City, as aging Boomers are expected to demand an increasing amount of housing. This estimate is used to approximate the potential housing limitations in 2021 and 2031. As the largest seniors demand is projected to be for ground-related private dwellings, whose supply is physically constrained, the report will investigate the benefits of developing retirement homes to meet the growing seniors housing demand. The two-fold challenge to increase the stock and capture rate of retirement homes in Toronto will be examined. Creative mechanisms will be proposed for the City to incentivize retirement homes development and for potential developers to attract Boomer seniors to retirement homes.

Objective: To explore the effects of COVID 19 on reproductive and child health services and gender relations. Methods: This is a Qualitative Exploratory Research. Due to lockdown, setting was online interviews on Zoom. Sampling was purposive. Five in-depth interviews were conducted in June 2020 followed by compilation of results and manuscript writing in July and August 2020. Results: Maternal Neonatal morbidity and mortality will rise as part of collateral damage of C19. As all routine services of maternity care, family planning, post abortion care and vaccination were also in lockdown. Baby boom, unwanted pregnancies, unsafe abortions and violence against women will be the secondary consequences of C19. Conclusion: Some critical services should never stop which include maternal and neonatal essential services. MNCH service continuity has to be maintained to optimize maternal neonatal health, prevent unwanted pregnancy and abortion. With appropriate standard operating procedures, and protective equipments, health facilities need to open. LHWs and community mobilisers with PPEs should continue services. doi: https://doi.org/10.12669/pjms.37.4.3877 How to cite this:Shah N, Musharraf M, Khan F, Shah N. Exploring Reproductive Health Impact of COVID 19 pandemic: In Depth Interviews with key stakeholders in Pakistan. Pak J Med Sci. 2021;37(4):1069-1074. doi: https://doi.org/10.12669/pjms.37.4.3877 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Popularity from each generation effects the economic movement, especially the retail business, which expected to have a slight decrease at 5-8% due to the customer’s behavior, ideas, and lifestyle that change with the era. This research aims to build a conceptual framework based on IS success model and loyalty model for initially studying the strategy model of OMNI business sustainability with intensely focusing on generation factors and understanding the attitude of each generation. This research would a better understand potential factors affecting the model of OMNI business sustainability on generations. Then, for further research after data collection, the AMOS program will be used to analyze the relationship of variables to develop sustainable practices in OMNI businesses from the perspective of consumers of each generation such as Baby Boom, X, Y, and Z.

Objective Mental disorders have been identified as a leading cause for reduced work ability in industrialized countries. Identification of workplace factors that can increase the work ability of employees with depressive symptoms from the Baby Boom generation is, therefore, highly relevant. This study thus aims to investigate whether changes in psychosocial working conditions can moderate the negative association between depressive symptoms and work ability. Methods Two waves with a 3-year time lag of the German lidA cohort study with 3609 participants born in 1959 and 1965 (aged 46 and 52 years at first wave) were analyzed. Self-report data about depressive symptoms at baseline and changes of working conditions from baseline to follow-up were used to calculate main and interaction effects on perceived work ability at follow-up. These analyses were controlled for baseline work ability and working conditions. Results Depressive symptoms were predictive for an unfavorable course of work ability from baseline to follow-up (B = − 0.173, 95% CI = − 0.219 to − 0.128). However, no interaction effect between depressive symptoms and psychosocial working conditions was found. Instead, independent from the level of depressive symptoms, a decrease in quantitative demands (B = − 0.279, 95% CI = − 0.326 to − 0.232) and increases in leadership quality (B = 0.242, 95% CI = 0.192–0.292) and development opportunities (B = 0.177, 95% CI = 0.127–0.277) were related to a more favorable course of work ability. Only small effects were found for social support (B = 0.057, 95% CI = 0.008–0.106) and job control (B = 0.043, 95% CI = − 0.005–0.091). Conclusions The results indicate that the lagged and negative effect of depressive symptoms on work ability was not moderated by changes in psychosocial working conditions. However, the promotion of favorable working conditions may contribute to a positive development of work ability among employees from the Baby Boom generation independently from the level of depressive symptoms.

Downward pressure on the natural rate of interest (r*) is often attributed to an increase in saving. This study uses microeconomic data from the SCF+ to explore the relative importance of demographic shifts versus rising income inequality on the evolution of saving behavior in the United States from 1950 to 2019. The evidence suggests that rising income inequality is more important than the aging of the baby boom generation in explaining the decline in r*. Saving rates are significantly higher for high income households within a given birth cohort relative to other households in the same birth cohort, and there has been a large rise in income shares for high income households since the 1980s. The result has been a large rise in saving by high income earners since the 1980s, which is the exact same time period during which r* has fallen. Differences in saving rates across the working age distribution are smaller, and there has not been a consistent monotonic shift in income toward any given age group. Both findings challenge the view that demographic shifts due to the aging of the baby boom generation explain the decline in r*.

CONTEXT Millennials have had a profound impact on society, the economy, and the US workforce. This study used generational definitions published by the Pew Research Center. Millennials includes respondents who reported an age between 21 and 36 years (born in 1981-1996) at the time the 2017 Public Health Workforce Interests and Needs Survey (PH WINS) was administered. Generation X includes respondents who reported an age between 37 and 52 years (born in 1965-1980), and the baby boom generation (baby boomers) includes respondents between 53 and 71 years of age (born in 1946-1964). Public sector agencies, including governmental public health, are increasingly interested in figuring out how to attract and retain millennials. As the governmental public health workforce anticipates upcoming retirements, knowledge about the motivations and organizational characteristics that appeal to millennials is crucial to understanding the millennial workforce and workplace dynamics for decades to come. In 2017, millennials made up 22% of the governmental public health workforce, Generation X 40%, and baby boomers 37%. OBJECTIVE This study examined opinions, expectations, and important workplace environment factors of millennials working in governmental public health compared with other generations. DESIGN We performed bivariate analyses and fit a logistic regression model to evaluate the association of generation with responses to a set of satisfaction and engagement PH WINS survey questions. SETTING AND PARTICIPANTS Data were drawn from the 2017 PH WINS of governmental health department employees, including state health agency and local health department staff. PH WINS excludes local health departments with fewer than 25 staff members or serving fewer than 25 000 people. PH WINS included responses from 47 604 staff members, which reflected a 48% overall response rate. RESULTS The generations that were examined (millennials, Generation X, and baby boomers) were similarly satisfied with their jobs, organizations, and pay security, and millennials intended to leave their jobs for similar reasons as other generations. Millennials reported more strongly than other generations that their supervisors treated them with respect, that they had sufficient training to utilize technology, that their training needs are assessed, and that creativity and innovation were rewarded. They, however, reported less strongly that they were completely involved in their work and determined to give their best every day. CONCLUSIONS Millennials in governmental public health agencies (excluding local health departments with

Populations around the world are ageing while in many developed countries the proportion of elderly patients admitted to critical care is rising. It is clear that age alone should not be used as a reason for refusing intensive care admission. Critical care in this patient group is challenging in many ways: with advancing age, several physiological changes occur which all lead to a subsequent reduction of physical performance and compensatory capacity, in many cases additionally aggravated by chronic illness. Subsequently, these age-dependent changes (with or without chronic illness) increase the risk for death, treatment costs and a prolonged length of intensive care and hospital stay. This review explores the potential of using co-morbidity and frailty to predict outcome and to help to make better decisions about critical care admission in the elderly. The authors explore the challenges of using different frailty assessment tools and offer a model for holistic approach to answer these questions.

Aim High-income countries are now experiencing a decline in fertility. After experiencing baby booms in 1947–1949 and 1971–1974, Japan's population has been decreasing since 2015. In an attempt to predict the next baby boom, we searched for any upward demographic trends occurring after 1974. Methods We analyzed time trends of the numbers and rates of live births, stillbirths and induced abortions using Japanese government data from 1975 to 2014. We then selected two birth cohorts: the first baby boomers who were 0–4 years old in 1950, and the second baby boomers who were 0–4 years old in 1975, and analyzed their rates of live births, stillbirths, and abortions by five-year age groups. Results There was no upswing in the numbers of births, stillbirths, or induced abortions; however, the abortion rate increased during 1996–2002. Compared with the first baby boomer cohort, the second baby boomer cohort had half the peak live birth rate for the same age group (25–29 years old), and half the peak rate of abortions, with a shift toward a younger age group (20–24). Conclusions This analysis of Japanese fertility trends derived from all pregnancy outcomes showed no upward trend in fertility in Japan since 1974.

Four challenges face the nursing workforce of today and tomorrow: the aging of the baby boom generation, the shortage and uneven distribution of physicians, the accelerating rate of registered nurse retirements, and the uncertainty of health care reform. This article describes these major trends and examines their implications for nursing. The article also describes how nurses can meet these complex and interrelated challenges and continue to thrive in an ever-changing environment.

Introduction The Fifty Shades of Grey (FSOG) trilogy were publicised by the media as inflaming increased coital activity, and that this would result a baby boom. Furthermore, increased coital activity skews the sex ratio at birth (M/T) toward male births. This study was carried out in order to ascertain whether there were any spikes in total births or in M/T in the United States (US) circa nine months following the FSOG books. Methods Monthly male and female births for the US were obtained directly from the website of the Centre for Disease Control (01/2007–12/2015). Results This study analysed 36,499,163 live births (M/T 0.5117, 95% CI 0.5116–0.5119). There are no discernible spikes in total births or M/T at annual level, or circa nine months after FSOG book releases i.e. 04/2012 and 01/2013. Discussion The absence of spikes in births or M/T may have been due to exaggeration of the FSOG effect, it may only have provoked planned pregnancies, or modern contraception was sufficiently effective to prevent extra conceptions. The media build-up may also have stimulated a Hawthorne effect, with FSOG-affected individuals employing effective contraception. This study highlights the importance of measurement of cause and effect since anticipated results may not always ensue from events.

We cast fresh light on how and why Americans’ views on marijuana legalization shifted between 1973 and 2014. Results from age-period-cohort models show a strong negative effect of age and relatively high levels of support for legalization among baby boom cohorts. Despite the baby boom effect, the large increase in support for marijuana legalization is predominantly a broad, period-based change in the population. Additional analyses demonstrate that differences in support for legalization by education, region, and religion decline, that differences by political party increase, and that differences between whites and African Americans reverse direction. We conclude by discussing the implications of these findings and by identifying promising directions for future research on this topic.

Transfusion safety includes the risk of transmission of pathogens, appropriate transfusion thresholds, and sufficient blood supply. All industrialized countries experience major ongoing demographic changes resulting from low birth rates and aging of the baby boom generation. Little evidence exists about whether future blood supply and demand correlate with these demographic changes. The ≥50% decline in birth rate in the eastern part of Germany after 1990 facilitates systematic study of the effects of pronounced demographic changes on blood donation and demand. In this prospective, 10-year longitudinal study, we enrolled all whole blood donors and all patients receiving red blood cell transfusions in the state of Mecklenburg-West Pomerania. We compared projections made in 2005 based on the projected demographic changes with: (1) number and age distribution of blood donors and transfusion recipients in 2015 and (2) blood demand within specific age and patient groups. Blood donation rates closely followed the demographic changes, showing a decrease of -18% (vs projected -23%). In contrast, 2015 transfusion rates were -21.3% lower than projected. We conclude that although changes in demography are highly predictive for the blood supply, transfusion demand is strongly influenced by changes in medical practice. Given ongoing pronounced demographic change, regular monitoring of the donor/recipient age distributions and associated impact on blood demand/supply relationships is required to allow strategic planning to prevent blood shortages or overproduction.

Violent environments are known to affect household fertility choices, demand for health services and health outcomes of newborns. Using administrative data with a difference-in- differences, we study how the end of the 50 years old Colombian conflict with FARC modified such decisions and outcomes in traditionally affected areas of the country. Results indicate that generalized reductions in total fertility rate were slowed down for municipalities traditionally affected by conflict as a result of the permanent ceasefire declared by the FARC insurgency. Total fertility rate observed a relative increase of 2.6% in the formerly conflict-affected areas, in all age groups. However, no impact was found for demand of health care services, neonatal and infant mortality rates, or birth outcomes such as the incidence of low weight at birth or the percentage of preterm births. Our evidence shows that municipalities with mines victims and expelled population by forced displacement before the ceasefire have significantly higher total fertility rate in the four years following the ceasefire. We argue that the mechanism behind this result is the optimism to raise the children in a better environment due to the reduction in victimization in areas that experience FARC violence.

Social media outlets are inundated with quips about the baby boom coming nine months after the COVID-19 pandemic.It’s not that funny. Or that simple.The global spread of the coronavirus has resulte...

As Americans live longer and the baby boom generation ages, the elderly will constitute an ever greater percentage of the US population in the coming decades. Many will struggle with chronic illnesses. This growing wave of chronically ill elderly is expected to stress healthcare resources and drive up the costs of care. It will require a fundamental shift in how healthcare will be delivered and financed. For this reason, competency in chronic care management for geriatric patients will become increasingly important for all healthcare practitioners. Underscoring the point, the American Medical Association recently identified core competencies in this field for inclusion in medical school curricula. This chapter will discuss the changing practice environment, introduce a model for managing chronic care, and review special clinical considerations that pertain to geriatric patients presenting with multiple chronic illnesses.

Maternal exposures to ambient temperatures during pregnancy may increase the preterm birth (PTB) risk; however, which periods have stronger effects remain controversial. The effects of temperature exposure on PTB in first- and second-born neonate groups may be different during the new baby boom that has followed the Two-child Policy in China. We examined a birth cohort of 4928 pregnant women beginning in 2016 in Guangzhou, China. An inverse distance weighted method was used to estimate the temperature exposure at each individual residential address. A distribution lag non-linear model incorporating a Cox proportional hazard model was employed to estimate the effects of temperature exposure on PTB and test the effects modification of birth order related to the new baby boom. A total of 4101 pregnant women were included, of which 234 (5.7%) experienced PTB. Compared with the mean temperature (23.0 °C), we found a significantly higher risks of PTB associated with high temperatures (i.e, 30 °C [95th centile]) from the 4th to 8th, and 22nd to 27th gestational weeks. A peak effect was found during the 6th week (HR = 1.79, 95% CI: 1.26, 2.54) and 24th week (HR = 1.83, 95% CI: 1.27, 2.62). The risks of PTB were reduced for low temperatures (i.e. 14 °C [5th centile] versus 23.0 °C) from the 2nd to 10th and 20th to 26th gestational weeks, and the negative peak effect was found during the 4th week (HR = 0.43, 95% CI: 0.26, 0.72) and 23rd week (HR = 0.59, 95% CI: 0.43, 0.83). Stratification analyses showed that significant effects of 30 °C versus 23 °C on PTB were observed during the 4th to 8th weeks in the second-born neonate, and the peak effect was found in the 6th week (HR = 2.13, 95% CI: 1.31, 3.47). However, we did not find significant effects of 30 °C during the same weeks in the first-born neonate group. Maternal exposures to higher temperatures during pregnancy may increase the risk of PTB, and lower temperatures may decrease the risk of PTB. Stronger effects of temperature exposures during the first trimester on PTB risk were found among the second-born neonates than among the first-born neonates.

Purpose Demographic data indicate that the Millennial generation (those born between 1982 and the early 2000s) are entering the workforce and will become an increasingly significant component of the workforce in the near future. The Millennial generation appears to have significant differences in values, attitudes and expectations regarding work than prior generations. Design/methodology/approach The authors reviewed the literature on the “Millennial” generation (those born between 1982 and the early 2000s) and the research on giving negative feedback to identify issues that are significant with respect to the manner in which managers give negative information to this new generation of workers. Findings To be effective, negative feedback to Millennials needs to be consistent and ongoing. The feedback must be perceived by Millennials as benefitting them now or in the future. Managers must be assertive enough to make sure the employee understands the concerns, but sensitive to the fact that many Millennials have difficulty accepting such feedback. Research limitations/implications These findings offer suggestions for future research that needs to explicitly examine the differences in the new generation of workers and how these persons respond to current managerial practices. Practical implications Millennials are now entering the workforce in significant numbers. Managers will find increasing opportunities to address the organizational and individual needs of these workers. Managers must learn how to effectively direct and motivate this generation of workers, including how to provide constructive negative feedback. Social implications Demographic data indicate that the so-called “Baby Boom” generation will be leaving the workforce in large numbers over the next few years, and will be replaced by the Millennial generation. Originality/value To date, there has been little attempt by management researchers to address the organizational implications of the generational shift that is occurring. We seek to draw attention to one specific area of management practice – delivering negative feedback – and explore how the knowledge may be changing as a new generation of workers enter the workplace.

A considerable number of studies have investigated the influence of new media on political attitudes and behaviors. However, much of this research focuses on young people, ignoring other age cohorts, particularly Baby Boomers (born between 1946 and 1964). To fill this gap, this research examines the influence of attention to specific forms of traditional and online media on Baby Boomers’ online and offline political participation during the fall 2012 U.S. presidential campaign. Drawing on a Baby Boomer survey panel, responses were collected during the 2012 general election to analyze the empirical relationship between attention to traditional and online media sources and political participation. Data analyses reveal that Boomers’ attention to traditional media sources, particularly television, did not increase their offline and online political participation. Instead, various forms of offline and online participation were consistently heightened by Boomers’ attention to presidential candidate webs...

Although studies have assessed the associations between prenatal exposure with fine particulate matter (PM) with birth weight, few have investigated the effect of PM1 exposure and identified the susceptible exposure window. Additionally, a baby boom occurred after China implemented the universal two-child policy, but whether the effects of PM are modified by birth order remains unknown. The objective of this study was to estimate the effects of prenatal exposure to PM (PM2.5 and PM1) on birth weight, identify the susceptible exposure windows, and assess the modifying effect of birth order on the effects of PM exposure. All participants were selected from the Prenatal Environment and Offspring Health (PEOH) cohort conducted since 2016 in Guangzhou, China. A spatiotemporal land–use-regression (STLUR) model was used to estimate a pregnant woman's weekly PM2.5 exposure, and a generalized additive model (GAM) was used to estimate each PM1 exposure. A distributed lag non-linear model (DLNM) was applied to assess the exposure–lag-response associations between weekly PM exposure and birth weight. The sample included 4086 pregnant women. The results showed that maternal exposure to PM2.5 and PM1 during the 15th to 24th and 16th to 24th gestational weeks were associated with lower birth weight, the strongest association was observed in the 19th week, during which each 10 μg/m3 increment in PM2.5 and PM1 was associated with a 1.47 g (95% CI: 2.49 g, 0.44 g) and 1.58 g (95%CI: 2.74 g, 0.41 g) decrease in birth weight, respectively. Compared with the first-born neonates, greater effects of PM2.5 and PM1 exposure on birth weight were observed among the second-born neonates in the 15th to 21st and 15 h to 22nd gestational weeks. Further studies tracking the health of the second-born children are warranted because they may be more sensitive to environmental factors than the first-born children.

This paper looks at the major changes in the French labour market since the 1960s. Over this period, the labour force has steadily increased, primarily owing to demographics (the post‑war baby boom). The labour force also saw increasing female employment, higher qualifications and a reduction in the length of working life at both ends. Three factors have driven changes in labour market trends in the last 50 years : economic globalisation, the emergence of ICT and development of automation, and the growth of the service economy, particularly financial services. For their part, employment policies have sought to “ enrich” the employment content of growth. After the 1974 break in the growth trend, the interaction of labour supply and demand led to rising unemployment and increasing diversity in employment statuses. The growth of short‑term and very‑short‑term contracts, as well as arrangements falling between salaried‑ and non‑salaried employment, illustrate a significant increase in employment precariousness., Marchand Olivier, Minni Claude. The Major Transformations of the French Labour Market Since the Early 1960s. In: Economie et Statistique / Economics and Statistics, n°510-512, Special Issue 50th Anniversary. pp. 89-107.

While the financial services industry wrestles with the challenges of change, our policymakers have an opportunity to take a lead role in defining Canada’s place within the global digital advice landscape. There are numerous creative and exciting solutions being discussed. What we haven’t seen a lot of are clientfacing holistic solutions – and what we don’t have is much time. This paper provides a series of steps for regulators and policymakers to follow that will improve innovation for incumbents and start-ups alike, all while providing an enhanced customer experience in financial advice. Firms are dealing with a looming perfect storm – fee compression, shifting demographics, unrelenting regulatory changes and an erosion in the number of human advisors as advisors who are part of the baby boom look to their own retirement. In this context, technology should be viewed as a savior, rather than a threat. We define a five-year aspiration for the application of digital technology to prudent and valued financial advice. There are several myths we were able to dispel as a result of our research, which we hope will form the basis for a discussion about what’s needed to facilitate a higher level of digital adoption. We nickname it “Next Generation Digital Advice.” The guiding principles and best practices encompass a holistic view of the client, objective data-driven recommendations, full transparency and ease of use. At a high level, the next generation of digital advice offers an opportunity for stronger client impact. It will see human advisors complemented by digital collaboration through technology that is not disruptive but generally proven, likely economical and widely available. Our current regulations per se are not a barrier to this next generation of advice – but our regulatory practices are. And just how much the industry will be disrupted matters because wholesale disruption of our financial services comes with wholesale economic risk. Policymakers play an important role in this transformation starting with a need to take the lead and get in front of the innovations in order to understand their full implications. We need to move swiftly towards open banking and improving on the benchmark set in Europe, break down regulatory silos to allow data mobility in furtherance of stronger client outcomes, update advisor proficiencies for a new normal where technical skills are automated and behavioural skills are required and de-risk the decision to innovate – for start-ups and incumbents alike.

Countries in the Asian region facing the need for developing community services for older adults may find the Australian experience illuminating. Australia has a relatively small population, approaching 20 million, 90 percent of whom are concentrated in coastal urban areas, notably Sydney and Melbourne. The Australian population has been aging at a modest rate, mainly because of the continuing arrival of younger immigrants and a continuing baby boom from 1946 to 1965. Among the minority of older people with a substantial disability, most resided in some form of long-term care accommodation, including hospitals, nursing homes, hostels, and the care-intensive sections of retirement villages. There is considerable controversy about the value base and sustainability of informal support for older Australians. Community-care services are delivered by a large number of organizations in the voluntary and public sectors. Some policymakers propose that one level of government should take full responsibility for aged care, but such radical proposals are unlikely to gain political acceptance.

The American system of long-term care is disorganized and expensive. Obtaining care for a loved one is a confusing and difficult journey. When it comes to paying for that care, a bit over half who receive care are supported at least partially by insurance, and those with no insurance pay entirely out of pocket. The costs are exorbitant. What makes the system function is reliance on unpaid family members, who care for their loved ones often at considerable cost to themselves. As the baby boom generation ages, this creaky system will become increasingly dysfunctional, and a likely shortage of caregivers will be at the heart of the difficulties. The supply of unpaid family caregivers will become limited, as the ratio of people in the category of ages forty-five to sixty-four compared to those who are eighty and older shrinks from just above seven to one in 2010 to just above four to one in 2030. Paid caregivers will be needed to take up the slack, yet they are poorly paid, work under very difficult conditions, and receive little respect from the health care system. In this essay, I discuss the circumstances facing these paid home-care workers and a possible path forward, illustrating the current problems by drawing on interviews I conducted for a book-length study published in 2017.

Homelessness in the United States is often examined using cross-sectional, point-in-time samples. Any experience of homelessness is a risk factor for adverse outcomes, so it is also useful to understand the incidence of homelessness over longer periods. We estimate the lifetime prevalence of homelessness among members of the Baby Boom cohort (n = 6,545) using the 2012 and 2014 waves of the Health and Retirement Study (HRS), a nationally representative survey of older Americans. Our analysis indicates that 6.2 % of respondents had a period of homelessness at some point in their lives. We also identify dramatic disparities in lifetime incidence of homelessness by racial and ethnic subgroups. Rates of homelessness were higher for non-Hispanic blacks (16.8 %) or Hispanics of any race (8.1 %) than for non-Hispanic whites (4.8 %; all differences significant with p < .05). The black-white gap, but not the Hispanic-white gap, remained significant after adjustment for covariates such as education, veteran status, and geographic region.

This paper summarizes findings from a phenomenological study designed to explore the experiences of degree-seeking, adult learners – specifically, Older Baby Boomers (OBB) born between 1946 and 1958. Findings seek to understand how adult development—psychosocial, cognitive, and spiritual dimensions—influences older adult students’ future aspirations, both career and retirement, and their transformational learning experiences within the context of higher education. Several national trends are converging that greatly impact adult education today. First, the increasing presence of adults in higher education is accentuated by the expansive Baby Boom generation. Older Baby Boomers, the leading edge of this large cohort, are not only nearing retirement, but are returning to higher education in record numbers (Creighton & Hudson, 2002). Second, the demographic phenomenon of increasing adult learners impacts workforce and economic development in the 21 century. Between 2000 and 2015 the highest growth rate in the U.S. workforce will be among workers aged 55 to 64 (Montenegro, Fisher, & Remez, 2002, p. 5). Even though four out of five Baby Boomers desire to continue working beyond typical retirement age, many will require upgraded skills and credentials (Freedman, 2005). A third significant trend impacting adult education is longer life expectancy—age 77 today compared to age 47 in 1900 (Zeiss, 2006). Longer life expectancy and longer life after retirement have encouraged older adults to participate in various new learning and work experiences. Study Purpose and Contribution To meet the demands created by these trends, we need a deeper understanding of how adult learners—particularly those who are at or near traditional retirement age—access institutions of higher education, experience successful learning in their higher education endeavors, and plan to utilize their college education in their remaining work-lives. This phenomenological study examines the experiences of degree-seeking OBB between the ages of 50 and 62. Specifically, this study explores: (a) who contemporary, degree-seeking OBB students are and how they describe their support needs as they transition back into college; (b) the learning experiences and expectations of OBB students as they move through college and how those impact their cognitive development and adult transformative learning experiences; and (c) the influence of spirituality as OBB students move out from their educational experience toward vocational aspirations. This study addresses qualitative research gaps in the higher education literature pertaining to the learning and development of older adult degree-seeking students. The majority of studies concerning older adult learners have focused on those seeking non-credit and informal education. Furthermore, the recent surge of studies regarding spiritual development in college has been quantitative in nature and largely focused on traditional-aged students. This study provides a deeper understanding of how those learners who are at or near traditional retirement age move into institutions of higher education, move through their college learning experience, and plan to move out of higher education toward their future vocational aspirations.

The “proud-parent” attitude of states towards higher education between 1945 and 1970—due to the baby boom, the technological contributions that research universities had made to the war effort, and...

There is much debate about the adequacy of the U.S. physician workforce and projections of its future size, distribution and composition. Beginning with 3 observations about the workforce we believe are largely not subject to dispute, we address the debate by providing an overview of the current state of the workforce and Graduate Medical Education in the United States; a brief history of both calls for graduate medical education reform since 1910 and the recent, intense debate about the reliability of workforce projections; and a discussion of the challenges to understanding the physician workforce. We draw 3 concluding observations: (1) Precisely because projections can be unpredictable in their impact on both physician workforce behavior and public policy development, policy makers need to devote more attention to workforce projections, not less. (2) More research devoted specifically to the workforce implications of delivery and payment reforms is strongly needed. (3) Such research must be pursued with a sense of urgency, given the rapid aging of the Baby Boom generation, which will put a disproportionate demand on the nation's physician workforce.

Are differences in disability prevalence between individuals at the top and bottom strata of society a product of non-random processes? Under the assumption that genetic mutations are unlikely to account for the notable differences by makers of social stratification, the research presents a class, race, and then sex (CSR) hypothesis. The cross-sectional study, situated in the continental USA, uses information on 4,914,628 community-dwelling individuals from the Baby Boom (born 1951–1961) and Generation-X (born 1971–1981) birth-cohorts. When population-weighted, the sample is said to represent 96,639,980 of their counterparts. The data come from the American Community Survey Public Use Microdata Sample 2008–2012 file. Findings indicate that intersectional markers of social stratification help explain the prevalence and risk of self-care and ambulatory disability as predicted by the CSR hypothesis. The analysis provides novel evidence for the plausibility of a “Mexican Paradox” for disability. Amongst those from the Generation-X birth-cohort, low-education Mexican-origin Latinos had lower risk of disability than low-education non-Latino whites. Ageing studies should consider using intersectional markers of social stratification.

Senior citizens` new life style has appeared according to the massive retirement of the baby boom generation since 2010. Consequently, Senior Welfare Centers, the provider of elderly leisure programs, has been asked for the programs and spaces which are able to meet the changing life style of the elderly. This study focuses on the survey for current status of leisure programs in accordance with the changing life style and on the investigation for sensible usage of space in senior welfare centers in Gwangju Metropolitan city. The result shows the portion of the programs which every center provides is quite different according to the life style. The program types for challenge and utility are provided 192 times a week and the program types for health and sociality 133 times a week. Both types shows high frequency of supply and use of the program especially 85 times of information-oriented education, 64 times of musical instruments, and 42 times of foreign language are supplied vividly. On the contrary, the program types for fashion and self-management and the program types for volunteer work and achievement are insufficient, so It should be reconsidered to establish the programs and to supply the space for the program from now on. The current status for spatial usage shows that most of the centers share a space for several programs. It means that the space of the Senior Welfare Center is limited and various programs should be run in the narrow space. High frequency programs like the program types for challenge and utility secure sufficient spaces not to miscarry the use for the programs. The center of case B has well equipped and large space and provides proper space for each programs to meet the demand of the senior citizens. Like these, Senior Welfare Centers in Gwangju Metropolitan city have supported Senior citizens` Life Style by supplying various leisure programs to meet the demand for it. This research could be used as the basis for the programs about the spatial utilization in accordance with various future life style of Senior citizens`.

The current study seeks to identify the past-year prevalence of intimate partner violence (IPV) and to find out how factors from the ecological system perspectives relate to IPV among baby boomers and the current elderly. The 2010 National Domestic Violence Survey data of South Korea were used. The samples consisted of current elderly men (N = 180), early baby boomers (N = 134), and late baby boomers (N = 168). The findings were that 21.4 % of the late baby boomers, 13.4 % of the early baby boomers and 11.7 % of the current elderly reported IPV in the past year. For the late and early baby boomers, it was shown that controlling behavior was associated with IPV. Among the current elderly group, depression and patriarchal attitude were associated with IPV. The findings suggest specifically targeted intervention programs in order to mitigate IPV by generation in South Korea.

Since 1950, the United States has been in the midst of a profound demographic change: the rapid aging of the population. The baby boom generation began turning 65 in 2011 and is now driving growth at the older ages of the population. This article highlights geriatric demographic changes and illustrates how these and future trends will have wide ranging implications for the US health care system.

The challenges of medical demography have become a major issue today in France, mainly because of the conjunction of two phenomena. Namely, a massive retirement of the “baby boom” generation and a delay in the medical training induced by the “numerus clausus” that had not anticipated that phenomenon. Unfortunately, the repercussion of the population ageing on hospital consumption and consequently on medical demography is very poorly integrated into the calculation and implementation of the medical professions’ numerus clausus in 2010. Thus we suggest a model that not only identifies the effective demand for care on operational geographical scale, namely, the health territory, but that also makes a projection of healthcare consumption based on the age of population of each “health territory” in a T+1 future. To illustrate this model, we take as example the obstetricians’ activity in France.